BACKGROUND: Although actinic keratosis and Bowens disease ar considered as carcinoma in situ, most of them are biologically benign and dont progress to invasive squamous cell carcinoma. It is little known why they take the benign courses and which factors are involved in the tumorigenesis. Keratoacanthoma, self-regresi;ing benign tumor, may be sometimes or fused morphologically with well-differentiated squamous cell carcinoma. So it is necessary to find a useful marker to help us distinguish them. OBJECTIVES: We performed this study to gain a better understani ling of biologic behaviour and tumerigenesis of epidermal keiatinocytic neoplasms. METHODS: We investigated the expression of p53 protein and priliferating cell nuclear antigen (PCNA) by an immunohistochemical method on the formalin-fixed, araffinembedded tissue specimens of epidermal keratinocytic neoplasms. RESULTS: Fourteen out of 20 cases of squamous cell carcinoma(70.0%), 14 out of 22 cases of actinic keratosis(63.6%), and 13 out of 20 cases of Bowens disease(65.0%) showed p53 protein expression, but keratoacanthoma was negative. All the tumors studied sho ved significantly increased numbers of PCNA-positive eells when compared with normal epidermis and characteristic distribution pattern. of PCNA-positive cells. Most cases of actinic keratosis exhibited the basal dysplastic pattern, but Bo wenoid variants showed diffuse dysplastic pattern. Karatoacanthoma revealed the marginal pattern and Bowens disease showed the diffuse dysplastic pattern. Well-differentiated squamous cell carcinoria showed the basal dysplastic pattern, while poorly differentiated squamous cell carcinoma revealed d ffuse dysplastic pattern. CONCLUSION: Our results suggest that p53 mutation is a common and early genetic change in the epidermal tumorigenesis and may be used as a good marker for malignan transformation, but it does not seem to correlate with the biollagic behavior or prognosis of epidermal neoplasms. PCNA, which is considered as a proliferation-relaited marker, was expressed with chavaceristic distribution patterns according to the type of tumors, but the frequency of PCNA expression is unlikely to reflct the malignant potential of epidermal neoplasms.
Actins ; Bowen's Disease ; Carcinogenesis ; Carcinoma in Situ ; Carcinoma, Squamous Cell ; Epidermis ; Keratoacanthoma ; Keratosis, Actinic ; Prognosis ; Proliferating Cell Nuclear Antigen*

BACKGROUND: Although actinic keratosis and Bowens disease ar considered as carcinoma in situ, most of them are biologically benign and dont progress to invasive squamous cell carcinoma. It is little known why they take the benign courses and which factors are involved in the tumorigenesis. Keratoacanthoma, self-regresi;ing benign tumor, may be sometimes or fused morphologically with well-differentiated squamous cell carcinoma. So it is necessary to find a useful marker to help us distinguish them. OBJECTIVES: We performed this study to gain a better understani ling of biologic behaviour and tumerigenesis of epidermal keiatinocytic neoplasms. METHODS: We investigated the expression of p53 protein and priliferating cell nuclear antigen (PCNA) by an immunohistochemical method on the formalin-fixed, araffinembedded tissue specimens of epidermal keratinocytic neoplasms. RESULTS: Fourteen out of 20 cases of squamous cell carcinoma(70.0%), 14 out of 22 cases of actinic keratosis(63.6%), and 13 out of 20 cases of Bowens disease(65.0%) showed p53 protein expression, but keratoacanthoma was negative. All the tumors studied sho ved significantly increased numbers of PCNA-positive eells when compared with normal epidermis and characteristic distribution pattern. of PCNA-positive cells. Most cases of actinic keratosis exhibited the basal dysplastic pattern, but Bo wenoid variants showed diffuse dysplastic pattern. Karatoacanthoma revealed the marginal pattern and Bowens disease showed the diffuse dysplastic pattern. Well-differentiated squamous cell carcinoria showed the basal dysplastic pattern, while poorly differentiated squamous cell carcinoma revealed d ffuse dysplastic pattern. CONCLUSION: Our results suggest that p53 mutation is a common and early genetic change in the epidermal tumorigenesis and may be used as a good marker for malignan transformation, but it does not seem to correlate with the biollagic behavior or prognosis of epidermal neoplasms. PCNA, which is considered as a proliferation-relaited marker, was expressed with chavaceristic distribution patterns according to the type of tumors, but the frequency of PCNA expression is unlikely to reflct the malignant potential of epidermal neoplasms.
Actins ; Bowen's Disease ; Carcinogenesis ; Carcinoma in Situ ; Carcinoma, Squamous Cell ; Epidermis ; Keratoacanthoma ; Keratosis, Actinic ; Prognosis ; Proliferating Cell Nuclear Antigen*

