Even though there are diverse tumors invading skull base, it is impossible to completely remove the tumor only by transcranial approach due to its anatomical complexity. Therefore we operated by transfacial approach as well which allows to have a good vision and remove the tumor from different directions. Transfacial approach is to approach tp the skull base for the tumor located on the margin of skull and face through exposing such as nasal cavity, paranasal cavity, nasopharyngeal cavity, etc. after separating facial bone. In 1990 Janecka introduced it, dividing the face into 4 groups: mini, standard, expanded, and bilateral facial translocation, based on neurovascular and aesthetic line. Transfacial approach makes it possible to do three dimensional tumor resection, remove the tumor, check its margin directly, and have functionally and aesthetically satisfactory reconstruction. In such cases that tumor invades lower part of skull base, the tumor can be removed only by transcanial approach. Although tumor can be removed by transcranial approach to find the location three dimensionally, transfacial approach can be used as adjunctive means which allow to get a good vision and remove the remnant completely. For 36 months, we have executed 16 cases of tranfacial approach, removing tumors located at the skull base. We classify and suggest the role of tranfacial approach based on our documents.
Facial Bones ; Nasal Cavity ; Skull Base* ; Skull*

Many craniofacial and neurosurgical procedures rely on cranial bone as a bone graft. In the majority of instances, the bone heals and gives good results. But we found that if either the dura or the pericranium were missing adjacent to the cranial bone, bone absorption would be increased. We studied a single animal model, investigating the contribution of the dura and the pericranium in the process of cranial bone absorption. The animals were divided into four groups of each five animals depending on the differential blockade of the dura and/or the pericranium by silastic sheet. Bilateral 100-mm2, parietal bone flaps were harvested from mature rabbits. Animals were humanely killed after 12 weeks, and histomorphometric analysis was performed. The volume maintenance is as follows; Group I; 89.0%, Group II; 80.0%, Group III; 63.3%, Group IV; 52.4%. The weight maintenance; Group I; 87.1%, Group II; 79.4%, Group III; 61.6%, Group IV; 51.1%. The histological contribution of living bone; Group I; 92.9%, Group II; 85.6%, Group III; 71.1%, Group IV; 56.2%. Significantly increased bone absorption occurred in Group II, III, IV compared with Group I. Conclusions are: 1. Cranial bone absorption is effected by both the dura and the pericranium. 2. The dura is more important than the pericranium in preventing cranial bone absorption. 3. The dura to be the source of central cranial bone and the pericranium to be the source of peripheral cranial bone.
Absorption* ; Animals ; Humans ; Models, Animal ; Neurosurgical Procedures ; Parietal Bone ; Rabbits ; Transplants

Chondrosarcoma is an extremely rare cause of pelvic mass mimicking ovarian carcinoma. Imaging techniques, even CT and MRI, failed to define the exact origin of the tumor. These findings as well as the elevated CA-125 level naturally resulted in a preoperative diagnosis of ovarian carcinoma. Surgical removal is the most important treatment of choice for chondrosarcoma. We experienced a case of extraskeletal myxoid chondrosarcoma of pelvic cavity in a 45-year-old patient, who presented with abdominal distension and lower abdominal palpable mass, and reported it with a brief review of literatures.
Chondrosarcoma* ; Diagnosis ; Humans ; Magnetic Resonance Imaging ; Middle Aged

No abstract available.
Osteochondroma*

Primary non-Hodgkin's lymphoma of the ovary is a rare ovarian malignancy. Previous reports of ovarian non-Hodgkin's lymphoma have included both primary and secondary cases, because exactly defined criteria was not available. Ovarian lymphoma has been reported poor prognosis. However, true primary ovarian lymphoma shows a favorable prognosis. We experienced a case of primary non-Hodgkin's lymphoma of the ovary in a 34-year-old patient, who presented with abdominal distension and abdominal pain, and reported it with a brief review of literatures.
Abdominal Pain ; Adult ; Female ; Humans ; Lymphoma ; Lymphoma, Non-Hodgkin* ; Ovary* ; Prognosis

S-1, a novel oral fluoropyrimidine, is an effective therapeutic agent for gastric cancer. Herein, we report a case with locally advanced gastric cancer that achieved a curative resection after S-1 monotherapy as neoadjuvant treatment. A 68-year-old man was diagnosed with gastric cancer and massive lymphadenopathy involving the perigastric, celiac axis and splenic hilum. His clinical stage was cT3N2H0P0M0. Considering his relatively poor performance (ECOG 2, severe weight loss) and advanced age, we started the patient on S-1 monotherapy at a dose of 35 mg/m2 bid for 4 consecutive weeks followed by a 2-week rest. Follow-up study after 4 treatment cycles revealed disappearance of the lymphadenopathy of the perigastric and celiac axis with diminished extension of the stomach mass. The patient had a partial response (PR) with a 72% tumor reduction, according to the Response Evaluation Criteria in Solid Tumors (RECIST). His performance status was improved to an ECOG 1 and he gained 7 kg. A curative (R0) resection was achieved with a radical total gastrectomy and D2 dissection. The pathological stage was pT3N2M0, stage IIIB. In conclusion, S-1 neoadjuvant chemotherapy aided in the treatment of gastric cancer in this patient.
Adenocarcinoma/*drug therapy/pathology/surgery ; Aged ; Antimetabolites, Antineoplastic/administration & dosage/*therapeutic use ; Drug Combinations ; Gastrectomy ; Humans ; Male ; *Neoadjuvant Therapy ; Neoplasm Staging ; Oxonic Acid/administration & dosage/*therapeutic use ; Stomach Neoplasms/*drug therapy/pathology/surgery ; Tegafur/administration & dosage/*therapeutic use

