No abstract available.
Umbilical Cord*

BACKGROUND AND OBJECTIVES: Although several oncogenes have been implicated in cellular resistance to ionising radiation or anticancer drug, there is little known about clinical information relating oncogene expression with clinical response to chemoradiotherapy. Correlation between expression of cyclin D1 and Ki-67 and clinical response to chemotherapy and radiotherapy in advanced squamous cell carcinomas was investigated. DESIGN: Retrospective study. MATERIALS AND METHODS: Formalin-fixed, paraffin-embedded tumor materials of 36 patients with advanced SCC of head and neck (clinical stage III, IV) were analyzed by immunohistochemical method with cyclin D1 and MIB-1 monoclonal antibodies. All patients were treated with induction chemotherapy and 22 patients were followed by radiotherapy. RESULTS: Overexpression of cyclin D1 protein was found in 33% (12/36). The expressed range of Ki-67 was from 0% to 80.1%. Expression of cyclin D1 protein was higher in the non-response group than in the response group to chemotherapy, but was not correlated with radiotherapy response. The Ki-67 index was not associated with tumor response to chemotherapy and radiotherapy. CONCLUSIONS: These data suggest that overexpression of cyclin D1 would be a marker for the chemotherapy response, although not for the radiotherapy response, whereas Ki-67 index may not be associated with tumor response to the chemotherapy and not to the radiotherapy in advanced squamous cell carcinomas of head and neck.
Antibodies, Monoclonal ; Carcinoma, Squamous Cell* ; Chemoradiotherapy ; Cyclin D1* ; Cyclins* ; Drug Therapy* ; Head* ; Humans ; Induction Chemotherapy ; Neck* ; Oncogenes ; Radiotherapy* ; Retrospective Studies

BACKGROUND AND OBJECTIVES: The wild-type p53 protein activates different tumor suppressor genes, leading to the Gl arrest following DNA damage. P21 and bax play a pivotal role in the regulation of apoptosis. The authors wanted to find out the relationship among p53, p21 and bax and the correlation between the staining results and dinicopathologic factors. We also assessed their influence on survival in the oral cavity cancer. MATERIALS AND METHODS: Paraffin embedded tissue sections were made from squamous cell carcinoma of oral cavity from 46 patients. Tissue sections were immunohistochemically stained for the expression of p53, p21 and bax. Results were then compared with the size of primary tumor, lymph node metastasis and histopathalogic diffrentiation. The probability of survival was calculated by the Kaplan-Meier method. RESULTS: Immunoreactivity of the p53 and p21 were detected dominantly in the nuclei at various levels, and immunoreativity of bax was detected in the cytoplasm, The positive rates of p53, p21, and bax were 54.4%, 58.7%, 26.1%, respectively. The positive rate of p53 and the negative rate of bax expression were significantly increased with T-stage but were not affected by N-stage and histopathologic differentiation. P21 had no correlation with the T-stage, N-stage nor with pathologic differentiation. In the multivariate analysis, neither the single oncoprotein nor the combinations of p53, p21, bax had influence on survival statistically. CONCLUSION: The bax protein and mutant p53 protein can be a biological marker for primary tumor progression.
Apoptosis ; bcl-2-Associated X Protein* ; Biomarkers ; Carcinoma, Squamous Cell ; Cytoplasm ; DNA Damage ; Genes, Tumor Suppressor ; Humans ; Lymph Nodes ; Mouth ; Multivariate Analysis ; Neoplasm Metastasis ; Neoplasms, Squamous Cell* ; Paraffin ; Prognosis

OBJECTIVE: Obturator neuropathy is a rare condition. Many neurosurgeons are unfamiliar with the obturator nerve anatomy. The purpose of this study was to define obturator nerve landmarks around the obturator foramen. METHODS: Fourteen cadavers were studied bilaterally to measure the distances from the nerve root to relevant anatomical landmarks near the obturator nerve, including the anterior superior iliac spine (ASIS), the pubic tubercle, the inguinal ligament, the femoral artery, and the adductor longus. RESULTS: The obturator nerve exits the obturator foramen and travels infero-medially between the adductors longus and brevis. The median distances from the obturator nerve exit zone (ONEZ) to the ASIS and pubic tubercle were 114 mm and 30 mm, respectively. The median horizontal and vertical distances between the pubic tubercle and the ONEZ were 17 mm and 27 mm, respectively. The shortest median distance from the ONEZ to the inguinal ligament was 19 mm. The median inguinal ligament lengths from the ASIS and the median pubic tubercle to the shortest point were 103 mm and 24 mm, respectively. The median obturator nerve lengths between the ONEZ and the adductor longus and femoral artery were 41 mm and 28 mm, respectively. CONCLUSION: The obturator nerve exits the foramen 17 mm and 27 mm on the horizontal and sagittal planes, respectively, from the pubic tubercle below the pectineus muscle. The shallowest area is approximately one-fifth medially from the inguinal ligament. This study will help improve the accuracy of obturator nerve surgeries to better establish therapeutic plans and decrease complications.
Cadaver ; Femoral Artery ; Ligaments ; Obturator Nerve* ; Spine

