PURPOSE: This study was attempted to investigate the prevalence of the expression of c-fos protein, TGF-alpha and -beta, PCNA , DNA ploidy pattern and histopathological parameters of giant cell tumor (GCT) of bone and to correlate with prognosis and to extend our understanding on tumorigenesis of GCT. MATERIALS AND METHODS: Twenty eight cases of paraffin-embedded tissue were studied, classified as recurrent (5 cases) and non-recurrent group (12cases) within the limits of the cases which afforded surgical material on first operation. RESULTS: No significant difference was observed in cellularity of stromal cells, atypia of stromal and giant cells, presence of hemorrhage and necrosis between recurrent and non-recurrent group. However, presence of more than 10 mitotic figures in 10 high power fields in recurrent group was significantly higher than non-recurrent group (p<0.05). The immunoreactivity for PCNA was seen only in nuclei of stromal cells, whereas nuclei of giant cells showed negative staining. The positivity of PCNA revealed no significant difference between non-recurrent (mean; 40.9%) and recurrent group (34.4%). The expression of c-fos oncogene was seen in 5 cases (100%) in recurrent group, and 8 cases (66.7%) in non-recurrent group, and no significant difference was seen. No significant difference of expression of TGF-alpha was seen in 5 cases (100%) in recurrent group and in 11 cases (91.7%) in non-recurrent group. The expression of TGF-beta in stromal cells was significantly higher in non-recurrent group (80%) compared to recurrent group (100%) (p<0.05). In DNA analysis out of 18 cases, 4 cases (22.2%) were aneuploidy and 14 cases (77.8%) were diploidy. Among 4 aneuploidy cases, 3 cases (75%) had no recurrence, and 1 case (25%) had metastasis to lung and expired. No significant difference of DNA ploidy pattern was seen between the recurrent and non-recurrent group. CONCLUSION: Presence of more than 10 mitotic figures in 10 high power fields and less expression of TGF-beta are related to higher possibility of recurrence and it is suggested that the number of mitotic figure (more than 10/10HPF) and expression of TGF-beta could be helpful parameters in predicting recurrence of GCT.
Aneuploidy ; Carcinogenesis ; Diploidy ; DNA* ; Giant Cell Tumor of Bone* ; Giant Cell Tumors* ; Giant Cells* ; Hemorrhage ; Lung ; Necrosis ; Negative Staining ; Neoplasm Metastasis ; Oncogenes ; Ploidies ; Prevalence ; Prognosis ; Proliferating Cell Nuclear Antigen* ; Recurrence ; Stromal Cells ; Transforming Growth Factor alpha ; Transforming Growth Factor beta ; Transforming Growth Factors*

BACKGROUND: Tracheal intubation commonly results in sympathetic stimulation manifested by increased heart rate and arterial blood pressure. This study was carried out to determine whether lightwand would result in less hemodynamic changes than direct laryngoscopy. METHODS: With informed consent, fourty healthy female patients scheduled of elective surgical procedures were randomly allocated into two groups; lightwand (LW) or direct laryngoscopy (DL) group. Mean arterial pressure (MAP) and heart rate (HR) were recorded upon arrival. Under a standardized anesthetic technique, the patients were intubated either with no. 3 curved blade direct laryngoscopy (DL group) or with lightwand (LW group). The MAP and HR were recorded before intubation and every 1 minutes following intubaion. Time to intubation (TTI) was also recorded. All patients were intubated by a same fourth grade resident. RESULTS: Fourty patients were studied. Every intubation was successed in first attempt. The TTI was significantly shorter in LW group. Even while there was no significant difference in HR changes, there was significant difference in the increase of MAP following intubation. The increase of MAP was significantly greater with DL than with LW. CONCLUSIONS: This study suggests that lightwand intubation requires shorter TTI and may give rise to less blood pressure change than direct laryngoscopy. So we found no difference in disadvantage and may offers advantage in terms of hemodynamic stability.
Arterial Pressure* ; Blood Pressure ; Female ; Heart Rate* ; Heart* ; Hemodynamics ; Humans ; Informed Consent ; Intubation ; Intubation, Intratracheal* ; Laryngoscopy* ; Surgical Procedures, Elective

