The giant cell tumor is an rather common primary bone tumor of young adult 20 to 40 years of age, most frequently found around the knee joint and the distal end of the radius. So the normal life expectancy and the active life style of patient necessitate a reliable and durable surgical remedy for eradicating the tumor and preserving joint function. Although almost are benign, sometimes these tumors are locally invasive and tend to have a high rate of recurrence, and malignant transformation is well known. Thus, a satisfactory method of treatment has not yet be found. Clinical observation were carried out on 44 cases of giant cell tumor of bone in the department of Orthopedic Surgery, Yonsei University College of Medicine from January 1981 through November 1991. Mean follow-up period was 2 years and 9 months. The age incidence was most frequent in third decade (50.0%), with male predominence as a whole. Usual location of the lesion was around the knee(70.5%). The recurrence rate for total cases was 25%: 46.2% after curettage and bone graft ; 25% after curettage and bone cement filling : no recurrence after segmental resection and replantation or amputation. We analyzed the recurrence rate according to the Jaffe s pathologic grades. It looked like higher incidence of local recurrence with higher grade. But due to the small number of patients and short follow-up, we need more cases and follow-up. The local recurrence was noted even after 2 years postoperatively, long term fol low-up is need to find it.
Amputation ; Curettage ; Follow-Up Studies ; Giant Cell Tumor of Bone ; Giant Cell Tumors ; Giant Cells ; Humans ; Incidence ; Joints ; Knee Joint ; Life Expectancy ; Life Style ; Male ; Methods ; Orthopedics ; Radius ; Recurrence ; Replantation ; Transplants ; Young Adult

A segmental resection and rotationplasty was performed in 23 patients with malignant and aggressive benign tumor of the distal femur or proximal tibia between February 1988 and September 1992 at the Severance Hospital. There were 13 male and 10 female patients. The yongest was 5 years old and the oldest was 37 years old. Mean age at operation was 26.2 years. Of the 23 cases, 14 were osteosarcoma, 7 were giant cell tumor and 2 were synovial sarcoma. After an average observation period of 32.5 months, there was no evidence of local recurrence but 6 distant metastases were developed. According to Shriner's rating scale, the functional result were excellent or good in all cases. All patient were convinced that they had chosen the appropriate operative procedure and the ability to achieve high level of activity was considered as the main benefit.
Female ; Femur ; Giant Cell Tumors ; Humans ; Knee ; Male ; Neoplasm Metastasis ; Osteosarcoma ; Recurrence ; Sarcoma, Synovial ; Surgical Procedures, Operative ; Tibia

The results of cementless total knee arthroplasty(TKA) have improved steadly during the past decade due to development of design, fixation and surgical technique. We analyzed the results of 45 total knee arthroplasties performed with Anatomic Modular Knee(AMK) prosthesis at the department of Orthopedic Surgery, Yonsei University College of Medicine between June 1989 and December 1991 and compared their results of rheumatoid arthritis(RA) and osteoarthritis(OA) patients. The follow up ranged from 2 years to 4 years and 2 months (average 2 years and 8 months). Using the Hospital for Special Surgery(H.S.S.) rating system and Knee Society(K.S.) clinical rating system, we found that the clinical results were similar for RA group(Average; H.S.S. 86.1, K.S. 81.2/74.4) and OA group(Average; H.S.S. 88, K.S. 87.8/77.1) even though the preoperative knee score was lower in RA group(Average;H.S.S.42.8) than OA group(Average;H.S.S. 57.7). The average age of RA patients was 14 years younger than that of OA patients. The improvement of range of motin and preoperative flexion contracture after TKA was remarkable in RA group. The radiologic evaluation based on Knee Society roentgenographic evaluation system revealed proper alignment of all component and no definite radiologic loosening except 1 case in which postoperative deep infection had occurred. On the basis of this prospective clinical and radiologic review, we concluded that uncemented implantation of AMK prosthsis both in RA and OA patients was encouraging.
Arthritis, Rheumatoid ; Arthroplasty ; Arthroplasty, Replacement, Knee ; Contracture ; Follow-Up Studies ; Humans ; Knee ; Orthopedics ; Osteoarthritis ; Prospective Studies ; Prostheses and Implants

