No abstract available.
Abscess*

No abstract available.
Thyroid Diseases* ; Thyroid Gland*

In 56 breast cancer tissues (infiltrating ductal carcinoma) with a clinical follow-up period of more than 5 years, positivity of estrogen receptor(ER) by enzyme immunoassay and expressions of bcl-2 and p53 oncoproteins by immunohistochemistry were evaluated. The purposes of this study were to determine prevalence of bcl-2 and p53 in breast cancer, the interrelationship between expression of the proteins and estrogen receptor, correlation between histologic grade and the expression of the tumor-related oncogenes, and to explore the biologic bahavior of breast cancer (lymph node metastasis, recurrence rate, and survival) via expression of bcl-2 and p53. Twelve of 56 (21.4%) carcinomas were bcl-2 positive, and seventeen (30.4%) were p53- positive. Eleven of 12 bcl-2 positive tumors (91.7%) were ER-positive, and bcl-2 expression was significantly associated with ER-positivity(P=0.043). Seven of 36 ER-positive tumors (12.5%) were p53 positive, and p53 expression was inversely associated with ER-positivity(P=0.006) significantly. The bcl-2 protein expression showed a significant relationship to low histologic grade of tumor (P=0.0002), and an almost significant relationship to lower recurrence rate (P=0.09). The p53 protein expression showed a significant relationship to high histologic grade of tumor (P=0.002) and an almost significant relationship to lymph node metastasis (P=0.09). Also an almost inverse relationship between bcl-2 and p53 was demonstrated (P=0.057). The bcl-2 expression had a tendency to be associated with longer patient survival(P= 0.09), but p53 immunoreaction was found not to be associated with shorter patient survival(P=0.16). These results provide further evidence that higher incidence of bcl-2 expression is correlated with higher incidence of ER and lower grade of tumor, while p53 expression is correlated with lower incidence of ER and higher grade of tumor. In conclusion, although the biologic function of bcl-2 protein is not yet well understood in breast cancer, our results suggest that bcl-2 and p53 oncoproteins might play significant roles in estrogen receptor and development of breast cancer. But their prognostic significance could not be determined; our results are 'not significant' but 'almost significant'. Thus, contribution of bcl-2 and p53 immunohistochemical phenotyping of breast cancer with ER to the clinical management need verification in larger series.
Humans ; Neoplasm Metastasis ; Breast Neoplasms

Fracture of the metal base of tihial components of total knee arthroplasty has heen occasionally reportecl. The most common cause of the failure of the metal hase plate was known to be a fatigue fracture around the screw hole where the strength of the metal hase plate was the weakest. We experienced a case of the fracture of the metal hase plate secondary to the t'racture of the posteromedial corner of the metal tihial condyle which was weakened due to the shoil peg hole for the base plate of MG II implant. Since the proximal portion of the posterior tihial condyle was normally thin, cutting the hone for the base plate made it thinner and wcaker than normal. Therefore stress fracture of the bone occurred and the overlying metal plate was subsequently hroken. From this experience. we concluded that the posterior peg hole may cause unwanted failure of the posteromedial corner of the tibial base plate.
Arthroplasty* ; Fractures, Stress ; Knee*

Thirty-six patients (24 with oral cavity or oropharynx cancers and 12 larynx cancers) were prospectively examined with computed tomography (CT) to determine its value in staging the primary tumor and to compare with the clinical staging. The CT staging agreed with the clinical staging in 50% (12/24) of the oral cavity or oropharynx cancers and in 67% (8/12) of the larynx cancers. The CT upgraded the clinical staging in 29% (7/24) of the oral cavity or oropharynx tumors and in 33% (4/12) of the larynx cancers, whereas the CT downgraded the clinical staging in 21 % (5/24) of the oral cavity or oropharynx cancers. There is no downgrade on CT in larynx cancer. The post-surgical confirmation was not made in most of the cases. The possible causes of disagreement between the CT and the clinical staging, and the diagnostic value of the CT in evaluation of the primary tumor in oral cavity, oropharynx and larynx were discussed.
Head and Neck Neoplasms ; Head ; Humans ; Laryngeal Neoplasms ; Larynx ; Mouth ; Oropharyngeal Neoplasms ; Oropharynx ; Prospective Studies

