OBJECTIVE: Internal carotid artery (ICA) trunk aneurysms are rare constituting about 0.9 to 6.5% of all ICA aneurysms. They may arise from medial, lateral, ventral (posterior) or dorsal (anterior) walls of ICA. The most frequent site of origin is dorsomedial, followed by dorsal, dorsolateral and ventromedial wall. ICA dorsal wall aneurysms can be divided into the saccular type and blister type, which have different shapes, wall histological features and surgical tactics. The authors report an analysis of 27 cases of ICA trunk aneurysms treated with surgical clipping or GDC embolization. METHODS: Of 145 cases of ICA aneurysms from May 1998 to December 2005, we found 27 cases (17.5%) of such unusual aneurysms located at nonbranching sites of the intradural ICA. Features of neuroimagings and medical records were analyzed. RESULTS: Out of 27 aneurysms, 10 were located at ICA dorsal wall, 8 aneurysms were developed at ICA medialwall. Seven aneurysms originated from ICA ventral wall. Seven cases presented with subarachnoid hemorrhage and 20 cases were found unruptured. Two patients had blister-like aneurysm, and the others had saccular aneurysms. All patients were treated successfully with microsurgical clippings or GDC embolization. Microsurgical clipping were performed in 14 cases and among them, removal of anterior clinoid process was done in 12 cases. Eleven aneurysms were occluded with detachabel coil. Two patients underwent balloon occlusion of ICA. Blister aneurysm was clipped including a portion of the normal ICA wall. Good outcomes were obtained in 25 patients, and two patients were dead. CONCLUSION: ICA trunk aneurysms are developed at any site of ICA circumference. Therefore we consider a variety of treatment strategies. On clipping of aneurysms at proximal ICA trunk, removal of anterior clinoid process is important. Endovascular treatment may be good an alternative. However, surgical treatment is essential for blister like aneurysms.
Aneurysm* ; Balloon Occlusion ; Blister ; Carotid Artery, Internal* ; Humans ; Intracranial Aneurysm ; Medical Records ; Subarachnoid Hemorrhage ; Surgical Instruments

No abstract available.
Anterior Cruciate Ligament* ; Patellar Ligament*

PURPOSE: Intraductal papilloma (IDP) is a benign breast disease with malignant potential, for which complete surgical excision is usually recommended. The aim of the present study was to investigate predictive factors for upgrading patients with a benign papillary lesion (BPL). METHODS: This study was an observational study using a prospectively collected cohort. In total, 13,049 patients who underwent a core needle biopsy (CNB) for a breast lesion between January 2009 and May 2015 were enrolled. We reviewed all patients with pathologically confirmed BPL from a CNB. RESULTS: Surgical treatment was performed for 363 out of a total of 592 lesions. According to the pathological differences, the lowest upgrade rate was shown in IDP without atypia (without atypia, 6.0%; with atypia, 26.8%; papillary neoplasm, 31.5%; p<0.001). The univariate analysis showed that, in IDP without atypia, the age at diagnosis, size of BPL on ultrasonography, and density on mammography were associated with upgrading. The multivariate analysis revealed that age >54 years and lesion size >1 cm were significantly associated with upgrade to malignancy (odds ratio [OR]=4.351, p=0.005 and OR=4.236, p=0.001, respectively). CONCLUSION: The indications for surgical treatment can be defined as age >54 years and mass size >1 cm, even in IDP without atypia in the CNB results; this also includes cases of IDP with atypia or papillary neoplasm. Therefore, we suggest that close observation without surgery is sufficient for younger women with a small IDP without atypia.
Biopsy ; Biopsy, Large-Core Needle* ; Breast Diseases ; Breast Neoplasms ; Breast* ; Cohort Studies ; Diagnosis ; Female ; Humans ; Mammography ; Multivariate Analysis ; Observational Study ; Papilloma, Intraductal ; Prospective Studies ; Ultrasonography

