Platelet-derived growth factor(PDGF) is known to accelerate soft tissue fracture and periodontal bone healing, but little information is available for characterizing the healing of articualr cartilage. This study was designed to demonstrate the regeneration potential of pasteurized autogeneous osteochondral graft when PDFG was applied locally in vivo. Eighteen rabbits in two groups were used in the experiment. The free osteochondral fragment(1x1x1 cm) were taken from distal femur. The fragment were pasteurized in 65degrees C for 5 minutes. In experimental group(group II), the fragment were soaked in 0.25 mg/ml of recombinant human PDGF mixed 5 ml normal saline and reimplanted to the resected site, and followed with local administration of 0.25 mg/ml PDGF to knee joint. In control group(group I), the pasteurized fragment were reimplanted in the resected site without any treatments. The histologic characteristics of the transplanted autografts for three rabbits in each group were observed at 3, 5 and 7 weeks postoperatively. The results were as follows; Group II revealed the more favorable regeneration of articular cartilage, less arthritic changes and more mature arrangement of chondrocytes than group I. Even thought the cartilage is avascular and the regeneration capacity of pasteurized cartilage is severely limited, the regeneration of grafted articular cartilage is thought to be accellerated by increased newly formed blood vessels and soft tissues due to the diffusion of PDGF on grafted cartilage, and probably also by differentiation of mesenchymal cells in the initial stage of experiment. The results of this study suggest that local administration of PDGF could be used for the treatment of posttraumatic or degenerative arthritis and various cartilage damages.
Autografts ; Blood Vessels ; Cartilage ; Cartilage, Articular ; Chondrocytes ; Diffusion ; Femur ; Humans ; Knee Joint ; Osteoarthritis ; Platelet-Derived Growth Factor* ; Rabbits* ; Regeneration* ; Transplants*

No abstract available.
Adult* ; Esophageal Atresia* ; Fistula* ; Humans

Cryptococcal meningoencephalitis is one of the most cornInon fungal infections of the central nervous system, which mainly affects immunocompromised hosts, especially AIDS patients and patients with long-term steroid therapy. In advanced cases, it causes various complications such as encephailitis, hydrocephalus, and even death if not treated or inadequately treated. Authors have treated a case of cryptococcal meningoencephalitis with focal cerebellar lesion, whose primary infection sources were thought to be right frontal sinus and the ethmoidal sinus, with combination chemotherapy of amphotericine B and flucytosine.
Amphotericin B ; Central Nervous System ; Drug Therapy, Combination ; Flucytosine ; Frontal Sinus ; Humans ; Hydrocephalus ; Immunocompromised Host ; Meningoencephalitis*

Polyarteritis nodosa(PAN) has been depicted as a necrotizing arteritis of small and medium-sized muscular arteries, affecting multiple organ systems throughout the body. The etiology of PAN remains unknown, but the histopathologic resemblance to chronic serim sickness has suggested an immune complex pathogenesis. The peripheral nervous system(PNS) is more frequently affected (in about 20-50% of patients) than the central nervous system(in about 10-20% of patients). Although multiple mononeuritis multiplex is generally considered to be the typical PNS manifestation of PAN, distal symmetrical polyneuropathy may occur more frequently than previous recognized. We report a case of polyarteritis nodosa with mononeuritis multiplex and distal symmetrical polyneuropathy, which was diagnosed by electrophysiological study and biopsies of muscle and sural nerve.
Antigen-Antibody Complex ; Arteries ; Biopsy ; Mononeuropathies* ; Polyarteritis Nodosa* ; Polyneuropathies ; Sural Nerve

