The significance of the posterior cruciate ligament (PCL) in the stability of the knee and the necessity for surgical repair of its tears are still controversial. The purpose of this study is to present the short term results of surgical repair and Kennedy LAD augmentation for 15 cases with PCL injury. In 14 patients (15 knees), the torn PCL was repaired with pullout suture technique and Kennedy LAD augmentation was done from june 1993 to june 1994. The follow-up period ranged from 12 months to 25 months (average, 18months). The main causes of injuries were traffic accidents in 12. Thirteen of the patients were men and one was a woman, ranging in age from 17 to 52 years(average, 35 years). 10 knees were acute injury and repaired at average 9 days after injury. There were 11 cases that had combined injuries(4 ACL injuries, 4 meniscus injuries, 3 MCL injuries etc). In eight knees, the tear was in mid substance area and in five it was near femoral attach site and in two it was near tibial attach site. Postoperative results were evaluated by roentgenographic evaluation of posterior sagging and Lysholm knee score. 11 knee were stable but 4 knees were unstable posteriorly during postoperative follow-up period. 3 chronic injuried knees were included in 4 posteriorly unstable knees. There are 7 combined knee injuries in 11 stable knees and no combined injuries in unstable knees and average Lysholm knee score was 89.7 in stable knees and 90 in unstable knees and there was no significant difference between two groups. On the based of this study, surgical repair with pollout suture technique and augmentation with Kennedy LAD in acute PCL injury is a one of the good method for preventing posterior sagging but more longer follow-up period and more cases must be needed to accept this method.
Accidents, Traffic ; Female ; Follow-Up Studies ; Humans ; Knee ; Knee Injuries ; Lysholm Knee Score ; Male ; Methods ; Posterior Cruciate Ligament ; Suture Techniques ; Tears

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

There have been many reports to date regarding the role of GnRH as a local regulatory factor of ovarian function as studies of human and rat ovaries revealed GnRH and its receptor. In recent studies it has been shown that GnRH directly causes apoptosis in the granulosa cells of the rat ovary, and such results leads to the suggestion that the use of GnRH agonist for more stable long term ovarian hyperstimulation in human IVF-ET programs causes granulosa cell apoptosis which may lead to follicular atresia. Therefore this study attempts to determine if granulosa-luteal cell apoptosis occurs in patients during IVF-ET programs in which GnRH agonist is employed for ovarian hyperstimulation. The quality of oocyte-cumulus complexes obtained during ovum pickup procedures were assessed morphologically and then the fertilization rate and developmental rate was determined. Apoptotic cells among the granulosa-luteal cells obtained during the same procedure were observed after staining with Hematoxylin-rosin. The fragmentation degree of DNA extracted from granulosa-luteal cells was determined and comparatively analyzed. There was no difference in the average age of the patients, the number of oocytes retrieved, and fertilization and developmental rates between the FSH/hMG group and GnRH-long group. There was also no difference in the apoptosis rate and pyknosis rate in the granulosa-luteal cells between the two groups. However, when the oocyte-cumulus complexes were morphoogically divided into the healthy group and atretic group without regard for the method of hyperstimulation, the results showed that the number of oocytes obtained averaged 11.09+/-8.75 and 10.33+/-4.53 per cycle, respectively, showing no significant difference, but the fertilization rate (77.05%, 56.99%, respectively, p<0.01) and developmental ,ate (65.96%, 41.51%, respectively, p<0.01) was significantly increased in the healthy group when compared to the atretic group. The degree of apoptosis in the granulosa-luteal cells showed that in the healthy group it was 2.25% which was not significantly different from the atretic group (2.77%), but the pyknosis rate in the atretic group (27.81%) was significantly higher compared to the healthy group (11.35%, p<0.01). The quantity of DNA fragmentation in the FSH/hMG group was 32.22%, while in the GnRH-long group it was 34.27%, showing no significant difference. On the other hand the degree of DNA fragmentation was 39.05% and 11.83% in the healthy group and atretic group, respectively, showing significantly higher increase in the atretic group (p<0.01). The above results suggest that death of granulosa-luteal cells according to the state of the oocyte-cumulus complex is more related to pyknosis rather than apoptosis. Also, the GnRH agonist used in ovarian hyperstimulation does not seem to directly affect the apoptosis of retrieved oocytes and granulosa-luteal cells, and which is thought to be due to the suppression of the apoptogenic effect of GnRH agonist as a result of the high doses of FSH administered.
Animals ; Apoptosis* ; DNA ; DNA Fragmentation ; Female ; Fertilization ; Follicular Atresia ; Gonadotropin-Releasing Hormone* ; Granulosa Cells ; Hand ; Humans* ; Luteal Cells ; Oocytes ; Ovary ; Ovum ; Rats

