No abstract available.
Focal Nodular Hyperplasia*

Chondrocytes isolated from the articular cartilage of rabbit knee joint were cultured in vitro within fibrin glue carrier for 2 weeks. Histochemical and electromicroscopical approaches were used to study chondrocytes behavior and phenotypic expression. In vitro study, chondrocyte assumed a rounded morphology, accumulated metachromatic matrix and took on the cytological characteristics of in vivo cartilage cells. Allogenic cultured chondrocyte in fibrin glue was transplanted into osteochondral defect in rabbit joint. The contralateral knee joint served as a control in which the defect was left empty. This in vivo study was performed for the investigation of the chondrogenic potential of cultured chondrocytes embedded in fibrin glue. Grafted defects was filled with cartilage in gross finding, repaired tissue consisted of differentiated chondrocytes and matrix resumed that of hyaline cartilage. At sixteen week after transplantation, subchondral region was partially transformed into bone without loss of overlying articular cartilage, but in control group, defect did not heal successfully. Repaired articular cartilage was thicker than host cartilage and tide mark was not shown up to 24 weeks. Some of repaired tissue was degraded partially. These results suggest that fibrin glue provides suitable environment for differentiation of chondrocyte and allograft of cultured chondrocyte in fibrin glue transplanted into large osteochondral defect improves cartilage repair.
Allografts ; Cartilage ; Cartilage, Articular ; Chondrocytes* ; Fibrin Tissue Adhesive ; Hyaline Cartilage ; Joints ; Knee Joint ; Rabbits* ; Transplantation ; Transplants*

BACKGROUND: Bioprosthetic materials have been made using glutaraldehyde fixation of porcine or bovine pericardium during cardiovascular surgery. But these bioprostheses have the problems of calcification and mechanical failure. We determined changes in tensile strength and elasticity of pericardium after glutaraldehyde, solvent, decellularization and detoxification. MATERIAL AND METHOD: Tissues were allocated to four groups: glutaraldehyde with and without solvent, decellularization, and detoxification. We studied tensile strength and strain on tissues. We measured the tensile strength of fresh pericardium stretched in six directions (with 5 mm width), and % strain, which we calculated from the breaking point when we pulled the pericardium in two directions. RESULT: Tensile strength was reduced when we used the usual concentrated glutaraldehyde fixation (n=83, MPa=11.47+/-5.40, p=0.006), but there was no change when we used solvent. Elasticity was increased after glutaraldehyde fixation (n=83, strain (%)= 24.55+/-9.81, p=0.00), but there was no change after solvent. After decellularization of pericardium, the tensile strength was generally reduced. The decrease in tensile strength after concentrated glutaraldehyde fixation for a long time was significantly greater less than after concentrated solvent (p=0.01, p=0.00). After detoxification, the differences in strength and strain were not significant. CONCLUSION: After glutaraldehyde treatment of pericardium there is no loss in tensile strength (even though we did the glutaraldehyde, solvent and detoxification treatments LOGIC IS UNCLEAR). Also, these treatments had a tendency to increase elasticity. Although post-treatment decellularization led to a significant loss in strength, this effect could be attenuated using a low concentration of solvent or hypertonic solution.
Bioprosthesis ; Elasticity ; Glutaral ; Logic ; Pericardium ; Sprains and Strains ; Tensile Strength

