Aneurysmal bone cyst is an uncommon tumor-like lesion of the bone, containing distended channels or cavities filled with blood. This case, a eighteen years old female, complained of pain and swelling in the right lateral aspect of thigh. Roentgenograms showed a ballooned-out distension of the shaft of the femur, eccentric buldging of the cortex and soap-bubble appearance of interior of the lesion. The case was treated with radical curettage and autogenous bone graft with bone chips which were taken from the iliac wing. Pathological examination grossly and microscopically revealed an aneurysmal bone cyst. Patient made an uneventful recovery, and 11 months later she had no complaints and no evidence of recurrence.
Aneurysm ; Bone Cysts ; Curettage ; Female ; Femur ; Humans ; Recurrence ; Thigh ; Transplants

We reviewed 90 cases of popliteal cyst in 88 patients, managed at Department of Orthopedic Surgery, Severance Hospital from January 1976 to June 1985 and the following results were obtained. 1. The average age of the 88 patients was 42 years. There were 23 males and 65 females. Of the all patients, 47 were occured in right side and 39 the left. Two patients were both sides. 2. Of the all cysts, 62 were found to be bursa between the semimembranosus and the medial head of the gastrocnemius muscles(68.8%). 3. Associated adnormalities of the knee joint were apparent in 29(33%) and the most common abnormalities were osteoarthritis. 3. Associated adnormalities of the knee joint were apparent in 29(33%) and the most common abnormalities were osteoarthritis. 4. Communication of the cyst with the joint was apparent in 44 cases(49%). 5. Twelve patients were recurred and associated abnormality of the knee joint was osteoarthritis. Three patients were children and they had no abnormality of the knee joint. 6. Recurrence after primary operation was rare when the stalk of the cyst had been opened.
Child ; Clinical Study ; Female ; Head ; Humans ; Joints ; Knee Joint ; Male ; Orthopedics ; Osteoarthritis ; Popliteal Cyst ; Recurrence

Eleven cases of the free vascularized bone graft have been performed in the Department of Orthopaedic Surgery, Yonsei University Hospital during the period of 30.9 months from February 1981 to December 1985. Follow up ranges from 8 to 62 months. The indication for the procedure was reconstruction of extensive bony defect after acute trauma in 3 cases, osteomyelitis in 3 cases, chronic nonunion 3 cases, bone tumor in one case and congenital pseudoarthrosis in one case. The results were obtained as follows; 1. To reconstruct the lower extremity the vascularzed bone graft has much more advantages than the other conventional method and the technique may be very useful in the management of certain difficult reconstructive problem of the lower extremity. 2. In the defects of bone and skin, even infected, composite bone and soft tissue transfer can be filled by one stage operation and made the infection heal more rapidly. 3. In children the vacularized fibular graft was hypertrophied and similar to thickness of tibia.
Child ; Follow-Up Studies ; Humans ; Lower Extremity ; Methods ; Osteomyelitis ; Pseudarthrosis ; Skin ; Tibia ; Transplants

No abstract available.
Hand* ; Regional Blood Flow*

No abstract available.

