No abstract available.
Idiopathic Pulmonary Fibrosis*

No abstract available.
Fanconi Anemia*

High tibial osteotomy is a useful procedure in the treatment of early stage osteoarthritis of the knee which is confined to the medial compartment. But long term follow-up study of high tibial osteotomy has not been provided yet and its prerequisite for a successful result still remains unrevealed. Since the osteoarthritis can progress after the osteotomy, it may result in the loss of correction and recurrence of pain and require conversion to total knee replacement arthroplasty. We studied clinically and radiologically the long term result of high tibial osteotomy in 11 patients(16 knees) who had been treated at the Department of Orthopaedic surgery of Seoul Paik Hospital during the period from January, 1978 to May, 1989, and follow-up for longer than 4 years. Preoperative mean varus angle was 6.4 degrees and immediate postoperative mean valgus angle was 8.6 degrees and final mean valgus angle was 4.7 degrees. The average loss of correction angle was 3.9 degrees. At 2-year follow-up, the results of 16 knees were as follows; excellent in six knees, good in seven knees. The final results at average 7.2-year follow-up were excellent in four knees, good in six knees and one knee was converted to total knee replacement arthroplasty. The results showed deterioration of clinical results and loss of correction with time after osteotomy. However, in more than half of the cases the results were good or excellent at the final follow-up, We, therefore, conclude that high tibial osteotomy is still a useful procedure in osteoarthritis of the knee if performed with a precise surgical technique and an adequate overcorrection more than 10 degrees.
Arthroplasty ; Arthroplasty, Replacement, Knee ; Follow-Up Studies ; Knee ; Osteoarthritis ; Osteotomy ; Recurrence ; Seoul

PURPOSE: To observe the hemodynamic change in brain tumors and peritumoral edemas after steroid treat-ment, and then nvestigate the clinical usefulness of perfusion MRI. MATERIALS AND METHODS: We acquired conventional and perfusion MR images in 15 patients with various in-tracranial tumors (4 glioblastoma multiformes, 4 meningiomas, 3 metastatic tumors, 1 anaplastic ependymo-ma, 1 anaplastic astrocytoma, 1 hemangioblastoma, and 1 pilocytic astrocytoma). For perfusion MR imaging, a 1.5T unit employing the gradient-echo EPI technique was used, and further perfusion MR images were ob-tained 2-10 days after intravenous steroid therapy. After processing of the raw data, regional cerebral blood volume (rCBV) maps were reconstructed. The maps were visually evaluated by comparing relative perfusion in brain tumors and peritumoral edemas with that in contralateral white matter. Objective evaluations were performed by comparing the perfusion ratios of brain tumors and peritumoral edemas. RESULTS: Visual evaluations of rCBV maps, showed that in most brain tumors (67%, 10/15), perfusion was high before steroid treatment and showed in (80%, 12/15) decreased afferwards. Objective evaluation, showed that in all brain tumors, perfusion decreased. Visual evaluation of perfusion change in peritumoral edemas revealed change in only one case, but objective evaluation indicated that perfusion decreased signifi-cantly in all seven cases. CONCLUSIONS: rCBV maps acquired by perfusion MR imaging can provide hemodynamic information about brain tumors and peritumoral edemas. Such maps could prove helpful in the preoperative planning of brain tumor surgery and the monitoring of steroid effects during conservative treatment.
Astrocytoma ; Blood Volume* ; Brain Neoplasms* ; Brain* ; Edema* ; Glioblastoma ; Hemangioblastoma ; Hemodynamics ; Humans ; Magnetic Resonance Imaging* ; Meningioma ; Perfusion* ; Steroids

