We found that the packing of a rolled tensor fascia lata flap after the excision of avascular lunate was reasonably effective in relieving symptoms in 4 patients with advanced Kienbock's disease, even though there was still some residual postoperative loss of wrist motion and grip strength, and the slightly progressive tendencies of earpal collapse and translation as well as rotational deformities of scaphoid. Pre-operatively all patients had pain and limited motion of the wrist as well as weakness of grip. Roentgenographically all had sclerosis, fragmentation and collapse of the lunate. They were analysed each two cases in advanced stage II and III according to the classification by Lichtman. Most had symptoms for longer than two and half years. After removal of the avascular lunate through a dorsal incision, a rolled tensor fascia lata flap was packed to fit the defect. Patients were followed for an average of sixteen months. All were improved clinically but there were somewhat postoperative progress in carpal collapse, translation and rotational deformities of scaphoid roentgenographically.
Classification ; Congenital Abnormalities ; Fascia Lata ; Fascia ; Hand Strength ; Humans ; Osteonecrosis ; Sclerosis ; Wrist

Sleeve type fracture of the patella in children is an extremely rare injury. Its avulsed fragment is so small that the diagnosis may be missed by radiogram and patella slta is complicated. A 14 year-old boy having the sleeve type fracture of the patella with patella alta was treated by open reduction with s screw fixation at St. Vincent Hospital in December 1985 and was followed up over two years. The final clinical result was good.
Child ; Diagnosis ; Humans ; Male ; Patella

This study was primarily undertaken to assess the value of continuous spinal anesthesia for total hip replacements (Charnley's low friction arthroplasty), which had been done under the Filtered Air Flow System for the prevention of wound contamination due to long term exposure. The results were as follows: 1. Preoperative diagnosis was in 4 cases hip joint tuberculosis,in 2 cases avascular necreosis, in 2 cases femur fracture, and in 2 cases osteoarthritis of the hip joint. 2. Average blood loss was 2, 800 ml for a one side operation and 5, 000 ml for a bilateral one. Overall average blood loss with continuous spinal anesthesia was 2, 600 ml and with general anesthesia was 1, 725 ml, and with amount of difference being 1. 175 ml more in the spinal anesthesia group (p<0. 025). 3. In 4 eases (40%) the hypotensive range was over 30% of the preoperative level, but recovery occurred soon after administration of Effortil. 4. Practically management of a patient with continuous spinal anesthesia is easier' thai with general anesthesia for total hip replacement, with fieeing of the anesthesio1ogist'a hands for better care of the patient during anesthesia.
Anesthesia ; Anesthesia, General ; Anesthesia, Spinal* ; Arthroplasty, Replacement, Hip* ; Asian Continental Ancestry Group ; Diagnosis ; Etilefrine ; Femur ; Friction ; Hand ; Hip Joint ; Humans ; Osteoarthritis ; Wounds and Injuries

Several mechanisms for subluxation of the lateral meniscus, such as a bucket-handle tear, popliteomeniscal fascicle tear or meniscocapsular junction separation, have been recognized. The cause can be identified through a magnetic resonance imaging (MRI) examination and the arthroscopic findings, and treatment can proceed accordingly. The authors report a case of a 28-year-old male in whom the lateral meniscus was subluxated and reduced without any abnormal findings on arthroscopic probing contrary to preoperative MRI findings.

