Osteosíntesis mínima invasiva percutánea con placa en fractura de tibia distal / Percutaneous Minimally Invasive Plate Osteosynthesis in Distal Tibial Fracture

Introducción: Las fracturas diafisarias de la tibia tienen una alta incidencia por año, incluidas las del tercio distal. Son las más frecuentes de los huesos largos y se observan sobre todo en adultos jóvenes. Se producen, generalmente, por traumatismos de alta energía como accidentes del tránsito y caídas de alturas. Objetivo: Presentar los resultados del tratamiento realizado a un paciente con fractura extrarticular del tercio distal de la tibia, mediante una técnica de osteosíntesis percutánea mínimamente invasiva. Presentación del caso: Paciente de 45 años, masculino, de piel blanca que sufrió accidente del tránsito, y fue atendido en el servicio de Ortopedia y Traumatología del Hospital General Docente Dr. Antonio Luaces Iraola, con trauma en pierna izquierda. Presentó dolor, inflamación e imposibilidad para caminar. A la exploración física se constató dolor, deformidad, crepitación, movilidad anormal, aumento de volumen e impotencia funcional absoluta. Se realizó radiografía, se corroboró diagnóstico y se decidió tratamiento quirúrgico con técnica mínima invasiva percutánea. Se siguieron los principios de la osteosíntesis biológica y se utilizó placa de segunda generación del sistema AO. Conclusiones: El tiempo quirúrgico fue de 45 minutos, la estadía hospitalaria fue de 48 horas. Se comenzó apoyo parcial a las ocho semanas, y total a las 15 semanas. Se logró la consolidación total de la fractura a las 16 semanas de operado, evaluado de excelente a través de la American Orthopaedic Foot and Ankle Society (AOFAS) score(AU)

Introduction: Diaphyseal fractures of the tibia have high incidence per year, including those of the distal third. They are the most common of the long bones and are seen mostly in young adults. They are generally caused by high-energy trauma such as traffic accidents and falls from heights. Objective: To present the results of the treatment on a patient with extra-articular fracture of the distal third of the tibia, using minimally invasive percutaneous osteosynthesis technique. Case report: A white 45-year-old male patient was injured in a traffic accident, and he was treated in the Orthopedics and Traumatology service at Dr. Antonio Luaces Iraola General Teaching Hospital, because of a trauma to his left leg. He had pain, swelling and inability to walk. Physical examination revealed pain, deformity, crepitus, abnormal mobility, increased volume, and absolute functional impotence. X-rays were performed. The diagnosis was confirmed, and surgical treatment was decided with a minimally invasive percutaneous technique. The principles of biological osteosynthesis were followed and a second generation plate of AO system was used. Conclusions: The surgical time was 45 minutes. The hospital stay was 48 hours. Partial support of the leg was started at eight weeks, and full support at 15 weeks. Full fracture healing was achieved 16 weeks after surgery, the procedure was evaluated as excellent according to the American Orthopedic Foot and Ankle Society (AOFAS) score(AU)

Isolation of Klebsiella pneumoniae from Sungai Skudai and in silico analysis of putative dehalogenase protein

Aims@#The surplus use of herbicide Dalapon® contains 2,2-dichloropropionic acid (2,2-DCP) poses great danger to human and ecosystem due to its toxicity. Hence, this study focused on the isolation and characterization of a dehalogenase producing bacteria from Sungai Skudai, Johor, capable of utilizing 2,2-DCP as a carbon source and in silico analysis of its putative dehalogenase.@*Methodology and results@#Isolation of the target bacteria was done by using 2,2-DCP-enriched culture as the sole carbon source that allows a bacterium to grow in 20 mM of 2,2-DCP at 30 °C with the corresponding doubling time of 8.89 ± 0.03 h. The isolated bacterium was then designated as Klebsiella pneumoniae strain YZ based on biochemical tests and basic morphological examination. The full genome of K. pneumoniae strain KLPN_25 (accession number: RRE04903) which obtained from NCBI database was screened for the presence of dehalogenase gene, assuming both strains YZ and KLPN_25 were the same organisms. A putative dehalogenase gene was then identified as type II dehalogenase from the genome sequence of strain KLPN_25. The protein structure of the type II dehalogenase of KLPN_25 strain was then pairwise aligned with the crystal structure of L-2-haloacid dehalogenase (L-DEX) Pseudomonas sp. strain YL as the template, revealing the existence of conserved amino acids residues, uniquely known to participate in the dehalogenation mechanism. The finding thus implies that the amino acid residues of type II dehalogenase possibly shares similar catalytic functions with the L-DEX.@*Conclusion, significance and impact of the study@#In conclusion, this study confirmed the presence of new dehalogenase from the genus Klebsiella with potential to degrade 2,2-DCP from the river water. The structural information of type II dehalogenase provides insights for future work in designing haloacid dehalogenases.

