No abstract available.

No abstract available.
Emergencies* ; Emergency Service, Hospital* ; Hospitals, General* ; Humans

To understand the expression of hoth TGF-beta l and II ligands and the receptors, artificial fracture was made on rat femur. Fracture callus and epiphyseul plate were stained immunohistochemically on 3rd. 7th, 14th, 21st, 42nd and 56th day after trauma. Polyclonal antibody was used to stain TGF-beta I and II ligands and receptors. At epiphyseal plate, both ligand and receptor were expressed from each cell in proliferating and maturing zone. But there was no difference between type I and II except expression time. TGF-beta II ligand and receptor were expressed earlier: they were expressed mostly by the cells at the zone of proliferating cartilage but TGF-beta1 ligand and receptor were expressed mostly hy the cells at zone of maturing cartilage. At fracture site, TGF-beta expression was observed from 3rd day after trauma and it reached its maximum intensity at 2 weeks. It decreased thereafter and disappeared at 6 weeks after trauma. In enchondral ossification area, TGF-beta expressing cells were scattered throughout the enchondral mass. In intramembranous ossification area, the ligands and receptors were expressed from the osteohlasts just heneath the periosteum. ln summary, TGF-beta ligands and receptors were expressed at epiphyseal plate and fracture callus. There was no difference between TGF-beta 1 and 2 expres.ion except the appearance time at epiphyseal plate. We could not draw any conclusion about ligand and rcceptor mechanism with this immunohistochemical staining.
Animals ; Bony Callus* ; Cartilage ; Femur ; Growth Plate* ; Ligands* ; Periosteum ; Rats ; Receptors, Artificial ; Transforming Growth Factor beta ; Transforming Growth Factor beta1

PURPOSE: Phyllodes tumor is a rare fibroepithelial tumor of the breast, first described by Johannes Muller in 1838. Much has been written about phyllodes tumor, but very few widely accepted conclusions about its clinical behavior, treatment modality, and prognosis have been reached. This study aims to analyze the clinical, radiological, and pathological characteristics of phyllodes tumor of the breast. METHODS: The medical records of 41 patients with phyllodes tumor who had been treated between February 1982 and August 1998 at the Department of Surgery, Seoul National University Hospital, were retrospectively reviewed for clinical, radiological and pathological findings, treatment modalities, and follow-up results. RESULTS: Of these 41 cases, there were 28 cases (68.3%) of benign tumors and 13 cases (31.7%) of malignanat tumors. All patients were females, and the mean ages of onset were 33.2 years for benign tumors and 40.8 years for malignant tumors. Most patients, 100% of benign and 92.3% of malignant, presented with a papable mass in the breast. The median duration of illness was 2 months for malignant tumors and 8 months for benign tumors. The tumor size was greater than 10 cm in diameter in 5 cases (38.5%) of malignant tumors and in 3 cases (10.7%) of benign tumors. Only 4 cases were preoperatively diagnosed as having a phyllodes tumor by using radiological and fine needle aspiration cytology. Out of the 10 malignant cases reviewed, 5 cases were confirmed as malignant, and 5 cases were confirmed as borderline phyllodes tumors. Cellularity was moderate or above in all 5 malignant and 5 borderline cases. Atypism above moderate degree was found in 4 of 5 (80%) malignant tumors, in 3 of 5 (60%) borderline tumors, and in 4 of 24 (16.7%) benign tumors. Mitotic counts in all 5 malignant cases were 5 or more per 10 high power field while those in the 5 borderline tumors were 2-5 mitoses per 10 high power field. The most commonly performed operative procedures were a simple mastectomy (50%) for malignant tumors and a simple excision (64.3%) for benign tumors. Post-operative adjuvant therapy was done for 4 cases; out of these, 1 case had been initially diagnosed as a malignant phyllodes tumor, but the diagnosis was changed to a benign phyllodes tumor upon review. Of the 27 follow-up cases, recurrences developed in 3 cases (16.7%) of benign tumors. CONCLUSION: From the above results, there were no specific clinical features for differentiating benign from malignant phyllodes tumor preoperatively; therefore, we cannot help depending on the pathologic findings. Pathologic reviews showed that among several criteria, atypism, cellularity, and mitotic count were the most definite pathologic characteristics in differentiating benign from malignant phyllodes tumor. But much more experience and long-term follow-up may be needed to define optimal treatments and to analyze the prognosis for phyllodes tumors of the breast.
Biopsy, Fine-Needle ; Breast* ; Diagnosis ; Female ; Follow-Up Studies ; Humans ; Mastectomy, Simple ; Medical Records ; Mitosis ; Phyllodes Tumor* ; Prognosis ; Recurrence ; Retrospective Studies ; Seoul ; Surgical Procedures, Operative

