Well differentiated osteosarcomas are variants of osteosarcoma composed mainly of fibrous and osseous tissue with minimal cystologic atypia. This tumor may be misinterpretated as a benign lesion if the radiologic and clinical features are not taken into account. We report a typical case of intraosseous well differentiated osteosarcoma occuring in the left distal femur of a 58-year-old woman. Radiologically, it appered as an ill-defined lesion with a mixture of sclerotic and osteolytic ares. But there was a lack of highly destructive appearance of conventional osteosarcoma. Grossly, the mass occupied a metaphysis of the distal femur with extension into the diaphysis and epiphysis. Multifocal cortical destruction and sclerosis were also associated. Histologically, the mass showed typical features of intraosseous well differentiated osteosarcoma. There were various patterns of osteoid deposits and bone formation mimicking those of fibrous dysplasia, nonossifying fibroma or parosteal osteosarcoma.
Female ; Humans

It is notoriously difficult to obtain a sound bony union of large segmental bone defects secondary to trauma or following tumor resection, infected nonunion, congenital pseudarthrosis of the tibia, and avascular necrosis of the femoral head with conventional methods. Recent advances in microsurgery have made it possible to provide a continuing circulation of blood in bone grafts so as to ensure viability. With the nutrient blood supply preserved, healing of the graft to the recipient bone is facilitated without the usual replacement of the graft by creeping substitution. Thus, the grafted bone is achieved more rapid stabilization of bone fragments separated by a large defect without sacrificing viability. Thirty nine cases of the free vascularized fibular graft had been performed in the Department of Orthopedic Surgery, Kyung Hee University Hospital during the period of 3 years from October 1978 to December 1981. Of these, ll cases were congenital pseudarthrosis of the tibia, 4 cases were tuberculous spondylitis, 4 cases were infected nonunion, 7 cases were large segmental bone defects secondary to trauma, 9 cases were avascular necrosis of the femoral head and the other was one case. The results were obtained as follows: 1. The advantages of free vascularized living fibular graft are one stage procedure, resistance of torsion and angular stress, union with rapid hypertrophy of the graft, a shorter immobilization period and more rapid incorporation of the graft into the recipient area. 2. Free vascularized fibular graft can be widely used in the field of Orthopedic surgery. 3. The fibula is the bone best suited for reconstruction of a defect in a long bone. 4. In children, distal tibiofibular synostosis must be performed. 5. For prevention of clawing toe, the muscles around the bone is meticulously dissected, 6. Evaluation by selective arteriography and isotopic scanning both before and after operation may be used to assess the viability of the fibula graft.
Angiography ; Animals ; Child ; Fibula ; Head ; Hoof and Claw ; Humans ; Hypertrophy ; Immobilization ; Microsurgery ; Muscles ; Necrosis ; Orthopedics ; Pseudarthrosis ; Spondylitis ; Synostosis ; Tibia ; Toes ; Transplants

Eleventh heel pad reconstruction with neurovascularized dorsalis pedis free flap or rotation flap have performed during recent three years in department of Orthopedic Surgery, Kyung Hee University Hospital. Neurovascularized dorsalis pedis free flaps were seven and neurovascularized dorsalis pedis rotation flaps were four. All patients had complained of painful limping and ulceration in grafted heel. In 5 months to 34 months follow up study, the following results were obtained. The success rate of dorsalis pedis flap was 100% except one partial peripheral necrosis. The weight bearing function and tactile protective sensation on reconstructed heel pads were excellent. Neurovascularized dorsalis pedis free flap or rotation flap is recommended to satisfactory methods in heel pad reconstruction. Neurovascularized dorsalis pedis rotation flap easier and safer technique than neurovascularized dorsalis free flap.
Follow-Up Studies ; Free Tissue Flaps ; Heel ; Humans ; Necrosis ; Orthopedics ; Sensation ; Transplants ; Ulcer ; Weight-Bearing

