Tamoxifen is an oral triphenylethylene antiestrogen that has been used for breast cancer, but also inhibits protein kinase C(PKC) in a minority of malignant gliomas. Tamoxifen was administered orally in very high dose to a female brain stem glioma patient who had failed treatment with external beam hyperfractionated radiaton therapy and additional chemotherapy. Tumor reduction on MRI with clinical improvement occurred. Complications were mild thrombocytopenia, elevaton of transaminases and profuse production of hairs around both nipples and face. Although several patients with brain stem glioma had been treated with tamoxifen in our hospital, only one patient responded. Further study for the mechanism of tamoxifen activity to malignant glioma and patient characteristic evaluation will be required.
Brain Stem* ; Brain* ; Breast Neoplasms ; Drug Therapy* ; Estrogen Receptor Modulators ; Female ; Glioma* ; Hair ; Humans ; Magnetic Resonance Imaging ; Nipples ; Protein Kinases ; Radiotherapy* ; Recurrence* ; Tamoxifen* ; Thrombocytopenia ; Transaminases

TMJ internal derangement has been treated by the conservative methods and the surgical methods according to the clinical state. There are several surgical methods for treatment of TMJ internal derangement, such as disk repositioning and repair, diskectomy with and without grafts, articular surface contouring, high condylectomy, condylotomy, and arthroscopic surgery etc. Especially, it has been reported that the condylotomy produced the increase of the joint space, the pain relief, the elimination of the joint dysfunction due to the antero-inferiorly movement of the condyle, and the condylar morphologic change resulted from the progressive remodeling in TMJ without the surgical intervention within the TMJ. We have performed EVRO(extraoral vertical ramus osteotomy) to the 5 patients diagnosed as ADDWR(Anterior disk displacement with reduction) from June 1997 to December 1997 in the Chin-Hae military hospital. We diagnosed them with MRI and clinical examination. And we compared the preoperative symptoms with postoperative 2 months symptoms. They were compared by Helkimo index, mandibular mobility index, and pain scale. Anamnestic Index(Ai) was changed from 2.0 preoperatively to 1.2 postoperatively, clinical dysfunction score from 11.8 to 2.8, and Clinical Dysfunction Index(Di) from 2.8 to 1.2. The pain scale of the affected side was changed from 4.4 to 2.6 and that of the non-affeted side from 2.2 to 2.6. The maximal mouth opening was changed from 35.2mm to 40.9mm, right lateral excursion from 7.8mm to 8.0mm, left from 8.8mm to 7.0mm, and protrusion from 6.2mm to 6.2mm. In these results, we could not expect any excellent improvement of the clinical symptoms during the immediate postoperative periods. But we could observe the disappearance of the joint noise and the improvement of the clinical dysfunction score. On the basis of the results of the previous investigations about condylotomy effect which presented the condyle position were changed antero-inferiorly in the articular fossa during the immediate postoperative period, the displaced condyles may prevent wide mouth opening. Therefore it is elucidated that the improvement of the maximal mouth opening and other functions were restricted during the immediate postoperative periods. After long term follow-up period, the symptomatic and functional improvement will be expected by the passive repositioning of the proximal segment. We report the preliminary results with the related references.
Arthroscopy ; Diskectomy ; Follow-Up Studies ; Hospitals, Military ; Humans ; Joints ; Magnetic Resonance Imaging ; Mouth ; Noise ; Postoperative Period ; Temporomandibular Joint* ; Transplants

No abstract available.
Thyroid Gland* ; Thyroid Neoplasms*

In the diagnosis of acute spinal trauma, meticulous physical examination and history taking is the most important tool and auxilliary support support can be given by plain X-ray, CT or myelography, etc. But these cannot show the state of cord injury directly. On the contrary, MRI shows the cord directly as well as the soft and bony tissues. We analysed retrospectively 39 patients who suffered from acute spinal trauma at the level of cervical and thoracic spine and had their spine MRI taken. We verified the meaningful correlation between the signal change in the spinal cord on MRI and the degree of neurologic deficit and prognosis, using Frankel classification and trauma motor index at the time of admission and the final follow-up.
Classification ; Diagnosis ; Follow-Up Studies ; Humans ; Magnetic Resonance Imaging* ; Myelography ; Neurologic Manifestations ; Physical Examination ; Prognosis ; Retrospective Studies ; Spinal Cord ; Spine

No abstract available.
Orbit* ; Orbital Fractures*

Deglutition ; Dislocations ; Ligaments ; Mastication ; Recurrence ; Temporomandibular Joint ; Transplants ; Zygoma

The purpose of this study is to evaluate the diagnostic accuracy of various quantitative indices for the differentiation of benign from malignant primary soft tissue tumors by FDG-PET. A series of 32 patients with a variety of histologically or clinically confirmed benign (20) or malignant (12) soft tissue lesions were evaluated with emission whole body (5min/bed position) PET after injection of [18F]FDG. Regional 20min transmission scan for the attenuation correction and calculation of SUV was performed in 16 patients (10 benign, 6malignant) followed by dynamic acquisition for 56min. Postinjection transmission scan for the attenuation correction and calculation of SUV was executed in the other 16 patients (10 benign, 6 malignant). The following indices were obtained : the peak and average SUV (pSUV, aSUV) of lesions, tumor-to-background ratio acquired at images of 51 min p.i. (TBR51), tumor-to-background ratio of areas under time-activity curves (TBRarea) and the ratio between the activities of tumor ROI at 51 min p.i. and at the time which background ROI reaches maximum activity on the time-activity curves (T51/Tmax). The pSUV, aSUV, TBR51, and TBRarea, in malignant lesions were significantly higher than those in benign lesions. We set the cut-off values of pSUV, aSUV, TBR51, TBRarea and T51/Tmax for the differentiation of benign and malignant lesions at 3.5, 2.8, 5.1, 4.3 and 1.55, respectively. The sensitivity, specificity and accuracy were 91.7%, 80.0%, 84.4% by pSUV and aSUV, 83.3%, 85.0%, 84.4% by TBR51, 83.3%, 100%, 93.8% by TBRarea and 66.7%, 70.0%, 68.8% by Tsl/Tmax. The time-activity curves did not give additional information compared to SUV or TBR. The one false negative was a case with low-grade fibrosarcoma and all four false positives were cases with inflammatory change on histology. The visual analysis of FDG-PET also detected the metastatic lesions in malignant cases with comparable accuracy. In conclusion, all pSUV, aSUV, TBR51, and TBRarea are useful metabolic semi-quantitative indices with good accuracy for the differentiation of benign from malignant soft-tissue lesions.
Fibrosarcoma ; Humans ; Positron-Emission Tomography ; Sensitivity and Specificity

No abstract available.
Aortic Stenosis, Supravalvular*

The “surgery-first” approach, defined as a team approach between surgeons and orthodontists for orthognathic surgery without preoperative orthodontic treatment, is aimed at dental decompensation. A brief historical background and indications for the surgery-first approach are reviewed. Considering the complicated mechanism of postoperative orthodontic treatment, the proper selection of patients is a vital component of successful surgery-first approach.
Humans ; Orthodontics ; Orthodontists ; Orthognathic Surgery ; Surgeons

Cartilage, Articular ; Cell Line ; Chondrocytes ; Electrophoresis ; Interleukin-2 ; Mass Screening ; Phosphotransferases ; Proteome ; Temporomandibular Joint ; Temporomandibular Joint Disorders