PURPOSE: To investigate the correlation between mammographic findings of infiltrating ductal carcinoma (IDC), patient age and pathologic grading. MATERIALS AND METHODS: The study included 103 cases of infiltrating ductal carcinoma in 102 women who during the preceding three years had undergone mammography and surgery. The mammograms were retrospectively reviewed by two radiologists. The mean age of the patients was 45.2 (range 26-74) years and the age distribution was seven in the 3rd decade, 37 in the 4th, 29 in the 5th, 24 in the 6th, and six in the 7th or above. Thirty-three lesions were histologic. Grade I, 59 were Grade II and 11 were Grade III. RESULTS: Ten (9.7%) of 103 cases, all of whom were younger than 50, were missed during mammographic diagnosis. On mammograms, primary findings of breast malignancy were found in 54 (74%) of 73 patients younger than 50 and 27 (90%) of 30 patients older than 51. Mass with or without microcalcification was found in 45 patients (62%) younger than 50 and in 26 (87%) older than 51. Nine (12%) and 3 (10%) in each age group showed secondary findings. There was no correlation between age distribution and histologic grading. Seventy-three percent of Grade I lesions and 78% of those of Grade III showed primary findings. Five lesions in each of Grade I and II were missed at mammographic interpretation, but this was not statistically significant (p=0.250). In all 11 Grade III cases, breast cancer were manifested as primary findings but this was not statistically significant (p=0.203). CONCLUSION: The majority of IDC were detected by mammography, but 9.7% of IDC patients, all younger than 50, were misdiagnosed. Most IDC was manifested as primary findings, particularly in patients aged over 51. There were no differences in pathlogic grading according to age distribution. All histologic Grade III lesions were detected by mammography.
Age Distribution ; Breast ; Breast Neoplasms ; Carcinoma, Ductal* ; Diagnosis ; Female ; Humans ; Mammography ; Retrospective Studies

OBJECTIVE: To estimate the long-term skeletal responses to hormone replacement therapy(HRT) with or without active vitamin D(VD) by using short-term changes of bone markers in postmenopausal women (PMW). METHODS: Biochemical markers of bone formation(osteocalcin,OC) and (&) resorption(deoxypyridinoline, Dpd ) at 3 months & lumbar bone mineral density(BMD) at 1 year were measured in 64 natural PMW taking HRT(n=41) & HRT with calcitriol 0.25 microgram/day(n=23). The correlation of percent changes of bone markers after 3 months of Tx with those in lumbar BMD after 1 year was evaluated. RESULTS: 1. serum-OC & urine-Dpd showed decrease of 20.9% & 30.1% at 3months respectively & BMD increase of 3.8% after 1 year of Tx. 2. Among 58 PMW with decreased u-Dpd change, 49 (84.5%) revealed increase in BMD, while 40 (81.6%) among 49 PMW with decreased serum-OC change showed increased BMD. 3. Bone gainers showed significant decrease in changes of serum-OC(18.1% vs 9.2% p<0.05) & urine-Dpd(32.6% vs 20.4%, p<0.05) compared with those of bone losers. 4. No correlations of change of serum-OC (r=-0.174 p>0.05) & urine-Dpd (r=-0.091 p>0.05) at 3month with BMD changes at 1year were seen in total PMW, but urine-Dpd changes in HRT without active VD group revealed significantly inverse correlation(r=-0.376 p<0.05). CONCLUSION: Short-term changes of bone markers did not precisely predict the long-term changes of BMD in total PMW except urine- Dpd in HRT without active VD.
Biomarkers ; Bone Density* ; Calcitriol ; Estrogen Replacement Therapy* ; Female ; Humans ; Osteocalcin ; Vitamin D* ; Vitamins*

