Here, we report a case of artificial prosthesis of the knee joint combining with homogenous bone transplantation for the treatment of giant cell tumor of the right distal femur. At one year follow up, the patient complains almost no pain nor tenderness at operative site and ambulates with partial weight bearing with crutches. The X-ray finding shows satisfactory bony union with progressive bony remodelling.
Bone Transplantation ; Crutches ; Femur ; Follow-Up Studies ; Giant Cell Tumors ; Humans ; Knee Joint ; Knee ; Prostheses and Implants ; Weight-Bearing

No abstract available.
Heart Rate* ; Heart* ; Shock, Hemorrhagic*

PURPOSE: Poly-N-acetyl glucosamine(PGlcNAc) nanofiber-based materials, produced by a marine microalga, have been characterized as effective hemostatic and angiogenic agents. The similarity between PGlcNAc patch and the natural extracellular matrix allows it to support new healthy tissue growth in an injured area and to encourage fluid absorption. In this study, we hypothesized that a poly-N-acetyl glucosamine fiber patch(PGlcNAc patch) may enhance wound healing in the db/db mouse. METHODS: PGlcNAc patches were applied on one square centimeter, full-thickness, skin wounds in the db/db mouse model. Wounds(n=15 per group) were dressed with a PGlcNAc nanofiber patch for 1 hour(1h), 24 hours(24h) or left untreated(NT). After the application time, patches were removed and wounds were allowed to heal spontaneously. The rate of wound closure was evaluated by digital analysis of unclosed wound area in course of time. At day 10, wounds(n=7 per group) were harvested and quantified with immunohistochemical markers of proliferation(Ki-67) and vascularization (platelet endothelial cell adhesion molecule, PECAM-1). RESULTS: Wounds dressed with PGlcNAc patches for 1 hour closed faster than control wounds, reaching 90% closure in 16.6 days, nine days faster than untreated wounds. Granulation tissue showed higher levels of proliferation and vascularization following 1h treatment than the 24h and NT groups. In addition to its hemostatic properties, the PGlcNAc material also appears to accelerate wound closure in healing-impaired genetically diabetic mice. CONCLUSION: This material, with its combination of hemostatic and wound healing properties, has the potential to be effective agent for the treatment of complicated wounds.
Absorption ; Acetylglucosamine ; Animals ; Endothelial Cells ; Extracellular Matrix ; Glucosamine ; Granulation Tissue ; Mice ; Nanofibers ; Skin ; Wound Healing

Congenital obstuction of pulmonary vein without anomalous drainage can cause long-standing pulmonary congestion and pulmonary arterial hypertension, and it may include stenosis of individual pulmonary veinsor total pulmonary vein atresia. We reviewed seven cases of pulmonary vein obstruction, five of which accompanied other cardiac anomalies. Right pulmonary veins were involved in all seven cases including one bilateral case. Pulmonary veins were occluded totally in five and partially in three lungs. Pumonary catheterization and angiography were done for diagnosis. Chest radiographs of total occlusion cases showed decreased lung volume, features of pulmonary edema, interstitial lesions, and pleural thickening, which were quite specific, whereas pulmonry venous dilatation was dominant findings in partial obstruction cases. Pulmonary perfusion scans (n=3) showed total perfusion defects in the cases of total occlusion of veins. MR imaging (n=2) demonstrated total occlusion of pulmonary veins in the venoatrial junction in two, and membranous focal obstruction in one lung. Two patients had pneumonectomy and histological confirmation, Although catheterization and angiography are essential for the diagnosis, MR imaging is thought to be useful for the diagnosis of pulmonary vein obstruction.
Angiography ; Catheterization ; Catheters ; Constriction, Pathologic ; Diagnosis ; Dilatation ; Drainage ; Estrogens, Conjugated (USP) ; Humans ; Hypertension ; Lung ; Magnetic Resonance Imaging ; Perfusion ; Pneumonectomy ; Pulmonary Edema ; Pulmonary Veins* ; Radiography, Thoracic ; Veins

