Heat-treated autogenous bone graft has been utilized in the cases with large hone defects associated with tumors, chronic osteomyelitis, and trauma. Conventional autoclaved autogenous bone grafting, however, has inherent disadvantages that included decreased biomechanical strength, and loss of osteogenesity. In contrast, despite devitalizing the tumor cells, low heat-treatment can render autogenous hone grafts to retain better biomechanical strength as well as to preserve osteogenesity by avoiding destruction of hone morphogenetic protein. To investigate biomechanical strength and osteogenesity of heat-treated autogenous bone grafts, rahbits were classified into three groups: groupl, in-situ implantation of autogenous graft in the diaphyseal defect of the tibia without any heat treatment; group 2, reimplantation of graft after low heattreatment; group 3, reimplantation of graft after autoclaving. Radiological, histological, and scintigraphic examination were performed postoperativeIy at 2nd, 4th, 6th, 9th, 12th weeks. And biomechanical test was performed postoperatively at 6th, 9th, 12th weeks. Biomechanical test revealed that there were no statistical differences among three groups at 6th week and 9th week. However, at 12th week postoperatively, there were significant differences between group 2 and group 3, and between group 1 and group 3. Radiological and histological examinations showed that new bone formation started earlier in groups l and 2, compared to group 3. Also bone remodeling was advanced in group I and 2, com- pored to group 3. Scintigraphically, the increase of 99mTc-MDP uptake was delayed in group3, compared to group l and 2. Based upon above findings, it was concluded that low heat-treated autogenous bone grafting was hetter than autoclaved autogenous bone grafting in promoting bone healing with retained biomechanical strength.
Bone Remodeling ; Bone Transplantation* ; Hot Temperature* ; Osteogenesis ; Osteomyelitis ; Replantation ; Technetium Tc 99m Medronate ; Tibia ; Transplants

PURPOSE: IL-10, one of the potent Th2 cytokine, has strong anti-inflammatory reaction and immunosuppression action by stabilization of polarized Th2 cell gene expression and blocking of function of antigen presenting cells. The aims of this study were to investigate the immunosuppressive effect of recombinant adenovirus mediated rat IL-10 (Ad:ratIL-10) in mouse to rat skin graft. METHODS: The transgene expression of the recombinant adenovirus was confirmed by X-gal staining of Ad:LacZ infected skin graft. The skin graft was done between mouse and rat after 1 hour infection of donated skin with Ad:ratIL-10, which was already been produced in our Institute for Medical Science. Checked gene expression in grafted skin by in situ RT-PCR and systemic blood by ELISA on day 1, 3, 5 and 7. Immunosuppressive effect of the Ad:ratIL-10 was evaluated by graft survival and compared with control group which was infected by saline. RESULTS: Transgene expression of recombinant adenovirus was peak on third day of skin graft and became disappeared on day 5 and 7. The same expression was confirmed by in situ RT-PCR of Ad:ratIL-10 infected skin graft. The systemic blood level of infected Ad:ratIL-10 checked by ELISA was undetectable but their expression checked in culture cell line of HeLa cell was 275 ng/mL on day 5. Mean grafted skin survival was 6.0 +/- 0.7 days in Ad:ratIL-10 group but statistically indistinguishable to control group of infection with saline (5.6 +/- 0.6 days, p>0.05). CONCLUSION: In summary, the Ad:ratIL-10 alone, infected in grafted skin, was peak on day 3 after graft but showed no immunosuppressive effect on mouse-to-rat skin graft.
Adenoviridae* ; Animals ; Antigen-Presenting Cells ; Cell Line ; Enzyme-Linked Immunosorbent Assay ; Gene Expression ; Graft Survival ; HeLa Cells ; Humans ; Immunosuppression ; Interleukin-10* ; Mice ; Rats* ; Skin* ; Th2 Cells ; Transgenes ; Transplants*

