The degenerative arthritis following total menisectomy has led to consideration of the need for meniscal transplantation, this study evaluates the morphologic and histologic changes fol lowing fresh meniscal autograft and allograft in therabbits. Transplantation of the medial meniscus was carried out in two groups of 32 rabbits(autograft group=16 rabbits, allograft group=16 rabbits). The morphological and histological changes of the transplanted auto-and allografted menisci and the articular cartilage of the medial femoral and tibial condyle were observed at 2,4,6,8,10,12,22,28 weeks postoperatively. There were no significant differences between auto and allograft groups in gross appearance. Histologically, the fibrous adhesion was noted between grafted meniscus and joint capsule 2 weeks after operation, but complete healing was seen at the suture sites without rejection phenomenon at 6 weeks in both groups. There were prominent inflammatory reactions such as lymphocytes and inflammatory cells infiltration during early postoperative stages(2,4 weeks) only in the allograft group, and more prominent fibrotic reactions in the allograft group than auto-graft group. The results of this study suggest that meniscal allografts are able to adapt to the host tissues, survive within the joint environment, and provide a functional replacement for the removed meniscus, but further studies for graft-host immune response and a method to take the maintenance and deposits of graft must be needed to perform the meniscal allograft in human.
Allografts ; Autografts ; Cartilage, Articular ; Humans ; Joint Capsule ; Joints ; Knee Joint ; Knee ; Lymphocytes ; Menisci, Tibial ; Methods ; Osteoarthritis ; Rabbits ; Sutures ; Transplants

We had a female patient with soft tissue tumor involving large portion of Achilles tendon. After resection of tumor, Achilles tendon was reconstructed using an allogenic human fascia lata manufactured by Pfrimmer-Viggo. EMG findings on postoperative 8 months show marked improvement of function of medial and lateral gastrocnemius muscles. Biopsy specimen of fascia lata allograft, which was acquired during TAL 8 months postoperatively, shows myxoid degeneration, a few lymphocytic infiltration and some foreign body giant cells. Functional, histologic and EMG findings suggest that human fascia lata allograft could be used to bridge defect of Achilles tendon being resected during tumor surgery.
Achilles Tendon ; Allografts ; Biopsy ; Fascia Lata ; Fascia ; Female ; Giant Cells, Foreign-Body ; Humans ; Muscles

PURPOSE: To learn the long-term prognosis of patients with deep vein thrombosis (DVT), we evaluated the location and extent of thrombotic changes, hemodynamic status and clinical symptoms of patients of more than 12 months after development of acute thrombosis. METHODS: 31 patients (man; 24, female; 7, mean age; 44.7 13.2 years) with phlebograpically documented DVT were followed-up for 13~90 months (mean: 32.6 20.4 months) with Duplex scanning, and photo-plethysmography (PPG), and clinical symptoms. To evaluate the effects of treatment modality, the patients were devided into 3 groups; Group 1 (heparine warfarin, n=17), Group 2 (heparine warfarin catheter directed urokinase, n=10), Group 3 (heparine warfarin systemic urokinase, n=4). But, the size of Group 3 was inappropriate to compare with other groups, we performed analysis of the results of Group 1 and 2. RESULTS: Remained thrombi were detected in 22 patients (70.2%) of 31 patients by Duplex scanning, even 1 year later. Of the 29 patients studied with PPG, 24 patients (83%) revealed valvular incompetence in deep (11 cases, 38%) and superficial venous systems (13 cases, 45%). Thrombolytic rate in Group 2 was much higher than Group 1; complete resolution (40% vs 23%), complete obstruction (0% vs 41%). The statistically significant correlation between resolution degree and symptomatic improvement was shown (p=0.008). CONCLUSION: Residual thrombi and valvular damages after DVT were common. But, thrombolysis by catheter-directed urokinase may be associated with a higher rate of thrombolysis and clinical improvement. Anticoagulation alone may not be a sufficient method for treatment of DVT.
Catheters ; Female ; Follow-Up Studies* ; Hemodynamics ; Humans ; Lower Extremity* ; Prognosis ; Thrombosis ; Urokinase-Type Plasminogen Activator ; Venous Thrombosis* ; Warfarin

