Histiocytosis X patients present with a variety of clinical manifestations and outcomes. The principal difficulty in the establishment of a definite protocol for treatment is based on the poor understanding of the basic nature of this disease, the absence of reliable prognostic criteria, and the problems with nomenclature. The objectives of this study were to analysis the course of the disease and the results of treatment in patients who had Langerhans cell histiocytosis and to suggest prognostic factors and guidelines for management. We reviewed the thirty patient who had Langerhans cell histiocytosis for past ten years. These patients were followed for an average 4.8 years (range, excluding patients who died of the disease, two to eleven years). The patients were divided into tow group; eighteen patients who Langerhans cell histiocytosis localized in skeleton (group I) and twelve patients who had Langerhans cell histiocytosis disseminate in both skeleton and extra-skeleton (group II). Methods of treatment included curettage with or without bone graft, radiotherapy, or watchful observation alone in group I; chemotherapy, chemotherapy and radiotherapy, or curettage in group II. All eighteen patients in group I had a complete response to the therapy. Seventeen of these eighteen patients had not a recurrence by the time of the latest follow-up examination; one had a recurrence. Four of twelve patients in group II had a complete response to the therapy, four had a partial response, and four had no response. Eight of these twelve patients had a recurrence; four did not. Two patients in group II died of the disease. The significant prognostic factor was the extent of the disease, limited to the skeleton or not, and the age of onset was an indirect prognostic factor predictin multiple organ involvement.
Age of Onset ; Curettage ; Drug Therapy ; Follow-Up Studies ; Histiocytosis, Langerhans-Cell ; Humans ; Radiotherapy ; Recurrence ; Skeleton ; Transplants

Interstitial cell tumor of testis is relatively rare, comprising only 0.8 to 1.4 percent of all testicular tumors. A 67-year-old man was admitted to our hospital with rapid growing testicular mass. He had the experience of hydrocele and many times of aspiration since childhood. On physical examination, the testicular mass (left) was hard, adult fist sized and associated with transparent cystic fluid. Under the impression of testicular tumor, orchiectomy was performed. We report this case with review of literature.
Adult* ; Aged ; Humans ; Leydig Cell Tumor* ; Orchiectomy ; Physical Examination ; Testicular Neoplasms ; Testis*

The gastrointestinal polyp is a premalignant lesion in varying degree. According to the size, the pathology and the location of polyps, it should be removed. Polyps in the gastrointestinal tract can be removed by surgical excision, electrosurgery, cryotherapy, regional radiotherapy and laser therapy with some limitations. Considerable advance in therapeutic endoscopy as well as in diagnostic endoscopy along with newly developed instruments has now made it possible to excise gastrointestinal polyps by means of high frequency generator. We have underwent endoscopic polypectomy, strip biopsy and "O" ring ligation on gastric polyps in 112 patients who visited in this hospital from July l988 to January 1994, and the clinical characteristics including histopathology has been evaluated. Removed polyps were variable in size from less than 0.5 cm up to 4cm. Finally, we concluded that endoscopic polypectomy is a safe and relativly simple procedure and postpolypectomy complication can be considerably reduced by conservative antiulcer therapy.
Biopsy ; Cryotherapy ; Electrosurgery ; Endoscopy ; Gastrointestinal Tract ; Humans ; Laser Therapy ; Ligation ; Pathology ; Polyps* ; Radiotherapy

BACKGROUND: The Fas/Fas ligand (FasL) system plays an important role in apoptosis by involvement in various immunologic functions, especially the removal of autoreactive and activated T-cells. sFas is a variant of the Fas receptor molecule, which lacks the transmembrane domain by alternative splicing of Fas mRNA and has an inhibitory effect in apoptosis by inhibition of the Fas/FasL pathway. sFasL is a coverted form of FasL by metalloproteinase and is increased in various malignant and autoimmune diseases. In this study, we investigated the expression of sFas and sFasL in systemic lupus erythematosus (SLE) and evaluated their usefulness as markers of disease activity. MATERIALS AND METHODS: The concentration of sFas and sFasL in sera from 43 patients with SLE, 17 with rheumatoid arthritis (RA) and 15 normal healthy persons were measured using sFas (S) ELISA Kit and sFas Ligand ELISA Kit (MBL Co., LTD., Nagoya, Japan), respectively. Twenty of 43 SLE sera were paired samples of 10 patients obtained on admission and discharge. RESULTS: The concentration of sFas in SLE (3.12 +/- 2.28 ng/mL) was significantly higher than in RA (2.23 +/- 0.37 ng/mL) and in the normal control (2.12 +/- 0.33 ng/mL). In particular, the concentration of sFas in sera on admission (4.35 +/- 3.68 ng/mL) was significantly higher than in the sera on discharge (2.89 +/- 0.66 ng/mL), but, the concentration of sFasL among the 3 groups was not statistically different. CONCLUSIONS: These results suggest that apoptosis is involved in the pathogenesis of SLE and sFas might be a useful marker as a predictor of disease activity. Further study on the correlation between sFas and other disease activity markers, such as CRP, CH50, CD4 cell count and autoantibody titer is needed. Also, the evalution of sFas as a predictor of disease progression on follow-up studies of these patients is needed.
Alternative Splicing ; Antigens, CD95 ; Apoptosis ; Arthritis, Rheumatoid ; Autoimmune Diseases ; CD4 Lymphocyte Count ; Disease Progression ; Enzyme-Linked Immunosorbent Assay ; Fas Ligand Protein* ; Follow-Up Studies ; Humans ; Lupus Erythematosus, Systemic* ; RNA, Messenger ; T-Lymphocytes

