BACKGROUND: Nucleolar organizer regions(NORs) are loops of DNA that transcribe ribosomal RNA; they can be easily identified in paraffin section using silver method. Recently, the application of NORs to the study of various types of benign and malignant proliferation has suggested that the number of NORs per nucleus can provide an indication of degree of cellur maligriancy. Many authors indicated a significant overlapping of NORs counts between benign and malignant proliferation. OBJECTIVE: The purpose of this study is to discriminate benign m laocytic nevi from malignant melanoma effectively, thus we use simple enumeration and computerized image analysis of AgNORs in melanocytic skin lesions. METHOD: NORs were investigated on silver stained histologicec ion of 18 malignant melanoma (MM), 19 acquired nevi(AN), 21 congenital nevi(CN). For each case, 100 nucleus sample were cuantified using image analysis system(AIC Inc., Roswell, GA). There is no consensus at present as to the best criterion for quantifying AgNORs proteins in melanocytic skin lesion. We prefer to quantify a large number of parameters. The mean value or standard deviation(SD), each calculated for a batch of 100 cells, are average again(mean+SD), over the 58 cases for six morphological criteria mean number of AgNORs per nucleu, mean ratio of AgNORs area per ruc eus area, mean area of largest AgNORs, mean ratio of largest AgNORs area per nucleus area, mean nucleus area per a AgNOR, and coefficient of variation of nucleus area. RESULTS: 1. All of the six parameters show significant difference between benign melanocytic nevi and malignant melanoma. But., there is no significant difference between acquired nevi and congenital nevi. 2. In stepwise discriminate analysis, we discriminate benign melanoctic nevi from malignant melanoma effectively using combined two parameters(number of AgNORs and mean ratio of AgNORs area per nucleus area). But there is some overlapping between malignant melanoma and ber ign melanocytic nevi using each six parameters. 3. In metastatic and non-metastatic malignant melanoma, six param ters have not shown significant difference. CONCLUSION: Study of AgNORs in the image analysis system is a very useful tool to differentiate malignant melanoma from benign melanocytic nevi.
Consensus ; DNA ; Melanoma ; Nevus ; Nevus, Pigmented ; Nucleolus Organizer Region ; Paraffin ; RNA, Ribosomal ; Silver ; Skin*

Fractures of the proximal humerus in children are rare and according to Neer and Horwitz, fractures of the proximal humeral epiphysis constitute 3% of all epiphyseal injury. The most frequently reported complications are humeral shortening, varus angulation, and neurovascular complications. Closed anatomic reduction in frscture of the proximsl humerus is very difficult, so reported modes of treatment have ranged from aggressive attempts at reduction to simple neglect. Twenty nine fractures of the proximal humerus in children which were treated at Seve- rance Hospital, Yonsei University, College of Medicine from July 1982 to December 1986 were snalyzed both clinically and radiologically and the following results were obtained. 1. The age of the patients in this series ranged from 3 years to 18 years and the most frequently between the age of 12 years to maturity. And the oldest age was 18 years in male and 17 years in female. 2. Among the 29 frsctures, 21 cases were involving the proximal humeral epiphysis and all the injuries were Salter-Harris type Il epiphyse14 fracture. And 8 cases were fracture through the proximal humeral metaphysis not involving epiphysis. 3. Sixteen cases(55%) hsd associated injuries and the common associated injuries were fracture of the lower extremity, and fracture of same upper extremity were 5 cases(17%). 4. The fracture were graded according to their initial displacement(Neer snd Horwitz) and grade I, 6 cases, grade II, 3 csses, grade , 5 cases and grade IV were 15 cases. 5. Eight cases of grade I and II fractures were treated by simple immobilization. And among the twenty cases of grade III and 1V fractures, 12 cases were trested by closed reduction and immobilization and 9 cases, by open reduction. 6. Regardless of displacement of fractures and modes of treatment, all cases were united between six weeks to twelve weeks with full range of motion and no pain. 7. There were two cases of K-wire loosening, two cases of transient nerve palsy and one case of varus angulation.
Child ; Clinical Study ; Epiphyses ; Female ; Humans ; Humerus ; Immobilization ; Lower Extremity ; Male ; Paralysis ; Range of Motion, Articular ; Upper Extremity

No abstract available.
Humans ; Mass Screening* ; Parents* ; Psychopathology*

No abstract available.

BACKGROUND: Nucleolar organizer regions (NORs) have recently attracted much attention because of claims that their frequency within nuclei is significantly higher in malignant cells than in normal, reactive, or benign neoplastic cells. OBJECTIVE: The purpose of this paper is to analyze a method allowing selection of the best morphometric criterion for quantifying AgNOR proteins under conventional observation conditions by light microscopy. METHOD: We tried to investigate the various parameters including NORs counting in cutaneous tumors using image analysis system. RESULTS: There were significant differences in mean nucleus area per a AgNOR, nucleus area between the benign and potentially malignant group. But the conventional counting of AgNORs is not able to differentiate between the two groups. We could discriminate squamous cell carcinoma from Bowen's disease using parameters of mean ratio of AgNORs area per nucleus area, mean ratio of greatest AgNORs area per nucleus area, coefficient of variation (C V) of nucleus area, and mean area of largest AgNORs. In squamous cell carcinoma and keratoacanthoma, C V of nucleus area has shown a significant difference. CONCLUSION: Study of AgNORs using image analysis system is a useful tool for the diagnosis of cutaneous tumors.
Bowen's Disease ; Carcinoma, Squamous Cell ; Diagnosis ; Keratoacanthoma ; Methods ; Microscopy ; Nucleolus Organizer Region* ; Skin*

