PURPOSE: With advances in various treatment modalities, limb salvage surgery has been commonly used in osteosarcoma of extremities. An alternative method for skeletal reconstruction is reimplantation of the tumor bearing bone following extracorporeal irradiation (ECI). We report the long-term results of ECI autograft in aspect of the oncological and functional outcomes, and complications. MATERIALS AND METHODS: We retrospectively reviewed 31 osteosarcoma patients who underwent reconstruction with ECI between July 1995 and January 2006. There were 24 males and 7 females with a mean age of 24 (7-74 years) and a mean follow-up of 117 months (17-177 months). Twenty-five cases were reconstructed with ECI autograft, 6 cases with ECI autograft-prosthesis composite. The pathologic subtypes were conventional in 29 cases, periosteal in 1 case, and parosteal in 1 case. The most common location of tumor was distal femur (15 cases) followed by humerus (3), proximal fibula (3) and proximal tibia (3). Musculoskeletal Tumor Society (MSTS) score was used for functional evaluation. The overall survival rate, local recurrence, complications were analyzed. RESULTS: The overall survival rate was 80.6% and the disease-free survival rate was 64.5%. Five patients died of distant metastasis. One patient required above-knee amputation due to local recurrence. All of them, twenty-three complications occurred, which included nonunion in 7 cases, deep infection in 5 cases, joint instability in 4 cases, metal failure in 2 cases, Limb-length discrepancy (LLD) in 2 cases, periprosthetic fracture in 1 case, epiphyseal collapse in 1, local recurrence in 1 case. The mean MSTS functional score was 62.5%. CONCLUSION: Extracorporeal irradiated autograft can be achieved relatively good result in aspect of oncological and functional aspect, but is needed to be additional research about occurring many complications. The reconstruction with ECI after intercalary or fragmentary resection is effective reconstruction in aspect of oncological and functional result, complications.
Amputation ; Disease-Free Survival ; Extremities ; Female ; Femur ; Fibula ; Follow-Up Studies ; Humans ; Humerus ; Joint Instability ; Limb Salvage ; Male ; Neoplasm Metastasis ; Osteosarcoma ; Periprosthetic Fractures ; Recurrence ; Replantation ; Retrospective Studies ; Survival Rate ; Tibia ; Ursidae

BACKGROUND: Long-term oral itraconazole and terbinafine are widely used in the treatment of onychomycosis. Accelerated nail growth in patients with itraconazole has been described in several reports. However, there has been no report regarding the effect of antifungal agents on cultured nail matrix cells(NMCs). OBJECTIVE: We applied several antifungal agents on cultured human NMCs and epidermal kera- tinocytes(EKs) to compare the cytotoxicity of several antifungal agents and also to verify possible stimulating effects of itraconazole and 6-hydroxyitraconazole on nail growth. METHODS: To evaluate the effect of antifungal agents, the 3-(4,5-dimethylthiazo1-2-yl) 2,5-diphenyl- tetrazolium bromide(MTT) test, tritiated thymidine incorporation test, and lactic dehydrogenase(LDH) leakage test were used. RESULTS: Dose dependent decreases in cell viability and DNA synthesis, and dose dependent increases in LDH liberation were observed in cultured human NMCs and EKs after exposure to several antifungal agents. The dose-response reaction patterns for NMCs and EKs to antifungal agents were similar. The cytotoxicity potency of several antifungal agents measured by each method were slightly different. Itraconazole and 6-hydroxyitraconazole did not show stimulating effects on cell proliferation in in vitro monolayer cell culture systems. CONCLUSION: These observations suggest that itraconazole appeared less cytotoxic but showed no stimulating effects on nail matrix cell proliferation in vitro. Cultured human EKs as well as NMCs may be useful in evaluating the effects of agents which are involved in nails.
Antifungal Agents* ; Cell Culture Techniques ; Cell Proliferation ; Cell Survival ; DNA ; Humans* ; Itraconazole ; Keratinocytes* ; Onychomycosis ; Thymidine

