We performed a procedure to transplant cultured growth plate chondrocyte embedded in type I collagen gel into the defects of the proximal tibial physis in a 6-week-old rabbit. Twenty eight New Zealand White rabbits were used and were divided into 4 groups, of which the medial half of the proximal epiphyseal plate of the right tibia were excised. In group I, the defects were left without collagen gel implantations served as a control. In group II, chondrocytes were embedded in collagen gel were inserted into defect, In group III, chondrocytes cultured with TGF-beta1 in collagen gel, and in group IV chondrocytes cultured with TGFbeta1 in collagen gel three weeks after excision of the growth plate. After transplantations of growth plate chondrocytes, we assessed the varus angulation and the length of tibia, and histological characteristics at 2, 4, 6, 8, and 12 weeks. Bone-bridge formation, growth artiest, and varus deformity between the tibial epiphysis and metaphysis were prevented or minimized in group III and IV. The transplanted chondrocyte retained its normal morphology in a columnar arrangement in group II, III and IV. These results indicate that it is possible to reduce varus angulation and growth arrest in epiphyseal plate defect of immature rabbits by using cultured chondrocytes embedded in type I collagen gel including TGF-beta1.
Chondrocytes* ; Collagen ; Collagen Type I ; Congenital Abnormalities ; Epiphyses ; Growth Plate* ; Rabbits ; Tibia ; Transforming Growth Factor beta1 ; Transplantation

Klippel-Trenaunay syndrome (KTS) is a rare congenital disorder and is essentially a disorder of capillary, venous, and lymphatic malformations. Hematochezia is the most common symptom associated with intestinal hemangiomatosis and remains one of the life-threatening emergencies in KTS. We reported one patient of KTS presented with rectal bleeding and severe anemia who was successfully managed by sphincter-saving operation.
Anemia ; Capillaries ; Congenital, Hereditary, and Neonatal Diseases and Abnormalities ; Emergencies ; Gastrointestinal Hemorrhage ; Hemorrhage ; Humans ; Klippel-Trenaunay-Weber Syndrome

To 100 patients who underwent various operations under general anesthesia, Effortil and methoxamine were given in order to assess and to compare their effects on blood pressure and pulse rate. The drugs were administered intravenously in 6 to 10 mg doses when the systolic pressure fell to 80 mmHg. or lower during the operation. The results obtained are as follows: 1. Excellent pressor effect was obtained with Effortil in 84% of 50 patients while in 72% with methoxamine. 2. Both drugs were equally effectve in elevating both systolic and diastolic pressures. 3. The effect of Effortil on pulse rate was much less than that of methoxamine which moderately reduced the pulse rate, especially in the early phase. 4. No untoward effects of either Effortil or methoxamine were observed in this study.
Anesthesia, General ; Blood Pressure ; Etilefrine* ; Heart Rate ; Humans ; Methoxamine

OBJECTIVE: The purpose of this study was to determine whether screw fixation without bone fusion in patients with a low lumbar burst fracture has satisfactory outcomes. METHODS: Twelve patients that underwent screw fixation without bone fusion for a low lumbar burst fracture (L3-5) between 2006 and 2009, were included in this study. Motor power was intact despite severe canal compromise in all. Surgical procedures included postural reduction for 2 days and screw fixation without bone fusion. Imaging and clinical findings, including level of the involved vertebra, vertebral height, canal compromise, clinical outcomes, and related complications were analyzed. RESULTS: Mean follow-up was 23.1+/-11.0 months. Mean pain score (visual analogue scale) prior to surgery was 7.8+/-2.0 and this decreased to 1.8+/-1.0 at final follow-up. In 5 patients, open screw fixation by midline skin incision was performed and 7 patients underwent percutaneous screw fixation at one level above, one level below the fractured vertebra and fractured level itself. The proportion of canal compromise at the fractured level improved significantly from 60% to 30% at final follow-up (p<0.001). Mean preoperative vertebral height loss was 31.0%, and improved to 20.5% at final follow-up, though this improvement was not statistically significant (p<0.001). No neurological aggravation related to neural injury was observed. CONCLUSION: Short segment pedicle screw fixation without bone fusion can be an effective and safe operative technique for the management of selected low lumbar burst fractures.
Follow-Up Studies ; Humans ; Lumbar Vertebrae ; Skin ; Spine

