Real-time ultrasound-guided fine-needle aspiration biopsy in 137 solid breast masses was performed. Sonographic findings were categorized into three group and aspirates were categorized into three cytologic groups. The cytologic result was reported benign masses (cytologic group 1) in 71 cases (52%), malignant masses (cytologic group 2 and 3) in 44 cases (32%) and insufficient specimens in 22 cases (16%). Insufficient specimens were treated as benign masses. Excisional biopsy in 44 malignant masses and 3 benigh masses according to cytologic results, clinical findings and follow up study was performed. The result was reported 41 malignant masses and 6 benign masses. Based on cytologic criteria, sensitivity for detection of malignancy was 93% and specificity was 94%. In conclusion, the high specificity provided by ultrasound-guided fine-needle aspiration biopsy could markedly reduce unnecessary surgical excisions for benign masses and it should be routinely performed, since it can give physical and emotional benefits to patients and lead to earlier and cost effective diagnosis of breast cancer.
Biopsy ; Biopsy, Fine-Needle* ; Breast Neoplasms ; Breast* ; Diagnosis ; Follow-Up Studies ; Humans ; Sensitivity and Specificity ; Ultrasonography

No abstract available.
Chlamydia trachomatis* ; Chlamydia* ; Female ; Humans ; Infant, Newborn* ; Nasal Cavity* ; Polymers* ; Pregnancy ; Pregnancy Trimester, Third* ; Pregnancy*

We present a case of adult onset Still's disease (AOSD) that was misdiagnosed as septic arthritis of the shoulder and knee. A forty-nine-year-old woman was admitted for pain in the left knee. The patient's medical history showed that she had undergone arthroscopic irrigation twice and an open debridement under the diagnosis of septic shoulder at another hospital. The laboratory and joint fluid analysis findings led us to suspect septic knee. Arthroscopic irrigation and antibiotics treatment were performed. At five weeks after discharge, she presented with pain in the same joint, fever, and rash. The symptoms were consistent with Yamaguchi's criteria for AOSD. We started corticosteroid therapy, and clinical remission was achieved. In conclusion, we suggest that AOSD should be considered as a diagnosis of exclusion to avoid misdiagnosis with septic arthritis.
Adult ; Anti-Bacterial Agents ; Arthritis, Infectious ; Debridement ; Diagnostic Errors ; Exanthema ; Female ; Fever ; Humans ; Joints ; Knee ; Shoulder ; Still's Disease, Adult-Onset

OBJECTIVE: Patients with schizophrenia are at a higher risk for developing insulin resistance and type 2 diabetes mellitus (T2DM). However, few studies have examined abdominal fat and mid-thigh low-density muscle areas, which are known risk factors for insulin resistance and T2DM, in patients with schizophrenia. Therefore, we measured the abdominal fat and mid-thigh low-density muscle areas of schizophrenics and compared them with normal controls. METHODS: Nineteen (four men and 15 women) drug-naive or -free subjects who met the DSM IV criteria for schizophrenia and 19 age- and sex-matched controls were recruited. We measured weight, height, waist circumference, and percent body fat, and calculated the body mass index (BMI). Abdominal fat and mid-thigh low-density muscle areas were evaluated using computed tomography. RESULTS: There was no significant difference in terms of age and BMI between the two groups. The areas of abdominal fat (262.4+/-101.8 vs. 257.1+/-93.8 cm2 ; p=0.919), subcutaneous fat (182.4+/-72.8 vs. 180.5+/-75.1 cm2 ; p=0.988), visceral fat (79.9+/-47.2 vs. 76.6+/-49.3 cm2 ; p=0.872), and mid-thigh low-density muscle (15.0+/-9.9 vs. 15.4+/-5.2 cm2, p=0.373) did not differ between schizophrenics and controls. CONCLUSION: Abdominal obesity is a well-recognized risk factor for developing certain medical conditions such as insulin resistance and T2DM. We demonstrated that drug-naive or- free patients with schizophrenia do not have increased visceral fat or mid-thigh low-density muscle areas, which might have explained the higher prevalence of insulin resistance and T2DM in these patients.
Abdominal Fat* ; Adipose Tissue ; Body Mass Index ; Diabetes Mellitus, Type 2 ; Humans ; Insulin Resistance ; Intra-Abdominal Fat ; Male ; Obesity, Abdominal ; Prevalence ; Risk Factors ; Schizophrenia* ; Subcutaneous Fat ; Waist Circumference