OBJECTIVE: To determine if birth weight greater than 4000gm can be predicted by ultrasound measurement of abdominal circumference(AC) and if shoulder dystocia in macrosomic infants can be predicted by ultrasound measurement of the difference between the abdominal diameter(AD) and biparietal diameter(BPD). METHODS: A Retrospective study was performed of births occuring from March, 1998 to August, 1999 at department of Obstetrics and Gynecology, College of Medicine, Chung-Ang University. Among neonates of birth weight greater than 4000 gm, 50 cases in that ultrasound examination was done within 2 weeks before delivery were selected for macrosomic group and 50 cases were selected for control group during the same period, among neonate of birth weight from 3100gm to 3900gm. RESULTS: 1) Normal spontaneous vaginal delivery(NSVD) was 41 cases in control group and 30 cases in macrosomic group. Among NSVD, shoulder dystocia was 1 case in 41 cases of control group and was 7 cases in 30 cases of macrosomic group. 2) On ultrasound measurement, 6 cases had AC greater than 35 cm in control group and 45 cases in macrosomic group. Among 30 cases in NSVD was done in macrosomic group, difference between AD and BPD was 2.9 0.271 cm when shoulder dystocia was existed and was 2.1 0.409 cm when shoulder dystocia was not existed. Between the two groups, statistically significant difference was detected. 3) When AC(cutoff value of 35cm) was used for screening of macrosomia, sensitivity for macrosomia was 88.2% and specificity was 89.8% and when AD-BPD difference(cutoff value of 2.6cm) was used for prediction of shoulder dystocia, sensitivity for shoulder dystocia was 66.6% and specificity was 95.2%. CONCLUSIONS: In prenatal ultrasound measurement, AC measurement at third trimester of pregnancy will be a valuable indicator for macrosomia screening. The AD-BPD difference of shoulder dystocia group was greater than uncomplicated group in macrosomia and the AD-BPD difference cutoff value of 2.6cm was significant value statistically.
Birth Weight ; Dystocia* ; Female ; Gynecology ; Humans ; Infant ; Infant, Newborn ; Mass Screening ; Obstetrics ; Parturition ; Pregnancy ; Pregnancy Trimester, Third ; Retrospective Studies ; Sensitivity and Specificity ; Shoulder* ; Ultrasonography*

No abstract available.
Ankle* ; Chondromatosis, Synovial*

OBJECTIVE: Cell to cell and cell to extracellular matrix interaction are crucial in tumor development and progression. Tight junction proteins such as claudins and zonula occludens-1 (ZO-1) play an important role in these processes. This study was performed to investigate the difference of expressions of claudin-1, claudin-4 and ZO-1 in low grade squamous intraepithelial lesion (LSIL), high grade squamous intraepithelial lesion (HSIL), and invasive squamous cell carcinoma (ISCC) of the uterine cervix. METHODS: The expressions of claudin-1, claudin-4 and ZO-1 were evaluated using immunohistochemical staining in 78 cervical tissue specimens (LSIL 22 case, HSIL 36 case, and ISCC 20 case). RESULTS: Claudin-1 expression was positive in 40.9% of LSIL, in 94.0% of HSIL and in 20.0% of ISCC. The expression of claudin-1 was significantly high in HSIL (p=0.0001). Claudin-4 expression was positive in 31.8% of LSIL, in 41.7% of HSIL and in 25.0% of ISCC. The expression of claudin-4 was high in HSIL, but it was not statistically different. ZO-1 expression was positive in 13.6% of LSIL, in 41.7% of HSIL, and in 25.5% of ISCC. The expression of ZO-1 was significantly high in HSIL (p=0.011). CONCLUSION: These results indicate increased expressions of claudin-1 and ZO-1 in the HSIL that includes cervical intraepithelial neoplasia (CIN) 2 and 3, which decrease during progression to cervical cancer.
Carcinoma, Squamous Cell* ; Cervical Intraepithelial Neoplasia* ; Cervix Uteri ; Claudin-1* ; Claudin-4* ; Claudins ; Extracellular Matrix ; Female ; Tight Junction Proteins ; Uterine Cervical Neoplasms

OBJECTIVE: To determine whether a routine ultrasonography (US) is necessary for diagnosis of developmental dysplasia of hip (DDH), presenting with congenital muscular torticollis (CMT). METHODS: Cases of 133 patients (81 males, 52 females) diagnosed as CMT were reviewed, retrospectively. We reviewed the medical charts and diagnostic examination. We also assessed the coincidence of CMT and DDH, and investigated the clinical features of CMT related to DDH. RESULTS: Twenty (15.0%) patients out of 133 CMT patients were diagnosed as having DDH by US. Of whom, 8 patients were radiographically positive and 4 patients were both clinically and radiographically positive. Nine patients were treated with a harness and 1 of them needed closed reduction and casting. Out of 9 patients treated with a harness, only 4 were clinically positive. The difference and ratio of the sternocleidomastoid (SCM) muscle thickness between the normal and abnormal side was significantly greater in DDH patients (p=0.014). Further, receiver operating characteristic analysis showed when the SCM ratio is greater than 2.08 and the SCM difference is greater than 6.1 mm, the efficiency of US for the diagnosis of the DDH was found to be the best (p<0.05). CONCLUSION: To evaluate DDH, physical examination showed low sensitivity and radiologic study has limitation for the child before 4 to 6 months of age. Therefore, we recommend that hip is screened by US for the diagnosis of DDH associated with CMT when physical examination is positive or CMT patients with large SCM difference and high SCM ratio.
Child ; Hip ; Hip Joint ; Humans ; Male ; Muscles ; Physical Examination ; Retrospective Studies ; ROC Curve ; Torticollis

