No abstract available.
Ultrasonography, Prenatal*

PURPOSE: To compare the clinical? results and stability of acute and chronic reconstruction of anterior cruciate ligament (ACL). MATERIALS AND METHODS: Patients who had ACL reconstruction with a quadruple hamstring tendon and ligament anchor (LA) screw with a minimum 2-year follow-up were included in this study. Acute (within 4 weeks) reconstruction group was composed of 27 knees and chronic (over 3 months) group was 44 knees. We compared the two groups with regard to Lysholm knee score, range of motion, thigh circumference, Lachman test, Tegner activity scale, associated meniscal injuries, and anterior laxity difference by Telos stress arthrometer. RESULTS: At last follow-up, no significant differences were found between the acute and chronic groups for Lysholm score, range of motion, Lachman test, Tegner activity scale, and instrumental laxity. 16 cases (59%) of acute and 33 cases (75%) of chronic patients had a meniscal injuries of which were reparable in 5 cases (28%) and 7 cases (17%). CONCLUSIONS: Acute reconstruction of ACL had excellent clinical and radiologic results as good as the chronic group without motion problem.
Anterior Cruciate Ligament* ; Follow-Up Studies ; Humans ; Knee ; Ligaments ; Range of Motion, Articular ; Tendons ; Thigh

Purpose: To evaluate the clinical and radiological results of a new innominate osteotomy in Legg-Calve-Perthes' disease (LCPD). Materials and Methods: This study examined 25 hips that were treated with a new innominate osteotomy for LCPD. The treatment involved the anterior half of the ilium being osteomized in a direction of 45degrees to the coronal plane and 30degrees to 45degrees to the sagittal plane, and the posterior half of the ilium being cut using a Gigli saw according to the conventional method. The mean follow-up duration was 5.5 years. Stable interposition of the bone block was achieved using a single biodegradable screw in 8 hips, and without any fixation device in 17 hips. Results: The clinical results according to the criteria of Robinson were good in 20 hips. Twelve hips was graded as good by the Mose method, according to the criteria of Stulberg, 8 hips were included in class I, 6 hips in class II, 8 hips in class III, and 3 hips in class IV. The mean center-edge angle improved from 19.4degrees to 30.2degrees. Conclusion: The new innominate osteotomy is simpler and easier to perform than a routine Salter osteotomy, and satisfactory clinical results can be obtained without fixing the Kirschner wire.
Follow-Up Studies ; Hip ; Ilium ; Osteotomy*

PURPOSE: The serial radiographs of 64 children with unilateral developmental dislocation of the hip (DDH) were reviewed in order to follow the natural hip development with age after a concentric reduction. MATERIALS AND METHODS: All patients were treated with a closed (22 patients) or open reduction (42 patients) and were followed up to the age of skeletal maturity. The radiographic measurements including the acetabular angle (AA), Sharp angle (SA), center-edge angle (CEA), acetabulum-head index (AHI) and neck-shaft angle (NSA) were obtained in 6 age groups; 0-2 years, 2-4, 4-8, 8-12, 12-16, 16 and over. RESULTS: The rate of acetabular development evaluated by both the AA and SA, was greatest before 4 years of age and continued to a lesser extent until skeletal maturity. The neck-shaft angle also continuously and gradually improved after the concentric reduction until skeletal maturity. Acetabular coverage of the femoral head, which was evaluated by the CEA and AHI, reached the normal level in the 8-12 year age group and was maintained a normal level through to skeletal maturity. CONCLUSION: The hip dysplasia continued to improve until skeletal maturity. Therefore, it is recommended that secondary surgery should not be performed if the X-ray shows continuous improvement and a concentric reduction is maintained.
Acetabulum ; Child ; Dislocations* ; Follow-Up Studies* ; Head ; Hip Dislocation ; Hip* ; Humans

BACKGROUND: Intravenous injection of mesenchymal and hematopoietic stem cells (MSCs, HSCs) has the disadvantages of low delivery rate to bone marrow and sequestration of cells in the lung and liver. This study was designed to determine whether there is a relationship between the administration route and dosage of stem cells and GVHD and survival. METHODS: MSCs were retrieved from five subcultured C3H/10T1/2, cell lines from C3H/He mice. HSCs were transplanted by injecting 1 x 10(7) of bone marrow mononuclear cells and 5 x 10(6) of spleen cells from six to eight week old female C3H/He mice into six week old irradiated female BALB/c mice. The groups were divided into intravenous injection (IV) and intra-marrow (IM) injection groups. IV and IM+MSC groups consisted of mice transplanted with the same bone marrow mononuclear cells and SP, IV and IM groups, with the additional co-injection of 1 x 10(6) MSCs. RESULTS: Evaluation of all mice, in both groups, showed no difference in GVHD and survival. However, high dose injection with 1 x 10(6) MSCs led to a decreased incidence of GVHD (P<0.05) and improved survival (P<0.01) in both groups. CONCLUSION: The results of this study showed that the positive effects of MSC on GVHD and survival were primarily dependent on the number of injected cells.
Animals ; Bone Marrow ; Cell Line ; Female ; Graft vs Host Disease* ; Hematopoietic Stem Cell Transplantation* ; Hematopoietic Stem Cells* ; Humans ; Incidence ; Injections, Intravenous ; Liver ; Lung ; Mesenchymal Stromal Cells* ; Mice ; Spleen ; Stem Cells ; Transplants*

