Fracturas del platillo tibial con hundimiento articular. Comparación entre reconstrucción con injertos óseos y sustitutos sintéticos. Revisión bibliográfica sistematizada / Depressed tibial-plateau fractures, a comparison between bone graft reconstruction and synthetic substitutes. Systematic bibliographic review / Fraturas do platô tibial com afundamento da articulação: comparação entre reconstrução com enxerto ósseo e substitutos sintéticos

Objetivo: comparar si existe diferencia en resultados clínicos, radiológicos y funcionales con el uso de diferentes tipos de injertos óseos o sustitutos sintéticos, así como tiempo quirúrgico y consolidación para el tratamiento de fracturas de platillo tibial con hundimiento articular en pacientes mayores de 18 años. Material y método: se realizó una búsqueda sistematizada en bases de datos de literatura médica, PubMed, Lilacs, Scielo, Cochrane y portal Timbó. Se utilizaron términos "tibial plateau fracture", "bone grafting", "bone substitutes". Se incluyeron estudios comparativos en seres humanos, pacientes mayores de 18 años, fracturas de platillo tibial que asociaron hundimiento articular, en los cuales se realizó aporte de injerto óseo o material sintético. Artículos en español, inglés, portugués. Publicaciones enero 1980 y diciembre 2021. Se obtuvieron 10 artículos. Resultados: los tipos de injertos y sustitutos óseos encontrados fueron 10. Las muestras en sumatoria total 524 pacientes. La edad promedio fue 49 años. El promedio de seguimiento fue de 12 meses. Se dividieron los estudios en tres grupos: comparación entre injerto autólogo (IOA) e injerto alogénico, IOA con sustitutos sintéticos, y los que comparan sustitutos sintéticos entre sí. El aloinjerto y los sustitutos sintéticos demostraron no ser inferiores en resultados clínicos, funcionales e imagenológicos, mejorando los tiempos intraoperatorios y disminuyendo complicaciones en el sitio donante con respecto al IOA. Conclusiones: el IOA continúa siendo el gold standard a pesar de sus posibles complicaciones vinculadas al sitio donante. El aloinjerto y los sustitutos sintéticos representan una opción válida para tratar estas lesiones.

Objective: to find out whether there are clinical, radiological and functional differences when using different types of bone grafts or synthetic substitutes, as well as surgical times and consolidation to treat depressed tibial-plateau fractures in patients older than 18 years old. Method: a systematized search was conducted in medical literature, PubMed, Lilacs, Scielo, Cochrane and Timbó portal databases using the following terms: "tibial plateau fracture", "bone grafting", "bone substitutes". The study included comparative studies in human patients older than 18 years old with depressed tibial-plateau fractures who were treated with bone grafts or synthetic materials. Publications in Spanish, English and Portuguese, between January, 1980 and December, 2021 were included in the search, what resulted in 10 articles found. Results: there were 10 kinds of bone grafts and bone substitutes found. Samples added up to 524 patients. Average age was 49 years old. Average follow up was 12 months. Studies were divided into 3 groups: comparison between autologous bone grafts and allogenic bone grafts, comparison between autologous grafts and synthetic substitutes and studies comparing synthetic substitutes with one another. Allogenic grafts and synthetic grafts proved at least equivalent in terms of clinical, functional and imaging studies results, improving intraoperative times and reducing complications in donor site when compared to autologous grafts. Conclusions: autologous grafts continue to be the gold standard despite possible complications associated to the donor site, and allogenic grafts and synthetic substitutes constitute a valid option to treat these lesions.

Objetivo: comparar os resultados clínicos, radiológicos e funcionais com o uso de diferentes tipos de enxertos ósseos ou substitutos sintéticos, bem como tempo cirúrgico e consolidação para o tratamento de fraturas do platô tibial com colapso articular em pacientes com mais de 18 anos. Material e método: foi realizada busca sistemática nas bases de dados da literatura médica, PubMed, Lilacs, SciELO, Cochrane e portal Timbó. Utilizaram-se os termos "tibial plateau fracture", "bone grafting", "bone substitutes". Foram incluídos estudos comparativos incluindo seres humanos maiores de 18 anos e fraturas do platô tibial associadas a colapso articular, nas quais foi realizado enxerto ósseo ou sintético, publicados entre janeiro de 1980 e dezembro de 2021 em espanhol, inglês e português. Foram obtidos 10 artigos. Resultados: foram identificados 10 tipos de enxertos e substitutos ósseos. 524 pacientes com idade média de 49 anos foram estudados. O seguimento médio foi de 12 meses. Os estudos foram divididos em 3 grupos: comparação entre enxerto autólogo (IOA) e enxerto alogênico, IOA com substitutos sintéticos e substitutos sintéticos entre si. O aloenxerto e os substitutos sintéticos mostraram-se não inferiores nos resultados clínicos, funcionais e de imagem, melhorando os tempos intraoperatórios e reduzindo as complicações da área doadora em relação à IOA. Conclusões: o IOA continua a ser o padrão ouro apesar de suas possíveis complicações relacionadas ao local doador; tanto o aloenxerto como os substitutos sintéticos representam uma opção válida para tratar essas lesões.

