This study was carried out to understand the relationship between specific chromosome changes and their phenotypic consequences at the tissue level of human lung cancers. Then paraffin-embedded human lung squamous cell carcinoma samples were investigated for in evidence of genetic alterations, using chromosome 7 and 17-specific repetitive alpha-satellite DNA probes. In situ hybridization procedure with chromosome-specific DNA probes was optimized for use on formalin-fixed paraffin-embedded lung tissue sections. The chromosome index ranged from 1.10 to 1.88(median, 1.49) for chromosome 7 and 1.20 to 1.98(median, 1.69) for chromosome 17. Normal lymphocytes and stromal cells showed one or two chromosome signals per cell in most cases. All tumors showed three or more chromosome signals per cell with range of 16.0% to 80.6% of cancer cells(median, 50.9%) for chromosome 7 and 32.7% to 84.7%(median, 69.9%) for chromosome 17. The chromosome index did not correlate with the DNA content in most cases. Chromosomes 7 and 17 were either overrepresented or underrepresented when they were compared with corresponding DNA index determined by FCM. An increase in copy number, particularly of chromosome 7 was associated with a less favorable phenotype, including high nuclear grade. In addition, chromosome alterations were differentially expressed in the different areas of the same tissue section, correlating with histologic heterogeneity. These results suggest that chromosome polysomy can be reliably detected in tissue sections using in situ hybridization. There is a strong correlation between genotypic abnormalities and tumor phenotype in human lung cancer. This capability will prove to be an important tool for determining the underlying genetic basis for tumor development, tissue phenotype heterogeneity and progression by allowing genetic determination to be made on paraffin-embedded tissue sections where tumor histologic architecture is preserved.
Humans ; Lung Neoplasms

Preperative radiologic indices, such as cortical index of Engh, morphological cortical index of Sportono and Romagnoli, canal flare index of Noble, and their relationship to the postoperative canal filling, femoral stem fitness, stability and clinical result at last follow up were analyzed in 111 hips of 96 patients treated with bipolar or total hip arthroplasty at the Department of Chthopedic Surgery, Korea University Hospital, between January 1985 and May 1993. The results obtained were as follows: 1. The cortical index had no correlations with age, metaphyseal filling and clinical result but isthmic filling was proportional to the cortical index. In femoral stem fitness and stability, most cases of press fit and optimal stability were obtained in group 3 and 4 that have thick cortex. 2. The morphological cortical index had no correlation with age, canal filling and clinical results. But it was proportional to the postoperative femoral stem fitness and stability. 3. The canal flare index had no correlation with age. The metaphyseal filling was increased in the stove piped canal group(less than 3.0 canal flare index), but isthmic filling was increased in normal canal group(3.0-4.7 canal flare index). The most cases of press fit and optimal stability were obtained in normal canal group. More satisfactory clinical results were obtained in nomal canal group. Above results suggest that straight type of cementless femoral component could get better press fit fixation, postoperative stability and more satisfactory clinical results in the cases of cortical index larger than 2.0, mophological cortical index larger than 2.7 and canal flare index larger than 4.0 but metaphyseal filling is unsatisfactor.
Arthroplasty ; Arthroplasty, Replacement, Hip ; Follow-Up Studies ; Hip ; Humans ; Korea

Traumatic atlanto-occipital dislocation is usually fatal. To date, few cases have been reported in the literature because survival after traumatic atlanto-occipital dislocation is extremely rare. We present the case of a 47-year-old man with traumatic atlanto-occipital rotatory posterior dislocation combined with atlanto-axial rotatory subluxation and treated by occipito-cervical fusion using Bohlman's triple wiring technique.
Dislocations* ; Humans ; Middle Aged

