The pathogenesis of cervical cancer is a clinically important example of multistage epithelial tumorigenesis from the progressive neoplastic changes known as premalignant cervical intraepithelial neoplasias (CINs) to invasive cervical cancers. Infection with high-risk human papillomavirus (HPV) types, such as HPV-16 and -18, is strongly correlated with the development of cervical cancer. The malignant phenotype of high-risk types depends on the expression of two viral oncogenes, E6 and E7. A number of genetic and biochemical studies have shown that E6 and E7 proteins cooperatively exert cellular immortalization and transformation by interfering with the functions of the cellular tumor suppressor proteins, p53 and pRb, respectively. The two oncoproteins inactivate the tumor suppressor proteins in such a way that E6 binds to p53 and promotes its ubiquitin/proteosome-dependent degradation and E7 binds to the hypophosphorylated form of pRb and interferes with its binding to E2F. In addition to these features of E6 and E7, other or additional activities have been reported that the independent of p53 and pRb in the course of cellular transformation. p73 was inactivated by both high-risk and low-risk HPV E6 proteins, independent of the E6-directed degradation. The inactivation of p73 by the high-risk E6 would provide another advantage for cervical carcinogenesis. We also found that HPV E7 is functionally associated with the interferon regulatory factor (IRF)-1 tumor suppressor, a key regulator of cellular immune response. Binding assays indicate a physical interaction between IRF-1 and HPV E7 at the molecular level both in vitro and in vivo. E7 transgene expression in an inducible cell line and transgenic mice abrogates transactivation function of IRF-1 in vivo, which might be important for the elucidation of the E7-mediated immune evading mechanism that is frequently found in cervical cancer. Furthermore, the functional inactivation of p73 or IRF-1 by both high-risk and low-risk HPV E6/E7 could play an important role in the malignant transformation and benign condyloma formation of the cervix.
Animals ; Carcinogenesis ; Cell Line ; Cervical Intraepithelial Neoplasia ; Cervix Uteri ; Female ; Human papillomavirus 16 ; Humans* ; Immunity, Cellular ; In Vitro Techniques ; Interferons ; Mice ; Mice, Transgenic ; Oncogene Proteins ; Oncogenes ; Papillomavirus Infections* ; Phenotype ; Transcriptional Activation ; Transgenes ; Tumor Suppressor Proteins ; Uterine Cervical Neoplasms

No abstract available.
Cervix Uteri* ; Classification* ; Female ; Humans*

No abstract available.
Rhinoplasty*

A patient with extraskeletal cervical epidural Ewing's sarcoma who presented with cervical radiculopathy is reported. A 58-year-old woman presented with right posterolateral neck pain and upper extremity radiculopathy. The computed tomography myelography showed epidural and paravertebral masses on right side, with widening of the ipsilateral neural foramina at the C2-C3 level. On magnetic resonance images, the mass was isointense to soft tissue on T1-weighted images, hyperintense on T2-weighted images, and showed diffuse enhancement on GdTA enhanced T1-weighted images. The staged, combined posterior and anterior approach were done and the tumor mass was subtotally removed. During postoperative adjuvant chemotherapy with Cytoxane, Adriamycin, Vincristine, Prednisolone regimen, the patient died of severe compression of upper cervical cord by recurrent, extended tumor mass in the spinal canal.
Chemotherapy, Adjuvant ; Cyclophosphamide ; Doxorubicin ; Drug Therapy ; Female ; Humans ; Middle Aged ; Myelography ; Neck Pain ; Prednisolone ; Radiculopathy ; Sarcoma, Ewing* ; Spinal Canal ; Upper Extremity ; Vincristine

