Fine needle aspiration of the breast is an important diagnostic tool in malignant lesions, but is also useful in differentiation of inflammatory breast diseases mimicking carcinoma clinically and radiologically. Recently, the authors have experienced eight biopsy-proven cases of chronic inflammatory diseases of the breast, which consisted of 4 cases of duct ectasia, 2 cases of fat necrosis, and a case of tuberculous mastitis and granulomatous mastitis respectively, Their cytoiogic features mainly based on the components and the relative frequency of inflammatory cells were evaluated for differential diagnosis of chronic inflammatory breast diseases. The results are as follows ; 1. In cases of duct ectasia, varying amount of neutrophils, mononuclear leukocytes, histiocytes and multinucleated giant cells were intermixed with benign epithelial cell clusters. 2, Abundant fat tissue fragments were diagnostic for fat necrosis. Histiocytes and mononuclear cells were main components but not rich, and neutrophils and giant cells were infrequently observed. 3. Characteristic granulomas composed of epithelioid cells, mononuclear leukocytes and Langhans' type giant cells and lymphocytic infiltrates were conspicuous in tuberculous mastitis, and occasionally neutrophils, necrotic materials and epithelial cell clusters were found. 4. In granulomatous mastitis, epithelioid cell granulomas were also noted but numerous neutrophils and histiocytes were intermingled within or outside the granulomas.
Biopsy, Fine-Needle ; Breast ; Breast Diseases ; Child* ; Diagnosis, Differential ; Dilatation, Pathologic ; Epithelial Cells ; Epithelioid Cells ; Fat Necrosis ; Female ; Giant Cells ; Granuloma ; Granulomatous Mastitis ; Histiocytes ; Humans ; Leukocytes, Mononuclear ; Mastitis ; Mothers* ; Neutrophils ; Salivary Glands

In a six-year period(1988. 5-1994. 4), fine needle aspiration cytology(FNAC) of 322 pulmonary lesions from 296 patients were performed at Soonchunhyang University Hospital. Of these 322, malignancy was diagnosed cytologically in 139(43.2%), suspicious malignancy in 7(2.2%), negative in 164(50.8%), and insufficient material in 12(3.8%). Malignant lesions consisted of 54 cases of adenocarcinoma, 50 cases of squamous cell carcinoma, 18 cases of small cell carcinoma. They were verified by histologic examination in 70 cases. There were 2(0.6%) false positive cases due to florid bronchoalveolar hyperplasia and atypical bronchial epithelial cells associated with granulomatous lesion. The overall accuracy rate was 90%, the sensitivity 84.3% and the specificity 94.7%.
Adenocarcinoma ; Biopsy, Fine-Needle ; Carcinoma, Small Cell ; Carcinoma, Squamous Cell ; Child* ; Epithelial Cells ; Humans ; Hyperplasia ; Multicystic Dysplastic Kidney* ; Sensitivity and Specificity ; Tuberculosis, Pulmonary

Background: White matter hyperintensity (WMH) is a risk factor for dementia and ischemic stroke. The atherogenic index of plasma (AIP) is a simple and cost-effective marker for the prediction of various vascular diseases. In this study, we evaluated the relationship between AIP and WMH in adults without cerebrovascular accidents. Methods: We analyzed the data of 281 adults, aged ≥26 years, who underwent brain magnetic resonance imaging (MRI) at the health promotion center of an education hospital between January 2014 and December 2018. Participants were divided into three categories according to tertiles of the AIP scores (T1: <0.20; T2: 0.20–0.48; and T3: >0.48). WMH was defined as a modified Fazekas scale score of 1–3 on brain MRI. A cubic spline curve was used to determine the linearity of the relationship between AIP and WMH. Multiple logistic regression analysis was used to evaluate the relationship between the AIP and WMH. Results: The prevalence of WMH was 45.7% in T1, 57.0% in T2, and 66.0% in T3 (T3 vs. T1, P for post-hoc analysis=0.005). The increased odds of WMH were associated with increased AIP. The odds ratio (OR) with a 95% confidence interval (CI) for WMH of T2 and T3 compared with T1 were 1.57 (0.88–2.80) and 2.30 (1.28–4.14), respectively. After adjusting for confounding variables, the OR with a 95% CI for WMH in the T2 and T3 groups vs. the referent T1 were 1.55 (0.76–3.13) and 2.27 (1.06–4.84), respectively. Conclusion AIP is independently and positively associated with WMH in a healthy population.

