BACKGROUND: Cubitus varus and cubitus valgus deformities are common complications of distal humeral fractures in children. We evaluated the usefulness of supracondylar dome osteotomy as a treatment option for adults with cubitus varus or valgus deformity developed during childhood. METHODS: Ten patients who had received supracondylar dome osteotomy and stabilization with plates to treat cubitus varus or valgus deformity between July 2006 and August 2013 were included in this study. Their mean age at the time of surgery was 36.50 ± 10.22 years. The mean follow-up duration was 54.80 ± 32.50 months. We evaluated humerus-elbow-wrist angles (HEWA), improvements in the lateral prominence index (LPI) or medial prominence index (MPI), Mayo elbow performance scores (MEPS), and overall results in accordance with the Banerjee criteria. RESULTS: For the six patients with cubitus varus, the mean postoperative HEWA, mean correction angle, and mean improvement in LPI were 9.72°± 3.95°, 27.67°± 10.75°, and 6.92% ± 3.40%, respectively. For the four patients with cubitus valgus, the mean postoperative HEWA, mean correction angle, and mean improvement in MPI were 14.73°± 2.97°, 11.55°± 3.26°, and 11.33% ± 6.39%, respectively. There was no significant difference between postoperative and preoperative mean MEPS. The subjective ulnar nerve symptoms were alleviated in all patients. The overall results were excellent in six and good in four patients. CONCLUSIONS: This study suggests that supracondylar dome osteotomy with secure fixation using double plates may be useful in correcting cubitus varus or cubitus valgus deformity, yielding good functional outcomes in adults.
Adult* ; Child ; Congenital Abnormalities* ; Elbow ; Follow-Up Studies ; Humans ; Humeral Fractures ; Osteotomy* ; Ulnar Nerve

No Abstract Available.

Although joint infection with severe destruction remains a serious problem and severe bone loss is relative contraindication of arthrodesis, knee arthrodesis is most commonly a salvage procedure. Its goals are to relieve pain and restore the patient to functional level of activity. The purpose of this study is to evaluate the results and complications of Ilizarov method for knee arthrodesis in the presence of infection. We retrospectively reviewed the records of twelve patients who had managed with knee arthrodesis with Ilizarov method. Indications for the operation included a infected skeletal defect secondary severe open trauma in four patients, an infection at the site of an arthroplasty in three (with failure of previous arthrodesis with monofixator in one), an infected charcot joint in four and one pyogenic arthritis spreading from osteomyelitis of proximal tibia. The average age of the patients at the time of operation was fifty-three years (range twenty-two to eighty years). Follow-up averaged 17 months. The minimum follow up periods was 9 months. Average duration of Ilizarov fixator application was 7.2 months. In 3 cases we performed corticotomy and internal bone transport to treat large bone defect (17cm, 8cm, 6.5cm). Autoiliac bone graft was done in fusion site in two cases, and in three cases we performed bone graft at the docking site. Solid osseous union occured in each patient. There was no reinfection and nonunion. Average shortening was 3.4 cm. Complications were related to pin tract. When last seen, all patients were free of pain and could walk without cruthes or cane. Despite its pin tract problems, bulky cumbersome and expensive apparatus, the Ilizarov method is one of effective method for knee arthrodesis in the presence of infection and large bone loss especially.
Arthritis ; Arthrodesis* ; Arthropathy, Neurogenic ; Arthroplasty ; Canes ; Follow-Up Studies ; Humans ; Ilizarov Technique* ; Joints ; Knee Joint* ; Knee* ; Osteomyelitis ; Retrospective Studies ; Tibia ; Transplants

No abstract available.
Eustachian Tube*

The first description on the discoid meniscus was made by Young in 1889 and was known as it affects only the lateral meniscus for a long time. However, Cave and Staples had reported the two cases of discoid changes on medial meniscus in 1941. Smillie(1948) had stated that the menisci exist as cartilagenous discs at an early stage of fetus and remain in discoid shape congenitally. Kaplan(1957) reported that the discoid meniscus is not caused by congenitally but acquired in relation of joint motion. A clinical analysis is made on the 22 discoid meniscus which were removed surgically and summarized as follows: 1. The click sound on walking, tenderness and positive McMurray test were important as diagnostic criteria and were present all of the cases. 2. The most of the discoid meniscus were found in first and second decade in 13 cases(76.5%) out of 22. The five cases were bilateral. 3. The discoid change of the meniscus had no sex defferences in their incidence but lateral involvement were far superior than in ten times. 4. The discoid meniscus shows degenerative change microscopically 17(77.3%). 5. The clinical result of surgical removal of discoid meniscus was satisfactory in resuming their full activities in six weeks.
Clinical Study ; Fetus ; Incidence ; Joints ; Menisci, Tibial ; Walking