Tratamiento de la discinecia ciliar primaria / Treatmen of ciliary primary discinesia

At present, there is no specific treatment for primary ciliary dyskinesia, nor controlled and randomized clinical trials to determine how the management and monitoring of these patients should be considered. The therapeutic options are extrapolated from other diseases, such as cystic fibrosis, or non-cystic fibrosis bronchiectasis. However, the implementation of specific groups of experts, both in the USA (PDC-foundation) and in Europe (BESTCILIA or BEAT-PD), are helping to increase knowledge of the disease, opening research channels and seeking new treatments. Until we have therapies capable of correcting the basic defect of the disease, the pillars of treatment are the daily cleansing of the airways and aggressive antibiotherapy against respiratory infections. Multidisciplinary care in specialized centers where pulmonary function is monitored and the infection is prevented and treated will improve, as in cystic fibrosis, the results of patients.

En la actualidad no existe un tratamiento específico para la discinesia ciliar primaria, ni se cuenta con ensayos clínicos controlados y randomizados que permitan determinar cómo debe plantearse el manejo y seguimiento de estos pacientes. Las opciones terapéuticas son extrapoladas de otras enfermedades, como la fibrosis quística, o las bronquiectasias no fibrosis quística. Sin embargo, la puesta en marcha de grupos específicos de expertos, tanto en USA (PDC-foundation) como en Europa (BESTCILIA o BEAT-PD), están permitiendo incrementar el conocimiento de la enfermedad, abriendo vías de investigación y buscando nuevos tratamientos. Hasta contar con terapias capaces de corregir el defecto básico de la enfermedad, los pilares del tratamiento son la limpieza diaria de las vías aéreas y la antibioterapia agresiva frente a las infecciones respiratorias. La atención multidisciplinar en centros especializados donde se monitorice la función pulmonar y se prevengan y traten las infecciones mejorará, como en la fibrosis quística, los resultados de los pacientes.

Study on the value of des-γ-carboxy-prothrombin combined with enhanced CT in predicting microvascular invasion of hepatocellular carcinoma / 中国实用外科杂志

OBJECTIVE: To explore the predictive value of preoperative enhanced CT combined with des-γ-carboxy-prothrombin(DCP) level for microvascular invasion(MVI) of hepatocellular carcinoma(HCC).METHODS: The clinicaldata of 105 cases of HCC diagnosed by pathology after surgical resection from January 1,2016 to March 1,2019 in thethe Affiliated Hospital of Southwest Medical University were analyzed retrospectively. According to the pathologicalresults,they were divided into two groups: experimental group(with MVI): 30 cases,control group(without MVI): 75 cases,using univariate and multivariate logistic regression analysis to predict influencing factors of MVI in HCC. Thereceiver working curve(ROC curve)was used to evaluate the predictive value of DCP combined with enhanced CT forMVI in HCC.RESULTS: Univariate analysis showed that serum DCP level(t=4.667,P<0.001),tumor size(t=9.427,P<0.001),capsule type(χ~2=18.456,P<0.001) and pathological type(χ~2=11.914,P=0.003) were risk factors for MVI in HCC,with statistically significant differences(P<0.05). Multivariate logistic regression analysis showed that tumor size(OR=12.610,P=0.001),capsule type(OR=14.363,P=0.008) and serum DCP level(OR=19.254,P=0.014)were independentrisk factors of MVI in HCC,with statistically significant differences(P<0.05). ROC curve analysis showed that thesensitivity,specificity and area under the curve(AUC) of serum DCP and enhanced CT model for predicting MVI in HCCwere 90.0%,74.7% and 0.856,respectively.CONCLUSION: Preoperative serum DCP level combined with enhanced CThelps predict MVI in HCC.

