No abstract available.
Tumor Lysis Syndrome*

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

No abstract available.
Neoplasm Metastasis*

No abstract available in English.

It is very important to obtain a reliable geometric data of the femoral canal for designing femoral component in total hip arthroplasty. So authors estimated the shape and measured the size of the proximal femoral canal by using 3 dimensional images obtained from computerized tomographic data of 60 korean normal adult cadaveric femora. EXTRACT II PROGRAM VERSION 2.5 BY CORNELL UNIVERSITY at the SUN 3 WORK STATION was used for this study. The averge femoral length was 416.0±25.2mm ranging from 358.6mm to 465. 1 mm. The average femoral anteversion angle was 20.5±9.1°ranging from 2° to 36.5°. The average neck-shaft angle was 127.8±5.7°, ranging from 115.5° to 139.0°. The average length of femoral offset was 37.5±5.2mm. The average length of transverse diameter measured at the center of lesser trochanter was 29.4+3.5mm and measured at 20mm above the lesser trochanter was 47.3±4.6mm. The isthmic position was located at 109.4±13.1mm belew the center of the lesser trochanter and the average transverse diameter at the isthmic position was 12.1±2.1mm in mediolateral direction and 14.4±2.4mm in anteroposterior direction. The average of canal flare index which indicates the shape of proximal femoral canal, was 3.8±0.7; Stove-pipe shape was 8.4% normal shape was 70.0% and Champagne-flute shape was 21.6%. The press-fit hip stem design(PFC) had much more improved stem-canal contact on total and priority regions. And the other four devices had better fit proximally than distally and viceversa(proximal-distal mismatch). The improvement of fit can be achieved by considering the proximal-distal geometry of the femur more carefully and by diversifying the stem design which adapts to the anatomical variation of femur.
Adult ; Arthroplasty, Replacement, Hip ; Cadaver ; Femur ; Hip ; Humans ; Solar System

Leiomyosarcomas of the stomach are unusual tumors, accounting for 1% to 3% of all malignant tumors and 17% to 20% of all smooth muscle tumors of the stomach. It is difficult to diagnosis these tumors preoperatively because of its vague symptoms and signs or producing symptoms only late. Despite their rarity and difficulty in diagnosis, thier diagnosis is important due to more favorable prognosis aasociated with these tumors than that of gastric carcinoma. Recently, endoscopy is being used with increasing frequency, but because these are submucosal lesions the diagnosis of thease tumors cannot be easily made through the endoscope. We experienced a case of relatively full-brown leiomyosarcoma in gastric fundus. Endoscopy showed 6x6cm sized, definite margined, protruding mass on gastric fundus, with central deep ulceration coated with blood clots. The mucosa overlying the mass was intact, smoothly effaced and the bridging fold was also visible. Postoperative ultrasound showed large protruding mixed echogenic solid mass with contral deep excavation due to ulcer, and intact serosa, so suggestive of endogastric tumor. We believed endoscopy combined with endoscopic ultrasound is probably useful method in early diagnosis of gastric submucosal tumors, especially exogastric type or early small tumors
Camellia ; Diagnosis ; Early Diagnosis ; Endoscopes ; Endoscopy ; Gastric Fundus ; Leiomyosarcoma* ; Mucous Membrane ; Prognosis ; Serous Membrane ; Smooth Muscle Tumor ; Stomach* ; Ulcer ; Ultrasonography

OBJECTIVES: APL, which characteristically shows t(15:17), accompanies fatal coagulopathy during remission induction with systemic chemotherapy alone. ATRA, a derivative of vitamin A, can differentiate APL cells as well as HL-60 cells in vitro and induce higher rate of complete remission(CR). Hence, we assessed the effect of ATRA on remission induction and coagulopathy in APL patients. METHODS: (1) 42 patients diagnosed histologically in St. mary's hospital from June 1991 to June 1994 were included. (2) We compared the CR rate, the time required for restoration of derranged coagulation profiles, and the amount of coagulation factors including platelets among the chemotherapy group (control) and ATRA group. RESULTS: 1) There was no difference in CR rate between the control group and ATRA group [84.2%(16 out of 19) vs 87.0%(20 out of 23), p>0.05)] and also no difference between two subgroups of ATRA [ATRA with chemotherapy; 83.3%(10 out of 12) vs ATRA without chemotherapy; 90.9%(10 out of 11), p>0.05] 2) In the ATRA group, the CR rate of newly diagnosed patients was 82.4%(14 out of 17). The first relapsed patients (4) and the second (2) were all achieved CR. 3) The mean duration of coagulopathy, time to normalization of PT, aPTT, FDP, fibrinogen level, was 12.0+/-10.4, 11.1+/-10.2, 16.5+/-9.3, 15.4+/-10.2 days after chemotherapy alone and 4.5+/-4.4, 3.7+/-3.7, 8.9+/-6.1, 8.1+/-6.5 days in the ATRA group(p<0.05). The amount of fresh frozen plasma used in the ATRA group for the purpose of correction of coagulopathy were significantly lower than the control group(p<0.05). The incidence of profound coagulopathy during the remission induction treatment in the ATRA group was significantly lower than the control group[40% (8 out of 20) vs 96.7%(13 out of 15), p
Blood Coagulation Factors ; Drug Therapy ; Fibrinogen ; HL-60 Cells ; Humans ; Incidence ; Leukemia, Promyelocytic, Acute* ; Plasma ; Remission Induction* ; Tretinoin* ; Vitamin A

