Gerstmann syndrome that was caused by a traumatic origin was very rare. We have reported a case of typical Gerstmann syndrome which was caused by a localized head injury. The case showed finger agnosia, right-left disorientation, acalculia and dysgraphia. And also the case revealed amnesic dysphasia and autotopagnosia. The lesion was an egg-shell typed depressed fracture(4 cm in diameter) of the left inferior parietal bone associated with the intracerebral hematoma in the lower parietal lobe which seemed to be the transitional area of the angular gyrus and the second occipital convolution.
Agnosia ; Agraphia ; Aphasia ; Craniocerebral Trauma ; Dyscalculia ; Gerstmann Syndrome* ; Hematoma ; Parietal Bone ; Parietal Lobe

We have reported a case of dumbbell shaped maligfnant melanoma which developed and formed a large mass(2x7x5 cm) in the frontal scalp at the midline, eroded the bone, and invaded directly into the epidural region through the bony defect and formed another large tumor(3x7x8 cm) in the frontal fossa. Several small nodules of malignant melanoma were found in the anterior chest wall, too. In spite of the huge mass in the frontal fossa the case developed only dull headache without any neurological deficits. The frontal mass was successfully excised, of which pathological finding showed malignant melanoma.
Cytochrome P-450 CYP1A1 ; Headache ; Melanoma* ; Scalp ; Thoracic Wall

OBJECTIVE: The aim of this study is to evaluate the role of tumor suppressor genes, p53 and Rb gene, as well as apoptosis in the carcinogenesis of ovarian epithelial tumors. And the value of these factors as prognostic markers to tell the transformation of borderline tumors to overt carcinomas is also studied. METHOD: Thirty cases of ovarian epithelial benign and borderline tumors and invasive carcinoma were used and the expression of the p53 protein and Rb gene protein were evaluated by immunohistochemical method. The apoptosis was evaluated by TUNNEL method. RESULTS: Positive rate of p53 expression in benign, borderline and invasive tumors were 0, 28, and 94 %, respectively. And also, p53 was highly expressed in chemoresistant cases (2/3), in residual tumor (4/5) and in recurred cancer (2/2). Rb protein was partly lost in the borderline tumors, but the rate of Rb protein loss in both borderline tumors and invasive carcinomas were similar. Apoptosis were more active in overt carcinomas than in borderline and benign tumors. In borderline tumors, p53 protein was expressed as 28.6% positivity, and apoptosis was expressed as 28.6% negativity, which showed indirectly that there was apoptosis induction effect of p53. In ten cases of invasive carcinomas showing highly expressed p53, apoptosis revealed all positive reaction except 2 cases, and Rb protein revealed variously. This result supported the apoptosis imduction effect of p53, but it was difficult to find the association of expression degree between the two tumor supressor genes CONCLUSION: In conclusion, the values of p53 is a discriminating factor of malignancy from benign and the expression of p53 is related with clinical aggressivity such as recurrence and residual cancers. Apoptosis are more active in overt carcinoma than in benign & borderline tumor, and in borderline tumor the expression of p53 is related to apoptosis induction which results to carcinomatous change.
Apoptosis* ; Carcinogenesis ; Genes, Retinoblastoma* ; Genes, Tumor Suppressor ; Neoplasm, Residual ; Recurrence ; Retinoblastoma Protein

Nasal lymphoma is an uncommon neoplasm in the sinonasal tract. The NK/T-cell type of lymphoma is more commonly found in Asian populations. However, B-cell lymphoma is more common in the western countries whereas it is rare in Asia. Recently, we experienced two cases of sinonasal B-cell lymphoma, which are rare cases in Korea, one in an advanced stage and one in an early stage. Both patients had no specific nasal symptoms or systemic B symptoms (fever, night sweat, weight loss). As our cases demonstrate, diagnosis of B cell lymphoma is often delayed in many cases because B-cell lymphoma does not show any specific symptoms. Thus, careful physical examination and biopsy under suspicion of malignancy are important for early diagnosis of nasal lymphoma.
Asia ; Asian Continental Ancestry Group ; B-Lymphocytes ; Biopsy ; Humans ; Korea ; Lymphoma ; Lymphoma, B-Cell ; Physical Examination ; Sweat

