It is notoriously difficult to obtain a sound bony union of large segmental bone defects secondary to trauma or following tumor resection, infected nonunion, congenital pseudarthrosis of the tibia, and avascular necrosis of the femoral head with conventional methods. Recent advances in microsurgery have made it possible to provide a continuing circulation of blood in bone grafts so as to ensure viability. With the nutrient blood supply preserved, healing of the graft to the recipient bone is facilitated without the usual replacement of the graft by creeping substitution. Thus, the grafted bone is achieved more rapid stabilization of bone fragments separated by a large defect without sacrificing viability. Thirty nine cases of the free vascularized fibular graft had been performed in the Department of Orthopedic Surgery, Kyung Hee University Hospital during the period of 3 years from October 1978 to December 1981. Of these, ll cases were congenital pseudarthrosis of the tibia, 4 cases were tuberculous spondylitis, 4 cases were infected nonunion, 7 cases were large segmental bone defects secondary to trauma, 9 cases were avascular necrosis of the femoral head and the other was one case. The results were obtained as follows: 1. The advantages of free vascularized living fibular graft are one stage procedure, resistance of torsion and angular stress, union with rapid hypertrophy of the graft, a shorter immobilization period and more rapid incorporation of the graft into the recipient area. 2. Free vascularized fibular graft can be widely used in the field of Orthopedic surgery. 3. The fibula is the bone best suited for reconstruction of a defect in a long bone. 4. In children, distal tibiofibular synostosis must be performed. 5. For prevention of clawing toe, the muscles around the bone is meticulously dissected, 6. Evaluation by selective arteriography and isotopic scanning both before and after operation may be used to assess the viability of the fibula graft.
Angiography ; Animals ; Child ; Fibula ; Head ; Hoof and Claw ; Humans ; Hypertrophy ; Immobilization ; Microsurgery ; Muscles ; Necrosis ; Orthopedics ; Pseudarthrosis ; Spondylitis ; Synostosis ; Tibia ; Toes ; Transplants

Adult stem cells are multipotent and self-renewing cells that contain several functions; i) migration and homing potential: stem cells can migrate to injured and inflamed tissues. ii) differentiation potential: stem cells which migrated to injured tissues can be differentiated into multiple cell types for repairing and regenerating the tissues. iii) immunomodulatory properties: stem cells, especially mesenchymal stem cells can suppress immune system such as inflammation. All those characteristics might be useful for the treatment of the digestive tract diseases which are complex and encompass a broad spectrum of different pathogenesis. Preclinical stem cell therapy showed some promising results, especially in liver failure, pancreatitis, sepsis, and inflammatory bowel disease. If we can understand more about the mechanism of stem cell action, stem cell therapy can become a promising alternative treatment for refractory digestive disease in the near future. In this review, we summarized current preclinical experiences in diseases of the digestive tract using stem cells.
Adult Stem Cells/cytology/*transplantation ; Digestive System Diseases/*therapy ; Drug Evaluation, Preclinical ; Humans

Diagnosis of a thymic carcinoid was made on transthoracic fine needle aspiration in a 36-year old woman who had an anterior mediastinal mass on chest X-ray and CT scan. The aspiration smears showed numerous anastomosing ribbons and cords of small round tumor cells. The tumor cells had slightly eccentric nuclei and some granular cytoplasm. The small and uniform nuclei of the tumor cells had finely granular chromatin and thin nuclear membrane. The cytologic diagnosis of a carcinoid was confirmed on histopathologic, immunohistochemical, and electromicroscopic examination of surgical specimen.
Adult ; Alleles* ; Biopsy, Fine-Needle ; Carcinoid Tumor ; Carotid Body ; Child* ; Chromatin ; Cytoplasm ; Diagnosis ; Female ; Humans ; Immunoglobulin A* ; Nuclear Envelope ; Paraganglioma ; Thorax ; Tomography, X-Ray Computed