Dermatofibrosarcoma protuberans(DFSP) is an uncommon soft-tissue neoplasm that usually presents as a painless, often long-standing mass arising in the dermis of skin. It has a frequent tendency to recur after standard surgical excision. Clinically, the initial appearance of the tumor is similar to that of benign tumor such as keloid and dermatofibroma. Therefore making an accurate clinical diagnosis and ensuring adequate surgical excision of this uncommon skin tumor are important. The authors experienced 5 patients of dermatofibrosarcoma protuberans during the recent 2 years, 3 male and 2 female patients. The age of the patients ranged from 21 to 43. Lesions were various in size and shape, and location varies: lower abdomen, right suprabrow region, right anterior superior iliec spine region, right clavicular region, and upper back. Wide excision of tumor with frozen section biopsy or Mohs' microscopic surgery was performed and reconstruction of surgical defect was made according to the size, shape and location. As reconstructive methods, the authors used median forehead flap, split thickness skin graft, or direct closure. The patients were followed up after operation from 4 to 14 months and all remained free of disease. The authors present the experience of 5 cases of dermatofibrosarcoma protuberans occurred in various sites during the short period of time . They obtained satisfactory results with appropriate diagnosis and treatment, which emphasize the importance of accurate diagnosis in early stage. They also present an operative plan of this locally aggressive and highly recurrent tumor.
Abdomen ; Biopsy ; Dermatofibrosarcoma* ; Dermis ; Diagnosis ; Female ; Forehead ; Frozen Sections ; Histiocytoma, Benign Fibrous ; Humans ; Keloid ; Male ; Skin ; Spine ; Transplants

Cyclosporine(CsA) has been used a prime immunosuppressive drug since Calne et al reported the excellent results of cyclosporin in renal transplantation, 1978. But many adverse effects has been reported, one of them, nephrotoxicity is a well-known adverse effect which is developed in high CsA blood level. When previously used Sandimmun was used in the field of various kinds of organ transplantation, there were many difficulties to keep optimal, consistent and stable CsA blood level because of the nature of lipophilic characteristics of drug, wide interpersonal and even intrapersonal variability of its dose and blood concentration. So, there has been the possibility of adverse effects caused by overdosage and rejection phenomenon caused by low dosage. The objective of this study is to assess the significance of drug dosage and CsA blood level in patients developed nephrotoxicity when Sandimmun Neoral was used as a major immunosupressive drug. From January 1995 to September 1996, a total of 21 renal transplant patients from Wonkwang University Hospital entered in this study. We retrospectively analysed CsA dosage, CsA blood level and serum creatinine concentration at postoperative 1, 3, 6, 12 months. These patient were divided into 3 groups according to occurrence of acute rejection and nephrotoxicity. The group A has no nephrotoxicity and no rejection(n=7), the group B has nephrotoxcity only(n=6) and the group C has acute rejection and nephrotoxicity(n=8). There is statistical significance at postoperative 1 month of drug dosage between groups, 10.0+/-2.18, 12.9+/-1.40, 10.5+/-2.01 mg/kg, respectively (p=0.035). Mean CsA blood trough level(ng/ml) in Group A are 427.2+/-73.73, 301.0+/-43.94, 224.8+/-48.39, 175.8+/-46.09 ng/ml at postoperative 1, 3, 6, 12 months, respectively; in Group B, 684.5+/-162.08, 409.5+/-60.67, 278.5+/-27.34, 169.1+/-37.87 ng/ml; in Group C, 484.3+/-131.99, 372.7+/-46.95, 270.8+/-61.17, 188.3+/-48.35 ng/ml. Statistical significance was shown in CsA at postoperative 1, 3 months (P=0.005, P=0.043). Mean serum creatinine concentration(mg/dl) in Group A are 1.3+/-0.20, 1.4+/-0.25, 1.3+/-0.22, 1.4+/-0.20 mg/dl at postoperative 1, 3, 6, 12 months, respectively; in Group 2, 1.7+/-0.24, 2.2+/-0.31, 1.7+/-0.37, 1.5+/-0.31 mg/dl; in Group C, 1.6+/-0.40, 2.8+/-0.38, 2.2+/-0.56, 1.9+/-0.19 mg/dl. Statistical significance in serum creatinine concentration was shown between groups at all index time(P=0.05, P=0.001, P=0.002, P=0.001). Nephrotoxic groups(B,C) regained the serum creatinine concentrations close to basal level according to lowering dosage, but it usually took 5~6 months. This article shows that nephrotoxicity caused by CsA peaked around 3 months and it lasted several months even after adequate dosage adjustment and blood trough level. For the best renal function and avoiding nephrotoxicity, adequate dose adjustment based on the whole blood trough level is needed.
Creatinine ; Cyclosporine* ; Humans ; Kidney Transplantation ; Kidney* ; Organ Transplantation ; Retrospective Studies ; Transplants

