No abstract available.
Ankle Fractures* ; Ankle*

Two patients, bulging fetal membrane accompanied with cervical dilatation & effacement in the late second-trimester, were treated by modified Shirodkar method. Pregnancies were prolonged effectively and viable fetuses were delivered in both cases. Our cases may help make objective decision prior to attempting cerclage placement when cervix is markedly dilated and something should be done to save pregnancy.
Cervix Uteri ; Extraembryonic Membranes* ; Female ; Fetus ; Humans ; Labor Stage, First ; Pregnancy ; Uterine Cervical Incompetence*

Lawsonia intracellularis is not culturable with a standard bacteriologic culture. One step PCR assay as a clinical diagnostic method was developed for the rapid detection of porcine proliferative enteritis (PPE) caused by L. intracellularis. Primers were designed based on the p78 DNA clone of L. intracellularis. The one step PCR resulted in the formation of a specific 210-bp DNA product derived from L. intracellularis. The nonspecific amplification product was not detected with swine genomic DNA or other bacterial strains causing similar symptoms to L. intracellularis infection. The one step PCR was as sensitive as 100 pg of L. intracellularis genomic DNA. We applied this method to field specimens diagnosed as PPE by macroscopic observation. Of 17 mucosal scraping specimens, 16(94%) were identified as positive to PPE and 15(88%) of 17 feces specimens. These results suggest that the one step PCR can be used as a rapid diagnostic method for L. intracellularis infection.
Animals ; Base Sequence ; DNA Primers ; Desulfovibrionaceae Infections/diagnosis/*veterinary ; Ileum/microbiology/pathology ; Intestinal Mucosa/microbiology/pathology ; Lawsonia Bacteria/genetics/*isolation & purification ; Polymerase Chain Reaction/*methods ; Reproducibility of Results ; Sensitivity and Specificity ; Swine ; Swine Diseases/*diagnosis/microbiology

OBJECTIVE: A number of disease-modifying anti-rheumatic drugs (DMARDs) have been shown to be more effective than placebo in the management of rheumatoid arthritis (RA). However, most course of DMARDs, except methotrexate, are discontinued after 2 or 3 years, because of toxicity, lack of efficacy or escape from control. The multi-drug resistance (MDR) is a phenomenon in which cells develop cross-resistance to many agents such as anthracyclin, vinca alkaloids and colchicine. In our hypothesis, MDR phenomenon could be implicated in acquired resistance to DMARDs in RA. We have established a mdr1 cell line and tested whether DMARDs are substrate for P-glycoprotein (P-gp). METHODS: The mdr1-cDNA was cloned into retroviral vector, and the recombinant retroviral vector was transfected into PA317 cells. The target cells, NIH3T3, were infected with recombinant retroviruses. A colony most resistant to vinblastin was selected for the following experiments; expression of mdr1 gene in NIH3T3 cells was confirmed by RT-PCR, and biological function of mdr1 gene product, P-gp, was tested using Rhodamine-123 (Rh123) efflux assay. Resistance of the target cells expression P-gp which can survive against hydroxychloroquine (HCQ) and methotrxate (MTX) were measured by MTT assay. RESULTS: RT-PCR for mdr1 gene showed successful transfer of the gene into the NIH3T3 cells. Rh123 assay revealed expression of P-gp on the selected cells as follows; Rh123 efflux activity of uninfected NIH3T3 cells was 6%, that of PLXSN was 0.2%, and that of selected cells was 44%. The 50% proliferation inhibitory capacity of the selected cells were twice for HCQ but there was no difference of that for MTX. CONCLUSION: We established a mdr1 cell line and using the cell line, HCQ was a substrate of MDR, but MTX was not related to MDR.
Antirheumatic Agents* ; Arthritis, Rheumatoid ; Cell Line ; Clone Cells ; Colchicine ; Drug Resistance, Multiple ; Hydroxychloroquine ; Methotrexate ; P-Glycoprotein ; Retroviridae ; United Nations ; Vinca Alkaloids ; Zidovudine

DNA immunization induces B and T cell responses to various pathogens and tumors. However, these responses are known to be relatively weak and often transient. Thus, novel strategies are necessary for enhancing immune responses induced by DNA immunization. Here, we demonstrated that co-immunization of influenza virus nucleoprotein (NP) gene significantly enhances humoral and cell-mediated responses to codelivered antigens in mice. We also found that NP DNA coimmunization augments in vivo proliferation of adoptively transferred antigen-specific CD4 and CD8 T cells, which enhanced protective immunity against tumor challenge. Our results suggest that NP DNA can serve as a novel genetic adjuvant in cocktail DNA vaccination.
Animals ; DNA ; Immunization ; Influenza, Human ; Mice ; Nucleoproteins ; Orthomyxoviridae ; T-Lymphocytes ; Vaccination

