Nonpalpable breast abnormalities which require excision and biopsy usually require marker localization. Many of these abnormalities are visible on ultrasound and this imaging technique can be used to guide fine needle aspiration and the placement of a wire marker prior to surgical excision. A non-invasive technique which does not require placement of a wire marker would offer significant advantages, being more pleasant for the patient and less demanding on resources. We attempted to localize 36 nonpalpable breast masses with non-invasive ultrasound marker technique at the department of general surgery, Soon Chun Hyang University Hospital, between January 1994 and February 1995. Cases clearly visible on ultrasound, whether on mammography(15 patients) or not(17 patients), underwent non-invasive ultrasound localization. In all cases the abnormality was easily identified and removed during surgery. The surgical biopsies contained fibroadenoma(19 cases), fibrocystic disease(12 cases), epithelial hyperplasia(1 case), intraductal papilloma(1 case), parasitic disease(1 case) and infiltrating ductal carcinoma(2 cases). The average age was 43 years old.. This non-invasive technique is a simple and accurate method for localizing small ultrasonically visible nonpalpable breast abnormalities, especially in younger female patient with dense breast, though further trials and studies will be attempted.
Adult ; Biopsy* ; Biopsy, Fine-Needle ; Breast* ; Female ; Humans ; Ultrasonography*

No abstract available.
Animals ; Isoproterenol* ; Plasma* ; Rats* ; Renin*

OBJECTIVE: To investigate the relationship between serum creatine kinase (CK) level and pulmonary function in Duchenne muscular dystrophy (DMD). METHODS: A total of 202 patients with DMD admitted to the Department of Rehabilitation Medicine, Gangnam Severance Hospital were enrolled from January 1, 1999 to March 31, 2015. Seventeen patients were excluded. Data collected from the 185 patients included age, height, weight, body mass index, pulmonary function tests including forced vital capacity (FVC), peak cough flow, maximal expiratory pressure (MEP), and maximal inspiratory pressure (MIP), and laboratory measurements (serum level of CK, CK-MB, troponin-T, and B-type natriuretic peptide). FVC, MEP, and MIP were expressed as percentages of predicted normal values. RESULTS: Serum CK activities were elevated above normal levels, even in the oldest DMD group. Serum CK level was strongly correlated with pulmonary functions of sitting FVC (p<0.001), supine FVC (p<0.001), MIP (p=0.004), and MEP (p<0.001). CONCLUSION: Serum CK level is a reliable screening test even in patients with advanced DMD, and is a strong predictor of pulmonary functions.
Body Weight ; Cough ; Creatine Kinase* ; Creatine* ; Humans ; Mass Screening ; Muscular Dystrophy, Duchenne* ; Reference Values ; Rehabilitation ; Respiratory Function Tests ; Troponin T ; Vital Capacity

OBJECTIVE: To evaluate the accuracy and safety of C1-C2 transarticular screw insertion, we retrospectively review surgical records and postoperative radiological findings. METHODS: From January 2001 to October 2003, the C1-C2 transarticular screw fixation and posterior wiring with iliac bone grafts was performed in 16 pateints. 6 patients had rheumatoid arthritis which caused cervical instability, 3 patients had os odontoideum, 3 patients had type 2 odontoid process fracture, 3 patients had traumatic transverse ligament injury and 1 patients who had been managed with C1-C2 wire fixation had psoriatic arthritis. RESULTS: Osseous fusion was documented in 15 patients(93.8%). Only one patient was recorded screw loosening because of postoperative infection. One patient had only one screw placed because of abnormal anatomical structure, one patients was breakage of a Kirschner wire, and one screw was medial location to lateral mass of C1, but clinical results was excellent and radiological instability was not noted. CONCLUSION: The author's experience demonstrates that C1-C2 transarticular screw fixation with wired bone graft is a safe procedure with higher fusion rate but precaution is needed to avoid the neural damage, vertebral artery injury, and hardware failure.
Arthritis, Psoriatic ; Arthritis, Rheumatoid ; Humans ; Ligaments ; Odontoid Process ; Retrospective Studies ; Transplants ; Vertebral Artery

