Early and longterm prognosis depended on the extents of acute myocardial infarction and residual myocardial function. Many clinical methods have been evaluated to determine their ability to estimate the size of myocardial infarcts. But because of many disadvantages simplified QRS scoring system, used with standard 12-lead EKG, was developed, which is noninvasive, inexpensive and easily releatible. Therefore, the correlation between QRS and peak CK,killip classification were evaluated in 55 patients with initial acute myocardial infarction at the Chung-Ang University, Yong-San and Pil-Dong Hospital during the period from January 1983 to December, 1986. The results were as follows : 1) The average QRS score of the anterior wall infarction is 7.1 and that of the inferior wall infarction is 4.5 and there is a statistical significance(p<0.01). 2) In the acute myocardial infarction, the correlation coefficeient between the QRS score and the killip classification is 0.66(p<0.05). 3) In the acute myocardial infarction, the average QRS score is 6.3 and the correlation coefficient between the leak CK and the QRS score is 0.52(p<0.05). 4) In the anterior wall infarction, the average QRS score is 7.1 and the correlation coefficient between the peak Ck and QRS score is 0.48(p<0.05). 5) In the inferior wall infarction, the average QRS score is a 4.5 and the correlation coefficient between the leak CK and QRS score is 0.79(p<0.05).
Classification ; Electrocardiography ; Humans ; Infarction ; Myocardial Infarction* ; Prognosis

No abstract available.
Plasma* ; Prostate* ; Prostatic Neoplasms* ; Stomach Neoplasms*

PURPOSE: To understand the normal endosonographic anatomy of the perianal spaces, and to evaluate the diagnostic efficacy and limitation of endorectal sonography(EUS), correlative study with MRI, cadaveric sectional image and cadaveric MRI were performed. MATERIALS AND METHODS: EUS images of the normal 6 perianal spaces (pelvirectal, ischiorectal, intersphincteric, subcutaneous, central, submucous space) which were bounded by internal and external anal sphincters, rectal wall and levator ani muscle were correlated with MRI in 10 normal persons, cadaveric sectional images and cadaveric MRI in 2 cadavers. RESULTS: Pelvirectal space located superior to levator ani muscle could be demonstrable only on anterior wall scan but could not be visualized on lateral or posterior wall scan on EUS. Five perianal spaces located inferior to levator ani muscle were well seen on anterior, lateral, and posterior wall EUS. MRI was superior to EUS in the evaluation of pelvirectal and ischiorectal spaces but equal or inferior to EUS in the evaluation of intersphincteric, subcutaneous, central and submucous spaces. CONCLUSION: EUS was valuable in the evaluation of perianal spaces inferior to levator ani muscle but was limited in the evaluation of perianal spaces superior to levator ani muscle.
Anal Canal ; Cadaver* ; Humans ; Magnetic Resonance Imaging*

STUDY DESIGN: A retrospective study OBJECTIVES: We analyzed clinical and radiological results to verify the efficacy of calcium phosphate cement in kyphoplasty for treatment of osteoporotic vertebral fracture. SUMMARY AND LITERATURE REVIEW: Calcium phosphate is a biocompatible alternative to PMMA for vertebral augmentation in painful osteoporotic vertebral fracture as it is osteoconductive, non-exothermic, and injectable. MATERIALS AND METHODS: We analyzed 45 cases treated from April 2005 to August 2006 with a minimum of 1 year follow-up. Preoperative and post operative pain scores (visual analogue scale), ambulatory status, and patient satisfaction were measured. Anterior vertebral height, as well as the status and size of cement were assessed radiologically preoperatively, postoperatively, and at 3 months and 1 year. RESULTS: Pain scores (visual analogue scale) and ambulatory status improved significantly after kyphoplasty and remained unchanged during follow-up. Overall patient satisfaction was 93%. Radiological findings showed that mean vertebral height was significantly higher than preoperative (p<0.05). According to follow-up radiological finding, we divided cases into 4 groups: Group 1, 2; maintained vertebral height with minimal or some cement resorption; Group 3, 4; cement crack resorption and vertebral collapse. Group 1, 2 and Group 3, 4 had 38 patients (84%) and 7 patients(16%) respectively. Revision surgery was needed in 3 cases (antero-posterior surgery in 2 cases of group 4, and decompression in 1 case of extravasation into the neural canal). CONCLUSIONS: Kyphoplasty with calcium phosphate may be a good alternative for treatment of osteoporotic vertebral fracture, but non-union of the vertebral body with a large cleft showed a high risk of premature resorption and collapse of the vertebral body. The presumed advantage over PMMA needs longer follow-up.
Calcium* ; Decompression ; Follow-Up Studies ; Humans ; Kyphoplasty* ; Patient Satisfaction ; Polymethyl Methacrylate ; Retrospective Studies

