ABSTRACT
Screw fixation of the tibial component offers advantages in initial fixation in cementless total knee replacement. But the high incidence of screw related osteolysis was reported. The purpose of this study is to evaluate clinical results of cementless total knee replacement and to look for radiographic changes at the screw-bone interface. From January 1988 to December 1991, primary cementless total knee replacements with Miller Galante I (Zimmer, Warsaw. IN) were performed to 53 knees at Kyung Hee university hospital. Among them, 21 cases which could be followed-up for more than 4 years were studied retrospectively about the clinical and radiographic results. The mean follow-up period was 5.5 years(ranged from 4.2 years to 8 years). At the last follow-up period, knee scores of Hospital for Special Surgery were improved from mean 56 points to 90 points and the range of motion from 72 degrees to 110 degrees. In the last follow-up radiographs, osteolysis around screw was classified as linear(type I ), cystic(type II ) and cavitary(type III ) according to the width of the lucency around screws. Among 21 cases, radiographic findings of osteolysis around screw were detected in 10 cases but not in 11 cases. But clinical results were similar between these two groups. Among the total 84 screws(4 screws in each case), 21 screws(25%) showed screw related osteolysis typed as I in 13 screws(15.4%), II in 4 screws(4.8%) and III in 4 screws(4.8%). Among the 13 cases that followed-up more than 6 years, 20 screws(38%) showed screw related osteolysis typed as in 11 screws(21.2%), I in 5 screws(9.6%) and II in 4 screws(7.8%). The most frequently involved site of screw was anteromedial(33.3%). In conclusion, after mean 5.5 year follow-up, the clinical results were satisfactory but the development of osteolysis around screw might be an indicator of the implant failure.
Subject(s)
Arthroplasty, Replacement, Knee , Follow-Up Studies , Incidence , Knee , Osteolysis , Range of Motion, Articular , Retrospective StudiesABSTRACT
No abstract available.
Subject(s)
Bystander Effect , Carcinoma, Hepatocellular , Cell Line , Ganciclovir , Herpes Simplex , Phosphotransferases , SimplexvirusABSTRACT
BACKGROUND: The first barrier carcinomas must cross is the basement membrane surrounding the cancer nest what we call cancer nest membrane. Since type IV collagen is the most important structure composing the basement membrane, investigation of the immunohistological localization and continuity of type IV collagen is of value in predicting the metastatic aggressiveness of squamous cell carcinoma. OBJECTIVES: This study was designed to investigate the relationship between type IV collagen expression in the cancer nest membrane and cervical lymph node metastasis in head and neck squamous cell carcinoma by immunohistochemistry. MATERIALS AND METHODS: Tissues were obtained from 55 patients with head head and neck squamous cell carcinoma who underwent the surgery of primary tumor resection and radical neck dissection. And paraffin embedded 5nm thin sections were immunohistochemically stained for type IV collagen. RESULTS: 1) The positive reaction of type IV collagen was identified as continuous linear pattern in basement membranes of normal mucosal epithelium and interstitial capillaries. Three main patterns of expression of type IV collagen in the cancer nest membrane were continuity, breaks(partial loss) and absence(total loss). 2) Membrane discontinuity correlated significantly with cervical lymph node metastasis, while intact membrane was associated with a low frequency of cervical lymph node metastasis(p<0.001). 3) Membrane discontinuity was noted in higher clinical stage(TNM classification), increased number of metastatic lymph nodes and poorly differentiated histologic type(p<0.05). 4) There was no significant correlation between the patient age, tumor size, primary tumor site and discontinuity in the cancer nest membrane. CONCLUSION: These results suggest that type IV collagen in the cancer nest membrane may be a biochemical parameter to predict the metastatic potential and aggressiveness of head and neck squamous cell carcinoma.
