Immunohistochemical analysis of 24 paraffin-embedded osteosarcomas was studied to evaluate the expression of simple cytokeratin, basal cytokeratin and epithelial membrane antigen(EMA) according to the histologic subtypes and anatomical locations. Mean age of the patients was 18 years. Anatomical locations of the tumors were femur(8), tibia(10), humerus(4), lumbar spine(1), and zygomatic arch(1). Histologic subtypes included osteoblastic(14), fibroblastic(4), chondroblastic(4), epithelioid(1), and mixed osteoblastic and fibroblastic(1). All were positive in the immunohistochemical stain for vimentin. The expression of cytokeratin and/or EMA was found in 10 cases(41.7%) regardless of anatomical locations and histologic subtypes. Positive immunoreaction for EMA was demonstrated in osteoblastic(5), chondroblastic(2), epithelioid(1), and mixed osteoblastic and fibroblastic(1) types. Osteoblastic (2), chondroblastic(2), and epithelioid(1) types among them also showed immunoreactivity with anti-simple cytokeratin monoclonal antibody, NCL-5D3. The expression of basal cytokeratin (NCL-LL002) was found in two osteoblastic, one chondroblastic, one epithelioid, and one mixed osteoblastic and fibroblastic types. These findings indicate that cytokeratin and EMA immunoreactivity can not be regarded as an absolute specific marker of the epithelial origin of tumor and may also occur in osteosarcoma.

BACKGROUND & OBJECTIVES: Although thalamic stroke is the most frequent cause of pure sensory stroke, non-thalamic strokes have been also occasionally reported to produce pure sensory stroke(PSS). We attempt to characterize the clinical and radiological features of 11 patients with PSS due to brainstem stroke. SUBJECTS AND METHODS: There were eight men and three women and their age ranged from 50 to 71 years. Their risk factors included hypertension in 10, diabetes mellitus in 2, hyperlipidemia in 3, alcohol drinking in 3 and cigarette smoking in 2. All underwent brain computed tomography(n=11) and/or magnetic resonance imaging(n=8). RESULTS: Five patients presented with pure lemniscal sensory deficits(position and vibration sensation); two presented with abnormalities in all sensory modalities but dominantly involving lemniscal sensation; remaining 4 presented with numbness only. Four patients had cheiro-oral syndrome with bilateral perioral involvement. Imaging studies showed that 6 patients had a small infarct in the paramedian pontine tegmentum, which was thought to be caused by small vessel(lacunar) inclusion. One patient had a small infarct in the lateral part of the midbrain which was probably caused by artery-to-artery embolism originated from mid-basilar stenosis. In addition, four patients had small hypertensive hemorrhage affecting the pontine tegmentum. CONCLUSION: Our result confirms that PSS can be caused by small brainstem stroke of various etiopathology, frequently involving the paramedian pontine tegmentum PSS due to braimtem stroke may be characterized by predom inant lemniscal sensory involvement and occasional bilateral perioral symptoms.
Alcohol Drinking ; Brain ; Brain Stem Infarctions ; Brain Stem* ; Constriction, Pathologic ; Diabetes Mellitus ; Embolism ; Female ; Hemorrhage ; Humans ; Hyperlipidemias ; Hypertension ; Hypesthesia ; Male ; Mesencephalon ; Risk Factors ; Sensation ; Smoking ; Stroke* ; Vibration

OBJECTIVES: Nasal continuous positive airway pressure (nCPAP) is the treatment of choice and has been shown to reduce the frequency of nocturnal respiratory events, improve sleep architecture, and decrease daytime sleepiness in patients with obstructive sleep apnea syndrome (OSAS). However, little is known about the compliance of nCPAP treatment in Korea. Our objective was to look into the nCPAP compliance and examine the factors influencing it. METHODS: We reviewed the records of one hundred and twenty consecutive patients with OSAS referred for nocturnal polysomnography with nCPAP pressure titration during the period of January 1995 through April 1999 to the Seoul National University Hospital. We performed a telephone interview and obtained data from eighty-three patients. RESULTS: In sixty patients who had accepted nCPAP treatment, twenty-six patients (43.3%) were still using nCPAP device, while thirty-four patients (56.7%) stopped using it. Fifteen patients (25%) were using nCPAP device everyday. In thirty-four patients who discontinued nCPAP use, twenty-five patients (73.5%) did within the first three months, and thirty-one (91.2%) within the first year. Significant predictor of long-term nCPAP use was the presence of subjective daytime sleepiness before nCPAP application. CONCLUSIONS: Long-term compliance with nCPAP treatment appears to be associated with the presence of subjective daytime sleepiness before nCPAP application. Long-term compliance with nCPAP may be mostly predicted from the usage pattern within the first three months of use.
Compliance* ; Continuous Positive Airway Pressure* ; Humans ; Interviews as Topic ; Korea ; Polysomnography ; Seoul ; Sleep Apnea, Obstructive*

