BACKGROUND: The combination of Philadelphia chromosome (Ph) and monosomy 7(-7) was rarely observed in acute lymphoblastic leukemia (ALL). With the results from immunophenotyplc and molecular analysis, Philadelphia chromosome positive ALL with monosomy 7[Ph(+)/-7] has been considered that it may be derived from neoplastic transformation at the pluripotent stem cell level. We compared the clini-cal, laboratory, and hematological findings between 5 cases of Ph(+)/-7 and 5 cases of Ph(+) without monosomy 7 [Ph (+) /N7]. METHODS: During the period from January, 1995 to December, 1996, total 72 cases of ALL were confirmed among 259 cases of hematologic malignancy with bone marrow cytogenetic analysis. Among 72 ALL cases, 5 cases of Ph(+)/-7(monosomy 7 or 7q abnormalities) were compared with Ph only or Ph without monosomy 7(ph(+)/N7] on the hematological, immunophenotypic, other laboratory, clinical findings and event ree survival (EFS) The karyotyping of the bone marrow specimens was analysed byshort-term unsynchronized culture methods such as overnight colcemid treatment and 24 hours incubation following ethidium bromide treatment. RESULTS: The mean age of Ph(+)/-7 was 30.6+/-12.8 years, and it was significantly different from that of Ph(+)/N7 (p=0.009), Four cases of Ph(+)/-7 were classified as ALL L2 subtype, and 2 cases revealed CNS involvements. Immunophenotyping was positive in CD10, CDl9, CD2O, CD22 and HLA-DR. But one case revealed e-B-lymphoid lineage with positivity in CD34, CDl3, and CD33. The response to chemotherapy and EFS was very poor in Ph(+)/-7 group, and the mean EFS was 3.2+/-1.9 months(p=0.014). All of cases showed induction on failure in chemotherapy, relapsed with bone marrow, CNS and extramedullary involvements, and expired due to sepsis. CONCLUSIONS: Ph(+)/-7 ALL had very Poor clinical course with being resistant to chemotherapy and unfavorable prognosis, revealed L2 subtype by FAB classification, and was slightly older in ages compared with Ph(+)/N7 ALL.
Bone Marrow ; Classification ; Cytogenetic Analysis ; Demecolcine ; Drug Therapy ; Ethidium ; Hematologic Neoplasms ; HLA-DR Antigens ; Hydrogen-Ion Concentration ; Immunophenotyping ; Karyotyping ; Monosomy* ; Philadelphia Chromosome* ; Pluripotent Stem Cells ; Precursor Cell Lymphoblastic Leukemia-Lymphoma* ; Prognosis ; Sepsis

No abstract available.
Hernia, Diaphragmatic* ; Stomach Volvulus*

Osteochondromadevelop most commonly at distal femur, proximal humerus and proximal tibia, but the rib osteochondroma was reported less commonly. In this report, scapular snapping syndrome complicated by adventitious bursa and soft tissue pseudotumor surrounding the osteochondroma of the 6th rib body was treated successfully by surgical excision of them. We report this rare case with reviewing the relevant literature.
Femur ; Humerus ; Osteochondroma* ; Ribs* ; Shoulder* ; Tibia

