PURPOSE: This is to evaluate the clinical results and radiologic changes of the mandibular condyle fractures following the open reduction and fixation using the Lag-screws introduced by Eckelt and Martin Co. MATERIALS & METHODS: Ten patients who had been treated by the Lag-screw fixation for the unilateral fracture of the mandibular condyle at the high level and followed up for over 6 months(ranged from 24 weeks to 33 weeks). The incisal opening by time elapsed, displacement of the fragments, bone resorption around the Lag-screws, operating time consumed, and untoward complications were evaluated. The data were tested by repeated measure ANOVA and paired t-test. RESULTS: The maximum mouth opening was increased by time as follows ; 20.2+/-2.8mm soon after reduction. 26.3+/-3.9 at the 2nd week, 37.7+/-4.2mm at the 4th week, 44.4+/-4.3mm in PO 2 months(P<0.05). The bone resorption at anterior to lag-screw nut was measured to 1.9+/-1.0mm, while the posterior resorption was 2.6+/-1.9mm on average(P<0.05). Reduction and fixation of the fragments by Lag-screw were done within 80 minutes including the skin closure. The clicking sound of the TMJ(40%), weakness of the marginal branch(60%) were complicated but transient for 4-8weeks. There were no signs of bony displacement, but loosening of screws were observed at the time of removal. CONCLUSION: Open reduction and fixation with condylar Lag-screw(Martin co., Germany) thru the ramus can be a good option to reduce the high level(Kruger's Level III & IV) fracture of the mandibular condyle with anterior or medial displacement. However, this procedure requires 2nd surgery to remove the devices and it may complicate improper reduction for delayed fractures and in case of 's' curved mandibular ramus.
Bone Resorption ; Humans ; Mandibular Condyle* ; Mouth ; Nuts ; Prognosis* ; Skin

PSTT has been established as a separate entity distinct from choriocarcinoma since 1983, because of its different morphological features, biologic behavior and response to chemotherapy. Most cases of PSTT have indolent clinical courses, but there have been several reports showing malignant behavior resulted in death of the patient. We report a case of PSTT showing vaginal metastatis. In biopsy specimen, it was difficult to make differential diagnosis from squamous cell carcinoma of uterine cervix due to uniform and mononuclear cytologic characteristics. Immunohistochemical stains for hPL and hCG were not typical for either PSTT or choriocarcinoma. We suggest that poorly differentiated PSTT may synthesize the lesser amount of hPL than typical PSTT and it may behave more aggressively.
Diagnosis, Differential ; Biopsy

The 56-kilodalton protein genes of Orientia tsutsugamushi TA678, TA686, TA716, TA763 strains were amplified by PCR. The amplified products were sequenced and cloned into pIH821 vector. The recombinant proteins were expressed in Escherichia coli as fusion proteins with maltose binding protein. The recombinant proteins were purified and used for the sensitization of sheep RBCs and the reactivity of the recombinant 56-kDa proteins of Orientia tsutsugamushi TA 678, TA686, TA716 strains were analyzed with 40 sera from scrub typhus patients in Korea, 40 sera from scrub typhus in Thailand, Malaysia and Philippines. The 56-kDa protein coding DNA sequence of Orientia tsutsugamushi TA678, TA686, TA716 show 70 to 88% homology with other known strains and four variable regions are also observed. 39 of 40 sera from scrub typhus patients in Korea showed the strongest reactivity to the recombinant protein of Boryong strain and one sera showed the strongest reactivity to the recombinant protein of Gilliam strain. 14 of 40 sera from patients in Thailand, Malaysia and Philippines showed the strongest reactivity to the recombinant protein of TA686 strain and 12 sera showed the strongest reactivity to the recombinant protein of TA716 strain. No serum from patients in Thailand, Malaysia and Philippines showed the strongest reactivity to the recombinant protein of Boryong strain.
Asian Continental Ancestry Group* ; Base Sequence ; Chungcheongnam-do ; Clinical Coding ; Clone Cells ; Cloning, Molecular* ; Escherichia coli ; Hemagglutination Tests* ; Hemagglutination* ; Humans ; Korea ; Malaysia ; Maltose-Binding Proteins ; Orientia tsutsugamushi* ; Philippines ; Polymerase Chain Reaction ; Recombinant Proteins ; Scrub Typhus ; Sheep ; Thailand

Hydropic degeneration is a frequent degenerative change in otherwise typical uterine leiomyomas. Very rarely, however, a significant amount of edema fluid accumulates around the fascicles of neoplastic smooth muscle bundles and forms the characteristic multinodular growth pattern that is called perinodular hydropic degeneration of leiomyoma (PHDL). The gross findings, showing a vague worm-like appearance and very rarely having an extrauterine extension, and the microscopic features, showing perinodular retraction artifacts forming pseudovascular spaces, make it difficult to differentiate the tumor from intravenous leiomyomatosis or myxoid leiomyosarcoma. We described two cases of leiomyomas showing perinodular hydropic degeneration (PHD), a condition that has rarely been described in English literature, and discussed the mechanism of forming "extrauterine extension" or cotyledonoid features. One of our cases showed the typical features of cotyledonoid dissecting leiomyoma, the other showed those of intramural dissecting leiomyoma. An awareness of the gross and microscopic findings of PHDL is important not to overdiagnose a benign smooth muscle neoplasm as a more aggressive type of tumor. It is thought that intramural dissecting leiomyoma, cotyledonoid dissecting leiomyoma, and PHDL are not distinct, but closely related subtypes showing different phases of evolutionary changes.
Artifacts ; Edema ; Leiomyoma* ; Leiomyomatosis ; Leiomyosarcoma ; Muscle, Smooth