Analysis of 2,2-DCP degrading bacteria isolated from a paddy field at a rural area in Malang, Indonesia

Aims@#The use of herbicide effectively controls weeds in agricultural practice. However, its release to the surrounding surface water bodies may lead to environmental issues. The aim of this study was to isolate the bacteria that were able to remove 2,2-dichloropropionic acid (2,2-DCP) from a paddy field located in Malang. @*Methodology and results@#The 2,2-DCP degrading bacteria were isolated and their ability to grow on higher 2,2-DCP concentrations (50 and 80 mM) was tested. Bacterial degradation of 2,2-DCP was examined through measurement of released chloride ions. The potential isolates were identified according to their 16S rDNA sequences. Two potential isolates, BB9.2 and BC14.3 were observed for their growth on 20, 50, and 80 mM 2,2-DCP. Isolate BC14.3 had the shortest cell doubling time of approximately 4.1 h with 100% 2,2-DCP (20 mM) utilization, whereas BB9.2 was only able to degrade 80% of 2,2-DCP at the same concentration. The 16S rDNA gene sequences suggested that BB9.2 and BC14.3 belong to Acinetobacter calcoaceticus and Pseudomonas plecoglossicida, respectively. @*Conclusion, significance and impact of study@#Bacterial strains with 2,2-DCP degrading potentials were successfully isolated from long-term exposed agricultural soil. They demonstrated notable utilization of the organic halide. This is the first time that strains of A. calcoaceticus and P. plecoglossicida were reported to utilize 2,2-DCP.

Effects of DCP on alcoholic fatty liver disease in rats via anti-inflammation and antioxidation / 中国药理学通报

Aim To study the effects of Dicliptera chinensis polysaccharide(DCP)on alcoholic fatty liver disease(AFLD)in rats based on anti-inflammation and antioxidation.Methods 60 rats were randomly divid-ed into six groups:control group,model group,silybin group and DCP of high,medium and low dose groups. The control group was fed with normal diet, other groups were fed with high sugar and high fat diet,and given 5% alcohol 5 mL·kg-1 by gavage.The alcohol consistency increased 5%every week until AFLD mod-els in rats were made after 7 weeks.Except control group,other groups were fed with high sugar and high fat diet,and given 35% alcohol 5 mL · kg-1 and DCP.All rats were killed after five weeks,and blood and liver tissues were collected.The activity of alanine aminotransaminase (ALT),aspartate aminotransferase (AST ), alkaline phosphatase (AKP ), triglyceride (TG),total cholesterol (TC ),low-density lipoprotein cholesterol(LDL-C)and high-density lipoprotein cho-lesterol(HDL-C)in serum were detected by using bio-chemical method. The contents of malondialdehyde (MDA),superoxide dismutase (SOD),reduced gluta-thione(GSH)in liver tissues were detected.The con-tents of tumor necrosis factor-α(TNF-α),interleukin-6 (IL-6 )and transforming growth factor-β1 (TGF-β1 ) were determined by enzyme-linked immunosorbent as-say(ELISA)in liver tissues.The liver tissues were ob-tained and histologic analysis was done through HE. Results DCP reduced the activity or content of ALT, AST,AKP,TG,TC,LDL-C,HDL-C,TNF-α,IL-6, TGF-β1 in serum and liver tissues of rats(P<0.05 ), and increased the activity or content of HDL-C,SOD and GSH (P<0.05 ).DCP could remarkably inhibit the NF-κB expression in liver tissues(P<0.01 ).The pathological examination indicated that DCP could ob-viously alleviate the inflammation and fat denaturation of the liver cells.Conclusion DCP can inhibit the de-velopment of AFLD.The mechanism may be related to antioxidation,free radical scavenging, inhibition of lipidperoxidation,anti-inflammation,and inhibition of the TGF-β1 and NF-κB expression.

