• Applied Microscopy
• /
• v.32 no.4
• /
• pp.385-398
• /
• 2002

The purpose of the present study is to investigate whether stromal cells supporting specific microenvironment for hematopoiesis of bone marrow are affected by toxicants and therapeutic drugs such as antibiotics and anticancer drugs and whether laminin-1 is associated with such effects. SD rats were intraperitoneally injected with 75 mg/kg of cyclophosphamide which is widely used to treat infant's solid tumor, leukemia and myeloma and sacrificed after 3 days, 1 week, 3 weeks or 5 weeks of injection. The bone marrow extracted and paraffin-sectioned was analyzed using immunohistochemical staining. A part of tissues was subjected to electron microscopy following reaction with rabbit anti-laminin antibody, biotinylated goat anti-rabbit IgG conjugated with 12 nm gold particles, and staining with uranyl acetate. 1. The bone marrow tissue at day 3 post injection with cyclophosphamide displayed dilated venous sinus, partial necrotic death, and decreased number of hematopoietic cells. Laminin-1 was intensively stained in the reticular and adipose tissues. 2. Up to 5 weeks post injection, laminin-1 was stained at a low level in the stromal tissue of bone marrow and the number of hematopoietic cell was increased. 3. Deposition of the gold particle which represents laminin-1 expression was observed at the highest level in the stromal cells of bone marrow obtained 3 days after injection, and decreased after 1 to 5 weeks. These results suggest that stromal cells which play a role in supporting microenvironment for bone marrow hematopoiesis augment induction of laminin-1 expression and activation upon administration of cyclophosphamide.

• Clinical and Experimental Pediatrics
• /
• v.48 no.7
• /
• pp.731-736
• /
• 2005

Purpose : Acute pyogenic osteomyelitis is uncommon in children. Delayed diagnosis and inappropriate treatment are leading to growth failure and deformation. We review the clinical manifestations and treatment of acute osteomyelitis in children according to age. Methods : A retrospective analysis was made of 32 patients who underwent antibiotic management or operation between Aug 1989 and Dec 2003 for acute pyogenic osteomyelitis in age from 0 to 15 years old. Results : The study group was composed of 21 boys and 11 girls. The subjects were divided into four groups according to age : 0-1 yr(n=6), 1-5 yr(n=11), 6-10 yr(n=8), and 11-15 yr(n=7). Nineteen cases were diagnosed in Winter. Femur was the most common infected site(37.5%). There were no predisposing factor in 17 patients, and 7 of 15 patients had trauma history. Sepsis was important predisposing factor in neonates. The chief complaints were pain, swelling and fever. S. aureus(61%) is the most common organism. Twenty-nine patients were treated with operation and concomitant antibiotics. Two cases had sequelae in follow-up period : One is avascular necrosis of femur and the other is discrepancy of leg length. Conclusion : In our review, because of poor prognosis in septic neonates, we recommend to treat actively neonatal sepsis and prevent or detect osteomyelitis early. Because most of patients were diagnosed and treated in orthopedic surgery, the rate of operation was too high. So, protocol for further evaluation and management of acute osteomyelitis in pediatric patients were needed.

• Journal of agricultural medicine and community health
• /
• v.27 no.1
• /
• pp.115-123
• /
• 2002

Objective: The aim of this study was to evaluate the patterns of helicopter emergency medical services (HEMS) in Ullung Island. Methods : The authors reviewed the records from emergency room diaries and the lists of helicopter transfers in the Ullung Public Health Medical Center over the 5-year period from Jan 1, 1997 to Dec 31, 2001. Results : One hundred thirteen cases were transferred by helicopters in 88 flights. According to year, the number of flights was 13(14.8%) and the number of cases was 15(13.3%) in 1997; 17(19.3%) and 21(18.6%) in 1998; 18(20.5%) and 20(17.7%) in 1999; 17(19.3%) and 20(17.7%) in 2000; and 23(26.1%) and 37(32.7%) in 2001. According to the kind of helicopter, the number of flights was 46(52.3%) and the number of cases was 60(53.1%) by Maritime police; and 19(21.6%) and 28(25.1%) by 119 rescue. According to time zone, there were no night flights. According to sex and age, there were 75 male cases(66.4%) and 28 cases(28.3%) of patients aged sixty years and over. The number of flights was 11(12.5%) and the number of cases was 15(13.3%) in November; 10 flights(11.4%) and 14 cases(12.4%) in March; and 7 cases(8.0%) in each of September, October and April. The most common season of helicopter transfer cases was autumn. According to transfer area, there were 48 cases (42.5%) in Pohang city, Gyeonsangbukdo; 35(31.0%) in Gangnung city, Gangwondo; and 17(15.0%) in Daegu metropolitan city. According to condition, there were 27 cases(23.9%) of cerebro-vascular accident, 13(11.5%) of fracture and 11(9.7%) of head injury. According to admission department, there were 42 cases(37.2%) in Neurosurgery, 21(18.6%) in Internal Medicine and 13(11.5%) in Orthopedic Surgery. According tothe Korea Standard Classification of Disease(3-KSCD), circulatory systemic disease(IX) and injury, intoxication and others (XIX) were the two most frequent categories with 34 cases(30.1%) each, followed by digestive system disease (XI) with 23 cases(20.4%). Conclusions : HEMS in Ullung Island leave much to be desired. Helicopters cannot make a night flight and are not equipped with medical facilities. HEMS in islands such as Ullung Island are essential. We hope that night flights, equipment-monitoring systems for emergency patients in the helicopters, and a law related to HEMS in the island will all be established.

