The emergency arteriography have been performed in a total of 13 patiens with extermity trauma, including 9fractures, 3 blunting traumas, and 1 penetrating injury. over 17 months period. The indications were as follows:absent or diminishe pulse, swelling, sensory or motor deficit , and hypotension. Patients with an absent pulse,the most reliable indication of arterial injury, should have immediate arteriography. The superficial femoralartery was commonly injured especially with distal femoral shaft fracture. The most common arteriographic findingswas arterial occlusion.
Angiography ; Emergencies ; Extremities ; Humans ; Hypotension

Sialosyl Tn mucin antigen (STn) is a carbohydrate antigen of tumor associated mucin formed by the premature 2~6 sialation of N-acetylgalactosamine. STn has been expressed in several tumor types and showed prognostic significance in colonic carcinoma. The authors evaluated the expression of STn immunohistochemically and correlated its expression with clinicopathologic variables in 100 gastric cancers. In early gastric cancer, STn was expressed in 24 cases out of 50 cases (48%). In advanced gastric cancer, STn was expressed in 48 of 50 (96%). The difference in STn expression between advanced gastric cancer and early gastric cancer was statistically significant. The difference in STn expression between tumors with lymph node metastasis and those without lymph node metastasis, between tubular adenocarcinoma and signet ring cell carcinoma, and between intestinal type and diffuse type adenocarcinoma was statistically insignificant in early or advanced gastric adenocarcinoma. These results suggest that the STn expression plays a role in the tumor progression in both early and advanced gastric adenocarcinomas.
Adenocarcinoma* ; Carcinoma, Signet Ring Cell ; Colon ; Lymph Nodes ; Mucins* ; Neoplasm Metastasis ; Stomach ; Stomach Neoplasms

PURPOSE: To examine the fate of muscle-derived stem cells (MDSC) after injection into different host conditions and provide an insight for their mechanism of action. MATERIALS AND METHODS: MDSCs differentiated in vitro towards the endothelial lineage and transfected with lentivirus tagged with green fluorescent protein (GFP) were injected into two animal models mimicking vascular diseases: hindlimb ischemia and carotid injury models. Injected cells were tracked at the site of injection and in remote organs by harvesting the respective tissues at different time intervals and performing immunofluorescent histological analyses. Stem cell survival was quantified at the site of injection for up to 4 weeks. RESULTS: MDSCs were successfully tagged with fluorescent material GFP and showed successful implantation into the respective injection sites. These cells showed a higher affinity to implant in blood vessel walls as shown by double fluorescent co-stain with CD31. Quantification of stem cell survival showed a time-dependent decrease from day 3 to 4 weeks (survival rate normalized against day 3 was 72.0% at 1 week, 26.8% at 2 weeks and 2.4% at 4 weeks). Stem cells were also fo und in distant organs, especially the kidneys and liver, which survived up to 4 weeks. CONCLUSION: MDSCs were successfully tracked in different vascular disease models, and their fate was assessed in terms of cell survival and distribution. Better understanding of the donor cell properties, including their interaction with the host conditions and their mechanism of action, are needed to enhance cell survival and achieve improved outcomes.
Adult Stem Cells ; Animals ; Blood Vessels ; Cell Survival ; Hindlimb ; Humans ; Ischemia ; Kidney ; Lentivirus ; Liver ; Models, Animal ; Stem Cell Niche ; Stem Cells* ; Tissue Donors ; Vascular Diseases

Recently short term chemotherapy has become popular for the treatment of genitourinary tuberculosis. But it is questionable weather short term chemotherapy can cure all cases of genitourinary tuberculosis regardless of their severity ;and the role of nephrectomy in patients with renal tuberculosis is still controversial. Herein we analyzed 52 patients with confirmed urinary tuberculosis who were treated with triple drugs, including isoniazid, rifampicin and ethambutol, for 6 to 9 months. The patients ranged from 13 to 71 years of age, and the male to female ratio was 2.4: 1. Follow up period ranged from 6 to 65 months with a mean period of 19.7 months. The patients were classified according to the severity of renal tuberculosis on pyelography into Group I ( minimal, 8 patients), II (moderate, 9 patients) and III (severe, 35 patients), and treatment result were analyzed in each group. Of 52 patients, 19 were treated by chemotherapy only and 33 (63.5%) reconstructive surgery. Success rates of short term chemotherapy in terms of cure of tuberculosis and preservation of functional renal tissue were :overall 75%, 100% in Group I , 77% in Group II and 68.6% in Group III. Two of 9 patients in Group II and 10 of 17 in Group III who were treated with chemotherapy only, deteriorated with loss of the kidney. Poor vascular pyonephrotic kidney and progressive ureteral stricture were suggested as the main cause of failure. Ureteroneocystostomy and double J enting were helpful not only in the preservation of the kidney but also in the rapid cure of a renal tuberculosis. 24 patients who were treated with 6 to 9 months chemotherapy after removal of their nonfunctioning kidney were relapse-free on follow up. In conclusion, 6 to 9 months chemotherapy is adequate minimal urinary tuberculosis. For the treatment of moderate to advanced urinary tuberculosis, a longer period of chemotherapy may be adequate, and meticulous follow up with IVP and aggressive management of ureteral stricture is essential. A far advanced, nonfunctioning, unilateral tuberculosis kidney is better to be removed early, followed by 6 to 9 months' chemotherapy.
Constriction, Pathologic ; Drug Therapy* ; Ethambutol ; Female ; Follow-Up Studies ; Humans ; Isoniazid ; Kidney ; Male ; Nephrectomy ; Rifampin ; Tuberculosis* ; Tuberculosis, Renal ; Ureter ; Urography ; Weather

