PURPOSE: We evaluated oncologic outcomes of chondrosarcomas and analyzed the disease-free survival rate of chondrosarcomas according to the various factors. MATERIALS AND METHODS: We performed a retrospective study for the disease-free survival rate of 48 chondrosarcomas, 44 of which underwent surgical treatment and followed up more than 18 months since 1993, and in the remaining 4 cases, the patients died before 18 months after surgery. The vsariables were location, tumor volume, histologic grade, stage, age at presentation and treatment performed. The mean follow up period was 43.8 months (1-196 months). RESULTS: The overall disease-free survival rate was 77.1% at mean 43.8 month follow up. The 5 year- and 10 year disease-free survival rates were 64% and 58% respectively. The histologic grade, stage, age at presentation revealed statistical significance on disease-free survival. All 9 patients treated with extended curettage for grade 1 central chondrosarcomas revealed disease-free survival with excellent functional outcome. CONCLUSION: The disease-free survival rate of chondrosarcomas mainly depended on histologic grade, stage and age at presentation. Local recurrence and distant metastasis also revealed statistically significant differences of disease-free survival rate. Comparing to wide resection, extended curettage for low-grade central chondrosarcomas in extremities were efficient methods with similar survival rate and less functional losses and complications.
Chondrosarcoma ; Curettage ; Disease-Free Survival ; Extremities ; Follow-Up Studies ; Humans ; Neoplasm Metastasis ; Recurrence ; Retrospective Studies ; Survival Rate ; Tumor Burden

No abstract available.
Humans ; Surgery, Plastic*

PURPOSE: To determine the activity and toxicities of PEF (Cisplatin, Etoposide, 5-Fluorouracil) chemotherapy for stomach cancer. MATERIALS AND METHODS: Patients with previously untreated metastatic stomach cancer were treated with PEF regimen which consisted of cisplatin (20 mg/m2 i.v. days 1~5), etoposide (100 mg/m2 i.v. days 1, 3, 5), and 5-fluorouracil (5-FU)(800 mg/m2 i.v. infusion for 12 hours days 1~5). Chemotherapy was repeated every 3 weeks until disease progressed or toxicities were intolerable. RESULTS: Between May 1989 and July 1990, 40 patients were enrolled in this protocol. Twelve patients were lost to follow up after one cycle of chemotherapy and inevaluable. After 2~8 cycles (median 3) of chemotherapy, 20 out of 28 evaluable patients showed objective responses without any complete response, making the response rate 71% (95% confidence interval: 54~89%). The responses lasted from 4+ to 39 weeks (median: 38 weeks). The overall survival of total evaluable patients was 4+ ~50+ weeks (median 38 weeks). Among total 109 cycles of chemotherapy, cycles were delayed or doses were reduced in 48 cycles (44%) because of leukopenia (in 61 cycles: 56%) and/or thrombocytopenia (in 14 cycles: 13%). However, there was no treatment-related death. Nausea/vomiting and alopecia were experienced in most of patients. The stomatitis was experienced in 7 patients (25%) but completely reversible. In contrast, the peripheral neuropathy which developed in 4 patients (14%) after 5 cycles of chemotherapy was not reversible. CONCLUSION: The PEF regimen was active and tolerable in stomach cancer.
Alopecia ; Cisplatin ; Drug Therapy* ; Etoposide* ; Fluorouracil* ; Humans ; Leukopenia ; Lost to Follow-Up ; Peripheral Nervous System Diseases ; Stomach Neoplasms* ; Stomach* ; Stomatitis ; Thrombocytopenia