Clinical observation of Tuina combined with Bu Zhong Yi Qi Tang in the treatment of rectocele / 针灸推拿医学（英文版）

Objective:To observe the clinical effect of Tuina(Chinese therapeutic massage)combined with Bu Zhong Yi Qi Tang(Middle Jiao-supplementing and Qi-boosting Decoction)in the treatment of rectocele of Qi sinking due to spleen deficiency.Methods:A total of 108 patients with rectocele(grades Ⅰ and Ⅱ)were randomly divided into a Chinese medicine group and a Tuina+Chinese medicine group,with 54 cases in each group.Both groups were treated with Bu Zhong Yi Qi Tang,and the Tuina+Chinese medicine group was treated with additional Tuina manipulation.The score of clinical symptoms and grade of rectocele were observed and compared between the two groups.Results:After treatment,39 cases were cured,10 cases were effective,and 5 cases failed in the Tuina+Chinese medicine group,making a total effective rate of 90.7%.In the Chinese medicine group,26 cases were cured,16 cases were effective,and 12 cases failed,making a total effective rate of 77.8%.The efficacy difference between the two groups was statistically significant,checked by the rank-sum test(P＜0.05).After treatment,the grades of rectocele in the two groups were statistically different from those before treatment(P＜0.05),and the difference between the two groups was statistically significant(P＜0.05).After treatment,the score of each item and the total score of traditional Chinese medicine symptoms in the two groups were lower than those before treatment,and the differences within the group were statistically significant(P＜0.05).The score of each item and the total score of the Tuina+Chinese medicine group were lower than those of the Chinese medicine group,and the differences between the two groups were statistically significant(P＜0.05).Conclusion:Tuina plus Bu Zhong Yi Qi Tang has better clinical efficacy than Bu Zhong Yi Qi Tang alone in the treatment of rectocele of Qi sinking due to spleen deficiency.

Ascending， Descending， Floating and Sinking Properties of Descurainiae Semen Lepidii Semen Based on Pulmonary Edema Model / 中国实验方剂学杂志

