OBJECTIVE: The aim of this study is to evaluate the role of tumor suppressor genes, p53 and Rb gene, as well as apoptosis in the carcinogenesis of ovarian epithelial tumors. And the value of these factors as prognostic markers to tell the transformation of borderline tumors to overt carcinomas is also studied. METHOD: Thirty cases of ovarian epithelial benign and borderline tumors and invasive carcinoma were used and the expression of the p53 protein and Rb gene protein were evaluated by immunohistochemical method. The apoptosis was evaluated by TUNNEL method. RESULTS: Positive rate of p53 expression in benign, borderline and invasive tumors were 0, 28, and 94 %, respectively. And also, p53 was highly expressed in chemoresistant cases (2/3), in residual tumor (4/5) and in recurred cancer (2/2). Rb protein was partly lost in the borderline tumors, but the rate of Rb protein loss in both borderline tumors and invasive carcinomas were similar. Apoptosis were more active in overt carcinomas than in borderline and benign tumors. In borderline tumors, p53 protein was expressed as 28.6% positivity, and apoptosis was expressed as 28.6% negativity, which showed indirectly that there was apoptosis induction effect of p53. In ten cases of invasive carcinomas showing highly expressed p53, apoptosis revealed all positive reaction except 2 cases, and Rb protein revealed variously. This result supported the apoptosis imduction effect of p53, but it was difficult to find the association of expression degree between the two tumor supressor genes CONCLUSION: In conclusion, the values of p53 is a discriminating factor of malignancy from benign and the expression of p53 is related with clinical aggressivity such as recurrence and residual cancers. Apoptosis are more active in overt carcinoma than in benign & borderline tumor, and in borderline tumor the expression of p53 is related to apoptosis induction which results to carcinomatous change.
Apoptosis* ; Carcinogenesis ; Genes, Retinoblastoma* ; Genes, Tumor Suppressor ; Neoplasm, Residual ; Recurrence ; Retinoblastoma Protein

Glycogen-rich clear cell carcinoma of the breast is very rare(l -3% of breast cancer). It is defined as a tumor composed of more than 50% of optically clear, neoplastic cells, characterized by centrally located nuclei and abundant cytoplasm, being positive for periodic acid Schiff(PAS) and negative for periodic acid Schiff after diastase(D-PAS) treatment. In the absence of intraductal or in situ lobular carcinoma component, metastatic clear cell carcinomas of other organs should be considered as diagnostic possibilities. We report a case of glycogen-rich clear cell carcinoma arisen in a 62-year-old woman. The tumor revealed both solid and papillary pattern with intraductal component. The neoplastic cells had clear cytoplasm, which were PAS positive, D-PAS negative, mucicarmine negative and oil red 0 negative. More than 90% of tumor cells exhibited moderate staining for anti-estrogen receptor monoclonal antibody. Flow cytometric DNA analysis revealed diploid DNA content.
Female ; Humans ; Neoplasm Metastasis ; Breast Neoplasms

No abstract available.
Diagnosis* ; Exanthema* ; Lymphadenitis* ; Scrub Typhus*

PURPOSE: We assessed the usefulness of high-resolution 3D dynamic MR imaging with sensitivity encoding (mSENSE) for evaluating bile duct cancer. MATERIALS AND METHODS: Twenty-three patients with extrahepatic bile duct cancer underwent multiphasic 3D GRE MRI, including two delayed phases without and with mSENSE. The first delayed phases were obtained with volumetric interpolated breath-hold imaging (VIBE) and then the higher in-plane resolution images (320x168) were obtained using mSENSE. The two delayed phase images were compared quantitatively by measuring the signal-to-noise ratio (SNR) of liver and tumor, the liver-visceral fat contrast and the tumor-visceral fat contrast-to-noise ratio (CNR); the two delayed phase images were compared qualitatively by evaluating the sharpness of the hepatic vessels and bile duct, the artifacts and the conspicuity of bile duct cancer. RESULTS: The quantitative results with mSENSE image were significantly better than those with conventional VIBE. Though the clarity of the intrahepatic vessels and the intrahepatic bile duct, and the artifacts did not differ significantly between the two images (p>0.05), the clarity of the extrahepatic vessels, the extrahepatic bile duct and the bile duct cancer were better on the mSENSE image than on the VIBE (p<0.05). CONCLUSION: The higher in-plane resolution 3D GRE image obtained with mSENSE was of a better image quality than the conventional VIBE images. This technique shows promise for use as a comprehensive exam for assessing bile duct cancer.
Artifacts ; Bile Duct Neoplasms ; Bile Ducts ; Bile Ducts, Extrahepatic* ; Bile Ducts, Intrahepatic ; Humans ; Liver ; Magnetic Resonance Imaging* ; Signal-To-Noise Ratio

