PURPOSE: The objective of this study was to ascertain the relationship between epidermal growth factor receptor(EGFR) status and estrogen receptor(ER) and other prognostic factors in primary human breast cancer patients. We tried to evaluate the value of EGFR as a prognostic factor. MATERIALS AND METHODS: EGFR and ER were measured by immunohistochemical staining. It was performed on section from paraffin blocks of 60 primary breast cancer patients who underwent mastectomy at Chung-Ang University Hospital. And we evaluate the relationship between EGFR and ER and other prognostic factors. RESULTS: In 20 of 60 patients(33.3%), the staining was positive for the expression of EGFR. Of the 60 patients, 6 were both positive for EGFR and ER, 25 were both negative, 14 were EGFR positive and ER negative, 15 were EGFR negative and ER positive. Between EGFR and estrogen receptor(ER) status, previously known clear inverse relationship was not observed in our study. The EGFR status was not correlated with axillary lymph node involvement, histologic type, and histologic grading. But it was correlated with tumor size(p=0.049), and there was a high tendency of recurrence rate of patients with EGFR-positive tumors as compared with those with EGFR-negative tumors(p=0.078). CONCLUSION: EGFR status may be valuable as a prognostic factor in determining the prognosis of breast cancer. However, the study of more cases will be needed for the significance of the information about the EGFR as an independent prognostic factor.
Breast Neoplasms* ; Breast* ; Epidermal Growth Factor* ; Estrogens ; Humans ; Lymph Nodes ; Mastectomy ; Paraffin ; Prognosis ; Receptor, Epidermal Growth Factor* ; Recurrence

Three beagle dogs aged over one and half years were used in this study. All mandibular premolars were carefully extracted. Two AVANA implants(Sumin, Korea) and two 3i implants(Implant Innovation, USA) were installed at each right and left side respectively. Each dog was sacrificed at 4, 8. 12 weeks. Non-decalcified specimens were made and stained for a light microscopic study. The results were as follows; 1. Inflammation was not observed in the area of bone tissue adjacent to the implant body. 2. With time, quantity of osseointegration increased in each type of dental implant. There was no difference between AVANA implant and 3i implant. 3. Maturation of the bone around each type of the dental implant increased with time. 12 weeks after implant installation, the bone around dental implant represented compact bone-like appreance. 4. In case implants were located adjacent to a root, newly-formed periodontal ligament tissue was observed around the implant. And the direction of the periodontal ligament fiber was parallel to the surface of the implant. Within the results of this study, AVANA implants represented similar osseointegration in comparision with 3i implants.
Dogs ; Animals

STUDY DESIGN: Cervical spine radiograms of 460 Jeju islanders. PURPOSE: To investigate the age-matched incidences and severity of the cervical disc degeneration and associated pathologic findings. OVERVIEW OF LITERATURE: Several related studies on the incidences of disc and Luschka's and facet joint degeneration have provided some basic data for clinicians. METHODS: Cervical radiographs of 460 (220 males and 240 females) patients in their fourth to ninth decade were analyzed. Ninety patients in their third decade were excluded because of absence of spondylotic findings. RESULTS: Overall incidence of cervical spondylosis was 47.8% (220 of 460 patients). The percentile incidences of spondylosis in the fourth, fifth, sixth, seventh, eighth and ninth decade was 13.2% (10 of 76 patients), 34.6% (37 of 107 patients), 58.9% (66 of 112 patients), 58.8% (50 of 85 patients), 70.3% (45 of 64 patients) and 75.0% (12 of 16 patients), respectively. The percentile incidences of one, two, three, four and five level spondylosis among 220 spondylosis patients was 45.5% (n=100), 34.1% (n=75), 15.0% (n=33), 4.5% (n=10), and 0.9% (n=2). Severity of disc degeneration ranged from ± to ++++, and was ± in 6.0% (24 segments), + in 49.6% (198 segments), ++ in 35.3% (141 segments), +++ in 9.0% (36 segments) and ++++ in 0.25% (one segment). Spurs and anterior ligament ossicle formed at the spondylotic segments, mostly at C4~6. The rate of posterior corporal spurs formation was very low. Olisthesis and ossification of the posterior longitudinal ligament were rarely combined with spondylosis. Cervical lordotic curve decreased gradually according to the progress of severity of spondylosis. CONCLUSIONS: The incidence of cervical spondylosis and number of spondylotic segments increase, and degeneration gradually becomes more severe with age.
Humans ; Incidence* ; Intervertebral Disc Degeneration ; Ligaments ; Longitudinal Ligaments ; Male ; Spine ; Spondylosis* ; Zygapophyseal Joint

