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.
Breast Neoplasms* ; Breast* ; Humans ; Soil*

No abstract available.
Intervertebral Disc*

PURPOSE: Ovarian dysgerminoma is a highly radiosensitive malignant tumor occurring in young age group. The conventional treatment was total abdominal hysterectomy and bilateral salpingo-oophorectomy followed by radiotherapy. We retrospectively analyzed the treatment results of patients who had received radiotherapy in the era before chemotherapy was widely used. MATERIAL AND METHOD: Twenty two patients with ovarian dysgerminoma were treated at the Department of Therapeutic Radiology, Seoul National University Hospital between August, 1980 and May, 1991. Four patients were excluded from this study, because three patients received incomplete treatment and one received combined chemotherapy. Sixteen patients received postoperative radiotherapy and two patients had radical radiotherapy as tumor was unresectable. Median follow-up period was 99 months (range, 51-178). Median age was 22 years (range, 11-42). Among the postoperatively treated patients, three patients were in stage IA, eight in stage IC, two in stage II, and three in stage III. One patient had Turner's syndrome. Radiotherapy was performed with high energy photon (telecobalt unit or linear accelerator, either 6MV or 10MV). The radiation dose to the whole abdomen was 1950-2100cGy (median, 2000) and 1050-2520cGy was added to the whole pelvis, the total dose to the whole pelvis was 3000-4500cGy (median, 3500). Prophylactic paraaortic area irradiation was done in six patients (dose range, 900-1500cGy). One patient who had positive paraaortic node, received radiation dose of 1620cGy, followed by additional 900cGy to the gross mass with shrinking field. Total dose to the paraaortic node was 4470cGy. Six patients, including one who had paraaortic node metastasis, received prophylactic irradiation to mediastinum and supraclavicular area (2520cGy). Of the two patients with unresectable tumors who received radical radiotherapy, one was in stage III and the other wasin stage IV with left supraclavicular lymph node metastasis. The stage III patient received radiation to the whole abdomen (2000cGy), followed by boost to whole pelvis (2070cGy) and paraaortic area (2450cGy). Stage IV patient received radiation to the whole abdomen (2000cGy), followed by radiation to the whole pelvis and paraaortic area (2400cGy), mediastinum (2520cGy), and left supraclavicular area (3550cGy). RESULT: The 5 year local control rate was 100% in patients who received postoperative adjuvant radiotherapy after total abdominal hysterectomy and bilateral salpingo-oophorectomy. Only one patient in stage III who did not receive prophylactic irradiation to mediastinum developed mediastinal metastasis, but was salvaged by chemotherapy. So, the 5 year overall survival rate was also 100%. Two patients who received radiation only, are alive without disease at 112 and 155 months. CONCLUSION: Postoperative adjuvant radiotherapy as well as radical radiotherapy in unresectable ovarian dysgerminoma was very effective. But chemotherapy is also an effective treatment modality. We now recommend chemotherapy for patients who need to save their ovarian function and reserve radiotherapy for chemo-resistant tumor or recurrence after chemotherapy.
Abdomen ; Drug Therapy ; Dysgerminoma* ; Follow-Up Studies ; Humans ; Hysterectomy ; Lymph Nodes ; Mediastinum ; Neoplasm Metastasis ; Particle Accelerators ; Pelvis ; Radiation Oncology ; Radiotherapy ; Radiotherapy, Adjuvant ; Recurrence ; Retrospective Studies ; Seoul ; Survival Rate ; Turner Syndrome

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

When reduced glutathione(GSH) was incubated at neutral pH and at 37degrees, its concentration decteased slowly with formation of oxidized glutathione(GSSG). Autooxidation of GSH was accelerated by Cu2+ and Hg2+, but not by other common mono-, di-, and tri-valent cations. Tranthyretin was found to stimulate autooxidation of GSH in the presence or absence of Cu2+ and Hg2+. EDTA inhibited perfectly the autooxidation of GSH regardless of the presence of transthyretin. The stimulating activity of transthyretin was maximal at pH 7.0, declining progressively with increase or decrease of pH from 7.0. Sulfhydryl-blocking agents such as p-hydroxymercuribenzoic acid and N-ethylmaleimide markedly inhibited the stimulating activity of transthyretin. Transthyretin stimulated autooxidation of other sulfhydryl compounds such as dithiothreitol and cysteine. However, it did not show a significant effect on autooxidation of sulfhydryl group of egg albumin and eye lens proteins. And transthyretin did not cause any oxidative change to thyroxine(T4), 3, 5, 3'-tri iodo thyronine(T3) and 3, 3', 5'-triiodothyronine(rT3) bound to it in the presence of GSH and Cu2+. The above results suggest that transthyretin may play a role in regulation of oxidized status of sulfhydryl groups in blood plasma and cerebrospinal fluid.
Cations ; Cerebrospinal Fluid ; Crystallins ; Cysteine ; Dithiothreitol ; Edetic Acid ; Ethylmaleimide ; Glutathione* ; Hydrogen-Ion Concentration ; Ovum ; Plasma ; Prealbumin* ; Sulfhydryl Compounds