PURPOSE: To observe the hemodynamic change in brain tumors and peritumoral edemas after steroid treat-ment, and then nvestigate the clinical usefulness of perfusion MRI. MATERIALS AND METHODS: We acquired conventional and perfusion MR images in 15 patients with various in-tracranial tumors (4 glioblastoma multiformes, 4 meningiomas, 3 metastatic tumors, 1 anaplastic ependymo-ma, 1 anaplastic astrocytoma, 1 hemangioblastoma, and 1 pilocytic astrocytoma). For perfusion MR imaging, a 1.5T unit employing the gradient-echo EPI technique was used, and further perfusion MR images were ob-tained 2-10 days after intravenous steroid therapy. After processing of the raw data, regional cerebral blood volume (rCBV) maps were reconstructed. The maps were visually evaluated by comparing relative perfusion in brain tumors and peritumoral edemas with that in contralateral white matter. Objective evaluations were performed by comparing the perfusion ratios of brain tumors and peritumoral edemas. RESULTS: Visual evaluations of rCBV maps, showed that in most brain tumors (67%, 10/15), perfusion was high before steroid treatment and showed in (80%, 12/15) decreased afferwards. Objective evaluation, showed that in all brain tumors, perfusion decreased. Visual evaluation of perfusion change in peritumoral edemas revealed change in only one case, but objective evaluation indicated that perfusion decreased signifi-cantly in all seven cases. CONCLUSIONS: rCBV maps acquired by perfusion MR imaging can provide hemodynamic information about brain tumors and peritumoral edemas. Such maps could prove helpful in the preoperative planning of brain tumor surgery and the monitoring of steroid effects during conservative treatment.
Astrocytoma ; Blood Volume* ; Brain Neoplasms* ; Brain* ; Edema* ; Glioblastoma ; Hemangioblastoma ; Hemodynamics ; Humans ; Magnetic Resonance Imaging* ; Meningioma ; Perfusion* ; Steroids

Spontaneous intracranial hypotension (SIH) is a rare disease with a symptom of a postural headache, which is aggravated by the erect position and relieved by the supine position. This persistent headache is dramatically improved with an epidural blood patch. C6-7 is the most common site of leakage of cerebrospinal fluid (CSF) from the subarachnoid space in SIH. The diagnosis of SIH is based on a typical history. It is supported by low CSF pressure in a lumbar puncture and diffuse dural enhancement on a brain MRI, and confirmed by a CSF leakage site on a radioisotope cisternography or on a myelography. However, we had two patients of SIH whose CSF leakage site was not found on cisternography. We tried an epidurogram just before an injection of autologous blood for an epidural blood patch, and found specific finding on the epidurogam suggesting the CSF leakage site, such as a filling defect on C6-7 during dye injection, and delayed washout of dye around the filling defect on the epidurogram performed at C7-T1/C6-7. Therefore, we suggest that an epidurogram is occasionally a useful diagnostic tool when looking for the site of CSF leakage in SIH.
Blood Patch, Epidural ; Brain ; Cerebrospinal Fluid ; Diagnosis ; Headache ; Humans ; Intracranial Hypotension* ; Magnetic Resonance Imaging ; Myelography ; Rare Diseases ; Spinal Puncture ; Subarachnoid Space ; Supine Position

A case of systemic amyloidosis involving the upper and lower gastrointestinal tract is presented. The initial manifestation of this case was bloody diarrhea. On colonoscopy, multiple submucosal hematomas and irregular ulcerations of the sigmoid and descending colon were found. The pathologic diagnosis was confirmed by an endoscopic mucosal biopsy of the gastrointestinal tract and the specimen revealed massive amyloid deposits in the wall of the upper and lower intestinal tract. With intensive medical treatment, the submucosal hematoma disappeared and the ulcerations decreased in size. However, on the 29th day, the patient was expired due to unexpected sepsis.
Amyloidosis* ; Biopsy ; Colon, Descending ; Colon, Sigmoid ; Colonoscopy ; Diagnosis ; Diarrhea ; Gastrointestinal Tract ; Hematoma* ; Hemorrhage* ; Humans ; Lower Gastrointestinal Tract* ; Plaque, Amyloid ; Sepsis ; Ulcer