To evaluate the relationship between eating behavior and neurotic trait in middle school students, the authors applied eating scale, Middlesex Hospital Puestionaire and Zung's self-reting depression scale to 419 middle school students(male : 187, female : 232) in Taegu city in 1993. There was no significant relationship between weight devided groups. Female middle school students showed significant high scores(p<0.05) in all scales compared to male middle school students. The correlation between eating scale and the other two scales showed significant correlationship(p<0.05) Among psychosocial factors, the items related to dissatisfaction to present and future self image(each p<0.05, p<0.05), dissatisfaction to present environmental status(p<0.05) and dissatisfaction to future attitude showed significant high score in both sex. The item related to dissatisfaction to present interpersonal relationship (p<0.05) showed significant high score in male middle school students. The items related to eat consumption rate of 61-90% (p<0.05), unsatisfied to relationship with family(p<0.05), unsatisfied to childhood family atmosphere(p<0.05), unsatisfied to past self image(p<0.05) and unsatisfied to present relationship between parent(p<0.05) showed significant high score.
Adolescent* ; Daegu ; Depression ; Eating* ; Feeding Behavior* ; Female ; Humans ; Male ; Psychology ; Weights and Measures

A case of carcinoma of the parathyroid gland causing hyperparathyroidism was experienced at the department of orthopaedic surgery, C.A.F.G.H. This patient, a 23 years old male, had complained of a left shoulder pain during the past 3months. And weakness of the lower extremities causing walking disturbance, multiple bone pain, and polyuria had occurred sinoe one month before admission. Physical examination revealed a hard palpable mass in the right anterior region of the neck. Radiologic examination revealed subperiosteal bone resorption in phalanges of the hands and feet, generalized osteoporosis and cystic lesions, and pathologic fracture of the ribs, left humerus, and left femur. Laboratory studies demonstrated hypercalcemia, hypophosphatemia, increased alkaline phosphatase and PTH, hypercalciuria, and hyperphophaturia. Sonogram and C-T scan of the neck revealed a mass in the right inferior portion of the thyroid. Rib biopsy revealed the findings of ostitis fibrosa cystica, and parathyroid gland and regional lymph node biopsy revealed a parathyroid carcinoma with regional lymph node metastasis.
Alkaline Phosphatase ; Biopsy ; Bone Resorption ; Femur ; Foot ; Fractures, Spontaneous ; Hand ; Humans ; Humerus ; Hypercalcemia ; Hypercalciuria ; Hyperparathyroidism ; Hypophosphatemia ; Lower Extremity ; Lymph Nodes ; Male ; Neck ; Neoplasm Metastasis ; Osteoporosis ; Parathyroid Glands ; Parathyroid Neoplasms ; Physical Examination ; Polyuria ; Ribs ; Shoulder Pain ; Thyroid Gland ; Walking

PURPOSE: To evaluate the accuracy of CT using water as an oral contrast material in a prone position in determining the depth of tumor invasion in gastric cancer patients. MATERIALS AND METHODS: Thirty three patients(19 male, 14 female) with surgically confirmed gastric cancer were studied. We performed CT in a prone position after ingestion of 1 liter of pure water. CT findings were classified into 4 groups by the morphologic appearances of infiltrates in the perigastric fat plane :normal perigastric fat(SO), fine mottled densities(S1), irregular aggregated or linear densities(S2) and direct extension and invasion of tumor into contiguous structures(S3). Also we prospectively compared the CT staging with pathologic T staging according to the TNM systems. RESULTS: The overall accuracy of CT staging in determining the pathologic T factor was 69.6%. As we regarded T1 and T2 lesions as one group on CT, the accuracy of CT staging was increased to 80.2% because of a limitation of CT for distinguishing T1 from T2 lesions. CONCLUSION: Prone position CT using water as an oral contrast agent is quite accurate in determining the T staging of gastric carcinoma.
Eating ; Humans ; Male ; Prone Position* ; Prospective Studies ; Stomach Neoplasms ; Water*

No abstract available.

