Bone scans with 99mTc-methylene diphosphonate were analysed in 44 patients with biopsy proven malignant bone tumor who admitted Department of Orthopedic Surgery in Seoul National University Hospital from March 1979 to June 1981. The results obtained were as follows: 1. Cases, there were 21 cases of primary malignant bone tumors and 23 cases of metastatic bone tumors. 2. Bone scan showed single lesion in 18 cases (86%) of 21 primery malignant bone tumors, and mutiple lesions in 15 csses (65%) of 23 metastatic bone tumors. 3. There were 2 cases of cold area in bone scan of a reticulum cell sarcoma and a metastatic adenocarcinoma. 4. In comparison of bone scan and roentgenogram by number of lesions, 96 lesions were positive in bone scan or roentgenogram in 44 cases. In 21 primary maligmant bone tumors of 29 lesions, 24 lesions (83%) were positive in both bone scan and roentgenograms. In 23 metaatatic bone tumors of 67 lesions, 28 lesions (54%) were positive in both bone scan and roentgenogram, 40 lesions (42%) were positive in bone scan and negative in roentgenogram 5. In only 2 cases of multiple myeloma, showes positive in roentgenogram but normal in bone scan. 6. In metastatic bone tumor, bone scan showed 39 hot lesions without clinical symptoms as well as 27 lesions with clinical symptoms.
Adenocarcinoma ; Biopsy ; Humans ; Lymphoma, Non-Hodgkin ; Multiple Myeloma ; Orthopedics ; Seoul ; Technetium Tc 99m Medronate

Various anatomical defects have been described in the surviving twin who had a stillborn, macerated monozygotic co-twin with Disseminated Intravascular Coargulation. The etiology is thought to be placental transfer of emboli or thromboplastic material through placental vascular anastomoses. We experienced a case of monozygotic twin with deceased co-twin at 30 weeks of gestation and confirmed to have antenatal periventricular germinal matrix and intraventricular hemorrhage, multicystic periventricular leukomalacia and diffuse encephalomalacia by neurosonography on first day of life despite of no clinical evidence of brain damage. The pathologic findings of placenta revealed infarct with massive fibrin deposition. A brief review of related literature is presented.
Brain* ; Encephalomalacia ; Fibrin ; Hemorrhage ; Humans ; Infant, Newborn ; Leukomalacia, Periventricular ; Placenta ; Pregnancy ; Twins ; Twins, Monozygotic*

Endometriosis of the rectum is unusual condition, since it represents an invasion of previously normal bowel by hormone-dependent nonmalignant cell from uterus of the same patient. It is estimated that the incidence of endometriosis is about 8-15% of reproductive women, of whom 3-34% show intestinal invasion of rectosigmoid colon, appendix, ileum, and cecum in order of decreasing frequency. Symptoms related bowel involvement may vary from none to complete intestinal obstruction. Because the mucosa is involved infrequently there is rarely rectal bleeding. X-ray and sigmoidoscopic studies are usually negative. It was not reported that colonic endometriosis was confirmed by endoscopic biopsy. Recently we experienced a case of rectal endometriosis which presented itself as a cyclic rectal bleeding with abdominal pain and diagnosed by colonoscopic biopsy.
Abdominal Pain ; Appendix ; Biopsy* ; Cecum ; Colon ; Colonoscopy ; Endometriosis* ; Female ; Hemorrhage ; Humans ; Ileum ; Incidence ; Intestinal Obstruction ; Mucous Membrane ; Rectum ; Uterus

