Purpose: We evaluated, retrospectively, twenty hips that had undergone revision surgeries because of massive pelvic osteolysis in order to determine the retention rate of acetabular metal shells and polyethylene liner exchanges.. Materials and Methods: We performed liner exchanges for massive osteolysis around stable HG acetabular cups with severe polyethylene wear in twenty-three hips, between June 1996 and May 2003. Clinical and radiological follow-up was available for 20 hips for more than 2 years. In 18 hips, we performed curettage of the granulomatous tissue and tightly packed morselized cancellous allografts into the screw holes or the peripheral rims for the acetabular osteolytic lesions. The mean follow-up period was 3.8 years (range, 2.4 to 9.3 years) and the mean of time from the primary total hip arthroplasties to the component exchanges, was 8.2 years (range, 5.6 to 12.4 years). Results: During the follow-up period, all of the hips were functioning well, and none required any subsequent repeat surgeries. Dislocations occurred three times after the repeat operations in one hip, which was treated successfully with an abduction brace. None of the hips demonstrated a progression of the pre-existing osteolytic lesions or the development of any new osteolytic lesions. At the final follow-up, none of the acetabular components demonstrated any evidence of loosening. Conclusion: Our results demonstrated that isolated liner exchanges and debridement of the granulomatous tissue, with or without bone grafting, can be an effective alternative solution to revision of the cup for massive osteolysis around well-fixed, cementless, acetabular cups in selected patients. Retention of the pre-existing cementless acetabular cup provides less intra-operative and post-operative morbidity. However, in order to determine the longevity of the retained cementless acetabular cups, further long-term studies are necessary.
Acetabulum* ; Allografts ; Arthroplasty ; Arthroplasty, Replacement, Hip ; Bone Transplantation ; Braces ; Curettage ; Debridement ; Dislocations ; Follow-Up Studies ; Hip ; Humans ; Longevity ; Osteolysis* ; Osteolysis, Essential ; Polyethylene ; Retrospective Studies ; Transplants*

The vectorcardiography was performed on 34 cases with PRWP of precordial leads. We have studied the vectorcardiographic finding for the differential diagnosis of disease entities were obtrained; 1) Poor R-Wave progression of precordial leads has simply considered as suggestion of anterior myocardial infarction, ischemic heart disease, chronic lung disease and normal variant. 2) The sensitivity and specificity of myocardial infarction criteria were 85.8% and 63.0% respectively in left sagittal plane and 85.8% and 66.7% respectively in horizontal plane. 3) The seneitively and specificity of more than 90 QRS-T vector angle in left sagittal plane were 100.0% and 62.5% respectively in ischemic heart disease and myocardial infarction. 4) The sensitively and specificity of chronic lung disease criteria were 85.7% and 51.9% respectively. 5) Vectorcardiographic study was considered as effective differentiating method for patients with PRWP in EKG.
Diagnosis, Differential* ; Electrocardiography* ; Humans ; Lung Diseases ; Myocardial Infarction ; Myocardial Ischemia ; Sensitivity and Specificity ; Vectorcardiography*

Fourteen healthy persons and 43 hypertensives were subjected to treadmill exercise testing to see responses of variable influenced by various degrees of hypertension. The hypertensive were subclassified into 3 groups, mild hypertension(diast. BP<104mmHg), moderate hypertension(diast. BP<129mmHg). 1) The attainability of maximal heart rate was inversely related with levels of basal blood pressure;92.8% of normal control group attained the maximal heart rate, 87.5% of mild hypertension, 69.2% of moderate hypertension and 66.7% of moderately severe hypertension. 2) As the exercise was geaded up, the rate of increase of heart rate was lower in higher blood perssure groups than in lower blood pressuer groups. 3) The rate and extent of rise in systolic pressure was inversely related with basal systolic pressure, the systolic pressure response being least in the group with highest pressure, that is, moderately severe hypertension group. The diastolic pressure seemed to decrease somewhat in early phase of exercise only to return back to basal level at the late phase of exercise. 4) Seven of 43 hypertensive showed significant ST depression during exercise, which may be due to imbalance between oxygen demand and supply caused sither by left ventricular hypertrophy or ischemic heart disease. 5) A case was characterized by very sluggish response in increase of heart rate despite progress in exercise grade and he fell into collase 12 minutes after the interruption of exercise. The tardy response in heart rate may be a hitherto unsuspected risk predictor in exercise test.
Blood Pressure ; Depression ; Exercise Test* ; Heart Rate ; Humans ; Hypertension ; Hypertrophy, Left Ventricular ; Myocardial Ischemia ; Oxygen

