PURPOSE: This study was done to determine the diagnostic efficacy of clinical examination, fine needle aspiration (FNA) cytology, mammography, and ultrasonography in palpable breast mass. METHODS: We performed 248 FNA cytologies for a palpable breast mass, among which 106 cases were histologically examined during the period from Jan. 1994 to Dec. 1997 at the Department of Surgery, Chonbuk National University Hospital. Among the 106 patients, mammography was done for 96 patients, and ultrasono graphy for 73 patients. RESULTS: The main clinical symptom was a palpable mass in the breast at the time of visitation. Clinical diagnosis based on symptoms and physical examination had a sensitivity of 96.9% and a specificity of 57.5%. Based on a definite histologic diagnosis, the sensitivity of FNA cytology was 96.9%, its specificity was 91.7%, and its diagnostic accuracy 93.5%. 86.1% of the cytologically malignant cases proved to be malignant histologically, and 100% of the cytologically benign cases turned out histologically benign. Mammography had a sensitivity of 89.3%, a specificity of 84%, and a diagnostic accuracy of 86.8%. Ultrasonography showed a 93.5% sensitivity, a 51.4% specificity, and a 74.6% diagnostic accuracy. CONCLUSION: FNA cytology was a reliable and safe diagnostic method compared to physical examination, mammography, and ultrasonography. FNA cytology of a palpable breast mass should be the diagnostic procedure of choice for those patients classified clinically as probably benign or malignant.
Biopsy, Fine-Needle* ; Breast* ; Diagnosis ; Humans ; Jeollabuk-do ; Mammography* ; Physical Examination ; Sensitivity and Specificity ; Ultrasonography*

No abstract available.
Heart Septal Defects, Atrial* ; Hemodynamics*

No abstract available.
Genioplasty*

BACKGROUND: Stereotactic core biopsy has been advocated as an alternative to open biopsies with needle localization which had been the mainstay of treatment for evaluating nonpalpable mammographic abnormalities. Recently, the ABBI (Advanced Breast Biopsy Instrumentation) system was developed. It enables complete removal of the entire lesion with local anesthesia and ambulatory care. METHODS: We analysed our results for 110 cases of nonpalpable mammographic lesions revealed by stereotactic core biopsies using a 14-gauge needle (n=42) or stereotactic excisional biopsy using the ABBI system (n=68) since December 1997 at the Samsung Medical Center. RESULTS: Of the 110 cases, 13 cases of malignancy were diagnosed, including 9 cases (69%) of DCIS (ductal carcinoma in situ). The pathologic results of the 6 cancers revealed by stereotactic core biopsy had same as the results from the surgical specimens including 5 DCIS and one infiltrating ductal carcinoma. Of the 7 cancers revealed by the ABBI system 4 were DCIS, 1 was LCIS (lobular carcinoma in situ), 1 was an infiltrating ductal carcinoma, and 1 was a mucinous carcinoma. Needle localization biopsy was performed in 5 patients who had benign results from the stereotactic core biopsy, despite the existence of mammographically suspicious lesions. Of these, 2 DCIS cases were finally revealed. CONCLUSIONS: The ABBI system is more ideal than stereotactic core biopsy and allows the advantageous replacement of needle localization and excisional biopsy in selected patients.
Adenocarcinoma, Mucinous ; Ambulatory Care ; Anesthesia, Local ; Biopsy* ; Breast* ; Carcinoma, Ductal ; Carcinoma, Intraductal, Noninfiltrating ; Humans ; Mammography ; Needles