Ovarian endometrioid adenofibroma is rare and characterized by prominent stroma. Its histologic classification is controversial but the malignant counterpart is distinguished from the borderline by the presence of confluent growth pattern of epithelium with invasion of the stroma by the endometrioid cells. A fifty-year-old woman was admitted with one month history of abdominal enlargement. Total abdominal hysterectomy with bilateral salpingo-oophorectomy was performed under the clinical diagnosis of ovarian malignancy. Grossly, the righy ovary had round, encapsulated, solid and whitish gray mass which measured 9 cm in the greatest dimension and showed peripheral small cysts. Microscopic examination revealed that the tumor consisted of endometria type glands set in fibrous stroma. The glands varied from tubules to cysts and the lining cells showed complicated architectural pattern with occasional papillary infoldings, atypical mitosis and malignant nuclear characteristics. Some cysts of glands showed intraluminal mucin products. Stromal invasions by individual epithelial cells showing malignant characteristics were often found. A brief summary of the histopathologic aspect of this tumor is presented together with review of literatures.
Female ; Humans ; Cysts

Ovarian endometrioid adenofibroma is rare and characterized by prominent stroma. Its histologic classification is controversial but the malignant counterpart is distinguished from the borderline by the presence of confluent growth pattern of epithelium with invasion of the stroma by the endometrioid cells. A fifty-year-old woman was admitted with one month history of abdominal enlargement. Total abdominal hysterectomy with bilateral salpingo-oophorectomy was performed under the clinical diagnosis of ovarian malignancy. Grossly, the righy ovary had round, encapsulated, solid and whitish gray mass which measured 9 cm in the greatest dimension and showed peripheral small cysts. Microscopic examination revealed that the tumor consisted of endometria type glands set in fibrous stroma. The glands varied from tubules to cysts and the lining cells showed complicated architectural pattern with occasional papillary infoldings, atypical mitosis and malignant nuclear characteristics. Some cysts of glands showed intraluminal mucin products. Stromal invasions by individual epithelial cells showing malignant characteristics were often found. A brief summary of the histopathologic aspect of this tumor is presented together with review of literatures.
Female ; Humans ; Cysts

OBJECTIVE: This study was carried out to evaluate the effect of the isolation methods of inner cell mass from mouse blastocyst, types of feeder cells and treatment time of mitomycin C on the formation rate of ICM colony. METHODS: The inner cells were isolated by conventional immunosurgery, partial trophoblast dissection with syringe needles and whole blastocyst co-culture method. Commercially available STO and primary cultured mouse embryonic fibroblast (pMEF) feeder cells were used, and mitomycin C was treated for 1, 2 or 3 hours, respectively. The formation rate of ICM colony was observed after isolation of ICM and culture of ICM on the feeder cells for 7 days. RESULT: The ICM colony formation rate on STO were significantly higher in partial trophoblast dissection group (58%) than that in immunosurgery (12%) or whole blastocyst culture (16%) group (p<0.05). The formation rate on pMEF feeder layer was higher in partial trophoblast dissection (88%) and whole blastocyst culture (82%) group than that in immunosurgery (16%) group (p<0.05). When mitomycin C treated to pMEF for 2 hours, the formation rate of 88% was significantly higher than those of other conditions. CONCLUSIONS: Above results showed that the efficient isolation method of ICM from blastocyst was the partial trophoblast dissection and the appropriate treatment time of mitomycin C was 2 hours. However, the subculture of ICM colony and characterization of stem cells should be carried out to confirm the efficacy of the partial trophoblast dissection method.
Animals ; Blastocyst ; Coculture Techniques ; Feeder Cells* ; Fibroblasts ; Mice* ; Mitomycin* ; Needles ; Stem Cells ; Syringes ; Trophoblasts

