Giant cell tumor is a predominantly benign condition but often the tumor is locally aggressive and tends to have high rate of recurrence and it can evolve into a malignant tumor. Thus the lesions have a practically difficult therapeutic problem for the orthopaedic surgeon and any method of treatment has not been satisfied. Between March 1984 and March 1993, clinical observation was carried out on 22 cases of giant cell tumor of bone to analyse the recurrence rate and functional evaluation of the joint according to the treatment methods, pathological grade and cortical destruction. The mean follow-up time was 75. 2 months. The recurrence rate of the intralesional excision group was 54.5% and that of the wide excision group was 9%, There was no relationship between the pathologic grade and recurrence rate. There was no recurrent case in the grade I cortical destruction but almost all of recurrence was occurred in the grade I or II cortical destruction. The functional result of the giant cell tumor occurred around the knee joint was that the mean ratings in the intralesional excision group were 79% and in the wide excision group were 51%. In conclusion, to achieve better joint function and less recurrence rate, intralesional or marginal excision with heat using bone cement or with chemical cauterization using phenol and alcohol can be used for cases of radiological grade I or II, and wide excision for grade III.
Cautery ; Follow-Up Studies ; Giant Cell Tumor of Bone ; Giant Cell Tumors ; Giant Cells ; Hot Temperature ; Joints ; Knee Joint ; Methods ; Phenol ; Recurrence

No abstract available.
Rhizotomy* ; Trigeminal Neuralgia*

The effect of surface roughness of ceramic-polymer CAD/CAM blocks on the mechanical properties was investigated in this study. Commercially available Polyglass (Vericom, Korea) and Enamic (Vita, Germany) were selected for this purpose. They were cut into either (4.0×2.1×17.0) mm and (3.0×4.0×17.0) mm, followed by grinding, and polished sequentially with 6 µm and 1 µm diamond paste. Flexural strength, fracture toughness, and Weibull analysis were determined according to ISO 6872 Dentistry-Ceramic materials. The elastic moduli were calculated from a stress-strain curves under flexural loading. The statistical significances of the mechanical properties between the products and surface roughness were analyzed with ANOVA and pared t-test at a significance level of 0.05. After grinding with 6 µm diamond paste after cutting by observing with an atomic force microscope, the arithmetic average roughness decreased to 47~49% and the maximum roughness decreased to 68~69%. When polishing with 1 µm diamond paste, The average roughness decreased to 13~22% and the maximum roughness decreased to 16~19%. When the flexural load was applied, stress increased linearly and fractured without plastic deformation both Polyglass and Enamic. As the surface roughness decreased, the mechanical properties were increased both Polyglass and Enamic. However, the mechanical properties of Polyglass increased up to P3, while Enamic showed almost maximal values at E2, after that there was no significant differences between E2 and E3. It could be due to the different microstructure between two blocks used in this experiment.
Diamond ; Plastics

Maple syrup urine disease(MSUD) is an autosomal recessive disorder involving the metabolism of the branched-chain amino acids(BCAA) such as leucine, isoleucine and valine. The disorder is due to a defect in branched-chain alpha-ketoacid dehydrogenase(BCKAD) and the classic form causes rapid progressive and overwhelming illness beginning in the first weeks of life, present with poor feeding, lethargy, change in muscle tone, acidosis, seizures and coma. The goal of therapy in acutely ill patients with MSUD is an immediate reduction in the plasma levels of the BCAAs and branched-chain ketoacids. In this report, we describe an infant with MSUD who was treated by dietary therapy alone. During the therapy, acrodermatitis enteropathica-like syndrome developed with low plasma isoleucine concentration while she was receiving a formula deficient in BCAAs.
Acer* ; Acidosis ; Acrodermatitis* ; Amino Acids, Branched-Chain ; Coma ; Diet Therapy* ; Diet* ; Humans ; Infant ; Isoleucine ; Lethargy ; Leucine ; Maple Syrup Urine Disease* ; Metabolism ; Plasma ; Seizures ; Valine

