The CT digital radiography is a new accurate technique for measuring the long bone length. Authors performed acomparative study on accuracy, time and film consumption and radiation dose between conventional spot scanogramand CT scanogram. We used two femur and two tibia specimen for materials, the Somatom II(Siemens) for CTscanogram, and Rad Check(Voctoreen) for radiation dosimetery. There was no significant difference in accuracybetween direct measurement, conventional scanogram and CT scanogram(lesser than 1% difference). The examinationtime of conventional scanogram was about 35 minutes, CT was 15 minutes, and the film consumption of spot scanogramwas 3 of 14x17'' size, but the CT scanogram need only one 8x10'' film for completion of study. The radiation doseof hip, knee and ankle joint were 220 mRad, 365 mRad, respectively, in spot scanogram, but it was lesser than 5mRad in all joints in CT scanogram. The advantages of the CT scanogram are simple, rapid and reduced radiation.
Ankle Joint ; Femur ; Hip ; Joints ; Knee ; Radiographic Image Enhancement ; Tibia

Embryonic stem cells can be differentiated into various types of cells, requiring a tight regulation of transcription. Biomarkers related to each lineage of cells are used to guide the differentiation into neural or any other fates. In previous experiments, we reported the guided differentiation (GD)-specific genes by comparing profiles of random differentiation (RD). Interestingly 68% of differentially expressed genes in GD overlap with that of RD, which makes it difficult for us to separate the lineages by examining several markers. In this paper, we design a prediction model to identify the differentiation into neural fates from any other lineage. From the profiles of 11,376 genes, 203 differentially expressed genes between neural and random differentiation were selected by random variance T-test with 95% confidence and 5% false discovery rate. Based on support vector machine algorithm, we could select 79 marker genes from the 203 informative genes to construct the optimal prediction model. Here we propose a prediction model for the prediction of neural fates from random differentiation which is constructed with a perfect accuracy.
Embryonic Stem Cells ; Stem Cells ; Support Vector Machine ; Biomarkers

Intussusception is rare in adult and usually caused by organic lesions, although there is a singnificant numbeof so-called idiopathic cases. The diagnosis of intussusception have been made by pali abdomen, barium enema andsmall bowel series. But recently ultrasound and CT make a contribution to diagnose intussusception. CT is not theprimary means for evaluation a gastrointestinal tract abnormality but also provides yaluable informations inevaluating disorders affecting the hollow viscera of the alimentary tract. CT image of intussusception demonstratea whirl like pattern of bowel loops separated by fatty stripe correlating to the intestinal walls. Abdominal ultrasonogram was used as the initial diagnostic test in 2 cases out of total 4 cases, with abdominal mass ofunknown cause. It revealed a typical pattern, composed of a round or oval mass with central dense echoes andperipheral poor echoes. We report 4 all cases of intussusception in adult who were performed by CT and/orultrasound. All cases were correlated with barium enema examination and/or surgical reports.
Abdomen ; Adult ; Barium ; Diagnosis ; Diagnostic Tests, Routine ; Enema ; Gastrointestinal Tract ; Humans ; Intussusception ; Ultrasonography ; Viscera

No abstract available.
Lupus Erythematosus, Systemic* ; Sarcoidosis* ; Thyroiditis, Autoimmune

