TGF-p receptor mutation is now considered as one of the carcinogenic process of many tumors. To evaluate whether there is an abnormality in TGF-p type II receptor in osteosarcoma cell lines, we performed Northern analysis, cross-linking assay, luciferase activity and TGF-p growth inhibition assay in four osteosarcoma cell lines: G292, U202, HOS and SaOS. We also transfected the tumor cells with normal TGF-p type II receptor sequence to find if there is a possibility of gene therapy in osteosarcoma. In Northern analysis, Type II receptor expressions were decreased at SaOS, U202 and HOS cell lines. In cross-linking assay, all four cell lines didnt show type II receptor at their cell surface. The growth of these tumor cells were not suppressed by TGF-p. From these findings, we concluded that the normal production of TGF-p type II receptor was impaired in osteosarcoma. The transfection of these tumor cells with normal type II receptor sequence restored growth inhibition by TGF-p. This means even though TGF-p type II receptor is abnormal in osteosarcoma, we can restore its function by transfection of normal sequence. We think that the TGF-p type Il receptor gene therapy can be one of the treatment method for osteosarcoma in the future.
Cell Line* ; Genetic Therapy ; Luciferases ; Osteosarcoma* ; Transfection

From May 1991 to December 1993, 30 male bladder cancer patients with 34 to 68 years old age (mean age 52.4 years) underwent bladder replacement with the ileocolic neobladder. A divided segment of ileum and colon was used to create a neobladder after radical cystectomy with a cecourethral anastomosis to provide volitional voiding with continence. Urodynamic studies were followed up 3, 6, l2 and 18 months postoperatively. The mean maximal reservoir capacity was 420+/-87.7, 553+/-65.3, 565+/-60.3, 563+/-53.5ml, mean maximal reservoir pressure was 33.2+/-7.5, 24.2+/-6.1, 24.0+/-5.9, 23.1+/-6.3cmH2O, mean maximal urethral closure pressure was 57.9+/-9.5, 61.3+/-7.6, 61.0+/-7.3, 61.5+/-6.9cmH2O, maximal flow rate was 23.2+/-7.2, 24.3+/-5.8, 24.0+/-6.1, 24.1+/-5.4ml/s and residual urine was 40.0+/-10.3, 35.0+/-7.8, 24.0+/-6.1, 24.1+/-5.4ml/s. The daytime continence rate was 100% and the nighttime continence rate was 93% at 6 months postoperatively. With its very good functional results and its ease of performance, ileocolic neobladder may be one of the ideal urinary diversion for bladder substitution after radical cystectomy.
Aged ; Colon ; Cystectomy ; Humans ; Ileum ; Male ; Urinary Bladder ; Urinary Bladder Neoplasms ; Urinary Diversion ; Urodynamics*

Although there has been recently noted a nation-wide spread of Trichophyton verrucosum infection in cattle associated with promoted stock raising and dairy farming, there were no case reports in Korean dermatologic literature describing the characteristic clinical features of tinea barbae caused by that particular fungus. We report 3 cases of tinea barbae due to T. verrucosum that developed in male stock farmers breeding cattle. One Patient acted 37, experienced acutely inflamed bo99y tumors on the chin and sub-mandible. The others aged 43 and 46 experienced inflammatory lesions with multiple follicular pustules, crusts and loss of hairs on their upper lips. They were successfully treated with oral griseofulvin and local antifungal ointment combined with short-term oral antibiotics or corticosteroid for about one month.
Animals ; Anti-Bacterial Agents ; Breeding ; Cattle ; Chin ; Fungi ; Griseofulvin ; Hair ; Humans ; Lip ; Male ; Tinea* ; Trichophyton*

