[Objective] To determine the long term survivorship and establish the idea I correction angle in proximal tibial osteotomy for primary osteoarthritis. [Method] Seventy-nine patients suffering from primary osteoarthritis (111 knees) were performed with proximal tibial valgus osteotomy from 1985 to 1997, among which 74 women (106 knees) and 5 men (5 knees). The age ranged from 37 to 70 years (mean, 55 years). Postoperatively, hospital for Special Surgery knee score (HSS) was used for clinical assessment. The femorotibial angle (FTA) was measured to classifiy patients to group Ⅰ of 61 knees with less than 7 of valgus; group Ⅱ of 23 knees with 7～9 of valgus; group Ⅲ of 27 knees with over 10 of valgus. Closed wedge osteotomy was performed in all cases. HSS was assessed pre-and post-operatively. [Result] The average follow-up period was 9 years and 6 months (2 years and 4 months to 14 years and 1 month). The HSS knee score averaged 60 points preoperatively, 94 after 1 year and 87 at the last follow-up. Falure I was the need for conversion of a proximal tibial osteotomy to a total knee arthrop lasty, and Failure Ⅱ was the need for conversion of HSS knee score of less than 60 points. The 4 and 14 years survival rates were 99% and 85% using the first definition of failure, and 96. 4% and 75.1% using the second. [Conclusion] Proximal tibial osteotomy is reliable for treating unicompartmental osteoarthritis, providing that the postoperative femorotibial angle is corrected to more than 7° of valgus and falls in the range of 10°～15°.

PURPOSE: To evaluate the findings of subchondral cyst of the humeral head, as seen on shoulder MRarthrography MATERIALS AND METHODS: Sixty-three patients( M:F=62:1 ; mean age 23 years) who underwent shoulder MRarthrography between September 1996 and May 1998 were retrospectively reviewed. No patient had a history of eithershoulder dislocation or certain diseases known to be commonl accompanied by subchondral cysts. All MR images wereobtained using a 1.5 Tesla unit after intraarticular injection of 20ml of diluted contrast material. T1 andT2-weighted axial, oblique coronal, and oblique sagittal images were analysed for the presence, location, number,shape, size, and connection to the joint cavity of subchondral cysts. RESULTS: We identified 58 subchondral cystsin 43(71.7%) of 63 cases. All were located in the posterolateral portion of the humeral head, and on the physealline. Twenty-eight patients(65.1%) had one cyst, and 15(34.9%) had two. Thirty-four cysts(58.6%) were round orovoid in shape and, 2-8mm in diameter(average, 3.9mm) ; 24(41.4%) were lobulated and 3-10mm in diameter(average5.3mm). Fifty-three cysts(91.4%) were connected to the joint cavity. CONCLUSIONS: In symptomatic patients, the incidence of subchondral cyst of the humeral head was 71.7%. All were located in the posterolateral portion, andon the physeal line. Most subchondral cysts were connected with the joint cavity.
Bone Cysts* ; Dislocations ; Humans ; Humeral Head* ; Incidence ; Injections, Intra-Articular ; Joints ; Magnetic Resonance Imaging* ; Retrospective Studies ; Shoulder

PURPOSE: To evaluate by means of MR arthrography the causal relationship between anterior capsularattach-ment type and anterior instability of the glenohumeral joint. MATERIALS AND METHODS: Sixty-five patients (M:F=64:1; mean age, 23 years), who had undergone shoulder MR arthrography were retrospectively reviewed. There wasno history of traumatic dislocation, and medical records relating to anterior instability were available. Physicalexamination revealed anterior instability in 25 patients(Group A), while in 40 (Group B), this was eithersuspicious or absent. With the aid of general anesthe-sia, 32 patients who had undergone surgery were physicallyexamined. Anterior instability was evident in 16 patients(Group C), and suspicious or absent in the remaining 16(Group D). All images were obtained after in-traarticular injection of Gd-DTPA. Fat-suppressed T1 axial imagingwas used to evaluate anterior capsular at-tachment type at mid and distal three-fourths levels of the glenoidfossa. The causal relationship between ante-rior capsular attachment types and anterior instability was analyzedusing the x2 test RESULTS: In group A, type I was most common at distal three-fourths level, and types I and IIwere equal and more common than type III at mid level. In group B, type I anterior capsular attachment type wasmost com-mon at both mid and distal three-fourths level. In these groups, no statistical significance was notedbetween anterior capsular attachment type and anterior instability (p value 0.611: 0.567). In group C, types I andII were equal and more common than type III at both mid and distal three-fourths level, while in group D, type IIwas most common at mid level, and type I was most common at distal three-fourths level. In these groups, nostatistical significance was noted between anterior capsular attachment type and anterior instability (p val-ue,0.772). CONCLUSION: There was no statistically significant difference between anterior capsular attachment typeand anterior instability of the shoulder joint.
Arthrography* ; Dislocations ; Gadolinium DTPA ; Humans ; Medical Records ; Retrospective Studies ; Shoulder ; Shoulder Joint*

