PURPOSE: Many articles have proposed that osteonecrosis of the femoral head (ONFH) is caused by fat embolism or intravascular coagulation linked to hyperlipidemia. To determine whether hyperlipidemia is an associated factor for ONFH, serum lipid levels were measured. MATERIALS AND METHODS: Nighty-eight patients presenting with ONFH and 110 controls were investigated. We compared the average value of serum lipid levels and the incidence of hyperlipidemia of the two groups. RESULTS: ONFH group showed generalized increase in lipid level and statistically significant difference in the average value of total cholesterol (P=0.0001), HDL-cholesterol (P=0.0261) and phospholipid (P=0.0465) compared with the control. The incidence of hyperlipidemia of the two groups showed statistically significant difference in HDL-cholesterol (P=0.019) and triglyceride (P=0.024). CONCLUSION: Hyperlipidemia seems to be associated with pathogenesis of ONFH. We speculated that hyperlipidemia might be a contributing factor of ONFH. Hyperlipidemia may play a role as a triggering factor in the pathogenetic process that results in osteonecrosis. However, it can not be ruled out that secondary hyperlipidemia might be a finding following ONFH.
Cholesterol ; Embolism, Fat ; Head* ; Humans ; Hyperlipidemias ; Incidence ; Osteonecrosis* ; Triglycerides

No abstract available.
Neck Dissection* ; Neck*

PURPOSE: Oxaliplatin is a third-generation platinum compound, and it has no nephrotoxicity and has reduced bone marrow toxicity. Cancer cells that are resistant to cisplatin are sensitive to oxaliplatin. Oxaliplatin is used widely for the treatment of colon cancers. Recently, oxaliplatin was reported to inhibit the expression of survivin, which protects cell apoptosis. However, there are no reports on the expressions of survivin variants and the changes in intracellular localization of survivin in cancer cells. We studied the expression of survivin caused by oxaliplatin in HCT116 colon cancer cells, and we observed the localization of survivin in the mitotic phase. METHODS: We treated the HCT116 colon cancer cells with 2.0 micrometer of oxaliplatin, and we studied the expressions of survivin protein, and survivin mRNA variants, as well as the changes in intracellular localization, by using the Western blot method, RT-PCR, immunocytochemistry, and flowcytometry. RESULTS: Oxaliplatin inhibits the expression of the survivin protein and survivin mRNA in HCT116 colon cancer cells. The expression of the survivin-2B variants, which have no antiapoptotic activity but control cell mitosis by localization on a microtubule, is reduced continuously 2 days after treatment with oxaliplatin. In immunocytochemistry, expression of survivin in the cytoplasm is reduced and especially is not expressed in microtubules and contractile rings. CONCLUSION: One of the mechanisms of oxaliplatin is to inhibit the expression of and to change the localization of survivin. Based on these results, we suggest that changes in the expression of survivin variants and in their localization are two effects of oxaliplatin.
Apoptosis ; Blotting, Western ; Bone Marrow ; Cisplatin ; Colon ; Colonic Neoplasms ; Colorectal Neoplasms ; Cytoplasm ; Immunohistochemistry ; Microtubules ; Mitosis ; Organoplatinum Compounds ; Platinum ; RNA, Messenger

In connective tissue diseases, autoantibodies cause pulmonary interstitial inflammation and fibrosis, and patients require treatment with an immunosuppressive agent such as a steroid. Dermatomyositis is an incurable, uncommon form of connective tissue disease that occasionally causes diffuse pulmonary inflammation leading to acute severe respiratory failure. In such cases, the prognosis is very poor despite treatment with high-dose steroid. In the present case, a 46-year-old man was admitted to our hospital with dyspnea. He was diagnosed with dermatomyositis combined with cryptogenic organizing pneumonia (COP) with respiratory failure and underwent treatment with steroid and an immunosuppressive agent, but the COP was not improved. However, the respiratory failure did improve after treatment with intravenous immunoglobulin, which therefore can be considered a treatment option in cases where steroids and immunosuppressive agents are ineffective.
Autoantibodies ; Connective Tissue Diseases ; Cryptogenic Organizing Pneumonia* ; Dermatomyositis* ; Dyspnea ; Fibrosis ; Humans ; Immunoglobulins* ; Immunosuppressive Agents ; Inflammation ; Lung Diseases, Interstitial ; Middle Aged ; Pneumonia ; Prognosis ; Respiratory Insufficiency ; Steroids

