Malignant tumors of the maxilla represent about 3-4% of head and neck malignant neoplasm and the origins are maxillary gingiva, hard palate and maxillary sinus. We are to investigate clinical features and results according to various treatment modalities of maxillary malignant tumor to get information for better treatment results. Sixty patients with malignant maxillary tumors treated at Yonsei medical center from 1992 to 1997 were studied retrospectively. They are evaluated according to clinical signs & symptoms, stages at first diagnosis, primary site, histopathologic features, treatment method, recurrence and survival rate with clinical records, biopsy results and CT radiograph. The most common primary site was maxillary sinus and most common histopathology was squamous cell carcinoma. The local recurrence rate was 18% at 5 years, neck failure was 3% and distant metastasis was 18%. Overall survival rate was 78% at 2 years and 69% at 5 years. Failure at primary site is the main problem in the curative treatment. So, to improve survival in these patients efforts should be directed toward improvement of local control.
Biopsy ; Carcinoma, Squamous Cell ; Diagnosis ; Gingiva ; Head ; Humans ; Maxilla* ; Maxillary Sinus ; Neck ; Neoplasm Metastasis ; Palate, Hard ; Recurrence ; Retrospective Studies ; Survival Rate

Attempts to quantify the parameters of optic nerve head structure have been made to recognize the earliest structural abnormalities in glaucoma, and to efficiently monitor the structural changes of the optic nerve head with advancing disease. Optic disc parameters were measured in 88 normal subjects and 149 primary open-angle glaucoma patients using a computer graphic program (Adobe photoshopTM) and the photographic magnification was corrected according to Littmanns method. The sensitivity, specificity, and predictive value of optic disc parameters were calculated to discriminate between normal and glaucomatous eyes at different stages of glaucoma. Receiver operating characteristics curves were used for comparisons of different disc parameters. In the group with mild glaucomatous visual field (VF) defects (mean deviation (MD); better than -5dB, group 1), optic disc parameters did not provide greater sensitivity and specificity enough to detect early glaucomatous optic nerve head damage. In the group with moderate VF defects (MD; -6~-10dB, group 2) and advanced VF defects (MD; worse than -11dB, group 3), the minimum rim width within the 60 sector across the vertical meridian (predictive value; 84.4%, 95.9%, respectively), vertical cup to disc ratio (83.7%, 95.2%, respectively), and rim area to disc area ratio (83.7%, 95.1%, respectively) were helpful to identify the glaucomatous eyes, whereas horizontal cup to disc ratio (77.3%, 90.3%, respectively) and cup area (75.2%, 89.0%, respectively) were less helpful in this regard.
Computer Graphics ; Glaucoma ; Glaucoma, Open-Angle* ; Humans ; Optic Disk ; ROC Curve ; Sensitivity and Specificity* ; Visual Fields

Mitomycin C (MMC) trabeculectomy combined with extracapsular cataract extraction and posteor chamber intraocular lens implantation (glaucoma triple procedure, 30 eyes) was clinically compared with MMC trabeculectomy alone (30 eyes). The age, type of glaucoma, and preoperative number of medications were matched with the previous group (P>0.05). The mean preoperative intraocular pressures (IOPs) were 30.2+/-8.3mmHg (range, 22~56mmHg) in the glaucoma triple procedure group and 31.6+/-8.9mmHg (range, 22~57mmHg) in the trabeculectomy alone group (p=0.55). The mean postoperative IOPs were significantly higher in the glaucoma triple procedure group compared with the trabeculectomy alone group at all postoperative vistis (one month to nine months) (p<0.05). However, there were no statistically significant differences in the mean number of postoperative rise exceeding 30 mmHg within the postoperative one month tended to occur more frequently in the glaucoma triple procedure group (7 eyes (23%)) than the trabeculectomy alone group (2 eyes(7%)) (p=0.13). Conjunctival filtering blebs were significantly frequently observed in the trabeculectomy alone group than the glaucoma triple procedure group (28 eyes (93%), 20 eyes (67%), respectively, P=0.02) at 6 months postoperatively. The common postoperative complications were hyphema (4 eyes) and posterior capsular opacification (4 eyes) in the glaucoma triple procedure group and shallow anterior chamber(4 statistical difference was noted between these two groups (p>0.05). Although hypotensive effect of MMC on the glaucoma triple procedure was less than on the trabeculectomy alone, glaucoma triple procedure using MMC could be recommended to be safe and effective on controlling the high IOP for treating glaucoma patients with coexisting cataract.
Blister ; Cataract ; Cataract Extraction ; Glaucoma* ; Humans ; Hyphema ; Intraocular Pressure ; Lens Implantation, Intraocular ; Mitomycin* ; Postoperative Complications ; Trabeculectomy*