Pelvic osteotomy is a surgery for correcting acetabular deformity, which causes incomplete coverage of the femoral head or biomechanically abnormal load to the hip joint. Pelvic osteotomy can be divided into two categories: reconstructive or realignment osteotomy and salvage osteotomy. Reconstructive osteotomy can be performed to correct the dysplastic hip with good congruency, and include most pelvic osteotomies, except Chiari osteotomy. Among these, Bernese osteotomy, rotational acetabular osteotomy, and periacetabular rotational osteotomy are commonly being used. Salvage osteotomy, which include Chiari osteotomy only, can be performed to increase the coverage of the femoral head of hip joint with joint incongruency due to the severely deformed femoral head and acetabulum or advanced osteoarthritis. Chiari osteotomy is a kind of arthroplasty reducing the pressure applied to the head, and increasing the bone coverage on the upper part of the femoral head. It is effective in reducing hip pain and slowing degenerative changes; however, as the surface is covered by fibrous cartilage, it is vulnerable to degenerative changes. The pelvic osteotomy is a very important and useful surgical technique to preserve joints, despite being a difficult procedure that is technically demanding.
Acetabulum ; Adult* ; Arthroplasty ; Cartilage ; Congenital Abnormalities ; Head ; Hip ; Hip Joint ; Humans ; Joints ; Osteoarthritis ; Osteotomy*

Ankylosing spondylitis is a rheumatic disease in which mainly the spinal and sacroiliac joints are affected. Patients with ankylosing spondylitis are at significant risk for spinal fracture when exposed to even minor trauma. Most spinal fractures with ankylosing spondylitis occur in the cervical spine, whereas spinal fractures in thoracic or lumbar spine are rare, especially in the lower lumbar spine. Furthermore, neurologic symptoms in cases of lower lumbar spine fracture are rarer than in cases of cervical and thoracic spinal fracture. We have experienced a case of translation injury of the 3rd lumbar vertebra accompanied by incomplete cauda equine syndrome in ankylosing spondylitis and the authors gained good clinical results with surgical treatment. We have reported here on this case and have included a review of the relevant literature.
Cauda Equina ; Humans ; Neurologic Manifestations ; Polyradiculopathy ; Rheumatic Diseases ; Sacroiliac Joint ; Spinal Fractures ; Spine ; Spondylitis, Ankylosing

Arm injuries occurring from high energy injuries such as falls or traffic accidents can be accompanied by wrist and elbow injuries. Monteggia fracture, Galeazzi fracture, and Essex-Lopresti fracture-dislocation are known some examples of such injuries. However, there are no reports on the dislocation of the elbow occurring from a distal radius fracture accompanied by scaphoid fracture, and there is nothing published about its prognosis. The authors report on the treatment and outcomes of a case of a 42-year-old male who had a distal radius and scaphoid fracture associated with posteromedial dislocation of the elbow on the same side of his arm along with a literature review.
Accidents, Traffic ; Adult ; Arm ; Arm Injuries ; Dislocations ; Elbow ; Humans ; Male ; Monteggia's Fracture ; Prognosis ; Radius ; Radius Fractures ; Wrist

