After dual plating with a locking compression plate for comminuted intraarticular fractures of the distal humerus, the incidence of ulnar nerve injury after surgery has been reported to be up to 38%. This can be reduced by an anterior transposition of the ulnar nerve but some surgeons believe that extensive handling of the nerve with transposition can increase the risk of an ulnar nerve dysfunction. This paper reports ulnar nerve injuries caused by the incomplete insertion of a screw head in dual plating without an anterior ulnar nerve transposition for AO/OTA type C2 distal humerus fractures. When an anatomical locking plate is applied to a distal humeral fracture, locking screws around the ulnar nerve should be inserted fully without protrusion of the screw because an incompletely inserted screw can cause irritation or injury to the ulnar nerve because the screw head in the locking system usually has a slightly sharp edge because screw head has threads. If the change in insertion angle and resulting protruded head of the screw are unavoidable for firm fixation of fracture, the anterior transposition of the ulnar nerve is recommended over a soft tissue shield.
Head* ; Humeral Fractures ; Humerus* ; Incidence ; Intra-Articular Fractures ; Surgeons ; Ulnar Nerve*

No abstract available.
Cleft Palate* ; Muscles* ; Palate, Soft*

No abstract available.
Intervertebral Disc*

BACKGROUND: Cancer of the esophagus is one of the most malignant tumors with poor prognosis. The p53 gene alteration, over expression of Cyclin D1, and Ki67 index were thought to be the prognostic factors. However, their clinical significances in esophageal squamous cell carcinoma are controversial and p53 accumulation may not correlate with genetic mutation. The current study investigates their prognostic significance in squamous cell carcinoma of the esophagus. MATERIAL AND METHOD: The Subjects studied were 124 esophageal squamous cell carcinoma patients who underwent esophagectomy. The mutation of p53, over expression of Cyclin D1, Ki67 labelling index, mitotic index were examined by using an immunohistochemical staining. We compared the results and investigated the correlation with the mutation of p53, overexpression of Cyclin D1, Ki67 labelling index, mitotic index and tumor size, and duration of survival. RESULT: There was no correlation between the results in immunohistochemical staining according to age, sex, tumor size, lymph node status, and clinical stage of the disease. Mutant p53 protein was found in 69 cases (55.6%). Median survival time was 21 months in cases with negative for mutant p53 protein and 22 months in positive cases. There was no significant difference in survival (p=0.46). Median survival time was 22 months in cases with negative for Cyclin D1 and 16 months in positive cases (p=0.18). Median and mean survival time was 22 months and 36 months when Ki67 labeling index was 40 or less (102 cases). Median and mean survival was 16 months and 23 months, when Ki67 labeling index was more than 40 (22 cases). There was significant difference in survival rate (p=0.011). CONCLUSION: Positivity of p53 and cyclin D1 was not useful in predicting the prognosis in our study. There was no significant correlation among mutant p53 protein accumulation, Cyclin D1 over expression, and Ki67 labeling index. However, in several studies, PCR single strand conformational polymorphism analysis of p53 showed a correlation to the prognosis. We thought that there was a significant discordance between p53 gene mutation and mutant p53 protein accumulation. When Ki67 labeling index was more than 40, prognosis was poorer. Ki67 seems to be a prognostic factor in our study. Therefore, we confirmed the possibility of using molecular markers as prognostic factors.
Carcinoma, Squamous Cell* ; Cyclin D1* ; Cyclins* ; Esophageal Neoplasms ; Esophagectomy ; Esophagus ; Genes, p53 ; Humans ; Lymph Nodes ; Mitotic Index* ; Polymerase Chain Reaction ; Prognosis* ; Survival Rate

A 43-year-old female patient with a congenital right coronary artery to right atrial fistula presented as congestive heart failure and aortic valve infective endocarditis. The diagnosis was made on the basis of echocardiography, especially TEE and confirmed by tight heart catheterization & aortography. She underwent aortic valve replacement due to severe aortic valve regurgitation with vegetations, fistulectomy and coronary aneurysmorrhaphy. The postoperative course was uneventful. She was treated with antibiotics because of infective endocarditis for 6 weeks. At present she remains well and visits out patient clinic regularly for oral anticoagulation without problem.
Adult ; Anti-Bacterial Agents ; Aortic Valve* ; Aortography ; Arteriovenous Fistula* ; Cardiac Catheterization ; Cardiac Catheters ; Coronary Vessels ; Diagnosis ; Echocardiography ; Endocarditis* ; Estrogens, Conjugated (USP)* ; Female ; Fistula ; Heart Failure* ; Humans

