No abstract available.
Rhinoplasty*

OBJECTIVES: In HFRS, there is a varying degree of disseminated intravascular coagulation which was evident in the early phase of the illness. It is believed also that DIC would be the consequence, at least in part, of functional changes of endothelium resulting in kinin activation and clinical syndrome. This study investigated the role of adhesion molecule in the pathogenesis of Hantaan virus-related disease. METHODS: The expression of ICAM-1 antigen on the cell membrane of human umbilical vein endothelial cells was assessed by immunohistochemistry, and ICAM-1 mRNA in the endothelial cells was assessed by in situ hybridization after Hantaan virus infection (2.6 x 10(4) PFU/mL) with the time course. RESULTS: In immunohistochemistry, the number of ICAM-1 positive cells increased with time during the 12 or 24 hours after infection. 5 to 10% of HUVECs had been positive after 12-24 hours and the number of positive cells decreased abruptly after 24 hours. Hantaan antigen had been noticed after 12 hours focally on the HUVECs but continued to proliferate into day 7 post-infection when most of HUVECs were infected by Hantaan virus. In situ hybridization showed identical patterns of ICAM-1 mRNA expression after Hantaan virus infection. CONCLUSION: It implies that the Hantaan virus infection on HUVECs would express more ICAM-1 on their surface and implicated in the pathogenesis of early clinical syndrome of HFRS.
Cell Line ; Endothelium, Vascular/virology ; Endothelium, Vascular/immunology ; Gene Expression ; Hantaan Virus/pathogenicity* ; Hemorrhagic Fever with Renal Syndrome/immunology* ; Hemorrhagic Fever with Renal Syndrome/genetics ; Hemorrhagic Fever with Renal Syndrome/etiology ; Human ; Immunohistochemistry ; In Situ Hybridization ; Intercellular Adhesion Molecule-1/metabolism* ; Intercellular Adhesion Molecule-1/genetics* ; RNA, Messenger/metabolism ; RNA, Messenger/genetics

PURPOSE: To evaluate the functional outcomes of the severely comminuted intra-articular calcaneal fractures that were selectively treated with primary subtalar arthrodesis. MATERIALS AND METHODS: This study is based on the 9 patients, 10 feet of intra-articular severely comminuted calcaneal fractures that were treated with open reduction and internal fixation with primary subtalar arthrodesis due to inability to reconstruct the subtalar articular surface with follow-up of more than 1 year. Postoperative clinical evaluation was performed with AOFAS Hindfoot functional scores. The patient satisfaction, returning to previous occupation and complications were also investigated. RESULTS: Follow-up period was average 20.3 months. Overall AOFAS functional score at final follow-up was average 71.8 points and VAS pain score was 3.9. Fifty percent of the patients were satisfied with the surgery and 80% of the patients were able to return to their previous occupations at average 8.4 months after trauma. Post-operative complications were 2 cases of sural nerve injuries and 1 hindfoot valgus malunion. CONCLUSION: We concluded that the primary subtalar arthrodesis is a viable surgical option for severely comminuted calcaneal fractures with favorable functional result and early returning of most patients to their previous occupations.
Arthrodesis* ; Calcaneus ; Follow-Up Studies ; Foot ; Fractures, Comminuted* ; Humans ; Occupations ; Patient Satisfaction ; Sural Nerve

No abstract available.
Angiofibroma*

PURPOSE: To evaluate the result of treatment of proximal femoral shaft fracture with limited open reduction and intramedullary nailing. MATERIALS AND METHODS: Fifteen patients who had limited open reduction and intramedullary nailing due to proximal femoral shaft fracture for follow-up for more than 12 months were selected between March 2001 and December 2005. The clinical and radiologic results were analyzed. Winquist-Hansen classification and OTA/AO classification were used. RESULTS: Thirteen cases achieved bone union and 2 cases showed delayed union. The mean bone union period was 21.3 weeks (14~32). There was no postoperative infection. Nonunion was observed in 2 cases of which bone union was acquired with the exchange of intramedullary nail and bone graft in one case and with the additional plate fixation and bone graft in the other case. CONCLUSION: Treating proximal femoral shaft fracture with limited open reduction and intramedullary nailing seems to be a technique to manage proximal femoral shaft fracture that has combined fracture or ipsilateral femoral fracture or is unable to acquire acceptable reduction with closed reduction.
Femoral Fractures ; Femur ; Follow-Up Studies ; Fracture Fixation, Intramedullary ; Humans ; Nails ; Transplants