• Investigative Magnetic Resonance Imaging
• /
• v.11 no.1
• /
• pp.27-32
• /
• 2007

Purpose : To evaluate the mucoid degeneration (MD) of the anterior cruciate ligament (ACL) of the knee by correlation of MRI findings with pathology, in the patients with osteoarthritis (OA). Materials and Methods : This study included 17 patients (mean 68.8 years old) who underwent preoperative MRI. In proton density-weighted sagittal and coronal images ACLs were evaluated for the thickness and signal intensity (SI). Total knee replacement arthroplasty was performed and the pathologic findings of ACL were evaluated. MD was classified as 3 grades according to the degenerated amount in microscopy. Thickness and SI was evaluated as normal or increased on MRI. Results : All of the 4 patients who showed thickened ACL showed increased SI on MRI. All of the 8 patients with increased SI of the ACL on MRI had MD in the ACL. However, remained 9 patients also had MD, in spite of their normal thickness and SI on MRI. Calcification was seen in 5 patients. Conclusion : Eight cases who showed ACL thickening or increased SI on MRI were well correlated with MD, however, because the other nine cases who showed normal thickness and normal SI of ACL on MRI also showed MD in pathology, normal MRI finding should not exclude the possibility of MD of ACL.

• The Korean Journal of Nuclear Medicine
• /
• v.31 no.1
• /
• pp.90-101
• /
• 1997

The purpose of this study is to evaluate the diagnostic accuracy of various quantitative indices for the differentiation of benign from malignant primary soft tissue tumors by FDG-PET. A series of 32 patients with a variety of histologically or clinically confirmed benign (20) or malignant (12) soft tissue lesions were evaluated with emission whole body (5min/bed position) PET after injection of [$^{18}F$]FDG. Regional 20min transmission scan for the attenuation correction and calculation of SUV was performed in 16 patients (10 benign, 6malignant) followed by dynamic acquisition for 56min. Postinjection transmission scan for the attenuation correction and calculation of SUV was executed in the other 16 patients (10 benign, 6 malignant). The following indices were obtained. the peak and average SUV (pSUV, aSUV) of lesions, tumor-to-background ratio acquired at images of 51 min p.i. ($TBR_{51}$), tumor-to-background ratio of areas under time-activity curves ($TBR_{area}$) and the ratio between the activities of tumor ROI at 51 min p. i. and at the time which background ROI reaches maximum activity on the time-activity curves ($T_{51}/T_{max}$). The pSUV, aSUV, $TBR_{51}$, and $TBR_{area}$ in malignant lesions were significantly higher than those in benign lesions. We set the cut-off values of pSUV, aSUV, $TBR_{51},\;TBR_{area}$ and $T_{51}/T_{max}$ for the differentiation of benign and malignant lesions at 3.5, 2.8, 5.1, 4.3 and 1.55, respectively. The sensitivity, specificity and accuracy were 91.7%, 80.0%, 84.4% by pSUV and aSUV, 83.3%, 85.0%, 84.4% by $TBR_{51}$, 83.3%, 100%, 93.8% by $TBR_{area}$ and 66.7%, 70.0%, 68.8% by $T_{51}/T_{max}$. The time-activity curves did not give additional information compared to SUV or TBR. The one false negative was a case with low-grade fibrosarcoma and all four false positives were cases with inflammatory change on histology. The visual, analysis of FDG-PET also detected the metastatic lesions in malignant cases with comparable accuracy In conclusion, all pSUV, aSUV, $TBR_{51}$, and $TBR_{area}$ are useful metabolic semi-quantitative indices with good accuracy for the differentiation of benign from malignant soft-tissue lesions.

