No abstract available.
Abdomen* ; Humans

Alveolar Process ; Maxilla ; Osteotomy

Displaced intra-articular fractures of the calcaneus result in serious and prolonged disability. These injuries continue to pose a therapeutic challange and there remains a great deal of controversy regarding treatment, operative versus nonperative. The lateral approach for open reduction, popularized by Palmer, has been used by many authors, with high percentage of excellent results. We treated 21 displaced intra-articular fractures of the calvaneus in 18 patients by open reduction and internal fixation through the lateral approach from July 1990 to May 1992 and the patients have been followed from 12 to 36 months from the time of their injury. The clinical and radiographic analyses were as follows; 1. The most common cause of injury was falls from a height: 19 fractures in 16 patients(88.8%), Spine fracture was most commonly associated injury : 5 patients (27.8%). 2. Fracture was classified according to classification of Paley and Hall. Eight fractures were tongue type(no comminution 4, with comminution 4), 12 joint depression type(no comminution 8, with comminution 4), and a comminuted type. 3. The average bohler tuber-joint angle was
Accidental Falls ; Calcaneus ; Classification ; Congenital Abnormalities ; Depression ; Follow-Up Studies ; Foot ; Fractures, Comminuted ; Heel ; Humans ; Hypesthesia ; Intra-Articular Fractures ; Joints ; Osteomyelitis ; Spine ; Toes ; Tongue ; Transplants

PURPOSE: To evaluate the functional results of the elbow and the complications after internal fixation for distal humeral fractures. MATERIALS AND METHODS: We reviewed 38 distal humeral fractures; 12 type A, 7 type B and 19 type C by AO classification. There were six low columnar fractures in type A and nine in type C. Six type C fractures were open. The fracture healing and complications were assessed and the functional result was evaluated by rating system of Jupiter et al. RESULTS: Type A fractures were healed in an average of 10.6 weeks, type B 7.7 weeks and type C 11.5 weeks. Ulnar neuropathy occurred in six cases, loss of fixation in two cases, nonunion in one case, heterotopic ossification in one case and traumatic arthritis in one case. The functional result showed excellent or good in 34 cases (89%) and fair or poor in 4 cases (11%). Open fractures showed significantly worse result than closed fractures. CONCLUSION: To obtain the satisfactory results, stable fixation followed by early motion is required in most distal humeral fractures. Ulnar neuropathy occurs postoperatively in high incidence and the result of open fractures is worse than that of closed fractures.
Arthritis ; Classification ; Elbow* ; Fracture Healing ; Fractures, Closed ; Fractures, Open ; Humeral Fractures ; Humerus* ; Incidence ; Ossification, Heterotopic ; Ulnar Neuropathies

