Platelet-derived growth factor(PDGF) is known to accelerate soft tissue fracture and periodontal bone healing, but little information is available for characterizing the healing of articualr cartilage. This study was designed to demonstrate the regeneration potential of pasteurized autogeneous osteochondral graft when PDFG was applied locally in vivo. Eighteen rabbits in two groups were used in the experiment. The free osteochondral fragment(1x1x1 cm) were taken from distal femur. The fragment were pasteurized in 65degrees C for 5 minutes. In experimental group(group II), the fragment were soaked in 0.25 mg/ml of recombinant human PDGF mixed 5 ml normal saline and reimplanted to the resected site, and followed with local administration of 0.25 mg/ml PDGF to knee joint. In control group(group I), the pasteurized fragment were reimplanted in the resected site without any treatments. The histologic characteristics of the transplanted autografts for three rabbits in each group were observed at 3, 5 and 7 weeks postoperatively. The results were as follows; Group II revealed the more favorable regeneration of articular cartilage, less arthritic changes and more mature arrangement of chondrocytes than group I. Even thought the cartilage is avascular and the regeneration capacity of pasteurized cartilage is severely limited, the regeneration of grafted articular cartilage is thought to be accellerated by increased newly formed blood vessels and soft tissues due to the diffusion of PDGF on grafted cartilage, and probably also by differentiation of mesenchymal cells in the initial stage of experiment. The results of this study suggest that local administration of PDGF could be used for the treatment of posttraumatic or degenerative arthritis and various cartilage damages.
Autografts ; Blood Vessels ; Cartilage ; Cartilage, Articular ; Chondrocytes ; Diffusion ; Femur ; Humans ; Knee Joint ; Osteoarthritis ; Platelet-Derived Growth Factor* ; Rabbits* ; Regeneration* ; Transplants*

Acute urinary retention is a common complication following anorectal surgery. However, the cause of this complication is poorly understood. We investigated the influence on postoperative urinary retention of age, sex, premedicants, intraoperative fluid volume administered, surgeon, operating time, type of operation, anesthetic technique in 278 patients undergoing elective surgery for benign anorectal disease by a review of the charts. The results were as follows. The overall urinary retention rate was 31.7%. Age, sex, premedicants (narcotics, anticholinergics), surgeon did not correlate with urinary retention. Increasing age was associated with a relatively high incidence of urinary retention, but the difference did not reach statistical significance (P=0.054). The variables of intraoperative fluid volume administered (>200 ml), anesthetic technique (spinal anesthesia vs. general or caudal anesthesia), type (hemorrhoidectomy, especially including multiple mucosal ligation or sphincterotomy) of the operation, and operating time (>30 min) correlated significantly with retention (P<0.05). Urinary retention was 2, 7 and 3 times more likely to occur in patients who had duration of operation more than 30 minutes, hemorrhoidectomy, and spinal anesthesia respectively. After all above variables were controlled for, duration and type of the procedure and anesthetic technique remained significantly correlated with retention (P<0.05). We concluded that operating time of more than 30 minutes, hemorrhoidectomy (especially using multiple mucosal ligations or sphincterotomy), and spinal anesthesia were significant precipitating factors, but could not determine whether age and intraoperative fluid volume administered were associated with urinary retention with this retrospective study.
Anesthesia ; Anesthesia, Spinal ; Hemorrhoidectomy ; Humans ; Incidence ; Ligation ; Precipitating Factors ; Retrospective Studies ; Urinary Retention*

The authors retrospectively reviewed the high resolution computed tomographic scans of 19 patients who had hematogenous or lymphangitic metastatic lung lesions. In all patients, the histologic diagnosis for primary cancers and the radiographic manifestations of pulmonary metastasis were established. Certain characteristic findings of metastatic lung tumors on HRCT scans were evident: uneven thickening of bronchovascular bundles, multiple small nodules, thickening of interlobular septum, and the presence of polygonal lines. The nodules are more predominent in hematogenous metastasis. The prevalent site of nodules is cortical portion of lung.
Diagnosis ; Humans ; Lung ; Neoplasm Metastasis* ; Retrospective Studies

