Allografts or autografts of bone-tendon unit have been used for ligament injuries or deficiencies after limb salvage operation for malignant bone tumors around joints. While the remodeling process of the ligament or tendon of the allograftor autograft and the microscopic and biomechanical changes of tendon-bone graft interface have been widely investigated, little is known about the ultrastructural and biochemical changes of the transitionall zone in tendon-bone junction. This study was performed to analyzed the ultrastructural and biochemical changes of the transitional zone after tendon-bone auto-and allo-grafting. A total of twenty four rabbits were divided into two group. In 12 animals(allograft group), two Achilles ten-don-bone unit per each animal were taken and transplanted to another rabbit after preservation below -70degrees C for 2 weeks. In the other 12 animals(autograft group), the Achilles tendon-bone unit was harvested from one side and transplanted to the other side of the rabbit. After operation, their legs were immobilized with short leg cast for 4 weeks, and then mobilized freely. Four animals in each group were sacrificed at four, eight and sixteen-weeks after the transplantation, and their grafted Achilles tendon-bone interfaces were used for analysis of the ultrasturctural and biochemical changes. The following results were obtained. 1. Histologically new cartilage cells were observed at postoperative 16 weeks with local presence of faint tidemark in the autograft group but not in the allograft group. Complete remodeling of the transitional zone had not observed histologically in both groups. 2. Ultrasturctural analysis revealed no definite differences between both groups. However, the slightly rapid appearance of parallelism and cross-striation of microfibrils in the autograft group and time-related restoration of fibers and fibroblasts were observed. 3. From biochemical analysis, type I collagen concentratin was increased, and an early rapid increase of type III collagen and glycosaminoglycan were also observed. In conclusion, these data suggested that type III collagen and glycosaminoglycan are important in stabilization of grafted tendon-bone unit, especially in the transitional zone. The histological and biochemical changes in allograft group were relatively similar to that of autograft group although the allograft group showed the delayed pattern of remodeling. Therefore, the tendon- allograft could be used as a good substitute for the autograft for tendon or ligament reconstruction when no suitable autograft is available.
Allografts ; Animals ; Autografts ; Cartilage ; Collagen Type I ; Collagen Type III ; Fibroblasts ; Joints ; Leg ; Ligaments ; Limb Salvage ; Microfibrils ; Rabbits* ; Tendons ; Transplants*

No abstract available.
Giant Cell Arteritis*

PURPOSE: Leptin, a product of the ob gene, is a 16-KDa protein that is mainly expressed in the adipose tissue and involved in the regulation of body weight. Elevated levels of serum leptin is noted in pregnant woman and the placenta is the site of nonadipose tissue production of leptin. In this study, we investigated the effect of serum leptin concentrations on fetal growth to estimate the effect of leptin on fetal growth. METHOD: Leptin concentrations were measured in venous and arterial cord blood and maternal serum at birth using a specific radioimmunoassay employing human recombinant leptin(Human Leptin RIA kit; Linco research, St. Louis, Mo). Thirty two full term pregnant women(n=32) had no medical complications and delivered the healthy babies(male=14, female=18). RESULTS: Serum leptin levels were 1.51 - 19,36 ng/ml(mean 7.16, SD 3.76) in arterial cord blood and 1.59 - 16.18(mean 7.47, SD 4.08) in venous cord blood and there was no difference between arterial and venous cord blood. Serum concentrations in arterial and venous cord blood were positively correlated with birth weight(r=0.7181, 0.6970; p<0.0001). There was no correlation in maternal BMI, maternal serum leptin and cord blood leptin concentrations. CONCLUSION: These findings suggest that cord blood leptin independently contributes to fetal body weight regardless of maternal serum leptin and body weight.
Adipose Tissue ; Birth Weight* ; Body Weight ; Female ; Fetal Blood* ; Fetal Development ; Fetal Weight ; Humans ; Hypertension, Pregnancy-Induced* ; Leptin* ; Parturition* ; Placenta ; Pregnancy* ; Pregnant Women ; Radioimmunoassay