Microsatellites are short nucleotide repeat sequences present throughout the human genome. Alterations of microsatellites, comprising extra or missing copies of these se quences, have been termed microsatellite instability(MSI, genetic instability, replication errors, RER(+) phenotype). To date, at least four genes involved in DNA mismatch repair, hMSH2, hMLH1, hPMS1 and hPMS2, are thought to account for the observation of microsatellite instability in tumor from Hereditary nonpolyposis colorectal cancer (HNPCC) patients. The genetic defect responsible for the MIN+ phenotype in sporadic colorectal cancer, however, has yet to be clearly delineated. The purpose of this study was to determine the presence of MSI in sporadic cancer and to correlate its occurrence with clinicopathological parameters, we have studied six microsatellite loci by use of polymerase chain reaction amplification and denaturing polyacrylamide gel electrophoresis. We found that 20%(9 of 46 cases) sporadic colorectal cancers showed RER at two or several loci(RER+). Microsatellite instability was associated with location of the tumor in the proximal colon 66%(6 of 9 cases) and with poorly differentiated tumor phenotype 56%(5 of 9 cases). In order to better understand the role of somatic alterations within hMSH2 in the process of colorectal tumorigenesis, we examined the most conserved regions(codon 598~789) of this gene in nine patients with MIN spotadic colorectal cancer. 6 patient of RER(+) colorectal ca. patients had a polymorphism which was a T to C base change in the intron sequence at -6 position of the splice acceptor site at the 5'end of exon 13. This particular sequence variation is a polymorphism rather than a mutation which increase cancer susceptability. These data suggest that the genetic instability is detect ed in some colorectal cancers and play an important role in the pathogenesis of sporadic colorectal cancer.
Carcinogenesis ; Colon ; Colorectal Neoplasms* ; Colorectal Neoplasms, Hereditary Nonpolyposis ; DNA Mismatch Repair ; Electrophoresis, Polyacrylamide Gel ; Exons ; Genome, Human ; Humans ; Introns ; Microsatellite Instability* ; Microsatellite Repeats* ; Phenotype ; Polymerase Chain Reaction ; RNA Splice Sites

The present study was attempted to investigate and compare the antioxidant potency of several well-know flavonoids, antioxidant vitamin and commercially available popular beverages. The antioxidant potency was assessed by the effect on reducing oxidative DNA damage of human lymphocytes. Cellular oxidative DNA damage was measured by SCGE (single-cell gel electrophoresis), also known as comet assay. Lymphocytes were pre-treated for 30 minutes with wide ranges of doses of apigenin, kaempferol, luteolin, myricetin, rutin, quercetin, alpha-tocopherol (10,25,50,100,200,500,1000 micrometer) ,green tea extract or grape juice (10,50,100,250,500,1000 microgram/mL) followed by a H2O2(100 micrometer) treatment for 5 min as an oxidative stimulus. The physiological function of each antioxidant substance on oxidative DNA damage was analyzed as tail moment (tail length X percentage migrated DNA in tail) and expressed as relative DNA damage score after adjusting by the level of control treatment. Cells treated with H2O2 alone (positive control) had an extensive DNA damage compared with cells treated with phosphate buffered saline (PBS, negative control) or pre-treated with all the tested samples. Of all the six flavonoids, quercetin was the most potent antioxidant showing the lowest ED50 of 8.5 microgram/mL (concentration to produce 50% protection of relative DNA damage). The antoxidant potency of individual flavonoids were ranked as follows in a decreasing order; luteolin (18.4 microgram/mL), myricetin (19.0 microgram/mL) , rutin (22.2 microgram/mL) , apigenin (24,3 microgram/mL) , kaempferol (25.5 microgram/mL). The protective effect of alpha-tocopherol was substantially lower (highest ED50 value of 55.0 microgram/mL) than all the other flavonoids, while the protective effect was highest in green tea and grape juice with low ED5O value of 7.6 and 5.3, respectively. These results suggest that flavonoids, especially quercetin, and natural compounds from food product, green tea and grape juice, produced powerful anti-oxidative activities, even stronger than alpha-tocopherol. Taken together, supplementation of antioxidants to lymphocytes followed by oxidative stimulus inhibited damage to cellular DNA, supporting a protective effect against oxidative damage induced by reactive oxygen species.
alpha-Tocopherol ; Antioxidants ; Apigenin ; Beverages ; Comet Assay* ; DNA Damage* ; DNA* ; Flavonoids* ; Humans ; Luteolin ; Lymphocytes* ; Quercetin ; Reactive Oxygen Species ; Rutin ; Tea ; Vitamins ; Vitis

Surgery is the mainstay of treatment for symptomatic pelvic organ prolapse (POP), and a variety of procedures can be performed to correct POP. When deciding on the proper surgical procedure, the surgeon must take into consideration the individual patient's risk for surgical complication and prolapse recurrence and her preference. This review will discuss the key issues faced in the surgical decision-making process for POP and recommendations based on the current scientific evidence.
Decision Making ; Pelvic Organ Prolapse ; Prolapse ; Recurrence

No abstract available in English.