PURPOSE: In comminuted intertrochanteric fractures, various operative options have been introduced. The purpose of this study was to determine whether there were differences in clinical and radiologic outcomes among bipolar hemiarthroplasty (BH), compression hip screw (CHS) and proximal femur nail antirotation (PFNA) in treating comminuted intertrochanteric fractures (AO/OTA classification, A2 [22, 23]) MATERIALS AND METHODS: We retrospectively evaluated total 150 patients (BH, 50; CHS, 50; PFNA, 50) who were operated due to intertrochanteric fractures from March 2010 to December 2012 and were older than 65 years at the time of surgery. We compared these three groups for radiologic and clinical outcomes at 12 months postoperatively, including Harris Hip Score, mobility (Koval stage), visual analogue scale and radiologic limb length discrepancy (shortening). RESULTS: There was no statistical significance among three groups in clinical outcomes including Harris Hip Score, mobility (Koval stage), visual analogue scale. However, there was significant differences in radiologic limb discrepancy in plain radiographs at 12 months postoperatively (radiologic shortening: BH, 2.3 mm; CHS, 5.1 mm; PFNA, 3.0 mm; P=0.000). CONCLUSION: There were no clinical differences among BH, PFNA, and CHS in this study. However, notable limb length shortening could be originated during fracture healing in osteosynthesis, compared to arthroplasty (BH Arthroplasty ; Classification ; Extremities ; Femur* ; Fracture Healing ; Hemiarthroplasty* ; Hip Fractures* ; Hip* ; Humans ; Retrospective Studies

BACKGROUND: An epidural steroid injection (ESI) is a commonly administered procedure in pain clinics. An unintentional lumbar facet joint injection during interlaminar ESI was reported in a previous study, but there has not been much research on the characteristics of an unintentional lumbar facet joint injection. This study illustrated the imaging features of an unintentional lumbar facet joint injection during an interlaminar ESI and analyzed characteristics of patients who underwent this injection. METHODS: From December 2015 to May 2017, we performed 662 lumbar ESIs and we identified 24 cases (21 patients) that underwent a lumbar facet joint injection. We gathered data contrast pattern, needle approach levels and directions, injected facet joint levels and directions, presence of lumbar spine disease as seen on magnetic resonance images (MRI), and histories of lumbar spine surgeries. RESULTS: The contrast pattern in the facet joint has a sigmoid or ovoid contrast pattern confined to the vicinity of the facet joint. The incidence of unintentional lumbar facet joint injection was 3.6%. The mean age was 68.47 years. Among these 21 patients, 14 (66.7%) were injected in the facet joint ipsilaterally to the needle approach. Among the 20 patients who received MRI, all (100%) had central stenosis and 15 patients (75%) had severe stenosis. CONCLUSIONS: When the operator performs an interlaminar ESI on patients with central spinal stenosis, the contrast pattern on the fluoroscopy during interlaminar ESI should be carefully examined to distinguish between the epidural space and facet joint.
Colon, Sigmoid ; Constriction, Pathologic ; Epidural Space ; Fluoroscopy ; Humans ; Incidence ; Magnetic Resonance Imaging ; Needles ; Pain Clinics ; Retrospective Studies ; Spinal Stenosis ; Spine ; Zygapophyseal Joint

PURPOSE: In general, the results and prognosis of surgical treatment in dialysis patients are poor compared to patients with normal kidney function. This study analyzes the complications in chronic renal failure patients who underwent primary hip arthroplasty for hip fractures and arthropathy. Orthopaedic complications and medical complications were analyzed for a consequential difference. MATERIALS AND METHODS: Between 2003 and 2008, 38 dialysis patients (40 cases) with chronic renal failure were enrolled with 24 cases of bipolar hemiarthroplasty and 16 cases of total hip arthroplasty. Types and rates of orthopaedic and medical complications were investigated. Patients were classified according to age, gender, duration of dialysis and diabetes mellitus status. Complications were analyzed for each group. RESULTS: Complications occurred in 15 patients (overall complication rate: 37.5%). Eight patients were died within 1 year (mortality: 20%). Gender and duration of dialysis were not correlated to number of complications. However, there were significant differences according to age (p=0.014) and having diabetes (p=0.026). With regard to mortality, there was no significant difference according to the above classification. CONCLUSION: Patients on hemodialysis have a high risk of complications after primary hip arthroplasty, especially in elderly patients and diabetic patients. Therefore, we require a full disclosure before recommending hip arthroplasty surgery in dialysis patients, and close postoperative care in patients undergoing dialysis.
Aged ; Arthroplasty ; Diabetes Mellitus ; Dialysis ; Disclosure ; Hemiarthroplasty ; Hip ; Hip Fractures ; Humans ; Kidney ; Kidney Failure, Chronic ; Postoperative Care ; Prognosis ; Renal Dialysis