40K, 226Ra AND 228Ra SERIES IN BOVINE AND POULTRY FEED AND IN DICALCIUM PHOSPHATE (DCP) SAMPLES BY GAMMA-RAY SPECTROMETRY

The aim of this study is to determine the amounts of radionuclides' activity present in samples of feed for young and adult chicken and feed for dairy and beef cattle, as well as in dicalcium phosphate (DCP) (CaHPO4), used as a nutritional supplement for animal feed. Radioactivity in these samples is due to the presence of the 238U and 232Th radioactive series, as well as their daughter. In addition, as it is for environmental samples, the activity of 40K should be an important source of radioactivity in all analyzed samples. Gamma rays were measured using a standard spectroscopy system, with a high-resolution HPGe detector. Measured activities in feed samples ranged from 0.23 to 1.51 Bq.kg-1, 0.67 to 4.21 Bq.kg-1, 0.29 to 1.63 Bq.kg-1 and 236 to 402 Bq.kg-1 for 226Ra, 228 Ra, 228 Th and 40K, respectively. Measured activities in DCP samples were 46.6 Bq.kg-1, 83 Bq.kg-1, 4.20 Bq.kg-1 and 16.61 Bq.kg-1 for 40 K, 226 Ra, 228 Ra and 228 Th, respectively. Although 40K activity has reached hundreds of Becquerel in feed samples, it should not represent a risk to human health, not even to animals, since potassium is an essential mineral to living organisms.

Novel functional roles of caspase-related genes in the regulation of apoptosis and autophagy

Caspases, a family of cysteine proteases, cleave substrates and play significant roles in apoptosis, autophagy, and development. Recently, our group identified 72 genes that interact with Death Caspase-1 (DCP-1) proteins in Drosophila by genetic screening of 15,000 EP lines. However, the cellular functions and molecular mechanisms of the screened genes, such as their involvement in apoptosis and autophagy, are poorly understood in mammalian cells. In order to study the functional characterizations of the genes in human cells, we investigated 16 full-length human genes in mammalian expression vectors and tested their effects on apoptosis and autophagy in human cell lines. Our studies revealed that ALFY, BIRC4, and TAK1 induced autophagy, while SEC61A2, N-PAC, BIRC4, WIPI1, and FALZ increased apoptotic cell death. BIRC4 was involved in both autophagy and apoptosis. Western blot analysis and luciferase reporter activity indicated that ALFY, BIRC4, PDGFA, and TAK1 act in a p53-dependent manner, whereas CPSF1, SEC61A2, N-PAC, and WIPI1 appear to be p53-independent. Overexpression of BIRC4 and TAK1 caused upregulation of p53 and accumulation of its target proteins as well as an increase in p53 mRNA levels, suggesting that these genes are involved in p53 transcription and expression of its target genes followed by p53 protein accumulation. In conclusion, apoptosis and/or autophagy mediated by BIRC4 and TAK1 may be regulated by p53 and caspase activity. These novel findings may provide valuable information that will aid in a better understanding of the roles of caspase-related genes in human cell lines and be useful for the process of drug discovery.

Fretting corrosion tests on orthopedic plates and screws made of ASTM F138 stainless steel

Introduction Although there has been significant progress in the design of implants for osteosynthesis, the occurrence of failures in these medical devices are still frequent. These implants are prone to suffer from fretting corrosion due to micromotion that takes place between the screw heads and plate holes. Consequently, fretting corrosion has been the subject of research in order to understand its influence on the structural integrity of osteosynthesis implants. The aim of this paper is to correlate the surface finish characteristics of bone plate-screw systems with fretting corrosion. Methods The surface finish (machined and polished) of five specimens taken from three commercial dynamic compression plates (DCP) were evaluated. For testing, the specimens were fixed with bone screws, immersed in a solution of 0.90% NaCl and subjected to a rocking motion with an amplitude of 1.70 mm and frequency of 1.0 Hz for 1.0 × 106 cycles, according to the ASTM F897 standard. Both, plate and screws were manufactured in Brazil with ASTM F138 stainless steel. Results Flaws on the hole countersink area and on the screw thread of some specimens were identified stereoscopically. At the end of the test all the specimens showed evidence of fretting corrosion with an average metal loss of 4.80 mg/million cycles. Conclusion An inadequate surface finish in some areas of the plates and screws may have favored the incidence of damage to the passive film, accelerating the fretting corrosion at the interfaces between the plate hole countersink and the screw head. Keywords Osteosynthesis, DCP, Bone plate, Screw, Fretting corrosion, Stainless steel.

