Flexible Intramedullary Nailing of Forearm Fractures at the Distal Metadiaphyseal Junction in Adolescents

BACKGROUND: The purpose of this study was to analyze the radiographic and functional outcomes of flexible intramedullary (IM) nailing in adolescent patients with forearm fractures at the diaphysis or at the metadiaphyseal junction (MDJ). METHODS: We retrospectively reviewed the results of 40 patients who underwent IM nailing for pediatric forearm fractures. Thirty males and 10 females were followed for an average of 16 months (range, 12 to 20 months). Their average age was 11 years (range, 10 to 16 years). The average duration from the onset of trauma to surgery was 3.8 days (range, 1 to 36 days). Fracture sites were located at the MDJ of the radius in 8 patients (MDJ group) while 32 patients had middle-third fractures (D group). We assessed the magnitude and location of the maximum radial bow and range of movements. Functional outcomes were evaluated using Daruwalla criteria. RESULTS: Open reduction was carried out in 8 cases. Union was achieved at an average of 8.3 weeks postoperatively. The results were classified as good in 38 and excellent in 2 according to Daruwalla criteria with restoration of forearm rotation. The mean angulation at the last follow-up was 1.8° on the anteroposterior radiograph and 3.3° on the lateral radiograph (MDJ group: 1.8° and 2.1°, respectively; D group: 1.9° and 2.8°, respectively). There was no significant difference in the mean angulation between the groups. The mean magnitude of maximal radial bow was 5.7% ± 1.8% (MDJ group, 5.2% ± 0.8%; D group, 5.9% ± 1.9%). The mean location of maximal radial bow was 58.0% ± 8.8% (MDJ group, 56.4% ± 8.9%; D group, 58.6% ± 8.9%). The differences in the mean magnitude and location of maximal radial bow with the normal contralateral arms (7.0% ± 1.2% and 50.9% ± 6.0%, respectively) were not significantly different between the groups. Complications included superficial infection (2), delayed union (1), and refracture (1). CONCLUSIONS: IM nail fixation provided satisfactory results and maintained adequate stability for both forearm bone fractures in adolescents, even though the fracture was located at the MDJ of the radius.

Development of a Korean Version of the Perceived Deficits Questionnaire-Depression for Patients with Major Depressive Disorder

OBJECTIVE: Cognitive symptoms are an important component of depression and the Perceived Deficits Questionnaire-Depression is one of only a few instruments available for the subjective assessment of cognitive dysfunction in depression. Thus, the present study aimed to validate a Korean version of the PDQ-D (K-PDQ-D) using patients with major depressive disorder (MDD). METHODS: This study included 128 MDD patients who were assessed at study entry and 86 of these patients were then completed 12 weeks of antidepressant monotherapy. All subjects were assessed with the K-PDQ-D, the Montgomery-Asberg Depression Rating Scale (MADRS), the Sheehan Disability Scale (SDS), the EuroQol-5 dimensions questionnaire (EQ-5D), and the number of sick leave days taken in the previous week. The internal consistency, Guttman's split-half and test-retest reliabilities, factorial analyses, and concurrent and predictive validities of the K-PDQ-D were investigated. RESULTS: The K-PDQ-D exhibited excellent internal consistency and reliabilities, and was composed of four factors with high coefficients of determination. The concurrent validity analyses revealed that the K-PDQ-D scores were significantly correlated with the MADRS, SDS, and EQ-5D scores and the number of sick leave days taken. The K-PDQ-D scores at study entry significantly predicted changes in sick leave days and EQ-5D score from study entry to the 12-week endpoint. CONCLUSION: The newly developed K-PDQ-D is a reliable and valid instrument for the evaluation of subjective cognitive symptoms in MDD patients. The K-PDQ-D may assist in the gathering of unique information regarding subjective cognitive complaints, which is important for the comprehensive evaluation of patients with MDD.