PURPOSE: It has long been controversial whether breast cancer of the younger women is more aggressive than that of older women and remains unclear whether the dismal outcome seen in the younger age group is a reflection of more advanced disease at the time of diagnosis or whether it is due to a difference in the underlying tumor biology. To investigate the outcome of primary breast cancers treated with breast conservation surgery according to the patient's age, we undertook this study. METHODS: One hundred and eighty-five patients with breast carcinoma, that underwent breast conservation surgery at the Severance Hospital, Yonsei University College of Medicine, during the period between July 1988 and December 1996, were divided into two groups on the basis of age 35 (patient group: age 35 or younger, and control group: over 35 years of age). Tumor stage by the American Joint of Committee on Cancer (AJCC) classification, histologic grade, adjuvant therapy, and the incidence of local or systemic recurrences were analyzed. Finally 10-year loco-regional recurrence free, distant relapse free (DRFS) and overall survival (OS) were estimates determined by Kaplan-Meier analysis. RESULTS: Among 185 patients, 42 women (22.7%) were included in the patient young group and the other 143 in the control group. There were no significant differences between the two groups in terms of the distribution of T stages, N stages, histologic subtypes, hormonal receptorexpressions, and mean follow-up duration. The younger group had higher 10-year local recurrence (14.3%) and systemic recurrence (28.6%) rates than the control group (4.2% and 12.6%), respectively (p<0.05). The younger group also had a significantly worse 10-year overall survival rate of 78.6% (p<0.01). CONCLUSION: These results indicate that breast cancer patients younger than 35 years of age have higher local and systemic recurrences and poorer DRFS and OS than their older counterparts. These differences may reflect difference in tumor biology and imply that younger patients with breast cancer need both more aggressive and adequate systemic treatment after surgery.
Biology ; Breast Neoplasms ; Breast* ; Classification ; Diagnosis ; Female ; Follow-Up Studies ; Humans ; Incidence ; Joints ; Kaplan-Meier Estimate ; Recurrence ; Survival Rate

PURPOSE: The objective of this study was to assess the supportive needs of breast cancer patients and determine the socio-demographic and clinicopathological predictors of those unmet needs. METHODS: Of 302 eligible breast cancer patients, attending Yonsei University Severance Hospital, 250 completed the surveys. The supportive care needs were assessed by administering a Supportive Care Needs Survey. RESULTS: Of the ten highest perceived needs items, 7 items were related to the health system and information domain and 2 to the psychological domain. The univariate analysis in each domain showed education (P=0.083) and chemotherapy (P=0.042) were significant predictors in the psychological domain; education (0=0.000), time since surgery (P=0.009), node metastasis (0.022), chemotherapy (P=0.001) and radiation therapy (P=0.003) in the physical and daily living domain; age (P=0, 009) and duration of marriage (P= 0.004) for sexuality; node metastasis (P=0.048), TNM stage (P=0.036), and recurrence (P=0.010) in the health system and information domain and religion (P=0.016) in the care and support domain. A multivariate analysis showed age (P=0.0253) and chemotherapy (P=0.0517) as significant independent predictors in the sexuality domain; education (P=0.0010), chemotherapy (P=0.0011), radiation therapy (P= 0.0133) and time since surgery (P=0.036) in the physical and daily living domain; recurrence (P=0.0324) in the health system and information; domain and education (P=0.0134) and chemotherapy (P=0.0207) in psychological domain. CONCLUSION: Breast cancer patients experience high levels of unmet supportive needs across each domain, but especially in the health systems and information domain. Also, the types of needs varied according to the patient subgroups. This study suggests considerable improvements be made in terms of supportive care of breast cancer patients.
Breast Neoplasms* ; Breast* ; Drug Therapy ; Education ; Humans ; Marriage ; Multivariate Analysis ; Neoplasm Metastasis ; Recurrence ; Sexuality

