In military training, the knee joint is more susceptible to trauma than any other joint in the body. Chronic knee instability is a difficult problem for both the patient and the orthopaedic surgeon who must correct the disability. To achieve the best possible result, the surgeon must first make the correct diagnosis and be aware of the type or types of instability that exist. There may be associated instability in a rotatory plane as described by Slocum and Larson, and the surgeon must examine carefully for this. Various surgical techniques have been used in the past to repair the knee static stabilizers such as ligaments and capsule. Since the introduction of the dynamic concept of rotatory instability and the need for muscular reinforcement of static repair, most orthopaedists have attempted to back up their reapirs with various types of dynamic stabilization such as the pes anserinus transfer and advancement of semimembranosus. 39 cases of medial instability of the knee joint were analysed clinically in the department of orthopaedic surgery of Busan Armed Froce General Hospital from Feb. 1977 to Feb. 1980 and following results were obtained. 1. All of the cases were military personnels, most of them were privates and P.F.C. showed most frequent incidence in 19 cases (49%). 2. Sports injury was a main causes of the knee instability. 3. The highest incidence in severity of the lesion was grade III in 21 cases (54%). 4. Among 39 cases of ligamentous injuries of medial side, rupture of collateral ligament alone were 30 cases, and mixed injuries with cruciate were 9 cases. 5. The pes transfer was performed in all of the cases with acute medial collateral rupture, and even in the cases with instability after primary repair, good results were obtained by carrying out dynamic muscle or tendon transfer. 6. In some cases, the patient did not feel much discomfort for the remaining static instability in valgus stress test after dynamic reconstruction. This was thought to be overcome by dynamic force during use of the leg. 7. For the purpose to prevent further stretching of repaired ligaments, derotation brace were recommended in 5 cases of dynamic reconstructive surgery.
Arm ; Athletic Injuries ; Braces ; Busan ; Clinical Study ; Collateral Ligaments ; Diagnosis ; Exercise Test ; Hospitals, General ; Humans ; Incidence ; Joints ; Knee ; Knee Joint ; Leg ; Ligaments ; Military Personnel ; Rupture ; Tendon Transfer

Eosinophilic cystitis is characterized by an eosinophilic infiltration usually of all layers of the bladder wall, ranges from a mild form of cystitis to a chronic recurrent relentless inflammation which even may progress to the point of damaging the upper urinary tracts with deterioration of the renal function. The etiology remains unclear, and there is no specific therapy available. The tumoral form of eosinophilic cystitis is a rare phenomenon and characterized by an extensive bladder wall infiltration, that may clinically imitate an invasive bladder cancer. We report a case of eosinophilic cystitis appeared to be an invasive bladder cancer extending to the pelvic side wall in a 37-year-old female, who was treated with transurethral resection.
Adult ; Cystitis* ; Eosinophils* ; Female ; Humans ; Inflammation ; Urinary Bladder Neoplasms* ; Urinary Bladder* ; Urinary Tract

BACKGROUND: Two tumor suppressor genes, p53 and p16, which have different roles in controlling the cell cycle and inducing apoptosis, are frequently inactivated during carcinogenesis including lung cancer. Single tumor suppressor gene therapies using tither with p53 or p16 have been studied extensively. However, there is a paucity of reports regarding a combined gene therapy using these two genes. METHODS: The combined effect of p53 and p16 gene transfer by the adenoviral vector on the growth of lung cancer cell lines and its interactive mechanism was investigated. RESULTS: An isobologram showed that the co-transduction of p53 and p16 exhibited a synergistic growth inhibitory effect on NCI H358 and an additive effect on NCI H23. Cell cycle analysis demonstrated the induction of a synergistic G1/S arrest by a combined p53 and p16 transfer. This synergistic interaction was again confirmed in a soft agar clonogenic assay. CONCLUSION: These observations suggest the potential of a p53 and p16 combination gene therapy as another potent strategy in cancer gene therapy.
Adenoviridae ; Agar ; Apoptosis ; Carcinogenesis ; Cell Cycle ; Cell Line* ; Genes, Neoplasm ; Genes, p16 ; Genes, Tumor Suppressor ; Genetic Therapy ; Lung Neoplasms* ; Lung*

