Transforming growth factor-beta (TGF-beta) has been suspected as a possible gene therapy candidate for orthopedic diseases. We demonstrated that the TGF-beta gene therapy can be applicable to orthopedic patients. After transfection of TGF-beta cDNA sequence to myoblasts [C2 (280)] and fibroblasts (NIH 3T3), stable cell lines with TGF-beta mRNA expression were selected by Northern analysis. To evaluate the possibility of clinical application of these cells to orthopedic diseases, the cells were injected into rabbit achilles tendon. Intratendinous injection was done to evaluate the viability of the cells and to determine the optimal concentration for in vivo expression. At 6 weeks after injection, the injected tendon was thickened with newly formed collagen. The results from this experiment indicates that these cells survived and stimulated matrix formation in rabbit achilles tendon. We concluded that TGF-beta cDNA transfected cells can be useful in the evaluation of TGF-beta biology in vivo.
Achilles Tendon* ; Biology ; Cell Line* ; Collagen ; DNA, Complementary ; Fibroblasts* ; Genetic Therapy ; Humans ; Myoblasts* ; Orthopedics ; RNA, Messenger ; Tendons ; Transfection ; Transforming Growth Factor beta*

BACKGROUND/AIMS: The nature of gallbladder polyp is obscure before operation, and surgical indication is still controversial. The aim of this study is to suggest the therapeutic guideline for patients with the gallbladder polyps in the laparoscopic era. METHODS: Among 49 patients who received cholecystectomy because of gallbladder polyp from January 1, 1992 to December 31, 2000 in Department of Surgery, Seoul Municipal Boramae Hospital, we studied 42 histopathologically confirmed gallbladder polyp patients retrospectively. These patients were divided into two groups as true polyp(adenoma, carcinoma) and pseudopolyp(cholesterol, inflammatory, hyperplastic), and clinical characteristics were compared between the groups. RESULTS: The mean age was 48.19+/-11.09 years and male to female ratio was 17:25 in all patients. Of 42 patients, 32 pseudopolyps(76.2%) and 10 true polyps(23.8%) were confirmed by pathologic examination. Of 32 pseudopolyps, cholesterol polyps(29cases, 90.6%) were most common type. 4 carcinomas and 6 adenomas were included in 10 true polyps. Of 6 adenomas, coexistence with dysplasia was present in two cases. 1 case of carcinoma was present as arising from underlying tubular adenoma. Compared with pseudopolyp, true polyp showed significant larger size in diameter than psedopolyp(p=0.014). Despite of these statistical difference, 44% of pseudopolyps was more than 10mm in maximum diameter. 2 cases of true polyp(20%) was less than 10mm. However all of the other clinical features such as, the patients's age, sex, symptom, presence of gallstones, and number of polypoid lesion were not significantly different between the groups. All 4 carcinoma patients received laparoscopic cholecystectomy are disease free state with mean 68.5 months follow-up period. CONCLUSION: Although true polyps showed statistically significant larger than pseudopolyps in maximum diameter, there was no clear cut point dividing the two groups. All of the other clinical characteristics could not differentiated true polyps from pseudopolyps. Because of the low morbidity of laparoscopic procedure, premalignant potential of gallbladder adenoma and the adenoma-carcinoma sequence are unquestionable, an aggressive surgical intervention should be proposed in the era of laparoscopic surgery.
Adenoma ; Cholecystectomy ; Cholecystectomy, Laparoscopic ; Cholesterol ; Female ; Follow-Up Studies ; Gallbladder* ; Gallstones ; Humans ; Laparoscopy ; Male ; Polyps* ; Retrospective Studies ; Seoul

No abstract available.
Hemangioma*

PURPOSE: To evaluate the radiographic and functional outcomes between who had unstable intertrochanteric fracture, treated with the ITST (lag screw design) and the PFNA (helical blade design). MATERIALS AND METHODS: We selected each 17 and 13 patients of unstable intertrochanteric fracture which were treated with ITST or PFNA from April 2005 to December 2008. We evaluated the radiographic results by follow-up radiography and the clinical outcomes with the mobility score of Parker and Palmer, Social function scoring system. RESULTS: The mean sliding distance of cervical screw with ITST nails was not shown significant differences than with using PFNA nails. The other factors were not statistically different. Decrease of mobility score of Parker and Palmer, Social function score were similar. 2 cases of cutting out was noted with ITST nails and 1 case of cutting out was noted with PFNA nails. CONCLUSION: Unlike the existed biomechanical reposts, there are no differences that are clinical and radiological results in treatment of unstable intertrochanteric fracture using the ITST nails and PFNA nails.
Follow-Up Studies ; Humans ; Nails

