No abstract available.

No abstract available.
Laryngeal Muscles*

We report a case of Eosinophilia- Myalgia syndrome with central nervous system (CNS) involvement following ingestion of the essential amino acid, tryptophan. The Eosinophilia- Myalgia syndrome can be diagnosed when there is a severe myalgia and peripheral eosinophilia in the absence of other diseases causing eosinophilia. This condition has been associated with the ingestion of the tryptophan in many cases, but the amount and duration of ingestion have been yet to be elucidated. Although many cases have been reported, few cases involved the CNS. We present a 28 year- old male who complained of a severe myalgia and disorientation after taking the taken tryptophan for 2 weeks. Thorough examination revealed the peripheral eosinophilia, vasculitis on brain MRI, abnormal VEP, and muscle atrophy on muscle biopsy. Symptoms improved with the steroid pulse after discontinuation of the tryptophan.
Biopsy ; Brain ; Central Nervous System* ; Eating* ; Eosinophilia ; Eosinophilia-Myalgia Syndrome* ; Humans ; Magnetic Resonance Imaging ; Male ; Muscular Atrophy ; Myalgia ; Tryptophan* ; Vasculitis

BACKGROUND AND OBJECTIVES: The Herpes Simplex type 2 Defective Infectious Single Cycle virus (DISC virus) is an attenuated virus originally produced as a viral vaccine, but it also serves as an efficient gene transfer vehicle. The main goals of this study were to examine determinants of gene transfer using DISC vectors for squamous cell carcinoma and to evaluate the efficacy of vaccination with the DISC virus carrying a combination of immunomodulatory genes (IL-2, GM-CSF) as cancer therapy in a model of squamous cell cancer in the C3H/HeJ mice. MATERIALS AND METHODS: We determinated the gene and protein expression of DISC-IL-2 and DISC-GM-CSF transfected SCCVII cells by RT-PCR and ELISA method. Also, we evaluated the ex vivo vaccination effects of DISC-IL-2 and DISC-GMCSF on preventing the development of SCCVII tumor. RESULTS: SCCVII cells transduced by the DISC virus vector (MOI=10) carrying the IL-2, or the GM-CSF gene, produced nanogram quantities of IL-2 or GM-CSF per 10(6) cells. Of particular interest was the observation that cells irradiated at different doses (5,000 cGy, 10,000 cGy) secreted levels of GM-CSF or IL-2 that were comparable to non-irradiated cells. In vivo vaccination using tumor cells transduced ex vivo with DISC-IL-2 or DISC-GMCSF resulted in protection against subsequent tumor challenge (p<0.01). Among the multiple immunomodulatory transgenes vaccination groups, the DISC-GMCSF transfected vaccine showed the greatest suppression of tumor development and growth (p<0.001). CONCLUSION: These data demonstrate that: 1) The DISC virus vector is capable of efficient gene transfer to SCCVII cells, 2) The GM-CSF secreting, genetically modified tumor vaccine (SCCVII/GMCSF) efficiently protected against tumor cell challenge and suppressed tumor growth in our tumor model. The DISC virus-mediated, cytokine gene transfer may prove to be useful in clinical therapy for head and neck cancers.
Animals ; Carcinoma, Squamous Cell ; Enzyme-Linked Immunosorbent Assay ; Genetic Therapy* ; Granulocyte-Macrophage Colony-Stimulating Factor* ; Growth and Development ; Head* ; Herpes Simplex ; Interleukin-2* ; Mice ; Neck* ; Neoplasms, Squamous Cell* ; Transgenes ; Vaccination

PURPOSE: The treatment of a clinically node-positive (cN+) neck is important in the management of oral cavity squamous cell carcinoma (OSCC). However, the extent of neck dissection (ND) remains controversial. The purpose of our study was to evaluate whether level IV or V can be excluded in therapeutic ND for cN+ OSCC patients. MATERIALS AND METHODS: We performed a retrospective chart review of 92 patients who underwent a comprehensive or selective ND as a therapeutic treatment of cN+ OSCC from January 1993 to February 2009. RESULTS: The incidence rate of metastasis to level IV or V was 22% (16 of 72) on the ipsilateral neck. Of 67 cases without clinically suspicious nodes at level IV or V, 11 cases (16%, 11 of 67) had pathologically proven lymphatic metastasis to level IV or V. Only a nodal staging above N2b was significantly relevant with the higher rate of level IV or V lymph node metastasis (p=0.025). In this series, selective ND, combined with proper adjuvant therapy, achieved regional control and survival rates comparable to comprehensive ND in patients under the N stage of cN2a OSCC. CONCLUSION: In conclusion, level IV and V patients can avoid recurrence under cN2a OSCC.
Adult ; Aged ; Carcinoma, Squamous Cell/mortality/*pathology/*surgery ; Chemoradiotherapy ; Disease-Free Survival ; Female ; Humans ; Lymphatic Metastasis ; Male ; Middle Aged ; Mouth Neoplasms/mortality/*pathology/*surgery ; Neck/surgery ; *Neck Dissection ; Neoplasm Metastasis ; Radiotherapy, Adjuvant ; Retrospective Studies ; Treatment Outcome

