No abstract available.
Pregnancy*

Thirty-one distal femoral and nine proximal tibial primary bone tumor patients who had prosthetic replacements were reviewed retrospectively. Average follow-up was thirty-eight months(range: 12- 109 months). There were thirty-two(osteosarcoma: 29, chondrosarcoma: 3) stage IIB lesions and eight 1B lesions(giant cell tumor). Twenty-nine patients were surviving at final follow-up. Overall prosthetic survival was 81%, 27% at 2 and 5 year respectively. Eleven prostheses were revised. The causes of revisions were infection(7), metal failure(2), fracture of host bone(1), and loosening(1). Eight revisions were successful, one was fair, and two patients needed an amputation. Prognostic factors which were analyzed for survival of prostheses were age, sex, location of primary lesion, percent of bone resected, and stage. Only the location of primary lesion showed statistical significance and diabolic pattern of survival curve was noted between two groups in resection length(<40% versus >40%). Average functional score was 26. The tibial side had worse prosthetic survival and a major threat to this procedure was due to infection.
Amputation ; Chondrosarcoma ; Follow-Up Studies ; Humans ; Knee Joint* ; Knee* ; Prostheses and Implants ; Prosthesis Failure ; Retrospective Studies ; Sarcoma

No abstract available.
Anterior Cruciate Ligament* ; Knee*

No abstract available.

No abstract available.
Tibia*

BACKGROUND: The aging of the patient population is one of rhe most important factirs influencing health care delivery. Currently 5% of the Korean population is elderly, defined as older than 65years of age, with this group projected to increase to 13.1% by the year 2021. Cardiovascular disease is the leading cause of death and of disability in the elderly age group. mong them, coronary heart disease is the most importane. METHOD: Study population composed of 216 patients who were admittied to the hospital with first acute myocardial infarction and they were divided into two groups according to the age(older than 65 years of age vs younger). Clonical features, risk factors of coronary heart disease, in-hospital outcome and complication were compared in elderly patients and others group. Results : 1) The risk factors of coronary heart disease is similar to younger patients but pattern of chest pain is less typical than younger patients. 2) Clinical presentation of elderly patients is similar to younger patients except Killip class on admission.(1.66vs 1.91,P=0.04) 3) In-hospital mortality of elderly patients in higher than younger patients. In addition to an increased incidence of death, recurrent ischemia, stroke, AV block, ventricular arrythmia, pulmonary edema occured more frequently with advanced age. 4) Especially in the thrombolytic therapy group, in-hospital death, reinfarction and recurrent ischemia is higher than primary PTCA group in elderly patients. CONCLUSIONS: Diagnosis of acute chest pain is difficult in elderly patients and in-hospital mortality and morbidity is higher than in younger patients. Thus more accurate diagnosis and discriminative therapeutic modality is needed.
Aged ; Aging ; Arrhythmias, Cardiac ; Atrioventricular Block ; Cardiovascular Diseases ; Cause of Death ; Chest Pain ; Coronary Disease ; Delivery of Health Care ; Diagnosis ; Hospital Mortality ; Humans ; Incidence ; Ischemia ; Myocardial Infarction* ; Pulmonary Edema ; Risk Factors ; Stroke ; Thrombolytic Therapy

PURPOSE: Although survival of osteosarcoma patient has markedly improved, cases of non-responders to chemotherapy and late-relapsers are still perplexing. Our strategy was to analyze the impact of chemotherapy and surgery on the survival for each stage, and to evaluate long-term survival and find prognostic factors within the same stage. MATERIALS AND METHODS: From May 1985 to Feb. 1999, 461 osteosarcomas were enlisted at our department and among them 348 cases were evaluable. There were 1 IB, 4 IIA, 302 IIB, and 41 IIIB. Two hundred and fifty-five (IIA/IIB:4/251) out of 348 cases followed our protocol of chemotherapy and surgery. Two hundred and ten cases had neoadjuvant chemotherapy and 45 had adjuvant only. RESULTS: Eleven year event free survival of the neoadjuvant group was 56.7%. On univariate analysis for 210 neoadjuvant cases, age (<13yrs), type of surgery (amputation), type of chemotherapy (methotrexate, adriamycin, cisplatin), pathologic response (>90%), local recurrence, pathologic fracture, location and size were statistically significant. But multivariate one revealed age, type of surgery, local recurrence and pathologic response as useful factors. There were 12 local recurrences (5.7%) and 100 metastasis among 255 stage II and their average onset from treatment was 17.8 month. Survival after metastasis was 5.6% at 55 months and the aggressively treated group made gains in survival (P<0.0001). Survival of 41 stage III was 0% at 64 months and this group also had an advantage in survival through intensive chemotherapy and surgery for primary and metastatic lesions (p=0.04). CONCLUSION: Long-term survival of the treated 255 stage II group was 55% at 14 years. For stage II: age, local recurrence and pathologic response were meaningful prognostic factors. Aggressive surgery and chemotherapy were necessary to improve the survival of stage III and stage II with late metastasis group.
Disease-Free Survival ; Doxorubicin ; Drug Therapy ; Fractures, Spontaneous ; Humans ; Korea* ; Neoplasm Metastasis ; Osteosarcoma* ; Recurrence ; Survival Rate*

