No abstract available.
Adenocarcinoma* ; Appendix*

Angiolymphoid hyperplasia with eosinophilia(ALHE) is a benign angiomatous neoplasm which usually arises from skin, blood vessel, soft tissue, heart and rarely from bone. The authors experienced a case of ALHE which involved the distal femur of 35-years old male and treated by marginal excision and autogenous cancellous bone graft with plate fixation.
Angiolymphoid Hyperplasia with Eosinophilia ; Blood Vessels ; Femur ; Heart ; Humans ; Hyperplasia ; Male ; Skin ; Transplants

No abstract available.
Leg* ; Myocutaneous Flap*

Orientia tsutsugamushi is obligate intracellular bacterium that grows within the cytoplasm of the eukaryotic host cells. Therefore capability of the attachment, entry into the host cell and intracellular survival should be critical process for oriential infection. In this study we investigated the cellular invasion mechanism of Orientia tsutsugamushi and the role of transmembrane heparan sulfate proteoglycan, which binds diverse components at the cellular microenvironment and is implicated as host cell receptors for a variety of microbial pathogens. First of all Orientia tsutsugamushi can invade a wide range of nonprofessional phagocytic cells including fibroblast, epithelial cells a#nd endothelial cells of various host species, including B and T lymphocytes. Thus, it was postulated that the attachment of O. tsutsugamushi requires the recognition of ubiquitous surface structures of many kinds of host cells. Treatments with heparan sulfate and heparin inhibited the infection of Orientia tsutsugamushi in dose-dependent manner for L cell, mouse fibroblast, whereas other glycosaminoglycans such as chondroitin sulfate had no effect. Collectively, these findings provide strong evidence that initial interaction with heparan sulfate proteoglycan is required for the oriential invasion into host cells.
Animals ; Cellular Microenvironment ; Chondroitin Sulfates ; Cytoplasm ; Endothelial Cells ; Epithelial Cells ; Eukaryotic Cells* ; Fibroblasts ; Glycosaminoglycans ; Heparan Sulfate Proteoglycans ; Heparin ; Heparitin Sulfate ; Mice ; Orientia tsutsugamushi* ; Phagocytes ; T-Lymphocytes

OBJECTIVE: Reflex sympathetic dystrophy (RSD) is a syndrome of post-traumatic neuropathic pain in association with dystrophic changes and signs of sympathetic overactivity. Pain following spinal cord injury occurs frequently, but RSD is not usually considered as one of the common sources of pain. There have only been a few reports of RSD in spinal cord injured patients, although this condition is well-known in the painful upper extremity of hemiplegia due to stroke. The purpose of this study was to investigate the rate of occurrence, characteristic clinical features and more objective evaluation tools for the diagnosis of RSD in cervical cord injured patients. METHOD: Thirty-two cervical cord injured patients were evaluated for hand pain, swelling, vasomotor changes and dystrophic skin or nail changes. The patients were evaluated with studies such as three phase bone scintigrathy, digital infrared thermographic imaging (DITI) and plain roentgenograms of the hands. RESULTS: Eighteen patients (56.3%) were diagnosed as RSD based on the clinical symptoms and findings of three phase bone scintigraphy. Characteristic symptoms were hand pain, edema and dystrophic skin or nail changes, in the order of frequency. In patients with spasticity of the upper extremity, the incidence of RSD was higher than in patients without spasticity. CONCLUSION: We should consider RSD as a cause of upper extremity pain in cervical cord injured patients. This will lead to early diagnosis and treatment of the condition and it will be helpful in preventing various complications.
Diagnosis ; Early Diagnosis ; Edema ; Hand ; Hemiplegia ; Humans ; Incidence ; Muscle Spasticity ; Neuralgia ; Radionuclide Imaging ; Reflex Sympathetic Dystrophy* ; Reflex* ; Skin ; Spinal Cord ; Spinal Cord Injuries ; Stroke ; Upper Extremity