• Journal of Preventive Medicine and Public Health
• /
• v.21 no.2 s.24
• /
• pp.217-223
• /
• 1988

A cross-sectional survey was conducted to determine the prevalence rate of scoliosis in elementary, middle and high school boys in May 1988. The study population included 1,393 male students in Pusan ; 463 students of 4th grade in two elementary schools, 543 students of 1st grade in one middle school and 387 students of 1st grade in one high school. The students of elementary school were screened with inspection by two physicians at the same time and the students of middle and high schools were screened with both inspection by the same physicians and 70mm chest X-ray. Positive students in any one of the two screening tests were measured for height and body weight and asked for the shoulder side on which he carries the school bag. The angle of curvature on X-ray film was measured by Cobb's method. The number of positive students in any one of the two screening tests were 15(3.2%) in elementary schools, 174(32.0%) in middle school and 92(23.8%) in high school. However, positive rates in both tests were only 2.2% for the middle school students and 2.6% for the high school students and among these students 1.1% out of total middle school students and 2.3% of high school students had a curvature equal to or greater than $5^{\circ}$ of Cobb's angle on 70mm chest X-ray film. There was a statistically significant association between the direction of spinal curve and the shoulder side on which one carries school bag among positive students in both screening 1.sts (p<0.05) Mean height and body weight of 281 positive students in any one of two screening tests were compared with the Korean standard for the same age. Mean weight of elementary school students was nearly the same as the standard weight but the height was slightly shorter than the standard. However, both mean height and weight of the middle school students were lower than the standard while those of the high school students were higher. The prevalence rate of scoliosis for the 2nd and 3rd grades of high school is presumed to be higher than that of the 1st grade of high school and the rate for girls will be even higher than the rate for boys of the same age. Thus, scoliosis seems to be an important school health problem. To prevent scoliosis, it is recommeded to reduce the weight of school bag, educate the students to keep a right posture and exercise periodically.

• Pediatric Infection and Vaccine
• /
• v.4 no.2
• /
• pp.210-217
• /
• 1997

Purpose: To prevent residual physical disability and chronic infection, prompt diagnosis and adequate treatment are important in the skeletal infections in children. Although radioisotope scanning is knwon as the method of choice for early diagnosis of bone infection, we conducted a study on twenty nine children who had skeletal infections to reevaluate the most appropriate way in diagnosis and management. Methods: A retrospective study was conducted on twenty nine children, who were admitted to the departments of Pediatrics and Orthopedic Surgery and who had acute osteomyelitis or septic arthritis, through review of medical records, radiologic & radioisotope study results. Their diagnoses were confirmed by bacteriologic cultures on the aspirated specimens from suspected bony lesions. Results: 1) Among twenty nine patients, there were 6 infants including 5 newborn infants, and 23 children were aged between 1 and 15 years. Male to female ratio was 1.4 to 1. 2) Point tenderness was noted in all cases, and the common physical signs were swelling, limitation of motion, fever and local heat in the order of frequency. 3) Fifty two percents of the patients were diagnosed within a week after onset of symptoms and all cases were within 15 days. 4) Leukocytosis was noted in only 58.6% of cases but erythrocyte sedimentation rate was increased in all cases except only one case. Staphylococcus aureus was revealed as the most common etiologic agent. 5) Radioisotope scans showed hot uptake in five of six cases(83.3%) who had no abnormal finding on plain skeletal radiolograms. Conclusions: Although radioisotope scan and MRI are helpful in early diagnosis before radiologic finding was detected on plain X-ray film, the antimicrobial therapy can be started after bacteriologic study of the aspirated specimens from the suspected skeletal lesions if skeletal infection is highly suspected clinically.