No abstract available.
Humans ; Interferon-alpha* ; Prednisolone*

A 36-year-old male patient with no remarkable medical history was admitted to our hospital for a health check up. On chest radiography, bilateral aortic notches at the level of aortic arch were shown suggesting aortic arch anomaly without any clinical symptoms. Two aortic arches were almost same-in-size on suprasternal view of transthoracic echocardiography. In addition, multidetector computed tomography showed balanced type double aortic arch forming a complete vascular ring which encircled the trachea and esophagus. The trachea was slightly compressed by the vascular ring whereas the esophagus was intact. Nevertheless, the pulmonary function test was normal. The patient was discharged from hospital with instructions for periodic follow-up.
Adult ; Aorta, Thoracic ; Echocardiography ; Esophagus ; Follow-Up Studies ; Humans ; Male ; Multidetector Computed Tomography ; Respiratory Function Tests ; Thorax ; Trachea

BACKGROUND: CATCH-22 syndrome is a common genetic disorder with features of cardiac defect, abnormal face, thymic hypoplasia, cleft palate, and hypocalcemia, along with microdeletion at chromosome 22. This study is to report twelve Korean patients with CATCH-22 syndrome diagnosed by the fluorescent in situ hybridization (FISH) method. METHOD: Clinical features were analyzed according to the FISH result and the Southern blot analysis using new probes DGCR680 and pDH-1 was performed to correlate with the clinical findings and FISH results. Twelve patients were studied by FISH method and eight of them were studied by Southern blot analysis. RESULTS: Seven patients had typical facial features for CATCH-22 syndrome, but five patients had equivocal face, although they were originally suspected to have the conotruncal face. The main cardiac lesion of eight patients were tetralogy of Fallot (TOF) and seven of them had pulmonary atresia. Two cases had other anomalies in the ventricular outflow tract, being common arterial trunk or pulmonary stenosis. Two cases had a patent arterial duct or atrial septal defect (ASD). All of twelve patients had positive result on FISH study. Among eight patients with positive FISH study, six cases were positive for Southern blot analysis. CONCLUSION: We conclude that CATCH-22 syndrome has variable facial, cardiac and genetic features, and the combined use of probes is recommended for a more accurate diagnosis.
Blotting, Southern ; Chromosomes, Human, Pair 22 ; Cleft Palate ; Diagnosis* ; DiGeorge Syndrome ; Heart Defects, Congenital ; Heart Septal Defects, Atrial ; Humans ; Hypocalcemia ; In Situ Hybridization, Fluorescence ; Pulmonary Atresia ; Pulmonary Valve Stenosis ; Tetralogy of Fallot

No abstract available.
Gene Ontology* ; Uterine Cervical Neoplasms*

BACKGROUND: Successful therapy for community-acquired pneumonia (CAP) requires appropriate empirical antimicrobial therapy based on the local microbe and resistance patterns. However, the available data on the bacterial etiology and antimicrobial susceptibility of CAP in Korea is very limited. MATERIALS AND METHODS: A nationwide prospective multicenter study of CAP in adult patients was carried out between March 2009 and February 2010. Most patients underwent detailed assessment for bacterial and viral pathogens (cultures, urinary antigen testing, serological methods and polymerase chain reaction). RESULTS: A total of 619 patients were studied. More than half (50.4%) of the patients were > or =65 years, 59.3% were males and 48.1% had underlying illness. The etiology was identified in 246 (39.7%) of the patients. The most common etiologic agent was Streptococcus pneumoniae (52 episodes, 21.1%), and the majority (36/52) of which were diagnosed by a positive urinary antigen test alone. The other common bacterial agents included Mycoplasma pneumoniae (41, 16.7%), Klebsiella pneumoniae (26, 10.6%), Chlamydia pneumoniae (13, 5.3%), Pseudomonas aeruginosa (11, 4.3%) and Staphylococcus aureus (8, 3.1%). All S. pneumoniae isolates were susceptible to penicillin with MIC of 2 microg/mL or less, only 1/16 (6.2%) was resistant to levofloxacin and 10/16 (62.5%) were resistant to erythromycin. Of the 26 K. pneumoniae isolates, 25 (96.2%) were susceptible to cefotaxime and ciprofloxacin. CONCLUSIONS: S. pneumoniae remains the most frequent pathogen in adults with CAP and this should be covered with empirical antimicrobial treatment. Atypical pathogens such as M. pneumoniae and C. pneumoniae were the second most common etiologic agents and they should be tested for. The rate of CAP caused by gram-negative bacilli such as K. pneumoniae and P. aeruginosa was high, which is similar to that of the previous Korean studies. Further study, with excluding healthcare-associated pneumonia, is needed to clarify the etiology of CAP in Korea.
Adult ; Cefotaxime ; Chlamydophila pneumoniae ; Erythromycin ; Humans ; Klebsiella pneumoniae ; Korea ; Male ; Mycoplasma pneumoniae ; Ofloxacin ; Penicillins ; Pneumonia ; Pneumonia, Bacterial ; Pneumonia, Mycoplasma ; Prospective Studies ; Pseudomonas aeruginosa ; Staphylococcus aureus ; Streptococcus pneumoniae

