OBJECTIVE: This study was carried out to evaluate the clinicopathologic significance of hepatocyte growth factor (HGF) and c-met expression as well as tumor angiogenesis in endometrial hyperplasia and adenocarcinoma. METHOD: By means of immunohistochemical staining, HGF, c-met expression, and angiogenesis were investigated in total of 49 patients (19 endometrial hyperplasia, 30 endometrial adenocarcinoma). HGF and c-met were identified with specific corresponding antibodies. To evaluate angiogenesis, the microvessels were highlighted by staining their endothelial cells immunohistochemically for anti-CD31. Areas close to the deepest myometrial invasion or those with the highest grade of endometrial hyperplasia and the highest angiogenic intensity were selected. Three fields of 400 magnification were selected for each slide, and the mean microvessel count was obtained. RESULTS: Diffuse staining for HGF was demonstrated in normal, endometrial hyperplasia and endometrial adenocarcinoma tissue in 45.5, 52.6 and 63.3 percent, respectively, while that for c-met was demonstrated in 9.1, 36.8 and 60.0 percent, respectively. c-Met overexpression was significantly correlated with high surgical stage as well as poor cellular differentiation. There were significant differences in microvessel count among normal, complex endometrial hyperplasia and adenocarcinoma (median 5, 9 vs. 22) and was between simple and complex endometrial hyperplasia (median 6 vs. 9). The microvessel counts were also significantly correlated with high surgical stage, poor cellular differentiation, lymph node involvement and deep myometrial invasion. CONCLUSION: This results suggested that both c-met overexpression and angiogenesis measured by microvessel count could be significantly important prognostic indicators for the prognosis of endometrial adenocarcinoma.
Adenocarcinoma* ; Antibodies ; Endometrial Hyperplasia* ; Endothelial Cells ; Female ; Hepatocyte Growth Factor* ; Hepatocytes* ; Humans ; Lymph Nodes ; Microvessels ; Prognosis

STUDY DESIGNS: Retrospective analysis of the surgical treatment in patients of thoracolumbar spine fractures. OBJECTIVES: To measure by modified Cobb method the correction angle of thoracolumbar vertebral fractures and to comparison the difference between short segment pedicular fixation with fractured vertebra(group A) and without fractured vertebra (group B). SUMMARY OF LITERATURE REVIEW: The major treatment of thoracolumbar spine fractures is surgical correction of kyphotic angle by posterior decompression and posterolat. fusion at one level or more. MATERIALS AND METHODS: The materials are the patients who visited due to trauma beween 1991.1 and 2000.12. and treated by post. decompression and short segment posterolat. fusion with iliac bone graft. The number were A group, 28 persons and B group, 15 persons. The method of radiologic measurement is done by the modified Cobb method. The follow up time is till 2001.7. and the duration are minimal 6 months and maximal 77 months. The age was between 17 old and 60 old. The neurologic abnormalities in patients are 12 persons. The fractures were classified by the Denis classification. There are compressive fracture are 3 persons and bursting fracture type A are 18 persons, type B are 22 persons. The materials were confirmed by radiologic union and excluded if more than one vertebra fusion is needed. RESULTS: The most fractures were due to falldown injury. The most fracture site was T-L level (T12-L3). The one case was complicated by deep infection and treated and the other case was reduction loss due to metallic failure. The results of the loss of correction were A group, 5.3 degree and B group, 6.2 degree. (P>0.05). The relative correction loss were A group, 42%, and B group, 54%. (P<0.05). CONCLUSION: The mean correction angle and loss of correction are more good results in the group of short segment pedicular fixation with fracture vertebra. But to get more good results, our study do more long term follow-up and rule out other statistical errors and consecutive radiologic follow-up.
Classification ; Decompression ; Follow-Up Studies ; Humans ; Retrospective Studies ; Spine* ; Transplants

Intraarticular ganglion of the knee joint is a cystic mass found around cruciate ligaments in infrapatellar fat pad or under patellar tendon. The first report on intraarticular ganglion of the knee joint along with some intermittent case reports or ganglion around the cruciate ligaments were in 1924 by Caan. Ganglion under the patellar tendon or in the patellar fat pad was first reported in 1972 by Muckle and Monahan. The two cases were treated with open arthotomy and mass excision. There was been no report on ganglion under patellar tendon since then. We managed two cases of ganglion under the patellar tendon with arthroscopic debridement. After 16 months of treatment, there has no recurrence of symptom. We report two cases of ganglion under patellar tendon with the review of the literature.
Adipose Tissue ; Debridement ; Ganglion Cysts* ; Knee Joint ; Ligaments ; Patellar Ligament* ; Recurrence