No abstract available.
Anoxia* ; Neurons*

STUDY DESIGN: This study is a prospective, clinical study assessing the efficacy of selective decompression of the level responsible in a two-level stenosis in accordance with the neurological findings defined by the gait load test with a treadmill. PURPOSE: To clarify the clinical features of multilevel lumbar spinal stenosis (LSS) regarding the neurological level responsible for the symptoms, neurogenic claudication, and outcomes of selective decompression. OVERVIEW OF LITERATURE: Most spine surgeons have reported that multilevel compression of the cauda equina induces a more severe impairment of the nerve function than a single-level compression. However, the clinical effects of multilevel LSS on the cauda equine and nerve roots are unknown. METHODS: A total of 21 patients with lumbar spinal canal stenosis due to spondylosis and degenerative spondylolisthesis were selected. The level responsible for the symptoms in the two-level stenosis was determined from the neurological findings on the gait load test and functional diagnosis based on a selective nerve root block. All patients underwent a prospective, selective decompression at the level neurologically responsible only. The average follow-up period was 2.6 years (range, 1 to 6 years). The postsurgical outcome was defined using the Visual Analogue Scale (VAS) at the post-gait load test, 2 weeks after surgery, 3 months after surgery and at the last follow up. RESULTS: Before surgery, the mean threshold distance and mean walking tolerance was 34.3 m and 113 m, respectively. All patients had neurogenic claudication and 19 of the patients had cauda equina syndrome, including hypesthesia in 11 cases, muscle weakness in 5 cases and radicular pain in 7 cases. Selective nerve blocks to determine the level responsible for the lumbosacral symptoms in 2 cases revealed a mean VAS score of 7.1, 2.61, 3.04, and 3.47 at the post-gait load test, 2 weeks after surgery, 3 months after surgery and at the last follow up, respectively. All subjects underwent surgery. After the operation, neurogenic claudication with or without cauda equna syndrome subsided in all patients. CONCLUSIONS: The gait load test allows an objective and quantitative evaluation of the gait characteristics of patients with lumbar canal stenosis and is useful for determining the appropriate level for surgical treatment.
Cauda Equina ; Constriction, Pathologic ; Decompression ; Evaluation Studies as Topic ; Follow-Up Studies ; Gait ; Humans ; Hypesthesia ; Muscle Weakness ; Nerve Block ; Polyradiculopathy ; Prospective Studies ; Spinal Canal ; Spinal Stenosis ; Spine ; Spondylolisthesis ; Spondylosis ; Walking

Ambulatory surgery is an established surgical system that all the procedures which are visiting hospital, undergoing surgery and recovery and returning home, performed on the same day. We evaluated our initial experiences to find out if there are any differences between ambulatory surgery and inpatient surgery especially during the perioperative period. We assessed the following 6 items: the degree of perioperative anxiety in parents, observation time in the recovery room, hospital charge, length of time to return to usual activities, postoperative complications and degree of postoperative satisfaction in parents. Between April 1995 and August 1996, we reviewed 30 patients who underwent ambulatory surgery (age: 1 mo-15.2 yrs, mean 5.8 yrs) - hydrocelectomy (16 cases), orchiopexy (10 cases), varicocelectomy (1 case), excision of cyst at urethral meatus (1 case) and circumcision (2 case). Then we compared the same parameters with those of 30 inpatient children who underwent similar surgical procedures (age: 7 mo-12 yrs, mean 3.8 yrs) - hydrocelectomy (15 cases) and orchiopexy (15 cases). The results were as follows: 1. There was no significant difference among the two groups in observation time at recovery room (p=0.381) and the time to return to normal activities (p=0.202).2. Ambulatory surgery group is more economical than the inpatient surgery group (p<0.05). 3. In ambulatory surgery group, the degree of perioperative anxiety in parents was higher than inpatient surgery group (p=0.001). However, postoperative satisfaction was higher than inpatient surgery group (p=0.001) with negligible complications, In conclusion, ambulatory surgery in pediatric urology was more advantageous than inpatient surgery with regards to postoperative satisfaction and alleviation of parental burden on time and money.
Ambulatory Surgical Procedures* ; Anxiety ; Child* ; Circumcision, Male ; Female ; Humans ; Inpatients* ; Male ; Orchiopexy ; Parents ; Perioperative Period ; Postoperative Complications ; Recovery Room ; Urology

Hepatocellular carcinoma (HCC) is one of the most common malignant tumors worldwide. Frequent sites of extrahepatic metastasis are the lung, adrenal gland, bone, etc. But, cutaneous metastasis from HCC is rare event. Several cases of subcutaneous seeding after percutaneous transhepatic biopsy or aspiration of liver were reported, however, most of these cases had solitary nodular lesion which was located at the biopsy site. We experienced a case of multiple cutaneous metastasis on whole body from HCC which was not related to percutaneous transhepatic biopsy of liver in a 34-ear-ld male patient. Thus, we report a case of multiple cutaneous metastasis from HCC with brief review of related literature.
Adrenal Glands ; Biopsy ; Carcinoma, Hepatocellular* ; Humans ; Liver ; Lung ; Male ; Neoplasm Metastasis*

OBJECTIVE: Recently, selective termination is employed in multifetal pregnancies, in the presence of an abnormal fetus, or in the complication of twin pregnancies. The purpose of this study is to evaluate effectiveness, safety of the tailored selective termination in multifetal pregnancies. METHODS: This study was retrospective and involved six cases. Indication of termination were 3 cases of structural anomalies (anencephaly, encephalocele, body stalk anomaly), 1 case of chromosomal anomaly (21 trisomy) and 2 cases of monochorionic twin complications (acardiac twin, twin to twin transfusion syndrome). RESULTS: We used KCL injection in 4 cases, they were all confirmed dichorionic twin, and in 2 cases of monochorionic twin, we used alcohol ablation of intra-abdominal umbilical artery in 1 case, and radiofrequency ablation of the cord in 1 case. CONCLUSION: All procedures were successful, and all normal infants were delivered in 3rd trimester. Tailored selective termination in 2nd trimester is effective and safe in abnormal multifetal pregnancies.
Catheter Ablation ; Encephalocele ; Female ; Fetofetal Transfusion ; Fetus ; Humans ; Infant ; Pregnancy ; Pregnancy Trimester, Second* ; Pregnancy, Twin* ; Retrospective Studies ; Umbilical Arteries

