The intertrochanteric fracture of the femur occurs frequently in the elderly who has osteoporosis. These fractures had been treated with many fixation devices. Recently dynamic hip screws been commomly used. But, some complications were reported by this fixation the patients who were osteoporotic and/or who had unstable type fracture. We have analysed the roentgenograms and the medical records to study impaction degree and change of neck-shaft angle according to fracture type and degree of osteoporosis in the 35 patiensts wit minimum 1 year follow-up who have intertrochanteric fracture of the femur treated with dynamic hip screws, from Jhn. 1989 to Jun. 1993, retrospectively. The results obtained were as follows; 1. The most common fracture type by Bord-Griffin classification was type I, 19 cases(57%), and the most common osteoporotic by Sight's index was grade II, 21 cases(60%). 2. There were no significant differences of impaction degree and neck-shaft angle according to the fracture types or osteoporosis degrees. 3. The mean impaction degree of fracture site was 9.3mm and the mean neck-shaft angle change was 0.8。 of varus angulation.
Aged ; Classification ; Femur ; Follow-Up Studies ; Hip Fractures ; Hip ; Humans ; Medical Records ; Osteoporosis ; Retrospective Studies

Endometrial stromal sarcoma (ESS) is a rare malignancy. Development of extrauterine ESS form endometriosis is particularly rare. The majority of extrauterine ESS occurs in areas with preexisting endometriosis. The most common site is the ovary. We experienced a case of ESS of the ovary that arose from endometriosis with multiple disseminated lesions. This disease was managed by total abdominal hysterectomy, bilateral salpingo-oophorectomy, both pelvic lymph nodes dissection, omentectomy, and appendectomy followed by postoperative high-dose progesterone therapy. Here, we report this case with literature review.
Appendectomy ; Endometriosis* ; Female ; Hysterectomy ; Lymph Nodes ; Ovary* ; Progesterone ; Sarcoma, Endometrial Stromal*

OBJECTIVE: This study was conducted using the human papillomavirus (HPV) DNA chip test (HDC), in order to determine whether the HPV genotype is a predictor of residual disease in a subsequent hysterectomy following a loop electrosurgical excision procedure (LEEP) for cervical intraepithelial neoplasia (CIN) 3. METHODS: Between January 2002 and February 2015, a total of 189 patients who underwent a hysterectomy within 6 months of LEEP caused by CIN 3 were included in this study. We analyzed their epidemiological data, pathological parameters, high-risk HPV (HR-HPV) load as measured by the hybrid capture II assay, and HR-HPV genotype as measured by the HDC. A logistic regression model was used to analyze the relationship between covariates and the probability of residual disease in subsequent hysterectomy specimens. RESULTS: Of the 189 patients, 92 (48.7%) had residual disease in the hysterectomy specimen, CIN 2 in seven patients, CIN 3 in 79 patients, IA1 cancer in five patients, and IA2 cancer in one patient. Using multivariate analysis, the results were as follows: cone margin positivity (odds ratio [OR], 2.43; 95% CI, 1.18 to 5.29; p<0.05), HPV viral load > or =220 relative light unit (OR, 2.98; 95% CI, 1.38 to 6.43; p<0.01), positive endocervical cytology (OR, 8.97; 95% CI, 3.81 to 21.13; p<0.001), and HPV-16 or HPV-18 positivity (OR, 9.07; 95% CI, 3.86 to 21.30; p<0.001). CONCLUSION: The HPV-16 or HPV-18 genotype is a reliable predictive factor of residual disease in a subsequent hysterectomy following a LEEP for CIN 3.
Adult ; Aged ; Aged, 80 and over ; Cervical Intraepithelial Neoplasia/*surgery/virology ; Electrosurgery/methods ; Female ; Genotype ; Genotyping Techniques/methods ; Human papillomavirus 16/genetics/*isolation & purification ; Human papillomavirus 18/genetics/*isolation & purification ; Humans ; Hysterectomy ; Middle Aged ; Neoplasm, Residual ; Papillomavirus Infections/*virology ; Prognosis ; Retrospective Studies ; Uterine Cervical Neoplasms/*surgery/virology ; Viral Load