Subject(s)
Humans , Basement Membrane , Capillaries , Carcinoma, Squamous Cell , Collagen Type IV , Epithelium , Head , Immunohistochemistry , Lymph Nodes , Membranes , Neck Dissection , Neck , Neoplasm Metastasis , ParaffinABSTRACT
No abstract available.
ABSTRACT
No abstract available.
ABSTRACT
Repeated operation in head injury is not uncommon. We experienced 46 repeated operations in 36 patients during 22-month-period. Rate of repeated operation is 14.6%. Occurrence of delayed or recurrent lesions was more common in the aged(mean=44years of age). Acute subdural hematoma was the most common initial lesion requiring repeated operation. The rate of repeated operation was relatively high in intracerebral hematoma(21.4%), acute subdural hematoma(16.0%), and chronic subdural hematoma(15.6%). The most common lesion requiring repeated operation was delayed intracerebral hematoma. Repeated operations were performed within 24 hours in 50% of the cases. Outcome at discharge was good recovery in 6, moderate disability in 12, severe disability in 8 and death in 10. It seemed to be related to the initial lesions rather the lesions requiring repeated operation. Even in the patients requiring repeated operations, early detection and appropriate management could improve the outcome. Early, repeated CT scans has almost importance especially in patients with certain risk of delayed or recurrent lesions.
Subject(s)
Humans , Craniocerebral Trauma , Head , Hematoma , Hematoma, Subdural, Acute , Tomography, X-Ray ComputedABSTRACT
Gangiogliomas are rare tumors, primarily seen in patients under the age of 30 years. They occure least commonly in the spinal cord. We present a 17-year-old girl who harbored an intramedullary conus ganglioglioma.
Subject(s)
Adolescent , Female , Humans , Conus Snail , Ganglioglioma , Spinal CordABSTRACT
Little informaition is available concerning the relation between the echocardiographic findings and the pulmonic to systemic flow ratio. Accordingly the author assessed the pattern of the systolic interventricular septal motion and the relation between the type of the systolic interventricular septal motion and the pulmonic to systemic flow ratio in 30 cases with catheterization evidence of secundum atrial septal defect employing the M-mode echocardiographic technique. The results were as follows: 1) Analysis of the pattern of the systolic interventricular septal motion (SESM) allowed classification of cases into 5 groups: Type 1A (4 cases)-Both the right (RS) and left (LS) sides of the interventricular septum move anteriorly during ventricular systole: Type1V (5 cases)-Both RS and LS of the interventricular septum move posteriorly during ventricular systole:Type 2A (9 cases)-LS of the interventricular septum moves posteriorly, while RS fo the interventricular septum remains relatively flat during ventricular systole; Type 2B (8 cases)-RS of the interventricular septum moves anteriorly, while LS of the interventricular septum remains relatively flat during ventricular systole;Type 3(4 cases)-SISM is the same as type 2 and the motion of the left ventricular posterior wall is relatively hyperactive. 2) The pulmonec to systemic flow ratio (Qp/Qs) was statistically different between type 1, 2, and 3 of SISm (Qp/Qs in type 3=2.3+/-0.33;Qp/Qs in type 2=3.4+/-0.79;Qp/Qs in type 3=5.1+/-1.37). 3) Qp/Qs was not different between type 1A and 1B (Qp/Qs in type 1A=2.3+/-0.28;Qp/Qs in type 1B=2.3+/-0.39) and between type 2A and 2B (Qr/Qs in type 2A=2.20+/-0.80; Qp/Qs in type 2B=3.7+/-0.76). 4) Tyep 2 in SISm predicts Qp/Qs> or =2.5(sensitivity=87.5%;specificity=100%;accuracy=90%), and type 3 in SiSm predicts Qp/Qs> or =4.0(sensitivity=40;specificity=100%;accuracy=80%). In conclusion, the pattern of the systolic interventricular septal motion (SISM) in the M-mode echocardiogram may be useful for the semiquantitative assessment of the pulmonic to systemic flow ratio (Qp/Qs) in cases with secundum atrial septal defect.