• Title/Summary/Keyword: bone loss

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Management of Vascular Injuries to the Extremities after Trauma (외상 후 사지 혈관손상의 치료)

  • Kim, Han Yong;Park, Jae Hong;Kim, Myoung Young;Hwang, Sang Won
    • Journal of Chest Surgery
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    • v.42 no.1
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    • pp.46-52
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    • 2009
  • Background: Vascular injuries to the extremities are potentially devastating and they can lead to limb loss and mortality if they are not appropriately managed. The vascular trauma caused by traffic and industrial accidents has recently increased according to the developing industry and transport system in Korea. Early recognition and treatment of these injuries are mandatory to achieve satisfactory outcomes. Material and Method: We retrospective reviewed 43 patients with vascular injuries that were due to blunt and penetrating trauma and they underwent emergency operations from January of 1998 to December of 2006. Result: There were 38 men and 5 women patients with a mean age of $42.0{\pm}16.8$ years (range: 17~77). The cause of vascular injuries were 28 traffic accidents (65%), 6 industrial accidents (14%), 6 glass injuries (14%) and 3 knife injuries (7%). The average time from admission to the operating room was $319.0{\pm}482.2$ minutes (range: 27~2,400 minutes). The average time from admission to discharge was $53.1{\pm}56.0$ days (range: 2~265 days). The anatomic injuries included the femoral artery in 16 cases (37%), the popliteal artery in 8 cases (19%), the brachial artery in 8 cases (19%), and the subclavian and axillary arteries in 7 cases (16%). The associated injuries were 23 bone fractures (53%), 18 muscle injuries (42%) 5 nerve injuries (12%) and 11 vein injuries (26%). The operation methods were 20 end to end anastomoses (46%), 16 interposition grafts (36%), 2 repairs with using patches (5%) and 5 others (12%). The number of amputations and cases of mortality were 3 cases (7%) and 4 cases (9%), respectively. Conclusion: Minimizing ischemia is an important factor for maximizing salvage of extremities. Prompt diagnosis and treatment can reduce the amputation and mortality rates.

Clinical and Laboratory Features of Korean Mucopolysaccharidoses (MPSs) (한국 뮤코 다당체 침착증 환자에 대한 임상적 고찰)

  • Sohn, Woo Yun;Lee, Jee Hyun;Paik, Kyung Hoon;Kwon, Eun Kyoung;Kim, Ahn Hee;Jin, Dong Kyu
    • Clinical and Experimental Pediatrics
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    • v.48 no.10
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    • pp.1132-1138
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    • 2005
  • Purpose : The mucopolysaccharidoses (MPSs) are a heterogeneous group of lysosomal storage disorders. They are caused by a deficiency of the enzymes involved in the degradation of glycosaminoglycans. Early recognition is important because recombinant enzyme replacement therapy is now available for MPS. We studied the clinical characteristics of 80 MPS children with the object of determining the epidemiological, clinical and radiological features in Korean MPS children. Methods : Diagnosis of MPS was confirmed by skin fibroblast enzyme analysis in 80 patients between February 1995 and December 2004. Charts were retrospectively reviewed for clinical and radiological findings, as well as for intelligence and speech evaluations. Results : Hunter syndrome (MPS type II) was the most prevalent type, appearing in 51/80 cases (64 %), followed by Sanfilippo syndrome (MPS III-18%), Hurler syndrome (MPS I-15%), and Morquio syndrome (MPS IV-4%). The average age at diagnosis was 5.5 years (range 1 to 20), and the male-to-female ratio was 4.7 : 1. Typical radiographic changes were observed in 45/54 cases (83%). Mitral regurgitation was the most common cardiac defect. Moderate to profound mental retardation and hearing loss were present in 14/35 cases (56%) and 33/38 cases (82%), respectively. Four MPS II patients had bone marrow transplantation, with mixed outcomes. Five MPS I patients are currently on enzyme replacement therapy. Conclusion : Our study showed a high proportion of MPS II cases (64%), which may represent population variability. By studying the clinical features of these patients, we hope to alert pediatricians of the warning signs of MPS.