BACKGROUND: Patients with sinus rhythm, the left atrial appendage(LAA) appeared as a vigorously contracting structure and the blood flow patterns of LAA showed biphasic configuration. However, patients with AF rhythm the blood flow showed irregular or no configuration in doppler echocardiographic study. The purpose of this study is to evaluate relationship between the blood flow patterns of LAA with the presence of spontaneous contrast(SC) and thrombi in LAA. METHODS: We performed TEE and TTE simultaneously to 58 consecutive patients who had native mitral valve disease or mitral prosthesis. Spontaneous contrast(SC) and the presence and location of LAA thrombi were evaluated during TEE and left atrial dimension(LAD) & ejection fraction(EF) were evaluated during TTE. We divided the whole subjects into three groups according to the blood flow patterns ; regular pattern(Group 1), irregular pattern(Group 2), no flow pattern(Group 3). RESULTS: 1) Blood flow within the left atrial appendage is divided with three groups among of them, atrial fibrillation have two blood flow patterns. 2) Peak prositive & negative flow velocity within LAA in AF rhythm groups were slower than normal sinus rhythm group.(p<0.01) 3) Left atrial dimension in group 3 is significantly larger than others groups.(p<0.01) 4) Spontaneous contrast(SC) with LAA could be detected in 2(6.8%) of the 29 patients of group 1, 6(31.5%) of the 19 patients of group 2, 10(100%) of the 10 patients of group 3. Incidence of SC within LAA in group 3 is significantly higher than others groups. 5) LAA thrombi could be detected in 1(3.4%) of the 29 patients of group 1, 1(5.2%) of the 19 patients of group 2, 3(30%) of the 10 patients of group 3. Incidence of LAA thrombi is significangly higher than other groups. CONCLUSIONS: We can suggest that blood flow within LAA is divided into three groups according to the blood flow patterns, and spontaneous contrast and thrombi in LAA were closely related with the blood flow pattern.
Atrial Appendage ; Atrial Fibrillation ; Echocardiography ; Humans ; Incidence ; Mitral Valve ; Prostheses and Implants

BACKGROUND: Recent reports suggest that Epstein-Barr virus (EBV) may play an important role in such a wide spectrum of human neoplasia. Recently, peripheral T cell lymphomas and particularly, angiocentric lymphomas (ACL), increasingly are reported to be associated with EBV.Nasal-type and nasal T/NK cell lymphoma (TNKL) have recently been reported to comprise most of ACLs. The prognosis of these tumors has been extremely poor. OBJECTIVE: The purpose of this study was to investigate EBV association in primary or secondary cutaneous T-cell lymphoproliferative disorders and to identify any prognostic association. METHODS: Thirty six patients with primary or secondary cutaneous T-cell lymphoproliferative (CTCL) disorders were examined to evaluate the presence of Epstein-Barr virus using in situ hybridization for EBV-encoded RNA (EBER). RESULTS: EBER was detected in tumor cells in one third of the total cases (13/36); 4/4 secondary skin lymphoma from nasal TNKL, 8/8 primary cutaneous nasal type TNKLs and 1/5 mycosis fungoides (MF).EBER was not detected in the following disease: 6 cases of anaplastic large cell lymphomas (ALCL) including 2 cases of probable NK-like T cell lineage, 3 lymphomatoid papulosis, 2 CD56 (-) T cell ACLs and 7 subcutaneous panniculitic T-cell lymphomas (SPTL) by Revised European-American Lymphoma (REAL) classification and recent concept of further classification into NK-cell lineage. One case of T-cell pseudolymphoma as a negative control was also negative in EBER. CONCLUSION: High incidence of EBV was observed in primary or secondary CTCLs in Koreans, with predilection for nasal and nasal type TNKL. In MFs, an erythrodermic MF with fatal outcome was associated with EBV and the EBV detection might reflect worse prognosis in MFs as seen in an aggressive course of nasal and nasal type TNKLs.
Cell Lineage ; Classification ; Fatal Outcome ; Herpesvirus 4, Human* ; Humans ; In Situ Hybridization ; Incidence ; Lymphoma ; Lymphoma, Large-Cell, Anaplastic ; Lymphoma, T-Cell ; Lymphoma, T-Cell, Peripheral ; Lymphomatoid Papulosis ; Lymphoproliferative Disorders* ; Mycosis Fungoides ; Prognosis ; Pseudolymphoma ; RNA* ; Skin ; T-Lymphocytes*

