PURPOSE: The purpose of this study was to perform a medical audit of the screening of mammographic results according to ACR BI-RADS Follow-Up and Outcome Monitoring and to evaluate the efficacy of screening mammography in the early detection of breast cancer. MATERIALS AND METHODS: We reviewed the results of 15,300 mammographic examinations of 13, 889 women aged 30 -75 years who underwent mammography at least once at the Severance Health Promotion Center between 1994 and 1998. Women with abnormal mammographic findings were recalled for additional study and those with dense breast composition (3, 4) underwent additional ultrasound. All results were categorized on the basis of the ACR BI-RADS final assessment scale, 1 -5. We reviewed the pathologic or follow-up results of all women in categories 4 and 5, and/or those in any category who took the films out of the health center. RESULTS: The recall rate was 13%. Biopsy or surgical Consultation was recommended for 92 women and biopsy was performed in 52. Pathology revealed 17 cancers and 35 benign lesions. Positive predictive value 2 was found in 18.5% of cases, and positive predictive value 3 in 33%. The cancer detection rate was 1.2/1,000, and sensitivity was 89.5%. Invasive cancers smaller than 1cm or in situ ductal cancers were found in eight of 17 cases (47%), while node-positive invasive cancers were found in nine of 14 cases (64%). Four of 17 mammo-graphically detected cancers were palpated by a surgeon. CONCLUSION: In asymptomatic women, screening mammography is an effective method for the detection of early breast cancer.
Biopsy ; Breast ; Breast Neoplasms ; Early Detection of Cancer ; Female ; Follow-Up Studies ; Health Promotion* ; Humans ; Mammography* ; Mass Screening* ; Medical Audit* ; Pathology ; Ultrasonography

No abstract available.
Humans ; Infant, Newborn* ; Mothers* ; Thrombocytopenia

Cytologic features of inflammatory pseudotumor of the lung have not been described frequently. We report fine needle aspiration cytologic(FNAC) finding of a case of inflammatory pseudotumor misdiagnosed as adenocarcinoma in a 63-year- old man. The FNAC displayed a mixture of histiocytes, myofibroblasts, pneumocytes, and plasma cells. Some histiocytes and myofibroblasts had large nuclei with irregular nuclear membrane and prominent nucleoli, which mislead the diagnosis of adeno- carcinoma on FNAC. The heterogeneous cell population is the unique cytologic features of inflammatory pseudotumor, which are helpful to distinguish it from other circumscribed benign and malignant lesions. Familiarity with these features is essential to avoid misdiagnosis and possible overtreatment.
Adenocarcinoma ; Carcinoma, Hepatocellular ; Neoplasm Metastasis

Blunt tracheobronchial injuries are rare, and usually lethal without aggressive and appropriate management. Recently, the incidence of tracheobronchial injuries has been increased with the increase of traffic accident and mechanization. We report a case of complete tracheal transection combined with a longitudinal rupture of the membranous portion of the trachea extending to the right main bronchus following blunt chest trauma, and review the anesthetic management.
Accidents, Traffic ; Bronchi ; Incidence ; Rupture ; Thorax ; Trachea

Gram-negative toeweb infections have clinical manifest,ations of variable severity. In its mildest form, the affected tissue is damp, softened, boggy and white. But. more severe form may progress to marked denudation of second, third and fourth toewebs with a profuse serous or purulent discharge, and its treatment is difficult. We described a 39-year-old man who had ulcerated arid oozing patches on several toewebs. Pseudomonas aeruginosa was detected in bacterial cultures. We successfullg treated with split-thickness skin graft, and enoxacin on first, visit and enoxacin with gentamicin ointment, for 2 weeks on second visit.
Adult ; Enoxacin ; Gentamicins ; Humans ; Pseudomonas aeruginosa ; Skin ; Transplants ; Ulcer

OBJECTIVE: To identify the factors which can delay home discharges or transfers to other hospitals of rehabilitation inpatients in a tertiary hospital and the change of discharge destination during past 6 years. METHOD: This was a retrospective study of patients with a diagnosis of stroke, traumatic brain injury or spinal cord injury who were admitted to our hospital in 1996, 1999, 2001 and 2003. Demographic data, length of stay, discharge destination and functional status by the FIM(TM) instrument were studied by a medical record review. RESULT: Patients who were transferred to other hospitals or discharged with delay showed significantly lower admission and discharge FIM scores, lower FIM efficiencies, longer length of stays and longer intervals between the onset and admission to a rehabilitation ward. CONCLUSION: Lower functional outcome was associated with a longer length of stay and discharge to another hospital. It would be necessary to establish the long term rehabilitation care facilities with extended rehabilitation program for the patients with lower functional gains in a rehabilitation unit of the tertiary hospitals.
Brain Injuries ; Diagnosis ; Humans ; Inpatients* ; Length of Stay ; Medical Records ; Rehabilitation* ; Retrospective Studies ; Spinal Cord Injuries ; Stroke ; Tertiary Care Centers*