With the development of antibiotics, tympanogenic labyrinthitis complicated by otitis media rarely occurs nowadays. Only few cases of acute serous or suppurative labyrinthitis in otitis media patients have been reported previously in the literature. Acute suppurative labyrinthitis caused by direct bacterial invasion into the inner ear leads to potentially severe, irreversible hearing loss, vertigo and spontaneous nystagmus toward the healthy side. Magnetic resonance image might be helpful to recognize the inflammatory lesions of the labyrinth. Treatment for tympanogenic labyrinthitis includes an appropriate use of antibiotics and establishment a draining route. Recently, we experienced an unusual case of acute suppurative labyrinthitis complicated by chronic otitis media without cholesteatoma. We also review and discuss the clinical manifestations, radiologic findings and treatment strategy of this disease.
Anti-Bacterial Agents ; Cholesteatoma ; Ear, Inner ; Hearing Loss ; Humans ; Labyrinthitis ; Magnetic Resonance Spectroscopy ; Otitis ; Otitis Media ; Vertigo

PURPOSE: To evaluate the exact prevalence of primary glomerular diseases in Korea. METHODS: We analyzed a retrospective cohort of biopsy proven 1,100 patients with primary glomerular disease in OO Hospital from April 1990 to March 2010. RESULTS: Pathologic diagnosises of 1,100 cases were as follows: IgA nephropathy (IgAN), 557 cases (50.6%), was the most common followed by 200 cases (18.1%) of minor glomerular abnormalities (MGA), 168 cases (15.2%) of focal segmental glomerulosclerosis (FSGS), 93 cases (8.0%) of membranous nephropathy (MN), 31 cases (2.8%) of membranoproliferative glomerulonephritis type I (MPGN), 17 cases (1.5%) of focal glomerulonephritis and 7 cases (0.6%) of diffuse mesangial proliferative glomerulonephritis (DMGN) in order. In idiopathic nephrotic syndrome, the most common pathologic diagnosis was minimal change nephrotic syndrome (MCNS) (40.2%), followed by FSGS (27.5%), MN (24.2%), MPGN (8.1%) and DMGN (0.5%). When the incidence rates between 1990-1992 and 2008-2010 were compared, IgAN and FSGS increased from 34.7, 12.5 to 47.8%, 30.4%, but MCNS (from 33.3 to 6.5 %) decreased significantly. CONCLUSION: IgAN was the most common primary glomerulonephritis. During the past 20 years, the prevalence of IgAN and FSGS were increased, while MCNS and MN were decreased.
Biopsy ; Cohort Studies ; Glomerulonephritis ; Glomerulonephritis, IGA ; Glomerulonephritis, Membranoproliferative ; Glomerulonephritis, Membranous ; Glomerulosclerosis, Focal Segmental ; Humans ; Incidence ; Nephrosis, Lipoid ; Nephrotic Syndrome ; Prevalence ; Retrospective Studies