The demand for uterine preservation in pelvic reconstructive surgery for uterovaginal prolapse is steadily increasing, and several procedures have been introduced, such as sacrospinous hysteropexy, uterosacral hysteropexy, sacrohysteropexy, and hysteropectopexy. However, the benefits and risks of uterine-preserving surgeries are not well understood. This review discusses the current evidence surrounding uterine-preserving surgery for uterovaginal prolapse repair. This may help surgeons and patients have a balanced discussion on how and on whom to perform uterine-preserving surgery.

PURPOSE: To evaluate the clinical characteristics of intertrochanteric or subtrochanteric fractures associated with ipsilateral femoral shaft fractures and assess the surgical outcomes of a novel, closed intramedullary nailing surgical approach designed to minimize fixation failure. MATERIALS AND METHODS: Between May 2013 and April 2017, 31 patients with intertrochanteric or subtrochanteric fractures associated with ipsilateral femoral shaft fractures treated with closed intramedullary nailing or long proximal femoral nail antirotation (PFNA) were enrolled in this study. Preoperative data included age, sex, injury severity score, body mass index, location of shaft fracture, injury mechanism, accompanying traumatic injury, walking ability before injury, and surgical timing. Perioperative outcomes, including follow-up period, types of intramedullary nails, number of blocking screws used, operation time, and blood loss were assessed. Radiologic outcomes, including union rate, time from surgery to union, and femoral shortening, and clinical outcomes, including hip flexion, walking ability, and Harris hip score were also evaluated. RESULTS: A total of 29 unions (93.5%) were achieved. The time to union was 16.8 months (range, 11–25 months) for hip fractures (15.7 weeks for intertrochanteric fractures and 21.7 weeks for subtrochanteric fractures) and 22.8 months for femoral shaft fractures. There were no significant differences in surgical outcomes between the two groups except for type of intramedullary nail. CONCLUSION: Closed intramedullary nailing in the treatment of intertrochanteric or subtrochanteric fractures associated with ipsilateral femoral shaft fractures may be a good surgical option. However, fixation of femoral shaft fractures might not be sufficient depending on the implant design.
Body Mass Index ; Follow-Up Studies ; Fracture Fixation, Intramedullary ; Hip ; Hip Fractures ; Humans ; Injury Severity Score ; Walking

The incidence of female voiding dysfunction is increasing nowadays and is getting more of attention with the aging society. Various treatment methods have been applied to treat stress urinary incontinence, overactive bladder, and voiding difficulty. However, surgery for stress urinary incontinence, medication and bladder training for overactive bladder, and intermittent self-catheterization to treat voiding difficulty remain as the mainstay of management. These standard methods cannot be applied to all patients, and does not always lead to successful outcomes, suggesting that we should acquire the correct knowledge in possible ways to treat these patients. In this review, we will focus on the treatment effects of conservative, medical, and surgical treatment which are currently available, based on the evidence of literatures, and address the promising therapeutic modalities such as new minimally invasive surgical procedures for stress urinary incontinence, botulinum toxin A injection, electrical stimulation (sacral neuromodulation, posterior tibial nerve stimulation), radiofrequency therapy, new pharmacologic agents for overactive bladder and voiding difficulty.
Aging ; Botulinum Toxins ; Electric Stimulation ; Female ; Humans ; Incidence ; Surgical Procedures, Minimally Invasive ; Tibial Nerve ; Urinary Bladder ; Urinary Bladder, Overactive ; Urinary Incontinence