A corticocancellous core was removed from both femurs and tibias in 5 skeletally immature pigs. The cavity was treated with 5%, 25% phenol cautery, cryosurgery, and normal saline irrigation (control). The animals were sacrified after 7days. The extent of the bone necrosis was assessed by gross examination, simple radiography, MRI evaluation and histological examination with tissue mapping. After cryosurgery, the extent of necrosis was most profound in the depth of 2.0-9.0mm beyond the cavity wall. The effect of 25%-phenol was next to cryosurgery, with a depth of 1.0-3.0mm of necrosis. 5%-phenol made necrosis with the depth of 1.0-2.5mm. Very mild degree of necrosis with the width of 0.5-1.0mm was found along the cavity wall even in control group. On MRI, signal change was well visualized on T2 weighted coronal section and it was quite coincided with the extent of bone necrosis proved by histological tissue mapping to all cases. When the epiphyseal plate was open or very close to the cavity, curettage itself, 5%- and 25%-phenol cautery and cryosurgery all produced mild ischemic necrosis along the provisional calcification zone of physeal plate. These findings suggest that cryosurgery made more profound necrosis beyond cavity than phenol cautery and MRI is very sensitive and specific to find osteonecrosis along the cavity wall after phenol cautery or cryosurgery. When epiphyseal plate is open or very close to the cavity, phenol cautery, or cryosurgery, or even curettage itself could produce an ischemic necrosis to the physeal plate itself.
Animals ; Cautery* ; Cryosurgery* ; Curettage ; Femur* ; Growth Plate ; Magnetic Resonance Imaging ; Necrosis* ; Osteonecrosis ; Phenol* ; Radiography ; Swine ; Tibia*

No abstract available.
Diskectomy*

No abstract available.
Diskectomy*

No abstract available.
Diabetic Ketoacidosis* ; Lung Abscess* ; Lung* ; Mucormycosis*

BACKGROUND: Living related liver transplantation (LRLT) has gained acceptance as treatment modality for children with end-stage liver disease. The left lobe used in LRLT doesn't provide adequate parenchymal mass for its application to adults. We have used right lobe for LRLT in adults. Some criticism has been aroused becuase of the potential significant risk to the donors. METHODS: We analyzed the surgical risk and the stress to 20 donors in a right lobectomy for LRLT. We also analyzed anatomical points for safe harvest, and we describe techincal points based on anatomical variations. RESULTS: There were no deaths, and 6 major complications (3 bleeding, 1 perihepatic fluid collection, 1 pleural effusion, and 1 bile peritonitis after removal of the T-tube) occurred in 6 patients. Liver function was normalized within 2 weeks. There were anatomical variations in the hepatic vein, the portal vein, and the bile duct, especially the right inferior hepatic vein (55%), trifurcation of the portal vein (10%), low inserion of the right posterior bile duct into the common hepatic duct (10%), and separate insertion of the right anterior bile duct and right posterior bile duct into the hepatic duct (10%). We made a vena cava patch for the right inferior hepatic vein. In cases of the low insertion of the right posterior hepatic duct into the common hepatic duct, the cholecystectomy should be done carefully so as not to injure the right posterior hepatic duct. We ligated and divided the right posterior bile duct before dissection of the hepatic artery and the portal vein. In cases of trifurcation of the portal vein, closure of the left portal vein should be done to prevent the narrowing of the left portal vein lumen. CONCLUSIONS: Our results suggest that a right lobectomy for LRLT is safe for donors. However, anatomical variations in the bile duct, the hepatic vein, and the portal vein should be kept in mind to ensure a safe and successful operation.
Adult* ; Bile ; Bile Ducts ; Child ; Cholecystectomy ; Hemorrhage ; Hepatic Artery ; Hepatic Duct, Common ; Hepatic Veins ; Humans ; Liver Diseases ; Liver Transplantation* ; Liver* ; Living Donors* ; Peritonitis ; Pleural Effusion ; Portal Vein ; Tissue Donors

PURPOSE: To differentiate the genes that are up-regulated or down-regulated and the cellular morphology in the corneal stromal cells between normal and diabetic rat. METHODS: After isolation with trizol (GIBCO, NY, USA), labeling and purification of complementary DNA(cDNA) probes were carried out using Atlas(TM) Glass Microarrays 1.0. RESULTS: Autoradiographic analysis showed that 35 genes were up-regulated and 8 genes were down-regulated by Atlas Image(TM) Software. Up-regulated genes were as calcium/calmodulin dependent protein kinase I, proteasome 26S subunit 1, prostaglandin F receptor. Down-regulated genes were aquaporin 8, cytochrome c oxidase polypeptide Vb, glypican 1. CONCLUSIONS: There were many differential genes in hormone receptor, voltage gated ion channels, oncogenes and tumor suppressors, G protein between normal and diabetic keratocyte of rat.
Animals ; Cornea* ; Electron Transport Complex IV ; Glass ; Glypicans ; GTP-Binding Proteins ; Ion Channels ; Oncogenes ; Proteasome Endopeptidase Complex ; Protein Kinases ; Rats* ; Stromal Cells

