The 5 year-survival rates were examined to evaluate the prognositic significance of the expression of the p53 protein and the positivity of the PCNA in 108 cases of advanced gastric carcinoma. The p53 protein and PCNA were stained by immunohistochemistry in the tissue of the gastrectomized specimen. The results were as follows. 1) The overall 5 year-survival rate of advanced gastric carcinoma was 42.3 % and the significant prognostic factors were a pathologic stage and p53 protein(p<0.005). 2) The expanding or infiltrating type by Ming's classification and the intestinal or difftise type by Lauren's classification had similar prognosis. 514_ @@l %R-t 3) The 5 year-survival rate of the p53-positive group was 25.1% and that of p53-negative group was 56.1%(p<0.005). 4) The 5 year-survival rate of the PCNA low-grade tumors by PCNA stain(<50%)was 48.7% and that of the high-grade tumor(>=50%)was 29.9%(p>0.1). 5) There was a tendency to have a good prognosis in the p53-negative group and low grade tumors in the stage 11, III, and IV. There was a significant difference between p53 protein positive and negative groups in the stage III(p<0.005), but no significant differences were found in the other groups. The above results indicate that the p53 protein is an another useful tool for prediction of the prognosis in advanced gastric carcinoma.
Stomach Neoplasms

No abstract available.
Adolescent* ; Child* ; Cushing Syndrome* ; Humans

Fracture of the femur during total hip arthroplasty presents the simultaneous problems of prosthetic stability and fracture treatment. The treatment of such fractures can be complex and is one of the major challenges and this complication is associated with a high morbidity and a significant delay in convalescence. Among the 237 cases, who were treated by cementless total hip arthroplasty from Jan. 1986 to Dec. 1992, 13 cases of femoral fracture were experienced. They usually occured during insertion of prosthesis and preparation of the medullary canal. There were 6 cases of type II fracture, 1 case of type III fracture, 5 cases of type IV fracture and 1 case of type V fracture according to AAOS classification. All of the fracture healed, but the prognosis of these cases must be determined by follow up. We recommend that femoral fractures can be prevented by accurate preoperative evaluation of the size of the femoral canal, identification and management of the predisposing factors for intraoperative fractures.
Arthroplasty, Replacement, Hip ; Causality ; Classification ; Convalescence ; Femoral Fractures ; Femur ; Follow-Up Studies ; Prognosis ; Prostheses and Implants

The authors did a clincal analysis of 95 cases of the osteomyelitis. Among them 72 were hematogenous in origin: 12 were secondary to open fracture: 6 were direct extension from adjascent soft tissue infection: 5 were complicated after open reduction of fracture, who were treated at Dept. of Orthopedics of Catholic Medical College for past 3 years from 1968 to 1971. Through this study following result were obtained: 1. Most of the patient were under age of 16 Years, In acute hematogenous osteomyelitis, over 80% of patient were under age of 12 years. Males were more frequently affected than females. 2. Generally, femur, tibia and humerus were most frequently affected than the others. In acute osteomyelitis, distal femur and proximal tibia were the most frequent site of involvement. 3. In acute osteomyelitis, early decompression, like drilling or fenestration operation gave more satisfactory result than the simple soft tissue drainage. Immediate surgical intervention with massive antibiotics administration is stressed without hesitation when diagnosis is made. The group treated within a week after onset gave relatively good result in this series. 4. Primary closure of the wound in acute osteomoelitis were considered not to be the good method which is usually adopted as procedure in the chronic type. 5. In the chronic osteomyelitis, continuous tube irrigation after saucerization was adopted when the bony defect is large. Primary closure of the wound were adopted in the case when surgical defect is small in size less than 4cm in diameter. 6. Treatment of the osteomyelitis complicated after open reduction of the fracture were generally treated with focal curettage and removal of fixative device when clinical union is evident, also fixative devices were out even in the group which were not united clinically but redisplacement is expected not to take place. In this group external support was given until fracture healing. Bony window was also made for drainage when cavitary change develped around the tip of nail.
Anti-Bacterial Agents ; Curettage ; Decompression ; Diagnosis ; Drainage ; Female ; Femur ; Fracture Healing ; Fractures, Open ; Humans ; Humerus ; Male ; Methods ; Orthopedics ; Osteomyelitis ; Soft Tissue Infections ; Tibia ; Wounds and Injuries

