This study was performed to observe the therapeutic effects of interferon-gamma(IFN-gamma) and gamma-globulin(gamma-globulin) in experimental Pneumocystis carinii pneumonia of immune suppressed mice. After 9 weeks, trimethoprim-sulfamethoxazole(TMP-SMZ; 10-50 mg/mouse/day), mouse IFN-gamma(5 x 10(4) units/mouse/day) and mouse gamma-globulin(20 mg/mouse/day) were administered to the mice for 3 weeks by the experimental group. The therapeutic efficacy was evaluated by body weights, histopathologic and electron microscopic findings of the lungs, and number of P. carinii cysts by Gomori's methenamine silver stain. Body weights of the mice were significantly increased in the group of combination therapy of TMP-SMZ with IFN-gamma or gamma-globulin, and in the group of TMP-SMZ treatment (p < 0.05), however, little effect was found in the group of gamma-globulin alone. Histopathologic findings of P. carinii pneumonia were much improved in the group of combination therapy of TMP-SMZ with IFN-gamma. Treatment with either TMP-SMZ or IFN-gamma significantly reduced the number of cysts in the P. carinii pneumonia, but gamma-globulin alone was ineffective. In electron microscopic findings of P. carinii pneumonia, the number of trophozoites and cysts were reduced by treatment with either TMP-SMZ or IFN-gamma, and most of the cysts were empty or containing one or two intracystic bodies. The present results suggested, that combination therapy of TMP-SMZ with IFN-gamma had synergistic effects in treatment of P. carinii pneumonia in experimental mice.
Drug-Synergism ; Drug-Therapy,-Combination ; English-Abstract ; Gamma-Globulins-administration-and-dosage ; Interferon-Type-II-administration-and-dosage ; Mice- ; Trimethoprim-Sulfamethoxazole-Combination-administration-and-dosage ; *Gamma-Globulins-therapeutic-use ; *Interferon-Type-II-therapeutic-use ; *Pneumonia,-Pneumocystis-carinii-therapy ; Gamma-Globulins ; Trimethoprim-Sulfamethoxazole-Combination ; Interferon-Type-II

p27kip1, a cyclin dependent kinase inhibitor, has been recognized as a negative regulator of cell cycle. To investigate the role of p27kip1 on progression of cancer and apoptotic pathway, we analyzed p27kip1 expression using immunohistochemical stain in 40 cases of prostatic adenocarcinoma and apoptotic index by TUNEL method in 30 cases of prostatic adenocarinoma. Both were correlated with Gleason grade and Gleason score. Loss of p27kip1 expression was more frequent in prostatic adenocarcinomas of higher score (Gleason score 7 to 10) (60.7%) than in those of lower score (Gleason score 4 to 6) (33.3%) (p<0.05). The value of mean apoptotic index of carcinoma was 1.13+/-0.26, 1.80+/-0.91, 2.06+/-0.79, and 2.12+/-0.82 in grade 2, 3, 4, and 5, respectively, and was positively correlated with grade of carcinoma (p<0.05). Mean apoptotic index of higher Gleason score (score 7 to 10; 2.05+/-0.63) was also significantly increased than in lower Gleason score (score 4 to 6; 1.34+/-0.39) (p<0.05). Mean apoptotic index in cases with and without p27kip1 expression was 1.92+/-0.86 and 1.89+/-0.81, respectively (p>0.05). These results suggest that loss of p27kip1 expression and increased apoptotic index may be the morphologic markers to predict the behavior of prostatic adenocaricnoma. The role of p27kip1 on apoptotic pathway seems to be meager in this study and needs further study.
Adenocarcinoma* ; Cell Cycle ; Cyclins ; In Situ Nick-End Labeling ; Neoplasm Grading ; Phosphotransferases

Focal segmental glomerulosclerosis is the renal histopathologic lesion observed in 10% of children with idiopathic nephrotic syndrome. Complications include infection, thrombosis, hypocalcemia and adverse effect of steroid use. The incidence of thrombosis reported ranges from 10~40%. The pathogenesis are changes in coagulation system, decrease of Antithrombin III, increase platelet aggregability and steroid or diuretics use. These changes take place passively as a result of increased protein synthesis and urinary loss of low molecular weight protein. We experienced a case of cerebral infarction due to thrombosis associated with focal segmental glomerulosclerosis and steroid resistant nephrotic syndrome in a 11 year old male patient who had been hospitalized because of convulsion and semicoma. MRI showed an evolving infarct in the occipital lobe, decreased antithrombin III and increased factor VIII on coagulation factor assay. We hereby report a case of cerebral infarction due to thrombosis associated with focal segmental glomerulosclerosis and steroid resistant nephrotic syndrome with a brief review of related literature.
Antithrombin III ; Blood Coagulation Factors ; Blood Platelets ; Cerebral Infarction* ; Child ; Diuretics ; Factor VIII ; Glomerulosclerosis, Focal Segmental* ; Humans ; Hypocalcemia ; Incidence ; Magnetic Resonance Imaging ; Male ; Molecular Weight ; Nephrotic Syndrome* ; Occipital Lobe ; Seizures ; Thrombosis*