Purpose: This study aimed to report the projected cancer incidence and mortality for the year 2022 to estimate Korea’s current cancer burden. Materials and Methods: Cancer incidence data from 1999 to 2019 were obtained from the Korea National Cancer Incidence Database, and cancer mortality data from 1993 to 2020 were acquired from Statistics Korea. Cancer incidence and mortality were projected by fitting a linear regression model to observed age-specific cancer rates against their respective years and then by multiplying the projected age-specific rates by the anticipated age-specific population for 2022. A joinpoint regression model was used to determine the year in which the linear trend changed significantly; we only used the data of the latest trend. Results: In total, 274,488 new cancer cases and 81,277 cancer deaths are expected to occur in Korea in 2022. The most common cancer site is expected to be the thyroid, followed by the lung, colon and rectum, breast, and stomach. These five cancers are expected to represent half of the overall burden of cancer in Korea. The most common type of cancer leading to death is expected to be lung cancer, followed by liver, colorectal, pancreatic, and gallbladder cancers. Conclusion The incidence rates for all types of cancer in Korea are estimated to gradually decrease. These up-to-date estimates of the cancer burden in Korea could be an important resource for planning and evaluating cancer-control programs.

BACKGROUND: Renal dysplasia is the abnormal development of the kidney. The condition is usually detected in childhood along with other urinary tract anomalies, but can remain unnoticed until adulthood. It was recently reported that a PAX2 gene mutation plays a major role in the development of renal dysplasia. The aim of this study was to examine the expression of PAX2 in dysplastic kidneys of children and adults. METHODS: A total of 30 cases diagnosed with renal dysplasia after a nephrectomy were examined. PAX2 expression was evaluated using immunohistochemistry. Apoptosis was detected using an Apop Tag detection kit. RESULTS: In the dysplastic kidneys, there was strong PAX2 expression in the epithelia of the primitive ducts in both children and adults, but the degree was significantly lower in adults (p=0.007). However, the mesenchyme surrounding the primitive ducts of children showed stronger staining for the smooth muscle actin antibody and trichrome than the adults. The apoptosis index was significantly higher in the primitive duct epithelia than in the surrounding normal collecting duct epithelia (p=0.000). CONCLUSIONS: PAX2 is overexpressed in the primitive ducts of renal dysplasia, which is sustained until adulthood and is associated with increased apoptosis. However, a decrease in PAX2 expression in the dysplastic epithelia and mesenchymal cuff of adults suggest a gradual regression of the dysplastic elements with time.
Actins ; Adult ; Apoptosis ; Child ; Humans ; Immunohistochemistry ; Kidney ; Mesoderm ; Muscle, Smooth ; Nephrectomy ; Urinary Tract

Enlargement of the extraocular muscles may cause diplopia and exophthalmos. The most common cause of the exophthalmos is thyroid associated ophthalmopathy(TAO), followed by inflammatory diseases and orbital tumors. TAO has the classical features of proptosis and lid retraction. However, the diagnosis is frequently confused with other eye diseases due to various symptoms and signs. Therefore, measurement of the size of extraocular muscles in both normal and TAO patients will make diagnosis and treatment plan easier in TAO and other muscular diseases of the orbit. For the clinical application, we measured the size of muscle with and without magnification and the results were compared. Normal mean values of cross sectional length and thickness of the extraocular muscles measured by CT scan showed 8.83x 3.60 in the inferior rectus, 9.20x3.20 in the superior muscle group, 9.45x 3.48 in the medial rectus and 9.65x3.23 mm in the lateral rectus muscle with no sex differences. All four muscles showed statistically significant enlargement in TAO and the thickness showed greater increase than the length. Superior muscle group(superior rectus and levator muscle)was the most frequently involved in TAO in both sexes. There was no significant statistical difference in the methods of measurement.
Diagnosis ; Diplopia ; Exophthalmos ; Eye Diseases ; Graves Ophthalmopathy* ; Humans* ; Korea* ; Muscles* ; Muscular Diseases ; Orbit ; Sex Characteristics ; Thyroid Gland* ; Tomography, X-Ray Computed ; Troleandomycin