Diagnosis of perilymphatic fistula (PLF) is considered in the patient presenting hearing loss associated with ataxia after penetrating injury of the tympanic membrane. PLF accompanies mixed type hearing loss and paralytic nystagmus. If audiovestibular symptoms and signs are not definite for those patients, in whom PLF is highly suspicious, they can be induced by affected ear down position. The direction of nystagmus induced by position change was reported either toward or away from the affected ear. But the direction changing nature has not been noted in the previous literature. We report on a case of traumatic PLF presented with direction changing positional nystagmus and discuss the possible mechanism involved in this case
Ataxia ; Diagnosis ; Ear ; Fistula* ; Hearing Loss ; Humans ; Nystagmus, Physiologic* ; Tympanic Membrane

For the patients suffering from extensive deep vein thrombosis (DVT), the placement of an inferior vena cava (IVC) filter in conjunction with anticoagulant therapy has been used to prevent pulmonary embolisms. However, for the patients who anticoagulant is contraindicated or if this is complicated, the use of an IVC filter without concurrent anticoagulation may become the sole treatment for pulmonary embolisms. In this situation, the thrombi trapped in the IVC filter may cause significant clinical problems. We report here on a case of IVC filter thrombosis that was successfully treated by aspiration thrombectomy after placing another filter proximal to the previous filter.
Humans ; Pulmonary Embolism ; Thrombectomy* ; Thrombosis* ; Vena Cava Filters* ; Vena Cava, Inferior* ; Venous Thrombosis

BACKGROUND: One of the important mechanisms responsible for a tumor escaping the immune response is an absence of the tumor associated antigen (TAA) on the cancer cell surface. To overcome this, combination gene therapy using a herpes simplex thymidine kinase (HSTK) gene, prototype of drug sensitizing gene, was conducted to enhance TAA release by cell destruction, as well as the cytokine genes for immune cell attraction. METHODS: We investigated whether or not transduction with the adenovirus-HSTK (Ad-HSTK) enhanced the sensitivity of Lewis lung carcinoma (LLC) to ganciclovir (GCV) and induced a bystander effect. A Tumor vaccine trial was performed using LLC with ad-HSTK ±ad-GM-CSF±ad-IL-2 to determine if they exhibit some antitumor effect on established lung cancer xenografts. RESULTS: LLC with ad-HSTK revealed a much higher sensitivity to ganciclovir (GCV). LLC transduced with ad-HSTK and/or ad-IL-2, ad-GM-CSF showed a lower in vivo tumorigenicity. In the treatment experiment, vaccination with LLC transduced with ad-HSTK, ad-IL-2, or ad-GM-CSF alone modestly suppressed the growth of an established tumor. Combined transduction with HSTK and GM-CSF induced stronger growth suppression of a established lung cancer, while HSTK and IL-2 combination transduction did not have any antitumor effect on individual transduction. Vaccination with LLC-HSTK-GM-CSF increased the infiltration of dendritic cells in the spleen. CONCLUSION: It was concluded that a tumor vaccine transduced with HSTK and GM-CSF induces strong antitumor immunity by activating the dendritic cells.
Adenoviridae ; Animals ; Bystander Effect ; Carcinoma, Lewis Lung ; Cytokines* ; Dendritic Cells ; Ganciclovir ; Genetic Therapy* ; Granulocyte-Macrophage Colony-Stimulating Factor ; Herpes Simplex* ; Heterografts ; Interleukin-2 ; Lung Neoplasms* ; Lung* ; Phosphotransferases* ; Simplexvirus* ; Spleen ; Thymidine Kinase ; United Nations ; Vaccination

Canal paresis in patients with benign paroxysmal positional vertigo (BPPV) has been variously reported from 26 to 50%. In such cases, BPPVs are developed secondary to accompanying vestibulopathy or other underlying inner ear diseases. Also the side of canal paresis is regarded as involved ear in the lateralization of horizontal canal BPPV (HC-BPPV), in which lateralization is sometimes ambiguous just by Eward's second law. In this case, authors report a woman who had HC-BPPV and pathologic canal paresis which resolved after canalith repositioning. This case may imply that dislodged particles block the endolymphatic flow resulting canal paresis.
Caloric Tests ; Ear ; Female ; Humans ; Jurisprudence ; Labyrinth Diseases ; Paresis* ; Vertigo*