Development of Smartphone Application for Cognitive Behavioral Therapy-Based Case Management in Patients with Schizophrenia / 대한정신분열병학회지

OBJECTIVES: This article aims to describe the development of smartphone application for the case management of patients with schizophrenia. METHODS: Gwangju Bukgu-Community Mental Health Center developed and launched a smartphone application (HYM) for cognitive-behavioral case management and symptom monitoring. The development of the application involved psychiatrists, nurses, social workers, psychologists, and software technicians from a software development company (Goosl Corp.). RESULTS: The HYM application for clients includes six main modules including Thought record, Symptom record, Daily life record, Official notices, Communication, and Scales. The key module is the 'Thought Record' for self-directed cognitive-behavioral treatment (CBT). When the client writes and sends the self-CBT sheet to the case manager, the latter receives a notification and can provide feedback in real time. 'Communication' and 'Official notices' are useful for promoting communication between case managers and clients with schizophrenia. Ratings in 'Symptom record', 'Daily life record', and 'Scales' modules are stored in graphic or table form representing changes in them and shared with case managers. CONCLUSION: The interactive function of this application is the key characteristics that distinguishes it from other mobile self-treatment tools. This smartphone application may contribute to the development of a youth- and customer-friendly case management system for individuals with early psychosis.

Transcriptional profiling in human HaCaT keratinocytes in response to kaempferol and identification of potential transcription factors for regulating differential gene expression

Kaempferol is the major flavonol in green tea and exhibits many biomedically useful properties such as antioxidative, cytoprotective and anti-apoptotic activities. To elucidate its effects on the skin, we investigated the transcriptional profiles of kaempferol-treated HaCaT cells using cDNA microarray analysis and identified 147 transcripts that exhibited significant changes in expression. Of these, 18 were up-regulated and 129 were down-regulated. These transcripts were then classified into 12 categories according to their functional roles: cell adhesion/cytoskeleton, cell cycle, redox homeostasis, immune/defense responses, metabolism, protein biosynthesis/modification, intracellular transport, RNA processing, DNA modification/ replication, regulation of transcription, signal transduction and transport. We then analyzed the promoter sequences of differentially-regulated genes and identified over-represented regulatory sites and candidate transcription factors (TFs) for gene regulation by kaempferol. These included c-REL, SAP-1, Ahr-ARNT, Nrf-2, Elk-1, SPI-B, NF-kappaB and p65. In addition, we validated the microarray results and promoter analyses using conventional methods such as real-time PCR and ELISA-based transcription factor assay. Our microarray analysis has provided useful information for determining the genetic regulatory network affected by kaempferol, and this approach will be useful for elucidating gene-phytochemical interactions.

Transcriptome analysis and promoter sequence studies on early adipogenesis in 3T3-L1 cells

To identify regulatory molecules which play key roles in the development of obesity, we investigated the transcriptional profiles in 3T3-L1 cells at early stage of differentiation and analyzed the promoter sequences of differentially regulated genes. One hundred and sixty-one (161) genes were found to have significant changes in expression at the 2nd day following treatment with differentiation cocktail. Among them, 86 transcripts were up-regulated and 75 transcripts were down-regulated. The 161 transcripts were classified into 10 categories according to their functional roles; cytoskeleton, cell adhesion, immune, defense response, metabolism, protein modification, protein metabolism, regulation of transcription, signal transduction and transporter. To identify transcription factors likely involved in regulating these differentially expressed genes, we analyzed the promoter sequences of up- or -down regulated genes for the presence of transcription factor binding sites (TFBSs). Based on coincidence of regulatory sites, we have identified candidate transcription factors (TFs), which include those previously known to be involved in adipogenesis (CREB, OCT-1 and c-Myc). Among them, c-Myc was also identified by our microarray data. Our approach to take advantage of the resource of the human genome sequences and the results from our microarray experiments should be validated by further studies of promoter occupancy and TF perturbation.

cDNA Microarray Analysis of Differential Gene Expression in Gastric Cancer Cells Sensitive and Resistant to 5-Fluorouracil and Cisplatin / Journal of the Korean Cancer Association, 대한암학회지

