Osteonecrosis (Avascular necrosis) of the bone is a known complication of systemic corticosteroid therapy and may he dose related. It also has been associated less commonly with nonsteroida1 chemotherapy. Nonetheless, avascular necrosis of bone has heen reported infrequently in children who have received antileukemia regimens including prednisone. We report our experience with one adolescent girl with acute lymphocytic leukernia (ALL) who developed hoth femoral condylar osteonecrosis presenting bone pain after aggressive chemotherapy that including high cumulative dosage of corticosteroid as well as other antileukemia agents. We performed arthroscopic surgery with debridement, multiple drilling and screw fixation to the lesion sites. Eight months after operation, she was free of pain with full range of both knee movements. We got good resuit according to Hughston criteria.
Adolescent ; Arthroscopy ; Child ; Debridement ; Drug Therapy ; Drug Therapy, Combination* ; Female ; Humans ; Knee* ; Osteonecrosis* ; Precursor Cell Lymphoblastic Leukemia-Lymphoma* ; Prednisone

The authors report a xase of primary non-gestational choriocarcinoma(PNGCO) of the ovary in a prepubertal female patient and reviewed. It is an extremely rere disease of which incidence is one in 369 million. Major clinical symptom is abdominal pain, precociois puberty and it can be misdiagneosed as ectopic pergnancy. Distinction from gestational choriocarcinoma(GCO) of the ovary is important because of the worse prognosis of PNGCO. But no distinctive ultrastructural or immunohistochemical differences are found between PNGCO and GCO. Most acceptable treatment modality is an aggressive surgical therapy and systemic chemotherapy, but its progrosis is poor.
Abdominal Pain ; Adolescent ; Choriocarcinoma, Non-gestational* ; Drug Therapy ; Female ; Humans ; Incidence ; Ovary* ; Prognosis ; Puberty

A case of calcifying synovial sarcoma, occuring in the deep muscle fascia of the left thigh is reported. The presence of extensive calcification in synovial sarcoma is a favorable sign for prognosis. The patient was a 31-year-old female. The tumor mass had been present for 3 years, accompanying local tenderness. X-ray revealed a soft tissue tumor with central calcification, which was located between the adductor magnus and brevis of the left thigh. The tumor size was 7 x 5.5 cm. There was no connection with the knee joint or the femur. Grossly, the tumor was a relatively well circumscribed hard tumor with massive calcification. Microscopically, the tumor was composed of predominantly spindle cells with accompanying hyalinization, numerous spherical concretions and ossification. The epithelial component was not clearly noted. Mitotic figures were rarely noted in the densely cellular area. Immunohistochemical staining for EMA, S-100, vimentin, and carcinoembryonic antigen was negative while vimentin and cytokeratin were weakly and focally positive. EM study revealed multiple desmosome-like calcification intercellular junctions with a slit-like lumen and an incomplete basal lamina, which suggest that tumor show these cells were undergoing epithelia] differentiation. Above evidence suggest that this tumor is a synovial sarcoma associated with a large area of calcification, a so called calcifying synovial sarcoma. No recurrence was noted in one and half years of follow up.
Female ; Humans

PURPOSE: This study was intended to evaluate the positional relationship between the hyoid bone and the mandible in patients with mandibular protrusion after mandibular set-back surgery by means of 3D-CT. MATERIALS AND METHODS: Preoperative(3 weeks before) and postoperative (6 weeks after) 3D-CT and cephalogram were taken on 32 patients(12 male, 20 female, mean age of 23.2) treated by bilateral sagittal split osteotomy with rigid fixation. The angular measurement on 3D-CT basilar view were deviation of Me and H, long axis angle of left and right cornu majus. The lineal measurement on 3D-CT basilar view were composed of intercondylar line and coordinates(x,y) of Me and H. The angular and lineal measurement of lateral cephalogram were composed of mandibular plane angle, SNA, SNB, ANB, FH-NA and FH-NB, and coordinates(x,y) of B, Pog, Me and H, PAS, Lpw, MPH and IAS. On the frontal cephalogram, deviation of Me were evaluated. RESULTS: The mean mandibular set-back was 8.0mm horizontally and mandibular plane angle was slightly increased. The hyoid bone was displaced postero-inferiorly, the distance between MP(mandibular plane) and H(hyoid bone) was increased and the posterior airway space values (PAS, Lpw, IAS) were decreased. The coordinates Me(x,y), H(x,y) and deviation angle Me' and H'were revealed the strong positive correlation. CONCLUSION: The results revealed that the horizontal, vertical and transverse relationship of the mandibular and the hyoid bone movements were significantly correlated in patients performed mandibular set-back surgery.
Axis, Cervical Vertebra ; Female ; Humans ; Hyoid Bone* ; Male ; Mandible* ; Orthognathic Surgery* ; Osteotomy