The authors had analysed retrospectively a series of 286 consecutive patients with head injury who were admitted to the department of neurosurgery. Dong Gang Hospital between March and July, 1992. 59 cases underwent craniotomy for evacuation of intracranial hematoma and/or placement of subarachnoid bolt for intracranial pressure monitoring under general anesthesia. Patients with a Glasgow Coma Scale(GCS) Score of 8 or less had significantly higher serum glucose levels postoperatively than patients with GCS score of 12 to 15(p<0.05). Patients who subsequently remained in a vegetative state or died had significantly higher glucose levels postoperatively than patients who had good outcome or moderate disability(p<0.05). Among the more severely injured patients(GCS Score< or =8), a serum glucose level greater than 200mg/dl on admission is associated with a significantly worse outcome(p<0.05). The results suggest that severely head-injured patients frequently showed hyperglycemia and the elevted serum glucose level may worsen the neurological outcome in such patients.
Anesthesia, General ; Blood Glucose* ; Coma ; Craniocerebral Trauma ; Craniotomy ; Glucose ; Hematoma ; Humans ; Hyperglycemia ; Intracranial Pressure ; Neurosurgery ; Persistent Vegetative State ; Retrospective Studies

BACKGROUND AND OBJECTIVES: The use of several approaches, involving different cerebellopontine angles, has enabled vestibular schwannoma removal to be tailored to each patient's pathology and physiological status. The retrosigmoid approach provides simple and direct access to cerebello-pontine angle lesions. SUBJECTS AND METHODS: We retrospectively assessed outcomes in 35 consecutive patients who underwent vestibular schwannoma removal via the retrosigmoid approach. RESULTS: Of the 35 patients, 12 were men and 23 women; their age was 52.5+/-10.4 years (range, 35-75 years). One tumor was small (< or =1 cm), 18 were medium (1-3 cm), and 16 (45.7%) were large (>3 cm). Symptoms included hearing disturbance (31 patients, 89%), tinnitus (14 patients, 40%), headache (12 patients, 34%), vertigo (11 patients, 31%), and facial palsy (9 patients, 25%). Postoperative complications included facial palsy, intracranial hemorrhage, dysphagia, and disseminated intravascular coagulopathy, with facial palsy remaining permanently. Four patients (11.4%) had tumor regrowth, at a mean of 36.3 months after primary surgery. The mean diameter of regrowing tumors was 20.5+/-4.4 mm (range 14.5-25.0 mm). CONCLUSIONS: The retrosigmoid approach for vestibular schwannoma removal was associated with higher rates of facial palsy and hearing loss. This approach, however, can minimize injury to the lower cranial nerve.
Cerebellopontine Angle ; Cranial Nerves ; Deglutition Disorders ; Facial Paralysis ; Headache ; Hearing ; Hearing Loss ; Humans ; Intracranial Hemorrhages ; Male ; Neuroma, Acoustic ; Postoperative Complications ; Retrospective Studies ; Tinnitus ; Vertigo

BACKGROUND AND OBJECTIVES: The use of several approaches, involving different cerebellopontine angles, has enabled vestibular schwannoma removal to be tailored to each patient's pathology and physiological status. The retrosigmoid approach provides simple and direct access to cerebello-pontine angle lesions. SUBJECTS AND METHODS: We retrospectively assessed outcomes in 35 consecutive patients who underwent vestibular schwannoma removal via the retrosigmoid approach. RESULTS: Of the 35 patients, 12 were men and 23 women; their age was 52.5+/-10.4 years (range, 35-75 years). One tumor was small (< or =1 cm), 18 were medium (1-3 cm), and 16 (45.7%) were large (>3 cm). Symptoms included hearing disturbance (31 patients, 89%), tinnitus (14 patients, 40%), headache (12 patients, 34%), vertigo (11 patients, 31%), and facial palsy (9 patients, 25%). Postoperative complications included facial palsy, intracranial hemorrhage, dysphagia, and disseminated intravascular coagulopathy, with facial palsy remaining permanently. Four patients (11.4%) had tumor regrowth, at a mean of 36.3 months after primary surgery. The mean diameter of regrowing tumors was 20.5+/-4.4 mm (range 14.5-25.0 mm). CONCLUSIONS: The retrosigmoid approach for vestibular schwannoma removal was associated with higher rates of facial palsy and hearing loss. This approach, however, can minimize injury to the lower cranial nerve.
Cerebellopontine Angle ; Cranial Nerves ; Deglutition Disorders ; Facial Paralysis ; Headache ; Hearing ; Hearing Loss ; Humans ; Intracranial Hemorrhages ; Male ; Neuroma, Acoustic ; Postoperative Complications ; Retrospective Studies ; Tinnitus ; Vertigo