Factores pronósticos de mortalidad en la neumonía adquirida de la comunidad en niños que requieren hospitalización

Objective: To identify predictors of mortality in CAP in children requiring hospitalization. Method: observational study, which included patients (pacientes) <16 years who were hospitalized between 2004-2008 by the NAC, distributed into two groups depending on whether they died or survived hospitalization. Demographic, clinical, laboratory, and outcome variables were compared. Comorbidity was defined in 3 categories: I (overweight, DCP I), II (congenital heart disease, Down Sx) and III (HIV, blood cancer, severe malnutrition). Univariate and multivariate analysis. Results: 341 pts were hospitalized with CAP (mean age 33.6 + 34.8 months), of which 37 (11%) died. The age <6 months (RR 0.12, CI 0.03 to 0.47, p = 0.006), presence of comorbidity II and III (RR 0.25, CI 0.14 to 0.45, p = 0.00003), hypotension (RR 0.05, CI 0.03 to 0.11, p = 0.00001), seizures (RR 0.20, CI 0.10 to 0.39, p <0.05) or Glasgow <12 (RR 0.02, CI 0.01-0.05, p = 0.00001) on admission were correlated with higher mortality. Laboratorial, the presence of GB <4000 (RR 0.21, CI 0.07 to 0.07, p = 0.02), pH <7.2, HCO3 <15 (RR 0.02, CI 0.01-0.06, p = 0.00001), O2 saturation <90% (RR 0.2, CI from 0.11 to 0.36, p = 0.0007), hyponatremia (RR 0.1, CI 0.04 to 0.23, p <0.05), and multilobar involvement were significantly more frequent in patients who died (RR 0.06, CI .02-.17, p <0005). During the clinical course, the risk of dying was correlated with the need for ARM and presence of renal insufficiency. (RR 0.04, CI 0.02-0.07, p = 0.0001) Conclusions. The mortality in CAP who are hospitalized is significant. Have been identified predisposing conditions, demographic, clinical, and developmental cabinet that are highly predictive of mortality

Objetivo: Identificar los factores pronósticos de mortalidad en NAC en niños que requieren hospitalización. Material y métodos. Estudio observacional, que incluyó a pacientes (pts) <16 años que se hospitalizaron entre 2004-2008 por NAC, distribuyéndose en dos grupos según que hayan fallecido o sobrevivido durante la hospitalización. Se compararon variables demográficas, clínicas, laboratoriales, y evolutivas. La comorbilidad se definió en 3 categorías: I (sobrepeso, DCP I), II (cardiopatía congénita, Sx de Down) y III (VIH, cáncer hematológico, desnutrición grave). Se realizó análisis univariado y multivariado Resultados. Se hospitalizaron 341 pacientes con NAC, (edad media 33,6+/-34,8 meses), de los cuales 37 (11%) fallecieron. La edad <6 meses (RR 0.12, IC 0.03-0.47, p=0.006), la presencia de comorbilidad II y III (RR 0.25, IC 0,14-0,45, p=0.00003), hipotensión (RR 0.05, IC 0.03-0.11, p=0.00001), convulsiones (RR 0.20, IC 0.10-0.39, p<0.05) o Glasgow<12 (RR 0.02, IC 0.01-0.05, p=0.00001) al ingreso se correlacionaron con mayor mortalidad. Laboratorialmente, la presencia de GB <4000 (RR 0.21, IC 0.07-0.07, p=0.02), pH<7.2, HCO3 <15 (RR 0.02, IC 0.01-0.06, p=0.00001), saturación de O2 <90% (RR 0.2, IC 0.11-0.36, p=0.0007), hiponatremia (RR 0.1, IC 0.04-0.23, p<0.05), y compromiso multilobar fueron significativamente más frecuentes en los que fallecieron (RR 0.06, IC 0.02-0.17, p<0.005). Durante la evolución clínica, el riesgo de morir se correlacionó con la necesidad de ARM y presencia de insuficiencia renal. (RR 0.04, IC 0.02-0.07, p=0.0001) Conclusión. La mortalidad en NAC que se hospitaliza es significante. Se han identificado condiciones predispo-nentes, variables demográficas, clínicas, de gabinete y evolutivas que son altamente predictoras de mortalidad.

