Epidemiological studies are important in both the prevention and treatment of mycobacterial infections. This study was initiated to establish the pulsed-field gel electrophoresis (PFGE) method, which are not yet extensively studied. The most apprpriate restriction endonucleases included Dral, AsnI, and XbaI. The optimal PFGE condition was different according to the enzymes used. Two stage PFGE was performed, in case of DraI first stage was performed with 10 seconds of initial pulse and 15 seconds of findA pulse, while the second stage was performed with 60 seconds of initial pulse and 70 seconds of final pu',se. The electrophoresis time for DraI-PFGE was 14 hours for each stage. Electrophoresis was performed for 22 hours, in case of XbaI, with 3 seconds of initial pulse and 12 seconds of final pulse. Electrophoresis was performed for 22 hours, in case of AsnI, with 5 seconds of initial pulse and 25 seconds of final pulse. In all cases the voltage of the electrophoresis was maintained constantly at 200 voltage. Standard mycobacterial strains, which included Mycobacterium bovis BCG, M. tuberculosis, and M. fortuitum, could not be differentiated by PFGE analysis. PFGE analysis was performed to differentiate 9 clinically isolated M. fortuitum strains using AsnI. All M. fortuitum strains showed different genotypes except 2 strains. Cluster analysis divided M. fortuitum strains into 2 large groups. PFGE analysis was performed to further differentiate M. fortuitum isolates using XbaI. The undifferentiated 2 M. fortuitum strains showed different PFGE patterns with Xba I. Cluster analysis of the XbaI-PFGE patterns showed more complex grouping than AsnI-PFGE patterns, which showed that XbaI-PFGE analysis was better than AsnI-PFGE in M. fortuitum genotyping. The top dissimilarity values of AsnI-PFGE and XbaI-PFGE were 0.74 and 0.75, respectively. This value was higher than that of arbitrarily primed polymerase chain reaction (AP-PCR) analysis and lower than that of restriction fragment length polymorphism (RFLP) analysis. This suggested that PFGE can be used as a supportive or alternative genotyping method to RFLP analysis.
DNA Restriction Enzymes ; Electrophoresis* ; Electrophoresis, Gel, Pulsed-Field ; Epidemiologic Studies ; Genotype ; Mycobacterium bovis ; Mycobacterium* ; Polymerase Chain Reaction ; Polymorphism, Restriction Fragment Length ; Tuberculosis

OBJECTIVE: Our purpose was to compare the expression of endothelial nitric oxide synthase in the placenta and umbilical cord of preeclamptic placenta with that of the normotensive placenta. METHOD: We compared placental endothelial nitric oxide synthase expression in preeclamptic (n=5) with in normal (n=5) pregnancies. Frozen sections of umbilical cords, chorionic plate vessels, and terminal villi were immunostained with a monoclonal endothelial nitric oxide synthase antibody. RESULTS: The age revaled no difference between control (28.1+4.2 years). and study group (26.1+4.7 years). The gestational age was statistically different between control (38.9+1.7 weeks) and study group (34.9+3.5 weeks). The neonatal body weight and placental weight were also statistically different between control (3060+528 g) and study group (2160 417 g). No difference in endothelial nitric oxide synthase immunostaining in the endothelium of the umbilical vessels and stem villous vessels was found between preeclamptic and normotensive pregnancies. In contrast, in the preeclamptic placental endothelial nitric oxide synthase immunostaining was seen in the terminal villous vessels. In the syncytiotrophoblast endothelial niric oxide synthase immunostaining appeared primary basal in location and diffuse in distribution in the preeclamptic placentas but primary apical in the normotensive placentas. CONCLUSION: Differences in endothelial nitric oxide synthase expression in terminal villous vessels and syncytiotrophblast may be a result of vascular alterations or damage that take place in the placenta in preeclampsia.
Body Weight ; Chorion ; Endothelium ; Frozen Sections ; Gestational Age ; Nitric Oxide Synthase Type III ; Nitric Oxide Synthase* ; Nitric Oxide* ; Placenta ; Pre-Eclampsia* ; Pregnancy* ; Trophoblasts ; Umbilical Cord

