We present two patients with a cerebral palsy who developed cervical myelopathy long from term involuntary movements. Frequently instability with a premature onset of spondylosis of the cervical spine is found in an athetoid cerebral palsy patient. These structural abnormalities appear to be related to the athetoid motion of neck in a cerebral palsy. The combination of a disk degeneration and listhetic instability with a narrow canal predisposes these patients for the relatively rapid progression to a devastating neurological defect. Early surgical management is a treatment of choice for the cervical myelopathy associated with an athetoid cerebral palsy.
Cerebral Palsy* ; Dyskinesias ; Humans ; Intervertebral Disc Degeneration ; Neck ; Spinal Cord Diseases* ; Spine ; Spondylosis

Background: The relationship between cystitis glandularis (CG) and bladder malignancy remains unclear. Methods: We identified the oncologic significance of CG at the molecular level using liquid chromatography-tandem mass spectrometry-based proteomic analysis of 10 CG, 12 urothelial carcinoma (UC), and nine normal urothelium (NU) specimens. Differentially expressed proteins (DEPs) were identified based on an analysis of variance false discovery rate < 0.05, and their functional enrichment was analyzed using a network model, Gene Set Enrichment Analysis, and Gene Ontology annotation. Results: We identified 9,890 proteins across all samples and 1,139 DEPs among the three entities. A substantial number of DEPs overlapped in CG/NU, distinct from UC. Interestingly, we found that a subset of DEP clusters (n = 53, 5%) was differentially expressed in NU but similarly between CG and UC. This “UC-like signature” was enriched for reactive oxygen species (ROS) and energy metabolism, growth and DNA repair, transport, motility, epithelial-mesenchymal transition, and cell survival. Using the top 10 shortlisted DEPs, including SOD2, PRKCD, CYCS, and HCLS1, we identified functional elements related to ROS metabolism, development, and transport using network analysis. The abundance of these four molecules in UC/CG than in NU was consistent with the oncologic functions in CG. Conclusions Using a proteomic approach, we identified a predominantly non-neoplastic landscape of CG, which was closer to NU than to UC. We also confirmed a small subset of common DEPs in UC and CG, suggesting that altered ROS metabolism might imply potential cancerous risks in CG.

PURPOSE: Phyllodes tumors of the breast are biphasic neoplasms. They are composed of epithelium and a spindle cell stroma. However, there is some controversy over its clinical behavior, pathologic characteristics, and local recurrence rates. Therefore we analyzed the clinicopathological characteristics of phyllodes tumor and the risk factor that influence a local recurrence after surgery were analyzed. METHODS: We retrospectively analyzed the medical records of 73 patients with a phyllodes tumor and who had undergone surgery at the Department of Surgery, Kosin University, from 1994 to 2005. The median follow up period was 73 months (range: 5-250 months). The microscopic slides were re-examined and the pathologic criteria we analyzed were cellular atypia, stromal cellularity, pleomorphism, necrosis, differentiation, the tumor margin, and the number of mitosis. The malignancy was reclassifed using the histological criteria reported by Pietruszka et at. (benign was 0-4 mitoses/10 highpower folds, borderline 5-9 mitoses, and malignant was more than 10 mitoses), The clinical features we evaluated included age, the preoperative diagnosis, the tumor size, surgical methods, and local recurrence. RESULTS: The mean age was 38.2 yr (range: 15-60 yr) and the mean tumor size was 4.3 cm (range: 1.6-18 cm), The most commonly performed surgical procedures were local or wide excision (60 cases, 82.2%), mastectomy in 10 cases (13.7%) and MRM in 3 cases (4.1%). Out of the 73 cases we reviewed, 49 (67.1%) were confirmed as being a benign, 3 (4.1%) were borderline, and 21 (28.7%) were malignant phyllodes tumor. Cellular atypia was minimal in 55 cases (75.3%) and it was prominent in 18 cases (24.6%). The stromal cellularity was minimal in 49 cases (67.1%) and it was prominent in 24 cases (32.8%). The tumor margin was infiltrating in 27 cases (36.9%) and pushing in 46 cases (63.0%). A local recurrence developed in 12 cases (16.4%). There were no dependable histopathological features to predict a local recurrence except for stromal cellularity, and an infiltrating margin. CONCLUSION: From the above results, the strong prognostic factors that can be used to predict a local recurrence appear to be stromal cellularity, and an infiltrating tumor margin.
Breast ; Diagnosis ; Epithelium ; Follow-Up Studies ; Humans ; Mastectomy ; Medical Records ; Mitosis ; Necrosis ; Phyllodes Tumor* ; Recurrence* ; Retrospective Studies ; Risk Factors*