BACKGROUND: In vitro study, normal cardiac prosthetic valve has functional regurgitation due to structural characteristics of prosthetic valve. To evaluate functional regurgitant characteristics of prosthetic valves, we examined patients who had clinically normal mitral prosthesis. METHODS: Transesophageal two-dimensional and color doppler echocardiography were performed to 25 patients who had the clinically normal mitral prosthesis. RESULTS: Seven patients had the mitral bioprosthesis and 18 patients had the mitral mechanical prosthesis. Regurgitation was found in 4 patients(57%) with bioprosthetic valve, and the pattern of regurgitation was central in three patients and unilateral in one patient. But regurgitation was detected in 17 patients(94%) with mechanical prosthesis, and the pattern of regurgitation was bilateral in twelve patients, unilateral in four patients and central in one patient(p=0.0035). The length of regurgitant jets were 22.00+/-6.73(mm) in bioprosthetic valve and 28.65+/-7.33(mm) in mechanical valve. The regurgitant jets were detected in systolic period in most of patients. But in 4 patients who had tachycardia during TEE, regurgitation was detected in systolic and early diastolic period. CONCLUSION: Regurgitation was found in clinically normal cardiac prosthetic valves by TEE. These findings may be useful to differentiate between normal and abnormal cardiac prosthesis.
Bioprosthesis ; Echocardiography, Doppler, Color ; Echocardiography, Transesophageal* ; Humans ; Prostheses and Implants* ; Tachycardia

The intraphepatic migration of a distal ventriculopritoneal shunt tube(Accu-flo shunt system medium pressure) is reported. This is rare complication of ventriculoperitoneal shunt, which was diagnosed by abdominal computed tomography. To our knowledge, this is the third reported case complication with migration of a peritoneal shunt tube into the liver.
Catheters* ; Liver ; Ventriculoperitoneal Shunt

BACKGROUND: The prompt and accurate diagnosis of acute aortic dissection is decisive for the prognosis of the patient, since an effective surgical and medical therapy can improve the high rate of mortality due to this pathology. Among the various diagnostic methods, transesophageal echocardiography can provide a rapid and accurate method of diagnosing and evaluating dissecting aortic aneurysm and permits prompt initiation of appropriate treatment. Thus we performed transesophageal echocardiography in patients supected to dissecting aortic aneurysm, as a preliminary examination, and now we reported the result. METHODS: We have studied 4 case of dissecting aortic aneurysms among the patient received examination of cardiovascular system by transesophageal echocardiography, since January 1991 at Keimyung University hospital. In these 4 cases, 3 cases had CT scan, 2 cases had MRI scan, and all cases had transthoracic echocardiography simultaneously as a adjuvant diagnostic method. RESULTS: All 4 cases could be promptly and accuratoly diagnosed and typed by transesophageal echocardiography. As a consequence, patients could receive the early medical treatment and good clinical results. CONCLUSION: Transesophageal echocardiography is fast, inexpensive and accurate method in diagnosis of dissecting aortic aneurysm. So we recommend transesophageal echocardiography, as a preliminary examination in case of suspecting dissecting aortic aneurysm.
Aortic Aneurysm* ; Cardiovascular System ; Diagnosis ; Echocardiography ; Echocardiography, Transesophageal* ; Humans ; Magnetic Resonance Imaging ; Mortality ; Pathology ; Prognosis ; Tomography, X-Ray Computed