PURPOSE: The ictal perfusion patterns of cerebellum and basal ganglia have not been systematically investigated in patients with temporal lobe epilepsy (TLE). Their ictal perfusion patterns were analyzed in relation with temporal lobe and frontal lobe hyperperfusion during TLE seizures using SPECT subtraction. MATERIALS AND METHODS: Thirty-three TLE patients had interictal and ictal SPECT, video-EEG monitoring, SPGR MRI, and SPECT subtraction with MRI co-registration. RESULTS: The vermian cerebellar hyperperfusion (CH) was observed in 26 patients (78.8%) and hemispheric CH in 25 (75.8%). Compared to the side of epileptogenic temporal lobe, there were seven ipsilateral hemispheric CH (28.0%), fifteen contralateral hemispheric CH (60.0%) and three bilateral hemispheric CH (12.0%). CH was more frequently observed in patients with additional frontal hyperperfusion (14/15, 93.3%) than in patients without frontal hyperperfusion (11/18, 61.1%). The basal ganglia hyperperfusion (BGH) was seen in 11 of the 15 patients with frontotemporal hyperperfusion (73.3%) and 11 of the 18 with temporal hyperperfusion only (61.1%). In 17 patients with unilateral BGH, contralateral CH to the BGH was observed in 14 (82.5%) and ipsilateral CH to BGH in 2 (11.8%) and bilateral CH in 1 (5.9%). CONCLUSION: The cerebellar hyperperfusion and basal ganglia hyperperfusion during seizures of TLE can be contralateral, ipsilateral or bilateral to the seizure focus. The presence of additional frontal or basal ganglia hyperperfusion was more frequently associated with contralateral hemispheric CH to their sides. However, temporal lobe hyperperfusion appears to be related with both ipsilateral and contralateral hemispheric CH.
Basal Ganglia* ; Cerebellum* ; Epilepsy, Temporal Lobe* ; Frontal Lobe ; Humans ; Magnetic Resonance Imaging ; Perfusion ; Seizures ; Temporal Lobe* ; Tomography, Emission-Computed, Single-Photon

Severely comminuted tibial condylar fracture is a major threat to the structures and function of the knee joint. Recently, anterior approach with Z-tenotomy of the patellar tendon was introduced for these complicated fractures. It provides wide exposure of the tibial articular surface for maximum joint reconstruction. The purpose of this study was to describe the operative technique and to evaluate the clinical results of this method. We had performed operative treatment in 13 cases (12 patients) of severely comminuted Schatzkers type II, V, and VI tibial condylar fractures through anterior approach from December 1993 to April 1996. Twelve cases out of 13 (92%) showed acceptable results according to Blokkers criteria. There was no superficial or deep infection. On the basis of these results, we suggest that the anterior approach is a valuable aid in the operative treatment of severely comminuted tibial condylar fractures.
Joints ; Knee Joint ; Patella* ; Patellar Ligament* ; Tenotomy* ; Tibia

We present a review of 131 cases in which blood was retrieved and reinfused using Constavac Blood Conservation blood retrieval and reinfusion device postoperatively. The total number of cases in this study included 84 THA, 19 Rev. THA, 16 unilateral TKA and 12 bilateral TKA. The examinations of hemoglobin, hematocrit, antithrombin III, fibrinogen and D-dimer were initiated prospectively before surgery in each case. These parameters were also examined at postoperative day 1 and at day 7 for the evaluation of safety of Constavace Blood Conservation system. The aerobic and anaerobic bacterial culture tests of draining blood were also taken. The results were as follows: 1. The amount of total blood lost averaged 1264±466cc in THA, 2187±632cc in Rev. THA, 1651±543cc in unilateral TKA and 3445±1532cc in bilateral TKA. 2. The amount of blood retrieved and transfused averaged 499±227cc(39% of total lost blood) in THA, 578±527cc(26%) in Rev. THA. 953±451cc(58%) in unilateral TKA and 2219±1191cc(64%) in bilateral TKA. The amount of reinfusion averaged 71% of blood retrieved in THA, 62% in Rev. THA, 80% in unilateral TKA and 84% in bilateral TKA. 3. Fifty one cases out of 84 cases in THA and 14 case out of 28 cases in TKA underwent operation without homologous blood replacement. In the remaining cases, transfused banked blood averaged 364cc(29% of total lost blood) in THA, 620cc(27%) in Rev. THA, 485cc(29%) in unilateral TKA and 914cc(26%) in bilateral TKA. 4. There were no significant change in hemoglobin and hematocrit at postoperative day 7 compared with the preoperative state. 5. The antithrombin III, fibrinogen and D-dimer were converted to normal range at postoperative day 7. 6. The aerobic and anaerobic bacterial culture tests of reinfusing blood proved to be negative in all cases.
Antithrombin III ; Arthroplasty ; Blood Transfusion, Autologous ; Fibrinogen ; Hematocrit ; Joints ; Prospective Studies ; Reference Values