Bony fixation of implants during the early phase of healing is important in order to get secondary stability of the implant assuring the success of the treatment. Because the successful placement of the implant is limited by the quality and quantity of bone, other agents which stimulate bone formation in the peri-implant spaces has been illustrated. Platelet-derived growth factor (PDGF) has been shown to regulate DNA and protein synthesis in bone cells in vitro and to interact synergistically to enhance soft tissue wound healing in vivo. The purpose of this study was to evaluate bone promotion around implants which were augmented with sagittal split osteotomy or autogenous veneer bone graft using the platelet derived growth factor(PDGF). After placement of newly designed twenty four screw-type implants, which were 12mm in length and 4mm in diameter in 6 dogs. 4microgram of PDGF B/B was applied with surgicel carriers. The dogs were sacrificed at 3 days, 1, 2, 3, 6, and 12 weeks after implantation. Specimens were examined clinically, radiographically, histologically, and histomorphometrically. The results were as follows: 1. Clinically and radiologically, there was no significant difference in bone formation and healing pattern between experimental and control group. 2. In autogenous veneer bone graft group, bone formation was observed at 1st week in the experimental groups but 2nd week in the control groups. At 3rd week, the expeimental groups showed more bone formation comparing to the control groups. 3. In sagittal split osteotomy group, bone formation was observed at 1st week in both groups. But the experimental groups showed more bone formation comparing to the control groups after 2nd week. 4. The bone growth rate of experimental group was more rapid than that of control group. These results indicated that PDGF did not affect the initiation of new bone formation, but it accelerated the bone formation at the early period.
Animals ; Blood Platelets ; Bone Development ; Dental Implants* ; DNA ; Dogs ; Osteogenesis* ; Osteotomy ; Platelet-Derived Growth Factor* ; Transplants ; Wound Healing

Fiberoptic bronchoscopy is a valuable diagnostic and therapeutic procedure in many clinical situations and is relatively simple to perform with proper technique. Local anesthetic technique is often preferable to general anesthesia for bronchoscopies since these examinations are mostly undertaken as outpatient procedures. Inhaled topical lidocaine, used to produce anesthesia of the repiratory tract prior to bronchoscopy, may cause anaphylactoid reaction in patients. However lidocaine hypersensitivity reaction is uncommon. We report the case of death due to hypersensitivity to topical lidocaine spray given during routine premedication for this procedure. The possibility of bronchospasm secondary to an adverse reaction to premedication or anesthesia must also be considered.
Anaphylaxis* ; Anesthesia* ; Anesthesia, General ; Bronchial Spasm ; Bronchoscopy* ; Humans ; Hypersensitivity ; Lidocaine* ; Outpatients ; Premedication

