Due to the instability of intertrochanteric fractures in elderly patients, various methods of reduction and fixation were introduced to obtain stable reduction and solid union, But there have been many controversies regarding advantages between anatomical reduction group and non-anatomical reduction group. The authors analyzed the 68 unstable intertrochanteric fractures out of total 94 cases of intertrochanteric fractures treated from Jan. 1988 to Jan. 1994 with mean follow-up 17 months and evaluated the radiologic and clinical results between those two groups. The results were obtained as follows: 1. The most common cause was low energy injury and according to the Tronzo classification, the type III was most common in 54 cases (79.4%). 2. The average union time was 14.0wks (84%), the union rate was low in the medialized reduction group(A-P) and anterior displaced reduction group(A-P), anterior displaced and anatomical reduction groups(Lateral). 3. The compression length more than 10mm of lag screw was deep in medialized reduction group(A-P), another displaced and anatomical reduction groups(Lateral). 4. The average length of lag screw sliding was 9.2mm and depth sliding of 6.8mm (74%) was occurred within immediate postoperative 1 month.
Aged ; Classification ; Femur ; Follow-Up Studies ; Hip Fractures ; Hip ; Humans

No abstract available.

Transient synovitis of the hip is non-specific inflammation and self limited condition, which is most common cause of painful limping in children under 10 years of age. Ultrasonography presents some merits, simple, rapid, non-invasive, low cost, repetitive to assess soft structures in and around the hip joint compared to other diagnostic methods. We prospectively studied 32 cases of unilateral transient synovitis at OPD from Jan. 1988 to Oct. 1989 using 5-7.5 MH, probe ultrasonography. 2-times serial check up in symptomatic and asymptomatic stage about capsule thickness and bone-capsule distance in 3 different positions of the both hips were performed for comparision. The following results were obtained; 1. Boys were 25 cases (78%) and 26 cases (83%) were between 3 and 7 years old of age. 2. Bone-capsule distance in ultrasonography revealed abnormal increase in 72%. 3. External rotation position showed wider bone-capsule distance than other position. 4. Capsule thickness was 3.3mm in diseased and 3.0mm in sound, 0.3mm decrease after treatment. 5. Bone-capsule distance was 4.5mm in symptomatic stage, 2.7mm in asymptomatic stage, 1.8mm decrease after treatment in averge.
Child ; Hip Joint ; Hip ; Humans ; Inflammation ; Prospective Studies ; Synovitis ; Ultrasonography

No abstract available.
Tibia*

Lecanora is one of the largest genera of lichens worldwide. These lichens can be easily seen, and are commonly found on trees and rocks. Most Korean Lecanora species belong to the Lecanora subfusca group, which has well-defined superficial thallus, red–brown apothecia, and soredia. The new species of L. neobarkmaniana grows on rocks, farinose soredia coalescing, usually covering the whole thallus, and containing atranorin and zeorin. We used internal transcribed spacer (ITS) and mitochondrial small subunit (mtSSU) sequence data to identify the phylogenetic relationship across Lecanora sequence data and found the species to form different clades. In this study, we reported some interesting findings and described the genetic relationship with other sorediate Lecanora species and the characteristics of the new species. An identification key for the Korean sorediate Lecanoraspecies is given.

