Multiple symmetric lipomatosis is a rare disease and affects almost exclusively middle aged man, usually with a background of excessive a alcohol intake. The disease is characterized by progressive growth of subcutaneous fat masses which are located symmetrically at neck, shoulders, chest, abdomen and groin, and which subsequently penetrate deeply into the surrounding spaces and structures with symptomatic compression of deep organs, such as trachea. A recent survey revealed a high incidence of sometic and autonomic neuropathy. The exact cause of the disease is not known, but a hyperplastic mechanism has been postulated, with in vitro studies demonstrating a defect in adrenergic-stimulated lipolysis of lipomatous tissue. We have experienced two cases of multiple symmetric lipomatosis. Case 1 was a 59-year-old male, complaining of slowly enlarging doughunt ring-shaped mass at his neck. He had a habit of excessive alcohol intake for many years. The subcutaneous mass at the neck was excised. The pathology report described the specimen as "normal adipose tissue". Case 2 was a 49-year-old male, complanining of slowly enlarging multiple symmetric masses at the neck, shoulders, chest, abdomen, flank and groin over a period of 6 years. He also complained of mild muscular weakness. He had a habit of excessive alcohol intake for many years. The subcutaneous mass in the neck was excised. The specimen had a tendency to form globular masses and microscopically indistinguishable from mature adipose tissue.
Incidence

PURPOSE: One of the major keys to achieve successful osseointegration of the implant is its surface properties. The aim of this study was to investigate the bone response to dental implants with different surface characteristics using the rabbit tibia model. Tricalcium phosphate (TCP) coated, anodic oxidized and turned (control) surfaces were compared. MATERIALS AND METHODS: Seventy two implants were placed in the tibia of eighteen rabbits. Nine rabbits were sacrificed at 3 weeks of healing and the remaining nine were sacrificed at 6 weeks of healing. The bone-to-implant contact (BIC) and the bone volume density (BVD) were assessed by light microscope after 3 and 6 weeks of healing. RESULTS: Statistical analysis showed that no significant differences in the BIC and BVD were observed between the different implant surfaces and the control group at 3 weeks and 6 weeks of healing. Data also suggested that the BVD of all the surfaces showed significant difference at 3 and 6 weeks. CONCLUSION: The present study has showed that osseointegration occurred in all investigated types of surface-treated implants. In the current study all of the threads of the implants were observed to calculate BIC and BVD values (instead of choosing some of the threads from the bone cortex for example), which didn't make BIC or BVD percentage values better than in the control group, therefore the clinical relevance of these results remains to be shown.
Calcium Phosphates ; Dental Implants ; Light ; Nitrogen Mustard Compounds ; Osseointegration ; Rabbits ; Surface Properties ; Tibia

No abstract available.
Insulin-Like Growth Factor Binding Proteins* ; Kidney Failure, Chronic*

No abstract available.

No abstract available.
Kidney Transplantation*

The 5 year survival rate after surgical resection for stage III non-small cell lung cancer(NSCLC) remains short, only 10-19%. Radiotherapy seems to show some benefit for local control, but it does not reflect to prolongation of survival, as distant metastasis prevails. Vinblastine is one of the most active agent against NSCLC. 5-Fluorouracil(5-FU) and cisplatin are synergistic in anti-cancer activity in adenocarcinoma of gastrointestinal tract and squamous cell cancer of head and neck. We initiated a phase II trial for advanced NSCLC to determine the effect of FVP regimen in response rate, survival and toxicities. The therapy consisted of 5-FU 500mg/m2/12 hours continious IV infusion for 36 hours from day 1, vinblastine 3mg/m2 IV bolus day 1 and 2, cisplatin 75mg/m2 IV infusion over 2 hours day 1 and it was repeated every 3 weeks. Among the 45 patients entered into this study, 40 patients were evaluable for response. The objective response rate was 50%(CR;1/40, 2.5% PRi19/40, 47.5%). The median survival of all the patients was 42.9 weeks(8.4+ - 140.6 weeks); the responding patients survived longer than the non-responders(mediansurvival; 54.4 weeks vs 29.7 weeks, p<0.05). The toxicities of this regimen were acceptable but 1 patient died of pneumonia associated with granulocytopenia. We concluded that the FVP regimen is effective in the treatment of advanced non-small cell lung cancer and a prospective randomized trial and long- term follow up is warranted.
Adenocarcinoma ; Agranulocytosis ; Carcinoma, Non-Small-Cell Lung* ; Cisplatin* ; Dronabinol* ; Drug Therapy ; Drug Therapy, Combination* ; Fluorouracil* ; Follow-Up Studies ; Gastrointestinal Tract ; Head ; Humans ; Lung ; Neck ; Neoplasm Metastasis ; Neoplasms, Squamous Cell ; Pneumonia ; Radiotherapy ; Survival Rate ; Vinblastine

