Fifty-nine knees with a specific diagnosis of mediopatella plica syndrom; under arthroscopy were treated by arthroscopic resection. The patients were se1ected for arthroscopy only if the symptoms had continued after a course of physical therapy and medication for at least three weeks. Seven patients were lost in follow up period. Fifty-two knees were reviewed after mean period of 21.5 monl;hs (range 12 to 37). The results were graded as excelient (61.5%), good (25%), poor (9.6%) and failure (3.9%). Majority of the patients ratect their result as excellent or good. We concluded that with the meticulous resection of the pathologic plica with arthroscopy, good result can he expected with resumption of athletic activities and no or mild pain in knee joint.
Arthroscopy ; Diagnosis ; Follow-Up Studies ; Humans ; Knee Joint* ; Knee* ; Sports

Idiopathic hypereosinophilic syndrome is a rare systemic, leukoproliferative disorder characterized by eosinophil- mediated tissue injury causing multiple organ failure, including the heart. Cardiac involvement occurs in more than 75% of patients with hypereosinophilic syndrome. Cardiac manifestations include subendocardial fibrosis, thrombus leading to peripheral emboli, restrictive cardiomyopathy, and valvular dysfunction. It is more common in men than in women (9:1), and trends to present between the ages of 20 and 50 years. Presentation in childhood is unusual. We report for the first time a case of a 58-year-old man with idiopathic hypereosinophilic syndrome manifested by prosthetic aortic valve dysfunction that was successfully treated by steroid and hydroxyurea therapy after surgical valvular replacement.
Aortic Valve* ; Cardiomyopathy, Restrictive ; Female ; Fibrosis ; Heart ; Humans ; Hydroxyurea ; Hypereosinophilic Syndrome* ; Male ; Middle Aged ; Multiple Organ Failure ; Thrombosis

The well-known prognostic factors for breast cancer, such as axillary lymph node status, do not always account for the exact outcome. The development of other accurate prognostic factors would help in assessing high risk for recurrence and death. Recently, much experimental evidence has accumulated showing that tumor growth and metastasis are dependent on tumor angiogenesis. To investigate the status of angiogenesis in breast cancer, we counted the microvessel density(MVD) of breast cancer tissues, which were stained with anti-CD34 antibody, as a measure of tumor angiogenesis. We classified 43 breast-cancer patients into 22 with low MVD (<47/200 PF) and 21 with high MVD (> or =47/200 PF). We estimated the correlations between the MVD and other established prognostic factors. We also calculated survivals based on MVD. The MVD was in the range between 10 and 93(mean SD=46.9 21.7). The positive rate of lymph-node metastasis in high-MVD patients was 32.6%, which was higher than the 23.3% for low- MVD patients. We found a significant correlation between MVD and histologic grade (p=0.037), but could not find any significant correlation between MVD and menopausal status, tumor size, nuclear grade, estrogen receptor, or progesterone receptor. Retrospectively, the receptor status of estrogen and of progesterone had significant impacts on survival (ER : p=0.0001, PR : p=0.0001). The 4-year disease-free survival rate of high-MVD patients was 56.6 12.5%, and that of low-MVD patients was 69.0 10.8% (p=0.449). The 4-year overall survival rate of high-MVD patients was 71.1 11.1%, and that of low-MVD patients was 74.1 12.2 (p=0.449). In conclusion, the determination of MVD in breast cancer tissue may be useful as a prognostic factor, but it is necessary to investigate the MVD in a large number of patients before this conclusion can be stated with certainty.
Breast Neoplasms* ; Breast* ; Disease-Free Survival ; Estrogens ; Humans ; Lymph Nodes ; Microvessels ; Neoplasm Metastasis ; Progesterone ; Receptors, Progesterone ; Recurrence ; Retrospective Studies ; Survival Rate

