Medroxyprogesterone acetate(MPA) is one of the most commonly used hormonal agents for the treatment of advanced or recurrent endometrial adenocarcinoma. However, the progesterone receptor content of endometrial carcinoma varies directly to the degree of differentiation and inversely with stage of the tumor. Thus one would predict that MPA therapy would be less effective in advanced and poorly differentiated tumors. In addition, MPA has been shown to reduce progesterone receptor content of both normal and malignant endometrial cells, which could result in loss of hormone responsiveness. Tamoxifen, which is often used in breast cancer therapy, has also been used in the treatment of patients with advanced and recurrent endometrial carcinoma. Tamoxifen is known to have some estrogenic effects at low concentration and one of these effects is induction of progesterone receptor both in normal and malignant endometrium. This property has focused interest on sequential or simultaneous use of tamoxifen and MPA in the therapy of endometrial carcinoma. The growth inhibitory effects of MPA and tamoxifen were tested on six longestablished endometrial carinoma cell line(HEC-1-A, HEC-1-B, RL 95-2, AN3CA, KLE) and on SCHE-1, a new endometrial carcinoma cell line established in our laboratory. MPA and tamoxifen were used in growth experiments either alone, simultaneously or sequentially. The MCF-7 breast cancer cell line was used as a control. Only 20% reduction in cell number was achieved after 10 days of exposure to the drug, even with the highest MPA concentration tested(10micronm) in endometrial carcinoma cell lines. But in MCF-7 cells, 60% reduction in cell number was achieved with the same concentration of MPA(10um). Ten days of feeding with 5micronm tamoxifen produced a 96% reduction in cell number in MCF-7, a 91% reduction in HEC-1-A, a 88% reduction in HEC-1-B, a 98% reduction in AN3CA and a 71% reduction in KLE cultures. In SCHE-1 cultures a 83% reduction in cell growth was seen and no viable cells remainde in RL 95-2 cultures after 10 days of feeding with a 5uM tamoxifen. In AN3CA cultures, simultaneous exposure to 5um tamoxifen and 5um MPA resulted in partial reversal of the tamoxifen-induced growth inhibition. In RL 95-2, HEC-1-A and HEC-1-B cultures, simultaneous use of these drugs had the same effect as tamoxifen alone, whereas in KLE and SCHE-1 cultures a slight additive growth effect was observed. All six endometrial carcinoma cell lines resumed logarithmic growth when medium containing tamoxifen of logarithmic growth under these conditions was slower than that in the other endometrial carcinoma cultures. Our results show that MPA does not have growth inhibitory effects in these endometrial carcinoma cell cultures, whereas tamoxifen has been shown to have potent endometrial carcinoma cells. These findings are of special importance since patients who are most likely to need adjuvant therapy for advanced or recurrent endometrial carcinoma are those with estrogen receptor and progesterone receptor negative tumors.
Adenocarcinoma ; Breast Neoplasms ; Cell Count ; Cell Culture Techniques ; Cell Line* ; Endometrial Neoplasms* ; Endometrium ; Estrogen Receptor Modulators* ; Estrogens ; Female ; Humans ; MCF-7 Cells ; Medroxyprogesterone ; Receptors, Progesterone ; Tamoxifen*

BACKGROUND: Along with the recent greater number of medical devices for the elderly in the market, there has been a parallel increase in the number of clinical trials for these devices. It is uncertain, though, whether the target population has the awareness and understanding of these clinical trials and the possible adverse events of the devices. METHODS: A total of 147 elderly subjects (mean age, 65.8+/-8.3 years; 39 males) responded to the questionnaire. A pilot study during the development of the questionnaire was conducted in 2009 with the actual survey taking place from June to November 2011. The questionnaire included 22 items-10 items on awareness and understanding of the clinical trial; 4 items on the understanding of adverse events; and 8 items on demographical characteristics. RESULTS: Of the responders, 62.5% had participated in at least one clinical trial and had heard about the clinical trials through a doctor, newspaper, or television. And 63.3% of the responders understood that the purpose of the trial was to show efficacy and safety for the medical device. There were significant differences on the awareness of the trial by gender and life level. However, there was no statistically significant difference in adverse events awareness. CONCLUSION: Although elderly subjects participate in clinical trials, it seems they do not receive enough information when involved in clinical trials of medical devices. In the future, before these trials are carried out, medical device companies need to ensure that they provide their elderly subjects with better education and information.
Aged ; Dietary Sucrose ; Health Services Needs and Demand ; Humans ; Hypogonadism ; Mitochondrial Diseases ; Periodicals ; Ophthalmoplegia ; Pilot Projects ; Surveys and Questionnaires ; Television