Cardiac rupture following blunt thoracic trauma is rarely encountered, since it commonly causes death at the scene. With advances in critical care, blunt cardiac rupture has been successfully treated with well-organized team approach including an emergency physician, anesthesiologist, and cardiac surgeon. We encountered a patient with blunt cardiac rupture of the junction of the superior vena cava and right atrium that extended 7 cm to the right ventricular junction. The patient was successfully resuscitated after a closed thoracostomy and pericardiocentesis with fluid loading. Cardiac injury was repaired via mid-sternotomy without cardiopulmonary bypass. The patient recovered without complications and was discharged on the 7th day after surgery.
Cardiopulmonary Bypass ; Critical Care ; Emergencies ; Heart Atria* ; Heart Injuries ; Heart Rupture* ; Humans ; Pericardiocentesis ; Thoracostomy ; Vena Cava, Superior*

BACKGROUND: Accessory tragi contain a central core of cartilage, which is the most important pathological factor, but often are misdiagnosed as soft fibroma/hair follicle nevi if sections cannot show a central core of cartilage. OBJECTIVES: The purposes of this study were aimed at comparing transverse sections with vertical sections and demonstrating the value of transverse sections about histological diagnosis for accessory tragus. METHODS: We studied 14 cases of patients with accessory tragi. All cases were totally excised and all 16 biopsy specimens (bilateral in 2 cases) were obtained. We classified these biopsy specimens into two groups regarding the removal of cartilage.All specimens were vertical or transverse seiral sectioned and we compared these histologic findings with established histologic diagnostic criteria which Satoh et al. reported. RESULTS: On the specimens of group 1 in which there was cartilage, subcutaneous prominent connective tissue framework whirling around cartilage could be observed on all transverse sections, but was not always present on vertical sections. Prominent connective tissue framework and pilosebaceous units with circular arrangement of eccrine glands were simultaneously in the center of transverse sections regardless of the presence of cartilage. CONCLUSIONS: In this study, transverse sections showed all diagnostic histologic important features for accessory tragus: presence of central cartilage, prominent subcutaneous connective tissue framework, and various degree of pilosebaceous unit, especially with circular arrangement of eccrine glands. So transverse sectioning could be a useful method for accurate histological diagnosis of accessory tragi regardless of the removal of cartilage when doing excisional biopsy.
Biopsy ; Cartilage ; Connective Tissue ; Diagnosis ; Eccrine Glands ; Humans ; Nevus

No abstract available.
Diagnosis* ; Humans ; Thoracic Injuries* ; Thorax* ; Tomography, X-Ray Computed*

Thirteen patients were operated for cubital tunnel syndrome and followed for an average of 26 months postoperatively. Ten patients had a history of relevant trauma and three patients had degenerative osteoarthritis of the elbow. The average duration of symptoms was 18 months (range, 2 to 96 months). Diagnosis was made by physical examination, electromyography and nerve conduction study. Among these, nerve conduction study was found to be the most valuable diagnostic method for the patients with atypical clinical findings. Most of the operations were performed by anterior transposition of the ulnar nerve. At the most recent follow-up, the result was excellent in two patients, good in eight, and fair in three; thus ten patients(77%) showed satisfactory results. The rating system for ulnar neuropathy based on sensory, motor dysfunction and pain was useful for evaluating the operative results. The postoperative gain of score for pain and sensory function were larger than that of motor function. Factors known to influence the result of the operation (age, duration of symptom, history of trauma, method of operation) did not effect the outcome in this study. For successful operation, the ulnar nerve must be thoroughly examined, all possible levels of compression must be released and new foci of compression must be created.
Cubital Tunnel Syndrome ; Diagnosis ; Elbow ; Electromyography ; Follow-Up Studies ; Humans ; Methods ; Neural Conduction ; Osteoarthritis ; Physical Examination ; Sensation ; Ulnar Nerve ; Ulnar Neuropathies

Total hip replacement, with a prosthesis replacing both the acetabular socket and the femoral head, has been developed during the last decade and is now being used extensively. Its major advantage is rapid rehabilitation of the patient, particularly when both the femorsl head and the acetabulum are diseased. Nine Cases of total hip replacements were performed at the Department of Orthopedic Surgery, Hanyang University Hospital from January 1972 to March 1976. Although the follow-up (range 4 months to 3 years) in the majority is too short to permit a complete assessment of the results, in our series, most patients presented for surgical treatment for the relief a pain and mobility has been complete.
Acetabulum ; Arthroplasty, Replacement, Hip ; Follow-Up Studies ; Head ; Humans ; Orthopedics ; Prostheses and Implants ; Rehabilitation