PURPOSE: Prompt operative management of patients with peripheral artery embolism remains the treatment of choice for this malady. The clinical status of the limb, rather than the elapsed time from the onset of occlusion, was recently determined to be the best predictor of limb salvage. We investigated the clinical features, therapeutic modalities and treatment results of popliteal artery embolism compared with that of ilio-femoral artery embolism. METHODS: A retrospective review was carried out for 21 cases that were treated for lower extremity arterial embolism, from March 2000 to June 2006. The patients were classified into two groups; Group A (ilio-femoral artery embolism, n=11) and Group B (popliteal artery embolism, n=10). We analyzed the interval time from the onset of symptoms to starting treatment (the interval time), the degree of limb ischemia, the therapeutic modalities and the treatment results. RESULTS: The average interval time was 16.2+/-16.9 hours in the total 21 cases; the average interval time for Group A was 7.7+/-2.9 hours and that for Group B was 25.5+/-20.9 hours (P<0.05), and the incidence of severe limb ischemia (class IIb according to the SVS/ISCVS reporting standard) was 72.7% vs 20.0%, respectively (P<0.05). For the therapeutic modalities, surgical thromboembolectomy was performed in all cases of Group A and for 3 cases of Group B. Seven cases of Group B received radiologic intervention (3 cases percutaneous aspiration embolectomy only, and 4 cases of additional thrombolytic therapy). CONCLUSION: This study shows that the interval time for popliteal artery embolism is longer than that for ilio-femoral artery embolism. In other words, it is suggested that the symptomatic progression of popliteal artery embolism is slower than that of ilio-femoral artery embolism. Therefore, we can have more chances for variable therapeutic options such as surgical thromboembolectomy, percutaneous aspiration embolectomy and/or thrombolytic therapy in patients suffering with popliteal artery embolism.
Arteries ; Embolectomy ; Embolism ; Extremities ; Humans ; Incidence ; Ischemia ; Limb Salvage ; Lower Extremity ; Popliteal Artery ; Retrospective Studies ; Stress, Psychological ; Thrombolytic Therapy