Thirty nine strains and 109 strains of Shigella sonnei were isolated from the outbreaks of Youngchun and Kyungju, respectively, while 15 strains were isolated from sporadic cases of eight regions in Kyungbuk province from September to November in 1998. We investigated the relationship among the S. sonnei strains by using biochemical characteristics, biotyping, antibiotic resistance pattern, and plasmid profile. Among the isolates, seven strains of S. sonnei isolated in Youngchun showed gelatin hydrolyase positive but the others showed gelatin hydrolyase negative. One hundred and fifty two strains were a type, while eleven among thirty nine strains isolated in Youngchun were g type. Antibiotics resistance patterns of S. sonnei strains isolated in Youngchun and Kyungju were significantly different. Thirty nine strains of S. sonnei isolated in Youngchun were resistant to SM, TE, and TMP/SMX, while eighty six of S. sonnei among one hundred and nine strains isolated in Kyungju were resistant to AM, CB, K, SM, TE, and TMP/SMX. Antibiotics resistance patterns of residual twenty three isolates were similar to those of eighty six strains. The Plasmid profiles of strains of S. sonnei isolated from the Kyungju were different from those of S. sonnei strains isolated in Youngchun. The Plasmid profiles of S. sonnei strains isolated from Youngchun were identical to those of a S. sonnei strains randomly selected from the outbreak in Daegu in 1998. The Plasmid profiles of S. sonnei strains isolated from Kyungju were identical to those of two strains of S. sonnei randomly selected from the outbreaks of Kanglung and Wonju in 1998. From the above results, it is considered that the strains of S. sonnei isolated from Kyungju and Youngchun region are not identical clone.
Anti-Bacterial Agents ; Clone Cells ; Daegu ; Disease Outbreaks ; Drug Resistance, Microbial* ; Gangwon-do ; Gelatin ; Gyeongsangbuk-do* ; Plasmids* ; Shigella sonnei* ; Shigella*

BACKGROUND: Several studies have been conducted on the role of the p63 gene family in non-small cell lung carcinoma (NSCLC). Nevertheless, the role of these genes in the development and progression of NSCLC remains controversial. This study was designed to examine the expression and clinicopathologic significance of the p63 family in NSCLC. METHODS: Immunohistochemical staining was performed on 92 cases of NSCLC (47 squamous cell carcinomas [SqCCs] and 45 adenocarcinomas [ACs]) using tissue microarray blocks. The results were analyzed and correlated with clinicopathologic data. RESULTS: The expression of delta Np63 (Delta Np63) was elevated in SqCC (39/47), but not in AC (2/45; p<0.01). Both p63 and Delta Np63 had high expression in 39 SqCCs; p63 and Delta Np63 also had a similar geomorphologic distribution in most positive tumors. The expression of Delta Np63 was correlated with histologic type, gender, pT stage, p53 expression, and p63 expression. pT and pN stages were independent factors in survival (p<0.05, respectively). CONCLUSIONS: The major p63 isoform in NSCLC, Delta Np63, had a strong correlation with p53 and p63, and was exclusively expressed in SqCC. However, our findings suggest that Delta Np63 was not an independent prognostic factor for NSCLC.
Adenocarcinoma ; Carcinoma, Non-Small-Cell Lung ; Carcinoma, Squamous Cell ; Humans ; Immunohistochemistry ; Lung

PURPOSE: The purpose of this study was to evaluate the prognostic value of skeletal muscle depletion measured on computed tomography (CT) in patients with non-metastatic invasive breast cancer. METHODS: This retrospective study included 577 consecutive women (mean age ± standard deviation: 48.9 ± 10.2 years with breast cancer who underwent a preoperative positron-emission tomography (PET)/CT scan and curative surgery between January 2012 and August 2014. The total abdominal muscle area (TAMA), subcutaneous fat area (SFA), and visceral fat area (VFA) were measured on CT images at the L3 vertebral level. Univariate and multivariate Cox proportional-hazard regression analyses were performed to evaluate whether there was an association between sarcopenia and overall survival (OS) outcome. RESULTS: Of the 577 women, 49 (8.5%) died after a mean of 46 months. The best TAMA threshold for predicting OS was 83.7 cm². The multivariate Cox proportional-hazard analysis revealed that sarcopenia (TAMA ≤ 83.70 cm²) was a strong prognostic biomarker (hazard ratio [HR], 1.951; 95% confidence interval [CI], 1.061–3.586), along with large tumor size, axillary lymph node metastasis, high nuclear grade, estrogen receptor status, and adjuvant radiation therapy. In the subgroup analysis of patients aged ≥ 50 years, TAMA (≤ 77.14 cm²) was a significant independent factor (HR, 2.856; 95% CI, 1.218–6.695). CONCLUSION Skeletal muscle depletion measured on CT was associated with worse OS outcome in patients with non-metastatic breast cancer.