BACKGROUND: Fascin is associated with motility in various transformed cells. Overexpression of fascin is known to aid in the progression of some cancers and is associated with a poor prognosis. E-cadherin is a major protein of epithelial cells and its expression is involved in the regulation of cell proliferation and differentiation. The aim of this study was to determine the expression pattern for fascin and E-cadherin and how it is related to the prognostic factors for renal cell carcinoma (RCC). METHODS: The expression of fascin and E-cadherin was evaluated in 208 RCCs including 175 clear cell, 20 papillary, and 9 chromophobe types using tissue array analysis. RESULTS: The expression of fascin increased as the tumor stage (p=0.00) and Fuhrman grade (p=0.00) increased. A high positive rate of expression for fascin was observed in cases with sarcomatoid changes (p=0.27). E-cadherin expression was seen in the distal tubules and collecting ducts of normal kidneys with a membranous pattern. The positive rate of expression for E-cadherin increased as the Fuhrman grade increased (1, 0%; 2, 23.2%; 3, 34.9%; and 4, 53.8%, p=0.00). An inverse correlation in RCCs was observed in the expression of fascin and E-cadherin (p=0.026, r=-0.158). CONCLUSIONS: In patients with RCC, the increased expression of fascin and E-cadherin was positively correlated to poor prognostic factors such as a higher Fuhrman nuclear grade and advanced pTNM stage.
Cadherins ; Carcinoma, Renal Cell ; Carrier Proteins ; Cell Proliferation ; Epithelial Cells ; Humans ; Kidney ; Microfilament Proteins ; Prognosis ; Tissue Array Analysis

PURPOSE: To determine the sonographic findings of degenerative change in femoral articular cartilage of the knee by comparative study of specimen sonography and pathology. MATERIALS AND METHODS: We obtained 40 specimens of cartilage of the femur (20 medial and 20 lateral condylar) from 20 patients with osteoarthritis of the knee who had undergone total knee replacement. The specimens were placed in a saline-filled container and sonography was performed using a 10MHz linear transducer. Sonographic abnormalities were evaluated at the cartilage surface, within the cartilage, and at the bone-cartilage interface, and were compared with the corresponding pathologic findings. In addition, cartilage thickness was measured at a representative portion of each femoral cartilage specimen and was compared with the thickness determined by sonography. RESULTS: 'Dot 'lesions, irregularity or loss of the hyperechoic line, were demonstrated by sonography at the saline-cartilage interface of 14 cartilages. Pathologic examination showed that these findings corresponded to cleft, detachment, erosion, and degeneration. Irregularities in the hyperechoic line at the bone-cartilage interface were revealed by sonography in eight cartilages and were related to irregularity or loss of tidemark, downward displacement of the cartilage, and subchondral callus formation. Dot lesions, corresponding to cleft and degeneration, were noted within one cartilage. Cartilage thickness measured on specimen and by sonography showed no significant difference (p=0.446). CONCLUSION: Specimen sonography suggested that articular cartilage underwent degenerative histopathological change. Cartilage thickness measured by sonography exactly reflected real thickness.
Arthroplasty, Replacement, Knee ; Bony Callus ; Cartilage ; Cartilage, Articular* ; Femur ; Humans ; Knee* ; Osteoarthritis ; Pathology* ; Transducers ; Ultrasonography

PURPOSE: To determine treatment protocol for inoperable esophageal cancer patients, we evaluated survival rate and prognostic factors. MATERIALS AND METHODS: We evaluated esophageal cancer treated by curative or palliative aim in KCCH from 1992 to 1996, retrospectively. Recurrent or underdose case below 40 Gy were excluded. The number of male and female were 35 and 5, respectively. Thirty-eight patients were squamous carcinoma and 2 patients were not biopsy proven. Ten patients were treated with radiation therapy and chemotherapy. Median dose of radiation therapy was 59.4 Gy and the range was 40-60 Gy. RESULTS:The median survival is 6.5 months and 1-year survival rate was 28.3%. Age, location, radiation dose and chemotherapy were not significant prognostic factors. Median survivals of patients with below stage III and over stage IVA were 7.6 and 6.2 months respectively, but it is not significant. CONCLUSION:The survival for esophageal cancer is very poor. For patients with curative aim, chemotherapy must be considered. For patients with palliative aim, short-term external beam radiation therapy and/or brachytherapy must be considered.
Biopsy ; Brachytherapy ; Carcinoma, Squamous Cell ; Clinical Protocols ; Drug Therapy ; Esophageal Neoplasms ; Female ; Humans ; Male ; Retrospective Studies ; Survival Rate