No abstract available.
Hemorrhage* ; Pregnancy* ; Round Ligament of Uterus*

From Mar. 1984 to Mar. 1994, we carried out 18 revision operations in patients who received Girdlestone operation due to the infection of hip was 7 cases, tuberculosis of hip was 3 cases, deep infections after implant insertion of hip were 5 cases, and pyogenic sequela was 1 case. The mean conversion period was 27 months. The leg length discrepancy, range of motion of hip, and Trendelenberg gait were examined before and after conversion to a total hip arthroplasty. The last functional state was evaluated and radiological examination was performed. In summary and Conclusion; 1. The time of performing revision hip arthroplasty was assessed by clinical, radiologic and laboratory finding, and the average time of conversion to total hip arthroplasty was 7.6 months after Girdlestone operation. 2. There was no case of recurrence of infection after revision operations. 3. At last follow-up after revision hip arthroplasty, the mean Harris Hip Score was 87.2(69.6–92.2) point. 4. Six patients had no pain, 8 patients had mild pain, and 2 patients had moderate pain. Nine patients were able to walk without ambulatory aids and 7 patients needed crutch or cane for walking. 5. At the time of revision hip arthroplasty, the average shortening of the resected limb was 4.2cm(1.6–7.3cm), and after revision operation, the average shortening was reduced to 1.2cm(0.8–2.2cm) 6. The technical difficulties, such as increased bleeding, bone deficiency, scar tissue formation, and limb shortening were encountered in all cases. 7. The peroneal nerve injury was developed in one patient who had conversion hip arthroplasty at 13 months after Girdlestone operation.
Arthroplasty ; Arthroplasty, Replacement, Hip ; Canes ; Cicatrix ; Extremities ; Follow-Up Studies ; Gait ; Hemorrhage ; Hip ; Humans ; Leg ; Peroneal Nerve ; Range of Motion, Articular ; Recurrence ; Tuberculosis ; Walking

Sinus histiocytosis with massive lymphadenopathy known as Rosai-Dorfman disease is characterized by painless bilateral cervical lymphadenopathy. Extranodal manifestations are uncommon and spinal involvement is rare. A 15-year-old man presented with intermittent midthoracic back pain only. He had no specific findings on neurologic examinations, hematologic and biochemical laboratory tests. Radiological examination of thoracic spine revealed collapse of T6 vertebrae with thoracic kyphosis and osteolytic lesion of T12 vertebra body. He underwent a removal of bone tumor, anterior reconstruction with mesh and pedicle screw fixation via posterior approach for pathologic confirmation and stabilization. Histopathologic study of the lesion revealed focal infiltration of large histiocytes showing emperipolesis. Immunochemistry stain of histiocytes was positive for CD68 and S-100 but negative for CD1a. This report presents a rare case and literature review of extranodal Rosai-dorfman disease in thoracic spine.
Adolescent ; Back Pain ; Emperipolesis ; Fractures, Compression* ; Histiocytes ; Histiocytosis, Sinus* ; Humans ; Immunochemistry ; Kyphosis ; Lymphatic Diseases ; Neurologic Examination ; Spine*

No abstract available.
Fistula*

PURPOSE: To evaluate the effectiveness of core decompression according to anatomic location and extent of necrotic portion. MATERIALS AND METHODS: The authors reviewed 28 hips with a mean follow-up of 36 months. Cases were classified according to Steinberg, Ficat, Ohzono, Kerboul index, Koo's index, and lateral head index. Failure was defined radiographically as depression of the femoral head compared with the previous one , and clinically HHS lesser than 80. RESULTS: Radiographically, success rates were 15.8% (3/19) in Steinberg IIC, 15.8% (3/19) in Ficat IIA, 26.3% (5/19) in Ohzono 1C, 28.6% (6/21) in Kerboul index greater than 250, 30.4% (7/23) in Koo's index greater than 40, and 15% (3/20) in lateral head index smaller than 12%. Clinically, success rates were 26.3% (5/19) in Steinberg IIC, 26.3% (5/19) in Ficat IIA, 36.8% (7/19) in Ohzono 1C, 38.1% (8/21) in Kerboul index greater than 250, 39.1% (9/14) in Koo's index greater than 40, and 25% (5/20) in lateral head index smaller than 12%. CONCLUSION: Core decompression was ineffective in preventing the collapse of the femoral head for the lesions with diffuse involvement and located laterally at weight- bearing portion, even though in the early stage of osteonecrosis, there was no collapse of the femoral head.
Decompression* ; Depression ; Follow-Up Studies ; Head* ; Hip ; Osteonecrosis*

