PURPOSE: Although breast reconstruction provides some advantages for women following mastectomy, few Korean breast cancer patients currently receive such reconstruction. Routine provision of breast reconstruction requires simplicity and easy availability for the procedure. This paper reports the possibility of performing breast reconstruction by insertion of a tissue expander by the breast surgeon. METHODS: We studied 22 cases of breast cancer patients who were treated in the Breast service of KangNam Cha Hospital. Nine cases were the group of immediate expander insertion and 13 were the group of MRM only. We evaluated age, histopathologic stage, starting time of chemotherapy, operation time, drainage amounts and periods, medication periods, time of discharge and depression score. RESULTS: The mean age of the expander insertion group was 41, which was younger than that of the MRM only group by 3 years. Histopathologic state was better in the expander insertion group and the time for chemotherapy start was almost the same between the two groups. Mean operation time in the expander insertion group was 2 hours and 41 minutes, and it was longer than the MRM only group by 1 hour, but it included additional wasting time to check the results of frozen biopsy. Periods for drainage were longer and amounts were larger, but this only delayed the medication period and time for discharge by two days. There were no other complications and mental suffering was alleviated. CONCLUSION: Tissue expander insertion for breast reconstruction could be offered on a routine basis by breast surgeons without problems. Breast reconstruction will become a more essential process for breast cancer patients to improve the quality of life. It is ideal if the same surgeon participates in both oncology and reconstruction surgery.
Biopsy ; Breast Neoplasms* ; Breast* ; Depression ; Drainage ; Drug Therapy ; Female ; Humans ; Mammaplasty* ; Mastectomy* ; Quality of Life ; Stress, Psychological ; Tissue Expansion Devices*

No abstract available.
Disasters*

The HUMACTBP2 locus was investigated to collect population genetic data in the Korean population and to evaluate the applicability for the forensic field. An Automatic fluorescent-based sequencer (377 automatic DNA sequencer, ABI) was used to detect amplified fragments of the HUMACTBP2 locus electrophoresed on 4% denaturing polyacrylamide sequencing gels. ACTBP2 allelic ladder consisting of different sizes of 18 alleles was constructed and employed as an internal size standard in combination with a GS-350 size standard for precision of allele-band sizing. By utilizing different fluorescent dyes, both the allelic ladders and samples were able to be analyzed in the same lane by 99% orecision of allele-band sizing. Among the Korean population (n=224), 26 alleles in the range of 239-313 bp are determined. allele No. 6 is found 45 times (0.100) which is mostly frequent, and the rest of allele is distributed with their relative frequency of 0.002-0.100. The comparison between observed and expected numbers of homozygous and heterozygous individuals confirms that ACTBP2 locus is in the state of Hardy-Weinberg equilibrium among the Korean population. The heterozygosity is 0.9389+/-0.0034(93.89%), and the power of discrimination(PD) and power of exclusion(PEX) are calculated to be 0.991(99.1%)and 0.890(89.0%), respectively, showing the high informativeness for individual identification. Thus, these results mean that the HUMACTBP2 locus can effectively be used for the forensic application.
Alleles ; DNA ; Fluorescent Dyes ; Gels ; Genetic Variation*

PURPOSE: While treating 14 phenylketonuria(PKU) patients, we evaluated bone density, changes in bone age, andbony changes such as spiculation or metaphyseal widening. MATERIALS AND METHODS: A total of 14 PKU patients agedbetween 1 month and 14 years(mean, 6.4 years) were under dietary treatment. Eight and eleven patients underwentradiography of the left hand and wrist and bone densitometry(BMD) of the lumbar spine, respectively. The resultswere reviewed with regard to abnormal bony changes, delayed bone age, and osteopenia. Patients were assigned toeither the early or late treatment group, depending on whether or not dietary therapy was started before 3 monthsof age. Those in whom a blood phenylalanine level of under 10 mg/dl was maintained were assigned to the 'goodcontrol' group; others were classified as 'variable control'. The findings of radiographs of the left hand andlumbar BMD were evaluated in relation to the time of dietary therapy, and adequacy of treatment. RESULTS: Onlumbar BMD, four of 11 patients (36%) showed reduced bone density of more than 1 S.D. None of the 11 who underwentradiography of the left hand showed bony abnormalities such as spiculation or metaphyseal widening. In four of the11, bone age was less than chronological age by at least one year. According to Fisher's exact test there was norelation between delayed bone age , osteoporosis and the time and adequacy of dietary therapy (p >0.05). CONCLUSION: None of the 14 PKU patients who underwent dietary therapy had bony abnormalities such as spiculationor metaphyseal widening. In four of the 11, bone age was at least one year less than chronological age, and onlumbar BMD, osteoporosis was seen. For the evaluation of bone change in PKU patients, plain radiography and BMDare thus complementary.
Bone Density ; Bone Diseases, Metabolic ; Hand ; Humans ; Metabolism ; Osteoporosis ; Phenylalanine ; Phenylketonurias* ; Radiography ; Spine ; Wrist

