PURPOSE: Prostatic tumor induced gene-1 (PTI-1) is a mutated human EF-la and putative prostatic carcinoma tumor-inducing oncogene, that is differently expressed in prostatic cancer and benign prostatic hyperplasia. And, it is more sensitive marker than prostate- specific antigen (PSA) for detecting human prostate cancer in the bloodstream. This study invastigated the expression of PTI-1 in paraffin embedded tissue of prostatic carcinoma, prostatic intraepithelial neoplasia, and benign prostatic hyperplasia using in situ PCR. MATERIALS AND METHODS: we evaluated expression of PTI-1 in prostatic carcinoma with prostatic intraepithelial neoplasia (PIN) of 32 cases, benign hyperplasia of 20 cases, high grade transitional cell carcinoma of 10 cases and colon cancer of 10 cases for control group. Also, the immunohistochemical staining for PSA was performed to comparison with clinical value of PSA. RESULTS: The serum level of PSA was closely related to stage and Gleason score (p < 0.05). However, the results of immunohistochemical stains were variable to stage and Gleason score. PTI-1 using in situ PCR expressed in 50% of prostatic carcinoma, 41% of prostatic intraepithelial neoplasia, 10% of benign hyperplasia and colon cancer (p < 0.05). No expression is observed in transitional cell carcinoma. In prostatic carcinoma, PTI-1 expressed in 43.8% (7/16) of stage II, 50.0% (5/10) of stage III, and 66.7% (4/6) of stage IV (p<0.05). In PIN, expression of PTI-1 was similar to prostatic carcinoma (p<0.05). CONCLUSION: PTI-1 represented a relatively sensitive marker for prostatic carcinoma and PIN, indicator of prostatic carcinoma progression.
Carcinoma, Transitional Cell ; Colonic Neoplasms ; Coloring Agents ; Humans ; Hyperplasia ; Neoplasm Grading ; Oncogenes* ; Paraffin ; Polymerase Chain Reaction* ; Prostatic Hyperplasia* ; Prostatic Intraepithelial Neoplasia* ; Prostatic Neoplasms

The purpose of this study is to observe the choroidal vascular occlusion by photocoagulation under intravenous administration of fluorescein sodium. Argon laser photocoagulation(intensity: 50 mW, duration: 0.05 sec., spot size: 200 micrometer) was applied to the retina of the left eye(control group) and the same method was repeated to the right eye combined with intravenous infusion of 2 ml of fluorescein sodium in the pigmented rabbit(experimental group). The photocoagulated rabbit eyes were enucleated after 2 hrs, 1, 3 and 5 days and the retina and choroid were observed under electron microscopy. The result were as follows. 1. In the control group, loss of melanin pigments in the retinal pigment epithelium and destruction of outer segments of the photoreceptor were observed but endothelial cells of choriocapillaris and Bruch's membrane were intact. 2. In the experimental group, two hours after irradiation, endothelial cells of choriocapillaries were destroyed and capillary lumen was occupied with thrombus components, the retinal pigment epithelium and outer segment of the photoreceptor cells were also destroyed. One day after irradiation, occupied materials in lumen were absorbed but residual debris of thrombus was demonstrated. Three days after irradiation, newly formed endothelial cel1 processes were extended in the area of destroyed choriocapilJaries. Five days after irradiation, long processes of newly fonned endothelial cells extended in the area of choriocapillaries. The outer part of retina was repaired with newly formed pale pigment epithelium and proliferated Miil1er cells. 3. In conclusion, argon laser-provoked vascular change was more easily recognized by intraluminal fluorescein sodium which probably acted as an energy absorbent.
Administration, Intravenous ; Argon ; Bruch Membrane ; Capillaries ; Choroid* ; Endothelial Cells ; Epithelium ; Fluorescein* ; Infusions, Intravenous ; Light Coagulation ; Melanins ; Microscopy, Electron ; Photoreceptor Cells ; Retina ; Retinal Pigment Epithelium ; Thrombosis