PURPOSE: Gastric cancer is one of the most prevalent cancers worldwide. 5-fluorouracil (5-FU) and cisplatin are the most commonly used drugs for the treatment of gastric cancer. However, a significant number of tumors often fail to respond to chemotherapy. MATERIALS AND METHODS: To better understand the molecular mechanisms underlying drug resistance in gastric cancer the gene expression in gastric cancer cells, which were either sensitive or resistant to 5-FU and cisplatin, were examined using cDNA microarray analysis. To confirm the differential gene expression, as determined using the microarray, semiquantitative RT-PCR was performed on a subset of differentially expressed cDNAs. RESULTS: 69 and 45 genes, which were either up-regulated (9 and 22 genes) or down-regulated (60 and 25 genes), were identified in 5-FU- and cisplatin-resistant cells, respectively. Several genes, such as adaptor-related protein complex 1 and baculoviral IAP repeat-containing 3, were up-regulated in both drug-resistant cell types. Several genes, such as the ras homolog gene family, tropomyosin, tumor rejection antigen, protein disulfide isomerase-related protein, melanocortin 1 receptor, defensin, cyclophilin B, dual specificity phosphatase 8 and hepatocyte nuclear factor 3, were down-regulated in both drug-resistant cell types. CONCLUSION: These findings show that cDNA microarray analysis can be used to obtain gene expression profiles that reflect the effect of anticancer drugs on gastric cancer cells. Such data may lead to the assigning of signature expression profiles of drug-resistant tumors, which may help predict responses to drugs and assist in the design of tailored therapeutic regimens to overcome drug resistance.

Effect of local background intensities in the normalization of cDNA microarray data with a skewed expression profiles

Normalization of the data of cDNA microarray is an obligatory step during microarray experiments due to the relatively frequent non-specific errors. Generally, normalization of microarray data is based on the null hypothesis and variance model. In the Yang's model (Yang et al., 2001), at least two types of noises are included. The one is additive noise and the other is multiplicative noise. Usually, background is considered as one of additive noise to the signal and the variation between the signal pixels is the representative multiplicative noise. In this study, the relation between the signal (spot intensity minus background intensity) and background was observed and the influence of background on normalization as a representative additive factor was investigated. Although the relation has not been considered as a factor affecting the normalization, it could improve the accuracy of microarray data when the normalization was carried out considering signal/background ratio. The background dependent normalization decreased the number of genes whose expression levels were changed significantly and it could make their distribution more consistent through the whole range of signal intensities. In this study, printing pin dependent normalization was also carried out regarding the printing pin as a representative multiplicative noise. It improved the distribution of spots in the Cy3-Cy5 scatter plot, but its effect was slight. These studies suggest that there are some influences of the signals on the local backgrounds and they must be considered for the normalization of cDNA microarray data.

A novel method using edge detection for signal extraction from cDNA microarray image analysis

Gene expression analyses by probes of hybridization from mRNA to cDNA targets arrayed on membranes or activated glass surfaces have revolutionized the way of profiling mega level gene expression. The main remaining problems however are sensitivity of detection, reproducibility and data processing. During processing of microarray images, especially irregularities of spot position and shape could generate significant errors: small regions of signal spots can be mis-included into background area and vice versa. Here we report a novel method to eliminate such obstacles by sensing their edges. Application of edge detection technology on separating spots from the background decreases the probability of the errors and gives more accurate information about the states of spots such as the pixel number, degree of fragmentation, width and height of spot, and circumference of spot. Such information can be used for the quality control of cDNA microarray experiments and filtering of low quality spots. We analyzed the cDNA microarray image that contains 10,368 genes using edge detection and compared the result with that of conventional method which draws circle around the spot.

Atlantoaxial Instability due to Hypoplasia of the Odontoid Process

The authors present a case of a 39-year old man, admitted with neck pain and tingling sensation on his right upper extremity. On radiological investigation, atlantoaxial instability due to odontoid process hypoplasia and mild upper cervical cord compression by abnormal soft tissue were revealed. We performed posterior C1-2 transarticular screw fixation with posterior bone graft and could obtain good postoperative result.