Bone scan using 99m Tc-MDP is the most accurate and reliable method for the early detection of fracture, andgive the most accurate in formation about the healing process of fractured bone. Recent days, the medicolegalproblem about the injured time is frequently provoked in vertebral fracture patient by trauma. The authorsanalyzed the bone scan of vertebral fracture patients from March to Dec. 1983. The authors obtained results asfollows: 1. The minimum time for a fracture to return to normal on a bone scan was 4 month in cervical spine. 2.It was 12 month in thoracic spine. 3. It was 6 month in lumbar spine. 4. Surrounding soft tissue injury was healedwithin 10 days after trauma in our cases. 5. Focal hot uptake is persisted in case of callus deposition on plainfilm, although very small in amount. 6. Healing time is delayed in case of severely compressed vertebral body,belowed the half than normal height. 7. With bone scan it is possible to differentiate the fresh fracture from oldhealed, impossible by plain film. 8. Healing time is delayed in old age.
Bony Callus ; Humans ; Methods ; Soft Tissue Injuries ; Spine

The hypervariable short tandem repeat (STR) locus D12S391 was investigated in a Korean population. A total of 14 alleles were detected by size under denaturing conditions in 517 unrelated individuals. To confirm all of the alleles detected in a Korean population, a total of 34 fragments were sequenced. Prior to allele designation, we constructed the allelic ladders containing 11 alleles sequenced in this study. Allele 18 is the most common with a frequency of 0.281 in Koreans, and one variant allele 19.3 which have been confirmed by sequencing, was detected. The observed heterozygosity, the power of discrimination (PD), and the mean exclusion chance (MEC) for the locus D12S391 is 0.781, 0.946 and 0.652, respectively. No deviation from Hardy-Weinberg equilibrium was observed in a Korean population (p=0.557). In the 424 meioses in 105 Korean families confirmed using other 17 STR loci, no mutation was detected in locus D12S391. The STR locus D12S391system is useful both for the analysis identification and parternity.
Alleles ; Discrimination (Psychology) ; Gene Frequency ; Genetics, Population* ; Humans ; Meiosis ; Microsatellite Repeats ; Sequence Analysis

PURPOSE: To evaluate the vascular pattern of lymph nodes, and the usefulness of color Doppler sonogaphy indifferentiating benign from malignant superficial lymphadenopathy. MATERIALS AND METHODS: Twenty-six patientswere pathologically and clinically confirmed to be suffering from benign reactive lymphadenitis and tuberculosis(n=16) or lymphoma and malignant lymphadenitis (n=10). Lymph node shape was assessed by the ratio of longitudinaldiameter to transverse diameter(L/T), and patients were thus assigned to one of two groups : L/T >or =2, or L/T<2.The hilar vascular pattern of lymph node was assessed by color Doppler sonography and classified as central,eccentric, or absent. On the basis of peripheral vascularity, patients were divided into three groups according tocircumferental linear vascularity. An absence of peripheral vascularity was classified as grade 0. If less thanhalf the periphery was covered by linear vascularity, a patient was assigned to as grade I, and if more than halfwas covered by a vessel, the classification was grade II. RESULTS: Statistically significant differences in L/Tratio were noted between malignant and benign node (p<.001). Of the 16 benign reactive nodes, 13 showed L/T >or =2,and 3 L/T<2. while in nine of the ten malignant nodes, L/T<2 was noted. Among 16 benign reactive nodes, hilarvascularity was central in 13, eccentric in one, and absent in two. Among the ten malignant nodes, thecorresponding totals were nil, four, and Six. The hilar vascular pattern showed statistically significantdifferentiation between malignant and benign node (p<.05). Among 16 benign reactive nodes, 13 were grade 0, twowere grade I, and one was grade II, while among ten malignant nodes, two were grade 0 and eight were grade I. Onthe basis of vascular pattern, the difference between benign and malignant nodes was statistically significant(p<.05). CONCLUSION: L/T ratio<2, absent or eccentric hilar vascularity, and the presence of peripheralvascularity are suggestive of malignant lymph node. The shape of LN and pattern revealed by an analysis of nodalvascularity using color Doppler sonography are useful in differential diagnosis of benign and malignantlymphadenopathy.
Classification ; Diagnosis, Differential ; Humans ; Lymph Nodes ; Lymphadenitis ; Lymphatic Diseases* ; Lymphoma