The purpose of the present study was to identify the factor structure of neurocognitive tests used on schizophrenia patients by using the confirmative factor analysis, and to assess the factor score differences of schizophrenia patients and healthy controls. Comprehensive neurocognitive tests were administered to stabilized schizophrenia patients (N=114) and healthy controls (N=120). In the results of factor analyses on patients, the multifactorial-6-factor model, which included the speed of processing, working memory, verbal learning and memory, visual learning and memory, attention/vigilance, and reasoning/problem solving as suggested by the Measurement and Treatment Research to Improve Cognition in Schizophrenia (MATRICS), showed the better goodness of fit than any of the other models tested. And assessing the group differences of factor scores, we found the patients performed worse than the controls in all factors, but the result showed meaningful variations of impairments across the cognitive factors. Our study identifies the six major domains with multifactorial structure of cognitive abilities in schizophrenia patients and confirms the distinctive impairment patterns of each cognitive domain. These results may have utility in better understanding the pathology of schizophrenia as well as in genetic studies.
Adolescent ; Adult ; Attention ; Cognition Disorders/etiology ; Factor Analysis, Statistical ; Female ; Humans ; Male ; Memory ; Middle Aged ; Models, Psychological ; Neuropsychological Tests ; Problem Solving ; Schizophrenia/*diagnosis/etiology ; Severity of Illness Index ; Verbal Behavior ; Verbal Learning

Type 1 diabetes is on the rise worldwide. Although nutrition education for patients with diabetes has become a routine practice, specifics and impacts of such educations need to be more researched. This study examined the status of nutrition knowledge, dietary attitude, and dietary behavior among children and adolescents with type 1 diabetes (9-19 year-old) and explored factors influencing dietary behaviors related to diabetes by applying the Theory of Planned Behavior. Face-to-face interviews, using a pre-tested structured questionnaire, were conducted with 32 participants (11 boys and 21 girls) with type 1 diabetes followed by a diabetes clinic in a university hospital. This study found that the level of nutrition knowledge related to diabetes was generally low at 4 points out of a possible 10, however, the dietary attitude related to diabetes was found to be generally good at 26 points out of a possible 30. Participants were motivated to follow medical staff recommendations the most; however, their family was also important. Perceived behavioral control was low especially for eating-out and portion control. The dietary behavior related to blood glucose control showed low at 13 points out of a possible 20. Regression analysis showed that perceived behavioral control (p < 0.001) was significantly related to the dietary behavior related to blood glucose control. This rare study with children and adolescents with type 1 diabetes showed that nutrition education should include a component to improve perceived behavioral control through high-risk situation management.
Adolescent ; Blood Glucose ; Child ; Humans ; Medical Staff ; Surveys and Questionnaires

Heat shock proteins (HSP) have been identified as an important factor of a very complex and highly conserved cellular defense mechanism to preserve cell survival under adverse environmental conditions. HSP 60 are immunodominant antigens of microbe such as Chlamydia trachomatis and have a potentiality to become a target antigen due to antigenic similarity between chlamydial and human HSP. This study was conducted to investigate the effects of Vero cell coculture to anti-HSP 60 on the early mouse embryo development in vitro. The 2-cell mouse embryos (ICR) were cultured and mouse embryo development was observed every 24 hr for 3 days. 45% and 22.1% of the embryos cultured in Ham's F-10 plus anti HSP 60 with Vero cells developed to the 4- to 8- cell stage (day 1) and morular stage (day 2) as compared with 29.2% and 2.7% of those cultured without Vero cells respectively. But at day 3, the beneficial effect of Vero cells was not noted. These findings suggest that Vero cells have some roles to overcome the detrimental effect of anti-HSP 60 to some degree. These results suggest that Vero cells coculture will promote reproductive outcome in patient previously sensitized to microbial (e.g. Chlamydia trachomatis) HSP 60.
Vero Cells ; Pregnancy ; Mice, Inbred ICR ; Mice ; Male ; Infertility, Female/etiology/immunology/therapy ; Immunodominant Epitopes ; Female ; Embryonic Development/*immunology ; Coculture Techniques ; Chlamydia trachomatis/immunology/pathogenicity ; Chaperonin 60/*immunology ; Cercopithecus aethiops ; Antigens, Bacterial ; Antibodies, Monoclonal/*administration & dosage ; Animals