Hysterosalpingography and Hysteroscopy have been used for the detection of intraute-rine pathology such as polyps, submucous myomas, intrauterine adhesion and endometrial hyperplasia or cancer. Recently the ultrasound has also been utilized for the detection of uterine pathology. Therefore the purpose of this study was to evaluate the diagnostic efficacy of SonoHysterography in detection of intrauterine pathology compared with HSG and Hysteroscopy. 32 patients underwent Sono-Hysterography and Hysteroscopy for the evaluation of the uterine pathology from september 1995 to January 1996. Nine of 32 patients had infertility problem and HSG performed prior to Sono-Hysterography and Hysteroscopy. The results are as follows : 1. The patients' ages ranged from 20 to 50 years(median 37.9). 2. All 9 patients with infertility who had positive HSG findings in uterine cavity showed the intrauterine pathology in Sono-Hysterography as well as Hysteroscopy. The detail findings are as follows :septated uterus(n=2), intrauterine adhesion :IUA(n=3), endometrial polyp(n=3), and IUA combined endmetrial hyperplasia(n=1). 3. Twenty two of 23 patients with abnormal uterine bleeding showed the intrauterne pathology and one patient had negative finding in Sono-Hysterography. However, Hysteroscopy revealed positive intrauterine pathology in 22 patients who had abnormal uterine bleeding. One patients who had positive finding in Sono-Hysterograply showed negative by Hysterography. In contrast, one patient who had negative finding in Sono-Hysterography had positive uterine pathology with polyp in Hysteroscopy. The histologic pathology in all 23 patients reported endometrial polyp(n=12), placental polyp(n=2), submucous myoma(n=1), endometrial hyperplasia(n=5), endometrial cancer(n=1), normal endometrial finding(n=2). 4. Sono-Hysterography, therefore, has a sensitivity and positive predictive value of 96.6%, 93.5% respectively. Our study showed a positive Sono-Hysterography is very predictive of the intrauterine pathology. Sono-Hysterography is safe, quick and minimal invasive procedure. So it is an invaluable technique in the evaluation of uterine cavity.
Endometrial Hyperplasia ; Female ; Humans ; Hysterosalpingography ; Hysteroscopy* ; Infertility ; Myoma ; Pathology* ; Polyps ; Ultrasonography ; Uterine Hemorrhage

The purpose of this study is to demonstrate the effectiveness of arthrocopic treatment for the avulsion fracture of intercondylar eminence of the tibia and of the technique of arthroscopically assisted reduction and fixation through pull-out suture method. Between January 1995 and May 1997, three patients were underwent arthroscopic reduction and suture fixation for type 0 of avulsion fracture of intercondylar eminence of tibia and were followed up. The result of two patients were graded as normal and one as nearly normal by the criteria of the International Knee Documentation Committee(IKDC) rating scale. The advantages of this technique include no retained hardware and ability to treat comminuted fracture(type g ). We describe technique of arthroscopic reduction and suture fixasion for displaced avulsion fractures, including those with comminution of intercondylar eminence of tibia.
Humans ; Knee ; Sutures* ; Tibia

Two cases of congenital anterior urethral diverticula which have occurred in a 4 year-old and one month-oldboys are presented. Etiology, diagnostic procedures, and its clinical results are briefly reviewed.
Diverticulum

Endovascular aneurysm repair (EVAR) for the treatment of abdominal aortic aneurysm (AAA) is a widely used method, and its decreased invasiveness compared to traditional surgical repair has brought about reduced rates of morbidity and mortality. Several vascular complications related to the procedure have been reported, but non-vascular complications have rarely occurred. We report herein the case of a 78-year-old man who underwent EVAR for AAA and presented with active duodenal ulcer bleeding and acute acalculous cholecystitis as complications after the procedure. We must consider that a wide spectrum of complications may occur following EVAR, and therefore it is important to evaluate the risks of complication and to take the necessary measures to minimize them.
Acalculous Cholecystitis ; Aged ; Aneurysm ; Aortic Aneurysm, Abdominal ; Duodenal Ulcer ; Hemorrhage ; Humans