No abstract available.
Extremities*

PURPOSE: Angiogenesis is essential for the growth and metastasis of tumors. Mechanism of angiogenesis of prostate cancer remains to be defined. Vascular endothelial growth factor(VEGF) is one of the most potent angiogenic factors and we have previously demonstrated that VEGF was expressed by rat ventral prostate in an androgen dependent manner. We herein investigated whether VEGF also plays an important role in tumor angiogenesis of prostate cancer and whether endocrine therapy inhibits expression of VEGF and angiogenesis in prostate cancer. MATERIALS AND METHODS: Frozen tumor tissues were obtained from 21 patients with prostate cancer before and 3 months after endocrine therapy and angiogenic activity was analyzed by measuring microvascular density(MVD) using immunohistochemical study for factor VIII and VEGF expression by RT-PCR -Southern blot assay and immunogistochemical study, respectively. RESULTS: Prostate cancer showed significantly increased expression of VEGF and MVD as compared with normal prostatic tissues and benign hyperplastic tissues(p<0.001). There were signficant correlations between VEGF expression and MVD of prostate cancer tissues. After endocrine therapy, both MVD and VEGF expression in prostate cancer tissues were signficantly decreased as compared with those of before endocrine therapy(p<0.001). There were no signficant differences between bilateral orchiectomy and leuprolelin therapy in inihibitory effect of VEGF expression and MVD in prostate cancer tissues. CONCLUSIONS: These results suggest that VEGF may be a major angiogenic factor in prostate cancer and one of important action mechanisms of endocrine therapy in prostate cancer may be in its inhibition of VEGF expression and tumor angiogenic activity.
Angiogenesis Inducing Agents ; Animals ; Factor VIII ; Humans ; Neoplasm Metastasis ; Orchiectomy ; Prostate* ; Prostatic Neoplasms* ; Rats ; Vascular Endothelial Growth Factor A*

PURPOSE: Renal oncocytoma has been a focus of interest in urologic oncology. The biologic and molecular characteristics of this disease remains ill defined due to paucity of ideal in vitro model. In this present study a new cell line of human renal oncocytoma, CURO, has been established and characterized. MATERIALS AND METHOD: The CURO cells were cultured from tissues obtained from radical nephrectomy specimen of incidentally found renal oncocytoma. The cellular and molecular biological characleristics of CURO cells were analyzed. RESULTS: CURO cells grew in monolayer with a rapid doubling time of 20 hours. The cells showed abundant mitochondria and well developed microvilli, and expressed cytokeratin, epithelial membrane antigen, and lectins of distal renal tubular and collecting duct origin. The cells showed aneuploidy with high proportion of cells in G2+M phase(27%) on flow cytometric analysis. Karyotyping study revealed clonal heterogeneity: Majority showed normal 46XX, whereas, 12% of cells showed deletion or translocation of chromosome 19, but none of the cells showed abnormality of 3p. The cells neither showed mutation of p53 gene and nor expressed two major angiogenic factors of renal cell carcinoma: vascular endothelial growth factor and basic fibroblast growth factor. The CURO cells didn't show tumorigenecity in athymic nude mouse on either subcutaneous or subrenal capsular implantation. CONCLUSIONS: The results of this study suggest that CURO may be a valuable model to study renal oncocytoma. Renal oncocytoma may be a benign tumor of distal renal tubular or collecting duct origin, but it may contain clone with high proliferative activity. Change of chromosome 19 may be a marker of development or proliferation of renal oncocytoma.
Adenoma, Oxyphilic* ; Aneuploidy ; Angiogenesis Inducing Agents ; Animals ; Carcinoma, Renal Cell ; Cell Line ; Chromosomes, Human, Pair 19 ; Clone Cells ; Fibroblast Growth Factor 2 ; Genes, p53 ; Humans* ; Karyotyping ; Keratins ; Lectins ; Mice ; Mice, Nude ; Microvilli ; Mitochondria ; Mucin-1 ; Nephrectomy ; Population Characteristics ; Vascular Endothelial Growth Factor A

A concealed penis is a normally developed penis that becomes camouflaged by the suprapubic fat pad. This anomally can be congenital or iatrogenic following circumcision. A special variety of this disease is a retractile concealed penis with dysgenetic band of dartos fascia which produce recurrence not infrequently after operative correction by conventional method. We herein report 2 cases of concealed penis of which one case was a recurrent one and another was a case of severe degree with concomittent obesity where a new method for operative correction was applied.
Adipose Tissue ; Circumcision, Male ; Fascia ; Female ; Male ; Obesity ; Penis* ; Recurrence