Eighty-eight patients who presented with a variety of head and neck symptoms were examined with intravenous oritraarterial digital subtraction angiography (IV or IA DSA), using the DSA equipment developed by Seoul NationalUniversity Hospital. A grading system was used to evaluate the ability of DSA to answer specific diagnsoticquestions. Diagnostic information without need of further study was obtained in 71% with IV DSA, in 86% withaortic arch DSA and in 81% with selective arterial DSA, showing a total of 79% of diagnostic accuracy with DSA. Itis concluded that IV DSA is useful in the evaluation of the cervical carotid and vertebral arterial disease, andpituitary mass lesion, while IA DSA is useful in the evaluation of the cervical carotid and vertebral arterialdisease, and pituitary mass lesion, while IA DSA is useful in the evaluation of most of the intracranial lesions,spinal arteriography and intra-arterial embolization. DSA is both an accurate and safe imaging modality in thestudy of head and neck diseases.
Angiography ; Angiography, Digital Subtraction ; Head ; Humans ; Neck ; Seoul

No abstract available.
Arthritis* ; Knee*

No abstract available.
Contrast Media* ; Magnetic Resonance Imaging*

OBJECTIVES: Surgical experiences of pseudoaneurysms such as traumatic, mycotic and ill-defined unknown causes of aneurysms are rare. The authors have studied the results of surgical management from such cases in our series. PATIENTS AND METHOD: In the last 17 years, 1320 patients with cerebrovascular aneurysms were managed surgically. Among these, 16 patients showed the pseudoaneurysms. The authors analyzed retrospectively the clinical characteristics, treatment methods, management outcomes and problems in the managements. RESULTS: There were 6 patients with traumatic aneurysm, 4 mycotic aneurysms and 6 ill-defined unknown causes of aneurysm. The sites of traumatic aneurysms were cavernous portion of the internal carotid artery(n=3), distal portion of the anterior cerebral artery (n=2) and vertebral artery(VA: n=1). Good outcomes in 5 cases could be obtained by extracranial - intracranial bypass followed by parent vessel occlusion or resection of aneurysm followed by re-anast-omosis of parent vessel. The sites of mycotic aneurysm were peripheral portions of middle cerebral artery(MCA: n=3) and posterior cerebral artery(PCA: n=1). The outcomes of the patients with a mycotic aneurysm were relatively poor. It was partially due to the development of new aneurysm after treatment in one. The sites of ill-defined unknown causes of aneurysm were extracranial carotid artery(n=3), V2 portion of the VA(n=1), peripheral portion of the PCA (n=1) and MCA(n=1). Good outcome in all cases could be obtained by resection of aneurysm with or without saphenous vein graft. CONCLUSION: For the treatments of cerebrovascular pseudoaneurysm, combinations of aggressive medical, endovascular and surgical managements seem mandatory. Insertion of stent for a extracranial carotid artery aneurysm and coiling for a peripheral mycotic aneurysm can be option in future.
Aneurysm ; Aneurysm, False* ; Aneurysm, Infected ; Anterior Cerebral Artery ; Carotid Arteries ; Humans ; Parents ; Passive Cutaneous Anaphylaxis ; Retrospective Studies ; Saphenous Vein ; Stents ; Transplants

OBJECTIVE: The authors present a retrospective clinical analysis of transsphenoidal surgery for acromegaly including preoperative factors determining the therapeutic outcome. METHODS: Forty-three patients(24 females, mean age 45.3 years) harboring growth hormone(GH)-secreting adenomas(13 microadenomas and 30 macroadenomas) were treated between the years 1987 and 2001. The mean duration of follow-up was 69 months. RESULTS: The average estimated duration of symptoms prior to diagnosis was 8 years. The control rate following surgery was 51%(22 out of 43 cases). Of the patients with postoperative persistent disease, 11 patients had had additional bromocriptine therapy with or without irradiation, and consequently 7 patients achieved biochemical remission. The overall remission rate of multimodality treatment was 67%. The preoperative GH value, tumor size, extrasellar extension of tumor, the number of surgeons, and the extent of the surgical removal were significant univariative predictors of outcome(p<0.05). CONCLUSION: This study suggests that surgical outcome for acromegaly could be achieved by a experienced neurosurgeon. In the group of the patients of large or invasive adenomas, with the less probability of surgical control, adjunctive medical or radiation therapy to control GH hypersecretion should be considered.
Acromegaly* ; Adenoma ; Bromocriptine ; Diagnosis ; Female ; Follow-Up Studies ; Growth Hormone ; Humans ; Microsurgery* ; Pituitary Neoplasms ; Retrospective Studies ; Treatment Outcome