Patellofemoral complications are the most frequent problems in total knee arthroplasty. In the literature, the subject of patella resurfacing and nonresurfacing is controversial. Twenty-seven osteoarthritic patients who received bilateral total knee prostheses were studied to evaluate the advantages and disadvantages of patella resurfacing prospectively. Only patients with mild patellofemoral disease were included in the study. The Ortholoc modular implant was used in all cases. Cementless femoral and tibial component were used. But, if we resurfaced the patella, cement was used. In all patients, patella resurfacing had been done in the left knee but not in the right knee. For the clinical analysis, We used Knee Rating Score of the Hospital for Special Surgery(HSS), For the roentgenographic analysis, We used Laurin's lateral patellofemoral angle & Merchant's congruence angle. In the follow up, blind test for patellar pain was performed to compare between right and left knee joint clinically. The average age was 61 years(range 28-72 years) and the average follow up was 21 months(range 12-27 months). Preoperative ROM was 104.4 degrees in right side and 106.7 degrees in left side. Postoperative ROM was 112.7 degrees in right side and 109.6 degrees in left side. Preoperative HSS Knee Rating Score was 53.1 point in right side and 54.8 point in left side. Postoperative HSS Knee Rating Score was 81.5 point in right side and 81.2 point in left side. In the plain knee AP view, preoperative tibiofemoral angle was varus 7.0 degrees in right side and varus 5.6 degrees in left side. Postoperative tibiofemoral angle was valgus 5.1 degrees in right side and valgus 4.9 degrees in left side. Preoperative Merchant's congruence angle was 14.9 degrees in right side and 15.3 degrees in left side. Postoperative Merchant's congruence angle was
Arthroplasty, Replacement, Knee ; Follow-Up Studies ; Humans ; Knee ; Knee Joint ; Knee Prosthesis ; Patella ; Prospective Studies ; Range of Motion, Articular

Choriocarcinoma associated with a normal pregnancy is rare. Futhermore, choriocarcinoma coexistent with a viable pregnancy is even rarer and associated with a greater risk of hepatic and cerebral involvement. So timely diagnosis of the disease is important for successful treatment and aggressive diagnostic procedures may therefore warranted. The patient should be treated with primary intensive combination chemotherapy(EMA-CO) and the selective use of irradiation and surgical therapy. We experienced a case of metastatic choriocarcinoma of lung and kidney following preterm delivery at 34th week of pregnancy and so present it with brief review of literature.
Choriocarcinoma* ; Diagnosis ; Female ; Humans ; Kidney ; Lung ; Pregnancy ; Pregnancy*

Teratomas of the fallopian tube are extremely rare, and only about 50 cases have reported in the world literature. Most cases of mature cystic tubal teratoma are asymptomatic and are discovered as an incidental finding on physical or radiologic examination, or at the time of laparatomy. We report a case of mature cystic teratoma of the right fallopian tube which was discovered during pelvic ultrasonogram for antenatal care in a 28 year old woman. Right salpingectomy was performed during cesarean section for cephalo-pelvic distortion at IUP 39 weeks. Gross examination of the right fallopian tube reveals a distended fallopian tube, measuring 8cm in length and 2cm in diameter. On section, it is filled with several small pedunculated nodules and cysts containing sebaceous materials. Microscopically the tumor was seen in continuity with the lining epithelium of mucosal folds. The majority of the tumor was composed of well differentiated mature elements of three germ layers with skin and skin appendages, mature brain tissue, bone, breast tissue, intestinal mucosa and bronchial epithelium.
Female ; Humans ; Cysts