BACKGROUND: Tumor necrosis factor(TNF)-alpha and Interleukin(IL)-1beta are thought to play a major role in the pathogenesis of the septic syndrome, which is frequently associated with adult respiratory distress syndrome(ARDS). In spite of many reports for the role of TNF-alpha in the pathogenesis of ARDS, including human studies, it has been reported that TNF-alpha is not sensitive and specific marker for impending ARDS. But there is a possibility that the results were affected by the diversity of pathogenetic mechanisms leading to the ARDS because of various underlying disorders of the study group in the previous reports. The purpose of the present study was to evaluate the roles of TNF-alpha and IL-lbeta as a predictable marker for development of ARDS in the patients with septic syndrome, in which the pathogenesis is believed to be mainly cytokine-mediated. METHODS: Thirty-six patients of the septic syndrome hospitalized in the intensive care units of the Asan Medical Center were studied. Sixteens suffered from ARDS, whereas the remaining 20 were at the risk of developing ARDS(acute hypoxemic respiratory failure, AHRF). In all patients venous blood sample were collected in heparin-coated tubes at the time of enrollment, at 24 and 72 h thereafter. TNF-alpha and IL-lbeta was measured by an enzyme-linked immunosorbent assay (ELISA). All data are expressed as median with interquartile range. RESULTS: 1) Plama TNF-alpha levels: Plasma TNF-beta levels were less than 10pg/mL, which is lowest detection value of the kit used in this study within the range of the mean+/-2SD, in all of the normal controls, 8 of 16 subjects of ARDS and in 8 in 20 subjects of AHRF. Plasma TNF-alpha levels from patients with ARDS were 10.26pg/mL(median;<10-16.99pg/mL, interquartile range) and not different from those of patients at AHRF(10.82, <10-20.38pg/mL). There was also no significant difference between pre-ARDS(<10, <10-15.32pg/mL) and ARDS(<10, <10-10.22pg/mL). TNF-alpha levels were significantly greater in the patients with shock than the patients without shock(12.53pg/mL vs. <10pg/mL) (P<0.01). There was no statistical significance between survivors(< 10, <10-12.92pg/mL) and nonsurvivors(11.80, <10-20.8pg/mL) (P=0.28) in the plasma TNF-alpha levels. 2) Plasma IL-lbeta levels: Plasma IL-1beta levels were less than 0.3ng/mL, which is the lowest detection value of the kit used in this study, in one of each patients group. There was no significant difference in IL-1beta levels of the ARDS(2.22, 1.37-8.01ng/mL) and of the AHRF(2.13, 0.83-5.29ng/mL). There was also no significant difference between pre-ARDS(2.53, <0.3-8.34ng/mL) and ARDS(5.35, 0.66-11.51ng/mL), and between patients with septic shock and patients without shock (2.51, 1.28-8.34 vs 1.46, 0.15-2.13ng/mL). Plasma IL-19 levels were significantly different between survivors(1.37, 0.4-2.36ng/mL) and nonsurvivors(2.84, 1.46-8.34ng/mL). CONCLUSION: Plasma TNF-alpha and IL-1beta level are not a predictable marker for development of ARDS. But TNF-alpha is a marker for shock in septic syndrome. These result could not exclude a possibility of pathophysiologic roles of TNF-alpha and IL-1beta in acute lung injury because these cytokine could be locally produced and exert its effects within the lungs.
Acute Lung Injury ; Adult* ; Chungcheongnam-do ; Enzyme-Linked Immunosorbent Assay ; Humans ; Intensive Care Units ; Interleukin-1beta* ; Lung ; Lymphotoxin-alpha ; Necrosis ; Plasma ; Respiratory Distress Syndrome, Adult* ; Respiratory Insufficiency ; Shock ; Shock, Septic ; Tumor Necrosis Factor-alpha*

PURPOSE: To establish the basis for a non-invasive and non-destructive assessment of the mechanical properties during natural fracture healing by analyzing the vibrational property of the fracture healing and comparing the vibrational property, the bone healing status (as determined by X-ray) and the mechanical strength parameters. MATERIALS AND METHODS: The tibial shafts of rabbits were broken under general anesthesia. The rabbits were sacrificed at 2, 4, 6 weeks after the fracture, then X-rays of the fractured tibias were sequentially taken to detect the fracture healing. The vibration mode and the biomechanical strength were measured. RESULTS: According to the results of a multiple regression analysis, the standardized coefficients of callus, apposition, lateral angulation, DAMP1, FREQ1 in the fractured tibias, were -0.80, -0.23, -0.21, -0.25, -0.25. In normal contralateral tibias, the standardized coefficients of the area, FREQ1, DAMP1, FREQ2, DAMP3 were -0.73, 0.28, 0.41, 0.39, -0.25. CONCLUSION: A monitoring of the fracture healing process that utilizes the frequency response function is thought to be useful in detecting the early phase of healing within 4 weeks. Additional studies on the vibrational characteristics of the healing bones after a clinical union or after simillar pathologies should be pursued so that future diagnostic applications ca be made.
Anesthesia, General ; Bony Callus ; Fracture Healing ; Fractures, Bone* ; Pathology ; Rabbits ; Tibia ; Vibration

Augmentation mammoplasty with anatomical breast implant, which was first introduced in Korea in February 2012, is expected to increase along with the round implant. This study reports the early experience of a single surgeon with this implant to Korean female patients. A total of one hundred patients who performed augmentation mammoplasty with Replicon(R) (POLYTECH Health & Aesthetics, Dieburg, Germany), a kind of anatomical breast implant, from February 2012 to August 2012 were studied. Patient's satisfaction with breast shape and touch was assessed using linear analogue scales with a maximum score of 5. All of the patients received augmentation mammoplasty for cosmetic purpose. Ninety-one patients were satisfied with their results. Neither implant malrotation nor capsular contracture was checked during the average follow up period of 7.9 months. Even though it is a preliminary report of early studies, we can see that anatomical implant is suitable for Korean female patients who have small breast, mild ptotic breast and constricted lower pole, given that anatomical implant proved excellent results in this studies.
Breast ; Breast Implantation ; Breast Implants ; Contracture ; Cosmetics ; Esthetics ; Female ; Follow-Up Studies ; Humans ; Korea ; Mammaplasty ; Weights and Measures

Cases of undifferentiated pleomorphic sarcoma of the thoracic aorta are rare, and usually present with embolic events, renovascular hypertension, or back pain. Mural-based undifferentiated pleomorphic sarcomas that present as ruptured saccular aneurysms are extremely rare and are difficult to differentiate from mycotic aneurysms or penetrating atherosclerotic ulcers. Herein, we report a case of histopathologically proven undifferentiated pleomorphic sarcoma arising from the wall of the descending thoracic aorta that manifested as a mass after thoracic endovascular aortic repair for the treatment of a ruptured saccular aneurysm. We present findings obtained by CT and PET to provide helpful information for the accurate diagnosis and appropriate treatment of future cases.