OBJECTIVE: To evaluate the effects of piroxicam patch(Trast) in rheumatoid arthritis patients with knee joint pain and swelling and to determine the concentration of plasma and synovial fluid following patch application. METHODS: Twenty-two patients with rheumatoid arthritis participated in a double-blind, placebo-controlled study. The patients were instructed to apply piroxicam or placebo patch at one knee and re-apply it every other day for 2 weeks. They had washout period for 2 weeks and then applied the other patch for 2 weeks at the same joint. The patients recorded knee joint pain using visual analog scale. Knee joint swelling and tenderness were assessed before and after application of piroxicam and placebo patch. Complete blood count, AST, ALT, BUN, creatinine, joint fluid analysis were also done. Piroxicam concentration in plasma and synovial fluid were measured by high performance liquid chromatography(HPLC) after 2 weeks of piroxicam patch application. RESULTS: Knee joint pain improved significantly after the application of piroxicam patch for 2 weeks(visual analog scale, 56. 2+5. 9m vs 48. 2+5. 7mm, p=0. 03 by Wilcoxon signed rank test). There was no significant change in white cell count of synovial fluid, peripheral blood cell count, chemistry, C-reactive protein and erythrocyte sedimentation rate. In terms of adverse effects, mild gastrointesti nal disturbance(8/21 cases, 38%) and local side effects such as pruritus and ery thema(3/21 cases, 14%) were developed, which were insignificant compared with control groups(30%, 15% respectively). Piroxicam concentrations in plasma and synovial fluid after the application of piroxicam patch were 0. 129+0. 04ug/ ml (mean+SE) and 0. 644+0. 202ug/ml respectively. CONCLUSIONS: Piroxicam patch is a safe and effective therapeutic modality for knee joint pain in patients with rheumatoid arthritis. Mild adverse effects such as gastrointestinal disturbance and local side effects were noted. Piroxicam concentration was higher in synovial fluid than in plasma following the application of piroxicam patch.
Arthritis, Rheumatoid* ; Blood Cell Count ; Blood Sedimentation ; C-Reactive Protein ; Cell Count ; Chemistry ; Creatinine ; Humans ; Joints ; Knee ; Knee Joint ; Piroxicam ; Plasma ; Pruritus ; Synovial Fluid ; Visual Analog Scale

This study was performed to identify the expression of neurofilament in sensory nerve of human cornea. The three normal corneal tissues were dissected. Monoclonal antibody to neurofilament protein were used to visualize the corneal nerve. The one normal cornea was examined to observe the corneal nerve with electron rnicroscope. Transmission electron rnicroscope showed that the corneal nerve contained the neurofilament within the axon. The indirect iinmunofluorescent techniques revealed the expression of neurofilament in corneal stroma. The results of this study show that immunofluorescent technique may useful method in identification of sensory nerve of human cornea, and make it easy for us to visualize corneal innervation pattern in flat section by using of antibody to neurofilament protein.
Axons ; Cornea* ; Corneal Stroma ; Humans*

No abstract available.
Hepatocyte Growth Factor* ; Hepatocytes* ; Placenta* ; Pre-Eclampsia*

The passive immunization of pregnant female rats to S-100 protein often leads to ultra-structural abnormalities in the brain glial structures of the offspring of these rats and induces signs of delayed development in the fetal brain. Additionally passive immunization of pregnant animals with certain antigens induces permanent Ag-specific changes in the immune response of their offspring. The purpose of this study was to investigate serum immunoreactiviy (SIR) to S-100 in cerebral-palsied and developmentally-delayed children as well as in their healthy parents and to evaluate its significance related to radiologic findings of brain MRI and single photon emission computed tomography (SPECT). The subjects were children with cerebral palsy and delayed development that had abnormal findings on brain MRI or Brain SPECT. SIR to S-100 protein was measured by ELISA method in the patients, their healthy parents, 20 normal adult controls and 22 normally developed children. The SIR to S-100 protein was significantly higher in the cerebral-palsied and developmentally-delayed children when compared to that of the normal control group children. Increased SIRs were detected in healthy mothers but not in their fathers. There was no difference of SIR between the cerebral-palsied and developmentally-delayed children or any significant difference of SIRs according to the findings of the brain MRI or to developmental quotients. But, the SIRs to S-100 protein were higher in the group of more abnormal findings on brain SPECT.
Adolescence ; Adult ; Cerebral Palsy/immunology* ; Cerebral Palsy/blood ; Child ; Developmental Disabilities/immunology* ; Developmental Disabilities/blood ; Female ; Human ; Male ; Nerve Tissue Protein S 100/blood* ; Parents* ; Reference Values