PURPOSE: To evaluate the association between multidrug resistance (MDR) gene and prognosis of acute lymphoblastic leukemia (ALL), several parameters were compared according to the expression status of MDR associated P-glycoprotein. METHODS: 40 bone marrow samples from 36 children of acute lymphoblastic leukemia were analyzed with immunohistochemical stain by C219 monoclonal antibody. RESULTS: 1) The expression of MDR associated P-glycoprotein was positive in 47% at the time of initial diagnosis & 66.7% at relapse. 2) There are no stastical difference between two groups in complete remission rate, relapse rate, mean 2 years survival rate. 3) Event free survival duration was 11.3 months (+/-8.5 months) in P-glycoprotein positive group, while 20 months (+/-7.3months) in P-glycoprotein negative group (P<0.05). 4) There are no stastical difference between two groups in the mean age, sex ratio, initial WBC and immunophenotype of subjects. CONCLUSION: These results suggested the possibility of adopting MDR associated P-glycoprotein in the design of therapeutic regimen and prognostification of childhood acute lymphoblastic leukemia. However, a prospective, randomized study incorporating a larger population should precede before a firm conclusion of significance would draw regarding the prognostic and the therapeutic implication of P-glycoprotein in childhood acute lymphoblastic leukemia.
Bone Marrow ; Child* ; Diagnosis ; Disease-Free Survival ; Drug Resistance, Multiple* ; Humans ; P-Glycoprotein* ; Precursor Cell Lymphoblastic Leukemia-Lymphoma* ; Prognosis ; Prospective Studies ; Recurrence ; Sex Ratio ; Survival Rate

Hydrogen peroxide solution is commonly used for irrigating and cleaning wounds. When it is applied to tissues, catalase causes its rapid molecular degeneration with the release of oxygen bubbles. We present case report illustrating two hazards ; chemical colitis and oxygen embolus. A 29-year-old previously healthy woman presented to the bloody diarrhea and anal pain after hydrogen peroxide enema. In the colonoscopic examination, severe mucosal edema and ulceration with bleeding was noted from anus to sigmoid colon. With use of anal endosonography, multiple high level echo were noted in the internal and external anal sphincter of the upper anal canal. Microscopically, mononuclear cells were infiltrated in lamina propria and congestion. She had treatment with IV fluid, IV antibiotics and NPO. At 3rd hospital day, anal pain was disappeared. Bloody stool was disappeared next day. At 8th hospital day, mucosal edema and ulceration were disappeared on colonoscopic examination. Recovery was full and the patient was discharged at nine days after the episode.
Adult ; Anal Canal ; Anti-Bacterial Agents ; Catalase ; Colitis* ; Colon, Sigmoid ; Diarrhea ; Edema ; Embolism ; Endosonography ; Enema* ; Estrogens, Conjugated (USP) ; Female ; Hemorrhage ; Humans ; Hydrogen Peroxide* ; Hydrogen* ; Mucous Membrane ; Oxygen ; Ulcer ; Wounds and Injuries

PURPOSE: Genetically engineered stem cells may be advantageous for gene therapy against various human cancers due to their inherent tumor-tropic properties. In this study, genetically engineered human neural stem cells (HB1.F3) expressing Escherichia coli cytosine deaminase (CD) (HB1.F3.CD) and human interferon-β (IFN-β) (HB1.F3.CD.IFN-β) were employed against lymph node–derived metastatic colorectal adenocarcinoma. MATERIALS AND METHODS: CD can convert a prodrug, 5-fluorocytosine (5-FC), to active 5-fluorouracil, which inhibits tumor growth through the inhibition of DNA synthesis,while IFN-β also strongly inhibits tumor growth by inducing the apoptotic process. In reverse transcription polymerase chain reaction analysis, we confirmed that HB1.F3.CD cells expressed the CD gene and HB1.F3.CD.IFN-β cells expressed both CD and IFN-β genes. RESULTS: In results of a modified trans-well migration assay, HB1.F3.CD and HB1.F3.CD.IFN-β cells selectively migrated toward SW-620, human lymph node–derived metastatic colorectal adenocarcinoma cells. The viability of SW-620 cells was significantly reduced when co-cultured with HB1.F3.CD or HB1.F3.CD.IFN-β cells in the presence of 5-FC. In addition, it was found that the tumor-tropic properties of these engineered human neural stem cells (hNSCs) were attributed to chemoattractant molecules including stromal cell-derived factor 1, c-Kit, urokinase receptor, urokinase-type plasminogen activator, and C-C chemokine receptor type 2 secreted by SW-620 cells. In a xenograft mouse model, treatment with hNSC resulted in significantly inhibited growth of the tumor mass without virulent effects on the animals. CONCLUSION: The current results indicate that engineered hNSCs and a prodrug treatment inhibited the growth of SW-620 cells. Therefore, hNSC therapy may be a clinically effective tool for the treatment of lymph node metastatic colorectal cancer.
Adenocarcinoma* ; Animals ; Chemokine CXCL12 ; Colorectal Neoplasms ; Cytosine Deaminase* ; Cytosine* ; DNA ; Escherichia coli ; Flucytosine ; Fluorouracil ; Genetic Therapy ; Heterografts* ; Humans ; Interferon-beta ; Lymph Nodes ; Lymphatic Metastasis ; Mice* ; Neural Stem Cells* ; Polymerase Chain Reaction ; Reverse Transcription ; Stem Cells ; Urokinase-Type Plasminogen Activator