Review of Anti-Leukemia Effects from Medicinal Plants (항 백혈병작용에 관련된 천연물의 자료조사)

  • Pae Hyun Ock;Lim Chang Kyung;Jang Seon Il;Han Dong Min;An Won Gun;Yoon Yoo Sik;Chon Byung Hun;Kim Won Sin;Yun Young Gab
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.17 no.3
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    • pp.605-610
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    • 2003
  • According to the Leukemia and Lymphoma Society, leukemia is a malignant disease (cancer) that originates in a cell in the marrow. It is characterized by the uncontrolled growth of developing marrow cells. There are two major classifications of leukemia: myelogenous or lymphocytic, which can each be acute or chronic. The terms myelogenous or lymphocytic denote the cell type involved. Thus, four major types of leukemia are: acute or chronic myelogenous leukemia and acute or chronic lymphocytic leukemia. Leukemia, lymphoma and myeloma are considered to be related cancers because they involve the uncontrolled growth of cells with similar functions and origins. The diseases result from an acquired (not inherited) genetic injury to the DNA of a single cell, which becomes abnormal (malignant) and multiplies continuously. In the United States, about 2,000 children and 27,000 adults are diagnosed each year with leukemia. Treatment for cancer may include one or more of the following: chemotherapy, radiation therapy, biological therapy, surgery and bone marrow transplantation. The most effective treatment for leukemia is chemotherapy, which may involve one or a combination of anticancer drugs that destroy cancer cells. Specific types of leukemia are sometimes treated with radiation therapy or biological therapy. Common side effects of most chemotherapy drugs include hair loss, nausea and vomiting, decreased blood counts and infections. Each type of leukemia is sensitive to different combinations of chemotherapy. Medications and length of treatment vary from person to person. Treatment time is usually from one to two years. During this time, your care is managed on an outpatient basis at M. D. Anderson Cancer Center or through your local doctor. Once your protocol is determined, you will receive more specific information about the drug(s) that Will be used to treat your leukemia. There are many factors that will determine the course of treatment, including age, general health, the specific type of leukemia, and also whether there has been previous treatment. there is considerable interest among basic and clinical researchers in novel drugs with activity against leukemia. the vast history of experience of traditional oriental medicine with medicinal plants may facilitate the identification of novel anti leukemic compounds. In the present investigation, we studied 31 kinds of anti leukemic medicinal plants, which its pharmacological action was already reported through many experimental articles and oriental medical book: 『pharmacological action and application of anticancer traditional chinese medicine』 In summary: Used leukemia cellline are HL60, HL-60, Jurkat, Molt-4 of human, and P388, L-1210, L615, L-210, EL-4 of mouse. 31 kinds of anti leukemic medicinal plants are Panax ginseng C.A Mey; Polygonum cuspidatum Sieb. et Zucc; Daphne genkwa Sieb. et Zucc; Aloe ferox Mill; Phorboc diester; Tripterygium wilfordii Hook .f.; Lycoris radiata (L Her)Herb; Atractylodes macrocephala Koidz; Lilium brownii F.E. Brown Var; Paeonia suffruticosa Andr.; Angelica sinensis (Oliv.) Diels; Asparagus cochinensis (Lour. )Merr; Isatis tinctoria L.; Leonurus heterophyllus Sweet; Phytolacca acinosa Roxb.; Trichosanthes kirilowii Maxim; Dioscorea opposita Thumb; Schisandra chinensis (Rurcz. )Baill.; Auium Sativum L; Isatis tinctoria, L; Ligustisum Chvanxiong Hort; Glycyrrhiza uralensis Fisch; Euphorbia Kansui Liou; Polygala tenuifolia Willd; Evodia rutaecarpa (Juss.) Benth; Chelidonium majus L; Rumax madaeo Mak; Sophora Subprostmousea Chunet T.ehen; Strychnos mux-vomical; Acanthopanax senticosus (Rupr.et Maxim.)Harms; Rubia cordifolia L. Anti leukemic compounds, which were isolated from medicinal plants are ginsenoside Ro, ginsenoside Rh2, Emodin, Yuanhuacine, Aleemodin, phorbocdiester, Triptolide, Homolycorine, Atractylol, Colchicnamile, Paeonol, Aspargus polysaccharide A.B.C.D, Indirubin, Leonunrine, Acinosohic acid, Trichosanthin, Ge 132, Schizandrin, allicin, Indirubin, cmdiumlactone chuanxiongol, 18A glycyrrhetic acid, Kansuiphorin A 13 oxyingenol Kansuiphorin B. These investigation suggest that it may be very useful for developing more effective anti leukemic new dregs from medicinal plants.