OBJECTIVE: To investigate the clinical characteristics of Korean JRA and the possible profiles related to prognosis and to compare these data to pre-existing occidental reports. METHODS: 140 cases of JRA patients were randomly selected from 1986 through 1995. Juvenile ankylosing spondylitis was excluded with the aid of modified New York criteria for ankylosing spondylitis. We used the classification of progression of rheumatoid arthritis (radiological stage III+IV / I+II+III+IV) as a index of prognosis. The study factors were sex, age, type, affected joints, degree of destruction of joint, anti-nuclear antibody (ANA), rheumatoid factor (RF), HLA-B27 and extra-articular manifestations. Chi-square test, One-way ANOVA test, and Pearson' s correlation coefficient were used as statistical methods. RESULTS: Our study show results as follows : (1) Systemic onset type (ll%) { polyarthritis subset (66%), oligoarthritis subset (34%) }, oligoarthritis onset type (62%) { sero (-) -HLA-B27 (+) subset (66%) , RF (+) subset (20%), not otherwise classified subset (14%) ANA(+)-chronic uveitis subset(O%) }, polyarthritis onset type (27%) { RF(+) subset (66%), not otherwise classified subset (34%) }, (2) Sex ratio was M:F=1.8:l. (3) Age of onset was 11+3.6 years. (4) Affected joints were knee, ankle, hand in decreasing order of frequency. (5) Patients show seropositivity of RF in 31%, HLA-B27 in 54%, ANA in 8%. (6) Chronic uveitis was observed in 7 cases (5%) (all oligoarthritis onset type, M:F=6:1, age of onset 11+4.3 years, ANA (0%), HLA-B27 (86%) , 2 cases leading to blindness. (7) Destructive bone change was significantly more prominent in female (p<0.01) , RF(+) (p<0.01), HLA-B27(-) (p<0.01) , polyarthritis onset type (p=0.02). CONCLUSIONS: In this study, we obtained interesting results that are somewhat different from Occidental data in sex ratio (male dominance), age of onset (older age) , profiles of HLA-B27 (high positivity in spite of low HLA-B27 positivity in Korean (about 2. 3%) , low rate of destructive change) , ANA (low positivity, older age of onset) , chronic uveitis (low incidence, male dominance, older age of onset, high association with HLA-B27, not associated with ANA) . This study suggests possible racial difference in clinical features of JRA. But for prove of racial difference, further multi-center trial and large scale epidemiological study should be done.
Age of Onset ; Ankle ; Antibodies, Antinuclear ; Arthritis ; Arthritis, Juvenile* ; Arthritis, Rheumatoid ; Blindness ; Classification ; Epidemiologic Studies ; Female ; Hand ; HLA-B27 Antigen ; Humans ; Incidence ; Joints ; Knee ; Male ; Prognosis ; Rheumatoid Factor ; Sex Ratio ; Spondylitis, Ankylosing ; Uveitis

PURPOSE: Mutation of the p53 gene seem to be the most common genetic changes in human malignancies. Recent studies have also shown p53 gene mutations in several premalignant conditions and preliminary data have suggested that p53 gene mutations may be involved in tumor progression. There is wide variation in reported incidence of p53 gene mutation in renal cell carcinoma, and its prognostic significance for this tumor is unknown. MATERIALS AND METHODS: This retrospective PCR-SSCP(the polymerase chain reaction of the single-strand conformation polymorphism) analysis and immunohistochemical study were designed to investigate the role of p53 gene mutation in renal cell carcinoma and to examine association between p53 gene mutation and tumor grade, clinical behavior and DNA ploidy. RESULTS: Forty eight renal cell carcinoma(RCC) specimens were analyzed. Mutations of p53 gene were detected in 8.3%(4/48) of tumors. There were significant correlation between the presence of the mutation of p53 gene and high tumor grade and DNA aneuploidy(p-value=0.016. 0.019). But no significant correlation between the presence of the mutations of p53 gene and sex, symptom and tumor stage. CONCLUSIONS: These results suggest that the mutations of p53 gene may not be significant in development of RCC but may be related to its progression or malignant transformation.
Carcinoma, Renal Cell* ; DNA ; Genes, p53* ; Humans ; Incidence ; Ploidies ; Polymerase Chain Reaction ; Retrospective Studies