STUDY DESIGN: Posterior and posterolateral fusions were performed in rabbit lumbar spines. OBJECTIVES: To investigate the osteoinductive effect of polyphosphates. SUMMARY AND LITERATURE REVIEW: Inorganic polyphosphates are known to be rich in osteoblasts and involved in the mineralization process in bone metabolism. However, no study has been undertaken to investigate the osteoinductive effect of polyphosphates. MATERIALS AND METHODS: Forty adult New Zealand white rabbits underwent monolevel lumbar fusions, and were divided into two groups according to the fusion beds: twenty each between the laminae (posterior fusion group, PF group) and between the transverse processes (posterolateral fusion group, PLF group). In ten of twenty rabbits in the PF group, 0.8gm of autogenous iliac bone was grafted onto the right sides of the laminae, which were used as a control group (C1), with 0.4gm autogenous bone immersed in polyphosphate solution in the left sides as an experimental group (E1). In the other ten, 0.8gm of autogenous bone was grafted onto the right sides (C2) and 0.8gm of tricalcium phosphate porous blocks containing polyphosphate in the left sides (E2). The other twenty rabbits of the PLF group were similarly divided into C1, E1, C2 and E2 groups by grafting the same amount of materials between the transverse processes. The animals were sacrificed at the 16th postoperative week and the fusions evaluated grossly, radiologically and histologically. Statistical differences between the groups (C1 vs. E1, C2 vs. E2 and E1 vs. E2) in each of the PF and PLF groups were compared by chi-square tests. RESULTS: The fusions were finally determined by the gross finding using manual palpation. In the PF group, bony fusions were obtained in 90, 80, 90 and 70% of the C1, E1, C2 and E2 groups, respectively. In the PLF group, these were 80, 70, 60 and 0% of the C1, E1, C2 and E2 groups, respectively. Statistical analysis revealed differences only between C2 and E2 (p=0.005), and between E1 and E2 (p=0.002) of the PLF group. Histologically, beta-tricalcium phosphate particles containing polyphosphate were transformed into the osteoid in some areas of the PLF-E2 group, although only fibrous unions were obtained grossly. CONCLUSIONS: It is suggested that the polyphosphate may have an osteoinductive effect, even though the osteoinductive potency was very week in this fusion model of the rabbit lumbar spine. Therefore, further explorations, such as the threshold and optimal concentrations of polyphosphate in vivo and the best carrier material of polyphosphate, should be performed to obtain the optimal conditions for fusion.
Adult ; Animals ; Bone Regeneration ; Humans ; Metabolism ; Osteoblasts ; Palpation ; Polyphosphates ; Rabbits ; Spine* ; Transplants

No abstract available.
Dysgerminoma* ; Female ; Ovary*

A clinicopathologic study was per formed on 14 cases of malignant nondysgerminomatous ovari an germ cell tumors(NDOGCT) treated at the department of obstetrics and gynecology in Korea Cancer Center Hospital between Jan. l987 and,Jun. 1992. The results obtained were as follows ; 1. Median age of the patients was 27.5 years (range, 5 to 54) 2.Clinical symptoms presented were abdminal pain(64.3%), abdominal palpable mass(42.9%), abdominal distension(28.5%) in order of frequency. 3. Histopathologically, 7 cases(50%) were irnmature teratoma, 4 cases(28.6%) were endoder mal sinus tumor, 1 case(7.1%) was embryonal cell carcinoma, 2 cases(14.3%) were mixed germ cell tumor. 4. Bystage, 6 casse(42.9%) were in stage I, 1 case(7.1%) in stage Il, 2 cases(14.3%) in stage III, 3 cases(21.4%) in stage IV, and 2 cases(14.3%) in recurrence. 5, Serum alphafetoprotein was elevated in all patients withendodermal sinus tumor or embryonal carcinoma, and serum CA125 was elevated in about one half of the patients with nondysgerminomatous gerrn cell tumr. 6. l0 cases were managed by salpingo-oophorectomy with poatoperative chemotherapy, 3 cases by hysterectamy and salpingo-oophorectomy with postoperative chemotherapy. 7. Durations of follow up ranged 5 to 66 months, in that period, 5 cases were died, 4 cases were alive with disease and 4 casee wero no evidence of disease. 1 case was loat follow up after operation. All 5 patients were alive who had been treated with REP regirnen. In conelusion, prognosis of malignant NDOGCT is still poor in spite of adjuvant chemotherapy following surgery, and study ineluding appropriate chemotherapeutic regimen may be needed.
Carcinoma, Embryonal ; Chemotherapy, Adjuvant ; Drug Therapy ; Follow-Up Studies ; Germ Cells* ; Gynecology ; Humans ; Korea ; Neoplasms, Germ Cell and Embryonal* ; Obstetrics ; Phytolacca dodecandra ; Prognosis ; Recurrence ; Teratoma