Internal Fixation of Proximal Humerus Fracture with Polyaxial Angular Stable Locking Compression Plate in Patients Older Than 65 Years (65세 이상의 상완골 근위부 골절 환자에서 다축 각안정 잠김 압박 금속판을 이용한 내고정술)

  • Lee, Ki-Won;Choi, Young-Joon;Ahn, Hyung-Sun;Kim, Chung-Hwan;Hwang, Jae-Kwang;Kang, Jeong-Ho;Choo, Han-Ho;Park, Jun-Seok;Kim, Tae-Kyung
    • Clinics in Shoulder and Elbow
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    • v.15 no.1
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    • pp.25-31
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    • 2012
  • Purpose: The clinical and radiographic outcomes of the internal fixation, which were executed on patients over the age of 65 with proximal humerus fracture by using a polyaxial angular stable locking compression plate (Non-Contact-Bridging proximal humerus plate, Zimmer, Switzerland, NCB), were evaluated. Materials and Methods: Thirty two patients over the age of 65 among the proximal humerus fracture treated with NCB plate, between August 2007 and January 2011, were chosen as the subjects. The average age of patients was 71 years, and the average postoperative follow-up period was 11.5 months. The fractures included 14 two-part and 18 three-part fractures. The clinical results were evaluated, using the visual analog scale (VAS) score and the Constant score. The radiological results were evaluated by time to union and Paavolainen method, which measures the neck shaft angle. Results: At the last follow-up examination, the mean VAS score was 3 points and the mean Constant score was 64.5 points, with bone union achieved after the average of 16.2 weeks following the surgery in all the cases. The mean neck shaft angle was 125.9 and 24 cases had good results, while 8 cases had fair results by Paavolainen method, at the last follow-up. There were 1 case of delayed union and cerclage wire failure, and 3 cases of subacromial impingement. There were no complications, such as loss of reduction, nonunion, screw loosening, or avascular necrosis of the humeral head. Conclusion: Internal fixation, using a NCB plate, was considered to be an effective surgical method in treating proximal humerus fracture in the elderly patients, on whom the fixation of the fracture and maintenance of reduction are difficult.

Clinical Characteristics of Miliary Tuberculosis (속립성 폐결핵의 임상적 특성)

