Giant cell tumor is a predominantly benign condition but often the tumor is locally aggressive and tends to have high rate of recurrence and it can evolve into a malignant tumor. Thus the lesions have a practically difficult therapeutic problem for the orthopaedic surgeon and any method of treatment has not been satisfied. Between March 1984 and March 1993, clinical observation was carried out on 22 cases of giant cell tumor of bone to analyse the recurrence rate and functional evaluation of the joint according to the treatment methods, pathological grade and cortical destruction. The mean follow-up time was 75. 2 months. The recurrence rate of the intralesional excision group was 54.5% and that of the wide excision group was 9%, There was no relationship between the pathologic grade and recurrence rate. There was no recurrent case in the grade I cortical destruction but almost all of recurrence was occurred in the grade I or II cortical destruction. The functional result of the giant cell tumor occurred around the knee joint was that the mean ratings in the intralesional excision group were 79% and in the wide excision group were 51%. In conclusion, to achieve better joint function and less recurrence rate, intralesional or marginal excision with heat using bone cement or with chemical cauterization using phenol and alcohol can be used for cases of radiological grade I or II, and wide excision for grade III.
Cautery ; Follow-Up Studies ; Giant Cell Tumor of Bone ; Giant Cell Tumors ; Giant Cells ; Hot Temperature ; Joints ; Knee Joint ; Methods ; Phenol ; Recurrence

No abstract available.
Rhizotomy* ; Trigeminal Neuralgia*

The effect of surface roughness of ceramic-polymer CAD/CAM blocks on the mechanical properties was investigated in this study. Commercially available Polyglass (Vericom, Korea) and Enamic (Vita, Germany) were selected for this purpose. They were cut into either (4.0×2.1×17.0) mm and (3.0×4.0×17.0) mm, followed by grinding, and polished sequentially with 6 µm and 1 µm diamond paste. Flexural strength, fracture toughness, and Weibull analysis were determined according to ISO 6872 Dentistry-Ceramic materials. The elastic moduli were calculated from a stress-strain curves under flexural loading. The statistical significances of the mechanical properties between the products and surface roughness were analyzed with ANOVA and pared t-test at a significance level of 0.05. After grinding with 6 µm diamond paste after cutting by observing with an atomic force microscope, the arithmetic average roughness decreased to 47~49% and the maximum roughness decreased to 68~69%. When polishing with 1 µm diamond paste, The average roughness decreased to 13~22% and the maximum roughness decreased to 16~19%. When the flexural load was applied, stress increased linearly and fractured without plastic deformation both Polyglass and Enamic. As the surface roughness decreased, the mechanical properties were increased both Polyglass and Enamic. However, the mechanical properties of Polyglass increased up to P3, while Enamic showed almost maximal values at E2, after that there was no significant differences between E2 and E3. It could be due to the different microstructure between two blocks used in this experiment.
Diamond ; Plastics

Maple syrup urine disease(MSUD) is an autosomal recessive disorder involving the metabolism of the branched-chain amino acids(BCAA) such as leucine, isoleucine and valine. The disorder is due to a defect in branched-chain alpha-ketoacid dehydrogenase(BCKAD) and the classic form causes rapid progressive and overwhelming illness beginning in the first weeks of life, present with poor feeding, lethargy, change in muscle tone, acidosis, seizures and coma. The goal of therapy in acutely ill patients with MSUD is an immediate reduction in the plasma levels of the BCAAs and branched-chain ketoacids. In this report, we describe an infant with MSUD who was treated by dietary therapy alone. During the therapy, acrodermatitis enteropathica-like syndrome developed with low plasma isoleucine concentration while she was receiving a formula deficient in BCAAs.
Acer* ; Acidosis ; Acrodermatitis* ; Amino Acids, Branched-Chain ; Coma ; Diet Therapy* ; Diet* ; Humans ; Infant ; Isoleucine ; Lethargy ; Leucine ; Maple Syrup Urine Disease* ; Metabolism ; Plasma ; Seizures ; Valine

With the development of antibiotics, tympanogenic labyrinthitis complicated by otitis media rarely occurs nowadays. Only few cases of acute serous or suppurative labyrinthitis in otitis media patients have been reported previously in the literature. Acute suppurative labyrinthitis caused by direct bacterial invasion into the inner ear leads to potentially severe, irreversible hearing loss, vertigo and spontaneous nystagmus toward the healthy side. Magnetic resonance image might be helpful to recognize the inflammatory lesions of the labyrinth. Treatment for tympanogenic labyrinthitis includes an appropriate use of antibiotics and establishment a draining route. Recently, we experienced an unusual case of acute suppurative labyrinthitis complicated by chronic otitis media without cholesteatoma. We also review and discuss the clinical manifestations, radiologic findings and treatment strategy of this disease.
Anti-Bacterial Agents ; Cholesteatoma ; Ear, Inner ; Hearing Loss ; Humans ; Labyrinthitis ; Magnetic Resonance Spectroscopy ; Otitis ; Otitis Media ; Vertigo