PURPOSE: To evaluate 12-month outcomes of anti-vascular endothelial growth factor (VEGF) therapy for polypoidal choroidal vasculopathy (PCV) with grape-like polyp clusters. METHODS: This retrospective observational study included 23 eyes of 23 patients who were newly diagnosed with PCV with grape-like polyp clusters, and who were subsequently treated with anti-VEGF monotherapy. The study compares the best-corrected visual acuity (BCVA) of the patients at diagnosis, at 3 months, and at 12 months after diagnosis. In addition, 12-month changes in BCVA values were compared between cases with subfoveal or juxtafoveal polyps and cases with extrafoveal polyps. RESULTS: The baseline, 3-month, and 12-month logarithm of the minimal angle of resolution BCVA was 0.62 ± 0.35, 0.50 ± 0.43, and 0.58 ± 0.48, respectively. Compared to the baseline, patient BCVA was not significantly different at 12 months after diagnosis (p = 0.764). Six eyes (26.1%) gained ≥0.2 logarithm of the minimal angle of resolution BCVA. In cases with subfoveal or juxtafoveal polyps, BCVA values at baseline and at 12 months after diagnosis were 0.66 ± 0.37 and 0.69 ± 0.53, respectively. In cases with extrafoveal polyps, the values were 0.54 ± 0.33 and 0.37 ± 0.31, respectively. Changes in BCVA values were significantly different between the two groups (p = 0.023). CONCLUSIONS: Although anti-VEGF therapy has favorable short-term efficacy for treating PCV with grape-like polyp clusters, long-term visual improvements are generally limited in the majority of afflicted eyes. The presence of subfoveal or juxtafoveal polyps may suggest unfavorable treatment outcomes.
Aged ; Angiogenesis Inhibitors/*administration & dosage ; Choroid/blood supply/*diagnostic imaging ; Choroidal Neovascularization/diagnosis/*drug therapy ; Female ; Fluorescein Angiography ; Follow-Up Studies ; Fundus Oculi ; Humans ; Intravitreal Injections ; Male ; Polyps/diagnosis/*drug therapy ; Retrospective Studies ; Tomography, Optical Coherence ; Vascular Endothelial Growth Factor A/*antagonists & inhibitors

PURPOSE: To evaluate the efficacy of an optical coherence tomography (OCT)-based diagnosis of polypoidal choroidal vasculopathy (PCV) in Korean patients. METHODS: This retrospective, observational case series included 263 eyes of 263 patients (147 eyes with PCV and 116 eyes with typical exudative, age-related macular degeneration [AMD]) who had been diagnosed with treatment naïve exudative AMD. Eyes with three or more of the following OCT findings were diagnosed with PCV: multiple retinal pigment epithelial detachment (RPED), a sharp RPED peak, an RPED notch, a hyporeflective lumen representing polyps, and hyperreflective intraretinal hard exudates. The OCT-based diagnosis was compared with the gold-standard indocyanine green angiography-based method. The sensitivity and specificity of the OCT-based diagnosis was also estimated. An additional analysis was performed using a choroidal thickness criterion. Eyes with a subfoveal choroidal thickness greater than 300 µm were also diagnosed with PCV despite having only two OCT features. RESULTS: In eyes with PCV, three or more OCT features were observed in 126 of 147 eyes (85.7%), and the incidence of typical exudative AMD was 16 of 116 eyes (13.8%). The sensitivity and specificity of an OCT-based diagnosis were 85.7% and 86.2%, respectively. After applying the choroidal thickness criterion, the sensitivity increased from 85.7% to 89.8%, and the specificity decreased from 86.2% to 84.5%. CONCLUSIONS: The OCT-based diagnosis of PCV showed a high sensitivity and specificity in Korean patients. The addition of a choroidal thickness criterion improved the sensitivity of the method with a minimal decrease in its specificity.
Aged ; Choroid/blood supply/*diagnostic imaging ; Choroid Diseases/*diagnosis/epidemiology/physiopathology ; Diagnosis, Differential ; Female ; Fluorescein Angiography ; Follow-Up Studies ; Fundus Oculi ; Humans ; Incidence ; Male ; Republic of Korea/epidemiology ; Retrospective Studies ; Tomography, Optical Coherence/*methods ; Visual Acuity

Computational virtual screening has become an essential platform of drug discovery for the efficient identification of active candidates. Moleculardocking, a key technology of receptor-centric virtual screening, is commonly used to predict the binding affinities of chemical compounds on target receptors. Despite the advancement and extensive application of these methods, substantial improvement is still required to increase their accuracy and time-efficiency. Here, we evaluate several advanced structure-based virtual screening approaches for elucidating the rank-order activity of chemical libraries, and the quantitative structureactivity relationship (QSAR). Our results show that the ensemble-average free energy estimation, including implicit solvation energy terms, significantly improves the hit enrichment of the virtual screening. We also demonstrate that the assignment of quantum mechanical-polarized (QM-polarized) partial charges to docked ligands contributes to the reproduction of the crystal pose of ligands in the docking and scoring procedure.
Drug Discovery* ; Ligands ; Mass Screening* ; Quantitative Structure-Activity Relationship ; Reproduction ; Small Molecule Libraries