Immunosuppressive medications after renal allograft transplantation have impacted the course of acute and chronic rejection: however, they have no defined effects on the prevention of recurrent and Glomerulonephritis (GN) in an allograft kidney. Authors experienced a case of rapidly progressive glomerulonephritis (RPGN). The 35-year-old female patient developed a rapid deterioration of renal function 4 years after renal transplantation. The allograft biopsy showed crescentic glomerulonephritis evolving from membranoproliferative glomerulonephritis (MPGN) type I. She was given pulse steroid and oral cyclophosphamide therapy immediately after the renal biopsy. Graft function stabilized and proteinuria decreased even though graft function did not recover to pre-treatment level and low grade proteinuria persisted.
Adult ; Allografts ; Biopsy ; Cyclophosphamide ; Female ; Glomerulonephritis* ; Glomerulonephritis, Membranoproliferative ; Humans ; Kidney Transplantation* ; Kidney* ; Proteinuria ; Transplants

PURPOSE: Early gastric cancer cases that are estimated to meet indications for treatment before endoscopic submucosal resection are often revealed to be out-of-indication after the treatment. We investigated the short-term treatment outcomes in patients with early gastric cancer according to the pretreatment clinical endoscopic submucosal resection indications. MATERIALS AND METHODS: We retrospectively reviewed the medical records of patients with early gastric cancer that met the pretreatment endoscopic submucosal resection indications, from 2004 to 2011. Curative resection rate and proportion of out-of-indication cases were compared according to the pre-endoscopic submucosal resection indications. Pre-endoscopic submucosal resection factors associated with out-of-indication in the final pathological examination were analyzed. RESULTS: Of 756 cases, 660 had absolute and 96 had expanded pre-endoscopic submucosal resection indications. The curative resection rate was significantly lower in the patients with expanded indications (64.6%) than in those with absolute indications (81.7%; P<0.001). The cases with expanded indications (30.2%) were revealed to be out-of-indication more frequently than the cases with absolute indications (13.8%; P<0.001). Age of >65 years, tumor size of >2 cm, tumor location in the upper-third segment of the stomach, and undifferentiated histological type in pre-endoscopic submucosal resection evaluations were significant risk factors for out-of-indication after endoscopic submucosal resection. CONCLUSIONS: Non-curative resection due to out-of-indication occurred in approximately one-third of the early gastric cancer cases that clinically met the expanded indications before endoscopic submucosal resection. The possibility of additional surgery should be emphasized for patients with early gastric cancers that clinically meet the expanded indications.
Humans ; Medical Records ; Retrospective Studies ; Risk Factors ; Stomach ; Stomach Neoplasms*

PURPOSE: The development of bronchiolitis obliterans syndrome (BOS) after allogeneic hematopoietic stem cell transplantation (HSCT) deteriorates patients' quality of life. This study aimed to analyze the prevalence, clinical features, risk factors and prognostic factors of BOS. MATERIALS AND METHODS: This retrospective study included patients who underwent allogeneic HSCT from January 2002 to December 2008 and survived for > or =100 days after transplantation. RESULTS: Of 860 patients who survived for > or =100 days, 36 (4.2%) met the diagnostic criteria. The duration of BOS development after transplantation was 466.00 (284.00-642.75) [median (interquartile range)] days. The risk factor for the development of BOS was peripheral blood as the stem cell source with a hazard ratio (HR) of 2.550 [95% confidence interval (CI): 1.274-5.104, p=0.008]. In multivariate analysis, pretransplant FEV1/FVC (HR: 0.956, 95% CI: 0.921-0.993, p=0.020) and time from HSCT to diagnosis of BOS (HR: 0.997, 95% CI: 0.994-0.999, p=0.009) were independent prognostic factors associated with mortality. CONCLUSION: Peripheral blood as a stem cell source is a risk factor for the development of BOS. A decreased pretransplant FEV1/FVC and shorter duration of time from transplantation to diagnosis of BOS are poor prognostic factors for BOS.
Adult ; Aged ; Bronchiolitis Obliterans/epidemiology/*etiology ; Disease Progression ; Female ; Graft vs Host Disease/etiology ; Hematopoietic Stem Cell Transplantation/*adverse effects ; Humans ; Male ; Middle Aged ; Multivariate Analysis ; Prevalence ; Proportional Hazards Models ; *Quality of Life ; Respiratory Function Tests ; Retrospective Studies ; Risk Factors ; Survival Analysis ; Transplantation, Homologous