BACKGROUND: Although pedobarographic measurement is increasingly used for clinical and research purposes, relatively few published studies have investigated normative data. This study examined pedobarographic findings in young healthy adults with regard to sex-related differences and correlations among measurement indices. METHODS: Twenty young healthy adults (mean age, 22.4 years; standard deviation, 1.2 years; and 10 males and 10 females) were included. Weight bearing anteroposterior (AP) and lateral foot radiographs were taken, and dynamic pedobarographic data during treadmill walking and maximum ankle dorsiflexion were obtained. AP talo-first metatarsal angle, naviculocuboid overlap, lateral talo-first metatarsal angle, and plantar soft tissue thickness were measured on foot radiographs. Pedobarographic data including peak pressure and pressure-time integral were measured on five plantar segments: medial forefoot (MFF), lateral forefoot (LFF), medial midfoot (MMF), lateral midfoot (LMF), and heel. RESULTS: Male and female subjects significantly differed in body mass index (BMI, p < 0.001), AP talo-first metatarsal angle (p = 0.018), soft tissue thickness under the metatarsal head (p = 0.040) and calcaneal tuberosity (p < 0.001), maximum dorsiflexion during stance phase (p = 0.041), peak pressure on the MFF (p = 0.005) and LFF (p = 0.004), and pressure-time integral on the MFF (p = 0.018) and heel (p = 0.001). BMI was significantly correlated with soft tissue thickness under the metatarsal head (r = 0.521, p = 0.018) and calcaneal tuberosity (r = 0.585, p = 0.007), peak pressure on the MFF (r = 0.601, p = 0.005) and LFF (r = 0.487, p = 0.029), pressure-time integral on the heel (r = 0.552, p = 0.012), and total pressure-time integral (r = 0.755, p < 0.001). Maximum dorsiflexion demonstrated significant negative correlations with pressure-time integral on the MFF (r = −0.595, p = 0.007) and total pressure-time integral (r = −0.492, p = 0.032). Pressure-time integral varus/valgus index was significantly correlated with pressuretime integral forefoot/heel index (r = 0.472, p = 0.036). CONCLUSIONS: Sex-related differences in pedobarographic examination were observed, which could provide useful information in setting appropriate treatment goals and obtaining appropriate control data. The effects of subtalar motion in distributing plantar pressure should be investigated in a future study.
Adult* ; Ankle ; Body Mass Index ; Female ; Foot ; Head ; Heel ; Humans ; Male ; Metatarsal Bones ; Sex Characteristics* ; Walking ; Weight-Bearing

PURPOSE: To report a case of endothelial keratitis occurred after reactivation of herpes simplex virus following immunosuppressant therapy for Kaposi's varicelliform eruption. CASE SUMMARY: A 23-year-old female was referred for ocular pain and blurred vision. She had atopic dermatitis and was diagnosed with Kaposi's varicelliform eruption on her face after using an immunosuppressant. Slit lamp examination revealed central corneal edema in the right eye. She was initially diagnosed with contact lens-induced keratitis. Subsequently, the contact lens was removed and topical antiviral agent used for prevention of ocular involvement. Four days after treatment, Wesseley immune ring of deep stromal haze and cells in the anterior chamber were present. She was diagnosed with endothelial keratitis caused by reactivation of herpes simplex virus after using an immunosuppressant. Topical steroid, hypertonic saline eye drops and cycloplegic eye drops were added to the treatment for the progression of endothelial keratitis. Corneal edema was decreased 2 weeks after treatment and anterior chamber cells decreased 1 month after treatment. There was no recurrence during the follow-up period. CONCLUSIONS: Patients diagnosed with Kaposi's varicelliform eruption after using immunosuppressants should have an ophthalmic examination to confirm ocular involvement; use of appropriate eye drops is necessary for the treatment of corneal involvement.
Anterior Chamber ; Corneal Edema ; Dermatitis, Atopic ; Female ; Follow-Up Studies ; Humans ; Immunosuppressive Agents ; Kaposi Varicelliform Eruption* ; Keratitis* ; Ophthalmic Solutions ; Recurrence ; Simplexvirus ; Slit Lamp ; Young Adult

purpose of this study was to investigate alterations in histochemical properties in the gastrocnemius & soleus muscles of rats following hindlimb suspension for 1 week. A modification of the Morey and Musacchia models was used to determine atrophic responses of rat muscle. The weights of rat's whole body and of gastrocnemius and soleus muscles were affected by suspensions. A reduction of type I distribution was accompanied by an increase in type II fibers. The cross sectional area of all fiber types was reduced after suspension. These results suggest that type I fibers showed greater susceptibility than type II fibers and some amount of type I fibers might have been converted to type II fibers.
Animals ; Hindlimb Suspension* ; Hindlimb* ; Muscles ; Rats* ; Suspensions ; Weights and Measures

Retrospective analysis of reoperation and complication was made for 186 patients with lumbar herniated disc. The results showed complication rate of 7%(13 cases) and reoperation rate of 10.2%(19 cases). The primary complications were infections(9 cases), technical errors(2 cases), and scores(2 cases). Rate of discitis was 1.6%(3 cases). The outcomes of reoperation resulted in excellent recovery of 16%(3 cases) and good recovery of 58%(11 cases). The most common intraoperative findings of reoperation were inadequate disectomy or missed disc fragments 31.6% or 6 cases;epidural fibrosis 26.3% or 5 cases;and new herniation at other level 15.8% or 3 cases. Excellent and good results could be achieved in patients operated within 1 month or more than 6 months after while the patients who underwent reoperation between 1 month and 6 months showed poor results. The delicate perioperative menagement and complete discectomy, adequate bleeding control and laminectomy were considered to be essential in reducing the chance of complication and reoperation.
Discitis ; Diskectomy ; Fibrosis ; Hemorrhage ; Humans ; Intervertebral Disc Displacement ; Laminectomy ; Reoperation* ; Retrospective Studies

