Purpose: To compare the results of arthroscopic rotator cuff repair and subacromial decompression in partial thickness rotator cuff tear (PTRCT) with those in full thickness rotator cuff tear (FTRCT). Subjects and method: Of the 46 patients who were rested of the rotator cuff tear based on the operational findings, 42 patients who were able to receive a serial follow-up for 2 years were selected as the study subjects. The average age of the patients at the time of the operation was 55 years, and the mean duration of the follow-up was 34 months. The subjects included 22 cases of PTRCT and 20 cases of FTRCT. In terms of rotator cuff repair, the average number of tendon to tendon repair (TTR) was 1 in both PTRCT and FTRCT, and that of tendon to bone repair (TBR) was 1 and 3 in PTRCT and FTRCT, respectively. The average number of use of suture anchor was 1 and 2 in PTRCT and FTRCT, respectively. The level of shoulder pain and function of the subjects were measured using shoulder functional evaluation score of American shoulder and elbow society (ASES score) at before and 2 years following the operation. Results: At the final follow-up following the operation, PTRCT group showed changes in scores from 7.2 to 0.9 on average pain score and 34 to 91 on ASES score, whereas FTRCT group showed changes in scores from 7.6 to 1.2 on pain score and 29 to 88 on ASES score. There were no significant differences between the two groups (P > 0.05). The average range of motion of shoulder significantly increased in both groups at the final follow-up in comparison with the pre-operative time point. The evaluation at the final follow-up showed that 93% of the total subjects showed good or excellent results, and 95% showed satisfactory results from the procedure with regard to pain reduction and functional outcomes. Two cases of the 3 fair results were caused by acromioclavicular arthritis. Conclusion: It may be anticipated that arthroscopic rotator cuff repair and subacromial decompression may bring satisfactory post-operative outcomes in both PTRCT and FTRCT on pain relief and functional recovery. However, careful preoperative examination of the acromioclavicular joint is critical to avoid failures of these procedures.
Kim, Young-Ki;Lee, Seung-Yong;Park, Se-Jin;Lee, Scott-S.;Kim, Jin-Hyun;Lee, Hee-Chun;Chang, Hong-Hee;Lee, Hyo-Jong;Yeon, Seong-Chan
Journal of Veterinary Clinics
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v.28
no.1
/
pp.122-127
/
2011
A 5-year old, intact male, Cocker spaniel dog was referred with paraplegia and loss of deep pain perception. Physical, neurological examinations, radiography, and computed tomography were evaluated. Based on the clinical examinations, the dog was diagnosed with severe disc herniation ($L_2$ to $L_3$ intervertebral disc space). On the next day of presentation (6 days after loss of deep pain perception), hemilaminectomy was performed. After decompression of spinal cord and removal of herniated disc materials, $1{\times}10^6$ canine allogenic adipose tissue-derived mesenchymal stem cells (MSCs) diluted by $50{\mu}l$ saline were directly applied to the injured site of the spinal cord. Ten weeks of follow-up after surgery, full recovery of deep pain perception and motor function were evaluated in both hind limbs. Based on the result, we suggest that the transplantation of allogenic adipose tissue-derived MSCs to dogs with spinal cord injuries could be a considerable method to expect better clinical outcomes in veterinary practice.
Ham, Sang-Soo;Jang, Yoon-Young;Song, Jin-Ho;Lee, Hyang-Mi;Kim, Kwang-Joon;Hong, Jun-Sik;Shin, Yong-Kyoo
The Korean Journal of Physiology and Pharmacology
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v.4
no.6
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pp.515-523
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2000
Polymorphonuclear leukocytes (PMNs) play an important role in myocardial ischemia/reperfusion (MI/R) injury. Moreover, platelets are also important blood cells that can aggravate myocardial ischemic injury. This study was designed to test the effects of PMNs and platelets separately and together in provoking cardiac dysfunction in isolated perfused rat hearts following ischemia and reperfusion. Additional control rat hearts were perfused with $75{\times}10^6$ PMNs, with $75{\times}10^6$ platelets, or with $75{\times}10^6\;PMNs+75{\times}10^6$ platelets over a five minute perfusion followed by a 75 min observation period. No significant reduction in coronary flow (CF), left ventricular developed pressure (LVDP), or the first derivative of LVDP (dP/dt max) was observed at the end of the observation period in any non-ischemic group. Similarly, global ischemia (I) for 20 min followed by 45 minutes of reperfusion (R) produced no sustained effects on the final recovery of any of these parameters in any group of hearts perfused in the absence of blood cells. However, I/R hearts perfused with either PMNs or platelets alone exhibited decreases in these variables of $5{\sim}10%$ (p<0.05 from control). Furthermore, I/R hearts perfused with both PMNs and platelets exhibited decreases of 50 to 60% in all measurements of cardiac function (p<0.01). These dual cell perfused I/R hearts also exhibited marked increases in cardiac myeloperoxidase (MPO) activity indicating a significant PMN infiltration, and enhanced P-selectin expression on the coronary microvascular endothelium. All cardiaodynamic effects as well as PMN accumulation and P-selectin expression were markedly attenuated by a recombinant soluble PSGL-1 which inhibits selectin mediated cell adhesion. These results provide evidence that platelets and PMNs act synergistically in provoking post-reperfusion cardiac dysfunction, and that this may be largely due to cell to cell interactions mediated by P-selectin. These results also demonstrate that a recombinant soluble PSGL-1 reduces myocardial reperfusion injury by platelet and PMNs interaction.