Hydroxyapatite particle(HA) impregnated polymethylmethacrylate(PMMA) bone cement was fabricated in order to induce bony tissue ingrowth into the pores left behind by the resorption of the HA. The amount of HA was 0, 10, and 30% by weight. After mixing the HA with bone cement it was cast in a 4mm inside diameter glass under(10mm long). Each specimen was cut into half and used for in vitro and in vivo experiment. Diametral and compressive mechanical test were made to evaluate it's mechanical properties. SEM(scanning electron microscope) and ESCA(electron spectroscopy for chemical analysis) were used to evaluate the surface characteristics of the specimen. Push-out test and histologic studies were made after implanting the specimens for 6 weeks in the distal portion of rabbit femur. The mechanical test results show that the average flexural and diametral strength decreased linearly with the increased amount of HA significant(p < 0.05). The SEM and qualitative analysis using ESCA of the implant specimens showed no definite exposure of HA particles due to PMMA covering the surface. The surface of the implanted specimens were ground for histologic comparative analysis and the halves of each sample were decalcified. The interfacial shear strength of the implanted specimens showed significant increases in the 30% HA specimens compared with the 0% ones but the 10% specimens did not show any difference. However, there was also no statistically significant(p>0.05) difference between nondecalcified and decalcified specimens in each 10% and 30%, although the latter showed higher interfacial shear strength. Histologic observation showed little evidence of bone ingrowth into HA, but not remarkable. In conclusion, this study could not confirm the earlier results of the bone particle impregnated bone cement without surface grinding since the HA particles were not exposed at the surface by casting it into a glass tube.
Durapatite ; Femur ; Glass ; In Vitro Techniques ; Polymethyl Methacrylate ; Shear Strength ; Spectrum Analysis

PURPOSE: The p16(INK4A) gene encodes a specific inhibitor of cell cycle progression. In recent years, genetic deletion and altered expression of p16(INK4A) gene were frequently showed in many human cancers. So, the p16(INK4A) gene is considered as tumor suppressor gene. However, there has been a few data for the p16(INK4A) in gastric cancer, colon cancer, and hepatoma.So.we investigated the genetic deldtion and altered expression of p16(INK4A) in gastric cancer, colon cancer and hepatoma cell lines. MATERIALS AND METHODS: The homozygous deletion of p16(INK4A) was examined by using PCR and the protein expression of p16(INK4A) by using Western blotting in cancer cell lines established from Korean patients: stomach cancer, colon cancer and hepatoma cell lines. RESULTS: Homozygous deletion of p16(INK4A) was detected only 1 stomach cancer cell line out of 13 cell lines examined. The p16(INK4A) was detected in 3 of 13 cancer cell line. These results showed the low frequency of p16(INK4A) homozygous deletion and high frequency of p16(INK4A) expression alteration in stomach cancer, colon cancer and hepatoma cell lines. CONCLUSION: In this study, it may be suggested that the altered pl6(INK4A) expression as well as p16(INK4A) gene deletion play important role in oncogenesis. Further studies to determine the mechanism of p16(INK4A) gene inactivation are expected.
Blotting, Western ; Carcinogenesis ; Carcinoma, Hepatocellular* ; Cell Cycle ; Cell Line* ; Colon* ; Colonic Neoplasms* ; Cyclin-Dependent Kinase Inhibitor p16 ; Gene Deletion ; Gene Silencing ; Genes, Tumor Suppressor ; Humans ; Polymerase Chain Reaction ; Stomach Neoplasms* ; Stomach*

