Multiple primary malignancies (MPMs) are defined as the presence of two or more malignancies in different organs, without a subordinate relationship. Although rarely reported, hepatocellular carcinoma (HCC) occasionally presents with simultaneous or metachronous primary malignancies in other organs. In this report, we describe a patient with lung adenocarcinoma and lymph node and bone metastases, treated with five chemotherapeutic regimens for 24 months. Changing the chemotherapy regimen based on the suspicion of metastasis of a new liver mass did not lead to improvements. This prompted a liver biopsy and a revised diagnosis of HCC. Sixth-line treatment with the concurrent use of cisplatin-paclitaxel for lung cancer and sorafenib for HCC, stabilized the disease. The concurrent treatment was not tolerated and was discontinued owing to adverse events. Considering our findings, treatment with increased efficacy and lower toxicity for MPMs is warranted.

Since researches and clinical experiences up to now provide us with little helps in predicting what type of spinal tuberculosis will result in good healing by chemotherapy alone without kyphosis or with minimum kyphosis, it seems impractical to await natural healing with unsightly kyphosis. Therefore, my opinion is that surgery to achieve early cure and to correct and/or prevent kyphosis is desirable. The two-stage operation
Child ; Drug Therapy ; Follow-Up Studies ; Humans ; Immobilization ; Kyphosis ; Parents ; Spine ; Transplants ; Tuberculosis ; Tuberculosis, Spinal

No abstract available.
Lipoma*

PURPOSE: . The purpose of this study was to investigate survival rates of the implants used in implant assisted removable partial dentures (IARPDs). MATERIALS AND METHODS: . The study was conducted on 21 patients who were treated with IARPDs. The mean follow-up period for IARPD patients ranged from 12 to 185 months (mean 47.9 months). A total of 58 implants were used for IARPDs in two different modalities: 41 for surveyed crowns and 17 for overdentures. The survival of implants was determined by clinical and radiographic evaluations considering relevant factors: location, RPD classification, opposing dentition, splinting, and implant diameter. RESULTS: The survival rate of total 58 implants was 93.1%: 95.1% for implants supporting surveyed crowns and 88.2% for implants used in overdentures. Considering only the implants supporting surveyed crown, regular diameter implants showed a higher survival rate than narrow or wide diameter implants. CONCLUSION The survival rate of the implants used in IARPDs was 93.1% (surveyed crown: 95.1%, overdenture: 88.2%).

Severe dental attrition causes pathological changes of the tooth, collapsed occlusion, and functional and aesthetic complications and can also result in a decrease in occlusal vertical dimension. Before increasing the vertical dimension with full-mouth rehabilitation, it is important to determine the amount of vertical dimension through accurate diagnosis. In this case, a 77 year old elderly male patient on anticoagulant medication with generalized attrition and fracture of teeth was treated with full-mouth rehabilitation in order to recover vertical dimension and aesthetics. Accurate clinical and radiographic examination, diagnostic, wax-up, and occlusal vertical dimension evaluation were step by step performed considering pre-medical history and old age. Patient adaptability was evaluated using an occlusal splint and interim restoration. After 3 months of stabilization with interim restoration, definitive prostheses were fabricated. Satisfactory functional and esthetic outcomes are observed after 6 months of follow up.
Aged ; Dentition ; Diagnosis ; Esthetics ; Follow-Up Studies ; Humans ; Male ; Mouth Rehabilitation ; Mouth ; Occlusal Splints ; Prostheses and Implants ; Rehabilitation ; Tooth ; Tooth Attrition ; Vertical Dimension

This study sought to demonstrate bone mineral density (BMD) conditions in elderly female patients with knee osteoarthritis (OA) undergoing total knee arthroplasty (TKA). In addition, we sought to determine whether their BMD conditions differ from those of community-based females without knee OA. Finally we sought to determine whether clinical statuses are related to BMD in the knee OA patients. BMD conditions in 347 female patients undergoing TKA and 273 community-based females were evaluated. Additionally, comparative analyses of BMD between age and body mass index-matched knee OA groups (n=212) and the control groups (n=212) were performed. In the pre-matched knee OA group, regression analyses were performed to determine whether preoperative clinical statuses were related to BMD. Considerable prevalence of coexistent osteoporosis (31%) was found in the pre-matched knee OA patients undergoing TKA. We found no significant differences of the BMD T-scores and the prevalence of osteoporosis between the age and body mass index-matched knee OA and control groups. In the pre-matched knee OA patients, poorer preoperative clinical scores were related to poorer BMD T-scores in the proximal femur and/or lumbar spine. Our study suggests that more attention should be paid to identify and treat osteoporosis in elderly female patients with advanced knee OA undergoing TKA.
Aged ; Aged, 80 and over ; *Arthroplasty, Replacement, Knee ; Body Mass Index ; Bone Density ; Female ; Humans ; Knee Joint/pathology/surgery ; Osteoarthritis, Knee/*epidemiology/*surgery ; Osteoporosis/*epidemiology

