No abstract available.
Female ; Pregnancy ; Pregnancy, Ectopic*

PURPOSE: To investigate the usefulness of the serum Creatine kinase(CK), especially brain typical creatine kinase(CK-BB) as an indicator of brain damage extent, mortality and long term nurologic sequelae, the study was done. METHODS: CK and CK isoenzyme activites were measured at 6-10 hours after birth in 160 asphyxiated newborn infants who admitted in Eulji General Hospital from August 1990 to July 1994. Infants were followed up for 1 years after birth to evaluate survival and neurologic outcome. RESULTS: 1) There was low correlation between CK-BB and 5 minute Apgar score(r=0.245, p=0.0026). 2) There was intermediate correlation between CK-BB and Lactic dehydrogenase (LDH)(r=0.470, p<0.0001). 3) Infants who died within 24 hours after birth had significantly higher CK-BB activity(144.9+/-98.5U/L) than survivors(82.2+/-159U/L), (p=0.0160). Infants who died within 72 hours after birth had significantly higher CK-BB activity(130.2+/-108.4U/L) than survivors(80.5+/-161.1U/L), (p=0.0209) 4) Infants who died within 24 hours after birth had significantly higher CK-BB%(23.4+/-17.4%) than survivors(9.6+/-11.9%), (p=0.0042). Infants who died within 72 hours after birth had significantly higher CK-BB%(20.0+/-15.4%) than survivors(9.3+/-11.8%), (p= 0.0027). Infants who died within 28 days after birth had significantly higher CK-BB% (12.7+/-13.4%) than survivors(9.7+/-12.3%), (p=0.0500). 5) In the cases of neonatal seizure in 24-48 hours after birth, CK-BB was higher than in the cases of no seizure or seizure in 48 hours after birth. 6) CK-BB was well correlated to the grade of hypoxic ischemic encephalopathy. 7) CK-BB, CK-BB% and 5 minute Apgar score showed similar positive and negative predictive values for survival rate, abnormal findings of imaging studies and neurologic outcomes. CONCLUSIONS: CK-BB is a good predictive value for the death within 24 and 72 hours after birth and the neonatal seizure in 24-48 hours after birth. CK-BB% is a good predictive value of the death within 24, 72 hours and 28 days after birth. CK-BB, CK-BB% and 5 minute Apgar score showed similar predictivity for neurologic outcomes during 1 years after birth.
Apgar Score ; Asphyxia* ; Brain ; Creatine Kinase* ; Creatine* ; Hospitals, General ; Humans ; Hypoxia-Ischemia, Brain ; Infant ; Infant, Newborn ; Isoenzymes* ; Mortality ; Oxidoreductases ; Parturition ; Seizures ; Survival Rate

OBJECTIVE: To evaluate the discrepancies between initial STO and final STO in Class III malocclusions and to find which factors are related to the discrepancies. METHODS: Twenty patients were selected for the extraction group and 20 patients for the non-extraction group. They were diagnosed as skeletal Class III and received presurgical orthodontic treatment and mandibular set-back surgery at Pusan National University Hospital. The lateral cephalograms were analyzed for initial STO (T1s) at pretreatment and final STO (T2s) after presurgical orthodontic treatment, and specified the landmarks as coordinates of the X and Y axes. RESULTS: Differences in hard tissue points (T1s-T2s) in the X coordinates of upper central incisor edge, upper first molar mesial end surface, lower central incisor apex, lower first molar mesial end surface and mesio-buccal cusp and Y coordinates of upper central incisor edge, upper central incisor apex, upper first molar mesio-buccal cusp were statistically significant in the extraction group. Differences in hard tissue points (T1s-T2s) in the X coordinates of upper central incisor edge, lower central incisor apex, lower first molar mesial end surface and Y coordinates of lower central incisor apex were statistically significant in the non-extraction group. In the extraction group, the upper arch length discrepancy (UALD) had a statistically significant effect on maxillary incisor and first molar estimation. Lower arch length discrepancy and IMPA had statistically significant effects on mandibular incisor estimation in both groups. CONCLUSIONS: Discrepancies between initial STO and final STO and factors contributing to the accuracy of initial STO must be considered in treatment planning of Class III surgical patients to increase the accuracy of prediction.
Humans ; Incisor ; Malocclusion ; Molar ; Organophosphorus Compounds ; Orthodontics