PURPOSE: The aim of this study was conducted to investigate the mean nRBC count in very low births weight infants (VLBWIs) and to determine the usefulness of the nRBC as an independent prognostic factors of perinatal complications in VLBWIs. METHODS: This study was conducted on 112 VLBWIs who were hospitalized in the neonatal intensive care unit (NICU) of the author's hospital within the period from March 2003 to and May 2008. Based on the infants' nucleated red blood cells (nRBC) counts at birth, on the third day after birth, on the seventh day after birth, in the second week after birth, and in the fourth week after birth in the medical records, the correlation between nRBC or absolute nRBC counts with birth weight, gestational age, and other perinatal outcomes were retrospectively investigated. RESULTS: In VLBWIs, their mean nRBC and absolute nRBC counts were showing a gradual decrease after birth, and they were consisteantly kept at low values since one week after and inversely proportional to the birth weights. The mean nRBC counts based on the stage after birth showed a significant correlation with perinatal death, necrotizing enterocolitis, and severe intraventricular hemorrhage. CONCLUSION: The increase in the nRBC count showed a significant correlation with having a severe intraventricular hemorrhage, necrotizing enterocolitis, and perinatal death in VLBWIs. If an increase or no decrease in the nRBC count after birth is observed, newborn-infant care precautions should be required.
Birth Weight ; Enterocolitis, Necrotizing ; Erythrocytes ; Gestational Age ; Hemorrhage ; Humans ; Infant ; Infant, Newborn ; Infant, Premature ; Infant, Very Low Birth Weight ; Intensive Care, Neonatal ; Medical Records ; Parturition ; Prognosis ; Reference Values ; Retrospective Studies

PURPOSE: Although there is an increasing incidence of upper third gastric cancers, the appropriate extent of resection for upper third gastric cancer is not known. This study was performed to analyze a 9-year experience with upper third gastric adenocarcinomas from one institution treated by either total gastrectomy (TG) or proximal gastrectomy (PG). METHODS: The records and survival data of 158 upper third gastric cancer patients who underwent curative TG (n=106) or PG (n=52) through an exclusively abdominal approach were retrospectively analyzed. RESULTS: There was no significant difference in age, sex, tumor gross type, tumor differentiation, and stage between the groups who underwent TG and those who underwent PG. In addition, there were no significant differences in hospital mortality, overall 5-year survival, and disease-free survival rates between PG and TG group. However, PG group showed higher rates of postoperative reflux esophagitis and anastomosis stricture than TG group. Regarding the main patterns of recurrence, local recurrence was dominant in PG group, whereas distant recurrence was dominant in TG group. CONCLUSION: The extent of resection for upper third gastric cancer does not affect long-term outcome, and both procedures can be accomplished safely. When the cancer is confined to upper third of the stomach without serosal invasion, PG combined with antireflux procedures can be indicated.
Adenocarcinoma ; Constriction, Pathologic ; Disease-Free Survival ; Esophagitis, Peptic ; Gastrectomy ; Hospital Mortality ; Humans ; Incidence ; Prognosis ; Recurrence ; Retrospective Studies ; Stomach ; Stomach Neoplasms*

To contribute to promotion of health and preservation of labor power of Korean laborers, the body height and body weight were measured for 10,407 workers (6,201 male, 4,206 female) in the age group of 20-29, engaged in manufactures in the Gumi industrial complex, Gumi city, Kyungpook province. The above data were extracted from the 1985 periodic examination chart for calculation of the mean body weight, mean body height, correlation coefficient and regression equation between weight and height, standard body weight, body mass index(BMI) and distribution of laborers within Garrow's classification of BMI by age and sex group. Mean body height of 20-29 age group was 168.2+/-5.61 cm for male and 155.9+/-5.26 cm for female. Mean body weight of 20-29 age group was 61.4+/-6.56 kg for male and 52.4+/-6.00 kg for female. Correlation coefficient and regression equation of 20-29 age group were +0.541 and Y(Wt)=0.632X(Ht)-44.975 for male and +0.559 and Y(Wt)=0.637X(Ht)-46.898 for female. Standard body weight of 20-29 age group was 53.0kg at 155cm, 59.3kg at 165cm, 65.6kg at 175cm for male and 51.8kg at 155cm, 58.2kg at 165cm, 64.6kg at 175 cm for female. Range of normal body weight of 20-29 age group was 47.5+/-58.5kg at 155cm, 53.8+/-64.8kg at 165cm, 60.1+/-72.1kg at 175cm for male and 46.9+/-56.8kg at 155cm, 53.2+/-63.2kg at 165cm, 59.6+/-69.6 kg at 175 cm for female. Range of obesity of 20-29 age group was 64.1kg and over at 155cm, 70.3kg and over at 165cm, 76.7kg and over at 175cm for male and 61.8kg and over at 155cm, 68.2kg and over at 165cm, 74.5kg and over at 175 cm for female. Body mass index (kg/m2) of 20-29 age group was 21.7+/-1.95 for male and 21.6+/-2.05 for female, 75.9% of male laborers and 71.3% of famale counterparts fall in the desirable range of BMI by Garrow's classification.
Body Height ; Body Mass Index ; Body Weight* ; Classification ; Female ; Gyeongsangbuk-do ; Health Promotion ; Humans ; Ideal Body Weight ; Male ; Obesity