BACKGROUND: Extracellular K+ concentration ([K+]o) can be increased within several mM by the efflux of intracellular K+. To investigate the effect of an increase in [K+]o on vascular contractility, we attempted to examine whether extracellular K+ might modulate vascular contractility, endothelium-dependent relaxation (EDR) and intracellular Ca2+ concentration ([Ca2+]i) in endothelial cells (EC). MATERIAL AND METHOD: We observed isometric contractions in rabbit carotid, superior mesentery, basilar arteries and mouse aorta. [Ca2+]i was recorded by microfluorimeter using Fura-2/AM in EC. RESULT: No change in contractility was recorded by the increase in [K+]o from 6 to 12 mM in conduit artery such as rabbit carotid artery. whereas resistant vessels, such as basilar and branches of superior mesenteric arteries (SMA), were relaxed by the increase. In basilar artery, the relaxation by the increase in [K+]o from 1 to 3 mM was bigger than that by the increase from 6 to 12 mM. In contrast, in branches of SMA, the relaxation by the increase in [K+]o from 6 to 12 mM is bigger than that by the increase from 1 to 3 mM. Ba2 (30microM) did not inhibit the relaxation by the increase in [K+]o from 1 to 3 mM but did inhibit the relaxation by the increase from 6 to 12 mM. In the mouse aorta without the endothelium or treated with NG-nitro-L-arginine (30microM), nitric oxide synthesis blocker, the increase in [K+]o from 6 to 12 mM did not change the magnitude of contraction induced either norepinephrine or prostaglandin F2alpha. The increase in [K+]o up to 12 mM did not induce contraction of mouse aorta but the increase more than 12 mM induced contraction. In the mouse aorta, EDR was completely inhibited on increasing [K+]o from 6 to 12 mM. In cultured mouse aorta EC, [Ca2+]i was increased by acetylcholine or ATP application and the increased [Ca2+]i was reduced by the increase in [K+]o reversibly and concentration-dependently. In human umbilical vein EC, similar effect of extracellular K+ was observed. Ouabain, a Na+-K+ pump blocker, and Ni2 , a Na+-Ca2+ exchanger blocker, reversed the inhibitory effect of extracellular K+. CONCLUSION: In resistant arteries, the increase in [K+]o relaxes vascular smooth muscle and the underlying mechanisms differ according to the kinds of the arteries; Ba2 -insensitive mechanism in basilar artery and Ba2 -sensitive one in branches of SMA. It also inhibits [Ca2+]i increase in EC and thereby EDR. The initial mechanism of the inhibition may be due to the activation of Na+-K+ pump.
Acetylcholine ; Adenosine Triphosphate ; Animals ; Aorta ; Arteries ; Basilar Artery ; Calcium ; Carotid Arteries ; Dinoprost ; Endothelial Cells ; Endothelium ; Endothelium-Dependent Relaxing Factors ; Humans ; Isometric Contraction ; Mesenteric Artery, Superior ; Mesentery ; Mice ; Muscle, Smooth, Vascular* ; Nitric Oxide ; Nitroarginine ; Norepinephrine ; Ouabain ; Potassium ; Relaxation* ; Umbilical Veins ; Vasodilation

Compression neuropathy can take place when the sciatic nerves come out from the sciatic notch and they are pressed by the nearby structure while traveling to their terminus. The common causes are the pyriformis syndrome that is caused by spasm of the pyrifomis muscle, lesions around the nerves and pressures from outside the spine. It has been occasionally reported that an intraneural ganglion develops within the sciatic nerve and this causes sciatic nerve compression. However, it has never been reported that the ganglion that developed around the nerves caused sciatic nerve compression. This case is about a 49-year-old man who underwent surgery due to the ganglion around the sciatic nerves, which had been found via a magnetic resonance image.
Ganglion Cysts* ; Humans ; Middle Aged ; Sciatic Nerve* ; Spasm ; Spine