PURPOSE: To analyze the clinical features and treatment outcome of Langerhans' cell histocytosis. MATERIALS AND METHODS: From August 1996 to June 2013, 28 patients who histologically proven with LCH were analyzed of medical records, radiography, pathologic character retrospectively. RESULTS: A total of 28 cases of LCH including 22 child has been reported. Onset age was 0.6 to 51 years old, occurred in the average age was 14.8 years. Follow-up period was 6 months to 134 months average was 44.6 months. The M:F ratio was 2.5:1. The initial symptoms was pain in 18 cases, 5 cases of pathologic fracture, 3 case of palpable mass, 1 case of discovered by accident in radiography, 1 case of torticollis. In radiological examination osteolysis was seen all cases, 7 cases showed a periosteal reaction, 1 case showed soft tissue extension. Clinical type of all cases were eosinophilic granuloma. 25 cases were classified as unifocal disease and 3 cases were multifocal single systemic diseases. In all cases, incisional biopsy was performed. After histologic confirmed, 14 cases was treated with curettage or surgical excision of the lesion and the other 14 cases were followed up without treatment. There is no death during follow up period. 11 cases has no radiological improvement after 3-6 months observation, intralesional steroid injection was performed. CONCLUSION: Patients with LCH who has rapid systemic onset is very rare, so if you meet the young children who suspected LCH, you shoulder avoid the examination which cause excessive radiation exposure to the young patient. In order to confirm the diagnosis of disease, biopsy is needed. Close observation after confirmed by histological method will bring the satisfactory results. But the patients who had pathologic fracture or wide bone destruction already may need curettage and bone grafting to lesion or internal fixation. The lesion which has no radiological improvement after 3-6 months observation or appear with pain interferes daily life may need local steroid injection as a good treatment.
Age of Onset ; Biopsy ; Bone Transplantation ; Child ; Curettage ; Diagnosis ; Eosinophilic Granuloma ; Follow-Up Studies ; Fractures, Spontaneous ; Histiocytosis, Langerhans-Cell ; Humans ; Medical Records ; Osteolysis ; Radiography ; Retrospective Studies ; Shoulder ; Torticollis ; Treatment Outcome*

A 63 Year-old-lady has had substernal chest pain on exertion for 8 years. The chest pain has been increased over the last 3 years. A continuous murmur was heard at the left second to third inercostal spaces along the left sternal border. The electrocardiogram showed the inverted T-waves in the precordial leads. The right heart catheterization revealed 5% oxygen step up between RV and PA. The right sided pressures were normal. The coronary arteriography revealed markedly tortuous vessels starting shortly after the left main stem coronary artery was normally originated. One of the large vessel was shown to be drained into the pulmonary artery. In the operation room, without using heart-lung machine this abnormally drained vessel was simply ligated at it's draining site into pulmonary artery. After the operation the patient is feeling well with little symptoms and the continuous murmur is no longer heard.
Angiography ; Arteriovenous Fistula* ; Cardiac Catheterization ; Cardiac Catheters ; Chest Pain ; Coronary Vessels* ; Electrocardiography ; Heart-Lung Machine ; Humans ; Middle Aged* ; Oxygen ; Pulmonary Artery*

PURPOSE: This study was performed to evaluate the efficiency of Platelet-rich plasma (PRP) for acceleration of bone healing process on allograft transplantation after curettage in benign bone tumor. MATERIALS AND METHODS: From December 2007 to February 2009, twenty-one patients who had benign bone tumor and underwent allograft transplantation after curettage were evaluated. Mean follow-up period was 14.6 months (range, 12-26 months). We compared with 13 cases of PRP group and 8 cases of non-PRP group in terms of size of lesion, bone resorption, amount of applied PRP and complications. The mean age at surgery was 23.6 years (range, 4-73 years). The most common diagnosis was simple bone cyst (7) followed by enchondroma (4), giant cell tumor (3), undifferentiated benign bone tumor (3) and so on. RESULTS: The mean size of lesion was 33.5 cm3 (range, 2.3-181.9 cm3) (29.4 cm3 in PRP group and 40.2 cm3 in non-PRP group). The mean volume of injected PRP was 7.4 cc (range, 3-12 cc). Bone union started at 3.0 months (range, 1.5-5.8 months) in PRP group and 5.3 months (range, 4-8 months) in non-PRP group. Three cases for each group were excluded due to recurrence and pathologic fracture. One patient had febrile episode 3 weeks later after surgery which subsided with antibiotics. CONCLUSION: The PRP could accelerate bone union in allograft transplantation after curettage of benign bone tumor. Furthermore, we expect that PRP can accelerate bone union in fracture or non-union.
Acceleration ; Anti-Bacterial Agents ; Bone Cysts ; Bone Resorption ; Chondroma ; Curettage ; Follow-Up Studies ; Fractures, Spontaneous ; Giant Cell Tumors ; Humans ; Platelet-Rich Plasma ; Recurrence ; Transplantation, Homologous ; Transplants

