No abstract available.
Extracellular Matrix Proteins* ; Extracellular Matrix* ; Peptides* ; Titanium*

Recently it is known that Turner's syndrome is frequently associated with hypothyroidism. We report a case of Turner's syndrome associated with subclinical hypothyroidism. A 23-year-old female was admitted to the hospital with complaints of amenorrhea and short stature. She had a mosaicism of 45, X0/46, Xi(X_q) in the cell, cultured from the peripheral blood. The plasma thyroxine and triiodothyronine were normal and there was no clinical symptom of hypothyroidism. But the thyroid-stimulating hormone(TSH) concentration was unusually higher(184 uU/L). She has been treated with the cyclic therapy of conjugated estrogen and medroxyprogesterone, in addition to the thyroxine replacement therapy. After 2 months, the menstruation was restored and TSH was normalized.
Amenorrhea ; Cells, Cultured ; Estrogens ; Female ; Humans ; Hypothyroidism ; Medroxyprogesterone ; Menstruation ; Mosaicism ; Plasma ; Thyroxine ; Triiodothyronine ; Turner Syndrome ; Young Adult

No abstract available.
Animals ; Periodontal Ligament* ; Phosphotransferases* ; Rats*

188 consecutive cases with basilar skull fractures(BSF) out of 2676 head injury patients who were treated in Chung-Ang Gil Hospital from July 1993 to June 1995, were analyzed. These fractures are difficult to diagnose by ordinary X-ray examinations, routine head computed tomography(CT) and are frequently inferred by clinical signs. Therefore, it's diagnosis is somtimes delayed or missed in initial assessment of trauma patients. They are different from cranial vault fractures in several aspects other than difficulties in the diagnosis. It involves more commonly the cranial nerves(CN), makes cerebrospinal fluid(CSF) fistulae and leads to central nervous system(CNS) infections if the CSF fistulae are not detected or treated early and properly. The authors reviewed the clinical features, radiological findings, rate of delayed diagnosis, complications and outcomes. The most common feature of BSF was otorrhea(64.4%) and followed by rhinorrhea(39.4%), raccoon eye(32.4%) and hemotympanum(24.5%). In only 6.4% of cases, the fracture lines were detected by ordinary skull radiographs and diagnosed as BSF. In contrast, the high resolution skull base CT confirmed the fractures in 62.2%. Clinical diagnoses were made in 14.9%. Commonly combined craniofacial lesions were cranial vault fractures(51.1%), intracranial hemorrhages(46.3%), and facial bone fractures(34.0%). Most of CSF leakages(89.7%) were noted within 24 hours after injury and most of the leakages (87.7%) had ceased by conservative management within 2 weeks, but 5.1% that did not respond to conservative treatment and lumbar CSF drainage, needed invasive operative repair. The incidence of meningitis was 3.2% and the prophylactic antibiotics had no benificial effect on lowering the infection rate. Facial nerve was the most frequently involved cranial nerve followed by vestibulo-cocchlear, oculomotor, and olfactory nerve in decreasing order of frequency. The onset of facial palsy was immediate in 31.8% and the remainder were delayed more than 24 hours after head injury. Of 188 patients, 21 cases(11.2%) were delayed in the diagnosis of BSF.
Anti-Bacterial Agents ; Cranial Nerves ; Craniocerebral Trauma ; Delayed Diagnosis ; Diagnosis ; Drainage ; Facial Bones ; Facial Nerve ; Facial Paralysis ; Fistula ; Head ; Humans ; Incidence ; Meningitis ; Olfactory Nerve ; Raccoons ; Skull ; Skull Base ; Skull Fracture, Basilar*

We report here on an uncommon case of metastatic choriocarcinoma to the lung, brain and lumbar spine. A 33-year-old woman was admitted to the pulmonary department with headache, dyspnea and hemoptysis. There was a history of cesarean section due to intrauterine fetal death at 37-weeks gestation and this occurred 2 weeks before admission to the pulmonary department. The radiological studies revealed a nodular lung mass with hypervascularity in the left upper lobe and also a brain parenchymal lesion in the parietal lobe with marginal bleeding and surrounding edema. She underwent embolization for the lung lesion, which was suspected to be an arteriovenous malformation according to the pulmonary arteriogram. Approximately 10 days after discharge from the pulmonary department, she was readmitted due to back pain and progressive paraparesis. The neuroradiological studies revealed a hypervascular tumor occupying the entire L3 vertebral body and pedicle, and the tumor extended to the epidural area. She underwent embolization of the hypervascular lesion of the lumbar spine, and after which injection of polymethylmethacrylate in the L3 vertebral body, total laminectomy of L3, subtotal removal of the epidural mass and screw fixation of L2 and L4 were performed. The result of biopsy was a choriocarcinoma.
Adult ; Arteriovenous Malformations ; Back Pain ; Biopsy ; Brain ; Cesarean Section ; Choriocarcinoma ; Dyspnea ; Edema ; Female ; Fetal Death ; Headache ; Hemangioma ; Hemoptysis ; Hemorrhage ; Humans ; Laminectomy ; Lung ; Neoplasm Metastasis ; Paraparesis ; Parietal Lobe ; Polymethyl Methacrylate ; Pregnancy ; Spine