PURPOSE: To assess the efficacy and toxicity of a new protocol that consists of CHOP- Bleo alternated with a new regimen of Cyclophosphamide, methotrexate, etoposide, and dexamethasone(CMED) for aggressive Non-Hodgkin's Lymphoma(NHL). PATIENTS AND METHODS: Between January 1991 and December 1996, forty-six patients with Ann Arbor stages II-IV aggressive NHL were treated with alternating cycles of CHOP-Bleo and CMED for a total of 12 cycles. All eligible patients were evaluated for response, disease-free survival, and overall survival. RESULTS: Twenty-two patients(47.8%) achieved a complete response and overall response rate was 83.9%. The range of survival duration was 1-68+months and the median survival time was 42 months. Overall 3-year survival rate was 54%. The range of disease-free survival time was 6-63+months and 3-year disease-free survival rate was 61%. The most common hematologic toxicity was leukopenia and the incidence of severe leukopenia(<1,000/mm3) was 11%. And alopecia(84.8%) was the most common non-hematologic toxicity. CONCLUSION: The results of CHOP-Bleo/CMED alternating chemotherapy for patients with aggressive Non-Hodgkin's Lymphoma is not superior to other results of previous studies. Therefore further study will be warranted to determine clinical effectiveness of alternating chemotherapy.
Cyclophosphamide ; Disease-Free Survival ; Drug Therapy* ; Etoposide ; Hodgkin Disease* ; Humans ; Incidence ; Leukopenia ; Lymphoma, Non-Hodgkin ; Methotrexate ; Survival Rate

PURPOSE: To evaluate the usefulness and radiologic findings of CT in the diagnosis of orbital blow-outfracture. MATERIALS AND METHODS: Forty-four patients with orbital blow-out fractures diagnosed by clinicalfindings and CT were evaluated retrospectively. On CT images, we evaluated the site and frequency of fracture,herniation of orbital fat, extraocular muscle abnormality, intraorbital hematoma, and intrasinus hemorrhage. RESULTS: Forty-eight sites of orbital wall fractures were seen. Of these, 25(52.1%) were observed at the medialwall and 18(37.5%) at the inferior wall. Combined fracture of the medial and inferior wall was seen in fivecases(10.4%), and orbital fat herniation to adjacent sinuses in 25. Associated extraocular muscle abnormalitieswere seen at the medial rectus (n=20) and inferior rectus muscle(n=18). Intrasinus hemorrhage was seen in 15cases, and intraorbital hematoma in five. CONCLUSION: CT is a useful diagnostic modality for the evaluation oforbital blow-out fracture and associated soft tissue abnormalities.
Diagnosis ; Hematoma ; Hemorrhage ; Humans ; Orbit* ; Orbital Fractures* ; Retrospective Studies

One of the purposes of this experiment is to observe the structure of crystalline lens with cataract, which is formed artificially, using the light microscope and electron microscope. The other is to observe the differences of structural variations in the cataract developed inside body. Twelve eyes of six pigs were used for this experiment. Two of them are normal crystalline lens, five are cystalline lens in distilled water, and the rest are in balanced salt solution through intact or ruptured capsule. We examined the time of cataract formation and compared the ultrastructural changes. Ruptured capsule and high osmotic pressure difference induced more rapid opacity. In case of distilled water, the capsule is maintained but it is very difficult to distinguish between epithelium and lens fibers. Also, there is a severe crack in the lens fibers. In electron microscopic, as the cataract progresses, the osmotic swelling becomes more prominent. One of the striking changes was a marked intercellular cyst formation. Lens cells became irregular in size and density and were extensively vacuolated. The swelling of the lens cells continuously induced large intracellular vacuoles and liquefied the cytoplasmic protein. In conclusion, the structural change of cataract, which was seen by an electron microscope, resulted from change in osmolarity from previously announced in vivo experiment and structural change resulted from this experiment are similar.
Cataract* ; Crystallins* ; Cytoplasm ; Epithelium ; Lens, Crystalline* ; Microscopy, Electron ; Osmolar Concentration ; Osmotic Pressure ; Strikes, Employee ; Swine ; Vacuoles ; Water