The lipoma is the neoplasm of mesenchymal origin. Although most lipomas occur on the trunk and the proximal portion of the extremities, lipomas of the oral and maxillofacial regions are relatively rare, approximately 13% of all cases. Lipomas have been found in all age, but usually found between 40 and 60 years of age. Clinically the lipoma is a painless, slowly growing, nearly always benign soft mass. The treatment of choice is a surgical excision, and the recurrence is rare. But the infiltrating lipoma originated from muscle has high recurrence rate. It has ill-defined border and little or no evidence of encapsulation. Histologically there is a consistent infiltration with dissociation of the surrounding muscle fiber. The infiltrating lipoma should be excised with surrounding normal muscle and tissue to prevent the recurrence. This case was a 57-year-old female with a painless swelling of the right cervical and parotid areas which was diagnosed as large infiltrating lipoma by clinical examination and radiographic findings. The patient was treated by surgical excision and showed good functional and esthetic results. Histologically the tumor was diagnosed as infiltrating lipoma with no evidence of malignancy.
Extremities ; Female ; Humans ; Lipoma* ; Middle Aged ; Recurrence

PURPOSE: This study was performed to provide an anatomical information of the mandibular ramus for the successful inferior alveolar nerve block. Three dimensional images were reconstructed from the computerized tomography (CT) and the anatomical evaluation of the mandibular ramus was done. MATERIALS AND METHODS: Sixty-four patients who had been taken the facial CT scans from 2000, Jan to 2003, June was selected. The patients who had the anterior or posterior teeth misssing, edentulous ridge, and jaw fracture were excepted. In the occulusal plane, the lingual surface angle (LSA) between the mid-sagittal plane and the mandibular molar lingual surface from the 2nd premolar to the 2nd molar, the inner ramal surface angle (IRSA), the maximum inner ramal surface angle (MxIRSA), and the outer ramal surface angle (ORSA) to the-mid sagittal plane were MEASURED: The inner ramal surface angle in the ligular tip level (IRSA-L) and the outer ramal surface angle in the ligular tip level (ORSA-L), the ramal length (RL), and the anterior ramal length (ARL) were also measured in the lingular tip level. RESULTS: In the lingular tip level, the mean IRSA-L and ORSA-L were 28.6+/-6.3 degrees and 17.9+/-4.9 degrees respectively. The larger was the IRSA, the larger was the ORSA. In the lingular tip level, the mean ramal length was 35.8+/-3.4 mm. The larger was the IRSA-L, the shorter was the ramal length. On the lingular tip level, the mean anterior ramal length from anterior ramus to lingular tip was 19.6+/-3.3 mm. when the ramal length was longer, the anterior ramal length was also longer. On the lingular tip level, there was positive correlation vetween the IRSA and the ORSA, negative correlation between the IRSA and the ramal length, and positive correlation between the ramal length and the lingular tip level to the anterior ramus. There was no statistical meaning of data between sex and age. CONCLUSION: In the clinical view of the results so far achieved, if the direction of needle is closer to posterior it is able to contact bone on lingular tip when the internal surface of ramus is wided outer.
Anesthesia* ; Bicuspid ; Humans ; Jaw Fractures ; Mandibular Nerve* ; Molar ; Needles ; Tomography, X-Ray Computed ; Tooth