Objective: We evaluated the protective effect of dexamethasone (DX) administration on brain damage produced in a perinatal model of cerebral hypoxia-ischemia in the rat. Since hyperglycemia has been shown to reduce hypoxic-ischemic brain injury (HI) in immature tar, we investigated the role of glucocorticoid-induced hyperglycemia in the neuroprotective mechanism of DX. Methods: Hypoxic-ischemic brain injury in 7-day-old rats was induced by right common carotid artery occlusion and 2 hours of 8% oxygen. Pups received 3 doses of DX (0.5mg/kg/d intraperitoneally) 48 hours, 24 hours and immediately before HI (Dx1)(n=12), a single dose of DX 24 hours(DX2)(n=16), 3 hours (DX3)(N=10)or immediately before HI (DX4)(n=14), a single dose of DX immediately after HI (DX5) (n=9), 3 doses of DX immediately, 24 hours and 48 hours after HI (DX6) (n=14) and a single dose of DX 24 hours before HI with insulin (0.5U/kg, subcutaneously, 1.5 hours before HI)(IN)(n=8). Control pups (n=15) received a single dose of normal saline 24 hours before HI. Blood glucose was estimated before hypoxia, 1 hour and 2 hours after hypoxia using glucometer in DX 1~4. IN and control rats. Pups were killed at 14 days of age for determination of mortality during HI, gross cerebral infarction and right cerebral hemisphere atrophy. We measured the diameter of each cerebral hemisphere and cortical thickness from a coronal section at the dorsal hippocampus level, and expressed the % atrophy from the change in the right vs left hemisphere diameter. Results: The mortality that occurred during and after HI was similar in all groups. The incidence of gross cerebral infarction was 0.0%, 0.0%, 75.0%, 83.3%, 87.5%, and 90.0% in DX 1~6, respectively, 0.0%in IN, and 100.0% in control group. There was a significant difference (p<0.001)in the incidence of gross cerebral infarction of DX1, DX2, IN vs control group. The mean % atrophy was 5.4 +/- 2.2, 4.9 +/- 1.8, 21.7 +/- 8.1, 29.7 +/- 5.0, 37.4 +/- 5.5, 33.4 +/- 9.3 in DX 1~6, respectively, 1.5 +/- 1.1 in IN, and 29.1 +/- 3.4 (mean+/-SEM) in control group. There was a significant difference in % atrophy of DX1, DX2, IN vs control group. Before hypoxia, there was no significant difference in blood glucose between saline, all DX, and DX with insulin treated groups. But after hypoxia, pups in DX1 and Dx2 were more hyperglycemic compared to DX 3~4, IN, or saline treated groups. Conclusions: Dexamethasone administration in the neonatal period protects the brain during the subsequent periods of hypoxia-ischemia in rats and glucocorticoid-induced hyperglycemia does not explain the neuroprotective effects dexamethasone.
Animals ; Anoxia ; Atrophy ; Blood Glucose ; Brain Injuries ; Brain* ; Carotid Artery, Common ; Cerebral Infarction ; Cerebrum ; Dexamethasone* ; Hippocampus ; Hyperglycemia* ; Hypoxia-Ischemia, Brain ; Incidence ; Insulin ; Mortality ; Neuroprotective Agents ; Oxygen ; Rats*

BACKGROUND: Recently, laparoscopic cholecystectomy becomes more favorite method than traditional open cholecystectomy. But postoperative pain control is still remaining problem. METHOD: Patients scheduled for elective laparoscopic cholecystectomy were assigned to two groups by simple randomization (15 patients per group). Group C (control) had no specific treatment and group B (bupivacaine) received 20 ml of 0.5% bupivacaine with epinephrine 1:200,000 before surgery. Immediately after the creation of a pneumoperitoneum, the surgeon sprayed the bupivacaine near and above the operation field. Operation was started 10 minutes after then. We attempted to investigate that the degree of postoperative pain which was assessed using the visual analogue scale (VAS) and the verbal rating scale (VRS) in the recovery room at postoperative 1 h., as well as the analgesic requirements during the first 24 h. postoperatively. RESULT: VRS of group B was significantly lower than group C (p<0.05), but VAS was not significantly different. Six patients in group B and only one in group C requested no analgesics. Group C had statistically more frequent request for analgesics than group B (p<0.05). CONCLUSION: The topical intraperitoneal anesthesia of 20 ml of 0.5% bupivacaine with epinephrine 1 : 200,000 before laparoscopic cholecystectomy is effective on the postoperative pain control. So, we recommmend that this simple and effective management is routinely treated in patients undergoing laparoscopic cholecystectomy.
Analgesics ; Anesthesia* ; Bupivacaine* ; Cholecystectomy ; Cholecystectomy, Laparoscopic* ; Epinephrine ; Humans ; Pain, Postoperative* ; Pneumoperitoneum ; Random Allocation ; Recovery Room

