The mesectodermal leiomyosarcoma of the orbit is extremely rare disease. An 81-year-old woman presented with progressive painless proptosis in her right eye of 1 month duration. Computed tomographic scan of the orbit demonstrated 5-cm size lobulating mass of the right orbit which displaces eyeball anteriorly and bulges out to temporalis portion with severe destruction of lateral orbital wall and intracranial extension. For diagnostic pur-pose, incisional biopsy was performed. Light microscopic examination showed the characteristics of neurogenic tumor. Electron microscopic examination disclosed the features of smooth muscle cells as well as neural differentiation of the tumor, leading to the diagnosis of mesectodermal leiomyosarcoma. To the best of our knowledge, this is the first case of mesectodermal leiomyosar-coma of the orbit in Korea
Aged, 80 and over ; Biopsy ; Diagnosis ; Exophthalmos ; Female ; Humans ; Korea ; Leiomyosarcoma* ; Myocytes, Smooth Muscle ; Orbit ; Rare Diseases

No abstract available.
Male ; Penile Erection*

Several effective treatment methods and materials have been developed for the treatment of furcation involvement. Currently, the combination of guided tissue regeneration (GTR) and bone grafts is the most commonly prescribed method of treating furcation involved defects. But because these cases often present with poor accessibility, placement of the membrane may be difficult and consequently, clinically impractical. In this study, the alveolar bone healing patterns of adult beagle dogs presenting with alveolar bone destruction treated by one of two methods - treatment using solely bone aIlografts (BBP(R)), or treatment using bone allografts (BBP(R)) stabilized by a fibrin adhesive - were comp ared. The effects of the fibrin adhesive on the initial stabilization of the newly formed bone, subsequent regeneration of bone, and the feasibility of the clinical application of the fibrin adhesive were analyzed. The results of the study were as follows: 1. Clinical signs of inflammation at the 4-8 week interval were not observed: but signs of mild inflammation were histologically observed at the 4-week interval. 2. Allografts stabilized by fibrin adhesive showed good bone formation, whereas defects treated with only the allograft material showed incomplete alveolar bone regeneration. 3. Allografts stabilized by fibrin adhesive showed a decrease in the amount old bone with a concurrent increase in the formation of new lamellar bone four weeks post-op, whereas defects treated with only the allograft material showed no new lamellar bone formation at the same interval. 4. In detects treated with only the allograft material, the defective area was filled with connective tissue 8- weeks post-op, whereas fibrin adhesive stabilized allografts showed viable connections between the original bone and the newly formed bone, in addition to neovascularization 8-weeks post-op. The results of this study show that concurrent use of fibrin adhesive materials can stabilize the allograft material and aid in new bone formation Although the stability of fibrin adhesives fall short of the results achievable by GTR membranes, in cases presenting with poor accessibility that contraindicate the use of membranes, fibrin adhesive materials provide a viable and effective alternative to graft stabilization and new bone formation.
Adhesives ; Adult ; Allografts ; Animals ; Bone Regeneration* ; Connective Tissue ; Dogs ; Fibrin Tissue Adhesive* ; Fibrin* ; Guided Tissue Regeneration ; Humans ; Inflammation ; Membranes ; Osteogenesis ; Regeneration ; Transplants

PURPOSE: We wanted to analyze the causes of revision and the clinical and radiographic results after revision total knee arthroplasty. MATERIALS AND METHODS: Thirty-eight knees in 34 patients underwent revision total knee arthroplasty using the PFC(R) Sigma revision system between March 1999 and May 2005. The average patient age was 71.2 years, and the average follow-up period was 6 years 7 months (range: 4 years~10 years 2 months). We evaluated the time interval between the primary and revision arthroplasty and the causes of revision. The clinical outcomes were assessed using the knee score and the functional score of the Knee Society Scoring system (KSS system), and the radiographic measurements were assessed using the roentgenographic method of the American Knee Society. RESULTS: The mean interval between primary and revision arthroplasty was 6 years 3 months. The causes of revision included 25 cases of aseptic loosening and osteolysis, 7 cases of infection, 3 cases of joint stiffness and 3 cases of polyethylene problems. At the follow up, the mean preoperative knee and functional scores improved from 45.1 points to 84.5 and 37.2 to 78.2, respectively. Radiographycally, the average femorotibial angle was corrected from 2.2degrees in valgus to 6.5degrees. The radiolucency score was below 4 in all the cases. The complications after revision arthroplasty were 2 cases of superficial infection and 1 case of wound dehiscence with a skin defect. CONCLUSION: The main causes of revision arthroplasty were aseptic loosening and osteolysis. Satisfactory results were obtained using the posterior cruciate ligament and substituting the PFC(R) Sigma knee system with appropriately selected metal augmentation and an allograft. This study showed favorable results on long term follow-up.
Arthroplasty ; Follow-Up Studies ; Humans ; Joints ; Knee ; Osteolysis ; Polyethylene ; Posterior Cruciate Ligament ; Skin ; Transplantation, Homologous