BACKGROUND & METHODS: Approximately 10% of the essential hypertensive patient have overt proteinuria due to renal target organ damage, which indicates poor prognosis. Recently microalbuminuria has been prove to be a good early predictor for renal damage in patients with diabetes or hypertension. Some authors reported that near 40% of the essential hypertensives have microalbuminuria. To determinate prevalence of microalbuminuria in Korea essential hypertensives, 24-hr ambulatory blood pressure monitoring and radioimmunoassay to detect BP and UAER were performed after 4 weeks wash-out period in 137(78 hypertensive and 54 normotensive) consecutive cases. RESULTS: Among 78 hypertensives, overt proteinuria was seen in 8.97%(7/78). And prevalence of microalbuminuria were 29.4%(23/78) in hypertensives and 16.7%(9/54) in normotensives. Urine microalbumin excretion rate(UAER) was significantly correlated with mean arterial pressure(MAP) in total subjects(r=0.286, p=0.0012), but not in total hypertensives(r=0.135, p=NS) or in hypertensives with UAER(r=-0.098, p=NS).UAER of female hypertensives was increase than that of male hypertensives(13.17+/-16.28microg/min vs 22.87microg/min, p=0.027). CONCLUSION: Prevalence of microalbuminuria in Korean hypertensives was relatively lower then other reports. Overt proteinuria was noted in 8.97% of the hypertensives which is same prevalence as other countries. Moreover MAP was well correlated with UAER in total subjects. Further evaluation should be done to detect exact role of UAER in hypertensives as an early predictor for renal target organ damage.
Blood Pressure Monitoring, Ambulatory* ; Blood Pressure* ; Female ; Humans ; Hypertension ; Korea ; Male ; Prevalence* ; Prognosis ; Proteinuria ; Radioimmunoassay

BACKGROUND & METHODS: Approximately 10% of the essential hypertensive patient have overt proteinuria due to renal target organ damage, which indicates poor prognosis. Recently microalbuminuria has been prove to be a good early predictor for renal damage in patients with diabetes or hypertension. Some authors reported that near 40% of the essential hypertensives have microalbuminuria. To determinate prevalence of microalbuminuria in Korea essential hypertensives, 24-hr ambulatory blood pressure monitoring and radioimmunoassay to detect BP and UAER were performed after 4 weeks wash-out period in 137(78 hypertensive and 54 normotensive) consecutive cases. RESULTS: Among 78 hypertensives, overt proteinuria was seen in 8.97%(7/78). And prevalence of microalbuminuria were 29.4%(23/78) in hypertensives and 16.7%(9/54) in normotensives. Urine microalbumin excretion rate(UAER) was significantly correlated with mean arterial pressure(MAP) in total subjects(r=0.286, p=0.0012), but not in total hypertensives(r=0.135, p=NS) or in hypertensives with UAER(r=-0.098, p=NS).UAER of female hypertensives was increase than that of male hypertensives(13.17+/-16.28microg/min vs 22.87microg/min, p=0.027). CONCLUSION: Prevalence of microalbuminuria in Korean hypertensives was relatively lower then other reports. Overt proteinuria was noted in 8.97% of the hypertensives which is same prevalence as other countries. Moreover MAP was well correlated with UAER in total subjects. Further evaluation should be done to detect exact role of UAER in hypertensives as an early predictor for renal target organ damage.
Blood Pressure Monitoring, Ambulatory* ; Blood Pressure* ; Female ; Humans ; Hypertension ; Korea ; Male ; Prevalence* ; Prognosis ; Proteinuria ; Radioimmunoassay

The neuroleptic malignant syndrome (NMS), a serious and potentially fatal complication, has been reported to occur in some patients with administration od neuroleptic medications. Its major manifestations are muscular rigidity, autonomic instability, altered consciousness, and hyperthermia, often accompanied by raised creatine kinase (CK) and leukocytosis. Manifestations of NMS are attributed to dopamine receptor blockade in the striatum, increasing thermogenesis, and in the hypothalamus, impaired heat dissipation. Owing to the potential lethality of NMS, the early diagnosis is important. The authors report two survived patients with the NMS who were treated by generalized supportive care and drug therapy.
Consciousness ; Creatine Kinase ; Drug Therapy ; Early Diagnosis ; Fever ; Hot Temperature ; Humans ; Hypothalamus ; Leukocytosis ; Muscle Rigidity ; Neuroleptic Malignant Syndrome* ; Receptors, Dopamine ; Thermogenesis