No abstract available.
Gastrectomy* ; Stomach Neoplasms* ; Stomach*

No abstract available.
Dislocations* ; Elbow*

The cervical spinal injuries may impose a fatal result or permanent neurological disability according to the severity of injury. Authors performed a clinical study consisting of 54 patients who have visited Daejeon Eulji General Hospital for the care of fracture and dislocation of the cervical spine from May 1981 to Jan. 1986, and obtained the following results. 1. The prevalent age distribution was between third and forth decade and the ratio between male and female was 3.5:1 and the most common cause of injury was traffic accident(53.7%). 2. The most common site of injury was CS, 6(22.2%) and the most frequent mechanism of injury was Aexion-rotation type(55.0%). 3. At initial examination, 39 patients(72.2%) had neurological damage and among these, 18 were complete paralysis below the level of injury, 12 were incomplete paralysis, 9 were nerve root injuries. 4. Operative treatment was performed on 24 patients, these were Rogers' posterior fusion on 19 patients, Brooks and Jenkins' atlantoaxial fusion on 3 patients, occipitocervical fusion on 1 patient and excision of hactured fragment on 1 patient. 5. There were no evidences of neurological recovery in completely paralyzed patients, but among incompletely paralyzed and nerve root injured patients, neurological recovery was found in 57.1% of conservatively treated patients and in 71. 4% of operated patients. 6. Radiological stability was found in entire patients who received operative treatment, but, in conservatively treated patients, remained 1 late instability.
Age Distribution ; Clinical Study ; Dislocations ; Female ; Hospitals, General ; Humans ; Male ; Paralysis ; Spinal Injuries ; Spine

PURPOSE: To find out the characteristic MR findings of reversible posterior leukoen-cephalopathy syndrome (RPLS) due to various causes in children. MATERIALS AND METHODS: Eight children with RPLS underwent MR imaging, and the findings were retrospectively analyzed. All eight were acutely hypertensive at the time of a neurotoxic episode. Three had intra-abdominal tumors (one adrenal pheochromo-cytoma, one para-aortic paraganglioma and one para-aortic ganglioneuroma encasing the left renal artery); three were being treated with cyclosporine; one was being treat-ed with steroid; and one had hemolytic uremic syndrome. Initial cranial MR images were analyzed with particular emphasis on the distribution of the lesions. To assess possible sequelae, follow-up MR images were obtained in seven patients at least one week after the treatment of hypertension. Four underwent proton MR spectroscopy. RESULTS: Characteristic distribution of lesions in the occipital and posterior parietal lobes was identified in all cases regardless of the causes of RPLS. The cerebellum, basal ganglia, anterior parietal, and frontal lobe were involved in four, two, one, and one case, respectively. Cortical gray matter involvement was predominant in six and subcortical white matter involvement predominated in two patients. The distribution of lesions was bilateral and asymmetric. Gyriform enhancement was identified in six cases, and small hemorrhage was noted in one. In seven patients, the clinical and MR findings improved without sequelae on follow-up study. In one, proton MR spectroscopy demonstrated a high lactate peak at the time of the neurologic event. Nearnormal spectra were noted in three children who underwent proton MR spectroscopy after recovery. CONCLUSION: The MR findings of RPLS are characteristic in that lesions are distributed in the posterior region of the brain and they are reversible on follow-up study. In children with RPLS due to unknown causes, the possibility of intra-abdominal tumors should also be considered.
Basal Ganglia ; Brain ; Cerebellum ; Child* ; Cyclosporine ; Follow-Up Studies ; Frontal Lobe ; Ganglioneuroma ; Hemolytic-Uremic Syndrome ; Hemorrhage ; Humans ; Hypertension ; Lactic Acid ; Magnetic Resonance Imaging* ; Magnetic Resonance Spectroscopy ; Paraganglioma ; Parietal Lobe ; Posterior Leukoencephalopathy Syndrome* ; Protons ; Rabeprazole ; Retrospective Studies

Systemic lupus erythematosus is a systemic disorder which has frequent involvement of gastrointestinal tract. Non specific symptoms such as anorexia, nausea, diarrhea and abdominal pain are well known symptoms when the gastrointestinal tract is involved. The most feared gastrointestinal complication of systemic lupus erythematosus is lupus enteritis. The pathological change in lupus enteritis is usually a result of mesenteric vasculitis. Major complications such as intestinal bleeding and perforation may occur and sometimes result in sugery. Because of high mortality rate in case of major complications, early diagnosis and appropriate treatment is very important. We experienced three patients with lupus enteritis who presented with severe abdominal pain and dirrhea. They were diagnosed by characteristic radiographical findings of small bowel series and barium study. All radiographical findings has been resolved completely with the steroid therapy. Conclusively we can induce complete remission by steroid therapy alone, if we diagnose lupus enteritis in the early period of disease course.
Abdominal Pain ; Anorexia ; Barium ; Diarrhea ; Early Diagnosis ; Enteritis* ; Gastrointestinal Tract ; Hemorrhage ; Humans ; Lupus Erythematosus, Systemic ; Mortality ; Nausea ; Vasculitis

