No abstract available.
Magnetic Resonance Imaging* ; Prostate* ; Prostatic Neoplasms*

No abstract available.
Antigens, Surface*

Fibrohistiocytic tumors are a diverse group of benign and malignant soft tissue lesions, including dermatofibroma, dermatofibrosarcomaprotuberans, and malignant fibrous histiocytoma. On the clinical point of view, the distinction between benign and malignant lesions and malignancy grading is far more important. Therefore, we investigated 23 fibrohistiocytic tumors, using PCNA (PC10) which was a useful marker of proliferating activity, to differentiate the benign lesions from the malignant and correlate with other prognostic factors including tumor necrosis. cellularity, histologic grade, and mitotic counts. The results obtained were as follows 1) Positive tumor cells were clearly identified by the characteristic diffuse or granular nuclear staining. 2) The number of PCNA-positive tumor cells were 2.16+/-2.39% in dermatofibroma, 16.12+/-7.38% in dermatofibrosacoma protuberans, and 28.02+/-17.47% in the malignant fibrous histiocytoma. The numbers of PCNA-positive tumor cells in the malignant lesions higher than in the benign (p<0.001). 3) Deep seated, large size (>5 cm) and recurred or metastatic cases of MFH were more the high PCNA index (more than 20%) than the low index (less than 20%) groups. 4) PCNA index in MFHs had positive correlation with the number of mitotic counts (r=0.7582, p<0.001), cellularity (r=0.5908, p<0.05) and histologic grade (r=0.4164, p<0.05). These results suggested that reactivity on PCNA might assist in the distinction between benign and malignant lesions in fibrohistiocytic tumors, and could be a useful prognostic factor in the patients with malignant fibrous histiocytoma.
Neoplasm Metastasis

Although the method to obtain a good results of treatment is still controversial in ankle fracture, most authors agree with open reduction and internal fixation for unstable ankle fracture. They also emphasize the importance of accurate reduction and rigid fixation of fractured lateral malleolus. Recently, the good results of early weight bearing and joint motion has been recognized. Therefore the cast immobilization for long duration is eliminated after surgery by many authorities. In addition to positive role of early ankle motion and weight bearing, we could expect the advantage of subsidence of stiffness, osteoporosis, and early returning to social activity. The seventy-eight unstable ankle fractures treated at Severance Hospital, Yonsei University College of medicine with open reduction and internal fixation were analyzed in clinical and radiological aspects. The following results were obtained. 1. In unstable ankle fracture, the good functional results were obtained with early joint motion and weight bearing after accurate reduction and rigid fixation. 2. The accurate reduction and rigid fixation for lateral malleolar fracture was the most significant factor in contributing to good results. 3. Syndesmotic ligament should be examined on each exploration of fractured fibular. In spite of the immediate weight bearing, the transfixion screw has remained in place without loosening or breakage. 4. The reduction of medial malleolar fracture was relatively easy and seems not to affect the results.
Ankle Fractures ; Ankle ; Clinical Study ; Immobilization ; Joints ; Ligaments ; Methods ; Osteoporosis ; Weight-Bearing

Laparotomy performed for resection of hepatoma in 34 cases at Seoul National University Hospital for 3 .5years since Oct. 1978. Resection of hepatoma was done in 21 cases, ligation with or without canulation of hepaticartery was performed in 12 cases, and open and closure was made in 1 case. Angiographic findins were analyzed forresectability of hepatoma. The results of hte analysis were as follows; 1. Most reliable signs for resectablehepatoma were peripheral location and confinement in one hepatic lobe. Most reliable signs for non-resectablehepatoma were presence of tumor thrombus in portal vein, bilateral hepatic arterial feeding. 2. Less reliablesigns for resectable hepatoma were absence of portal vein invasion, less than 10cm in size and absence of findingsof liver cirrhosis. Less reliable signs for non-resectable hepatoma were right or left massive type. 3. Presenceof arteriovenous fistula, more than 10cm in size, and presence of findings of liver cirrhosis were no reliablecriteria for resectability of hepatoma. 4. Predictability for resectability with those reliable signs ofangiography was around 80%. 5. In addition to routine celiac angiography, oblique celiac angiography or superiormesenteric arteriography for portal vein opacification will be helpful in order to obtaine highly reliable signsfor resectability of hepatoma.
Angiography ; Arteriovenous Fistula ; Carcinoma, Hepatocellular ; Laparotomy ; Ligation ; Liver Cirrhosis ; Portal Vein ; Seoul ; Thrombosis