PURPOSE: Soft tissue sarcomas have a wide variety of manifestation and its course is still unpredictable in many cases. This study altlempts to analyze the meaningful prognostic factors and to find optimal treatment strategies for each clinical stage. MATERIALS AND METHODS: From May 1985 to Mar. 1997, 432 soft tissue sarcomas were enlisted and 319 cases were eligible for this retrospective study. Staging followed AJCC classification and there were 34 stage I, 69 stage II, 151 stage III and 64 cases of stage IV. For stage I and II, operation was a major tool. Radiotherapy and chemotherapy were added for each situation. Intensive chemotherapy and surgery were done for stage III and IV. Metastasectomy was added in feasible cases. RESULTS: Actual survival rate for the 319 cases was 50% at 152 months. Disease free survival for stage I, II, III was 84%, 41%, and 38%, respectively. The stage itself had a statistical significance (P<0.00001). In univariate analysis, surgical margin in stage II and local recurrence in stage III had statistical significance. Multivariate study revealed the local recurrence as the only meaningful factor in stage I, II, III. An aggressive treatment for stage IV and I, II, III with late metastasis group had significant gain on survival. CONCLUSIONS: The stage itself predicts the course of soft tissue sarcomas. Evaluation of sound surgical margin to prevent the local recurrence is necessary.
Classification ; Disease-Free Survival ; Drug Therapy ; Metastasectomy ; Neoplasm Metastasis ; Radiotherapy ; Recurrence ; Retrospective Studies ; Sarcoma* ; Survival Rate

PURPOSE: We tried to determine how many patients comply with semen analysis recommendations after vasectomy and how often the operation is followed by surgical failure or recanalization. MATERIALS AND METHODS: We determined the percentage of patients who underwent vasectomy from 1995 to 2003 who had follow-up semen analysis. To determine the vasectomy failure or recanalization rate, we evaluated the rates of sperm appearance in patients who were preparing for vasovasostomy and those with chronic prostatitis who had undergone vasectomy in the past. RESULTS: Among the 130 vasectomized patients, 29(22.3%) had received semen analysis, and in 120 healthy vasectomized patients, only 19(9.9%) received semen analysis. Of the 8 semen samples examined before vasovasostomy, 2(25%) had sperm. In the 121 chronic prostatitis patients, 9(7.4%) had sperm in their semen despite earlier vasectomy. Overall, 11 of 129 vasectomized patients(8.5%) were potentially fertile. CONCLUSIONS: The vasectomy failure or recanalization rate is higher than we generally think. Vasectomy failure or recanalization is usually followed by unwanted pregnancy and abortion. Unfortunately, physicians as well as patients are indifferent to the need for post-vasectomy semen analysis, and we need to emphasize its importance.
Female ; Follow-Up Studies ; Humans ; Infertility ; Pregnancy ; Pregnancy, Unwanted ; Prostatitis ; Semen Analysis* ; Semen* ; Spermatozoa ; Vasectomy* ; Vasovasostomy

PURPOSE: Gelatin-hydroxyapatite nanocomposite is similar to inorganic nanostructure of bone. To make a scaffold with osteoinductivity, bone marrow derived stem cells from rabbit femur were impinged into the nanocomposite. This vitro study was to test osteogenic differentiation of the stem cells in the nanocomposite, which was made by authors. MATERIAL & METHODS: Gel-HA nanocomposite with 10g of HA, 3 g of Gel has been made by co-precipitation process. Bone marrow was obtained from femur of New Zealand White rabbits and osteogenic differentiation was induced by culturing of the BMSCs in an osteogenic medium. The BMSCs were seeded into the Gel-HA nanocomposite scaffold using a stirring seeding method. The scaffolds with the cells were examined by scanning electron microscopy (SEM), colorimetry assay, biochemical assay with alkaline phosphatase (ALP) diagnostic kit, osteocalcin ELISA kit. RESULTS: Gel-HA nanocomposite scaffolds were fabricated with relatively homogenous microscale pores (20-40 micrometer). The BMSCs were obtained from bone marrow of rabbit femurs and confirmed with flow cytometry, Alizarin red staining. Attachment and proliferation of BMSCs in Gel-HA nanocomposite scaffold could be identified by SEM, ALP activity and osteocalcin content of BMSCs. CONCLUSION: The Gel-HA nanocomposite scaffold with micropores could be fabricated and could support BMSCs seeding, osteogenic differentiation.
Alkaline Phosphatase ; Anthraquinones ; Bone Marrow ; Colorimetry ; Durapatite ; Enzyme-Linked Immunosorbent Assay ; Femur ; Flow Cytometry ; Microscopy, Electron, Scanning ; Nanocomposites ; Nanostructures ; Osteocalcin ; Rabbits ; Seeds ; Stem Cells