We meniscectomized 27 knees with meniscal lesions for disabling symptoms after the diagnosis by clinical evaluation and arthrography from January, 1970 to May,1979. Statistical analyses were as follows: 1. Male was affected 2 times more than female. The most meniscal lesions occurred in the age group between 10 and 29 years old (67%). 2. The lateral menisci were affected 2 times than the medial. In the former, the middle segments were affected most frequently and in the latter, the posterior horns. 3. The general diagnosis of torn meniscus for the 27 knees was correct by clinical evaluation for 19(71%), by arthrography for 20 (74%) and by two methods for 24 (88%). 4. In the follow-up study, satisfactory results were obtained in. 79%.
Animals ; Arthrography ; Clinical Study ; Diagnosis ; Female ; Follow-Up Studies ; Horns ; Humans ; Knee ; Male ; Menisci, Tibial

No abstract available.
Humans ; Infant, Newborn* ; Leukocytes*

Syndromal acanthosis nigricans is associated with cellular resistance to the action of insulin and other endocrinopathies. In the insulin resistant state, increased insulin binds to the receptors of insulin-like growth factors (IGFs). IGFs are growth prompting peptides, which act as direct mitogens on cells containing the receptors. Through these actions, increased cellular growth and metabolism cause the skin lesions of acanthosis nigricans. Hyperandrogenism is also found in syndromal acanthosis nigricans patients. When associated with insulin resistance, these states are proportionally related. Increased insulin prompts the synthesis of androgen and conversely, increased androgen elevates the insulin resistance. We present three cases of syndromal acanthosis nigricans with hyperpigmented skin lesions and obesity. Laboratory findings demonstrated normal fasting blood suga levels with increased insulin and C-peptide levels and decreased insulin receptors. The oral glucose tolerance test was normal. We suggest that these patients were in an insulin resistant state. Skin biopsies from the axilla in all three cases showed hyperkeratosis, irregular acanthosis and upward projection of dermal papillae as finger like fashion. Thus all three cases represent syndromal acanthosis nigricans associated with an insulin resistant state based on clinical, histopathological, and laboratory findings. The three patients were treated with dietary control.
Acanthosis Nigricans* ; Axilla ; Biopsy ; C-Peptide ; Fasting ; Fingers ; Glucose Tolerance Test ; Humans ; Hyperandrogenism ; Insulin Resistance* ; Insulin* ; Metabolism ; Mitogens ; Obesity ; Peptides ; Receptor, Insulin ; Skin ; Somatomedins

BACKGROUND: Laser resurfacing of cutaneous scars, rhytides, and photodamaged skin has become very popular. Pulsed erbium:YAG laser resurfacing has recently come into favor for the treatment of pitted acne scars. OBJECTIVE: This study was designed to investigate the efficacy and safety of pulsed erbium:YAG laser in cutaneous resurfacing of pitted acne scars. METHODS: 100 patients with pitted acne scars were enrolled in this study. All patients were treated by means of a pulsed erbium:YAG laser with a 2 mm handpiece at the setting of 500 to 1000mJ/pulse and fluences used varied between 5-15J/cm2. Photographs of the face were obtained at baseline and 2 week postoperatively. Two weeks after treatment, postoperative care such as applying hydroquinone 4% and tretinoin 0.05% was recommended for 2 to 4 weeks. RESULTS: Out of 100 patients, 20% of patients showed an excellent response, 50% a good response, 21% a fair response and 9% a poor response. After 6 months, erythema had developed in two patients and and three patients had developed postinflammatory hyperpigmentation, hypopigmentation and delayed contact dermatitis. CONCLUSION: Treatment with pulsed erbium:YAG laser shows high efficacy and low morbidity in pitted acne scar resurfacing.
Acne Vulgaris* ; Cicatrix* ; Dermatitis, Contact ; Erythema ; Humans ; Hyperpigmentation ; Hypopigmentation ; Postoperative Care ; Skin ; Tretinoin

No abstract available.

