BACKGROUND: Proximal humerus fracture is considered to be the third most common fracture for patients aged 65 years or older. Conservative treatment has been known to treat most of humerus fracture. However, fractures with severe displacement or dislocation may require surgical treatment. Intramedullary fibular allograft with a locking plate is frequently used in patients accompanying medial metaphyseal disruption. In this study, author intends to evaluate clinical and imaging results based on patients who underwent surgical treatment using fibular allograft with a locking plate. METHODS: This study is conducted prospectively at Wonju Severance Christian Hospital, targeting patients who previously underwent surgical treatment using open reduction and intramedullary fibular allograft with a locking plate between 2011 and 2015. A total of 26 patients were evaluated on the following: postoperational clinical assessment measuring Constant score, American Shoulder and Elbow Society (ASES) score, and the Disabilities of the Arm, Shoulder and Hand (DASH) score. Postoperational imaging assessments are evaluated via measuring the neck-shaft angle. The study subject were Neer classification type 3, 4 proximal humerus fracture cases with disrupted medial hinge and having cortical comminution in the region of the surgical neck. RESULTS: The average period of progression was 22.5 months, and the average age of patients was 72.6 years. At the final follow-up, the average Constant, average ASES, and average DASH scores were 80.1, 78.5, and 20.6 respectively. The average neck-shaft angle was 127.5°. CONCLUSIONS: In conclusion, fibular allograft augmentation with a locking plate showed satisfying results in both clinical and imaging studies.

BACKGROUND: It has been suggested that the regulation of hair growth might involve complex interaction between dermal papilla cells and hair matrix cells. Dermal papilla cells secrete diffusible factors that would act an hair matrix cells. During anagen the papilla appears to have prominent capillary loop, whereas in telogen it is nonvascularized. Vascular endothelial growth factor(VEGF) was recently reported to be produced by dermal papilla cells in rats. OBJECTIVES: We performed this study in order to evaluate the effect of VEGF on human hair growth in vitro and on the proliferation of dermal papilla cells and to define the splice forms of VEGF. METHODS: To detect the isoforms of VEGF, RT-PCR was performed on RNA isolated from dermal papilla cells and RT-PCR products were hybridized with VEGF-specific oligonucleotide probe located in exon 4. Isolated human hair follicles were cultured with various concentrations of VEGF165 and VEGF121. Hair follicle growth was measured by an Olympus inverted microscope with an eyepiece measuring graticule. RESULTS: The following results were obtained from this study. 1. Southern hybridization and size calculation of RT-PCR products revealed that mRNA species corresponding to 121, 165, 189, and 206 amino-acid forms of VEGF were praduced by cultured human dermal papilla cells. 2. 10 ng/ml of rhVEGF165, 0.1 ng/ml of rhVEGF165 and 10 ng/ml of rhVEGF121 stimulated follicle elongation in vitro(p < 0.05). 3. rhVEGF165 and rhVEGF121 had no effect on the numbers and thymidine incorporation of dermal papilla cells. CONCLUSION: These results suggest that VEGF is produced by dermal papilla cells and is able to promote hair growth in vitro. Increased hair growth by VEGF might occur other than by proliferation of dermal papilia cells.
Animals ; Capillaries ; Endothelial Growth Factors* ; Exons ; Hair Follicle ; Hair* ; Humans ; Protein Isoforms ; Rats ; RNA ; RNA, Messenger ; Thymidine ; Vascular Endothelial Growth Factor A

Hyperreflexic bladder is a disease manifested in patients with spinal cord lesions above the sacral segment. The treatments for hyperreflexic bladder are medical therapy, interruption of innervation, argumentation cystoplasty, etc. We treated four hyperreflexic bladder patients with 12% a phenol injection into the subarachnoid space for sacral nerve block. Before treatment the average bladder capacity was about 100 ml, and there was one case of autonomic dysreflexia. After the subarachnoid block the average bladder capacity increased above 300 ml and maximal intravesical pressure decreased below 30cmH2O, autonomic dysreflexia disappeared in one patient. The decreased bladder compliance after nerve block was managed by repetitive bladder overdistention. We suggest that subarachnoid block is easier and more effective than sacral nerve block individually, and is a treatment for hyperreflexic bladder refractory to medical therapy.
Autonomic Dysreflexia ; Compliance ; Humans ; Nerve Block ; Phenol ; Spinal Cord ; Subarachnoid Space ; Urinary Bladder*

