On strains of dematophytes isolated from superficial fungal infection patients, susceptibility tests were undertaken to topical antifungal agents (econazole, clotrimazole, siccanin, and tolnaftate). Minimal inhibitory concentration of the drugs was cletermined after 4 days incubation at room temperature on Sabourauds dextroes agar. Diverse susceptibility pattern was observed among different fungal species. Minor variability of susceptibilities was noted within the same species except for Trichophyton rubrum to econazole and tolnaftate in which a marked variation of susceptibilities was noted, Among drug tested, tolnaftate showed the most strong antifungal action, and Trichophyton mentagrophytes was the least sensitive species to all drugs. Minimal inhibitory concentration levels of each drug are as follows; clotrimazole was in the range of 2-8 mcg/ml., econazole was in the range of 0.06-2 mcg/rnl., siccanin was in the range of 05-2 mcg/ml., and tolnaftate was in the range of 0.01-0.25 mcg/ml.

PURPOSE:To evaluate the factors influencing the prognosis in avascular necrosis(AVN) of the femoral head by MR. MATERIALS AND METHODS:Radiographic and MRI findings of twenty-three patients(30 cases, aged 23-67 years) with AVN identified clinically and radiologically were evaluated. The radiography included follow up study for at least 6 months. The mean age of these patients was 43 years and M: F ratio was 20: 3. MR imaging was performed at 1. 5T unit using T1- and T2-weighted coronal and Tl-weighted sagittal and axial spin echo sequences. We categorized the changes of the femoral head on radiographic follow-ups to three grades of mild, moderate and severe. We also analyzed the changes of the signal intensity and sizes of the lesion at sagittal and coronal MR images. On MR imaging we classified the extent of AVN of the fernoral head to 2 grades according to the size of lesion. RESULTS:In the cases of mild changes in fernoral head on radiography, the mean age of the patient was 37 years and the extent of AVN was below 1/2 in eleven out of seventeen cases. In the cases of moderate changes, the mean age was 43 years and the extent was above 1/2 in five out of seven cases. In the cases of severe changes, the mean age was 60 years and the extent was above 1/2 in all 6 cases. With 95% confidence coefficient, comparisons in the age and necrosis extent revealed statistical significance in severe versus moderate changes and in severe versus mild changes. Comparisons in the change of signal intensity on T1 and T2 weighted images showed no statistical relationship between each other. CONCLUSION: We conclude that if patient is younger and has smaller extent of the AVN, bone destruction is slower that these factors may be helpful in predicting the prognosis of AVN. However, the modes of the changes of the signal intensity on T1- and T2- weighted images may not be useful in predicting the prognosis of AVN.
Follow-Up Studies ; Head* ; Humans ; Magnetic Resonance Imaging* ; Necrosis* ; Prognosis ; Radiography

No abstract available.
Cefazolin* ; Erythromycin* ; Latency Period (Psychology)* ; Membranes* ; Rupture*

BACKGROUND: Osteoporosis is an important health concern among the postmenopausal women. Therefore, it is necessary to find out acceptable screening tools for osteoporotic patients. The purpose of this study was to evaluate the Risk Index by OSTA as a screening test for osteoporosis. METHODS: The study population was 322 naturally caused menopausal women in Korea. Their was of femoral neck and lumbar spine BMD measured by DEXA. Risk Index by OSTA, based on weight and age, was calculated and the sensitivity and specificity for osteoporosis and osteopenia were evaluated. To find out the proper cut-off point for osteoporosis and osteopenia among the postmenopausal women in Korea, we also compared the sensitivity and specificity of each Risk Index value. RESULTS: The mean age and ages at menopause were 59.1(+/-6.2) and 50.7 (+/-2.7) years, respectively. The prevalence of osteoporosis was 9.6% with femoral neck BMD. For oeteoporosis, using a cut-off point of -1 yielded a sensitivity of 74.3% and a specificity of 52.2% with femoral neck BMD. Using a cut-off of -2 yielded a sensitivity of 87.3% and a specificity of 70.9%. The ROC curve showed an AUROC 0.88 for Risk Index in identifying osteoporosis. CONCLUSION: The Risk Index is an acceptable, simple and useful method in the diagnosis of osteoporosis with a Risk Index of -2 in Korean postmenopausal women.
Bone Diseases, Metabolic* ; Diagnosis ; Female ; Femur Neck ; Humans ; Korea ; Mass Screening* ; Menopause ; Osteoporosis* ; Prevalence ; ROC Curve ; Sensitivity and Specificity ; Spine