We analysed the ultrasonographic findings in 46 cases of PID, examined atYyonsei Universtiy Severance Yondong Hospital from June 1983 to Dec. 1984. Among them, 29 cases of PID were well correlated with pathologic findings bysurgery or laparascopy. The results were as follows; 1. The age was ranged from 14 years to 57 years of age andthe majority was between 21 years and 50 years of age. 2. We evaluated the ultrasonographic findings of 46 casesunder the criteria of Swayne's classification. They are 67% in type II, 17% in type III and 4% in type I. Theremained is 11% in normal finding. 3. Among 29 cases pathologically proven,the ultrasonographic findings areclassifed to be 66% in type II, 21% in type III, 3% in type I and the remained is normal. Among type II PIDcases, tubo-ovarian abscess is 32%, pelvic abscess is 26% and pyosalphinx is 16%. The pelvic-peritoneal adhesionis demonstrated in 83% of 6 cases of type II lesion. 4. In 36 cases of PID, uterine mass formation is demonstrated and located unilaterally in 64%, associated fluid collection in 47% and bladder indentation in 36% was noted. The diameter of mass shadow is about 4.4cm of average, ranged between 2-9cm. The echogenecity was mixed in 64%, cysticin 31% and solid in 5% of mass lesion.
Abscess ; Classification ; Female ; Pelvic Inflammatory Disease ; Urinary Bladder

In the orthopaedic field, some elective surgeries such as joint replacement, spinal surgery and limb salvage procedures for musculoskeletal tumors frequently need various amounts of blood transfusions. However, homologous transfusion occasionally results in various side effects, such as allergic reaction, febrile reaction, and the transmission of infectious diseases such as syphilis, hepatitis and AIDS, ctc. Recently, these complications especially in elective surgery might result in medicolegal or social problems. Risks from transfusions in elective surgery can be minimized with prebanked autologous transfusion. To evaluate the necessity of prehanked autogenous transfusion, fifty five patients who had unilateral hybrid total knee arthroplasty (noncemented at the femoral side and cemented at the tibial and patellar sides) were operated on by the same surgeon from April 199S to July 1997 and had autogenous shed blood transfusion were evaluated for postoperative blood loss, amount of autogenous shed blood, amount of transfusion, hemoglobin and hematocrit. The results were as follows: 1. The distribution of preoperative hemoglobin was from 9.6g/dL to 16.5g/dL (average: 1.8g/dL). 2. The distribution of the amount of blood loss for three days postoperatively was from 156ml to 2001 ml (average: 798ml). 3. The distrihution of the amount of transfusion of autogenous shed blood was from 30ml to 600ml (average: 448ml). 4. There were two patients who had febrile reactions above 38 after transfusion of autogenous shed blood. 5. Forty-six patient(84%) had a homologous transfusion and the average amount of transfusion was 1.9 pint. 6. Total amount of homologous transfusion was decreased according to the increased amount of hemoglobin and the amount of transfusion was statistically decreased above the level of I 3g/dL(Students t-test, P=0.0005). 7. There were no significant differences in the amount of homologous transfusion between age, sex, type of disease, type of implants. In conclusion, most of our patients(84%) needed homologous blood transfusion in unilateral hyhrid total knee arthroplasty and the amount of transfusion decreased in patients who had hemoglobin above 13.0g/dL. So we recommend preparing banked autogenous hlood preoperatively in patients who have a lower hemoglobin level in unilateral hyhrid total knee arthroplasty.
Arthroplasty* ; Blood Transfusion* ; Communicable Diseases ; Hematocrit ; Hepatitis ; Humans ; Hypersensitivity ; Joints ; Knee* ; Limb Salvage ; Postoperative Hemorrhage ; Social Problems ; Syphilis