BACKGROUND AND OBJECTIVES: The pathogenesis of cholesteatoma behind an intact tympanic membrane remains controversial. Squamous metaplasia of the middle ear mucosa is thought to be a possible mechanism in such cases. However, to date, no definitive experimental results have proved the association. This study was undertaken to investigate whether normal human middle ear epithelial (NHMEE) cells undergo keratinizing squamous differentiation in retinoic acid (RA)-deficient culture. MATERIALS AND METHOD: We examined the morphological differences between RA-deficient and RA-sufficient cultures, and determined the expressions of the mucin gene and cornifin-alpha mRNAs as indicators of mucous and squamous differentiation, respectively. RESULTS: Histomorphologically, the NHMEE cells differentiated into a keratinizing squamous epithelium in RA-deficient culture. In addition, the expressions of mucin gene 5AC (MUC5AC) and MUC8 mRNA were suppressed, and the expression of cornifin-alpha mRNA increased progressively as a function of differentiation in RA-deficient culture. CONCLUSION: Our study shows that RA depletion induces keratinizing squamous differentiation in NHMEE cell culture.
Cell Culture Techniques ; Cholesteatoma ; Ear, Middle* ; Epithelial Cells* ; Epithelium ; Humans* ; Metaplasia ; Mucins ; Mucous Membrane ; RNA, Messenger ; Tretinoin* ; Tympanic Membrane

PURPOSE: Most of the former studies about the occlusal contact patterns during the mandibular movement focused on foreigner. The purpose of this study is analyzing the occlusal contacts of young Koreans by using T-Scan system. MATERIALS AND METHODS: The sample size was 87 and the occlusal contacts of each right and left lateral movements were measured from the maximum intercuspation to the 3mm excursive position for three times respectively. All of the occlusal contacts were double checked through the thin metal foil. The results were categorized as two; 1) considering occlusal contact patterns on working side only, 2) considering occlusal contact patterns on working and nonworking sides. RESULTS: The results showed that the nonworking side occlusal contacts play major roles in the lateral mandibular movement. In both cases of considering with and without the nonworking side occlusal contacts, the group function was the most prevalent. In the working side, the contacts were the most frequent in canine and the frequency of contacts was decreased as the distance was increased from canine to molar. In the nonworking side, the contacts were the most frequent in second molar. And the gender factor was statistically significant (alpha=.05), as females have more nonworking side occlusal contacts in this study. CONCLUSION: Among the three factors of anterior guidance, the group function was the most dominant factor. The analysis of 87 samples showed that canine contact was the most frequent in the working side and second molar contact was the most common in the nonworking side.
Emigrants and Immigrants ; Female ; Humans ; Molar ; Sample Size

Severe dental attrition causes pathological changes of the tooth, imbalanced occlusion, and functional and aesthetic complications and can also result in a decrease in occlusal vertical dimension that can incur temporomandibular joint and muscular complications. Before restoring the vertical dimension with full-mouth prosthetic restorations, it is important to determine the amount of vertical lifting through complete diagnosis. In this study, a 59 year-old male patient with generalized attrition and fracture of teeth was treated with full-mouth zirconia prosthetic restoration in order to recover vertical dimension and aesthetics. Through the analysis of physiologic rest position and inter-canine distance, the treatment was planned for lifting 3 mm in vertical dimension. Interim crown were fabricated after full-mouth wax up, having the patient use for 6 months. The final monolithic and bilayered zirconia restorations were completed. The patient showed satisfaction in function and aesthetics for 18 months of follow-up since delivering the final restorations.
Crowns ; Diagnosis ; Esthetics ; Follow-Up Studies ; Humans ; Lifting ; Male ; Mouth Rehabilitation* ; Mouth* ; Temporomandibular Joint ; Tooth Attrition ; Tooth Fractures* ; Tooth Wear* ; Tooth* ; Vertical Dimension*

