Analysis about Associated Factors of Nonunion Following Tibiotalar Arthrodesis / 대한족부족관절학회지

PURPOSE: The aim of this study was to analyze the factors related to nonunion in tibiotalar arthrodesis. MATERIALS AND METHODS: Eighty cases of ankle arthritis treated with tibiotalar arthrodesis in our hospital from November 2008 to November 2015 with more than one year follow up were analyzed. Simple anteroposterior and lateral radiographs after 6 and 12 months of surgery were analyzed. Union was defined as more than 50% connection of the trabecular bone at the ankle joint surface in the anteroposterior and lateral radiographs. The nonunion group was defined as no signs of union with persistent pain 9 months after surgery. The surgical approach, type of used screw, preoperative and postoperative ankle alignment, body mass index (BMI), bone mineral density, and patients' prior history were compared between the two groups. RESULTS: There were 69 union cases and 11 nonunion cases. In the patient factors, the gender and BMI was related to nonunion (p0.05). In the technical factors, the transfibular approach showed a better relationship but the association was not significant (p<0.05). In 40 cases of the transfibular approach, 12 cases used cancellous screws, and 4 cases showed nonunion due to screw breakage. CONCLUSION: Technical factors, such as the surgical approach and the type of screw used can be a risk factor in nonunion. In addition, patients' factors, such as gender and BMI, must be considered to reduce the nonunion rate.

Sunitinib Malate Synergistically Potentiates Anti-Tumor Effect of Gemcitabine in Human Bladder Cancer Cells

PURPOSE: Sunitinib malate (Sutent; Pfizer, New York, NY, USA) is a highly selective multi-targeted agent and has been reported to have potent anti-tumor effects against various tumors, including renal cell carcinoma and gastrointestinal stromal tumors. In this study, we explored in vitro the anti-tumor effect and related molecular mechanisms of sunitinib malate against human bladder cancer cell lines. We also determined the synergistic anti-tumor effect between sunitinib and conventional cytotoxic drugs, cisplatin and gemcitabine, in bladder cancer cells. MATERIALS AND METHODS: Six human cancer cell lines (HTB5, HTB9, T24, UMUC14, SW1710, and J82) were exposed to an escalating dose of sunitinib alone or in combination with cisplatin/gemcitabine, and the cytotoxic effect of the drugs was examined by CCK-8 assay. The synergistic effect between sunitinib and cisplatin/gemcitabine was determined by the combination index (CI) and clonogenic assay. Alterations in cell cycle (cyclin D, B1), survival (p-Akt, t-Akt), and apoptosis (Bax, Bad) regulator expression were analyzed by Western blotting. RESULTS: Like cisplatin and gemcitabine, sunitinib exerted a dose- and time-dependent anti-tumor effect in bladder cancer cells. However, sunitinib exhibited entirely different sensitivity profiles from cisplatin and gemcitabine. Sunitinib suppressed the expression of cyclin B1, p-Akt, and t-Akt while augmenting the expression of cyclin D and pro-apoptotic Bax and Bad in HTB5 cells. Analysis of the drug combination by the isobolic method and clonogenic assay revealed that sunitinib acts in synergy with gemcitabine in HTB5 cells. CONCLUSIONS: These results indicate that sunitinib malate has a potent anti-tumor effect and may synergistically enhance the anti-tumor effect of gemcitabine in human bladder cancer cells.

Two Cases of HHH Syndrome in Siblings

Hyperornithinemia-hyperammonemia-homocitrullinuria(HHH) syndrome is a rare autosomal recessive disorder caused by a defect in the urea cycle. Protein intolerance, mental retardation, seizure, ataxia, and stupor are characteristic symptoms. Patients showing these symptoms may also present symptoms of acute hepatic disease at the same time. When fed with a high protein diet, they may refuse to eat, vomit, become lethargic, or go into coma. After childhood, most patients avoid meats or milk spontaneously and eat a low protein diet. The liver and spleen are normal or slightly enlarged. The coagulation time is prolonged and sometimes there is a deficiency in factor VII and X. Treatment is aimed at preventing hyperammonemia after meals by restricting daily protein intake to 1.2 g/kg/day and this lowers serum ornithine concentration. Prolonged ornithine supplement(0.5 to 1.0 mM/kg/day; i.e., 66 to 132 mg/kg/day divided into three doses) improved patients' protein intolerance and accelerated growth. Since Shih and coworkers first reported this syndrome in 1969, there have been 40 cases reported worldwide but not yet in Korea. We, for the first time in Korea, report two cases of HHH syndrome in brothers.

Comparative Study for Detection of Specific IgE in Allergic Disease; Skin Prick Test, RAST, and Dipstick Test / 소아알레르기및호흡기학회지

PURPOSE: To evaluate the valuability of dipstick IgE detection method as a screening test for allergic diseases, we compared the results of dipstick test to that of RAST and skin prick test. METHODS: Twenty children who visited to pediatric allergy clinic in Soon Chun Hyang University were enrolled to comparative study of dipstick IgE detection method to Skin prick test and RAST. Dipstick IgE detection method was performed by using AllergodipR(Allergopharma Joachim Ganzer KG). We compared the sensitivity and specificity of dipstick IgE detection method to RASt and skin prick test. RESULTS: The sensitivity and specificity of AllergodipR for inhalant allergen(D.pteronyssinus) to RAST were 100%, respectively. The sensitivity and specificity of AllergodipR for inhalant allergen(D. pteronyssinus) to skin prick test were 77.8% and 90.9%, respectively. The sensitivity and specificity of AllergodipR for food allergen to RAST were 0% and 100%, respectively. The sensitivity and specificity of AllergodipR for inhalant allergen(D. pteronyssinus) to skin prick test were 0% and 100%, respectively. CONCLUSION: The dipstick method(AllergodipR) can be used as a screening test for detection of specific IgE to inhalant allergen.