BACKGROUND: The neuropathy disability score (NDS) is a type of clinical grading method for diabetic polyneuropathy. In clinical practice, a nerve conduction study (NCS) is routinely employed as a non-invasive test for the evaluation of polyneuropathy. However, the consensus regarding the degree of abnormalities in NCS as a parameter for the severity of the disease is lacking. The objective of our study is to assess the relation between NDS and NCS parameters and thus verifying the reliability of our new NCS grading method in the representation of objective neurological defects. METHODS: Seventy three patients (man 31, women 42) with diabetes mellitus were included in the study. The NDS was scored in each patient by a single examiner and a NCS was performed on one side of extremities by an experiencedtechnician. Also, the gastrocnemius-soleus H-reflex was performed and analysed for the representation of a deep tendon reflex. The observed values of CMAP and CNAP were transformed into square root and log values. The transformed individual amplitudes and nerve conduction velocities were graded in relation to the mean normal values and standard deviations of our control group study. Then, the sum of the graded score was calculated in each individual and was correlated to the NDS using correlational analysis. RESULTS: There has been a significant linear relationship between NDS and our new NCS scoring system (Pearson's correlation coefficient r=0.703, p<0.01) CONCLUSIONS: The study showed significant correlations between NDS and our new grading system for NCS. Thus, NCS appears to reliably represent theobjective neurologic findings. In asddition, the quantititive grading of NCS would be useful in determining the grade of peripheral polyneuropathy in diabetic patients.
Consensus ; Diabetes Mellitus ; Diabetic Neuropathies* ; Extremities ; Female ; H-Reflex ; Humans ; Neural Conduction ; Neurologic Manifestations ; Polyneuropathies ; Reference Values ; Reflex, Stretch

Background: Spine-hip discordance (SHD) increases fracture risk. However, its prevalence and clinical implications have not been investigated in patients with hip fractures. This study determined the prevalence and association of SHD with mortality and investigated the cause of SHD in patients with hip fractures. Methods: This study included patients admitted for fragility hip fractures between 2011 and 2020. All patients underwent dual energy X-ray absorptiometry and anteroposterior and lateral views of the lumbosacral spine during admission. Data on demographics, diagnosis, American Society of Anesthesiologists score, and mortality were collected. A T-score difference of more than 1.5 between L1-4 and the femur neck was considered discordant, and 3 groups (lumbar low [LL] discordance, no discordance [ND], and femur neck low [FL] discordance) were compared. In the discordance group, lumbar radiographs were reviewed to determine the cause of discordance. Results: Among 1,220 eligible patients, 130 were excluded due to patient refusal or bilateral hip implantation; therefore, this study included 1,090 patients (271 male and 819 female). The prevalence of LL, ND, and FL was 4.4%, 66.4% and 29.2% in men and 3.9%, 76.1%, and 20.0% women. Mortality was not associated with discordance. The most common causes of discordance were physiological in the LL group and pathological in the FL group for both sexes. Conclusions Patients with hip fractures showed lower rates of ND and higher rates of FL compared to the general population. True discordance should be carefully judged for pathological and artifact reasons. The clinical implications of SHD require further investigation.

The estrogen receptor (ER) is present in a wide variety of mammalian tissues and is required for the physiological responses of estrogen, including estrogen-induced tissue-specific changes in gene expression. But most of our knowledge on the regulation of ER mRNA levels comes from in vivo steroid replacement experiments or cancer cell lines that express the ER. Thus the present study was attempted to determine 1) the anterior pituitary ER mRNA levels during rat estrous cycle 2) if estradiol itself directly modulates the ER mRNA levels in cultured rat anterior pituitary using RT-PCR method. In rats with 4 day estrous cycle, the ER mRNA levels in anterior pituitary gland reached to maximum at proestrus 11:00h just before serum estradiol concentration showed the highest. From then, the ER mRNA levels gradually declined during the rest of the proestrus. On the other hands, in cultured rat anterior pituitary cells, the ER mRNA levels were significantly decreased by the treatment of estradiol. These results indicate that the surge of estradiol was proceeded by the increase in pituitary ER mRNA levels during the proestrus and in cultured anterior pituitary cells, estrogen might be involved in the down-regulation of the ER mRNA levels.
Animals ; Cell Line ; Down-Regulation ; Estradiol ; Estrogens* ; Estrous Cycle ; Gene Expression ; Hand ; Pituitary Gland, Anterior* ; Proestrus ; Rats* ; RNA, Messenger*

No abstract available.
Nevus, Blue*

Quercetin is a natural flavonoid phytochemical that is extracted from various plants. Having an advantages due to its varied biological properties, such as anti-inflammatory, anti-viral, anti-oxidant, and anti-cancer effects, quercetin is used to treat many diseases. Recently, it has been reported that autophagy inhibition may play a key role in anti-cancer therapy. Therefore, in this study, we investigated the molecular mechanisms and anti-cancer effects of quercetin in human osteosarcoma cells via autophagy inhibition. We ascertained that quercetin inhibited cell proliferation and induced cell death, these process is demonstrated that apoptosis via the mitochondrial pathway and the caspase cascade. Quercetin also induced autophagy which was inhibited by 3-MA, autophagy inhibitor and the blockade of autophagy promoted the quercetin-induced apoptosis, confirming that autophagy is a pro-survival process. Thus, these findings demonstrate that quercetin is an effective anti-cancer agent, and the combination of quercetin and an autophagy inhibitor should enhance the effect of anti-cancer therapy.
Apoptosis* ; Autophagy* ; Cell Death ; Cell Proliferation ; Humans ; Osteosarcoma* ; Quercetin*