Effects of Reduction in Surgical Treatment of Low Grade Spondylolisthesis

OBJECTIVE: To evaluate the effect of reduction on postoperative results in patients with low grade spondylolisthesis, the authors retrospectively analyze ninety three patients managed surgically. METHODS: Ninety three patients with low grade spondylolisthesis underwent surgery were classified into two groups. Reduction was obtained in one group and not obtained in the other group. The clinical severity was assessed with Prolo's grade and radiological severity was measured with simple lateral radiographs(static and dynamic views). The patients were followed for a mean of 18.6 months(range 9 to 21 months). RESULTS: All patients were treated with decompression, instrumentation, and bone graft. Reduction was done in fifty eight patients and not in thirty five cases. Overall postoperative clinical results(Prolo's grade) were not statistically different in both groups. CONCLUSION: In surgical management of spondylolisthesis, decompression and stabilization with instrumentation and bone graft provide good clinical outcome. In cases of low grade spondylolisthesis, reduction performed additionally has no advantage on clinical outcome.

Comparison of the Result of Lumbar Posterolateral Bone Fusion using Autogenous Bone Graft with Allobone Graft

OBJECTIVE: The purpose of this study is to analyze clinical outcome of lumbar spinal fusion with autobone graft and with allobone graft as an additional autograft extender. METHODS: Fifty two patients who underwent lumbar posterolateral arthrodesis for degenerative lumbar diseases between February, 1998 and October, 2000 were evaluated. Arthrodesis was performed by transpedicular screw fixation. We used autogenous bone graft in 32 cases (Group A) and allobone graft in 20 cases (group B). Post operative radiographs were obtained to review the resorption of graft bone and the evidence of fusion. A modified Lenke scale was used to assess the status of the fusion. RESULTS: There were 17 men and 35 women. Mean follow up period was 12 months. According to the modified Lenke scale, spinal bone fusion rate was 93.75% in the group A and 85% in the groub B. CONCLUSION: Lumbar spinal fusion using allobone graft is favorably good compare to autobone graft.

A Case of Giant-cell Tumor of the Thoracic Spine

No abstract available.

Detection of tumor cell contamination in peripheral blood by RT-PCR in gastrointestinal cancer patients

We analyzed the peripheral blood of patients with gastrointestinal tract cancer at different stages to assess the presence of carcinoembryonic antigen (CEA) mRNA by reverse transcriptase-polymerase chain reaction (RT-PCR), which we used as an indicator for micrometastatic malignant cells. A total of 35 gastric, 24 colorectal, 4 esophageal and 4 biliary tract cancer patients and nine normal healthy subjects were studied. No CEA mRNA was detected in the nine normal healthy volunteers. CEA mRNA was detected in 100% (10/10) of metastatic, 33.3% (3/9) of early gastric cancer (EGC), and 18.8% (3/16) resectable gastric cancer patients, respectively. In colorectal cancer, 55.6% (5/9) of metastatic cancers were positive for CEA mRNA, and 26.7% (4/15) Duke stage B/C showed positive. One patient with stage III gastric cancer who was negative CEA mRNA initially and turned positive during follow-up, developed multiple bone metastasis one month later. Another stage III patient, who was positive for CEA mRNA, preoperatively revealed early relapse in two months. These results suggest that the identification of circulating tumor cells using RT-PCR for the detection of CEA mRNA is feasible and this analysis may be a promising tool for early detection of micrometastatic circulating malignant cells in patients with gastrointestinal tract cancer.