Schwann cell, one of important components of peripheral nervous system, interact with neurons to mutually support the growth and replication of embryonal nerves and to maintain the different functions of adult nerves. The Ara-C, known as an antimitotic agent, have been used to have high effectiveness in eliminating fibroblasts during Schwann cell culture period. This enrichment effect is also known to be cummulative with each successive pulse of Ara-C applied and is due to a progressive loss of fibroblasts. But the cytotoxicity by Ara-C is also cummulative and noticeable over the period. To determine the most effective application time and interval of Ara-C in the Schwann cell culture, we observed the Schwann cell purity and density with the Ara-C treatment in plain and three-dimensional culture from dorsal root ganglion of new born rat. By culturing dispersed dorsal root ganglia, we can repeatedly generate homogenous Schwann cells, and cellular morphology and cell count with mean percentages were evaluated in the plain culture dishes and in the immunostainings of S-100 and GFAP in the three-dimensional culture. The Ara-C treated cultures showed a higher Schwann cell percentage (31.0%+/-8.09% in P4 group to 65.5%+/-24.08% in P2 group), compared with that obtained in the abscence of Ara-C (17.6%+/-6.03%) in the plain culture after 2 weeks. And in the three-dimensional culture, S-100 positive cells increased to 56.22%+/-0.67% and GFAP positive cells to 66.46%+/-1.83% in G2 group (p<0.05), higher yield than other groups with Ara-C application. Therefore, we concluded that the Ara-C treatment is effective for the proliferation of Schwann cells contrast to the fibroblasts in vitro culture, and the first application after 24 hours from cell harvesting and subsequent 2 pulse treatment (P2 group in plain culture and G2 group in three-dimensional culture) was more effective than other application protocols.
Adult ; Animals ; Cell Count ; Cell Culture Techniques ; Cytarabine* ; Fibroblasts ; Ganglia, Spinal* ; Humans ; Neurons ; Peripheral Nervous System ; Rats* ; Schwann Cells ; Spinal Nerve Roots*

Xanthogranulomatous cholecystitis is an unusual inflammatory disease of the gallbladder characterized by severe proliferative fibrosis and the accumulation of lipid-laden macrophages in areas of destructive inflammation. Its macroscopic appearance may occasionally be confused with gallbladder carcinoma. We present a case of perforated xanthogranulomatous cholecystitis presenting as biloma. An 80-year-old woman was referred to our hospital with a 1-week history of abdominal pain and febrile sensation. Abdominal CT showed a biloma in the subhepatic area. The follow-up CT showed that the biloma increased in size. Therefore, ultrasonography-guided aspiration was performed. The aspirated fluid/serum bilirubin ratio was greater than 5, which was strongly suggestive of bile leakage complicated by perforated cholecystitis. She underwent a laparoscopic cholecystectomy with cyst aspiration and adhesiolysis. A histological diagnosis of perforated xanthogranulomatous cholecystitis was made.
Aged, 80 and over ; Bilirubin/blood ; Cholecystectomy ; Cholecystitis/*diagnosis/pathology/ultrasonography ; Drainage ; Female ; Gallbladder Neoplasms/diagnosis ; Granuloma/*diagnosis/pathology/ultrasonography ; Humans ; Tomography, X-Ray Computed ; Xanthomatosis/*diagnosis/pathology/ultrasonography

PURPOSE: To compare the treatment outcomes and to analyze prognostic factors between the use of a breast-conserving treatment (BCT) and a mastectomy for early stage breast cancer. MATERIALS AND METHODS: We retrospectively reviewed 1,200 patients with pathological stage T1-2N0 breast cancer who received surgery between September 1994 and December 2002 at Samsung Medical Center. We compared the patient characteristics and treatment outcomes between the two treatment groups. RESULTS: Among the 1,174 eligible patients, 601 (51.2%) patients received a BCT and the remaining 573 (48.8%) patients received a mastectomy. The mastectomy group of patients had significantly more cases with a larger tumor size, multicentricity, extensive intraductal component, and estrogen- and progesterone-receptor negativity. The ten-year overall survival rates (OS) of the BCT and mastectomy groups were 91.96% and 91.01%, respectively (p=0.1274). The ten-year disease-free survival rates (DFS) were 80.48% for the BCT group of patients and 84.95% for the mastectomy group of patients, respectively (p=0.8795). CONCLUSION: Our study shows some differences in patient characteristics between the two treatment groups. However, these differences did not result in significant survival differences.
Breast Neoplasms

Cases of phenotypic heterogeneity of cells within tumors have recently been reported. Here, we report on a patient with characteristic intra-tumor double primary metastases in the lung. This patient was a 40-year-old Korean woman who had been diagnosed with breast cancer (T1N0M0, estrogen receptor/progesterone receptor/HER2 +/+/+) and papillary thyroid cancer three years prior and underwent a complete surgical resection followed by appropriate adjuvant treatment with radiation, hormone, and radioactive iodine. She was recently admitted for newly developed pulmonary nodules. Metastasectomy through video-assisted thoracoscopic surgery revealed recurrent double primary cancer with two different components (metastatic ductal carcinomas from the breast and metastatic papillary carcinomas from the thyroid gland) in each pulmonary nodule in the right upper lobe and right middle lobe. To the best of our knowledge, this is the first report of simultaneous recurrent double metastasis in one organ from different primary origins.
Adult ; Breast Neoplasms ; Breast* ; Carcinoma, Ductal ; Carcinoma, Papillary ; Estrogens ; Female ; Humans ; Iodine ; Lung* ; Metastasectomy ; Neoplasm Metastasis ; Population Characteristics ; Thoracic Surgery, Video-Assisted ; Thyroid Gland ; Thyroid Neoplasms*