OBJECTIVE: The molecular pathology of cervical cancer associated with human papillomavirus infection is presently unclear. In an effort to clarify the multiple interactions of a number of genes involved in cervical carcinogenesis, the gene expression profiles and pathogenic cellular processes between human cervical squamous cell carcinoma and normal cervix were investigated by mRNA differential display and the Gene Ontology analysis. METHODS: Cervical cancer biopsies were obtained from patients at the Department of Obstetrics and Gynecology, The Catholic University of Korea. The disease status was assigned according to the International Federation of Gynecology and Obstetrics. The squamous cell carcinoma tissue samples of 3 patients invasive cancer stage II (1), IV (2) were investigated by mRNA differential display. As a control, we used a common reference that was mixed with equal amount of RNA obtained from 17 normal cervix to obtain variation- independent control. Also, we constructed hierarchical functional structures using gene ontology. Then, the specific function groups were correlated with differential gene expression profiles. In addition, specific gene expression patterns in several tissue samples were investigated by using DDRT-PCR analysis. RESULTS: Differentially expressed 191 genes were identified in tumor samples. Of these genes, 128 were up-regulated and 63 were down-regulated above 1.5-fold. The gene expression profiles were classified into 46 mutually dependent function sets and organized into sub-function sets depending on the cervical cancer pathway, suggesting the potentially significant genes of unknown function affected by carcinogenesis pathway. The genes related to metabolism, signal transduction, and chaperon activity were significantly up-regulated. In contrast, significant down-regulations were shown in nucleic acid binding activity, tumor suppressor and structural activity. Reliable gene expression data shows the validation of profiling method for studying the cervical cancer-specific pathway. CONCLUSION: The specific functions assigned to each expressed gene were correlated with gene ontology for the establishment of a powerful cervical carcinogenesis pathway. The results suggest that the differentially regulated cellular process profiles have an important impact on discovery of pathogenic pathway in human cervical squamous cell carcinoma and provide the potentially significant genes of unknown function. Also, the gene ontology analysis can overcome the complexity of the expression profiles of mRNA differential display via a cellular process level approach. Thereby, a valuable prognostic candidate gene with real relevance to disease-specific pathogenesis can be found at the cellular process levels.
Biopsy ; Carcinogenesis ; Carcinoma, Squamous Cell* ; Cervix Uteri ; Classification* ; Female ; Gene Expression Profiling ; Gene Expression* ; Gene Ontology* ; Gynecology ; Humans* ; Korea ; Metabolism ; Obstetrics ; Papillomavirus Infections ; Pathology, Molecular ; RNA ; Signal Transduction ; Transcriptome ; Uterine Cervical Neoplasms

PURPOSE: The tumor suppressor gene, p53, has been established as an essential component for the suppression of tumor cell growth. In this study, we investigated the time-course anticancer effects of adenoviral p53 (Adp53) infection on human ovarian cancer cells to provide insight into the molecular-level understanding of the growth suppression mechanisms involved in Adp53-mediated apoptosis and cell cycle arrest. MATERIALS AND METHODS: Three human cervical cancer cell lines (SiHa, CaSki, HeLa and HT3) were used. The effect of Adp53 infection was studied via cell count assay, cell cycle analysis, FACS, Western blot and macroarray assay. RESULTS: Adp53 exerts a significant role in suppressing cervical cancer cell growth. Adp53 also showed growth inhibitory effects in each cell line, and it induced apoptosis and cell cycle arrest. Adp53 differentially regulated the expression of genes and proteins, and the gene expression profiles in the SiHa cells revealed that the p21, p53 and mdm2 expressions were significantly up-regulated at 24 and 48 hr. Western blot shows that the p21 and p53 expressionlevels were significantly increased after Adp53 infection. In addition, in all cell lines, both the CDK4 and PCNA protein expression levels were decreased 48 h after Adp53 infection. Cell cycle arrest at the G1 phase was induced only in the SiHa and HeLa cells, suggesting that exogenous infection of Adp53 in cancer cells was significantly different from the other HPV-associated cervical cancer cells. CONCLUSION: Adp53 can inhibit cervical cancer cell growth through induction of apoptosis and cell cycle arrest, as well as through the regulation of the cell cycle-related proteins. The Adp53-mediated apoptosis can be employed as an advanced strategy for developing preferential tumor cell-specific delivery.
Adenoviridae* ; Apoptosis ; Blotting, Western ; Cell Count ; Cell Cycle Checkpoints ; Cell Cycle* ; Cell Line ; G1 Phase ; Genes, Tumor Suppressor ; Genetic Therapy ; HeLa Cells ; Humans* ; Ovarian Neoplasms ; Papilloma* ; Proliferating Cell Nuclear Antigen ; Transcriptome ; Uterine Cervical Neoplasms*