No abstract available.
Myasthenia Gravis*

It is well-known that the infection of bone and joints could produce the shortening by destroying the articuiar cartilage and growth plate, or the lengthening hy increased hlood circulation to the epiphyseal and metaphyseal regions of long bone. Since 1985, we have treated total l7 cases of children s pyogenic or tuberculous children s knee with early arthrotomy and continuous irrigation etc. and followed their long hone growth for average 53 months after surgical intervention. Five patients (group I ) were early treated within 2 weeks and twelve patients(group 3 ) were delayed to treat their knees for more than 2 weeks of symptom development. Total 11 patients out of 17 cases(64.7%) (2 cases of group 1 pyogenic arthritis, and 1 case of group l and 8 cases of group II tuberculous arthritis) revealed growth acceleration. Femoral lengthening was much more greater than that of tibial growth, and the size of patella, distal femoral and proximal tibial epiphysis which were measured by computerized digitizer were also significantly larger than that of opposite knee. The total limb length was increased hy average 7mm in 6 months, l4mm in 1 year and 3mm in 2 years after operation. These results suggest the pyogenic and tuberculous arthritis in children s knee should he treated as early as possible after symptoms developed, and followed them to trace their limh inequality for at least 2 years after surgery. That means the early arthrotomy for tuberculous knee or even in pyogenic arthritis can preserve normal articular cartilage and can also prevent the early epiphyseal closure hy infection. and can get the limh lengthening by increased blood circulation around the knee joint.
Acceleration ; Arthritis ; Blood Circulation ; Cartilage ; Cartilage, Articular ; Child* ; Epiphyses ; Extremities ; Growth Plate ; Humans ; Joints ; Knee Joint* ; Knee* ; Lower Extremity* ; Patella ; Socioeconomic Factors

No abstract available.
Leukoencephalopathies*

An unusual case of intraspinal peripheral neuroepithelioma arising from the cauda equina is reported. The patient, a 21-year old female, suffered from low back pain with radiation to the posterior aspect of both legs. Myelographic, computed tomographic scan and magnetic resonance imaging studies of lumbosacral spine showed the intradural extramedullary mass lesion on the L3-S1 level which was excised surgically, but recurred rapidly. It could be diagnosed by the histopathologic findings. The postoperative radiotherapy and chemotherapy were administered. We report this rare case with review of the literatures.
Cauda Equina* ; Drug Therapy ; Female ; Humans ; Leg ; Low Back Pain ; Magnetic Resonance Imaging ; Neuroectodermal Tumors, Primitive, Peripheral* ; Radiotherapy ; Spine ; Young Adult

No abstract available.

To study why the palmar capsular connections between radius and lunate remain intact in perilunate ligamentous injury of the wrist joint, and to compare the material properties of the short radiolunate, long radiolunate, and radioscaphoid region of the radioscaphocapitate ligaments (as the extrinsic ligaments) with those of the intrinsic ligaments of the previous papers, the anatomical and mechanical characteristics of those three palmar radiocarpal ligaments of twenty cadavers were measured and tested by a servo-hydraulic test machine. In spite of its small cross-sectional area (24% of short radiolunate ligament), the radioscaphoid ligament demonstrates a failure load of 58% and a stress of 260% of the short radiolunate ligament, and toughness similar to both the short and long radiolunate ligaments. This suggests that the radioscaphocapitate ligament may contribute as an initial constraint to perilunate injury. The failure load of the scapholunate ligament might be smaller than previously reported due to testing strain rate, which coupled with its short initial length may make it more vulnerable to injury at lower applied loads. The short radiolunate ligament, in spite of the largest width and cross-sectional area, has a failure load and toughness similar to the long radiolunate ligament. The material properties of short and long radiolunate ligaments may explain why the rest of the carpals persistently dislocate or fracture about lunate.
Cadaver ; Ligaments* ; Radius ; Wrist Joint ; Wrist*

BACKGROUDN: Small cell lung cancer (SCLC) is a chemotherapy-sensitive tumor. However, the duration of response is usually short and most patients experience relapses. Topotecan is commonly used for treatment of these patients. Nevertheless, the response rate of topotecan as a single regimen is only about 20% and the resulting severe myelosuppression is troublesome. Vincristine is also an active agent, and it does not compromise the marrow function. In this background, we evaluated the efficacy and toxicities of topotecan and vincristine combination chemotherapy. METHODS: Patients with pathologically confirmed SCLC refractory to or recurrent after platinum-based chemotherapy were eligible for this study. The treatment regimen was as follows; topotecan 1.5 mg/m2/day IV bolus on day 1, 2 and 3 and vincristine 1.5 mg/m2 (maximum 2 mg on day 1 (on every cycle)) and day 2 (on odd cycles only). This regimen was repeated every 3 weeks. The efficacy was evaluated in terms of response rate, time to progression and overall survival duration. The toxicities were assessed according to NCI-CTC version 3.0. RESULTS: A total of 19 patients were entered into this study. The median age was 63 years (range 43-85 years). Partial response was obtained for 3 patients (response rate 15.8%, 95% CI: 0-32.5%). The median time to progression and survival duration was 51 days and 199 days, respectively. For a total of 52 cycles of treatment, grade 3 or 4 neutropenia and thrombocytopenia were observed in 25.0% and 11.5% of the patients, respectively. Grade 2 neurotoxicities were observed in 15.4% of the patients. There was no treatment-related mortality. CONCLUSIONS: The topotecan and vincritine combination is active and safe for patients with recurrence or refractory SCLC. However, the benefit of adding vincristine to topotecan needs to be confirmed in further studies.
Bone Marrow ; Drug Therapy ; Drug Therapy, Combination* ; Humans ; Mortality ; Neutropenia ; Recurrence ; Small Cell Lung Carcinoma* ; Thrombocytopenia ; Topotecan* ; Vincristine*