Familial juvenile polyposis is a rare intestinal polyposis characterized by the occurrence of multiple juvenile polyps in the gastrointestinal tract. We report a case of familial juvenile polyposis in a 17-year-old man with a review of the literature. This patient underwent total colectomy due to a 6 years history of rectal bleeding. Grossly, the colon showed 36 variable sized pedunculated polyps, measuring 2.5cm x 2cm from the largest size and 0.2cm x 0.2cm to the smallest size. Histologically, the polyps consisted of cystically dilated glands, lined by normal colonic epithelial cells, scattered in loose, edematous stroma containing inflammatory cell infiltration. There were no areas of tubular adenoma or malignancy in any of the polyp.
Adenoma ; Adolescent ; Colectomy ; Colon ; Epithelial Cells ; Gastrointestinal Tract ; Hemorrhage ; Humans ; Intestinal Polyposis ; Polyps

PURPOSE: This study was tried to evaluate the potential benefits of concurrent chemoradiation therapy (low dose daily cisplatin combined with split course radiation therapy) compared with conventional radiation therapy alone in stage III non-small cell lung cancer. The end points of analyses were response rate, overall survival, survival without locoregional failure, survival without distant metastasis, prognostic factors affecting survival and treatment related toxicities. MATERIAL AND METHODS: Between April 1992 and March 1994, 32 patients who had stage III non-small cell lung cancer were treated with concurrent chemoradiation therapy. Radiation therapy for 2 weeks (300cGy given 10 times up to 3000cGy) followed by a 3 weeks rest period and then radiation therapy for 2 more weeks (250cGy given 10 times up to 2500cGy) was combined with 6mg/M2 of cisplatin. Follow-up period ranged from 13 months to 48 months with median of 24 months. Historical control group consisted of 32 patients who had stage III non-small cell lung cancer were received conventionally fractionated (daily 170-200cGy) radiation therapy alone. Total radiation dose ranged from 5580cGy to 7000cGy with median of 5940 cGy. Follow-up period ranged from 36 months to 105 months with median of 62 months. RESULTS: Complete reponse rate was higher in chemoradiation therapy (CRT) group than radiation therapy (RT) group (18.8% vs. 6.3%). CRT group showed lower in-field failure rate compared with RT group (25% vs. 47%). The overall survival rate had no significant differences in between CRT group and RT group (17.5% vs. 9.4% at 2 years). The survival without locoregional failure (16.5% vs. 5.3% at 2 years) and survival without distant metastasis (17% vs. 4.6% at 2 years) also had no significant differences. In subgroup analyses for patients with good performance status (Karnofsky performance scale 80), CRT group showed significantly higher overall survival rate compared with RT group (62.5% vs. 15.6% at 2 years). The prognostic factors affecting survival rate were performance status and pathologic subtype (squamous cell cancer vs. nonsquamous cell cancer) in CRT group. In RT alone group, performance status and stage (IIIa vs IIIb) were identified as a prognostic factors. RTOG/EORTC grade 2-3 nausea and vomiting (22% vs. 6%) and bone marrow toxicities (25% vs. 15.6%) were significantly higher in CRT group compared with RT alone group. The incidence of RTOG/EORTC grade 3-4 pulmonary toxicity had no significant differences in between CRT group and RT group (16% vs. 6%). The incidence of WHO grade 3-4 pulmonary fibrosis also had no significant differences in both group (38% vs. 25%). In analyses for relationship of field size and pulmonary toxicity, the patients who treated with field size beyond 200cm2 had significantly higher rates of pulmonary toxicities. CONCLUSION: The CRT group showed significantly higher local control rate than RT group. There were no significant differences of survival rate in between two groups. The subgroup of patients who had good performance status showed higher overall survival rate in CRT group than RT group. In spite of higher incidence of acute toxicities with concurrent chemoradiation therapy, the survival gain in subgroup of patients with good performance status were encouraging. CRT group showed higher rate of early death within 1 year, higher 2 year survival rate compared with RT group. Therefore, to evaluate the accurate effect on survival of concurrent chemoradiation therapy, systematic follow-up for long term survivors are needed.
Bone Marrow ; Carcinoma, Non-Small-Cell Lung* ; Cisplatin ; Follow-Up Studies ; Humans ; Incidence ; Nausea ; Neoplasm Metastasis ; Pulmonary Fibrosis ; Survival Rate ; Survivors ; Vomiting