PURPOSE: In this paper we tried to evaluate the most appropriate surface for rhBMP-2 coating among 4 rough titanium surfaces. MATERIALS AND METHODS: We used machined surface as a control group and anodized, RBM and SLA surfaces as test groups. We coated rhBMP-2 on the 4 surfaces and with uncoated surfaces for each case, we cultured human mesenchymal stem cells on all 8 surfaces. 24 hours after we measured the stem cell'attachment with SEM, and on 3rd, 7th, and 14th days, we checked the cell proliferation and differentiation by using MTT and ALP activity assay. And on the 7th day after the culture, we performed RT-PCR assay to determine whether the expression levels of Type I collagen, osteocalcin, osteopontin were changed. RESULTS: We observed with SEM that 4 rhBMP-2 coated surfaces exhibited wider and tighter cell attachment and more cell process spreading than uncoated surfaces. The anodized rhBMP-2 surface caused robustest effects. In MTT assay we could not find any meaningful difference. In ALP assay there was a significant increase (P<.05) in the ALP activity of anodized rhBMP-2 coated surface compared with that of the control (3rd and 14th days) and with that of the RBM rhBMP-2 coated surface (14th day). In RT-PCR assay there was increased expressions in the anodized rhBMP-2 coated surface for osteocalcin, and osteopontin. CONCLUSION: We found that the anodized rhBMP-2 coated surface were most prominent stem cell attachment and differentiation in compared to control and Machined rhBMP-2 coated, RBM rhBMP-2 coated surface.
Cell Proliferation ; Collagen Type I ; Humans ; Mesenchymal Stromal Cells ; Osteocalcin ; Osteopontin ; Stem Cells ; Titanium

The development of cancer in a pre-existing benign cystic teratoma of the ovary with distant metastasis to the supraclavicular lymph nodes has not been previously reported. We experienced a case of a 28-year-old woman with distant metastasis from small cell cacinoma arising in benign mature cystic teratoma of the ovary to the supraclavicular lymph nodes. The staging laparotomy and total abdominal hysterectomy with both salpingooophorectomy were peformed. There was no metastatic site except the supraclavicular lymph nodes, thereafter adjuvant chemotherapies with bleomycin, etoposide, cisplatin have been doing. We report a case of benign cystic teratoma with malignant change and metastasis with the literature.
Adult ; Bleomycin ; Carcinoma, Small Cell* ; Cisplatin ; Drug Therapy ; Etoposide ; Female ; Humans ; Hysterectomy ; Laparotomy ; Lymph Nodes* ; Neoplasm Metastasis* ; Ovary* ; Teratoma*

PURPOSE: The objective of this study was to test the efficacy and toxicity of adriamycin plus docetaxel as the primary chemotherapy for women with advanced breast carcinoma, and including those patients with inflammatory breast cancer. Our study also evaluated the clinicopathologic factors influencing the response rate to neoadjuvant chemotherapy. METHODS: Twenty-eight patients who underwent neoadjuvant chemotherapy between 2002 and 2004 were included for this study. The patients were treated with adriamycin (50 mg/m2; intravenous bolus) followed by docetaxel (75 mg/m2; 1-hr intravenous infusion) on the first day of each cycle for an average four cycles. We analysed the response rate to adjuvant chemotherapy by reviewing the post operative pathologic report. Additionally we compared the clincopathologic factors related to the response rate. Statistical analyses were performed with 2-tests and using SPSS 11.0. RESULTS: The mean age at diagnosis was 48.9 yr old (range 29-63 yr). The tumoral response to neoadjuvant chemotherapy was, 3 patients (10.7%) showed a complete response (CR), 21 patients (75%) showed a partial response (PR). and which about lymph node were that 15 patients (75%) have shown responder, 5 patients (25%) have shown non-responder. The overall response rate to neoadjuvant chemotherapy was 85.7%. The preoperative serum-CEA level was influenced the response rate to neoadjuvant chemotherapy (p=0.025). Grade 3 or 4 neutropenia was recorded in 81.9% of the patients (N=59/72). Grade 3 or 4 anemia was recorded in 2.8% of the patients. CONCLUSION: Neoadjuvant chemotherapy with adriamycin plus docetaxel was effective treatment for patients with locally advanced breast cancer. The preoperative serum CEA level colud be the important factor for the neoadjuvant chemotherapy response rate.
Anemia ; Breast ; Breast Neoplasms ; Chemotherapy, Adjuvant ; Doxorubicin ; Female ; Humans ; Inflammatory Breast Neoplasms ; Lymph Nodes ; Neutropenia ; Taxoids

