Early detection of skeletal disorders was very important role in establishing therapeutic modality and prevention of complications. Since Tc-99m-phosphates derivatives used in bone scan agent, remarkable improvement was noted in effectiveness, cost, radiation hazard to patient and image quality than previously used agents such as strontium or fluoride. Bone scan with Tc-99m-MDP was done in 155 cases for early diagnosis of skeletal disorders at Severance Hospital, College of Medicine, Yonsei University from August, 1980 to May, 1982 were analyzed both clinically and radiologically, and the following results were obtained. l. Among 19 cases of avascular necrosis, positive cases were 17 (89.5%) in bone scan and 6(31.6%) in X-ray. Positive pattern could be classified into 3 types and the radionuclide uptake in the femoral head was decreased in 3 cases which was negative in X-ray and duration of their symptoms was within 4 months. 2. Fifteen among 17 hip fractures or dislocations were positive in bone scan. In 12 (80.0%) among 15 cases, complications were revealed and positive cases in X-ray were 7(58.3%), which were all positive in bone scan. 3. In 20 bone scans for early diagnosis of acute osteomyelitis, positive in bone scan were 17 and 14 (82.4%) of 17 cases were finally diagnosed as acute osteomyelitis. Among 15 cases diagnosed as acute osteomyelitis, positive in X-ray were 8(53.3%) and sensitivity of acute osteomyelitis in bone scan was 93.3%. 4. In 25 cases of the suspected infection of the joint, 15 were positive in bone scan and among them, cases diagnosed as pyogenic arthritis were 12 (80.0%) and positive in X-ray were 2 (16.7%). Only one of 10 cases of transient synovitis of the hip joint was positive in bone scan. 5. In rheumatoid arthritis, 13 of 15 cases were positive in bone scan and 10 among them were revealed the diffuse uptake of the radionuclide in the joint. In degenerative arthritis, 7 of 8 cases were positive in bone scan and they were revealed the focal uptake of the radionuclide in the same site where the bone was changed in x-ray. 6. Among 28 cases showed spine fracture in X-ray after trauma, 15 (53.6%) were positive in bone scan. In spine fracture, it was difficult to differentiate fresh fracture from old fracture with bone scan. The positive duration of bone scen in fracture of weight bearing bone was longer than in spine fracture. Rib fracture which was not found in X-ray could be diagnosed with bone scan.
Arthritis ; Arthritis, Rheumatoid ; Clinical Study ; Cost-Benefit Analysis ; Diagnosis ; Dislocations ; Early Diagnosis ; Fluorides ; Head ; Hip Fractures ; Hip Joint ; Humans ; Joints ; Necrosis ; Osteoarthritis ; Osteomyelitis ; Rib Fractures ; Spine ; Strontium ; Synovitis ; Weight-Bearing

Speckled lentiginous nevus is a clinical variant of nevus-cell nevus first described by Stewart et al. in 1978. It is characterized by small, dark hyperpigmentated speckles superimposed on a tannish-brown background. The speckled areas show varying histologic patterns ranging from nevus incipiens to junctional or compound nevus. The back ground shows histologic features of Ientigo simplex. Recently, we observed clinical and histological features of 5 cases of speckled lentiginous nevi. The age of onset ranges from birth to infancy, The locations are face, thigh, back and scapula. One has zosteriform distribution in upper extrernity, chest and back. Histologic features of speckles are junctional or compound nevus. We suggest that the origin of dark speckles may be from the tannish-brown background, lentigo simplex.
Age of Onset ; Lentigo ; Nevus* ; Parturition ; Scapula ; Thigh ; Thorax

