Discoid meniscus has been defined as a morphological anomaly, and several clinical classification has been proposed. Commonly used classification is Watanabes classification; complete, incomplete and Wrisberg ligament type discoid meniscus. It is a relatively more common disease of the knee in Korea and Japan than western countries. Eighty-one discoid meniscal tears which were operated arthroscopically between the period of June, 1991 and August, 1996 were reviewed retrospectively. The purpose of this study is to analyze the pattern of the tear and the extent of arthroscopic resection according to the arthroscopic classification of the discoid meniscus. Thirty-three cases were classified as complete and forty-five cases as incomplete and three cases were Wrisberg ligament type. The major pattern of the tear in the complete type lesions was horizon- tal(in twenty-three) and complex(in seven) tear. Of the knees that had an incomplete type lesion, longitudinal(in ten including six bucket-handle tear) and degenerative tear(in eight) were observed more frequently, and horizontal tear(in ten) less frequently than that of the complete type. The extent of arthroscopic resection of the discoid meniscus was related to the pattern of tear and type of the discoid meniscus. For the majority of the horizontal tear, arthroscopic partial meniscectomy (twentyeight of thirty-four) was performed, but arthroscopic subtotal and total meniscectomy was performed more frequently for longitudinal tear, complex tear, and Wrisberg ligament type.
Classification* ; Japan ; Knee ; Korea ; Ligaments ; Retrospective Studies

BACKGROUND: Malignant thyroid tumors may mimic the clinical symptoms and signs of a non-malignant tumor in the early course of the disease. The choice of the treatment modality for a thyroid tumor can be based on exact interpretation of FNAC (fine needle aspiration cytology) and frozen section. METHODS: We have experienced 237 cases of thyroid tumors during the past ten years at St. Columban hospital. From September 1988 to August 1998, subjects were selected and a retrospective study was done. RESULTS: (1) Of the 237 cases in this study, 194 had non-malignant lesions and 43 had malignant lesions, a ratio of 4.5:1. (2) The female to male ratio was 9.2:1 with non-malignant lesions (female: 195/male: 19) and 9.8:1 with malignant lesions (female: 39/male: 4). (3) The age distribution was the 4th to the 6th decades, regardless of the nature of the lesions. (4) The duration of disease was within 3 months with 42.2% of subjects, and 71.8% of subjects came within first year of disease, regardless of the nature of lesions. (5) Thyroid function tests showed no abnormality with most of the patients, regardless of the nature of lesions. (6) Fine needle aspiration cytology biopsy showed a sensitivity of 32.7%, a specificity of 100%, and an accuracy of 90.8%, and revealed preoperative diagnostic validity. (7) Ultrasonography of the neck, showed a sensitivity of 32.7%, a specificity of 88.1%, and an accuracy of 77.4%, and had no diagnostic value. (8) With benign lesions, adenomatous goiters were most common (96 cases), and with malignant lesions papillary carcinomas were predominant (36 cases). CONCLUSIONS: FNAC and frozen section are valuable preoperative and intraoperative diagnostic tool for thyroid tumors.
Age Distribution ; Biopsy ; Biopsy, Fine-Needle ; Carcinoma, Papillary ; Female ; Frozen Sections ; Goiter ; Humans ; Male ; Neck ; Needles ; Retrospective Studies ; Sensitivity and Specificity ; Thyroid Function Tests ; Thyroid Gland* ; Ultrasonography

A 68 year old, ASA physical status 11, hypertensive male patient underwent open reduction, angulated blade plate fixation, and bone graft of femur intertrochanteric fracture due to non-union. Anesthesia was induced with thiopental and succinylcholine and maintained with vecuronium- Halothane-nitrous oxide-oxygen. Three uints whole blood was transfused and any significnat change in vital signs and EKG were not found during 4 hours operation. Soon after the patient was recovered. But he was found to be hemiplegia and sensory disturbance on the next day. Brain CT revealed infarction of middle cerebral artery territory. He expired 7 days following the surgery despite strenuous supportive measure.
Aged ; Anesthesia ; Brain ; Cerebral Infarction* ; Electrocardiography ; Femur ; Hemiplegia ; Humans ; Infarction ; Male ; Middle Cerebral Artery ; Succinylcholine ; Thiopental ; Transplants ; Vital Signs

OBJECTIVE: This study was performed to determine the smoking status and its associated factors in military life among young Korean men to provide date for smoking prevention in military areas as a part of the health promotion program for soldiers. METHODS: 1,033 infantrymen serving in 17 military units, which are located in suburbs of K city, were enrolled in this study. A questionnaire on the soldiers smoking status and other various characteristics was obtained from October 2nd to 12th, 2000. Logistic regression analysis was performed on the various variables in order to determine the factors related to smoking. RESULTS: 1) 830(80.3%) out of 1033 subjects had smoked cigarettes and 759 persons(73.4%) were regular smokers. 2) Among the 734 soldiers who started smoking before their military service, 714 soldiers(97.2%) continued to smoke after, while 45 soldiers(15.0%) among the 299 non-smokers started smoking after joining the army. 3) Through the logistic regression analysis, the education level, specialty in the army, smoking amongst the friends they met before military service, smoking amongst soldiers in the army, dating girl friends, drinking, satisfaction with their army lives and the presence of convenient smoking places at the barracks were significant factors related to the prevalence of smoking in soldiers. CONCLUSION: the factors related with incidence of smoking in the army are the complicated interactions among the individuals personal background, general charcterisitcs of the solider and the special environment in the barracks. Therefore, to improve national soldiers' health, an active non-smoking campaign and education should be pushed to discourage smoking in the barracks.
Drinking ; Education ; Female ; Friends ; Health Promotion ; Humans ; Incidence ; Logistic Models ; Male ; Military Personnel* ; Prevalence ; Smoke* ; Smoking* ; Tobacco Products

