Controversy persists regarding the abnormality of the bone metabolism in various bone diseases. Osteocalcin, the vitamin K-dependent protein synthesized in bone, has been shown to be a specific and sensitive marker of bone turnover in metabolic bone diseases. The author measured the serum osteocalcin level using newly developed radioimmunoassay (RIA) in the patients with osteogenesis imperfecta, metastatic bone tumor, postmenopausal osteoporosis and rheumatoid arthritis, which can be the causes of osteoporosis, and ankylosing spondylitis. The aim of this paper is to demonstrate the value of the osteocalcin measurement comparing the each data of disease group with the normal control group. The results were as followings ; 1. The mean of osteocalcin in normal Korean was 4.43±1.04 ng/ml. (4.45±1.08 ng/ml in male, 4.41±1.01 ng/ml in female). The difference between male and female was not significant statistically. 2. The osteocalcin of osteogenesis imperfects was 9.14±2.21 ng/ml, which was significant statistically, And it was thought to be the result of increasing bone turnover rate and the osteocalcin was useful as biochemical marker. 3. In metastatic bone tumor, osteocalcin was under the normal level in both untreated and treated groups, which meant low bone turnover rate or low osteoblastic activity. Osteocalcin was not a useful marker for the assessment of the effect of treatment in this study, but if the radioimmunoassay was done in the same tumor group, a valuable results could be expected. 4. Osteocalcin level in the patients with postmenopausal osteoporosis and rheumatoid arthritis was not different with normal control group and osteocalcin was not useful marker for the evaluation of the degree of osteoporosis and bone turnover. 5. Osteocalcin didn't play a role in the pathologic ossification of ankylosing spondylitis. In conclusion, the osteocalcin by radioimmunoassay can be used as a biochemical marker in metabolic bone diseases and metastatic cancer for the disgnosis and the assessment of prognosis or the effect of treatment.
Arthritis, Rheumatoid ; Biomarkers ; Bone Diseases ; Bone Diseases, Metabolic ; Bone Remodeling ; Female ; Humans ; Male ; Metabolism ; Ossification, Heterotopic ; Osteoblasts ; Osteocalcin ; Osteogenesis ; Osteogenesis Imperfecta ; Osteoporosis ; Osteoporosis, Postmenopausal ; Prognosis ; Radioimmunoassay ; Spondylitis, Ankylosing ; Vitamins

Iatrogenic damage of the rotator cuff followed by postoperative shoulder function loss is a potential complication after antegrade intramedullary nailing (AIN) for a humeral fracture. The authors present a case of arthroscopic rotator cuff repair and subacromial decompression of a non-healed rotator cuff tendon (mainly supraspinatus) and secondary impingement syndrome caused either by the tear or a proud nail after AIN for a mid-shaft humeral fracture. At presentation, the patient complained of right shoulder pain and 'snapping', especially during forward elevation and abduction of the shoulder, of 4 years duration. Right shoulder pain started sometime after pain due to the humeral shaft fracture, operation had subsided, and persisted after nail removal. Arthroscopic findings showed a longitudinal rotator cuff tear at the nail entry point that had not healed and severe fibrous hypertrophy on the acromion underspace, which is a unique finding since most longitudinal splits of tendon fibers are more likely to heal than conventional rotator cuff tears detached from bone. The torn rotator cuff was repaired after debridement and placing side-to-side sutures. At his 34-month follow-up after rotator cuff repair, the patient showed complete recovery and had excellent clinical scores.
Acromion ; Arthroscopy ; Debridement ; Decompression ; Follow-Up Studies ; Fracture Fixation, Intramedullary* ; Humans ; Humeral Fractures ; Hypertrophy ; Rotator Cuff ; Shoulder ; Shoulder Pain ; Sutures ; Tendons