No abstract available.
Hip* ; Pyomyositis*

Background: To report the long-term clinical and radiologic results of impaction bone grafting and standard cemented polished stem for femoral revision arthroplasty in patients with extensive bone deficiency. Methods: We retrospectively reviewed 47 hips that underwent femoral revision hip arthroplasty using an impaction-morselized allograft with a standard cemented polished stem. The average age at the time of revision hip arthroplasty was 55 years (range, 39–75 years). The modified Harris hip score (HHS) was used for clinical evaluation. The radiologic evaluation focused on stem subsidence, stem position, progressive radiolucent lines, bone remodeling, and the incorporation of allografts. Results: The modified HHS improved from an average of 55.04 (range, 25–79.5) preoperatively to 90.1 (range, 81–93.2) at the last follow-up. The mean follow-up duration was 13.5 years (10.9–17.8 years). The radiographic analysis revealed stable stems.Femoral stems showed an average subsidence of 3.2 mm (range, 2–8 mm) in the cement mantle. However, there was no mechanical failure or subsidence of the cement mantle in the femurs. The stem position was neutral or varus less than 5°. No progressive radiolucent line or osteolysis was observed. Evidence of cortical and trabecular remodeling was observed in all cases. There were four cases of intraoperative cracks and four cases of distal femur splitting. Conclusions Initial stem stability using impaction bone grafting and a standard cemented polished stem in femoral revision arthroplasty resulted in good outcome. Delicate impaction grafting techniques and intraoperative crack and splitting fixation are the points that need attention for successful long-term results.

BACKGROUND: Brain death is irreversible coma due to injury of brain hemisphere and brain stem regardless of any treatment. In brain-dead patients, diabetes insipidus, hypothermia, acute respiratory failure, and multiorgan failure occur due to brain stem compression injury. The primary goal of organ donor management is maintenance of optimal physiologic environment for organs prior to donation. This study is performed for suggesting the guideline of the prediction and management of multiorgan failure in the brain-dead patient. METHODS: We analyzed 16 brain-dead patients waiting for organ donation in the intensive care unit. The causes of brain death among the donors consisted of closed head injury in 8 patients, subarachnoid hemorrhage in 4, drowning in 1, aplastic anemia in 1, asthmatic attack in 1 and falling-down injury in 1. PaO2/FIO2 (arterial oxygen tension/fractional inspired O2 concentration) was analyzed to demonstrate the progress of respiratory failure. Body temperature, vital signs, urine output, serum osmolarity, urine osmolarity, serum K+, serum Na+, AST(aspartate aminotransferase), ALT(alanine aminotransferase), total bilirubin, BUN(blood urea nitrogen) and creatinine were also analyzed in all patients. RESULTS: Diabetes insipidus were found in 15 patients, hypothermia in 8, renal dysfunction in 2, hepatic dysfunction in 0, and acute respiratory failure in 2 at the time of arrival to intensive care unit. Diabetes insipidus was found in 16patients, hypothermia in 0, renal dysfunction in 0, hepatic dysfunction in 0, and acute respiratory failure in 9 at 16 hours after arrival to intensive care unit. CONCLUSIONS: We concluded that hepatic and renal functions were well preserved for long time after brain death and brain-dead patients rapidly progressed to acute respiratory failure. It can be suggested that organ procurement should be performed as soon as possible after brain death was confirmed for successeful organ transplantation.
Anemia, Aplastic ; Bilirubin ; Body Temperature ; Brain ; Brain Death ; Brain Stem ; Creatinine ; Diabetes Insipidus ; Drowning ; Head Injuries, Closed ; Humans ; Hypothermia ; Intensive Care Units ; Lung ; Multiple Organ Failure ; Organ Transplantation ; Osmolar Concentration ; Oxygen ; Respiratory Insufficiency ; Subarachnoid Hemorrhage ; Tissue and Organ Procurement ; Tissue Donors ; Transplants ; Urea ; Vital Signs

BACKGROUND: This study was performed to verify the correlation between abdominal subcutaneous fat thickness (ASFT) measured by ultrasonography (US) during the first trimester of pregnancy and gestational diabetes mellitus (GDM) of the second trimester in Korean women and to establish a standard of ASFT for predicting GDM. METHODS: A total of 333 singleton pregnant women participated in this study. Their ASFT was measured by US during the 10+6 to 13+6 weeks of pregnancy; then a GDM confirmatory test (100 g oral glucose tolerance test) was conducted during the 24 to 28 week period of pregnancy. Based on the GDM tests, comparative analyses of the ages of the subjects, pre-pregnancy body mass index (BMI), and weight gain during pregnancy were conducted. RESULTS: The ages of the subjects and weight gains during pregnancy were not correlated to the GDM of the second trimester of pregnancy, but the pre-pregnancy BMIs (22±3.3 kg/m²) and the ASFT (1.9±0.5 cm) measurements between the control group and subjects during the first trimester of pregnancy were found to show significant differences (P < 0.001). The cut-off value of the ASFT for predicting GDM was determined to be 2.4 cm (area under the curve=0.90, sensitivity 75.61%, specificity 91.78%, P < 0.001). The odds ratio was 2.91 (95% confidence interval, 1.07 to 7.92; P=0.034), which was higher than the 2.4 cm ASFT. CONCLUSION: It was determined that ASFT as measured by US during the first trimester of pregnancy can be used to predict the risk of developing GDM during the second trimester of pregnancy and for prognosis.
Body Mass Index ; Diabetes, Gestational* ; Female ; Glucose Tolerance Test ; Humans ; Obesity ; Odds Ratio ; Pregnancy ; Pregnancy Trimester, First ; Pregnancy Trimester, Second ; Pregnant Women ; Prognosis ; Sensitivity and Specificity ; Subcutaneous Fat, Abdominal* ; Ultrasonography* ; Weight Gain