Multiple rice body formation is a complication of chronic bursitis frequently associated with seronegative rheumatoid arthritis or tuberculosis. It resembles synovial chondromatosis on imaging and clinically. We report on a pathologically diagnosed multiple rice body formation in subacromial and subdeltoid bursitis in a 44-year-old man who was treated by surgical removal and bursectomy. At 16 months after the removal, range of motion of affected shoulder was normal. No evidence of recurrence of rice body in plain X-ray and ultrasonography. Multiple rice body formed in chronic subacromial and subdeltoid bursitis could be treated with surgical removal and bursectomy successfully.
Adult ; Arthritis, Rheumatoid ; Bursitis* ; Chondromatosis, Synovial ; Humans ; Range of Motion, Articular ; Recurrence ; Shoulder ; Tuberculosis ; Ultrasonography

PURPOSE: Rett syndrome(RTT) is an X-linked dominant neurodevelopmental disorder affecting 1 per 10,000-15,000 female births worldwide. It was initially described by Andreas Rett in 1966. RTT involves developmental regression characterized stereotypic hand movements, tremors, gait apraxia, seizures, deceleration of head growth after the age of 6-18 months. The disease-causing gene was identified as MECP2 on chromosome Xq28. We carried out mutational analysis of MECP2 genes in RTT patients. METHODS: Whole blood(5 cc) of 34 sporadic RTT patients was collected in EDTA-anticoagulated tubes. Genomic DNA was extracted from peripheral blood using the E.Z.N.A. blood DNA kit. Four exons of the MECP2 gene were amplified by PCR in 34 Korean with RTT. We carried out PCR divided the exon three into two parts and the exon four into five parts. Primer sequences designed by Amir et al. in 1999 were almost used(AF030876). Sequencing primers used were the same as PCR. DNA sequencing reactions were performed using an ABI 377 DNA sequencer and ABI PRISM dye terminator cycle sequencing reaction kit(Perkin-elmer). The results were compared with the normal DNA sequence(X99686). To confirm the change of sequence on novel mutations, RFLP analysis was performed. RESULTS: The MECP2 mutations were detected in 23(67.6%) of the 34 patients. The mutations consisted of 12 different types including nine missense and three nonsense mutations. Of these, three (L100V, G161E and T311M) mutations were newly identified. Most of the mutations discovered are located within MBD(39.1%) and TRD(39.1%). In this study, three(T158M, R270X, R306C) mutations were identified high frequency. CONCLUSION: MECP2 gene was also an important cause of Korean RTT patients. MECP2 gene study is an important tool for diagnosis of Korean RTT patients.
Codon, Nonsense ; Deceleration ; Diagnosis ; DNA ; Exons ; Female ; Gait Apraxia ; Hand ; Head ; Humans ; Parturition ; Polymerase Chain Reaction ; Polymorphism, Restriction Fragment Length ; Rett Syndrome* ; Seizures ; Sequence Analysis, DNA ; Tremor

Moyamoya disease is an unusual cerebrovascular disorder characterized by occlusive intimal dysplasia of the distal internal carotid and proximal cerebral arteries as well as other collateral arteries. However,moyamoya diseases are recently being reported as a systemic process.We experienced one case of coronary artery occlusive disease affected by moyamoya disease.The patient was a 35-year-old female,experiencing intermittent NYHA class II dyspnea and exertional chest pain for 6 months and right parest hesi a f or 1 month before admission.Cerebral artery angiogram showed abnormal cerebrovascular systems and confirmed moyamoya disease with cerebral infarction of the left f r ont al l obe. I n cor onar yartery angiogram,left coronary artery was not visualized due to total occlusion of the left main ostium and left coronary blood flow was supplied from normal right coronary artery. CABG was performed with OPCAB.Both internal mammary arteries were used f or LAD and LCx.Intraoperative coronary artery findings showed intimal hyperplasia and no definite thrombi,and nondiseased coronary arteries were good and patent.We concluded that this patient's coronary artery disease was affected by moyamoya disease,and moyamoya disease should be evaluated in the extracerebral cardiovascular system.
Adult ; Arteries ; Cardiovascular System ; Cerebral Arteries ; Cerebral Infarction ; Cerebrovascular Disorders ; Chest Pain ; Coronary Artery Disease* ; Coronary Vessels* ; Dyspnea ; Humans ; Hyperplasia ; Mammary Arteries ; Moyamoya Disease*