The well-known prognostic factors for breast cancer, such as axillary lymph node status, do not always account for the exact outcome. The development of other accurate prognostic factors would help in assessing high risk for recurrence and death. Recently, much experimental evidence has accumulated showing that tumor growth and metastasis are dependent on tumor angiogenesis. To investigate the status of angiogenesis in breast cancer, we counted the microvessel density (MVD) of brest cancer tissues, which were stained with anti-CD34 antibody, as a measure of tumor angiogenesis. We classified 43 breast-cancer patients into 22 with low MVD (<47/200xPF) and 21 with high MVD (> or =47/200xPF). We estimated the correlations between the MVD and other established prognostic factors. We also calculated survivals based on MVD. The MVD was in the range between 10 and 93 (mean+/-SD=46.9+/-21.7). The positive rate of lymph-node metastasis in high MVD patients was 32.6%, which was higher than the 23.3% for low-MVD patients. We found a significant correlation between MVD and histologic grade (p=0.037), but could not fine any significant correlation between MVD and menopausal status, tumor size, nuclear grade, estrogen receptor, or progesterone receptor. Retrospectively, the receptor status of estrogen and of progesterone had significant impacts on survival (ER: p=0.0001, PR: p=0.0001). The 4-year disease-free survival rate of high-MVD patients was 56.6+/-12.5%, and that of low-MVD patients was 69.0+/-10.8% (p=0.449). The 4-years overall survival rate of high-MVD patients was 71.1+/-11.1%, and that of low-MVD patients was 74.1+/-12.2 (p=0.449). In conclusion, the determination of MVD in breast cancer tissue may be useful as a prognostic factor, but it is necessary to investigate the MVD in a large number of patients before this conclusion can be stated with certainty.
Breast Neoplasms* ; Breast* ; Disease-Free Survival ; Estrogens ; Humans ; Lymph Nodes ; Microvessels ; Neoplasm Metastasis ; Progesterone ; Receptors, Progesterone ; Recurrence ; Retrospective Studies ; Survival Rate

BACKGROUND: Rapid and accurate diagnosis is essential for successful management of acute aortic dissection. As transesophageal echocardiography(TEE) provides excellent imaging of thoracic aorta conveniently, TEE is widely indicated as a effective diagnostic method of aortic disease. To evaluate clinical usefulness of TEE in patients with suspected aortic dissection, we assessed diagnostic accuracy and feasibility of TEE. METHODS: Ninety-one consecutive patients with clinically suspected aortic dissection were examined by TEE, computerized tomography(CT), magnetic resonance imagion(MRI) and aortic angiography between August 1991 and September 1994. The diagnosis was confirmend by these techniques and surgery. RESULTS: 1) We diagnosed 27 proximal aortic dissection, 22 distal aortic dissection, 8 aortic intramural hematioma, 12 thoracic aortic aneurysm, 2 penetration ulcer, 1 necrotizing aortitis, 1 traumatioc aortic rupture and 18 normal findings in 91 study patients. 2) The sensitivity and specificity of TEE for aortic dissection were 98% and 97%, respecitively. The sensitivity and specificity of TEE to detect ascending aorta involvement were 94% and 100%. 3) CT was chosen in 62 cases as primary diagnostic method of aortic dissection, whereas TEE was performed in 21 cases. TEE was chosen as confirmative diagnostic method following CT in 45 cases, in one-third of whom TEE played a great role in diagnosis or decision of treatment modality. CONCLUSION: As TEE is and accurate and practical method in diagnosis of aortic dissection, TEE may be suggested as primary diagnostic method in suspected aortic dissection. TEE was also useful as confirmative diagnostic method complemention CT.
Angiography ; Aorta ; Aorta, Thoracic ; Aortic Aneurysm, Thoracic ; Aortic Diseases ; Aortic Rupture ; Aortitis ; Complement System Proteins ; Diagnosis* ; Echocardiography, Transesophageal* ; Humans ; Sensitivity and Specificity ; Ulcer

PURPOSE: We examined the effect of lowering prostate-specific antigen (PSA) threshold on the number of Korean men requiring a prostate biopsy. MATERIALS AND METHODS: We evaluated men who had serum PSA levels tested at routine physical check-ups between 1999 and 2005 at 11 domestic hospitals. Men with PSA> or =10ng/ml or patients with prostate cancer were excluded. A total of 45,074 men(aged 50 to 79 years) were enrolled and split into three age groups: 50-59 years, 60-69 years, and 70-79 years. For each age group, we calculated the number and proportion of men whose PSA level exceeded potential biopsy thresholds: 2.5ng/ml, 3.0ng/ml, and 4.0ng/ml. Results were extrapolated to the 4.992 million men older than 50 years old, or 21.3% of the Korean male population in 2005. RESULTS: The number of biopsy candidates at the threshold of 4.0ng/ml, 3.0ng/ml, and 2.5ng/ml were 1,321(2.9%), 2,248(5.4%), and 3,577(7.9%), respectively. Extrapolating to the male population in Korea, lowering the PSA threshold from 4.0ng/ml to 3.0 or 2.5ng/ml would increase the number of men needing biopsy by 1.75 and 2.49 times, respectively. CONCLUSIONS: Lowering the PSA threshold would increase the number of men receiving prostate biopsy despite the low reference age for PSA in Korea. Considering the low incidence of prostate cancer, physicians should be careful in altering the PSA threshold.
Biopsy ; Humans ; Incidence ; Korea ; Male ; Prostate ; Prostate-Specific Antigen ; Prostatic Neoplasms