OBJECTIVE: Surgically removed herniated lumbar disc specimen are immunostained to evaluate the production of MMPs(Matrix metalloproteinases) -1, 2, 3 for the investigation of the possible correlation of MMPs in lumbar disc herniation depending on the types of disc herniation. METHODS: The study population consists of 30 patients with lumbar disc herniation. There were 18 men and 12 women with patient age averaging 43.4 years(19-68years). The types of disc herniation identified at the time of surgery were classified as follow ; protruded type(Group 1, 10cases), extruded type(Group 2, 10cases), sequestrated type(Group 3, 10cases). Immunohistochemical study for the MMPs of the herniated disc tissue was performed and results of staining were graded to examine differences in histology among three types of disc herniation . RESULTS: The MMPs immunopositive cells were increased in old patients but statistically it was not significant(p=0.074). A significantly increased incidence of positive cells for MMP-1, 2 was found in the herniated lumbar disc tissue than the control group(p=0.02) but there were no significant differences among the three types of disc herniation. The MMP-3 positive cells were predominantly detected in the sequestrated disc tissue group(p=0.037) more than other groups. CONCLUSION: These results suggest that the MMP-1, 2, 3 may play important roles in the process of degeneration, herniation, and resorption of the lumbar intervertebral discs and that the MMP-3 may express the severity of lumbar disc herniation and play a role in resorption of the sequestrated disc tissue.
Female ; Humans ; Immunohistochemistry ; Incidence ; Intervertebral Disc ; Intervertebral Disc Displacement ; Male ; Matrix Metalloproteinases*

We report a 43-year-old male who suffered cognitive dysfunction after an electric injury. He underwent evaluation for cognitive dysfunction and cerebral glucose hypometabolism at 1 week and 6 months. In contrast to the progressive decline of frontal lobe functions and visuospatial functions, memory and depressive mood were improved. SPM99 showed hypometabolic areas in the frontal and occipital lobes which were widened. Moreover new cingulate lesions appeared. This illustrates that the progression of derangement of cerebral glucose metabolism is correlated with neuropsychological impairment.
Adult ; Electric Injuries* ; Follow-Up Studies* ; Frontal Lobe ; Glucose ; Humans ; Male ; Memory ; Metabolism ; Neuropsychology ; Occipital Lobe ; Positron-Emission Tomography

Achalasia is very uncommon in children, and cases accompanied with alacrima and adrenal insufficiency is even more uncommon. When these three disorders are seen altogether, it is called triple A syndrome. It is inherited in an autosomal recessive manner and has potentially life-threatening sequelae. So, pediatricians should always consider the possibility of triple A syndrome when seeing children with achalasia. Neurological abnormalities such as autonomic neuropathy, peripheral neuropathy, sensory impairment and mental retardation occasionally accompany. We report a 2-year-old girl who presented with repeated vomiting, short stature and alacrima. Diagnosis of achalasia was made after perfoming esophagogram and endoscopy and was confirmed with esophageal manometry. After pneumatic dilatation, she became asymptomatic.
Adrenal Insufficiency ; Child ; Child, Preschool ; Diagnosis ; Dilatation ; Endoscopy ; Esophageal Achalasia ; Female ; Humans ; Intellectual Disability ; Manometry ; Peripheral Nervous System Diseases ; Vomiting

