Limb salvage operations for osteosarcoma of the extremity usually consist of wide excision and skeletal reconstruction. Most osteosarcoma patients are anemic prior to the surgery as majority of them undergo preoperative neo-adjuvant chemotherapy; thus, it is necessary to treat anemia before and after the surgery since limb salvage operation tends to accompany significant blood loss. Despite the fact that blood transfusion has bad influence on prognosis, complication, and postoperative outcome of cancer patients, it is still considered as a standard management to fix anemia for limb salvage operations. We would like to present a case report in which the authors succeeded in performing limb salvage operations on patients with distal femur osteosarcoma without transfusion.
Anemia ; Blood Transfusion* ; Drug Therapy ; Extremities ; Femur* ; Humans ; Limb Salvage* ; Osteosarcoma* ; Prognosis

No abstract available.
Animals ; Mice* ; T-Lymphocytes*

PURPOSE: To evaluate the efficacy of the tension-free vaginal tape (TVT) procedure in patients with recurrent stress urinary incontinence. Therefore, the effectiveness of the procedure in patients whom previous traditional surgical procedures had failed was retrospectively reviewed. MATERIALS AND METHODS: A total of 48 women, in whom a previous traditional surgical procedure had failed, received the TVT procedure (Group I). A further 124 women received the TVT procedure as the primary anti-incontinence surgical procedure (Group II) over the same time period, who were followed up for at least 1 year after the TVT procedure, were also included in the study. The preoperative evaluations included a symptom questionnaire, physical examination and urodynamic evaluation. Uroflowmetry, postvoiding residual urine and the symptom questionnaire were evaluated postoperatively, and the pre- and postoperative results compared between the two groups. The surgical results were classified into 3 categories; cured, improved and failed. RESULTS: According to the protocol, 40 (83.3%) and 106 (85.5%) patients in Groups I and II were cured. There were no significant differences in the cure rates between the two groups. Thirty four and 58 intrinsic sphincter deficiency patients were noted in Groups I and II, respectively; of these, 76.5 and 79.3% of the patients in groups I and II were cured of their incontinence. There were no significant differences in the incidences of intra- or postoperative complications, postoperative voiding problems and patient satisfactions between the two groups. CONCLUSIONS: There were no differences in the results of the TVT procedure in women with recurrent stress urinary incontinence or who had received the procedure as the primary anti-incontinence surgical treatment. These results imply the TVT procedure can be performed as the primary choice in patients having failed previous anti-incontinence surgery.
Female ; Humans ; Incidence ; Physical Examination ; Postoperative Complications ; Surveys and Questionnaires ; Reoperation ; Retrospective Studies ; Suburethral Slings* ; Urinary Incontinence* ; Urodynamics