ObjectiveThe pulmonary edema （PE） model where the disease was located in the viscera was established according to the treatment principle that patients with the disease location inside should be treated with descending and sinking medicine， combined with changes in the disease tendency， to verify the scientificity of descending and sinking properties of Descurainiae Semen Lepidii Semen （SD）， and to preliminarily elucidate the scientific connotation of descending， ascending， floating and sinking of Chinese medicine. MethodSixty male SD rats were randomly divided into normal control group， model group （20 mg·kg-1）， positive drug group （dexamethasone， 0.075 mg·kg-1） and SD low （1.167 g·kg-1）， medium （2.334 g·kg-1）and high （4.668 g·kg-1） dose groups. The PE model was established by intrapleural injection of 1% carrageenan （2 mL·kg-1）. The evaluation indexes （lung autopsy， amount of pleural effusion， number of white blood cells， lung wet/dry weight ratio， lung water content and lung permeability） were tested to determine the optimal dose of SD decoction for intervention of PE. The relevant indexes of the five major systems （central nervous system， respiratory system， circulatory system， digestive system and urinary system） closely related to the body's Qi movement were detected and changes in the disease tendency in PE rats were analyzed， to determine the descending， ascending， floating and sinking properties of SD. In addition， histopathological changes were investigated by hematoxylin-eosin （HE） staining， and types and numbers of inflammatory cells and mediators were detected to preliminarily explore the mechanism of SD in improving PE. ResultCompared with the conditions in the normal control group， the amount of pleural effusion， number of white blood cells in pleural effusion， lung wet/dry weight ratio， lung water content and lung permeability were increased （P<0.01） in the model group， where the rats presented cough， dyspnea， shortness of breath and arched back， and a small number of them had wet nose and bubble liquid in nostrils. In the autopsy of the rats in the model group， the lungs were enlarged or accompanied by congestion and plenty of pink bubble liquid appeared at the trachea. Compared with the conditions in the model group， SD reduced the amount of pleural effusion， number of white blood cells in pleural effusion， lung coefficient， lung wet/dry weight ratio and lung water content （P<0.01）， and improved pulmonary edema symptoms such as damage， inflammation and infiltration around the lumen， thickening of the trachea， and accumulation of edema fluid， and the SD medium dose group had the best effect on the treatment of PE. In terms of respiratory system， compared with the normal control group， the model group had reduced latent time of cough and asthma （P<0.05， P<0.01） and elevated number of cough and wheezing （P<0.01）. The three SD groups had increased latent time of cough and asthma and decreased number of cough and wheezing （P<0.01）. In terms of urinary system， compared with the normal control group， the model group presented decreased urine volume. The SD low， medium and high dose groups had increased urine volume （P<0.05， P<0.01）， but they had no effect on perspiration. In terms of digestive system， compared with the conditions in the normal control group， the gastric residual rate and gastrin （GT） level were increased （P<0.05， P<0.01）， and the gastric emptying rate and small intestine transit rate were decreased （P<0.01）. The SD low dose group had elevated small intestine transit rate （P<0.01）， and the SD high and medium groups had enhanced gastric emptying rate and small intestine transit rate （P<0.01）， reduced gastric residual rate， lowered GT level to promote gastrointestinal movement and transportation （P<0.01）， and increased motilin （MTL） level to promote gastric emptying in rats （P<0.05， P<0.01）. In terms of circulatory system， compared with the normal control group， the model group displayed reduced left ventricular ejection fraction （LVEF）， left ventricular short axis shortening rate （LVFS） and cardiac output （CO） （P<0.01）， and elevated tendency of heart rate， systolic blood pressure （SBP， P<0.01） and diastolic blood pressure （DBP， P<0.05）. Compared with the model group， the SD low dose group increased LVEF and decreased DBP （P<0.05）， while the SD medium dose group increased LVEF， LVFS， CO and SBP （P<0.01） and decreased DBP （P<0.05）， and the SD high dose group increased LVFS （P<0.01） and decreased SBP （P<0.01） and DBP （P<0.05）. In terms of central nervous system， compared with the conditions in the normal control group， the standing times dropped in the model group （P<0.01）. SD reduced the movement distance， movement time， standing times and activity time in the center of the open field， and increased the rest time and activity time at the edge of the open field （P<0.05， P<0.01）. Moreover， compared with the normal control group， the model group had serious inflammatory infiltration around the lung lumen， thickened trachea with accumulated edema fluid， seriously damaged lung tissue， increased number of white blood cells and percentage of neutrophils in blood （P<0.01）， elevated percentage of monocytes， interleukin-4 （IL-4）， immunoglobulin E （IgE） level and reactive oxygen species （ROS） level in lung tissue （P<0.05，P<0.01）， and decreased IFN-γ in alveolar lavage fluid （P<0.01）. Compared with the model group， SD decreased the number of white blood cells， neutrophil accumulation， pulmonary congestion and interstitial edema， IFN-γ and IL-4 levels in alveolar lavage fluid and ROS level in lung tissue， and increased IgE level （P<0.05， P<0.01）. ConclusionSD had a significant improvement effect on PE model where the disease was located in the viscera. It could regulate the excretion of water by purgation， regulate Qi movement and expel Qi stagnation by descending and sinking lung Qi， and promote purification and descent of lung qi to make Qi movement downward. This indicated SD had the descending and sinking properties. The medium dose of SD decoction exerted the best effect， and its mechanism of action might be through regulating the neutrophil inflammatory response.

Mahuang Shengmatang Based on Five Depression Syndromes in Huangdi Neijing / 中国实验方剂学杂志

