No abstract available.
Humans ; Religion*

We report our series of the Ilizarov surgery for lengthening and deformity correction in upper extremity at the Severance Hospital and the Yong-Dong Severance Hospital between February 1992 and October 1994. We performed the Ilizarov surgery in 12 limb segments, there were 3 humerus, 5 radius, 3 ulna and 1 metacarpal bone. The etiologies of the limb length discrepancies were 7 posttraumatic physeal injuires, 2 congenital deformities, 1 posttraumatic bone loss, 1 posttraumatic amputation and 1 postinfectious physeal injury. The goals of treatment were bone lengthening alone in 8 cases, bone lengthening and deformity correction including angular correction in 4 cases. The bone was lengthened between 1.0 cm and 9.2 cm (mean 3.7 cm) representing a 8.1% to 63.0% (mean 24.5%) increase in length. The healing index varies from 1.0 mos/cm to 10.5 mos/cm (mean 3.4 mos/cm) except three cases which need additional fixation with plate and screws add to wedge osteotomy. By radiologic appearance of the distraction callus, the straight type were 6 cases, the attenuated type were 4 cases and the pillar type were 2 cases. The healing indices of each type were 1/5 mos/cm, 7.7 mos/cm and 12.4 mos/cm, respectively. In conclusion, lengthening and deformity correction of the upper extremity can be successfully achieved by gradual mechanical distraction using the Ilizarov method. In case of pillar type, healing index was high and therefore control of the rate and the rhythm should be tried. If this control is of no use, early interventional procedure would be beneficial. The healing index of the straight type was much lower than that of the attenuated or the pillar type.
Amputation ; Bone Lengthening ; Bony Callus ; Congenital Abnormalities ; Extremities ; Humerus ; Ilizarov Technique ; Osteotomy ; Radius ; Ulna ; Upper Extremity

PURPOSE: We compared the recurrence rate and mean interval to recurrence according to tumor grade after complete transurethral resection and adjuvant intravesical instillation with bacillus Calmette-Guerin (BCG), in patients with stage T1 transitional cell carcinoma of the bladder. MATERIALS AND METHODS: Between January 1994 and May 2000, 31 patients presenting to our hospital with T1 superficial bladder cancer received adjuvant intravesical instillation with BCG after complete transurethral resection of the bladder tumor. Tumors with CIS lesion or recurrent tumors were excluded. The recurrence rates, mean interval to recurrence, tumor size and number of tumors were compared according to tumor grade. RESULTS: Of the 31 patients, 5 presented with grade I tumor, 17 with grade II tumor and 9 with grade III tumor. Mean follow-up period was 22 months (range 6-58) and mean tumor sizes according to tumor grade were 1.6, 1.6 and 1.7cm in grade I, II and III, respectively. Twelve (38.7%) patients experienced tumor recurrence. The recurrence rates according to tumor grade were 20.0%, 41.2% and 44.4% in grade I, II and III, respectively. Mean interval to recurrence were 40, 11.4 and 7.5 months, respectively. CONCLUSIONS: Our results suggest that the recurrence rates were higher in grade II and III tumors than in grade I tumor. Therefore close follow-up is necessary in both grade II and III tumors.
Administration, Intravesical ; Bacillus ; Carcinoma, Transitional Cell ; Follow-Up Studies ; Humans ; Mycobacterium bovis* ; Recurrence* ; Urinary Bladder Neoplasms* ; Urinary Bladder*

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

PURPOSE: There diagnostic modalities have been commonly used to detect prostate cancer to date: digital rectal examination (DRE), serum prostate specific antigen (PSA) and transrectal ultrasonography(TRUS). We evaluated the diagnostic values of these three modalities in the early detection of prostate cancer. MATERIALS AND METHODS: We analysed 215 patients with low urinary tract symptoms who had pathologic diagnosis for prostatic cancer was possible by biopsy or transurethral resection. Transectal ultrasonography guided sextant biopsies were performed if the PSA level was greater than 4.0 ng/ml or DRE was suspicious, even if TRUS revealed no ateas suspicious for cancer. TURP were performed without TRUS or biopsies if the PSA level was lesser than 4.0 ng/ml and DRE was negative. RESULTS: Of the 215 patients, 36 (16.7%) revealed prostate cancer. Positive predictive value, sensitivity and specificity was 37.0%. 83.3%. 71.5% for DRE, 30.0%, 91.7%, 58.3% for PSA and 27.6% 58.3%. 43.3% for TRUS respectively. Positive findings on serum PSA or DRE or both tests detected significantly more tumors(97.2%, 35of 36 cancers) than only PSA (91.7%, 33 for 36 cancers), DRE (83.3%, 30 of 36 cancers) and TRUS (60.0%, 21 of 35 cancers) alone. CONCLUSIONS: These result shows that DRE is more valuable and cost effective method for detection of prostate cancer than serum PSA and the use of DRE in conjunction with serum PSA enhances prostate cancer detection.
Biopsy ; Diagnosis ; Digital Rectal Examination* ; Humans ; Prostate* ; Prostate-Specific Antigen ; Prostatic Neoplasms* ; Sensitivity and Specificity ; Transurethral Resection of Prostate ; Ultrasonography* ; Urinary Tract