PURPOSE: This study was performed to determine the feasibility and safety of the use of induction chemotherapy combined with docetaxel, cisplatin, and 5-fluorouracil (TPF) followed by concurrent chemoradiation therapy for locally advanced squamous cell carcinoma of the head and neck (SCCHN). MATERIALS AND METHODS: The patients, that were initially not treated for locally advanced SCCHN, underwent three cycles of induction chemotherapy every 3 weeks at a dose of 70 mg/m2 docetaxel D1, 75 mg/m2 cisplatin D1, 1000 mg/m2 5-FU D1-4, and subsequently received concurrent chemoradiation therapy. RESULTS: Forty-nine patients were enrolled in this study and forty-three of the patients completed the treatment. The median duration of follow-up was 18 months (range, 6~39 months). All of the patients had stage III (26.5%) or IV (73.5%) squamous cell carcinoma. After sequential therapy, a complete response and partial response was seen in 28 (65.2%) and 13 (30.2%) patients, respectively. The overall response rate was 95.4%. Overall survival and progression-free survival (PFS) at 2 years were 88.7% and 69.7%, respectively. Grade 3~4 neutropenia occurred in 42.2% of the patients and grade 4 thrombocytopenia in 1 cycle (0.7%). Two patients (4.1%) died during the induction chemotherapy due to pneumonia and a subdural hemorrhage, respectively. The group of patients over 65 years of age showed a significant lower dose intensity than that of patients under 65 years of age, but PFS was not significantly different between two groups (p=0.105). CONCLUSION: TPF induction chemotherapy followed by concurrent chemoradiotherapy showed a high level of CR and moderate treatment-induced toxicity. Adequate dose modification in elderly patients should be considered to maintain efficacy and avoid treatment-related toxicity.
Aged ; Carcinoma, Squamous Cell ; Chemoradiotherapy* ; Cisplatin* ; Disease-Free Survival ; Drug Therapy, Combination ; Fluorouracil* ; Follow-Up Studies ; Head and Neck Neoplasms* ; Head* ; Hematoma, Subdural ; Humans ; Induction Chemotherapy* ; Neck ; Neutropenia ; Pneumonia ; Radiotherapy ; Thrombocytopenia

BACKGROUND: The aim of this study was to assess the efficacy and toxicity of thalidomide-containing regimens as the first-line therapy for patients with multiple myeloma. METHODS: A total of 60 patients were initially treated with thalidomide-containing regimens at three institutions. Thalidomide was given with two different regimens: the TD regimen (thalidomide and dexamethasone) and the TCD regimen (thalidomide, cyclophosphamide, and dexamethasone). Autologous peripheral blood stem cells (PBSC) were collected after mobilizing with G-CSF with or without cyclophosphamide. RESULTS: Of all the patients, 56 patients (TD regimen: 12 patients, TCD regimen: 44 patients) who received at least 4 cycles or more were evaluated for response and toxicity. The median age of the patients was 65.5 years (age range: 39~80 years). The overall response rate for the thalidomide-containing regimens was 85.5%. There were 3 (25%) complete responses and 6 (50%) partial responses for the TD regimen and there were 17 (38.6%) complete responses and 21 (47.7%) partial responses for the TCD regimen, respectively. The toxicity, according to the NCI-CTC (grade 3/4) included neutropenia in 7 patients (12.5%), thrombocytopenia in 4 patients (7.1%), infection in 6 patients (10.7%) and neuropathy in 10 patients (17.8%). In addition, there were 2 patients (3.6%) with thrombosis. Thirteen patients, who achieved more than a partial response to the thalidomide-containing regimen, proceeded to PBSC collection and the median number of CD34+ cells collected was 3.8 x 106/kg. CONCLUSION: Thalidomide-based combination chemotherapy is a safe, well tolerated and effective regimen for patients with newly diagnosed multiple myeloma, and it showed a high response rates, relatively low toxicity and sufficient collection of PBSCs.
Cyclophosphamide ; Drug Therapy, Combination ; Granulocyte Colony-Stimulating Factor ; Humans ; Multiple Myeloma* ; Neutropenia ; Stem Cells ; Thalidomide* ; Thrombocytopenia ; Thrombosis