PURPOSE: Sentinel lymph node (SLNB) is the first confronted lymph node from primary lesion of tumor through lymphatic drainage, which is important for determining early metastasis and setting guidelines for treatment. We reported significant of sentinel lymph node biopsy in malignant melanoma (MM) and squamous cell carcinoma (SCC) of lower extremities. MATERIALS AND METHODS: Twenty-five cases of surgically treatment and being possible for follow up more than 1 year among the patients who were diagnosed as MM and SCC in this institution from Sep. 2005 to Jan. 2009, and 10 cases of them were performed SLNB. Average age was 64 years old, and 15 cases of male and 10 cases of female were in this group. RESULTS: 3 years overall survival rate was 100% and 3 years disease-free survival rate was 76%. Metastasis occurred in total 6 patients, 4 cases of inguinal lymph nodes, 1 case of soft tissue around knee, 1 case of left achilles tendon. In 15 cases of not performing SLNB, overall survival rate was 93.3% and disease-free survival rate was 73.3%. In 10 cases of performing SLNB, overall survival rate was 100% and disease-free survival rate was 90%. And only 1 case showed positive finding in the biopsy, and none of the 10 cases showed metastasis in follow-up. CONCLUSION: SLNB leads simpler and less complications compared to prior elective lymph node dissection, and shows high degree of accuracy. Throughout the SLNB, setting guidelines for treatment by accurate staging is thought to be helpful for increasing the survival rate in the patient with MM and SCC.
Achilles Tendon ; Biopsy ; Carcinoma, Squamous Cell ; Disease-Free Survival ; Drainage ; Female ; Follow-Up Studies ; Humans ; Knee ; Lower Extremity ; Lymph Node Excision ; Lymph Nodes ; Male ; Melanoma ; Neoplasm Metastasis ; Nitriles ; Pyrethrins ; Sentinel Lymph Node Biopsy ; Survival Rate

No abstract available.
Female ; Pregnancy ; Pregnancy, Ectopic*

In the implantation of intraocular lens, anterior chamber lenses are usually avoided in glaucoma patients. And because of its close anatomic proximity to the cornea, iris and outflow structures, anterior chamber lense may give rise to more complications as compared with posterior chamber lenses. Thus, the dramatic trend toward clear decrease in the number of anterior chamber lens implantations continues. But despite these complications, the anterior chamber lenses are most often implanted secondarily in the aphakic patients, who, after having had intracapsular cataract extraction or a complicated extracapsular cataract extraction, have lost posterior capsular support. To avoid the many potential complications associated with anterior chamber lenses, attention has shifted toward posterior chamber lens insertion in these cases and particularly in glaucoma patients. From January 1989 to June 1989, we performed newly developed surgical techniques for the implantation of posterior chamber lenses in 7 eyes, including 5 eyes with glaucoma, without posterior capsular support, This was done by securing both haptics of the posterior chamber lens to the sclera at the ciliary sulcus with 10-0 nylon suture. The patients have been followed from 3 to 8 months, all have achieved visual acuity of 20/30 or better without any serious complications, and the postoperative intraocular pressure was well controlled in all 5 eyes with glaucoma.
Anterior Chamber ; Cataract Extraction ; Cornea ; Glaucoma ; Humans ; Intraocular Pressure ; Iris ; Lenses, Intraocular ; Nylons ; Sclera ; Sutures ; Visual Acuity

