Sclerosis is a disease process in which idiopathic hardening occurs in the skin and/or internal organs as a result of the accumulation of type I collagen, induced mainly by transforming growth factor-beta. Colchicine and D-penicillamine are widely used for its treatment. Their effects are known to be due to post-translational down-regulation of type I collagen synthesis, with colchicine also up-regulating interstitial collagenase. To determine whether or not they have any pre-translational effect on type I collagen and MMP-1, and also to observe their effects on the action of TGF-beta, cultured neonatal foreskin fibroblasts were treated with colchicine and D-penicillamine, singly and together. The amount of type I collagen and MMP-1 mRNA were quantitated by Northern blot hybridization. Colchicine suppresses the basal level of type I collagen mRNA but minimally stimulates the mRNA expression of MMP-1, whereas D-penicillamine does not have any significant effects on either. Colchicine was also able to significantly suppress the TGF-beta-induced up-regulation of type I collagen mRNA expression.
Cells, Cultured ; Colchicine/pharmacology* ; Collagen/genetics* ; Fibroblasts/metabolism ; Gene Expression Regulation/drug effects* ; Human ; Interstitial Collagenase/genetics* ; Penicillamine/pharmacology* ; RNA, Messenger/analysis* ; Skin/metabolism ; Skin/cytology ; Transforming Growth Factor beta/pharmacology

OBJECTIVES: To identify various factors that might affect stigmas affecting outpatients with schizophrenia, and to further clarify the effects of both factors affected by the treatment and other factors on stigmas in a clinical setting. METHODS: Of patients who had been receiving outpatient treatments at the Donga University Hospital Department of Psychiatry and those who had been attending the community mental health center and community psychiatric rehabilitation center, 178 patients with a DSM-IV diagnosis of schizophrenia with stable symptoms were enrolled in this study. In these patients, through an interview or self-reporting, we assessed stigmas (the Korean version of Mental Health Consumers' Experience of Stigmas), psychiatric symptoms (the Korean version of the Positive and Negative Syndrome Scale), social functions (the Korean version of the Social Functioning Scale), insight (the Self-Appraisal of Illness Questionnaire), empowerment (a Consumer-Constructed Empowerment Scale), and self-esteem (Rosenberg Self-Esteem Scale). In more detail, we performed an ANOVA in consideration of 11 factors (age, gender, the level of education, economic status, the duration of disease, the frequency of hospitalization, symptoms, insight, self-esteem, empowerment, and social functions) as explanatory variables for stigmas. RESULTS: On a multiple regression analysis using backward elimination, the following five factors were found to be significant explanatory variables for stigmas that are experienced by outpatients with schizophrenia : the disease of duration, self-esteem, insight, age, and gender. The coefficient of determination for these five explanatory variables was 0.44. CONCLUSION: In conclusion, our results showed that five factors were found to be significant explanatory variables for stigmas that are experienced by outpatients with schizophrenia. These five factors were the duration of the disease, self-esteem, insight, age, and gender. Because these five variables accounted for only 44% of total stigmas, however, further studies in a larger group of patients are warranted to identify other factors that might affect stigmas.
Analysis of Variance ; Diagnostic and Statistical Manual of Mental Disorders ; Diagnostic Self Evaluation ; Hospital Departments ; Hospitalization ; Humans ; Mental Health ; Outpatients ; Power (Psychology) ; Rehabilitation Centers ; Schizophrenia

The pubic bone is an unusual site for an aneurysmal bone cyst. This case, a 15year old male patient, was diagnosed as an aneurysmal bone cyst in the superior ramus of the right pubic bone. He was treated by complete excision of the superior ramus and on five years follow up no problems were noted in terms of weight bearing as well as hip function or evidence of recurrence.
Aneurysm ; Bone Cysts ; Follow-Up Studies ; Hip ; Humans ; Male ; Pubic Bone ; Recurrence ; Weight-Bearing