PURPOSE: We compared CT findings of thickened wall-type gallbladder cancer with those of complicated cholecystitis. MATERIALS AND METHODS: We retrospectively reviewed abdominal CT scans of ten patients with thickened wall-type gallbladder cancer and eight patients with complicated cholecystitis, from March 1991 to November 1995. RESULTS: CT findings of thickened wall-type gallbladder cancer showed diffuse or focal wallthickening. Wall thickness was 5.3-18.0 mm(mean value, 12.2mm ; n=10). Gallbladder wall thickness of complicatedcholecystitis was 3.0-14.0mm (mean value, 6.6mm ; n=8). Statistical significance was noted between thickened wall-type gallbladder cancer and complicated cholecytitis(p<0.0029). Irregular wall thickening was noted in 7/10cases of thickened wall-type gallbladder cancer(70%). Regular wall thickening was noted in 6/8 cases of complicated cholecystitis(75%). The luminal diameter of thickened wall-type gallbladder cancer was 3.3-5.4cm (meanvalue, 4.2cm ; n=10). The luminal diameter of complicated cholecystitis was 5.2-8.0cm (mean value, 6.5cm ; n=8).Statistical significance was noted between thickened wall-type gallbladder cancer and complicated cholecystitis(p<0.0003). The halo sign was noted in only 3/8 cases of complicated cholecystitis(38%). Secondary findings of thickened wall-type gallbladder caner was lymphadenopathy in 3/10 cases(30%), and liver invasion in 2/10 cases(20%). Secondary findings of complicated cholecystitis were liver abscess in 2/8 cases(25%), and RLQ abdominal fluid collection and pleural effusion in 4/8 cases(50%). CONCLUSION: Differential factors of thickened wall-type gallbladder cancer from complicated cholecystits are gallbladder wall thickness, regularity of wall thickness, halo sign, secondary findings and luminal distention.
Cholecystitis* ; Gallbladder ; Gallbladder Neoplasms ; Humans ; Liver ; Liver Abscess ; Lymphatic Diseases ; Phenobarbital ; Pleural Effusion ; Retrospective Studies ; Tomography, X-Ray Computed

OBJECTIVE: Destructions of vertebral body due to various etiologies including acute fracture, tumor, post-traumatic deformity and infection lead to progressive destruction of vertebral body, kyphotic deformities and further neurological deficits. Titanium mesh cages (TMCs) with cancellous autograft bone after corpectomy of the thoracolumbar spine provide immediate structural support to the anterior column. The aim of this study is to evaluate the radiological, neurological and clinical outcomes of patients with the TMCs-bone graft composite after thoracolumbar corpectomy. METHODS: Sixteen patients underwent reconstruction using titanium mesh cages in thoracolumbar corpectomy between July 2000 and February 2005. The radiological and clinical course was documented over a mean follow up duration of 28.2 months. The degree of kyphosis, construct height and the subsidence of the cage in relation to the vertebral endplates were measured preoperatively, early postoperatively, and at the latest follow up. RESULT: The mean kyphotic angle of 3.9degrees before surgery was reduced to -2.6degrees immediately after surgery, and at the last follow up to be 3.4degrees. There was a significant difference between the preoperative versus postoperative kyphotic angle (p=0.003). The mean construct height of involved vertebra before surgery was 41.6 mm and the mean construct height immediate after surgery and at follow up were 47.9 mm and 41.5 mm, respectively. There was a significant difference between the preoperative versus postoperative construct height (p<0.0001). But there was no significant difference between the preoperative versus follow up in kyphotic angle and construct height. The mean subsidence was 5.7 mm. However, there was no case of severe collapse or significant recurrence of deformity. All patients had not attained significant neurological deterioration after surgery without major complications. CONCLUSION: In this study, TMCs after thoracolumbar corpectomy is a successful adjunct for anterior vertebral column reconstruction. In our cases, TMCs with anterior instrumentation alone allows a good structural support and maintain spinal alignment.
Congenital Abnormalities ; Follow-Up Studies ; Humans ; Kyphosis ; Recurrence ; Spine ; Titanium ; Transplants