In gliomas, the most frequently studied tumor suppressor gene is the p53 gene which has been found to be mutated in a considerable fraction of astrocytomas and glioblastomas. Mutations that alter the function of the p53 gene product are thought to play a critical role in glial tumorigenesis. The murine double minute 2(MDM2) gene has been shown to code for a cellular protein that forms a complex with the p53 tumor suppressor gene product and inhibits its function. The fact that MDM2 can negatively regulate p53 suggests MDM2 could function as an oncogene when overexpressed. We investigated the expression of p53, MDM2 and proliferative activity of the tumor cells in 71 cases of gliomas(17 cases of differentiated astrocytomas. 25 cases of anaplastic astrocytomas and 29 cases of glioblastomas). Their paraffin-embedded tissue sections were immunostained with monoclonal antibody(p53 and PCNA, proliferating cell nuclear antigen) and polyclonal antibody(MDM2) for detection of p53, MDM2 and PCNA respectively. The results were as follows: The p53 staining was positive in 28 cases(39.4%) and MDM2 staining in 5 cases(7.0%) of 71 gliomas. The p53 positive-staining was detected in 2 cases(11.8%) of 17 differentiated astrocytomas, 9 cases(36.0%) of 25 anaplastic astrocytomas and 17 cases(58.6%) of 29 glioblastomas. The p53 expression was associated with malignancy grade(p<0.005) and proliferative activity was strongly associated with malignancy grade(p=0.0001). The p53 expression was closely associated with proliferative activity : p53-positive tumors had significantly higher median PCNA-labeling index than p53-negative tumors(40.6+/-10.1% versus 19.6+/-15.0%)(p=0.0001). But, MDM2 expression was not associated with proliferative activity(p=0.4575). The proportion of p53 immunoreactivity had significant association with proliferaive activity: the more the proportion of p53 immunoreactivity increased, the higher PCNA-labeling index elevated(p=0.0001). None of the tumors with MDM2 expression showed immunoreactivity for p53. These results suggest that the mutation of p53 gene plays a critical role in malignant transformation in glioma and it could be the prognostic factor for histologically same grade gliomas and that a subset of human gliomas escapes from p53-regulated growth control by amplification and overexpression of MDM2. Therefore gene study targeting these genes may be useful for the management of human glioma as a diagnostic modality.
Astrocytoma ; Carcinogenesis ; Genes, p53 ; Genes, Tumor Suppressor ; Glioblastoma ; Glioma* ; Humans ; Oncogenes ; Proliferating Cell Nuclear Antigen ; Proto-Oncogene Proteins c-mdm2 ; United Nations

Between March 1994 and March 1995, 10 patients with thoracolumbar burst fractures underwent a one-stage operation consisting of anterior decompression, reduction, bony fusion with iliac bone and stabilization with Kaneda device. The mean follow-up was 6.4 Months. Most patients with incomplete neurologic lesions showed postoperative improvement and were upgraded one or two steps in the Frankel scale. No patient showed neurological deterioration after surgery. Loss of reduction was 5.5 degree during follow-up period. Anterior decompression and strut fusion was used to effectively recover the neurological deficit and reduce the pain in a thoraco-lumbar burst fracture.
Decompression ; Follow-Up Studies ; Humans

Gastrointestinal stromal tumors (GISTs) are rare, but are the most common mesenchymal neoplasm of the gastrointestinal tract. The most common sites of metastasis are liver and peritoneum, while bone metastasis is rare. We report on a patient with skull metastasis after seven years of treatment with imatinib for metastatic GIST. She underwent metastasectomy consisting of craniectomy with excision of the mass, and cranioplasty and continued treatment with imatinib and sunitinib, without evidence of cranial recurrence. She died of pneumonia sepsis one year after metastasectomy. Skull metastasis of GIST is a very rare presentation, and an aggressive multidisciplinary approach should be considered whenever possible.
Gastrointestinal Stromal Tumors* ; Gastrointestinal Tract ; Humans ; Imatinib Mesylate ; Liver ; Metastasectomy ; Neoplasm Metastasis* ; Peritoneum ; Pneumonia ; Recurrence ; Sepsis ; Skull*

No abstract available.
Fistula* ; Stomach* ; Tuberculosis*

This work describes tamaoxifen, a nonsteroidal antiestrogen compound, which has been used extensively in the treatment of breast cancer on account of its efficacy and relatively low toxicity. It has been reported to inhibit glioma proliferation in all cell line tested, acting by a mechanism independent of estrogen receptor blockade. Tamoxifen causes cytotoxicity at higher concentration(>or=5 micrometer), as compared with control. Our results showed that this compound decreased the rate of cell proliferation in dose-dependent manner. Its treatment against the C6 glioma cells also resulted in enhancement of the antitumor effect. These data suggest that tamoxifen may serve as an useful agent in chemotherapy of glioma.
Breast Neoplasms ; Cell Line ; Cell Proliferation ; Drug Therapy ; Estrogen Receptor Modulators ; Estrogens ; Glioma* ; Tamoxifen*