To assess the prognostic factors of the femoral neck fractures in patients with CVA, we compared the survival rates in 12 cases of CVA group with 12 cases of non-CVA group and evaluated the various clinical factors of CVA group affect the mortality. All of the patients both CVA group and non- CVA group were treated hemiarthroplasty for femoral neck fractures between June 1990 and June 1992. The mean age was 68.9 years old in the CVA group and 69.3 years old in the non-CVA group. The mean follow-up periods were 32.8 months in the CVA group and 33.6 months in the non-CVA group. The results were as follows; 1. The incidence of the femoral neck fracture with CVA was 15%(12 cases among SO femoral neck fractures). 2. The survival rates in the CVA group at l-year, 2-year, and 3-year were 83.3%, 66.7%, and 58.3% respectively. In the non-CVA group, the survival rates were 83.3%, 75.0%, and 62.5%. 3. In the CVA group, serum total protein, nutritional index, hypertension, lung disease, and cardiac disease may be valuable prognostic factors. In conclusion, the pretraumatic patient's general physical condition could affect the mortality of femoral neck fracture in the CVA patients rather than CVA itself or postoperative status.
Femoral Neck Fractures ; Femur Neck ; Follow-Up Studies ; Heart Diseases ; Hemiarthroplasty ; Humans ; Hypertension ; Incidence ; Lung Diseases ; Mortality ; Nutrition Assessment ; Stroke ; Survival Rate

Isolated acute monoarticular septic arthritis of the sternoclavicular joint is a extremely rare disorder, and is usually associated with predisposing factors such as contiguous foci of infection, heroin addiction, rheumatoid arthritis, diabetes mellitus and maintenance hemodialysis. This case occurred in healthy adult. The etiological agent was staphylococcus aureus. Good result wads achieved by applying appropriate antibiotic therapy combined with an adequate drainage.
Adult ; Arthritis, Infectious ; Arthritis, Rheumatoid ; Causality ; Diabetes Mellitus ; Drainage ; Heroin Dependence ; Humans ; Renal Dialysis ; Staphylococcal Infections ; Staphylococcus aureus ; Sternoclavicular Joint

We reviewed 205 hips (in 151 patients, 125 men and 26 women) which were diagnosed osteonecrosis of femoral head and treated with bipolar endoprosthesis from 1985 to 1993 in Seoul National University Hospital to delineate the efficacy and indication of use of bipolar endoprosthesis in osteonecrosis. They were followed up for an average of 56 months (16 to 100 months). The mean age at operation was 44 years (21 to 84 years). The types of prosthesis used were as follows : Omnift (107), AML (57), Harris-Galante (19) and others (22). The preoperative Harris hip score improved from 49 points preoperatively to 89 points at last follow-up. The pain score improved from 18 points to 39 points, activity score from 9 points to 12 points and gait scare from 19 points to 31 points. The improvement pattern of activities and gait was converse, but that of pain was diverse. One hundred and seventy-eight hips (87%) were satisfactory (Harris hip score : more than 80 points) and 27 (13%) were unsatisfactory. Radiologic findings of last follow-up showed stable bony fixation in 186 hips (91%), stable fibrous fixation in 12 hips (6%) and unstable fixation in 7 hips (3%), Ten migrations of prosthesis were noted: cup migration 5 (2.4%) and stem sinking 5 (2.4%). Heterotopic ossification was noted in 9 (4.4%). Osteolysis in acetabular side was observed in 6 (3%) and in femoral side, 22 (11%). Complications were as follows : 4 stem loosening (1.9%), 5 fixed varus position of cup (2.4%) and 1 dislocation of cup (0.5%). Revision was performed in 4 (1.9%) and the causes were 1 infection, 1 protrusio acetabuli, 1 stem loosening and 1 cup dislocation. In conclusion, biopolar endoprosthesis generally gave good results. However, the improvement of pain was unpredictable. Increasing tendency of osteolysis was noted with increasing follow-up duration. Long-term follow-up is mandatory for the accurate determination of osteolysis.
Acetabulum ; Dislocations ; Follow-Up Studies ; Gait ; Head ; Hip ; Humans ; Male ; Ossification, Heterotopic ; Osteolysis ; Osteonecrosis ; Prostheses and Implants ; Seoul

Aneurysms of superior mesenteric artery (SMA) represent an uncommon but important vascular disease. High mortality rates from rupture of aneurysm and thrombosis of SMA are reported. These lesions are most often infectious in etiology. In the case of relatively abundant collaterals, aneurysm exclusion or SMA ligation is a safe surgical method to prevent serious complications. But in insufficient collaterals, stent-grafting of aneurysm or reconstruction of mesenteric blood flow is unavoidable. Recently we treated a 49-year-old man with SMA pseudoaneurysm and its large orifice located at near the enlarged jejunal branch which is a main collateral of mesenteric blood flow.
Aneurysm ; Aneurysm, False* ; Humans ; Ligation ; Mesenteric Artery, Superior* ; Middle Aged ; Mortality ; Rupture ; Thrombosis ; Vascular Diseases