Bronchogenic cysts (BCs) are relatively common congenital anomalies in the mediastinum. Most of the patients with BC can be managed both safely and effectively by minimally invasive methods. Selected patients with a BC in a favorable location can have the cyst partially or completely excised by mediastinoscopic techniques. Herein we report on a case of a left lower paratracheal bronchogenic cyst that was completely resected by a video-assisted mediastinoscopic technique, and we discuss the technical aspects of this procedure.
Bronchogenic Cyst ; Humans ; Mediastinal Diseases ; Mediastinoscopy ; Mediastinum

Heterotopic pregnancy with coexistiong intrauterine and extrauterine pregnancy, is a rare event in natural pregnancy. However, in recent years, the increase in the incidence of pelvic inflammatory disease and use of assisted reproductive technology had led to an increase in the frequency of heterotopic pregnancy. When the diagnosis of heterotopic pregnancy is delayed, maternal mortality and morbidity may be increased, and unwanted loss of intrauterine pregnancy may occur. Therefore, the early diagnosis of heterotopic pregnancy is clinically important, and clinicians have to consider the possibility of heterotopic pregnancy and conduct careful and thorough evaluation if suspected. We experienced a case of heterotopic pregnancy in a woman in the absence of the known risk factors. She underwent underwent spontaneous abortion of intrauterine pregnancy at postoperative 4th day, after laparoscopic salpingectomy for left tubal pregnancy. We report this case with brief review of literature.
Abortion, Spontaneous ; Diagnosis ; Early Diagnosis ; Female ; Humans ; Incidence ; Maternal Mortality ; Pelvic Inflammatory Disease ; Pregnancy ; Pregnancy, Heterotopic* ; Pregnancy, Tubal* ; Reproductive Techniques, Assisted ; Risk Factors ; Salpingectomy

Heterotopic pregnancy with coexistiong intrauterine and extrauterine pregnancy, is a rare event in natural pregnancy. However, in recent years, the increase in the incidence of pelvic inflammatory disease and use of assisted reproductive technology had led to an increase in the frequency of heterotopic pregnancy. When the diagnosis of heterotopic pregnancy is delayed, maternal mortality and morbidity may be increased, and unwanted loss of intrauterine pregnancy may occur. Therefore, the early diagnosis of heterotopic pregnancy is clinically important, and clinicians have to consider the possibility of heterotopic pregnancy and conduct careful and thorough evaluation if suspected. We experienced a case of heterotopic pregnancy in a woman in the absence of the known risk factors. She underwent underwent spontaneous abortion of intrauterine pregnancy at postoperative 4th day, after laparoscopic salpingectomy for left tubal pregnancy. We report this case with brief review of literature.
Abortion, Spontaneous ; Diagnosis ; Early Diagnosis ; Female ; Humans ; Incidence ; Maternal Mortality ; Pelvic Inflammatory Disease ; Pregnancy ; Pregnancy, Heterotopic* ; Pregnancy, Tubal* ; Reproductive Techniques, Assisted ; Risk Factors ; Salpingectomy

OBJECTIVE: This study had three objectives: 1) to investigate the rehabilitation professionals' way of thinking on physical, psychological and social characteristics of older patients: 2) to assess their actual knowledge level about aging; and, 3) to deduce and analyze the influences that cause these different kinds of perceptions and attitudes. METHOD: Total 239 rehabilitation professionals (including rehabilitation doctors, nurses, physical therapists, occupational therapists, speech therapists, social workers, psychologists, prosthetists & orthotists) responded to our questionnaire were included in this study. Self-addressed questionnaires were composed of two categories: 1) the perception of older patients compared with younger patients: and 2) the actual knowledge level about aging. RESULTS: 1) There were significant (p<0.05) differences by job classification on a speculative disposition with the physical characteristics, motive of treatment, emotional characteristics, and discharge problem of older patients. 2) There were also significant (p<0.05) differences by job classification in the actual knowledge level about aging by job classification. A higher score on the questionnaire correlated with a more optimistic view of the motive of treatment, emotional characteristic and discharge problem. CONCLUSION: Many rehabilitation professionals have a misconceptions about older patients due to insufficient knowledge on aging. Therefore we propose an objective understanding of older patients along with proper education on aging to provide an effective rehabilitation treatment.
Aging* ; Classification ; Education ; Humans ; Physical Therapists ; Psychology ; Surveys and Questionnaires ; Rehabilitation* ; Social Workers ; Sociology ; Thinking