Rheumatoid arthritis (RA) is a systemic disease with medication as the treatment of choice. However, surgical treatment is recommended when no improvement is noted despite aggressive conservative treatment. Synovectomy provides desirable outcomes for RA patients in the early stage with a glenohumeral joint of Larsen grade II or less; conversely, arthroplasty is recommended for patients with a glenohumeral joint of grade III or higher. RA patients often have attenuation and dysfunction of the rotator cuff, and reverse shoulder arthroplasty has been proven to provide favorable outcomes in some patients. RA is often complicated with osteoporosis and bony deformity; therefore, close attention is necessary to prevent fractures during shoulder arthroplasty.
Arthritis, Rheumatoid ; Arthroplasty ; Congenital Abnormalities ; Humans ; Osteoporosis ; Rotator Cuff ; Shoulder Joint* ; Shoulder*

No abstract available.
Extracorporeal Circulation* ; Heart* ; Potassium* ; Thoracic Surgery*

The management of the femoral neck fractures remains a major challenge to the orthopaedic surgeons because there are many critical complications such as non-union and avasular necrosis in spite of the advanced technics of treatment. The posterior comminution of this fracture is known to be an important comtributing factor of these complications as the most important cause of the instalility of reduction after internal fixation as well as difficulty of stable reduction, Authors reviewed 61 cases of the femoral neck fractures which were able to identify the presence or absence of posterior comminution on x-ray or operative findings and were managed at Daegu Fatima Hospital during the 10 years from 1975 to 1984 and the following results were obtained. 1. The incidence of posterior comminution in 61 femoral neck fractures was 56% in x-rays of lateral view and operative findings. 2. Open reductions were performed in 31% of 39 cases in which reductions were necessary for internal fixation and 43% of the fractures with posterior comminution were unstable to reduce by closed method while 88% of the fractures without postrior comminution were reduced by closed method. 3. The positions of reductio were in valgus in 46% and anatomic in the rest of cases and valgus reductions were more common in the cases of posterior comminution. 4. Loss of the reduction after internal fixation noted in 48% of the fractures with posterior comminution and 9% without posterior comminution. 5. 77% of the fractures united including 14% of mal-union and the late complication of non-union noted in 14% and avascular necroris in 9% in 35 cases which were followed for over 1 year. 6. The normal unions were more common in the fractures without posterior comminution, the cases of open reduction and the reduction in valgus position. 7. Most of the mal-unions and non-unions noted in the fractures with posterior comminution, the cases of closed reduction and the reduction in anatomic position. 8. These results suggest that the posterior comminution of the femoral neck fracture causes considerable instability and the better results could be expected in the femoral neck fractures with posterior comminution by the reduction in valgus and by the open reduction if necessary.
Clinical Study ; Daegu ; Femoral Neck Fractures ; Femur ; Femur Neck ; Incidence ; Methods ; Necrosis ; Surgeons

O1igodendrocytes are known to be responsible for the synthesis and maintenance of myelin sheath in the central nervous system, and their functional disturbance leads to defect in myelination. But, the fine mechanism of myelination by oligodendrocytes is not yet known, and iron metabolism in central nervous system is suspected to be related with myelination process by oligodendrocytes. Carbonic anhydrase-II[CA-II], transfe-rrin, and ferritin are known to be present at oligodendrocytes and suspected to play a role in iron metabolism of central nervous system. In this study, demyelination and remyelination of ICR mouse brains were induced using cuprizone, the copper-chelating agent, and immunohistochemical changes of CA-II-, transferrin-, and ferritin-immunoreactive oligodendrocytes at corpus callosum were observed. During demyelination by cuprizone feeding, the numbers of CA-II- and transferrin-immunoreactive oligodendrocytes were decreased. Especially, the decrease ratio of CA-II-positive cells was great. In contrast, the number of ferritin-positive oligodendrocytes was increased during demyelination by cuprizone feeding. Cessation of cuprizone feeding leaded remyelination and the numbers of CA-II-, transferrin-, and ferritin-immunoreactive oligodendrocytes were returned to normal level. In conclusion, the derangement of iron metabolism in oligodendrocytes may be related to demyelination mechanism of central nervous system, and the CA-II is suspected to have an important role in iron metabolism of oligodenrocytes in relation to demyelination and remyelination induced with cuprizone.
Animals ; Brain ; Carbon* ; Central Nervous System ; Corpus Callosum ; Cuprizone* ; Demyelinating Diseases ; Ferritins ; Iron ; Iron-Binding Proteins* ; Metabolism ; Mice* ; Mice, Inbred ICR ; Myelin Sheath ; Oligodendroglia ; Transferrin