The Superior Shoulder Suspensory Complex (SSSC) is a bony and soft tissue ring comprising the glenoid process, the coracoid process, the coracoclavicular ligaments, the distal clavicle, the acromioclavicular joint, and the acromion. The SSSC maintains a normal stable relationship between the upper extremity and the axial skeleton. High-energy injury, such as traffic accident or a fall, can cause disruption of the SSSC. Single traumatic disruption of the SSSC is common. However, double disruption of the SSSC is infrequent and surgical management is generally necessary. We have experienced a case of triple fracture involving the coracoid process, the acromion, and the distal end of the clavicle. Such disruption of the SSSC has not been previously reported in our country and only one case has been reported in the Western literature; the authors obtained positive clinical results with surgical treatment. We report here on this case and include a review of the relevant literature.
Accidents, Traffic ; Acromioclavicular Joint ; Acromion ; Clavicle ; Ligaments ; Shoulder ; Skeleton ; Upper Extremity

PURPOSE: Nonunion of intra-articular fractures of calcaneus is rarely reported complication. We present our experiences with 4 patients (5 cases) treated operatively for nonunion after intra-articular fracture of calcaneus. MATERIALS AND METHODS:4 patients (5 cases) with nonunion of intra-articular fracture of calcaneus after operative treatment were followed for 4 years (from 2002 to 2006). For assessment, the American Orthopedic Foot and Ankle Society (AOFAS) ankle-hindfoot score and Visual Analogue Scale (VAS) were assessed for clinical outcome and the union of fracture site, the talocalcaneal height and the angle of talar declination were determined for radiologic outcome. RESULTS:The mean talocalcaneal height was 6.94 cm (range, 5.9~7.6 cm) preoperatively and 7.34 cm (range, 6.0~8.3 cm) at last follow-up. The mean angle of talar declination was 5.68 degrees (range, 4.6~8 degrees) preoperatively and 13.1 degrees (range, 5.7~21 degrees) at last follow-up. The mean preoperative AOFAS score and VAS were 20.4 (range, 14~36) and 4 (range, 3~6), respectively. At last follow-up, these scores improved to a mean of 59.6 (range, 54~68) and 3 (range, 2~4), respectively. Unions of previous nonunion site of intra-articular fracture of calcaneus were achieved in all 4 patients (5 cases). CONCLUSION: The reconstructive procedure for nonunion of intra-articular fracture of calcaneus showed good results in terms of bone union, radiologic results and functional improvement than preoperative state. Because the plantar pain for the inferior angular formation in nonunion site may happen, we will pay attention to reduction of fragment.
Animals ; Ankle ; Calcaneus ; Follow-Up Studies ; Foot ; Humans ; Intra-Articular Fractures ; Orthopedics

PURPOSE: Ulrasound-quided percutaneous renal biopsy in useful in diagnosis of renal diseases and assessment of progression. We performaed 420 cases of percutaneous renal biopsy in children since 1980. We analysis the method, results and complications. METHODS: We used modified Vim-Silverman needle or Biopty?gun (pat 4699154, BARD) with Toshiba, 4 MHz GCE-406, aspiration transducer. Sedation was done by demerol(1mg/kg IM) and chlorpromazine(0.6mg/kg IM) 30 minutes before doing biopsy. If needed, general anesthesia was done by ketamine(1mg/kg). RESULTS: Among 420 cases 410 (97.6%) were adequate for diagnosis. There were no life threatening complications such as bleeding or infections. None required blood transfusion or nephrectomy. Two cases developed minor perirenal hematoma, however subsided completely in 2 weeks. The histologic diagnoses in order of frequencies were as follow: MCNS 114(27.1%), IgA nephropathy 88(21.1%), H-S-P nephritis 58(13.8%), MesPGN 22(5.4%), AGN 22(5.4 %),FSGS 19(4.5%). CONCLUSIONS: We recommend renal biopsy with ultrasound localization in children, because it is very safe modality for biopsy.
Anesthesia, General ; Biopsy* ; Blood Transfusion ; Child* ; Diagnosis ; Glomerulonephritis, IGA ; Hematoma ; Hemorrhage ; Humans ; Needles ; Nephrectomy ; Nephritis ; Transducers ; Ultrasonography