BACKGROUND: Cytokeratins were subdivided into 20 different cytokeratins. It is known that cytokeratin 19 is particularly abundant in carcinoma of the lung. METHOD: A sandwich enzyme-linked immunosorbent assay called CYFRA 21-1, combining two monoclonal antibodies directed specifically aganist cytokeratin 19 was done by ES-300(Boehringer Mannheim, Germany). We investigated the diagnostic value of the new tumor marker CYFRA 21-1 in lung cancer in comparison to carcinoembryonic antigen(CEA) and neuron specific enolase(NSE) in the pilot study on 39 serum samples from lung cancer (17 squamous cell cancer, 11 adenocarcinoma, 11 small cell carcinoma) and 51 benign lung diseases and 41 normal healthy persons. RESULTS: Postulating a specificity 95% versus benign lung disease and healthy group, the diagnostic sensitivity of CYFRA 21-1 in lung cnacer independent of histologic type was 43.6% whereas CEA was 48.7% and NSE was 30.8%. The diagnostic sensitivity is increased to 69.2% by combining CYFRA 21-1 with CEA. Classifying the lung carcinomas following their histologic type, squamous cell carcinomas proved to possess the highest CYFRA 21-1 sensitivity(CYFRA 21-1 47.1%, CEA 23.5%, NSE 11.8%) and the combination with CEA 52.9% could not markedly increase the number of true-positive test results. In adenocarcinoma, CEA possessed the highest sensitivity (81.8%) whereas CYFRA 21-1 was 45.5% and NSE was 9.1%. In small cell carcinoma of lung, NSE possessed the highest sensitivity(81.8%) whereas CYFRA 21-1 was 36.4% and CEA was 54.5%. CONCLUSION: This study indicates that CYFRA 21-1 has a potential as a new marker for squamous cell lung cancer. If histologic type is unknown at the time of primary diagnosis. the combined determination of CYFRA 21-1 and CEA showed the best discrimination between benign and malignant lung disease.
Adenocarcinoma ; Antibodies, Monoclonal ; Carcinoma, Small Cell ; Carcinoma, Squamous Cell ; Diagnosis ; Discrimination (Psychology) ; Enzyme-Linked Immunosorbent Assay ; Humans ; Keratin-19 ; Keratins ; Lung Diseases ; Lung Neoplasms* ; Lung* ; Neoplasms, Squamous Cell ; Neurons ; Pilot Projects ; Sensitivity and Specificity

PURPOSE: To compare the differential radiologic findings of renal cell carcinoma presenting as a homogeneous solid mass (HS-RCC) and muscle-predominant angiomyolipoma (MP-AML). MATERIALS AND METHODS: Nine of 76 surgically and pathologically proven RCCs presenting at CT or magnetic resonance (MR) imaging as a homogeneous solid mass, and four cases of MP-AML were included in this study. Echogenicity at sonography, attenuation at non-enhanced CT (NECT), the contour of the mass, signal intensities at T1- and T2-weighted MR imaging, the existence of a capsule, and the pattern and degree of enhancement at CT and MR imaging were retrospectively analyzed. RESULTS: Two of five HS-RCCs were isoechoic and three were hyperechoic. Two of three MP-AMLs, however, were isoechoic, and one was mixed echoic. All nine HS-RCCs were round or oval in shape, but three MPAMLs were lobulated and one was round. At NECT, seven of eight HS-RCCs were isodense and one was hypodense compared to surrounding normal renal parenchyme, but three MP-AMLs were hyperdense masses and one was isodense. At enhanced CT, HS-RCCs showed various degrees of homogeneous enhancement, but all MP-AMLs showed moderate homogeneous enhancement. All three MP-AMLs demonstrated heterogeneous hypointensity at T2-weighted MRI and homogeneous hypointensity at T1-weighted MRI. HS-RCCs showed various signal intensities at both T1- and T2-weighted MRI, and in five cases, heterogeneous high signal intensity at T2-weighted MRI. Capsules were observed in seven of nine HS-RCCs but not in any of the three MP-AMLs. At enhanced T1-weighted MRI, MP-AMLs showed mild to moderate enhancement, but HSRCCs showed mild, moderate, and strong enhancement in two, two, and five cases, respectively. CONCLUSION: Echogenicity, density at NECT, signal intensity at MR T2-WI, the contour of the mass, and the existence of a capsule are features which are useful in the differential diagnosis of HS-RCC and MP-AML.
Angiomyolipoma* ; Capsules ; Carcinoma, Renal Cell* ; Diagnosis, Differential ; Magnetic Resonance Imaging ; Retrospective Studies