Recently xenotransplantation has been thought as a final solution for the controi of donor organ shortage in allograft. In order to be a ciinicai entity, xenotransplantation has many obstacles such as hyperacute rejection and delayed xenogratt rejection as a potent immunologic reaction, zoonosis and ethical problems. We already reported the eariy immunoiogic events occuring soon after xenograft in animal model, in which natural antibody and complement have a crucial roie in rejection response. As a further step for the prolongation of graft survival, we used anticomplement agent (cobra venom factor, CVF) in the same model. Graft survival in discordant (guinea pig-to-rat) xenogratt was extended from 30.6 minutes to 2 days following singie injection of CVF, which showed similar pattern of rejection with the concordant xenogratt in terms of time of rejection response after grafting. In this setting antibody response in the blood did not show any difference between that of pre CVF and post CVF, even though IgM response was more pronounced than IgG. The complement activity in the blood showed marked suppression following CVF injection. Intragraft complement gene (C3 mRNA) expression in CVF injected discordant showed delayed response in a similar pattern like that of concordant xenograft. Interestingly enough intragraft anticomplement gene expression showed the simiiar pattern of response with the complement. From these results we can conclude that anticomplement agent (CVF) extended the graft survival in discordant xenograft upto the level of concordant xenograft by shifting the complement activation response from that of discordant to concordant xenograft.
Rats ; Animals

BACKGROUND: A high incidence of chronic liver disease is reported in end-stage renal failure patients due to hemodialysis and blood transfusion. An average of 20% of the patients who received renal hemodialysis are infected with hepatitis C virus, but the incidence of infection in these patients varies widely according to geographic location and the diagnostic methods used. Controversy exists regarding the impact of pretransplantation HCV infection on the outcome of renal transplantation. We measured the seroprevalence of the antibody to hepatitis C (anti-HCV) in renal transplant candidates and compared the prevalence of posttransplantation liver disease, graft, and patient survival among renal transplant recipients with and without anti-HCV at the time of the transplantation, and we attempted to define the possible factors affecting the clinical course following renal transplant in positive HCV patients. METHODS: Between June 1990 and December 1997, 634 patients underwent renal transplants at our institute. Viral infection with hepatitis were analyzed in these patients by using anti-HCV positivity using first, second, and third generation EIA, and RT-PCR. RESULTS: Twelve (12) of the 634 (1.9%) had positive anti-HCV before renal transplantation. During a mean follow-up of 29.4 months, viral mRNA was detected in the pretransplantation serum in 3 out of 8 (37.5%) positive anti-HCV patients. Among the 12 patients with positive anti-HCV, 2 (16.6%) showed early liver dysfunction, and 1 (8.3%) showed histologic progression to chronic hepatitis leading to hepatic failure and death. Graft loss occurred in 1 of the 12 (8.3%) patients with positive anti-HCV and in 62 of the 622 (9.8%) patients with negative anti-HCV. Three (3) out of the 12 (25%) patients with positive anti-HCV, and 121 of the 622 (19.6%) patients with negative anti-HCV had episodes of rejection. One (1) of the 12 (8.3%) patients with positive anti-HCV and 26 of the 622 (4.2%) patients with negative anti-HCV died after kidney transplantation. There were no statistical differences in patients or graft survival between the positive anti-HCV (+) and the negative anti-HCV patients. CONCLUSION: From these results, we can assume that the presence of anti-HCV without advance liver disease should not be a contraindication for kidney transplantation.
Blood Transfusion ; Follow-Up Studies ; Graft Survival ; Hepacivirus ; Hepatitis ; Hepatitis C ; Hepatitis, Chronic ; Humans ; Incidence ; Kidney Failure, Chronic ; Kidney Transplantation* ; Liver Diseases ; Liver Failure ; Prevalence ; Renal Dialysis ; RNA, Messenger ; Seroepidemiologic Studies ; Transplantation ; Transplants