Magnetic resonance image of INFH were correlated with histologic sections. Seventeen patients withe eighteen hips were included in this study. reoperative radiographs and MRI were taken for the patients. Three hips were in stage II, nine hips were in stage III, and remaining six were in stage IV respectively(Ficat and Alert). These hips were replaced with artificial joint and resected heads were examined. The specimens were bisected along the imaging plane, and studied histologically and matched with respective MR images of T1 and T2. Specimen MRI was performed on three femoral head immediately after femoral head removal. Necrotic portion of the femoral head in earlier stage showed higher signal intensity in T1-weighted image. Subchondral void, necrotic bone and saponified fat were responsible for low signal intensity in necrotic portion. Low signal band adjacent to the necrotic foci represented inner fibrous tissue and outer reactive sclerotic bone. Outside the fibrous band, the signal intensity diminished compared with normal fatty marrow. these findings were attributed by cellular infiltration and trabecular bony proliferation. MRI patterns were variable in various stages, but corresponded well with histologic findings.
Bone Marrow ; Head ; Hip ; Humans ; Joints ; Magnetic Resonance Imaging ; Necrosis

PURPOSE: To determine whether intracellular localization of intravenously injected infection specific MoAb can be localized in the infected cells, immunohistochemical staining was obtained in animals infected with Mycobacterium tuberculosis. MATERIALS AND METHODS: One mg of intact mouse MoAb against mwobacteria (group I, n=10) and F(ab')2 (group II, n=6) were intravenously injected to the rabbits of each groups infected with M. tuberculosis H37RV. Immunohistochemical staining using an anti-mouse antibody was obtained at the 1,3, 5, 7 and 8th days in Group I and at the 1, 2, 3rd days in group II by streptavidin biotin method. For the control study, I mg of non specific polyclonal human IgG (group III, n=10) and 100 microgram of normal rabbit IgG F(ab')2 (group IV, n=6) were injected to the rabbits and guinea pigs respectively. RESULTS: Both groups (group I & II) showed a positive Ag-Ab reaction within the cytoplasm of monocytes. A weak but positive reaction was observed intracellularly in group III, however no positive reaction in group IV. CONCLUSION: Our results suggest intracellular Ag-Ab reaction plays an important role in the localization of infection by immunoscintigraphy using a specific MoAb fragments.
Animals ; Biotin ; Cytoplasm ; Guinea Pigs ; Humans ; Immunoglobulin G ; Mice ; Monocytes ; Mycobacterium tuberculosis ; Rabbits ; Streptavidin ; Tuberculosis ; Tuberculosis, Pulmonary*

A 61-year-old man who had cholangiocarcinoma with multiple metastasises was referred to our hospital for his pain control.Celiac plexus block with 99.9% alcohol was performed by the retrocrural approach under fluoroscopic guidance.Examination of the patient at fifteen minutes after successfully performing the diagnostic block showed no sensory or motor change.Forty-eight hours after the neurolysis, the patient's lower extremities were totally paralyzed, and he could not walk nor control his anal sphincter.But thereafter he progressively recovered.Five days after celiac plexus neurolysis, he was able to walk with support from one hand.Reversible ischemia of the spinal cord due to damage to the Adamkiewicz arterial blood supply was thought to be the cause.
Celiac Plexus ; Cholangiocarcinoma ; Humans ; Ischemia ; Lower Extremity ; Middle Aged ; Neoplasm Metastasis ; Paraplegia ; Spinal Cord

OBJECTIVE: To evaluate whether mTOR inhibition by rapamycin can enhance the inhibitory effect of sodium butyrate, a histone deacetylase (HDAC) inhibitor on human cervical cancer cell line HeLa. METHODS: Cervical cancer cells (HeLa) were treated with sodium butyrate alone or in combination with rapamycin. Cell viability was analyzed by 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTS) assay and flow cytometry was performed to ascertain the effects of sodium butyrate and combinations of sodium butyrate with rapamycin. Expression of cell cycle related proteins were evaluated by Western blot analysis. RESULTS: As proven previously rapamycin, the mTOR inhibitor was effective in reducing the cell growth of cervical cancer cell line HeLa. Rapamycin and sodium butyrate induced growth inhibition in a dose dependent manner, with 100 nM/L rapamycin and 10 mM/L sodium butyrate blocked 78% cell growth. FACS analysis data substantiated the competence of rapamycin in inducing G1 arrest of mammalian cells, and this ability was greatly enhanced by the combination of sodium butyrate and rapamycin. The percentage of sub G1 fraction of cells was remarkably increased by the combination of sodium butyrate and rapamycin. Sodium butyrate in combination with rapamycin showed the increased expression of CDK inhibitors p21, p27, and dephosphorylation of Rb whereas the expression levels of cyclin A, cyclin D1 and cyclin B1 were reduced. CONCLUSION: The findings implicate that rapamycin could enhance the anti-cancer effect of sodium butyrate. Further in depth studies and in vitro studies would throw more light on the growth inhibitory mechanism and its potential use as therapeutic drugs of butyric acid and rapamycin.
Blotting, Western ; Butyric Acid* ; Cell Cycle ; Cell Line ; Cell Survival ; Cyclin A ; Cyclin B1 ; Cyclin D1 ; Flow Cytometry ; HeLa Cells ; Histone Deacetylases ; Humans* ; Mental Competency ; Sirolimus* ; Sodium* ; Uterine Cervical Neoplasms*

