Objective: To evaluate anti-diabetic effect of Caulerpa lentillifera (C. lentillifera).Methods:The inhibitory effect of C. lentillifera extract on dipeptidyl peptidase-IV andα-glucosidase enzyme was measured in a cell free system. Then, interleukin-1β and interferon-γinduced cell death and insulin secretion were measured in rat insulinoma (RIN) cells by 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide assay and ELISA kit, respectively. Glucose uptake and glucose transporter expression were measured by fluorometry and western blotting, using 3T3-L1 adipocytes.Results: C. lentillifera extract significantly decreased dipeptidyl peptidase-IV and α-glucosidase enzyme activities, and effectively inhibited cell death and iNOS expression in interleukin-1βand interferon-γ induced RIN cells. Furthermore, C. lentillifera extract significantly enhanced insulin secretion in RIN cells and glucose transporter expression and glucose uptake in 3T3-L1 adipocytes.Conclusions:Thus, our results suggest that C. lentillifera could be used as a potential anti-diabetic agent.

Introduction: This study examined the factors related to the amount of blood loss and transfusion after primary total hip arthroplasty. Materials and methods: Sixty THRA patients, who had records of perioperative complete blood counts and transfusion, were enrolled in this study. Age, gender, diagnosis, use of cement, size of an incision, operative time, intraoperative crack, estimated blood loss, use of suction drain and the amount drained were used as possible variables. Results: The decrease in the serum hemoglobin level immediately after and 1 day after surgery was 3.18 and 3.90g/dL respectively. An average of 2.30 units were transfused in 78.3% of cases. The preoperative serum hemoglobin level, the use of a suction drain and the amount drained was related to the total amount of transfusion. Adverse transfusion reactions were found to be associated with the amount of transfusion Discussion: The reduction in the hemoglobin level and total amount of blood transfused showed no relationship with the variances associated with the surgical techniques. The total amount of blood transfused was significantly lower in the groups that had no suction drain. Therefore, a reduction in the volume of intraoperative transfusion and avoiding use of a suction drain can reduce the total amount of blood needed and reduce the adverse reactions of the transfusion.
Arthroplasty, Replacement, Hip* ; Blood Cell Count ; Blood Group Incompatibility ; Diagnosis ; Humans ; Operative Time ; Suction

Isolated acute monoarticular septic arthritis of the sternoclavicular joint is a extremely rare disorder, and is usually associated with predisposing factors such as contiguous foci of infection, heroin addiction, rheumatoid arthritis, diabetes mellitus and maintenance hemodialysis. This case occurred in healthy adult. The etiological agent was staphylococcus aureus. Good result wads achieved by applying appropriate antibiotic therapy combined with an adequate drainage.
Adult ; Arthritis, Infectious ; Arthritis, Rheumatoid ; Causality ; Diabetes Mellitus ; Drainage ; Heroin Dependence ; Humans ; Renal Dialysis ; Staphylococcal Infections ; Staphylococcus aureus ; Sternoclavicular Joint

No abstract available.
DNA Fingerprinting* ; DNA* ; Oligonucleotide Probes* ; Polymerase Chain Reaction*

STUDY DESIGN: Retrospective clinical study. OBJECTIVES: To assess the efficacy of a cortical bone trajectory pedicle screw (CBT-PS) for the treatment of lumbar pyogenic spondylodiscitis. SUMMARY OF LITERATURE REVIEW: Pedicle screws were used for surgical treatment of pyogenic spondylodiscitis to prevent instability and deformity. CTB-PS are typically inserted from the inferomedial to superolateral direction of the pedicle and have yielded satisfactory results in degenerative or osteoporotic spinal disorders. MATERIALS AND METHODS: Eight patients with single segment lumbar pyogenic spondylodiscitis were analyzed. At first, anterior debridements and interbody fusions were perfomed with autogenous strut bone grafts, followed by posterior fixations and fusions with CBT-PS. The lordotic angles of operated levels were checked at the preoperative, postoperative, and final follow-ups. Visual analogue scales (VAS) were checked at the preoperative and final follow-ups. RESULTS: Lesion sites were found at four L3-4, three L4-5, and one L2-3. Follow-ups were held at 26.13±8.23 months. The lordotic angles at preoperative, postoperative, and final follow-ups were 12.13±3.09°, 14.63±3.16°, and 12.75±3.99°, retrospectively. There were significant differences between results from the preoperative-postoperative and postoperative-final follow ups. There was no difference in the preoperative-final follow up. There was a significant difference between the VAS at the preoperative and final follow-ups (8.13±0.83 and 2.38±0.92, retrospectively). Complete bony unions of were observed at the final follow-up in all cases. CONCLUSIONS: The advantages of using a CBT-PS for lumbar pyogenic spondylodiscitis included the ability to minimize damage from the screw for both the posterior structure damage and the operated anterior area to prevent instability and deformity, and to achieve rigid bone union. CBT-PS is a potential surgical option for pyogenic spondylodiscitis.
Clinical Study ; Congenital Abnormalities ; Debridement ; Discitis* ; Follow-Up Studies ; Humans ; Pedicle Screws* ; Retrospective Studies ; Transplants ; Weights and Measures