Bronchiolitis obliterans organizing pneumonia (BOOP) is a pulmonary disorder that exhibits various radiographic findings. It often shows bilateral, patched, or ground glass interstitial infiltrate, but a solitary nodular pattern rarely appears. We report a case of an 8-year-old boy suffering from BOOP that showed a single nodular pattern of the lung in the chest radiography. We conclude that when there is a solitary nodule discovered in the lungs of children or adolescence, the differential diagnosis must include BOOP.
Adolescent ; Bronchiolitis ; Bronchiolitis Obliterans ; Child ; Cryptogenic Organizing Pneumonia ; Diagnosis, Differential ; Glass ; Humans ; Lung ; Solitary Pulmonary Nodule ; Stress, Psychological ; Thorax

Cortical Dysplasia(CD) is increasingly recognized as a cause of intractable epilepsy since it can be easily diagnosed with high resolution magnetic resonance imaging(MRI). We analyzed 24 consecutive cases with cortical dysplasia who underwent resective surgery at our institute between September, 1992 and December, 1995. MRI was demonstrated to be a decisive tool to identify CD in 16 cases(66.7%). However, the remaining 8 cases(33.3%) were confirmed to have CD based on histological examination. Location of the lesion included temporal(n=9), central(n=5), multilobar(n=5), and frontal(n=5). Intracranial EEG recording was performed to delineate the epileptogenic zone in 16 cases:subdural grid(10 cases) and depth electrode(6 cases). Resection was performed in temporal(n=9), frontal(n=7), central(n=6), parietal(n=1), and multilobar(n=1). Complete resection was possible in 15(62.5%) and partial resection in 9(37.5%). Histological examination revealed dyslamination of cortical layers only(n=9), additional dysplastic neurons(n=7), and additional balloon cells(n=8). Surgical outcome was graded as seizure free(n=14:58.3%), rare seizures(n=3:12.5%), <50% reduction of seizure frequency(n=2:8%), and no change(n=5:20.8%) after mena follow-up of 12.7 months. The most influencing factor on the surgical outcome was the degree of completeness of resection(p<0.05). However, detectability of CD on MRI, severity of histological findings, age of seizure onset, and duration of seizure were not significantly related with the surgical outcome. High suspicion is required to detect the CD among the patients with intractable epilepsy and surgical strategies should be well-planned to improve the surgical outcome in the patients with CD.
Electroencephalography ; Epilepsy ; Follow-Up Studies ; Humans ; Magnetic Resonance Imaging ; Malformations of Cortical Development* ; Seizures

Objective: The present study aimed to analyze and compare the prognostic performances of Revised Trauma Score (RTS), Injury Severity Score (ISS), shock index (SI), and modified Early Warning Score (MEWS) for in-hospital mortality in severe trauma. Methods: This retrospective observational study included elderly (≥65 years) patients admitted for severe trauma between January 2018 and December 2018. Receiver operating characteristics analysis was performed to examine the prognostic performance of the four different tools. The primary outcome was in-hospital mortality following an injury. Results: Of the 279 patients included in the study, in-hospital mortality was 20.1% (n=56). In multivariate analysis, age (odds ratio [OR], 1.055; 95% confidence interval [CI], 1.004-1.109), ISS (OR, 1.080; 95% CI, 1.008-1.157), Glasgow Coma Scale (OR, 0.842; 95% CI, 0.785-0.904), and respiratory rate (OR, 1.261; 95% CI, 1.071-1.486) were independently associated with in-hospital mortality. The area under the curves (AUCs) of MEWS, RTS, ISS, and SI were 0.851 (95% CI, 0.763-0.857), 0.733 (0.677-0.784), 0.664 (0.606-0.720), and 0.567 (0.506-0.626), respectively. The AUC of MEWS was significantly different from those of RTS (P=0.034), ISS (P=0.001), and SI (P<0.001). Conclusion MEWS has the highest prognostic performance for in-hospital mortality among four different tools in elderly patients with severe trauma.