The cytochrome P450 (CYP) 3A subfamily is estimated to participate in the biotransformation of 50% of the currently prescribed drugs. Four members of the CYP3A subfamily have been identified in humans: CYP3A4, CYP3A5, CYP3A7, and CYP3A43. Initial data suggested that CYP3A5 accounts for only a small proportion of the total hepatic CYP3A in about 20% of samples, but it was later revealed that CYP3A5 represents more than 50% of the total CYP3A amount in some individuals. Several genetic variants have been described for the CYP3A5 gene, of which the CYP3A5*3 allele (gA6986G), the most common form and leading to the loss of CYP3A5 activity, has been extensively investigated in the aspect of pharmacokinetics and disease risk. This review summarized the molecular characteristics of the CYP3A5 gene, and discusses the association of the CYP3A5*3 polymorphism with disease risks such as cancer and hypertension, along with its role in the pharmacokinetics of CYP3A substrates.
Alleles ; Biotransformation ; Cytochrome P-450 CYP3A ; Cytochrome P-450 Enzyme System ; Humans ; Hypertension ; Pharmacogenetics ; Pharmacokinetics

The rectal prolapse syndome is a disease entity includes rectocele and rectal prolapse, presenting prolapse(procidentia) of rectum. In rectocele, rectum is prolapsed anteriorly into the vagina, whereas in procidentia, inferiorly out of the anus. This study was aimed at analyzing pathogenesis and adequacy of surgical treatment in rectocele and rectal prolapse. Twenty-one patients with rectocele and 18 patients with rectal prolapse were assessed pre- and post-operatively in respect to symptoms and signs, pathogenesis, defecography, and manometry. In analysis of symptoms and sings, constipation was the commonest in both diseases(86% of rectocele and 67% of rectal prolapse) and incontinence was not infrequently found in both diseases as well(14% of rectocele and 33% of rectal prolapse). In analysis of the underlying causes, two patients with rectal prolapse had prolapse from childhood. Defecography showed anorectal angle of rectal prolapse in rest and push period. They were significantly wider than those of rectocele(p<0.05). The perineal descent of rectal prolapse was longer than that of rectocele. In analysis of the associated factors, average number of delivery was more than three times in both diseases(3.5 of rectocele and 5.1 of rectal prolapse). We could easily find previous operation history in both diseases. Among them, hysterectomy was the most frequent, especially in patients with rectocele. The hemorrhoids was associated more common in rectocele than in rectal prolapse(p<0.05). Preoperative maximal resting pressure of rectal prolapse was more significantly decreased than that of rectocele(p<0.05). The sensation of fullness was significantly decreased in patients with rectal prolapse postoperatively(p<0.05). Patients with rectocele underwent levator plication by transrectal or vaginal approach. Patients with rectal prolapse underwent posterior rectopexy in 11 patients, resection and rectopexy in 3 patients, Delorme's operation and Thiersch operation in 2 patients each. Constipation was significantly improved in patients with rectocele postoperatively(p<0.05). Incontinence was markedly improved in patients with rectal prolapse postoperatively(p<0.05). At the interview about subjective improvement of symptom, 95% of patients with rectocele and 89% of patients with rectal prolapse were satisfied with surgery. In conclusion, rectocele and rectal prolapse can be categorized as rectal prolapse syndrome because both diseases have anatomical derangements caused by similar pathogenesis such as altered bowel habits, anatomical factor, delivery, past history of hysterectomy, and hemorrhoids. Levator plication and posterior rectopexy seem to be useful surgical methods of anatomical repair for the respective disease.
Anal Canal ; Constipation ; Defecography ; Hemorrhoids ; Humans ; Hysterectomy ; Manometry ; Prolapse ; Rectal Prolapse* ; Rectocele ; Rectum ; Sensation ; Vagina

OBJECTIVE: Pituitary adenylate cyclase-activating polypeptide (PACAP), a novel hypothalamic neuropeptide, has been suggested to play a role in ovarian folliculogenesis. The present study evaluated the effect of PACAP on the growth of preantral follicles. METHODS: Preantral follicles were mechanically isolated from ovaries of 21-day-old rats and cultured in groups for 3 days in serum-free medium in the absence or presence of PACAP-38 (10-6 M). RESULTS: Treatment with PACAP-38 resulted in an increase in follicle diameter by 75% whereas treatment with follicle stimulating hormone (FSH) increased follicle diameter by 65%. PACAP-38 treatment enhanced the granulosa cell proliferation as measured by thymidine incorporation analysis. Furthermore, the production of progesterone by cultured granulosa cells and GFSHR-17 cell line was stimulated by PACAP-38. Interestingly, PACAP enhanced FSH action on stimulation of SF-1 and aromatase gene expression. CONCLUSION: The present results demonstrate that PACAP stimulated preantral follicle growth by potentiating proliferation and by stimulating steroidogenesis.
Animals ; Aromatase ; Cell Line ; Female ; Follicle Stimulating Hormone* ; Gene Expression ; Granulosa Cells ; Neuropeptides ; Ovarian Follicle* ; Ovary ; Pituitary Adenylate Cyclase-Activating Polypeptide* ; Progesterone ; Rats ; Thymidine