OBJECTIVE: Ovarian cancer represents a relatively chemosensitive solid tumor, with responsiveness to a range of agents. Cisplatin is the mainstay of drug treatment and is one of the most active single agent. However, the overall outcome for patients remains unsatisfactory and the emergence of drug resistance is a major factor in treatment failure. Loss of DNA mismatch repair is a common finding in many types of sporadic cancer as well as in patients with hereditary nonpolyposis colon cancer. Cells that lack DNA mismatch repair are resistant to commonly used chemotherapeutic agents. Selection of cells for resistance to cisplatin, a well-recognized mutagen, could result in mutation in genes involved in DNA mismatch repair. METHODS: This study evaluated the mutation of hMLH1 and hMSH2, and its relation to the Taxol and Topotecan chemosensitivity in the clones from the ovarian cancer cell line 2008 and cisplatin-resistant cell line 2008/ C13*5.25. RESULTS: 1. Cells from 2008 and 2008/C13*5.25 expressed both hMLH1 and hMSH2 when analysed with immunoblotting. 2. Twenty two out of 100 single-cell clones from 2008 and 27 of clones from 2008/C13*5.25 expressed no hMLH1. hMSH2 was expressed in all clones. 3. There was no difference of Taxol chemosensitivity between 2008 and 2008/C13*5.25 cell lines. In the 2008/C13*5.25 cell line, the hMLH1-deficient clones were more sensitive to Taxol than the hMLH1-proficient clones(P=0.049), but in 2008 cell lines hMLH1-proficient clones were more sesitive to Taxol(P=0.003). 4. There was no difference in Topotecan chemosensitivity between 2008 and 2008/C13*5.25 cell lines. In the 2008/C13*5.25 cell line, the hMLH1- deficient clones were not more sensitive to Topotecan than the hMLH1-proficient clones. In the 2008 cell lines hMLH1-deficient clones were more sesitive to Topotecan(P=0.001). Overall, hMLH1-deficient clones from both 2008 and 2008/C13*5.25 cell lines were significantly more sensitive to Topotecan(P=0.001). 5. Microsatellite instability was not demonstrated in all 4 types of single-cell clones from 2008 and 2008/C13*5.25 cell lines. CONCLUSIONS: The present results indicate that there is no relation between mutation of mismatch repair gene and cisplatin resistance. But hMLH1-deficient ovarian cancer cells are more sensitive to Taxol or Topotecan in this study. The latter finding mandates the examination to assess the mutation of hMLH1 in tumor cells before treatment or at the time clinical resistance to cisplatin develops in ovarian cancer.
Cell Line* ; Cisplatin ; Clone Cells* ; Colorectal Neoplasms, Hereditary Nonpolyposis ; DNA Mismatch Repair* ; DNA* ; Drug Resistance ; Humans ; Immunoblotting ; Microsatellite Instability ; Ovarian Neoplasms* ; Paclitaxel* ; Topotecan* ; Treatment Failure

OBJECTIVES: Despite severe oligospermia, males with Y chromosome microdeletion can achieve conception through ICSI (Intracytoplasmic Sperm Injection). However, ICSI may not only result in the transmission of microdeletions but also the expansion of deletion to the offspring. The purpose of this study was to screen vertical transmission, expansion of microdeletions and de novo deletion in male fetuses conceived by ICSI. MATERIALS AND METHODS: A total of 32 ICSI treated patients with their 33 (a case of twin) male fetuses conceived by ICSI were used to make this study group. Sequence-tagged sites (STSs)-based PCR analyses were performed on genomic DNA isolated from peripheral blood of fathers and from the amniocytes of male fetuses. Ten primer pairs namely, sY134, sY138, MK5, sY152, sY147, sY254, sY255, SPGY1, sY269 and sY158 were used. The samples with deletions were verified at least three times. RESULTS: We detected a frequency of 12.5% (4 of the 32 patients) of microdeletions in ICSI patients. In 4 patients with detected deletions, two patients have proven deletions on single STS marker and their male fetuses have the identical deletion in this region. Another two patients have two and three deletions, but their male fetuses have more than 3 deletions which include deletions to their father's. Meanwhile, seven male fetuses, whose fathers were analyzed to have all 10 STS markers present, have deletions present in at least one or more of the markers. CONCLUSIONS: Although the majority of deletions on the Y chromosome are believed to arise de novo, in some cases a deletion has been transmitted from the fertile father to the infertile patient. In other cases the deletion was transmitted through ICSI treatment, it is likely that one sperm cell is injected through the oocyte's cytoplasm and fertilization can be obtained from spermatozoa. Our tests for deletion were determined by PCR and our results show that the ICSI treatment may lead to vertical transmission, expansion and de novo Y chromosome microdeletions in male fetuses. Because the sample group was relatively small, one should be cautious in analyzing these data. However, it is important to counsel infertile couples contemplating ICSI if the male carries Y chromosomal microdeletions.
Cytoplasm ; DNA ; Family Characteristics ; Fathers ; Fertilization ; Fetus* ; Humans ; Male* ; Oligospermia ; Polymerase Chain Reaction ; Sequence Tagged Sites ; Sperm Injections, Intracytoplasmic* ; Spermatozoa ; Y Chromosome*