BACKGROUND: It is important to evaluate the patient presenting with non-traumatic chest pain in emergency department, and it is also difficult to classify appropriately. The purpose of this study is to predict probability of acute myocardial infarction(AMI) and assess the group for low probability of AMI that is target for observation-unit of chest pain in emergency department. METHODS: A prospective, clinical study was performed from March 1998 to August 1998 at the department of emergency medicine, Ewha Womans University Mokdong hospital. We classified high-probability group and low-probability group of AMI according to Goldman's algorithm and then compared with the final diagnosis. RESULTS: The study included 218 patients. 84 patients(39%) was the high-probability group and 134 patients(61%) was the low-probability group of AMI. As compared with final diagnosis, AMI was 47 patients(56%) among the high-probability group and 1 patient(0.7%) among the low-probability group. We observed sensitivity of 98%, specificity of 78% in predicting AMI. CONCLUSION: The classification according to Goldman's algorithm may be useful predictor of AMI and improve triage for emergency department patient with chest pain. It is also helpful for management of observation-unit of chest pain in emergency department.
Chest Pain* ; Classification ; Diagnosis ; Emergencies* ; Emergency Medicine ; Emergency Service, Hospital* ; Female ; Humans ; Prospective Studies ; Sensitivity and Specificity ; Thorax* ; Triage

It is very important to obtain a reliable geometric data of the femoral canal for designing femoral component in total hip arthroplasty. So authors estimated the shape and measured the size of the proximal femoral canal by using 3 dimensional images obtained from computerized tomographic data of 60 korean normal adult cadaveric femora. EXTRACT II PROGRAM VERSION 2.5 BY CORNELL UNIVERSITY at the SUN 3 WORK STATION was used for this study. The averge femoral length was 416.0±25.2mm ranging from 358.6mm to 465. 1 mm. The average femoral anteversion angle was 20.5±9.1°ranging from 2° to 36.5°. The average neck-shaft angle was 127.8±5.7°, ranging from 115.5° to 139.0°. The average length of femoral offset was 37.5±5.2mm. The average length of transverse diameter measured at the center of lesser trochanter was 29.4+3.5mm and measured at 20mm above the lesser trochanter was 47.3±4.6mm. The isthmic position was located at 109.4±13.1mm belew the center of the lesser trochanter and the average transverse diameter at the isthmic position was 12.1±2.1mm in mediolateral direction and 14.4±2.4mm in anteroposterior direction. The average of canal flare index which indicates the shape of proximal femoral canal, was 3.8±0.7; Stove-pipe shape was 8.4% normal shape was 70.0% and Champagne-flute shape was 21.6%. The press-fit hip stem design(PFC) had much more improved stem-canal contact on total and priority regions. And the other four devices had better fit proximally than distally and viceversa(proximal-distal mismatch). The improvement of fit can be achieved by considering the proximal-distal geometry of the femur more carefully and by diversifying the stem design which adapts to the anatomical variation of femur.
Adult ; Arthroplasty, Replacement, Hip ; Cadaver ; Femur ; Hip ; Humans ; Solar System

N,N-Diethylnitrosamine (DEN) has been proved to have carcinogenic potential in the initiation or promotion stage and the transformed cells proliferate to form preneoplastic nodules which are positive for placental form of glutathione S-transferase (GST-P). E-Cadherin, a member of the cadherin family, is expressed in epithelial cells. To evaluate the role of adhesion molecules (E-Cadherin, alpha-catenin, and beta-catenin), which have not been well understood in carcinogenesis, we investigated the changes of E-cadherin, alpha-Catenin and beta-Catenins by immunohistochemistry and immunoblotting in DEN-induced hepatocarcinogenesis of rat liver. In addition, the sequential analysis of histopathology and the expression of GST-P were also examined. Immunoreactive areas for GST-P were gradually increased from early period of carcinogenesis and strong GST-P positive foci were noted in various lesions, especially in the clear cell and eosinophilic cell nodules. Immunohistochemically, the E-Cadherin expression was increased in DEN-treated preneoplastic nodules in 4 and 10 weeks and hepatocellular carcinomas displayed relatively reduced expression compared with the hyperplastic nodules. But alpha- and beta-catenin expression was increased in hyperplastic nodules and hepatocellular carcinomas. Immunoblotting studies revealed that the level of alpha-catenin (cytosol and membranous fraction) was overexpressed in hyperplastic nodules as well as hepatocellular carcinomas, which showed markedly increased expression. The membranous fraction of beta-catenin was markedly increased in 10 weeks of DEN treatment and slightly reduced in hepatocellular carcinomas. These findings suggest that during DEN-induced hepatocarcinogenesis, the clear cell and eosinophilic cell nodules expressing GST-P in their cytoplasm are early transformed cell nodules. The altered expression of E-Cadherin and catenins is closely related with tumor propagation. Loss or reduced expression of E-cadherin may play a role in the progression of late hyperplastic nodule to hepatocellular carcinoma in DEN-induced rat hepato carcinogenesis.
alpha Catenin ; Animals ; beta Catenin ; Cadherins* ; Carcinogenesis ; Carcinoma, Hepatocellular ; Catenins* ; Cytoplasm ; Eosinophils ; Epithelial Cells ; Glutathione Transferase* ; Glutathione* ; Humans ; Immunoblotting ; Immunohistochemistry ; Liver* ; Rats*