Average anteversion of the femur is 15.3 degree. Ultrasound, computerized tomogram, and three dimensional reconstruction from CT or MRI have been used for more accurate measurement of the anteversion. There are two methods in measuing anteversion angle from CT scan:one is by drawing a mid line through long axis of the femoral neck (conventional method). Another is by drawing a line from the center of the head to that of the neck at the base of the trochanter using several cut slices (Murphy’s method). We compared these methods with fluoroscopic measurement of the Anteversion. We traced the change of the anteversion before and after closed femoral intramedullary (IMO) nailing to evaluate the origin of malrotation of the femur. 1. Normal anteversion angles were measured in 15 cases. Average anteversion angle was 6.9 degrees by conventional method, 12.3 degrees by Murphy’s method, and 12.2 degrees by fluoroscope. 2. Anteversion angles were measured after IM nailing in 18 cases. Average was 17 degrees by Murphy’s method and 15.2 degrees by fluoroscope. Mean of difference between these two methods sea 6.3 degrees. That was 1.7 degrees in normal side. 3. Change of the anteversion angle between before and after IM nailing was measured in 17 cases by fluoroscope. Average anteversion angle before the operation was 11.9 degrees and it was change to 15.8 degrees after operation. Mean of these change was 7.1 degrees. 4. Pereperative traction provides important information on change of anteversion. Reduction excessive flexion of proximal fragment was a origin of change of anteversion during nailing procedure. Conclusion : Malrotation of the femur after IM nailing must be keep in mind and it may be preventable by fluoroscopic control of the rotation in nailing procedure.
Femur ; Femur Neck ; Fracture Fixation, Intramedullary ; Head ; Magnetic Resonance Imaging ; Methods ; Neck ; Traction ; Ultrasonography

Twenty-seven consecutive patients who had post-traumatic stiffness of the elbow were treated by operative soft tissue release or by soft tissue release and distraction arthroplasty. The purpose of this study was to describe the method of operation and postoperative management and to evaluate the results in the patients who had operative treatment for the post-traumatic stiffness of the elbow. The type of operative procedure was determined by whether the factors limiting motion were extra-articular (extrinsic) or intra-articular (intrinsic) and by pre-operative radiographic evaluation. The soft tissue release was performed by staged adhesiolysis through lateral or combined lateral and medial approaches. And if the factors limiting motion included a severe intraarticular lesions, distraction arthroplasty using the Judet or Oganesian apparatus was added to soft tissue release. The mean pre-operative arc of active motion was 42 degrees. At follow-up examination, nineteen to sixty-six months postoperatively, the mean post-operative arc of active motion was 103 degrees. There were nine complications (33 percent) in twenty-seven patients. All of them was transient ulnar nerve paresthesia. And we analysed the final results with Mayo elbow performance index for the evaluation of clinical outcome. Twenty-five (93%) of twenty-seven patients had satisfactory result according to Mayo elbow performance index. We conclude arthrolysis with or without distraction arthroplasty is useful for the treatment of posttraumatic elbow stiffness. However, the accurate anatomical knowledge, operative skill, and careful postoperative rehabilitation program were needed in the operative treatment of post-traumatic elbow stiffness.
Arthroplasty ; Elbow* ; Follow-Up Studies ; Humans ; Paresthesia ; Rehabilitation ; Surgical Procedures, Operative ; Ulnar Nerve

No abstract available.
Female ; Pregnancy ; Pregnancy, Ectopic*

OBJECTIVE: The purpose of this study was to evaluate whether clusterin expression is significantly correlated with paclitaxel resistance in cervical cancer cell lines. METHODS: The expressions of clusterin in cervical cancer cell lines were validated with western blotting. And subsequently, the correlation between clusterin expression levels and the IC50 of paclitaxel in several cervical cancer cell lines was evaluated. After transfection of clusterin siRNA into HeLaS3, which expressed high level of clusterin, their effect on chemo-resistance was evaluated by XTT assay. RESULTS: Clusterin expression levels were correlated with paclitaxel resistance in cervical cancer cell lines. And after transfection of clusterin siRNA into HeLa-S3 significantly decreased paclitaxel resistance (P<0.05). CONCLUSION: These findings suggest that clusterin expression may correlate with paclitaxel resistance.
Blotting, Western ; Cell Line* ; Clusterin* ; Drug Resistance ; Inhibitory Concentration 50 ; Paclitaxel* ; RNA, Small Interfering ; Transfection ; Uterine Cervical Neoplasms*