Pain, traumatic arthritis, joint stiffness and joint subluxation are common sequelae of fracture dislocations of the proximal interphalangeal joints of the finger. Many kinds of methods were used to treat fracture dislocation of the proximal interphalangeal joint. The prognosis is greatly influenced by the method and the time of treatment. Authors treated 4 cases of fracture dislocations of the proximal interphalangeal joint with 3 different method. For a case with small bony fragment, we used the extension block splint of McElfresh. For a old case, we used the volar plate arthroplasty mothod of Eaton. And for two cases with large bony fragment, we used the force couple splint method of Agee after open reduction and internal fixation. The results were satisfactory.
Arthritis ; Arthroplasty ; Dislocations ; Fingers ; Joints ; Methods ; Prognosis ; Splints

Since CT scanning was introduced in the diagnosis of calcaneal fracture, we became to understand more clearly the pathoanatomy of the injury. However we have to determine if we would or would not take CT scanning by simple radiography in the acute setting and most of the surgeons still use simple radiography in evaluating postoperative result. And also we have to determine the accuracy of reduction and position of screws by simple radiography intraoperatively. The purpose of this report is to determine the accuracy of simple radiography in assessing the pathological anatomy of the intraarticular calcaneal fracture by experimental and clinical studies. This is a combined experimental and clinical studies using four below knee amputation specimens and 15 patients with 19 displaced intraarticular calcaneal fractures treated at Hanil General Hospital between Jan. 1996 and May 1997. The lateral view of the foot was the best radiographic view for visualizing the degree of depression of the posterior facet. With regard to the location of a fracture line, findings of Broden views correlated well with findings on CT in 17 of 19 fractures. With regard to gapping between fragments, the axial view was not satisfactory in the majority of cases(15 of 19 cases). There was no case which showed more than 2 mm of discrepancy between the findings on Broden view and CT. We conclude that we may obtain most of the important informations about the pathological anatomy of the intraarticular calcaneal fracture by simple radiography.
Amputation ; Depression ; Diagnosis ; Foot ; Hospitals, General ; Humans ; Knee ; Radiography* ; Tomography, X-Ray Computed

No abstract available.
Hand Strength*

BACKGROUND: The purposes of this study are to determine the prevalence of malnutrtion and its trend of change and to establish its relationship with dysphagia and functional outcome in rehabilitation patients. METHOD: We included 39 patients who were admitted into rehabilitation ward, and we evaluated nutri- tional parameters(serum albumin, serum lymphocyte, and weight loss) and dysphagia at the time of admi- ssion and four weeks after admission. We analyzed total rehabilitation inpatients and stroke patients who were major inpatients of rehabilitation ward. We measured Functional Independence Measure(FIM) and length of stay as clinical outcome scales. RESULTS: Malnutrition was observed in 76.9% of total patients and 69.6% in stroke patients at the time of admission. After four weeks, malnutrition was observed in 65.4% and 66.7%, respectively. Prevalence of dysphagia was 25.0% in non-malnourished patients and 22.0% in malnourished patients at the time of admission. It was not changed significantly after four weeks of rehabilitation. The length of stay was 31.3+/-16.0 days in non-malnourished patients and 39.8+/-19.4 days in malnourished patients. The FIM effi- ciency was 1.0+/-0.6 in non-malnourished patients and 2.3+/-6.5 in malnourished patients. CONCLUSION: Our findings suggest that malnutrition was highly prevalent in rehabilitation inpatients and it did not improved significantly through four weeks of rehabilitation. Therefore, it is important to be concerned about malnutrition and it needs proper and active management.
Deglutition Disorders ; Humans ; Inpatients* ; Length of Stay ; Lymphocytes ; Malnutrition* ; Prevalence ; Rehabilitation* ; Serum Albumin ; Stroke ; Weights and Measures