The Leber's hereditary optic neuropathy, which affects mainly males in the late teens or in the early twenties, is a rare inherited disorder characterized by bilateral rapid loss of central vision. Leber's disease undergoes like optic neuritis in acute stage, but in late stage it results in optic atrophy with severe impairment of visual acuity and absolute central scotoma. Recently the authors have experienced two cases of Leber's optic neuropathy in a family. We observed a patient whose visual acuity of right eye was 0.8 at first examination, but reduced to 0.04 by 2 months after onset in spite of medical treatment, So we described the characteristic clinical findings of Leber's disease with brief review of the literatures.
Adolescent ; Humans ; Male ; Optic Atrophy ; Optic Atrophy, Hereditary, Leber* ; Optic Neuritis ; Scotoma ; Siblings* ; Visual Acuity

We report 23 cases of silicone stents intubation for obstruction of lacrimal drainage system in 23 patients with tearing and mucopurulent material discharge from January 1985 to April 1988. The success rate of silicone stents intubation was 47.4% and the most common site of obstruction was nasolacrimal duct(56.5%). 30.3% of patients had complications related to silicone stents, conjunctivitis, punctal erosion etc. With these results, we consider that congenital dacryostenosis, partical and complete nasolacrimal duct obstruction is mainly indicated for silicone stents intubation and better results will be gained if be done with acryocystorhinostomy to prevent complications related to silicone stents.
Conjunctivitis ; Drainage* ; Humans ; Intubation* ; Nasolacrimal Duct ; Silicones* ; Stents

A cadaveric study was performed to investigate the relationship between disc degeneration and morphological changes in the intervertebral foramen of cervical spine, including the effect on the nerve root. Seven fresh frozen human cadavers were dissected from C1 to T1, preserving the ligaments, capsules, intervertebral disc and the neural structures. The specimens were scanned with MRI and then scanned through CT scan in the upright position. Direct mid-sagittal and 45 degree oblique images were obtained to measure the dimension of the intervertebral disc height, foraminal height, width, area and segmental angles. Disc degeneration was inversely correlated with disc height. There was a significant correlation between disc degeneration and foraminal width (p<0.005) and foraminal area (p< 0.05), but not with foraminal height. Disc height was correlated with foraminal width but not with height. The segmental angles were decreased more in advanced degenerated discs. There was a correlation between nerve root compression and decreased foraminal width and area (p<0.005). This information and critical dimensions of the intervertebral foramen for nerve root compression should help in the diagnosis of foraminal stenosis of the cervical spine in patients presenting with cervical spondylosis and radiculopathy.
Adult ; Aged ; Aged, 80 and over ; Cadaver ; Female ; Human ; Intervertebral Disk/*pathology/radiography ; Magnetic Resonance Imaging/*methods ; Male ; Middle Aged ; Spine/*pathology/radiography ; Support, Non-U.S. Gov't ; Tomography, X-Ray Computed/*methods

