No abstract available.
Biopsy* ; Diagnosis* ; Humans

Radiation therapy is used for the palliative treatment of malignant tumors and the radiation induced osteonecrosis is one of the well documented complications. Especially, in pelvic region, there are a few reports for osteonecrosis of the femoral head and acetabulum after the radiation therapy for the the malignant tumors such as cervical carcinoma or prostatic cancer. Roentgenographic changes that are caused by radiation include the rarefaction of bone and coarsening of the trabeculae. The radiolucencies tend to coalesce and patchy sclerosis appears. In acetabular region, this Pagetoid appearance mimics the findings of other malignant bone tumors, the recurrence of preexisting malignant peivic tumors and other infectious condition. After the diagnosis is confirmed, the treatment for the femoral head and acetabulum is also difficult. The authors report one case of osteonecrosis of the femoral head and acetabulum following radiation therapy which had many difficulties in its diagnosis and treatment.
Acetabulum* ; Diagnosis* ; Head* ; Osteonecrosis* ; Palliative Care ; Pelvis ; Prostatic Neoplasms ; Recurrence ; Sclerosis

From 1981 to 1993, one hundred and thirty eight patients had been treated by free flap or island flap, for the tissue defects of the extremities. Among these 138 patients, vascularized bone graft was 29 cases, soft tissue free flap 40, replantation 22, local island flap 45, and lymphovenous shunt 2. Average age at the time of operation was 27 years(1-66 years), and men were 110, women 28. Average duration of follow-up was 2 years and 8 months(4 months-11 years and 8 months). Twenty nine cases of vascularized bone graft was consisted of fibular graft in 15 patients, ilium 8, joint transplantation 4, thumb reconstruction using big toe 1, and rib 1. Four of them were failed. Among 40 patients of soft tissue free flap, latissimus dorsi flap was 12 cases, dorsalis pedis flap 11, scapular flap 8, wraparound procedure 7 and gracilis flap 2. Seven of them were failed. The levels of replantations were both lower extremities in one patient, leg 1, arm 2, distal forearm 2, and finger(s) 16. In six patients, replantation was nor successful. Among 45 patients of local island flap, lateral supramalleolar island flap was performed in 8 patients, dorsalis pedis flap 2, Chinese flap 10, reverse ulnar artery flap 4, reverse posterior interosseous artery flap 3, neurovascular island flaps for fingers 14, and others 4. Two of them were failed. Two cases of lymphovenous shunt for the treatment of lymphedema were successful. As a whole, 119 cases were successful(86%) among 138 cases including local island flap 45 cases.
Arm ; Arteries ; Asian Continental Ancestry Group ; Extremities ; Female ; Fingers ; Follow-Up Studies ; Forearm ; Free Tissue Flaps ; Hallux ; Humans ; Ilium ; Joints ; Leg ; Lower Extremity ; Lymphedema ; Male ; Replantation ; Ribs ; Superficial Back Muscles ; Surgical Flaps ; Thumb ; Transplants ; Ulnar Artery

Aggressive angiomyxoma (AAM) is a rare, benign tumor. It usually involves the connective tissue of the perineal regions in women of reproductive age. In this report, we present a case of AAM in a 66-year-old female, which presented itself as a retrovesical tumor on pelvic magnetic resonance imaging and caused lower urinary tract symptoms. The tumor was resected en bloc and the patient's voiding symptoms disappeared.
Aged ; Connective Tissue ; Female ; Humans ; Lower Urinary Tract Symptoms ; Magnetic Resonance Imaging ; Myxoma ; Pelvic Neoplasms

No abstract available.
Giant Cell Tumor of Bone* ; Giant Cell Tumors* ; Giant Cells*

PURPOSE:The purpose of this study is to assess the pulmonary airway reactivity in asthmatic patients directly and noninvasively by using high-resolution CT(HRCT). MATERIALS AND METHODS: 130 bronchial luminal areas were measured by HRCT in 16 asthmatic patients before and after inhalation of bronchodilator (Salbutamol sulfate). The change of bronchial luminal area on HRCT was analyzed and correlated with the change of forced expiratory volume in 1 second(FEV1) on pulmonary function test in each patient. RESULTS: The mean percentage of increase in luminal areas of the 130 bronchi after bronchodilator inhalation was 95.4 +/- 103.3%. The group with the smallest luminal areas (lesser than 1.35mm2) was more sensitively increased in area than the group with the largest areas (equal or larger than 3.72 mm2) ;183.5% versus 63.5%. The mean percentage of increase in FEV1 was 21.7% and there was no statistically significant correlation between the increased degrees of luminal areas and that of FEV1(r=-0.04). CONCLUSION:We can measure the bronchial luminal area directly and noninvasively with HRCT and can also estimate the degree of airway reactivity in asthmatic patient by measuring of the changes of bronchial luminal areas after administration of bronchodilator.
Asthma* ; Bronchi ; Forced Expiratory Volume ; Humans ; Inhalation ; Phenobarbital ; Respiratory Function Tests