Objective : This study was undertaken to evaluate the effect of Sunghyangchungisan (SHCS) on the regulation of vascular tone and $Ca^{2+}$ metabolism in arterial tissues. Vascular rings isolated from rabbit carotid artery were myographed isometrically in isolated organ baths and the effect of SHCS on contractile activities, endothelial function and $Ca^{2+}$ metabolism were determined. Methods : In phentobarbital sodium-anesthetized rabbits, SHCS administered through ear vein (100 mg/Kg body wt.) or intragastric dwelling tube (300 mg/Kg body wt.) attenuated phenylephrine (PE, 10 ${\mu}g$/Kg, i.v.)-induced increases in both systolic and diastolic cartoid arterial blood pressure. Results : In experiments with isolated arterial strips, SHCS relaxed arterial rings which were pre-contracted by phenylephrine (PE, 1 ${\mu}M$). The responses to SHCS were partially dose-dependent at concentrations lower than 0.5 mg/ml. When SHCS was applied prior to the exposure to PE, it inhibited the PE-induced contraction by a similar magnitude which was comparable to the relaxation of pre-contracted arterial rings. Washout of SHCS after observing its relaxant effect resulted in a full recovery of PE-induced contractions, indicating that the action mechanism is reversible. The observation that SHCS did not change the $ED_{50)$ of PE oh its dose-response curve ruled out the possible interaction of SHCS with ${\alpha}$-receptors. The relaxant effect of SHCS was not affected by removal of endothelium or a nitric oxide synthase inhibitor, L-NAME. Methylene blue, an inhibitor of the soluble guanylate cyclase, did not affect the relaxant effect of SHCS. These results suggest that the action of SHCS is not mediated by the endothelium nor soluble guanylate cyclase. Constant cGMP production determined in arterial strips in the presence or absence of SHCS is consistent with this conclusion. When contraction was induced by additive application of $Ca^{2+}$ in arterial rings which were pre-depolarized by high $K^+$ in a $Ca^{2+}$-free solution, the relaxant effect of SHCS was attenuated by increasing the $Ca^{2+}$ concentration. SHCS, when applied to the arterial rings pre-contracted by PE and then relaxed by nifedipine, a $Ca^{2+}$ channel blocker, did not show additive relaxation. SHCS partially blocked $Ca^{2+}$ influx stimulated by PE and high $K^+$ which was determined by 5-min ^{45}Ca$ uptake, while it did not affect $Ca^{2+}$ efflux. Conclusions : From above results, it is suggested that SHCS relax PE-induced contraction of rabbit carotid artery in an endothelium independent manner, andinhibition of $Ca^{2+}$ influx may contribute to the underling mechanism.