Mahuang Shengmatang was first recorded in the chapter "Reverting Yin Diseases" in the Treatise on Cold Damage （《伤寒论》）. Whether it is a classic prescription created by ZHANG Zhong-jing is controversial among scholars and physicians due to its distinctiveness in contexts and drug composition. In fact， its proven efficacy in a number of clinical cases cannot be denied， and it is rather biased to judge that Mahuang Shengmatang is a fallacy of later generations. The present study pointed out that Mahuang Shengmatang was a representative in the Treatise on Cold Damage in the treatment of diseases with complicated syndromes. In this formula， although the compatibility of drugs effective in dispersion， astringing， nourishing Yin， assisting Yang， clearing heat， dissipating cold， ascending， floating， sinking， and descending seems complex， it follows certain therapeutic principles. Five depression syndromes in the Huangdi Neijing （《黄帝内经》） highly reflect the Five Elements losing the nature， and embody multiple characteristics of the five elements， such as the movement forms， functions， and disease nature. Furthermore， the corresponding treatment methods were pointed out in the Plain Questions · Major Discussion on the Progress of the Six Climatic Changes of Huangdi′s Internal Classic， including "stagnation of wood should be treated by smoothing， stagnation of fire by dispersing， stagnation of earth by attacking， stagnation of metal by dredging， and stagnation of water by inhibiting"， aiming to restore the physiological conditions of the five elements. The indicated syndromes of Mahuang Shengmatang are complex in superior-inferior， asthenia-sthenia， and cold-heat. The five depression syndromes and their treatment methods recorded in the Huangdi's Internal Classic can reflect the key syndrome pathogenesis and therapeutic principles， which are conducive to analyzing the syndrome differentiation and formulating principles of Mahuang Shengmatang. In the disease progression， impaired Yang Qi in greater Yin and inward invasion of cold pathogens in reverting Yin happen in the initial stage of indicated syndromes of Mahuang Shengmatang， with characteristics of water stagnation， earth stagnation， and wood stagnation. Furthermore， mental stagnation and fire stagnation triggered by Yang Qi accumulation in greater Yang and Yang brightness are the secondary consequences. The compatibility of five types of drugs in Mahuang Shengmatang can act on five depression syndromes in a targeted manner. Based on the five-depression theory in the Huangdi′s Internal Classic and available literature， the present study summarized syndrome pathogenesis and medication characteristics of Mahuang Shengmatang， clarified the correlation between formula and syndrome， and reviewed clinical reports in recent years， which is expected to provide references for the clinical application of Mahuang Shengmatang.

Clinical Application of Shengxiantang： A Review / 中国实验方剂学杂志

Shengxiantang， one of the classical traditional Chinese medicine （TCM） prescriptions， was developed by ZHANG Xi-chun， a well-known doctor in the Republic of China， to treat the syndrome of pectoral Qi sinking. Due to the unique herbal composition， this prescription has yielded remarkable outcomes， and it is still widely used for dealing with diseases of various systems. This paper reviewed the clinical research concerning Shengxiantang in order to provide reference for its clinical application. Following the retrieval of related articles published in the past ten years from China National Knowledge Infrastructure （CNKI）， Wanfang Data Knowledge Service Platform， Chongqing Weipu Database for Chinese Technical Periodicals （VIP）， and Chinese Biomedical Literature Service System （SinoMed） with the Chinese key words of “Shengxiantang （升陷汤）”， “sinking of pectoral Qi （大气下陷）”， “replenishing Qi and raising the sinking （益气升陷）”， and“pectoral Qi theory （大气理论）”， this paper collated the clinical application experience of Shengxiantang. To be specific， the corresponding etiology and pathogenesis， interpretations of Shengxiantang， as well as its indications， application experience and precautions were summarized to provide a basis for its further research and application. Based on the collected more than 50 representative articles， it was found that Shengxiantang has been extensively utilized for treating complex and critical diseases of various systems， especially the circulatory and respiratory diseases and organ prolapse. The research on the clinical application of Shengxiantang has deepened， exhibiting a promising development trend， which will provide new ideas for its clinical application.

Relação espacial entre o estojo córneo e a falange distal em éguas Campolina adultas com e sem obesidade / Spatial relationship between the hoof capsule and the distal phalanx in adult Campolina mares with and without obesity