Seventeen cases of cancers in and adjacent to the pancreas were studied by high resolution and wide field realtime ultrasonographic scanner with 3.5MHz linear array electronically focusing transducer. The results were asfollows; 1. In a total of 17 cases, 7 cases were pancreatic cancers and the rests were 3 cases of ampulla of Vatercancers, 3 cases of distal CBD cancers, and 4 cases of metastatic cancers, respectively. 2. Pancreatic cancerswere located mainly in head portion, and metastatic cancers were noted in head, tail, and retropancreatic areas.3. The sized of all distal CBD cancer were less than 1.8cm, usually smaller than other tumors, and the size ofmetastatic cancers were variable (1-6cm). 4. The shape, margin, contour and echogenicity of the tumors werevariable. 5. Pancreatic duct showed marked dilatation in one of pancreatic cancer, and mild dilatation in one ofampullar of Vater cancer. 6. The caliber of extrahepatic duct were moderately or markedly dilated in nearly allcases except 2 cases of pancreatic body cancer. 7. The pancreatic margin is partially obliterated in pancreaticand ampulla of Vater cancers but not in distal CBD cancer. 8. Gallbladder enlargement is secondary change due tothe obstruction of extrahepatic bile duct. 9. Effects on the vessles are due to not only direct mass effect butdirect invasion resulting in obliteration. The most commonly involved vessels are spleno-portal junction, splenicvein and portal vein. In case of pancreatic cancer in uncinated process, the superior mesenteric vessels aredisplaced anteriorly. 10. Surrounding metastatic lesions were suspected in pancreatic and ampulla of Vater cancer,but not seen in distal CBD cancer. 11. Ascites were seen in only two cases of metastasis.
Ampulla of Vater ; Ascites ; Bile Ducts, Extrahepatic ; Diagnosis ; Dilatation ; Gallbladder ; Head ; Neoplasm Metastasis ; Pancreas ; Pancreatic Ducts ; Pancreatic Neoplasms ; Portal Vein ; Tail ; Transducers

BACKGROUND: The cross-matching test is regarded as an essential pre-transfusion test. It serves an important role in confirming the ABO/Rh compatibility of transfusion and screening for possible unexpected antibodies. We evaluated cross-matching tests in QWALYS-3 (DIAGAST, Loos Cedex, France), comparing the automated process to manual tube methods. METHODS: A total of 545 crossmatching tests from 169 patients, collected from RBC concentrate transfusion orders, were performed using both QWALYS-3 and manual tube methods. All patients were follow-up tested later on with antibody identification tests to confirm the presence of unexpected antibodies in plasma. RESULTS: None of the samples were ABO/Rh incompatible. The presence of unexpected antibodies was later confirmed in 277 tests in 56 patients. Out of those 277 tests, the concordance rate between two methods was 83.8% (232/277). In 268 tests which were later confirmed with no unexpected antibodies, manual tube methods did not show any positive results while five tests were false-positive (5/268, 1.9%) only in QWALYS-3. The overall concordance rate between two methods was 90.82%, and the kappa coefficient was 0.696 (P<0.05) (n=545). CONCLUSION: The QWALYS-3 system has its merits in accuracy, precision, and lack of possible human errors, however, the automated procedure showed some disadvantages, including relatively low cost-and-time-effectiveness, less effective cold antibody detection, and difficulties in handling small quantity samples. Thus, the QWALYS-3 system has meaningful, but only a limited value in the automation of routine cross-matching tests.
Antibodies ; Automation ; Blood Banks* ; Follow-Up Studies ; Humans ; Mass Screening ; Plasma

The radiofrequency has been used for percutaneous cordotomy in patient having intractable pain. Recently the use of this radiofrequency has been extended to include other neurosurgical procedures, which in the past were done with chemical agents or mechanical methods etc. We treated one case of trigeminal neuralgia with the radiofrequency. The gasserian ganglion was punctured through the foramen ovale using a modified Hartel technique and the radiofrequency lesion was made in the second and third branches of the right trigeminal nerve selectively. The postoperative result was satisfactory. We reviewed the literature and described the technical procedures and complications.
Cordotomy ; Foramen Ovale ; Humans ; Neurosurgical Procedures ; Pain, Intractable ; Trigeminal Ganglion ; Trigeminal Nerve ; Trigeminal Neuralgia*