PURPOSE: The effect of PTK inhibitors (herbimycin A and genistein) on the induction of radiation-induce d apoptosis in Ph-positive K562 leukemia cell line was investigated. MATERIALS AND METHODS: K562 cells in exponential growth phase were irradiated with a linear accelerator at room temperature. For 6 MV X-ray irradiation and drug treatment, cultures were initiated at 2x10' cells/mL. The cells were irradiated with 10 Gy. Stock solutions of herbimycin A and genistein were prepared in dimethyl sulphoxide (DMSO). After incubation at 37C for 0-48 h, the extent of apoptosis was determined using agarose gel electrophoresis and TUNEL assay. The progression of cells throughth the cel l cycle after irradiation and drug treatment was also determined with flow cytometry. Western blot analysis was used to monitor bcl-2, bcl-X and bax protein levels. RESULTS: Treatment with 10 Gy X-irradiation did not result in the induction of apoptosis. The HMA alone (500 nM) also failed to induce apoptosis. By contrast, incubation of K562 cells with HMA after irradiation resulted in a substantial induction of nuclear condensation and fragmentation by agarose gel electro-phoresis and TUNEL assay. Genistein failed to enhance the ability of X-irradiation to induce DN A fragmentation. Enhancement of apoptosis by H MA was not attributable to downregulation of the bcl-2 or bcl-X anti-apoptotic proteins. When the cells were irradiated and maintained with HMA, the percentage cf cells in G2/M phase decreased to 30-40% at 48 h. On the other hand, cells exposed to 10 Gy X-irradiation alone or maintained with genistein did not show marked cell cycle redistribution. CONCLUSION: We have shown that nanomolar concentrations of the PTK inhibitor HMA synergize with X-irradiation in inducing the apoptosis in Ph (+) K562 leukemia cell line. While, genistein, a PTK inhibitor which is not selective for p2 10""'' failed to enhance the radiation induced apoptosis in K562 cells. It is unlikely that the ability of HMA to enhance apoptosis in K562 cells is attributable to bcl-2 family. It is plausible that the relationship between cell cycle delays and cell death is essential for drug development based on molecular targeting designed to modify radiation-induced apoptosis.
Apoptosis Regulatory Proteins ; Apoptosis* ; bcl-2-Associated X Protein ; Blotting, Western ; Cell Cycle ; Cell Death ; Cell Line ; Dimethyl Sulfoxide ; Down-Regulation ; Electrophoresis, Agar Gel ; Flow Cytometry ; Genistein ; Hand ; Humans ; Hydrogen-Ion Concentration ; In Situ Nick-End Labeling ; K562 Cells* ; Leukemia ; Particle Accelerators ; Sepharose