Induction of complete courtship ritual in Amblyomma cajennense using 2,6-dichlorophenol at female-equivalent quantities / Indução dos comportamentos de cortejo em Amblyomma cajennense pelo 2,6-diclorofenol em quantidades equivalentes às das fêmeas

In order to clarify the role of 2,6-dichlorophenol (2,6-DCP) in the courtship of Amblyomma cajennense, sexually mature males that had previously fed on rabbits were tested in bioassays. The males were released onto dummies treated with whole female extract or synthetic 2,6-DCP at a concentration of two female equivalents, or with hexane (control), and their responses were observed. In the presence of both the extract and 2,6-DCP, excitation was observed among the males, expressed in the form of touching and probing the dummy, and mounting occurred readily. The percentages of mounting (73 percent) and tipping over (60 percent) were equal in the two treatments and higher than in the control group (27 and 20 percent, respectively). Relatively short durations of mounting were recorded, and these were statistically similar in all treatments. Almost all instances of mounting resulted in tipping-over behavior. A few isolated cases of males that went directly to ventral positioning without mounting were observed. It was confirmed that 2,6-DCP alone is capable of mediation of mounting behavior in A. cajennense.

Visando elucidar o papel do 2,6-diclorofenol (2,6-DCF) no cortejo de Amblyomma cajennense, machos sexualmente maduros, previamente alimentados em coelhos, foram avaliados em testes biológicos. Os machos foram liberados sobre manequins tratados com um extrato de fêmeas, ou com 2,6-DCF sintético na concentração equivalente a duas fêmeas, ou com hexano (controle), e suas respostas foram observadas. Na presença do extrato e do 2,6-DCF, a excitação dos machos foi expressa na forma de toques e sondagens, e a monta ocorreu rapidamente. As porcentagens de respostas observadas nos dois tratamentos foram iguais, sendo a monta (73 por cento) e retorno na superfície ventral (60 por cento) mais altos que no controle (27 e 20 por cento, respectivamente). Foram observados períodos de monta relativamente curtos, sendo esses estatisticamente iguais em todos os tratamentos, e quase todos resultando em posicionamento ventral. Alguns casos isolados de posicionamento ventral sem monta foram observados. Foi confirmado que o 2,6-DCP sozinho é capaz de mediar o comportamento de monta de A. cajennense.

The role of co (II) in the increased medicinal potency of glimepride analyzed by electrochemical methods.

The formation of complexes of glimepride and Co(II) was studied by polarography, The catalytic hydrogen wave of glimepiride and glimepride complex was measured at -1.36v (vs SCE) in 0.09 mol x L(-1) Na2B4O7-KH2PO4 (pH 6.24 +/- 0.1) supporting electrolyte. When 1.0 x 10(-2) mol x L(-1) K2S2O8 was present.. The polarogram indicated formation of complexes between glimepride and Fe (II). Glimepride produces a well-defined direct current polarogram and differential pulse polarogram in 0.09 mol x L(-1) Na2B4O7- KH2PO4 (pH 6.24 +/- 0.1) supporting electrolyte. When 1.0 x 10(-2) mol x L(-1) K2S2O8 was present. The stoichiometry of the Fe(II)-curcumin complex is 1 : 1. Antidiabetic studies on the drug and its metal complex have been performed more potent in antidiabetic activity compared to the parent drug.

A Finite Element Analysis of Biomechanical Stability of Compression Plate Fixation System in according to Existing of Fracture Gap after Bone Fracture Augmentation

