A fetal rhabdomyomatous nephroblastoma is considered to be a predominantly monophasic mesenchymal variant of Wilms' tumor, which acts less aggressively than a conventional Wilms' tumor despite its much larger size. Bilaterality of this tumor in a nine month-old girl, however, may negatively affect the overall prognosis. A radical nephrectomy for bulky masses in the left kidney and a partial nephrectomy for right kidney with five small tumor masses was performed at the same time. Two small tumor masses in the upper part of right kidney were left behind because of preserving minimal renal functional capacity. Pathological study revealed a mixed type of nephroblastoma which was composed predominantly of mesenchymal components with fetal rhabdomyomatous differentiation. After post-operative chemotherapy with vincristine, actinomycin D and adriamycin, and radiotherapy(2,130 rad), residual tumor masses became a single tumor 5 cm in diameter and well demarcated, which was resected at 15 months after first operation when the size and renal function of remained right kidney was appropriate to resect out the residual tumor. The tumor resected out at second operation was entirely composed of scattered differentiated fetal skeletal muscle cells in the fibrovascular tissue. Only a few entrapped epithelial components were seen but no blastemal cornponents were present. Follow up abdominal CT and ultrasonographic examinations revealed no evidence of tumor recurrence. The girl has developed normally without disease.

PURPOSE: To evaluate the prevalence of the opacification of paranasal sinuses and to correlate the prevalence and severity of the sinus opacification with presence of upper respiratory infection (URI) in infants and children using CT. MATERIALS & METHODS: We analyzed CT scans of 162 children aged under 16 who have no signs and symptoms of paranasal sinusitis. Both sides of maxillary and ethmoidal sinuses were evaluated. We scored from 0 to 3 according to the degree of soft tissue opacification of each sinus and then summed up the scores of each sinus. We divided the children into 5 groups according to their age. We paid particular attention to the following respects: 1) the prevalence of the opacification of the paranasal sinuses in each group; 2) the difference in the prevalence between the children with and without URI ;3) the correlation between the severity of the sinus opacification and the presence of URI. RESULTS: Of 162 children, one or more paranasal sinus opacification was noted in 76(47 %):31(65%) less than 1 year old;11(52%) between 1 and 2 years old;16(53%) between 2 and 6 years old ;15(28%) between 6 and 12 years old;and 3(33%) above 12 years old. In children less than 1 year old, no significant difference in the prevalence of the sinus opacification was found between URI-positive(71%) and URI-negative(58%) subgroups. In chilren between 1 and 12 years old, although the prevalence of the sinus opacification in URI-positive subgroups was much greater than that in URI-negative subgroup, statistically significant difference was noted only in children between 2 and 6 years old. As to the correlation between the severity of the sinus opacification and the presence of URI, these was a statistically significant difference in children between 2 and 6 years old and between 6 and 12 years old. CONCLUSION: Although the exact pathophysiology is not fully understood, the opacification of the paranasal sinuses is not an uncommon finding at CT in children without the signs and symptoms of sinusitis. We think that the clinical correlation is essential in determining the diagnosis and treatment plan in cases that the sinus radiographs or CT scans show the abnormal findings.
Child* ; Diagnosis ; Humans ; Infant* ; Paranasal Sinuses ; Prevalence* ; Sinusitis* ; Tomography, X-Ray Computed

No abstract available.
Computer Simulation* ; Orthognathic Surgery*

No abstract available.
Computer Simulation* ; Orthognathic Surgery*

Complications after a median sternotomy incision, which is used currently in most open heart surgery, are serious, although it is infrequent. Reconstruction of the sternal defect resulting from dehiscence of median sternotomy is still big challenge to the most plastic surgeons. Since vascularized greater omentum was transposed to eliminate mediastinal wound problems, many vascularized regional muscle flaps became mainstay in reconstruction of median sternotomy wound. We treated 13 patients with median sternotomy dehiscence between October of 1993 and March of 1998. In two patients, the wound problems were so confined to superficial tissue that debrided and closed primarily. Eleven patients with deep wound infection were managed with vigorous debridement of all necrotic tissues and resultant defects were covered with regional muscle flaps: rectus myocutaneous flap(3) and bilateral pectoralis advancement flap(8). We used the pectoralis major advancement flaps without counter incision at humeral insertion site and the dissections were limited only medial to the anterior axillary line to preserve the axillary fold. In five patients with larger defects, we elevated muscle and cutaneous flaps separately to make these flaps more mobile. Large portion of two rectus abdominis flaps could not survive, whereas pectoralis advancement flaps had mo special wound problems. Only one patient developed fistula due to remained wire, regardless to flap surgery.
Debridement ; Fistula ; Humans ; Omentum ; Rectus Abdominis ; Sternotomy* ; Thoracic Surgery ; Wound Infection ; Wounds and Injuries