OBJECTIVE: The purpose of this study is to review the surgical results of 19 patients with idiopathic trigeminal neuralgia treated by percutaneous ballooning compression(PBC) of trigeminal gasserian ganglion under brief general anesthesia. METHODS: The mean patient age was 63.5 years(range, 27-78). The mean follow-up period was 24 months(range, 1-46). Three patients had already undergone radiofreqnency trigeminal rhizotomy and two patients had previously microvascular decompression. The balloon was inflated by injecting radio-contrast media 0.7-1cc in amount. The mean inflating time is 81 seconds(range, 60-90). RESULTS: During the procedure, brief intraoperative bradycardia and hypotension were noted in seven cases(36.7%). All patients had immediate relief of pain except 1 case. 18 cases(94.5%) of patients were satisfied or very satisfied with their pain relief. There were immediate, mild to moderate sensory complication of hypesthesia, dysesthesia or paraesthesia in all cases and the immediate motor complication-difficulty of mastication in 3 cases, transient 6th nerve palsy in 2 cases. The immediate motor and sensory complications disappeared or much improved after 3-4 months. CONCLUSION: It is the simple technique that can be performed effectively in a brief period of general anesthesia. This procedure might be one of attractive methods in the treatment of idiopathic trigeminal neuralgia.
Abducens Nerve Diseases ; Anesthesia, General ; Bradycardia ; Follow-Up Studies ; Humans ; Hypesthesia ; Hypotension ; Mastication ; Microvascular Decompression Surgery ; Paresthesia ; Rhizotomy ; Trigeminal Ganglion* ; Trigeminal Neuralgia*

Congenital agenesis, aplasia or hypoplasia of the internal carotid artery is rare vascular disease and usually combine with intracranial aneurysm, subarachnoid hemorrhage, or intracerebral hemorrhage. We report a case of bilateral congenital hypoplasia of internal carotid artery in a 36 year-old woman presented with semicomatose mentality. The brain computed tomography(CT) revealed intracerebral hemorrhage with intraventricular hemorrhage, and cerebral angiography showed hypoplasia of bilateral internal carotid artery without narrowing of the bony carotid canal on the temporal bone CT.
Adult ; Brain ; Carotid Artery, Internal* ; Cerebral Angiography ; Cerebral Hemorrhage ; Female ; Hemorrhage ; Humans ; Intracranial Aneurysm ; Subarachnoid Hemorrhage ; Temporal Bone ; Vascular Diseases

BACKGROUND: In korea, tsutsugamushi disease is one of the common diseases which occurs in more than 40% among acute febrile diseases during Autumn. The diagnosis is confirmed with Rickettsia tsutsugamushi antibody, and is characterised by fever, chill, headache, myalgia, skin rash, escha and lymphadenopathy. METHODS: We have conducted a survey on 16 clinically and serologically confirmed cases of Tsutsugamushi disease occurring during the period of October -November, 2000. RESULTS: Of 16 cases,7 were males and 9 were females with an average age of 67.76. Most patients had fever, chill, headache, myalgia, sore throat, cojunctival injection, cough, abdominal, pain, nausea, vomiting, hematuria in order of frequency. The physical findings were eachar (81.257) and skin rash (62.77) . Serologically 7 cases (43.75%) of 16 cases were confirmed positively R.tsutsugamushi antibody. General hematologic findings were decreased platelet count (37.57) , increased or decreased WBC (31.25% and 25% each other) , and anemia (25%) , Test for liver function included elevated AST, ALT (68.76%) , alkaline phosphatase (62.6%) , hypoalbuminemia (12.6%) , and hyperbilirubinemia(6.25) . Urinalysis showed hematuria (50%) , proteinuria (50%) , and pyuria (12.67) . Doxyrcycline therapy decreased fever in 2.85 days and after 5-6 days patients were discharged with improvement of almost all symptoms. CONCLUSION: Primary care physician in a community should always consider tsutsugamushi disease when he encounters patients with acute febrile disease in late Autumn and early winter and expect good prognosis with early diagnosis and treatment.
Alkaline Phosphatase ; Anemia ; Cough ; Diagnosis ; Early Diagnosis ; Exanthema ; Female ; Fever ; Headache ; Hematuria ; Humans ; Hypoalbuminemia ; Jeollabuk-do* ; Korea ; Liver ; Lymphatic Diseases ; Male ; Myalgia ; Nausea ; Orientia tsutsugamushi ; Pharyngitis ; Physicians, Primary Care ; Platelet Count ; Prognosis ; Proteinuria ; Pyuria ; Scrub Typhus* ; Urinalysis ; Vomiting