PURPOSE: To evaluate the minimum 10-year follow up results of primary total hip arthroplasty (THA) performed using a sandwich-type (alumina-polyethylene-titanium) ceramic bearing. MATERIALS AND METHODS: Thirty four patients (40 hips) who underwent a THA with sandwich typed liners from November 1998 to December 2000 were analyzed. Among the 34 patients, 25 were men and nine were women. Mean follow-up was 134 months (range, 120~145 months) and mean patient age at the time of THA was 47.1 years (range, 24~65 years). The clinical results were evaluated using the Harris hip score and level of thigh pain with a limping gait. The radiographic evaluation was done in terms of the endosteal new bone formation, radiolucent line, subsidence of the stem, migration of the acetabular cup, and proof of loosening. RESULTS: The mean preoperative Harris hip score of 50.2 points (range, 31~87 points) was improved to 90.9 points (range, 75~99 points) at the final follow-up and thigh pain with limping gait in one case. All cases had fixation by bony ingrowth. No radiographically detectable loosening was observed in any hip. Fracture of ceramic liner in one case required change of the polyethylene liner. CONCLUSION: At the minimum 10-year follow up, survival rate as the end-point was favorable. However, fracture of the ceramic is still a major problem. Satisfactory results can be obtained by more precise surgical technique for acerabular inclincation and anteversion, and by improving the quality of the ceramic.
Arthroplasty ; Ceramics ; Female ; Follow-Up Studies ; Gait ; Hip ; Humans ; Male ; Osteogenesis ; Polyethylene ; Survival Rate ; Tacrine ; Thigh

PURPOSE: Drug resistance plays an important role in the failure of chemotherapy in breast cancer. The purpose of the study was to investigate the chemosensitive and chemoresistance indices of breast carcinomas and see if the in vitro chemosensitivity test correlated with the prognostic indices. METHODS: The immunohistochemical expressions of MDR1, MRP1 and topoisomerase IIalpha(topo IIalpha) were studied and then correlated these with the in vitro chemosensitivities using the histoculture drug response assay (HDRA) and clinicopathological factors in 51 breast carcinomas. RESULTS: In the breast carcinomas examined, the immunohistochemical expressions of MDR1, MRP1 and topo II alpha were strongly observed in 26 (51.0%), 16 (32.0%), 15 (31.3%) carcinomas, respectively. The MRP1 was more frequently expressed in poorly differentiated carcinomas (P= 0.006), and those of MDR1 and topo II alpha were more frequently observed in tumor overexpressing cerbB2 (P=0.038, P=0.036). The expression of MDR1 was related to that of topo II alpha (P=0.015). Comparing these markers with the in vitro chemosensitivities to cyclophosphamide, 5-FU, adriamycin, taxol and taxotere, no correlations were found between the expression of MDR1, MRP1, and topo II alpha but from the chemosensitivity using the HDRA, the growth inhibition rate for cyclophosphamide was higher in MRP1 expressing carcinomas (P=0.009). CONCLUSION: MDR1, MRP1 and topo II alpha were all found to be associated with the poor prognostic indices, but assessment of their immunohistochemical expressions did not allow for prediction of the response to chemotherapy by the in vitro chemosensitivity test in breast carcinomas.
Breast Neoplasms* ; Breast* ; Cyclophosphamide ; Doxorubicin ; Drug Resistance ; Drug Therapy ; Fluorouracil ; Paclitaxel