BACKGROUND: The testes are one of the most common extramedullary sites of relapse in boys with acute lymphoblastic leukemia(ALL). The reported incidence of isolated testicular relapse varies from 3 to 40%. If these patients are treated exclusively with testicular irradialion, a systemic relapse occurs within a few months. Recently, the use of intensive chemotherapy and testicular irradiation improved the survival rate for boys with testicular leukemia. So, we performed this study to identify clinical manifestations, disease free survival and prognostic factors of testicular leukemia in children. METHODS: We reviewed 33 patients of testicular leukemia among total 410 boys with ALL diagnosed at the Department of Pediatrics, Seoul National University Children's Hospital from Jan. 1970 to Aug. 1996. Testicular leukemia was confirmed by testicular biopsy in all 33 patients. These patients were treated with combined local testicular irradiation(2,400~2,500 cGy/8~12fractions) and systemic chemotherapy. Two patients, in whom testicular relapse was diagnosed before 1979, unilateral orchiectomy of the involved site and testicular irradiation of the opposite site were performed. Probability estimates of disease free survival (DFS) were calculated by the method of Kaplan and Meier, and the relationship of prognostic factors to DFS was compared using the chi-square test in survival analysis. RESULTS: In 410 boys with ALL, testicular leukemia occurred in 33 patients(8%). Of 33 patients, 6 patients presented with testicular involvement at initial diagnosis, 16 patients had testicular relapse while still receiving chemotherapy and 11 patients had testicular relapse 3 to 57 months(median : 15 months) after cessation of chemotherapy. The median age of 33 patients was 7.4 yrs(9 months~18 yrs) and median WBC count 7,600/ L(2,700~270,000/L). All patients presented with painless testicular enlargement and testicular leukemia was confirmed by testicular biopsy. Among 33 patients, 2 had prior CNS relapse and 11 had concomitant bone marrow and/or CNS relapse. Twenty nine patients were treated with combined local testicular irradiation and systemic chemotherapy. Eleven had second relapse(6 bone marrow, 3 CNS, 2 opposite testis). Seventeen have been followed until now: 6 patients on chemotherapy and 11 patients(37.9%) in complete remission for 48.5+/-22.3 months(19~86 months). The 3 year DFS for 29 patients was 55.3%+/-10.1%. The following prognostic factors showed no significant association with DFS in testicular relapse : age and WBC count at initial diagnosis, age at testicular relapse, and concomitant relapse. Whether testicular relapse occurred on initial therapy or off initial therapy has prognostic value in predicting DFS. The 3 year DFS for boys with testicular relapse on and off initial therapy were 40.0%+/-12.9% and 78.8%+/-13.4%, respectively(P: 0.046). CONCLUSION: With the use of chemotherapy and testicular irradiation, prolonged second re mission can be achieved in many patients with testicular leukemia. The patients with testicular relapse off initial therapy fared significantly better than patients on therapy. So, to improve the DFS for boys with testicular leukemia, a better understanding of its biology and prognostic factors is needed.
Biology ; Biopsy ; Bone Marrow ; Child ; Diagnosis ; Disease-Free Survival ; Drug Therapy ; Humans ; Incidence ; Leukemia ; Missions and Missionaries ; Orchiectomy ; Pediatrics ; Precursor Cell Lymphoblastic Leukemia-Lymphoma* ; Recurrence ; Seoul ; Survival Rate ; Testis

PURPOSE: It is known that heat production in breast cancer is caused by hypermetabolism, hypervascularization and hyperperfusion in the affected regions of the breast. The object of this study is to detect the heat production in breast cancer of Korean women. MATERIALS AND METHODS: 240 patients with breast cancer and benign mass were examined by digital infrared thermographic system from January 1991 through December 1995. The heat production was detected when there was a hot spot on clinically palpable breast mass area on the breast thermogram. RESULTS: Of the 240 patients, 130 with breast cancer and 110 with benign mass, as control group. 118 (90.8%) of 130 patients with breast cancer had the heat production, but only 12 (10.9%) of 110 patients with benign mass had the heat production (p<0.0001). The sensitivity of breast thermogram was 90.8% and the specificity was 89.1%. 16 (64%) of 25 breast cancer of which size was smaller than 2 cm had the heat production. But all of 45 breast cancer of which size was larger than 4 cm had the heat production (p<0.0001). 103 (79.2%) of breast cancer had greater than 2degrees C in thermal difference (delta T), and 120 (92.3%) had greater than 1degrees C. CONCLUSION: We conclude that there is heat production in breast cancer. And also the heat production in breast cancer could be detected by the breast thermography. We suggest that further studies of mechanism about heat production in breast cancer is necessary.
Breast Neoplasms* ; Breast* ; Female ; Hot Temperature* ; Humans ; Sensitivity and Specificity ; Thermogenesis* ; Thermography