PURPOSE: The newborn period is a time of rapid physiological change in the gastrointestinal tract, when adaptation from a state of parenteral nutrition to the demands of enteral feeding take place. little is known about the intestinal vascular responses that accompany intestinal adaptive changes, although there is much speculation about the relationship between entreral feeding, alterations in gut perfusion, and the development of necrotizing enterocolitis.. Doppler ultrasound can be readily used to measure intestinal blood flow velocities in human newborn. It provides a noninvasive technique for investigating adaptive postnatal changes in the intestinal circulation, and, in particular, the response to feeds. In this study, we have measured blood flow indices in both the superior mesenteric artery and ceLiac axis, Looking for postprandial changes in response to feeding in 16 healthy preterm infants. METHODS: By using the Doppler ultrasound, PSV(peak systolic blood flow velocity), EDV(end diastolic blood flow velocity), Pulsatility index and blood flow per minute were measured pre and postprandially on day 1, 3, and 5 of life. Since the postprandial changes were similar during the study periods, the pre- and postfeed values are presented as combined resuLts. RESULTS: 1) The PSV and EDV from the superior mesenteric artery before the feed were 65.12+/-11.16 cm/sec and 15.40+/-3.58 cm/sec, respectively, and rose to 74.55+/-13.11 cm/sec and 19.10+/-4.81 cm/sec (p<0.001)(p<0.001). The pulsatility index fell from 0.761+/-0.053 to 0.735+/-0.055 (p<0.05) and blood flow per minute was increased from 0.110+/-0.032 l/min to 0.123+/-0.027 l/min (p<0.05). 2) Similar results were obtained from the celiac axis : The PSV and EDV increased from 68.23+/-16.29 cm/sec, 16.54+/-5.77 cm/sec to 77.92+/-15.08 cm/sec, 21.14+/-6.95 cm/sec, respectively (p<0.05) (p<0.001). The pulsatility index fell from 0.760+/-0.068 to 0.722+/-0.077 (p<0.001) and blood flow per minute was increased from 0.126+/-0.029 l/min to 0.153+/-0.033 l/min, posprandially (p<0.001). 3) The magnitude of increment in velocity was independent of gestational age, sex, and initial body weignt. CONCLUSIONS: We have measured intestinal blood flow indices in response to feeding by Doppler ultrasound and Doppler ultrasound may be able to provide evidence regarding disturbed perfusion as a potential etiological agent in the pathogenesis of necrotizing enterocolitis.
Axis, Cervical Vertebra ; Blood Flow Velocity ; Enteral Nutrition ; Enterocolitis, Necrotizing ; Gastrointestinal Tract ; Gestational Age ; Humans ; Infant, Newborn ; Infant, Premature* ; Intestines ; Mesenteric Artery, Superior ; Parenteral Nutrition ; Perfusion ; Ultrasonography

The posterior chamber intraocular lens(PC-IOL) implantation is the most effective method for adult cataract. In children, however, its use and effectiveness are still being debatd. To investigate the effect of PC-IOL implantation in unilateral pediatric cataracts, we analysed the results of visual acuities and refractive powers, the presence of complications, and the differences according to the types of posterior capsulectomy in 16 eyes of 16 children who underwent PC-IOL implantation and amblyopia treatment for unilateral pediatric cataracts. Postoperatively, nine eyes(56.3%) showed an improvement of visual acuities more than two lines on Han`s visual acuity chart. Average difference between target which was adjusted to the fellow eye and postoperative refractive power is -0.68diopters after at least 8 months follow-up. Four eyes in which had an intact capsule after surgery or were underwent posterior capsulectomy developed after-cataract, but not in eyes underwent posterior capsulectomy and anterior vitrectomy simultaneously. In unilateral pediatric cataracts, PC-IOL implantation, posterior capsulectomy, and anterior vitrectomy may give a good result for visual rehabilitation but the follow-up is necessary to evaluate the long-term safety.
Adult ; Amblyopia ; Cataract* ; Child ; Follow-Up Studies ; Humans ; Lens Implantation, Intraocular* ; Lenses, Intraocular* ; Rehabilitation ; Visual Acuity ; Vitrectomy