No abstract available.
Carcinoma, Renal Cell* ; Melena*

Nicotine is one of the major components of cigarette smoking which causes various systemic and local diseases to human body. The purpose of the present study was to investigate the effects of nicotine on bone mineralization in human fetal osteoblasts cell line(hFOB1). To compare the alkaline ph-osphatase(ALP) synthesis, hFOB1 were cultured with DMEM/F-12 1:1 Mixture and 100 pg/ml, 1 ng/ml, 10 ng/ml, 100 ng/ml, 1 microgram/ml, 10 microgram/ml, 100 microgram/ml of nicotine. And to compare the calcium accumulation, hFOB1 cultured for 23 days were quantified and photographed. ALP activity of hFOB1 exposed to nicotine was not significantly changed at a lower concentrations of nicotine, but was significantly decreased at a higher concentrations (10 microgram/ml, 100 microgram/ml) of nicotine (p<0.05). A quantified calcium acculation in hFOB1 was significantly decreased at 1, 10, and 100microgram/ml of nicotine (p<0.05). Significantly decreased calcium deposition was observed at 1, 10, and 100microgram/ml of nicotine. These results indicate that a higher concentration of nicotine show a negative effects on mineralization of hFOB1.
Calcification, Physiologic ; Calcium ; Human Body ; Humans* ; Nicotine* ; Osteoblasts* ; Smoking

PURPOSE: To compare the performance of a fixed bearing with a PFC Sigma with that of a rotating platform in a total knee arthroplasty performed on patients with a moderate to severe varus deformity. MATERIALS AND METHODS: Among the patients who had received a total knee arthroplasty with either a PFC sigma fixed bearing or a rotating platform between October 1998 to June 2002, 77 cases (53 patients) with a > 15degrees varus deformity were examined. The surgery time and the clinical ratings and the radiographic images for each patient were investigated. RESULTS: There were no significant differences in the knee score, functional score, activity level, or radiological findings. There were seven cases where friction sounds were produced from the insertions in the rotating platform whilst walking and there were three cases of lateral instability. CONCLUSION: The PFC sigma fixed bearing was more effective for stabilizing the knees with a moderate to severe varus deformity because the rotating platform had a friction sound from the insertions while walking and lateral instability.
Arthroplasty* ; Congenital Abnormalities* ; Friction ; Humans ; Knee* ; Walking

BACKGROUND AND OBJECTIVES: There are various surgical approaches for resection of base of tongue cancer, but reports on indications of each approach are lacking. PATIENTS AND METHODS: From 1993 to 1999, surgically treated patients with base of tongue cancer were reviewed retrospectively. Fourteen patients were included in this study. All but one were previously untreated. Approaches used to remove the tongue base lesions were as follows: lateral pharyngotomy, transhyoid pharyngotomy, mandibular swing approach with or without supraglottic partial laryngectomy (SPL), extended supraglottic partial laryngectomy (ESPL), lingual release or lingual-mandibular release technique, and pull through approach. Free flap or myocutaneous flap were used for the reconstruction of surgical defect in five patients. RESULTS: Surgical resection margin was positive in five patients. In these, the lateral wall of oropharynx was the most frequent site of positive margin. All patients, except one total laryngectomee, could do well without tracheostoma and oral feeding was possible in all cases. CONCLUSIONS: In small lateral tumor, transpharyngeal resection was a good alternative for vigorous transmandibular resection. In case of tumor with vallecular or supraglottic involvement, supraglottic partial laryngectomy with or without mandibular swing was needed. For total glossectomy, lip and mandible could be spared with pull through or lingual release approach. Even though we could choose any surgical approach with very wide surgical field, we needed more generous safety margin for this notorious tongue base cancer.
Free Tissue Flaps ; Glossectomy ; Humans ; Laryngectomy ; Lip ; Mandible ; Myocutaneous Flap ; Oropharynx ; Retrospective Studies ; Tongue Neoplasms* ; Tongue*

Congenital intratympanic membrane cholesteatomas (ITMCs) are very rare. We present 3 cases of congenital ITMCs. In the first case, there was a small keratin pearl in the center of the tympanic membrane. In the other cases, cholesteatomas were found in the periphery. In all cases, cholesteatomas were confined to the space between the outer epithelial layer and the middle fibrous layer. The pathogenesis of this rare disease and the natural history are not well known. In some reported cases, it grows and invades into the middle ear. However, in the present study, the lateral growing of the ITMC was observed in one of the three cases. Furthermore, it naturally grew outward and finally moved to the external auditory canal. Careful periodic observation should be considered for alternative treatments. We present three different cases of ITMC with a review of the literature.
Cholesteatoma ; Ear Canal ; Ear, Middle ; Keratins ; Membranes ; Natural History ; Rare Diseases ; Tympanic Membrane