No abstract available.
Eosinophilia ; Eosinophils ; Liver Abscess ; Necrosis

BACGROUND: Recently, transfusion by component blood products instead of whole blood has gradually increased. And also filtered and/or irradiated blood products for the prevention of GVHD and other transfusion reaction has been used. To probe trends of recent transfusion, we analysed the use of blood components from 1989 through 1996 in Chonnam University Hospital. METHODS: We reviewed blood bank records from 1989 through 1996 in Chonnam University Hospital. RESULTS: 1. Total numbers of transfused blood units from 1989 to 1996 were 369,326 and the rate of component transfusion increased from 24.5% (1989) to 99.6% (1996) in Chonnam University Hospital. 2. Total numbers of transfused whole bloods were 5,569 units (24.5%) in 1989, then declined to 327 units (0.5%) in 1996. 3. Transfusion of PRC increased from 9,325 units (41.1%) in 1989 to 24,368 units (35.8%) in 1996, and also FFP from 7,371 units (32.4%) in 1989 to 15,546 units (22.9%) in 1996. 4. Use of platelet concentrates increased 16.4-fold from 2,223 units (2.5%) in 1989 to 36,531 units (46.8%) in 1996. 5. In 1996, percentage of filtered and irradiated blood products was 32.3% from cellular blood products. 6. With the use of the advanced blood seperator, hemapheresis showed slight increase annually. CONCLUSION: This paper will provide the basis of blood supply in Chonnam University Hospital and blood center.
Blood Banks ; Blood Group Incompatibility ; Blood Platelets ; Jeollanam-do*

BACKGROUNDS: As Korea has advanced into the aging society, Acute Coronary Syndrome is increased in number, especially elderly age group. The symptoms of acutecoronary syndrome in eldery were presented in atypical feature frequently. We studied the relation of the first symptom and diagnosis of acutecoronary syndrome and distribution of risk factor and coronary angiographic finding in elderly patient of korea society. METHODS: The subjects who were under went coronary angiography between 2002.5 and 2003.8 were dividedunder 65 years old group and over 65 years old group. And each group described diagnosis, risk factor, first symptom and coronary angiographic finding retrospectively. RESULTS: The diagnosis of unstable angina are more higher(46.5% vs. 26.1%, p<0.01) in the over 65 years old group and the first significant symptom of typical chest pain was more higher(57.4% vs. 47.6%, p<0.01) in the under 65 years old group and dyspnea was more higher(22.8% vs. 9.2%, p<0.01) in the over 65 years old group. The number of abnormal vessel were more higher(66.3% vs. 46.9%, p<0.01) in the over 65 years old group. CONCLUSION: Over 65 years old group compared with younger age group were prewented more frequently angina equivalent symptom than typical chest pain. And at the diagnosis of Acute Coronary Syndrome, over 65 years old group showed more severe coronary angiographic finding. Consequently, early stage of diagnostic approach and treatment need scrupulous attention in the elderly patients.
Acute Coronary Syndrome* ; Aged* ; Aging ; Angina, Unstable ; Chest Pain ; Coronary Angiography ; Diagnosis* ; Dyspnea ; Humans ; Korea* ; Retrospective Studies ; Risk Factors