OBJECTIVES: Using a retrospective analysis on the fusion rate and the postoperative improvement in symptoms, this study evaluated the clinical feasibility of a bone graft in lumbar fusion surgery in the following cases: (1) Group I: local autograft, (2) Group II: local autograft and iliac crest autograft, and (3) Group III: local autograft and customized heterograft. MATERIALS AND METHODS: Among the patients who had undergone a decompression and lumbar posterolateral fusion for various lumbar diseases, between January 1997 and December 1999, 178, in who 2 year follow-up observations had been possible, were selected for this study. The patients were allocated to 1 of 3 groups, Group I (47 patients), Group II (57 patients) and Group III (74 patients). For each group, the mean patient ages were 58.3, 49 and 62.4 years old, respectively, with male to female ratios of 24:23, 23:24 and 36:38. Postoperative radiographs were taken at 2 weeks, 3 months and 1 year, and further follow-up observations were conducted at 1-year intervals. The bone fusions was determined, along with the fusion rates, based on Lenke's criteria, and the post-operative clinical outcomes were evaluated as excellent, good, normal and poor, using Kim's method. A statistical analysis was performed with Chi-square tests. RESULTS: From the follow-up observations for over a year, the radiographic evaluations showed that the fusion rates of Groups I and II, over B: 86.6 and over B: 88.9%, were superior to the over B: 80.1% of Group III, but with no statistical significance. For the clinical outcomes, the 78.1 88% over good results were superior to the 69.4% of Group III, which also showed statistical significance. CONCLUSIONS: The selective use of customized heterograft was assumed to be effective in an insufficient autogenous bone or a difficult autogenous bone collection even though it causes significantly lower improvement in the symptoms.
Autografts ; Decompression ; Female ; Follow-Up Studies ; Heterografts ; Humans ; Male ; Retrospective Studies ; Transplants*

PURPOSE: This study was aimed at assessing the difference of the prevalence of iron deficiency and iron deficiency anemia among rural and urban middle school students in relation to dietary habit. METHODS: With a questionnaire, blood samples were obtained from 439 apparently healthy rural and urban middle school students residing in Ulsan. Anemia was defined as hemoglobin level of 12.6 g/dL or less for boys and 11.9 g/dL or less for girls. Iron deficiency was defined as serun ferritin level less than 12 micrograms/L or/and transferrin saturation less than 14%. Iron deficiency anemia was defined as iron deficiency plus low hemoglobin. RESULTS: 1) In boys, the prevalence rate of anemia was 17.2%. Among these anemias, 5.4% were found to be iron deficiency anemia. In girls, the prevalence of anemia increased with age. The prevalence of iron deficiency anemia was 6.9%. 2) In girls, the prevalence rate of anemia in rural area was higher than that of anemia in urban area (12.6% in rural, 6.1% in urban, P<0.01). 3) The prevalence of anemia and iron deficiency in the students with menstruation was 10.6% and 33.1%, which was higher than the prevalence of 2.5% and 7.5% in those who did not have the menarche (P<0.001 and P<0.001, respectively). 4) Dietary intake of rural and urban middle school students was estimated lower in energy, iron than the recommeded dietary allowance (RDA). In girls, dietary intake of rural middle school students was estimated lower in iron, niacin, and vitamin C than that of urban middle school students. 5) Nutritional factors such as energy, carbohydrate, protein, and phosphorus showed positive correlation with RBC, hemoglobin (P<0.05). CONCLUSION: It is recommended to enforce the nutritional education to take enough iron in middle school students to reduce the high prevalence rate of anemia among pubertal students.
Anemia* ; Anemia, Iron-Deficiency ; Ascorbic Acid ; Education ; Female ; Ferritins ; Food Habits ; Humans ; Iron* ; Menarche ; Menstruation ; Niacin ; Phosphorus ; Prevalence ; Surveys and Questionnaires ; Transferrin ; Ulsan*

PURPOSE: The role of the amniotic membrane with or without radiation was investigated with regard to preventing adhesion after flexor tenorrhaphy of chicken. MATERIALS AND METHODS: Nine chicken were divided into three groups. The second flexor tendon of the chicken was operated on. In group A, the flexor tendon was excised and one half and the tendon was repaired. In group B, the repaired tendon was covered with an amniotic membrane. In group C, the repaired tendon was covered with a lyophilised and 25 kGy irradiated amniotic membrane. The gross and histology findings on the level of inflammation and fibrosis of the repaired tendon were evaluated at 3, 6 and 9 weeks after surgery. RESULTS: Group C had the least inflammatory cell infiltration and fibroblast proliferation at any time. CONCLUSION: The use of radiated amniotic membrane was effective in preventing inflammation and adhesion after flexor tenorrhaphy in chickens.
Amnion* ; Chickens* ; Fibroblasts ; Fibrosis ; Inflammation ; Tendons ; Tissue Adhesions*

