No abstract available.
Rabbits ; Transplants

No abstract available.
Carcinoma, Hepatocellular* ; Collagen* ; Liver Cirrhosis* ; Liver*

This is to report a case of immediate reconstruction after hemimandibulectomy by using of bicorticocancellous block bone harvested from the iliac crest in the case of an ameloblastomaon the mandible. Because the lesion involved condylar area, it was reconstructed with titanium artificial condyle attached to A/O metal plate. Three weeks after the operation, infection developed with suppuration and was well treated with adequate antibiotic therapy and drainage. The patient has been followed up over a four-year period and taken an orthopantomogram every three or six month for the examination of mandibular movement, the potentiality of recurrence and the remodeling of the grafted bone. At present, the patient is satisfied with her appearence and has a normal occlusion with proper masticatory function, and there is no sign of recurrence.
Ameloblastoma* ; Drainage ; Humans ; Mandible ; Mandibular Osteotomy ; Recurrence ; Suppuration ; Titanium ; Transplants*

BACKGROUND: Amrinone is a nonglycosidic noncatecholamine with both vasodilator and positive inotropic effects that has not been evaluated widely in pediatric patients with intracardiac left to right shunts. The present study was performed to evaluate the hemodynamic effects of amrinone in infants and children with intracardiac left to right shunts. METHODS: Twenty patients (aged 2 months to 24 months) who underwent open heart surgery to correct one or more intracardiac left to right shunts were evaluated. Before cardiopulmonary bypass, a 22 gauge angiocatheter was placed at the main pulmonary artery by surgeons to measure pulmonary arterial pressure. Patients with a mean pulmonary arterial pressure < 25 mmHg were assigned to Group A (n = 10) and > or = 25 mmHg were assigned to Group B (n = 10). Mean systemic arterial pressure (MAP), mean pulmonary arterial pressure (MPAP), central venous pressure (CVP) and heart rate (HR) were measured before loading of amrinone (3 mg/kg), 5 minutes, and 15 minutes after continuous infusion of amrinone (10 microgram/kg). The mean pulmonary arterial pressure to mean systemic arterial pressure ratio (MPAP/MAP) and rates of changes of mean arterial pressure (delta MAP) and mean pulmonary arterial pressure (delta MPAP) were calculated. RESULTS: Amrinone reduced MAP, MPAP, CVP and increased HR. MPAP/MAP increased in Group A but decreased in Group B (P < 0.05). In Group A, delta MAP was significantly greater than that of Group B (P < 0.005). In Group B, delta MPAP was significantly greater than that of Group A (P < 0.005). CONCLUSION: In infants with intracardiac left to right shunts, amrinone reduces MAP, MPAP, CVP and increases HR. Amrinone appears to have a potent vasodilating effect on the pulmonary artery in infants with pulmonary hypertension. However, more hemodynamic measurements such as cardiac output, vascular resistance and doppler echocardiographic study are necessary to evaluate the hemodynamic effects of amrinone precisely.
Amrinone* ; Arterial Pressure* ; Cardiac Output ; Cardiopulmonary Bypass ; Central Venous Pressure ; Child ; Echocardiography ; Heart Rate ; Hemodynamics ; Humans ; Hypertension, Pulmonary ; Infant* ; Pulmonary Artery ; Thoracic Surgery ; Vascular Resistance

OBJECTIVES: The aim of this study was to compare the osteogenic effects of demineralized dentin matrix (DDM) combined with recombinant human bone morphogenetic protein-2 (rhBMP-2) in rabbit calvarial defects with DDM and anorganic bovine bone (ABB) combined with rhBMP-2. MATERIALS AND METHODS: Four round defects with 8-mm diameters were created in each rabbit calvaria. Each defect was treated with one of the following: 1) DDM, 2) ABB/rhBMP-2, or 3) DDM/rhBMP-2. The rhBMP-2 was combined with DDM and ABB according to a stepwise dry and dip lyophilizing protocol. Histological and microcomputed tomography (µCT) analyses were performed to measure the amount of bone formation and bone volume after 2- and 8-week healing intervals. RESULTS: Upon histological observation at two weeks, the DDM and ABB/rhBMP-2 groups showed osteoconductive bone formation, while the DDM/rhBMP-2 group showed osteoconductive and osteoinductive bone formation. New bone formation was higher in DDM/rhBMP-2, DDM and ABB decreasing order. The amounts of bone formation were very similar at two weeks; however, at eight weeks, the DDM/rhBMP-2 group showed a two-fold greater amount of bone formation compared to the DDM and ABB/rhBMP-2 groups. The µCT analysis showed markedly increased bone volume in the DDM/rhBMP-2 group at eight weeks compared with that of the DDM group. Notably, there was a slight decrease in bone volume in the ABB/rhBMP-2 group at eight weeks. There were no significant differences among the DDM, ABB/rhBMP-2, and DDM/rhBMP-2 groups at two or eight weeks. CONCLUSION: Within the limitations of this study, DDM appears to be a suitable carrier for rhBMP-2 in orthotopic sites.
Dentin* ; Humans* ; Osteogenesis ; Skull ; X-Ray Microtomography