Epithelial cadherin (E-cadherin) is a Ca2+ -dependent cell-cell adhesion molecule that connects cells via homotypic interactions. Its function is critical in the induction and maintenance of cell polarity and differentiation, and its loss is associated with an invasive and poorly differentiated phenotype in a wide range of tumors. Formalin-fixed, paraffin-embedded tissue sections from 36 cases of cervical intraepithelial neoplasia (CIN) and 14 cervical squamous cell carcinomas were investigated for the expression of E-cadherin immunohistochemically. While E-cadherin expression was usually restricted on the cell membrane of basal and parabasal cells in normal cervix, the presence of cytoplasmic E-cadherin was found to be associated with its grade in CIN lesions. Also, marked cytoplasmic staining was commonly revealed in poorly differentiated ones than well-differentiated squamous cell carcinomas. More intense reactivity of cytoplasmic E-cadherin was frequently seen in the foci of invasion than adjacent carcinoma in situ, and in its periphery than the center of tumor islands. In addition, DNA ploidy and S-phase fraction of squamous cell carcinomas were analyzed and compared with those of CIN lesion. We found that invasive squamous cell carcinomas more frequently disclosed DNA aneuploidy than CIN lesions, and there was correlation between cytoplasmic E-cadherin expression and DNA aneuploidy. Also, cytoplasmic E-cadherin-reactive cervical neoplasms had a higher rate of cell proliferation than that of membranous E-cadherin-reactive cases. These data suggest that the increased cytoplasmic E-cadherin expression may represent one of the abnormalities underlying the loss of polarity and invasiveness of cancer cells, and the abnormal E-cadherin expression combined with/without DNA ploidy or S-phase fraction may serve as a prognostic indicator.
Aneuploidy ; Cadherins* ; Carcinoma in Situ ; Carcinoma, Squamous Cell* ; Cell Membrane ; Cell Polarity ; Cell Proliferation ; Cervical Intraepithelial Neoplasia ; Cervix Uteri* ; Cytoplasm ; DNA* ; Female ; Islands ; Phenotype ; Ploidies* ; Uterine Cervical Neoplasms

To elucidate the histologic pattern of alcoholic liver disease (ALD) in Korea, liver biopsies from 173 chronic alcoholics with clinical liver diseases were classified according to the pathologic parameters. One hundred and seventeen cases, the sum of 91 of 116 serum HBsAg negative and 26 of 57 HBsAg positive patients, had the histologic evidence of ALD. Fatty change(23.9%), alcoholic fibrosis (AF)(23.1%) and cirrhosis (23.1%), comprised the three major ALDs, and only 8.5% of cases fit the criteria of alcoholic hepatitis. Chronic sclerosing hyaline disease (CSHD), chronic active alcoholic hepatitis (CAAH) and AF, where non-cirrhotic fibrosis is the predominant change, comprised 44.5% of ALD. Both features of ALD and HBV liver disease (HBV-LD) were found in 17 cases that included 8 AF and 7 cirrhosis. These 17 patients tended to consume less alcohol than patients with other types of pure ALD except alcoholic heaptitis. Patients with the serum HBsAg positive ALD (37.4years) were about 8 years younger than those with the serum HBsAg negative ALD (45.1years). More or less fatty change and foamy degeneration were seen in 77.4% and 31.6% of ALD respectively. Mallory bodies, megamitochondria, iron deposition and perihepatocellular fibrosis were found in 20.5%, 29.9%, 42.7% and 77.8%, respectively. These findings indicate that non-cirrhotic chronic ALD such as CSHD, CAAH and AF are the important histologic patterns of ALD in Korea, and that chronic alcohol consumption and HBV may act synergistically in developing liver disease.
Biopsy

A clinical observation was made on the injuries of genitourinary tract of the in-patients in the Department of Urology, Kyung Hee University Hospital during the period from July 1, 1972 to June 30. 1977. The following results were obtained. 1) Of 689 cases hospitalized, 61 cases were injuries of genitourinary tract, giving a rate of 8.9%. 2) The age ranged from 3 to 70 years and most favorable age was in from 20 to 39 years for 47.6%. The sex ratio, male to female, was 11.2 : 1. 3) The urethra was involved most frequently in 39.3 %, the kidney in 32.8 %, the bladder in 14.8 %, the external genitalia in 11.5 % and the ureter in only one case which was caused by grnecologic operation. 4) Traffic accident was most common cause of the injury in 39.3% and the next was kick and blow in 26.2 %, fail in 13.1 %. 5) Operation in renal injuries was performed in 5 of 20 cases. 6) In bladder injuries, the extraperitoneal type was in 5 cases, the intraperitoneal in 2 cases and Contusion in only one case. 7) 66.7 % of urethral injuries were associated with pubic bone fracture.
Accidents, Traffic ; Contusions ; Female ; Genitalia ; Humans ; Kidney ; Male ; Pubic Bone ; Sex Ratio ; Ureter ; Urethra ; Urinary Bladder ; Urology