Inverted papillomas are relatively rare, benign tumors of the sinonasal cavity that generate interest to many clinicians because of their high rate of recurrences, locally invasive character and malignant transformation. The incidence of bilateral occurrence, ranging from 2 to 7%, is extremely rare, and the incidence of synchronous malignancy is also rare too. Here, we report an unusual case of bilateral inverted papilloma with a malignant transformation on one side. We compared the expression of molecules that suggested a relation with malignant transformation in inverted papilloma between each side of the tumors.
Carcinoma, Squamous Cell ; Incidence ; Papilloma, Inverted ; Recurrence

OBJECTIVE: Ovarian cancer represents a relatively chemosensitive solid tumor, with responsiveness to a range of agents. Cisplatin is the mainstay of drug treatment and is one of the most active single agent. However, the overall outcome for patients remains unsatisfactory and the emergence of drug resistance is a major factor in treatment failure. Loss of DNA mismatch repair is a common finding in many types of sporadic cancer as well as in patients with hereditary nonpolyposis colon cancer. Cells that lack DNA mismatch repair are resistant to commonly used chemotherapeutic agents. Selection of cells for resistance to cisplatin, a well-recognized mutagen, could result in mutation in genes involved in DNA mismatch repair. METHODS: This study evaluated the mutation of hMLH1 and hMSH2, and its relation to the Taxol and Topotecan chemosensitivity in the clones from the ovarian cancer cell line 2008 and cisplatin-resistant cell line 2008/ C13*5.25. RESULTS: 1. Cells from 2008 and 2008/C13*5.25 expressed both hMLH1 and hMSH2 when analysed with immunoblotting. 2. Twenty two out of 100 single-cell clones from 2008 and 27 of clones from 2008/C13*5.25 expressed no hMLH1. hMSH2 was expressed in all clones. 3. There was no difference of Taxol chemosensitivity between 2008 and 2008/C13*5.25 cell lines. In the 2008/C13*5.25 cell line, the hMLH1-deficient clones were more sensitive to Taxol than the hMLH1-proficient clones(P=0.049), but in 2008 cell lines hMLH1-proficient clones were more sesitive to Taxol(P=0.003). 4. There was no difference in Topotecan chemosensitivity between 2008 and 2008/C13*5.25 cell lines. In the 2008/C13*5.25 cell line, the hMLH1- deficient clones were not more sensitive to Topotecan than the hMLH1-proficient clones. In the 2008 cell lines hMLH1-deficient clones were more sesitive to Topotecan(P=0.001). Overall, hMLH1-deficient clones from both 2008 and 2008/C13*5.25 cell lines were significantly more sensitive to Topotecan(P=0.001). 5. Microsatellite instability was not demonstrated in all 4 types of single-cell clones from 2008 and 2008/C13*5.25 cell lines. CONCLUSIONS: The present results indicate that there is no relation between mutation of mismatch repair gene and cisplatin resistance. But hMLH1-deficient ovarian cancer cells are more sensitive to Taxol or Topotecan in this study. The latter finding mandates the examination to assess the mutation of hMLH1 in tumor cells before treatment or at the time clinical resistance to cisplatin develops in ovarian cancer.
Cell Line* ; Cisplatin ; Clone Cells* ; Colorectal Neoplasms, Hereditary Nonpolyposis ; DNA Mismatch Repair* ; DNA* ; Drug Resistance ; Humans ; Immunoblotting ; Microsatellite Instability ; Ovarian Neoplasms* ; Paclitaxel* ; Topotecan* ; Treatment Failure

STUDY DESIGN: Lateral mass was measured using MRI for lateral mass screw fixation. OBJECTIVES: To measure the lateral mass of cervical spine using MRI for lateral mass screw fixation and find out the ideal entry point and insertion angle and length of lateral mass screws. SUMMARY OF LITERATURE REVIEW: Two methods of screw placement are in common use. The original technique, described by Ray-mond Roy-Camille, places the screw in a more or less straight sagittal direction and angling the screw laterally 10 to 20 degrees. Margerl technique involves placing the screw parallel to the facet joint and angling the screw laterally 25 to 30 degrees. MATERIALS AND METHODS: Axial MR images of the cervical spine parallel to the facet joints were obtained from C3 to C6 of 10 patients. The mean age of the patients were 48.0 years. The patients consisted of 6 male and 4 female patients. Ideal entry points, insertion angle and length of the lateral mass for lateral mass screw fixation were measured on the axial MR images using PACS digital measuring instument . RESULTS: Ideal entry point of a lateral mass screw was center of lateral mass in sagittal plane, 16mm lateral to the midline of the cervical spine, ideal direction of the lateral mass screw was parallel to the facet joint and angling the screw laterally 25.3 degrees, and ideal length of lateral mass screw was 17.9mm. CONCLUSIONS: Based on the results of the study, there were some differences of measurements depending on the patients and the level of the cervical spine. Therefore, a preoperative measurement of lateral mass was recommended in each patient and each level of the cervical spine.
Female ; Humans ; Magnetic Resonance Imaging* ; Male ; Spine* ; Zygapophyseal Joint