Clinical Analysis of Basal Skull Fractures

The authors analysed 147 cases of basal skull fracture which were treated in the Department of Neurosurgery, Chungnam National University Hospital from January 1989 to December 1992. These fractures are difficult to diagnose by ordinary X-ray examination and are frequently inferred by clinical signs. The clinical features and radiological findings were reviewed. The results of the analysis are summarized as follows : 1) The basal skull fractures were more common in men than women-the ratio being 6 : 1. 2) In decreasing order of cause of basal skull fractures were traffic accidents(77%), fall down, assault and slipping. 3) The minor head injury, Glasgow Coma Scale Score(GCS) of 13 to 15, was 79 cases(54%), the moderate head injury 40 cases(27%) and the severe head injury 18 cases(19%). 4) In decreasing order of clinical features were otorrhea(71%) rhinorrhea(48%) and raccoon eye(33%) etc. 5) In decreasing order of the combined pathologies were skull fracture(55%), subdural hematoma(17%), epidural hematoma(16%) and intracerebral hematoma(12%) etc. 6) The facial nerve, vestibulo-cochlear nerve and optic nerve were the most commonly injured cranial nerve. 7) CSF leakage was noted in 139 cases and among them immediate type was far more common(96%) than the delayed type. 8) The incidence of meningitis was 5.4% and most of them associated with CSF leakage and the prophylatic antibiotic treatment has no effect to decrease infection rate. 9) In decreasing order of the frequency associated injuries were facial bone fracture(47%), clavicle fracture(19%), lower extremities fracture(9%) and upper extremities fracture(7%) etc.

The Effect of Carbon Monoxide Intoxication on The Metabolites of Monoamine Neurotransmitters in Human Cerbrospinal Fluid

This study was done in order to show the effects of carbon rnonoxide (CO) induced hypoxia on the steps of metabolism of rnonoamine neurotransmitters. There were 9 patients exposed to CO and 5 patients of control group. We evaluated their cerebrospinal fluid within 24 hours after CO exposure. And we measured the amounts of 5-hydroxy-indole acetic acid (5-HIAA) and homovanillic acid (HVA) with high performance liquid chromatography (HPLC). In the CO exposure group, the levels of 5-HIAA and HVA were reduced compared with the control group. It was thought that the changes in the levels of 5-HIAA and HVA were due to the transient decrease in monoamine oxidase activity in acute hypoxia.

A Case of Frontal Ganglioglioma Coincidence with Pituitary Adenoma

A case of frontal ganglioglioma coexisting with pituitary adenoma is reported. A 37-year-old male presented with chief complaint of headache for 2 months. A neurological examination of the patient revealed no deficit. Brain MRI showed a well enhanced lobulated mass on left frontal lobe and another homogeneously enhanced mass on intrasellar and suprasellar portion. The frontal mass was grayish in color and rubbery hard in consistency on operative field, having relatively good boundary from the adjacent normal brain tissue. The sellar mass was 3X3cm in size and compressed optic chiasm. Histological diagnosis of frontal mass was ganglioglioma and sella mass showed typical features of pituitary adenoma.

Anti-pre-S2 and anti-HBS responses to a heat inactivated hepatitis B vaccine in patients with mental retardation / 대한임상병리학회지

No abstract available.

Anti-pre-S2 and anti-HBS responses to a heat inactivated hepatitis B vaccine in patients with mental retardation / 대한임상병리학회지

No abstract available.

A Case of Traumatic Arteriovenous Fistula of the Superficial Temporal Artery

Since Winslow and Edwards24) reviewed 20 cases of the arteriovenous fistulas involving temporal artery described in the world wide literatures up to 1934, several authors have added the cases sporadically, but the arteriovenous fistula of the superficial temporal artery is unusual to the head and neck surgeons. Recently we experienced one case of huge traumatic arteriovenous fistula involving the superficial temporal artery and present it here.

Histiocytosis-X with Giant Occipital Scalp Mass: A Case Report

Histiocytosis is a relatively rare disorder of the reticuloendothelial system involving the proliferation of histicoytes, granulation tissue, and inflammatory cells in many different organ systems1). Thus, the three manifestations of the same basic pathologic process:Eosinophilic granuloma, Hand-Schuller-Christian disease, and Letterer-Siwe disease have been classified as localized, chronic disseminated and acute disseminated histiocytosis-X. They were therefore included under the term histiocytosis-X and this concept has been generally accepted. The authors have experienced one case of histiocytosis-X, a rare disease. A 11 month-old femal patient presented with gradually enlarged palpable mass on the occipital area. The occipital skull was defected in a punched out fashion. The mass was completely removed. The pathologic findings revealed Histiocytosis-X and the patient was given chemotherapy.