Papillary carcinoma of the thyroid is a well differentiated neoplasm and usually has a good prognosis. However, a subset of morphologically distinct papillary carcinoma has bad prognoses. The tall cell variant of papillary carcinoma (TCPC), characterized by tall columnar cells with a height at least twice the width, is the one of these. In order to differentiate TCPC from usual papillary carcinoma (UPC) in terms of prognosis, we performed immunohistochemical studies for the expression of p53, bcl-2 and Leu-M1 proteins in 25 cases of TCPC, 26 cases of UPC and 14 cases of poorly differentiated, solid type papillary carcinoma (SPC) with an analysis of clinical parameters. The nuclear expression of p53 was noted in one case each of UPC and TCPC. The cytoplasmic p53 expression of TCPC, UPC, and SPC was observed in 17/25 cases (68%), 14/26 cases (54%), 3/14 cases (21%), respectively. bcl-2 expression was 19/25 cases (76%), 18/26 cases (69%), 5/14 cases (36%), and that of Leu-M1 was 21/25 cases (84%), 18/26 cases (69%), 4/14 cases(29%), respectively. There were no statistical significance in the expression of those immunoproteins among these three groups (p>0.05). The p53 protein was consistently expressed in the cytoplasm rather than nucleus in this study and was very well correlated to bcl-2 positivity (p<0.01). There were no statistical significance in any clinical parameters examined among these three groups (p>0.05). In conclusion, TCPC can not be separated from UPC as a distinct entity in this study and the cytoplasmic expression of p53 protein provides another mechanism of p53 inactivation in tumorigenesis of the thyroid papillary carcinoma, possibly by bcl-2 related mechanism.
Carcinogenesis ; Carcinoma, Papillary ; Cytoplasm ; Immunoproteins ; Prognosis ; Thyroid Gland* ; Thyroid Neoplasms*

PURPOSE: To compare the value of Gd-DTPA enhanced, fat-suppression T1-weighted (Gd-FST1SE) MR images in thediagnosis of female pelvic disorders with that of fast spin-echo T1-weighted(T1FSE) and fast spin-echoT2-weighted(T2FSE) MR images. MATERIALS AND METHODS: Pelvic MR images of 42 women (24 ovarian disorders, 19uterine disorders) were reviewed by two radiologists. Discrimination of normal anatomic structures, identificationof pathologic lesions and recognition of internal structure of the lesions such as solid and cystic portion,papillary nodule, septa and wall were evaluated using a scoring system. The Friedman two-way ANOVA test was usedfor data analysis. RESULT: T2FSE was useful for evaluation of the uterine cervix(T1/T2/Gd, 2.5/3.9/2.8,respectively), junctional zone(1.6/3.1/2.5), endometrium (2.0/3.3/3.0), ovary(1.1/2.1/1.7) and uterine myoma(1.7/2.4/2.1)(P<0.001), but secondary degeneration was best visualized on Gd-FS T1SE. The Gd-FS T1SE ;lymphadenopathy(3.4/1.5/3.7) was better visualised on this modality than on eithor TIFSE or T2FSE. Gd-FS T1SEimages also clearly depicted papillary projection(2.4/3.1/3.8) and the solid component (2.9/3.1/3.5) of ovariancystic neoplasm(P<0.01). The confidence level in the identification of ovarian mass, internal septation andsurrounding wall of cystic neoplasm was not improved on Gd-FS T1SE. CONCLUSION: The Gd-FS T1SE images were usefulfor the evaluation of metastatic lymphadenopathy in uterine cervical malignancy and for identification of thesolid component and papillary projection of ovarian cystic neoplasm.
Discrimination (Psychology) ; Endometrium ; Female* ; Gadolinium DTPA ; Humans ; Lymphatic Diseases ; Magnetic Resonance Imaging* ; Ovarian Cysts ; Pelvis* ; Statistics as Topic

No abstract available.
Child* ; Drug Therapy ; Humans

From 1986 to 1995, 75 eyes of 75 patients who were admitted with a diagnosis of infectious corneal ulcer at Chunbuk university hospital were analyzed on the etiologic agents and clinical findings. Etiologic agents of infectious corneal ulcer were classified as 49 bacterial ulcers(65.3%) and 26 fungal ulcers(34.7%). The most common isolated bacteria was 8 cases of coagulase negative staphylococcus and pseudomonas species was the most common isolated gram negative organism. Candida species was the most commonly isolated fungus. Hypopyon was noted in 30 cases(40%) of infectious corneal ulcers, 14 cases in small ulcer group and 16 cases in large ulcer group. There was no difference between severity and presence of hypopyon of the 75cases (P>0.05. chi-square test).
Bacteria ; Candida ; Coagulase ; Corneal Ulcer* ; Diagnosis ; Fungi ; Humans ; Pseudomonas ; Staphylococcus ; Ulcer