  • Kim, Jin-Ho;Moon, Doo-Seop;Lee, Dong-Suck;Park, Ik-Soo;Yoon, Ho-Joo;Shin, Dong-Ho;Kim, Tae-Wha;Park, Sung-Soo;Lee, Jung-Hee
    • Tuberculosis and Respiratory Diseases
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    • v.41 no.2
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    • pp.144-151
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    • 1994
  • Background: Miliary tuberculosis almost always results from the discharge of infected caseous material into the blood stream, usually from a well hidden lymph node in the presentation of this disease in the past four decades, and although it is seen less frequent1y today than previously, its presentation and manifestation may require greater suspicion and diligence by the physician. We investigated the clinical characteristics, predisposing factors and accompanying diseases of miliary tuberculosis and tried to acquire the early diagnosis and treatment of this disease. Methods: A retrospective clinical study was done on 40 cases of miliary tuberculosis admitted to Hanyang University Hospital from Mar. 1989 to Dec.1992. The study investigated age and sex distribution, seasonal distribution, duration of symptoms before admission, pre-disposing factors, clinical symptoms, biochemical findings, chest X-ray findings, extrapulmonary tuberculosis associated with miliary tuberculosis, prognosis and mortality rate. Results: 1) The patients were most common in the age group between 20 and 29(23%) and the ratio of male to female was 1.4:1(male 23 : female 17). 2) Sputum smears for tubercle bacilli were positive in 5 cases(13%). 3) The most common clinical symptoms were fever with chilling(47.5%), coughing(47.5%), second most common symptom was dyspnea(32.5%), and the physical findings on admission were tachycardia(30%), weight loss(27.5%), meningeal signs(17.5%) in order. 4) The predisposing factors were heavy alcohol drinking(6 cases), steroid use(3 cases), pregnancy(2 cases) etc. 5) The chest X-ray findings on admission were miliary shadow only(40%), in addition pneumonic infiltration, pleurisy, and calcification in order. 6) The extrapulmonary tuberculosis associated with miliary tuberculosis were tuberculous meningitis(30%), bone and joint tuberculosis(17.5%), intestinal tuberculosis(15%) in order. 7) Biochemical findings were increased SGOT/SGPT(32.5%), increased alkaline phosphatase(32.5%), hypoalbuminemia(15%), hyponatremia(15%) etc. 8) About 4-6 weeks later after treatment(INH, RFP, PZA, EMB), 26 cases(65%) were improved on clinical symptoms or chest X-ray, 12 cases(30%) were stationary or aggravated, and 2 cases(5%) were died. Conclusion: For the early diagnosis and treatment of miliary tuberculosis, we must see its presentation and manifestation with greater interest and suspicion and investigate its predisposing factors and accompanying diseases.

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Characteristics of Carcass and Meat Yields of Fattening Pigs by Production Step (비육돈 생산단계에 따른 도체 및 부분육 생산 특성)

  • Kim, J.H.;Park, B.Y.;Yoo, Y.M.;Cho, S.H.;Kim, Y.K.;Lee, J.M.;Yun, H.J.;Kim, K.N.
    • Journal of Animal Science and Technology
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    • v.44 no.6
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    • pp.793-800
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    • 2002
  • The characteristics of carcass and meat yields of fattening pigs by production steps were investigated with Landrace (LL, n=41), Yorkshire (YY, n=33), and Duroc (DD, n=30), $F_1$ (LY, n=25), the Crossbred of LYD (n=48). Duroc had more weight loss in carcasses weight than that of the other breed(p<0.05). Yorkshire and $F_1$ had higher production weight in retail cut than that of the other pure or crossbred. Carcass from Landrace and $F_1$ were significantly longer in length than the other breed(p<0.05). $F_1$ produced wider carcass than the other breed. Carcass thickness at aitch bone was higher for $F_1$ and Crossbred than the other breed(p<0.05). Landrace, Yorkshire and $F_1$ produced more loin and tenderloin in weight than the other breed (p<0.05). Yorkshire and $F_1$ produced more picnic shoulder when compared to the other breed. The hind legs produced from Yorkshire and $F_1$ were higher in weight and the fore legs produced from the Crossbred were higher in weight. Duroc produced the lowest weight of belly among the breeds. The acceptance level of loin were extremely low for all breed. Landrace had the highest acceptance level for tenderloin. Yorkshire had the highest acceptance level for picnic shoulder and ham when evaluated by export standard of Japan. In conclusion, The introduction of pure breed and establishment of mating steps are necessary to produce highly accepted pork with high acceptance in carcass and meat yields.

Effects of Dietary Crude Protein Level on Growth and Meat Quality of Korean Native Goats (사료의 조단백질 수준이 육성기 흑염소의 발육과 육질에 미치는 영향)

