No abstract available.
Femur*

In so-called primary osteoarthritic knees, there may be secondary osteoarthritis due to the instability from chronic cruciate ligament and/or meniscal tear. The purpose of this study is to compare the findings of bone single-photon emission computed tomography(SPECT) and those of simple radiography in osteoarthritic knees which we consider as primary on the status of anterior cruciate ligament(ACL). We reviewed the preoperative bone SPECT and simple radiography of forty-three osteoarthritic knees in 23 patients who underwent total knee arthroplasty between 1995 and l996. We divided the cases into two groups on the status of ACL: thirty intact ACLs(Group I), thirteen insufficient ACLs(Group II). Meniscal tear and/or ACL insufficiency were found in 38 of 43 knees, As regards with presence of osteophytes and sclerotic changes on simple radiograph, there was no significant differences between group I and II. Joint space narrowing was more prominent and diffuse in group I(medial 29, lateral 24) than group II(medial 7, lateral 6). Bone SPECT showed diffuse uptake in group I(medial 30, lateral 23), but less uptake on the lateral compartment(medial 13, lateral 3) in group II. In ACL-intact osteoarthritic knees, joint space narrowing on simple radiograph and hot uptake on bone SPECT were more prominent and diffuse than in ACL-insufficient knees. Clinical relevance is still uncertain and further investigation is needed.
Anterior Cruciate Ligament* ; Arthroplasty ; Humans ; Joints ; Knee* ; Ligaments ; Osteoarthritis ; Osteophyte ; Radiography* ; Tomography, Emission-Computed, Single-Photon*

No abstract available.
Humans ; Nephritis, Interstitial* ; Nephrotic Syndrome*

PURPOSE: To evaluate the clinical outcome of high-dose-rate (HDR) interstitial brachytherapy (IBT) in patients with oral cavity cancer. MATERIALS AND METHODS: Sixteen patients with oral cavity cancer treated with HDR remote-control afterloading brachytherapy using 192Ir between 2001 and 2013 were analyzed retrospectively. Brachytherapy was administered in 11 patients as the primary treatment and in five patients as salvage treatment for recurrence after the initial surgery. In 12 patients, external beam radiotherapy (50-55 Gy/25 fractions) was combined with IBT of 21 Gy/7 fractions. In addition, IBT was administered as the sole treatment in three patients with a total dose of 50 Gy/10 fractions and as postoperative adjuvant treatment in one patient with a total of 35 Gy/7 fractions. RESULTS: The 5-year overall survival of the entire group was 70%. The actuarial local control rate after 3 years was 84%. All five recurrent cases after initial surgery were successfully salvaged using IBT +/- external beam radiotherapy. Two patients developed local recurrence at 3 and 5 months, respectively, after IBT. The acute complications were acceptable (< or =grade 2). Three patients developed major late complications, such as radio-osteonecrosis, in which one patient was treated by conservative therapy and two required surgical intervention. CONCLUSION: HDR IBT for oral cavity cancer was effective and acceptable in diverse clinical settings, such as in the cases of primary or salvage treatment.
Brachytherapy* ; Humans ; Mouth Neoplasms ; Mouth* ; Radiotherapy ; Recurrence ; Retrospective Studies

Pulmonary edema is a recognized comphcation of acute airway obstruction. When pulmonary edema occurs, it usually follows relief of obstruction and is likely to be of noncardiogenic origin. We present a case of noncanhogenic pulmonary edema that occured in a ncy woman who was transfered to our hospital, because of endotracheal intubation failure and unrelieved bronchospasm, during general anesthesia for Cesarian section.
Airway Obstruction ; Anesthesia, General ; Anesthetics ; Bronchial Spasm ; Female ; Humans ; Intubation, Intratracheal ; Kidney ; Kidney Transplantation* ; Pulmonary Edema ; Transplantation

The rupture of the aorta commonly follows major blunt truma to the thorax. It was markdly increased in recent years, paralleling the rising number of vehicular accidents, The patient underwent surgical repair with femoro-femoral partial bypass 40 days after injury. The anesthesia for descending aortic surgery presented problems involving large hemodynamic alterations during thoracic aortic cross-clamping, protection of the heart and brain from large increases in pressure occuring above the cross clamp, and prevention of spinal cord and renal ischemic damage below the cross-clamp. One lung ventilation was also employed with this anesthetic technique. A 23 years old male patient with traumatic aneurysm of descending thoracic aorta was treated successfully.
Anesthesia ; Aneurysm ; Aorta ; Aorta, Thoracic ; Aortic Aneurysm* ; Brain ; Heart ; Hemodynamics ; Humans ; Male ; One-Lung Ventilation ; Rupture ; Spinal Cord ; Thorax ; Young Adult