We report a case of neuroblastoma with multiple skin metastases as a chief complaint in a 2-month-old girl. the skin lesions were rnultiple, pea-sized, bluish, nontender, moable subcutaneous nodules on abdomen, back and scalp. Histopathology showed small round or poly gonal tumor cells which have deeply stained, basophilic, hyperchromatic nuclei with some mitoses. Th.se tumor cells showed clumping tendency which is one of early menifestations of rosette formation. Immunohistochemically positive reaction was demonstrated by anti-NSE(neuron specific enolase) antilody but negative reaction by anti-NFP (neurofilament proteiin ) antibody. She has been succesfully treated with combined chemotherapy for 10 months without relapse.
Abdomen ; Basophils ; Drug Therapy ; Female ; Humans ; Infant ; Mitosis ; Neoplasm Metastasis* ; Neuroblastoma* ; Phosphopyruvate Hydratase ; Recurrence ; Rosette Formation ; Scalp ; Skin*

OBJECTIVES: Chronic HBsAg carriers are the principal source of infection for other susceptible people, and are themselves at high risk of developing serious liver diseases. In Korea, it has been estimated that 65-75% of the HBsAg positives remained as persistent carriers. Additionally, familial clustering of HBV infection has frequently been observed among carriers. Some would become progressive, chronic hepatitis patients, and others would not. The aim of this study was to evaluate the association between various factors, such as the duration of infection, type of virus, mutation of precore/core region in HBV, major histocompatibility class-I, and developing chronic liver diseases among familial HBV carriers. METHODS: Chronic carrier status was identified by repeated serological tests for HBsAg at intervals of six months or more. A familial chronic carrier was defined when the disease was observed in a family member over two generations. Two families were recruited, among which a total of 20 chronic HBsAg carriers(11 carriers in No.1, and 9 in No.2 family) were identified. Data on the general characteristics and liver disease status were collected. Identification of the HBV-DNA was successful only for 13 subjects among the 20 carriers. Analysis of viral DNA in terms of subtype, pre-core and core region mutations was carried out. The type of major histocompatibility class-I for the 13 subjects was also analysed. RESULTS & CONCLUSIONS: Seven of 10 chronic HBV carriers of the 1st generation and one of 10 of the 2nd generation were clinical patients with chronic hepatitis, the others, three of the 1st and nine of the 2nd generation, were asymptomatic carriers. This data indicates that the duration of HBV carriage is one of the major factors for disease severity. The subtype of HBsAg analysed using HBV-DNA identified in 13 carriers were adr, and the pattern of precore nonsense mutation in HBV-DNA was identical among family members, which means that the same virus strains were transmitted between the family members. The association between the precore or core mutations in HBV-DNA and the disease severity was not observed. While it was suggested that a specific type of MHC class-I may be related to disease progression.
Codon, Nonsense ; Disease Progression* ; DNA, Viral ; Family Characteristics ; Hepatitis B Surface Antigens ; Hepatitis B virus* ; Hepatitis B* ; Hepatitis* ; Hepatitis, Chronic ; Histocompatibility* ; Humans ; Korea ; Liver Diseases ; Serologic Tests

Hemorrhagic radiation proctitis is infrequently seen in patients receiving pelvic irradiation. The treatment of hemorrhagic ralation proctitis is often difficult. Many patients need reyeated hospitalizations and blood transfusions. Occasionally patiets will develop severe or recurrent rectal bleeding. In case of massive bleeding requiring excessive transfusion, colonic diversion by construction of a colostomy or excision of the diseased segment may be inevitable. However, surgical procedures in these patients are associated with a high mortality and morbidity. Moreover, medical therapy is usually ineffective. Recently formalin therapy has been introduced as a simple and effective treatment for hemorrhagic radiation proctitis. We experienced a 69 year-old woman patient who developed severe homorrhagic proctitis 1 year after radiotherapy for carcinoma of the cervix. She had not improved by conservative management and required blood tranafusions and repetitive hospitalizations. After local application of a 4% formalin solution in the diseased rectum under caudal anesthesia, the bleeding immediately stopped and the patient was discharged from the hospital, and no recurrence has been observed until now.
Aged ; Anesthesia, Caudal ; Blood Transfusion ; Cervix Uteri ; Colon ; Colostomy ; Female ; Formaldehyde* ; Hemorrhage ; Hospitalization ; Humans ; Mortality ; Proctitis* ; Radiotherapy ; Rectum ; Recurrence