PURPOSE: Injury to articular cartilage is likely progressive to develop arthritis and dysfunction of joint because its regeneration is limited. Transplantation of cultured autologous chondrocytes was proved to be a satisfactory treatment method and could prevent a dysfunction of joint. However chondrocytes propagated in monolayer culture lose their original characteristics by assuming a morphologic shift to fibroblast like cell and biosynthetic shift to production of collagen type I from type II and to decrease in synthesis of DNA and proteoglycans. A three dimensional culture of articular chondrocytes using microcarrier was performed to overcome disadvantages of phenotypic changes in monolayer culture. MATERIALS & METHODS: Cultured articular chondrocytes, 6 times passed in 13 weeks, were innoculated and propagated in flasks for monolayer culture and spinner flasks for three dimensional culture respectively for 2 weeks. RESULTS: Cells in three dimensional culture proliferated faster and showed more markedly increase in cell number than those in monolayer culture. Expression of type II collagen was observed in three dimensional culture, but was hardly observed in monolayer culture. CONCLUSION: Degree of synthesis of DNA and proteoglycans also more markedly increase in three dimensional culture than in monolayer culture. Our experiments demonstrate that three dimensional culture of articular chondrocyte using microcarrier provides increase in growth and reexpression of phenotype of chondrocytes.
Arthritis ; Cartilage, Articular ; Cell Count ; Chondrocytes* ; Collagen Type I ; Collagen Type II ; DNA ; Fibroblasts ; Joints ; Phenotype ; Proteoglycans ; Regeneration

PURPOSE: Injury to articular cartilage is likely progressive to develop arthritis and dysfunction of joint because its regeneration is limited. Transplantation of cultured autologous chondrocytes was proved to be a satisfactory treatment method and could prevent a dysfunction of joint. However chondrocytes propagated in monolayer culture lose their original characteristics by assuming a morphologic shift to fibroblast like cell and biosynthetic shift to production of collagen type I from type II and to decrease in synthesis of DNA and proteoglycans. A three dimensional culture of articular chondrocytes using microcarrier was performed to overcome disadvantages of phenotypic changes in monolayer culture. MATERIALS & METHODS: Cultured articular chondrocytes, 6 times passed in 13 weeks, were innoculated and propagated in flasks for monolayer culture and spinner flasks for three dimensional culture respectively for 2 weeks. RESULTS: Cells in three dimensional culture proliferated faster and showed more markedly increase in cell number than those in monolayer culture. Expression of type II collagen was observed in three dimensional culture, but was hardly observed in monolayer culture. CONCLUSION: Degree of synthesis of DNA and proteoglycans also more markedly increase in three dimensional culture than in monolayer culture. Our experiments demonstrate that three dimensional culture of articular chondrocyte using microcarrier provides increase in growth and reexpression of phenotype of chondrocytes.
Arthritis ; Cartilage, Articular ; Cell Count ; Chondrocytes* ; Collagen Type I ; Collagen Type II ; DNA ; Fibroblasts ; Joints ; Phenotype ; Proteoglycans ; Regeneration

PURPOSE: The renal histological and hemodynamic changes and the expressions of hypoxia inducible factor-1alpha (HIF-1alpha) and vascular endothelial growth factor (VEGF) were evaluated according to the differential renal function (DRF) during total ureteral obstruction (TUO) in a rabbit model. MATERIALS AND METHODS: In forty-nine control (5) and 16 experimental rabbits (16 in TUO 3 days, 13 in TUO 7 days and 15 in TUO 14 days), the renal blood flow (RBF) and 99mTc-DTPA renal scan were measured both before and after TUO. The cut-off of the DRF group was 40%. The histological changes and expressions of HIF-1alpha and VEGF were evaluated using H&E and immunohistochemical stain, respectively. RESULTS: The entire control group demonstrated more than 40% DRF. Contrary to the control group, the DRF was less than 40% in 4 (25%), 7 (53%) and 6 rabbits (40%) in TUO 3, 7 and 14 day groups, respectively. The postobstructive compared to preobstructive RBF was decreased in each group. The RBF was more decreased in the lower than the higher DRF group (more than 40%) in all of the experimental groups. Abnormal histological changes were more prominent in the experimental groups, and increased with the obstruction time. However, there was no difference in relation to the DRF. The expressions of HIF-1alpha and VEGF were more prominent in the experimental and lower DRF groups. CONCLUSIONS: During acute TUO, the decreased RBF and hypoxia may play a role in preservation of the DRF.
Anoxia* ; Hemodynamics ; Hypoxia-Inducible Factor 1 ; Rabbits ; Renal Circulation ; Ureter* ; Ureteral Obstruction* ; Vascular Endothelial Growth Factor A*