This study examined the effectiveness of Holmium-166 (Ho-166) chitosan complex therapy for a malignant glioma. Cultured C6 glioma cells (100, 000 in 5microliter) were injected into the caudate/putamen of 200 - 250 gram Wistar rats. Five days later, a Ho-166 chitosan complex was injected into the same site of the glioma injection. Four injection doses were administered: the control group received PBS 10microliter, group 1 received an injection of 100micro Ci (10microliter), group 2 received an injection of 50microCi (5microliter), and group 3 received an injection of 10micro Ci (1microliter). The average tumor volume for each group was 1.385 mm3 for the control group, 0.036 mm3 for group 1, 0.104 mm3 for group 2, and 0.111 mm3 for group 3. Compared with the control group, the size of the tumors in groups 1, 2 and 3 was reduced by an average of 97.4%, 92.5% and 91.9%, respectively. The Kaplan-Meier survival curve of group 2 was the longest, followed by groups 3, group 1 and the control. The mean survival was 22.8, 59, 60, and 44.6 days for the control group and groups 3, 2 and 1, respectively. H-E staining revealed that group 2 yielded the best results in the destruction of the malignant glioma. TUNEL staining and immunohistochemical studies indicated apoptotic features. The Ho-166 chitosan complex proved to be effective in destroying the malignant glioma.
Animals ; Brachytherapy ; Brain Neoplasms/mortality/pathology/*radionuclide imaging ; Cell Line, Tumor ; Chitin/analogs & derivatives/*pharmacology ; Disease Models, Animal ; Glioma/mortality/pathology/*radionuclide imaging ; Holmium/*pharmacology ; Radioisotopes/*pharmacology ; Rats ; Rats, Wistar ; Research Support, Non-U.S. Gov't

PURPOSE: To compare the treatment outcomes and to analyze prognostic factors between the use of a breast-conserving treatment (BCT) and a mastectomy for early stage breast cancer. MATERIALS AND METHODS: We retrospectively reviewed 1,200 patients with pathological stage T1-2N0 breast cancer who received surgery between September 1994 and December 2002 at Samsung Medical Center. We compared the patient characteristics and treatment outcomes between the two treatment groups. RESULTS: Among the 1,174 eligible patients, 601 (51.2%) patients received a BCT and the remaining 573 (48.8%) patients received a mastectomy. The mastectomy group of patients had significantly more cases with a larger tumor size, multicentricity, extensive intraductal component, and estrogen- and progesterone-receptor negativity. The ten-year overall survival rates (OS) of the BCT and mastectomy groups were 91.96% and 91.01%, respectively (p=0.1274). The ten-year disease-free survival rates (DFS) were 80.48% for the BCT group of patients and 84.95% for the mastectomy group of patients, respectively (p=0.8795). CONCLUSION: Our study shows some differences in patient characteristics between the two treatment groups. However, these differences did not result in significant survival differences.
Breast Neoplasms

Mucopolysaccharidosis (MPS) III has 4 enzymatically distinct forms (A, B, C, and D), and MPS IIIC, also known as Sanfilippo C syndrome, is an autosomal recessive lysosomal storage disease caused by a deficiency of heparan acetyl-CoA:alpha-glucosaminide N-acetyltransferase (HGSNAT). Here, we report a case of MPS IIIC that was confirmed by molecular genetic analysis. The patient was a 2-yr-old girl presenting with skeletal deformity, hepatomegaly, and delayed motor development. Urinary excretion of glycosaminoglycan (GAG) was markedly elevated (984.4 mg GAG/g creatinine) compared with the age-specific reference range (<175 mg GAG/g creatinine), and a strong band of heparan sulfate was recognized on performing thin layer chromatography. HGSNAT enzyme activity in leukocytes was 0.7 nmol/17 hr/mg protein, which was significantly lower than the reference range (8.6-32 nmol/17 hr/mg protein). PCR and direct sequencing of the HGSNAT gene showed 2 mutations: c.234+1G>A (IVS2+1G>A) and c.1150C>T (p.Arg384*). To the best of our knowledge, this is the first case of MPS IIIC to be confirmed by clinical, biochemical, and molecular genetic findings in Korea.
Acetyltransferases/*genetics ; Asian Continental Ancestry Group/*genetics ; Base Sequence ; Child, Preschool ; Chromatography, Thin Layer ; Female ; Glycosaminoglycans/urine ; Heparitin Sulfate/chemistry/metabolism ; Humans ; Leukocytes/immunology/metabolism ; Mucopolysaccharidosis III/*diagnosis/genetics/radiography ; Mutation ; Republic of Korea ; Sequence Analysis, DNA