A laminite endocrinopática tem acometido um número crescente de equinos com sinais de obesidade. Em um estudo recente com fêmeas jovens (até cinco anos) da raça Campolina, demonstraram-se indícios de alterações no dígito, ainda discretas, aparentemente associadas ao aumento da adiposidade. Com a hipótese de que essa associação é mais evidente em animais em faixa etária superior, o objetivo do presente estudo foi estudar éguas adultas (acima de cinco anos) da raça Campolina com e sem obesidade, avaliando-se radiograficamente a relação espacial entre estojo córneo e falange distal. Foram utilizadas 27 éguas entre seis e 14 anos de idade, sendo analisadas variáveis de adiposidade e medidas radiográficas dos cascos dos membros torácicos de equinos com escore corporal de 5 a 7/9 (grupo controle) e de 8 a 9 (grupo obeso). Foram feitas comparações entre os grupos e correlacionaram-se as variáveis de adiposidade com variáveis casco. A distância de afundamento da falange distal foi cerca de 20% superior nas éguas obesas (12,3±2,5 contra 10,2±2,2mm no grupo controle). Esse parâmetro também correlacionou (P<0,01) com vários parâmetros de adiposidade, com destaque para o escore de condição corporal (r=0,47) e a circunferência de pescoço a 75% (r=0,42). Os resultados corroboram estudos prévios que demonstraram associação entre obesidade e indícios de separação entre falange distal e estojo córneo em equinos de raças nacionais, comprovando, assim, a utilidade da avaliação radiográfica nesses animais. Em conclusão, éguas da raça Campolina com obesidade possuem alterações evidentes na relação espacial entre estojo córneo e falange distal, que se intensificam com o aumento da idade e da adiposidade.(AU)

In a recent study with young females (up to 5 years old) of the Campolina breed, there were discrete indications of alterations in the digit, apparently associated to the increase in adiposity. With the hypothesis that this association is more evident in horses in the upper age group, the objective was to study Campolina adult mares (above 5 years) with and without obesity, evaluating radiographically the spatial relationship between the horn and distal phalanx. Eighteen mares between six and fourteen years and with a body score of 5 to 7/9 (Control Group) and 8 to 9 (Obeso Group) were used. Adiposity and radiographic measurements from the forelimbs were analyzed. Comparisons were made between groups and adiposity variables were correlated with hoof variables. The sinking distance of the distal phalanx was about 20% higher in obese mares (12.3±2.5 versus 10.2±2.2mm). This parameter also correlated (P< 0.01) with several adiposity parameters, with emphasis on body score condition (r= 0.47) and neck circumference at 75% (r= 0.42). In conclusion, Campolina mares with obesity have obvious alterations in the spatial relation between the corneal and the distal phalanx, which get intense according to increases in age and adiposity.(AU)

Analysis of "sinking requires moxibustion" in / 中国针灸

"Sinking requires moxibustion", a sentence coming from : ), is one of the basic principles of moxibustion treatment. Sinking of vessel and sinking of are the two primary recognitions for the word "sinking" in ancient and modern. This paper organizes all related references comprehensively and illustrates the meaning of "sinking" in context with the expectancy of helping readers understand the classic original accurately.

Experience of GU Wei-chao in Treating Heart and Lung Diseases Through Application of Modified Shengxian Decoction / 中国中医药信息杂志

Professor GU Wei-chao is with great academic and clinical experience. He has thoughts in ZHANG Xi-chun's academic thoughts, especially his application of Zhang's theory. He added Rhodiolae Crenulatae Radix et Rhizoma, Agrimoniae Herba, Taxilli Herba, Nardostachyos Radix et Rhizoma, Corni Fructus, and Glycyrrhizae Radix et Rhizoma Praeparata cum Melle to Shengxian Decoction to make modified Shengxian Decoction to strengthen the efficacy of invigorating qi and ascending qi collapse, reinforcing heart and astringing qi, cultivating the essence and notifying kidney, and inducing resuscitation and allaying tiredness, with a purpose to treat sinking qi syndrome of heart and lung diseases and expand the application areas of Zhang's Shengxian Decoction. This article introduced experience of GU Wei-chao in treating heart and lung diseases by using modified Shengxian Decoction through three clinical cases of effusion after lung surgery, chest and heart pain and difficulties in breathing.

A Study on Psychological and Physical Health of Families of Victims One Year after the Sewol Ferry Disaster / 정신신체의학

OBJECTIVES: The purpose of this study was to assess physical illnesses, psychological difficulties, and daily life function of victims' family members one year after the Sewol ferry disaster, in order to establish a basis of strategies to promote their mental health and resilience. METHODS: We statistically analyzed self-reported data collected from a survey conducted between March 22 and 28, 2015 with 139 family members of victims. RESULTS: All respondents complained about one or more psychological difficulties, and 95.4% of them had newly diagnosed or exacerbated physical illnesses. An increased number of psychological difficulties was associated with a greater tendency to present physical illnesses including chronic headache, gastrointestinal, musculoskeletal, obstetrico-gynecological, genitourinary, and cardiovascular disease. In addition, the majority of respondents reported a decrease in life functioning. Specifically, 71.9% reported interpersonal avoidance and 63.9% reported difficulty in returning to work. CONCLUSIONS: Not only psychological trauma but also physical illness and daily functioning should be evaluated in detail and actively addressed in the bereaved family members after a catastrophe.