No abstract available.
Cerebral Hemorrhage* ; Eclampsia* ; Female ; Pregnancy

The knee joint is one of the most susceptable joint to ligamentous injury. For good results, it is very important to make an early diagnosis and to give prompt management. The aim of treatment is to restore the ligaments to their previous anatomic position and tension. The authors reviewed 420 cases of ligamentous injuries in 400 patients who were admitted and managed for 6 years from March, 1981 to February, 1987. The results were as follows : 1. The athletic injury was the most commcn cause of injury(55%), and fall-down was next(26%). 2. The most common ruptured individual ligament was the medial collateral ligament. Combined ligament rupture was more common in medial collateral ligament and anterior cruciate ligament. 3. The ruptured sites of the individual ligament were found to be the following ; a) the medial collateral ligament was ruptured most frequently at the femoral attachment(43%), with the superficial layer ruptured in the midsubstance and the deep layer at the femoral attachment; b) the lateral collateral ligament torn at the fibular attachment(51%); c) the anterior cruciate ligament torn at the femoral attachment(39%); d) the posterior cruciate ligament torn at the femoral attachment(64%). 4. Many ligamentous injuries were associated with fracture(44%) and tear of meniscus- (42%). 5. In stress-radiogram, the significance of ligament injuries was present in more than 10 and 10 mm. 6. Excellent and good results were obtained in 94% by non-surgical treatment and in 92% by surgical treatment. 7. Early surgical repair of the ligament within 2 weeks after injury, gave much better result than later repairs.
Anterior Cruciate Ligament ; Athletic Injuries ; Clinical Study ; Collateral Ligaments ; Early Diagnosis ; Humans ; Joints ; Knee Joint ; Knee ; Lateral Ligament, Ankle ; Ligaments ; Posterior Cruciate Ligament ; Rupture ; Tears

The main problem in peripheral nerve repair is adhesion, axonal escape, and the ingrowth of extraneurial tissue into the wound. Meticulous microsurgical neurorrhaphy is one of possible answer for these problem. Shielding of nerve suture is another attractive practice. But the results are still unpredictable. We compared the results of nerve repair between microsurgical epineurial neurorrhaphy plus silastic cuff shielding group and epineurial neurorrhaphy group in the sciatic nerve of white rat. The reasults we obtained are as follows; 1. Silastic cuff shielding method was effective for reducing abnormal neurial growth and neuroma formation into the surrounding soft tissue. 2. Some adhesion was formed over the silastic cuff, but there was no adhesion at the inner space of the cuff. 3. Silastic cuff could prevent fibrous tissue ingrowth into the nerve. 4. The slit of the silastic cuff provided vascular ingrowth between surrounding connective tissue and nerve tissue. 5. No evidence of foreign body reaction was observed in and out of the silastic cuff. 6. Nerve conduction test showed a little supperior results in the silastic cuff shielding group. Silastic cuff shielding method in nerve suture might be recommanded to prevent axonal escape, fibrous scar tissue ingrowth to the nerve, and fibrous adhesion in clinical practice. But, it seemed that the final evaluation of the functional recovery of the nerve needed long term follow-up and nerve conduction study.
Animals ; Axons ; Cicatrix ; Connective Tissue ; Follow-Up Studies ; Foreign-Body Reaction ; Methods ; Nerve Tissue ; Neural Conduction ; Neuroma ; Peripheral Nerves ; Rats ; Sciatic Nerve ; Sutures ; United Nations ; Wounds and Injuries

No abstract available.
Animals ; Rats* ; Sepsis*

In order to extract useful tumor cell-specific information. DNA contents and other morphological parameters were measured by image analysis. Single cell preparation was made from archived paraffin blocks of 14 cases of bronchogenic squamous cell carcinoma, poorly differentiated, by protease treatment. The cells were Feulgen stained, and DNA content, area, perimeter, and major axis of the tumor cell nuclei were measured. Inflammatory lymphocytes concurrent with the tumor cells were used as an internal standard. DNA ploidies of the lymphocytes and 2C tumor cells showed simple peaks with Gaussian distribution and mean coefficients of variation of 10% and 14% respectively. By the location and proportion of the tumor cells other than 2C cells, DNA ploidies could be classified into diploidy(1 case), polyploidy(2 cases), and aneuploidy(11 cases). The mean proportion of DNA aneuploidal tumor cells relative to the total tumor cells was 82.8%. In 8 cases, nuclear areas showed more or less overlapped distribution, whereas DNA contents showed discrete peaks. THes results suggest that many bronchogenic squamous cell carcinomas, poorly differentiated, have DNA aneuploidy and high proportion of aneuploidal cells, and that nuclear size and DNA content are more or less independent parameters.