OBJECTIVE:The purpose of this study is to evaluate the CT findings of the carcinoma of the ampulla of Vater and to differentiate from other periampullary carcinoma including the carcinoma of the distal common bile duct and pancreas head. MATERIALS AND METHODS: We retrospectively reviewed the CT findings of 13 cases of the carcinoma of the ampulla of Vater, 20 cases of the carcinoma of the distal common bile duct and 20 cases of the carcinoma of the pancreas head confirmed by pathology. Five millimeter consecutive settings of CT scan were performed in all cases on ampulla level with supine position. The CT findings were retrospectively evaluated in view of common bile duct dilatation, pattern of termination of bile duct, pancreatic duct dilatation, protruding mass in duodenal lumen, and regional lymph node metastasis. RESULTS: All case of the carcinoma of the ampulla of Vater(13/13) and distal common bile duct(20/20) showed common bile duct dilatation with abrupt termination. Among the 10 cases of the carcinoma of the pancreas head with common bile duct dilatation, five cases each had is abrupt termination(5/20) and gradual stenosis of bile duct(5/20). Five cases of the carcinoma of the ampulla of Vater(5/13) and four cases of the carcinoma of distal common bile duct(4/20) showed pancreatic duct dilatation and all cases of the carcinoma of pancreas head show pancreatic duct dialtation(20/20). Twenty cases of the carcinoma of the ampulla of Vater showed protruding mass in the medial wall of the second portion of the duodenum(12/13) but only one case of the carcinoma of the distal common bile duct(I/20) and five cases of the carcinoma of the pancreas head (5/20) had protruding mass in the duodenal lumen. Only one case of the carcinoma of the ampulla of Vater showed(1/13) regional lymph node metastasis but three cases of the carcinoma of the distal common bile duct(3/20) and 18 cases of the carcinoma of the pancreas head(18/20) showed regional lymph node metastasis. CONCLUSION: Common bile duct dilatation with abrupt termination, protruding mass in the duodenal lumen and rare lymph node metastasis in CT may suggest the carcinoma of the ampulla of Vater.
Ampulla of Vater* ; Bile ; Bile Ducts ; Common Bile Duct ; Constriction, Pathologic ; Dilatation ; Head ; Lymph Nodes ; Neoplasm Metastasis ; Pancreas ; Pancreatic Ducts ; Pathology ; Retrospective Studies ; Supine Position ; Tomography, X-Ray Computed

PURPOSE: To determine the usefulness of fluid attenuated inversion recovery(FLAIR) imaging for the in detection of high signal intensity of hippocampus or amygdala in mesial temporal sclerosis (MTS), compared with that of turbo spin-echo T2-weighted imaging. MATERIALS AND METHODS: Two neuroradiologists independently analyzed randomly mixed MR images of 20 lesions of 17 patients in whom MTS had been diagnosed, and ten normal controls. All subjects underwent both who performed both FLAIR and turbo spin-echo T2-weighted imaging, in a blind fashion. In order to determine hippocampal morphology, oblique coronal images perpendicular to the long axis of the hippocampus were obtained. The detection rate of high signal intensity in hippocampus or amygdala, the radiologists 'preferred imaging sequence, and intersubject consistency of detection were evaluated. Signal intensity in hippocampus or amygdala was considered high if substantially higher than signal intensity in the cortex of adjacent temporo-parietal lobe. RESULTS: In all normal controls, FLAIR and spin-echo T2-weighted images showed normal signal intensity in hippocampus or amygdala. In MTS, the mean detection rate of high signal intensity in hippocampus or amyg-dala, as seen on FLAIR images was 93%, compared with 43% on spin-echo T2-weighted images. In all cases in which signal intensity on FLAIR images was normal, signal intensity on spin-echo T2-weighted images was also normal. The radiologists preferred the contrast properties of FLAIR to those of spin-echo T2-weighted images. CONCLUSION: In the diagnosis of MTS using MRI, FLAIR images are more useful for the detection of high signal intensity of hippocampus or amygdala than are spin-echo T2-weighted images. In the diagnosis of MTS, FLAIR imaging is therefore a suitable alternative to spin-echo T2-weighted imaging.
Amygdala ; Axis, Cervical Vertebra ; Diagnosis ; Hippocampus ; Humans ; Magnetic Resonance Imaging ; Sclerosis

No abstract available.
Osteoporosis* ; Radionuclide Imaging*

Isometric tension was recorded in uterine arterial ring preparation contracted by potassium (60 mM) and norepinephrine(1.8 X 10(-7) M). With pretreatment of various concentrations of nifedipine(2.9 x 10(-9) ~2.9 X10(-7) M) and verapamil(2.2 X 10(-7) -2.2 X 10(-5) M), the relaxation was dose-dependent and inhibitory effects of both agents were more marked on the potassium than norepinephrine-evoked contraction. After immersion of the arterial preparation in calcium-free solution, the potassium-evoked contraction was decreased to 21+/-4.1%(mean+/-SEM) of the response in normal Krebs solution and norepinephrine-evoked contraction to 26+/-3.8%. The responses to both agents were completely restored when the calcium concentration was increased to 4.0 mM. Pretreated nifedipine(2.9 x 10(-7) M) in calcium-free solution depressed the potassium-evoked contraction to 7.3+/-1.6% and norepinephrine-evoked contraction to 12+/-3.7%. In addition of calcium(0-4.0mM), the potassium-evoked contraction increased to 30+/-4.6% and that by norepinephrine to 45+/-5.4%. Pretreated verapamil(2.2 X 10(-5) M) in calcium-free solution depressed the potassium-evoked contraction to 14+/-3.6% and norepinephrine-evoked contraction to 18+/-3.3%. In addition of calcium(0-4.0mM), the potassium-evoked contraction increased to 41+/-4.2% and that by norepinephrine to 57+/-4.7%. It was concluded that nifedipine and verapamil relaxed KC1 contracted ring in the presence of external calcium and relaxed norepinephrine contracted ring in both the presence and absence of external calcium. These findings suggest that calcium antagonists interfere with the release of calcium from intracellular sites as well as with the slow inward current of calcium.
Calcium ; Humans* ; Immersion ; Nifedipine* ; Norepinephrine ; Potassium ; Relaxation ; Uterine Artery* ; Verapamil*