The most common form of genetic nephrogenic diabetes insipidus(NDI), a rare inherited disorder, is congenital and is transmitted in an X-linked recessive mode. It is refractory to the antidiuretic effect of normal to moderately increased levels of plasma arginine vasopressin(AVP) but, in some cases, may respond to high levels of the hormone or its analogue, deamino-D-arginine vasopressin(DDAVP). X-linked congenital NDI has now been linked to over 128 different mutations in diverse coding regions of the AVP receptor 2(AVPR2) gene. The functional effects of these mutations vary from complete loss of responsiveness to a simple shift to the right in the dose response curve. We report a case of congenital partial NDI, with transversion of A to G at codon 280 of the AVPR2 gene, resulting in a subsequent change of amino acid from tyrosine to cysteine, and that has been effective with hydrochlorothiazide and high dose of DDAVP.
Antidiuretic Agents ; Arginine ; Clinical Coding ; Codon ; Cysteine ; Deamino Arginine Vasopressin ; Diabetes Insipidus, Nephrogenic* ; Hydrochlorothiazide ; Plasma ; Tyrosine

BACKGROUND: Compliance from kidney transplant recipients might improve with less frequent doses of immunosuppressant drugs. We describe the development of an extended-release formulation of tacrolimus that enables taking the drug just once a day, instead of the current twice a day tacrolimus formulation. METHODS: We performed a prospective, open-label, 1:1 randomized, and multicenter study. Patients received Prograf(R) (Astellas Inc.) twice a day for 1 month post-transplantation. The patients of the investigational group converted to a dose of Advagraf(R) (Astellas Inc.) given once a day. We evaluated the efficacy, safety, and patient satisfaction of both groups. RESULTS: Within 5 months after conversion to Advagraf, the incidence of biopsy-confirmed acute rejection was 0%, while patient and graft survival was 100%. We could not find differences of the patients' estimated glomerular filtration rate (eGFR) between the Prograf and Advagraf treated groups 1~6 months post-transplantation. The safety profile and satisfaction profiles (immunosuppressant therapy barrier scale) were also equivalent between the treated groups. CONCLUSIONS: The preliminary results of this study support the safety, efficacy, and patient satisfaction from a single daily formulation of tacrolimus (Advagraf(R)).
Compliance ; Glomerular Filtration Rate ; Graft Survival ; Humans ; Immunosuppression ; Incidence ; Kidney ; Kidney Transplantation ; Patient Satisfaction ; Prospective Studies ; Rejection (Psychology) ; Tacrolimus

PURPOSE: The purpose of this study was to compare once-daily tacrolimus with twice-daily tacrolimus in terms of safety, efficacy, and patient satisfaction. MATERIALS AND METHODS: This prospective, randomized, open-label, multicenter study was conducted at three institutes. Patients in the investigational group were converted from tacrolimus twice daily to the same dose of extended-release tacrolimus once daily at 1 month post-transplantation, while patients in the control group were maintained on tacrolimus twice daily. The efficacies, safeties, and patient satisfaction for the two drugs at 6 months post-transplantation were compared. RESULTS: Sixty patients were enrolled and randomized to the investigational group (28 of 29 patients completed the study) or the control group (26 of 31 patients completed the study). At 6 months post-transplantation, composite efficacy failure rates including the incidences of biopsy-confirmed acute rejection in the investigational and control groups were 0% and 10.7%, respectively; patient survival was 100% in each group. No difference in estimated glomerular filtration rate values were observed at 6 months post-transplantation (p=0.97). The safety and satisfaction profile (immunosuppressant therapy barrier scale) of once-daily tacrolimus was comparable with that of twice-daily tacrolimus (p=0.35). CONCLUSION: Conversion from twice-daily tacrolimus to once-daily tacrolimus one month after transplantation is safe and effective.
Adult ; Drug Administration Schedule ; Female ; Graft Rejection/drug therapy/prevention & control ; Humans ; Immunosuppressive Agents/*administration & dosage/adverse effects/therapeutic use ; *Kidney Transplantation ; Male ; Middle Aged ; Safety ; Tacrolimus/*administration & dosage/adverse effects/therapeutic use

