PURPOSE: This study was aimed to evaluate the recurrence rate of a giant cell tumor (GCT) of the bone. MATERIALS AND METHODS: The medical records of fifty four patients who were diagnosed with a giant cell tumor of the bone between March 1980 and December 2008 were analysed retrospectively. Among 54 patients, 27 were men, remaining 27 were women with the mean age of 33.1 years (range, 13-67 years). The mean duration of follow-up was 67.1 months. RESULTS: Twenty-one patients (38.9%) had a local recurrence. The mean time to recurrence was 21.5 months (range, 2-59 months). The local recurrence rate of the upper extremities was higher than that of lower extremities. According to Campanacci classification, patients with a grade I diseae had lower recurrence rate than those with grade II or III disease. There was no significant differences in the recurrence rates based on cryotherapy, the filling of bone cement or bone grafts and surgical margin. CONCLUSION: To prevent local recurrence of GCT of bone, curettage of the tumor and elimination of the remaining cells are more important than adjuvant therapy.
Cryotherapy ; Curettage ; Female ; Follow-Up Studies ; Giant Cell Tumors ; Giant Cells ; Humans ; Lower Extremity ; Male ; Medical Records ; Recurrence ; Retrospective Studies ; Transplants ; Upper Extremity

About 40% of patients with diabetes mellitus develops to diabetic nephropathy, and these patients show increment of glomerular filtration rate and renal volume at early phase. 99mTc-DMSA SPECT (single photon emission computed tomography) can measure a functional renal volume because 99mTc- DMSA it is taken up by the viable proximal tubular cells located in the renal cortex. To evaluate the renal volume in early diabetic nephropathy, we compared functional renal volume between diabetic patients and control, renal transplantation donor. 99mTc-DMSA was injected intravenously and SPECT was done after 2 hours in 15 diabetic patients, 18 renal transplantation donors, and 2 patients with end stage renal disease due to chronic glomerulonephritis. In diabetic patients with creatinine clearance more than 30ml/min and proteinuria, right and left renal volume were 247+/-22ml/BSA(m2), 256+/-37ml/BSA (m2), which were greater than those of diabetic patients with normal renal function and without proteinuria, or renal transplantation donors(P<0.05). In conclusion, we measured the functional renal volume by 99mTc-DMSA SPECT. Renal volume of diabetic patients with proteinuria were larger than the volume of control group or diabetic patients with normal renal function and without proteinuria. 99mTc-DMSA SPECT was thought to be useful test a for the measurement of functioning renal volume.
Creatinine ; Diabetes Mellitus* ; Diabetic Nephropathies ; Glomerular Filtration Rate ; Glomerulonephritis ; Humans ; Kidney Failure, Chronic ; Kidney Transplantation ; Proteinuria ; Succimer ; Technetium Tc 99m Dimercaptosuccinic Acid* ; Tissue Donors ; Tomography, Emission-Computed, Single-Photon*

Primary gout is a metabolic disease that has its basis in an inborn error in the intermediary metabolism of purines and related compounds. It is characterized by hyperuricemia, recurrent attacks of acute arthritis, deposition of monosodium urate crystals in and around the joints of the extremities, urolithiasis, renal and cardiovascular disease. Thirty-eight patients with gout managed at the department of orthopaedic surgery, Dong-A University Hospital, from April, 1990 to November 1993, had been reviewed retrospectively and the following results were obtained. 1. Most of cases were male(95%) and the mean age was 55.4 years old. 2. The case of first attack was 8 cases(21%), the most common age of first attack was fifth decade and mean duration of disease was 7.4 years. 3. The most common precipitating factor was overindulgence in food and alcohol. 4. The avarage uric acid level of serum and that 24-hour urine collection in acute attacks were 11.2 mg/dl and 24.5mg/D. Respectively all of the cases except four revealed increased ESR (average 43 mm/hr). 5. When the acute attack was developed, the most common involved joint was the first M-P joint (83%) of the foot, but as the acute gout was progressed to the chronic form, multiple joints were affected. 6, The punched out lesion in the radiograph was found in 7 cases(25 joints), among them 6 cases had suffered from the disease for longer than 3 years. 7. The most common complication was nephropathy(18 cases). 8. In case of acute gouty attack, we administered colchicine in the 22 cases. The therapeutic method of colchicine usually consisted of oral administration of 2 tablets(1.3mg) initially, followed by 1 tablet(0.65mg) every hour untill the relief of joint pain or the development of gastointestinal symptoms. We rocomended 6-8 tablets of colchicine for the management of acute gouty attack with safety. 9. Colchicine in small daily dose(0.65mg qd or bid) could be effective to prevent the recurrent attacks of high risk gouty arthritis.
Administration, Oral ; Arthralgia ; Arthritis ; Arthritis, Gouty ; Cardiovascular Diseases ; Clinical Study ; Colchicine ; Extremities ; Foot ; Gout ; Humans ; Hyperuricemia ; Joints ; Metabolic Diseases ; Metabolism ; Methods ; Precipitating Factors ; Purines ; Retrospective Studies ; Tablets ; Uric Acid ; Urine Specimen Collection ; Urolithiasis