OBJECTIVE: Human papillomavirus (HPV) is strongly implicated as a causative agent in the etiology of cervical cancer. Of its gene products, E6 and E7 oncoproteins play major roles by inactivation of cellular p53 and pRb tumor suppressor proteins, respectively. However, it has been recently suggested that p53 and/or pRb-independent functions of E6 and E7 are involved in cervical carcinogenesis. The purpose of this study is to identify novel a cellular target, p73, of E6 and to determine how E6 inactivates p73 function, METHODS: The interaction between E6 and p73 were identified by the yeast two-hybrid assay in vivo and the GST pull-down assay in vitro. The function of the interaction was determined by transient transfections using p21 promoter-CAT reporter plasmid. The molecular mechanism underlying the functional significance of the interaction was further assessed by in vivo and in vitro protein degradation assays, and gel mobility shift assays. RESULTS: Yeast two-hybrid and GST pull-down assays indicate a physical interaction between p73 and either HPV-16 or HPV-11 E6 proteins in vivo and in vitro, respectively. Transactivation domain (amino acid residues 1-49) is found to be absolutely required for this interaction. Transient co-expression of E6 significantly inhibits the p73-mediated activation of p21WAF1 promoter in a p53-defective C33A cell line. Using Ga14-p73 fusion protein, we demonstrate that E6 inhibition of p73 transactivation function is independent of sequence-specific DNA binding, which is confirmed by direct electrophoretic mobility shift assay. Moreover, E6 inhibits p73 function by interfering with the activity of the amino-terminal activation domain. The protein degradation assays in vivo and in vitro indicate that p73, unlike p53, is not susceptible to E6-dependent proteolysis. CONCLUSION: Throughout this study, we identified p73 as a novel cellular target of HPV-E6 protein and found that E6 binds p73 through the amino-terminal transactivation domain, and inhibits its transactivation function independent of the protein degradation and DNA binding. These overall results, consequently, suggest that in addition to the inactivation of p53, the functional interference of p73 by HPV-E6 may, at least in part, contribute to E6-mediated cellular transformation.
Carcinogenesis ; Cell Line ; DNA ; Electrophoretic Mobility Shift Assay ; Human papillomavirus 11 ; Human papillomavirus 16 ; Humans ; Oncogene Proteins ; Plasmids ; Proteolysis ; Transcriptional Activation ; Transfection ; Tumor Suppressor Proteins ; Two-Hybrid System Techniques ; Uterine Cervical Neoplasms ; Yeasts

We investigate the serial change of the bone density of the lengthening sites in distraction osteogenesis in long bone lengthening of the lower extremity by measuring the pixel value of the PACS(Picture Archiving Communication System). The purpose of this study was to find the clinical implication of the pixel value in PACS in the distraction osteogenesis. The number of the distraction sites were 22 in tibia and 16 in femur. The average distraction length was 4.5cm ranged between 2.1cm and 7.0cm in femur, 4.1cm ranged hetween 1.9cm and 6.8cm in tibia. When the image were sent to the PACS workstations, they were directly interfaced to the workstation without any processing. The absolute and the relati ve pixel values of cortical bones of the original and the lengthening sites repr sented in workstation of PACS were obtained by average value measuring 3 times by 3 different persons. The average absoiute pixel value of the original cortical bone near distraction site was not significantly changed, maintaining 575+/-6 in femur, and 570+/-7 in tibia. The absolute pixel vaIues in AP and lateral view were not significantly changed until 6 week/cm, but rapidly increased after 7 week/cm hoth in the tibia and the femur. The relative pixel value of the lengthening sites were more than 95% in three of the four cortices at the time of the removal of the external fixators. in conclusion, the pixel value of the PACS can be a rapid, simple and easy method for detection of the change of the bone density in distraction osteogenesis.
Bone Density* ; Bone Lengthening* ; External Fixators ; Femur ; Humans ; Lower Extremity* ; Osteogenesis, Distraction* ; Tibia

Open carpal tunnel release has been the standard method of sumical treatment of carpal tunnel syndrome. Recently endoscopic carpal tunnel release has been introduced and is heing used by many authors. The advantages of this new technique are less postoperative pain, rapid restoration of power and rapid return-to-work. However many considerate authors, in spite of these advantages. insist that the inevitahle risk of neurovascular injury during the endoscopic procedure should not he underestimated. The purpose of our study is to compare the clinical results of endoscopic carpal tunnel release with those of open release. 20 open carpal tunnel releases in 16 patients and 15 endoscopic carpal tunnel reieases (single-portal technique) in 11 patients were performed hy the first author. Preoperative conditions of both groups are not different. Authors compared the clinical results between the two groups with some parameters. The overall clinical results were not different significantly hetween two groups. Rapid return-to-work(36 days in endoscopic group versus 60 days in open group) and less postoperative scar and pillar pain in endoscopic group were demonstrated. However, the major complication of one median nerve injury in endoscopic group seemed to overweigh these some benefits. We suggest that the standard operative technique for carpal tunnel syndrome should be open carpal tunnel release and more considerations should be takcn in choosing endoscopic method because of its inherent risk.
Carpal Tunnel Syndrome ; Cicatrix ; Humans ; Median Nerve ; Pain, Postoperative ; Return to Work

No abstract available.
Hand* ; Regional Blood Flow*

No abstract available.

Real-time ultrasongraphy is a simple, accurate, noninvasive and potentially valuable means of studying gallbladder size and emptying. The authors calculated ultrasonographically the ejection fraction of 80 cases of normally functioning gallbladder on oral cholecystography, from June 1983 to April 1984, at the department of radiology, Hangang Sacred Heart Hospital. The results were obtained as follows; 1. Ultrasongraphic Ejection Fraction at 30 minutes after the fatty meal was 73.1+-16.85. 2. There was no significant difference in age and sex, statistically.
Cholecystography ; Gallbladder ; Heart ; Meals