Background: This study aims to identify the incidence and risk factors of periprosthetic infections following endoprosthetic reconstruction of femoral metastatic bone disease (MBD). In this population with MBD, the marked impact of infection on the patient’s systemic treatment highlights the importance of understanding both the incidence and associated risk factors. Methods: This retrospective cohort study included a total of 140 patients who underwent endoprosthetic reconstruction for femoral MBD at a tertiary referral hospital in South Korea between 2009 and 2019. Infection-free survival was estimated using the Kaplan-Meier method, and Cox proportional hazards model analyses were performed to evaluate the risk factors associated with periprosthetic infection. Results: The incidence of periprosthetic infection in patients who underwent endoprosthetic reconstruction for femoral MBD was 9% (12 out of 140 patients). Risk factors for periprosthetic infection were hepatocellular carcinoma (HCC) as the primary tumor (hazard ratio [HR], 6.08; 95% CI, 1.63–22.6; p = 0.007) and low preoperative absolute neutrophil count (HR, 6.99; 95% CI, 1.79–27.4; p = 0.005). Conclusions Patients with femoral MBD had a 9% risk of developing a periprosthetic infection. Given their limited life expectancy, this translated to a substantial rate of 58.9 infections per 1,000 person-joint-years. Possible risk factors for periprosthetic infection were low preoperative absolute neutrophil count and HCC as the primary tumor. The high incidence of periprosthetic infection and its associated risk factors should be considered in patients undergoing endoprosthetic reconstruction for femoral MBD.

Background: This study aims to identify the incidence and risk factors of periprosthetic infections following endoprosthetic reconstruction of femoral metastatic bone disease (MBD). In this population with MBD, the marked impact of infection on the patient’s systemic treatment highlights the importance of understanding both the incidence and associated risk factors. Methods: This retrospective cohort study included a total of 140 patients who underwent endoprosthetic reconstruction for femoral MBD at a tertiary referral hospital in South Korea between 2009 and 2019. Infection-free survival was estimated using the Kaplan-Meier method, and Cox proportional hazards model analyses were performed to evaluate the risk factors associated with periprosthetic infection. Results: The incidence of periprosthetic infection in patients who underwent endoprosthetic reconstruction for femoral MBD was 9% (12 out of 140 patients). Risk factors for periprosthetic infection were hepatocellular carcinoma (HCC) as the primary tumor (hazard ratio [HR], 6.08; 95% CI, 1.63–22.6; p = 0.007) and low preoperative absolute neutrophil count (HR, 6.99; 95% CI, 1.79–27.4; p = 0.005). Conclusions Patients with femoral MBD had a 9% risk of developing a periprosthetic infection. Given their limited life expectancy, this translated to a substantial rate of 58.9 infections per 1,000 person-joint-years. Possible risk factors for periprosthetic infection were low preoperative absolute neutrophil count and HCC as the primary tumor. The high incidence of periprosthetic infection and its associated risk factors should be considered in patients undergoing endoprosthetic reconstruction for femoral MBD.