Thymic cyst is relatively rare tumor which usually occurs in the neck or mediastinum. Cervical thymic cyst is usually situated laterally and deep to the anterior border of the sternocleidomastoid muscle, simulating a branchial cyst. Thymic cyst of the mediastinum is usually detected incidentally and differential diagnoses include cystic degeneration of thymoma, and cystic teratoma. Two case of a cervical and a mediastinal thymic cysts were reported. The one was a cervical thymic cyst developed slowly growing mass in a 53-year-old male a for 10 years. The cyst was unilocular and measures 5.4x2.9x2.8 cm with columnar or squamous cell linings. The other is a mediastinal thymic cyst developed in a 37-year-old female with chest discomfort for 7 months. The cyst was uniocular and measures 2.8x2.2x2.0 cm. The epithelial lining of the cyst was largely desquamated and covered by macrophages with cholesterol granuloma. Involutional thymic stissue in their walls were noted in both cysts. In both cases presence of thymic tissue in the wall of the cyst thought to be the most important diagnostic feature.
Female ; Male ; Humans ; Diagnosis, Differential ; Cysts

No abstract available.
Femur* ; Hip*

PURPOSE: Although adjuvant chemotherapy after resection of gastric cancer is a popular practice in Korea, there are still controversies about the effectiveness of the treatment. The fact that the relatively less effective drugs have been used and the rarity of large-scaled controlled studies may be partially responsible for the controversies. FP(5-FU, Cisplatin) combination is one of the most active regimen against advanced gastric cancer, consistently showing a response rate of 50~60%. We tried the FP chemotherapy as an adjuvant treatment for high-risk patients after curative resection of gastric cancer. MATERIALS AND METHODS: Between February 1992 and June 1996, 35 patients with completely resected high-risk gastric cancer(postoperative stage III or IV except thase with M1) received six courses of FP chemotherapy. Endpoints were toxicities of treatment, relapse free survival, and overall survival. RESULTS: With a median follow-up time of 17.1 months, Kaplan-Meier estimates of 2-year overall survival was 63.3% and relapse free survival estimates was 49%. There were no differences between stage III and IV patients in terms of overall survival or relapse free survival. Hematologic and non-hematologic toxicities were tolerable for most of the patients. CONCLUSION: Postoperative FP combination chemotherapy was tolerable for patients with high-risk(stage III and IV) gastric cancer. It is too early to determine the long term survival rates for this patients, but 2-year overall and relapse free survival were comparable to that of historical non-cisplatin containing regimens. Randomized phase III studies are warranted.
Chemotherapy, Adjuvant ; Cisplatin* ; Drug Therapy* ; Drug Therapy, Combination ; Fluorouracil* ; Follow-Up Studies ; Humans ; Korea ; Recurrence ; Stomach Neoplasms* ; Survival Rate

No abstract available.

Spinal fusion has performed for instability and anatomical reconstruction since 1985 by Barthe. Bone grafts and synthetic materials has been used for spinal fusion, but they have several limitations and complications. Recently a new synthetic polymer B.O.P.(Biocompatible Osteoconductive Polymer) was developed and it overcome the limitations of other materials. The B.O.P. showed no foreign body reaction and gave scaffolding for the osteoconduction and osteointegration. Authors operated 35 cases of spinal fusion with B.O.P. and the results and literature reviews were discussed.
Bone Regeneration ; Bone Substitutes ; Foreign-Body Reaction ; Polymers ; Spinal Fusion* ; Transplants

Anterior interbody fusion has used for instability and anatomical reconstruction in various cervical diseases since 1958 by cloward. Bone grafts such as autograft, allograft, xenograft and synthetic materials were utilized in fusion as a graft material. But conventional fusion materials have problems including postoperative morbidity, transmission of diseases, foreign body reaction, collapse, prolongation of operation time. A new synthetic material, Biocompatible Osteoconductive Polymer(B.O.P) is developed and it was useful for cervical anterior interbody fusion as a substitute for other fusion materials.
Allografts ; Autografts ; Foreign-Body Reaction ; Heterografts ; Transplants

OBJECTIVE: Many previous studies have shown that electrocardiographic (ECG) changes occur patients with subarachnoid hemorrhage (SAH). This study was designed to identify the frequency, influencing factors, and outcome of clinically significant cardiac arrhythmias after SAH. METHODS: We retrospectively analyzed clinical data of 122 patients including ECG finding, age, sex, the Hunt-Hess grade, the Fisher's grade, the history of hypertension, peak blood pressure and heart rate, location of aneurysm, Glasgow Outcome Scale (GOS) score, the days of admission to the intensive care unit, the presence of symptomatic vasospasm. RESULTS: Of 122 SAH patients, 50% (n = 61) had a verified clinically significant arrhythmia. There were no statistically significant independent factors associated with clinically significant arrhythmia in multivariate analysis. Although adjustments for the effects of age, Hunt-Hess grade, and the presence of symptomatic vasospasm on death were made, clinically significant arrhythmias were still independently predictive of death (no arrhythmia versus arrhythmia, 11.5% versus 27.9%, adjusted odds ratio [OR] 3.524, 95% confidence interval [CI] 1.229-10.100, p = 0.019) and poor outcome (GOS < or = 2, 13.1% versus 29.5%, adjusted OR 3.202, 95% CI 1.174-8.732, p= 0.023). CONCLUSION: Clinically significant arrhythmias after SAH are associated with a high mortality rate, and serious cardiac and neurological comorbidity. Patients with an abnormal ECG on admission should undergo close cardiac monitoring, and the presence of rhythm disturbances should prompt aggressive measures to treat myocardial infarction (MI), maintain a normal cardiac rhythm, and minimize the presence of autonomic stress.
Aneurysm ; Arrhythmias, Cardiac ; Blood Pressure ; Comorbidity ; Electrocardiography ; Glasgow Outcome Scale ; Heart Rate ; Humans ; Hypertension ; Intensive Care Units ; Multivariate Analysis ; Myocardial Infarction ; Odds Ratio ; Retrospective Studies ; Subarachnoid Hemorrhage