PURPOSE: To determine the necessity of site-specific bone mineral density(BMD) measurement and the difference between the BMD of the two femora using DXA in the evaluation of osteoporosis. MATERIALS & METHODS: Total BMD and regional BMD(Lumbar spine, femoral neck, Ward's area, intertrochanter area) were measured on seventy-eight healthy persons without previons diseases, and the statistical significance analyzed. RESULTS: Total BMD did not reliably reflect the site-specific BMD. There was a high correlation between BMD in opposing femora. Correlation coefficients between the femoral neck, Ward's area, trochanter area were 0. 939, 0.874 and 0.916 respectively. CONCLUSION: We conclude that a measuremnt of site-specific BMD is necessory because the total BMD can not reliably predict the regional BMD. The measurement of BMD in one femur can predict the BMD of the contralateral femur. If there is no history of femoral neck disease, unilateral BMD measurement is recommended for femoral evaluation.
Absorptiometry, Photon* ; Femur ; Femur Neck ; Humans ; Osteoporosis ; Spine

Dental Occlusion ; Female ; Humans ; Incisor ; Jaw ; Lip ; Male ; Mandible ; Orthodontics ; Orthognathic Surgery ; Reference Values

PURPOSE: To assess the MR findings of Tolosa-Hunt syndrome and to evaluat differential point of cavernous sinus lesions. MATERIALS AND METHODS: Eleven cases of Tolosa-Hunt syndrome were evaluated by MRI with specific regard to the shape of cavernous sinus, signal intensity, and pattern of enhancement. Other associated findings were also anlaysed. RESULTS: Two patients had normal MR features of the cavernous sinus. When compared with the contralateral normal cavernous sinus, the involved cavernous sinus was enlarged in six of the nine patients. The outer dural margin was convex and bulged laterally in 6 cases, flat in 2 cases, and concave in 1 case. Of the nine patients, five had iso-signal intensity and four had low signal intensity relative to gray matter on short TR/short TE. Three had isosignal intensity and 6 were not detectale on long TR/short and long TE pulse sequence. Contrast enhancement was seen in 8 cases ;7 cases showed homogeneous enhancement, 1 case heterogeneous enhancement. CONCLUSION: In the appropriate clinical setting of painful ophthalmoplegia, MR findings of cavernous sinus abnormality that consist of iso to low signal intensity on short TR/short TE images and isointense or undetectale mass on long TR/short TE or long TR/Iong TE images may suggest the dignosis of Tolosa-Hunt syndrome.
Cavernous Sinus ; Humans ; Magnetic Resonance Imaging ; Ophthalmoplegia ; Tolosa-Hunt Syndrome*

No abstract available.
Edema* ; Hydrops Fetalis*

Papillary and solid epithelial neoplasm is a rare pancreatic tumor of low-grade malignancy. We report a case of a 23 year old female having solid and papillary neoplasm of the pancreatic tail with mutiple omental and peritoneal metastases. Microscopically, the main tumor showed typical histologic findings including solid and papillary areas with cystic change. But the metastasizing nodules were largely solid and the tumor cells demonstrated increased nuclear pleomorphism, hyperchromasia and an increased mitotic rate. The tumor cells contained considerable amount of intracellular and extracellular eosinophilic inclusions which were ultrastructually zymogen-like granules. These inclusions were more frequently found in the metastatic nodules. By flow cytometric study, the tumor was hyperdiploid. The DNA index was not significant.
Female ; Humans ; Neoplasm Metastasis

On video fluorescein angiogram, it is known that arm-to-retinal circulation(ART)influences retinal macrocirculation and arterio-venous passage time(AVP)influences microcirculation.In diabetic retinopathy(DR), midperiphery involved earlier than posterior pole.However, there has been no study on the circulation of the entire retinal circulation including the peripheral retina. The authors conducted a prospective study by performing fluorescein angiography on 19 controls and 19 DR patients in order to measure the ART, AVP and venous filling time(VFT). The VFT correspond to the circulation of the peripheral retina. In the DR group, the retina circulation time was compared with the existence of proliferative diabetic retinopathy(PDR), distribution of nonperfusion area and beading vessels. There was no significant difference between diabetic group and the control group in the ART.AVP was 1.8+/-0.7sec in the control group and 2.5+/0.7sec(p=0.04)in the DR group and venous filling time was 6.4+/-2.4sec and 8.9+/-1.5sec(p=0.006)respectively. Patients with PDR showed prolongation only in VFT compared to patients with non-proliferative diabetic retinopathy(NPDR). In addition, patients presenting with nonperfusion areas and beading of vessels showed longer prolongation of VFT than of AVP. In conclusion, the VFT is delayed in DR compared to control group and in PDR compared to NPDR. The VFT can be utilized as an indicator of DR to measure the retinal circulation including the peripheral retina.
Diabetic Retinopathy* ; Fluorescein Angiography* ; Fluorescein* ; Humans ; Microcirculation* ; Prospective Studies ; Retina ; Retinaldehyde*