To explore the relationship between economic status and food and nutrient intake patterns, the 2001 National Health and Nutrition Survey result was analyzed. Dietary intake data of 6,978 Korean adults of 20 years and older who participated in the 2001 National Health and Nutrition Survey were used along with their demographic data. Economic status of the subjects was classified into the following 4 groups based on the self-reported average monthly income of household with reference to the minimum monthly living expenses (MLE) in 2001: low<100% MLE < or = middle<200% MLE < or = high<300% MLE < or = higher. Individuals in the higher income class had significantly higher mean intake for most of the nutrients including energy, protein, carbohydrate, fat, calcium, thiamin, riboflavin, niacin and vitamin C, and a higher percentage of energy intake from fat. In addition, they consumed more animal foods including meats, eggs, fish/shellfish, milk/dairy products and fats. On the other hand, the mean intakes of individuals in the lower economic class for calcium, vitamin A, and riboflavin were lower than 75% of RDAs. And, there was a predominant difference in contribution of fat to total energy intake among the groups of different economic status. These results showed that household income is an important factor influencing the food and nutrient intake patterns of the Korean adult population. Although individuals at different age classes may respond differently to a change in economic status, developing and implementing nutrition policy and intervention programs for those nutritionally vulnerable groups should consider the economic status as an important factor to customize and differentiate the content of the program.
Adult* ; Animals ; Ascorbic Acid ; Calcium ; Eggs ; Energy Intake ; Family Characteristics ; Fats ; Hand ; Humans ; Meat ; Niacin ; Nutrition Policy ; Nutrition Surveys* ; Ovum ; Riboflavin ; Vitamin A

PURPOSE: A retrospective analysis was performed to investigate the factors that affect stone recurrence in patients who were stone-free after extracorporeal shock wave lithotripsy(SWL). MATERIALS AND METHODS: From February 1990 to December 1992, 1039 patients were treated by SWL with EDAP LT-01+ lithotriptor. Among them 200 patients were followed up at 60 months. Fifty eight(29.0%) of 200 patients had recurrent stone after SWL. We analysed the patients according to patient age, sex, location, multiplicity and size of the original stones, serum calcium and uric acid level, urinary calcium and uric acid level at presentation, anatomical abnormality and pyuria after SWL as possible factors affecting stone recurrence. RESULTS: Mean age of the patients was 43.6 years(range 7 to 81) and there were 115 male and 85 female patients with sex ratio 1.35:1. Age and sex did not affect stone recurrence. The recurrence rates according to the stone location were 100%(1/1) for staghorn calculi, 28.6%(2/7) for pelvic stones, 26.2%(16/61) for single calyceal stone, 47.8%(11/23) for multiple calyceal stones and 29.7%(41/138) for ureteral stones. Stone location did not affect stone recurrence. 16(47.0%) of 34 renal units with multiple stones had recurrent stones, whereas 55(28.1%) of 196 renal units with single stone recurred. Multiplicity of the stone was the risk factor for stone recurrence(p<0.05). The stone size(renal unit) of less than 20mm were identified in 213 and 64(30.0%) of them had recurrent stones, whereas stone size(renal unit) of more than 20mm were identified in 17 and 7(41.2%) of them had recurrent stones. More than 20mm of the stone size was the risk factor for stone recurrence(p<0.05). Hypercalcemia, hyperuricemia, hypercalciuria, and hyperuricosuria did not affect stone recurrence. 14(28.6%) of 49 patients who had pyuria after SWL had recurrent stones, whereas sterile urine after SWL were noted in 151 and 44(29.1%) of them had recurrent stones. Pyuria after SWL did not affect stone recurrence. Anatomical abnormality was noted in 5 patients and 4(80%) of them showed recurrence, but there was no statistical significance due to small populations. CONCLUSIONS: Multiplicity and size of the stones were the risk factor for stone recurrence. But patient age, sex, location of the original stones, serum calcium and uric acid level, urinary calcium and uric acid level at presentation and pyuria after SWL did not affect stone recurrence.
Calcium ; Calculi ; Female ; Humans ; Hypercalcemia ; Hypercalciuria ; Hyperuricemia ; Lithotripsy* ; Male ; Pyuria ; Recurrence* ; Retrospective Studies ; Risk Factors ; Sex Ratio ; Shock* ; Ureter ; Uric Acid