PUEPOSE: To analysis the clinical and radiographic results of patients who could be followed more than five years in the cemented total knee arthroplasty. MATERIALS AND METHODS: Twenty-two cases(30 patients) were analysed clinically and radiographically, which underwent cemented total knee arthroplasties between March 1991 and December 1994, and were followed up at least more than 5 years. Several factors such as pain at walking, range of motion(ROM), knee rating score of the Hospital for Special Surgery(HSS), flexion contracture for clinical evaluation were evaluated and femorotibial angle, radiologic component position, radiolucent zone according to the roentgenographic evaluation of american knee society for the radiologic evaluation were analysed. RESULTS: Twenty-nine cases(90.7%) were rated as good or excellent, HSS scores were improved from preoperatively 51.5 points to postoperatively 85.5 points, Flexion contracture was relieved from 11degrees pre-operatively to 1degree postoperatively and ROM of knee joint were increased from 118degrees to 120.2 degrees . There were 4 complications; patellar subluxation in three cases, aseptic loosening in one case. The survival rate was 96.9% at six years and seven months. CONCLUSION: According to the clinical and radiologic assessments, cemented total knee arthraplasty seemed to be one of the best methods to fix the prostheses of total knee arthroplasty, which gave good or excellent clinical results at more than five years follow up.
Arthroplasty* ; Contracture ; Follow-Up Studies* ; Humans ; Knee Joint ; Knee* ; Prostheses and Implants ; Survival Rate ; Walking

We investigated the risk factors for resistance to ciprofloxacin, cefazolin, ampicillin and co-trimoxazole in Escherichia coli isolates from urine of Korean female patients with acute uncomplicated cystitis (AUC). A total of 225 patients and their E. coli isolates were prospectively and nationwidely enrolled between May and October, 2006. All the antimicrobials did not show any differences according to the age group. A higher rate of ciprofloxacin resistance was observed in the south (OR: 3.04, 95% CI: 1.19-7.80 for Chungcheong-do & Jeolla-do; OR: 3.04, 95% CI: 1.22-7.58 for Gyeongsang-do) compared to Gyeonggi-do. Two recurrences of AUC in the past year was an important risk factor for antimicrobial resistance (ciprofloxacin; OR: 6.71, 95% CI: 1.86-24.11 and cefazolin; OR: 5.72, 95% CI: 1.20-27.25). However, the resistance to co-trimoxazole and ampicillin was not associated with any of the risk factors. This study also revealed the pattern of multi-drugs resistance in ciprofloxacin resistant E. coli strains. In conclusion, for Korean patients with two more recurrences of AUC in the past year, it is strongly recommended to perform an antimicrobial sensitivity test with a urine sample before empirical treatment.
Acute Disease ; Adolescent ; Adult ; Aged ; Ampicillin/pharmacology ; Anti-Bacterial Agents/pharmacology ; Cefazolin/pharmacology ; Ciprofloxacin/pharmacology ; Cystitis/*microbiology ; *Drug Resistance, Bacterial ; Escherichia coli/*drug effects/isolation & purification ; Female ; Humans ; Microbial Sensitivity Tests ; Middle Aged ; Prospective Studies ; Republic of Korea ; Risk Factors ; Trimethoprim-Sulfamethoxazole Combination/pharmacology

Over 26 kinds of tablets and capsules, such as Tetracycline, Quinidine and Potassium preparations were reported to cause esopbageal ulcerations, eharacterized in various size, shape and number, ind sually in mid-esophagus, Recently authors experienced 10 cases of drug-induced esophageal ulcerations due to antibiotics and antiinflammatory agents such as Tetracycline, Aspirin, etc. Four cases were men and six were women. Four cases were in third dades, three in fourth cleeades, two in fifth decades and one in sixth decades. Presenting symptoras were odynophagia(4/10), dysphagia(3/10), substernal pain(7/10) and epigastric pain(3/10). Endoscopic examination of the esophgus showed single or multiple, small and shallow ulcers on the mid-esophgeal mucosa at the level of 30cm from the ineisor in eight cases, one Iarge and deep ulcer at the level of 40cm from incisor in one patient and one amall, shallow and one large, deep ulcers at the same time. in one patient The shape of alcers were various from a round to a large horseshoe shaped one. The clinical course was mild without complications. It was suggested that drug-induced esophsgeal ulcers with antibiotics and antiinflammatory agents could be found frequently and they had benign and mild clinicalc ourse,
Anti-Bacterial Agents ; Anti-Inflammatory Agents ; Aspirin ; Capsules ; Female ; Humans ; Incisor ; Male ; Mucous Membrane ; Potassium ; Quinidine ; Tablets ; Tetracycline ; Ulcer*