Gastritis cystica superficialis (GCS) is a rare lesion which is characterized by glandular hyperplasia with regeneration and degeneration in the mucosa and muscularis mucosa. Recently, GCS is revealed as precancerous lesion, but most report has been associated with those found at the site of a gastroenterostomy. So, we report two cases with GCS who had not previous gastric surgery. A 45-year-old woman visited for epigastric discomfort and another 4Q-year-old woman for epigastric pain. They had not undergone any gastric surgery. The gastroscopy discovered one polyp on anterior wall of greater curvature, upper body and another polyp in the center of the fold of greater curvature, lower body. We removed it by snare polypectomy and the histologic finding showed the character of GCS.
Female ; Gastritis* ; Gastroenterostomy ; Gastroscopy ; Humans ; Hyperplasia ; Middle Aged ; Mucous Membrane ; Polyps ; Regeneration ; SNARE Proteins

Alexander disease (ALXD) is a rare demyelinating disease of the white matter of the brain that is caused by a mutation in the glial fibrillary acidic protein (GFAP) gene. The overexpression of GFAP in astrocytes induces a failure in the developmental growth of the myelin sheath. The neurodegenerative destruction of the myelin sheath of the white matter is accompanied by an accumulation of abnormal deposits of Rosenthal fibers in astrocytes, which is the hallmark of ALXD. The disease can be divided into four groups based on the onset age of the patients: neonatal, infantile, juvenile, or adult. Early-onset disease is more severe, progresses rapidly, and results in a shorter life span than late-onset cases. Magnetic resonance imaging and genetic tests are mostly used for diagnostic purposes. Pathological tests of brain tissue for Rosenthal fibers are definitive diagnostic methods. Therapeutic strategies are being investigated. Ceftriaxone, which is an enhancer of glial glutamate transporter (GLT-1) expression, is currently in clinical trials for the treatment of patients with ALXD. To date, there are no clinically available treatments. The cause, pathology, pathophysiology, inheritance, clinical features, diagnosis, and treatment of ALXD will be reviewed comprehensively.
Adult ; Age of Onset ; Alexander Disease* ; Amino Acid Transport System X-AG ; Astrocytes ; Brain ; Ceftriaxone ; Demyelinating Diseases ; Diagnosis ; Glial Fibrillary Acidic Protein ; Humans ; Magnetic Resonance Imaging ; Methods ; Myelin Sheath ; Pathology ; Wills

Fat embolism is a significant complication following total joint arthroplasty. Fat embolism syndrome has both pulmonary and neurologic manifestations that can be life threatening. But, with appropriate fluid management, adequate ventilation, and the prevention of hypoxemia, outcome is usually excellent. We experienced fat embolism following bilateral total knee replacement. A 65-year-old woman had a surgery under general anesthesia. There was no specific anesthetic problems during the operation. After bilateral tourniquet release, O2 saturation decreased to 85% and neurologic symptom was developed. With adequate supportive treatment including mechanical ventilation, she was cured without complication.
Aged ; Anesthesia, General ; Anoxia ; Arthroplasty* ; Arthroplasty, Replacement, Knee* ; Embolism, Fat* ; Female ; Humans ; Joints ; Neurologic Manifestations ; Respiration, Artificial ; Tourniquets ; Ventilation