No abstract available.
Autopsy* ; Enzyme-Linked Immunosorbent Assay*

Globally, cancer research has been considered one of the most important field of biomedical researches. Recently, in Korea, there are increasing concerns about cancer research and the development of national cancer control programme. For the efficient investment in cancer research at the national level, strategic approach is needed based on the nationwide information about current status of research. However even the basic data on cancer research have not been systematically collected, and are not available when necessary. The aim of this study is to assess current status of cancer research. For this purpose, this study applied two round Delphi method in which fifteen experts in cancer research fields participated. They rated each items on the initial list at the first round, and modified their responses at the second round. Panels responded that pathogenesis of cancer, research and development of cancer drug, and oncogene, etc. are the most urgent and important research fields. They assessed national level of cancer research as being 49.6% of the world highest level. Coefficient of variation tended to be lowered with the iteration. Predictive stability was evaluated to be lower in items of urgency than in items of importance and research level. Although this study shares the same limitations in the selection of the experts with many other Delphi studies, it provides a primary data that would be required to plan the national strategy of the cancer research.
Delphi Technique ; Forecasting ; Investments ; Korea ; Oncogenes ; Technology Assessment, Biomedical

Recent evidence shows that transcriptional silencing as a consequence of hypermethylation of CpG islands is an important mechanism in the inactivation of p16INK4 tumor suppressor gene. This study is designed to clarify the significance of p16INK4 hypermethylation in 23 cases of glioblastomas (GBMs) by methylation-specific polymerase chain reaction (PCR) and p16 immunostaining. Fourteen cases (60.9%) out of 23 GBMs revealed hypermethylation on p16. p16 immunostaining revealed that 13 (93%) of these 14 hypermethylation cases showed complete loss of immunoreactivity and only one (7%) case retained immunoreactivity. Among 9 methylation-negative cases, 4 were immunonegative, which might be related to mutations or deletions other than hypermethylation. The most significant finding was that of 17 cases with immunonegativity, 13 cases (76.5%) showed hypermethylation. We reconfirmed that p16 hypermethylation may be one of the major mechanisms of tumorigenesis of GBMs and the results between the methylation specific-PCR study and p16 immunostaining had a good correlation.
5' Untranslated Regions/metabolism* ; 5' Untranslated Regions/genetics ; Adult ; Antisense Elements (Genetics) ; Brain Neoplasms/pathology ; Brain Neoplasms/genetics* ; Brain Neoplasms/chemistry ; CpG Islands/physiology* ; DNA Methylation* ; Female ; Gene Silencing/physiology ; Glioblastoma/pathology ; Glioblastoma/genetics* ; Glioblastoma/chemistry ; Human ; Male ; Middle Age ; Polymerase Chain Reaction ; Protein p16/genetics* ; Protein p16/analysis

In Korea, the quality control(QC) program forcytopathology was introduced in 1995. The program consists of a checklist for the cytolopathology departments, analysis data on all the participating institutions' QC data, including the annual data on cytologic examinations, the distribution of the gynecological cytologic diagnoses, as based on The Bethesda System 2001, and the data on cytologic-histolgical correlation of the gynecological field, and an evaluation for diagnostic accuracy. The diagnostic accuracy program has been performed 3 times per year with using gynecological, body fluid and fine needle aspiration cytologic slides. We report here on the institutional QC data and the evaluation for diagnostic accuracy since 2004, and also on the new strategy for quality control and assurance in the cytologic field. The diagnostic accuracy results of both the participating institutions and the QC committee were as follows; Category 0 and A: about 94%, Category B: 4~5%, Category C: less than 2%. As a whole, the cytologic daignostic accuracy is relatively satisfactory. In 2008, on site evaluation for pathology and cytology laboratories, as based on the "Quality Assurance Program for Pathology Services" is now going on, and a new method using virtual slides or image files for determining the diagnostic accuracy will be performed in November 2008.
Biopsy, Fine-Needle ; Body Fluids ; Checklist ; Korea ; Quality Control