BACKGROUND: The aim of this study was to compare the efficacy of ketorolac, paracetamol, and paracetamol plus morphine on pain relief after thyroidectomy. METHODS: Eighty patients were randomly allocated to one of the 4 groups: normal saline (group C), ketorolac 30 mg (group K), paracetamol 1 g (group P), and paracetamol 700 mg plus morphine 3 mg (group PM). Each regimen was administered intravenously (IV) 30 min. before the end of surgery. If pain was not relieved, patients received an IV bolus of pethidine hydrochloride 25 mg. Pain intensity using a visual analogue scale (VAS) was recorded at 0.5, 1, 2, 4, and 6 hr after the end of surgery. RESULTS: VAS at 0.5 and 1 hr after the end of surgery were significantly lower in group K, group P, and group PM than in group C (P < 0.05). The number of patients receiving pethidine hydrochloride at 0.5 and 1 hr after the end of surgery was significantly lower in group K, group P, and group PM than in group C (P < 0.05). There was no significant difference among the groups in the incidences of adverse events associated with study medications and patient satisfaction (P > 0.05). CONCLUSIONS: Paracetamol 1 g IV possesses a similar analgesic efficacy to ketorolac 30 mg IV after thyroidectomy. Paracetamol may represent an alternative to ketorolac for pain prevention after mildly to moderately painful surgery in situations where the use of NSAIDs is unsuitable.
Acetaminophen ; Analgesics ; Anti-Inflammatory Agents, Non-Steroidal ; Humans ; Incidence ; Ketorolac ; Meperidine ; Morphine ; Patient Satisfaction ; Thyroidectomy

Primitive neuroectodermal tumors (PNET) of the ovary are rare tumors with an exclusive or almost exclusive malignant neuroectodermal composition, and are generally regarded as a monodermal expression of an ovarian teratoma. The tumors are basically identical with the lesions of the same name occuring typically in the central nervous system of children. These tumors consist chiefly of undifferentiated small cells resembling neuroblasts. There are also mature, well- differentiated neuroectodermal cells, such as astrocytes and ependymal cells. We report a case of ovarian PNET with glial and neuroblastic differentiation and focal teratomatous foci of non-neural tissue in a 17-year-old female.
Adolescent ; Astrocytes ; Central Nervous System ; Child ; Female ; Humans ; Neural Plate ; Neuroectodermal Tumors, Primitive* ; Ovary* ; Teratoma

Purpose: The treatment of fractures has shown excellent safety enabling solid fixation and early exercise treatment with the development of internal metal fixtures and fixation techniques. On the other hand, complications remain, such as secondary surgery for implant removal and, discomfort caused by internally fixed metal materials. Recently, a bioabsorbable magnesium implant with relatively high strength and low decomposition, manufactured using only body components, was developed in the form of screws and K-wire for use in orthopedic surgery. This study aimed to apply bioabsorbable magnesium screws and K-wires to upper extremity fracture surgery and investigate the results. Materials and Methods: From May 2019 to September 2019, 46 cases (clavicle 11, humerus 4, olecranon 2, radial head 4, coronoid process 3, radius 4, ulna 1, phalanx 8, metacarpals 8, and hamate 1) in 44 patients who agreed to use a bioabsorbable magnesium implant among patients requiring internal fixation using screws and K-wires for upper extremity fractures at the author’s orthopedic surgery department were enrolled. The U&I Corporation commissioned this study, and a prospective study was conducted. The radiological findings and The Disabilities of the Arm, Shoulder, and Hand (DASH) score, hydrogen gas generation, and complications were evaluated. In comminuted fractures, the magnesium screws and K-wires were used for additional interfragmentary fixation with a conventional metal plate and screws in 22 cases. There were 24 cases of exclusive usage. The most common surgical method was intramedullary fixation of bioabsorbable magnesium K-wires in 10 cases. Results: In all cases, bone union was achieved on average 16 weeks (4–28 weeks) after surgery, and the mean DASH score at the last follow-up was 45.0 (30–116). A hydrogen gas cavity produced around the absorbable magnesium implant was observed at an average of two weeks and six days, and the largest was noted at an average of 12 weeks. There were no interactive reactions with drugs, infection, osteolysis, tendon rupture and swelling with hydrogen gas. There were two cases of the loss of reduction, one case of implant breakage, two cases of urticaria. Conclusion Bioabsorbable magnesium screws and K-wires can be applied for upper extremity fractures, but caution is required.