PURPOSE: To report a case of Charles Bonnet syndrome that developed after resection of a meningioma. CASE SUMMARY: The authors reviewed the medical record, brain magnetic resonance image, and Goldmann visual field test of a 56-year-old male patient who was diagnosed with a meningioma in the right parietal and occipital lobe and underwent resection of the tumor. The preoperative Goldmann visual field test showed homonymous left inferior quadrantanopsia. Subtotal resection of the mass in the right parietal and occipital lobe was performed, and postoperative histopathologic examination confirmed the diagnosis of a meningioma. Postoperatively, the patient complained of visual hallucination in an area of the eye with visual field defects. However, his consciousness and orientations were intact, and other cognitive functions were also normal. CONCLUSIONS: Visual hallucination can manifest in an area with visual field defects after resection of abrain tumor. In such a case, a diagnosis of Charles Bonnet syndrome should be considered.
Brain ; Brain Neoplasms ; Consciousness ; Eye ; Hallucinations ; Hemianopsia ; Humans ; Magnetic Resonance Spectroscopy ; Male ; Medical Records ; Meningioma ; Middle Aged ; Occipital Lobe ; Orientation ; Visual Field Tests ; Visual Fields

PURPOSE: Persistence of urgency in women after anti-incontinence surgeries is a distressing problem. We compared post-operative outcome of urgency according to clinical factors and urodynamic findings. And we evaluated the effects of post-operative persistent or de novo urgency on patient satisfaction. MATERIALS AND METHODS: Medical records of 279 consecutive women who had undergone modified fascial sling operation were reviewed. Motor urge defined as urgency with detrusor instability, and patients with urgency but no demonstrable detrusor instability on urodynamic study were diagnosed as sensory urge. Post-operative symptoms and satisfaction were assessed by questionnaire. RESULTS: Of the 279 patients, 53 with motor urge and 115 with sensory urge had pre-operative urgency. Cure or improvement in urgency occurred in 45 (84.9%) and 5 (9.4%) of the motor urge, and 70 (60.9%) and 23 (20.0%) of sensory urge cases, respectively (p<0.05). 105 (84.0%) of 125 patients with cure or improvement of urgency were satisfied for the operation, however, de novo urgency was noted in 8 patients (2.9%) and only 34 (66.7%) of 51 patients with persistent urgency or de novo urgency were satisfied (p<0.05). CONCLUSIONS: Our results suggest that we can predict cure or improvement of urgency with resolution of stress urinary incontinence after sling operation in many patients, and patients with motor urge are more likely to have urgency resolution after sling operations than those with sensory urge. Among various factors, post-operative outcome of urgency has a considerable effect on patient satisfaction.
Female ; Humans ; Medical Records ; Patient Satisfaction* ; Surveys and Questionnaires ; Urinary Incontinence* ; Urodynamics

No abstract available.
Hand* ; Humans

PURPOSE: To determine the correlation between intraocular pressure (IOP) and the bottle heights during vitrectomy using TONO-PEN(R)XL applanation tonometer and Icare(R) PRO rebound tonometer. METHODS: Twenty-four eyes of 24 patients who underwent 23-gauge sutureless vitrectomy were evaluated. After complete vitrectomy, the IOP was gradually increased by lifting the irrigation bottle height from the trocar insertion site by 40 cm, 45 cm, 50 cm, and 55 cm. The distance between the floor and patient's eye was consistent in all cases (105.5 cm). Before the removal of 23-gauge microcannulas, IOP was measured five times using each of the two methods, Tono-Pen(R)XL and Icare(R) PRO. RESULTS: The mean IOPs were 8.25 +/- 0.35 mm Hg for TONO-PEN(R)XL and 8.96 +/- 0.32 mm Hg for Icare(R) PRO at 40 cm bottle height. As the bottle height increased, the differences in IOP was also increased, 10.71 +/- 0.37 mm Hg at 45 cm, 14.18 +/- 0.39 mm Hg at 50 cm and 17.93 +/- 0.40 mm Hg at 55 cm for TONO-PEN(R)XL and 11.48 +/- 0.31 mm Hg at 45 cm, 14.64 +/- 0.31 mm Hg at 50 cm and 18.13 +/- 0.38 mm Hg at 55 cm for Icare(R) PRO. In TONO-PEN(R)XL, the linear equation was Y = 0.65 X - 18.108 (R2 = 0.794, p = 0.000) and the quadratic equation was Y = 0.013 X2 - 0.569 X + 10.446 (R2 = 0.801, p = 0.000). In Icare(R) PRO, the linear equation was Y = 0.614 X - 15.842 (R2 = 0.820, p = 0.000) and the quadratic equation was Y = 0.010 X2 - 0.306 X + 5.688 (R2 = 0.825, p = 0.000). The results show correlation of the quadratic equation was stronger than the linear equation in both tonometers. CONCLUSIONS: The differences of IOP were positively correlated with bottle heights in the form of a curve during vitrectomy. Therefore, the patients who are susceptible to retina or optic nerve damage during vitrectomy should be closely monitored.
Humans ; Intraocular Pressure* ; Lifting ; Optic Nerve ; Retina ; Surgical Instruments ; Vitrectomy*