PURPOSE: To investigate the effect of bevacizumab (Avastin; Genentech, San Francisco, CA, USA) on vascular endothelial growth factor (VEGF) expression and inflammation in fibrovascular membranes in patients with proliferative diabetic retinopathy (PDR). MATERIALS AND METHODS: Fibrovascular membranes from 19 eyes of 18 patients with PDR were studied using immunohistochemistry and analyzed in the following 3 groups; group 1: 4 inactive PDR eyes, group 2: 10 active PDR eyes treated preoperatively with adjunctive intravitreal bevacizumab, group 3: five active PDR eyes not treated preoperatively with bevacizumab. Immunohistochemical staining for VEGF, CD31 and CD68 were done. RESULTS: The immunoreactivity to VEGF and CD 31-positive blood vessels was significantly higher in membranes from group 3 than group 1 (p = 0.007 for VEGF, 0.013 for CD 31-positive vessels). Intravitreal bevacizumab caused a reduction in VEGF expression and vascular densities in 4 out of 10 (40%) excised membranes from eyes with PDR. However, six membranes (60%) in group 2 still demonstrated relatively strong VEGF expression and high vascular density. Infiltration of macrophages was observed in 16 out of the 19 membranes, and the density of macrophages was increased in group 2 compared with group 1 (p = 0.043). CONCLUSION: Intravitreal bevacizumab injections caused some reduction in VEGF expression and vascular densities in a limited number of active PDR patients. A single intravitreal bevacizumab injection may not be enough to induce complete blockage of VEGF and pathologic neovascularization in active PDR patients. Repeated injections, panretinal photocoagulation and/or PPV may be necessary following intravitreal bevacizumab to reinforce the anti-VEGF effect of the drug.
Adult ; Angiogenesis Inhibitors/*therapeutic use ; Antibodies, Monoclonal/*therapeutic use ; Diabetic Retinopathy/*drug therapy/*metabolism ; Female ; Humans ; Immunohistochemistry ; Male ; Middle Aged ; Vascular Endothelial Growth Factor A/*metabolism

PURPOSE: To evaluate the effect of combined immunosuppressive treatment with FK 506-cyclophosphamide on surgical angiogenesis in non-vascularized bone xenografts. MATERIALS AND METHODS: Twenty-seven hamster-to-rat non-vascularized bone xenografts were performed. For surgical angiogenesis, recipient origin saphenous arteriovenous bundles were implanted into the medullary canals of graft bones. Immunosuppression with FK 506-cyclophosphamide was performed in group 1, not in group 2, control group. At postoperative 4 weeks, microangiography with microfil was conducted. Decalcified bones were cleared and the area of newly formed capillary, capillary density, were quantitatively evaluated using Scion image program. Bone specimens stained with hematoxylin-eosin were evaluated histologically also. RESULTS: There was no significant difference of capillary densities between immunosuppressed group and non-immunosuppressed control group (0.37+/-0.03/0.39+/-0.02, P=0.58). On histological examination, both groups showed neoangiogenesis into the medullary canals and endosteal bones. CONCLUSION: FK 506-cyclophosphamide immunosuppression did not suppress the angiogenesis in non-vascularized bone xenografts, FK 506-cyclophosphamide combination of immunosuppression will be useful even in the condition of surgical angiogenesis.
Capillaries ; Heterografts ; Immunosuppression ; Silicone Elastomers ; Transplants

PURPOSE: To evaluate the effect of combined immunosuppressive treatment with FK 506-cyclophosphamide on surgical angiogenesis in non-vascularized bone xenografts. MATERIALS AND METHODS: Twenty-seven hamster-to-rat non-vascularized bone xenografts were performed. For surgical angiogenesis, recipient origin saphenous arteriovenous bundles were implanted into the medullary canals of graft bones. Immunosuppression with FK 506-cyclophosphamide was performed in group 1, not in group 2, control group. At postoperative 4 weeks, microangiography with microfil was conducted. Decalcified bones were cleared and the area of newly formed capillary, capillary density, were quantitatively evaluated using Scion image program. Bone specimens stained with hematoxylin-eosin were evaluated histologically also. RESULTS: There was no significant difference of capillary densities between immunosuppressed group and non-immunosuppressed control group (0.37+/-0.03/0.39+/-0.02, P=0.58). On histological examination, both groups showed neoangiogenesis into the medullary canals and endosteal bones. CONCLUSION: FK 506-cyclophosphamide immunosuppression did not suppress the angiogenesis in non-vascularized bone xenografts, FK 506-cyclophosphamide combination of immunosuppression will be useful even in the condition of surgical angiogenesis.
Capillaries ; Heterografts ; Immunosuppression ; Silicone Elastomers ; Transplants