Fistula ; Hemorrhage ; Humans ; Hygiene ; Maxilla ; Mucous Membrane ; Osteotomy ; Perfusion ; Prognosis ; Tooth, Nonvital ; Transplants ; Wounds and Injuries

Acute pancreatitis(AP) in children is not common but can be associated with severe morbidity rates and its diagnosis is often delayed. Thus, reported mortality rates range from 0 to 78%. We have treated 26 patients with AP from 5 to 17 years of age over the past 17 years. We are intended to assess the relevance of the prognostic criteria used to assess severity of adult AP and to review the etiology, clilical presentation, diagnosis, and management of AP in children. The authors retrospectively reviewed 26 children with AP managed in Kyung Hee University Hospital from 1978 to 1995. Among 26 patients with AP, male were 12, and female were 14. And the mean age of patients was 11.8 years. In 9(34.6 %), no definitive cause was identified. Common causes of AP were trauma(23.1 %) and biliary tract disease(23.l%). Other etiologies were viral infection(15.4%) and post ERCP(3.8%). The presenting features were abdominal pain(92.3%), vomiting(61.5%), fever(l9.2%), submandibular pain(l1.5%), and abdominal mass(7. 6%). Back pain was rare(3.8%). Abdominal ultrasonographic findings were abnormal in 10 of 16 patients(62.5%) and abdominal CT findings were abnormal for 9 of 9 patients(100%). Seventeen patients(65.3%) were managed conservatively, and nine patients(34.6%) required surgical treatment. There was no mortality. To evaluate the severity of disease, we used the Imrie prognostic criteria used to assess the severity in adult AP. The number of positive criteria was correlated to the duration of hospitalization(r2=0.91) but statistically insignificant(p > 0.05). But, the number of positive criteria was correlated to the operative incidence(r2 = 0.93) and statistically significant(p < 0.05). The common causes of AP in children were unkown origin(34.6%), trauma(23.l %), and bili.ary tract disease(23.1 %). Ultrasonography and computed tomography were useful imaging tools of AP in children. The Imrie criteria used to evaluate the severity in adult AP were suspected to be valuable to asssess the severity of AP in children.
Adult ; Back Pain ; Biliary Tract ; Child ; Diagnosis ; Female ; Humans ; Male ; Mortality ; Pancreatitis ; Retrospective Studies ; Tomography, X-Ray Computed ; Ultrasonography

OBJECTIVE: We wanted to investigate the mechanisms that could account for the pathogenesis of rheumatoid arthritis, so we examined the different expressions of the genes in rheumatoid arthritis (RA) synovial fluid macrophages as compared with that of normal peripheral blood (PB) monocyte-derived macrophages using microarray and bioinformatic analysis. METHODS: We examined the expression of genes by using a gene expression oligonucleotide microarray. The differences of the gene expressions between the RA synovial macrophages and the normal PB monocytes-derived macrophages were analyzed using bioinformatic tools, including cytoscape and its plugin. RESULTS: In this study, we found that 899 genes (464 genes up-regulated and 435 genes down-regulated) were differentially expressed between the two groups. Among the 899 genes, 552 genes were included for gene ontology analysis and network analysis. Based on biological process ontology, they were categorised mainly into immune response processes, responses to stimulus and signaling and regulation of biological processes. In addition to the genes related with STAT1 and AP-1 signaling, we found that the genes involved in the antigen processing and the cell cycle are abundantly expressed in RA synovial macrophages, suggesting that these genes may play an important role in the pathogenesis of RA. CONCLUSION: Our study suggest that this approach using integration of the gene expression profile with the protein interaction data may help to find several important pathogenic mechanisms in RA.
Antigen Presentation ; Arthritis, Rheumatoid ; Biological Processes ; Cell Cycle ; Computational Biology ; Gene Expression ; Genes, vif ; Macrophages ; Oligonucleotide Array Sequence Analysis ; Synovial Fluid ; Transcription Factor AP-1 ; Transcriptome