Many symptoms of age related bladder dysfunction may be associated with urethral dysfunction. We compared the contractile responsiveness of urethral strips from young adults (6-9 months) and old (24-27 months) male Fisher 344 rats. Circularly and longitudinally oriented urethral strips from proximal (bladder neck) and distal urethra were obtained and suspended in organ baths containing Tyrodes buffer. Contractile responses to field stimulation (FS), phenylephrine, bethanechol and KC1 were recorded. Results were as followed: 1. Contractile responses of proximal urethral strips from old rats to FS, bethanechol, phenylephrine, KCI were greater than those of young rats. In young rats, general order of responsiveness was FS >KC1 = phenylephrine >bethanechol. In old rats, it became FS >bethanechol >KCI = phenylephrine. 2. Magnitude of the contractile responses for distal urethral strips were significantly lower than for proximal urethra and there were no significant differences of the responses between two age group. 3. For the circularly oriented strips, responses of old rats to FS, bethanechol, phenylephrine and KC1 also were greater than those of young rats. In young rats, general order of responsiveness was FS>KCl =phenylephrine =bethanechol. In old rats, it became FS>bethanechol >KC1 >phenylephrine. 4. For the longitudinally oriented strips, responsiveness to FS and bethanechol was similar between younger and old rats. However, responses to phenylephrine were greater for young rats than for old ones. For both young and old rats, general order of contractile responsiveness was FS>phenylephrine=KCl>bethanechol, In old rats contractile responses of proximal, circular urethral strips to various stimulation were greater than those in young ones. 5. Degree of field stimulated relaxant responses of the urethra precontracted by phenylephrine were similar between two age groups at higher frequencies(16-64 Hz.): whereas higher degrees of relaxation were observed in young rats at lower frequencies(1-8 Hz.). Circularly oriented urethral strips showed better relaxation with FS than did longitudinal ones. Relaxant responses were only partially (50%) blocked by preincubation of L-NAME. These results suggest that as male became older, their urethra responds to various stimulation with obstructive pattern than did the younger ones and also, lesser degree of urethral relaxation may causes obstructive voiding due to poor Opening of bladder outlet. Also it can be said that the ratio of the receptor density of cholinergic and adrenergic nerves varies as one become old.
Aging* ; Animals ; Baths ; Bethanechol ; Humans ; Male* ; NG-Nitroarginine Methyl Ester ; Phenylephrine ; Rats* ; Relaxation ; Urethra ; Urinary Bladder ; Young Adult

Many symptoms of age related bladder dysfunction may be associated with urethral dysfunction. We compared the contractile responsiveness of urethral strips from young adults (6-9 months) and old (24-27 months) male Fisher 344 rats. Circularly and longitudinally oriented urethral strips from proximal (bladder neck) and distal urethra were obtained and suspended in organ baths containing Tyrodes buffer. Contractile responses to field stimulation (FS), phenylephrine, bethanechol and KC1 were recorded. Results were as followed: 1. Contractile responses of proximal urethral strips from old rats to FS, bethanechol, phenylephrine, KCI were greater than those of young rats. In young rats, general order of responsiveness was FS >KC1 = phenylephrine >bethanechol. In old rats, it became FS >bethanechol >KCI = phenylephrine. 2. Magnitude of the contractile responses for distal urethral strips were significantly lower than for proximal urethra and there were no significant differences of the responses between two age group. 3. For the circularly oriented strips, responses of old rats to FS, bethanechol, phenylephrine and KC1 also were greater than those of young rats. In young rats, general order of responsiveness was FS>KCl =phenylephrine =bethanechol. In old rats, it became FS>bethanechol >KC1 >phenylephrine. 4. For the longitudinally oriented strips, responsiveness to FS and bethanechol was similar between younger and old rats. However, responses to phenylephrine were greater for young rats than for old ones. For both young and old rats, general order of contractile responsiveness was FS>phenylephrine=KCl>bethanechol, In old rats contractile responses of proximal, circular urethral strips to various stimulation were greater than those in young ones. 5. Degree of field stimulated relaxant responses of the urethra precontracted by phenylephrine were similar between two age groups at higher frequencies(16-64 Hz.): whereas higher degrees of relaxation were observed in young rats at lower frequencies(1-8 Hz.). Circularly oriented urethral strips showed better relaxation with FS than did longitudinal ones. Relaxant responses were only partially (50%) blocked by preincubation of L-NAME. These results suggest that as male became older, their urethra responds to various stimulation with obstructive pattern than did the younger ones and also, lesser degree of urethral relaxation may causes obstructive voiding due to poor Opening of bladder outlet. Also it can be said that the ratio of the receptor density of cholinergic and adrenergic nerves varies as one become old.
Aging* ; Animals ; Baths ; Bethanechol ; Humans ; Male* ; NG-Nitroarginine Methyl Ester ; Phenylephrine ; Rats* ; Relaxation ; Urethra ; Urinary Bladder ; Young Adult