We report a case of hydrocephalus in a 8-year-old boy who presented bilateral hand tremor. The hydrocephalus was caused by the aqueductal stenosis due to expanding lacunae in the mesencephalothalamic area on MR findings. The tremor was improved after CSF drainage by spinal tap and ventriculoperitoneal shunt. The authors present the possible mechanism of hydrocephalus induced tremor.
Child ; Drainage ; Hand ; Humans ; Hydrocephalus* ; Male ; Spinal Puncture ; Tremor* ; Ventriculoperitoneal Shunt

BACKGROUND: Intrachromosomal amplification of chromosome 21 (iAMP21) is known to be associated with poor prognosis in B-cell ALL (B-ALL). To determine the frequency and clinical characteristics of iAMP21 in Korean B-ALL patients, we performed FISH and multiplex ligation-dependent probe amplification (MLPA) analyses. METHODS: A total of 102 childhood B-ALL patients were screened with ETV6-RUNX1 FISH probes (Abbott Molecular, USA). The presence of an iAMP21 was confirmed by using MLPA P327 iAMP21-ERG probemix (MRC Holland, The Netherlands). RESULTS: iAMP21 was detected in one of the screened B-ALL patients (1/102 patients, 1.0%) who presented the ALL immunophenotype and complex karyotype at initial diagnosis. The patient relapsed twice after bone marrow transplantation. MLPA showed 12.5-Mb and 4.28-Mb regions of amplification and deletion, respectively. CONCLUSIONS: The frequency of iAMP21 is considerable in Korean pediatric patients. Our report suggests that iAMP21 in childhood B-ALL has very unfavorable impact on patient's prognosis. Additional methods such as MLPA analysis is essential to rule out patients with equivocal interphase FISH results.
Adolescent ; Asian Continental Ancestry Group/*genetics ; B-Lymphocytes/*metabolism ; Child ; Child, Preschool ; *Chromosomes, Human, Pair 21 ; Core Binding Factor Alpha 2 Subunit/genetics ; DNA Probes/metabolism ; Female ; Humans ; Immunophenotyping ; In Situ Hybridization, Fluorescence ; Infant ; Infant, Newborn ; Male ; Multiplex Polymerase Chain Reaction ; Precursor Cell Lymphoblastic Leukemia-Lymphoma/*diagnosis/genetics ; Proto-Oncogene Proteins c-ets/genetics ; Repressor Proteins/genetics ; Republic of Korea ; Translocation, Genetic ; Young Adult

Aggressive angiomyxoma is a rare, locally infiltrative soft tissue tumor that usually arises in the vulvoperitoneal region of young female. Frequent relapses are common. Clinicians should consider the diagnosis of aggressive angiomyxoma when a patient presents with an atypical vulvoperineal mass, because an incorrect diagnosis may lead to repeated surgical procedures. Treatment is wide surgical excision. Medical management with a GnRH agonist and radiation therapy with total dose of 60 Gy may be helpful adjuvant treatment in recurrent aggressive angiomyxoma. We experienced a case of recurrent aggressive angiomyxoma and report it with a brief review of literatures.
Adolescent* ; Diagnosis ; Female ; Gonadotropin-Releasing Hormone ; Humans ; Myxoma* ; Recurrence ; Vulva*

Primary Sjogren's syndrome is a chronic autoimmune disorder characterized by xerostomia and keratoconjunctivitis sicca result from lymphocytic infiltrations of salivary and lacrimal glands.It may accompany by the wide spectrums of extraglandular symptoms,such as musculoskeletal,pulmonary,renal,intestinal,hematologic,and nervous system.However,overt cardiac manifestations are very rare and are documented only a few cases sporadically. We report a patient with primary Sjogren's syndrome who developed reversible congestive heart failure as part of a myocarditis.A 39-year-old woman with primary Sjogren's syndrome developed fatigue,dyspnea,and abdominal discomfort.An echocardiography revealed global hypokinetic left ventricle with markedly decreased ejection fraction (EF=39%),abnormal restrictive filling pattern,secondary tricuspid valve insufficiency and no pericardial effusion or thickening.A myocardial biopsy disclosed myocardial degeneration with lymphocyte infiltration.Following treatment with digitalis,diuretics,ACE inhibitor and corticosteroid,the symptoms of congestive heart failure improved.A repeat echocardiography showed an improved ventricular contractility and recovered both diastolic (normalized E/A ratio)and systolic (EF=50%)functions.
Adult ; Biopsy ; Echocardiography ; Female ; Heart Failure ; Heart Ventricles ; Humans ; Keratoconjunctivitis Sicca ; Lymphocytes ; Myocarditis* ; Pericardial Effusion ; Sjogren's Syndrome* ; Tricuspid Valve Insufficiency ; Xerostomia