Cushing's syndrome is produced by the hypersecretion of adrenal glucocorticoids and is characterized by moon face, central obesity, disappearance of diurnal variation of plasma cortisol and unsuppressibility of plasma cortisol by low-dose dexamethasone. On the other hand, hyperaldosteronism is produced by the hypersecretion of aldosterone and is characterized by hypertension and hypokalemia. We report a rare case of adrenal adenoma with concurrent hypercortisolism and hyperaldosteronism manifestated with hypertension, cushingoid appearance, left adrenal mass with low-normal plasma potassium. Laparoscopic unilateral tumor excision was performed and hypertension disappeared after the operation.
Adenoma* ; Aldosterone ; Cushing Syndrome* ; Dexamethasone ; Glucocorticoids ; Hand ; Hydrocortisone ; Hyperaldosteronism* ; Hypertension ; Hypokalemia ; Obesity, Abdominal ; Plasma ; Potassium

Osteopetrosis is a rare bone disease characterized by systemic osteosclerosis due to an osteoclast dysfunction that decreases bone resorption. This report demonstrates two cases of adult osteopetrosis with secondary osteomyelitis of the maxilla, in siblings who are 43-year old female and 55-year old, male respectively. The common radiographic features of these cases were increased radiopacity in skull, rib and vertebra. The radiographic features that differed between these two cases were the osteosclerotic pattern of the jaw bones, that is, diffuse patterns in the female case, while the male case showed nodular patterns that were confined to the root apices. The diagnosis of osteopetrosis may be complicated due to the varying degree of osteosclerosis on panoramic radiograph. Additional radiographs such as the chest and skull radiograph may be helpful for the diagnosis of osteopetrosis.
Adult ; Bone Diseases ; Bone Resorption ; Female ; Humans ; Jaw ; Male ; Maxilla ; Osteoclasts ; Osteomyelitis ; Osteopetrosis ; Osteosclerosis ; Radiography, Panoramic ; Ribs ; Siblings ; Skull ; Spine ; Thorax

BACKGROUND: The aim of this study was to evaluate differences in cytologic findings between conventional preparation (CP) and SurePath(TM) liquid-based preparation (LBP) in thyroid fine needle aspiration (FNA). METHODS: We analyzed cytological features on a total of 182 thyroid FNAs (83 CP and 99 LBP) that were histologically confirmed as nodular hyperplasia (NH) or papillary carcinoma (PAC). RESULTS: LBP was superior in cellular preservation and cellularity than CP. Interestingly, in LBP, cellularity of NH was similarly high compared to that of PAC. The three-dimensional pattern was more prominent in LBP than in CP. The presence of follicle structures was more frequently found in LBP than in CP in the PAC group. Dispersed single cells in the background were more prominent in LBP than in CP. In the PAC group, contrast of the nuclear membrane was more distinctive in CP than in LBP. CONCLUSIONS: In thyroid FNA, LBP is better for cellular preservation, cellularity, background and nuclear detail than CP. However, some features in LBP such as high cellularity in NH, prominent dispersed single cells, and frequent follicle patterns were unfamiliar findings in CP. Hence, we should be aware of these cytomorphologic features in LBP to make a proper diagnosis.
Biopsy, Fine-Needle ; Carcinoma, Papillary ; Hyperplasia ; Nuclear Envelope ; Thyroid Gland

STUDY DESIGN: A case report and review of the literature. OBJECTIVES: To discuss an epidural hemangioma and review the literature. MATERIAL AND METHOD: A 56-year-old woman had back pain and pain radiating to the left lower extremity that had gradually worse over 2 weeks. No definite history of trauma was disclosed. The straight leg raising test was positive at 60degree on the left side. Sensation to pinprick was diminished in the L5, S1 dermatome on her left leg. Examination of the left leg revealed weakness of the extensor hallucis longus(3/5 strength). Plain films of the lumbar spine showed degenerative scoliosis and degenerative L4-5 spondylolisthesis with no bone involvement. In retrospective study, T1-,T2-weighted image showed a hyperintense signal mass, unlike an usual MR imaging of epidural hemangioma. A preoperative diagnosis of spondylolisthesis with spinal stenosis was made. RESULTS: The mass compressing L5 root was excised through posterior approach and the fusion was performed from L4 to S1 with bone graft, instumentation. A purple encapsulated tumor, size 1.5x1x.8cm, was found. Histopathologic examination revealed a thin walled sinusoidal vascular space of varying sizes, lined with a single layer of endothelial cells, consistent with typical hemangioma. The patient had a complete neurologic recovery and is doing well 5 months after surgery. CONCLUSIONS: Although the diagnosis of epidural hemangioma was difficult, because of the rarity of that, we should pay attention to awareness of the possibility of such lesion, differential diagnosis in clinical manifestration, neuroradiologic study.
Back Pain ; Diagnosis ; Diagnosis, Differential ; Endothelial Cells ; Female ; Hemangioma* ; Humans ; Leg ; Lower Extremity ; Magnetic Resonance Imaging ; Middle Aged ; Radiculopathy ; Retrospective Studies ; Scoliosis ; Sensation ; Spinal Stenosis ; Spine ; Spondylolisthesis ; Transplants