BACKGROUND AND OBJECTIVES: Newborn Hearing Screening (NHS) program aims to identify babies at risk of hearing loss and provide appropriate rehabilitation within the crucial period for language development. The risk of hearing loss in increased in babies discharged from neonatal intensive care unit (NICU) compared to wellbaby nursery. Transient evoked otoacoustic emission (TEOAE) or automated auditory brainstem response tests are utilized. The purpose of this study is to assess the outcome of NHS using TEOAE as initial evaluation method in NICU graduates. SUBJECTS AND METHODS: TEOAE was performed as initial screening method for NHS in NICU neonates born between February 2010 and November 2011. Babies referred from TEOAE were reevaluated with repeated TEOAE or auditory brainstem response. Referral rates were estimated and quality indicators for screening (Joint Committee on Infant Hearing position statement, 2007) were evaluated. RESULTS: Among 149 neonates graduated from NICU, 50 (33.6%) babies failed initial TEOAE ('refer'). A second stage TEOAE testing was performed in 41 (82.0%) of these babies: 35 (85.4%) passed and 6 (14.6%) were referred for diagnostic testing. From 2-stage TEOAE screening program, 6 neonates were referred for diagnostic audiological evaluation: sensorineural hearing loss was identified in 2 babies and 3 babies were lost to follow up. Quality indicators for screening were as follows: 1) 94.0% of all newborn infants admitted to NICU completed screening by 1 month of age, and 2) 4.0% of all newborn infants who fail initial screening and fail any subsequent rescreening before comprehensive audiological evaluation. CONCLUSIONS: Timely and adequate screening of hearing loss is prerequisite for accurate diagnosis and appropriate rehabilitation in infants especially from NICU. Further refinement of the current NHS with additional reliable screening technology is required for more stable and successful screening program.
Diagnostic Tests, Routine ; Evoked Potentials, Auditory, Brain Stem ; Hearing ; Hearing Loss ; Hearing Loss, Sensorineural ; Humans ; Infant ; Infant, Newborn ; Intensive Care, Neonatal ; Language Development ; Lost to Follow-Up ; Mass Screening ; Nurseries ; Quality Indicators, Health Care ; Referral and Consultation

BACKGROUND AND OBJECTIVES: Newborn Hearing Screening (NHS) program aims to identify babies at risk of hearing loss and provide appropriate rehabilitation within the crucial period for language development. The risk of hearing loss in increased in babies discharged from neonatal intensive care unit (NICU) compared to wellbaby nursery. Transient evoked otoacoustic emission (TEOAE) or automated auditory brainstem response tests are utilized. The purpose of this study is to assess the outcome of NHS using TEOAE as initial evaluation method in NICU graduates. SUBJECTS AND METHODS: TEOAE was performed as initial screening method for NHS in NICU neonates born between February 2010 and November 2011. Babies referred from TEOAE were reevaluated with repeated TEOAE or auditory brainstem response. Referral rates were estimated and quality indicators for screening (Joint Committee on Infant Hearing position statement, 2007) were evaluated. RESULTS: Among 149 neonates graduated from NICU, 50 (33.6%) babies failed initial TEOAE ('refer'). A second stage TEOAE testing was performed in 41 (82.0%) of these babies: 35 (85.4%) passed and 6 (14.6%) were referred for diagnostic testing. From 2-stage TEOAE screening program, 6 neonates were referred for diagnostic audiological evaluation: sensorineural hearing loss was identified in 2 babies and 3 babies were lost to follow up. Quality indicators for screening were as follows: 1) 94.0% of all newborn infants admitted to NICU completed screening by 1 month of age, and 2) 4.0% of all newborn infants who fail initial screening and fail any subsequent rescreening before comprehensive audiological evaluation. CONCLUSIONS: Timely and adequate screening of hearing loss is prerequisite for accurate diagnosis and appropriate rehabilitation in infants especially from NICU. Further refinement of the current NHS with additional reliable screening technology is required for more stable and successful screening program.
Diagnostic Tests, Routine ; Evoked Potentials, Auditory, Brain Stem ; Hearing ; Hearing Loss ; Hearing Loss, Sensorineural ; Humans ; Infant ; Infant, Newborn ; Intensive Care, Neonatal ; Language Development ; Lost to Follow-Up ; Mass Screening ; Nurseries ; Quality Indicators, Health Care ; Referral and Consultation