STATEMENT OF PROBLEM: Within the elastic limit of the screw, the greater the preload, the tighter and more secure the screw joint. However, additional tensile forces can incur plastic deformation of the abutment screw when functional loads are superimposed on preload stresses, and they can elicit the loosening or fracture of the abutment screw. Therefore, it is necessary to find the optimum preload that will maximize fatigue life and simultaneously offer a reasonable degree of protection against loosening. Another critical factor in addition to the applied torque which can affect the amount of preload is the joint connection type between implant and abutment. PURPOSE: The purpose of this study was to evaluate the influence of tightening torque on the implant-abutment screw joint stability. MATERIAL AND METHODS: Respectively, three different amount of tightening torque (20, 30, and 40 Ncm) were applied to implant systems with three different joint connections, one external butt joint and two internal cones. The initial removal torque value and the postload (cyclic loading up to 100,000 cycles) removal torque value of the abutment screw were measured with digital torque gauge. Then rate of the initial and the postload removal torque loss were calculated for the comparison of the effect of tightening torques and joint connection types between implant and abutment on the joint stability. Results and CONCLUSION: 1. Increase in tightening torque value resulted in significant increase in initial and postload removal torque value in all implant systems (P < .05). 2. Initial removal torque loss rates in SS II system were not significantly different when three different tightening torque values were applied (P > .05), however GS II and US II systems exhibited significantly lower loss rates with 40 Ncm torque value than with 20 Ncm (P < .05). 3. In all implant systems, postload removal torque loss rates were lowest when the torque value of 30 Ncm was applied (P < .05). 4. Postload removal torque loss rates tended to increase in order of SS II, GS II and US II system. 5. There was no correlation between initial removal torque value and postload removal torque loss rate (P > .05).
Fatigue ; Joints ; Plastics ; Torque

OBJECTIVES: To assess the clinical efficacy and safety of Hyruan(sodium hyaluronate) in patients with osteoarthritis of the knee. METHODS: A 12-week open study of Hyruan was conducted in 48 patients with osteoarthritis(OA) of the knee. Hyruan was injected into knee joints weekly for 5 weeks. Clinical evaluations were performed using visual analog scale(VAS) for pain, Lequesne's index, tenderness and swollen joint counts weekly for the first 5 weeks and then monthly up to 3 months post-injection. RESULTS: Significant improvements in VAS, Lequesne's index, tenderness and swollen joint counts were noted from the first week and maintained until the end of 3 month follow-up period. At 3 months post-injection, 68.8% of patients had >20mm reduction in the VAS. The patients with Kellgren stage lIl showed significant response in VAS and Lequesne's index as patients with Kellgren stage I and II. The clinical improvement after treatment was slower in patients(n=16) with late(>5 years) OA than in patients(n=32) with early(<5 years) OA, but it was statistically significant in either groups, compared to baseline. There were no severe adverse reactions to Hyruan therapy and laboratory examinations revealed no evidence of toxicity. CONCLUSION: Hyruan has been shown to be effective and safe in the treatment of patients with osteoarthritis of the knee.
Follow-Up Studies ; Humans ; Hyaluronic Acid ; Joints ; Knee Joint ; Knee* ; Osteoarthritis*