OBJECTIVE: To know the genotypic distributions of Angiotensinogen, Thermolabile Methylenetetrahydrofolate Reductase (MTHFR) and Factor V Gene Variants, suggested as risk factors of preeclampsia, among Korean Women. METHODS: 113 preeclampsia patients and 70 normotensive pregnancy controls were evaluated. DNA was extracted from peripheral leukocytes, then PCR and restriction by appropriate enzymes were done to identify the single nucleotide polymorphism. The genotypic distributions of preeclampsia and the control group were compared. RESULTS: Nineteen of 113 women with preeclampsia (17%) and 14 of 72 with nulliparous preeclampsia (19%) were heterozygous for the angiotensinogen T704C mutation, and 94 of 113 women with preeclampsia (83%) and 58 of 72 women with nulliparous preeclampsia (81%) were homozygous. While 7/70 (10%) were heterozygous, and 59/70 (84%) were homozygous for the T704C mutation among the control subjects. The frequency of the MTHFR T677 allele was 36% in the preeclamptic group and 38% in the control group, and TT homozygosity was found in 26 preeclamptic women (23%) and in 13 controls (19%). No women were homozygous or heterozygous for the factor V Leiden mutation. CONCLUSION: Angiotensinogen T704C mutation is associated with preeclampsia in the Korean population. There was no association between the thermolabile variant of MTHFR and risk of preeclampsia in our study population. We observed no factor V Leiden mutation. We also suggested that a person with angiotensinogen T704C mutation plus MTHFR C677T variant does not have more of an increased risk for preeclampsia than with angiotensinogen T704C mutation only.
Alleles ; Angiotensinogen* ; DNA ; Factor V* ; Female ; Humans ; Leukocytes ; Methylenetetrahydrofolate Reductase (NADPH2)* ; Polymerase Chain Reaction ; Polymorphism, Single Nucleotide ; Pre-Eclampsia* ; Pregnancy ; Risk Factors*

PURPOSE: The purpose of this study is to evaluate the clinical and radiographic results of internal fixation using multiple Kirschner wires (K-wires) for the fifth metatarsal base fracture. MATERIALS AND METHODS: We retrospectively reviewed 14 patients with a displaced fifth metatarsal base fracture. We measured the distance of fracture displacement on the foot oblique radiograph pre- and post-operatively. We evaluated the clinical results using the visual analog pain scale at six weeks and three months postoperatively and the American Orthopaedic Foot and Ankle Society (AOFAS) midfoot score at six months postoperatively. RESULTS: In our series, 10 cases were zone I fracture and four cases were zone II fracture. We achieved anatomical reduction and bony union in all of our cases. The average time to bone union was 43 days. The degree of pain around the fifth metatarsal base was significantly decreased after surgery. The average AOFAS score was 95 at six months postoperatively. CONCLUSION: Multiple K-wire fixation is a relatively simple fixation method for displaced fifth metatarsal base fractures. If we place a K-wire into the medial cortex of the fifth metatarsal, we could prevent proximal migration of the K-wire.
Ankle ; Bone Wires* ; Foot ; Humans ; Metatarsal Bones* ; Pain Measurement ; Retrospective Studies

Ullrich's disease is a congenital muscular dystrophy clinically characterized by generalized muscle weakness, multiple contractures of the proximal joints, and hyperextensibility of the distal joints. All the patients develop rigidity of spine, often assoicated with scoliosis, failure to thrive, and early and severe respiratory involvement, irrespective of their levels of motor function. Intellectual development is normal. The biopsied muscles show dystrophies including remarkable variation in the fiber size, notably proliferated endomysial connective tissues, and a lot of degenerated and regenerated fibers. The expression of merosin and dytrophin is normal. Recent studies have demonstrated that collagen VI is deficient in the muscles of the patients with Ullrich's disease, and some result from recessive mutations of the collagen VIalpha 2 gene(COL6A2). And a marked reduction of fibronectin receptors in the extracellular matrix of skin and cultured fibroblasts of these patients is also reported. These results suggest that collagen VI deficiency may lead to the reduction of fibronectin receptors and that any abnormalities of cell adhesion may be involved in the pathogenesis of the disease. A case of Ullrich's disease has not been reported yet in Korea. So, we describe a male patient with Ullrich's disease with a brief review of the literature.
Cell Adhesion ; Collagen ; Connective Tissue ; Contracture ; Extracellular Matrix ; Failure to Thrive ; Fibroblasts ; Humans ; Integrin alpha5beta1 ; Joints ; Korea ; Laminin ; Male ; Muscle Weakness ; Muscles ; Muscular Dystrophies ; Receptors, Fibronectin ; Scoliosis ; Skin ; Spine