The purpose of this study was to regenerate human dental pulp tissues similar to native pulp tissues. Using the mixture of type I collagen solution, primary cells collected from the different tissues (pulp, gingiva, and skin) and NIH 3T3 (1 x 10(5) cells/ml/well) were cultured at 12-well plate at 37degrees C for 14 days. Standardized photographs were taken with digital camera during 14 days and the diameter of the contracted collagen gel matrix was measured and statistically analyzed with student t-test. As one of the pulp tissue engineering, normal human dental pulp tissue and collagen gel matrix cultured with dental pulp cells for 14 days were fixed and stained with Hematoxyline & Eosin. According to this study, the results were as follows: 1. The contraction of collagen gel matrix cultured with pulp cells for 14 days was significantly higher than other fibroblasts (gingiva, skin) (p < 0.05). 2. The diameter of collagen gel matrix cultured with pulp cells was reduced to 70.4% after 7 days, and 57.1% after 14 days. 3. The collagen gel without any cells did not contract, whereas the collagen gel cultured with gingiva and skin showed mild contraction after 14 days (88.1% and 87.6% respectively). 4. The contraction of the collagen gel cultured with NIH 3T3 cells after 14 days was higher than those cultured with gingival and skin fibroblasts, but it was not statistically significant (72.1%, p > 0.05). 5. The collagen gel matrix cultured with pulp cells for 14 days showed similar shape with native pulp tissue without blood vessels. This approach may provide a means of engineering a variety of other oral tissue as well and these cell behaviors may provide information needed to establish pulp tissue engineering protocols.
Blood Vessels ; Collagen ; Collagen Type I* ; Dental Pulp* ; Eosine Yellowish-(YS) ; Fibroblasts ; Gingiva ; Hematoxylin ; Humans ; NIH 3T3 Cells ; Skin ; Tissue Engineering*

We have analysed 144 patients with hypertensive putaminal hemorrhage, admitting from January 1992 to December 1993. Surgical treated group with Komai's stereotactic system was 71 patients and medical treated group was 73 patients. The results were as follows: 1) The patients with ventricular rupture were 36 cases(25%). According to the degree of ventricular rupture, the mortality was increased and the good outcome was decreased(P<0.01). 2) The prognosis was evaluated in favorable condition(alert and drowsy) and unfavorable condition(stuporous, semicomatose, comatose). In unfavorable condition, the mortality of surgical patients was lower than that of non-surgical patients(P<0.01). 3) Surgical patients with smaller hematoma(< or = 40ml) showed btter outcome than non-surgical patients:The statistical difference was not significant. But in larger hematoma(>40ml), the outcome in both treated group was similar. 4) According to CT classification, in class II(extending to anterior limb of internal capsule), good outcome of surgical group was better than that of non-surgical group. In class V(extending th thalamus or subthalamus), the mortality in surgical group was lower than that of non-surgical group(P<0.05) .
Classification ; Extremities ; Humans ; Mortality ; Prognosis ; Putaminal Hemorrhage* ; Rupture ; Thalamus

Objective: Traumatic brain injury (TBI) is an important public health concern due to its high prevalence and mortality rate among young people. We investigated the clinical and social characteristics of patients who visited the emergency department due to TBI in whom brain computed tomography, was performed by age. Methods: We retrospectively analyzed 15,567 TBI patients who received a brain computed tomography evaluation at the emergency department of Korea University Hospital from March 2013 to February 2016. We divided patients into age groups by decade and analyzed factors such as sex, trauma mechanism, need for operation, hospitalization, and results of treatment. Results: The mean age was 42.0±22.8 years; the most common age group was the 50s (16.5%). Except for the age group over 70 years, males predominated. Under 9 years of age, public ambulance usage rate was lower than in other age groups. Regarding severity based on the Glasgow Coma Scale score, the proportion of mild cases was higher in those under 9 years of age (99.3%) and the proportion of severe cases was higher in those in their 20s (4.6%). The most common injury mechanism was blunt trauma, followed by car accidents. For those under 9 years of age, falls were more common than in other age groups. Only 20.5% of TBI patients were hospitalized and 11.9% were treated surgically, while 70.6% of patients were discharged home after treatment. Conclusion TBI may present with different characteristics depending on the age of the patients, thus prevention policies and clinical practice should be tailored to age.