BACKGROUND: Most stroke patients are unable to receive thrombolytic therapy because they do not reach a hospital within 3 hours from symptom onset. The aim of this study was to determine the factors (including knowledge of stroke) that affect the admission delay. METHODS: From May 2007 to December 2007, consecutive ischemic stroke patients presenting within 3 days from symptom onset and their relatives were interviewed about their knowledge of the following aspects of stroke: stroke warning signs, thrombolytic therapy, the 3-hour time limit for admission delay, and use of emergency medical services. Clinical data of patients were collected from medical records. RESULTS: One hundred and fifty-three patients were finally included, 37 of which (24.2%) reached our hospital within 3 hours from symptom onset. In univariate and multivariate analyses, factors independently associated with an admission delay of less than 3 hours were age (odds ratio [OR]=0.95, 95% confidence interval [CI]=0.91.0.99; p=0.008), atrial fibrillation (OR=5.02, CI=1.35.18.70; p=0.016), NIHSS score at admission (OR=1.09, CI=1.01.1.18; p=0.028), and knowledge of the 3-hour time limit (OR=3.55, CI=1.45.8.72; p=0.006). In the patients with an NIHSS score of >4 points, knowledge of the 3-hour time limit was the only independent factor associated with an admission delay of less than 3 hours. This knowledge was significantly associated with graduation from high school (p=0.038). CONCLUSIONS: Knowledge of the 3-hour time limit was the only modifiable factor that influenced an admission delay of less than 3 hours. Therefore, educating the public about stroke, including about the 3-hour time limit, could increase the ability to apply thrombolysis to acute stroke patients.
Atrial Fibrillation ; Emergency Medical Services ; Humans ; Multivariate Analysis ; Stroke ; Thrombolytic Therapy

Malignancy-related cerebral embolism, which is generally attributed to hypercoagulability, is an uncommon cause of ischemic stroke. However, ischemic stroke developed with intracardiac extension of lung cancer has rarely been reported. We report a case of acute embolic stroke caused by pulmonary adenocarcinoma that invaded the right inferior pulmonary vein and extended into the left atrium. Microembolism developing as a result of lung cancer may have been the cause of stroke in this case.
Adenocarcinoma ; Cerebral Infarction ; Heart Atria ; Intracranial Embolism ; Lung Neoplasms ; Pulmonary Veins ; Stroke ; Thrombophilia

BACKGROUND: Transforming growth factor- alpha(TGF-alpha) may play important roles in carcinogenesis, tumor growth, and angiogenesis. Transforming growth factor-beta(TGF-beta) are known to be involved in cell-cycle control and regeneration. TGF-alpha positively acts on growth control of many epithelial cells in contrast to the negative role of TGF-beta. METHOD: To evaluate the possible role of TGF-alpha and TGF-beta in human primary lung cancers, the expression of TGF-alpha and TGF-beta were immmunohistochemically investigated in tissue sections from forty seven cases with lung cancers and ten cases with non-cancerous lung tissues. Recombinant cloned monoclonal antibody of TGF-alpha and neutralizing antibody of TGF-beta were employed as primary antibodies after dewaxing the formalin-fixed, paraffinized tissue sections. RESULTS: TGF-alpha was expressed in the cytoplasms of tumor cells in thirty five cases of forty seven(74.5%) primary lung cancers, whereas the control expressed in two of ten brochial epithelial cells. The expression of TGF-alpha was disclosed in four cases of eleven(36.4%) small cell carcinomas and thirty one cases of thirty six(86.1%) non-small cell carcinomas of the lung. Expressions of TGF-beta was discernible in bronchial epithelium in eight of ten non-cancerous lung tissues. The expression of TGF-beta was noted in the cytoplasms of tumor cells in eight cases of forty seven(17.0%) primary lung cancers. The expression of TGF-beta disclosed in two cases of eleven(18.2%) small cell carcinomas and six cases of thirty six(16.7%) non- small cell carcinomas of the lung. CONCLUSION: These findings suggest that up-regulation of TGF-alpha and down-regulation of TGF-beta are involved during development and growth of primary lung cancers.
Antibodies ; Antibodies, Neutralizing ; Carcinogenesis ; Carcinoma, Small Cell ; Clone Cells ; Cytoplasm ; Down-Regulation ; Epithelial Cells ; Epithelium ; Growth and Development ; Humans* ; Lung Neoplasms* ; Lung* ; Paraffin ; Regeneration ; Transforming Growth Factor alpha ; Transforming Growth Factor beta ; Up-Regulation