This study was undertaken to investigate the in vivo effects of cyclophosphamide (CY) on subpopulations of macrophages and other types of immune cells including dendritic cells (DCs) as well as on ICAM-1 expression in the spleen of rats. After a single dose of CY (150 mg/kg) was administered to Sprague-Dawley rats by intraperitoneal injection, the rats were sacrificed at 1, 3, 7, 14 and 28 days. The immunocytochemical characterization of the tissues were carried out using the monoclonal antibodies W3/25, OX8, HIS24, 8A2, OX6, OX62, ED1, ED2, ED3, and TLD-4C9 for analysis of macrophage subpopulations, DC(s), CD4(+) and CD8(+) T cells, B cells and ICAM-1 expression in cryostat-cut sections. CY exhibited a profound immunosuppressive effect on CD4(+) and CD8(+) T cells as well as B cells as was expected. However, it was found that CY induced an increase in number of certain subpopulations of macrophages, including ED1(+), ED2(+) and ED3(+) macrophages. Contrarily, CY elicited a decrease in number of DCs. CY induced a conspi-cuous upregulation of ICAM-1 on certain populations of leukocytes. This increased expression of ICAM-1 after CY treatment appears to be related with the recruitment of certain populations of leukocytes. Most of these features began to appear from the first day and reached the maximun on the third and especially, the seventh day, but two weeks after CY administration, these phenomena declined. In conclusion, the present study provided a new insight into the differential effects of CY on various populations and subpopulations of immune cells in the rat spleen.
Animals ; Antibodies, Monoclonal ; B-Lymphocytes ; Cyclophosphamide* ; Dendritic Cells ; Injections, Intraperitoneal ; Intercellular Adhesion Molecule-1 ; Leukocytes ; Macrophages* ; Rats* ; Rats, Sprague-Dawley ; Spleen* ; T-Lymphocytes ; Up-Regulation

PURPOSE: To evaluate the usefulness of routine mammography in the detection of local recurrence of breast cancer after mastectomy. MATERIALS AND METHODS: The clinical and mammographic records of 45 patients whounderwent modified mastectomy due to breast cancer were prospectively reviewed. The methods of mastectomy wereAuchincloss (n=36), Patey (n=8) and simple resection (n=1). RESULTS:s Among the 45 patients, five palpable lesionswere detected on physical examination: two of the five were confirmed as tumor recurrence; on mammography, anodule with microcalcifications and low-density lesion was seen, but the other three were benign. In 40 patientsthe results of palpation were negative and during follow-up (mean, 10.9 months ) no newly developed lesions wereseen. On mammography, ten of 45(22.2%) patients showed abnormalities, namely local skin thickening(n=4,40%),increased density in subcutaneous tissue(n=2,20%), nodules(n=2,20%), benign calcification(n=1,10%) and focallow-density lesion(n=1,10%), but only one case with a nodule was confirmed to be recurrence. CONCLUSION: Routinemammography of a mastectomy site was not useful for the differentiation of palpable lesions.
Breast Neoplasms* ; Breast* ; Follow-Up Studies ; Humans ; Mammography* ; Mastectomy* ; Mastectomy, Modified Radical ; Palpation ; Physical Examination ; Prospective Studies ; Recurrence ; Skin

PURPOSE: A number of flap for nipple reconstruction have been well described in the literature. However, most of these techniques do not permit the reconstruction of a projecting nipple and all are hampered to some extent by long-term loss of nipple projection. The objective of this study is to evaluate the long-term result and clinical efficacy of nipple reconstruction using skate flap technique after breast reconstruction. METHODS: A retrospective chart review was carried out on 23 patients who underwent 25 nipple reconstructions. In those patients with greater than 10 mm nipple projection, reconstruction with skate flap and full-thickness skin graft and/or tattooing was performed. Maintenance of nipple projection was then carefully assessed over one-year follow-up. The following factors were analyzed: type of breast reconstruction, type of areola reconstruction, follow-up period, decrease in nipple projection, complication, and whether secondary nipple reconstruction was necessary and/or performed. RESULTS: Breast reconstructions were performed in 17 patients with free transverse rectus abdominis musculocutaneous flap, 3 patients with extended latissimus dorsi musculocutaneous flap, and 3 patients with expander and implant. The mean follow-up after nipple reconstruction was 17 months. Mean loss of projection were 17.0 +/- 13.99%, 25.0 +/- 12.70%, 30.0 +/- 12.57% and 30.8 +/- 12.49% at 3, 6, 9 months and over one year, respectively. The greatest decrease in projection was noted in the first 3 months following surgery. CONCLUSION: These results indicated that nipple reconstruction with skate flap showed about 70 percent of the projection achieved over one year postoperation. Therefore, the skate flap may be a reliable method of nipple reconstruction in those patients with greater than 10 mm nipple projection.
Breast ; Female ; Follow-Up Studies ; Humans ; Mammaplasty ; Nipples ; Rectus Abdominis ; Retrospective Studies ; Skin ; Tattooing ; Transplants

Superficial epithelioma with sebaceous differentiation (SESD) is a histologically distinct, rare, benign neoplasm characterized by a superficial plate-like proliferation of basaloid cells with broad attachments to the overlying epidermis. Clusters of sebaceous cells were present within the lobules. We herein report a case of SESD in a 73-year-old female.
Aged ; Carcinoma ; Epidermis ; Female ; Humans