We have seen a primitive glioma which can be regarded as ependymoblastoma arising at the left frontal lobe of four-year-old boy. He has complained of excitement, hyperesthesia, mild incomplete paralysis of the left lower extremity for 1 1/2 months, and also incontinence of urine and stool was complained. The signs of increased intracranial pressure such as papilledema and separation of suture line were noted. Brain scanning showed tumor mass at the left frontal lobe, and which was revealed to be vascular tumor on carotid angiogram and delta wave was found at those area by electroencephalogram. Operative findings were that the tumor was hemorrhagic vascular mass showing partly cystic and necrotic in appearance, not bulged above outer surface and not connected with ventricle. The tumor mass measured 6x5x4cm which cut surface was pinkish white and focal necrotic areas were also seen. On microscopic examination the tumor was composed of relatively uniform primitive glial cells and the tumor cells arranged in perivascular area forming multiple layers while other region showed well formed tubules. Fibrillated cytoplasmic process between central vessel and glial cells that could be seen in matured ependymoma was not identified.
Brain ; Cytoplasm ; Electroencephalography ; Ependymoma ; Frontal Lobe ; Glioma ; Humans ; Hyperesthesia ; Intracranial Pressure ; Lower Extremity ; Male ; Neuroectodermal Tumors, Primitive* ; Neuroglia ; Papilledema ; Paralysis ; Sutures

Recent studies have shown that side population (SP) cells, isolated from adult myocardium, represent a distinct cardiac progenitor cell population that exhibits functional cardiomyogenic differentiation. However, information on the intrinsic characteristics and endothelial potential, of cardiac SP cells, is limited. The present study was designed to investigate whether cardiac SP cells exhibit endothelial differentiation potential. The cardiac SP cells more highly expressed the early cardiac transcription factors as well as endothelial cell markers compared to the bone marrow-SP cells. After treatment with VEGF, for 28 days, cardiac SP cells were able to differentiate into endothelial cells expressing von Willebrand factor as determined by immunocytochemistry. Furthermore, expression of endothelial cell markers increased several-fold in VEGF-treated cardiac SP cells compared to the control group when assessed by real-time PCR. We also confirmed that cardiac SP cells provided a significantly augmented ratio of ischemic/normal blood flow, in the cardiac SP cell-transplanted group compared with saline-treated controls on postoperative days 7, 14, 21 and 28, in a murine model. These results show that cardiac SP cells may contribute to regeneration of injured heart tissues partly by transdifferentiation into angiogenic lineages.
Animals ; Base Sequence ; Bone Marrow Cells/cytology/drug effects ; Cell Differentiation/drug effects ; Cell Separation ; Colony-Forming Units Assay ; DNA Primers/genetics ; Endothelial Cells/*cytology/drug effects/metabolism/transplantation ; Mice ; Mice, Inbred BALB C ; Myocardium/*cytology/metabolism ; Vascular Endothelial Growth Factor A/pharmacology

PURPOSE: To evaluate the radiological and clinical outcomes of the standard total knee arthroplasty without internal fixation or extended long stem in tibial bone defect with severe varus deformity. MATERIALS AND METHODS: Between July 2012 and April 2014, 32 patients (45 cases; 4 men and 41 women with a mean age of 74.2 years) who underwent total knee arthroplasty with autologous bone grafting were enrolled for analysis. The mean follow-up period was 34.4 months. The cancellous bone defect site was exposed, and a longitudinal sulcus was made. Subsequently, a premolded bone graft was inserted in the sulcus at 45°. The defect size was measured, and the radiological and clinical results were evaluated. RESULTS: The mean defect size according to the radiograph was found to be 15.31×30.36 mm in the frontal view and 15.46×45.98 mm in the sagittal view. The mean defect size of depth during the operation was found to be 8.38 mm. The preoperative mean varus angle was 14.1° (4.0°–26.9°), and the follow-up mean valgus angle was 5.4° (0.5°–10.5°). The implant position was α=95.7°, β=90.4°, γ=2.1°, δ=89.1° on the follow-up. No implant loosening was observed, and the mean bone union period was 4.3 months. The Hospital for Special Surgery score was improved from a preoperative mean of 50.1 to a postoperative mean of 90.4. CONCLUSION: Standard total knee arthroplasty using autologous structural bone grafting without internal fixation in a tibial bone defect demonstrated a rapid, stable bone healing and excellent radiological and clinical results. Thus the index procedure was considered to be simple, and effective for bone grafting.
Arthroplasty, Replacement, Knee* ; Bone Transplantation ; Congenital Abnormalities ; Female ; Follow-Up Studies ; Humans ; Male ; Transplants*