Purpose: We compared the efficacy of focal laser photocoagulation and intravitreal bevacizumab injection in the treatment of chronic central serous chorioretinopathy. Methods: We conducted a retrospective analysis involving 46 eyes of 46 patients with chronic central serous chorioretinopathy who received focal laser photocoagulation (22 eyes) or intravitreal bevacizumab injection (24 eyes). Changes in best-corrected visual acuity (BVCA), central macular thickness, and rates of complete subretinal fluid (SRF) resolution and recurrence were compared over a 6-month period. Results: Although the focal laser photocoagulation and intravitreal bevacizumab injection groups demonstrated a significant reduction in central macular thickness at 6 months (p < 0.001), no statistically significant differences were observed between these groups at the end of the follow-up period. Notably, a gradual improvement in BVCA was observed in both groups following initial treatment, with significant improvement seen at 6 months (p = 0.049 and p = 0.048 for the laser and injection groups, respectively). However, no statistically significant difference in BVCA improvement was observed between the groups. Complete SRF resolution was achieved in 22 eyes in the laser group and 23 eyes in the injection group. Although recurrence of SRF was observed in 9 and 13 eyes in the laser and injection groups, respectively, there was no statistically significant difference between the groups (p = 0.229). Conclusions Focal laser photocoagulation and intravitreal bevacizumab injection significantly improved anatomical and visual acuity outcomes in patients with chronic central serous chorioretinopathy. Although focal laser photocoagulation was associated with more rapid visual recovery and a lower recurrence rate compared to intravitreal bevacizumab injection, further studies are needed to evaluate its potential complications.

Purpose: Despite the widespread use of liquid skin adhesives (LSA), concerns persist regarding the increase in wound care costs. This study aimed to investigate the cost-effectiveness of LSA for surgical wound management. Methods: In this prospective, open-label, single-center randomized controlled trial, adults aged 19 years and older who were scheduled for elective minimally invasive colorectal surgeries were included. The participants were randomly divided into 2 groups: an n-butyl cyanoacrylate skin adhesive was used in the experimental group (LSA group), while a surgical skin stapler was employed in the control group (stapler group). The primary outcome measure was the sum of the total time required for wound management. Results: A total of 58 patients were randomly assigned to 2 groups, with 29 patients in each group. The findings revealed comparable wound complication rates in the 2 groups (8 out of 29 in the LSA group vs. 5 out of 29 in the stapler group, P = 0.530). Notably, the LSA group had a significantly shorter wound management time (median 235 seconds vs. 1,201 seconds, P < 0.001) and similar wound management cost (median US dollar [USD] 50.6 vs. USD 54.6, P = 0.529) compared to the stapler group. Subgroup analysis showed that the LSA group had a shorter management time for uncomplicated wounds and a lower cost for complicated wounds. Conclusion LSA not only provides a safe alternative but also offers a resource-efficient option for wound management compared to staplers.

Purpose: Despite the widespread use of liquid skin adhesives (LSA), concerns persist regarding the increase in wound care costs. This study aimed to investigate the cost-effectiveness of LSA for surgical wound management. Methods: In this prospective, open-label, single-center randomized controlled trial, adults aged 19 years and older who were scheduled for elective minimally invasive colorectal surgeries were included. The participants were randomly divided into 2 groups: an n-butyl cyanoacrylate skin adhesive was used in the experimental group (LSA group), while a surgical skin stapler was employed in the control group (stapler group). The primary outcome measure was the sum of the total time required for wound management. Results: A total of 58 patients were randomly assigned to 2 groups, with 29 patients in each group. The findings revealed comparable wound complication rates in the 2 groups (8 out of 29 in the LSA group vs. 5 out of 29 in the stapler group, P = 0.530). Notably, the LSA group had a significantly shorter wound management time (median 235 seconds vs. 1,201 seconds, P < 0.001) and similar wound management cost (median US dollar [USD] 50.6 vs. USD 54.6, P = 0.529) compared to the stapler group. Subgroup analysis showed that the LSA group had a shorter management time for uncomplicated wounds and a lower cost for complicated wounds. Conclusion LSA not only provides a safe alternative but also offers a resource-efficient option for wound management compared to staplers.

Purpose: Despite the widespread use of liquid skin adhesives (LSA), concerns persist regarding the increase in wound care costs. This study aimed to investigate the cost-effectiveness of LSA for surgical wound management. Methods: In this prospective, open-label, single-center randomized controlled trial, adults aged 19 years and older who were scheduled for elective minimally invasive colorectal surgeries were included. The participants were randomly divided into 2 groups: an n-butyl cyanoacrylate skin adhesive was used in the experimental group (LSA group), while a surgical skin stapler was employed in the control group (stapler group). The primary outcome measure was the sum of the total time required for wound management. Results: A total of 58 patients were randomly assigned to 2 groups, with 29 patients in each group. The findings revealed comparable wound complication rates in the 2 groups (8 out of 29 in the LSA group vs. 5 out of 29 in the stapler group, P = 0.530). Notably, the LSA group had a significantly shorter wound management time (median 235 seconds vs. 1,201 seconds, P < 0.001) and similar wound management cost (median US dollar [USD] 50.6 vs. USD 54.6, P = 0.529) compared to the stapler group. Subgroup analysis showed that the LSA group had a shorter management time for uncomplicated wounds and a lower cost for complicated wounds. Conclusion LSA not only provides a safe alternative but also offers a resource-efficient option for wound management compared to staplers.