PURPOSE: This study was performed to evaluate prognostic factors for survival from first relapse (SFFR) in stage I-III breast cancer patients. MATERIALS AND METHODS: From June 1994 to June 2008, 3,835 patients were treated with surgery plus postoperative radiotherapy and adjuvant chemotherapy for stage I-III breast cancer at Samsung Medical Center. Among them, a total of 224 patients died by June 2009, and 175 deaths were of breast cancer. Retrospective review was performed on medical records of 165 patients who met the inclusion criteria of this study. Univariate and multivariate analysis were done on survivals according to variables, such as age, stage, hormone status of tumor, disease-free interval (DFI), sites of first failure, number of organs involved by recurrent disease (NOR), application of salvage treatments, and existence of brain or liver metastasis (visceral metastasis). RESULTS: Patients' median overall survival time was 38 months (range, 8 to 123 months). Median SFFR was 17 months (range, 5 to 87 months). Ninety percent of deaths occurred within 40 months after first recurrence. The patients with SFFR < or =1 year had tendency of triple-negativity, shorter DFI (< or =2 years), larger NOR (>3), visceral metastasis for first relapse than the patients with SFFR >1 year. In multivariate analysis, longer DFI (>2 vs. < or =2 years), absence of visceral metastasis, and application of salvage treatments were statistically significant prognosticators for longer SFFR. CONCLUSION: The DFI, application of salvage treatments, and visceral metastasis were significant prognostic factors for SFFR in breast cancer patients.
Brain ; Breast Neoplasms* ; Breast* ; Chemotherapy, Adjuvant ; Humans ; Liver ; Medical Records ; Multivariate Analysis ; Neoplasm Metastasis ; Prognosis ; Radiotherapy ; Recurrence* ; Retrospective Studies

PURPOSE: We analyzed the association of lymph node ratio (LNR) wth locoregional control (LRC) in breast cancer patients with ≥10 involved axillary lymph nodes who underwent multimodality treatment. METHODS: We retrospectively analyzed 234 breast cancer patients with ≥10 involved axillary lymph nodes between 2000 and 2011. All patients received adjuvant chemotherapy and radiotherapy (RT) after radical surgery. The cutoff value of LNR was obtained using receiver operating characteristic curve analysis. The majority of patients (87.2%) received chemotherapeutic regimen including taxane. RT consisted of tangential fields to the chest wall or intact breast, delivered at a median dose of 50 Gy, and a single anterior port to the supraclavicular lymph node area, delivered at a median dose of 50 Gy. For patients who underwent breast-conserving surgery, an electron boost with a total dose of 9 to 15 Gy was delivered to the tumor bed. RESULTS: Within a median follow-up period of 73.5 months (range, 11-183 months), locoregional recurrence (LRR) occurred in 30 patients (12.8%) and the 5-year LRC rate was 88.8%. After multivariate analysis, LNR ≥0.7 was the only independent factor significantly associated with LRC (hazard ratio, 2.06; 95% confidence interval, 0.99-4.29; p=0.05). CONCLUSION: An aggressive multimodal treatment approach showed favorable locoregional outcome in patients with ≥10 involved axillary lymph nodes. However, patients with a high LNR ≥0.7 still had an increased risk for LRR, even in the setting of current local treatments.
Breast Neoplasms* ; Breast* ; Chemotherapy, Adjuvant ; Combined Modality Therapy ; Follow-Up Studies ; Humans ; Lymph Nodes* ; Mastectomy, Segmental ; Multivariate Analysis ; Radiotherapy ; Recurrence* ; Retrospective Studies ; Risk Factors* ; ROC Curve ; Thoracic Wall