No abstract available.
Ischemia* ; Skin*

The treatment of articular cartilage and bone defect has been challenging for many years. Autologous osteochondral grafting represents the most physiologic procedure for reconstructing joint defects but is severely limited by the availability of donor material. Allogenic osteochondral grafting differs from the other grafting method in obtaining almost unlimited amounts of material of exact size and form for complex joint reconstructions. An alternative approach that may improve allograft revascularization and incorporation was to combine an autologous muscle flap with an allograft and vascularized osteochondral allografts that have reported excellent long term results. The vascular characteristics of muscle flaps, with their capacity as a source for mesenchymal stem cells, provide the muscle flap with the ability to initiate bone formation and repair in transplanted allografts in response to osteogenic factors. Forty adult New Zealand White rabbits underwent complete resection of the proximal 2/3 of the humerus. The defects were immediately grafted following substance: (1) lyophilized osteochondral allografts (n=10); (2) lyophilized osteochondral allograft with a muscle flap filling the bone marrow cavity(n=10); (3) OP-1(Osteogenic protein-1) treated lyophilized osteochondral allografts (n=10); (4) OP-1 treated lyophilized osteochondral allograft with OP-1 injected muscle flap filling the bone marrow cavity(n=0). All the examinations were operated under aseptic conditions, and follow-up evaluations were performed in the 4th, 6th, 8th, 10th, 12th, and 24th week. Range of motion showed no difference between the groups, but more limited in OP-1 treated allograft groups. Under the histologic examination, the groups of lyophilized osteochondral allograft with a muscle filling the bone marrow cavity regenerated more articular cartilage than that of OP-1 treated allograft. These results suggest that using OP-1 treated lyophilized osteochondral allograft with OP-1 injected muscle flap filling the bone marrow cavity could get more organized articular cartilage and bone regeneration.
Adult ; Allografts* ; Bone Marrow ; Bone Regeneration ; Cartilage, Articular ; Follow-Up Studies ; Humans ; Humerus ; Joints ; Mesenchymal Stromal Cells ; Osteogenesis ; Rabbits ; Range of Motion, Articular ; Tissue Donors ; Transplants

The purpose of this study was to investigate the effects of smoking on adult periodontitis after non-surgical periodontal therapy. The study population consisted of 40 patients with moderate to advanced periodontitis. Smokers(n=20) were defined as individuals smoking at least twenty cigarettes per day at the time of the initial examination. The non-smoking group(n=20) second and the fourth weeks after periodontal non-surgical therapy. The results were as follows; 1. Clinical indices including plaque index, gingival index, and pocket depth were decreased in both smoking and non-smoking group at the first, the second, and the fourth weeks. Especially, clinical indices of non-smokers were more significantly decreased than those of smokers. 2. Non-motile rods were increaseed and motile rods were reduced at the fourth week. spirochetes were reduced significantly in the non-smoking group at the fourth week. These results suggest that smoking play a minor role in adult periodontitis after non-surgical periodontal therapy.
Adult* ; Chronic Periodontitis* ; Humans ; Periodontal Index ; Periodontitis ; Smoke* ; Smoking* ; Spirochaetales ; Tobacco Products

Over the years, many surgeons have used various natural and synthetic materials to bridge the nerve defect. However, none of these materials has surpassed the effectiveness of the nerve autograft. Among natural materials, a vein graft has been used as conduit for nerve regeneration in both research protocols and clinical situations. Unfortunately, the comparison of various research reports is difficult, for each research has employed a different experimental model and method of evaluation for the study of the nerve regeneration. This study introduced various modifications of the vein graft technique, and investigated several vein graft models in an attempt to find the most effective formulation . Four vein graft models were employed: 1) the empty vein graft, 2) the inside-out pattern vein graft, 3) the vein graft filled with skeletal muscle strips, 4) the inside-out pattern vein graft filled with skeletal muscle strips. Regeneration was assessed with gross appearance, histologic examination and electromyography(EMG). In the vein graft filled with muscle strips, there was the increased axonal diameter, myelin sheath thickness, ratio of myelinated axon to unmyelinated axon, and conduction velocities. The result showed that any vein graft filled with muscle strips is superior to the empty vein graft and the inside-out pattern vein graft model which are not filled with muscle strips. It is concluded that the nerve repair using a vein graft filled with skeletal muscle strips can be effectively employed in the clinical field. Further study should be aimed at the regeneration of a longer distance nerve gap and its clinical application.
Animals ; Autografts ; Axons ; Models, Theoretical ; Muscle, Skeletal ; Myelin Sheath ; Nerve Regeneration* ; Rats* ; Regeneration ; Research Report ; Transplants ; Veins*