Over 60 different types of human papillomavirus (HPV) have been identified, and they are classified into high and low risk groups based on the risk for malignant progression of HPV associated lesions. HPVs belonging to a high risk group have been shown to express two major transforming proteins, E6 and E7. With respect to the transforming activity of these proteins, many investigators have reported the location of these proteins in the cell, but their results are still controversial. In the present study, HPV type 16 E6 or E7 open reading frame (ORF) proteins were expressed and localized in human epidermal keratinocytes (RHEK-1) using the vaccinia virus as an expression vector. Immunofluorescence detection using monoclonal antibodies against E6 or E7 ORF proteins revealed that E6 or E7 proteins of HPV type 16 were located in the cytoplasm of RHEK-1 cells. These results suggest that E6 and E7 proteins bind to the tumor suppressor counterparts, thereby preventing transport of these proteins into the nucleus. These antioncogene products that fail to be rapidly transported out of the cytosol may be degraded by certain proteases such as the ubiquitin dependent system. In this way, the precise function of antioncogene products in the regulation of cell growth could be destroyed, and abnormal cell growth could occur.
Animal ; Base Sequence ; Cell Line ; Fluorescent Antibody Technique ; Haplorhini ; Human ; Keratinocytes/metabolism ; Molecular Sequence Data ; Oncogene Proteins, Viral/*biosynthesis ; Open Reading Frames/*physiology ; Papillomavirus, Human/*chemistry ; Plaque Assay ; Polymerase Chain Reaction ; Recombinant Proteins/biosynthesis ; Support, Non-U.S. Gov't ; Vaccinia virus/genetics

PURPOSE: This study was attempted to investigate the prevalence of the expression of c-fos protein, TGF-alpha and -beta, PCNA , DNA ploidy pattern and histopathological parameters of giant cell tumor (GCT) of bone and to correlate with prognosis and to extend our understanding on tumorigenesis of GCT. MATERIALS AND METHODS: Twenty eight cases of paraffin-embedded tissue were studied, classified as recurrent (5 cases) and non-recurrent group (12cases) within the limits of the cases which afforded surgical material on first operation. RESULTS: No significant difference was observed in cellularity of stromal cells, atypia of stromal and giant cells, presence of hemorrhage and necrosis between recurrent and non-recurrent group. However, presence of more than 10 mitotic figures in 10 high power fields in recurrent group was significantly higher than non-recurrent group (p<0.05). The immunoreactivity for PCNA was seen only in nuclei of stromal cells, whereas nuclei of giant cells showed negative staining. The positivity of PCNA revealed no significant difference between non-recurrent (mean; 40.9%) and recurrent group (34.4%). The expression of c-fos oncogene was seen in 5 cases (100%) in recurrent group, and 8 cases (66.7%) in non-recurrent group, and no significant difference was seen. No significant difference of expression of TGF-alpha was seen in 5 cases (100%) in recurrent group and in 11 cases (91.7%) in non-recurrent group. The expression of TGF-beta in stromal cells was significantly higher in non-recurrent group (80%) compared to recurrent group (100%) (p<0.05). In DNA analysis out of 18 cases, 4 cases (22.2%) were aneuploidy and 14 cases (77.8%) were diploidy. Among 4 aneuploidy cases, 3 cases (75%) had no recurrence, and 1 case (25%) had metastasis to lung and expired. No significant difference of DNA ploidy pattern was seen between the recurrent and non-recurrent group. CONCLUSION: Presence of more than 10 mitotic figures in 10 high power fields and less expression of TGF-beta are related to higher possibility of recurrence and it is suggested that the number of mitotic figure (more than 10/10HPF) and expression of TGF-beta could be helpful parameters in predicting recurrence of GCT.
Aneuploidy ; Carcinogenesis ; Diploidy ; DNA* ; Giant Cell Tumor of Bone* ; Giant Cell Tumors* ; Giant Cells* ; Hemorrhage ; Lung ; Necrosis ; Negative Staining ; Neoplasm Metastasis ; Oncogenes ; Ploidies ; Prevalence ; Prognosis ; Proliferating Cell Nuclear Antigen* ; Recurrence ; Stromal Cells ; Transforming Growth Factor alpha ; Transforming Growth Factor beta ; Transforming Growth Factors*

OBJECTIVE: To determine the efficacy of various posterior fusion techniques in managing C1/2 instability. PATIENTS AND METHODS: Retrospective review of patients undergoing C1/2 posterior fusioin was undertaken with the aim of determining the long-term outcome of the selected procedures. Forty-two patients requiring posterior atlantoaxial fusion for various pathologies were treated with various instruments for internal spinal fixation. Forty-two patients underwent 45 procedures from 1990 to 1997, with a mean follow-up of 2.7 years(range 8 months-7 years) RESULTS: The most common disease processes were odontoid fracture(12 patients), os odontoideum(13), and rheumatoid instability(7). Nineteen interspinous wirings, 17 transarticular screw fixations, 9 halifax clamp applications were performed. Three of Halifax fixation and 2 of wiring failed in long term follow up. Among of them, bony fusion was failed in 3 patients which consequently required reoperation. All transarticular screw procedures resulted in successful fusions. CONCLUSIONS: Transarticular screw fixatioin has several potential advantages compare to other procedures as a technique for C1/2 posterior arthrodesis.
Arthrodesis ; Follow-Up Studies* ; Humans ; Pathology ; Reoperation ; Retrospective Studies