OBJECTIVE: To examine the mechanism for the inhibited differentiation of osteoclasts in rheumatoid arthritis synovial CD14+ osteoclast precursors, the different expressions of the osteoclastogenesis-related genes in rheumatoid arthritis (RA) synovial fluid CD14+ osteoclast precursors were compared with those of normal peripheral blood (PB) CD14+ osteoclast precursors. METHODS: The expression of osteoclastogenesis-related genes were examined using a gene expression oligonucleotide microarray. To validate the results of the microarray analysis, the mRNA expressions of osteoclastogenesis-related genes were measured by real-time PCR. RESULTS: Comparative analysis of the mRNA profiles showed significantly different expression of osteoclastogenesis- related genes, such as MafB, Id3 and LILRB4, in the RA synovial CD14+ osteoclast precursors, compared to that of normal PB CD14+ osteoclast precursors. CONCLUSION: The expression of the osteoclastogenesis-related genes in RA synovial CD14+ osteoclast precursors is different from that of the normal PB CD14+ osteoclast precursors. These results suggest that the different expression of osteoclastogenesis-related genes might be involved in the altered osteoclastogenesis in RA synovial osteoclast precursors.
Arthritis, Rheumatoid ; Genes, vif ; Macrophages ; Microarray Analysis ; Oligonucleotide Array Sequence Analysis ; Osteoclasts ; RNA, Messenger ; Synovial Fluid

BACKGROUND: Hydroxyethyl starch (HES) solutions are used as plasma expanders for correcting hypovolemia, but can lead to impaired coagulation. We evaluated the changes in hematological and hemostatic profiles with three types of HES. METHODS: Patients were randomized to receive volume replacement with 10% pentastarch 260/0.45 in 0.9% saline (Group-PEN, n = 25), 6% tetrastarch 130/0.4 in 0.9% saline (Group-TET(S), n = 25), or 6% tetrastarch 130/0.4 in a balanced electrolyte solution (Group-TET(B), n = 25). Coagulation was assessed using rotational thromboelastometry (ROTEM(R)) and other laboratory tests were performed, including measurements of hematological and hemostatic parameters and electrolytes. RESULTS: Post-operative ROTEM(R) parameters changed toward hypocoagulable states in all groups. The post-operative parameters of EXTEM and FIBTEM were more impaired in Group-PEN than in Group-TET(B). The percentage change in INTEM clot formation time (P = 0.004) and alpha-angle (P = 0.003) were smaller in Group-TET(S) and Group-TET(B) than in Group-PEN. The percentage change in the FIBTEM maximum clot firmness was greatest in Group-PEN (P = 0.011). The international normalized ratio of prothrombin time (P < 0.001) and the activated partial thromboplastin time (P < 0.001) were significantly prolonged in Group-PEN compared to those of Group-TET(B). CONCLUSIONS: The 6% HES 130/0.4 in a balanced electrolyte solution seemed to have less of an impact on blood coagulation than the 10% HES 260/0.45. No differences in hemostatic profile were observed between the balanced electrolyte and saline-based 6% HES 130/0.4.
Arthroplasty, Replacement, Hip* ; Blood Coagulation* ; Colloids* ; Electrolytes ; Humans ; Hydroxyethyl Starch Derivatives* ; Hypovolemia ; International Normalized Ratio ; Partial Thromboplastin Time ; Plasma ; Prothrombin Time ; Starch ; Thrombelastography