We measured serum lipoprotein (a) [Lp (a)] concentrations in 304 uremic patients treated on predialysis, hemodialysis (HD) and continuous ambulatory peritoneal dialysis (CAPD), and compared them with those in 43 normal controls. The mean values were 46.1mg/dl in predialysis, 35.7mg/dl in HD, 54.7mg/dl in CAPD patients and 17.0mg/dl in controls, respectively. Serum Lp (a) levels were elevated both in the predialysis patients (P<0.001) and in the CAPD patients (P<0.001) compared with those in controls, and were also elevated in the CAPD patients (P<0.01) compared with HD patients. Serum Lp (a) levels tended to be higher in HD patients compared with controls, although these differences did not reach statistical significance. We observed statistically significant positive correlations of Lp (a) to serum levels of total cholesterol (TC) (r=0.279, P<0.01), LDL-cholesterol (r=0.335, P<0.01), and Apo (B) (r=0.352, P<0.01), and significant negative correlation of Lp (a) to serum level of albumin (r=-0.278, P<0.01) in 304 CRF patients. CAPD patients had a more atherogenic lipoprotein profile than did HD patients; besides significantly higher Lp (a) levels (P<0.01), total (P<0.001) and LDL (P<0.001) cholesterol, triglycerides (P<0.05), and apo (B) (P<0.001) were significantly elevated in comparison to HD patients. The marked elevation of serum Lp (a) in patients on CAPD may be due to increased hepatic synthesis as a consequence of the substantial amounts of plasma proteins lost in the dialysate. The increased serum concentrations of Lp (a) may contribute to the high risk for atherosclerosis in end stage renal disease, especially in patients treated by CAPD.
Atherosclerosis ; Blood Proteins ; Cholesterol ; Humans ; Kidney Failure, Chronic* ; Lipoprotein(a) ; Lipoproteins* ; Peritoneal Dialysis, Continuous Ambulatory ; Renal Dialysis ; Triglycerides

PURPOSE: Calcium ionophore (CI) is used to generate dendritic cells (DCs) from progenitor cells, monocytes, or leukemic cells. The aim of this study was to determine the optimal dose of CI and the appropriate length of cell culture required for acute myeloid leukemia (AML) cells and to evaluate the limitations associated with CI. MATERIALS AND METHODS: To generate leukemic DCs, leukemic cells (4 x 10(6) cells) from six AML patients were cultured with various concentrations of CI and/or IL-4 for 1, 2 or 3 days. RESULTS: Potent leukemic DCs were successfully generated from all AML patients, with an average number of 1.2 x 10(6) cells produced in the presence of CI (270 ng/ml) for 2 days. Several surface molecules were clearly upregulated in AML cells supplemented with CI and IL-4, but not CD11c. Leukemic DCs cultured with CI had a higher allogeneic T cell stimulatory capacity than untreated AML cells, but the addition of IL-4 did not augment the MLR activity of these cells. AML cells cultured with CI in the presence or absence of IL-4 showed increased levels of apoptosis in comparison to primary cultures of AML cells. CONCLUSION: Although CI appears to be advantageous in terms of time and cost effectiveness, the results of the present study suggest that the marked induction of apoptosis by CI limits its application to the generation of DCs from AML cells.
Apoptosis ; Calcium* ; Cell Culture Techniques ; Cost-Benefit Analysis ; Dendritic Cells ; Humans ; Interleukin-4 ; Leukemia, Myeloid, Acute ; Monocytes ; Stem Cells

Primary non-Hodgkin's lymphoma of bone (PLB) is rare, and generally presents as a single extensive and destructive bone lesion. Histopathologically, most cases present as diffuse large B-cell lymphoma, and T-cell lymphoma is rare. By contrast, multiple myeloma is a disease defined as the neoplastic proliferation of a single clone of plasma cells producing a monoclonal immunoglobulin. We report a case of multiple myeloma that developed during treatment of PLB in a type of T-cell. A 48-yr-old man was diagnosed as T-cell PLB, stage IE, 18 months ago. The patient received the chemoradiotherapy and salvage chemotherapy for PLB. However, the lymphoma progressed with generalized bone pain, and laboratory findings showed bicytopenia and acute renal failure. On bone marrow biopsy, the patient was diagnosed as having multiple myeloma newly developed with primary T-cell lymphoma of bone. In spite of chemotherapy, the patient died of renal failure.
Bone Neoplasms/*complications/diagnosis/therapy ; Fatal Outcome ; Humans ; Kidney Failure, Acute/etiology ; Lymphoma, T-Cell/*complications/diagnosis/therapy ; Male ; Middle Aged ; Multiple Myeloma/*complications/diagnosis/therapy