Enlargement of bone tunnels has been noted on plain X-rays following arthroscopic ACL reconstruction. The cause of this widening is unclear, but it has been hypothesized that it may be due to either mechanical or biological cases. Ishibashi et al. reported anatomical proximal fixation resulted in the most stable reconstructed knee, with increasing instability as the level of fixation moved away from the tibial plateau. The purpose of this study is to determine if any difference exists in the amount of enlargement of the femoral tunnel following arhotoscopic ACL reconstruction with position of interference screw fixation and instability, and to know the factors which affected to the enlargement of the femoral tunnels. Total 39 patients were retrospectively reviewed for tunnel measurements radiologically at one year post-operation. (27 patients received bone-patellar tendon-bone autograft, 12 patients received bone-patellar tendon-bone autograft and Kennedy LAD-ligament augmentation device). The surgery was performed using an arthroscopic single and double incision technique. AP and lateral X-rays were obtained and the tunnels were measured by two independent observers using a digital caplper. The measurements were made at the widest part of the tunnel. Correction for magnification was performed by comparing the measured width of the interference screw used for fixation of the graft with its actual width. Statistical analysis was performed using a one-way analysis of variance(ANOVA) and t-test. 1. Radiographic tunnel enlargement of femoral side was average 2.42 mm (bone-patellar tendon-bone autograft : 2.36 mm, Kennedy-LAD and autograft : 2.56 mm)(p>0.05). 2. According to the position of the interference screw, the femoral tunnel enlargement were 2.25 mm in anatomical fixation, 2.40 mm in mid-tunnel fixation, 2.62 mm in mid-tunnel fixation, 2.62 mm in outer-tunnel fixation(p < 0.05). 3. The femoral enlargement according to the overall results(Clancy, 1982) were 2.39 mm in above good result group and 2.50 mm in below fair result group(p < 0.05). Tunnel enlargement group of femoral side was related to a distance between femoral articular surface and the position of interference screw. We conclude that femoral tunnel enlargement following arthoscopic bone tendon-bone ACL reconstruction is related to the mechanical effect rather than the properties of grafts and the clinical results.
Autografts ; Humans ; Knee ; Retrospective Studies ; Transplants

OBJECTIVE: As interest in life quality and expectancy increases, cognitive dysfunction is becoming an important topic. Although there are many foreign articles on this topic, they require cultural interpretation to be applicable to Koreans. The purpose of this study was to assess cognitive function in Korean neurosurgical patients. METHODS: We recruited 214 adult Korean patients with various cerebral pathologies and treatments from an outpatient clinic. The male-to-female ratio was 88:126, and their ages ranged from 28 to 81 years (mean: 57.9 years). The Korean version of the mini-mental status examination (K-MMSE) was adopted as an instrument for measuring cognitive function, and a score < or =23 was defined as cognitive dysfunction. K-MMSE scores were analyzed considering the patients' gender, age, time elapsed since treatments, pathology and treatment modality. A serial analysis was performed for 59 patients who completed the K-MMSE more than once. RESULTS: The mean K-MMSE score of 214 patients was 22.3, and 133 patients (62.1%) had a score < or =23. Cognitive dysfunction was common regardless of age, gender, pathology or treatment modality. Serial analysis revealed K-MMSE score improvement in 45 of 59 patients (76.3%). The mean time interval between two tests was 11.9 months, and the mean K-MMSE score improvement was 2.7, which was statistically significant (P = 0.000). However, many still had cognitive impairment. CONCLUSION: Most Korean neurosurgical patients showed cognitive dysfunction despite improvement after several months. Patients with trauma or ischemic disease were more vulnerable. More attention should be paid to neuropsychological complications such as cognitive dysfunction.
Adult ; Ambulatory Care Facilities ; Craniotomy ; Cross-Sectional Studies ; Humans ; Korea ; Neurosurgery ; Quality of Life

A low grade endometrial stromal sarcoma is a rare malignant tumor in woman. We experienced this infrequent malignant tumor in a 36 years old woman showing metas- tasis to both ovaries, omentum, rectum and mesenteric lymph nodes, and she was treated by total abdominal hysterectomy with bilateral salpingo-oophorectomy followed by VAC(vincristi n, actinomycin, cyclophoshamide) chemotherapy. The authors report this case with the clinicopathologic findings and brief review of literature.
Adult ; Dactinomycin ; Drug Therapy ; Female ; Humans ; Hysterectomy ; Lymph Nodes ; Omentum ; Ovary ; Rectum ; Sarcoma, Endometrial Stromal*