PURPOSE: To determine the necessity of an additional posterior lumbar interbody fusion (PLIF) after a posterolateral fusion (PLF) for the treatment of degenerative spondylolisthesis (DS). MATERIALS AND METHODS: A retrospective study, after a minimum follow-up of 2 years was conducted on forty patients who underwent a single level decompression and instrumented fusion for DS with spinal stenosis at the L4-5 level. A PLF was performed in 21 patients, and a circumferential fusion (CF) with an additional PLIF in 19 patients. According to the fusion methods and preoperative segmental mobility, the patients were divided into four groups; s-PLF group (PLF in the stable group, n=13), s-PLIF group (CF in the stable group, n=11), u-PLF group (PLF in the unstable group, n=8), and u-PLIF group (CF in the unstable group, n=8). Clinical and radiographic comparisions between the PLF and PLIF groups were performed. RESULTS: The mean decrements of Oswestry Disability Index (Visual Analog Scale) scores were 29% (5.5), 29% (5.9), 22% (2.6) and 42% (5.9) respectively for the s-PLF, s-PLIF, u-PLF and u-PLIF groups, and a statistical difference was found only between the u-PLF and u-PLIF groups (ODI: p=0.032, VAS: p=0.004). Fusion rates were 92%, 100%, 88% and 100% respectively. The mean slip angle increments were serially 2.5 degrees, -3.1 degrees, -1.5 degrees and -0.3 degrees, and the mean percent slip decrements were 6.7%, 8.7%, 5.1% and 3.7%, and the mean disc height increments were -0.4 mm, 1.8 mm, 0.5 mm and 3.0 mm, and the mean lumbar lordosis increments were 8.6 degrees, 4.7 degrees, -1.9 degrees and 1.9 degrees and the mean sacral tilt increments were 3.8 degrees, 3.4 degrees, -1.3 degrees and 0.9 degrees. Statistical differences were found only between the s-PLF and s-PLIF groups in slip angle increments (p=0.029) and between the s-PLF and s-PLIF groups (p=0.043) and between the u-PLF and u-PLIF groups (p=0.042) in disc height increments. CONCLUSION: PLF alone provided successful clinical outcome in stable group, but CF provided better clinical outcomes in the unstable groups. This study suggests that preoperative segmental mobility may be a criterion to determine whether or not an additional PLIF is necessary in the treatment of lumbar DS.
Animals ; Decompression ; Follow-Up Studies ; Humans ; Lordosis ; Retrospective Studies ; Spinal Stenosis ; Spondylolisthesis*

No abstract available.
Adenocarcinoma* ; Uterus*

PURPOSE: To compare the radiological and clinical results of Wayne-County reduction with anatomical reduction in treatment of the intertrochanteric fractures of the femur in elderly patients. MATERIALS AND METHODS: Among one hundred-three of intertrochanteric fractures treated with 135- degree angled compression hip scresw, eighty three cases treated by Wayne-County reduction (Group 1, 42 cases) and anatomical reduction (Group 2, 41 cases) with at least 1 year follow-up were reviewed. The average pateint ages were 72.4 (65~92) in group 1, 71.6 (65~89) in group 2, respectively. 33 cases (75.2%) in group 1 and 31 cases (77.5%) displayed unstable fractures by Jensen classification. The radiological observation was included neck-shaft angle, penetrating length of lag screw into head, sliding length of lag screw and time of bony union. The clinical results were evaluated by Koval criteria, Kyle's functional evaluation, leg length inequality and complications. RESULTS: There were no significant changes between group 1 and group 2 in stable fractures in the radiological and clinical results. In unstable fractures, the neck-shaft angle averaged 132.2 degree in group 1 and 129.4 degree in group 2 in the final follow-up films. The penetrating length of lag screw into head were 2.2 mm in group 1 and 3.1 mm in group 2 (p<005). But there were little differences in the sliding length of lag screw, the time of bony union and complication rates between groups. In post- operative evaluation of walking abilility by Koval, 31 patients (73.8%) in group 1 and 28 (68.3%) recovered the activity level before injury by the postoperative 1 year follow-up. Leg length discrepancy at final follow-up was 4.1+/-6 mm shortening in group 1 and 6.5+/-8 mm in group 2, respectively. CONCLUSION: Both Wayne-County reduction and anatomical reduction had a favorable results after treatment of stable intertrochanteric fractures of the femur, but Wayne-County reduction may be a better method in treatment of unstable fractures, especially in elderly patients, in which it is difficult to obtain anatomical reduction.
Aged* ; Classification ; Femur* ; Follow-Up Studies ; Head ; Hip ; Hip Fractures* ; Humans ; Leg ; Leg Length Inequality ; Walking

BACKGROUND/AIMS: In Korea, few studies have examined primary cardiac tumors, which have a reported incidence of 0.0017~0.19% in autopsy series. This study surveyed the status of primary cardiac tumors over the past 7 years in one region. METHODS: A retrospective review examined all patients with primary cardiac tumors, except for confirmed thrombus, using hospital medical records from 2000 to 2006 at six community hospitals. Identified cases undergoing biopsy and surgery were selected for the study. RESULTS: The operative mortality was 7.7%. Of the 71 patients (26 males) with identified primary cardiac tumors, 65 (91.5%) tumors were benign and 6 (8.5%) were malignant. The benign tumors were myxoma (78.9%), rhabdomyoma (4.2%), fibroelastoma (2.8%), fibroma (1.4%), and leiomyoma (1.4%). Two of the myxomas were present at multiple locations. The malignant tumors included sarcomas (67%) and lymphomas (33%). Most of the tumors were located in the left atrium (76%). The majority of patients presented with chest pain and dyspnea. During follow-up for an average of 26.8+/-21.3 months, all but one patient with benign tumors was alive; one myxoma patient died perioperatively (1.5%). Four of the patients with malignant tumors (67%) died. CONCLUSIONS: Cardiac myxomas and sarcomas were the most common primary benign and malignant tumors, respectively. Benign tumors had excellent postoperative survival rates, while malignant tumors had high mortality.
Autopsy ; Biopsy ; Chest Pain ; Dyspnea ; Fibroma ; Follow-Up Studies ; Heart Atria ; Heart Neoplasms ; Hospitals, Community ; Humans ; Incidence ; Korea ; Leiomyoma ; Lymphoma ; Medical Records ; Myxoma ; Retrospective Studies ; Rhabdomyoma ; Sarcoma ; Survival Rate ; Thrombosis