PURPOSE: To report a case of functional bilateral hemianopia which was not associated with any organic causes. CASE SUMMARY: A 35-year-old female patient presented with bilateral disturbance of visual acuity and visual field, which had begun 8 months prior. Goldmann perimetry showed bitemporal hemianopsia respecting the vertical meridian. Pupillary response was normal, and the anterior segment, fundus, and optic nerve were also normal bilaterally. However, the tangent screen test and Humphrey visual field test showed a widening of hemianopia not respecting the vertical meridian, and the crossing of isopters at 1 m and 2 m with the tangent screen test. In addition, multifocal electroretinogram and multifocal visual evoked potential did not reveal any abnormal findings corresponding to the bitemporal hemianopia. Brain magnetic resonance imaging showed no abnormal findings in the orbit and brain. CONCLUSIONS: Bitemporal hemianopsia can be developed functionally, although it may be rare. Repetition of various visual field tests and use of multifocal electrophysiologic studies can be helpful in the differential diagnosis.
Adult ; Brain ; Diagnosis, Differential ; Evoked Potentials, Visual ; Female ; Hemianopsia ; Humans ; Magnetic Resonance Imaging ; Optic Nerve ; Orbit ; Visual Acuity ; Visual Field Tests ; Visual Fields

PURPOSE: To evaluate the relationship between urethral hypermobility and Valsalva leak point pressure (VLPP), subjective symptom degree in women with stress urinary incontinence. MATERIALS AND METHODS: 229 patients who were diagnosed as stress urinary incontinence and had undergone all of standing cystourethrogaphy, urodynamic study including VLPP, and recording questionnaire of incontinence were included in this study. The subjective degree of stress urinary incontinence was graded to 3 grades by Stamey classification, and urethral mobility more than 2.0 cm on standing cystourethrography was determined as the urethral hypermobility. And patients were stratified 3 groups according to the VLPP of less than 60, 60 to 90 and greater than 90 cmH2O. Correlation between urethral hypermobility and VLPP, subjective symptom degree were evaluated. RESULTS: According to the VLPP of less than 60, 60 to 90 and greater than 90 cmH2O, urethral hypermobility was noted in 49.4%, 86.6%, 92.4%, respectively. The rate of urethral hypermobility increased according to VLPP does with statistical significance (p<0.05). And in subjective symptom grade I, II, III urethral hypermobility was noted in 75.0%, 79.7%, 61.0%, respectively. There was not significant correlation between urethral hypermobility and subjective symptom degree (p=0.15). CONCLUSION: Our results suggest that there is significant correlation between urethral hypermobility and VLPP. And in some of patients with stress urinary incontinence urethral hypermobility and intrinsic sphincter deficiency are coexist. However, we suggest that the preoperative evaluation for urethral hypermobility and intrinsic sphincter deficiency is needed to assess the surgical outcome more exactly in the patients with stress urinary incontinence.
Classification ; Female ; Humans ; Surveys and Questionnaires ; Urinary Incontinence ; Urodynamics

A case of malignant eccrine acrospiroma of the anterior chest wall is reported. This mass had been present for 20 years and during rescent 5 years it showed frequent ulceration and bleeding suggesting malignant transformation. Microscopically, several foci malignant transformation from preexisting benign eccrine acrospiroma are seen and in immunohistochemical staining, the tumor cells both benign and malignant portion, show positive reaction to cytokeratin.