PURPOSE: This is to review the complicated jaw fractures that had been referred for revision of the unsatisfactory results, and to provide proper managements for the easily complicated jaw fractures. MATERIALS AND METHODS: Twenty-nine patients who had been revised due to malunion or complicated fractures of facial bones for last 3 years were reviewed. The main problems required for revision, type of fractures complicated, the primary managements to be reclaimed, the specialties to be involved, the management to be reclaimed, time elapsed to seek reoperation, type of revision surgeries, residual complication were analysed with medical records, radiographs and final examinations. RESULTS: The major complaints were malocclusion(79.3%), facial disfigurement(41.3%), TMJ problems (13.7%), neurologic problems(10.3%), non-union(10.3%), and infection(6.8%). Unsatisfactory results were occurred most frequently after improper management of the multiple fractures of the mandible (62.2%), combined fractures of maxilla and mandible (20.6%), fracture of zygomatico-maxillary complex and midpalate (17.2%). The complications to be corrected were widened or collapsed dental arches (79.3%), improperly reduced condyles (41.3%), painful TMJ (34.4%), limited jaw excursion (31.0%), over-reduction of zygoma (13.7%), and nonunion with infection(13.7%). and dysesthesia (10.3%). The primary managements were nendereet by plastic surgeons in 82.7%(24/29) and by oral surgeons in 7.6%(2/29). Main causes of malunion are inadequate ORIF in 76%, unawareness & delay in 17%, and delayed due to systemic cares in 17%. 76% of 29 patients had been in state of intermaxillary fixation for over 4 weeks. Revision were done by means of "refracture and ORIF" in 48.2%(14/29), orthognathic osteotomies with bone grafts in 55.1%(16/29), and camouflage ountering & alloplastic implantations in 37.9%(11/29), TMJ surgeries in 17.2%, micro-neurosurgeries in 11.6%. Residual complications were limited mouth opening in 24.1% (7/29), paresthesia in 13.7%, resorption of reduced condyle in 10.3%. CONCLUSIONS: Failure of initial treatment of jaw fractures is due to improper diagnosis and inadequate treatment with lack of sufficient knowledge of stomatognathic system. It is crucial to judge jaw fracture and patients accurately, moreover, the best way of treatments has to be selected. Consideration of these factors in treatment could minimize the complication of jaw fractures.
Dental Arch ; Diagnosis ; Facial Bones ; Humans ; Jaw Fractures* ; Jaw* ; Mandible ; Maxilla ; Medical Records ; Mouth ; Osteotomy ; Paresthesia ; Reoperation ; Stomatognathic System ; Temporomandibular Joint ; Transplants ; Zygoma

PURPOSE: Bone morphogenetic proteins (BMPs) are members of the transforming growth factor-beta family and play an important role in cellular growth. Recent reports suggest that exogenous bone morphogenetic protein-2 (BMP-2) acts as an antiproliferative agent in a variety of cell lines. We will study whether BMP-2 is altered in human colorectal cancer. METHODS: We analyzed 40 colorectal cancer cases and 6 colorectal cancer cell lines by using reverse transcription-polymerase chain reaction (RT-PCR) to determine the expression of BMP-2. RESULTS: Thirteen of 40 colorectal cancers (33%) and 3 of 6 colorectal cancer cell lines (50%) revealed decreased expression of BMP-2. The rates of decreased expression were 0% (0/7), 42.1% (8/19), 28.6% (2/7), 33.3% (2/6), and 100% (1/1) in stages I, II, III, and IV, respectively. Histologically, the rates were 33.3% (2/6), 32.2% (10/21), 50% (1/2), and 0% (0/1) in well-differentiated, moderately-differentiated, poorly-differentiated and mucinous cancers, respectively. As for location, the rates for colon and rectal cancers were 27.8% (5/18) and 36.4% (8/22), respectively. We identified methylation in the CpG island of the BMP-2 gene in 60% of colorectal cancer cells and in 50% of colorectal cancer cell lines. The 13 cases without BMP-2 gene expression showed no significant correlation with clinicopathological factors. Epigenetic silencing through DNA methylation is one of the key steps during carcinogenesis. CONCLUSION: We found, through an analysis using the methylation-specific polymerase chain reaction technique, CpG island methylation of the BMP-2 promoter region in colorectal cancer. Thus, aberrant BMP-2 methylation and the resultant loss of BMP-2 expression may be related to colorectal carcinogenesis.
Bone Morphogenetic Proteins ; Cell Line ; Colon ; Colorectal Neoplasms ; CpG Islands ; DNA Methylation ; Epigenomics ; Gene Expression ; Humans ; Methylation ; Mucins ; Polymerase Chain Reaction ; Promoter Regions, Genetic ; Rectal Neoplasms

Traditionally, surgical access to the midface structures for the removal of benign or malignant tumors has been through paranasal sinuses, external facial incisions, or hard palate. However, large or malignant lesions of the nose, paranasal sinuses and nasopharynx have a particularly difficult problem of these surgical approach. The midfacial degloving approach combined with/without medial maxillectomy provide an alternative method that requires no facial incisions and minimal functional impairment. Exposure and surgical facility may be equal or superior to that of traditional procedures in selected cases. Combining this method with bi-frontal, brow, transtemporal, and transpalatal approach is also possible for extensive lesions. We did midfacial degloving in 13 patients who were seen with benign or malignant lesions involving the midface structures from Jan. 1991 to Dec. 1994. Thus we analysed the clinical data including the advantage and complications of this method retrospectively.
Humans ; Nasopharynx ; Nose ; Palate, Hard ; Paranasal Sinuses ; Retrospective Studies