BACKGROUND: This study was undertaken to determine the effect-site concentration of remifentanil for blunting hemodynamic responses to double lumen endobronchial intubation during target controlled infusion (TCI)-total intravenous anesthesia (TIVA) using 4.0 microg/ml of propofol with remifentanil. METHODS: Sixty patients (American society of anesthesiologists physical status classification 1 or 2) were randomly allocated according to the target effect-site concentration of remifentanil (R3.0: remifentanil 3.0 ng/ml; R3.5: remifentanil 3.5 ng/ml; R4.0: remifentanil 4.0 ng/ml). The effect-site concentration of propofol at loss of consciousness was recorded. Mean arterial pressure (MAP), heart rate (HR) and bispectral index (BIS) were recorded at just before remifentanil administration (baseline), at the time of target effect site concentration of remifentanil and propofol, at just before intubation and 1, 2, 3 min after intubation. RESULTS: MAP was significantly increased compared with baseline at 1, 2 min after intubation in R3.0, but was significantly decreased in R4.0. MAP of R3.5 was not different from the baseline after intubation. HR was significantly decreased compared with baseline at the time of target effect site concentration of propofol and immediate before intubation in R3.5 and R4.0. After intubation, HR was significantly increased compared with baseline at only 1 min after intubation and returned to the baseline in R3.0. However, HR was continuously decreased in R4.0. CONCLUSIONS: These findings suggest that effective target effect-site concentration of remifentanil for blunting hemodynamic responses to double lumen endotracheal intubation was 3.5 ng/ml during TCI-TIVA using 4.0 microgram/ml of propofol with remifentanil.
Anesthesia, Intravenous ; Arterial Pressure ; Heart Rate ; Hemodynamics ; Humans ; Intubation ; Intubation, Intratracheal ; Piperidines ; Propofol ; Unconsciousness

Human gingival fibroblasts have proven to useful as a species specific cell culture system in various system on periodontal disease and regeneration. However, their use is limited, since they are hard to obtain and lifespan is short due to replicative senescence. To overcome these disadvantages, we transfected primary human gingival fibroblasts by the E6 and E7 genes of the Human papilloma virus(HPV) 16. The full length of HPV 16 E6 and E7 was cloned from the pBR322 into BamH1 and Sal I of a pBabe vector including hygromycin B resistance. Before pBabeE6/E7 plasmid transfection, peak 8 GFP including G418 resistance was transfected into primary GF to check the transfection efficency. PBabe E6/E7 plasmid was transfected using Lipofectamine plus following manufacter's instruction into primary normal human gingival fibroblasts in 60mm dishes with FBS free DMEM. After 2 days of transfection, the cells were treated with hygromycin for 2 weeks until the transfected control cells died. The resulting hygromycin resistant colonies were pooled, and clonned, and sucessful transfection was established for immortalized gingival fibroblast cell lines. Immoralized GF cells showed stellate shape, that is similar to that of orange grains, and more rapid growth and higher proliferation than that of primary gingival fibroblasts. This cell lines overcame crisis and could be cultured over 30 subcultured, could be use for three dimentional culture, epithelial-mesenchymal interaction study.
Cell Aging ; Cell Culture Techniques ; Cell Line* ; Edible Grain ; Citrus sinensis ; Clone Cells ; Fibroblasts* ; Human papillomavirus 16 ; Humans* ; Hygromycin B ; Papilloma ; Periodontal Diseases ; Plasmids ; Regeneration ; Transfection