No abstract available.
Wolf-Hirschhorn Syndrome*

BACKGROUND: To assess the myocardial perfusion state after myocardial infarction, Tl-201 SPECT (Thallium-201 Single Photon Emission Computed Tomography) with a repeated "booster" injection before the acquisition of delayed redistribution image is more sensitive and more effective than conventional 4 hour redistribution image. However, this protocol has several disadvantages such as patient inconvenience, additional Tl-201 dose and compromised quantitative analysis. In this study, we compared 4 hour nitrate-augmented redistribution protocol with standard 24 hour delayed redistribution protocol with reinjection to evaluate the usefulness of sublingual nitrate to augment myocardial perfusion and the effectiveness of myocardial assessment for each protocol. METHODS: In 20 myocardial infarction patients, stress-redistribution Tl-201 SPECT was performed. Immediately after resting redistribution image was taken, each patient was administered 0.6 mg of nitroglycerin sublingually without additional Tl-201 and nitrate-augmented SPECT was taken after 30 minutes. Each patient then returned the next day and was injected with a booster dose of Tl-201 30 minutes before the delayed redistribution SPECT acquisition. For the analysis of SPECT study, the myocardium was divided into 22 segments, and the perfusion to each segment was scored on a four-point scale by consensus. An overall cardiac perfusion score was derived by summing the perfusion score for each segment. RESULTS: Reduced stress perfusion was identified in 258 segment among total 440 segments: 61 (23.6%) had improved perfusion after rest redistribution; 145 (56.2%) had improved perfusion after nitrate-augmented redistribution; 140 (54.2%) had improved perfusion after 24 hour delayed redistribution after Tl-201 reinjection. The cardiac perfusion score after stress was 38.2+/-13.1. The score increased to 41.5+/-13.1 after rest redistribution. The perfusion score were improved to 46.3+/-10.4 (p< or =0.05 vs. rest redistribution) after nitrate augmentation. The cardiac perfusion score, 46.2+/-10.8, did not improve further after delayed redistribution. CONCLUSION: Tl-201 SPECT with sublingual nitrate-augmented redistribution is as same or better than 24-hour delayed redistribution with reinjection to detect viable myocardium. Therefore, Tl-201 SPECT with sublingual nitrate-augmented redistribution has economic and time sparing advantage over traditional 24 hour delayed redistribution with reinjection.
Consensus ; Humans ; Myocardial Infarction ; Myocardium* ; Nitroglycerin ; Perfusion* ; Tomography, Emission-Computed, Single-Photon*

Bilateral sagittal split ramus osteotomy is considered a standard technique in mandibular orthognathic surgeries to reduce unexpected bilateral stress in the temporomandibular joints. Unilateral sagittal split ramus osteotomy (USSO) was recently introduced to correct facial asymmetry caused by asymmetric mandibular prognathism and has shown favorable outcomes. If unilateral surgery could guarantee long-term postoperative stability as well as favorable results, operation time and the incidence of postoperative complications could be reduced compared to those in bilateral surgery. This report highlights three consecutive cases with long-term follow-up in which USSO was used to correct asymmetric mandibular prognathism. Long-term postoperative changes in the condylar contour and ramus and condylar head length were analyzed using routine radiography and computed tomography. In addition, prior USSO studies were reviewed to outline clear criteria for applying this technique. In conclusion, patients showing functional-type asymmetry with predicted unilateral mandibular movement of less than 7 mm can be considered suitable candidates for USSO-based correction of asymmetric mandibular prognathism with or without maxillary arch surgeries.
Facial Asymmetry* ; Follow-Up Studies ; Head ; Humans ; Incidence ; Orthognathic Surgery ; Osteotomy, Sagittal Split Ramus* ; Postoperative Complications ; Prognathism ; Radiography ; Temporomandibular Joint

PURPOSE: The well-known prognostic factors for breast cancer, such as axillary lymph node status, do not always account for the exact outcome. The developinent of other accurate prognostic factors would help in assessing high risk for the disease recurrence and death. Recently, there are reports that peritumoral lymphatic vessel invasion is a good prognostic factor to solid tumors in animal studies and clinical trials. This study was performed to estimate the significance of peritumoral lymphatic vessel invasion (PLVI) as a prognostic factor in breast cancer. Also, PLVI was compared with established clinicopathological prognostic factors and hormone receptors. MATERIALS AND METHODS: A group of patient was selected from the Department of Surgery, College of Medicine, Hallym University, which consists of 43 out of 96 patients who received curative operation from 1985 to 1993. Peritumoral lymphatic vessel invasion by tumor cells on H&E stain was considered PLVI positive. We classified 43 breast-cancer patients into 32 with negative PLVI and ll with positive PLVL. We estimated the correlation between the PLVI and other established prognostic factors. We also calculated survivals based on PLVI. RESULTS: The 4-year disease-free survival rate was 61.8+/-8.7%, and the 4-year overall survival rate was 73.0+/-8.0%. The receptor status of estrogen and of progesterone had significant impacts on survival (ER: p=0.0001, PR: p=0.0001). Also, metastasis status of lymph node had significant impacts on overall survival (p=0.0148). We found a significant correlation between PLVI and tumor size (p=0.004), estrogen receptor (p=0.002), progesterone receptor (p=0.006), but could not find any significant corelation between PLVI and menopausal status, histologic grade, nuclear grade, lymph node metastasis. PLVI status was corelated with disease free survival rate (p=0.01) and overall survival rate (p=0.01). CONCLUSION: The determination of PLVI in breast cancer tissue may be useful as a prognostic factor, but it is necessary to investigate the PLVI in a large number of patients before this conclusion can be stated with certainty.
Animals ; Breast Neoplasms* ; Breast* ; Disease-Free Survival ; Estrogens ; Humans ; Lymph Nodes ; Lymphatic Vessels ; Neoplasm Metastasis ; Progesterone ; Receptors, Progesterone ; Recurrence ; Survival Rate