Clonorchiasis procucts diffuse dilatation of the small and medium sized intrahepatic bile ducts and its cholangiogram shows visualization of many bile ducts, especially, tertiary, quaternary, and more peripheral tributaries up to the 6th tributaries. In an attempt to clarify this cholangiographic sign quantitively, we counted the visualized smaller bile ducts in clonorchiasis and compared the number of visualized ducts in normal cholangiogram, recurrent pyogenic chlangitis and carcinoma of the extrahepatic ducts. In clonorchiasis the number of visualized smaller bile ducts was considerably geater than in normal subjects and recurrent pyogenic cholangitis, but there was no singnificant statistical differences in the number of visualized bile duct tributaries between clonorchiasis and carcinoma of the bile ducts. Thus it is considered that too many ducts sign is not a unique cholangiographic finding of clonorchiasis, but we believe that in the presence of this sign with other we l known cholangiographic findings, diagnosis of clonorchiasis is very easy.
Bile Ducts ; Bile Ducts, Intrahepatic ; Cholangitis ; Clonorchiasis* ; Diagnosis ; Dilatation

Adiponectin, an adipokine predominantly secreted from adipose tissue, exhibits diverse biological responses, including metabolism of glucose and lipid, and apoptosis in cancer cells. Recently, adiponectin has been shown to modulate autophagy as well. While emerging evidence has demonstrated that autophagy plays a role in the modulation of proliferation and apoptosis of cancer cells, the role of autophagy in apoptosis of cancer cell caused by adiponectin has not been explored. In the present study, we demonstrated that globular adiponectin (gAcrp) induces both apoptosis and autophagy in human hepatoma cell line (HepG2 cells) and breast cancer cells (MCF-7), as evidenced by increase in caspase-3 activity, Bax, microtubule-associated protein light chain 3-II (LC3 II) protein levels, and autophagosome formation. Interestingly, gene silencing of LC3B, an autophagy marker, significantly enhanced gAcrp-induced apoptosis in both HepG2 and MCF-7 cell lines, whereas induction of autophagy by rapamycin, an mTOR inhibitor, significantly prevented gAcrp-induced apoptosis in hepatoma cells HepG2. Furthermore, modulation of autophagy produced similar effects on gAcrp-induced Bax expression in HepG2 cells. These results implicate that induction of autophagy plays a regulatory role in adiponectin-induced apoptosis of cancer cells, and thus inhibition of autophagy would be a novel promising target to enhance the efficiency of cancer cell apoptosis by adiponectin.
Adipokines ; Adiponectin ; Adipose Tissue ; Apoptosis* ; Autophagy* ; Breast Neoplasms ; Carcinoma, Hepatocellular ; Caspase 3 ; Cell Line ; Gene Silencing ; Glucose ; Hep G2 Cells ; Humans ; MCF-7 Cells ; Metabolism ; Sirolimus