PURPOSE: This study using the finite element analysis (FEA) focused on evaluating the biomechanical stability of the LC-DCP in accordance with existing of the fracture gap at the facture site after bone fracture augmentation. MATERIALS AND METHODS: For FEM analysis, total eleven types with different fracture models considering clinical fracture cases were constructed according to the fracture gap sizes (0, 1, 4 mm)/widths (0, 25, 50, 75, 100%). Limited contact dynamic compression plate (LC-DCP) fixation system was used in this FEM analysis, and three types of load were applied to the bone-plate fixation system: compressive, torsional, bending load. RESULTS: The results in FEM analysis showed that the 1, 4 mm fracture gap sizes and 75% or more fracture gap widths increased considerably the peak von Mises stress (PVMS) both the plate and the screw under all loading conditions. PVMS were concentrated on the center of the LC-DCP bone-plate, and around the necks of screws. CONCLUSION: Based on the our findings, we recommend at least 50% contact of the fracture faces in a fracture surgery using the compression bone-plate system. Moreover, if x-ray observation after surgery finds 100% fracture gap or 50% or more fracture gap width, supplementary measures to improve biomechanical stability must be taken, such as restriction of walking of the patient or plastering.

Effect of Fracture Gap on Biomechanical Stability of Compression Bone-Plate Fixation System after Bone Fracture Augmentation

PURPOSE: The goal of this study using the biomechanical test was to evaluate the mechanical stability of the bone-plate fixation system according to changes of the fracture gap sizes and widths. MATERIALS AND METHODS: For mechanical test, four types with different fracture models simulating the clinical situations were constructed depending on the gap size (FGS, mm) and the gap width (FGW, %) at the fracture site: 0 mm/0%, 1 mm/100%, 4 mm/100%, 4 mm/50%. For analyzing the effects of fracture gap on the biomechanical stability of the bone-plate fixation system, 4-point bending test was performed under all same conditions. RESULTS: It was found that the fracture gap sizes of 1 and 4 mm decreased mechanical stiffness by about 50~60% or more. Furthermore, even without fracture gap size, 50% or more fracture gap width considerably decreased mechanical stiffness and suggested the possibility of plate damage through strain results. CONCLUSION: Our findings suggested that at least 50% contact of the fracture faces in a fracture surgery would be maintained to increase the mechanical stability of the bone-plate fixation system.

Des-γ-carboxy prothrombin in hepatocellular carcinoma / 国际肿瘤学杂志

Des-γ-carboxy prothrombin (DCP)is produced abnormally in hepatocellular carcinoma cells. Vitamin K utilizing deficiency and the decreasing activity of vitamin K-dependent γ-glutamyl carboxylate and coenzyme may involve in production of DCP. The enzymes in bepatocellular carcinoma cells are failed in carboxylating all the ten glutamic acid residues in amino- terminus of prothrombin precursor to Gla and make the difference between DCP and prothrombin. DCP is considered to be the marker for diagnosis of hepatocellular carcinoma. DCP might also be one of the growth-promoting factors to carcinoma cells. Therefore, inhibition of DCP in hepatocellular carcinoma cells is considered to be the therapeutic method of blocking hepatocellular car-cinoma growth. Vitamin K and its analogs are found to have the functions of inhibiting hepatocellular carcinoma cell producing DCP. The mechanism may relate to the increase of γ-glutamyl carboxylase activity.

The Comparison of LC-DCP versus LCP Fixation in the Plate Augmentation for the Nonunion of Femur Shaft Fractures after Intramedullary Nail Fixation

PURPOSE: The purpose of this study was to evaluate the efficacy of the surgical treatment through the comparison of LC-DCP (Limited Contact-Dynamic Compression Plate) versus LCP (Locking Compression Plate) fixation in the plate augmentation for the nonunion of femur shaft fractures after intramedullary nail fixation. MATERIALS AND METHODS: Twenty-four patients with the nonunion of femur shaft fractures after intramedullary nail fixation who underwent plate augmentation were evaluated from Mar. 2001 to Sept. 2005. The group with LC-DCP augmentation was done bicortical screw fixation and the group with LCP was done monocortical fixation. RESULTS: There was one case of nail breakage in LC-DCP group, but sound bony union were achieved uneventfully in all the cases of both group. LCP fixation was slightly superior to LC-DCP fixation in view of the bony union time, operating time, postoperative Hb down, amount of postoperative transfusion, but there was no statistical difference (p>0.05). CONCLUSION: We got the satisfactory results after monocortical LCP augmentation as well as bicortical LC-DCP fixation and have concluded that monocortical LCP fixation was an effective treatment option for nonunion of femur shaft fracture occurred after Intrmedullary nail fixation.