Kim, Seung-Ho;Ha, Kwon-lck;Park, Jong-Hyuk;Kang, Jin-Seok;Oh, Sung-Kyun;Oh, Ir-Vin;Yoo, Jae-Chul
Clinics in Shoulder and Elbow
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v.5
no.2
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pp.88-97
/
2002
The purpose of this study was to compare the outcomes between arthroscopir repair and mini-open repair of medium and large rotator cuff tears in which arthroscopic repair was technically unsuccessful. We evaluated 76 patients of full-thickness rotator cuff tears, among them 42 patients had all-arthroscopic and 34 patients had mini-open salvage repairs. Patients who had acromioclavicular arthritis, subscapularis tear, or instability were excluded. There were 39 males and 37 females with mean age of 56 years (range,42 to 75 years). At a mean follow-up of 39 months (range, 24 to 64 months), the results of both groups were compared with regard to the UCLA and ASES shoulder rating scale s. Shoulder scores improved in all ratings in both groups (p > 0.05). Overall, sixty-six patients showed excellent or gr)of and ten patients showed fair or poor scores by the UCLA scale. Seventy-two patients satisfactorily returned to prior activity. Four showed unsatisfactory return. The range of motion, strength, and patient's satisfaction were improved postoperatively. There were no difference in shoulder scores, pain, and activity return between the arthroscopic and mini-open salvage groups (p > 0.05). However, Patients with larger size tear showed lower shoulder scores and less predictive recovery of the strength and function (p < 0.05). Postoperative pain was not different with respect to the size of the tear (p : 0.251). Arthroscopic repair of medium and large full-thickness rotator cuff tears had iln equal outcome to technically unsuccessful arthroscopic repairs, which were salvaged by conversion to a mini- open repair technique. Surgical outcome depended on the size of the tear, rather than the method of repair.
Journal of Korean Academy of Fundamentals of Nursing
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v.4
no.1
/
pp.43-60
/
1997
This study was to identify the nursing intervention method in finding out the incidence, risk factor, prevention and treatment of bed sore cilents who received regional home care nursing services. The eleven home care nurse practitioners took the survey on 97 patients who received home care nursing service from Seoul City Nurses Association for one month from September 26 to October 26 1996. A modified version of Braden's bed sore assessment tool for bed sore risks and a tool for assessment of bed sore stage and measurement bed sore sizes by Bergstrom, Braden, Laguzza and Holman(1987) were as research tools for this study and a questionnare with 40 questions and 12 items on nursing activities was used to find out the prevention and treatment of bed sores. Also, two open ended questions were used on current approaches and efforts of the treatment being applied to clients. The finding of the study were summarized as following : 1. The rate of bed sore occurrence was 47.4% 2. The areas of bed sore occurrence were hip(28.9%), sacrum(18.6%), great trochanter(14.4%) and the average number of sore spots were 2.26 3. Two groups-one with bed sores and the other without-were studied to determine prediction factors for bed sore risks. Sensory function, humidity, level of activity, mobility, nutrition, skin friction and chapping and body temperature turned out to be statistically significant factors for bed sores. Also the age of clients turned out to be a individual characteristic variable significantly affecting the rate of bed sore occurrences. 4. The education for clients and family on systematic skin assessment and bed sores and practice of active/passive R.O.M. are mainly used as nursing activities for bed sore care. 5. The treatment method varied by stages of bed sores. Sometimes folk remedies like applying the powders of dried elm tree roots to sores were used. Good nutrition, frequent position change and skin care turned to be the most effective means to fast recovery of sores.
Apoptosis is a physiologic or programmed cell death process which is controlled by genes. It is essential for the function and the appropriate development of multicellular organism. It is also thought to be one of the main mechanisms of cell death in ischemic tissues. The effect of prostaglandin $E_1$($PGE_1$) is proven to be useful in the recovery of ischemic changes by inducing vasodilation of peripheral vessels and platelet disaggregation. $PGE_1$ is also known to suppress apoptosis in human liver sinusoidal endothelial cell from ischemia-reperfusion injury. The purpose of this study is to evaluate the effects of $PGE_1$ on the apoptosis in the ischemia reperfusion injury of rat intestine. Thirty Sprague-Dawley rats were used. In control group(N=15), superior mesenteric artery was occluded for 60 minutes and after removing the vessel clamp, it was reperfused for 60 minutes and harvested. In experimental group(N=15), a jejunal flap was also made as in the control group except for the intraarterial administration of the $PGE_1$ right after clamping the artery and removing the clamp. H&E, TUNEL and immunohistochemical stains for p53, bax, and bcl-2 were performed. There were ischemic changes in gross and microscopic findings in both groups. The apoptotic index was significantly lower in the experimental group($1.29{\pm}0.82$(p=0.003)) than in the control group ($2.33{\pm}0.95$). The rat intestinal ischemia apoptosis by ischemia-reperfusion was partly related to the modulating of bcl-2, bax, and p53 expression. Our results indicate that $PGE_1$ suppresses the apoptosis in the ischemic jejunal flap and this effect is probably the result of a increase in expression of bcl-2.
