The anterior cruciate ligament(ACL) is one of the most important structure for maintenance of the sta- bility of the knee joint. Chronic instability as a result of insufficiency can lead to functional disability, pain, meniscal tears, and degenerative change in articular cartilage. The incidence of injuries of this liga- ment is increasing tendency due to development of vehicle system, industrial system and sports activities. Different authors have recommended both operative and nonoperative treatment for anterior cruciate ligament injuries. Variable methods for functional recovery of anterior cruciate ligament were introduced and argued about ideal method. As arthroscopic techniques improve, surgeons are more inclined to rec- ommend surgical treatment. The methods of repair of acute rupture of the anterior cruciate ligament through the arthrotomy tech- nique have been used widely, but the arthroscopic repair is a relatively new technique. This arthroscopic technique is idealy applicable for rupture at femoral and tibial attachment site. A arthroscopic repair of anterior cruciate ligament was performed with use of the arthroscopy, in 15 consecutive, selected anterior cruciate ligaments that were ruptured at femoral or tibial attachment site, and within 2 weeks after injury. The 15 patients were followed for a minimum of one year(mean, eighteen months; maximum, thirty-eight months). The mean age of the 15 patients at the operation was thirty years(range, seventeen to forty-eight years). The results of arthroscopic repair of anterior cruciate ligament in 15 cases were satisfactory, and as fol- lows. l. All of the 15 cases, the laxity of repaired anterior cruciate ligaments were decreased. 2. The average Lysholm Knee Score Scale was increased from 16 points preoperatively to 89 points postoperatively. Five of the patients(33%) were rated as excellent, and ten patients(67%) were rated as good. 3. The range of motion of the repaired knee joints were from Oo to 135o that results were achieved at postoperative 6 months.
Anterior Cruciate Ligament* ; Arthroscopy ; Cartilage, Articular ; Humans ; Incidence ; Knee ; Knee Joint ; Range of Motion, Articular ; Rupture* ; Sports

No abstract available.
Fractures, Open* ; Tibia*

Interlocking intramedullary nailing has many advantages for long bone fracture. However, we can meet many problems during the operative procedure. Among the patients who were treated with interlocking intramedullary nailing from March, 1990 to December, 1991, forty-eight patients(49 cases) of femur and tibia fracture who were followed up more than twelve months(average 14months: 12months 18months) were included in this study. 1) Forty-nine cases consisted of 20 cases(41%) of femur fracture and 29 cases(59%) of tibia fracture. 2) Two cases of proximal protrusion were developed because of inadequate implant length. 3) Operative complications were encountered with 3 cases of new fracture line, 1 case of new fragmentation, 1 case of reduction loss, 2 cases of failure of proximal targeting, 3 cases of failure of distal targeting, 2 cases of distraction of fracture site more than 3 mm, 1 case of sciatic nerve injury due to excessive traction and 1 case of tibial inlet error. 4) Postoperative complications were encountered with 1 case of distal targeting screw failure, 4 cases of infection and 8 cases of delayed union. 5) According to the result, sufficient planning and confirmations(preoperatively, intraoperatively and postoperatively) can diminish the complications. And then the interlocking intramedullary nailing will be useful method in the case of long bone fracture when the operator has extensive experiences.
Bays ; Femur ; Fracture Fixation, Intramedullary ; Fractures, Bone ; Humans ; Methods ; Postoperative Complications ; Sciatic Nerve ; Surgical Procedures, Operative ; Tibia ; Traction

PURPOSE: Two types of chitosan oligosaccharides (COSs), COS I and COS II, were investigated for the effects on ascitic tumor and enzymes for cancer chemoprevention. MATERIALS AND METHODS: Chitosan oligosaccharides were administered once daily for 10 days after the tumor implantation. The change of body weight was observed for 20 days, and the survival rate of mice was determined after 21 days. Chitosan oligosaccharides were administered once daily for 10 days before the tumor implantation (1 106 cells). The number of ascitic tumor cells were measured at 6 days after tumor implantation. Chemopreventive potential of chitosan oligosaccharides was examined by the induction of quinone reductase and inhibition of cytochrome P450 1A1. RESULTS: Chitosan oligosaccharides exerted antitumor activity by inhibiting the growth of Ehrlich ascites tumor cells in vivo. Mice given Ehrlich cells and 10 or 100 mg/kg body weight of chitosan oligosaccharides had 33% survival after 21 days. Quinone reductase activity was increased with chitosan oligosaccharides. There were 26% and 33% inhibition in the activity of cytochrome P450 1A1 enzyme with the treatment of COS I and COS II, respectively. CONCLUSION: These results suggest that chitosan oligosaccharides has antitumor activity and cancer chemo preventive potential by inducing QR activity and inhibiting cytochrome P450 1A1.
Animals ; Body Weight ; Carcinoma, Ehrlich Tumor ; Chemoprevention* ; Chitosan* ; Cytochrome P-450 Enzyme System ; Mice ; NAD(P)H Dehydrogenase (Quinone) ; Oligosaccharides ; Survival Rate