We experienced a case of congental hepatic fibrosis in a 21-year-old Korean male. He had frequent episodes of esophageal variceal bleeding. His liver and kidney functions were preserved. He had cystic lesions on both kidneys. A diagnosis of congenital hepatic fibrosis was made by an inferior venacavogram and peritoneoscopic liver biopsy. A Kobayashi operation was performed for esophageal varices. He had no more variceal bleeding and his general condition was good after operation.
Biopsy ; Diagnosis ; Esophageal and Gastric Varices ; Fibrosis* ; Humans ; Kidney ; Laparoscopy ; Liver ; Male ; Young Adult

Tuberculosis is an adverse event in patients with Crohn’s disease receiving anti-tumor necrosis factor (TNF) therapy. However, tuberculosis presenting as a bronchoesophageal fistula (BEF) is rare. We report a case of tuberculosis and BEF in a patient with Crohn’s disease who received anti-TNF therapy. A 33-year-old Korean woman developed fever and cough 2 months after initiation of anti-TNF therapy. And the symptoms persisted for 1 months, so she visited the emergency room. Chest computed tomography was performed upon visiting the emergency room, which showed BEF with aspiration pneumonia. Esophagogastroduodenoscopy with biopsy and endobronchial ultrasound with transbronchial needle aspiration confirmed that the cause of BEF was tuberculosis. Anti-tuberculosis medications were administered, and esophageal stent insertion through endoscopy was performed to manage the BEF. However, the patient’s condition did not improve; therefore, fistulectomy with primary closure was performed. After fistulectomy, the anastomosis site healing was delayed due to severe inflammation, a second esophageal stent and gastrostomy tube were inserted. Nine months after the diagnosis, the fistula disappeared without recurrence, and the esophageal stent and gastrostomy tube were removed.

Small bowel diseases are uncommon and difficult to be diagnosed by conventional methods such as endoscopy and radiologic study. Recently, wireless capsule endoscopy has been known as a new diagnostic method to detect the small bowel diseases, especially in patients with obscure gastrointestinal bleeding. A 48-year-old male patient admitted our hospital with signs of gastrointestinal bleeding and iron deficiency anemia. There was no evidence of bleeding in upper and lower endoscopic exams. Finally, wireless capsule endoscopy demonstrated small bowel polyp as a cause of obscure gastrointestinal bleeding. We report a case of small bowel polyp bleeding diagnosed by wireless capsule endoscopy with a review of relevant literatures.
Anemia, Iron-Deficiency ; Capsule Endoscopy* ; Endoscopy ; Hemorrhage* ; Humans ; Male ; Middle Aged ; Polyps*

BACKGROUND: Atrial fibrillation (AF) can be a risk factor for development of significant tricuspid regurgitation (TR). We investigated which clinical and echocardiographic parameters were related to severity of functional TR in patients with lone AF. METHODS: A total of 89 patients with lone AF were enrolled (75 +/- 11 years; 48% male): 13 patients with severe TR, 36 patients with moderate TR, and 40 consecutive patients with less than mild TR. Clinical parameters and echocardiographic measurements including right ventricular (RV) remodeling and function were evaluated. RESULTS: Patients with more severe TR were older and had more frequently persistent AF (each p < 0.001). TR severity was related to right atrial area and tricuspid annular systolic diameter (all p < 0.001). The patients with moderate or severe TR had larger left atrial (LA) volume and increased systolic pulmonary artery pressure (SPAP) than the patients with mild TR (p = 0.04 for LA volume; p < 0.001 for SPAP). RV remodeling represented by enlarged RV area and increased tenting height was more prominent in severe TR than mild or moderate TR (all p < 0.001). Multivariate analysis showed type of AF, LA volume, tricuspid annular diameter and tenting height remained as a significant determinants of severe TR. In addition, tenting height was independently associated with the presence of severe TR (p = 0.04). CONCLUSION: In patients with lone AF, TR was related to type of AF, LA volume, tricuspid annular diameter and RV remodeling. Especially, tricuspid valvular tethering seemed to be independently associated with development of severe functional TR.
Atrial Fibrillation* ; Echocardiography* ; Humans ; Multivariate Analysis ; Pulmonary Artery ; Risk Factors ; Tricuspid Valve Insufficiency*