No abstract available.
Biopsy, Fine-Needle ; Neck

PURPOSE: We prospectively analyzed the clinical results of auto-iliac cancellous bone graft with autologous bone marrow mononucleated cell implantation for osteonecrosis of the femoral head. MATERIALS AND METHODS: In a prospective evaluation, 45 hips in 37 patients with osteonecrosis of the hip were treated with auto-iliac cancellous bone graft after core decompression combined with implantation of autologous bone marrow cells. The average duration of clinical follow up of the patients was 32 months. Core decompression of the femoral head was performed and most of the necrotic part of the head was removed. Auto-iliac cancellous bone grafting was then done to fill up the defect, and this was followed by cell therapy with implantation of autologous monocytes isolated from the iliac bone marrow. RESULTS: The mean Merle d' Aubigne and Postel score improved from 11.6 points preoperatively to 15.5 points. Collapse of the femoral head developed in 13 hips, of which 12 hips showed an extensive lesion on the preoperative radiogram. Total hip replacement surgery was performed in 9 hips: 8 hips were due to progressive collapse of the femoral head with clinical deterioration, and 1 hip was due to postoperative bacterial infection. The preoperative stages of the 8 hips that were converted to THRA were stage II in 1 hip, stage III in 4 hips and stage IV in 3 hips. The head preservation rate according to the preoperative stage was 94.4% in stage II, 77.8% in stage III and 66.7% in stage IV. CONCLUSION: Auto-iliac cancellous bone grafting combined with implantation of autologous bone marrow cells after core decompression showed a good clinical results on the short term follow-up. Long term follow-up studies are still necessary to validate this point.
Arthroplasty, Replacement, Hip ; Bacterial Infections ; Bone Marrow ; Bone Marrow Cells ; Bone Transplantation ; Decompression ; Follow-Up Studies ; Head ; Hip ; Humans ; Monocytes ; Osteonecrosis ; Prospective Studies ; Tissue Therapy ; Transplants

OBJECTIVES: Child sexual abuse is a highly prevalent societal problem that cuts across all ethnic, racial, educational, and socioeconomic groups. There has been mounting empirical evidence for the efficacy of manual-based, cognitive behavioral treatment(CBT) for sexually abused children. Therefore, the aim of this review was to address the rationale and efficacy of CBT for sexually abused children, and to introduce a broad outline of a typical CBT program for young people suffering the emotional and behavioral consequences of sexual abuse. METHODS: A selective literature review was undertaken. RESULTS: To date, trauma-focused CBT is the most effective treatment for the sexually abused child. The rationale and efficacy of CBT was reviewed and a typical CBT program was outlined session by session. CONCLUSION: Based on trauma-focused CBT for sexually abused children, the results demonstrate the need for future development of a standard CBT program for the Korean population.
Child ; Child Abuse, Sexual ; Cognitive Therapy ; Humans ; Stress, Psychological

PURPOSE: The quality of life questionnaire in Korean children with allergic rhinitis (QoL-KCAR) was developed to assess the quality of life in Korean children aged 6–12 years old with allergic rhinitis. The aim of this study was to validate the QoL-KCAR in Korean middle school students with allergic rhinitis. METHODS: A survey with questionnaire and skin prick test was performed on 277 middle school students. The students were classified into 3 groups: allergic-rhinitis (AR), non-allergic rhinitis (non-AR), and controls. AR was defined who had nasal symptoms within 12 months and positive response to skin test. Non-AR group was composed of students with nasal symptoms but had negative response to skin test. The rest who had no symptoms of rhinitis and negative response to skin test were classed as control group. QoL-KCAR has 10 questions with 5-point scales for response options. RESULTS: There were significant differences in the answer scores among the 3 groups (P<0.05). Total answer score is 20.9±10.2, 17.3±8.8, 4.4±5.6 in the AR, non-AR group, and control groups, respectively. It showed significant differences in all items between the AR and control groups, and 4 questions between the AR and non-AR groups. There were significant differences in total score and each score of 8 questions between before and after education in AR group. CONCLUSION: QoL-KCAR questionnaire can be useful for assessing quality-of-life in the Korean students aged 12 to 15 years old with allergic rhinitis as well as children aged 6 to 12 years old.
Child* ; Education ; Humans ; Quality of Life ; Rhinitis ; Rhinitis, Allergic ; Skin ; Skin Tests