In an attempt to develop a new anticancer platinum complex with greater or equivalent antitumor activity but reduced side effects compared with cisplatin (CDDP), a series of new platinum complexes having a glycolate leaving ligand was synthesized. Among them, five complexes were selected for further development on the basis of adequate water solubility, low nephrotoxicity and high antitumor activity in a murine system. The chemosensitivity of these five complexes was examined in MTT assay against two human pulmonary adenocarcinoma cell lines, PC-9 and PC-14, and two human stomach adenocarcinoma cell lines, MKN-45 and KATO III. Their IC50 and relative antitumor activity (RAA) values were compared with those of CDDP and 254-S, a second-generation platinum complex with a glycolate leaving ligand under phase III clinical trial. The lowest mean IC50 value was observed in CDDP, followed by SKI 2034R and SKI 2033R. In this study, the antitumor activity was evaluated in terms of RAA values and SKI 2034R showed the highest RAA value. The order of RAA values was SKI 2034R > CDDP > SKI 2032R > SKI 2033R > SKI 2030R > SKI 2029R > 254-S. Based on the RAA order, we have recommended SKI 2034R as the most promising candidate for further development of a clinically useful platinum complex.
Antineoplastic Agents/*pharmacology ; Cisplatin/pharmacology ; Comparative Study ; Drug Evaluation, Preclinical ; Human ; Organoplatinum Compounds/*pharmacology ; Tumor Cells, Cultured

OBJECTIVE: To evaluate the efficacy and safety of concurrent chemotherapy of paclitaxel and carboplatin with standard pelvic radiotherapy as adjuvant therapy after primary surgery in high-risk cervical cancer. METHODS: Twenty-eight patients with FIGO stage IB1-IIB cervical cancer who received adjuvant concurrent chemoradiotherapy with paclitaxel and carboplatin from February 2000 to November 2001 were analyzed retrospectively in this study. Adjuvant chemoradiotherapy was done if there were lymph node involvement or at least 2 positive findings among following risk factors; lymphovascular space invasion, full- thickness involvement of cervix and tumor size larger than 4 cm in diameter. Two cycles of paclitaxel 135 mg/m2, followed by carboplatin with AUC of 4.5 were administered intravenously with an interval of at least 4 weeks. The radiotherapy was initiated concurrently at the first day of chemotherapy. The therapeutic results were evaluated by pelvic examination, Pap smear, SCCA (Squamous cell carcinoma antigen) and computed tomography (CT). The toxicities of the treatment were evaluated and graded by NCI-CTC version 2.0. RESULTS: Total 56 cycles of paclitaxel/carboplatin chemotherapy with concomitant pelvic radiotherapy was delivered. None of the patients had a progressive or recurrent disease during the follow-up period ranging from 6 to 33 months (median: 12.5 months). Neutropenia was the most common and concerned toxicity. Fifteen cases of grade 3 and 4 neutropenia (26.8%) were observed. Non-hematologic toxicities were mild and mainly related to neurologic or gastrointestinal symptoms. Eight cases of grade 1 and 2 neurotoxicity were observed (14.3%). CONCLUSION: The adjuvant chemoradiotherapy with paclitaxel and carboplatin seems to be effective and well-tolerated for the treatment of high risk group cervical cancer after primary surgical therapy. But a large randomized study with longer duration of follow-up is needed to justify this conclusion.
Area Under Curve ; Carboplatin* ; Cervix Uteri ; Chemoradiotherapy* ; Chemoradiotherapy, Adjuvant ; Drug Therapy ; Female ; Follow-Up Studies ; Gynecological Examination ; Humans ; Lymph Nodes ; Neutropenia ; Paclitaxel* ; Radiotherapy ; Retrospective Studies ; Risk Factors ; Uterine Cervical Neoplasms*

Background: Long-term glucocorticoid use increases fracture risk by reducing bone mass. This study evaluated the relationship between hip and vertebral fractures and the total amount of systematic glucocorticoid use. Methods: We randomly selected 1,896,159 people aged 20 to 100 years who participated in the National Health Checkup program in 2006. The amount of glucocorticoids prescribed was calculated based on the defined daily dose (DDD). The total DDD was obtained by adding oral and parenteral glucocorticoids for 6 months from the index date. Subjects were categorized into four groups according to total glucocorticoid DDDs: non-users (DDDs=0), low users (0< DDDs ≤45), intermediate users (45< DDDs ≤90), and high users (90< DDDs). We followed them for 2 years. A multivariate Cox proportional hazard model was used to evaluate the effects of the total amount of glucocorticoid use on hip and vertebral fractures. Results: Higher glucocorticoid use was associated with a higher risk of vertebral fracture. Relative to non-users, the vertebral fracture risk was 1.39 times higher in the low-user group, 1.94 times higher in the intermediate-user group, and 2.43 times higher in the highuser group. The risk of hip fracture was 1.72 times higher in intermediate users and 3.28 times higher in high users than in non-users. Conclusion As the amount of glucocorticoid use for 6 months increased, the risk of hip and vertebral fractures became higher. In order to prevent fractures, it is necessary for doctors to evaluate the total amount of glucocorticoid prescribed to the patient and to provide appropriate treatment.