The nm23 gene was originally identified from murine melanoma cell lines of varying metastatic potential. A strong association has been observed between reduced expression of nm23 gene and acquisition of metastatic behavior in some tumor cells including breast cancer and melanoma, but not in others such as colon cancer, neuroblastoma, and cervical cancer. It was proposed that nm23 may function as a suppressor gene for tumor metastasis. It has recently been found that the sequence of nm23 and NDP-kinase(NDP-K) was identical. Mortality associated with human breast carcinoma is almost entirely due to subsequent metastasis, but the molecular basis of this metastasis is not understood. Elucidation of the genetic control of metastatic propensity of a tumor is important in determining prognosis and choice of therapy. The purpose of this study was to investigate the relationship of nm23 protein expression with axillary lymph node metastasis and other prognostic factors. Using an immunohistochemical technique and employing a polyclonal antibody to nm23 protein, we have determined nm23 expression in a series of 72 infiltrating ductal carcinomas of the breast. Immunostaining for the nm23 gene product have heterogenous cytoplasmic and nuclear staining in 61 patients(84.7%). Sections were scored according to relative abundance(1 = less than 25% of the cells, 2 = 26-75%, 3 = 76-100%). In 61 patients with positive immunostaining, the staining was scored as 1 in 41.6%, 2 in 18.0%, and 3 in 40.2%. The staining of tumor cells was greater than that in normal epithelial cells and stromal cells. No relationship was found between nm23 expression and lymph node metastasis, histologic grade, tumor size, estrogen receptors or progesterone receptors. Therefore, nm23 protein is increased in neoplastic tissues but no correlation with metastatic potential could be demonstrated. The biological mechanism of over-expression of nm23 in malignant cells and its role in tumor progression remain to be determined.
Breast Neoplasms ; Breast* ; Carcinoma, Ductal* ; Cell Line ; Colonic Neoplasms ; Cytoplasm ; Epithelial Cells ; Genes, Suppressor ; Humans ; Lymph Nodes ; Melanoma ; Mortality ; Neoplasm Metastasis ; Neuroblastoma ; Prognosis ; Receptors, Estrogen ; Receptors, Progesterone ; Stromal Cells ; Uterine Cervical Neoplasms

The nm23 gene was originally identified from murine melanoma cell lines of varying metastatic potential. A strong association has been observed between reduced expression of nm23 gene and acquisition of metastatic behavior in some tumor cells including breast cancer and melanoma, but not in others such as colon cancer, neuroblastoma, and cervical cancer. It was proposed that nm23 may function as a suppressor gene for tumor metastasis. It has recently been found that the sequence of nm23 and NDP-kinase(NDP-K) was identical. Mortality associated with human breast carcinoma is almost entirely due to subsequent metastasis, but the molecular basis of this metastasis is not understood. Elucidation of the genetic control of metastatic propensity of a tumor is important in determining prognosis and choice of therapy. The purpose of this study was to investigate the relationship of nm23 protein expression with axillary lymph node metastasis and other prognostic factors. Using an immunohistochemical technique and employing a polyclonal antibody to nm23 protein, we have determined nm23 expression in a series of 72 infiltrating ductal carcinomas of the breast. Immunostaining for the nm23 gene product have heterogenous cytoplasmic and nuclear staining in 61 patients(84.7%). Sections were scored according to relative abundance(1 = less than 25% of the cells, 2 = 26-75%, 3 = 76-100%). In 61 patients with positive immunostaining, the staining was scored as 1 in 41.6%, 2 in 18.0%, and 3 in 40.2%. The staining of tumor cells was greater than that in normal epithelial cells and stromal cells. No relationship was found between nm23 expression and lymph node metastasis, histologic grade, tumor size, estrogen receptors or progesterone receptors. Therefore, nm23 protein is increased in neoplastic tissues but no correlation with metastatic potential could be demonstrated. The biological mechanism of over-expression of nm23 in malignant cells and its role in tumor progression remain to be determined.
Breast Neoplasms ; Breast* ; Carcinoma, Ductal* ; Cell Line ; Colonic Neoplasms ; Cytoplasm ; Epithelial Cells ; Genes, Suppressor ; Humans ; Lymph Nodes ; Melanoma ; Mortality ; Neoplasm Metastasis ; Neuroblastoma ; Prognosis ; Receptors, Estrogen ; Receptors, Progesterone ; Stromal Cells ; Uterine Cervical Neoplasms