Although intramedullary nailing is mostly used in the management of fractures in the long bone shaft, plate fixation is still alternative option in periprosthetic or metaphyseal fractures. For the rigid fixation during plating, sometimes we need wiring. Many surgeons experience slippage of wire resulting in loss of rigid fixation because plate and wire is so slippery and the diameter of bone is changing by level especially in the metaphyseal area. Wiring plate(CHO plate) was designed to prevent slippage. This plate has transverse holes for wires between screw holes on traditionally used dynamic compression plate. Sixteen fractures of long bone shaft were fixed with wiring plate and 11 cases which were followed up for more than one year were evaluated. There were periprosthetic fractures(4 cases), spiral or butterfly fractures(4 cases) and fractures of poor bone quality(two cases of malignancy and one case of osteoporosis). Nine cases were successfully reduced and the healed without loss of fixation. In two cases, delayed union and nonunion were observed due to wire breakage with plate loosening. Preliminarily, wiring plate fixation can be used for the periprosthetic fracture and one of alternative option in butterfly or spiral fracture and fracture in osteoporotic bone or pathologic fracture.
Butterflies ; Fracture Fixation, Intramedullary ; Fractures, Spontaneous ; Periprosthetic Fractures

Recently, imaging of prostate cancer has greatly advanced since the introduction of multiparametric magnetic resonance imaging (mpMRI). mpMRI consists of T2-weighted sequences combined with several functional sequences including diffusion-weighted imaging, dynamic contrast-enhanced imaging, and/or magnetic resonance spectroscopy imaging. Interest has been growing in mpMRI because no single MRI sequence adequately detects and characterizes prostate cancer. During the last decade, the role of mpMRI has been expanded in prostate cancer detection, staging, and targeting or guiding prostate biopsy. Recently, mpMRI has been used to assess prostate cancer aggressiveness and to identify anteriorly located tumors before and during active surveillance. Moreover, recent studies have reported that mpMRI is a reliable imaging modality for detecting local recurrence after radical prostatectomy or external beam radiation therapy. In this regard, some urologic clinical practice guidelines recommended the use of mpMRI in the diagnosis and management of prostate cancer. Because mpMRI is the evolving reference standard imaging modality for prostate cancer, urologists should acquire cutting-edge knowledge about mpMRI. In this article, we review the literature on the use of mpMRI in urologic practice and provide a brief description of techniques. More specifically, we state the role of mpMRI in prostate biopsy, active surveillance, high-risk prostate cancer, and detection of recurrence after radical prostatectomy.
Humans ; Image Interpretation, Computer-Assisted/methods ; Image-Guided Biopsy/methods ; Magnetic Resonance Imaging/*methods ; Male ; Neoplasm Recurrence, Local/diagnosis ; Practice Guidelines as Topic ; Prostate/pathology ; Prostatectomy ; Prostatic Neoplasms/*diagnosis/surgery ; Watchful Waiting

PURPOSE: The Fas-associated death domain (FADD) constitutes a novel protein that specifically associates with the cytoplasmic death domain of Fas, and induces apoptosis. FADD is composed of a death effector domain (DED) and a death domain. In this study, we evaluated the in vivo antitumor effect of the FADD, or FADD-DED, gene in renal cell carcinoma cells, using a plasmid vector expressing the human FADD and FADD-DED genes. MATERIALS AND METHODS: The cDNA of the human FADD and FADD-DED genes were amplified by RT-PCR, and cloned to the pCR(R) 3.1. The expressions of the cloned FADD and FADD-DED (pCR(R)3.1-FADD and pCR3.1-FADD-DED) were observed by Western blot analysis. The efficacy of the growth inhibition by the cloned FADD and FADD-DED genes was tested, in vitro, on A498 and Caki-1 human renal cell carcinoma cell lines using the MTT assay. To evaluate the apoptosis, DNA fragmentation and caspase-3 assays were performed. RESULTS: Expressions of the FADD protein, and the FADD-DED, of the transfected A498 and Caki-1 cells had increased by 48 and 24 hours, respectively, compared with the control cell lines. The cytotoxicity of the pCR3.1-FADD and pCR3.1-FADD-DED on the A498 and Caki-1 cells significantly increased compared to the empty vector. The increased cytotoxicity of the FADD- or FADD-DED-transfected cell lines was associated with enhanced apoptosis, as assessed by DNA fragmentation and caspase-3 assays. CONCLUSIONS: Our results showed that the cloned FADD or FADD-DED expression plasmid vector efficiently inhibited the growth of A498 and Caki-1 human renal cell carcinoma cell lines. These data suggest that the exogenous FADD or FADD-DED expressions may have therapeutic applications in renal cell carcinomas.
Apoptosis* ; Blotting, Western ; Carcinoma, Renal Cell* ; Caspase 3 ; Cell Line ; Clone Cells ; Cytoplasm ; DNA Fragmentation ; DNA, Complementary ; Humans ; Plasmids