PURPOSE: p53 gene is a well-known suppressor gene of tumor. And the p53 protein expression in immunohistochemical staining acts a role as a prognostic indicator in prostate and bladder tumor. However, the validity of p53 protein expression was not determined as an independent factor of prognosis in renal cell carcinoma(RCC). Furthermore, there were not enough studies about whether the expression of p53 protein plays a role as a prognostic indicator in RCC or not. Therefore, we evaluate the prognostic significance of p53 protein expression in RCC. MATERIALS AND METHODS: To evaluate the prognostic significance of p53 immunohistochemical staining in RCC, paraffin embedded specimens taken from 84 patients with RCC were studied from January 1982 to April 1997, retrospectively. In addition to the prognostic significance of p53 immunohistochemical staining, correlation between p53 immunohistochemical staining and pT category, nuclear grade, and histologic type was studied. RESULTS: The expression rate of p53 protein was 19.0%(16/84). The most important prognostic indicator of RCC was pT category(relative risk=2.19, p=0.007). And the second important prognostic indicator was the expression of p53 protein(relative risk=1.82, p=0.017). Nuclear grade had prognostic significance(p=0.027) but was not an independent prognostic indicator. The expression of p53 protein did not correlate with pT category, nuclear grade or histologic pattern. CONCLUSIONS: We have shown that the expression of p53 protein in RCC is the second most important prognostic indicator. In conclusion p53 immunohistochemical staining can be used to predict the prognosis in patients with localized RCC after radical nephrectomy.
Carcinoma, Renal Cell* ; Genes, p53 ; Genes, Suppressor ; Humans ; Nephrectomy* ; Paraffin ; Prognosis ; Prostate ; Retrospective Studies ; Urinary Bladder Neoplasms

BACKGROUND: Biochemical bone markers have been suggested to reflect postmenopausal high bone turnover. These markers could be useful in following response to hormone replacement therapy (HRT). But we have few studies about the sequential changes of biochemical bone markers and bone mass after HRT in Korean women, and it is unclear whether women with early menopause have different response to HRT from women with normal menopause. The aims of the present study were to see the sequential changes of biochemical bone markers and bone mass after HRT in Korean women, to examine whether a single baseline biochemical bone marker or a change in biochemical bone marker could predict subsequent bone mass, and to determine the difference of response to HRT between women with early menopause and women with normal menopause. METHODS: Postmenopausal women (n=21) were divided with into three groups according to their age at menopause (AAM): the first group with AAM < or = 43 years (early menopause group, n=7), the second group with 43 years < or = AAM < or = 50 years (n=4), and the third group with AAM > or = 50 years (normal menopause group, n=10). For the HRT, conjugated estrogen (0.625mg per day) and continuous or cyclic medroxyprogesterone (2.5-10mg per day) were administered. Bone mineral density (BMD) was measured at baseline and 12 months and biochemical bone markers were measured at baseline and 3, 6, and 12 months during HRT. RESULTS: Deoxypyridinoline, type 1 collagen N-telopeptide, bone alkaline phosphatase, and osteocalcin were significantly decreased at 3 months, and mean percent changes from baseline of bone resorption markers were larger than those of bone formation markers. At 12 months, BMD was significantly increased at lumbar spine and Ward's triangle. But BMD was not significantly increased at femur neck and femur trochanter. Two baseline bone markers (bone alkaline phosphatase and type 1 collagen N-telopeptide) correlated with changes of BMD but any changes of bone markers at 3, 6 months didn't correlate with changes of BMD. In early menopause group, changes of bone markers and BMD were larger than those in normal menopause group, but the difference between the two groups was not significant. CONCLUSION: All four bone markers showed significant reduction at 3 months, but bone resorption markers were decreased more markedly and rapidly, and some baseline bone markers can predict the change of BMD after HRT. The difference of response to HRT between early menopause group and normal menopause group was not significant.
Alkaline Phosphatase ; Bone Density* ; Bone Resorption ; Collagen Type I ; Estrogens ; Female ; Femur ; Femur Neck ; Hormone Replacement Therapy* ; Humans ; Medroxyprogesterone ; Menopause ; Osteocalcin ; Osteogenesis ; Spine

Renal cell carcinoma (RCC) in autosomal dominant polycystic kidney (ADPKD) is rare. To date, 54 cases of RCC in ADPKD have been reported. Among these, only 2 cases have different histologic types of RCC. Here we describe a 45-year-old man who received radical nephrectomy for multifocal RCC with synchronous papillary and clear cell histology in ADPKD and chronic renal failure under regular hemodialysis. The case reported herein is another example of the rare pathological finding of RCC arising in a patient with ADPKD.
Carcinoma, Renal Cell ; Humans ; Kidney Failure, Chronic ; Middle Aged ; Nephrectomy ; Polycystic Kidney, Autosomal Dominant ; Renal Dialysis

PURPOSE: The prognostic factors influencing the survival rate of patients with localized renal cell carcinomas were evaluated. MATERIALS AND METHODS: The records of 100 patients that had undergone a radical nephrectomy for renal cell carcinomas, and who were pathologically diagnosed with T1N0M0 and T2N0M0 carcinomas, between January 1990 and January 2002, were reviewed. The survival rate according to each prognostic factor, such as T1 or T2 stage, nuclear grade, histologic type, microscopic vascular invasion, the expression of p53 protein and the expression of Human Erythrocyte Glucose Transporter (Glut-1), was analyzed by the Kaplan-Meier method. RESULTS: Among the 100 patients, metastases occurred in 11 and death in 10. The 5-year survival rates of the T1 and 2 were 84 and 89%, respectively. According to the Fuhrman grade, the 5-year survival rates for grades I, II, III and IV were 100, 87, 84 and 64%, respectively. According to the histologic type, the 5-year survival rates for the conventional type, papillary type and chromophobe type were 84, 100 and 88%, respectively. There was no significant difference in the survival rate between the groups, according to the stage, Fuhrman grade and histologic type (p>0.05). No statistical differences were noted between the two groups for microscopic vascular invasion, the expression of p53 protein and the expression of Glut-1 (p>0.05). CONCLUSIONS: Localized renal cell carcinomas treated by a radical nephrectomy had a good prognosis (5-year survival rate: 85%). Fuhrman nuclear grade IV and microscopic vascular invasion tended to have poor prognoses.
Carcinoma, Renal Cell* ; Glucose Transporter Type 1 ; Humans ; Neoplasm Metastasis ; Nephrectomy ; Prognosis ; Survival Rate*