No abstract available.
Antibodies* ; Fetus* ; Heart Block* ; Heart*

BACKGROUND: It has long been suggested that neutrophils and their products are implicated as the central mediators of the acute lung injuries. Contrary to the dominant role of neutrophils in ARDS, many cases of ARDS has occurred in the setting of severe neutropenia without pufrnonary neutrophil infiltration. Therefore it is certain that effector cell(s) other than neutrophil play an important role in the pathogenesis of ARDS. This experiment was performed to define the mechanism of ARDS in the setting of neutiopenia, 1) by comparing the severity of endotoxin-induced lung injury, 2) by measurement of hydrogen peroxide production and cytokine concentration in the bronchoalveolar lavage cells and fluids obtained from different rats with and without cyclophosphamide-pretreatment. METHOD: The male Sprague-Dawleys were divided into the normal control (NC)-, endotoxin (ETX)-, and cyclophosphamide (CPA)-group in which neutropenia was induced by injecting cyclophosphamide intraperitoneally. Acute lung injury was evoked by injecting lipopolysaccharide (LPS) into a tail vein. The bronchoalveolar lavage (BAL) was performed at 3 and 6 hour after administration of LPS to measure the change of cell counts and concentrations of protein and cytokines, tumor necrosis factor-alpha (TNF-alpha) and interleukin-6 (IL-6). Hydrogen peroxide (HPO) production from BAL cel]s was measured at 6 hour after LPS administration by phenol red microassay with and without zymosan stimulation. RESULTS: The results were as follows. A change of leukocyte counts in the peripheral blood after treatment with CPA More than 95% of total leukocytes and neutrophils were reduced after CPA administration, resulting in severe neutropenia. A change of BAL cells In the ETX-group, the number of total cells (p<0.01) and of macrophage and neutrophll (p<0.05) were increased at 3 and 6 hour after LPS administration compared to those of NC- group. In the CPA-group, the number of total leukocyte and macrophage were not changed after LPS administration, but neutrophil counts were significantly reduced and jt took part in less than 0.1% of total BAL cells (p<0.01 vs NC-group). BAL cells in this group were almost all macrophages (99.7%). A change of protein concentration in the BALF In the ETX-group, protein concentration was increased at 3 hour and was more increased at 6 hour after LPS administration (p<0.05 and <0.01 vs NC-group, respectively). In the CPA-group, it was also significantly elevated at 3 hour after LPS administration (p<0.05 vs NC-group) , but the value was statistically not different from that of ETh-group. The value measured at 6 hour after LPS administration in the CPA-group became lower than that of ETX-group (p<0.05), but showed still a higher value compared to that of NC-group (p<0.05). A change of cytokine concentration in the BALF TNF-alpha and IL-6 were elevated in the ETX- and CPA-group compared to those of NC-group at both time intervals. There was no statistical difference in the values of both cytokines between the ETX- and CPA-groups. Measurement of hydrogen peroxide production from BAL cells There was no intergroup difference of HPO production from resting cells. HPO production after incubation with opsonized zymosan was significantly elevated in all groups. The percent increment of HPO production was highest in the ETX-group (89.0%, p<0.0008 vs NC-group ), and was 42.85 in the CPA-group (p = 0.003 vs NC-group ). Conclusion Acute lung injury in the setting of neutropenia might be caused by functional activation of resident alveola r macrophages.
Acute Lung Injury* ; Animals ; Bronchoalveolar Lavage ; Cell Count ; Cyclophosphamide ; Cytokines ; Humans ; Hydrogen Peroxide ; Interleukin-6 ; Leukocyte Count ; Leukocytes ; Lung Injury ; Macrophages* ; Male ; Neutropenia ; Neutrophil Infiltration ; Neutrophils ; Phenolsulfonphthalein ; Rats* ; Tumor Necrosis Factor-alpha ; Veins ; Zymosan

No abstract available.
Female ; Ovary* ; Teratoma*

PURPOSE: evaluate the effectiveness of minimally invasive plate osteosynthesis (MIPO) in unstable fractures of the distal tibia. MATERIALS AND METHODS: From March 2001 to December 2003, 21 cases with unstable fractures of the distal tibia were treated with MIPO technique and followed for at least one year. Eighteen cases were extra-articular and three cases were intra-articular fractures. According to AO classification, six cases were 42-A, four 42-B, one 42-C, seven 43-A, and three 43-C. There was only one case of Gustilo-Anderson type II open fracture. We reviewed the results of fracture healing, axial and rotational deformity, ankle motion, and complications RESULTS: All fractures were healed in an average of 16.1 weeks (range, 11 to 24 weeks). There was only one case of 7-degree posterior angular deformity, but no cases of rotational malalignment. Recovery of ankle motion was satisfactory in all patients within 5-degree loss of motion. Subcutaneous abscess was developed in one case after fracture healing and cured by a drainage with implant removal. CONCLUSION: Although MIPO technique is technically more demanding than the traditional open technique, MIPO technique is an effective method for unstable fractures of the distal tibia because it minimizes incidence of soft-tissue compromise and infection and provides good fracture healing.
Abscess ; Ankle ; Classification ; Congenital Abnormalities ; Drainage ; Fracture Healing ; Fractures, Open ; Humans ; Incidence ; Intra-Articular Fractures ; Tibia*