Tuberculosis of the thyroid gland is extremely rare with few cases reported in recent years. Tuberculosis may involve the thyroid gland in two main forms. The more common of theses is miliary spread to the thyroid as part of generalized dissemination and less commonly focal or caseous tuberculosis of the thyroid may occur, presenting as a nodule, as a thyroiditis, as a abscess, or as carcinoma like.We experienced two cases of tuberculosis of the thyroid gland presenting with palpable thyroid nodule in 26 year-old female and 65 year-old female patients. They have been clinically and biochemically euthyroid and their thyroid scans demonstrated a cold nodule at right thyroid gland. We found no evidence of tuberculosis elsewhere. The goiter was removed surgically and confirmed to be tuberculosis. They were medicated antituberculous agents after operation and followed up regulary out patient department.We report the cases of two patients with tuberculosis involving thyroid with reviews of literature.
Abscess ; Female ; Goiter ; Humans ; Thyroid Gland ; Thyroid Nodule ; Thyroiditis ; Tuberculosis

STUDY DESIGN: Retrospective study. PURPOSE: To investigate influence of bone mineral density (BMD) on the surgical correction of lumbar degenerative kyphosis (LDK). OVERVIEW OF LITERATURE: No studies so far have reported the influence of BMD on the surgical correction of LDK. METHODS: Forty LDK patients with more than 2 years follow-up were studied. Pelvic incidence (PI), pelvic tilt, sacral slope, sagittal vertical axis (SVA), lumbar lordosis (LL), and thoracic kyphosis were measured preoperatively, immediate postoperatively and at final follow-up. Adverse outcomes: proximal adjacent fractures, sagittal decompensation, pseudoarthrosis, and cage subsidence were documented. RESULTS: There were 37 females and 3 males. Average age was 65.1+/-4.5 years and mean follow-up was 34.2+/-16.7 months. 42.5% were Takemitsu type 3 curves, 27.5% type 2, 20.0% type 4 and 10.0% type 1. 37.5% had osteopenia, 40.0% osteoporosis and 22.5% had severe osteoporosis. SVA improved from 237.0+/-96.7 mm preoperatively to 45.3+/-41.8 mm postoperatively (p=0.000). LL improved from 10.5degrees+/-14.7degrees to -40.6degrees+/-10.9degrees postoperatively (p=0.000). At final follow-up SVA deteriorated to 89.8+/-72.2 mm and LL to 34.7degrees+/-15.8degrees (p=0.000). The association between late sagittal decompensation, pseudoarthrosis, or proximal adjacent fractures and osteoporosis was insignificant. The difference between immediate postoperative LL and PI (PIDiff) had a significant association with sagittal decompensation and pseudoarthrosis. CONCLUSIONS: Osteoporosis did not influence the degree of correction, late sagittal decompensation, proximal adjacent fractures, and pseudoarthrosis in LDK. PIDiff had a significant association with sagittal decompensation and pseudoarthrosis.
Animals ; Axis, Cervical Vertebra ; Bone Density* ; Bone Diseases, Metabolic ; Female ; Follow-Up Studies* ; Humans ; Incidence ; Kyphosis* ; Lordosis ; Male ; Osteoporosis ; Pseudarthrosis ; Retrospective Studies

Central diabetes insipidus caused by pineal gland neoplasm is rare. Here, we describe a case of central diabetes insipidus and pineal germinoma with seeding to pituitary stalk along CSF pathway. A 27 year-old male patient was admitted due to polyuria, polydipsia, headache, vomiting, diplopia, and decreased visual acuity for recent two months. Urine osmolality measured after water deprivation was below 100mOsm/kg. However, urine osmolality increasd above 300 mOsm/kg with pitressin administration. Brain MRI showed a 2cm sized mass with seeding into pituitary stalk along CSF in pineal region. Surgical biopsy revealed pineal germinoma. Two cycles of chemotherapy with etoposide and cis-platin were done followed by brain irradiation(2,500cGy). Follow up brain MRI after second chemotherapy showed complete remission. The patient had no neurologic and endocrinologic deficit after the treatment.
Adult ; Biopsy ; Brain ; Diabetes Insipidus* ; Diabetes Insipidus, Neurogenic ; Diplopia ; Drug Therapy ; Etoposide ; Follow-Up Studies ; Germinoma ; Headache ; Humans ; Magnetic Resonance Imaging ; Male ; Osmolar Concentration ; Pineal Gland ; Pinealoma ; Pituitary Gland ; Polydipsia ; Polyuria ; Vasopressins ; Visual Acuity ; Vomiting ; Water Deprivation