PURPOSE: Recently, tension free vaginal tape (TVT) has been widely used in the management of stress urinary incontinence (SUI), and has been applied to SUI by intrinsic sphincter deficiency (ISD). This study was performed to identify the efficacy of the TVT procedure in SUI patients by ISD. MATERIALS AND METHODS: A total of 196 incontinent women, who underwent TVT procedures were enrolled in this study. The patients were divided into four groups according to their preoperative Valsalva leak point pressure (VLPP) and maximum urethral closure pressure (MUCP): Group I (anatomical incontinence, AI, n=78), Group II (mild ISD: 40cmH2O < or=VLPP<60cmH2O, n=54), Group III (moderate ISD: MUCP< or=20cmH2O or 30cmH2O< or=VLPP<40cmH2O, n=38) and Group IV (severe ISD: MUCP< or= 10cmH2O or VLPP< or=30cmH2O, n=26). One year after the TVT procedure, a symptom questionnaire and the urodynamic parameters were compared with the preoperative data. RESULTS: There were no significant differences in the Q-tip test, peak uroflow (Qmax) and post-voiding residual volume among the four groups preoperatively. There were no significant differences in success rates between ISD and AI. The postoperative cure rates were 82% (64/78) and 78% (92/118) for AI and ISD, respectively. In an urodynamic analysis, Groups III and IV the postoperative Q max were significantly decreased compared with Groups I and II, and the postoperative voiding difficulties were significantly higher in Groups III and IV (p<0.05). CONCLUSIONS: The TVT procedure showed high cure rates of SUI in the mild ISD and AI groups compared with those in the moderate and severe ISD groups. The rates of voiding difficulty were more frequent in moderate and severe ISD groups. According to our results, it can be suggested that TVT can be undertaken for stress incontinent women associated with ISD.
Female ; Humans ; Surveys and Questionnaires ; Residual Volume ; Suburethral Slings* ; Surgical Mesh ; Urinary Incontinence* ; Urodynamics

BACKGROUND: This study focused on the association between preoperative serum carcinoembryonic antigen (CEA) and cytokeratin 19 fragment (Cyfra 21-1) levels and pathologic parameters in patients with resected non-small-cell lung cancer (NSCLC). MATERIALS AND METHODS: The records of 527 patients who underwent pulmonary resection of NSCLC were reviewed. The association between preoperative serum CEA and Cyfra 21-1 levels and variables that had p-values of less than 0.05 in a t-test or one-way analyses of variance was analyzed by multiple linear regression. RESULTS: The mean serum CEA and Cyfra 21-1 levels prior to surgery were 6.8+/-23.1 mg/dL (range, 0.01 to 390.8 mg/dL) and 5.4+/-12.3 mg/dL (range, 0.65 to 140.2 mg/dL). The serum CEA levels were associated with tumor (T) and lymph node (N) stage and histology. The serum Cyfra 21-1 levels were associated with T stage, tumor size, and histology. Multiple linear regression indicated that serum CEA levels were associated with T (T3/4 vs. T1: beta=8.463, p=0.010) and N stage (N2/3 vs. N0: beta=9.208, p<0.001) and histology (adenocarcinoma vs. squamous cell: beta=6.838, p=0.001), and serum Cyfra 21-1 levels were associated with tumor size (beta=2.579, p<0.001) and histology (squamous cell vs. adenocarcinoma: beta=4.420, p=0.020). CONCLUSION: Serum CEA level was correlated with T and N stage, and Cyfra 21-1 with tumor size. CEA and Cyfra 21-1 showed histologic correlation. CEA is mainly elevated in adenocarcinoma and Cyfra 21-1 in squamous cell carcinoma. These results might be helpful for predicting pathologic status in preoperative NSCLC.
Adenocarcinoma ; Antigens, Neoplasm ; Carcinoembryonic Antigen ; Carcinoma, Non-Small-Cell Lung ; Carcinoma, Squamous Cell ; Humans ; Keratin-19 ; Keratins ; Linear Models ; Lung Neoplasms ; Lymph Nodes