Proliferative activity of a malignant tumor is known to reflect its biological aggressiveness. Proliferating cell nuclear antigen (PCNA) is a marker of cellular proliferation, and silver-stained nucleolar organizer regions (AgNORs) have been shown to correlate with ploidy and proliferative activity of cells. In transitional cell carcinoma of the renal pelvis, the prognostic value of these markers has not been well defined. We studied PCNA expression and the AgNORs count in 22 transitional cell carcinoma of the renal pelvis to assess their prognostic significance compared with their cumulative survival rate, the stage of disease and histopathologic features of the tumors. An immunohistochemical method and a standard colloidal silver staining were used. The mean percentage of PCNA positivity (PCNA index) and the mean number of AgNORs per nucleus (AgNORs score) were determined. In a multivariable analysis, PCNA indexes were significantly associated with tumor stage (p=0.024), whereas AgNORs scores were not significantly associated with the stage or histopatholgic features of the tumors. Histologic grade was correlated to disease stage at a significant level (p=0.000). But there was a trend of low tumor PCNA-indices or AgNORs counts with survival advantage for patients, but this did not reach statistical significance. The results suggest that the fraction of PCNA positive nuclei would be useful for investigating the malignant potential of renal pelvic cancers, although their clinical use as markers of biologic behavior may be limited.
Carcinoma, Transitional Cell* ; Cell Proliferation ; Colloids ; Humans ; Kidney ; Kidney Pelvis* ; Nucleolus Organizer Region ; Pelvic Neoplasms ; Ploidies ; Proliferating Cell Nuclear Antigen* ; Silver Staining ; Survival Rate

No abstract available in English.
Clinical Study ; Neck

BACKGROUND: Ichthyosis is the name of a group of disorders characterized by a generalized, persistent, non-inflammatory scaling disorder of the skin. Filaggrin is an intermediate filament associated protein which functions to aggregate keratin intermediate filaments in the stratum corneum of mamrnalian epidermis. It is synthesized as a large precursor protein, profilaggrin, that consists of multiple filaggrin units and is localized in keratohyalin granules(KHG). Some reports elucidated the pathogenetic role of filaggrin in ichthyosis, especially autosomal-dominant ichthyosis(ADI). OBJECTIVE: We conducted an immunohistochemical study in order to observe the relationship between clinical phenotypes of various ichthyosiform dermatoses and the exprassion of filaggrin. MATERIALS AND METHODS: Clinically and histopathologically proven ADI, lamellar exfoliation of the newborn, lamellar ichthyosis, epidermolytic hyperkeratosis, and acquired ichthyosis cases were included in this study. Using monoclonal mouse anti-human filaggrin antibodies, an immunohisto-chemical study was performed with formalin-fixed, parraffin-embedded involved skin tissues via the ABC technique. RESULTS: Filaggrin was staind linearly or in a punctuate pattern along the granular cell layer of the normal epidermis. The expression of the filaggrin was decreased or partly absent in the skin tissue of ADI in accordance with the changes of KHGs. Similar immunoreactivities with filaggrin antibodies were noted in the skin of acquired ichthyosis. In lamellar exfoliation of the newborn, filaggrin was staineil from the stratum granulosum to the mid-layer of the stratum corneum with basket-weave byperkeratosis. Filaggrin was intensely and focally labelled in the normal acrosyringium of the lamellar ichthyosis from the granular layer to the mid horney layer. A decreased positive immunorcactivity was observed in the interfollicular stratum granulosum. A strong immunoreactivity was noted in the area with relatively normal KHGs of epidermolytic hyperker atosis, and a decreased l membranous staning pattern was observed in the layer with degenerated vacuolar KHGs. CONCLUSION: It can be concluded that decreased expression of filaggin may play a causative role in the pathogenesis of ADI. However in lamellar exfoliation of the newborn, lamellar ichthyosis, epidermolytic hyperkeratosis, and acquired ichhtyosis, the altered expression of filaggrin must reflect the changes of KHGs in the stratum granulosum.
Animals ; Antibodies ; Epidermis ; Humans ; Hyperkeratosis, Epidermolytic ; Ichthyosis ; Ichthyosis, Lamellar ; Immunohistochemistry ; Infant, Newborn ; Intermediate Filaments ; Mice ; Phenotype ; Skin ; Skin Diseases*

