Traumatic anterior shoulder dislocation combined with scapular fracture in elderly patients is relatively rare. In this case, a patient visited Emergency Room of Dong-A University Hospital for shoulder pain after falling off a ladder. Radiographs demonstrated anterior shoulder dislocation with displaced Ideberg type IIb scapula (glenoid fossa) fracture combined with a large rotator cuff tear on magnetic resonance imaging. We performed arthroscopic rotator cuff repair, but a large fragment in the inferior glenoid was left untreated. At the 1 year follow-up visit, the pain visual analogue scale of the patient was 2, the American Shoulder and Elbow Society score was 88 and the patient had gained nearly full range of motion without any apprehension.
Accidental Falls ; Aged ; Elbow ; Emergency Service, Hospital ; Follow-Up Studies ; Humans ; Magnetic Resonance Imaging ; Range of Motion, Articular ; Rotator Cuff* ; Scapula* ; Shoulder Dislocation* ; Shoulder Pain ; Shoulder* ; Tears*

To determine effects of the direction of the rotational work shifting on the circadian rhythm and adaptation of physiological and psychological components were investigated with nursing students. Two groups of seven volunteers participated as experimental subjects, and eight nursing students participated as a control group. The directions of rotation work shift were as follows : CW(clockwise)-shift system rotation in the direction of day shift(3 lays), evening shift(3days), off duty(1day) and night shift(5days). and CCW(counterclockwise)-shift system rotation in the reverse direction. Urinary free cortisol and 17-hydroxycorticoster oids in the urine were measured by the solid-phase radioimmunoassay and the colorimetry methods, re spectively. Plasma melatonin was measured by radioimmunoassay. The urinary free cotisol rhythm changed to ir-regular on the evening and night shift in the CCW shift system, whereas the rhythm seems to adapt on night shift in the CW shift system. The daily rhythms of urinary 17-OHCS indicate that they are well synchronized to shift work. These results show that the rotation of shift in the CW direction is more acceptable in terms of the adaptation of hormonal rhythms. These results indicate that the CCW rotation of shift work makes it more difficult for the workers to adapt on a physiological level, and has many more negative effects on nurses when compared with the CW rotation. Thus, a clockwise rotating shift systern seems to be more desirable for the optimal health and performance of nurses.
Circadian Rhythm* ; Colorimetry ; Humans ; Hydrocortisone* ; Melatonin ; Plasma ; Radioimmunoassay ; Students, Nursing ; Volunteers

BACKGROUND: In our previous report, we observed the increaseed epidermal glucose concentrations and decreased hexokinase actiuities of diabetic patients which were ciimpared to those of normal individuals. And we considered that, there were some derrangement of lipid metabolism and glycolysis of diabetic epidermis. OBJECTIVES: This study wns planed to prove the above possible changes of lipid metabolism and glycolysis of diabetic epidermis. METHODS: The epidermal enzymatic activties of glucose-6-phophate dehydrogenase(G6PDH), phosphofructokinase(PFK), 1-glycerophosphate dehydrogenase(GOPDH) and b-hydroxybutyryl CoA dehydrogenase(HBDH) were assayed in the skin samples obtained friom diabetic patients and normal individuals by the fluorometric: method. RESULTS: Teh epidermal PFK activities of diabetic patients were decreased(3.49+1.35(mmole/hr/kg dry weight)) compared to that of normal individuals(5.00+0.56(mmcle/hr/kg dry weight))(p<0.05). The epidermal HBDH activities of diabetic patients were decreised(0.28+0.10(mole/hr/kg dry weight)) compared to that of normal individuals(0.49+0.20(mole/hr/kg dry weight)(p<0.01). The mean epidermal G6PDH activity of diabetic patients was decreasec. compased to that of normal individuals, but there was no statisical significance. The mean epidermal 3OPDH activittes of diabetic patients and normal individual; showed no significant difference. CONCLUSION: We consider that the decreased epidermal HBDH actiities of diabetic patients can decrease keton body formatiori, and the abnormal glycolysis can exist in the diabetic epidermis because the decreased enzymatic activities of diabetic epidermal PFK may decrease the velocity of glycolysis.
Diabetes Mellitus ; Epidermis ; Glucose ; Glycolysis ; Hexokinase ; Humans ; Lipid Metabolism ; Skin