PURPOSE: Preoperative assessment of the depth of invasion in the rectal wall and of lymph node metastases is very important in determining the treatment modality in rectal cancer. The purposes of study were to evaluate the accuracy of transrectal ultrasonography (TRUS) in preoperative staging of rectal cancer and to compare that accuracy with the accuracy for computed tomography (CT). METHODS: We reviewed 59 patients who were diagnosed as having rectal cancer and who had been staged by using TRUS and CT preoperatively. Ultrasonographic tumor (uT) and nodal (uN) stage and computerized tomographic tumor (cT) and nodal (cN) stage were entered into the database prospectively. The accuracy of each staging was compared with the pathologic staging. The accuracy, the sensitivity, the specificity, the positive predictive value, and the negative predictive value of each diagnostic test were calculated. Chi- square tests were conducted to identify the factors influencing the accuracy. RESULTS: The accuracies of TRUS and CT in assessing the depth of invasion were 66.1% and 62.5%, respectively. The accuracies of TRUS and CT in assessing the nodal involvement in patients treated with radical surgery were 70.4% and 63.6%, respectively. For detection of fat infiltration, the sensitivities were 97.4% for TRUS and 76.3% for CT. The specificities were 45.0% for TRUS and 55.6% for CT. The sensitivities for detection of lymph node involvement were 59.3% for TRUS and 42.9% for CT. The specificities were 81.5% for TRUS and 85.2% for CT. The gross appearance of the tumor had a significant influence on the assessment of the depth of invasion (P=0.015). In 9 out of 77 patients (11.7%) could not be performed the TRUS examination due to obstruction or the location of the tumor. CONCLUSIONS: In spite of some limitations, TRUS is considered a very useful tool in the preoperative assessment of the depth of invasion and of the lymph node involvement in rectal cancer. However, CT examination is mandatory to overcome the limitations of TRUS in the preoperative diagnosis of rectal cancers.
Diagnosis ; Diagnostic Tests, Routine ; Humans ; Lymph Nodes ; Neoplasm Metastasis ; Prospective Studies ; Rectal Neoplasms* ; Sensitivity and Specificity ; Ultrasonography*

BACKGROUND AND OBJECTIVES: Human epidermis is a continuously dividing tissue, in which keratinocytes gradually differentiate and mature while moving from basal cells to suprabasal cell layers. Epidermal homeostasis is maintained by a delicate balance between proliferation and terminal differentiation. Cholesteatoma is characterized by the presence of a squamous epithelium invading the middle ear, which is believed to have hyperproliferative properties. The aim of this study is to determine whether the hyperproliferative character of cholesteatoma is associated with differentiation of basal cell or suprabasal cell layers. MATERIALS AND METHODS: Using immunohistochemical techniques, we investigated the reaction pattern of monoclonal antibody to involucrin and filaggrin as differentiation markers in the cholesteatoma matrices which were harvested during surgery. For the control, the same immunohistochemical study was also done in deep meatal skin and retroauricular skin during the same surgery. RESULTS: The immunostaining intensity of filaggrin at suprabasal cell layers was higher in cholesteatoma than in retroauricular skin and deep meatal skin. The immunostaining intensity of involucrin at suprabasal cell layers was higher in cholesteatoma and deep meatal skin than in retroauricular skin. CONCLUSION: This result represents that the epidermal cells in cholesteatoma at suprabasal layers actively differentiate more than the epidermal cells in retroauricular skin. So this study suggests that hyperkeratinization in cholesteatoma might be due to altered differentiation of suprabasal keratinocytes. Furthermore, this study reveals that the deep meatal skin has unusual hyperproliferative behavior in contrast to the retroauricular skin.
Antigens, Differentiation ; Cholesteatoma ; Cholesteatoma, Middle Ear* ; Ear, Middle* ; Epidermis ; Epithelium ; Homeostasis ; Humans* ; Keratinocytes ; Skin

Hip subluxation and dislocation are common orthopaedic problems in children with cerebral palsy. Selective posterior rhizotomy(SPR) is a neurologic procedure aimed in reducing spasticity. Several recent studies have indicated a decrease in spasticity and functional improvement after SPR, and also decrease the tendency toward hip subluxation in children with cerebral palsy. This is a retrospective study to examine whether SPR halts hip subluxation. Between May 1994 and July 1996, 22 children below age of 5 underwent SPR. Twenty children were spastic diplegic types and 2 were mixed type and quadriplegic type respectively. Approximately 50-80% of L2-Sl level dorsal roots was cut, and 13 children had 50% of both Ll roots cut. Migration percentage score (MP) was used to determine progression of hip subluxation during the follow up period (12 36 mos.; Average 15 mos.). Of the total 44 hips in 22 patients, 45.5% (20 hips) improved, 34% (15 hips) remained unchanged, and 20.5% (9 hips) were worsened after SPR. Radiographic stability was achieved in 79.5%. Ll root cut rate (Ll SPR) was 55.5% for improved hips, 67% for unchanged hips, and 50% for worsened hips. Two patients had undergone orthopaedic procedure for progressive hip migration. Most patients experienced postoperative hip stability after SPR, but 20.5% were worsened and 2 patients had orthopaedic procedure. Also it is unlikely that Ll root involvement prevents progression of hip migration.
Cerebral Palsy* ; Child ; Dislocations ; Follow-Up Studies ; Hip* ; Humans ; Muscle Spasticity ; Retrospective Studies ; Rhizotomy* ; Spinal Nerve Roots