Backgound: The placement of stents in coronary arteries has been shown to reduce acute closure and restenosis in comparison to balloon angioplasty. However, clinical use of intracoronary stents is impeded by the subacute stent thrombosis and hemorrhagic complications associated with the anticoagulant regimen. It's known that the complete stent deployment with high pressure inflation and new antiplatelet agents are effective in reduction of subacute thrombosis and hemorrhage. So we evaluated initial results (success and complication rate) after high pressure-stent deployment with new anticoagulation protocol. METHODS: One hundred and ninety one patients with 201 lesions were treated with 231 stents of various types. The high pressure balloon inflation and antiplatelets agents were used in all cases. Final high pressure balloon inflation guided by IVUS were performed in 23 consecutive cases with incomplete stent deployment according to angiographic findings. RESULTS: 1) The indications of stenting (n=210) were De novo in 124 (59%), bailout procedure in 57 (27%), suboptimal result after PTCA in 19 (8%), and restenosis after PTCA in 14 (6%). The location of lesions were LAD in 101, RCA in 67, circumflex in 28, ramus intermedius in 3, and LMT artery in 2 lesions. Angiographic morphologic characteristics were type A in 2, type B in 158 (B1: 57, B2: 101), and type C in 22 lesions. 2) The angiographic and clinical success rate was 96% (192/201) and 92% (186/201) respectively. 3) In angiographic analysis, the baseline average reference vessel dirmeter was 3.33+/-0.35 mm. Baseline minimum lumen diameter (MLD) was 0.58+/-0.29 mm, with baseline percent diameter stenosis of 82.86+/-8.64%. The final stent diameter was 3.37+/-0.29 mm, with mean final percent stenosis of 0.63+/-8.25. The mean MLD after stenting was significantly increased (p<0.001). The mean MLD within stent increased 14%, from 2.91+/-0.39 mm at the nominal balloon inflation (inflation pressure=7 atm) to 3.37+/-0.29 mm at high pressure balloon inflation (inflation pressure <0A65B>12atm) (p<0.001). The length of lesions in GR I (cook), GR II, and Micro II stents were significantly longer than ones in PS, Cordis, Wiktor, Nir (p<0.001). 4) In intravascular ultrasound analysis, the mean lumen CSA at the tightest point within stent increased 11%, from 8.4+/-2.4 mm2 at the intial intravascular ultrasound to 9.4+/-2.1 mm2 at the final intravascular ultrasound (p<0.001). 5) The procedural and postprocedural complications were 2 acute closures associated with AMI and emergent CABG, 1 subacute closure which was revascularized by bail out stenting, 5 major hemorrhage requiring transfusion associated with 1 CVA and 2 metabolic acidosis induced by acute renal failure, and 5 death. CONCLUSION: The high pressure stent deployment procedure and new anticoagulation protocol associating tidopidine and aspirin without coumadin or prolonged heparin infusion allow us to obtain an acceptably low subacute thrombosis or bleeding complication rate. These results are encouraging and allow a wide use of coronary stenting.
Acidosis ; Acute Kidney Injury ; Angioplasty, Balloon ; Arteries ; Aspirin ; Constriction, Pathologic ; Coronary Vessels* ; Hemorrhage ; Heparin ; Humans ; Inflation, Economic ; Platelet Aggregation Inhibitors* ; Stents* ; Thrombosis ; Ultrasonography ; Warfarin

No abstract available.
Child* ; Fibroma* ; Frontal Bone* ; Humans

Eighteen patients with primary hyperparathyroidism were treated by one of the authors (SKO) from 1981 through 1988 at the Department of Surgery, Seoul National University Hospital and the data were analyzed retrospectively. Eighteen patients comprised 6 males and 12 females, with the male to female ratio of 1 to 2. The age distribution was between 18 and 64 years. The chief complaints were associated with skeletal symptoms in 9 urinary symptoms in 5, and neurologic manifestation in 1 patient. There were 3 patients with asymptomatic hypercalcemia. All patients showed hypercalcemia and hypophosphatemia was found in 11 patients. Serum PTH level was elevated in 13 cases. performing preoperative localization with computed tomorgam, ultrasonogram and thallium-technetium subtraction scan, positive localization was made in 62.5% (10/16), 53.8% (7/13) and 85.7% (12/14), respectively. one patient, angiography and selective venous sampling were peformed and positive localization was made. All patients were treated by surgery. There were 17 patients with solitary adenoma and one with double tumors. Pathologic findings revealed adenoma of the parathyroid in all patients except one which was proved later to be carcinoma. There were no recurrent cases except one with carcinoma. There were no postoperative complications. primary hyperparathyroidism is a very rare disease in Korea. Causes of primary hyperparathyroidism in our study was confined to tumors of the parathyroid, such as adenoma and carcinoma.There was no hyperplasia causing primary hyperparathyroidism. Thallium-technetium subtraction scan was proved to be the best method for localization of the parathyroid tumors Excision of the tumor with involved parathyroid followed by frozen-section biopsy of the univolved parathyroid was the best way to treat primary hyperparathyroidism in our study.
Adenoma ; Age Distribution ; Angiography ; Biopsy ; Female ; Humans ; Hypercalcemia ; Hyperparathyroidism ; Hyperparathyroidism, Primary* ; Hyperplasia ; Hypophosphatemia ; Korea ; Male ; Methods ; Neurologic Manifestations ; Postoperative Complications ; Rare Diseases ; Retrospective Studies ; Seoul ; Ultrasonography