PURPOSE: To compare the clinical results of BRTO in the gastric varices with those of TIPS. MATERIALS AND METHODS: From January 2004 to March 2006, eight patients who had been followed up for more than 1 month after BRTO were enrolled in this study. This study compared the clinical efficacy of BRTO with that of TIPS in 13 patients who had undergone TIPS from January 2000 to March 2006. The change in laboratory parameters before and after each procedure and the incidence of rebleeding, encephalopathy, asictes and varices were analyzed after each procedure. Results:In the BRTO group, the level of albumin increased, and the levels of ammonia and the Child-Pugh score decreased. The TIPS group showed no improvement in the liver function. In the BRTO group, the gastric varices were eradicated in 7 patients. Gastric variceal rebleeding and encephalopathy did not occur. However, the esophageal varices worsened in 6 patients. In the TIPS group, rebleeding (n=4), encephalopathy (n=7) and a worsening of the gastric (n=5) or esophageal varices (n=2) occurred. CONCLUSION: BRTO improves the metabolic activity of the liver and has a lower incidence of encephalopathy. Hence, BRTO is a good alternative to TIPS in the gastric varices accompanied by a gastrorenal shunt although a treatment for a worsening of the esophageal varices may be needed after BRTO.
Ammonia ; Esophageal and Gastric Varices* ; Humans ; Incidence ; Liver ; Portasystemic Shunt, Surgical* ; Varicose Veins

Although bladder cancers are very common, little is known about their molecular pathogenesis. It is known, that p53 alteration is found in about 60%p of muscleinvasive bladder cancer, necessiating aggressive therapy and poor outcome. We examined the nuclear expression of p53 protein, using D07 monoclonal antibody in the urine samples, from 31 patients with transitional cell carcinoma of the bladder to investigate the correlation of p53 overexpression with histologic grades and depth of invasion. The positive rate of p53 protein was 27%o in superficial bladder tumor, but increased up to 71% in the invasive bladder carcinomas. The overexpression of p53 protein increased according to Mostofi grading system from 18% in grade I, 45% in grade Il, and up to 100% in grade ill. The p53 expression tended to be higher in the invasive and high grade bladder cancers than in the superficial and low grade ones(p<0.05). These results suggest that immunohistochemical analysis of the urine specimen in the bladder cancer patients could be a useful method of screening for the presence of p53 mutant protein. The mutant p53 protein expression may be an indicator of bladder cancer with more proliferative potential and/or aggressive biologic behavior.
Carcinoma, Transitional Cell ; Genes, p53* ; Humans ; Immunohistochemistry ; Mass Screening ; Mutant Proteins ; Urinary Bladder Neoplasms* ; Urinary Bladder*

Abnormalities of p53 gene are common in lung cancers and are associated with immunologically detectable p53 protein. p53 immunoreactivity is uncommon in normal cells but is frequently seen in neoplasia. Therefore, assessment of p53 expression may assist in the cytological diagnosis of malignancy. The usefulness of p53 immunostaining as a marker of malignancy in the cytological analysis of bronchial brush specimens from the patients with lung cancers was investigated in this study. A total of 71 bronchial brush samples submitted for cytologic diagnosis were immunostained with D07, a monoclonal antibody to recombinant p53 protein. Resultant p53 data were correlated with cytologic diagnosis and clinical information. Of the 17 smears with a benign cytodiagnosis, all were p53 negative. Of the 40 cases with a malignant cytodiagnosis(histologically confirmed), 35 were p53 positive and 5 were negative. Of the 14 cases that were cytologically suspicious but nondiagnostic for malignancy, 11 were p53 positive, 9 of which were subsequently proved to be malignant by histologic examination, and the remaining 2 cases were tuberculosis clinically. Forty four of 51 histologically confirmed lung carcinomas were p53 positive, including 25 of 28 squamous cell carcinomas, 13 of 17 small cell carcinomas, 3 of 3 adeno- carcinomas, and 3 of 3 large cell undifferentiated carcinomas. These results suggest that p53 immunostaining could be of value as a marker of malignancy in the cytologic examination of bronchial brush specimens. Furthermore, we have shown the possible clinical utility of p53 immunostaining in cytopathological diagnosis, that is, as a valuable adjunct to morphological assessment in the analysis of cytopathologically suspicious cases.
Carcinoma ; Carcinoma, Small Cell ; Carcinoma, Squamous Cell ; Cytodiagnosis ; Diagnosis ; Genes, p53 ; Humans ; Immunohistochemistry ; Lung ; Lung Neoplasms ; Tuberculosis