PURPOSE: Axillary node involvement is the single most important prognostic variable in patients with breast cancer. If axillary lymph node status of breast cancer patients could be accurately predicted from basic clinical information and from characteristics of their primary tumors, many patients could be spared axillary lymph node dissection. With the availability of numerous histologic prognosticators and new immunochemical prognostic indicators, it is reasonable to reconsider the necessity of axillary node dissection for lesions more advanced than duct carcinoma in situ. MATERIALS AND METHODS: Six hundred fifty-six patients with Tl invasive breast cancer were evaluated. All the patients underwent axillary dissection, and the pathologic status of the nodes was known. The parameters of the primary tumor in this study were age, size, family history, tumor palpability, nuclear and histological grade, hormone receptor status, lymphatic vessel invasion (LVI), and various tumor markers (bc1-2, cathepsinD, c-erbB2, E-cadherin, p53). RESULTS: Approximately 31% of the 656 patients with Tl breast carcinoma had axillary node metastasis. Four factors were identified as significant predictors of node metastasis: age 35 or less (p=0.01), lymphatic vessel invasion (p < 0.01), tumor palpability (p=0.02), and tumor size (p<0.01). However, independent predictors of lymph node metastasis in the multivariate logistic regression analyses were tumor size (p=0.04) and LVI (p=0.03). CONCLUSION: Characteristics of the primary tumor can help assess the risk for axillary lymph node metastases in Tl breast cancer. Selected patients who have 1cm or less without lymphatic vessel invasion are considered to be at minimal risk of axillary node metastasis and might be spared routine axillary dissection.
Breast Neoplasms* ; Breast* ; Cadherins ; Carcinoma in Situ ; Humans ; Logistic Models ; Lymph Node Excision ; Lymph Nodes ; Lymphatic Vessels ; Neoplasm Metastasis* ; Prognosis ; Biomarkers, Tumor

BACKGROUND: A papillary carcinoma in the breast is a rare carninoma with a predominantly papillary growth patttern. Its incidence is said to be 1% to 2% of all breast carcinomas in women. Because of its rarity, little is known about its histopathological features. This study was undertake to analyze the histopathological characteristics of papillary breast cancer. METHODS: During the 17 years from January 1980 through December 1996, among 2166 primary breast cancer patients, 26 patients, who had been diagnosed with papillary breast cancer pathologically at the Department of Surgery, Seoul National University Hospital, were elegible for this study. The histopathological characteristics of the tumors in these patients, including immunohistochemically stained tumor marker-e.g., bcl2, c-erbB2, cathepsin D, and p53-were compared to those of patients with an invasive ductal carcinoma, NOS (IDC). RESULTS: The mean age of the patients was 47 years old, ranging from 28 to 74 years. There was no statistically significant difference in the primary tumor size between the papillary cancer and the IDC (2.62 cm vs 3.33 cm, p=0.127). Twenty-four of the papillary cancer patients had no metastatic axillary node, and metastatic nodes were present in the papillary cancer than in the IDC, with statistical significance (0.27+/-0.19 vs 3.43+/-0.08, p=0.023). Papillary cancer seemed to have more frequent ER and PgR (60%, 77.8%) than IDC (44.1%, 56.1%), but there was no significance to these results (p=0.351, 0.309). In terms of tumor markers, the positivity of bcl2, c-erbB2, cathepsin D, and p53 in papillary cancer were 42.9%, 100%, 85.5%, and 66.7%, respectively. Of all significance, immunohistochemically determined tumor markers, c-erbB2 expression was observed with statistical significance, more frequently in papillary cancer (100% vs 68.5%, p=0.044). Patients with papillary cancer had an overall 10-year survival rate of 83.3%. CONCLUSION:Papillary breast cancer had fewer metastatic axillary node, but with little statistical significance for a more favorable outcome. The relation between c-erbB2 expression and papillary cancer seems to be interesting and needs to be further elucidated.
Biomarkers, Tumor ; Breast Neoplasms ; Breast* ; Carcinoma, Ductal ; Carcinoma, Papillary ; Cathepsin D ; Female ; Humans ; Incidence ; Middle Aged ; Seoul ; Survival Rate

