This study was performed on 50 cases of primary breast cancer removed surgically during the period 1990~1991 and compared the results of four morphologic methods developed for the detection of estrogen receptors, progesterone receptors, monoclonal antibody PCNA immunoreactivity, and the mean number of argyrophilic nucleolar organizer regions(mAgNORs) to ascertain the prognostic significance and also to detect highly malignant heterogenous cancer. To determine the validity of these measurements, a variance analysis was done with Kruskal-Wallis 1-way ANOVA. The results showed that the significant correlation between histologic grade and ER/PR status(P=0.005/P=0.015), the borderline significant correlation between mAgNORs and ER/PR status(P=0.08), and between AgNORs and stage(P=0.07), PCNA has no correlation with ER/PR status(P=0.25), clinical stage and histologic grade. In follow up, four cases of invasive ductal carcinoma with ER/PR, developed early and rapid metastasis within 2 years, three of them were classified as histologic grade 3 and another case was grade 2, whereas two of them were classified ans stage III(+) and the rest were in stage IIB(+) and stage IIA(-). The mAgNOR count of these four cases were ranged from 3.32 to 4.29 which were in the aneuploid category most likely. One of them had rather stormy rapid course with multiple organ metastases resulting death within one year. These results indicated that ductal carcinoma(>2cm size) with ER-/PR- and high mAgNOR level or high PCNA grade, and hihg histologic grade had h highly malignant course, marked by rapidly developing metastases. Thus we concluded that the status of ER/PR alone in tumor tissue is an important information for selecting hormone treatment btu, for the ultimate prognosis, is a weak indicator. Therefore for early detection of such heterogenous tumor, besides ER/PR, AgNORs or PCNA, histologic grade and tumor size are very useful as biological indicators of prognosis. The status ER/PR in combination with these indicators are more accurate and provide better basis on which to base a decision for early implementation of chemotherapy from which to give probably benefit by inhibition of rapid progress.
Humans ; Neoplasm Metastasis ; Breast Neoplasms

BACKGROUND: Pulmonary tuberculosis with a remaining cavitary lesion is considered to be a problem with the course of treatment. In particular, re-treatment cases tend to respond poorly to current anti-tuberculosis agents. Therefore the factors that are related with the poor closure of a cavitary lesion in pulmonary tuberculosis during treatment were evaluated. METHODS: A retrospective review of the medical records and chest X-ray films of 68 patients who had chemotherapy for the pulmonary tuberculosis with cavitary lesions was made. All the patients had been followed up for more than 12 months at National Masan Tuberculosis Hospital as of Aug. 2000. RESULTS: The male to female ratio was 3.9:1. 72.4% of the patients were between 20 to 50 years of age. 66.2% of the cavitary lesions on the chest X-ray films were confined to the upper lung fields : 36.8% in the right upper lung field and 29.4% in the left upper lung field. 82.4% of the cavities were less than 40mm in their size, and 83.8% were less than 6mm thick. The cavitary lesions were closed in 48 cases and remained in 20 cases during a follow-up period of more than 12 months. The factors that are though to affect ot the outcomes of the cavities were age, past medication history, the number of unused drugs, and the number of sensitive drugs. CONCLUSION: In the treatment courses of pulmonary tuberculosis with cavitary lesions, the following factors are associated with less desirable outcome:an age over 45, a past medication history of more than 2 courses of treatment, The number of unused drugs not exceeding average 6 and the number of sensitive drugs not exceeding average 7.
Drug Therapy ; Female ; Follow-Up Studies ; Hospitals, Chronic Disease ; Humans ; Lung ; Male ; Medical Records ; Retrospective Studies ; Thorax ; Tuberculosis, Pulmonary* ; X-Ray Film

PURPOSE: To evaluate clinical and radiological results and to analyse the parapatellar complications after endoscopic anterior cruciate ligament reconstruction using central one-third bone-patellar tendon-bone autografts. MATERIALS AND METHODS: 66 cases among 158 consecutive cases from Feb 1990 to May 1996 were reviewed and evaluated with regard to patellofemoral pain, crepitus, quadriceps atrophy, graft donor site complication, Lysholm knee scoring system and radiological assessment. The average period of follow up was 23 months (range, 12-57 months) and the average age at operation was 31 years old (range, 18-58 years). RESULTS: The average Lysholmn knee score improved from 57.5 points preoperatively to 91.3 points at follow up. The instrumented anterior laxity test showed that excellent anterior stability was regained in most patients. There were many cases of parapatellar complications, 7 cases (10.6%) of anterior knee pain, 21 cases (32.8%) of crepitus, 43 cases (65.1%) of quadriceps weakness, 29 cases (45.3%) of graft donor site paresthesia and 15 cases (23.4%) of pain on kneeling. CONCLUSIONS: Although endoscopic ACL reconstruction using central one-third bone-patellar tendon-bone autografts had good clinical results, many parapatellar complications were noted. In order to prevent these complications, different reconstruction techniques and graft materials should be considered
Adult ; Anterior Cruciate Ligament Reconstruction ; Atrophy ; Autografts* ; Follow-Up Studies ; Humans ; Knee ; Paresthesia ; Tissue Donors ; Transplants