Background: This study aims to identify the incidence and risk factors of periprosthetic infections following endoprosthetic reconstruction of femoral metastatic bone disease (MBD). In this population with MBD, the marked impact of infection on the patient’s systemic treatment highlights the importance of understanding both the incidence and associated risk factors. Methods: This retrospective cohort study included a total of 140 patients who underwent endoprosthetic reconstruction for femoral MBD at a tertiary referral hospital in South Korea between 2009 and 2019. Infection-free survival was estimated using the Kaplan-Meier method, and Cox proportional hazards model analyses were performed to evaluate the risk factors associated with periprosthetic infection. Results: The incidence of periprosthetic infection in patients who underwent endoprosthetic reconstruction for femoral MBD was 9% (12 out of 140 patients). Risk factors for periprosthetic infection were hepatocellular carcinoma (HCC) as the primary tumor (hazard ratio [HR], 6.08; 95% CI, 1.63–22.6; p = 0.007) and low preoperative absolute neutrophil count (HR, 6.99; 95% CI, 1.79–27.4; p = 0.005). Conclusions Patients with femoral MBD had a 9% risk of developing a periprosthetic infection. Given their limited life expectancy, this translated to a substantial rate of 58.9 infections per 1,000 person-joint-years. Possible risk factors for periprosthetic infection were low preoperative absolute neutrophil count and HCC as the primary tumor. The high incidence of periprosthetic infection and its associated risk factors should be considered in patients undergoing endoprosthetic reconstruction for femoral MBD.

Background: This study aims to identify the incidence and risk factors of periprosthetic infections following endoprosthetic reconstruction of femoral metastatic bone disease (MBD). In this population with MBD, the marked impact of infection on the patient’s systemic treatment highlights the importance of understanding both the incidence and associated risk factors. Methods: This retrospective cohort study included a total of 140 patients who underwent endoprosthetic reconstruction for femoral MBD at a tertiary referral hospital in South Korea between 2009 and 2019. Infection-free survival was estimated using the Kaplan-Meier method, and Cox proportional hazards model analyses were performed to evaluate the risk factors associated with periprosthetic infection. Results: The incidence of periprosthetic infection in patients who underwent endoprosthetic reconstruction for femoral MBD was 9% (12 out of 140 patients). Risk factors for periprosthetic infection were hepatocellular carcinoma (HCC) as the primary tumor (hazard ratio [HR], 6.08; 95% CI, 1.63–22.6; p = 0.007) and low preoperative absolute neutrophil count (HR, 6.99; 95% CI, 1.79–27.4; p = 0.005). Conclusions Patients with femoral MBD had a 9% risk of developing a periprosthetic infection. Given their limited life expectancy, this translated to a substantial rate of 58.9 infections per 1,000 person-joint-years. Possible risk factors for periprosthetic infection were low preoperative absolute neutrophil count and HCC as the primary tumor. The high incidence of periprosthetic infection and its associated risk factors should be considered in patients undergoing endoprosthetic reconstruction for femoral MBD.

PURPOSE: To compare the mammographic features and histologic subtypes of ductal carcinoma in situ(DCIS) of the breast. MATERIALS AND METHODS: Mammograms of 34 patients with DCIS of the breast detected between January 1992 and November 1998 were retrospectively analyzed. Histologic subtypes were classified as either comedo or noncomedo. Mammographic findings were classified in one of four ways : microcalcification only, microcalcification with mass, mass or asymmetrical density only, or normal. Microcalcifications was classified as either predominantly casting or granular. We also determined whether microcalcification was multifocal. RESULTS: Histologic examination revealed the comedo type in eight patients and the noncomedo type in 26. Among the eight comedo-type cases, mammography demonstrated microcalcification only in five and micro-calcification with mass in three. Among 26 noncomedo-type cases, microcalcifications only was seen in ten, microcalcification with mass in two, mass or asymmetrical density only in six, and normal features in eight. Six of the comedo type were predominantly casting and two were predominantly granular. Predominantly casting calcification was present in four of 12 cases of the noncomedo type and predominatly granular was in eight. Multifocality was seen in four comedo-type cases, but in none of those that were of the noncomedo type. CONCLUSION: We conclude that the comedo subtype of DCIS of the breast is more likely than the noncomedo subtype to be accompanied by microcalcification of the predominantly casting type. Multifocally located microcalcification is a more frequent feature of the comedo subtype than of the noncomedo subtype.
Breast ; Carcinoma, Ductal* ; Carcinoma, Intraductal, Noninfiltrating* ; Humans ; Mammography ; Retrospective Studies