PURPOSE: There has been an epidemic of measles in Korea since 2000. Therefore, we analyze the epidemiologic haracteristics of measles in Gwangju Metropolitan City. METHODS: We reviewed the epidemiologic investigation records and laboratory data of the measles patients reported in Gwangju Metropolitan City from January 1st 2000. RESULTS: 1) Demographic characteristics: Totally, 3,392 cases were surveyed and 3,300 cases were enrolled (3,300/3,392, 97.3%). Fifty-four percents of the patients were male (1,771/3,300) and forty-six percents of the patients were female (1,529/3,300). Average age of the patients was 8.20 years (8.20 5.56 years). Forty-seven percents of the patients were reported in the interval from November 2000 to December 2000 (1,582/3,298, 47.9%). 2) Clinical manifestations of the patients: Common symptoms of measles patients were fever (3,300/3,300, 100.0%), skin rash (3,068/3,300, 93.0%), cough (2,889/3,300, 87.5%), rhinorrhea (1,883/3,300, 57.1%), headache (1,445/3,300, 43.8%), conjunctival injection (1,182/3,300, 35.8%), and oral thrush (832/3,300, 25.2%). Among the patients, 250 patients had complications (250/3,300, 7.6%) and most of them were respiratory complications (220/250, 88.0%). 3) Vaccination: Eighty-six percent of the enrolled patients answered the question about vaccination (2,854/3,300, 86.4%); 808 patients were not taken a shot (808/2854, 28.3%), 1,762 patients received one dose (1,762/2,854, 61.7%), and 284 patients received additional dose (284/2,854, 9.9%). 4) Laboratory data: Laboratory confirmed cases were 780 patients (780/3,300, 23.6%); 603 cases were confirmed serologically, 185 cases were positive in PCR, and virus was isolated in 6 cases. Genetic sequencing of the isolated viruses was clade H1 and closely related to that of China. CONCLUSION: Therefore, adequate surveillance and maintenance of high coverage rate of the vaccination would be the crucial factors to eradicate measles
Candidiasis, Oral ; China ; Cough ; Exanthema ; Female ; Fever ; Gwangju ; Headache ; Humans ; Korea ; Male ; Measles* ; Polymerase Chain Reaction ; Vaccination

No abstract available.
Adult* ; Humans ; Purpura, Thrombocytopenic, Idiopathic* ; Splenectomy*

Lateral neck metastasis is an independent risk factor of the loco-regional recurrence in papillary thyroid carcinoma (PTC). Ultrasonography (US) and computed tomography are frequently performed to diagnose the lymph node (LN) metastasis. However, some metastatic LNs can remain after initial treatment and can present as regional recurrences. A 19-year-old woman was diagnosed as having 1.99 cm PTC. No abnormal LNs was detected on preoperative CT and US. She underwent operation and radioactive iodine (RAI) therapy: seven months after RAI therapy, thyroglobulin level was elevated. However, no metastatic LNs were detected on neck CT, US and positron emission tomography-CT. Neck exploration was performed and metastatic PTC was diagnosed in bilateral level III and IV. A radiologist retrospectively reviewed the neck CTs taken before the first surgery and the second surgery. There was no significant difference in the LN appearances of two CTs. On both CT scans, all LNs were very small, homogenously enhanced, without calcification or cystic changes.
Electrons ; Female ; Humans ; Iodine ; Lymph Nodes* ; Neck ; Neck Dissection ; Neoplasm Metastasis* ; Radiotherapy, Adjuvant ; Recurrence* ; Retrospective Studies ; Risk Factors ; Thyroglobulin ; Thyroid Gland* ; Thyroid Neoplasms* ; Tomography, X-Ray Computed ; Ultrasonography ; Young Adult

. Implants were placed immediately after tooth extraction on anterior alveolar ridges in the maxilla and mandible. The pinguide system was used to help determine the location and path of implants during the surgical process. The horizontal distance from implants to the outer border of alveolar bone was measured at the rim and middle of the implants in the cone beam computed tomography images. The alteration of alveolar bone was evaluated comparing the horizontal distances measured immediately after surgery and 3 months after surgery. RESULTS. The results show that more resorption occurred towards the labial bone than the lingual bone in the maxilla.A similar amount of labial and lingual bone resorption was observed in the mandible. CONCLUSION. Considering the horizontal alteration of alveolar bone, labio-lingual positioning of the implant towards the lingual bone in the maxilla and at the center of the alveolar ridge in the mandible is recommended when it is placed immediately after tooth extraction.