No abstract available.
Thanatophoric Dysplasia*

No abstract available.
Vascular Endothelial Growth Factor A*

A 19-year-old man had a good neurologic recovery from a severe hypothermia(19 degrees C) and a prolonged coma following active infernal rewarming. From inhaling hydrocarbons, he was left unconscious on the cold floor for 24 hours. As soon as the patient was brought into the emergency medical center, he was early evaluated arid treated aggressively. ECG showed Osborn(J) wave on all leads. The temperature o( patient was increased by 2-3 degrees C per hour through active external rewarming (by heating blankets and warm bag) and active infernal rewarming (by airway rewarming, warmed IV fluids, gastrointestinal tract irrigation, and bladder irrigation). The temperature reached 36 degrees C after 6 hours. Active infernal rewarming provides rapid core rewarming with the additional benefit of circulatory support during the period of cardiac instability.
Coma ; Electrocardiography ; Emergencies ; Gastrointestinal Tract ; Heating ; Hot Temperature ; Humans ; Hydrocarbons* ; Hypothermia* ; Inhalation ; Rewarming ; Unconsciousness* ; Urinary Bladder ; Young Adult

PURPOSE: To establish the interobserver and intraobserver reliability of the Coonrad classification for an idiopathic coronal curve pattern. MATERIALS AND METHODS: Radiographs of 257 idiopathic scoliosis patients that had a rib humping of more than 1 cm and a Cobb angle of more than 10 were reviewed. The interobserver and intraobserver reliability was assessed by a comparison of the classification of the curves between four observers. RESULTS: In the Coonrad classification, a 1A type-curve occurred in 37 cases, the 1B type-curve occurred in 27 cases, the 2A type-curve occurred in 70 cases, a 2B type-curve occurred in 22 cases, a 3 type-curve occurred in 44 cases, a 4 type-curve occurred in 6 cases, a 5 type-curve occurred in 15 cases, a 6 type-curve occurred in 22 cases, a 7 type-curve occurred in 13 cases and a 8 type curve occurre in 1 case. The interobserver reliability for the Coonrad classification was 0.60 and the intraobserver reliability was 0.71. CONCLUSION: The Coonrad classification proved to be relatively reliable, but revealed some confusion, particularly between type 2A and type 3. Also, there seemed to be no advantage in using this method of determining the treatment modality compared with the conventional scoliosis classification system.
Adolescent* ; Classification* ; Humans ; Ribs ; Scoliosis*

The ability of viral oncoproteins to subvert cell cycle checkpoints may constitute a mechanism by which viral oncoproteins induce genetic instability. HPV 16 E6 and E7 disrupt cell cycle checkpoints, particularly affecting nearly all cyclin-dependent kinase inhibitors linked to the G1- and G2- checkpoints, in each case by means of a different mechanism. HPV 16 E7 shows homology with the pRb binding sites of cyclin D1, which consequently releases E2F. In addition, E7 directly binds to p21, and releases PCNA and other S-phase promoting genes. In turn, released E2F activates cyclin E, and cyclin E accelerates p27 proteolysis as a function of the antagonistic reaction of its own inhibitor. The induction of p16 expression is assumed to be indirectly associated with E7, which is upregulated only after prolonged inactivation of Rb. HPV 16 E6 decreased the fidelity of multiple checkpoints controlling both entry into and exit from mitosis, with the mechanism of p53 inactivation. In addition, HPV 16 E6 increased the sensitivity to chemically induced S-phase premature mitosis and decreased mitotic spindle assembly checkpoint function. Alongside the impressive advances made in the understanding of the molecular mechanisms, which HPV disrupts, the validity of these conclusions should be evaluated in the diagnostic and prognostic fields.
Cervix Neoplasms/*pathology/virology ; Cyclin-Dependent Kinases/*antagonists & inhibitors ; Cyclins/analysis ; Female ; *G1 Phase ; *G2 Phase ; Human ; Microfilament Proteins/analysis ; Papillomavirus Infections/*pathology ; *Papillomavirus, Human ; Proliferating Cell Nuclear Antigen/analysis ; Protein p16/analysis ; Tumor Virus Infections/*pathology

No abstract available.
Endometrial Neoplasms* ; Female