Contact urticaria refers to a wheal-and-flare response which occurs on intact skin after application of a chemical. When contact urticaria is accompanied by systemic symptoms, it is known as the contact urticaria syndrome. We report a case of contact urticaria syndrome occurring in a 24-year-old nurse, due to occupational exposure to cefotiam. An open patch test showed a positive reaction to cefotiam.
Cefotiam ; Humans ; Occupational Exposure ; Patch Tests ; Skin ; Urticaria* ; Young Adult

Argyria is a rare cause of cutaneous discoloration due to silver deposition. We report a case of argyria occurring in a 38-year-old man due to excessive silver pill intake. He had a diffuse, bluish-gray pigmentation on his face and finger nails. ICPMS (inductively coupled plasma mass spectrometry) revealed that an excess of silver was present in the patient's blood, liver and skin tissue.
Adult ; Argyria* ; Fingers ; Humans ; Liver ; Pigmentation ; Plasma ; Silver* ; Skin

OBJECTIVE: To determine of the regulation of cyclooxygenase-2 (COX-2) expression by Interleukin-1beta in WISH cells. METHODS: Amnion WISH cells were incubated in media containing increasing concentrations of IL-1beta or with various inhibitors. Increased COX-2 expression was determined by Western blot analysis with anti-COX-2 antibody. Concomitant measurements of culture media PGE2 were made by an enzyme immunoassay. RESULTS: The COX-2 and prostaglandin E2 production induced by IL-1beta increased in a dose- and time-dependent manner. One of the regulating factors that induced COX-2 by IL-1beta was protein kinase C (PKC). PKC inhibitor, Ro 31-8220 was pretreated and continued treating by IL-1beta. Then, PKC inhibitor completely blocked COX-2 protein induction by IL-1beta. In contrast, COX-2 induction by IL-1beta after pretreating PKC stimulator, phobol 12-myristate 13-acetate was potentiated with synergism. Another factor in controlling COX-2 protein induction was identified as phosphatidylinositol 3-kinase (PI 3K). COX-2 protein induction by IL-1beta after pretreating PI 3K inhibitors, wortmannin and LY294002 strongly increased. This kind of result reflected that PI 3K act as negative regulator. COX-2 induction by IL-1beta was known to be regulated in not only transcription step, but also translation step after performing experiment of actinomycin and cycloheximide treatment. CONCLUSION: COX-2 protein and prostaglandin E2 production induced by IL-1beta were controlled by many factors in amnion cell. Among those factors, PKC and PI 3K have an important role, but their control mechanism act as positive and negative, respectively.
Amnion ; Blotting, Western ; Culture Media ; Cycloheximide ; Cyclooxygenase 2* ; Dactinomycin ; Dinoprostone ; Immunoenzyme Techniques ; Interleukin-1beta* ; Phosphatidylinositol 3-Kinase ; Protein Kinase C

Recently, video-assisted surgical approaches for achalasia have been adopted by many surgeons. Many reports showed that the minimal invasive video-assisted operations for the achalasia revealed such good results as the conventional operations via thoracotomy. In some studies, among the minimal invasive video assisted surgeries for achalasia, the laparascopic assisted operations have some advantages mainly in respect to patient satisfaction over the thoracoscopic assisted surgeries. In this case, the patient had not responded to repeated balloon dilatation, and we made 5 small incisions over the abdominal wall and performed an esophageal myotomy and partial anterior fundoplication by laparascopic guide. The patient's symptoms were almost relieved, and the postoperative radiologic findings were satisfactory.
Abdominal Wall ; Dilatation ; Esophageal Achalasia* ; Fundoplication ; Humans ; Laparoscopy ; Patient Satisfaction ; Surgical Procedures, Minimally Invasive ; Thoracotomy

After dual plating with a locking compression plate for comminuted intraarticular fractures of the distal humerus, the incidence of ulnar nerve injury after surgery has been reported to be up to 38%. This can be reduced by an anterior transposition of the ulnar nerve but some surgeons believe that extensive handling of the nerve with transposition can increase the risk of an ulnar nerve dysfunction. This paper reports ulnar nerve injuries caused by the incomplete insertion of a screw head in dual plating without an anterior ulnar nerve transposition for AO/OTA type C2 distal humerus fractures. When an anatomical locking plate is applied to a distal humeral fracture, locking screws around the ulnar nerve should be inserted fully without protrusion of the screw because an incompletely inserted screw can cause irritation or injury to the ulnar nerve because the screw head in the locking system usually has a slightly sharp edge because screw head has threads. If the change in insertion angle and resulting protruded head of the screw are unavoidable for firm fixation of fracture, the anterior transposition of the ulnar nerve is recommended over a soft tissue shield.
Head ; Humeral Fractures ; Humerus ; Incidence ; Intra-Articular Fractures ; Surgeons ; Ulnar Nerve