PURPOSE: To evaluate the exact prevalence of primary glomerular diseases in Korea. METHODS: We analyzed a retrospective cohort of biopsy proven 1,100 patients with primary glomerular disease in OO Hospital from April 1990 to March 2010. RESULTS: Pathologic diagnosises of 1,100 cases were as follows: IgA nephropathy (IgAN), 557 cases (50.6%), was the most common followed by 200 cases (18.1%) of minor glomerular abnormalities (MGA), 168 cases (15.2%) of focal segmental glomerulosclerosis (FSGS), 93 cases (8.0%) of membranous nephropathy (MN), 31 cases (2.8%) of membranoproliferative glomerulonephritis type I (MPGN), 17 cases (1.5%) of focal glomerulonephritis and 7 cases (0.6%) of diffuse mesangial proliferative glomerulonephritis (DMGN) in order. In idiopathic nephrotic syndrome, the most common pathologic diagnosis was minimal change nephrotic syndrome (MCNS) (40.2%), followed by FSGS (27.5%), MN (24.2%), MPGN (8.1%) and DMGN (0.5%). When the incidence rates between 1990-1992 and 2008-2010 were compared, IgAN and FSGS increased from 34.7, 12.5 to 47.8%, 30.4%, but MCNS (from 33.3 to 6.5 %) decreased significantly. CONCLUSION: IgAN was the most common primary glomerulonephritis. During the past 20 years, the prevalence of IgAN and FSGS were increased, while MCNS and MN were decreased.
Biopsy ; Cohort Studies ; Glomerulonephritis ; Glomerulonephritis, IGA ; Glomerulonephritis, Membranoproliferative ; Glomerulonephritis, Membranous ; Glomerulosclerosis, Focal Segmental ; Humans ; Incidence ; Nephrosis, Lipoid ; Nephrotic Syndrome ; Prevalence ; Retrospective Studies

PURPOSE: To evaluate the sagittal alignment and the main factors contributing to sagittal compensatory mechanism in lumbar stenosis. MATERIALS AND METHODS: 63 patients of spinal stenosis surgically treated were evaluated using 14x36 inch standing lateral films. The global sagittal balance was measured with C7 plumb line and hip flexion angle. The thoracic kyphosis, lumbar lordo-sis and pelvic tilting angle were compared to each of normal korean values to find out main factors participating in compensatory mechanism. At last follow-up, at least 6 months after surgery, the changes of sagittal parameters and global balance were evaluated according to the correction amount of pathologic segments angle to understand the compensatory mechanism and its contributing factors. RESULTS: The C7 plumb line was +3.04 cm(/0.91 SD), thoracic kyphosis 30.0dgree(/12.1), lumbar lordosis 43.1dgree(/14.7) and pelvic tilting angle 21.7dgree(/8.2). All patients except 8 showed global compensation state. The differences compared to normal korean values were 10 dgree of pelvic tilting angle and 2dgreeof thoracic kyphosis. Pelvic tilting angle was more contributing factor of compensatory mechanism than thoracic kyphosis. At last follow up, 14 patients surgically corrected 5dgreeor more showed significant posterior shift of C7 plumb line and increased lumbar lordosis(p<0.05). 11 patients aggravated 5dgree or more showed significant increase of adjacent segment angle to participate in compensatory mechanism(p<0.05). CONCLUSION: Most lumbar spinal stenosis patients showed compensated sagittal balance state. Adjacent segments and pelvic tilting were thought as main contributing factors of compensation mechanism.
Animals ; Compensation and Redress ; Constriction, Pathologic ; Follow-Up Studies ; Hip ; Humans ; Kyphosis ; Lordosis ; Spinal Stenosis*

PURPOSE: The objectives of this study were to estimate the prevalence of obesity in adolescents; to study the association between obesity, blood pressure, and dyslipidemia; and to evaluate the superiority of waist circumference to waist/hip ratio(WHR) in central obesity. METHODS: We selected 1382 adolescents(M : F=690 : 692) aged from 11 to 18 years(mean age; boys15.0, girls 15.4) in Incheon. We measured weight, height, waist, waist/hip ratio, and blood pressure, with blood sampling to evaluate the dyslipidemia. RESULTS: The prevalence of obesity was 6.7% in boys and 6.9% in girls by body mass index(BMI). The prevalence of systolic hypertension was 15.7% in normal group, 32.4% in the overweight group, and 35.4% in the obese group by BMI. The prevalence of diastolic hypertension was 4.9% in the normal group, 6.9% in the overweight group, and 14.6% the in obese group. In boys and girls, BMI, waist circumference, and WHR were positively correlated with systolic and diastolic blood pressure. respectively. In boys, triglyceride was positively correlated with waist circumference(r=0.34, P<0.05). In boys and girls, BMI was highly correlated with obesity index(r=0.98, each), with waist circumference(r=0.89, r=0.82, respectively), and with body fat(r=0.85, r=0.89) respectively. CONCLUSION: These data suggest the importance of the screening of blood pressure in obese adolescents, with prevention and intervention of obesity since it may be the most cost-effective way of reducing the complications related with obesity.
Adipose Tissue* ; Adolescent* ; Blood Pressure ; Body Fat Distribution* ; Dyslipidemias ; Female ; Humans ; Hyperlipidemias ; Hypertension ; Incheon ; Mass Screening ; Obesity ; Obesity, Abdominal ; Overweight ; Prevalence ; Risk Factors* ; Triglycerides ; Waist Circumference