Leptin, an adipokine predominantly produced from adipose tissue, is well known to induce tumor growth. However, underlying molecular mechanisms are not established yet. While p53 has long been well recognized as a potent tumor suppressor gene, accumulating evidence has also indicated its potential role in growth and survival of cancer cells depending on experimental environments. In the present study, we examined if p53 signaling is implicated in leptin-induced growth of cancer cells. Herein, we demonstrated that leptin treatment significantly increased p53 protein expression in both hepatic (HepG2) and breast (MCF-7) cancer cells without significant effect on mRNA expression. Enhanced p53 expression by leptin was mediated via modulation of ubiquitination, in particular ubiquitin specific protease 2 (USP2)-dependent manner. Furthermore, gene silencing of p53 by small interfering RNA (siRNA) suppressed leptin-induced growth of hepatic and breast cancer cells, indicating the role of p53 signaling in tumor growth by leptin. In addition, we also showed that knockdown of p53 restored suppression of caspase-3 activity by leptin through modulating Bax expression and prevented leptin-induced cell cycle progression, implying the involvement of p53 signaling in the regulation of both apoptosis and cell cycle progression in cancer cells treated with leptin. Taken together, the results in the present study demonstrated the potential role of p53 signaling in leptin-induced tumor growth.
Adipokines ; Adipose Tissue ; Apoptosis ; Breast Neoplasms* ; Breast* ; Caspase 3 ; Cell Cycle ; Gene Silencing ; Genes, Tumor Suppressor ; Leptin ; RNA, Messenger ; RNA, Small Interfering ; Ubiquitin ; Ubiquitination

OBJECTIVE: This study investigates the safety and effectiveness of laparoscopic myomectomy by comparing with minilaparotomic myomectomy in terms of the operation time, hemorrhage, pain, complications and pregnancy rates after operation. METHOD: Total 56 patients who underwent myomectomy in Chonnam National University Hospital from January 1996 to December 2000 were included. 26 subjects underwent minilaparotomy and 30 subjects laparoscopic myomectomy respectively. The number, size and place of uterine myoma, the operation time required, hemoglobin reduction, and operation indication were compared. The frequency of analgesics application, the period without analgesics injection, complications, and pregnancy rates after operation were investigated. RESULTS: 1. The amount of hemorrhage and hemoglobin markedly decreased in laparoscopic myomectomy in comparison with minilaparotomy (P<0.01). 2. Analgesics were much less frequently used in laparoscopic myomectomy than minilaparotomy (P<0.01). Also Analgesics were injected for a significantly shorter period after laparoscopic myomectomy (P<0.01). 3. There was no significant difference in operation time, hospital period and complications rates between two groups. 4. Total 24 patients conceived after myomectomy. 12 of them belonged to minilaparotomy patients group and 13 patients to laparoscopic myomectomy group. 10 patients of the former and 11 of the latter were delivered of a baby through elective cesarean section and there was no significant difference. One to each group tried vaginal delivery, and there was no complication such as uterine rupture. CONCLUSION: Laparoscopic myomectomy is a safe and effective to treat uterine myoma and better than minilaparotomy in terms of post operative pain and hemoglobin.
Analgesics ; Cesarean Section ; Female ; Hemorrhage ; Humans ; Jeollanam-do ; Laparoscopy ; Laparotomy ; Leiomyoma* ; Pregnancy ; Pregnancy Rate ; Uterine Rupture

To evaluate the normal development of the paranasal sinuses in children with CT, authors prospectively studied with brain CT scans of 260 children without known sinus diseases, ranging in age from 7 days to 16 years. Maximal anteroposterior and transverse diameters(mm) and maximal cross-sectional area(mm2) of both sides of the maxillary sinus were measured with the aid of computer device. As to the ethmoidal and sphenoidal sinuses, we simply documented the presence of the aplastic ethmoidal sinus and calculated the age-incidence of the sphenoidal sinus pneumatization, respectively. There noted three phases in the development of the maxillary sinus. The anteroposterior and transverse diameters of the maxillay sinus increased nearly in parallel. The former was always greater than the latter. In no cases was the ethmoidal sinus aplastic and almost all sinuses were pneumatized even in infants as early as 7 days old. CT identified the conchal pattern of sphenoidal sinus pneumatization in infants as early as 11 days old. Sphenoidal sinus pueumatization was seen in 38% of the children under the age of 1 year, 82% of the children between the age of 1 and 2 years, and almost all children older than 2 years. The anteroposterior and transverse diameters of the maxillary sinus seem to reach the adult size by 8 years of age, and the conchal pattern of sphenoidal sinus pneumatization can be recognized earlier with CT than on the plain radiographs.
Adult ; Brain ; Child* ; Humans ; Infant ; Maxillary Sinus ; Paranasal Sinuses* ; Prospective Studies ; Tomography, X-Ray Computed