BACKGROUND: Ectopic thyroid gland is relatively rare condition and a developmental anomaly characterized by an aggregated of thyroid tissue in the midline anywhere from the base of the tongue to the mediastinum. The role of ectopic thyroid in the pathogenesis of non-goitrous sporadic cretinism and primary hypothyroidism has been emphasized. 19 cases of ectopic thyroid for 12 years was presented with Tc-pertechnetate or radioactive iodine, which were diagnosed by scintigraphy. METHODS: We wish to report these 19 cases and 12 cases of brief review of literatures on the incidence, etiology and development, symptomatology, diagnosis and treatment of ectopic thyroid gland was done. RESULTS: The most frequent incidental age was between the age 1 year and 29 years. And the frequency of ectopic thyroid was about 7 times more common in female(27 cases) than in male(4 cases). The location of ectopic thyroid were found to be lingual in 18 cases, sublingual in 9 cases, prelaryngeal in 1 case, and combine with lingual and sublingual in 3 cases. In chief complaints, palpable mass was most common and there were foreign body sensation on throat, dysphagia, dysphonia, and hoarseness. In 15 cases of hypothyroidism, l2 cases were taken thyroid hormone replacement therapy, 1 case was removed ectopic thyroid gland. In 2 of 10 cases of euthyroidism, replacement of thyroid hormone were done and 2 cases were removed ectopic thyroid gland, in 6 cases of unknown thyroid function, 1 case was removed ectopic thyroid gland and 131I therapy was done in 1 case, and others were observed with following up thyroid function test. CONCLUSION: These results suggest that the long terms thyroid function test, thyroglossal duct eyst and malignant change in ectopic thyroid tissue when finding the ectopic thyroid in thyroid scintigraphy were recommended highly.
Congenital Hypothyroidism ; Deglutition Disorders ; Diagnosis ; Dysphonia ; Foreign Bodies ; Hoarseness ; Hormone Replacement Therapy ; Hypothyroidism ; Incidence ; Iodine ; Mediastinum ; Pharynx ; Radionuclide Imaging ; Sensation ; Thyroid Dysgenesis* ; Thyroid Function Tests ; Thyroid Gland ; Tongue

"BACKGROUND: Between 80 to 85% of patients with hyperparathyroidsm have a solitary adenoma of the parathyroid glands and another 15% have a parathyroid hyperplasia. Preoperative localization of the parathyoid glands is generally accepted as warranted in patients who have failed an initial attempt at parathyroidectomy, ectopic locations and inexperienced surgeons. Different imaging techniques have been used for detection of abnormal parathyroid glands such as high resolution ultrasonography, computerized tomography, arteriography, venous sampling or magnetic resonance imaging and 201Tl/99mTc subtraction scintigraphy. But these methods have had varying rates of success, with low specificity and low sensitivity. Among the several different techniques available for parathyroid radionuclide imaging, the most common is the use of a dualradioisotope procedure combining of Tl with Tc. However, there are some controversies regarding the optimal technical aspects of this procedure, including the relative amount of injected dose of radiotracers, failed detection for small sized and deeper cervical located parathyroids, and not easy procedures. Recently, double phase Tc-sestamibi scintigraphy would be useful to solve these technical limitations, more convenient and have higher sensitivities. The purpose of this study was to compare the diagnostic accuracy of 99mTc-sestamibi with 201Tl/ 99mTc subtraction scintigraphy in the localization of hyperparathyroidism. METHODS: 9 patients with hyperparathyroidism underwent preoperative evaluation with double phase 99mTc-sestamibi scintigraphy and 201Tl/99mTc subtraction scintigraphy for attempted localization of abnormal parathyroid glands and surgical explorations. Imaging results were compared to surgical findings. RESULTS: Of 9 patients, 7 had a solitary parathyroid adenoma, 1 had a carcinoma and 1 had parathyroid hyperplasia. The 201Tl/99mTc subtraction scintigraphy preoperatively localized 8 of 9 patients(sensitivity: S9%) and 99mTc-sestamibi scintigraphy correctly localized all lesions for a sensitivity of 100%. In one case, 201Tl/99mTc subtraction scan show only a hot uptake at left upper parathyroid area, but 99mTc-sestamibi scan was shown the three site of hot uptake at left upper, both inferior parathyroid area. CONCLUSION: In patients with hyperparathyoridism, 99mTc-sestamibi scintigraphy may be used as the single imaging technique as it show a very high sensitivity and specificity in the preoperative localization of pathological parathyroid glands.
Adenoma ; Angiography ; Humans ; Hyperparathyroidism* ; Hyperplasia ; Magnetic Resonance Imaging ; Parathyroid Glands ; Parathyroid Neoplasms ; Parathyroidectomy ; Radionuclide Imaging* ; Sensitivity and Specificity ; Technetium Tc 99m Sestamibi* ; Ultrasonography