PURPOSE: Sling procedures have been used successfully for the treatment of all type of female stress urinary incontinence. Polypropylene mesh has more biocompatibility with less erosion rate over other synthetic sling materials. We investigated the objective, subjective success rate, satisfaction on pubovaginal sling operation using polypropylene mesh in stress urinary incontinence women. MATERIALS AND METHODS: Between November 2001 and July 2002, thirty three women with stress urinary incontinence underwent polypropylene mesh sling procedure were analyzed. Preoperative evaluations included the patient's history, a physical examination, urinalysis, a urodynamic test, incontinence staging with Stamey grade, Balivas type, and so forth. A 1.5x20cm polypropylene mesh was placed under the bladder neck to proximal urethra. Postoperatively, the patients were evaluated with a symptom questionnaire, physical examination, uroflowmetry, and postvoid residual volume at 3 day, 3 months. RESULTS: The average follow-up period was 164.6 days (minimum; 2 months). The average operation time was 83.6 minutes (including the anesthesia). No major intra-operative, post-operative complication occurred. No patient has permanent retention, erosion, or repeated surgery. The 22 patients (66.7%) were completely continent, 11 (33.3%) had an improvement, subjectively. The 27 patients (81.8%) were completely continent, 6 (18.2%) had an improvement, objectively. The treatment result was showed satisfactory by all patients (very satisfaction; 20 (60.6%), satisfaction; 13 (30.4%)). The follow-up period, valsalva leak point pressure, Pdetmax, opened bladder neck at rest, preop. urgency, preop. and postop. urge incontinence, total score of preop. and postop. Urge syndrome were related to subjective success rate, satisfaction statistically (p<0.05). CONCLUSION: Placement of a polypropylene mesh under the bladder neck to proximal urethra provides a simple, safe, inexpensive and effective method to correct stress urinary incontinence.
Female ; Follow-Up Studies ; Humans ; Neck ; Physical Examination ; Polypropylenes* ; Surveys and Questionnaires ; Residual Volume ; Risk Factors* ; Urethra ; Urinalysis ; Urinary Bladder ; Urinary Incontinence* ; Urinary Incontinence, Urge ; Urodynamics

We report herein an unusual case of tick bite. A 56 year old woman complained of erythematous nodular skin lesion on the left upper chest. An excision biopsy specimen of the lesion showed darkish-red nodule, in which there was a tick. It was identified as an adult female of Ixodes nipponensis by the scanning electron microscopic examination.
Adult ; Biopsy ; Female ; Humans ; Ixodes* ; Middle Aged ; Skin ; Thoracic Wall* ; Thorax* ; Tick Bites ; Tick Infestations* ; Ticks*

Systemic air embolism occurs when air enters the pulmonary venous system as a result of a positive gradient caused by low pulmonary venous pressure or increased airway pressure, or both. Systemic air embolism has been frequently reported after penetrating thoracic trauma and can induce life-threatening complications. In blunt thoracic trauma, systemic air embolism has been rarely diagnosed. Because air embolism associated with blunt trauma is more insidious, diagnosis is usually not appreciated unless special circumstances allow discovery of air in major vessels or coronary arteries, such as during emergency resuscitative thoracotomy. We report a case of systemic air embolism in an 18-month-old girl after accidental thoracic blunt trauma and review related literature.
Child* ; Coronary Vessels ; Diagnosis ; Embolism, Air* ; Emergencies ; Female ; Humans ; Infant ; Thoracotomy ; Venous Pressure

BACKGROUND: Trichomonas vaginalis is a pathogenic protozoa infecting human genitourinary tract. Metronidazole is currently the drug of choice to treat T. vaginalis infection. However, because of the side effects and the occurrence of resistant strains of metronidazole, it is needed to investigate alternatives. METHODS: The antiprotozoal effect of aquatic extract from Sophora flavescens on the growth and fine structure of T. vaginalis was examined by using trypan blue exclusion assay and electron microscopy. RESULTS: One hour after the addition of 4 mg/mL extract and half hour after the addition of 5 mg/mL showed antiprotozoal effect. One to two hours after the addition of 3 mg/mL extract, the movement of flagella and axostyle had disappeared, but death of the cells had not occurred until two hours after the addition. The fine structure of the cytoplasm was also changed half an hour to two hours after addition. The number of polyribosome decreased when that of single ribosomes in the cytoplasm increased. CONCLUSION: These results indicated that S. flavescens had the antiprotozoal effect on T. vaginalis by inhibition of cell multiplication as well as an impairment of protein synthesis.
Cell Proliferation ; Cytoplasm ; Flagella ; Humans ; Metronidazole ; Microscopy, Electron ; Polyribosomes ; Ribosomes ; Sophora* ; Trichomonas vaginalis* ; Trichomonas* ; Trypan Blue