Multiple large bowel polyps are the hallmark of familial adenomatous polyposis (FAP), and many progress to colorectal cancer. Desmoid tumors are more common in patients with FAP than in other people, occurring, particularly, in those who have previously undergone prophylatic total colectomy. In such patients, desmoid tumors are a common cause of death. In an FAP patient without extracolic manifestation, who has undergone prophylatic surgery, multifocal desmoid tumors occur periodically. We report the serial radiologic findings of progressive desmoid tumors in FAP, drawing attention to the related findings of previous research.
Adenomatous Polyposis Coli ; Cause of Death ; Colectomy ; Colorectal Neoplasms ; Fibromatosis, Aggressive* ; Humans ; Polyps

PURPOSE: The purpose of this study was to evaluate MR findings among patients with phenylketonuria (PKU). MATERIALS AND METHODS: Eleven patients with biochemically documented PKU underwent MR imaging ; In nine, the typical classic form was seen, and two were atypical. We evaluated signal intensity, the distribution of abnormal signal intensity, the extent of brain atrophy, and possible clinical correlation between IQ scores of the patients and abnormal signal intensity. RESULTS: Varying degrees of symmetrical high signal intensity were noted on T2-weighted sequences in the parietal white matter of six patients ; the periventricular deep white matter was most seriously affected, but there was no evidence of brain atrophy. In one advanced case, high signal intensity of both the parietal and frontal lobes was seen on T2-weighted images, and brain atrophy and gyriform enhancementon contrast enhanced T1-weighted images. In five patients, findings were normal. no abnormality was found in the basal ganglia, brain stem or cerebellum. There was no correlation between IQ level and severity of high signal intensity. CONCLUSION: Although MR findings were nonspecific, PKU patients showed symmetrical high signal intensity, predominantly in the peritrigonal region. In the advanced case, the lesion, as seen on T2-weighted images, extended to the periventricular and subcortical white matter.
Atrophy ; Basal Ganglia ; Brain ; Brain Stem ; Cerebellum ; Frontal Lobe ; Humans ; Magnetic Resonance Imaging* ; Phenylketonurias* ; Rabeprazole

PURPOSE: To evaluate the usefulness of color Doppler ultrasonography in the differential diagnosis of breast masses. MATERIALS AND METHODS: We prospectively evaluated to pathologically proven breast lesions. Forty-three were benign (39 fibroadenomas, two papillomas and two lipoma) and 27 were malignant (25 infiltrating ductal cardinomas, one mucinous carinoma and one atypical medullary caricinoma). In 32 cases, we categorized color signal from 0 to III, according to the degree of vascularity, and analysed peak systolic velocity (PSV) and resistive index (RI). RESULTS: Color signals of malignant lesions tended to be high grade (II, III), whereas those of benign lesions tended to be low (0, I), and the difference was statistically significant (P<0.005). In the analysis of spectral waveform , correlation between RI, PSV and malignancy was statistically significant (P<0.02). RI above 0.7 and PSV above 10 were the highest recorded values for sensitivity and specificity. CONCLUSION: Color Doppler ultrasound is a useful modality to distinguish benign from malignant breast masses. Malignancy is suggested when the color signal is grade II or III, the resistive index is higher than 0.7, and peak systolic velocity is higher than 10cm/sec.
Breast* ; Diagnosis, Differential ; Fibroadenoma ; Mucins ; Papilloma ; Prospective Studies ; Sensitivity and Specificity ; Ultrasonography ; Ultrasonography, Doppler, Color*