The posterior cruciate ligament is an anatomically and biomechanically complex structure. PCL injuries are reported to occur in 1-40% of acute knee injuries, with isolated PCL tear, less common than PCL tears combined with other Iigament injuries. Controversy exists concerning the geatment of the PCL injures. Recently, arthroscopic techniques of PCL reconstruction are becoming nore refined and reproducible. Between July 1993 and May 1995, 25 operations for PCL rupture were performed in our hospital. At the follow-up examinations we noted mild to moderate posterior instablilty which was not noted at the time of operation and during the immediate postoperative period. We reviewed type (if injuries, amplitude of initial posterior tibia1 translation, surgical techniques, which seemcd to be in relation ivith the postoperative instabilities. At final follow-up, the mean Lysholm knee score was 86 points, and the posterior tibial translation 6.5mm on posterior stress radiographs. The ligament augmentation device provided no benefit. The ideal positioning and fixation of the graft and protection of the graft from abrasion seemed to be important to get a good results.
Follow-Up Studies ; Knee ; Knee Injuries ; Ligaments ; Patellar Ligament* ; Posterior Cruciate Ligament ; Postoperative Period ; Rupture ; Transplants*

We reviewed 205 hips (in 151 patients, 125 men and 26 women) which were diagnosed osteonecrosis of femoral head and treated with bipolar endoprosthesis from 1985 to 1993 in Seoul National University Hospital to delineate the efficacy and indication of use of bipolar endoprosthesis in osteonecrosis. They were followed up for an average of 56 months (16 to 100 months). The mean age at operation was 44 years (21 to 84 years). The types of prosthesis used were as follows : Omnift (107), AML (57), Harris-Galante (19) and others (22). The preoperative Harris hip score improved from 49 points preoperatively to 89 points at last follow-up. The pain score improved from 18 points to 39 points, activity score from 9 points to 12 points and gait scare from 19 points to 31 points. The improvement pattern of activities and gait was converse, but that of pain was diverse. One hundred and seventy-eight hips (87%) were satisfactory (Harris hip score : more than 80 points) and 27 (13%) were unsatisfactory. Radiologic findings of last follow-up showed stable bony fixation in 186 hips (91%), stable fibrous fixation in 12 hips (6%) and unstable fixation in 7 hips (3%), Ten migrations of prosthesis were noted: cup migration 5 (2.4%) and stem sinking 5 (2.4%). Heterotopic ossification was noted in 9 (4.4%). Osteolysis in acetabular side was observed in 6 (3%) and in femoral side, 22 (11%). Complications were as follows : 4 stem loosening (1.9%), 5 fixed varus position of cup (2.4%) and 1 dislocation of cup (0.5%). Revision was performed in 4 (1.9%) and the causes were 1 infection, 1 protrusio acetabuli, 1 stem loosening and 1 cup dislocation. In conclusion, biopolar endoprosthesis generally gave good results. However, the improvement of pain was unpredictable. Increasing tendency of osteolysis was noted with increasing follow-up duration. Long-term follow-up is mandatory for the accurate determination of osteolysis.
Acetabulum ; Dislocations ; Follow-Up Studies ; Gait ; Head ; Hip ; Humans ; Male ; Ossification, Heterotopic ; Osteolysis ; Osteonecrosis ; Prostheses and Implants ; Seoul