OBJECTIVES: The Korean College of Neuropsychopharmacology and the Korean Academy of Schizophrenia developed the Korean algorithm project for schizophrenia to aid clinical decisions. The purpose of this study was to assess the feasibility of Korean Medication Algorithm for Schizophrenia patients in clinical settings in Korea. METHODS: A total of 108 schizophrenia and schizophreniform disorder patients were enrolled at 19 centers and treated according to the algorithm. PANSS (Positive and Negative Symptom Scale) and CGI (Clinical Global Impression) were used to evaluate symptom severity. Also UKU (UKU side effect rating scale) and LUNSERS (Liverpool University Neuroleptic Side Effect Rating Scale), DAI-10 (Drug Attitude Inventory-10), PPS (Patient Preference Scale), SWN (Subjective Well-Being under Neuroleptic treatment) and WHOQOL (World Health Organization Quality of Life) were used to evaluate tolerability and satisfaction of patient respectively. RESULTS: Overall ratings including symptom severity, compliance of medication, side effect of medication, quality of life were favorable. The treatment response (PANSS improvement > or = 20%) rate was 63%, 75% at the first Clinical decision point (CDP) and 4 month respectively. CONCLUSION: Symptom improvement, tolerability and quality of life were all favorable. These results suggest that this algorithm can be useful in clinical practices.
Compliance ; Humans ; Korea ; Psychotic Disorders ; Quality of Life ; Schizophrenia ; World Health Organization

OBJECTIVES: The reliability and validity of the Korean version of Hamilton Depression Rating Scale (K-HDRS) were examined in Korean patients depressive symptoms. METHODS: 33 inpatients and 70 outpatients diagnosed as major depressive disorder or depressive episode of bipolar I disorder according to the DSM-IV criteria were assessed with K-HDRS, Clinical Global Impression score(CGI), Beck Depression Inventory (BDI) and Montgomery-Aberg Depression Rating Scale (MADRS). RESULTS: Internal consistency (Cronhach's alpha coefficeint=0.76) and interrater reliability (r=0.94, p<0.001) were statistically significant. Principal axis factoring analysis revealed 4 factors that accounted for 50.4% of the total variance. The correlations of K-HDRS with CGI, BDI and MADRS were 0.84, 0.54, 0.58 respectively. CONCLUSION: These results showed that the K-HDRS could be a reliable and valid tool for the assessment of depressive Korean patients. The K-HDRS will be a useful tool for assessing depressive symptoms in Korea.
Axis, Cervical Vertebra ; Depression* ; Depressive Disorder, Major ; Diagnostic and Statistical Manual of Mental Disorders ; Humans ; Inpatients ; Korea ; Outpatients ; Reproducibility of Results*

PURPOSE: Microsatellite instability in patients with defects in the mismatch repair system resulting in RER has a high risk of accumulating mutations in oncogene and tumor suppressor gene. In this study, we evaluated the incidence of microsatellite instability in breast cancer by comparing PCR-amplified sequences from frozen samples of normal and tumor tissue fram affected patients. We also investigated whether RER was associated with TGF-beta RII mutation. MATERIALS AND METHODS: Fifty surgically resected breast cancer specimens from Jan. 1996 to June, 1997 were used for study. Microsatellite instability(referred to as replication error, RER) at three loci with BAT 26, BAT 40, TA10 was analyzed by polymerase chain reaction and the results were compared with clinicopathologic characteristics. RESULTS: Of the 50 breast cancer patients, 14(28%) were RER(+) at one or more microsatellite loci, and 4(8%) showed TGF-beta RII mutation. Microsatellite instability was significantly correlated with lymph node involvement(especially in case of 4 or more lymph nodes involvement). But we could not find any correlation between RER and other prognostic factors including tumor size, tumor grade, hormone receptor status and pathology. One of fourteen tumors with RER(+) showed TGF-beta RII mutstion. There was no signiticant correlation between RER(+) and TGF-beta type II receptor gene mutation. CONCLUSION: The findings suggest that microsatellite instability would be useful prognostic factor in unilateral breast cancer patients, and the role of targeting to gene mutation will be explored in future studies.
Breast Neoplasms* ; Breast* ; DNA Mismatch Repair ; Genes, Tumor Suppressor ; Humans ; Incidence ; Lymph Nodes ; Microsatellite Instability* ; Microsatellite Repeats* ; Oncogenes ; Pathology ; Polymerase Chain Reaction ; Prognosis* ; Transforming Growth Factor beta

Takayasu's arteritis (TA) is a nonspecific, chronic and stenotic panarteritis which usually involves the aorta and its major branches. Corticosteroid and immunosuppressants are recommended to manage the acute inflammatory phase, but their long term benefits are uncertain. Blood pressure (BP) control during the chronic phase of TA is essential to preserve renal function, which is associated with the patient's long-term prognosis and survival. Revascularization in organ damaging arterial stenosis with percutaneous angioplasty (PTA)/stenting or bypass surgery have been accepted as established treatment options in chronic complicated phase of TA. We present a case of a 31-year-old female patient with a two-day history of sudden onset oliguria and generalized edema whose acute oliguric renal failure was successfully reversed following PTA and stenting in a solitary functioning kidney with critical renal artery stenosis (RAS) caused by TA.
Acute Kidney Injury ; Adult ; Angioplasty ; Aorta ; Blood Pressure ; Constriction, Pathologic ; Edema ; Female ; Humans ; Immunosuppressive Agents ; Kidney ; Oliguria ; Prognosis ; Renal Artery ; Renal Artery Obstruction ; Renal Insufficiency ; Stents ; Takayasu Arteritis