PURPOSE: The aim of this study was to review the outcome of local control after the local excision for T1/T2 rectal cancers and, thus, to assess its effectiveness as an alternative to a more radical resection. METHODS: This retrospective study analyzed 23 patients with T1/T2 rectal cancer treated by local excision (LE), and their results were compared with the results for 22 patients with rectal cancer of the same stage treated by a radical resection (RR). All patients with pT2 lesions in the LE group received postoperative adjuvant chemoradiation. The outcomes were defined as 5-year local-recurrence-free survival (LRFS). The median follow-up was 72 (range, 40~92) months. RESULTS: Recurrence occurred in 4 patients (pT1, 1; pT2, 3) in the LE group and in 3 patients (all pT2) in the the RR group. One patient with vascular invasion (T2N1M0) in the RR group showed multiple liver metastases at 23 months postoperatively. The difference in 5-year LRFS was not statistically significant between the two groups. In the LE group, the 5-year LRFS for pT2 lesions was significantly less favorable than that for pT1 lesions (40% vs. 94%; P= 0.005). The 5-year LRFS for pT2 in the RR group was more favorable than that in the LE group, although the difference was not statistically significant (76.9% vs. 40%, P=0.138). CONSLUSIONS: Local excision provides a favorable local control for pT1 rectal cancers. A more radical resection, however, remains an effective surgical option for pT2 lesions because local excision, even combined with adjuvant chemoradiation, showed substantial local recurrences.
Follow-Up Studies ; Humans ; Liver ; Neoplasm Metastasis ; Rectal Neoplasms* ; Recurrence ; Retrospective Studies

No abstract available.
Vascular Endothelial Growth Factor A*

To investigate the effects of prostaglandin E1(PGX1) in prevention of proliferative scar formation, we cultured fibroblasts of normal skin (NS), hypertrophic scar (HS) and keloid (KL) tissues obtained from patients. We have compared type I collagenase production of cultured fibroblasts from normal skin, hypertrophic scar, and keloid tissues under various concentrations of PGE1. Our results demonstrate that type I collagenase production was significantly increased after addition of PGE1 in HS and KL, but not NS. Type I collagenase production of HS and KL fibroblasts were increased similarly in 10M and 10M of PGE1 and maximally increased in the concentration of 10M. This promotive effects of PGE1 on the production of type I collagenase was larger in KL than in HS. These results also suggest that PGE1 may play the promotive effects on type I collagenase production in dose-dependent manner. PGE1 may have a role in the prevention of hypertrophic scar and keloid by enhancing the production of type I collagenase of HS and KL fibroblasts. The promotive effects of PGE1 on type I collagenase production was variable depending on its concentration, and its effects was maximum in certain optimal condition. The maximally effective concentration of PGE1 in the prevention of proliferative scar formation should be searched in further investigations for clinical use.
Alprostadil ; Cicatrix ; Cicatrix, Hypertrophic* ; Collagenases* ; Fibroblasts* ; Humans ; Keloid* ; RNA, Messenger* ; Skin

An unusual case of homicide of a 21-year-old man who was smothered with a hot steam towel by his mother and a pastoress in the name of exorcism. Homicidal smothering in adults is rare, but does occur when the victims are not capable of defending themselves in situations such as chronic illness, old age, drug intoxication or when restrained by other people. In this case, distinct facial scalding was a clue to smothering with a hot steam towel.
Adult ; Chronic Disease ; Homicide ; Humans ; Mothers ; Steam

Accidents, Traffic ; Diagnosis ; Facial Injuries ; Female ; Head ; Humans ; Incidence ; Inpatients ; Jeollanam-do ; Lacerations ; Male ; Mandibular Fractures ; Neck ; Postoperative Complications ; Social Environment ; Surgery, Oral ; Violence