• Journal of Yeungnam Medical Science
• /
• v.7 no.1
• /
• pp.81-93
• /
• 1990

The author fractographically analyized the cause of metal failure(the first time this procedure has been used for this metal failure)and also analyized it clinically. In this study, I selected eight cases which have been analyized fractographically. In all these cases, the analysis was done after treatment of metal failure of implants internally fixed to femur shaft fractures at the Department of Orthopedic Surgery, Yeung-Nam University Hospital during the six year period from May 1983 to September 1989. 1. Metal failure occured in five dynamic-compression plates, one Jewett nail, one screw in Rowe plate, and one interlocking nail. 2. The clinical cause of metal failure was deficiency of medial butress in five cases, incorrect position of implant in one case, and incorrect selection of implant in two cases. 3. The time interval between internal fixation and metal failure was four months in one case, between five months to twelve months in six cases, three years in one case. 4. The fractographically analytical cause of metal failure was ; first, impact failure, one case, second, fatigue failure, six cases, machining mark(stress liser), four cases type : low consistent cyclic fatigue failure irregular cyclic fatigue failure third, stress corrosion crack, one case. 5. 316L Stainless Steel has good resistance to corrosion. However, when its peculiar surface film is destroyed by fretting, it shows pitting corrosion. This is, perhaps, the main cause of metal failure. 6. It is possible that mechanical injury occured in implants during the manufacturing of implants or that making a screw hole is the main cause of metal failure.

• Journal of Life Science
• /
• v.33 no.2
• /
• pp.169-175
• /
• 2023

As a protective defensive mechanism against ultraviolet (UV) light exposure in skin tissue, melanocytes produce the pigment melanin. Tyrosinase plays a key role in melanin production in melanocytes. However, the overproduction of melanin can lead to lesions, such as freckles and dark spots. Thus, it is clinically important to find a modulating molecule to control melanogenesis by regulating tyrosinase expression and/or activity. It is known that catechin, a plant flavonoid, can reduce melano- genesis through the downregulation of tyrosinase expression. Here, we tested whether catechin derivatives isolated from the stem bark of Ulmus parvifolia have an effect on melanin production by regulating tyrosinase in mouse melanoma cells and in vitro mushroom tyrosinase. The catechin derivatives used in this study included C5A, C7A, C7G, and C7X. Treatments using these catechin derivatives reduced melanin production in mouse melanoma B16F10 cells in which melanogenesis was stimulated by α-MSH. Notably, the anti-melanogenic effects of catechin derivatives were similar to those of kojic acid, a well-known anti-melanogenic molecule. Both C5A and C7A directly inhibited the activity of tyrosinase isolated from mushrooms in vitro. Furthermore, our in silico computational simulation showed that these two compounds were expected to bind to the active site of tyrosinase, which is similar to kojic acid. In addition, all four catechin derivatives reduced tyrosinase protein expression. In summary, our results showed that catechin derivatives can reduce melanogenesis by regulating tyrosinase activity or expression. Thus, this study suggests that catechin derivatives isolated from U. parvifolia can be novel modulators of melanin production.

• Journal of the Korean Orthopaedic Association
• /
• v.54 no.2
• /
• pp.110-119
• /
• 2019

Proximal humerus fracture can be defined as a fracture that occurs in the surgical neck or proximal part of the humerus. Despite the appropriate treatment, however, various complications and sequelae can occur, and the treatment is quite difficult often requiring surgical treatment, such as a shoulder replacement. The classification of sequelae after a proximal humerus fracture is most commonly used by Boileau and can be divided into two categories and four types. Category I is an intracapsular impacted fracture that is not accompanied by important distortions between the tuberosities and humeral head. An anatomic prosthesis can be used without greater tuberosity osteotomy. In category I, there are type 1 with cephalic collapse or necrosis with minimal tuberosity malunion and type 2 related to locked dislocation or fracture-dislocation. Category II is an extracapsular dis-impacted fracture with gross distortion between the tuberosities and the humeral head. To perform an anatomic prosthesis, a tuberosity osteotomy should be performed. In category II, there are type 3 with nonunion of the surgical neck and type 4 with severe tuberosity malunion. In type 1, non-constrained arthroplasty (NCA) without a tuberosity osteotomy should be considered as a treatment. On the other hand, reverse shoulder arthroplasty (RSA) should be considered if types 1C or 1D accompanied by valgus or varus deformity or severe fatty degeneration of the rotator cuff. In general, the results are satisfactory when NCA is performed in type 2 sequelae. On the other hand, RSA can be considered as an option when there is no bony defect of the glenoid and a defect of the rotator cuff is accompanied. In type 3, it would be effective to perform internal fixation with a bone wedge graft rather than shoulder replacement arthroplasty. Recent reports on the results of RSA are also increasing. On the other hand, recent reports suggest that good results are obtained with RSA in type 3. In type 4, RSA should be considered as a first option.