High-risk localized prostate cancer traditionally includes patients with clinical T3 disease but also includes those with apparently localized disease but with adverse prognostic factors such as a Gleason score of 8 to 10, prostate-specific antigen of more than 20 ng/ml, or extensive disease on biopsy. In the past, these patients were treated primarily with radiation therapy due to concerns that surgery was not likely to be curative and was associated with a high incidence of side-effects. In addition, the lack of randomized trials comparing curative treatments for high-risk prostate cancer makes treatment decisions in this patient population difficult. Several retrospective series have reported the long-term efficacy of radical prostatectomy monotherapy in a high-risk population, showing that the 5-year cancer-specific survival rate was more than 80% and the 5-year biochemical recurrence-free survival rate was about 50%. In addition, comparisons of different treatment options by means of nonrandomized trials have shown improved outcomes with surgery compared with radiation therapy or observation. Thus, there is renewed interest in radical prostatectomy as the primary treatment for patients with high-risk prostate cancer. Here, we reviewed the outcomes of radical prostatectomy, with or without neoadjuvant or adjuvant therapies, in high-risk patients and what is known about the choice and timing of adjuvant therapies.
Biopsy ; Humans ; Incidence ; Neoplasm Grading ; Prostate ; Prostate-Specific Antigen ; Prostatectomy ; Prostatic Neoplasms ; Retrospective Studies ; Risk Assessment ; Survival Rate

PURPOSE: Paraquat is a deadly chemical which may cause death in 70~90% of patients even after small ingestion. In this study, the authors gathered initial information which could be obtained from paraquat-poisoning patients, and attempted to identify factors which might influence the prognosis, and used those factors in determining the prognosis. METHODS: The authors conducted a retrospective study of 44 patients who had been admitted with paraquat ingestion between January 2000 and December 2001. Based on the initial information obtained in the emergency room, through an analysis of mono-factor studied factors which might influence death, and using the obtained factors, the authors used the discriminant analysis. When new patients occurred, the authors conducted discriminant function found in this study in order to determine prognosis. RESULTS: Among the examinations conducted in the emergency room, potassium, BUN, creatinine, HCO3-, proteinuria, glycosuria, urinalysis of paraquat, glucose, PaCO2, pH, blood-paraquat concentration, and O2 saturation were factors which might affect the prognosis for paraquat poisoning.The discriminant functional equation which utilizes these factors is as follows: Z= -5.885 + 0.560A + 0.481B - 0.980C + 0.036D + 1.648E -0.076F- 0.052G - 0.023H + 0.775I + 0.002J + 0.077K +0.239L(A; urine paraquat, B; serum paraquat, C; potassium, D;PaCO2, E; pH, F; HCO3-, G; O2 Saturation, H; BUN, I; creatinine, J; glucose, K; proteinuria, L; glycosuria) This discriminant function for the actual group was 88.6%, which was a relatively high level of discrimination. CONCLUSION: The hit ratio of the discriminant function obtained through this study was 88.6%, so it should help in categorizing patients early on and in determining their prognosis.
Creatinine ; Discrimination (Psychology) ; Eating ; Emergency Service, Hospital ; Glucose ; Glycosuria ; Humans ; Hydrogen-Ion Concentration ; Mortality* ; Paraquat ; Potassium ; Prognosis* ; Proteinuria ; Retrospective Studies ; Risk Factors* ; Urinalysis

In spite of multidisciplinary treatment, about 70% of lymph node (LN) positive bladder cancer reported to be recurred within 5-year after radical cystectomy and pelvic lymphadenectomy although considerable number of patients survived for a long period without adjuvant treatment after surgery. Current TNM nodal staging system doesn't account for this survival differences. In this regard, several LN-related parameters were developed to predict prognosis of LN positive bladder cancer. In this article, we will state the controversies on current TNM nodal staging system for bladder cancer. In addition, we will review the accuracy of imaging studies to predict LN metastasis before surgery and impact of several surgical and pathologic LN-related parameters, such as extent of lymphadenectomy, number of removed LNs, number of metastatic LNs, LN density, extracapsular extension of LN, on prognosis of LN positive bladder cancer. Moreover, we will review the value of adjuvant chemotherapy on LN positive bladder cancer.
Chemotherapy, Adjuvant ; Cystectomy ; Drug Therapy ; Humans ; Lymph Node Excision ; Lymph Nodes* ; Neoplasm Metastasis ; Prognosis ; Urinary Bladder Neoplasms* ; Urinary Bladder*