In Order to evaluate determinants of successful percutaneous transluminal coronary angioplasty (PTCA), PTCA was performed for 172 coronary arterial lesions in 120 patients(89 male, 31 female) at Yeungnam university hospital from Sep. 1992 to Aug 1993. The corinary artery luminal diameter at the site of the original stenosis was eveluated from end-diastolic frames of identical projections of the preangioplasty and immediate post angioplasty. The coronary luminal and balloon diameters were measured with using of computer measuring system. Overall success rate of 172 attempted lesions was 87.2%. Success rate of female patients was 93.5% and higher than those of male patients. According to the clinical diagnosis, success rate in stable angina was 93.7% and higher than those of post myocardial infarction angina, unstable angina and acute myocardial infarcrion. Success rate of American Heart Association type C lesion was 65.5% and lower those of type A(95.7%), type B (89.%). There was significantly difference in preangioplasty luminal stenosis, elastic recoil and length of lesion between successful PTCA group and failed PTCA group. Success rate of lesion location at a bed >45° and presence of intracoronary thrombus were lower than than those of other angiographic findings. In coclusion, primary angioplasty success was affected by specific angiographic factors, Stenosis severity, thrombus, lesion location at a bend >45°, elastic recoil, and length of lesion were the principle of determinants of coronary angioplasty success rate.
American Heart Association ; Angina, Stable ; Angina, Unstable ; Angioplasty ; Angioplasty, Balloon, Coronary* ; Arteries ; Constriction, Pathologic ; Diagnosis ; Female ; Humans ; Male ; Myocardial Infarction ; Phenobarbital ; Thrombosis

OBJECTIVE: This prospective, non-randomized study compared the safety and efficacy of the Angio-Seal(TM) Evolution(TM) to that of manual compression for common femoral artery punctures in neurovascular diagnostic angiography. METHODS: From June 2009 to September 2009, we performed 169 diagnostic trans-femoral cerebral angiographies, using either the Angio-Seal(TM) Evolution(TM) or manual compression to achieve hemostasis. We included 60 patients in this study, 30 in each group. We defined minor complications as those requiring no further treatment such as hematoma size less than 6 cm and bruise size less than 25 cm. Major complications were those requiring surgery of the femoral artery pseudoaneurysm and/or the second line increase of hospital stay even without further treatment. RESULTS: Mean time to hemostasis was 0.42+/-0.04 minutes for the angioseal and 15.83+/-1.63 minutes for manual compression (p<0.001). Overall complication rate did not differ between the 2 groups. After the patients were fully mobile, at 24 hours, the rate of onset of new complication differed significantly between the 2 groups (p=0.032). In the angioseal group, 5 (16.7%) of the 30 patients experienced the onset of a new complication after 24 hours, including 3 (60.0%) of the 5 who experienced major complications. CONCLUSION: The Angio-Seal(TM) Evolution(TM) is effective at decreasing mean time to hemostasis, like other closing devices. However, it may not be effective at producing early ambulation and discharge, compared to manual compression, because delayed complications may occur significantly after 24 hours.
Aneurysm, False ; Angiography ; Cerebral Angiography ; Contusions ; Early Ambulation ; Femoral Artery ; Hematoma ; Hemostasis ; Humans ; Length of Stay ; Prospective Studies ; Punctures

To develop an objective and scientific method to evaluate the brain injured and brain diseased persons with motor dysfunction, American Medical Association's Guides to the Evaluation of Permanent Impairment was used as an exemplar. After the motor dysfunction due to brain injury or brain disease was confirmed, active range of motion and muscle strength of affected extremities were measured. Also, the total function of extremities was evaluated through the assessment of activities of daily living, fine coordination of hand, balance and gait. Then, the total score of manual muscle test and functional assessment of impaired upper and lower extremity were added, respectively. Spasticity of upper and lower extremity was used as minus factors. Patients with movement disorder such as Parkinson's disease were assessed based on the degree of dysfunction in response to medication. We develop a new rating system based on the concept of total score.
Brain Diseases/classification/*diagnosis/physiopathology ; Brain Injuries/classification/*diagnosis/physiopathology ; *Disability Evaluation ; Hand/physiopathology ; Humans ; Korea ; Lower Extremity/physiopathology ; Motor Skills ; Program Development ; Severity of Illness Index ; Upper Extremity/physiopathology