Psychiatric Symptoms in Teachers from Danwon High School after Exposure to the Sinking of the Motor Vessel Sewol

OBJECTIVE: The goal of this study was to describe the psychiatric symptoms in the teachers from Danwon High School who were exposed to the sinking of the Motor Vessel Sewol. METHODS: Data were collected from 32 teachers who underwent psychiatric interventions by 16 volunteer psychiatrists for 3 months after the sinking of the Motor Vessel Sewol. RESULTS: The most commonly diagnosed clinical diagnosis in the teachers were normal reaction, acute stress disorder and adjustment disorder. Psychiatric symptoms including anxiety, depressed mood and sleep disturbances were also observed. CONCLUSION: In the acute aftermath of the Sewol Ferry sinking on April 16, 2014, psychiatrists volunteered to provide professional psychiatric interventions to Danwon High School teachers. These results suggest the importance of crisis intervention focused on the teachers who are exposed to disasters. The implications for future research and interventions are discussed.

Analytic Report of Treatment Experience of GU Wei-chao in Theory of Sinking Qi for Cases ;of Chronic Diseases / 中国中医药信息杂志

GU Wei-chao has been a TCM doctor for over 50 years, with enriched learning and practicing experience. He has experience in ZHANG Xi-chun's academic thoughts, especially used Zhang’s theory of sinking qi in his medical practice. He added Rhodiolae Crenulatae Radix et Rhizoma, Agrimoniae Herba, Taxilli Herba, Nardostachyos Radix et Rhizoma, Corni Fructus, and Glycyrrhizae Radix et Rhizoma Praeparata cum Melle to Shengxian Decoction to make modified Shengxian Decoction, in order to strengthen the efficacy of invigorating qi and ascending qi collapse, cultivating the essence and notifying kidney, reinforcing heart and astringing qi, and inducing resuscitation and allaying tiredness. This article introduced GU Wei-chao using Zhang’s theory of sinking qi to strengthen the efficacy of modified Shengxian Decoction for chronic diseases by combining two medical cases of unexplained diabetes and myasthenia gravis. Therefore, this article believed that invigorating qi and ascending qi collapse method has advantages in treating chronic diseases, with worth of clinical promotion and application.

Intracerebral Hemorrhagic Infarction after Cranioplasty in a Patient with Sinking Skin Flap Syndrome / 대한신경손상학회지

The sinking skin flap syndrome (SSFS) is a rare complication after a large craniectomy. Hemorrhage infarction after a cranioplasty is a very rare complication with only 4 cases to date. We report a case of the patient who underwent an autologous cranioplasty to treat SSFS that developed intracerebral hemorrhage infarction. A 20-year-old male was admitted to our emergency department with stuporous mentality. Emergent decompressive craniectomy (DC) have done. He had suffered from SSFS and fever of unknown origin (FUO) since DC. After 7 months of craniectomy, cranioplasty was done. After 1 day of surgery, acute infarction with hemorrhagic transformation involved left cerebral hemisphere. We controlled increased intracranial pressure by using osmotic diuretics, steroid and antiepileptic drugs. After 14 day of surgery, he improved neurological symptoms and he had not any more hyperthermia. Among several complication of large cranioplasty only 4 cases of intracerebral hemorrhagic infarction due to reperfusion injury has been reported. In this case, unstable autoregulation system made brain hypoxic damage and then reperfusion and recanalization of cerebral vessels resulted in intracerebral hemorrhagic infarction. 7 month long FUO was resolved by cranioplasty.

Cognition in clinical traditional Chinese medicine by Lu Zhaolin / 国际中医中药杂志

Lu Zhaolin professor thinks,at present,according to the efficacy of traditional Chinese medicine classification method is not conducive to a comprehensive understanding and grasp of the knowledge of traditional Chinese medicine in clinical application.Understanding of the efficacy of traditional Chinese medicine,we should start from the overall regulation of drugs on the human body,and make full use of the theory closely related to traditional Chinese medicine properties such as the four properties and five tastes,ascending-descending-floating-sinking,medicinal guide,etc.Meanwhile the modern pharmacological research achievements should be taken to accurately grasp the efficacy of traditional Chinese medicine.