Hemorrhagic radiation proctitis is infrequently seen in patients receiving pelvic irradiation. The treatment of hemorrhagic ralation proctitis is often difficult. Many patients need reyeated hospitalizations and blood transfusions. Occasionally patiets will develop severe or recurrent rectal bleeding. In case of massive bleeding requiring excessive transfusion, colonic diversion by construction of a colostomy or excision of the diseased segment may be inevitable. However, surgical procedures in these patients are associated with a high mortality and morbidity. Moreover, medical therapy is usually ineffective. Recently formalin therapy has been introduced as a simple and effective treatment for hemorrhagic radiation proctitis. We experienced a 69 year-old woman patient who developed severe homorrhagic proctitis 1 year after radiotherapy for carcinoma of the cervix. She had not improved by conservative management and required blood tranafusions and repetitive hospitalizations. After local application of a 4% formalin solution in the diseased rectum under caudal anesthesia, the bleeding immediately stopped and the patient was discharged from the hospital, and no recurrence has been observed until now.
Aged ; Anesthesia, Caudal ; Blood Transfusion ; Cervix Uteri ; Colon ; Colostomy ; Female ; Formaldehyde* ; Hemorrhage ; Hospitalization ; Humans ; Mortality ; Proctitis* ; Radiotherapy ; Rectum ; Recurrence

BACKGROUND/AIMS: To investigate the use of measurements of liver stiffness (LS) by two-dimensional real-time shear wave elastography (SWE) for predicting the development of hepatocellular carcinoma (HCC) in patients with chronic hepatitis B (CHB). METHODS: We retrospectively collected data on 291 enrolled patients with CHB whose LS had been measured using SWE. RESULTS: The mean age of the patients was 46.8 years; males predominated (67%), and 40 of the patients (14%) had clinical cirrhosis. Among the patients, 165 (56.7%) received antiviral treatment. The median LS value was 7.4 kPa, and the median follow-up period was 35.8 months (range, 3.0 to 52.8 months). During follow-up, HCC developed in 13 patients (4.5%), and the cumulative incidence rates of HCC at 1, 2, and 4 years were 1.1%, 3.6%, and 8.4%, respectively. Based on a multivariate analysis, older age (≥50 years) and higher LS value (≥10 kPa) were independently associated with the risk of developing HCC (hazard ratio [HR], 4.53, p=0.023; and HR, 4.08, p=0.022). The cumulative incidence rate of HCC was significantly higher in patients with higher LS values (≥10 kPa) than in those with lower LS values ( < 10 kPa) (p=0.001). CONCLUSIONS: Increased LS measured by SWE at any time point regardless of antiviral treatment is associated with an increased risk of HCC in patients with CHB.
Carcinoma, Hepatocellular* ; Elasticity Imaging Techniques* ; Fibrosis ; Follow-Up Studies ; Hepatitis B ; Hepatitis B, Chronic* ; Hepatitis, Chronic* ; Humans ; Incidence ; Liver ; Male ; Multivariate Analysis ; Retrospective Studies

PURPOSE: Although there is an increasing incidence of upper third gastric cancers, the appropriate extent of resection for upper third gastric cancer is not known. This study was performed to analyze a 9-year experience with upper third gastric adenocarcinomas from one institution treated by either total gastrectomy (TG) or proximal gastrectomy (PG). METHODS: The records and survival data of 158 upper third gastric cancer patients who underwent curative TG (n=106) or PG (n=52) through an exclusively abdominal approach were retrospectively analyzed. RESULTS: There was no significant difference in age, sex, tumor gross type, tumor differentiation, and stage between the groups who underwent TG and those who underwent PG. In addition, there were no significant differences in hospital mortality, overall 5-year survival, and disease-free survival rates between PG and TG group. However, PG group showed higher rates of postoperative reflux esophagitis and anastomosis stricture than TG group. Regarding the main patterns of recurrence, local recurrence was dominant in PG group, whereas distant recurrence was dominant in TG group. CONCLUSION: The extent of resection for upper third gastric cancer does not affect long-term outcome, and both procedures can be accomplished safely. When the cancer is confined to upper third of the stomach without serosal invasion, PG combined with antireflux procedures can be indicated.
Adenocarcinoma ; Constriction, Pathologic ; Disease-Free Survival ; Esophagitis, Peptic ; Gastrectomy ; Hospital Mortality ; Humans ; Incidence ; Prognosis ; Recurrence ; Retrospective Studies ; Stomach ; Stomach Neoplasms*