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

In the present study, we aimed to identify the synergistic effects of concurrent treatment of low concentrations of cilostazol and probucol to inhibit the oxidative stress with suppression of inflammatory markers in the cultured human coronary artery endothelial cells (HCAECs). Combination of cilostazol (0.3~3micrometer) with probucol (0.03~0.3micrometer) significantly suppressed TNF-alpha-stimulated NAD(P)H-dependent superoxide, lipopolysaccharide (LPS)-induced intracellular reactive oxygen species (ROS) production and TNF-alpha release in comparison with probucol or cilostazol alone. The combination of cilostazol (0.3~3micrometer) with probucol (0.1~0.3micrometer) inhibited the expression of vascular cell adhesion molecule-1 (VCAM-1) and monocyte chemoattractant protein-1 (MCP-1) more significantly than did the monotherapy with either probucol or cilostazol. In line with these results, combination therapy significantly suppressed monocyte adhesion to endothelial cells. Taken together, it is suggested that the synergistic effectiveness of the combination therapy with cilostazol and probucol may provide a beneficial therapeutic window in preventing atherosclerosis and protecting from cerebral ischemic injury.
Atherosclerosis ; Chemokine CCL2 ; Coronary Vessels ; Endothelial Cells ; Humans ; Monocytes ; Oxidative Stress ; Probucol ; Reactive Oxygen Species ; Superoxides ; Tetrazoles ; Tumor Necrosis Factor-alpha ; Vascular Cell Adhesion Molecule-1

BACKGROUND: The prevalence rate of pulmonary tuberculosis (PTB) is steadily decreasing in South Korea. However, PTB is a disease with relatively high mortality and morbidity rates throughout Korea. Although there are many studies and statistics about the risk factors of PTB mortality in many countries, there are only a limited number of domestic papers on this topic. The aim of this study is to determine predictive factors for mortality among in-hospital patients associated with PTB. METHODS: From December 2006 to January 2011, we reviewed medical records of 2,122 adult patients diagnosed with tuberculosis at a single tertiary hospital in a suburban area. In this study period, 960 patients were diagnosed with PTB by positive Acid fast bacilli smear and/or mycobacterial culture of the respiratory specimen. We compared the groups of patients deceased and patients discharged alive with PTB. The number of dead patients was 82 (47 males, 35 females). RESULTS: Mortality was significantly associated with increased values of white blood cells (WBC), blood urine nitrogen (BUN), creatinine, C-reactive protein (CRP), numbers of involved lung field, and length of hospitalization. Also, it was associated with the decreased values of hemoglobin, lymphocyte, sodium, albumin, and cholesterol. Furthermore, admission through the emergency department, initial intensive care unit admission, and drug resistant PTB affected mortality in PTB patients. Independent predictors associated with PTB mortality are BUN, initial intensive care unit care, and admission during treatment of tuberculosis. CONCLUSION: In our study, mortality of pulmonary tuberculosis was related with parameters associated with nutritional status, disease severity at the time of admission, and drug resistance.
Adult ; C-Reactive Protein ; Cholesterol ; Creatinine ; Drug Resistance ; Emergencies ; Hemoglobins ; Hospitalization ; Humans ; Intensive Care Units ; Korea ; Leukocytes ; Lung ; Lymphocytes ; Male ; Medical Records ; Nitrogen ; Nutritional Status ; Prevalence ; Republic of Korea ; Risk Factors ; Sodium ; Tertiary Care Centers ; Tuberculosis ; Tuberculosis, Pulmonary