BACKGROUND: The purpose of this study was to evaluate mivacurium in the pharmacokinetics of onset and offset. METHODS: In 127 adult patients of ASA physical status I or II without any factors involving the neuromuscular function under general anesthesia, onset time (lag and manifest time) and clinical duration were measured after bolus or divided doses of ED95 x 2 of succinylcholine (SCC), rocuronium (ROC), atracurium (ATR), mivacurium (MIV), pancuronium (PAN) or vecuronium (VEC). Recovery time was defined as the recovery index and total duration measured after subsequent ED95 of MIV at 25% recovery of control twitch height from neuromuscular block induced by ED95 x 2 of ATR, MIV, PAN or VEC. Plasma cholinesterase (PChE) levels were measured following PAN or ATR. RESULTS: Onset time was faster with SCC and ROC, the low potency drugs, than with ATR, MIV, PAN or VEC, the high potent drugs. Manifest time was shorter in low potency drugs but longer in high potency drugs than lag time after bolus or divided doses of muscle relaxants given. Divided doses of various drugs induced a shortened onset time, but the patterns of relationship between lag and manifest time associated with drug potency did not alter. The recovery times with administered MIV were slowest after PAN pretreatment, and fastest after MIV pretreatment. PChE levels decreased significantly from 3 min to over 180 min after PAN administeration but not ATR. CONCLUSIONS: The onset time of MIV was not improved due to high drug potency as other nondepolarizing neuromuscular blockers. However, in spite of high potency, the recovery time of MIV was faster than other drugs. This results may be depend upon PChE activity rather than drug potency. Additionally, the prolonged recovery of MIV was not only under the influence of low PChE activity but also other some factors such as: the first relaxants administered before MIV dominated the neuromuscular block so that the duration of MIV given subsequently changed to resemble that of the first. The longer elimination half-life of the underlying relaxant prolonged the effects of subsequentshorter acting MIV. Structural similarities or dis-similarities between the interacting MIV and other drugs may have effects more potent in dis-similarity than in similarity.
Adult ; Anesthesia, General ; Atracurium ; Cholinesterases ; Half-Life ; Humans ; Neuromuscular Blockade ; Neuromuscular Blocking Agents ; Pancuronium ; Pharmacokinetics* ; Plasma ; Succinylcholine ; Vecuronium Bromide

Satisfactory surgical reconstruction of the external ear and nose is still a major challenge for the plastic surgeon. Therefore, the use of prosthesis in selected cases should be considered as viable alternative. During the period from December, 1995 to January, 1998, 10 patients, including 9 patients of ear defect and 1 patient of nose defect resulting from the resection of recurrent tumor ablation, were reconstructed by using osseointegration and prosthesis. The surgery was performed in two stages. All procedures were performed under local anesthesia and on an outpatient. At the first stage, the fixtures of titanium implant were placed in the mastoid process and maxilla. These implants were then left for 3 months before the second stage takes place, in which the skin penetrating abutments were attached. After 3-4 weeks, the impression of the defect area were taken and the silicone prosthesis was made by Anaplastologist. Two patients had focal infection but healed without problem. One patient had soft tissue infection, then flap was excised and skin graft performed. There was one loss from 20 fixtures, that was 3 years after implantation. We have concluded that osseointegration for reconstruction of the ear and nose defect is simple, soft, reliable method, which is more than autologous reconstruction and provides excellent aesthetic results.
Anesthesia, Local ; Ear ; Ear, External ; Focal Infection ; Humans ; Mastoid ; Maxilla ; Nose* ; Osseointegration* ; Outpatients ; Prostheses and Implants ; Silicones ; Skin ; Soft Tissue Infections ; Titanium ; Transplants

No abstract available.
Animals ; Coculture Techniques* ; Embryonic Structures* ; Mice*

We reviewed 48 skin bicpsies obtained from 48 patients with epidermal nevus during a 10 year period from January 1981 to December 1990. The results are summarized as follows : 1) Of our 48 patients, 23 were male and 25 were female, and male to female ratio was 1 to 1.1. 2) The average of the patients was 19.8 years at the time of diagnois. 3) Lesions were present at birth in 45.7 percent of patients, and most of the remainder de veloped in childhood. The mean age of onset was 7.7 years. 4) The clinical varieties of the nevi in 48 patients were classified according to caicegories of nevus verrucosus, including systematized epidermal nevus, nevu, unius lateris, ichthyosis hystrix, epidermal nevus syndrome and inflammatory linear veirucous epidermal nevus. The most common type was nevus verrucosus(88.6%). 5) A large variety of histopathologic changes can be seen in epidermal nevi. The most common histopathologic .ype was nonspecific(31.3%), follows by common(12.5%), epidermolytic hyperkertosis(12.5%), and acanthosis nigricans(10.4%). 6) The most commonly affected area was head and neck(48.5%) followed by trunk(28.6%), upper limb(11.4%) and lower limb(2.9%).
Age of Onset ; Female ; Head ; Humans ; Ichthyosis ; Male ; Nevus* ; Parturition ; Porcupines ; Skin