Hematological malignancies rarely affect the breast, and the majority of those that do are lymphomas. In this review, we describe the clinical aspects and multimodal imaging findings of breast lymphoma. We also illustrate the key clinical and radiological findings that allow it to be distinguished from various other malignant and benign diseases of the breast. Breast lymphoma manifests as a breast mass, a change in the subcutaneous tissue or the skin, or enlargement of the associated lymph node on radiological examination. Radiological findings associated with other breast malignancies, such as calcifications, spiculations, or architectural distortions are extremely rare. Skin and subcutaneous changes frequently accompany T-cell lymphoma. Multimodal breast imaging characteristics may aid in the diagnosis of breast lymphoma.
Breast ; Hematologic Neoplasms ; Lymph Nodes ; Lymphoma ; Lymphoma, T-Cell ; Magnetic Resonance Imaging ; Skin ; Subcutaneous Tissue

Amyloidosis is the definition for a group of diseases that have, in common, the infiltration of one or more tissues by an abnormal protein material-the amyloid substance, which is detected histologically by their green polarization color after Congo red staining. Despite increased interest on basic nature of amyloidosis by recent immunohistochemical or experimental study, the knowledge about the incidence and neurotoxic effect of cerebral amyloid or concomitant occurrence with brain tumor is still inchoate. We examined the incidence and clinico-pathologic characteristics of the patients with amyloid deposits in supratentorial meningiomas. Particularly about their neurotoxic effect to adjacent brain is considered one of the possible cause of seizure in 33 patients who underwent resection surgery for meningioma at the Keimyung University during the past three years. The pathological review and subgrouping by histologic type were done in all 33 specimens with sufficient size of paraffin block, defined by their morphology and polarization color after Congo red staining for diagnosis of amyloid deposits localized in the tumor. Immunohistochemical studies using monoclonal antibodies for amyloid-A protein(AA) and beta-amyloid(A beta) were evaluated to identify subtypes of amyloidosis. The rate of incidence of amyloid deposit in meningioma was 21%, i.e. seven out of thirty three cases. All laboratory findings and clinical studies did not suggest a systemic form. Seizure occurrence was one out of seven cases(14%), which was of no statistical significance. Immunohistochemical study for AA subtype was all negative, but showed all positive for A beta protein around the vessels. Recent reports has also demonstrated that Amyloid precusor protein(APP) and A beta is related in Alzheimer's disease, hereditary cerebral hemorrhage with amyloidosis-Dutch type(HCHWA-D) and amyloid angiopathy. Our research data indicates that the incidence of amyloid deposit is as high as 21% in supratentorial meningiomas. It seems that it is one of the possible cause of seizure. Nonsystemic microdeposits of amyloid and their subtype and it's relationship to neurotoxic effect in meningiomas remain to be confirmed by immunoelectron microscopic examination or immunohistochemical methods.
Alzheimer Disease ; Amyloid* ; Amyloidosis ; Antibodies, Monoclonal ; Brain ; Brain Neoplasms ; Cerebral Hemorrhage ; Congo Red ; Diagnosis ; Humans ; Incidence ; Meningioma* ; Paraffin ; Plaque, Amyloid* ; Seizures

To establish a simple recirculation model in rats without craniectomy and to determine the recirculation time necessary to benefits the infarction area with restoration of the blood flow in a series of 30 adult rats, the authors induced irreversible ischemia(group I) in 15 rats through unilateral occlusion of the middle cerebral artery(MCA) by inserting a 16mm length of 4-0 nylon surgical thread through the internal carotid carotid artery(ICA). Reversible ischemia(group II) was induced by pullin the thread that occluded the MCA with hours recirculation in 5 rats. The author again divided the rats into 4 hours(Ia and Iia), 6 hours(Ib and Iib) and 12 hours(Ic and Iic) groups designated as according to the sacrifice time of rats in group I and the starting time of recirculation in group II following the MCA occlusion. The percentage of the infarction area to the total brain was calculated by a computer image analysis system, and the infarction size between reversible and irreversible groups were compared. The results showed that although the total average infarction sizes of irreversible ischemic groups were larger than those of reversible ischemic groups, the difference of the infarction size between each group o irreversible and reversible ischemia was not significant(group Ia Vs. Iia:7.78+/-8.37% Vs. 3.28+/-1.98%; group Ib Vs. Iib: 9.07+/-4.72% Vs. 6.61+/-3.19;group Ic Vs. Iic: 8.35+/-4.47% Vs. 6.90+/-6.07%. p>0.05, one-way ANOVA test). However, the degree of difference of the infarction size between irreversible and reversible ischemia decrease along with the prolongation of ischemic duration(difference between group Ia and IIa:4.5%;group Ib and Iib:2.46%;group Ic and Iic:.45%. The author concludes that ischemic brain injury may be decreased by making a restoration of the blood flow within 4 hours after occlusion of a blood vessel in rats, and this kind of reversible ischemic model may be useful in various studies on the focal cerebral ischemia without manipulation of the brain tissue and blood vessel.
Adult ; Animals ; Blood Vessels ; Brain ; Brain Injuries ; Brain Ischemia ; Cerebral Infarction* ; Humans ; Infarction* ; Infarction, Middle Cerebral Artery* ; Ischemia ; Middle Cerebral Artery* ; Nylons ; Rats*