Stem cells derived from adult tissues or the inner cell mass (ICM) of embryos in the mammalian blastocyst (BL) stage are capable of self-renewal and have remarkable potential for undergoing lineage-specific differentiation under in vitro culturing conditions. In particular, neural stem cells (NSCs) that self-renew and differentiate into major cell types of the brain exist in the developing and adult central nervous system (CNS). The exact function and distribution of NSCs has been assessed, and they represent an interesting population that includes astrocytes, oligodendrocytes, and neurons. Many researchers have demonstrated functional recovery in animal models of various neurological diseases such as stroke, Parkinson's disease (PD), brain tumors, and metastatic tumors. The safety and efficacy of stem cell-based therapies (SCTs) are also being evaluated in humans. The therapeutic efficacy of NSCs has been shown in the brain disorder-induced animal models, and animal models may be well established to perform the test before clinical stage. Taken together, data from the literature have indicated that therapeutic NSCs may be useful for selectively treating diverse types of human brain diseases without incurring adverse effects.
Adult ; Animals ; Astrocytes ; Blastocyst ; Brain ; Brain Diseases ; Brain Neoplasms ; Central Nervous System ; Embryonic Structures ; Humans ; Models, Animal ; Neural Stem Cells ; Neurons ; Oligodendroglia ; Parkinson Disease ; Stem Cells ; Stroke

OBJECTIVE: Because villoglandular adenocarcinoma (VGA) of the uterine cervix has favorable features and outcomes, patients receive less radical surgery and young women preserve their ovaries. We aimed to evaluate the clinicopathological features and outcomes of VGA and to see if the ovarian preservation is safe in young women with VGA. METHODS: We retrospectively reviewed medical records and identified patients with VGA, who had been treated and followed from January 2004 to December 2015. RESULTS: This study consisted of 17 patients with VGA, including 9 premenopausal women. International Federation of Gynecology and Obstetrics (FIGO) stage IB1 disease was found in 12 patients (70.6%), IA1 in 2, IA2 in 1, IB2 in 1, and IIA1 in 1. Of the 12 women diagnosed with stage IB1 disease, a young woman received only conization and she has not showed a recurrence. During a median follow-up of 58 months (range: 12–116), 4 patients, who had undergone radical surgery for stage IB1 disease, had a recurrence and one of them died due to disease progression. Among patients with stages IB–IIA disease, 2 premenopausal women did not receive simultaneous oophorectomy or chemoradiation therapy. Both of them had a recurrent tumor at adnexa. CONCLUSION: This study revealed favorable features and outcomes of VGA. However, the appropriate treatment for young women with early-stage VGA must be cautiously selected. Ovarian preservation might not be safe when young women with stages IB–IIA VGA undergo surgical procedures.
Adenocarcinoma* ; Adenocarcinoma, Papillary ; Cervix Uteri* ; Conization ; Disease Progression ; Female ; Fertility Preservation ; Follow-Up Studies ; Gynecology ; Humans ; Medical Records ; Obstetrics ; Ovariectomy ; Ovary ; Recurrence ; Retrospective Studies ; Treatment Outcome ; Uterine Cervical Neoplasms