BACKGROUND: Insulin exerts an effect on cell proliferation and inhibition of apoptosis. However, the actions of insulin on cell cycle progression and signal transduction pathway are not well understood and insulin shows diverse effects on cell proliferation depending on cell types. OBJECTIVE: We attempted to understand the underlying mechanism by which insulin exerts this proliferative effect on 3T3 L1 fibroblasts by various markers of cell proliferation. METHOD: We investigated the effect of insulin on cell proliferation by [3H]thymidine incorporation, analyzing the cell cycle stages by flow cytometric measurement of DNA content per cell, cell counting, analysing cell division as well as the signal transduction pathway of insulin by measuring of phosphatidylinositol 3-kinase(PI3-kinase) and p44/42 mitogen-activated protein kinase (p44/42 MAPK/ERK) activity. RESULTS: The results were as follows: 1. Total accumulated [3H]thymidine incorporation increased approximately two-fold with insulin over the 0.5% serum control at 48 h incubation, and the maximal rate of DNA synthesis was observed during 8-12 h incubation and continuously declined until 48 h without a second increase in DNA synthnesis.. 2. The flow cytometric analysis of cell population distribution showed that insulin increased the cell population in S phase. 3. After insulin treatment for 48 h, cell number was increased approximately 45% in comparison with 0.5% serum control. 4. The cell division analysed after staining 3T3 L1 fibroblasts with carboxyfluorescein diacetate succinimidyl ester (CFSE). Cell division occured only once in 24h after insulin treatment.. 5. Insulin stimulated PI3-kinase and p44/42 MAPK/ERK activity about three- and two-folds, respectively. CONCLUSION: Taken together, this data indicates that insulin stimulated the transit from G0/G1 to S phase, progressed cell cycle through G2/M phase, increased the cell number and PI3-kinase, p44/42 MAPK/ERK stimulate cell proliferation. However, under our experimental conditions, insulin has a limited efficacy for late cell cycle events required for completion of miosis and cell cycle progression into the second round and the increase of the cell number by insulin was much less than the increase of the PI3-kinase and p44/42 MAPK/ERK activity. Therefore, the authors think that another pathways other than PI3-kinase or p44/42 MAPK/ERK might be involved in the effect of insulin on cell proliferation.
Apoptosis ; Cell Count ; Cell Cycle* ; Cell Division ; Cell Proliferation* ; Demography ; DNA ; Fibroblasts* ; Insulin* ; Miosis ; Phosphatidylinositol 3-Kinases ; Phosphatidylinositols ; Protein Kinases ; S Phase ; Signal Transduction

Relapsing polychondritis, a rare multisystem disease, is characterized by wide spread potentially destructive inflammatory lesions, involving cartilaginous structures throughout the body. Auricular chondritis is the most frequent presenting sign of this disease, with arthritis being the second. Other clinical menifestations include nasal chondritis, scleritis, damage to tracheobroncheal cartilage, and cardiovascular and renal involvement. We experienced three cases of relapsiug polychondritis. One case is 66 year old male with bilateral auricular chondritis with histologic confirmation, episcleritis, polyarthritis, periarterial vasculitis, and sensorineural hearing loss. Another case is 42 year old male with respiratory, nasal, auricular chondritis and psoriasis with arthritis. The third case is 46 year old female with three year history of relapsing polychondritis, presenting bilateral auricular and nasal chondritis and severe respiratory tract involvement with histologic confirmation. We also reviewed the other case reports of relapsing polychondritis in Korea. The major presenting manifestations of relapsing polychondritis in Korea were respiratory tract symptoms of dyspnea, cough, and sputum. That is, auricular chondritis was less frequent thari laryngotracheal-bronchial involvement.
Adult ; Aged ; Arthritis ; Cartilage ; Cough ; Dyspnea ; Female ; Hearing Loss, Sensorineural ; Humans ; Korea ; Male ; Middle Aged ; Polychondritis, Relapsing* ; Psoriasis ; Respiratory System ; Scleritis ; Sputum ; Vasculitis

OBJECTSIVE: This study investigated the frequency of metabolic syndrome, associated factors and its risk for cardiovascular morbidity in schizophrenic patients. METHODS: In this cross-sectional study, nineteen-six patients with schizophrenia defined by DSM-IV criteria were included. All subjects were assessed for the presence of metabolic syndrome by means of the criteria of the National Cholesterol Education Program-Adult Treatment Panel III. In addition, we compared clinical characteristics, laboratory variables and risk for cardiovascular morbidity between patients with and without metabolic syndrome. RESULTS: Of patients, 43% had metabolic syndrome. Metabolic syndrome was associated with illness chronicity and current status of antipsychotic agents use, total duration of atypical agents used, but not with daily chlorpromazine equivalent dose. Compared with the patients without metabolic syndrome, patients with metabolic syndrome had higher risk for cardiovascular morbidity. CONCLUSION: This study suggests that metabolic syndrome is common among patients with chronic schizophrenia. Clinicians should be cautious to aware the increased risk for the metabolic syndrome and intervene actively to prevent and treat metabolic morbidity among chronic patients with schizophrenia.
Antipsychotic Agents ; Chlorpromazine ; Cholesterol ; Cross-Sectional Studies ; Diabetes Mellitus ; Diagnostic and Statistical Manual of Mental Disorders ; Dyslipidemias ; Education ; Humans ; Hypertension ; Obesity ; Schizophrenia*