Low-Grade Inflammation, Metabolic Syndrome and the Risk of Chronic Kidney Disease: the 2005 Korean National Health and Nutrition Examination Survey

Either chronic inflammation or metabolic syndrome (MetS) is associated with renal impairment. This cross-sectional study was designed to investigate the relationship between elevated white blood cell (WBC) counts and chronic kidney disease (CKD) stage 3 or more according to the presence of MetS in adult Koreans. In total, 5,291 subjects (> or = 20 yr-old) participating in the 2005 Korean National Health and Nutrition Examination were included. CKD stage 3 or more was defined as having an estimated glomerular filtration rate below 60 mL/min/1.73 m2, as calculated using the formula from the Modification of Diet in Renal Disease study. The odds ratio (95% confidence interval) for CKD stage 3 or more in the highest WBC quartile (> or = 7,200 cells/microL) was 1.70 (1.17-2.39) after adjusting for MetS and other covariates, compared with the lowest WBC quartile (< 5,100 cells/microL). In subjects with MetS, the prevalence risk for CKD stage 3 or more in the highest WBC quartile was 2.25 (1.28-3.95) even after fully adjusting for confounding variables. In contrast, this positive association between WBC quartile and CKD stage 3 or more disappeared in subjects without MetS. Low-grade inflammation is significantly associated with CKD stage 3 or more in subjects with MetS but not in those without MetS.

Toe Partial Pulp Free Flaps in Multiple Digits Reconstruction

Reconstruction of a finger-pulp defect is one of the most difficult procedures. The reasons are that the identical donor tissue is not easy to obtain and the reducing the donor site morbidity is not easy to achieve. Particularly, reconstruction of multiple digit pulp defect is more difficult. We propose toe partial pulp free flaps for the replacement of defects of multiple fingertip. It can provide identical color matching to donor defect, and cut down the morbidity of donor site. The 33 digits of 15 patients were treated with this method. The donor sites were medial aspect of the second toe or third toe and lateral aspect of big toe. The neurovascular pedicles were composed of medial plantar digital artery, medial plantar digital nerve, and superficial plantar vein of the second toe, third toe or big toe. All flaps were survived. The average of static two-point discrimination was 5.9 mm. Primary closure of donor sites was possible in all cases. Toe partial pulp free flaps has many advantages in multiple digit reconstruction. It can provide excellent color and texture matching, excellent sensory recovery. It avoids long term immobilization. Vascular anatomy was so consistent that vessels were easily dissected. Primary closure of donor site was possible. However, there were some restrictions. The flap could not be applied to a large defect, and to patients with vascular disease and old age. It also required skillful technique in anastomosis of pedicle. In conclusion, we consider that toe partial-pulp free flaps are useful method to reconstruct the defects of multiple fingertips.

Total Knee Replacement Arthroplasty In Varus Deformity

Vnrus deformity is a common finding in patients who are candidates for toial knee replacement arthropiasty. To obtain excellent clinical results and to maintain well-aligned and stable prosthetic components in patients who have such a deformity, adequate ligament balancing as well as accurate cone.ction of bony alignment is required. But many technical problems are encountered. Especially the bony defect on the medial aspect of the tibia after adequate bone cutting and ligament imbalance with laxity in the lateral side and contracture in the medial side. Total knee replacement arthroplasty with 43 patients(56 cases) to be mcre than 10 degrees of varus of tibio-femoral angle was done by a single surgeon and reviewed retrospectively. The diagnosis was osteoarthritis in 46 cases, rheumatoid arthritis in 9 cases. The average follow up period was average 33 months(l-7 years). Preoperative varus deformity of average 13.5 degree., was corrected to valgus 6.69 degrees at last follow-up. Postoperative range of motion was 122.5 degree. And the mean knee society score improved from 24.8 to 87.2 postoperatively and the function score improved from 23.6 to 83.9 postoperatively. At self-assements, 88.2% of the patients was very satisfied or somewhat satisfied. Total knee replacement ;u1hroplasty in the patients with vaus deformity is effective procedure to corri.ct deformity and improve clini- c;1 and functional status, but long-term follow up period is required for changing alignment.

Ultrastructural Changes of Gastrocnemius Muscles after Shortening of Tibia and Neurectomy in the Rat / 대한정형외과연구학회지

This study was performed to compare the ultrastructural changes of muscles in fracture(group A), fracture with shortening(group B), neurectomy(group C) and fracture with neurectomy(group D) and to search for factors that lead to muscular atrophy. A total of 65 rats weighing about 350g were used as experimental animals. These animals were sacrificed in 3 weeks, 5 weeks and 7 weeks after the operation. The superficial portion (3 X 1 X 1mm3) of the gastrocnemius muscle was dissected and was prepared by routine methods. The results were as follows. 1. The contracted gastrocnemius muscle returned to its normal size at 7th week in group B. However in group C and D, the gastrocnemius muscles atrophied gradually. 2. Under light microscope, fibrotic change and atrophy in the muscles in group C and D progressed as time passed. 3. Myofibrillolysis and kinking of myofibrils in the muscles was observed in group B, and segmentation of Z-line was seen in group 4. At 7th week in group B, the muscles returned to its normal ultrastructures. Irregular shaped myofibrils, streaming of Z-line, dilation of cisternae of sarcoplasmic reticulum and mitochondria with dilation of cristae and electron lucent matrix in group C and the helical complex in the myofibrils of muscle fibers of the rats at 7th week in group D were observed. Consequently, it is suggested that 7 weeks after 20% shortening of tibia in length, contracted gastrocnemius muscles were reformed to its normal shape and the loss of nerve stimuli was a more significant factor that lead to atrophy of the muscle than the decrease of working tension by shortening of bone.

Clinical evaluation of the prolapse of the umbilical cord / 대한산부인과학회잡지

No abstract available.

Simulated Nystagmus Blockage Syndrome

Manifest latent nystagmus (MLN) combined with esotropia may be confused with the nystagmus blockage syndrome (NBS), so the NBS may be overdiagnosed. The NBS is similar to MLN in the characteristics of the nystagmus and the clinical features, thus two diseases must be differentiated. In order to differentiate the MLN with esotropia from the NBS, accurate calibration of slow phase of nystagmus is essential with the aid of electro-oculography (EOG). With EOG recording, authors report a case of MLN associated with esotropia which may be misdiagnosed as the NBS.

Clinical survey of fetal macrosomia / 대한산부인과학회잡지

No abstract available.

A Case of Mobius Syndrome

Mobius syndrome is a rare congenital condition of uncertain etiology, characterized by facial diplegia, bilateral external rectus paralysis, and various abnormalities of other tissues such as extremities and branchial musculature. We have experienced a case of Mobius syndrome, reporting it with a review of literature.

Studies on the larval trematodes from brackish water crabs. Studies on a kind of Levinseniella

Metacercariae of a kind of Levinseniella species were found from a brackish water crabs, Macrophthalmus japonicus de Haan, in the brackish area of Hyungsan river of Kyungpook province. Habitats were the epigastric and progastric regions of Macrophthalmus japonicus. One hundred and seventy five crabs out of 178 examined (98.3 per cent) were infested with metacercariae of Levinseniella species. The infested number of metacercariae in each crabs was average 100 ea. The excystation of metacercaria has not developed in vitro (both saline and tyrode's solution). Many eggs were observed in the metacercariae maintained for 24 or 48 hours in the water-bath. No differences were observed between semi-adult fluke from rat host and those maintained for 24 or 48 hours in vitro.