The superficial sural artery flap is supplied by the superficial sural artery that accompanies the sural nerve. The superficial sural artery connects distally with a peroneal artery septocutaneous perforator via a suprafascial network of vessels that permits the flap to be raised on its distal pedicle. We treated 10 patients who showed soft tissue defect of the lower third of the leg, around the ankle and the hindfoot with this flap. The causes of the soft tissue defect were trauma in 6 cases, pressure sore in 2 cases, squamous cell carcinoma in 1 case and osteomyelitis in 1 case. The sites of the soft tissue defect were the lower third of the leg in 5 cases, around the ankle in 2 cases and the hindfoot in 3 cases. The size of the soft tissue defect was from 5x6 cm to 8xl2 cm. All 10 flaps survived. Two flaps showed slight venous congestion which cleared in a few days. The time for flap dissection was 15 minutes in average. The results of our cases show that the distally based superficial sural artery flap is useful for the soft tissue coverage of the lower third of the leg, around the ankle and the hindfoot. The advantages of the flap are that the blood supply is reliable, elevation is easy and quick, the major arteries are not sacrificed and the donor site morbidity is negligible.
Ankle ; Arteries* ; Carcinoma, Squamous Cell ; Humans ; Hyperemia ; Leg ; Lower Extremity ; Osteomyelitis ; Pressure Ulcer ; Sural Nerve ; Tissue Donors

The ankle joint is a modified complex hinge joint which plays an important role in weight bearing, walking and standing. Hence, the ankle injuries include not only fractures of bone but often also the rupture of ligaments and soft tissues, so if the structures were not accurately repaired, many complications may be developed. The authors have reviewed a series of 70 cases of ankle fractures which were treated in department of orthopaedic surgery of Inha hospital from January 1988 to February 1992. Among the seventy cases, 41 patients (59.4%) were male, and 28 patients (40.6%) were female. Average age was 41.4 years and 3 cases (4.35%) were open fracture. The most common cause was slipping 34 cases (48.6%) and the other causes were traffic accident 23 cases (32.9%), fall from height 6 cases (8.6%), direct blow 5 cases (7.0%) and sports injury 2 cases (2.9%) in order. The rusults obtained form this study were as follows. l. According to the classification fo Lauge-Hansen, the most common fracture mechanism was supination-external rotation injury (24 cases: 34.4%). 2. Among them, 51 cases were treated by operative treatment and 19 cases by conservative treatment. 3. Ten cases (14.3%) in this series were complicated; traumatic arthritis in 7 cases, infection in 2 cases and nonunion 1 case. 4. Open reduction and internal fixation and early anatomical reduction were better than closed reduction and delayed reduction. 5. The incidence of traumatic arthritis occured higher in the cases treated with closed method.
Accidents, Traffic ; Ankle Fractures ; Ankle Injuries ; Ankle Joint ; Ankle ; Arthritis ; Athletic Injuries ; Classification ; Female ; Fractures, Open ; Humans ; Incidence ; Joints ; Ligaments ; Male ; Methods ; Rupture ; Walking ; Weight-Bearing

No abstract available.
Child* ; Humans

OBJECTIVES: A significant number of patients who had a previous surgical treatment in the hip area experience subsequent hip fracture (SHF) on the opposite side. This study aims to analyze the risk factors and the correlation between osteoporosis and SHF on the opposite side by measuring bone mineral density (BMD) and treatment provided by risedronate for the prevention of SHF. MATERIAL & METHODS: We studied 475 patients without treatment who had unilateral hip and included following: death, SHF, alcoholism, living alone, dementia, dizziness, health status, osteoporotic treatment after fracture and BMD from March 1997 to June 2006. We selected 26 patients with SHF and the other 26 patients without SHF who had similar age, sex, BMI, BMD, diagnosis, treatment and follow up. The average follow up was 6.4 years (4~12 years) and 6.2 years (4~12 years).
Alcoholism ; Bone Density ; Dementia ; Dizziness ; Etidronic Acid ; Follow-Up Studies ; Hip ; Humans ; Osteoporosis ; Risk Factors ; Risedronate Sodium

No abstract available.
Ameloblastoma*

BACKGROUND: While the effect of the flashlamp pumped dye laser in the treatment of telangiectasia and other vascular disease has been reported by many authors, there have been a few reports on the therapeutic effect of the copper vapor laser(CVL) on telangiectasia and other vascular lesions. OBJECTIVE: Our purpose was to assess the clinical results in Korean patients who had cutaneous vascular disorders that were treated with the CVL at 578 nm. METHODS: A total of 23 patients with vascular lesions such as telangiectasia were involved. The effect of the laser treatment was evaluated 3 months after the last treatment. RESULTS: Of the 15 patients with telangiectasia, 12 patients showed good or excellent responses. 2 out of 3 patients with strawberry hemangioma showed good results. As for the other lesions, 2 out of the remaining patients 5 showed excellent results. CONCLUSION: The CVL has a beneficial effect and is a good alternative treatment modality for vascular lesions.
Copper* ; Hemangioma, Cavernous ; Humans ; Lasers, Dye ; Lasers, Gas* ; Telangiectasis ; Vascular Diseases