Pfeiffer syndrome is one of a rare form of craniosynostosis syndrome, showing variable degree of craniosynostosis, midface hypoplasia, broad thumbs and toes and syndactyly. This is transmitted in autosomal dominant pattern and known to be related to mutations in FGFR (Fibroblast Growth Factor Receptor) 1 or FGFR 2. We experience a case of newborn Pfeiffer syndrome type 3 who had multiple facial anomalies, thumbs and great toes anomalies, ankylosis of radius and ulnar and hydrocephalus.
Acrocephalosyndactylia* ; Ankylosis ; Craniosynostoses ; Humans ; Hydrocephalus* ; Infant, Newborn ; Radius ; Syndactyly ; Thumb ; Toes

PURPOSE: To document the relative usefulness of true Fast-imaging steady-state precession(FISP) comparing to breath-hold turbo spin-echo(TSE), and half-Fourier single-shot turbo spin-echo(HASTE) as a fast T2-weighted sequence during hepatic MR imaging. MATERIALS AND METHODS: For 46 patients with 87 focal hepatic lesions(hepatocellular carcinoma, n=26; metastasis. n=5; cavernous hemangioma, n=37; cyst, n=19), we obtained MR imaging of the liver at 1.5T. True FISP, TSE with and without fat-suppresion(FS), and HASTE with and without FS images were obtained during one breath-hold. Images were compared on the basis of tumor detectability and lesion-to-liver contrast-to-noise ratio(CNR). Qualitative analysis of each imaging sequence was also performed in terms of hepatic contour, visibility of vascular landmarks and imaging artifacts. RESULTS: TSE-FS depicted more focal lesions(78/87, 90%) than other sequences(TSE, 75/87=86%;HASTE, 74/87=85%; HASTE-FS, 75/87=86%;true FISP,73/87=84%). However, there was no statistical significance between each sequence(p> .05). Using true FISP or HASTE, there was a statistically significant difference(p< .01) between the CNRs of solid tumors, crystal and hemangiomas. Additionally, true FISP sequence showed better hepatic contour, vascular landmarks and less artifacts comparing with TSE or HASTE regardless of FS(p< .001). CONCLUSION: True FISP sequence allows differentiation between solid tumors, hemangiomas and cystic lesions in terms of CNR, and provides better imaging quality than other fast T2-weighted MR sequences.
Artifacts ; Hemangioma ; Hemangioma, Cavernous ; Humans ; Liver* ; Magnetic Resonance Imaging* ; Neoplasm Metastasis

PURPOSE: Although an axillary lymph node dissection (ALND) has been considered as an ultimate procedure for axilla in the breast carcinoma, complications after ALND and conceptual revolution for the role of axillary nodes have made it necessary to look for an alternative. Recent studies of sentinel lymphadenectomy (SLND) have shown that SLND accurately predict axillary nodal status. However, for a satisfying outcome in SLND, a learning period would be required, as other surgical procedures do. In this study, the necessity of the learning period for SLND were examined. METHODS: From Nov. 1998 to Dec. 2001, 178 patients with invasive breast carcinoma were treated with SLND simultaneously followed by ALND. The period for the first 54 patients, Nov. 1998 to May. 1999, was set as a 'learning period'. Differences of the detection rate and the false negative rate for the 'learning period' and 'after the learning period' were compared. Also changes in the detection rate and the false negative rate with the accumulated experiences for SLND were evaluated. RESULTS: The sentinel lymph nodes were not identified in 5 patients through the whole period. Three of them occurred in the 'learning period' (5.6%, 3/54) and the rest occurred 'after the learning period' (1.6%, 2/124)(P=0.04). The false negative rate was 16.7% (4/24) in the 'learning period' and 0.0% in 'after the learning period' (P=0.00). The detection rate and the false negative rate improved with the accumulation of experiences for SLND. CONCLUSION: It is certain that 'learning period' for SLND is crucial. During this period, the improvement and stabilization of this skill is achieved.
Axilla ; Breast Neoplasms* ; Breast* ; Humans ; Learning* ; Lymph Node Excision* ; Lymph Nodes