Laminite crônica em equídeos da raça Crioula: características clínicas e radiográficas / Chronic laminitis in Criollo horses: clinical and radiographic characteristics

Este estudo visou analisar o perfil clínico e radiológico de cavalos crioulos com laminite crônica internados na Clínica de Equinos no período de 2010 a 2011. A partir das fichas de registro, avaliações clínicas diárias e estudos radiográficos, foram computados nove equinos, cinco fêmeas e quatro machos, com idade média de 8,6±5,9 anos e período médio de internação de 104,2±91,7 dias. As fêmeas representaram 55,6% (5/9) da casuística, enquanto os machos inteiros representaram 44,4% (4/9); 22,2% (2/9) dos animais apresentaram laminite nos quatro membros, enquanto 77,8% (7/9) apresentaram laminite apenas nos membros anteriores. Quanto às causas da laminite, 11,1% foram decorrentes de endotoxemia (1/9), 44,4% (4/9) de síndrome metabólica equina e, em 44,4% (4/9), não foi possível determinar a origem. Afundamento ≥20mm da terceira falange ocorreu em 66,7% (6/9) dos animais. Apenas 11,1% (1/9) dos animais apresentaram afundamento distal unilateral. Não houve correlação entre o afundamento da coluna óssea e o grau de claudicação. Dos nove animais deste estudo, 66,7% (6/9) apresentaram rotação ≥5.5° em pelo menos um dos membros. Quanto maior o grau de rotação, maior o grau de claudicação (0.1≤r<0.5; P<0.05). Dois pacientes (22,2%) foram submetidos à tenotomia do flexor digital profundo. A resistência à insulina foi a causa predisponente a laminite mais comum neste estudo. As terapias de suporte, cuidados intensivos de enfermagem, casqueamento e ferrageamento corretivos resultaram em alta taxa de sobrevivência, permitindo que, após a alta, os animais pudessem ser mantidos com conforto sem uso de medicação.

This study aimed to analyze the clinical and radiographic profile of Criollo horses affected by chronic laminitis brought to the Equine Clinic between 2010 and 2011. Medical records, daily clinical evaluations and radiographic studies were analyzed. Data of nine horses, 55.6% (5/9) females and 44.4% (4/9) intact males with a mean age 8.6±5.9 years and 104.2±91.7 days of hospitalization were included. Laminitis occurred on all four limbs on 22.2% (2/9), while 77.8% (7/9) occurred only on the forelimbs. One out of nine cases laminites was due to endotoxemia (11.1%), 44.4% (4/9) was related to equine metabolic syndrome and on 44.4% (4/9) the cause could not be determined. Sinking of third phalanx ≥20mm identified on radiographic studies occurred on 66.7% (6/9) horses. Only 11.1% (1/9) of the animals presented unilateral sinking of the third phalanx. Sinking of the third phalanx was not correlated with the degree of lameness. Rotation of the distal phalanx (≥5.5°) on at least one member was observed in 66.7% (6/9). There was a positive correlation of the third phalanx rotation degree and the lameness degree (0.1≤r<0.5; P<0.05). Two patients (22.2%) required tenotomy of the deep digital flexor tendon. Insulin resistance was the predisposing cause laminitis most common in this study. Supportive therapy, intensive nursing care, corrective trimming and shoeing provided a high survival rate after discharge so that the animals could be kept comfortable without pain medication.

Reperfusion Injury after Autologous Cranioplasty in a Patient with Sinking Skin Flap Syndrome

The sinking skin flap syndrome is a rare complication after a large craniectomy. It consists of a sunken skin above the bone defect with neurological symptoms such as severe headache, mental changes, focal deficits, or seizures. In patient with sinking skin flap syndrome, cerebral blood flow and cerebral metabolism are decreased by sinking skin flap syndrome, and it may cause the deterioration of autoregulation of brain. We report a case of a patient with sinking skin flap syndrome who suffered from reperfusion injury after cranioplasty with review of pertinent literature.

Sinking Skin Flap Syndrome after Craniectomy in a Patient Who Previously Underwent Ventriculoperitoneal Shunt / 대한신경손상학회지

Sinking skin flap syndrome, resulting from decompressive craniectomy, is defined as a series of neurologic symptoms with skin depression at the site of cranial defect. A 61-year-old male was hospitalized with high fever and operative site swelling. He underwent decompressive craniectomy on his left side for treatment for acute subdural hematoma and traumatic intracerebral hematoma 5 years ago. Four months later, a ventriculoperitoneal shunt was performed for treatment for hydrocephalus and cranioplasty was also performed. We suspected infection at the previous operative site and proceeded with craniectomy and epidural abscess removal. Following the procedure, the depression of the sinking flap became significant, and he has suffered from right hemiparesis. We performed a shunt catheter tie at the level of the right clavicle under local anesthesia, and the patient recovered his health to his baseline. We present a patient who was successfully managed with a tie of the shunt catheter for sinking skin flap syndrome.