BACKGROUND/AIMS: Transforming growth factor-a(TGF-a) is a polypeptide cytokine related to cell proliferation and transformation. TGF-a binds to EGF receptor and stimulating DNA synthesis in liver cell. The hepatitis B virus (HBV) by itself is also believed to play a role in the hepatic carcinogenesis. Recently, it was reported that TGF-a and HBV were synergistic in action with rapid appearance of hepatocelluar carcinoma in bitransgenic mice. Although TGF- a is thought to play an important role in hepatocarcinogenesis, its expression during the natural history of HBV hepatitis was poorly understood. This investigation was performed to elucidate the dynamic changes and istinct immunohistochemical staining patterns in the course of chronic HBV hepatitis with specific reference to hepatocelluar carcinoma and to explain the role of TGF-a in the pathogenesis of hepatocelluar carcinoma. MATERIALS/METHODS: Employing TGF-a monoclonal antibody, signal detection was carried out by peroxidase-conjugated streptavidin in deparaffinized liver tissue sections taken from HBsAg positive patients. All of the liver tissue sections were proven HBV DNA positive by in situ hybridization. Immunohistochemical staining was performed in the tissue sections obtained from four normal controls, six from patients with chronic persistent hepatitis, five with chronic active hepatitis, eight with liver cirrhosis and eleven with hepatocellular carcinoma. RESULTS: The patterns of TGF-a immunoreactivity were cytoplasmic-grain types in normal controls and chronic persistent hepatitis, honeycomb types in chronic active hepatitis, occasional cytoplasmic-flooding types in liver cirrhosis, and cytoplasmic-grape types in hepatocellular carcinoma. A Shapiro-Wilk W test for frequency table analysis for the expression of TGF-a in these different disease groups was statistically significant. CONCLUSION: These data suggest that step-wise distinct expression of TGF-a enhancement in HBV associated chranic liver diseases which eventually resulted in the development of hepatocellular carcinoma were conceivably due to dysregulation of liver cell cycles by both HBV and TGF-a during the persistent repetition of cell cycles.
Animals ; Carcinogenesis ; Carcinoma, Hepatocellular* ; Cell Cycle ; Cell Proliferation ; DNA ; Hepatitis ; Hepatitis B Surface Antigens ; Hepatitis B virus ; Hepatitis, Chronic* ; Humans ; In Situ Hybridization ; Liver Cirrhosis* ; Liver Diseases ; Liver* ; Mice ; Natural History ; Receptor, Epidermal Growth Factor ; Streptavidin

No abstract available.
Female ; Meigs Syndrome*

OBJECTIVE: The involvement of IGF system in hyperandrogenism and abnormal follicular development is controversial. This study is to assess whether IGF system contribute to it in the women with polycystic ovary(PCO). METHODS: Baseline serum levels of luteinizing hormone (LH), follicle stimulating hormone (FSH), estradiol (E2), testosterone (T), androstenedione (ADD), prolactin, thyroid stimulating hormone (TSH), free insulin-like growth factor(IGF)-I, free IGF-II, insulin-like growth factor binding protein(IGFBP)-1, and IGFBP-3 were measured in twelve healthy regularly cycling volunteers and forty-two women with PCO then, the changes of baseline serum levels were evaluated after laparoscopic ovarian electrocauterization in nine PCO patients. In addition, the expression pattern of IGF-I and IGF-II was examined in the ovary of control and PCO group. RESULTS: Baseline levels of LH, ADD, free IGF-II, and IGFBP-3 were significantly higher in PCO group. However, there were no significant differences in the levels of free IGF-I and IGFBP-1, although free IGF-I showed decreasing tendency in PCO group. And there was a significant positive correlation between the LH and free IGF-II level in the PCO(P=0.011, r2=0.3899), but not in the control. After ovarian electrocauterization, LH, T, and ADD levels decreased, and free IGF-I and IGFBP-3 level increased. While free IGF-II and IGFBP-1 level showed no significant changes. In the ovary, expression of both IGFs showed similar pattern in normal and PCO ovaries. CONCLUSIONS: The elevated IGFBP-3 level may alter the bioavailability of IGF(s) in the PCO. The change in IGF-I level and resumption of ovulation after electrocauterization, suggest a possible role of IGF system in the impairment of follicular development in the PCO.
Androstenedione ; Biological Availability ; Carrier Proteins* ; Estradiol ; Female ; Follicle Stimulating Hormone ; Humans ; Hyperandrogenism ; Insulin-Like Growth Factor Binding Protein 1 ; Insulin-Like Growth Factor Binding Protein 3 ; Insulin-Like Growth Factor I ; Insulin-Like Growth Factor II ; Luteinizing Hormone ; Ovary* ; Ovulation ; Prolactin ; Somatomedins* ; Testosterone ; Thyrotropin ; Volunteers