PURPOSE: Since the discovery of estrogen receptor-beta(ER-beta, five C-terminal variants of ER-beta were identified. We designed this study to investigate the pattern and clinical implications of ER-betaand its splicing variants expression in normal and malignant mammary tissues. METHODS: Using reverse transcription polymerase chain reaction (RT-PCR), we examined the expression levels of ER-alpha and ER-betaand its five splicing variants (beta1, beta2, beta3, beta4, beta5) in 50 paired normal and cancer tissues. We measured the densities of RT-PCR products using Tina version 2.10 (Raytest, Germany). Firstly, the incidence and intensity of ER-alpha and ER-beta and its five splicing variants were compared. Then the expression of ER-betamRNA splicing variants was also analyzed with regard to the ER-alphaprotein expression measured by immuno-histochemical staining and the menopausal status of the patients. Chi-square test and paired samples t-test were used for statistical analysis. Differences were considered to be significant with a p-value of less than 0.05. RESULTS: The expression of ER-betamRNA variants in normal breast and cancer tissues were as follows: ER-beta2 (100%/100%), ER-beta4 (76%/74%), ER-beta5 (32%/58%), and ER-beta1 (14%/16%). ER-beta3 was not detected at all. In terms of intensity, we observed a significant decrease of ER-beta2 (P<0.001) and an increase of ER-beta5 (P=0.004) in the mRNA expression levels among breast cancers compared to the corresponding normal breast tissues. Compared to the corresponding normal tissues, a significant decrease of ER-beta2 in cancer tissues was observed in patients with ER-alpha-positive (P<0.001), with age over 50 (P=0.01), and under 50 (P=0.04) as well, but not in patients with ER-alpha-negative (P=0.48). ER-beta4 also significantly decreased in patients with ER-alpha-positive (P=0.004) and with age over 50 (P=0.07). ER-beta5 showed a significant increment only in patient aged over 50 (P=0.04). CONCLUSION: ER-alpha mRNA expression significantly increases but ER-beta mRNA expression decreases in the cancer tissues compared to the corresponding normal tissues. Among ER-beta variant forms, ER-beta2 is predominant in both normal and malignant mammary tissues and ER-beta4, ER-beta5, and ER-beta1 in descending order but ER-beta3 does not express in mammary tissues. The decrease of ER-beta2 and ER-beta4 expression is prominent in cancer tissue especially in ER-alpha-positive cancers, which suggests that ER-beta2 and ER-beta4 may possess a regulatory function in mammary carcinogenesis. Further investigations to verify the roles of ER-beta variants are mandatory.
Breast ; Breast Neoplasms ; Carcinogenesis ; Estrogens* ; Humans ; Incidence ; Polymerase Chain Reaction ; Receptors, Estrogen ; Reverse Transcription ; RNA, Messenger

A 44-year-old man had Sweet's syndrome (acute febrile neutrophilic dermatosis), accompanied by erythematous tender subcutaneous nodules resembling erythema nodosum(EN). The EN-like lesions histologically showed a septal panniculitis with predominantly neutrophilic in-filtrates. The association of Sweet's syndrome with EN seems to be uncommon and only a few cases have been reported until the present. We describe a patient with Sweet's syndrome associated with acute EN.
Adult ; Erythema Nodosum* ; Erythema* ; Humans ; Neutrophils ; Panniculitis ; Sweet Syndrome*

OBJECT: Pre-ALL is a very rare preteukemic state, which percedes acute lymphocytic leukemia, while MDS(pre-ANLL), usually the well-known type of preleukemic state, precedes acute non-lymphocytic leukemia. Initially it shows transient pancytopenia without any evidence of leukemia in bone marrow findings, followed by acute lymphocytic leukemia after recovery from pancytopenia of a short period within weeks or months. We report a case with pre-ALL in childhood. CASE: A 15-month-old male baby was admitted with the complaints of fever and cough for 5 days and pallor for 2 weeks prior to admission. On admission, CBC showed pancytopenia without any evidence of leukemia, which was recovered spontaneously in a short period, and then was followed by acute lymphocytic leukemia of CALLA negative, early pre-B cell type. During antileukemic chemotherapy, he had suffered from severe bacterial infections and was finally died of sepsis 8 months after first admission. CONCLUSION: We report a case of pre-ALL in childhood, which was preceded by CALLA negative, early pre-B cell ALL, with a review of the literatures, briefly.
Bacterial Infections ; Bone Marrow ; Cough ; Drug Therapy ; Fever ; Humans ; Infant ; Leukemia ; Male ; Pallor ; Pancytopenia ; Precursor Cell Lymphoblastic Leukemia-Lymphoma* ; Precursor Cells, B-Lymphoid ; Sepsis