Henoch-Sch nlein purpura is a small-vessel vasculitis characterized by palpable purpura, abdominal pain, hematuria and arthralgia. Joint involvement occurs in 2/3 of the cases and the joint symptoms are misapprehended as an orthopaedic problem because they are often severe and occurs before characteristic purpura. It has been reported that the joint symptoms can be improved without any sequelae. But, recently some authors suggest that severe joint destruction can occur when combined with rheumatoid arthritis and the patients are FILA-DR4 positive. So, the regular follow-up for joint symptoms and screening test for the risky patients having possibility for progression of arthritis are required. In order to increase the attention of the orthopaedic surgeons on this disease and study the progression of joint symptoms, possibility of development of screening test for the risky patients and the characterisitics of the disease, we analyzed the 58 patients of Henoch-Sch nlein purpura. The following results were obtained. Among 58 patients 34 cases were male and 25 cases were female, 5 to 10-year-old children were affected more frequently and the disease occurs frequently in spring and winter season. Joint symptoms developed in 22/58 patients(37.9%) and occurs before characteristic purpura in 5/22 patients(22.7%) among the joint symptom-developed patients. Knee and ankle were affected in most patients and the inflammatory signs such as high fever, leukocytosis and elevated ESR were accompanied with joint symptom, so it resembled the symptoms and signs of pyogenic arthritis. Most of the patients recovered without remaining sequelae but 9 patients(15.5%) among joint symptom-developed patients complained repeated attacks of arthralgia. The HLA B27 were all positive in those patients. So, it was assumed that the joint symptom in Henoch-Sch nlein purpura has a correlation with genetic environment and through the broad prospective study, the HLA typing can be a screening test for the risky group prone to suffer from repeated attack or aggravation of arthritis.
Abdominal Pain ; Ankle ; Arthralgia ; Arthritis ; Arthritis, Rheumatoid ; Child ; Female ; Fever ; Follow-Up Studies ; Hematuria ; Histocompatibility Testing ; Humans ; Joints* ; Knee ; Leukocytosis ; Male ; Mass Screening ; Purpura* ; Seasons ; Vasculitis

STUDY DESIGN: A retrospective study OBJECTIVES: To evaluate postoperative muscle damage after microendoscopic discectomy (MED) and open discectomy (OD), using analysis of serum creatine phosphokinase (CPK) levels. SUMMARY OF LITERATURE REVIEW: Paravertebral muscle damage after retraction during posterior lumbar surgery can cause postoperative back pain. Serum CPK level is elevated in these patients and may indicate postoperative muscle damage. MATERIALS AND METHODS: We examined 35 cases with MED (group 1) and 11 cases with OD (group 2). Serum CPK levels were checked preoperatively and postoperatively at day 1 and day 3. We analyzed intra-group and inter-group differences in CPK levels according to sex, age, and operation time. Surgical outcomes were evaluated with a visual analog scale (VAS) preoperatively and 1 year postoperatively. RESULTS: CPK levels at postoperative 1 day were increased significantly and decreased significantly at postoperative 3 day in both groups (p<0.05), with levels in group 1 significantly lower than in group 2 (p<0.05). There were no differences in CPK levels according to sex, age, or operation time, except between the 3rd and 5th decades of age at postoperative 1 day in group 2. VAS was significantly different in intra-group analysis (p<0.05) with no significant differences in intergroup analysis. CONCLUSIONS: MED induced a lower increase in serum CPK than OD with similar VAS outcomes. MED results in less postoperative muscle damage than OD, with similar surgical outcomes.
Back Pain ; Creatine Kinase* ; Creatine* ; Diskectomy* ; Humans ; Retrospective Studies ; Visual Analog Scale

STUDY DESIGN: This is a retrospective and preliminary study. OBJECTIVES: We wanted to evaluate the characteristics of recompression of vertebral bodies without trauma after balloon kyphoplasty (KP) for treating osteoporotic vertebral compression fractures (VCF). SUMMARY OF THE LITERATURE REVIEW: KP has been used for fracture reduction, maintenance of vertebral height and relief of pain in VCF. Despite of numerous satisfactory results, several factors have been noted to affect the clinical results of KP. MATERIALS AND METHODS: Six patients with recompression of vertebral bodies without trauma after KP were reviewed. All the patients were female and their mean age was 75.9+/-4.1 years old. The follow-up period was 17.2+/-8.5 months. The compression rates of the operated vertebral bodies (CR) and the kyphotic angles (KA) were checked by using plain roentgenograms at the initial, postoperative and last follow-up periods. The preoperative MRIs were also reviewed. The clinical results were checked using the VAS. RESULTS: The CRs at the initial, postoperative and last follow-up periods were 33.7+/-14.8%, 13.4+/-7.6% and, 26.9+/- 9.9%, respectively. The KAs were 19.2+/-7.2degrees , 14.8+/-6.2degrees and 20.5+/-7.4degrees for each period, respectively. Statistically, the CR and KA at the initial-postoperative period and at the postoperative-last follow-up period showed significant differences (p < 0.05). Intervertebral clefts were found in all the cases on MRI. Normal bones superior or inferior to cement were also seen in all the cases after KP. The VAS scores were 8.5+/-0.5, 2.3+/-0.5 and 3.0+/-0.6, retrospectively, and there were significant differences between each periods (p<0.05). CONCLUSIONS: Recompression of a vertebral body without trauma after KP for treating VCF was observed in the cases with a intervertebral cleft seen on MRI and normal bones superior or inferior to the cement were observed after KP. The causes of recompression may be subsequent compression or resorption of the remaining vertebral body.
Female ; Follow-Up Studies ; Fractures, Compression ; Humans ; Kyphoplasty ; Retrospective Studies