BACKGROUND: Mesial temporal sclerosis (MTS) is a well-known cause of temporal lobe epilepsy. Coexistence with cortical dysplasia (CD) has been reported, but its role is not well recognized. This study aims to determine whether there is any difference about clinical feature and surgical outcome between patients with MTS and coexistent CD (group 1) and patients with isolated MTS (group 2). METHODS: Retrospectively, surgical series of 45 patients (male:22, female:23) diagnosed as temporal lobe epilepsy were reviewed. We excluded patients who had another pathology (e. g., tumor, vascular malformation) except MTS or CD. The pathology, case histories, interictal EEG, and surgical outcome were compared. RESULTS: There was a tendency for group 1 patients to have earlier seizure onset age (10.9+/-6.35 versus 14.5+/-6.03, p=0.06) There was no statistically significant difference in the history of febrile convulsions (68.4% versus 53.8%, p>0.16) No statistically significant difference between groups were also found in disease duration, the head trauma/mental retardation history, seizure frequency, interictal EEG, and surgical outcome. CONCLUSIONS: CD in MTS appears to have an influence on seizure onset. The relationships among CD, febrile convulsion, and mesial temporal sclerosis must be more investigated.
Age of Onset ; Electroencephalography ; Epilepsy, Temporal Lobe* ; Head ; Humans ; Malformations of Cortical Development* ; Pathology* ; Retrospective Studies ; Sclerosis* ; Seizures ; Seizures, Febrile ; Temporal Lobe*

BACKGROUND: Mesial temporal sclerosis (MTS) is a well-known cause of temporal lobe epilepsy. Coexistence with cortical dysplasia (CD) has been reported, but its role is not well recognized. This study aims to determine whether there is any difference about clinical feature and surgical outcome between patients with MTS and coexistent CD (group 1) and patients with isolated MTS (group 2). METHODS: Retrospectively, surgical series of 45 patients (male:22, female:23) diagnosed as temporal lobe epilepsy were reviewed. We excluded patients who had another pathology (e. g., tumor, vascular malformation) except MTS or CD. The pathology, case histories, interictal EEG, and surgical outcome were compared. RESULTS: There was a tendency for group 1 patients to have earlier seizure onset age (10.9+/-6.35 versus 14.5+/-6.03, p=0.06) There was no statistically significant difference in the history of febrile convulsions (68.4% versus 53.8%, p>0.16) No statistically significant difference between groups were also found in disease duration, the head trauma/mental retardation history, seizure frequency, interictal EEG, and surgical outcome. CONCLUSIONS: CD in MTS appears to have an influence on seizure onset. The relationships among CD, febrile convulsion, and mesial temporal sclerosis must be more investigated.
Age of Onset ; Electroencephalography ; Epilepsy, Temporal Lobe* ; Head ; Humans ; Malformations of Cortical Development* ; Pathology* ; Retrospective Studies ; Sclerosis* ; Seizures ; Seizures, Febrile ; Temporal Lobe*

BACKGROUND: The objective of this study was to evaluate a newly-developed EASYPREP liquid-based cytology method in cervicovaginal specimens and compare it with SurePath. METHODS: Cervicovaginal specimens were prospectively collected from 1,000 patients with EASYPREP and SurePath. The specimens were first collected by brushing for SurePath and second for EASYPREP. The specimens of both methods were diagnosed according to the Bethesda System. Additionally, we performed to REBA HPV-ID genotyping and sequencing analysis for human papillomavirus (HPV) on 249 specimens. RESULTS: EASYPREP and SurePath showed even distribution of cells and were equal in cellularity and staining quality. The diagnostic agreement between the two methods was 96.5%. Based on the standard of SurePath, the sensitivity, specificity, positive predictive value, and negative predictive value of EASYPREP were 90.7%, 99.2%, 94.8%, and 98.5%, respectively. The positivity of REBA HPV-ID was 49.4% and 95.1% in normal and abnormal cytological samples, respectively. The result of REBA HPV-ID had high concordance with sequencing analysis. CONCLUSIONS: EASYPREP provided comparable results to SurePath in the diagnosis and staining quality of cytology examinations and in HPV testing with REBA HPV-ID. EASYPREP could be another LBC method choice for the cervicovaginal specimens. Additionally, REBA HPV-ID may be a useful method for HPV genotyping.
Cytological Techniques ; Humans ; Prospective Studies ; Sensitivity and Specificity ; Vaginal Smears