No abstract available.
Isoniazid* ; Poisoning*

No abstract available.
Sturge-Weber Syndrome*

BACKGROUND: Urticaria pigmentosa(UP) is primarily a disease of children. There have been no clinical studies of UP in Korea. OBJECTIVE: This study was performed to find the clinical characteristics of UP in Korean child-hood patients. METHOD: Twenty-nine cases of urticaria pigmentosa confirmed clinically and histopathologically were analyzed. RESULTS: The maculopapular type was the most common with the usual age of onset before the age of 6 months, and the lesions tended to be distributed in the central portion of the body. Darier sign was positive in 92% of the patients(24/26). No systemic involvements were detected in any of the patients with minimal associated symptoms. Seven patients of the maculopapular type and one patient of the multiple nodular type followed up for more than 2 years showed a tendency to improve or clear by the age of 6 years. CONCLUSION: Neonatal or infantile-onset patients of UP in Korean pediatric population were considered to have a benign clinical course and to require no aggressive therapy.
Age of Onset ; Child* ; Clinical Study* ; Humans ; Korea ; Methods ; Urticaria Pigmentosa* ; Urticaria*

PURPOSE: The criteria for Suspected hereditary nonpolyposis colorectal cancer(Suspected HNPCC) has been devised by the Korean Hereditary Tumor Registry for families who do not fulfill Amsterdam criteria, but hereditary background is strongly suggested. This study was performed to define the clinical characteristics of 'Suspected HNPCC'. METHODS: The 'Suspected HNPCC' criteria include the followings: a) vertical transmission of colorectal cancer or at least two siblings affected with colorectal cancer in a family and b) development of multiple colorectal tumors (including adenoma) or at least one colorectal cancer case diagnosed before the age of 50 years or development of extracolonic cancers (endometrium, urinary tract, small intestine, stomach, hepatobiliary system, ovary) in family members. We analysed the clinical characteristics of 93 patients from 39 Suspected HNPCC families and compared these characteristics with 176 HNPCC familes and with 1,204 non-hereditary colorectal cancer patients. RESULTS: The mean age of Suspected HNPCC patients at the time of diagnosis (49.0 years) was significantly lower than that of non-hereditary colorectal cancer patients (56.1 years), but higher than that of the HNPCC patients (44.5 years). Tumors were more frequently located in the right colon (34%) in Suspected HNPCC compared to non-hereditary colorectal cancer (23%). Dukes' A and B cancers were more frequent in the Suspected HNPCC as compared to non-hereditary colorectal cancer (55% vs. 48%, p<0.05), but tumor differentiation was not statistically different between the two groups. Among the Suspected HNPCC, 24.0% of the patients had synchronous adenomatous polyps and 20.0% had synchronous colorectal cancers and 15.6% had metachronous polyps or cancers. These findings were similar to HNPCC, but significantly higher than non-hereditary colorectal cancers (p<0.05). In Suspected HNPCC families, 42 patients had extracolonic malignancies with the stomach cancer being the most common (n=22). CONCLUSION: These data indicate that the clinical characteristics of Suspected HNPCC are similar to those of HNPCC and may suggest that the management principles of the HNPCC should also be applied to the Suspected HNPCC.
Adenomatous Polyps ; Colon ; Colorectal Neoplasms ; Diagnosis ; Humans ; Intestine, Small ; Korea* ; Polyps ; Siblings ; Stomach ; Stomach Neoplasms ; Urinary Tract

