So many modalities have been suggested for the treatment of servere pain and ankylosis of the elbow with destruction of the articular surfaces. Among them, two major methods which have been widely used are resection arthroplasty and prosthetic replacement arthroplasty. However prosthetic replacement arthroplasty has some problems. Its indications are limited in the elderly inactive subjects. And there have been many kinds of complications including loosening and infection. Also, resection arthroplasty in now rarely indicated due to severe instability. From July 1980 to July 1987, we tried distraction arthroplasty in 8 cases of elbow with severe destruction of its articular surfaces, mainly in the young active persons. The average follow-up period was 45 months. The effect of distraction arthroplasty on relief of pain was not remarkable. The average increase in ROM, including that of one reankylosed elbow, was 51 ±22 degrees in flexion-extension and 48 ±23 degrees in pronstion-supinstion. No deep wound infection and instability which was main complication of resection arthroplasty were observed with our method of distraction arthroplasty. On the basis of functional results, the the results were excellent in 4, good in 1, fair in 2 and poor in 1 cases. In conclusion, distraction arthroplasty of the elbow can be one of the of effective methods reconstruction for the young active patients with the destruction of the elbow, if they are intelligent and motivated.
Aged ; Ankylosis ; Arthroplasty ; Arthroplasty, Replacement ; Elbow ; Follow-Up Studies ; Humans ; Methods ; Wound Infection

No abstract available.
Bacteria*

No abstract available.
Heart Diseases* ; Heart*

No abstract available.
Arteries* ; Cardiomyopathy, Hypertrophic* ; Humans ; Infant* ; Mothers*

Vascular leak syndrome(VLS) is characterized by endothelial damage, which causes extravasation of plasma proteins and fluid from capillaries into the extravascular space. It has been suggested that the increased vascular permeability is the result of an IL-2-induced suppression of endothelin-1 secretion by endothelial cells, an IL-2-induced activation of the complement cascade or TNF-alpha release from IL-2-activated T-cells. A 13-year-old male patient visited our hospital with abdominal pain. He was diagnosed with acute lymphoblastic leukemia(T cell type) by bone marrow study on his 2 nd day in hospital. On the 3 rd day of induction chemotherapy(prednisone, L-asparaginase, vincristine, intrathecal methotrexate), pulmonary edema and pleural effusion, ascites and generalized edema developed and lasted for 53 days without responding to supportive care. The laboratoy finding was that TNF-alpha was increased without evidence of infection and hypoalbuminemia was noted. It was suggested that the patient's clinical feature was induced by VLS.
Abdominal Pain ; Adolescent ; Ascites ; Blood Proteins ; Bone Marrow ; Capillaries ; Capillary Permeability ; Complement System Proteins ; Edema ; Endothelial Cells ; Endothelin-1 ; Humans ; Hypoalbuminemia ; Induction Chemotherapy* ; Male ; Pleural Effusion ; Precursor Cell Lymphoblastic Leukemia-Lymphoma* ; Pulmonary Edema ; T-Lymphocytes ; Tumor Necrosis Factor-alpha ; Vincristine

No abstract available.
Echocardiography* ; Echocardiography, Doppler, Pulsed ; Heart Diseases* ; Heart*

BACKGROUND: TRAIL (TNF-related apoptosis inducing ligand) is a newly identified member of the TNF gene family which appears to have tumor-selective cytotoxicity due to the distinct decoy receptor system. TRAIL has direct access to caspase machinery and induces apoptosis regardless of p53 phenotype. Therefore, TRAIL has a therapeutic potential in lung cancer which frequently harbors p53 mutation in more than 50% of cases. However, it was shown that TRAIL also could activates NF-kappaB in some cell lines which might inhibit TRAIL-induced apoptosis. This study was designed to investigate whether TRAIL can activate NF-kappaB in lung cancer cell lines relatively resistant to TRAIL-induced apoptosis and inhibition of NF-kappaB activation using proteasome inhibitor MG132 which blocks I kappa B alpha degradation can sensitize lung cancer cells to TRAIL-induced apoptosis. METHODS: A549 (wt p53) and NCI-H1299 (null p53) lung cancer cells were used and cell viability test was done by MTT assay. Apoptosis was confirmed with Annexin V assay followed by FACS analysis. To study NF-kappaB-dependent transcriptional activation, a luciferase reporter gene assay was used after making A549 and NCI-H1299 cells stably transfected with IgGkappa-NF-kappaB luciferase construct. To investigate DNA binding of NF-kappaB activated by TRAIL, electromobility shift assay was used and supershift assay was done using anti-p65 antibody. Western blot was done for the study of I kappa B alpha degradation. RESULTS: A549 and NCI-H1299 cells were relatively resistant to TRAIL-induced apoptosis showing only 20~30% cell death even at the concentration 100 ng/ml, but MG132 (3microM) pre-treatment 1 hour prior to TRAIL addition greatly increased cell death more than 80%. Luciferase assay showed TRAIL-induced NF-kappaB transcriptional activity in both cell lines. Electromobility shift assay demonstrated DNA binding complex of NF-kappaB activated by TRAIL and supershift with p65 antibody. I kappa B alpha degradation was proven by western blot. MG132 completely blocked both TRAIL-induced NF-kappaB dependent luciferase activity and DNA binding of NF-kappaB. CONCLUSION: This results suggest that inhibition of NF-kappaB can be a potentially useful strategy to enhance TRAIL-induced tumor cell killing in lung cancer.
Annexin A5 ; Apoptosis ; Blotting, Western ; Cell Death ; Cell Line ; Cell Survival ; DNA ; Genes, Reporter ; Homicide ; Humans ; I-kappa B Proteins ; Leupeptins ; Luciferases ; Lung ; Lung Neoplasms ; NF-kappa B ; Phenotype ; Proteasome Endopeptidase Complex ; Proteasome Inhibitors ; Transcriptional Activation

No abstract available.
Heel* ; Molluscum Contagiosum* ; Weight-Bearing* ; Zea mays

Between January 1982 and September 1986, at the Department of Orthopaedic Surgery of Kyung Hee University Hospital, 82 total knee arthroplasties were performed in 57 patients. We studied 25 patients (50 Knees) who had been operated by bilateral total knee arthroplasties to compare one stage and two stage operations. The follow-up ranged from 10 months to 5 years and 7 months (average 1 year and 8 months). All operations were performed by one of the authors (D.K.B.), but the follow-up study and the entire medical record were independently evaluated by another authors. The clinical results of preoperative and postoperative assessments and rehabilitation processes are as follows; 1. Group I (10 patients) had both kness replaced by one stage simultaneous operation under same anesthesia, and Group II(15 patients) had replaced by two stage operation at the intervals of 2 weeks. 2. The periods required to do bilateral weight bearing were 10.3 days for Group I, 23.6 days for Group II. 3. Complications in one stage operation was no more than the in two stage operation. 4. The postoperative pain and ROM were not significantly different in both groups. 5. Using the hospital for special surgery rating system, we found the clinical results to be similar in both groups. 6. Comparing to two stage operation, the advantages of one stage operation were shorter operative and tourniquet time, lesser use of antibiotics, reduced medical cost and hospital stay. In conclusion, if patient conditions do not prevent prolonged anesthetic time and surgeons have good surgical techniques, we recommend one stage simultaneous operation in bilateral total knee replacement.
Anesthesia ; Anti-Bacterial Agents ; Arthroplasty ; Arthroplasty, Replacement, Knee ; Follow-Up Studies ; Humans ; Knee ; Length of Stay ; Medical Records ; Pain, Postoperative ; Rehabilitation ; Surgeons ; Tourniquets ; Weight-Bearing