Background/Aims: We explored whether high sodium intake, assessed by urinary excretion, determines the risk of sarcopenia and nonalcoholic fatty liver disease (NAFLD). Methods: We analyzed 10,036 adult participants with normal kidney function from the Korea National Health and Nutrition Examination Survey (2008–2011). NAFLD was identified using the fatty liver index, and the muscle mass was evaluated using dual X-ray absorptiometry. The dietary sodium intake was estimated using Tanaka’s equation. Results: The mean 24-hour urinary sodium excretion was 144.2±36.1 mmol/day (corresponding to 3.3 g/day Na) in the total population. The 24-hour urinary sodium excretion showed moderate accuracy in predicting NAFLD (area under the receiver operating characteristic, 0.702; 95% confidence interval [CI], 0.692 to 0.712). A cutoff value of 99.96 mmol/day (corresponding to 2.30 g/day Na) for urinary sodium excretion in predicting NAFLD showed 76.1% sensitivity and 56.1% specificity. The results of multiple adjusted models indicated that the participants with the highest urinary sodium excretion had a significantly higher risk of NAFLD (odds ratio, 1.46; 95% CI, 1.27 to 1.66; p<0.001) and sarcopenia (odds ratio, 1.49; 95% CI, 1.28 to 1.73; p<0.001) than those with the lowest urinary sodium excretion. The association between a higher 24-hour urinary sodium excretion and NAFLD was independent of sarcopenia. Conclusions Participants with a high sodium intake, as assessed by sodium excretion, had a substantial risk of NAFLD and sarcopenia

BACKGROUND AND PURPOSE: Migraine is a genetically heterogeneous disorder that is frequently associated with a familial history, and mitochondrial dysfunction has been suggested to be associated with its pathogenesis. We screened and scanned mitochondrial gene polymorphisms to determine the significance of mitochondrial DNA mutations in Korean migraineurs. METHODS: One hundred and sixty-four migraineurs aged 33.9+/-11.7 years (mean+/-SD range 12 to 65 years) were studied. Clinical data of the familial history were obtained, and blood samples were collected for DNA purification. An A-to-G substitution at mitochondrial DNA (mtDNA) position 11,084 (A11084G) was determined by a polymerase chain reaction (PCR) with BsmI restriction. In addition, new single-nucleotide polymorphism (SNP) sites in the mitochondrial genome were scanned for using PCR and direct sequencing. RESULTS: Ninety-eight migraine patients (59.8%) had a maternal familial history. The A11084G polymorphism, which was previously reported in 25% of Japanese migraineurs, was not evident in our Korean migraine patients. However, scanning of new SNP sites in mtDNA revealed six candidate SNPs whose incidences were higher in migraine patients than in normal subjects. CONCLUSIONS: Our study found no association between the A11084G polymorphism in mitochondrial DNA and migraine in Koreans. However, we found potential new mitochondrial SNP sites in Korean migraineurs, which warrant further investigation.
Asian Continental Ancestry Group ; DNA ; DNA, Mitochondrial ; Genes, Mitochondrial ; Genome, Mitochondrial* ; Humans ; Incidence ; Mass Screening* ; Migraine Disorders ; Mitochondria ; Polymerase Chain Reaction ; Polymorphism, Single Nucleotide

Insulin-like growth factor binding proteins (IGFBPs) are major regulators of insulin-like growth factor bioavailability and activity in metabolic signaling. Seven IGFBP family isoforms have been identified. Recent studies have shown that IGFBPs play a pivotal role in metabolic signaling and disease, including the pathogenesis of obesity, diabetes, and cancer. Although many studies have documented the various roles played by IGFBPs, transcriptional regulation of IGFBPs is not well understood. In this review, we focus on the regulatory mechanisms of IGFBP gene expression, and we summarize the findings of transcription factor activity in the IGFBP promoter region.
Biological Availability ; Gene Expression ; Humans ; Insulin-Like Growth Factor Binding Protein 2* ; Insulin-Like Growth Factor Binding Proteins ; Liver ; Metabolic Diseases ; Obesity ; Promoter Regions, Genetic ; Protein Isoforms ; Transcription Factors