PURPOSE: The aim of this study was to assess the expression of VEGF-C (vascular endothelial growth factor-C) and LYVE-1 (lymphatic vessel endothelial HA receptor-1) mRNA in human breast cancer, and to compare the expression of VEGF-C protein and VEGF-C, LYVE-1 mRNA with the clinico-pathological outcomes. METHODS: RT-PCR was carried on the VEGF-C, LYVE-1 mRNA drawn from three samples of adjacent normal breast tissues, the MCF-7 breast cancer cell line and 39 breast cancer tissues. Immunohistochemical staining was done to detect the expression of VEGF-C protein in 39 cancer tissues and in 5 benign tissues with using well preserved, paraffin embedded tissues. The clinico-pathological findings were retrospectively reviewed for menopausal status, lymphatic invasion, hormonal status, the expression of p53 and c-erbB2. RESULTS: RT-PCR analysis revealed the expression of VEGF-C mRNA in 22 of 39 (56.4%) and LYVE-1 mRNA in 19 of 39 breast cancer tissues (48.7%). The expression of VEGF-C mRNA was positive in all cases except for one in LYVE-1 mRNA positive case, this revealed good correlation between the two molecules. Immunohistochemical analysis revealed that VEGF-C protein was expressed only in the breast cancer cells, with specific VEGF-C staining evident in 10 of 39 (25.6%). There was no significant correlation between VEGF-C, LYVE-1 mRNA expressions and the other pathologic variables. However, VEGF-C protein expression was negative in the group with a postmenopausal status, positive estrogen receptor and negative c-erbB2 significantly. CONCLUSIONS: VEGF-C mRNA seems to be related to the lymphangiogenetic marker-LYVE-1 mRNA and the amplification of the VEGF-C may be correlated with some clinico-pathological factors in the breast cancer.
Breast Neoplasms* ; Breast* ; Cell Line ; Estrogens ; Humans ; Paraffin ; Retrospective Studies ; RNA, Messenger ; Vascular Endothelial Growth Factor C*

PURPOSE: The aim of this study was to assess the expression of VEGF-C (vascular endothelial growth factor-C) and LYVE-1 (lymphatic vessel endothelial HA receptor-1) mRNA in human breast cancer, and to compare the expression of VEGF-C protein and VEGF-C, LYVE-1 mRNA with the clinico-pathological outcomes. METHODS: RT-PCR was carried on the VEGF-C, LYVE-1 mRNA drawn from three samples of adjacent normal breast tissues, the MCF-7 breast cancer cell line and 39 breast cancer tissues. Immunohistochemical staining was done to detect the expression of VEGF-C protein in 39 cancer tissues and in 5 benign tissues with using well preserved, paraffin embedded tissues. The clinico-pathological findings were retrospectively reviewed for menopausal status, lymphatic invasion, hormonal status, the expression of p53 and c-erbB2. RESULTS: RT-PCR analysis revealed the expression of VEGF-C mRNA in 22 of 39 (56.4%) and LYVE-1 mRNA in 19 of 39 breast cancer tissues (48.7%). The expression of VEGF-C mRNA was positive in all cases except for one in LYVE-1 mRNA positive case, this revealed good correlation between the two molecules. Immunohistochemical analysis revealed that VEGF-C protein was expressed only in the breast cancer cells, with specific VEGF-C staining evident in 10 of 39 (25.6%). There was no significant correlation between VEGF-C, LYVE-1 mRNA expressions and the other pathologic variables. However, VEGF-C protein expression was negative in the group with a postmenopausal status, positive estrogen receptor and negative c-erbB2 significantly. CONCLUSIONS: VEGF-C mRNA seems to be related to the lymphangiogenetic marker-LYVE-1 mRNA and the amplification of the VEGF-C may be correlated with some clinico-pathological factors in the breast cancer.
Breast Neoplasms* ; Breast* ; Cell Line ; Estrogens ; Humans ; Paraffin ; Retrospective Studies ; RNA, Messenger ; Vascular Endothelial Growth Factor C*