Patients undergoing maintenance dialysis show an increased susceptibility to tuberculosis because host immunity is decreased secondary to malnutrition, impaired cellular immunity, acidosis and etc. Extrapulmonary tuberculosis is more prevalent in patients with end stage renal disease than in normal subjects. Among the extrapulmonary tuberculosis in patients receiving hemodialysis, the diagnosis of tuberculous spondylitis is difficult because the symptoms are non specific and attributable to uremia, and the appearance of plain radiographs is often normal during the early phase of the disease. We experienced a case of tuberculous spondylitis in a hemodialysis patient. A 55 years old female admitted with fever, weight loss and back pain. Conventional radiograph of T-spine showed no definite abnormal finding. However, chest CT revealed heterogeneously enhancing soft tissue around the T8 vertebral body and T-spine MRI showed compatible finding to tuberculous spondylitis. She received radical excision of involved vertebra and confirmed tuberculous spondylitis with histologic finding from a surgical specimen. Following the administration of anti-tuberculosis medication(isoniazid, rifampin, pyraziamide, ethambutol) and radical excision, patient's symptom and sign were improved. The patient is maintaining dialysis with anti-tuberculosis medication for 5 months.
Acidosis ; Back Pain ; Diagnosis ; Dialysis ; Female ; Fever ; Humans ; Immunity, Cellular ; Kidney Failure, Chronic ; Magnetic Resonance Imaging ; Malnutrition ; Middle Aged ; Renal Dialysis* ; Rifampin ; Spine ; Spondylitis* ; Tomography, X-Ray Computed ; Tuberculosis ; Uremia ; Weight Loss

Chronic endometritis (CE) is a condition involving the breakdown of the peaceful co-existence between microorganisms and the host immune system in the endometrium. A majority of CE cases produce no noticeable signs or mild symptoms, and the prevalence rate of CE has been found to be approximately 10%. Gynecologists and pathologists often do not focus much clinical attention on CE due to the time-consuming microscopic examinations necessary to diagnose CE, its mild clinical manifestations, and the benign nature of the disease. However, the relationship between CE and infertility-related conditions such as repeated implantation failure and recurrent miscarriage has recently emerged as an area of inquiry. In this study, we reviewed the literature on the pathophysiology of CE and how it may be associated with infertility, as well as the literature regarding the diagnosis and treatment of CE. In addition, we discuss the value of hysteroscopic procedures in the diagnosis and treatment of CE.
Abortion, Habitual ; Diagnosis ; Endometritis* ; Endometrium ; Female ; Fertilization in Vitro ; Hysteroscopy ; Immune System ; Infertility* ; Pregnancy ; Prevalence

Various materials have been proposed for use in aesthetic and reconstructive augmentation of the face. Three basic types of material are currently available: autografts, homografts, and alloplasts. Alloplastic materials have been used widely for soft tissue augmentation. Many synthetic material have been developed for alloplasty; among these, the porous material, Gore-Tex(r)(ePTFE) allows minimal fibrous tissue ingrowth but the amount is sufficient to confer some stability of the implant in soft tissue over time. The purpose of this study is to evaluate the tissue reaction and size change of Gore-Tex in rabbits. A precise pockets were made in the plane below the panniculus carnosus and periosteum. The 25x5x3mm sized rectangular shape of Gore-Tex(r) was then inserted into the pocket. Tissue specimens including skin and implant were obtained in 1, 3, 6 months after implantation. The specimens were examined grossly and microscopically. Grossly, none of the implants were lost or extruded and there was no evidence of wound infection, hematoma, or seroma formation. Thickness of implants under periosteum decreased more than panniculus carnosus. Results of light microscopy revealed a mild inflammatory cell reaction in the early implant group(1 month) at the tissue-implant interface. Within the substance of the material, tissue ingrowth was not observed in the early implant group(1 month and 3 months), but was observed in the late implant group(6 months). In this study the Gore-Tex appears to be a safe and reliable substance for use in augmentation of bony and soft tissue structure of the face.
Allografts ; Autografts ; Hematoma ; Microscopy ; Periosteum ; Polytetrafluoroethylene* ; Rabbits ; Seroma ; Skin ; Wound Infection