BACKGROUND: Oxidative stress contributes to vascular diseases in patients with diabetes. As the mechanism of development and progression of diabetic vascular complications is poorly understood, this study was aimed to assess the potential role of hyperglycemia-induced oxidative stress and to determine whether the oxidative stress is a major factor in hyperglycemia-induced migration of vascular smooth muscle cells (VSMCs). METHODS: We treated primary cultured rat aortic smooth muscle cells for 72 hours with medium containing 5.5 mM D-glucose (normal glucose), 30 mM D-glucose (high glucose) or 5.5 mM D-glucose plus 24.5 mM mannitol (osmotic control). We measured the migration of VSMCs and superoxide production. Immunoblotting of PKC isozymes using phoshospecific antibodies was performed, and PKC activity was also measured. RESULTS: Migration of VSMCs incubated under high glucose condition were markedly increased compared to normal glucose condition. Treatment with diphenyleneiodonium (DPI, 10 micromol/L) and superoxide dismutase (SOD, 500 U/mL) significantly suppressed high glucose-induced migration of VSMCs. Superoxide production was significantly increased in high glucose condition and was markedly decreased after treatment with DPI and SOD. High glucose also markedly increased activity of PKC-delta isozyme. When VSMCs were treated with rottlerin or transfected with PKC-delta siRNA, nitro blue tetrazolium (NBT) staining and NAD(P)H oxidase activity were significantly attenuated in the high glucose-treated VSMCs. Furthermore, inhibition of PKC-delta markedly decreased VSMC migration by high glucose. CONCLUSION: These results suggest that high glucose-induced VSMC migration is dependent upon activation of PKC-delta, which may responsible for elevated intracellular ROS production in VSMCs, and this is mediated by NAD(P)H oxidase.
Acetophenones ; Animals ; Antibodies ; Benzopyrans ; Diabetic Angiopathies ; Glucose ; Humans ; Immunoblotting ; Isoenzymes ; Mannitol ; Muscle, Smooth, Vascular ; Myocytes, Smooth Muscle ; NADPH Oxidase ; Onium Compounds ; Oxidative Stress ; Oxygen ; Protein Kinase C ; Rats ; RNA, Small Interfering ; Superoxide Dismutase ; Superoxides ; Vascular Diseases

BACKGROUND: Previous studies have shown that a higher resistive index (RI) on renal duplex ultrasonography was related with renal progression and acute kidney injury, especially in patients with chronic kidney disease (CKD) using an angiotensin converting enzyme inhibitor (ACEI) or angiotensin receptor antagonist (ARB). We evaluated whether a RI value is a predictive factor for renal progression regardless of ACEI or ARB medication in patients with moderate renal dysfunction. METHODS: We retrospectively analyzed 119 patients with moderate renal dysfunction that had been evaluated with renal duplex ultrasonography from February 2011 to April 2015. Moderate renal dysfunction was defined as a stage 3 to 4 CKD. Renal progression was defined as a doubling of the baseline serum creatinine (sCr), a decrease of baseline glomerular filtration rate by > 50%, or initiation of renal replacement therapy. RESULTS: The mean age was 64.7 ± 11.0 years and sCr level was 2.1 ± 1.2 mg/dL. The RI ≥ 0.79 group showed a higher incidence of renal progression (P = 0.004, log-rank test) compared with the RI < 0.79 group, irrespective of ACEI or ARB usage. In the Cox proportional hazard model, RI ≥ 0.79 was an independent prognostic factor after adjusting for age, sex, diabetes mellitus, sCr, proteinuria, and use of ACEI or ARB (hazard ratio, 4.88; 95% confidence interval, 1.06–22.53; P = 0.043). CONCLUSION: RI ≥ 0.79 on the renal duplex ultrasonography can be a helpful predictor for renal progression in patients with moderate renal dysfunction, regardless of their ACEI or ARB usage.
Acute Kidney Injury ; Angiotensin Receptor Antagonists ; Angiotensin-Converting Enzyme Inhibitors ; Angiotensins* ; Creatinine ; Diabetes Mellitus ; Glomerular Filtration Rate ; Humans ; Incidence ; Peptidyl-Dipeptidase A* ; Proportional Hazards Models ; Proteinuria ; Renal Insufficiency, Chronic ; Renal Replacement Therapy ; Retrospective Studies ; Ultrasonography ; Ultrasonography, Doppler, Duplex