PURPOSE: To analyze the end results of the treatment for patients with wide gap non-unions of the long bones in the lower extremities. MATERIALS AND METHODS: A total of 62 cases of wide gap unions, with a mean age of 38 years, were included for analysis. Study cohort included six children under the age of seven years. The average size of established bone defect was 7 cm (4-23 cm). Bone defects under 7 cm were treated with plating and various bone grafts, and those over 7 cm were managed with vascularized fibular graft (VFG), distraction-osteogenesis, tibial strut, plating and etc. Two boys with a defect of the whole tibia but with an intact fibula were treated with tibialization of intact fibula and with rotation-plasty of the leg. Their end results were evaluated by the time of bony union in accordance with the treatment of defect size of the long bone as well as their age. RESULTS: Bony unions were obtained for an average period of at least 27 months. Fifty-one cases showed an average leg-length discrepancy of 2.8 cm, and 11 cases showed no leg-length discrepancy. The VFG, distraction-osteogenesis, and tibial cortical-strut graft and plating were the most effective methods for non-unions of wide, long bone defections (>7 cm). The prognosis was more favorable in children, muscular femur, and in cases with tibial defect but intact fí bula. CONCLUSION: Various bone union techniques should be considered carefully, considering the ages of patients and the size of bone defects. Due to severe physical and mental disabilities of patients during the long-treatment period, specialized orthopedic doctors for trauma and mental care were necessary.
Child ; Cohort Studies ; Femur ; Fibula ; Fractures, Open ; Humans ; Leg ; Lower Extremity* ; Orthopedics ; Prognosis ; Tibia ; Transplants

PURPOSE: To analyze the end results of the treatment for patients with wide gap non-unions of the long bones in the lower extremities. MATERIALS AND METHODS: A total of 62 cases of wide gap unions, with a mean age of 38 years, were included for analysis. Study cohort included six children under the age of seven years. The average size of established bone defect was 7 cm (4-23 cm). Bone defects under 7 cm were treated with plating and various bone grafts, and those over 7 cm were managed with vascularized fibular graft (VFG), distraction-osteogenesis, tibial strut, plating and etc. Two boys with a defect of the whole tibia but with an intact fibula were treated with tibialization of intact fibula and with rotation-plasty of the leg. Their end results were evaluated by the time of bony union in accordance with the treatment of defect size of the long bone as well as their age. RESULTS: Bony unions were obtained for an average period of at least 27 months. Fifty-one cases showed an average leg-length discrepancy of 2.8 cm, and 11 cases showed no leg-length discrepancy. The VFG, distraction-osteogenesis, and tibial cortical-strut graft and plating were the most effective methods for non-unions of wide, long bone defections (>7 cm). The prognosis was more favorable in children, muscular femur, and in cases with tibial defect but intact fí bula. CONCLUSION: Various bone union techniques should be considered carefully, considering the ages of patients and the size of bone defects. Due to severe physical and mental disabilities of patients during the long-treatment period, specialized orthopedic doctors for trauma and mental care were necessary.
Child ; Cohort Studies ; Femur ; Fibula ; Fractures, Open ; Humans ; Leg ; Lower Extremity* ; Orthopedics ; Prognosis ; Tibia ; Transplants