  • Choi, S.H.;Kim, S.W.;Park, B.Y.;Sang, B.D.;Kim, Y.K.;Myung, J.H.;Hur, S.N.
    • Journal of Animal Science and Technology
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    • v.47 no.5
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    • pp.783-788
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    • 2005
  • This study was conducted to investigate the optimal CP level in growing goat kids. Forty male goats were divided into four treatment groups fed diets containing CP 12, 14, 16, and 18% of concentrate feed, and rice straw, respectively. Results are summarized as follows. Average daily gain’s(ADG) of groups fed diets with CP 14% and CP 18% were 84.0 and 83.0g/d each, which were higher than group fed diets with CP 12% grown at 69.2g of ADG(P<0.05). Daily feed intakes of concentrate and rice straw were 590g and 45g each and there was no difference found between treatments. The amounts of feed required for body weight gain(g) were similar in the range of 7.0-7.3 for groups fed diets with CP 14%, 16% or 18%. But the group fed diets with CP 12% required somewhat more feed for gain at 8.8g. Dressing percentage of groups fed diet with CP 12% was 61.7%, which was higher than groups fed diets with CP 14% or CP 18%(P<0.05) but similar to that fed diet with CP 16%. Meat percentage from goats fed diet with CP 16% was 51.7%, which were higher than goats fed diets with CP 12% or CP 14%(P<0.05). Fat deposition of CP 12% group was higher than the other groups(P<0.05). Percentage of bone weight averaged 17.0% without any difference among treatment groups. Shear force and cooking loss, which are physical properties of goat meats, were lower in CP 16% and CP 14% groups than the other two groups. Water holding capacity of goats meats from CP 16% was higher than those from CP 18% group(P<0.05). Results from panel test showed that juiciness of meats from CP 16% group was higher than those from CP 12% group(P<0.05). Meats from CP 16% also was tested to be more tender than meats from the other groups. Results from this work suggest that the optimum crude protein level in growing goat's concentrate is 14-16% and that increase above this level seems not to improve meat production.

ORTHODONTIC TRACTION OF HORIZONTALLY ERUPTED LOWER LATERAL INCISOR ON THE LINGUAL SIDE (설측으로 수평 맹출한 하악 측절치의 교정적 견인)

  • Mah, Yon-Joo;Sohn, Hyung-Kyu;Choi, Byung-Jai;Lee, Jae-Ho;Kim, Seong-Oh
    • Journal of the korean academy of Pediatric Dentistry
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    • v.37 no.1
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    • pp.117-123
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    • 2010
  • Tooth eruption is the movement of the tooth from the developing place in the alveolar bone to the functional position in the oral cavity. The permanent incisors originate from the dental lamina on the lingual side of preceding deciduous tooth and erupt to the level of the occlusion through the well developed gubernacular cord. Ectopic eruption is a developmental disturbance in the eruption pattern of the permanent dentition. Most of the ectopically erupted lower incisor has been found in lingual side. The ectopically erupted tooth could be repositioned by orthodontic force in the early mixed dentition, which could help preventing the problems of loss of space and the lingual tilting of the lower anterior teeth. An eight-year-old girl visited the department of pediatric dentistry, Yonsei Dental University Hospital, for the evaluation and the treatment of the lower right lateral incisor, which was horizontally erupted in the lingual side, parallel to the mouth floor. Her tongue was placed on the labial side of that tooth. There was no previous dental history of dental caries or trauma on the pre-occupied primary incisor. Clinical and radiographic examinations including the computed tomography(CT), showed no evidence of dilacerations on root. Therefore, we decided to start active orthodontic traction of the lower right lateral incisor. We designed the fixed type of buccal arch wire and the lip bumper with hook for the traction. Button was attached to the lingual side of the ectopically positioned tooth. Elastic was used between the appliance and the button on that tooth. After the tooth become upright over the tongue level, appliance was change to the removable type and periodic check-up with occlusal guidance was followed to monitor the position of the tooth. In this case using the fixed appliance with modified form of lip bumper and hook embedded in acrylic part instead of extraction was very efficient up-righting the ectopically erupted tooth toward the occlusal plane.