We assessed the efficacy of trabeculectomy with mitomycin C in the management of congenital glaucoma of which prognosis is known to be poor. Twelve consecutive eyes of 7 primary congenital glaucoma patients who underwent trabeculectomy with mitomycin C were retrospectively reviewed. The mean age was 3.2 years(ranging from 1 to 10 years) and the mean follow-up period was 31.6 months (ranging from 15 to 42 months). The mean postoperatie intraocular pressure (IOP) at the end of follow-up period was 11.0 +/-3.0mmHg, significantly lower than the mean preoperative IOP which was 25.4 +/-6.3mmHg (P<0.01). The overall success rate was 50% after a single procedure. All the 6 failed eyes underwent the same operation again and the overall success rate was 83%. The complications included hypotony in 4 eyes (33.3%) and shallow anterior chamber in 2 eyes (16.6%), and they were all resolved spontaneously. There was no evidence of hypotonic maculopathy and endophthalmitis. Trabeculectomy with mitomycin C successfully lowered the IOP in congenital glaucoma patients without serious complication and further investigation will be required to determine ling-term effects in terms of successful filtration and possible late complications.
Anterior Chamber ; Endophthalmitis ; Filtration ; Follow-Up Studies ; Glaucoma* ; Humans ; Intraocular Pressure ; Mitomycin* ; Prognosis ; Retrospective Studies ; Trabeculectomy*

This study was conducted to measure the lead level in the blood, scalp hair and toenail of the elementary schoolchildren and assess the relationship among those samples. Lead concentration of the blood, scalp hair and toenail was measured for l00(male 50, female 50) fourth grade elementary schoolchildren in Taegu city. The mean lead level in the blood, scalp hair and toenail was 6.00+/-2.44 microgram/dl, 6.28+/-3.54 microgram/dl 6. 68 and 7.33+/-3.18 microgram/g. The mean lead level in the blood of schoolboys was 6.43+/-2.77 microgram/dl and that of schoolgirls was 5.59+/-2.01 microgram/dl. The mean lead level in the scalp hair of schoolboys was 7.66+/-2.97 microgram/dl and that of schoolgirls was 6.88+/-3.54 microgram/g. The mean lead level in the toenail of schoolboys was 8.19+/-3.5 microgram/g and that of schoolgirls was 6.47+/-2.52 microgram/g and their difference was statistically significant. In schoolboys, the correlation coefficient between the lead level in the blood and scalp hair was 0.4909, and the data were fitted best by the regression equation Y=0.5255X+4.2810, where Y and X are scalp hair and blood concentration. In schoolgirls the correlation coefficient between the lead level in the blood and scalp hair was 0.3778, and the data were fitted best by the regression equation Y=0.6655X+2.9632, where Y and X are scalp hair and blood concentration. In schoolboys. the correlation coefficient between the lead level in the blood and in the toenail was 0.5533, and the data were fitted best by the regression equation Y=0.7076X+3.6472, where Y and X are toenail and blood concentration. In schoolgirls the correlation coefficient between the lead level in the blood and in the toenail was 0.2738, and the data were fitted best by the regression equation Y=0.3431X+4.5570 where Y and X are toenail and blood concentration. In schoolboys, the correlation coefficient between the lead level in the scalp hair and in the toenail, in the schoolboys was 0.4148, and the data were fitted best by the regression equation Y=0.4956X+4.3986, where Y and X are toenail and scalp hair concentration. In schoolgirls the correlation coefficient between the lead level in the scalp hair and in the toenail 0.1159, and the data were fitted best by the regression equation Y=0.0825X+5.9214 here Y and X are toenail and scalp hair concentration. Correlation among lead concentration in the blood, scalp hair and toenail of schoolchildren were statistically significant except between scalp hair and toenail in schoolgirls. These finding suggest that blood, scalp hair and toenail can be used substitutive samples between each others.
Daegu ; Female ; Hair* ; Humans ; Nails* ; Scalp*