Comparison of LC-DCP versus LCP for Internal Fixation of Humeral Shaft Fractures in Elderly Patient

PURPOSE: To compare outcomes of humeral shaft fractures fixed with locking compression plate and those fixed with dynamic compression plate in elderly patients. MATERIALS AND METHODS: Nineteen consecutive elderly patients with a fracture of the humeral diaphysis were evaluated retrospectively. Ten patients had been fixed with LC-DCP, and nine had been fixed with LCP. Radiological and clinical results were compared and comparison of implants was done. RESULTS: Loosening of the plate occurred in one case each from the LCP group and the LC-DCP group. The rest of the patients achieved union uneventfully without any complications. Union rate, clinical score and hardware were not significantly different between the two groups. One patient who developed loosening in the LC DCP underwent reoperation whereas one patient with loosening in the LCP was successfully managed conservatively. CONCLUSION: Principle of fracture fixation was more important than plate selection in humeral shaft fracture of elderly patient.

PIVKA-II as a Serological Marker of Hepatocellular Carcinoma / 대한간학회지

No abstract available.

The Surgical Results of Balloon Catheter Dacryocystoplasty in Both Children and Adults

PURPOSE: The purpose of this study was to evaluate the surgical results of balloon catheter dacryocystoplasty (DCP) for congenital nasolacrimal duct (NLD) obstruction in children and partial NLD obstruction in adults. METHODS: The authors performed balloon catheter DCP as a secondary treatment of eight children (nine lacrimal systems) over 12 months of age who had been failed by probing, and as a primary treatment of five adults (five lacrimal systems) whose lacrimal system was partially obstructed. In children, Lacricath was inflated at the level of the valve of Hasner and 5 mm proximal to that level, three times with eight atm (bars) for 90 seconds at each level. In adults, the procedure was the same for children, but if there is any doubt of common canalicular stenosis, inflation at that level was included. RESULTS: Seven of eight children (eight of nine lacrimal systems) and three of five adults (three of five lacrimal systems) showed objective and subjective improvement at the mean follow-up period of 5.3 months and 5.0 months, respectively. CONCLUSIONS: Balloon catheter DCP was thought to be an alternative to silicone tube intubation in children with NLD obstruction who had been failed by probing and also a useful primary treatment in adults with partial NLD obstruction in the office setting.

A Clinical Study of Comminuted Fractures of the Tibial Shaft Treated by Open Reduction and Internal Fixation with D.C.P / 대한정형외과학회잡지

The tibia is the most commonly fractured bone of all the long bones. In this age of vehicular accidents, the tibia is frequently subjected to high energy trauma. Anatomically the tibia has poor soft tissue coverage and poor blood supply. Therefore severe injury on the tibia can lead to severe complication and major disability. 41 adult patients with comminuted fracture of the tibial shaft were treated by OR/IF with D.C.P. and bone graft at the Department of Orthopedic Surgery, Kyungpook University Hospital from January 1978 to June 1986. These were analysed according to mechanism of injury, degree of comminution, timing of operation, soft tissue injury and operation time. Bone union and end results of treatment were reviewed. The results were as follows Of 41 cases, causes of injury were vehicular accident in 32 cases. 34 cases had associated injury on other part of body and average injury per case was 1.7 injuries. Based on the classification of Johner and Wruhs, the B group with butterfly fragment was 27 cases and C group was 14 cases. Among the B group, B2 was most common as 14 cases. Average union time was 18 weeks and delayed union and nonunion were 6 cases. Degree of comminution of fracture might be important fractor to bone union. According to the end result of Johner and Wruhs, excellent and good were 31, fair and poor were 10. Of the 41 cases, 10 cases had permanent disability. 4 cases had angular and rotational deformity alone and 1 case had shortening of tibia more than 1 cm, 1 case had both of them. Limited R.O.M. of ankle joint (>50%) occured in 4 cases. The post-operative infection occured in 6 cases, 3 were superficial infection but 3 cases were osteomyelitis. OR/IF with D.C.P. on comminuted tibial shaft fracture was a risk operation. Therefore proper method of treatment should be selected according to degree of comminution, timing of operation, presence or abscence of open wound and associated injury.