Horizontal canal benign paroxysmal positional vertigo (HC-BPPV) is characterized by direction-changing nystagmus of the horizontal component induced by lateral head turning in supine position. Yet, some patients with HC-BPPV show nystagmus inversion during head turning to one side. And, mostly, the nystagmus started in a geotropic direction and the inversion was observed only when the head is turned to the lesion side. Reversal of the clot movement in the canal and sensory adaptation were suggested as the hypothesis for such finding. However, bilateral inversion of geotropic nystagmus into apogeotropic nystagmus in HC-BPPV has seldom been described before. In this paper, the authors presented the characteristic features and progression during reposition of a patient with bilateral nystagmus inversion and speculated its mechanisms.
Diagnosis ; Head ; Humans ; Semicircular Canals ; Supine Position ; Vertigo*

PURPOSE: To investigate the effect of Ginkgo biloba extract (GBE) on hypoxic cell fraction and metabolic status in fibrosarcoma (FSa II) of C3H mouse. MATERIALS AND METHODS: Fibrosarcoma (Fsa II), 6mm in diameter, growing in the right hindleg muscle of C3H mouse was used for estimation of hypoxic cell fraction using comparison of TCD50. Radiation was given one hour after administrationof GBE (100 mg/Kg, i.p.) with or without priming dose of GBE (100 mg/Kg, i.p.) given 24 hours earlier. Radiation was also given under air breathing condition or clamp hypoxia withour GBE as controls. 31P NMR spectroscopy was performed before and one hour after administration of GBE with or without priming dose of GBE. RESULTS: TCD50/120's were 81.7(77.7-86.0) Gy when irradiated under clamped hypoxia, 69.6 (66.8-72.5) Gy under air breathing condition,67.5(64.1-71.1) Gy with a single dose of GBE (100 mg/kg) given one hour before irradiation, and 62.2(59.1-65.5) Gy with two doses of GBE given at 25 hours and one hour before irradiation. The hypoxic cell fractions, estimated from TCD50/120's were 1.6% under air breathing ondition, 7.2% after single dose of GBE, and 2.7% after two doses of GBE. He results of 31P NMR spectroscopy were as follows. PCr/Pi ratio was 0.27 +/- 0.04 and 0.40 +/- before nd one hour after a single dose of GBE(p<0.01). These findings indicate that the metabolic status is slightly improved after a single dose and markedly after repeated administrations. CONCLUSION: GBE decreases the hypoxic cell fraction and improves the metabolic status of tumor, probably by increasing the blood flow and delivery of oxygen and nutrients, resulting in increased radiosensitivity of tumor.
Animals ; Anoxia ; Fibrosarcoma* ; Ginkgo biloba* ; Magnetic Resonance Spectroscopy ; Mice ; Mice, Inbred C3H* ; Oxygen ; Radiation Tolerance ; Respiration

PURPOSE: This study examined the morphological characteristics of the thoracic and lumbar vertebrae of normal Koreans and the factors causing breakage of the pedicular wall by measuring the thoracolumbar vertebrae relative to the pedicle screw insertion. MATERIALS AND METHODS: The effect of the pedicle screw shape on the pedicle wall integrity of 56 normal Koreans was examined by performing a computer simulation of the inserting pedicle screws into the pedicle wall by superimposing the graphical images of the screws onto the CT scan images. RESULTS: Because the inner pedicle diameters of the most thoracic vertebrae from T4 to T10 were <5 mm, most pedicles of the thoracic vertebrae were expected to be broken after inserting the 5 mm-diameter cylindrical screws. The pedicles of the thoracic and lumbar vertebrae were classified into 6 groups by performing the cluster analysis using morphometric parameters. Group 1 was labeled "relatively narrow". Group 2 "moderate". Group 3 "wide and angular". Group 4 "severly narrow and short", Group 5 "long", and group 6 "relatively wide and angular". The simulation showed the pedicles of groups 1 and 4 to be too narrow for the 5 mm-diameter cylindrical screws to preserve the pedicular wall integrity. CONCLUSION: The pedicles of the vertebra of Koreans are similar in size to those of Caucasians. Personal morphological characteristics of the pedicles as well as their sizes and levels of the vertebrae are believed to be the significant factors that can cause the breakage of the pedicular wall.