There is considerable need for reliable prognostic markers to guide clinicians in management decisions for the breast cancer. The cell cycle is governed by a family of cyclin-dependent kinases(Cdks), regulated by associated cyclin p27, a cyclin dependent kinase inhibitors, regulates progression from GI into S phase by inhibiting cyclin/cdks complex. This study was performed to evaluate the association between p27 expression, determined by immunohistochemical stain, and various histopathologic features in breast cancer. It was also determined whether p27 expression had the significance as the prognostic factorin the breast cancer patients. 45 patients who got the relatively good preserved paraffin blocks among the 100 patients was chosen for immunohistochemical staining against p27, cyclin E, c-erbB2, cathepsin D and p53 and reexamined their unclear and histological grades from Jan. 1989 through Dec. 1992. As a results, the patients with negative expression of p27 had more metastatic axillary nodes than those with positive expression. (5.87+/-1.87 vs 1.14+/-0.54, p=0.021) p27 negative group got worse nuclear grade than p27 negative group but beyond statistical significance. (48.4% vs 28.6%, p=0.281) On univariate analysis, primary tumor size, status of axillary nodes and the expression of p27 were the significant prognostic factors affecting overall survival rates. In particular, p27 positive group had better outcomes on 5 years survival rate than p27 negative group. (92.31+/-7.39% vs 73.33+/-8.07%, p=0.0441) but didn't affect the disease free survival with statistical significance. On multivariate analysis, the primary tumor size and axillary node were significant prognostic factors on overall and disease free survival. In conclusion, despite relativeiy small size of this study group, considering that p27 negative group got the more metastatic node and worse overall survival, 27 expression might be a novel prognostic indicator in the breast cancer.
Breast Neoplasms* ; Breast* ; Cathepsin D ; Cell Cycle ; Cyclin E* ; Cyclins* ; Disease-Free Survival ; Humans* ; Multivariate Analysis ; Paraffin ; Phosphotransferases ; S Phase ; Survival Rate

PURPOSE: To determine the clinical feature, surgical management of primary and recurrent disease, predictive factors for outcome, and impact of multimodality therapy in retroperitoneal sarcoma. MATERIALS AND METHODS: 60 patients were confirmed pathologically as soft-tissue sarcoma of the retroperitoneum by operation or needle biopsy in Seoul National University Hospital from 1983 to 1995. A retrospective analysis was performed. RESULTS: The abdominal mass was common presenting symptom. Histologically liposarcomas(25%) and leiomyosarcomas(23.3%) were most common, and MFHs(11.7%) and malignant schwannomas(11.7%) followed. The overall 5 year survival rate was 54.6%. Complete resection was possible in 51.7% of patients and strongly predicts outcome (<0.0001). These patients had a median survival of 130 months compared to 20 months for those undergoing partial resection and 9 months for those with unresectable tumors. 11(35%) of completely resected patients have had local recurrence. These patients underwent reoperation when feasible. Complete resection of recurrent disease was performed in 10 patients(90%), with a 42 months median survival time after reoperation. Resection of adjacent organ was performed in 19 patients. 14 of these were completely resected, and showed 100% of 5 year survival rate. Tumor grade was not a significant predictor of outcome. Gender, histologic type, encapsulation, stage, resectability, combined resection were significant prognostic factors by univariate analysis. But resectability was only independent prognostic factor on mutivariate analysis. Radiation therapy and chemotherapy could not be shown to have significant impact on survival. CONCLUSION: Complete resection is the most important prognostic factor of retroperitoneal sarcoma. Extensive and aggressive surgery must be considered including resection of adjacent organs. Multiple resection seems to improve survival in recunent cases.
Biopsy, Needle ; Drug Therapy ; Humans ; Recurrence ; Reoperation ; Retrospective Studies ; Sarcoma* ; Seoul ; Survival Rate

BACKGROUND: The activation of phospholipase C(PLC) is one of the early cellular events in various growth process, including malignant transformation. PLC-gamma1 is activated through direct interaction with growth factor receptor tyrosine kinase. MATERIAL AND METHODS: Using immunoblot assay, we evaluated overexpression of PLC-gamma1 expression in twenty human breast cancer tissues. It was also determined whether there was any connection between other prognostic factors(numbers of metastatic axillary nodes, nuclear and histological grade, c-erbB2, p53 and E-cadherin) and the overexpression of PLC-gamma1 protein. RESULTS: Seventeen of 20 breast cancer tissues showed overexpression of PLC-gamma1, which was corresponded to that seen on the immunohistochemistry( kappa= 0.8275, p = 0.003). Of 3 tumor markers, immunohistochemically determined, positive expression of E-cadherin only was associated with PLC-gamma1 protein overexpression in a range of statistical significance (p=0.045, kappa=0.607). CONCLUSION: PLC-gamma1 overexpression might be pathogenic trigger involved in breast cancer and the relationship between expression of E-cadherin and PLC-gamma1 would require further elucidation.
Breast Neoplasms ; Cadherins ; Humans ; Phospholipases* ; Protein-Tyrosine Kinases ; Biomarkers, Tumor