Atrial flutter, a common rhythm disturbance, was first described over 80 years ago. Despite extensive investigations, several important issues remain unresolved concerning its exact mechanism and management. Present therapeutic strategies often appear effective to prevent and terminate atrial flutter. However, controlled trial and definitive studies comparing the various treatment options are surprisingly scarce. Here we report on a study of 9 episodes of spontaneous atrial flutter(AF)(flutter wave cycle length 224+/-39 msec) treatedd by transesophageal atrial pacing(TAP) in 9 patients(7 men and 2 women; mean age 56.9 yrs). TAP was effective in 5 patients : sinus rhythm resumption was immediate in 3 patients and followed a short period of atrial fibrillation in 2 patients. TAP was unsuccessful in 4 patients. All the patients tolerated the procedure well. These data strongly support the immediate first choice use of TAP in AF therapy.
Atrial Fibrillation ; Atrial Flutter* ; Female ; Humans ; Male

OBJECTIVES: To evaluate the clinical manifestations and perinatal outcomes of pregnancies complicated with gestational impaired glucose tolerance (GIGT) and gestational diabetes mellitus (GDM). METHODS: We performed 50gm oral glucose tolerance test (OGTT) for GIGT and GDM screening in 4,367 pregnant women at 24-28 weeks of gestation. In 1,010 women with plasma glucose level over 130mg/dl, 753 women underwent 100gm OGTTs at 28-32 weeks of gestation. According to the NDDG criteria, 113 cases with GIGT (single positive level of OGTT ; group 2), 125 cases with GDM (group 3), and 515 cases with control (group 1) were identified among the 753 cases. Retrospective review of outcome of these patients was performed. ANOVA and chi-square test were used to determine the statistical significance. RESULTS: The incidence of GIGT and GDM was 2.7%, 3.0%. The prepregnant body mass index (21.4+/- 3.0kg/m2, 21.3+/-2.8kg/m2, 23.2+/-4.1kg/m2), overweight of BMI over 26 (7.4%, 4.4%, 14.4%) and obesity of BMI over 30 (1.2%, 0.0%, 8.0%) was significantly higher in group 3 than group 1 (p<0.05). We defined poor maternal outcome as those suffering from any one of birth canal injury, hydramnios or oligohydramnios, preeclampsia, cesarean delivery due to cephalopelvic disproportion, dystocia, fetal distress. Group 3 showed most highest poor maternal outcome (22.3%, 28.3%, 39.2%, p<0.05). And we defined poor neonatal outcome as those suffering from any one of hyperbilirubinemia, hypoglycemia, congenital anomaly, admission to neonatal intensive care unit due to respiratory distress syndrome. Group 2 and group 3 showed poor neonatal outcome than group 1 (6.2%, 13.3%, 21.6%, p<0.05). CONCLUSION: Pregnancies complicated with GDM showed poor maternal and neonatal outcome, and GIGT experienced no adverse maternal outcomes but showed poor neonatal outcomes compared to normal pregnancy, and showed less correlation with obesity than GDM. Further study of pathophysiology and proper management of GIGT will be mandatory.
Blood Glucose ; Body Mass Index ; Cephalopelvic Disproportion ; Diabetes, Gestational* ; Dystocia ; Female ; Fetal Distress ; Glucose Tolerance Test ; Glucose* ; Humans ; Hyperbilirubinemia ; Hypoglycemia ; Incidence ; Infant, Newborn ; Intensive Care, Neonatal ; Mass Screening ; Obesity ; Oligohydramnios ; Overweight ; Parturition ; Polyhydramnios ; Pre-Eclampsia ; Pregnancy* ; Pregnant Women ; Retrospective Studies