PURPOSE: It is known that the wild-type p53 (w-p53) gene has several functions such as suppression of tumor cell growth, control of the cell cycle, stabilization of the genes and cellular differentiation. Recombinant w-p53 adenovirus was transfected and 5-FU was administered into the LoVo (w-p53 gene positive) and SW-837 (mutant-p53 gene positive) colon cancer cell lines to determine the cell death effects according to the presence or absence of the w-p53 gene. METHODS: The transduction of the p53 gene was done using recombinant adenovirus and liposomes, and the cell death effect was determined by performing MTT assay. RESULTS: The cell death effect by 5-FU was higher in the LoVo cell line than that in the SW-837 cell line. The rate of w-p53 gene transduction was about 90%. The cell death effect by w-p53 gene transduction was shown by the administration of 10 microM of 5-FU. The cell death effect according to the administration of 5-FU after w-p53 gene transduction was 10 fold of that with 5-FU administration in the both cell lines, and there was a more significant effect in the LoVo cell line. CONCLUSION: The cell killing effect by 5-FU administration after w-p53 gene transduction showed a synergistically higher effect than those of w-p53 transduction only or 5-FU administration only in the colon cancer cell lines. Gene therapy using w-p53 gene transduction requires more extensive clinical trials.
Adenoviridae ; Cell Cycle ; Cell Death ; Cell Line* ; Colon* ; Colonic Neoplasms* ; Colorectal Neoplasms ; Fluorouracil* ; Genes, p53 ; Genetic Therapy ; Homicide* ; Liposomes

BACKGROUND: The purpose of this study is to assess the ability of dipyridamole99mTc-MIBI SPECT to identify and localize coronary artery disease(CAD). METHODS: The study population consists of 60 patients(37 males, 23 females : mean age 57+/-10 years) including 30 with prior myocardial infarction who underwent both dipyridamole99mTc-MIBI SPECT and coronary angiography for the evaluation of chest pain. RESULTS: The sensitivities for detection of CAD(> or =50% and > or =70% coronary stenosis by angiography) by dipyridamole99mTc-MIBI SPECT are 96% and 98% respectively, and specifities are 71% and 73% respectively. The sensitivities for detection of individual diseased vessels(> or =50% and > or =70%) are 79% and 90% for left anterior descending artery(LAD), 53% and 59% for left circumflex artery(LCX), 45% and 53% for right coronary artery(RCA), 64% and 77% for LCX/RCA, 63% and 72% for total. The specificities for detection of individual diseased vessels(> or =50% and > or =70%) are 62% for LAD, 98% and 98% for LCX, 92% and 89% for RCA, 91% and 89% for LCX/RCA, 87% and 86% for total. The concordances for ditection of individual didseased vessels beteen coronary angiography and dipyridamole99mTc-MIBI SPECT are all fair for SAD(Kappa=0.4 in > or =50% stenosis, 0.54 in > or =70% stenosis)LCX(Kappa=0.56,0.63),RCA(Kappa=0.4,0.44) and LCX/RCA(Kappa=0.56,0.67). CONCLUSION: Dipyriddamole99mTc-MIBI SPECT appers to be an useful noninvasive test for both identification and localization of coronary artery disease.
Chest Pain ; Constriction, Pathologic ; Coronary Angiography* ; Coronary Artery Disease* ; Coronary Stenosis ; Coronary Vessels* ; Diagnosis* ; Female ; Humans ; Male ; Myocardial Infarction ; Tomography, Emission-Computed, Single-Photon*

Cervical pregnancy is a life threatening, rare type of ectopic pregnancy. Hysterectomy was considered as the only treatment for cervical pregnancy. In 1982, as a conservative treatment of ectopic pregnancy, local injection of methotrexate was tried by Tanaka et al. We reviewed a case of sucessful treatment of cervical pregnancy after 45 days from direct local injection of methotrexate into gestational sac under the guidance of vaginal ultrasonogram in department of obstetrics and gynecology, Korea university hospital.
Female ; Gestational Sac ; Gynecology ; Hysterectomy ; Korea ; Methotrexate* ; Obstetrics ; Pregnancy* ; Pregnancy, Ectopic ; Ultrasonography

A heterogenic group of staphylococcal exotoxins, including staphylococcal superantigenic toxins, enterotoxin (SE), toxic shock syndrome toxin-1 (TSST-1), and coagulase are the most important virulence factors of Staphylococcus aureus. We analyzed the prevalence of genes encoding five enterotoxins and TSST-1 in S. aureus isolated from clinical ear discharges. The genes were identified by multiplex PCR and we compared the results to references of coagulase serotypes. In 102 isolates of S. aureus, 44 of them were methicillin-resistant S. aureus (MRSA) and the others were methicillin-susceptible S. aureus (MSSA). Among both types of S. aureus, 33 strains were positive for sea, 2 for seb, 23 for sec, 26 for see, and 26 for tst. Overall, 59 (57.8%) isolates were positive for one or more superantigenic toxin genes. From these, 71.2% (42/59) strains harbored more than one toxin gene in different combinations. The major combinations of genes were sea and see, and sec and tst. The degree of possession of superantigenic toxic genes was similar in both MRSA and MSSA isolates (56.8% vs 58.6%, respectively), yet significant differences in toxin gene profiles and coagulase serotypes between two isolates were detected. All of 13 positive strains for sec and tst were MRSA and belonged to coagulase serotype II. On the other hand, 80.0% of 20 positive strains for sea and see were MSSA with coagulase serotype IV and VII, whereas 20.0% of them were MRSA with coagulase serotype IV. This data indicates that the profile of superantigenic toxin genes correlates to coagulase serotype and methicillin resistance in S. aureus isolates.
Bacterial Toxins ; Coagulase ; Ear ; Enterotoxins ; Exotoxins ; Hand ; Methicillin Resistance ; Methicillin-Resistant Staphylococcus aureus ; Multiplex Polymerase Chain Reaction ; Prevalence ; Shock, Septic ; Staphylococcus ; Staphylococcus aureus ; Superantigens ; Virulence Factors