Open reduction and internal fixation of the displaced fractures of the acetabulum represents one of the greatest challenge in fracture surgery. The purpose of our study is to report the results of operative treatment and establish the guideline for the operative treatment of the displaced acetabular fractures with the analysis of the clinical and radiological results. This retrospective study reports the results of 21 fractures in 21 patients(19 male and 3 female) treated by open reduction and internal fixation from January 1990 to July 1994. The patients were followed up more than 1 year and mean length of follow-up was 2.3 years. According to Letournel's classification, we had 9 elementary fractures(42.8%) and 12 associated fractures(57.2%). Among the elementary fractures, the posterior wall fracture was the most common type(7 cases, 33.3%) and the transverse-posterior wall fracture was the most common type among associated fractures(4 cases, 19.0%). Surgical approaches were 14 Kocher-Langenbeck, 6 Ilioinguinal and 1 extended iliofemoral. Indirect reduction and specially designed reduction method using C-arm and radiolucent operating table were also helpful to achieve satisfactory reduction. Overall quality of clinical results was graded according to the D'Aubigne and Postel rating score. Satisfactory reduction was gained in 16 cases(76.1%). Unsatisfactory reduction was gained in 5 cases(23.8%). Among the cases within category of satisfactory reduction, there were 7 excellent and 8 good clinical results. But among unsatisfactorily reduced 5 cases, there were 2 good clinical results. It seems that the satisfactory operative reduction of the fracture is the factor that correlates with a satisfactory clinical result. There were complications such as 3 secondary osteoarthritis(14.2%), 3 wound infection(14.2%, 2 superficial and 1 deep), 2 iatrogenic nerve palsy(9.5%, 1 sciatic and 1 obturator nerve) and 1 intrapelvic protrusion acetabuli(4.7%) and no postoperative ectopic ossification.
Acetabulum ; Classification ; Follow-Up Studies ; Humans ; Male ; Methods ; Operating Tables ; Ossification, Heterotopic ; Retrospective Studies ; Wounds and Injuries

Abdominal cystic lymphangioma is a rare congenital malformation of lymphatics. Prognosis is excellent with exact diagnosis and complete surgical excision. The aughors analysed 10 US scans and 9 CT scans of surgically proven cystic lymphangiom for the last 5 years. US scan showed it as a septated cystic mass and 2 cases showed fluid-fluid level. CT scan showed a huge unilocular or multilocular density mass with uniformly thickened septae. A huge unilocular or multilocular cystic mass with uniformly thickened septae could suggest cystic lymphangioma would be differentiated from the other cystic masse.
Diagnosis ; Lymphangioma, Cystic* ; Prognosis ; Tomography, X-Ray Computed

In spite of the many improvements in arthroscopic surgical techniques for the treatment of mild to moderate degree degenerative joint diseases which were resistant to conservative treatment, the results are variable, showing a tendency to decline in therapeutically following the passage of time. Using a 2.1 un holmium: YAG laser we operated on patients with mild to moderate degenerative joint diseases which had not improved through conservative treatment. We evaluated the results of arthroscopic laser surgery for degenerative joint disease and investigated the proper indication and complications of laser surgery. We operated on 28 knees of 28 patients between July 1995 and June 1996. There were 16 females and 12 males. The average follow-up period was 16.3 months and the average age was 54.5 years. Under epidural or general anesthesia, we used arthroscopic tools, including laser, and the laser power was modified according to the type of operation (chondroplasty: 1.0Jx20pulse/sec, meniscectomy: 2.0Jx15pulse/sec, bone drilling: 2.5Jx10 pulse/sec). We used Bauer & Jackson's classification of articular cartilage change, and performed 12 laser chondroplasties in grade II, III, V lesions, 16 chondroplasties and laser bone drilling in grade IV, VI lesions, 16 laser meniscectomies, 6 laser synovectomies and 2 lateral retinacular releases. Medial femorotibial arthritis was the most common site. Postoperative results by Orgilvis-Harris & Fitsialos's methods indicated that 82% of treated patients were satisfied and only two patients (7%) did not improve. As a postoperative complication, eight patients complained of postoperative effusion which was subsided by medication and physical therapy. We performed second-look arthroscopic examinations in four knees that had been treated with laser chondroplasy and drilling. Regenerated tissues at the operated site were observed in three cases, but denuded articular cartilage and naked subchondral bone at the operated site were found in one case as a sign of osteonecrosis. Concluding this short-term study, 2.1 holmium: YAG laser in arthroscopic surgery seems to be effective in mild to moderate degenerative joint disease but care should be taken to avoid thermal injuries to the adjacent normal cartilages.
Anesthesia, General ; Arthritis ; Arthroscopy ; Cartilage ; Cartilage, Articular ; Classification ; Female ; Follow-Up Studies ; Holmium* ; Humans ; Joint Diseases ; Knee Joint* ; Knee* ; Laser Therapy ; Lasers, Solid-State* ; Male ; Osteoarthritis* ; Osteonecrosis ; Postoperative Complications ; United Nations