CD44 is a family of transmembrane glycoproteins involved in cell-cell and cell-matrix interactions. Expression of CD44 isofonns (splice variants) has been shown to be associated with poor prognosis in several human cancers. We evaluated the expression patterns of the CD44 isofortn (CD 44 splice variant v6) in infiltrating ductal carcinoma of the breast by immunohistochemical and RT-PCR method. Paraffin embedded blocks from seventy-five cases of mastectomized samples were analyzed immunohistochemically using monoclonoal antibody against CD44v6. CD44v6 was detected in fifty-seven cases (76%) of the tumor samples. Adjacent normal myoepithelial cells and ductal epithelial cells revealed focal positive reaction to CD44v6. Thirtytwo cases (80.0%) with lymph nodal metastasis revealed overexpression of CD44v6 monoclonal antibody, but twenty-five cases (71.4%) without nodal metastasis also showed positive reaction to CD44v6 monoclonal antibody, and there is no statistically significant value. Other prognostic factors of infiltrating ductal carcinoma, such as tumor size, histologic grade and hormonal receptors did not show any significant correlation with CD44v6 expression. The RT-PCR studies for 9 cases of infiltrating ductal carcinoma showed the same band patterns both in the normal and tumor tissues. From the above results, it is concluded that the expression of CD44v6 is not a valuable prognostic marker of infiltrating ductal carcinoma of breast.
Breast* ; Carcinoma, Ductal* ; Epithelial Cells ; Glycoproteins ; Humans ; Neoplasm Metastasis ; Paraffin ; Prognosis

Optic nerve evulsion is a devastating, uncommon cause of sudden visual loss following major head trauma. Less frequently, it is associated with pointed non penetrating orbital injuries with minimal ocular trauma. Possible mechanisms of injury include extreme rotation and forward displacement of the globe, penetrating orbital injury causing a backward, pull on the optic nerve, and sudden increase in intraocular pressure causing rupture of the lamina cribrosa. Funduscopic examination may reveal total or partial lack of the optic disc and variable degrees of intraocular hemorrhage. Fluorescein angiographic finding is variable, visually evoked potential often shows the delay in latency or the decrese in amplitude, Computed tomography or magnetic resonance imaging usually demonstrates an intact optic nerve sheath. We report a case of optic nerve evulsion which diagnosed by retinoscopic finding, fluorescein angiography, computed tomography, and clinical history. We present it with a review of the literature.
Craniocerebral Trauma ; Evoked Potentials ; Fluorescein ; Fluorescein Angiography ; Hemorrhage ; Intraocular Pressure ; Magnetic Resonance Imaging ; Optic Nerve* ; Orbit ; Rupture

We experienced a case of congenital rubella syndrome manifesting patent ductus arteriosus, petechiae, microcephaly, intrauterine growth retardation, and hepatomegaly in one-day-old female newborn infant. Congenital rubella syndrome was confirmed by positive results of anti-rubella IgM in the sera of patient. Anti-rubella IgM was negative in the sera of mother, while anti-rubella IgG was positive.
Ductus Arteriosus, Patent ; Female ; Fetal Growth Retardation ; Hepatomegaly ; Humans ; Immunoglobulin G ; Immunoglobulin M ; Infant, Newborn ; Microcephaly ; Mothers ; Purpura ; Rubella Syndrome, Congenital*

Aconitine, a principal constituent of aconite, may cause myelopathy on the visual pathway, spinal cord and peripheral nerve of the rabbits. A single dose of aconitine (O.6mg/kg), was administered intraperitoneally in order to analyze electrophysiological change of the eye in a rabbit model. The changes of the VEP after an aconitine injection consisted of delay in the onset and peak latency, and a reduction in the amplitude of the contralateral a cortical response. The amplitude of YEP was reduced prominently for several days after the aconitine injection and thereafter recovered quickly. However, the onset and peak latency were significantly delayed until 8 weeks after the aconitine injection. The analysis of YEP afttords us an excellent opportunity to access the precise structural correlates of the functional changes associated with demyelination within the central nervous system in rabbits.
Aconitine* ; Aconitum ; Central Nervous System ; Demyelinating Diseases* ; Evoked Potentials, Visual* ; Peripheral Nerves ; Rabbits ; Spinal Cord ; Spinal Cord Diseases ; Visual Pathways*

Intracranial fibro-osseous lesion, also reported as calcifying pseudoneoplasm of the neural axis, is an uncommon lesion of the central nervous system. Since the discovery of this entity by Rhodes and Davis in 1978, there have been a total of 21 cases reported in the literature. We encountered one such case in a 28 year old male, who presented with left hemiparesis for 1 year. By the MR images, a 1.5 cm sized round mass was found at right parietal lobe near motor cortex. The mass lesion enhanced well, homogenously and revealed clear, slightly irregular margin. Excisional biopsy of the mass was performed. Microscopically the lesion was composed of calcified fibrous tissue with an amorphous gray-blue, coarsely fibrillar to chondromyxoid nodular areas. Sparse spindle cells, immunohistochemically negative for GFAP, vimentin and S-100, were scattered within the amorphous material. Palisading spindle or polygonal cells were present at the more cellular periphery of the lesion, which were vimentin positive but S-100 negative. There was no evidence of the pilocytic astrocytes, Rosenthal fibers, or GFAP positive hypertrophic astrocytes. Intracranial fibro-osseous lesions are apparently slow-growing with generally excellent prognosis after wide excision. The etiology remains unclear, but most investigators favor a reactive rather than neoplastic process.
Adult ; Astrocytes ; Axis, Cervical Vertebra ; Biopsy ; Central Nervous System ; Humans ; Male ; Motor Cortex ; Paresis ; Parietal Lobe ; Prognosis ; Research Personnel ; Vimentin