BACKGROUND: This study focused on the association between preoperative serum carcinoembryonic antigen (CEA) and cytokeratin 19 fragment (Cyfra 21-1) levels and pathologic parameters in patients with resected non-small-cell lung cancer (NSCLC). MATERIALS AND METHODS: The records of 527 patients who underwent pulmonary resection of NSCLC were reviewed. The association between preoperative serum CEA and Cyfra 21-1 levels and variables that had p-values of less than 0.05 in a t-test or one-way analyses of variance was analyzed by multiple linear regression. RESULTS: The mean serum CEA and Cyfra 21-1 levels prior to surgery were 6.8+/-23.1 mg/dL (range, 0.01 to 390.8 mg/dL) and 5.4+/-12.3 mg/dL (range, 0.65 to 140.2 mg/dL). The serum CEA levels were associated with tumor (T) and lymph node (N) stage and histology. The serum Cyfra 21-1 levels were associated with T stage, tumor size, and histology. Multiple linear regression indicated that serum CEA levels were associated with T (T3/4 vs. T1: beta=8.463, p=0.010) and N stage (N2/3 vs. N0: beta=9.208, p<0.001) and histology (adenocarcinoma vs. squamous cell: beta=6.838, p=0.001), and serum Cyfra 21-1 levels were associated with tumor size (beta=2.579, p<0.001) and histology (squamous cell vs. adenocarcinoma: beta=4.420, p=0.020). CONCLUSION: Serum CEA level was correlated with T and N stage, and Cyfra 21-1 with tumor size. CEA and Cyfra 21-1 showed histologic correlation. CEA is mainly elevated in adenocarcinoma and Cyfra 21-1 in squamous cell carcinoma. These results might be helpful for predicting pathologic status in preoperative NSCLC.
Adenocarcinoma ; Antigens, Neoplasm ; Carcinoembryonic Antigen ; Carcinoma, Non-Small-Cell Lung ; Carcinoma, Squamous Cell ; Humans ; Keratin-19 ; Keratins ; Linear Models ; Lung Neoplasms ; Lymph Nodes

Pulmonary Embolism, one of the causes of maternal death, is a life threatening disease that needs early and accurate diagnosis. We have exprerienced a case of a fatal pulmonary embolism which was diagnosed by lung perfusion scan on the postoperative 1 day after cesarean delivery and was managed with heparin therapy. We present this case with a brief review of literatures.
Diagnosis ; Heparin ; Lung ; Maternal Death ; Perfusion ; Pulmonary Embolism*

The purpose of this research is to find out the degree of cartilage regeneration by inserting the atelo- collagen scaffold obtained from dermis of a calf on cartilage defect site. Dissection underneath the perichondrium by the periosteal elevator on both side of ears of six New Zealand white rabbits were made to expose the cartilage, leaving pairs of circular holes 3, 6, 9 mm width with punches. One hole was left for a control, and on the other hole atelo-collagen scaffold of the same size was transplanted. In postoperative 1, 2, 4 weeks, the tissues were dyed. The length of long axis of neocartilage was measured through an optical microscope with a 0.1mm graduation at original magnification, x40. In the first and second week, both group showed no sign of cartilage regeneration. In the fourth week, regeneration on marginal portions was observed on all groups and the average values of length of long axis of neocartilage according to defect size were as follows: In the cases with 3mm defect, it was 0.85+/-0.30mm in the control group, and 1.85+/-0.38mm in the graft group; in the cases with 6 mm defect, 1.33+/-0.58mm in the control group, and 2.25+/-0.46mm in the graft group; and in the cases with 9mm defect, 2.33+/-0.77mm in the control group, and 4.47+/-1.39mm in the graft group. This means that the collagen scaffold has an influence on the regeneration of neocartilage. But the relative ratio of the length of neocartilage to cartilage defect size was not significant in the statistics.
Axis, Cervical Vertebra ; Cartilage* ; Collagen ; Collagen Type I* ; Dermis ; Ear ; Elevators and Escalators ; Rabbits ; Regeneration ; Transplants