Nam, Han Ga Wi;Hwang, Hyung Sik;Moon, Seung-Myung;Shin, Il Young;Sheen, Seung Hun;Jeong, Je Hoon
Journal of Trauma and Injury
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v.26
no.3
/
pp.131-138
/
2013
Purpose: The aim of this study is to present a retrospective review of patients who had a sudden onset of facial palsy after trauma and who underwent facial nerve decompression. Methods: The cases of 25 patients who had traumatic facial palsy were reviewed. Facial nerve function was graded according to the House-Brackmann grading scale. According to facial nerve decompression, patients were categorized into the surgical (decompression) group, with 7 patients in the early decompression subgroup and 2 patients in the late decompression subgroup, and the conservative group(16 patients). Results: The facial nerve decompression group included 8 males and 1 female, aged 2 to 86 years old, with a mean age of 40.8. In early facial nerve decompression subgroup, facial palsy was H-B grade I to III in 6 cases (66.7%); H-B grade IV was observed in 1 case(11.1%). In late facial nerve decompression subgroup, 1 patient (11.1%) had no improvement, and the other patient(11.1%) improved to H-B grade III from H-B grade V. A comparison of patients who underwent surgery within 2 weeks to those who underwent surgery 2 weeks later did not show any significant difference in improvement of H-B grades (p>0.05). The conservative management group included 15 males and 1 female, aged 6 to 66 years old, with a mean age of 36. At the last follow up, 15 patients showed H-B grades of I to III(93.7%), and only 1 patient had an H-B grade of IV(6.3%). Conclusion: Generally, we assume that early facial nerve decompression can lead to some recovery from traumatic facial palsy, but a prospective controlled study should and will be prepared to compare of conservative treatment to late decompression.
Kim, Soon-Hee;Lee, Joon-Hyun;Seo, Kyoung-In;Ryu, Boyeong;Sung, Yongju;Chung, Taijoon;Deng, Xing Wang;Lee, Jae-Hoon
Molecules and Cells
/
v.37
no.11
/
pp.833-840
/
2014
Cullin4-RING ubiquitin ligase (CRL4) is a family of multi-subunit E3 ligases. To investigate the possible involvement of CRL4 in heat stress response, we screened T-DNA insertion mutants of putative CRL4 substrate receptors that exhibited altered patterns in response to heat stress. One of the mutants exhibited heat stress tolerance and was named heat stress tolerant DWD1 (htd1). Introduction of HTD1 gene into htd1-1 led to recovery of heat sensitivity to the wild type level, confirming that the decrease of HTD1 transcripts resulted in heat tolerance. Therefore, HTD1 plays a negative role in thermotolerance in Arabidopsis. Additionally, HTD1 directly interacted with DDB1a in yeast two-hybrid assays and associated with DDB1b in vivo, supporting that it could be a part of a CRL4 complex. Various heat-inducible genes such as HSP14.7, HSP21, At2g03020 and WRKY28 were hyper-induced in htd1-1, indicating that HTD1 could function as a negative regulator for the expression of such genes and that these genes might contribute to thermotolerance of htd1-1, at least in part. HTD1 was associated with HSP90-1, a crucial regulator of thermotolerance, in vivo, even though the decrease of HTD1 did not affect the accumulation pattern of HSP90-1 in Arabidopsis. These findings indicate that a negative role of HTD1 in thermotolerance might be achieved through its association with HSP90-1, possibly by disturbing the action of HSP90-1, not by the degradation of HSP90-1. This study will serve as an important step toward understanding of the functional connection between CRL4-mediated processes and plant heat stress signaling.
Cardiovascular disease (CVD) and its complications are the leading cause of morbidity and mortality in the world. Because of the side effects and incomplete recovery from current therapy, stem cell therapy emerges as a potential therapy for CVD treatment, and endothelial progenitor cell (EPC) is one of the key stem cells used for therapeutic applications. The effect of this therapy required the expansion of EPC function. To enhance the EPC activation, proliferation, and angiogenesis using dronedarone hydrochloride (DH) is the purpose of this study. DH received approval for atrial fibrillation treatment and its cardiovascular protective effects were already reported. In this study, DH significantly increased EPC proliferation, tube formation, migration, and maintained EPCs surface marker expression. In addition, DH treatment up-regulated the phosphorylation of AKT and reduced the reactive oxygen species production. In summary, the cell priming by DH considerably improved the functional activity of EPCs, and the use of which might be a novel strategy for CVD treatment.
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