The present study compared the actigraphic indices between both wrist actigraphies (WATGs), and the sleep estimates between each WATG and nocturnal polysomnography (NPSG) to assess their differences and consistencies. We studied 22 right-handed subjects (mean age 43.9+/-13.3 years, M:F=14:8) with untreated primary sleep disorders (primary insomnia=8, simple snorer=2, obstructive sleep apnea=12) undergone by overnight both WATGs and NPSG, simultaneously. Comparison and correlation were analyzed between right and left wrist actigraphic data. In the sleep estimates of both WATGs and NPSG, each WATG was compared and correlated with NPSG in sleep period time (SPT), total sleep time (TST), sleep latency (SL), sleep efficiency (SE) and wake time (WT). Sleep indices between both WATGs showed significant positive correlations with no correlations in SL and fragmentation index (FI). There were no differences in sleep indices between both WATGs. SPTs of both WATGs, SL of left WATG, and TST of right WATG showed positively significant correlations, and SE of right WATG did negatively significant correlation in sleep indices between each WATG and NPSG. As each WATG was compared to PSG, SPTs of both WATGs and WT of right WATG were decreased, and TST and SE of right WATG and SL of left WATG were increased. Inconsistent SL and FI between both WATGs indicate that the activities between both WATGs can differentially happen during wake or arousal. Inconsistent sleep estimates between each WATG and NPSG may indicate the limited usefulness in measuring and analyzing one-night sleep by using WATG.
Arousal ; Functional Laterality ; Polysomnography* ; Sleep Wake Disorders ; Wrist*

OBJECTIVE: If bowels and other structures are in the pathway of high-intensity focused ultrasound (HIFU) beam during magnetic resonance image-guided HIFU (MRgFUS) therapy, filling to the bladder and the rectum and then emptying the bladder (i.e., the BRB technique) is used to avoid them. A modified BRB technique might be useful method to using a uterine elevator method or by inducing uterus downward traction to lower the position of the uterus. METHODS: A total of 156 patients who had undergone MRgFUS surgery treatment for uterine fibroids from March 2015 to February 2016 were included in this retrospective study. Of the 156 patients, 40 were treated using a uterine elevator while 29 were treated using downward traction of uterus. HIFU was performed using Philips Achieva 1.5 Tesla MR and Sonalleve HIFU system. RESULTS: MRgFUS surgery was feasible with modified BRB technique in 69 cases. Using uterine elevator method, the intensity of HIFU for group with antefletxio uteri was significantly lower than that for the group without antefletxio uteri (105.37±17.62 vs. 118.71±26.88 W). The group with downward traction of uterus induced was found to have significantly lower intensity of HIFU compared to the group without downward traction of uterus induced (110.26±22.60 vs. 130.51±27.81 W). CONCLUSION: Modified BRB technique was useful in avoiding bowels and other structures located in HIFU beam pathway during MRgFUS treatment to ablate uterine fibroids.
Elevators and Escalators ; Humans ; Leiomyoma* ; Methods ; Rectum ; Retrospective Studies ; Traction ; Ultrasonography* ; Urinary Bladder ; Uterus