Bilateral Multiple Intracerebral Hemorrhagic Infarction after Cranioplasty in a Patient with Cerebral Infarction: Case Report / 대한뇌혈관외과학회지

Bilateral multiple intracranial hemorrhagic infarction after cranioplasty is an extremely rare complication. We present a case of a bilateral multiple intracranial hemorrhagic infarction following cranioplasty with an autologous bone graft. A 63-year-old woman had a previous decompressive craniectomy after a right middle cerebral artery infarction. The possible pathogenesis of the complication is discussed.

Sinking and fit of abutment of locking taper implant system

STATEMENT OF PROBLEM: Unlike screw-retention type, fixture-abutment retention in Locking taper connection depends on frictional force so it has possibility of abutment to sink. PURPOSE: In this study, Bicon(R) Implant System, one of the conical internal connection implant system, was used with applying loading force to the abutments connected to the fixture. Then the amount of sinking was measured. MATERIAL AND METHODS: 10 Bicon(R) implant fixtures were used. First, the abutment was connected to the fixture with finger force. Then it was tapped with a mallet for 3 times and loads of 20 kg corresponding to masticatory force using loading application instrument were applied successively. The abutment state, slightly connected to the fixture without pressure was considered as a reference length, and every new abutment length was measured after each load's step was added. The amount of abutment sinking (mm) was gained by subtracting the length of abutment-fixture under each loading condition from reference length. RESULTS: It was evident, that the amount of abutment sinking in Bicon(R) Implant System increased as loads were added. When loads of 20 kg were applied more than 5 - 7 times, sinking stopped at 0.45 +/- 0.09 mm. CONCLUSION: Even though locking taper connection type implant shows good adaption to occlusal force, it has potential for abutment sinking as loads are given. When locking taper connection type implant is used, satisfactory loads are recommended for precise abutment location.

Antropología de la depresión / Anthropology of depression

La depresión se caracteriza por ser un hundimiento vital en el que se sufre en todo el ser, se sufre por vivir. El hecho de la depresión es universal, pero su manifiestación sintomática es diferente en las diversas culturas. En occidente, la depresión constituye el fenómeno epidemiológico más importante, con tendencia a crecer. Podríamos decir que la frustración derivada del individualismo occidental lleva a la depresión, y ésta a la drogadicción. Estudiar, pues, la depresión nos permite comprender al hombre actual, desde su dimensión más frágil, como ser práctico y mortal.

A depressão se caracteriza por um afundamento vital, em que o ser sofre em seu todo, sofre por viver. O feito da depressão é universal, mas sua manifestação sintomática é diferente nas diversas culturas. No ocidente, a depressão constitui o fenômeno epidemiológico mais importante, com tendência a crescer. Poderíamos dizer que a frustração derivada do individualismo ocidental leva à depressão, e essa à toxicomania. Então, estudar a depressão nos permite compreender o homem atual, desde sua dimensão mais frágil, como ser prático e mortal.

Depression is characterized by a vital sinking, in which the being suffers in its entirety, suffers by living. Depression is universal, but its symptomatic manifestations differs in the many cultures. In the west, depression constitutes the most important epidemiologic phenomenon, which tends to grow. We could say that frustration derived from western individualism leads to depression, and then to drug addiction. Therefore, studying depression allows us to understand the present day's man from his most frangible dimension, as a practical, mortal being.

"Syndrome of the Sinking Skin-Flap" Secondary to the Ventriculoperitoneal Shunt after Craniectomy

The syndrome of the sinking skin flap was introduced to explain the phenomenon of neurological deterioration after decompressive craniectomy. A 37-year-old man was admitted with acute subdural hematoma and traumatic intraparenchymal hematoma. After decompressive craniectomy, the patient suffered from hydrocephalus for which a ventriculoperitoneal (V-P) shunt was inserted. Following this procedure, the depression of the skin flap became remarkable and his mentation was deteriorated. The patient recovered uneventfully after temporary elevating of valve pressure and cranioplasty. We present a patient who was successfully managed with elevation of valve pressure and cranioplasty for the syndrome of the sinking scalp flap with review of a pertinent literature.