PURPOSE: The purpose of this study was to assess the effectiveness and complications of an ultrasound-guided axillary brachial plexus block performed by orthopedic surgeons. MATERIALS AND METHODS: From March to May 2017, an ultrasound-guided axillary brachial plexus block was performed on a total of 103 cases of surgery. A VF13-5 transducer from Siemens Acuson X300 was used. The surgical site was included in the range of the anatomic sensory distribution of the blocked nerve, except for the case where an operation time of more than 2 hours was expected due to multiple injuries and the operation of the upper arm. The procedure was performed by 2 orthopedic surgeons in the same method using 50 ml of solution (20 ml of lidocaine HCl in 2%, 20 ml of ropivacaine in 0.75%, 10 ml of normal saline in 0.9%). The success rate of anesthesia induction during surgery, anesthetic induction time, anatomical range of operation, duration of postoperative analgesia and complications were investigated. RESULTS: The results from the 2 practices were similar. The anesthesia was successful in 100 out of 103 patients (97.1%). In these patients, the average needling time was 5.5 minutes (2.5–13.2 minutes), the average induction time to complete anesthesia was 18.4 minutes (5–40 minutes), and the average duration of postoperative analgesia was 402.8 minutes (141–540 minutes). The post-anesthesia immediate complications were dizziness in 1 case, nausea and vomiting in 4 cases, and peri-oral numbness in 2 cases, but surgery was performed without problems. All these 7 cases with complications recovered on the same day. A total of 3 cases failed with anesthesia, and they were treated by an injection with local anesthesia in the operation room in 2 cases and switched to general anesthesia in 1 case. CONCLUSION: An ultrasound-guided axillary brachial plexus block, which was performed by orthopedic surgeons allows anesthesia in a brief period and the high success rates of anesthesia for certain surgeries of the elbow and surgeries on forearm, wrist and hand. Therefore, it can reduce the waiting time to the operating room. This technique is a relatively safe procedure and dose selective anesthesia is possible.
Analgesia ; Anesthesia ; Anesthesia, General ; Anesthesia, Local ; Arm ; Brachial Plexus Block* ; Brachial Plexus* ; Dizziness ; Elbow ; Forearm ; Hand ; Humans ; Hypesthesia ; Lidocaine ; Methods ; Multiple Trauma ; Nausea ; Operating Rooms ; Orthopedics* ; Surgeons* ; Transducers ; Vomiting ; Wrist

PURPOSE: In the present study, human neural stem cells (hNSCs) with tumor-tropic behavior were used as drug delivery vehicle to selectively target melanoma. A hNSC line (HB1.F3) was transduced into two types: one expressed only the cytosine deaminase (CD) gene (HB1.F3. CD) and the other expressed both CD and human interferon-β (IFN-β) genes (HB1.F3.CD. IFN-β). MATERIALS AND METHODS: This study verified the tumor-tropic migratory competence of engineered hNSCs on melanoma (A375SM) using a modified Boyden chamber assay in vitro and CM-DiI staining in vivo. The antitumor effect of HB1.F3.CD and HB1.F3.CD.IFN-β on melanoma was also confirmed using an MTT assay in vitro and xenograft mouse models. RESULTS: A secreted form of IFN-β from the HB1.F3.CD.IFN-β cells modified the epithelial-mesenchymal transition (EMT) process and metastasis of melanoma. 5-Fluorouracil treatment also accelerated the expression of the pro-apoptotic protein BAX and decelerated the expression of the anti-apoptotic protein Bcl-xL on melanoma cell line. CONCLUSION: Our results illustrate that engineered hNSCs prevented malignant melanoma cells from proliferating in the presence of the prodrug, and the form that secreted IFN-β intervened in the EMT process and melanoma metastasis. Hence, neural stem cell-directed enzyme/prodrug therapy is a plausible treatment for malignant melanoma.
Animals ; Cell Line ; Cytosine Deaminase ; Epithelial-Mesenchymal Transition ; Flucytosine ; Fluorouracil ; Heterografts ; Humans ; In Vitro Techniques ; Melanoma ; Mental Competency ; Mice ; Neoplasm Metastasis ; Neural Stem Cells ; Stem Cells