BACKGROUND: The heart transplantation is now accepted as a definitive therapeutic modality in patients with terminal heart failure. The first successful heart transplantation in human was done in 1967 and the first case in Korea was performed in November, 1992. Since the first case in 1992, more than 25 cases have been performed in Korea. The purpose of this study is to evaluate the early results and the follow-up course of 9 cases of heart transplantation done in Asan Medical Center. METHODS: Total 9 patients had orthotopic heart transplantation since November, 1992 in Asan Medicla Center. The No. of male patients was 7 and the average age of 9 patients was 41 years old(20-51). The preoperation status was status I in 5 patients and status II in 4 patients. The mean follow-up duration was 9.5 months(2-26). All patients are alive till now. RESULTS: 1) The blood type was identical in 6 and compatible in 3 patients. 2) The original heart disease was dilated cardiomyopathy in 7, ischemic cardiomyopathy in 1 and giant cell myocarditis in 1 patient. 3) IgG Ab for CMV was positive in all recipients and donors and igM Ab for CMV was positive in only one reipient. The serial cultures for CMV shell vial method have been negative till now. 4) HLA cross matching for recipient and donor was done in 8 cases and the results were all negative for T-cell and B-cell. Among 6 loci of A, B and DR, one locus was matched in 4 cases and 2 loci was matched in 2 cases. 5) The No. of acute allograft rejection per case was average 3.7(1-6) and the No. of acute allograft rejection requiring treatment was average 1.4(1-3) per case. The time interval from operation to the first acute rejection requiring treatment was 40 days(5-60). Acute humoral rejection was supected strongly in 1 case and was successfully treated. 6) The left ventricular ejection fraction measured by echocardiography and/or MUGA scan was dramatically increased from 15%(10-24) to 59%(45-70%) after heart transplantation. 7) Temporary pacing was needed in 2 parients over24 hours but normal sinus rhythm was appeared within 7 day in all cases. One patient had permanent pacemaker due to complte AV block appeared 140 days after heart transplantaion. CONCLUSION: The heart transplantation of Asan Medical Center is on developing stage but the early result is comparable to that of well established center in other countries, even though the long-term follow-up result must be reevaluated. We can conclude that the heart transplantion is a promising therapeutic option in parients with terminal heart failure.
Allografts ; Atrioventricular Block ; B-Lymphocytes ; Cardiomyopathies ; Cardiomyopathy, Dilated ; Chungcheongnam-do ; Echocardiography ; Follow-Up Studies ; Giant Cells ; Heart Diseases ; Heart Failure ; Heart Transplantation ; Heart* ; Humans ; Immunoglobulin G ; Immunoglobulin M ; Korea ; Male ; Myocarditis ; Stroke Volume ; T-Lymphocytes ; Tissue Donors

BACKGROUND/AIMS: This study characterized the cisplatin nephrotoxicity occurring in patients treated with chemotherapy for lung cancer. METHODS: In all, 124 patients with lung cancer received cisplatin 70 mg/m2 on day 1 every three weeks for up to six cycles with preventive hydration using 3 L of 0.45% saline. Acute and chronic cisplatin nephropathy were defined as an increase in serum creatinine > or =30% at 3 weeks after each cisplatin administration and an increase in serum creatinine > or = 50% after the six cycles of chemotherapy, respectively. RESULTS: Acute cisplatin nephropathy occurred in 23 of 124, 8 of 110, 6 of 92, 10 of 68, 7 of 59, and 7 of 45 patients after the 1st to 6th cycle of chemotherapy, respectively. In all, 51 patients (51.5%) experienced acute cisplatin nephropathy. Chronic cisplatin nephropathy occurred in 25 out of 45 patients (55.5%). The occurrence of chronic cisplatin nephropathy was significantly associated with that of acute cisplatin nephropathy (p<0.01). In chronic cisplatin nephropathy, the serum creatinine increased to 1.82+/-1.18 mg/dL from the basal 0.82+/-0.11 mg/dL (p<0.01). It was 1.60+/-1.05 mg/dL at the end of the follow-up period (112+/-90 days). CONCLUSIONS: Despite prophylactic hydration, the incidence of cisplatin nephropathy in patients with lung cancer is still high. Acute cisplatin nephropathy may predispose patients to chronic cisplatin nephropathy, but the latter does not seem to be progressive.
Cisplatin ; Creatinine ; Follow-Up Studies ; Humans ; Incidence ; Lung ; Lung Neoplasms ; Renal Insufficiency