BACKGROUND: Both remifentanil and sevoflurane are known for their rapid recovery characteristics, and the bispectral index (BIS) has been used as an indicator of the sedative state during anesthesia. Therefore, it is expected that if they are used together, the anesthetic-sparing effect of remifentanil and titration of the sevoflurane concentration using the BIS monitor will contribute to a faster recovery. This study examined the effect of a remifentanil infusion on the hemodynamics, the decrease in the sevoflurane concentration, and the recovery from BIS-guided sevoflurane anesthesia. METHODS: Thirty patients undergoing laparoscopic gynecologic surgery were assigned to receive a remifentanil (0.1microng/kg/min)(Group I) or saline infusion (Group II) with sevoflurane. The sevoflurane concentration was adjusted to maintain a BIS value between 40 and 60. The mean arterial pressure, heart rate, BIS, and end-tidal sevoflurane concentration were recorded during anesthesia. The eye opening time and the incidence of postoperative nausea, vomiting and shivering were checked. RESULTS: During anesthesia, the hemodynamics were more stable in Group I than in Group II with the reduced use of cardiovascular drugs. The BIS value was lower and the end tidal sevoflurane concentration was higher in group II than in group I. Group I had a shorter eye opening time and there was a similar incidence of postoperative nausea, vomiting and shivering in both groups. CONCLUSIONS: A remifentanil infusion with BIS-guided sevoflurane anesthesia produces more stable hemodynamics, reduced sevoflurane concentration, and a more rapid recovery without side effects than in BIS-guided sevoflurane anesthesia alone.
Anesthesia* ; Arterial Pressure ; Cardiovascular Agents ; Female ; Gynecologic Surgical Procedures ; Heart Rate ; Hemodynamics* ; Humans ; Incidence ; Postoperative Nausea and Vomiting ; Shivering ; Vomiting

Primitive neuroectodermal tumors (PNET) usually arise in the brain and central nervous system, but rarely occur outside of the brain, such as in the limbs, pelvis, paravertebral region or chest wall. Herein, a case of PNET on the buttocks is reported. A 24-year-old female was admitted for evaluation of a mass on her left buttock. An incisional biopsy revealed a primitive neuroectodermal tumor, with focal neural differentiation histologically. Preoperative MRI demonstrated the tumor was located in the subcutaneous layer of the left perineum, and extended to the ischiorectal fossa. The lesion showed an irregular, but well defined border; however, the differentiation from the left posterior wall of anus was focally obliterated. On operation, the tumor was not adhered to the surrounding structure, except for the external anal sphincter. The mass was completely resected. The tumor was about 8 x 9 x 5.8 cm in size, and the pathological evaluation confirmed a PNET, with a free anal sphincter margin. Therefore, chemoradiation therapy was planned, but the tumor recurred two months later. It was recommended the patient undergo a re-resection, but was lost before the procedure could be undertaken.
Anal Canal ; Biopsy ; Brain ; Buttocks* ; Central Nervous System ; Extremities ; Female ; Humans ; Immunohistochemistry ; Magnetic Resonance Imaging ; Neuroectodermal Tumors, Primitive* ; Pelvis ; Perineum ; Thoracic Wall ; Young Adult

BACKGROUND: Pyelonephritis is one of the major causes of chronic renal failure in children, and the transforming growth factor-beta1 (TGF-beta1) is a molecule with pivotal roles in fibrogenesis. This study was performed to investigate the alteration and clinical implications of urinary TGF-beta1/creatinine ratio in children with acute pyelonephritis. METHODS: Urine was collected from 67 normal children and 25 children with acute pyelonephritis. After routine urinalysis, urine TGF-beta1 was quantitated by ELISA method and creatinine was measured by alkaline picrate method. Urinary TGF-beta1/ creatinine ratios in children with pyelonephritis were compared with those of age-matched controls, and sequential changes of the ratios in pyelonephritic children were traced after antibiotic treatment. Correlation of urinary TGF-beta1/creatinine ratio with the degree of pyuria and renal scar was analyzed each. RESULTS: Neonates showed higher urinary TGF-beta1/creatinine ratios than older children. The ratio increased in acute pyelonephritis and gradually returned to the control level two days after antibiotic treatment. Urinary TGF-beta1/creatinine ratio in acute pyelonephritis was not correlated with the degree of pyuria and renal scar. CONCLUSION: The age should be considered in evaluation of urinary TGF-beta1/creatinine ratio in children. The ratio increases in acute pyelonephritis, and is independent of the degree of pyuria or renal scarring.
Child ; Cicatrix ; Creatinine ; Enzyme-Linked Immunosorbent Assay ; Humans ; Infant, Newborn ; Kidney Failure, Chronic ; Pyelonephritis* ; Pyuria ; Transforming Growth Factor beta1 ; Urinalysis