Pueraria lobata Ohwi as an Osteoporosis Therapeutics (칡의 부위별 골다공증 치료효과)

  • Kim, Chung-Sook;Ha, Hye-Kyung;Kim, Hye-Jin;Lee, Je-Hyun;Song, Kye-Yong
    • Korean Journal of Food Science and Technology
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    • v.34 no.4
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    • pp.710-718
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    • 2002
  • It is reported that Pueraria Radix contains phtoestrogens whereas flower, and bud of Pueraria lobata Ohwi were not known. In the present study, we determined the amount of phytoestrogen in each portion of P. lobata Ohwi and carried out therapeutic effects of osteoporosis. The amounts of genistein, daidzein, and formononetin in Pueraria Radix (PR), Pueraria Flos (PF), and young Pueratia Folium (PL) were quantitated using a HPLC system. Proliferation of osteoblast and growth inhibitory effect on osteoclast were measured in order to screen their effects on osteoporosis. Proliferation of osteoblast-like cells (Saos-2) was analyzed by both MTT methods and alkaline phosphatase (ALP) assays. Growth inhibitory effect on osteoclast was also detected as Tartrate resistant acid phosphatase (TRAP) assay. Ovariectomized rat as an in vivo animal model was selected and administrations of PR were 1 g/kg/day (PR-1) and 5 g/kg/day (PR-5) for 9 weeks, respectively. Trabecular bone areas (TBAs) of tibia and lumbar were analyzed usibg histomorphological methods. Results show that PR contains the highest level of daidzein ($10435{\pm}2143\;mg/kg$ of dried herb) and stimulated ALP activity, approximately 160% of the control. Growth inhibitory effect on osteoclast by both PR and daidzein were almost identical with control although $IC_{50}$ of genistein was $5.81{\times}10^{-7}$ M. Increases in body weight of OVX rats were suppressed by administration of PR but wet weights of uterus in PR-5 group were increased (p<0.05). Plasma ALP and HDL-cholesterol levels were decreased following ages (p<0.01), and LDL-cholesterol level was also decreased in PR-5 group at 20 week of age (p<0.01). TBAs of tibia and lumbar in PR-1 and PR-5 groups were higher than those of the control although the values were less than those of the sham group (each p<0.01) In conclusion, administrations of PR prevented loss of TBAs of tibia and lumber in OVX rats, while PL and PF did not (p<0.01).

Effect of High Calcium Diet on the Zinc and Copper Balance in Korean Female Adolescents (청소년기 여자에서 고칼슘 섭취가 아연과 구리 평형에 미치는 영향)

  • 최보영;남혜경;황용주;김선희
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.30 no.5
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    • pp.894-899
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    • 2001
  • Intakes and excretions of zinc and copper were determined for 8 female adolescents (aged 16.4$\pm$0.5 y; body mass index 20.4$\pm$1.3kg/$m^2$; body fat 33.3$\pm$2.5%; bone mineral density of lumbar spine in L2-L4; 0.96$\pm$0.08g/$\textrm{cm}^2$) when they consumed diets basal and high in calcium for 6 days each. All subjects consumed a basal Ca diet containing 800 mg, Korean RDA level of the subjects, and a high Ca diet containing 1200mg, RDA plus 2 SDs of calcium intake. The diets provided 58% of energy intake as carbohydrate, 25% as fat, and 17% as protein. Food, urine and fecal samples were collected during the last 3 days of each feeding period and were assayed. Mean daily intakes on the basal and high calcium diets, respectively, were 6.57 and 6.37 mg for zinc and 910 and 812 $\mu\textrm{g}$for copper. Fecal excretion of copper and zinc in relation to intake was significantly greater on the high calcium than on the basal calcium diet. Hence, apparent absorption rate was significantly lowered from 98.7% on the basal calcium diet to 97.9% on the high calcium diet for zinc from 66.3% to 56.4% for copper, respectively. Urinary loss of copper was not detectable but that of zinc was 0.38mg on the basal diet and 0.47mg on the high calcium diet. Copper retention was 899$\pm$105$\mu\textrm{g}$/day on the basal calcium diet and 792$\pm$20.8$\mu\textrm{g}$/day on the high calcium diet, and zinc retention was 3.95$\pm$0.91mg/day and 3.11$\pm$0.89mg/day. Thus, copper and zinc retention was significantly decreased on the high calcium diet (p<0.05). Summarizing the results, apparent absorption and retention of zinc and copper were significantly decreased by calcium supplementation. Therefore, it is suggested that interactions among minerals should be considered in determining RDA.

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