Rheumatic manifestations in non-Hodgkin's lymphoma (NHL) are common but actual arthritis as a presenting feature appears to be very rare. We experienced a case of NHL presenting as polyarthritis in a 24-year-old woman. Eight months ago she was admitted to the hospital due to polyarthritis and skin rash. She had pleural and pericardial effusion. Antinuclear antibody was positive and rheumatoid factor was negative. Joint X-ray showed periarticular osteopenia at both knees, wrists, hands and feet. Prednisolone, salsalate and anti-tuberculosis drugs were administered under the impression of either probable lupus or rheumatoid arthritis and pleural tuberculosis. After then pleuropericardial effusion and skin rash improved. But polyarthralgia persisted and she developed right cervical lymphadenopathy. On her second admission she was found to have a round mass in left lower lung field and multiple mediastinal lymph node enlargement. Cervical lymph node biopsy revealed non-Hodgkin's lymphoma. She received 8 cycles of systemic chemotherapy until 1996 July. NHL was remitted completely and polyarthralgia disappeared. We report a case of non-Hodgkin's lymphoma presenting as polyarthritis and literatures are reviewed.
Antibodies, Antinuclear ; Arthralgia ; Arthritis* ; Arthritis, Rheumatoid ; Biopsy ; Bone Diseases, Metabolic ; Drug Therapy ; Exanthema ; Female ; Foot ; Hand ; Humans ; Joints ; Knee ; Lung ; Lymph Nodes ; Lymphatic Diseases ; Lymphoma, Non-Hodgkin* ; Pericardial Effusion ; Prednisolone ; Rheumatoid Factor ; Tuberculosis, Pleural ; Wrist ; Young Adult

Symptomatic vasospasm is still one of the major causes of death and disability in patients who suffer an aneurysmal subarachnoid hemorrhage(SAH). To identify risk factors related to symptomatic vasospasm, to determine the outcome in patients with SAH, and to determine the differences identified risk factors between patients with good and bad outcomes, we performed this retrospective study. From a total of 279 SAH patients who were admitted to our hospital between January 1993 and December 1995, 212 were chosen for study. These were patients who had been admitted within 7 days of SAH, had undergone brain computed tomography(CT) within 3 days of SAH and had survived more than 6 days after SAH. Nine variables were examined as to their relationship to symptomatic vasospasm: age, sex, admission day after SAH, hypertension history, frequency of SAH, clinical grade, CT grade, operation day after SAH, and outcome. Data were analyzed by the univariate and multivariate logistic regression method using the Statistical Analysis System(SAS). Symptomatic vasospasm was demonstrated in 30 cases(14.2%). Univariate analysis showed that admission more than 4 days after SAH(p=0.07), clinical grades III-V(p=0.001), and CT grade III(p=0.00001) were associated with a higher risk of symptomatic vasospasm. When study cases were grouped into either good or bad outcome groups, and multivariate logistic regression analysis was performed, these factors were associated with a higher risk of symptomatic vasospasm only in the good outcome group. This suggests that there is a group of patients with a predisposition to symptomatic vasospasm that is independent of these risk factors, and that in these patients, the outcome may be worse.
Aneurysm* ; Brain ; Cause of Death ; Humans ; Hypertension ; Intracranial Aneurysm ; Logistic Models ; Retrospective Studies ; Risk Factors ; Subarachnoid Hemorrhage*

Among 875 patients with intracranial aneurysm operated on during the past 14 years, the authors encountered eleven who had experienced recurrent hemorrhage caused by the rupture of aneurysms which had not been noticed at the time of the initial operation and the interval between initial and recurrent hemorrhage varied between 4 and 16 years. Age at the time of initial hemorrhage was relatively young(average 43.7 years). Multiple aneurysms occurred in four cases and hypertension in four others. Clinical grades at the time of the second admission were relatively poor, and in eight patients there were complications with intracerebral hematomas, intraventricular hemorrhages or acute subdural hematoma. Retrospective evaluation of the first angiograms disclosed suspicious tiny aneurysms in five cases, and these grew and ruptured at recurrent hemorrhage. In eight patients, the outcome was good; One remained moderately disabled, and two died. We conclude that the possibility of recurrent hemorrhage, after the clipping of a ruptured aneurysm, should be considered in all aneurysmal patients, especially in those who are young or have multiple aneurysms. To defermine whether or not suspicious tiny aneurysms are present in these patients, their angiograms should be subjected to detailed examination. Late postoperative follow-up angiography to determine the growth or development of another aneurysm might also be needed.
Aneurysm* ; Aneurysm, Ruptured ; Angiography ; Follow-Up Studies ; Hematoma ; Hematoma, Subdural, Acute ; Hemorrhage* ; Humans ; Hypertension ; Intracranial Aneurysm* ; Retrospective Studies ; Rupture