PURPOSE: Colorectal resection for elderly patients is associated with significant morbidity and mortality. It is still unclear whether or not laparoscopic colorectal resection (Lap CR) is indicated in elderly patients. The aim of this study is to evaluate the outcome of colonic surgery in elderly patients and to assess the feasibility and safety of laparoscopic colorectal surgery in elderly patients. METHODS: Patient characteristics and perioperative and pathologic data on 295 patients who underwent Lap CR for cancer from Jan. 2004 to Aug. 2011 were prospectively collected. Exclusion criteria were emergency and palliative by-pass surgery. Outcomes for elderly patients (> or =75 years) were compared with those of younger patients (<75 years). RESULTS: In comparison of 257 younger patients (<75 years, median age 61 years), 38 elderly patients (> or =75 years, median age 79 years) showed a greater proportion off emale gender (52.6% vs. 37.0%, p=0.065) and American Society of Anesthesiologists score 2~3 (97.3% vs.42.0%, p<0.001). No differences in tumor location, median operative time, conversion rate, duration of hospital stay, and perioperative complications (23.7% vs. 30.0%, p=0.427) were observed between the two groups. Distributions of American Joint Committee on Cancer stages and number of harvested lymph nodes were comparable between groups. CONCLUSION: Although elderly patients are more likely to be affected by co morbidities, postoperative outcome in this group after Lap CR is comparable with that of younger patients. Use of Lap CR in elderly patients is safe, and is associated with a low morbidity. It should be also regarded as the optimal approach for very elderly patients.
Aged ; Colon ; Colorectal Neoplasms ; Colorectal Surgery ; Emergencies ; Humans ; Joints ; Laparoscopy ; Length of Stay ; Lymph Nodes ; Operative Time ; Prospective Studies

This study evaluated the pharmacokinetic profile and therapeutic efficacy of piroxicam (PX), a long acting non-steroidal anti-inflammatory drug for the treatment of arthritis, following intra-articular (IA) injection in comparison to the pharmacokinetic profile and therapeutic efficacy of PX after intramuscular (IM) injection. In the pharmacokinetic study in rats, systemic exposure and pharmacokinetic parameters of PX after a single IA dose were compared with systemic exposure and pharmacokinetic parameters of PX after administration of the same dose IM (0.6 mg/kg). The anti-inflammatory and analgesic effects of IA PX were evaluated simultaneously in a monoiodoacetate-induced osteoarthritis rat model. The plasma PX concentration rapidly rose following IA injection, and it was comparable to the plasma PX concentration following IM injection, suggesting the rapid efflux of the drug molecule from the joint cavity. However, in the efficacy study, the IA PX administration significantly reduced the knee swelling by reducing the level of prostaglandin E2 in the joint, compared to that following administration of IA vehicle and after administration of the IM PX dose. In addition, we found that the anti-inflammatory and anti-nociceptive efficacies of IA PX were synergistically increased upon co-treatment with hyaluronic acid (HA), a potent agent for the treatment of osteoarthritis, at the weight ratio of 1:1 or 1:2, and these effects were more pronounced than those following administration of HA or PX alone. In conclusion, this study demonstrated the efficacy of the IA use of PX alone and/or in combination with HA in osteoarthritis.
Animals ; Arthritis ; Dinoprostone ; Hyaluronic Acid ; Injections, Intra-Articular ; Joints ; Knee ; Models, Animal ; Osteoarthritis ; Pharmacokinetics* ; Piroxicam* ; Plasma ; Rats*

PURPOSE: After adolescent varicocelectomy, there is a lack of standards for the follow-up and evaluation of the catch-up growth. We investigated the time to achieve catch-up growthaccording to the difference in testicular volume as compared to the contralateral testis. MATERIALS AND METHODS: From 1997 to 2004, 51 patients with at least a 1cc difference in testicular volume, as compared to the contralateral testis, and for whom the follow up was longer than 6 months were the subjects of this study. Testicular volume was measured using a Prader orchidometer and catch-up growth was defined as the equalization of testicular volume to the contralateral testis. The time to catch-up growth was investigated. RESULTS: 47 of 51 patients had a GIII varicocele and 4 had a GII varicocele. The mean difference in testicular volume was 2.9+/-1.8cc. Catch-up growth was noted in 33(64.7%) and the mean time to catch-up growth was 14.7 months. Catch-up growth occurred in 52.2%, 67.8 and 74.3% of the patients at 1, 2 and 3 years, respectively(the Kaplan-Meier). The time to catch-up growth was significantly shorter in those with a testicular volume difference of less than 3cc prior to operation(p=0.02, the log-rank test). There was no significant difference according to the age when surgery was performed(<12 years vs. >or=12 years, p>0.05, the log-rank test). CONCLUSIONS: Catch-up growth following varicocelectomy in adolescents can be expected in about 65% of patients and this occurs within 2 years for most patients. The preoperative testicular volume difference is associated with the speed of the catch-up growth. However, whether recovery of testicular volume means recovery of testicular function needs further study.
Adolescent* ; Follow-Up Studies ; Humans ; Testis ; Varicocele