OBJECTIVE: Multipotent bone marrow stromal cells have the ability to differentiate toward a variety of connective tissue lineages including cartilage. The future use of adult mesenchymal stem cells (MSCs) for human therapies depends on the establishment of preclinical studies. Therefore, in this preclinical study we demonstrated the expression of MSC surface markers CD29, CD105, and CD44 on human bone marrow derived stromal cells during chondrogenic differentiation. METHODS: Adult human bone marrow was collected from the iliac crest of 7 donors following informed consent. Mononuclear cells were isolated, incubated in monolayers, and embedded in alginate beads for three-dimensional cultures. Cellualr viability was assessed by MTT assay. Flow cytometry of alginate bead cultures was performed on days 0, 7, 14, 21, and 28 using monoclonal antibody against surface molecules, CD105, CD29, CD44, CD34 and CD45. Total contents of collagen and glycosaminoglycan (GAG) of the alginate beads was measured. SPSS 11.0 was used for data analysis. RESULTS: After 7 days of culture, 89% of the cells expressed the human integrin beta 1 antibody, CD29. The CD29-positive cells remained elevated at 83% on days 28. However, while only 18% expressed the type II TGF-beta receptor endoglin, CD105 on day 7, the CD105-positive cells increased abruptly 65% on day 14 remaining elevated up to day 28. The expression of CD44 was maximal in the first passage cell (63%). High concentration of TGF-beta 3 (10 ng/mL) was more favorable for sustaining cell viability than a low concentration (0.5 ng/mL)(n=4, p= 0.002, day 21). The total contents of collagen and GAG in the MSC-alginate beads increased during the three-dimensional culture (n=4, p=0.02, p=0.006) suggesting its differentiation into a chondrogenic lineage. CONCLUSION: CD29 was expressed earlier than CD105 during chondrogenic differentiation of human bone marrow MSC. CD44 expression was highest in the first passage cells and gradually decreased afterwards.
Adult ; Bone Marrow* ; Cartilage ; Cell Survival ; Collagen ; Connective Tissue ; Flow Cytometry ; Humans* ; Informed Consent ; Mesenchymal Stromal Cells ; Receptors, Transforming Growth Factor beta ; Statistics as Topic ; Stromal Cells* ; Tissue Donors ; Transforming Growth Factor beta

No abstract available.

PURPOSE: To describe the computed tomographic (CT) findings and follow-up changes of pulmonary epithelioidhemangioendothelioma (PEH). MATERIALS AND METHODS: The clinical and serial radiological findings [follow-up,5months-5 years (mean, 26.4 months)] of five patients with histologically proven PEH were retrospectivelyreviewed. Three were men and two were women, and they were aged between 25 and 54(mean, 35.6) years. Initial chestradiographs were available in all cases and HRCT, conventional CT and MRI were available in one, respectively.Follow-up conventional CT (n=3) and HRCT (n=2) were performed, and the size, number and distribution of thenodules, calcification and follow-up changes were analyzed. RESULTS: In four patients, chest radiography and CTrevealed bilateral multiple nodules 1-15mm in size. In two patients, the nodules showed interstitial distribution,and one had a single nodule in the right upper lobe. On follow-up CT images, an endobronchial mass withobstructive pneumonitis (n=1) or consolidation with pleural effusion (n=1) was noted. In three patients, thenodules had increased in size and number, and calcification within the nodules was observed in two. CONCLUSION:PEH usually manifests as widespread nodules, sometimes with calcification. Along with larger and increased numbersof nodules, follow-up images of PEH may show an endobronchial mass with obstructive pneumonitis or aconsolidation-like mass with pleural effusion.
Female ; Follow-Up Studies ; Hemangioendothelioma, Epithelioid* ; Humans ; Magnetic Resonance Imaging ; Male ; Pleural Effusion ; Pneumonia ; Radiography ; Thorax