OBJECTIVE: We report an evaluation of incidence of the traumatic disc herniation and an effect of early closed reduction without prior magnetic resonance(MR) imaging in cervical spine fracture-dislocation injury. METHODS: The medical records and radiologic images of twenty consecutive traumatic cervical spine injury from the C2-3 to C7-T1 were reviewed. The disc injury on MR images was divided into two category: a herniation defined as deforming the thecal sac or nerve root and a disruption defined as a disc with high T2-weighted signal characteristics. Closed reduction was attempted in all patients and neurologic status was measured on admission and following reduction. MR image was obtainted within three days after early closed reduction. RESULTS: Early closed reduction by Gardner-Wells skeletal traction and serial plain radiography was achieved in 90% of patients and there was no associated neurological deterioration after reduction. The incidence of disc injury at the level of the fracture subluxation on the postreduction MR images was 60%(herniation-30%, disruption-30%), but the presence of disc herniation or disruption did not affect the degree of neurological recovery, as measured by American Spinal Injury Association(ASIA) motor score and the Frankel scale following early closed reduction. The average ASIA motor score prior reduction was 48.4 compared with 62.5 following reduction. CONCLUSION: Although disc herniation and disruption can occur following traumatic cervical fracture-dislocation, the actual incidence of neurological deterioration following early closed reduction is rare. Therefore, immediate closed reduction using traction in patients with any neurological deficit can be safe and effective before MR imaging.
Asia ; Humans ; Incidence ; Magnetic Resonance Imaging* ; Medical Records ; Radiography ; Spinal Injuries ; Spine ; Traction

BACKGROUND: This bispectral index, which is used for intravenous anesthetics and inhalation anesthesia, is a scale of sedation and hypnotic effect, which is widely used in clinics. Atypical changes in BIS are expected due to increased cardiac output, decreased blood albumin concentrations and renal function in severe burn patients undergoing early escharectomy. The aim of this study was to compare BIS according to effected site concentrations of propofol during anesthetic induction using propofol TCI in severe burn and nonburn patients. METHODS: Forty patients were classified as twenty nonburn elective surgical patients (group 1) and twenty burn patients scheduled for escharectomy (group 2). For induction, a propofol TCI device incorporating a prefilled syringe was adjusted to a target concentration of 6mug/ml in flash mode. The bispectral index was checked before induction and at each effect site concentration of propofol (0.5mug/ml interval) until an effect site concentration of 4.5mug/ml. Other suspected contributory factors such as cardiac index, creatinine clearance and albumin were checked simultaneously. The unpaired t-test and repeated measures ANOVA were performed for the statistical analysis. RESULTS: Below an effect site concentration of propofol of 3mug/ml, no BIS difference was evident between group 1 and group 2. However, at 3.5mug/ml, group 1 was 41.1+/-13.5 and group 2 was 54.7+/-16.6 and at 4mug/ml, group 1 was 40.1+/-2.6 and group 2 was 50.1+/-13.1. Among the suspected contributing factors, cardiac index and albumin showed significant differences between groups 1 and 2 (cardiac index: 3.4+/-0.5 L/min/m2 vs 2.7+/-0.3 L/min/m2, albumin: 4.1+/-0.3 g/dl vs 2.6+/-0.3 g/dl, P<0.05). Creatinine clearance showed no significant difference between the groups. CONCLUSIONS: Severe burn patients who are expecting early escharectomy had higher BIS values than nonburn patients from an effect site concentration of propofol of 3.5mug/ml. This study suggest that cardiac index should be considered as a factor that influences propofol.
Anesthesia, Inhalation ; Anesthetics, Intravenous ; Burns* ; Cardiac Output ; Creatinine ; Humans ; Hypnotics and Sedatives ; Propofol* ; Syringes