PURPOSE: Intimal hyperplasia (IH) due to vascular smooth muscle cell proliferation is a leading cause of late vascular graft failure. Transforming growth factor-beta1 (TGF-beta1), known to influence smooth muscle cell growth in vascular wall has been subjected for experimental research as a cause of IH. It has been also showed that IH can be mediated by local renin-angiotensin system in vascular intimal injury. Under the assumption that TGF-beta1 and local angiotensin II (ANG II) have a major role as a cause of IH, we carried out this study to see if there are any relationship between intimal hyperplasia and TGF-beta1 mRNA expression, and effect of angiotensin-converting enzyme inhibitor (ACEI) on IH. METHODS: 14 New Zealand White rabbits were subjected for this experiment. The right carotid arteries of 14 rabbits had been bypass grafting with polytetrafluoroethylene. 14 rabbits were allocated into two groups: 7 rabbits had bypass grafting only (graft only) and the other 7 rabbits had bypass grafting with ACEI (graft with ACEI). The rabbits, graft with ACEI were on Captopril (10 mg/kg/day PO) from day of operation to 8 weeks when to harvest. There were patent 9 carotid bypass grafts at harvest, and the studies were performed in patent grafts. Intimal hyperplasia was defined by the intima to media height ratio (IMHR). The mRNA expression of TGF-beta1 was determined by semiquantitative RT-PCR. RESULTS: IMHR of graft with ACEI was lower than that of graft (p<0.05). The mRNA expression of TGF-beta1 in graft with ACEI was lower than that in graft only (p<0.05). In summary, there was evidence that TGF-beta1 is closely related with intimal hyperplasia and there is also relationship between ANG II and TGF-beta1. CONCLUSION: ANG II and TGF-beta1 may mediate intimal hyperplasia of vascular graft, and ACE inhibitor may be a armamentarium for inhibition of intimal hyperplasia in vascular graft procedures.
Angiotensin II ; Captopril* ; Carotid Arteries* ; Cell Proliferation ; Hyperplasia ; Muscle, Smooth, Vascular ; Myocytes, Smooth Muscle ; Polytetrafluoroethylene* ; Rabbits ; Renin-Angiotensin System ; RNA, Messenger* ; Transforming Growth Factor beta1* ; Transplants*

PURPOSE: Natural killer (NK) cells have a spontaneous cytotoxic capacity against tumor cells. NK cell infiltration is known to be related to the prognosis of colorectal cancer, but their prognostic significance has not been determined. The purpose of this study was to determine the prognostic importance of NK cell infiltration in colorectal cancer. METHODS: Ninety-one patients, diagnosed with colorectal cancer, between Jan. 1994 to Dec. 1995, and consequently operated on at the Department of surgery, Korea University college of medicine, were retrospectively reviewed. Immunohistochemical stains were performed for NK cells using the monoclonal antibody CD57 (IOT-10; 1: 50 diluted; Chemicon, Temccula, U.S.A.). The intratumoral CD57 expressions were divided into 4 grades. Intensity 0 was defined as a total absence of CD57 expression in the tumor cells, Intensities 1+, 2+ and 3+ were defined as less than 25, 25~50 and more than 50% expression, respectively. Consecutively, intensities 0, 1+ and 2+ were regarded as low CD57 expression, with 3 regarded as high CD57 expression. The clinical characteristics, 5-year survival rates and recurrence rates by stage, according to the CD57 expression, were then analyzed. RESULTS: Patients with high CD57 expression showed better survival rates and lower recurrence rates than those with low CD57 expressions (77.8 versus 53.4% and 14.8 versus 25.0%, respectively, P=0.0856). According to stage, the patient with high CD57 expressions showed better survival rates than those with low CD57 expressions in stages II and III (76.4 versus 69.9% [P=0.6802] and 66.7 versus 40.0% [P=0.4496], respectively). CONCLUSION: Although there was not statistical significance, these data suggest that high intratumoral infiltration of NK cells, as determined by the CD57 expression, seems to be a favorable prognostic factor in colorectal cancer, although further study will be needed.
Colorectal Neoplasms* ; Coloring Agents ; Humans ; Killer Cells, Natural* ; Korea ; Prognosis ; Recurrence ; Retrospective Studies ; Survival Rate