BACKGROUND: Hepatitis C virus (HCV) has been identified as one of the most frequent causative agent of posttransplant non-A, non-B hepatitis, but the significance of anti-HCV antibodies after transplantation remains controversial. In the present study, we performed anti-HCV and HCV-RNA RT-PCR (HCV PCR) in the kidney recipients to assess the incidence and the outcome of HCV markers after transplantation. MATERIALS AND METHODS: In randomly selected 95 patients' paired sera (before and after transplant samples, respectively), we performed anti-HCV test by Abbott HCV EIA 3.0. We also performed HCV PCR in 80 paired sera of the 95 patients. We evaluated the incidence of anti-HCV and HCV PCR and compared the results in the kidney recipients between anti-HCV test and HCV PCR before and after transplantation. RESULTS: In the recipients' sera before transplantation, 16 (16.8%) among 95 sera were anti-HCV positive and 27 (33.8%) among 80 sera were HCV RNA positive. Among the 80 pretransplant sera performed HCV PCR, 23 (28.8%) discordant results were noted between anti-HCV and HCV PCR, and 17 sera among these were HCV PCR positive and anti-HCV negative. A seroconversion from anti-HCV negative to positive after transplantation was observed in 10 sera, but a conversion from positive to negative was not observed. In case of HCV PCR, a conversion from negative to positive was observed in 21 paired sera, and positive to negative in 13 paired sera. CONCLUSIONS: Our study indicated that disapperance of anti-HCV antibodies after transplantation in kidney recipients was rare. The overall concordance rates between anti-HCV test and HCV PCR in the recipients before and after renal transplantation were lower than other non-transplanted groups reported, and it may be due to the immunosuppressive therapy or the changes in immunoregulatory function of the patients. Further study such as follow-up liver function tests or liver biopsy will be needed for accurate decision about posttransplant HCV status of kidney recipients.
Biomarkers* ; Biopsy ; Follow-Up Studies ; Hepacivirus ; Hepatitis C Antibodies ; Hepatitis C* ; Hepatitis* ; Humans ; Incidence ; Kidney Transplantation* ; Kidney* ; Liver ; Liver Function Tests ; Polymerase Chain Reaction ; RNA

PURPOSE: This study was conducted to evaluate the influence of the implant-abutment connection design and diameter on the screw joint stability. MATERIALS AND METHODS: Regular and wide-diameter implant systems with three different joint connection designs: an external butt joint, a one-stage internal cone, and a two-stage internal cone were divided into seven groups (n=5, in each group). The initial removal torque values of the abutment screw were measured with a digital torque gauge. The postload removal torque values were measured after 100,000 cycles of a 150 N and a 10 Hz cyclic load had been applied. Subsequently, the rates of the initial and postload removal torque losses were calculated to evaluate the effect of the joint connection design and diameter on the screw joint stability. Each group was compared using Kruskal-Wallis test and Mann-Whitney U test as post-hoc test (alpha=0.05). RESULTS: The postload removal torque value was high in the following order with regard to magnitude: two-stage internal cone, one-stage internal cone, and external butt joint systems. In the regular-diameter group, the external butt joint and one-stage internal cone systems showed lower postload removal torque loss rates than the two-stage internal cone system. In the wide-diameter group, the external butt joint system showed a lower loss rate than the one-stage internal cone and two-stage internal cone systems. In the two-stage internal cone system, the wide-diameter group showed a significantly lower loss rate than the regular-diameter group (P<.05). CONCLUSION: The results of this study showed that the external butt joint was more advantageous than the internal cone in terms of the postload removal torque loss. For the difference in the implant diameter, a wide diameter was more advantageous in terms of the torque loss rate.
Joints* ; Torque

Animals ; Bone and Bones ; Bone Marrow ; Bone Regeneration ; Hydrogel ; Hydrogels ; Mesenchymal Stromal Cells ; Osteoblasts ; Osteogenesis ; Polyesters ; Polyethylene Glycols ; Rats ; Transplants

BACKGROUND AND PURPOSE: Rapid recanalization might improve clinical outcomes after intraarterial thrombolysis (IAT) for acute ischemic stroke patients with collateral circulation. We determined whether rapid recanalization and collateral circulation affect clinical outcomes after IAT. METHODS: We retrospectively evaluated the clinical and radiological data of 134 consecutive patients who underwent IAT for intracranial artery occlusion. The interval from symptom onset to recanalization after IAT (onset-to-recanalization time) as an estimate of the probability of good clinical outcome (modified Rankin scale 0-2) was calculated in patients with collateral circulation in the ischemic hemisphere, which was rated poor (0/1 American Society of Interventional and Therapeutic Neuroradiology criteria) or good (2-4). Changes in National Institute of Health Stroke Scale (NHISS) score before and after IAT and modified Rankins scale scores 3 months after discharge were compared with respect to onset-to-recanalization time. RESULTS: In patients with good collateral circulation, the estimated onset-to-recanalization time for a 0.5 probability of a good clinical outcome was 347 minutes; with poor collateral circulation, it was 172 minutes for a 0.2 probability of good clinical outcome. Outcome analyses according to onset-to-recanalization time showed patients recanalized <6 hours had lower NHISS scores (<4.5, 4.5-6, >6 hours of onset-to-recanalization time, and non-recanalization: 5.1, 6.9, 11.9, and 19.8, respectively) at discharge and higher percentages of good clinical outcome (69%, 66.7%, 21.9%, and 0%, respectively) 3 months after IAT. CONCLUSIONS: The time window to expect a high probability of a good clinical outcome after IAT is highly dependent on the collateral circulation.
Arteries ; Collateral Circulation* ; Humans ; Retrospective Studies ; Stroke