OBJECTIVE: The prevalence rate of osteoarthritis in Koreans aged 50 years or older is 14.3%, and the total amount of medical costs is more than KRW 1 trillion. Recently, the reimbursement guidelines for osteoarthritis treatment have changed. METHODS: In this study, we sought to describe prescription patterns of nonsteroidal anti-inflammatory drugs (NSAIDs) and gastro-protective agent (GPA) and analyze the clinical and economic impacts of the new policy using the national health insurance claims data. The incidence of upper gastrointestinal adverse event by policy change was identified through the odds ratio, and changes in medicine and medical costs related to osteoarthritis through mean and median. RESULTS: There were 204,552 patients before the reimbursement guidelines relaxation and 239,710 after it, a 17.2% rise. The prescription ratio was 3.3% for the patients prescribed with COX-2 selective NSAIDs alone and 1.3% for those with both COX-2 selective NSAIDs and GPA combination before the reimbursement guidelines relaxation. The reimbursement guidelines relaxation significantly increased their ratios to 6.9% and 2.8%, respectively. Gastrointestinal adverse events significantly reduced by 1.21%p after reimbursement guidelines relaxation. The average medicine cost per person increased significantly to KRW 140,291 from KRW 137,323 after the reimbursement guidelines relaxation, while the average medical cost per person slightly decreased from KRW 311,605 to KRW 310,755 after the relaxation, showing no meaningful difference. CONCLUSION: The reimbursement guidelines relaxation may influence on decreasing the upper gastrointestinal adverse event, increasing the medicine costs and maintaining the medical costs for osteoarthritis.

PURPOSE: The aim of this study was to discuss about availability of patella resurfacing in primary total knee arthroplasty through evaluation and analysis of the patella in revision total knee arthroplasty. MATERIALS AND METHODS: The study was performed for 27 patients who could be followed up more than 12 months after having the revision TKA from March, 2004 to July 2008 among 105 patients (145 knees) who could be followed up more than 5 years after having primary TKA due to degenerative arthritis from 1989 to 1997. There were Group A (15 knees) which had patella resurfacing in revision TKA without patella resurfacing in primary TKA, Group B (12 knees) which had patella resurfacing in primary TKA, but didn't have patella resurfacing in revision TKA. There was difference of mean 11.2 years (6~15 years) between the time that the patients had primary TKA and the time that the patients had revision TKA. The patients consisted of 3 males and 24 females. The average age of the patients who had revision TKA was 76.2 years old (68~87). The Feller's patella score was used as clinical evaluation system after primary TKA, before and after revision TKA, and last follow-up. Ahlback's score was used by for the radiological evaluation of preoperative and postoperative outcome. And Outerbridge classification was used for the evaluation of group A which about wear of articular surface of patellofemoral joint in primary TKA and revision TKA, and positions of wear were classified. RESULTS: The Feller's patella score of group A, The outcome before revision TKA, 14.5 points, after 3 months TKA, 22.6 points, and 12 months follow-up, 24.2 points. The Feller's patella score of group B, The outcome before revision TKA, 24.2 points, after 3 months TKA, 24.3 points, and 12 months 24.8 points. The Ahlback score of group A decreased from 3.4 to 1.7 points, group B decreased from 1.6 to 1.5 points and group C decreased from 3.8 to 1.7 points. The Outerbridge classification of group A was mean 1.9 grade in primary TKA, and mean 3.6 grade in revision TKA. The wear of patella mainly occurred at medial facet. CONCLUSION: The patella resurfacing in primary TKA is considered as a useful treatment on the basis of these clinic and radiologic evaluation.
Arthroplasty* ; Classification ; Female ; Follow-Up Studies ; Humans ; Knee* ; Male ; Osteoarthritis ; Patella* ; Patellofemoral Joint

In cancer patient, hypercalcemia may develop. The mechanism is local osteolysis by metastasis of cancinoma, or secretion of hormone such as PTHrP (parathyroid hormone related peptides). Bone metastasis in carcinoma of uterine cervix is uncommon. In this report, we present a case of hypercalcemia caused by metastasis of cervical carcinoma to the right acetabulum with a brief review of the literature.
Acetabulum* ; Cervix Uteri ; Female ; Humans ; Hypercalcemia* ; Neoplasm Metastasis* ; Osteolysis ; Parathyroid Hormone-Related Protein