Syphilitic granulomatous pancreatitis is an extremely rare condition,and can occur in the generalized acquired syphilitic patient in tertiary or secondary phase. The most serious problem with granulomatous pancreatic lesion is clinical or radiological misdiagnosis as cancer. We experienced a case of syphilitic granulomatous pancreatitis arising in 54 year old female patient. She was treated for syphilis 20years ago. But she and her husband are still strong positive to VDRL and TPHA. On abdominal computed tomography and endoscopic pancreatico- duodenography, there was an obstructive mass of low density in the distal common bile duct or pancreatic head. Under the preoperative diagnosis of pancreatic head carcinoma, Whipple's operation was done. On gross examination, the pancreas was fibrotic, and the common bile duct was well preserved without tumor mass. Microscopically, numerous intralobular noncaseating epithelioid cell granulomas with multinucleated giant cells are identified. They surround thick-walled, small to medium sized arteries and involve vascular wall with luminal narrowing or obliteration, which are characteristic findings of the syphilitic granuloma. The remaining parenchyme shows fibrosis, acinar atrophy or destruction with dense infiltration of lymphohistiocytes, plasma cells with granuloma formation. Although the Warthin-Starry stain reveals no spirochetes, the serologic result and pathologic findings are compatible with syphilitic granulomatous pancreatitis.
Female ; Humans

The p53 gene, which resides on the short arm of chromosome 17, has been described as a tumor suppressor gene playing a role of G1 checkpoint monitering DNA damage, but mutation of this gene has been shown in numerous types of human cancers. The nm23-H1 gene encodes human NDP(nucleotide diphosphate) kinase. The expression of nm23-H1 gene was postulated to inversely correlate with metastatic potential of malignant tumors. We examined immunohistochemical expression in 30 cases of stomach cancers including 10 cases each of early gastric cancers(EGC), advanced gastric cancers without lymph node involvement, and advanced gastric cancers with lymph node involvement, which were stained with mouse monoclonal antibody of p53(PB53-12) and nm23-H1. Positive nuclear staining of p53 was frequently found in advanced gastric cancers with lymph node involvement (80%). The lymph node positive group showed high expression of p53(80%), and low expression of nm23-Hl(30%) than lymph node negative group. There was no significant correlation of p53 and nm23-H1 expression with tumor size, invasion depth, TNM stages, distant metastasis and histologic differentiation. Based on the present study, the expression of p53 and down regulation of nm23-H1 are thought to be correlated with tumor progression and lymph node involvement, and may be a useful prognostic factor in gastric cancers.
Humans ; Mice ; Animals ; Neoplasm Metastasis ; Genes, Tumor Suppressor ; Stomach Neoplasms ; Genes, p53

We report a case of reticulum cell sarcoma in the right cervical lymph node of a 42-year-old male. It was a slowly growing, non-tender movable mass of 8 months duration. Microscopically, the lymph node was effaced by proliferating spindle cells arranged in broad sheets, bands, or fascicular patterns in paracortical area sparing of B-cell region. The tumor component was divided by fibrous band. The individual cells had oval to round or elongated nuclei, with inconspicuous nucleoli and moderate amounts of cytoplasms with indistinct cell borders. Pleomorphic large cells with binucleated, or multinucleated bizarre nuclei with prominent nucleoli, were partly admixed. In immunohistochemical stain, the tumor cell was strong positive for S-100 protein, HLA-DR, Mac387 and weakly positive for Leukocyte common antigen and equivocal for Vimentin. But it was negative for CD21, Ki-1, Desmin, Epithelial membrane antigen and Cytokeratin. These immunohistochemical findings suggested that the neoplastic cell was originated from the interdigitating reticulum cell of lymph node. The patient was treated by radiation therapy, and alive well at 37 months of follow-up.

p27Kip1 protein, a negative cell cycle regulator in G1 progression, has been reported to be related with human cancers including colon, breast and non-small cell lung carcinomas. To elucidate a possible prognostic indicator, we studied 49 cases of human breast carcinoma for expression of p27Kip1 protein using an immunohistochemical method, and compared these results with known prognostic parameters of the breast cancer. p27Kip1 protein was intensely stained in nuclei of carcinoma cells in 26 cases (53.1%). The expression rate of p27Kip1 protein was significantly higher in higher nuclear grade (p<0.05), lower histologic grade (p<0.01), lower N classification (p<0.001) and lower clinical stage (p<0.05) than in lower nuclear grade, higher histologic grade, higher N classification and higher clinical stage, respectively. p27Kip1 protein expression was significantly correlated with progesterone receptor status (p<0.05) or cyclin D expression (p<0.05). No statistical correlations were found between expression of p27Kip1 protein and other parameters including tumor size, estrogen receptor status, p53 overexpression and c-erbB-2 expression. The results suggest that reduced expression of p27Kip1 protein plays a role in biologically aggressive behavior of breast carcinoma and might contribute in predicting breast cancer patient's survival.
Breast Neoplasms* ; Breast* ; Cell Cycle ; Classification ; Colon ; Cyclin D ; Cyclin-Dependent Kinase Inhibitor p27 ; Estrogens ; Humans* ; Lung ; Phosphotransferases* ; Prognosis ; Receptors, Progesterone