BACKGROUND: It is known that airway inflammation is present in most patients with asthma, but the relationship between symptoms and the severity and nature of airway inflammation has not been established. Cough variant asthma is defined as an asthma in which the dominant symptom is cough and the condition can be successfully treated with inhaled steroids. This study was performed to evaluate the time coulee of bronchial responsiveness according to an inhaled anti-inflammatory therapy and the factors which affect the resolution of bronchial responsiveness, and an efficacy of nedocromil to cough asthma. METHOD: A prospective study for the investigation of bronchial responsiveness according to an inhaled anti-inflammatory treatment in sixty-one cough asthmatics was performed. Twenty-three entered budesonide (400microgram 2/day), twenty-two entered nedocromil (4mg2/day) and sixteen patients entered combined group. The bronchial hyperresponsiveness (BHR) was estimated by methacholine challenge test using counted breath method. The symptom was estimated by 'symptom score'. Reevaluation of BHR and symptom was performed at 2 month after treatment, and if BHR was not resoluted at this time, regarded as a non-responder, and then follow-up of BHR and symptom was performed at 4-and/or 6 month after treatment. RESULTS: The improvement of BHR and symptom was significant in 2 month (p < 0.05), but there was no change of them during follow-up period of 4-and/or 6 month in non-responders. In comparison of allergic markers such as serum total IgE, peripheral eosinophil count and skin test reactivity between responders and non-responders, there was no difference in each other. However, in comparison of other factors such as cumulative pack-years, symptom duration age, gender, and the initial degree of PC20, there was a significant difference in each other(p < 0.05). The percent of patients with the resolution of BHR in 2 month was not different in each group (p=0.95). There was no significant difference in the degree of improvement of BHR and symptom in each group. CONCLUSION: Bronchial responsiveness and symptom was not significantly improved in non-responders during follow-up period of 4-and/or 6 month. The effect of inhaled nedocromil was equivalent to that of inhaled steroid in cough asthmatics, and the response to combined treatment is not superior to that achieved by either of these agents used alone.
Asthma* ; Budesonide ; Cough* ; Eosinophils ; Follow-Up Studies ; Humans ; Immunoglobulin E ; Inflammation ; Methacholine Chloride ; Nedocromil ; Prospective Studies ; Skin Tests ; Steroids

BACKGROUND AND OBJECTIVES: The aim of this article is to report our experience of inadvertent parathyroidectomy during thyroid surgery and to analyze its associated factors and clinical implications. In addition, we attempted to determined causative factors that result in permanent hypocalcemia after thyroid surgery. MATERIALS AND METHODS: We performed a retrospective review of 500 patients who underwent thyroid surgery for the treatment of papillary thyroid carcinoma from 2004 to 2008. RESULTS: Inadvertent parathyroidectomy was identified in 7.4% of patients and only 1 parathyroid gland was inadvertently removed in most cases. The incidence of inadvertent parathyroidectomy was not associated with gender, age, type of surgical procedure, tumor size, coexisting Hashimoto's thyroiditis (HT), extra-thyroidal extension (ETE), lymph node (LN) metastasis, and surgeon's experience. Nor was inadvertent parathyroidectomy associated with permanent postoperative hypocalcemia. Although operating time >120 min, ETE, and total thyroidectomy (TT) with central neck dissection (CND) were found to be related to permanent hypocalcemia on univariate analysis, tumor size > or =1 cm and surgeon's experience < or =5 years was statistically associated with permanent hypocalcemia on both univariate and multivariate analyses. CONCLUSION: Although inadvertent parathyroidectomy is not an uncommon complication of thyroid surgery, it appears to have only modest clinical implications. Permanent hypocalcemia was significantly associated with tumor size > or =1 cm and short surgical experience of surgeons, especially in the case of TT with CND. Therefore, we suggest that more accurate risk stratification should be made for routine CND, when it is performed by young surgeons.
Carcinoma ; Humans ; Hypocalcemia ; Incidence ; Lymph Nodes ; Neck Dissection ; Neoplasm Metastasis ; Parathyroid Glands ; Parathyroidectomy ; Retrospective Studies ; Thyroid Gland ; Thyroid Neoplasms ; Thyroidectomy ; Thyroiditis