BACKGROUND: Hepatocyte growth factor (HGF) is a potent mitogenic cytokine. C-met protein, which is known to be the HGF receptor has transmembrane tyrosine kinase activity and is encoded by the c-met oncogene. The HGF/c-met signaling pathway may play various roles in the carcinogenesis of various organs. METHODS: We examined HGF and c-met mRNA expression by utilizing reverse transcription polymerase chain reaction on 40 surgically resected intracranial meningiomas (25 benign, 10 atypical, and 5 anaplastic cases). RESULTS: An HGF overexpression was detected in 28%, 50%, and 80% of the benign, atypical and anaplastic meningiomas, respectively; a high expression of HGF or the coexpression of HGF/c-met was detected in the high grade meningiomas (the atypical and anaplastic cases, p=0.046, p=0.014). An HGF expression was statistically significant in the recurrent meningiomas (p=0.003), and HGF expression was significantly lower than c-met mRNA expression in benign meningiomas (p=0.034). CONCLUSIONS: There was no correlation between histologic subtypes and HGF/c-met expression. Determination of HGF expression can be used as a molecular predictor for recurrence of meningioimas. These results suggest that HGF and c-met expression in meningiomas may be associated with anaplastic progression.
Hepatocyte Growth Factor ; Hepatocytes ; Meningioma ; Neoplasm Recurrence, Local ; Oncogenes ; Polymerase Chain Reaction ; Protein-Tyrosine Kinases ; Proto-Oncogene Proteins c-met ; Recurrence ; Reverse Transcription ; RNA, Messenger

PURPOSE: We evaluated the correlation of the pathologic diagnosis, including the grade or location of the inflammation on a prostate biopsy specimen, to the serum prostate-specific antigen(PSA) level. MATERIALS AND METHODS: 172 patients(the patients' PSA was> or=4ng/ml) who received prostate biopsy at our department from January 2000 to August 2003 were retrospectively studied. The pre-biopsy PSA and pathology, including the diagnoses and inflammatory patterns, were analyzed. The pathologic patterns of inflammation were divided as acute or chronic by the predominant inflammatory cell type; especially, the chronic inflammation was divided by grade or location, and then this was reviewed by 1 pathologist. Chronic Inflammation was graded as I, II or III according to the severity of inflammation. The PSA levels were compared among the grades. The presence or absence of chronic inflammation was checked in the periglandular, stromal and perivascular areas, respectively. The PSA levels were compared between the presence and absence of inflammation at each location. RESULTS: Among 172 patients, the number of patients with prostate cancer was 37(21.5%), and 68 patients had only BPH(39.5%), 27 had only prostatitis(15.7%) and 40 patients had benign prostatic hyperplasia(BPH) with prostatitis(23.3%). The number of patients with any prostatitis was 67(39.0%). The age of the patients was 68.4+/-8.7 years(45-91), the serum PSA was 13.30+/-14.38ng/ml(4.30-102.48), and the prostate size was 49.5+/-21.1ml(20-126). One case of BPH with prostatitis had a PSA level above 100ng/ml. Among the 67 specimens that showed prostatitis, 16 patients had histologically acute inflammation(23.9%) and 51 patients had chronic inflammation(76.1%). The PSA levels of the acute or chronic inflammation patients were 24.04+/-25.95ng/ml(4.46-102.48) and 9.93+/-4.73ng/ml(4.3-21.12, p=0.047), respectively. The PSA levels were not different among the 3 grades of chronic inflammation. In periglandular, stromal and perivascular locations, the PSA levels were not different between the presence and absence of chronic inflammation. CONCLUSIONS: About 39% of the prostate biopsy specimens showed prostatitis. The PSA level was higher for the acute inflammation than for the chronic inflammation. However, there was no difference in PSA levels among the each of the grades or locations of chronic prostatic inflammation.
Biopsy ; Diagnosis ; Humans ; Inflammation* ; Pathology* ; Prostate* ; Prostate-Specific Antigen* ; Prostatic Neoplasms ; Prostatitis* ; Retrospective Studies