BACKGROUND: Although radiofrequency catheter ablation (RFCA) is useful in the treatment of idiopathic ventricular tachycardia, especially right ventricular outflow tract tachycardia (RVOTT), some tachycardias remain resistant despite several attempts. This study was focused to search of electrocardiographic characteristics suggestive of successful radiofrequency ablation of idiopathic ventricular tahycardia showing LBBB and inferior axis. MATERIALS AND METHODS: The study subjects were 19 patients (mean age 4415, male 5, female 14) those we tried RFCA under the diagnosis of RVOTVT. The study subjects were grouped into success group (N=14) and failed group (N=5). We analyzed the morphologic characteristics of QRS complex during ventricular tachycardias or ventricular premature beats in both groups. RESULTS: Acute success was obtained in 14 of 19 patients. For RFCA of RVOTT, pace mapping and/or activation mapping were used to select an ablation site as described previously(1). Activation mapping was possible only for 5 patients. All patients except one patient of success group showed inferior axis of QRS during VT. We didn't find significant difference in QRS axis, QRS morphologies in lead 1 and aVL, and QRS width in lead II and V2 between success (N=14) and failed group (N=5). However, in analysis of morphologic comparison of precordial leads, 12 out of 14 patients in success group showed initial r wave in V1 (p=0.017) and 11 patients had precordial transition >V3 (p=0.038). Whereas, in failed group, 4 patients had precordial transition V3 and only one patient showed precordial transition >V3. Initial r of V1 was seen in one patient and remaining 4 patients showed QS pattern in V1. CONCLUSION: Analysis of QRS morphology in V1 and precordial transition site may identify patients with high and low success rate during RFCA of idiopathic RVOTT
Axis, Cervical Vertebra* ; Bundle-Branch Block* ; Cardiac Complexes, Premature ; Catheter Ablation* ; Diagnosis ; Electrocardiography* ; Female ; Humans ; Male ; Tachycardia ; Tachycardia, Ventricular*

Mitochondrial myopathy, encephalopathy, lactic acidosis and stroke-like episode (MELAS) and myoclonic epilepsy and raggedred fibers (MERRF) are rare disorders caused by point mutation of the tRNA gene of the mitochondrial genome. To understand the pathogenetic mechanism of MELAS and MERRF, we studied four patients. Serially sectioned frozen muscle specimens with a battery of histochemical stains were reviewed under light microscope and ultrastructural changes were observed under electron microscope. The polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) analysis was performed and the tRNA genes were sequenced to confirm mutations. In two patients with MELAS, strongly succinyl dehydrogenase positive blood vessels (SSVs) and many cytochrome oxidase (COX) positive raggedred fibers (RRFs) were observed, and A3243G mutations were found from the muscle samples. In two patients with MERRF, neither SSV nor COX positive RRFs were seen and A8344G mutations were found from both muscle and blood samples. In the two MERRF families, the identical mutation was observed among family members. The failure to detect the mutation in blood samples of the MELAS suggests a low mutant load in blood cells. The histochemical methods including COX stain are useful for the confirmation and differentiation of mitochondrial diseases. Also, molecular biological study using muscle sample seems essential for the confirmation of the mtDNA mutation.
Adolescent ; Adult ; Electron Transport Complex IV/metabolism ; Female ; Humans ; Korea ; MELAS Syndrome/*genetics/metabolism/*pathology ; MERRF Syndrome/*genetics/metabolism/*pathology ; Male ; Pedigree ; Polymerase Chain Reaction/methods ; Polymorphism, Restriction Fragment Length ; RNA, Transfer ; Sequence Analysis, DNA

Tricuspid valve endocarditis accounts for 5% to 10% of cases of infective endocarditis. It commonly occurs in intravenous drug abusers, intravenous catheters, alcoholism, immune deficiency and genital sepsis. But right sided infective endocarditis without predisposing factor is very rare. S. aureus is the usual pathogen. We experienced a case of tricuspid valve endocarditis in a 32 year old female with vegetation in a non drug addict without underlying cardiac disease. The vegetation on the septal cusp of tricuspid valve and tricuspid regurgitation were found by TTE & TEE. S. aureus was identified in 4 bottles of blood cultures. The diagnosis was delayed because the cardiac manifestations of the disease were subtle, and pleuropulmonary manifestations predominant. So we report a case of tricuspid valve endocarditis in a non drug addict without underlying cardiac disease with a review of literature.
Adult ; Alcoholism ; Catheters ; Causality ; Diagnosis ; Drug Users ; Endocarditis* ; Female ; Heart Diseases* ; Humans ; Sepsis ; Tricuspid Valve Insufficiency ; Tricuspid Valve*