OBJECTIVE: Intraoperative monitoring using somatosensory evoked potential (SEP) study has been used increasingly to monitor neurological function during scoliosis surgery and other high-risk spinal surgeries. However, there are few studies related to this intraoperative monitoring, particularly in severe spinal deformity surgery, in Korea. So we evaluated the clinical efficacy of intraoperative SEP monitoring and considered the risk factors related to spinal surgery. METHOD: We performed a posterior tibial nerve somatosensory evoked potential study for intraoperative monitoring during surgical procedures in 101 patients (male 46, female 55). RESULTS: Neurologic damage occurred in 16 patients (10 congenital scoliosis cases, 5 tuberculous kyphosis cases, and 1 degenerative spondylosis case) after surgical procedures. Delayed postoperative neurologic damage occurred in 4 patients (2 mild damage cases, 2 severe damage cases) among 85 cases which showed normal responses during surgical procedures. Sensitivity of this study was 75%, and specificity was 95.3%. CONCLUSION: Somatosensory evoked potential study for intraoperaive monitoring is a sensitive and very useful method to detect iatrogenic lesions during spinal deformity surgery with satisfactory specificity. However, to improve the sensitivity and specificity of the intraoperative monitoring, combination of motor evoked potentials is recommended.
Congenital Abnormalities* ; Evoked Potentials, Motor ; Evoked Potentials, Somatosensory* ; Female ; Humans ; Korea ; Kyphosis ; Monitoring, Intraoperative* ; Risk Factors ; Scoliosis ; Sensitivity and Specificity ; Spondylosis ; Tibial Nerve

No abstract available.
Lasers, Gas* ; Subgingival Curettage*

PURPOSE: Nodular duodenitis is defined as two or more erythematous nodules in the duodenum, with surrounding inflammation and with or without apical erosions. But the clinical features and natural history of nodular duodenitis remain largely undefined, therefore we examined clinical, endoscopic and pathologic features of nodular duodenitis in children to find about its natural history, relationship between endoscopic and pathologic findings, relationship between Helicobacter pylori and nodular duodenitis as well as clinical response to antisecretory therapy. METHODS: Forty-nine children presented with chronic abdominal pain, chronic diarrhea, vomiting and indigestion showed nodular duodenitis on gastroduodenoscopic examinations at the Department of pediatrics of Hangyang University Hospital from January 1995 to August 1997. Endoscopic and pathologic findings were graded and the correlation coefficient between endoscopic and pathologic grades were analyzed. Clinical responses to therapy were compared between Helicobacter pylori (H. pylori)-associated and non H. pylori-associated children. RESULTS: The chief most common complaint was chronic abdominal pain and this disease was most commonly developed in females and in school-aged children. In endoscopic examinations, Grade 1 was the most commonly noted, while in pathologic examinations, Grade 2 was most common. The correlation coefficient between endoscopic and pathologic findings was 0.278 (P= 0.053). Clinical symptoms were improved by H2-blocker or anti-H. pylori therapy in most patients. CONCLUSION: There was no significant correlation between endoscopic and pathologic grades. H. pylori infection may be an etiologic factor of nodular duodenitis in some cases.
Abdominal Pain ; Child* ; Diarrhea ; Duodenitis* ; Duodenum ; Dyspepsia ; Female ; Helicobacter pylori ; Humans ; Inflammation ; Natural History ; Pediatrics ; Vomiting

OBJECTIVES: To investigate expressions of matrix metalloproteinases (MMPs) and tissue inhibitors of metalloproteinases (TIMPs) in squamous cell carcinoma of the tonsil and to correlate expression profiles with clinicopathological characteristics. METHODS: Paraffin blocks were obtained from 45 tonsil squamous cell carcinoma (SCC) patients, who underwent surgery as an initial treatment between 1994 and 2004, and from 20 normal controls. Expressions of MMP-2, MMP-9, MMP-13, TIMP-1, and TIMP-2 were investigated immunohistochemically. RESULTS: The expressions of MMPs (except MMP-2) and TIMPs were found to be significantly different in tonsil SCC and normal control tissues. Furthermore, MMP-13 expression was found to be correlated with tumor invasion (P=0.05), and the expressions of MMP-9 and TIMP-1 with nodal metastasis (P=0.048, 0.031). No relation was found between MMP or TIMP expression and recurrence. However, MMP-9 expression was found to be significantly associated with 5-year survival in tonsil SCC patients by multivariate analysis (hazard ratio, 3.853; P=0.013). CONCLUSION: Significant overexpressions of multiple MMPs and TIMPs were found in tonsil SCC tissues. Furthermore, our findings suggest that MMP-9 expression might be a useful prognostic factor.
Carcinoma, Squamous Cell ; Humans ; Matrix Metalloproteinases ; Metalloproteases ; Multivariate Analysis ; Neoplasm Metastasis ; Palatine Tonsil ; Paraffin ; Prognosis ; Recurrence ; Tissue Inhibitor of Metalloproteinase-1 ; Tissue Inhibitor of Metalloproteinase-2

No abstract available.
Adult ; Anemia, Hemolytic/diagnosis/*etiology/therapy ; Colic/diagnosis/*etiology/therapy ; Drug Contamination ; Drugs, Chinese Herbal/*adverse effects ; Female ; Humans ; Lead Poisoning/diagnosis/*etiology/therapy ; Risk Factors ; Treatment Outcome