Present study aimed to investigate the immunological activities of cell wall associated protein antigen solubilized with Triton X-100 (TSP) from Mycobacterium tuberculosis H37Rv and conducted on 43 patients with pulmonary tuberculosis (newly diagnosed, medicated within 12 months and chronic refractory patients) and 17 normal healthy controls. These immunological responses were compared with those induced by the PPD or 30 kDa antigen from M, tuberculosis H37Rv culture filtrates, identified as biologically important secreted proteins. Proliferative responses to mycobacterial antigens were compared in peripheral blood mononuclear cells (PBMC) of healthy subjects and pulmonary tuberculosis patients. Signiticant blastogenic responses to the TSP were observed in healthy tuberculin reactors, newly diagnosed and some of antituberculosis drug-medicated patients by H-thymidine incorporation assay. IL-12 p40 and IFN-r mRNA expressions to the TSP were markedly increased, whereas IL-10 and TNF-a mRNA expressions were decreased at a 5 day-stimulation by PBMC in healthy tuberculin reactors, newly diagnosed and medicated patients. However, patients with chronic refractory tuberculosis exhibited more depressed IL-12 p40 and IFN-r mRNA expressions to all of the antigens than another groups. Interestingly, very low IL-10 and TNF-a mRNA expressions cultured with the TSP were also shown. These data suggest that the TSP may be involved in the macrophage activation by induction of Th1 stimulatory signals, such as IL-12, and suppression of Th1 inhibitory cytokine, IL-10.
Tumor Necrosis Factor-alpha

PURPOSE: To determine the incidence, risk factors, and clinical characteristics of pelvic insufficiency fracture (PIF) in patients with cervical cancer. MATERIALS AND METHODS: Between July 2004 and August 2009, 235 patients with non-metastatic cervical cancer were treated with definitive chemoradiation or postoperative radiotherapy. Among 235 patients, 117 (49.8%) underwent the first positron emission tomography/computed tomography (PET/CT) within 1 year after radiotherapy. The median radiation dose was 55 Gy (range, 45 to 60 Gy). Medical charts and imaging studies, including PET/CT, magnetic resonance imaging (MRI), CT, bone scintigraphy were reviewed to evaluate the patients with PIF. RESULTS: Among 235 patients, 16 developed PIF. The 5-year detection rate of PIF was 9.5%. The 5-year detection rate of PIF in patients who underwent the first PET/CT within a year was 15.6%. The median time to development of PIF was 12.5 months (range, 5 to 30 months). The sites of fracture included 12 sacroiliac joints, 3 pubic rami, 3 iliac bones, and 1 femoral neck. Eleven of 16 patients having PIF complained of hip pain requiring medications. One patient required hospitalization for pain control. The significant risk factors of PIF were old age, body mass index less than 23, bone mineral density less than -3.5 SD, and the first PET/CT within a year after radiotherapy. Radiation dose and concurrent chemotherapy had no impact on PIF rate. CONCLUSION: PIFs were not rare after pelvic radiotherapy in cervical cancer patients in the era of PET/CT. Timely diagnosis and management of PIF can improve quality of life in patients with cervical cancer, in addition to reducing unnecessary medical expenses.
Body Mass Index ; Bone Density ; Electrons ; Femur Neck ; Fractures, Stress ; Hip ; Hospitalization ; Humans ; Incidence ; Magnetic Resonance Imaging ; Quality of Life ; Risk Factors ; Sacroiliac Joint ; Uterine Cervical Neoplasms

OBJECTIVES: The purpose of this study is to evaluate effects of patients' age, amenorrhea duration, motivation, purpose, regimen, side effects on compliance to hormone replacement therapy(HRT) Methods: Compliance to HRT was assessed in 258 postmenopausal women who began HRT in the Menopause Clinic of Hangang Sacred Heart Hospital, Hallym university. One hundred sixty nine women who had intact uterus received continuous combined therapy with 0.625 mg of conjugated equine estrogen (CEE) and 100 mg of micronized progesterone. Eighty nine women who were hysterectomized received only 0.625 mg of CEE. RESULTS: A total of 103 women (39.9%) reported that they continued HRT at least for one year. Continuation of HRT was significantly more common among women who started HRT becuase of recommendation by gynecologist after hysterectomy in our department (p< 0.05). A greater percentage of women who received only CEE without uterus continued HRT than women who received continuous combined therapy (p< 0.05). Duration of amenorrhea, reasons for taking HRT and side effects such as irregular bleeding or breast tenderness were not related to the continuation of HRT. CONCLUSION: Education of menopausal women about the benefit/risk and side effects of HRT may be critical in improving compliance.
Amenorrhea ; Breast ; Compliance* ; Education ; Estrogens ; Female ; Heart ; Hemorrhage ; Hormone Replacement Therapy ; Humans ; Hysterectomy ; Menopause ; Motivation ; Progesterone ; Uterus