BACKGROUND/AIMS: Ulcerative colitis is an inflammatory bowel disease with unknown etiology, which has waxed and waned course. It is diagnosed by colon study, pathology, and especially colonoscopy. It is difficult to differentiate between ulcerative colitis and other infectious colitis, especially amebic colitis, and to confirm of remnant lesion by endoscopic findings. METHODS: Magnifying colonoscopy has 100 time magnifying power compared to 30 time of conventional colonoscopy. By spraying 0.2% indigo carmine dye, we evaluated the magnifying and microscopic findings of 31 colonic mucosa of 23 patients with ulcerative colitis. RESULTS: Initial and magnifying chromoscopic findings in ulcerative colitis were loss of cryptal opening 72% (13/18), loss of submucosal vessel 89% (16/18), mucosal denudation (or microscopic erosion) 83% (15/18), and mucosal unevenness 94% (17/18). Recovery rate of magnifying chromoscopic findings after treatment in ulcerative colitis were in crytal opening 80% (8/10), submucosal vascularity 60% (6/10), mucosal denudation (microscopic erosion) 30% (3/10), and in mucosal unevenness 40% (4/10). CONCLUSIONS: It is suggested that magnifying chromoscopic findings in ulcerative colitis may be useful in initial diagnosis and confirmation of remnant lesion, but, not in prediction of clinical severity.
Colitis ; Colitis, Ulcerative* ; Colon ; Colonoscopy ; Diagnosis ; Dysentery, Amebic ; Humans ; Indigo Carmine ; Inflammatory Bowel Diseases ; Mucous Membrane ; Pathology ; Ulcer*

Although tubal pregnancy is increasing, primary ovarian ectopic pregnancy has remained a rare event. However, recent reports suggest an increasing incidence to both tubal and term pregnancies. Ovarian pregnancy occurs within the ovary and on the corpus luteum. Earlier diagnosis is now possible, owing to the availability of highly specific radioimmunoassay for human chorionic gonadotrophin and the development of transvaginal ultrasonography. Clinical and even intraoperative diagnosis is difficult and confirmation may be made only by microscopic examination of the tissue specimen. Current understanding of the etiological factors, classification, possible pathogenesis, clinical presentation, diagnostic steps, reevaluation of diagnostic criteria, preferred management and future fertility are detailed. The therapy is surgical and currently more conservative than in the past, because of improvement in operative laparoscopy. We report a case of primary ovarian pregnancy treated conservatively under laparoscopic surgery with a brief review of literature.
Chorion ; Classification ; Corpus Luteum ; Diagnosis ; Female ; Fertility ; Humans ; Incidence ; Laparoscopy ; Ovary ; Pregnancy ; Pregnancy, Ectopic* ; Pregnancy, Tubal ; Radioimmunoassay ; Ultrasonography

BACKGROUND AND OBJECTIVES: We investigated in patients with coronary vasospastic angina whether the exercise ECG test results are influenced by the different modes of exercise load and compared the clinical characteristics including coronary risk factors between patients with positive and negative exercise tests. MATERIALS AND METHODS: This study comprised 34 patients with documented coronary artery spasm without significant stenosis (coronary artery luminal diameter narrowing <70%) and treadmill exercise test. Treadmill exercise ECG test was performed based on Bruce's protocol (graded exercise test, GET) and sudden rapid exercise protocol (non-graded exercise test, NGET) in the morning of the same day. RESULTS: 1) Of 29 patients who underwent both GET and NGET, 19 patients manifested positive result by NGET, whereas only 11 patients did by GET (66 vs. 38%, P=0.04). All patients with positive GET had positive NGET and 8 of 18 patients with negative GET had positive NGET. 2) Of 34 patients who underwent GET, there was no significant difference in frequency of hypertension, diabetes, current smoking, presence of effort chest pain by history, mixed disease (fixed stenosis >50%, <70% of luminal diameter) or total cholesterol level between patients with positive and negative results. In 18 typical variant angina patients by clinical history, 8 of 10 patients with high disease activity (5 times or more attack per week) manifested positive result by GET or NGET, whereas 4 of 8 patients with low disease activity (80 vs. 50%, P=NS). CONCLUSION: In patients with coronary vasospastic angina, sudden rapid exercise could induce more frequently coronary artery spasm than multistage exercise. The result of an exercise test may not be correlated with coronary risk factors, coronary anatomy, effort chest pain, and the disease activity.
Arteries ; Chest Pain ; Cholesterol ; Constriction, Pathologic ; Coronary Vessels ; Electrocardiography ; Exercise Test* ; Humans ; Hypertension ; Phenobarbital ; Risk Factors ; Smoke ; Smoking ; Spasm