OBJECTIVES: Pregnanolone is a potent positive modulator of the gamma-aminobutyric acid(GABA) response that enhances the binding of [3H]flunitrazepam to the GABA A receptor. Recently, it was reported that chronic treatment with pregnanolone uncouples allosteric interactions between steroid and benzodiazepine recognition sites. The present study was designed to assess the effect of repeated stress on the modulation of neuroactive steroids on the GABA A receptor. METHODS: The effect of steroids on the ligands binding to GABA A receptor was investigated using cerebral cortices of unstressed and repeatedly immobilized rats. Male Sprague-Dawley rats, weighing 200-250g were forced to suffer an immobilization stress for 2 hours. RESULTS: Pregnanolone enhanced the binding of [3H]flunitrazepam to GABA A receptor in both of unstressed and repeatedly stressed rats. However, repeatedly stressed rats showed significantly higher values in EC50 and lower values in E max of enhancement binding of [3H]flunitrazepam than those of unstressed rats. CONCLUSIONS: From these findings, it can be concluded that repeated stress reduced the positive modulation of neuroactive steroid on the GABA A-receptor complex.
Animals ; Benzodiazepines ; Cerebral Cortex ; gamma-Aminobutyric Acid ; Humans ; Immobilization ; Ligands ; Male ; Pregnanolone ; Rats* ; Rats, Sprague-Dawley ; Receptors, GABA-A ; Steroids*

BACKGROUND: The single radius total knee prosthesis was introduced with the advantage of reduced patellar symptoms; however, there is no long-term follow-up study of the same. The purpose of this study was to determine the survival rate of single radius posterior-stabilized total knee arthroplasty and patellofemoral complication rates in a consecutive series. METHODS: Seventy-one patients (103 knees) who underwent arthroplasty without patellar resurfacing using a single radius posterior-stabilized total knee prosthesis were followed up for a minimum 10 years. Clinical evaluation using Knee Society knee and function scores and radiologic evaluation were performed at regular intervals. Anterior knee pain as well as patellofemoral complications were evaluated with a simple questionnaire. The Kaplan-Meier product-limit method was used to estimate survival. RESULTS: Seventeen patients (23 knees) were excluded due to death (12 knees) or lost to follow-up (11 knees). Of the 80 knees enrolled, all femoral components and 78 tibial components were well fixed without loosening at final follow-up. Two revisions were performed because of tibial component loosening and periprosthetic joint infection. One patient with tibial component loosening refused to have revision surgery. No obvious tibial insert polyethylene wear was observed. The survivorships at 132 months were 96.7% using revision or pending revision as end points. Anterior knee pain was present in 6 patients (6 knees, 7.5%) at the latest follow-up. No patellofemoral complication requiring revision was encountered. CONCLUSIONS: The single radius posterior-stabilized total knee prosthesis demonstrated an excellent minimum 10-year survivorship. The low rates of implant loosening and 7.5% of anterior knee pain as a patellofemoral complication are comparable with those reported for other modern total knee prosthesis.
Aged ; Arthralgia/*surgery ; Arthroplasty, Replacement, Knee/*instrumentation/*methods ; Cementation ; Female ; Follow-Up Studies ; Humans ; Knee Joint/*surgery ; Knee Prosthesis ; Male ; Middle Aged ; Patella/surgery ; Prosthesis Failure ; Retrospective Studies ; Treatment Outcome

PURPOSE: The purpose of this study was to establish optimal imaging acquisition conditions for the GE Advance(TM) PET imaging system by performing the acceptance tests designed by National Electrical Manufacturers Association (NEMA) protocol and General Electric Medical Systems (GEMS) test procedures. MATERIALS AND METHODS: Performance tests were carried out with 18FDG radioactivity source and phantoms by using a standard acquisition mode. Transaxial resolution and scatter fraction tests were performed with a line source and axial resolution with a point source, respectively. A cylindrical phantom made of polymethylmethacrylate (PMMA) was used to measure sensitivity, count rate losses and randoms, uniformity correction, and attenuation inserts were added to measure remaining tests. The test results were acquired in a diagnostic acquisition mode and analyzed mainly on high sensitivity mode. RESULTS: Transaxial resolution and axial resolution were measured as average of 4.65 mm and 3.98 mm at 0 cm, and 6.02 mm and 6.71 mm at 20 cm on high sensitivity mode, respectively. Average scatter fraction was 9.87%, and sensitivity was 225.8 kcps/micronCi/cc of trues. Activity at 50% deadtime was 4.6 Ci/cc, and the error of count rate correction at that activity was from 1.49% to 3.83%. Average nonuniformity for total slice was 8.37%. The accuracy of scatter correction was -0.95%. The accuracies of attenuation correction were 5.68% for air, 0.04% for water and -6.51% for polytetrafluoroethylene (PTFE). CONCLUSION: The results satisfied most acceptance criteria, indicating that the GE AdvanceTM PET system can be optimally used for clinical applications.
Electrons* ; Fluorodeoxyglucose F18 ; Polymethyl Methacrylate ; Polytetrafluoroethylene ; Positron-Emission Tomography* ; Radioactivity ; Water