Malignant lymphomas of the female genital tract are rare. When it involves the female genital tract, information in the literature regarding the classification, treatment and diagnosis of malignant lymphoma are few. Non-Hodgkin lymphomas (NHL) of the female genital tract occurs primarily in the ovary (49%), uterus (11%), vagina (7%), and vulva (4%). The vulva as the primary location is a very rare occurrence. However, autopsy studies have shown that about 40% of women who die of non-Hodgkin's lymphoma had involvement of the uterus or ovaries. There have been many cases of high-stage lymphomas presenting as secondary involvement of the female genital tract, but when the primary involvement site is the vulva, the stage of lymphoma was most commonly stage IE or IIE. Therefore, physicians should keep in mind the possibility of the presence of a malignant neoplasm when the suspected Bartholin's gland tumor does not respond to treatment. The authors propose that thorough gynecological evaluation should be conducted as a routine screening method in female patients with suspected lymphoma. We represent a case of primary non-Hodgkin's lymphoma patient who was relatively young in age and who was consequently determined to be of a high stage.
Autopsy ; Classification ; Diagnosis ; Female ; Humans ; Lymphoma ; Lymphoma, Non-Hodgkin* ; Mass Screening ; Ovary ; Uterus ; Vagina ; Vulva*

OBJECTIVE: Survivin is a novel inhibitor of apoptosis. Suppression of apoptosis is important for carcinogenesis and tumor growth. The purpose of this study was to investigate whether survivin is expressed in the tissues of normal uterine cervix, cervical intraepithelial neoplasia grade III (CIN III) and squamous cell carsinoma of the uterine cervix, as a first step for evaluation of the clinical significance of survivin in uterine cervical cancer. METHODS: We investigated the expression of survivin in the tissues of 11 cases of normal uterine cervix and 14 cases of CIN III and 20 cases of uterine cervical cancer, using Immunohistochemistry at department of obstetrics and gynecology of Ajou university hospital from Jan. 2000 to Jan. 2001 and then compared with the results of three groups. RESULTS: The expression of survivin is increased significantly in cases of CIN III and uterine cervical cancer compared with controls. (p<0.05, One way ANOVA test) CONCLUSION: This study shows survivin could play an important role in the carcinogenesis mechanism of uterine cervix. And further study will be followed to evaluate the clinical relationship of survivin in uterine cervical cancer and whether to act a prognostic factor or not.
Apoptosis ; Carcinogenesis ; Cervical Intraepithelial Neoplasia ; Cervix Uteri ; Female ; Gynecology ; Immunohistochemistry ; Obstetrics ; Uterine Cervical Neoplasms

PURPOSE: To determine the upper limit of peripheral nerve lengthening without loss of function, the recovery time of peripheral nerve palsy due to nerve lengthening and their histological changes. MATERIALS AND METHODS: Twelve adult New Zealand rabbits weighing about 2.5 kg were assigned to the following groups. Group 1 (n=6) was subjected to slow tissue expansion with 30% of nerve lengthening while group 2 (n=6) was rapid expansion with 40% lengthening of nerve. The expanders were refilled every 2 times during the 2nd and 4th weeks making a total four times of expansion. The rabbits were assessed in terms of affected leg paralysis, neural length gain, EMG with nerve conduction velocity and histological changes. RESULTS: In group 1 (n=6), paralysis on affected leg was found in one rabbit and was recovered spontaneously on the 4th weeks after expander removal. In Group 2 (n=6), paralysis was found in four rabbits, and three of them were recovered on 4, 5 and 9 weeks after removal of the expander. EMG study showed increase in distal latency of 2.50+/- 0.20 m/sec, and decrease in nerve conduction velocity of 62.49+/- 5.30 m/sec compared to normal side with 1.89+/- 0.14 m/sec and 75.39+/- 7.82 m/sec. The mean neural length gain was 6 mm (30% of 20 mm of initial pre-experimental nerve length) in group 1 and 8 mm (40% of 20 mm) in group 2. Light microscopic examination revealed the loss of segmental myelination, decrease of myelination, and vacuolation. Electron microscopic examination showed that the normal ring shaped contour of axon was changed to convoluted shape.
Adult ; Axons ; Humans ; Leg ; Myelin Sheath ; Nerve Expansion ; Neural Conduction ; Paralysis ; Peripheral Nerves ; Rabbits ; Sciatic Nerve* ; Tissue Expansion*