PURPOSE: To evaluate the NT in the first trimester associated with fetal chromosomal abnormality, fetal structural abnormality and adverse pregnancy outcome. METHODS: From Mar. 1993 to Dec. 1997, 133 cases of increased NT were reviewed retrospectively. All these fetues were taken a karyotyping and/or a high resolution ultrasonography for associated anomaly. The NT was measured by transvaginal ultrasonography(TVS) and transabdominal ultrasonography(TAS) if difficulty was encountered with TVS in the period of the 10th-14th week of gestation. The increased NT is approved when it is over 3mm. RESULTS: Of these 133 cases, 102 cases(76.7%) revealed normal outcomes and 31 cases(23.3%) revealed abnormal outcomes such as chromosomal abnormality, structural abnormality and adverse pregnancy outcome, The mean value of NT was 3.44+/-0.68mm in the normal group and 4.93+/-2.70mm in the abnormal group, respectively. The chromosomal abnormalities were found in 16 of the 31 cases: nine Down SD, two Patau syndrome, one Tuner synrome, one triploidy, one 46, XX,i(18q), one 47,iso(Xp)/46,XX one confined placental mosaicism. In 12 cases of the 31 cases, the structural anomalies were detected. Of these 12 cases, 3 cases were eventually developed to cytsic hygroma, 3 cases were cardiac anomaly, 3 cases were renal anomaly, 1 case was congenital diaphragmatic hernia, 1 case was skeletal dysplasia and 1 case was suspected syndrome. The adverse pregnancy outcome such as intrauterine growth restriction, intrauterine fetal death and preterm labor was revealed in 3 cases. In the cases of NT over 7mm, the result was 100% abnormal outcome. CONCLUSION: Increased NT in the first trimester could be a highly efficient the predictor for detection of chromosomal abnormality, structural anomaly and adverse pregnancy outcome.
Chromosome Aberrations ; Female ; Fetal Death ; Hernia, Diaphragmatic ; Humans ; Karyotyping ; Lymphangioma, Cystic ; Mosaicism ; Nuchal Translucency Measurement ; Obstetric Labor, Premature ; Pregnancy ; Pregnancy Outcome* ; Pregnancy Trimester, First ; Pregnancy* ; Retrospective Studies ; Triploidy ; Ultrasonography

Hyponatremia, well known as a serious medical condition, is the most frequent electrolyte disorder in clinical medicine. The aim of this study is to bring to readers affecting factors in hyponatremia treatment and to suggest effective treatment guideline. We studied general characteristics, associated serum potassium change, relationship of sodium concentration in urine, and affecting factors on serum sodium correction in 76 hyponatremic patients who had admitted Hanyang University Kuri Hospital. These 73 hyponatremic patients were divided into 10 groups according to cause and treatment by retrospective analysis(1 group : G-I origin, 2 group : CRF, 3 group : CHF, 4 group: LC, 5 group : adrenal origin, 6 group : diuretics use, 7 group : CHF with di- uretics use, 8 group : LC with diuretics use, 9 group : polydypsia, 10 group : SIADH). Serum sodium were 124.2+/-6.9mEq/L in initial diagnosis, 125.6 +/-7.7mEq/L after 48 hour, and 129.8+/-6.3mEq/L in final evaluation. Among these hyponatremic patients, thirty patients' (41.1%) sodium correction rate were below 0.5mEq/L/hr during initial 48 hour and fifteen patients(20.5%) were corrected above 135mEq/l in serum sodium Initial serum potassium was average 4,07mEq/L, and 15 patients in 73 hyponatremic patients were hypokalemic feature. Eight patients of 15 hypokalemic patients were corrected to normal potassium level and in addition, four patients of 8 corrected patients were corrected to normal sodium level above 135mEq/L. The disease frequency were highest in GI origin (31.5%), followed by SIADH(20.5%) and LC(12.3%). In our study, hyponatremia correction was not related to patient sex, age, and initial serum sodium concentration. In conclusion, Hyponatremia prognosis was not related to initial serum sodium concentration and corection rate, but related to treatment of underlying disease. And hypokalemia acompanied by hyponetremia was corrected after correction of hyponatremia.
Clinical Medicine ; Diagnosis ; Diuretics ; Humans ; Hypokalemia ; Hyponatremia* ; Potassium ; Prognosis ; Retrospective Studies ; Sodium