OBJECTIVE: To determine whether there is a difference in nerve conduction studies depend on the body mass index (BMI) of subjects METHOD: Twenty normal healthy volunteers were enrolled for the study. A routine usual sensory and motor nerve conduction study and a sensory nerve conduction study using the near nerve needle technique were performed. BMI was calculated as weight (kg) divided by height (m) squared. In order to evaluate the effect of BMI on the various measure ments of the nerve conduction study, one-way analysis of variance (ANOVA) was used. RESULTS: The sensory nerve amplitudes of median, ulnar and sural nerves correlated significantly (p<0.05) with BMI. However, no correlation was noted between BMI and sensory nerve amplitude by near nerve needle technique. There was no statistical differences noted in the measurements of latency of examined motor and sensory nerves neither the velocity of examined motor nerves. CONCLUSION: In clinical practice, the effect of BMI should be taken into account when the interpretation of abnormal sensory nerve study has to be soli.
Body Mass Index* ; Healthy Volunteers ; Needles ; Neural Conduction* ; Obesity ; Sural Nerve ; Weights and Measures

Acute appendicitis is one of the most common diseases of young people that requires emergency operation. This is especially true for those age 10 years old and older. However, the numbers of cases of appendicitis are increasing in both the young and the elderly. The main purpose of this study is to understand the clinical features of acute appendicitis in children and elderly patients. We retrospectively compared clinical characteristics in 4 groups of patients who underwent appendectomy in our hospital. There were 16 patients in the pre-school age group, 9 were males and 7 females. The total number of patients in the juvenile group were 287, 156 were males and 131 females. The total numbers of patients in the adult group were 794, 436 were males and 358 females. The numbers of elderly patients were 189, 91 were males and 98 females. Complicated appendicitis was found in 15 patients (93.7 %) in the pre-school age group, 79 patients (27.5 %) in the juvenile group, 332 patients (41.8 %) in the adult group, and 96 patients (50.7 %) in the elderly group. Four patients (40 %) had generalized panperitonitis in the pre-school group. The occurrence of perforated appendicitis was the highest in the pre-school age group and the lowest in the juvenile group. Since generalized panperitonitis has a higher incidence in the pre-school age group, prudent and careful diagnosis and treatment are required for the pre-school age group.
Adult ; Aged ; Appendectomy ; Appendicitis ; Child ; Emergencies ; Female ; Humans ; Incidence ; Male ; Retrospective Studies

OBJECTIVES: The purpose of this study was to see the correlation between the auditory cognitive evoked potential and the clinical improvement in schizophrenics. METHOD: The subjects were 23 patients with schizophrenia. Auditory cognitive evoked potential was examined at pretreatment or the acute phase of treatment. The change of symptom was assessed by the PANSS(Positive and Negative Syndrome Scale) before drug treatment and in the 4th week of treatment. RESULTS: The results were as follows: 1) The change of positive subscale was positively correlated with P1 latency(p<.05), N1 latency (p<.05) and negatively correlated with P3 latency(p<.05), P2 amplitude(p<.05). 2) The change of negative subscale was negatively correlated with P3 latency(p<.05). 3) The change of general psychopathology subscale was negatively correlated with P3 latency(<.05). CONCLUSIONS:These results suggest that the auditory cognitive evoked potential in schizophrenic patients could be valuable on prediction of clinical improvement. But, further studies are required to support these results.
Evoked Potentials* ; Humans ; Psychopathology ; Schizophrenia

Nonsurgical endoscopic or percutaneous dilatation and insertion of an endoprosthesis is the treatment of choice in the majority of patiens with incurabie malignant biliary obsturction. But these palliative treatment of extrahepatic cholestasis with an endoscopic or percutaneous biliary endoprosthesis is limited by clogging. One of the factors thought to be of importance is the diameter of the stent. So in order to avoid being limited by the size of the instrumentation channel of the endoscope, expandable stents have been developed. Wallstent is braided in the form of a tubular mesh from surgical grade stainless alloy. This prosthesis is geometrically stable, pliable and self expanding. Its elastic properties are such that its diameter can be substantially reduced by moderate elongation. The stent is constrainded on a small diameter delivery catheter(total outside diameter: 9 French). During the implantation procedure the final position of the partially released endoprosthesis can be adjusted by gradual removal of the delivery catheter. If full expansion to 30 French occurs, the stent will be shortened by approximately 30% to their normal length range between 34-102mm. Now in this article we report a new method for endoscopic retrograde placement of biliary Wallstent in a patient with obsturctive jaundice due to periampullary choangiocacrcinoma.
Alloys ; Catheters ; Cholestasis, Extrahepatic ; Dilatation ; Endoscopes ; Humans ; Jaundice ; Palliative Care ; Prostheses and Implants ; Stents