Financial stability is the foremost prerequisite for the continuous growth and development of hospitals. The present study aimed at developing a deterministic model using the factors which affect the hospitals profitability and at discovering which factor affected the hospital profitability. The study conducted questionnaire surveys on all general hospitals, with the exception of special hospitals, with over eighty hospital beds. Of the 274 subject hospitals, 136 of them, consituting 49.6% of the whole, were used in the study. The results are as follow. 1. In the deterministic model, outpatient revenue was affected more by the number of physician visits than by outpatient service intensity. Inpatient revenue was found to be affected more by the number of discharged patients than by inpatient service intensity. However, the increase rate of the service intensity not only contributed in stepping up the operating margin by 4~8% in outpatient and 3~6% in inpatient, but it was statistically significant. 2. Among the factors which determined the operating cost within the deterministic model, the number of patients had a greater impact on the operating cost than the resource consumption per patient. 3. The resource consumption per patient were proved to have the greatest effect on the profitability within the probabilistic model. The management cost per adjusted patient, in particular, was proven to have a statistically significant effect on the profitability in all hospitals.
Growth and Development ; Hospitals, General ; Hospitals, Special ; Humans ; Inpatients ; Models, Statistical ; Outpatients ; Surveys and Questionnaires

Blood and urine samples were taken from 447 welders exposed to manganese containing welding fumes and 127 office workers not exposed to welding fumes as a control. The air samples were analyzed by flame atomic absorption spectrophotometer (Varian 30A, Australia), and blood and urine samples were analyzed by flameless atomic absorption spectrophotometer(Z-8100, Hibachi, Japan). Data were evaluated in accordance with type of industry, smoking habits, and work duration. The results obtained were as follows: 1. The limit of detection(LOD) levels of manganese in blood and urine were 0.11 microgram/100ml of and 0.14 microgram/l, respectively. Our results of manganese concentration were shown within +/-2 standard deviation which was the upper and lower warning limit (UWL or LWL) on quality control chart. 2. The airborne concentrations of manganese in welding workplaces were 0.067 mg/m3 showing differences by type of industry ; 0.017 mg/m3 in automobile assembly and manufacturing industries, 0.084 mg/m3 in steel heavy industries and 0.180 mg/m3 in shipyards. 3. The blood manganese concentrations showed differences by type of industry showing the highest values of 1.70 microgram/100m1 in shipyards, 1.24 microgram/100m1 in automobile assembly and manufacturing industries and 1.11 microgram/100ml in steel heavy industries. Urinary manganese concentration corrected by urinary creatinine concentrations was 0.34 microgram/g creatinine in automobile assembly and manufacturing industries, 0.43 microgram/g creatinine in steel heavy industries and 0.48 microgram/g creatinine in shipyards. There were no difference urinary manganese concentrations by type of industry. 4. The overall blood manganese concentration was 1.26 microgram/100ml, and urinary manganese concentration was 0.35 microgram/g creatinine in welders. In contrast to these values, blood and urinary manganese concentrations were lower in control group showing 0.73 microgram/100m1, and 0.28 microgram/g creatinine, respectively. 5. Smoking habits did not seem to affect on blood and urinary manganese concentrations both in welders and office workers. 6. Blood manganese concentrations were significantly higher in welder who had worked longer than 10 years than in welder who had worked less than 10 years. 7. The blood manganese concentrations were significantly correlated to airborne manganese concentrations(r=0.318, n=64), work duration(r=0.425, n=538), and cumulative exposure indices(CEI) (r=0.354, n=64).
Absorption ; Automobiles ; Creatinine ; Manganese* ; Metallurgy ; Quality Control ; Smoke ; Smoking ; Steel ; Welding*

Twenty-one patients of the adult Japanese encephalitis, who had been admitted in National Medical Center during recent two years, were investigated to evaluate their epidemiological features and clinical courses. Male patients were more frequently affected than female, and forty-three percepts of patients were third decade. The peripheral leukocytosis and mild pleocytosis and non specific inflammatory findings in cerebrospinal fluid were observed, all case had positive titer in hemoagglutination inhibition test. The incidence of neuropsychiatric sequelas of Japanese encephaltis was about 67%, and among them speech disturbance was most frequent. Further epidemiological and microbiological studies should be necessary to evaluate the tendency of recent increment in incidence of adult type of Japanese encephalitis.
Adult ; Asian Continental Ancestry Group* ; Cerebrospinal Fluid ; Encephalitis, Japanese* ; Female ; Humans ; Incidence ; Leukocytosis ; Male

No abstract available.
Breast Neoplasms* ; Breast* ; Lymph Nodes* ; Neoplasm Metastasis*