In a consecutive series of 15 patients with unstable C1,2 cervical spine injuries treated with halo vest, 1992-1996, a total 7 patients (comprising 46%) among the patients with C1,2 cervical spine injuries, had odontoid fractures, no patient had neurologic injury. In all cases, initial treatment was Halter or skull traction for 1-2weeks. In the vitally stable state, they were stabilized with halo vest for 12-16 weeks. In 2 cases of C1,2 instability, initial treatment was internal fixation and halo vest for the same time. 2 cases of the patients, who were treated with halo vest, had additional posterior wiring and fusion due to instability checked after removal of halo vest. There was no other serious complications during the treatment. One case (25%) of 4 Anderson-d' Alonzo type II fractures was failed to unite. The halo vest was well tolerated in all patients and assured a high percentage of healing. Flexion-extension motion was measured with dynamic lateral cervical tomography. The age range was 17-67 (mean 41.3) years and male/female ratio was 3/2. Complications during the treatment were pin loosing (1 case) and halo vest frame breakage due to falling down. Pain on motion and stiffness of neck were the most frequently remained symptoms. But the symptoms were mild and did not usually have any major impact on return to work or leisure activities.
Humans ; Leisure Activities ; Neck ; Return to Work ; Skull ; Spine* ; Traction

It is well known that fractures around the knee joint are usually combined with ligament injuries but it is easy to miss the ligament injuries during the treatment of fractures. The invention of the MRI and the development of arthroscopic techniques has made it easy to diagnose and care for ligament injuries. Authors reviewed the patients who had fractures around the knee joint to evaluate the frequencies, types, treatments and the results of combined ligaments injuries. There were 57 cases with the fracture of the proximal tibia and fibula which could be follwed up at least one year: from January 1992 to June 1995. There were 19 cases (33%) which had combined ligament injuries. The ligament injuries were diagnosed by stress X-ray & MRI evaluation and confirmed by arthroscopic examination. Single lateral rim avulsion fracture of proximal tibia was the most common type of fractures (7 cases, 37%). There were 11 cases (57%) of combined injuries of anterior cruciate ligament and medial collateral ligament. It was the most common combined ligament injury. Except for one, eleven cases that were combined with lateral rim avulsion of proximal tibia had anterior cruciate ligament injury. There were ten cases (53%) of fibula head and neck fractures which were combined with ligament injuries. The total number of the injured ligament was 35 and the common rupture sites of the injured ligaments was the attachment site of femur (13 cases) and tibia (16 cases). There were seven meniscal injury cases (37%). The interval from injury to operation averaged 14.1 days because many cases were acute injuries. Primary repairs for ruptured ligament were done in 31 cases (88%) because of their attachment site injuries. There were no instabilities except one case which was treated with posterior cruciate ligament reconstruction using semitendinosus ligament. It had a grade I posterior instability at the last follow-up. Early diagnosis and proper treatment on the ruptured ligaments and the torn meniscus combined with proximal tibia and fibular fractures seem to be important for a good prognosis.
Anterior Cruciate Ligament ; Collateral Ligaments ; Early Diagnosis ; Femur ; Fibula* ; Follow-Up Studies ; Head ; Humans ; Inventions ; Knee ; Knee Joint ; Ligaments* ; Magnetic Resonance Imaging ; Neck ; Posterior Cruciate Ligament ; Prognosis ; Rupture ; Tibia*

Pigmented villonodular synovitis and synovial chondromatosis are known as a poup of interrelated tumorous disorders that involve the lining of the joints, hursa and tendon sheath. Pigmented villonodular synovitis consists of proliferatin synovia1 tissue containing histiocytes, librohlasts, multinucleated giant cells, and capillaries that can destroy dense fihrous tissue, form soft tissue masses, and invade bone. Synovial chondromatosis consists of hyaline cartilage nodules within the synovium and synovial joint cavities, develop multiple loose fragments of cartilage within the joint. They may represent a reactive inflammatory process or henign neoplasm and usually occur in latge synovial joints, including the knee, hip and ankle. There are some reports stating that pigmented villonodular synovitis has coexisted with synovial chondromatosis. but none have reported that they occurred simultaneously in a large single joint. This is a report on a diagnosed and arthroscopicully treated pigmented villonodular synovitis and synovial chondromatosis that occurred simultaneously in the same ankle joint.
Ankle Joint* ; Ankle* ; Capillaries ; Cartilage ; Chondromatosis, Synovial* ; Giant Cells ; Hip ; Histiocytes ; Hyaline Cartilage ; Joints ; Knee ; Synovial Membrane ; Synovitis, Pigmented Villonodular* ; Tendons