BACKGROUND AND PURPOSE: Serial nerve conduction studies (NCSs) are recommended for differentiating axonal and demyelinating Guillain-Barré syndrome (GBS), but this approach is not suitable for early diagnoses. This study was designed to identify possible NCS parameters for differentiating GBS subtypes. METHODS: We retrospectively reviewed the medical records of 70 patients with GBS who underwent NCS within 10 days of symptom onset. Patients with axonal GBS and acute inflammatory demyelinating polyneuropathy (AIDP) were selected based on clinical characteristics and serial NCSs. An antiganglioside antibody study was used to increase the diagnostic certainty. RESULTS: The amplitudes of median and ulnar nerve sensory nerve action potentials (SNAPs) were significantly smaller in the AIDP group than in the axonal-GBS group. Classification and regression-tree analysis revealed that the distal ulnar sensory nerve SNAP amplitude was the best predictor of axonal GBS. CONCLUSIONS: Early upper extremity sensory NCS findings are helpful in differentiating axonal-GBS patients with antiganglioside antibodies from AIDP patients.
Action Potentials ; Antibodies ; Axons* ; Classification ; Diagnosis ; Early Diagnosis ; Electrodiagnosis ; Guillain-Barre Syndrome* ; Humans ; Medical Records ; Neural Conduction ; Retrospective Studies ; Ulnar Nerve ; Upper Extremity*

PURPOSE: Combined resection of invaded organ in advanced gastric cancer has been performed for complete removal of tumor and clearance of regional lymph node. However, higher morbidity and mortality associated with this procedure have been reported in recent large series and the efficacy of the procedure in survival remains controversial. In this study, we analyzed the efficacy of gastrectomy combined with invaded organ resection. METHODS: The medical records of 153 patients with T4 gastric carcinoma who underwent operation at Department of Surgery, Kangnam St. Mary's Hospital, The Catholic University of Korea from 1990 to 1998 were evaluated retrospectively. The patients were divided into three groups. Thirty five patients with combined resection were included in group I, and 72 patients with gastrectomy alone were in group II and 46 patients with no resection were included in group III. RESULTS: Pancreas was the most frequently invaded organ (100 patients: 65.4%), followed by colon (57 patients: 37.3%). The patients of group III were older than that of group I, and the tumor size was bigger in group I than group II. Incidence of the lower one third of the gastric cancer was higher in group II and III than that of group I. Histologically, undifferentiated carcinomas were more frequent in all groups. Postoperative complications in group I occurred in 11 patients (31.5%): intraabdominal abscess (4 patients: 11.4%), duodenal stump leakage (2 patients: 5.7%), renal failure (2 patients: 5.7%), and followed by bleeding, pulmonary complication, pancreatitis. Operative mortality of group I was 2.9%. The 5-year survival rate of group I and II was 15.6% and 3.1%, respectively and 0% in group III. In patients without peritoneal or liver metastasis, the 5-year survival rate of group I and II was 27.0% and 5.5%, respectively. But in patients with incurable factors, there was no difference in survival between the two groups. Median survival of group I with incurable factors was only 7 months. CONCLUSION: Combined resection of invaded organ in patients with T4 gastric carcinoma is a relatively safe procedure. Combined resection should be considered in patients without incurable factors such as peritoneal or liver metastasis.
Abscess ; Carcinoma ; Colon ; Gastrectomy ; Hemorrhage ; Humans ; Incidence ; Korea ; Liver ; Lymph Nodes ; Medical Records ; Mortality ; Neoplasm Metastasis ; Pancreas ; Pancreatitis ; Postoperative Complications ; Renal Insufficiency ; Retrospective Studies ; Stomach Neoplasms* ; Survival Rate

PURPOSE: Bone metastasis is not a common event in patients with gastric cancer. Therefore, most studies of bone metastasis in such patients have been in the form of case reports, so the clinical features of the bone metastasis are not well understood. To clarify metastatic patterns, the efficacy of radiation or chemotherapy, and the prognosis, we analyzed 29 cases of patients with bone metastases after curative surgery for gastric cancer. MATERIALS AND METHODS: Twenty-nine (29) gastric cancer patients with bone metastasis who underwent curative resection from January 1989 to December 2002 at the Departments of Surgery, Kangnam St. Mary's Hospital and Our Lady of Mercy's Hospital, The Catholic University of Korea, were analyzed. RESULTS: Nineteen (19) patients were males and, 10 patients were females. The mean age of the patients was 53+/-12 years. There were more Borrmann type-3 and type-4 cancers and more undifferentiated histologic types. Most of the original cancers were stage III or IV. The most frequently involved bone was the spine. Treatment after recurrence was done in 16 patients (55.2%). The median survival time after recurrence of the patients who received treatment was seven (7) months (0~75 months in range), which was significantly longer than that of the patients who did not received treatment (P=0.019). However, there was no difference according to the treatment modality (P=0.388). CONCLUSION: Bone metastasis after a curative resection of gastric cancer tends to occur in Borrmann type-3 and type-4 cancers, cancers with undifferentiated histology and, in stage III/IV disease. The prognosis of bone metastasis is dismal, and aggressive treatment is the only way to prolong survival.
Drug Therapy ; Female ; Humans ; Korea ; Male ; Neoplasm Metastasis* ; Prognosis ; Recurrence ; Spine ; Stomach Neoplasms*