Anterolateral Minimally Invasive Plate Osteosynthesis of Distal Tibial Fractures Using an Anterolateral Locking Plate / 대한족부족관절학회지

PURPOSE: Anterolateral minimally invasive plate osteosynthesis (MIPO) was performed to treat patients with distal tibial fractures associated with open fractures or extensive soft tissue injuries, which is limited medial MIPO. The treatment results of the anterolateral MIPO technique were evaluated and analyzed.MATERIALS AND METHODS: Seventeen patients with distal tibial fractures associated with an open fracture or large bullae formation on the distal tibia medial side were treated with anterolateral MIPO using anterolateral locking plates. Within 24 hours of visiting the emergency room, external fixation was applied, and the medial side wound was managed. After damage control, the anterolateral locking plate was applied using an anterolateral MIPO technique. The union time, nonunion, or malunion were evaluated with regular postoperative radiographs. The ankle range of motion, operative time, blood loss, Iowa score, and wound complications were investigated.RESULTS: Radiological evidence of bony union was obtained in all cases. The mean time to union was 16.7 weeks (12~25 weeks). The mean operation time was 44.0 minutes. Regarding the ankle range of motion, the mean dorsiflexion was 15°, and the mean plantarflexion was 35°. Satisfactory results were obtained in 15 out of 17 cases; five results were classified as excellent, four were good, and six were fair. The mean blood loss was 125.2 mL. Two complications were recorded.CONCLUSION: In distal tibial fractures with severe medial soft tissue damage caused by high-energy trauma, the staged anterolateral MIPO technique using anterolateral locking plates is a useful alternative treatment to achieving optimal wound care, rapid union with biological fixation, and intra-articular reduction.

Aripiprazole Effects in Patients with Acute Schizophrenia Experiencing Higher or Lower Agitation / 신경정신의학

OBJECTIVES: The purpose of this study was to investigate the efficacy and predictors of response to aripiprazole treatment in acute schizophrenic patients. We investigated whether baseline agitation level influences the treatment response, and examined the effects of oral aripiprazole in acute patients with schizophrenia experiencing either higher or lower levels of agitation. METHODS: In this 8-week non-comparative clinical trial, 19 patients with a DSM-IV diagnosis of acute schizophrenia were enrolled. They were divided into groups experiencing higher or lower agitation at baseline. PANSS scores, CGI scores, GAF scores, and PANSS-EC score were used for efficacy assessments. RESULTS: 63.2% of patients completed the study. The average dosage of aripiprazole was 26.2+/-4.8 mg. Treatment with aripiprazole resulted in significant improvement from baseline in all efficacy measures. In both the higher and lower groups, aripiprazole treatment produced significantly lower PANSS total and PANSS-EC scores, compare with baseline. Moreover, these significant improvements were sustained throughout a 8-week period. A shorter duration of the present episode is associated with a better clinical response. Extrapyramidal symptoms were observed in 36.8% of patients; however, the side effects did not influence the treatment response. CONCLUSION: High doses of aripiprazole significantly improved acute symptoms of schizophrenia irrespective to baseline agitation level, without any significant adverse event. These results suggest that aripiprazole is an effective and safe treatment option for patients with acute schizophrenia who manifest agitation symptoms.

Mutation analysis of p31(comet) gene, a negative regulator of Mad2, in human hepatocellular carcinoma

Failure of mitotic checkpoint machinery leads to the chromosomal missegregation and nuclear endoreduplication, thereby driving the emergence of aneuploidy and tetraploidy population. Although abnormal nuclear ploidy and the resulting impairment of mitotic checkpoint function are typical physiological event leading to human hepatocellular carcinoma, any mutational change of mitotic checkpoint regulators has not yet been discovered. Therefore, we investigated the mutation of p31(comet), a recently identified mitotic checkpoint regulator, in human hepatocellular carcinoma. Of 51 human hepatocellular carcinoma tissue and 6 cell lines tested, five samples exhibited nucleotide sequence variations dispersed on four sites within the entire coding sequence. Among these sites with sequence substitutions, three were found to be missense mutation accompanied with amino acid change but one was a silent mutation. Of these sequence substitutions, two were present in both tumor and non-tumor liver tissues, suggesting the possibility of polymorphism. The present findings indicate that p31(comet) does not have an impact on the formation of aneuploidy and tetraploidy found in human hepatocellular carcinoma.

A Case of the Middle Ear Adenoma / 대한이비인후과학회지

The middle ear adenoma is a rare neoplasm originating from the lining epithelium of the middle ear mucosa. The first report of a middle ear glandular tumor was published in 1898 by Treitel and since then over 100 cases have been reported. At least 14 different descriptions have been given to these lesions, reflecting the controversies relating to their presumed histogenesis and differentiation. The middle ear adenoma has been often classified into mixed and papillary type by cellular morphology, growing pattern, prognosis, and clinical manifestations. The most common initial symptom was decreased hearing, followed by ear-fullness, otalgia, headache, and otorrhea. Radiologically, the most common finding is a soft tissue mass in the middle ear. In this study, we present a case of the middle ear adenoma of the patient complaining hearing difficulty and otorrhea, which was diagnosed by histopathologic finding, and then discuss the current approach to this tumor with a review of literature.

Effect of obesity and age on the blood pressure

BACKGROUND: In recent years, the incidence of obesity increased in Koreans. The main cause suggested is the diet style of Korean changed to that of Western. It has been proved that obesity is a risk factor or an aggravating factor of hypertension and diabetes mellitus, cardiovascular disease, etc. Primary physician has been interested in the correlation of blood pressure with relative body weight and aging. The purpose of this study was to focus on the influence of age and relative body weight on blood pressure. METHODS: Subjects were collected from 2,068 adults who had received Adult Health Examination. That subjects were divided according to age, relative body weight and then the relation of blood pressure with age according to relative body weight and relation with relative body weight according to age were investigated. RESULTS: Systolic blood pressure increased significantly according to age in all male and female three weight groups and then increased significantly according to relative body weight in all male and female three age groups except male seventh decade group. Diastolic blood pressure increased significantly according to age in all male and female three weight groups except male obesity group and then increased significantly according to the relative body weight in all male and female three age groups except male and female seventh decade groups. Systolic blood pressure has higher correlation with age than relative body weight and diastolic blood pressure has higher correlation with relative body weight in male. In female, systolic and diastolic blood pressure have higher correlations with age. CONCLUSIONS: It can be suggested that blood pressure increase significantly according to aging process and relative body weight. These two factors have a little different effects to systolic and diastolic blood pressure according to sex. Relative body weight has more effect to diastolic blood pressure than systolic blood pressure in male.