PURPOSE: Plasma levels of renin, angiotensin II and aldosterone are increased during normal pregnancy. However, these values in preeclampsia are decreased to nearly that of a nonpregnant subject, and vascular sensitivity to angiotensin II is increased. In preeclampsia, aldosterone is decreased less than rennin. Therefore current studies were undertaken to determine the relationship between aldosterone to renin ratio (ARR) and uterine artery perfusion via RI value. MATERIALS AND METHODS: In this study, the relationship between plasma aldosterone and renin concentration was determined in 27 preeclamptic women and 50 normal pregnant women, whose gestational weeks were matched. The aldosterone to renin ratio was calculated and compared between the two groups. Doppler velocimetry of the uterine artery, which was used to calculate resistance index (RI), was performed on all subjects. The relationship between ARR and RI value was reviewed. RESULTS: In the preeclampsia group, RI value of the uterine artery was significantly higher than that of normal pregnant women. Both plasma renin and aldosterone concentrations were lower in the preeclampsia group. However, the ratio of these two parameters was significantly higher (38.3 vs. 16.1, p < 0.001); the greater ARR, the higher the RI of the uterine artery (r(2)=0.053, p=0.048). CONCLUSION: This study demonstrates that a high aldosterone to renin ratio may have a negative effect on perfusion of the uterine artery and play an important role in the pathophysiology of preeclampsia.
Adult ; Aldosterone/*blood ; Arteries/metabolism ; Case-Control Studies ; Female ; Gestational Age ; Health ; Humans ; Pre-Eclampsia/*blood ; Pregnancy ; Renin/*blood ; Uterus/*blood supply/*metabolism

OBJECTIVE: We have used diffusion tensor tractography (DTT) for the evaluation of the somatotopic organization of corticospinal tracts (CSTs) in the posterior limb of the internal capsule (PLIC) and cerebral peduncle (CP). MATERIALS AND METHODS: We imaged the brains of nine healthy right-handed subjects. We used a spin-echo echo-planar imaging (EPI) sequence with 12 diffusion-sensitized directions. DTT was calculated with an angular threshold of 35 degrees and a fractional anistropy (FA) threshold of 0.25. We determined the location of the CSTs by using two regions of interest (ROI) at expected areas of the pons and expected areas of the lateral half of the PLIC, in the left hemisphere of the brain. Fiber tracts crossing these two ROIs and the precentral gyrus (PCG) were defined as CSTs. Four new ROIs were then defined for the PCG, from the medial to lateral direction, as ROI 1 (medial) to ROI 4 (lateral). Finally, we defined each fiber tract of the CSTs between the pons and each ROI in the PCG by using two ROIs methods. RESULTS: In all subjects, the CSTs were organized along the long axis of the PLIC, and the hand fibers were located anterior to the foot fibers. The CSTs showed transverse orientation in the CP, and the hand fibers were located usually medial to the foot fibers. CONCLUSION: Corticospinal tracts are organized along the long axis of the PLIC and the horizontal direction of the CP.
Adult ; Diffusion Magnetic Resonance Imaging/*methods ; Female ; Humans ; Internal Capsule/*anatomy & histology ; Male ; Pyramidal Tracts/*anatomy & histology ; Tegmentum Mesencephali/*anatomy & histology

PURPOSE: We wanted to evaluate the usefulness of MDCT for localizing a bleeding site and for helping make a decision on further management for acute intestinal bleeding. MATERIALS AND METHODS: We conducted a retrospective review of 17 consecutive patients who presented with acute intestinal bleeding and who also underwent MDCT before angiography or surgery. The sensitivity of MDCT for detecting acute intestinal bleeding was assessed and compared with that of conventional angiography. RESULTS: The sensitivity of MDCT for the detection of acute intestinal bleeding was 77% (13 of 17), whereas that of angiography was 46% (6 of 13). All the bleeding points that were subsequently detected on angiography were visualized on MDCT. In three cases, the bleeding focus was detected on MDCT and not on angiography. In four cases, both MDCT and angiogphy did not detect the bleeding focus; for one of these cases, CT during SMA angiography was performed and this detected the active bleeding site. CONCLUSION: In patients with acute intestinal bleeding, MDCT is a useful image modality to detect the bleeding site and to help decide on further management before performing angiography or surgery. When tumorous lesions are detected, invasive angiography can be omitted.
Angiography ; Hemorrhage* ; Humans ; Retrospective Studies