Distal hereditary motor neuropathy (dHMN) is a heterogeneous disorder characterized by degeneration of motor nerves in the absence of sensory abnormalities. Recently, mutations in the small heat shock protein 27 (HSP27) gene were found to cause dHMN type II or Charcot-Marie-Tooth disease type 2F (CMT2F). The authors studied 151 Korean axonal CMT or dHMN families, and found a large Korean dHMN type II family with the Ser135Phe mutation in HSP27. This mutation was inherited in an autosomal dominant manner, and was well associated with familial members with the dHMN phenotype. This mutation site is located in the ?-crystallin domain and is highly conserved between different species. The frequency of this HSP27 mutation in Koreans was 0.6%. Magnetic resonance imaging analysis revealed that fatty infiltrations tended to progressively extend distal to proximal muscles in lower extremities. In addition, fatty infiltrations in thigh muscles progressed to affect posterior and anterior compartments but to lesser extents in medial compartment, which differs from CMT1A patients presenting with severe involvements of posterior and medial compartments but less involvement of anterior compartment. The authors describe the clinical and neuroimaging findings of the first Korean dHMN patients with the HSP27 Ser135Phe mutation. To our knowledge, this is the first report of the neuroimaging findings of dHMN type II.
Adolescent ; Adult ; Age of Onset ; Animals ; Asian Continental Ancestry Group ; Charcot-Marie-Tooth Disease/*genetics/physiopathology/radionuclide imaging ; Child ; Child, Preschool ; Female ; *Genetic Predisposition to Disease ; Humans ; Intracellular Signaling Peptides and Proteins/*genetics ; Korea ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Muscular Atrophy/physiopathology/radionuclide imaging ; *Mutation, Missense ; Neural Conduction/genetics ; Pedigree ; Protein-Serine-Threonine Kinases/*genetics ; alpha-Crystallins/genetics

Clinical, light and electron microscopic studies of 6 cases of acute and 8 cases of chronic active hepatitis were made and results were compared. Light microscopically acute viral hepatitis was dominated by intralobular changes characterized by ballooning degeneration, random individual and small group cell necrosis of hepatocytes with mononuclear cell reaction, cholestasis and Kupffer cell proliferation, while chronic. active hepatitis was dominated by periportal and portal changes characterized by piecemeal necrosis, heavy mononuclear cell infiltration, moderate fibrosis and mild biliary proliferation. Kupffer cell proliferation with large amount of diastase-resistant PAS positive pigments and patchy reticulin condensation were noted in both acute and chronic active hepatitis, but reticulin condensation was more advanced in chronic active hepatitis. Electron microscopically, acute hepatitis showed marked changes of nucleus, RER, bile canaliculus, and decrease of glycogen content, while chronic active hepatitis showed marked changes of mitochondria with giant fomrs and intramitochondrial inclusion, increase of polyribosomes and glycogen content, and appearance of collagen bundles in the sinusoidal wall. Kupffer cell changes were very marked in both acute and chronic active hepatitis showing large numbers of dense bodies. These dense bodies in acute cases were in the form of secondary lysosomes while they were residual bodies in chronic cases. A case which showed ground glass appearing cytoplasm by light microscopy showed massive fibrillar and tubular structures by electron microscopy. In all cases, no definite virus-like particles were observed within either the nucleus or cytoplasm. From the data, it was evident that distinction between acute and chronic active hepatitis is more clearly made with light microscopy, and the ultrastructural changes of intralobular lesions showed more similarities than differences. The meaning of minor ultrastructural differences is not clear and further evaluation is desirable. Clinically, acute cases showed higher serum bilirubin, transaminase level and hypoalbuminemia while in chronic active hepatitis serum globulin level was higher and hepatomegaly was more regularly observed.
Hepatitis, Viral, Human/pathology* ; Human ; Liver/ultrastructure*

PURPOSE: This study was designed to determine the quantitative changes of the numbers of the mechanoreceptors in the experimentally tenotomized Achilles tendon of rabbits as compared with short-term immobilization and long-term immobilization. MATERIALS AND METHODS: 14 white rabbits were used. After tenotomizing the right Achilles tendon, the subjects were divided into 2 groups according to the periods of immobilizaton. The left side of each Achilles tendon of the rabbits were used as controls. The tendons were stained with a modified gold-chloride method. RESULTS: The number of mechanoreceptor was significantly decreased in the tenotomized Achilles tendon group than the control group (p<0.01). There was no statistical difference between the two experimental groups in the numbers of the mechanoreceptors (p>0.01). CONCLUSION: The injured Achilles tendons may more vulnerable to injury because of the decreased numbers of mechanoreceptors, but no difference between the periods of immobilization. It may suggest that post-operative immobilization period may not affect on the outcome of operative treatment from the viewpoint of mechanoreceptors.
Achilles Tendon ; European Continental Ancestry Group ; Humans ; Immobilization ; Mechanoreceptors ; Rabbits ; Tendons