Seminal vesicle cysts combined with ipsilateral renal agenesis represent a rare urologic anomaly. This urogenital malformation is explained as a developmental failure in the same mesodermal region. We report a case of seminal vesicle cyst, ipsilateral dilated ureter and renal agenesis which was treated by surgical excision. And we searched the literature to review the clinical presentation, diagnosis and treatment options of this anomaly.
Diagnosis ; Mesoderm ; Seminal Vesicles* ; Ureter*

Purpose: Long-term culture- initiating cells(LTC-IC) are stem cells that have the capacities of long-term engraftment and helping to establish hematopoietic microenvironment. For evaluation of the LTC-IC, we measured the counts and function with multidimentional flowcytometry in long-term culture media. METHODS: Samples were obtained from umbilical cord blood, leukapheresis products and bone marrow(BM). LTC-IC were counted with flowcytometric analysis using anti- CD34, anti-CD38, and anti-HLA-DR antibodies at 0, 5, and 8 weeks. Cell adhesion molecule related with stem cell were evaluated with flowcytometric analysis also using anti-VCAM-1(CD106) and anti-VLA-4(CD49d) at 0 and 8 weeks. RESULTS: The proportion of CD34+/CD38- cell from fractionated mononuclear cells at 0 week were 0.46%, 0.044%, and 0.038% for BM, leukapheresis products, and umbilical cord blood respectively and then rapidly decreased at 5 weeks, but still persisted at 8 weeks in all three groups. The proportion of CD34+/HLA-DR- cells was the same tendency to CD34+/CD38-. VCAM+ expression rate from fractionated CD34+ cells at 0 and 8 weeks were 67.3% and 40.2% for BM and 64.1% 44.2% for umbilical cord blood but it was very low 31.2% and 5.1% for leukapheresis products. VLA-4+ expression rate for fractionated CD34+ cells at 0 and 8 weeks were similar tendency to VCAM+ cells. CONCLUSION: This study suggest that the count of LTC-IC decreased with time but still persisted until 8 weeks. Umbilical cord blood including BM help to establish the hematopoietic microenvironments.
Antibodies ; Cell Adhesion ; Culture Media ; Fetal Blood ; Leukapheresis ; Stem Cells

Twenty species representing five genera of arbuscular mycorrhizal fungi were isolated from twenty-four soil samples of the rhizosphere of the family Gramineae in Paekryung and Daecheong islands. A few species such as Glomus invermaius, G. marcrocapus var. marcrocarpus and Scutellospora coralloidea were recorded for the first time in Korea. The number of spores per 10g of soil was in the range of 8~337 in Paekryung and 16~349 in Daecheong island, respectively. The number of species per 10g of soil was 2~8 species in Paekryung and 2~7 species in Daecheong, respectively. Among them, G. macrocarpus var. macrocarpus was the most abundant species in both islands. The species diversity and evenness were almost similar in Paekryung and Daecheong Islands. Based on the host plants in two islands, the species diversity showed the highest value of 1.63 in Ischaemum crassipes, whereas the eveuness of species showed the lowest value of 0.35 in Eragrostis ferraginea.
Eragrostis ; Fungi* ; Humans ; Islands* ; Korea ; Poaceae ; Rhizosphere ; Soil ; Spores

Background: The scalp is an important functional and aesthetic structure that protects the cranial bone. Due to its inelastic characteristics, soft-tissue defects of the scalp make reconstruction surgery difficult. This study aims to provide an improved scalp reconstruction decision making algorithm for surgeons. Methods: This study examined patients who underwent scalp reconstruction within the last 10 years. The study evaluated several factors that surgeons use to select a given reconstruction method such as etiology, defect location, size, depth, and complications. An algorithmic approach was then suggested based on an analysis of these factors. Results: Ninety-four patients were selected in total and 98 cases, including revision surgery, were performed for scalp reconstruction. Scalp reconstruction was performed by primary closure (36.73%), skin graft (27.55%), local flap (17.34%), pedicled regional flap (15.30%), and free flap (3.06%). The ratio of primary closure to more complex procedure on loose scalps (51.11%) was significantly higher than on tight scalps (24.52%) (p= 0.011). The choice of scalp reconstruction method was affected significantly by the defect size (R = 0.479, p< 0.001) and depth (p< 0.001). There were five major complications which were three cases of flap necrosis and two cases of skin necrosis. Hematoma was the most common of the 29 minor complications reported, followed by skin necrosis. Conclusion There are multiple factors affecting the choice of scalp reconstruction method. We suggest an algorithm based on 10 years of experience that will help surgeons establish successful surgical management for their patients.