BACKGROUND: The Ivor-Lewis operation has been widely applied for treating thoracic esophageal cancer, but more acceptable results from three-field lymph node dissection have recently been reported. In this study the efficacy of the Ivor-Lewis operation was evaluated. MATERIAL AND METHOD: Among the 273 patients, who underwent operation for esophageal cancer between September 1994 and August 2004, we retrospectively studied 172 patients with esophageal squamous cell carcinoma and who had no other primary cancer and who underwent complete resection with an Ivor-Lewis operation. The postoperative complications, the short and long-term survival and the recurrence patterns were analyzed. RESULT: The postoperative staging was as follows: stage I in 40 cases, IIA in 48 cases, IIB in 18 cases, III in 55 cases, IVA in 5 cases and IVB in 6 cases. The operative mortality rate was 4% (7 of 172 pts). Postoperative complication occurred in 32 patients (18%) and tumor recurred in 55 patients (32%). The overall 5-year survival rate was 48%; it was 85.6% in stage I patients, 47.6% in IIA patients, 65% in IIB patients, 22.8% in III patients and 0% for those in IV (p<0.05). The 5-year survival rate according to the location of esophageal cancer was 26.5% for patients with tumor in the upper 1/3 of the esophagus and 52.4% for patients with tumor in the mid and lower 1/3 (p>0.05). CONCLUSION: The Ivor-Lewis operation is an acceptable surgical procedure for thoracic esophageal squamous cell carcinoma. Yet it is necessary to consider other surgical procedures, and especially three-field lymph node dissection for treating upper 1/3 esophageal cancer.
Carcinoma, Squamous Cell* ; Esophageal Neoplasms ; Esophagus ; Humans ; Lymph Node Excision ; Mortality ; Postoperative Complications ; Recurrence ; Retrospective Studies ; Survival Rate

Purpose: Compressive hip dressings have been used to decrease the amount of postoperative bleeding after total hiparthroplasty. However, there is no data showing that a compressive dressing is effective. This study evaluated the effect of compressive dressings on the level of postoperative bleeding after total replacement arthroplasty. Materials and Methods: This prospective randomized clinical trail included 80 consecutive primary total hip arthroplasties in 72 patients. The 80 hips were randomly assigned to a compressive dressing group or a non-compressive dressing group using a table of random numbers. Forty-two hips in 37 patients were treated using the compressive dressing and the remaining 38 hips in 35 patients were treated using a non-compressive dressing. The patients were followed up for an average of 10.3 months. In all patients, a hemovac suction drain was inserted postoperatively. Results: The mean level of bleeding was 626.6 mL in the compressive group and 693.8 mL in the non-compressive group. There was no statistical difference between the two groups (P=0.416). Moreover, the incidence of postoperative complications including dislocation, nerve injury, symptomatic deep vein thrombosis and heterotopic ossification was similar in both groups. Conclusion: These results suggest that the compressive dressing has no significant effect on the amount of postoperative bleeding and clinical results after total hip arthroplasty.
Arthroplasty* ; Arthroplasty, Replacement ; Arthroplasty, Replacement, Hip* ; Bandages ; Dislocations ; Hemorrhage* ; Hip ; Humans ; Incidence ; Ossification, Heterotopic ; Postoperative Complications ; Prospective Studies ; Suction ; Venous Thrombosis

BACKGROUND: In this study, the optimal effect-site concentration of remifentanil for blunting hemodynamic responses to endotracheal intubation during total intravenous anesthesia using propofol were evaluated. METHODS: 137 ASA class I and II patients, aged 18-60 years, were randomly allocated to one of six groups according to the effect-site concentration of remifentanil. Remifentanil was then infused at a target effect-site concentration of 0, 1, 2, 3, 4 or 6 ng/ml in groups R0, R1, R2, R3, R4 and R6, respectively. Anesthesia was induced with propofol infusion at a target effect-site concentration of 4microgram/ml endotracheal intubation was performed 5 minutes after remifentanil administration. Blood pressure (BP), heart rate (HR) and cardiac index (CI) were recorded at the baseline and then every 30 seconds until 3 minutes after intubation. RESULTS: BP and HR in groups R0, R1 and R2 increased significantly after intubation when compared with the baseline values. The CI in group R0 also increased significantly after intubation when compared with the baseline values. Incidences of hypertension and hypotension were 50% and 5% in R0, 32% and 14% in R1, 18% and 32% in R2, 10% and 48% in R3, 8% and 54% in R4, and 0% and 81% in R6. There were also 2 cases in which the mean blood pressure was less than 50 mmHg in group R6. CONCLUSIONS: We suggest that the optimal target effect-site concentrations of remifentanil for blunting hemodynamic responses to endotracheal intubation are 3 or 4 ng/ml during total intravenous anesthesia using propofol at an effect-site concentration of 4microgram/ml.
Aged ; Anesthesia ; Anesthesia, Intravenous ; Blood Pressure ; Heart Rate ; Hemodynamics ; Humans ; Hypertension ; Hypotension ; Incidence ; Intubation ; Intubation, Intratracheal ; Piperidines ; Propofol