Malignant bone tumors would be classified as primary malignant bone tumors, secondary malignant bone tumors, and metastatic bone tumors. Primary malignant bone tumors are rare diseases occupying 1% of adult cancers, and 6% of pediatric cancers. The chief complaint of malignant bone tumor patients is pain different from that of malignant soft tissue tumor patients. Diagnostic procedures start with clinical evaluation including current illness, past medical history, family history, and physical examination. Then we take a radiograph first and obtain important and diagnostic clues from it. However pathological diagnosis and information about the extent of tumor are required to obtain a more definite diagnosis and staging. Examinations for detection of local and systemic tumor extent are scintigraphy, computed tomography (CT), magnetic resonance imaging, and positron emission tomography-CT. If the clinical and radiographic information suggests aggressive or malignant bone tumor, the patient should be referred to a bone tumor specialist without further evaluations.
Adult ; Biopsy ; Bone Neoplasms ; Diagnosis ; Electrons ; Humans ; Magnetic Resonance Imaging ; Physical Examination ; Radionuclide Imaging ; Rare Diseases ; Specialization

Purpose: Triple-negative breast cancer (TNBC) represents a major clinical challenge due to its aggressive and metastatic behavior and the lack of available targeted therapies. Therefore, therapeutic strategies are needed to improve TNBC patient management. Recently, atezolizumab and nab-paclitaxel chemotherapy has been approved by the Food and Drug Administration for the first-line treatment of patients with locally advanced and metastatic TNBC. The programmed death-ligand 1 (PD-L1) immunohistochemical SP142 assay was also approved as a companion diagnostic device for selecting TNBC patients for atezolizumab treatment. This study aimed to evaluate and compare the analytical performance of the PD-L1 22C3/SP263 assays in comparison with the SP142 assay for ≥ 1% immune cells (ICs). Methods: Immunohistochemical expression for the PD-L1 22C3/SP263 assays, in comparison with the SP142 assay, was analyzed for the ≥ 1% ICs in 95 TNBCs. Results: At the 1% cut-off value, the proportions of positive cases were 52.6% for the SP142 assay in infiltrating ICs and 50.5% and 52.6% for the 22C3 and SP263 assays in tumor cells, respectively. The PD-L1 SP263 assay had the highest while the PD-L1 22C3 assay had the lowest total positive expression rate at all cut-off values. The concordance rate between the assays was highest at a 1% cut-off value and decreased when the cut-off value increased.The concordance rate between the SP142 and SP263 assays at 1% cut-off was high, while in comparison, the concordance rate between the SP142 and 22C3 assays at 1% cut-off was relatively lower. Conclusion This study demonstrates that although the 22C3 assay at a 1% cut-off value compared with the PD-L1 SP142 assay at the clinically relevant cut-off shows comparable but not interchangeable analytical performance, the analytical performance of the SP263 assay at a 1% cut-off value shows interchangeable performance with the PD-L1 SP142 assay at the clinically relevant cut-off.

BACKGROUND: This study was aimed at preparing basic data required for establishment of a cancer screening program by evaluating the screening rate and related factors in rural and urban areas. METHODS: The study population of 2,157 respondents was selected by a random cluster sampling method in one rural area (Gun) and one urban area (Gu). The subjects answered the structured questionnaire. The Andersen model was used to evaluate the related factors. RESULTS: The results by proportions of the study population who had received cancer screening tests in the last three years were 8.9% for stomach cancer, 10.5% for hepatic cancer, 4.5% for colorectal cancer, 46.3% for cervical cancer and 16.0% for breast cancer. Application of Andersen model revealed that sex, age, education level, economic status, knowledge and alcohol drinking for stomach cancer; sex age, knowledge alcohol drinking, and smoking for liver cancer; sex, age, education level, marital satus, knowledge, alcohol drinking, and smoking for colorectal cancer; age, eucational level, marital status, area, economic status and attitude for cervical cancer; age, area, attitude and family history for breast cancer were significant. CONCLUSION: These results could be used to develop a program that facilitates change of community people's knowledge and attitude and practice of health behavior.
Alcohol Drinking ; Breast Neoplasms ; Colorectal Neoplasms ; Surveys and Questionnaires ; Early Detection of Cancer* ; Education ; Health Behavior ; Humans ; Liver Neoplasms ; Marital Status ; Mass Screening ; Smoke ; Smoking ; Stomach Neoplasms ; Uterine Cervical Neoplasms