We report our recent experience of successful ultrasonography-guided catheter drainage of a huge retro-mammaryabscess in a 27-year-old female patient with pulmonary tuberculosis. For breast abscesses, the pro-cedure can beused instead of surgery. Its merits are that it is easy and cost-effective, there is less scar forma-tion,outpatient management may be possible, and in reported cases there has been no recurrence.
Abscess* ; Adult ; Breast ; Catheters ; Cicatrix ; Drainage* ; Female ; Humans ; Recurrence ; Tuberculosis, Pulmonary

An aneurysm of the pulmonary artery is a rare entity, but has a potentially fatal prognosis. We report a case of a 28 year-old asymptomatic woman, with an idiopathic pulmonary artery aneurysm. She was admitted to our hospital because of an abnormal bulging contour of the left hilum on chest X-ray. A computed tomographic scan and pulmonary angiography showed dilatation of the main and proximal left pulmonary arteries. She has a stable, non-progressive condition without treatment during the 8 month follow-up period.
Adult ; Aneurysm* ; Angiography ; Dilatation ; Female ; Follow-Up Studies ; Humans ; Prognosis ; Pulmonary Artery* ; Thorax

Background: Oral propranolol has recently been introduced as a successful treatment for infantile hemangioma (IH).Though, there are limited reports on this treatment including large number of Korean patients with IH covering a long-term powder and solution formulation period. Objective: We investigated the effectiveness and side effects of two different formulations of oral propranolol treatment in patients with IH at a Korean tertiary university hospital. Methods: From June 2011 to October 2019, 375 patients were treated with powder- or solution-type oral propranolol starting at 1 mg/kg/day and increasing up to 3 mg/kg/day. Drug effectiveness was evaluated on four scales through sequential photographs by two dermatologists. Side effects were recorded on a medical chart. Results: Overall, the mean improvement scale was 2.61±0.73 at 3 months after treatment initiation. The scale was higher for solution-type than for powder-type oral propranolol at the 3-month follow-up (2.71±0.79 vs. 2.54±0.67, p＜0.05). The patients’ mean duration of treatment was 8.56±5.85 months, which was shorter for solution-type than for powder-type oral propranolol (6.0 vs. 10.69 months, p＜0.05). Among the total number of patients, 22 reported mild side effects, including loose stools and noticeable sleep disturbance, and few serious side effects such as grunting, while two patients required medical intervention. Conclusion The patients in our study were effectively treated for IH with oral propranolol without significant side effects and had a shorter treatment duration with solution-type oral propranolol than with powder-type oral propranolol.

Background: Venous malformations (VMs) are the most common type of vascular malformations. Intramuscular venous malformations (IMVMs) are lesions involving the muscles, excluding intramuscular hemangiomas. The purpose of this study was to compare clinical outcomes between patients with IMVMs who were treated with sclerotherapy and those who were treated with surgical excision. Methods: Of 492 patients with VMs treated between July 2011 and August 2020 at a single medical center for vascular anomalies, 63 patients diagnosed with IMVM were retrospectively reviewed. Pain, movement limitations, swelling, and quality of life (QOL) were evaluated subjectively, while radiological outcomes were assessed by qualified radiologists at the center. Complication rates were also evaluated, and radiological and clinical examinations were used to determine which treatment group (sclerotherapy or surgical excision) exhibited greater improvement. Results: Although there were no significant differences in pain (P=0.471), swelling (P=0.322), or the occurrence of complications (P=0.206) between the two treatment groups, the surgical treatment group exhibited significantly better outcomes with regard to movement limitations (P=0.010), QOL (P=0.013), and radiological outcomes (P=0.017). Moreover, both duplex ultrasonography and magnetic resonance imaging showed greater improvements in clinical outcomes in the surgical excision group than in the sclerotherapy group. Conclusions Although several studies have examined IMVM treatment methods, no clear guidelines for treatment selection have been developed. Based on the results of this study, surgical excision is strongly encouraged for the treatment of IMVMs.