The most important prognostic factor of breast cancer is the status of lymph node or distant metastasis, which is resisted by basement membrane and stromal matrix. MMP (matrix metalloproteinase)-2 is a 72-kilodalton type IV collagenase/ gelatinase and degrades the type IV collagen which is a main component of the basement membrane. Therefore, MMP-2 is believed to be one of the key molecule for cancer invasion and metastasis. Enzymatic activity of MMP is inhibited by TIMPs (tissue inhibitors of metalloproteinase). TIMP-2 forms a complex with latent pro-MMP-2 and inhibits the active forms of MMP-2. The balance of MMPs and TIMPs is suspected as the important factor of invasion and metastasis of the tumor cells. We studied the association between the expression of MMP-2/TIMP-2 and growth pattern of tumor border, lymph node metastasis, and estrogen receptor expression in the 57 cases of invasive ductal carcinoma of the breast using immunohistochemical staining methods. The results revealed increased expression of MMP-2 in the infiltrating tumor border and tumors with positive lymph node metastasis and negative estrogen receptor with no statistical significance (p>0.05). But the expression of TIMP-2 was increased in expanding tumor border and tumors with positive lymph node metastasis and negative estrogen receptor without statistical significance (p>0.05).
Basement Membrane ; Breast Neoplasms ; Breast* ; Carcinoma, Ductal* ; Collagen Type IV ; Estrogens* ; Gelatinases ; Lymph Nodes* ; Matrix Metalloproteinases ; Neoplasm Metastasis* ; Tissue Inhibitor of Metalloproteinase-2*

To evaluate the tissue expression rate and pattenr of HBsAg and HBcAg in tumors and peritumoral livers, an immunohistochemical study was undertaken on 47 surgically resected hepatocellular carcinomas(HCCs). The results are as follows. 1. Patient's sera were positive for HBsAg in 40 cases(85.1%). In the remaining 7 cases, the tumor and peritumoral liver expressed neither HBcAg nor HbSaG, suggesting that they were caused by other etiologies than hepatitis B virus. 2. The peritumoral liver had HBsAg and HBcAg in 95.0% and 27.5% among the 40 cases, respectively. But the tumor expressed HBsAg in 50.0% and HBcAg in none. 3. The expression of HBsAg within the tumor and both HBsAg and HBcAg in the peritumoral liver tended to be more frequent in the pretreated cases before surgery. 4. Edmondson-Steiner grade IV tumors revealed a lower expression rate of HBsAg than the low grade tumors(p<0.05). Incases with cirrhosis at peritumoral tissues, HBcAg was less frequently found than in those without cirrhosis. The majority of tissue HBsAg and HBcAg was represented as groups of positive cells. These results suggest that, during the development and progression of HCCs, the HBcAg containing cells are repeatedly removed and the HBcAg negative cells are selected, because cellular expression of HBcAg is the target of host immune response.
Carcinoma, Hepatocellular

Although a lot of articles examining concomitant intrauterine and ectopic pregnancy have been presented, we have not found any reports on ectopic implantation of chorionic villi in the vagina with normal intrauterine pregnancy. We experienced a case of chorionic villi on the vaginal wall as a hemorrhagic mass during the second trimester of pregnancy. A pregnant woman (gestational age of 16 weeks and 1 day) visited our hospital due to vaginal bleeding. There was no abnormal finding except vaginal hemorrhagic mass, and the mass revealed a product of conception.
Chorion* ; Chorionic Villi* ; Female ; Fertilization ; Humans ; Pregnancy ; Pregnancy Trimester, Second* ; Pregnancy* ; Pregnancy, Ectopic ; Pregnant Women ; Uterine Hemorrhage ; Vagina

A retrospective study was designed to determine the diagnostic contribution of oblique view in 740 consecutive lumbar spine examinations done in adults. In 12 cases (1.62%) there was a change in the radiographic interpretation when the oblique views were used for diagnosis. Considering the significant gonadal radiation, additional cost, and limited diagnostic value, the authors feel that the oblique view should not be a routine part of the initial lumbar spine examination in adults.
Adult ; Diagnosis ; Gonads ; Humans ; Retrospective Studies ; Spine

PURPOSE: When there is a varus deformity in proximal tibia, the extension of a tibial shaft axis tends to pass through the lateral intercondylar eminence. A prospective randomized study was conducted to find out whether the lateral eminence of tibia could serve as a reference point for proximal tibial osteotomy during total knee arthroplasty and results from 6-years follow up period were reported. MATERIALS AND METHODS: Forty-six patients (50 knees) who received total knee replacement arthroplasty from April to December 2004, were randomly divided into two groups. For a proximal tibial osteotomy, the proximal tibial reference point was located at the center of intercondylar eminence for group I and at the lateral eminence for group II and subsequently, the results were evaluated. Radiologic indices were the angles between the axis of the prosthesis and the mechanical/shaft axes of tibia and angle of the prosthesis in sagittal plane. Clinical indices were pain and function score of American knee society, functional score of Hospital for Special Surgery and range of knee joint motion. RESULTS: The angles between the axis of the prostheses and the mechanical/shaft axes of tibia were varus 1.64degrees/2.12degrees in group I and valgus 0.57degrees/0.38degrees in group II (p=0.589/p=0.558). There were 6 cases of outliers (27.2%) in group 1 and 3 cases (15.0%) in group 2. There was a significant difference in the pain score between group I (82.9) and II (91.4) (p=0.032), respectively. CONCLUSIONS: By moving the reference point of proximal tibial osteotomy laterally, lower incidence of outlier and residual varus deformity could be achieved.
Arthroplasty ; Arthroplasty, Replacement, Knee ; Axis, Cervical Vertebra ; Congenital Abnormalities ; Follow-Up Studies ; Humans ; Incidence ; Knee ; Knee Joint ; Osteotomy ; Prospective Studies ; Prostheses and Implants ; Tibia

Angiodysplasia is a vascular lesion of the gut, which reveals intestinal bleeding as a major symptom. It is the cause of as much as 5~6% of the intestinal bleeding of unkown origin. Pathologically, it reveals anomalous submucosal vascular overgrowth, which is characterized by tortuous, dilated and thin-walled vessels. Because the lesion is mainly submucosal. It is hard to diagnosis with endoscopy and even in laparotpmy. Angiography has a low detection rate for angiodysplasia, but some of this typical findings are delayed excretion of dye into the venous structure around the lesion, vascular tuft in the arterial phase, and accelerated dye secretion into venous structure in the situation of arteriovenous malformation. Endoscopy, especially colonoscopy is so effective a diagnostic method as to make interventional therapy. Conjugated estrogen therapy is effective and is regarded as choice of treatment in the not-life-threatening intestinal bleeding caused by angiodysplasia. Surgery is only indicated in the case of uncontrolled bleeding. Intestinal obstruction has rarely been reported as another manifestation of intestinal angiodysplasia. Therefore pathologic definition should be confirmed, and research for pathophysiology of mucosal hypertrophy in the angiodysplasia is needed.
Angiodysplasia* ; Angiography ; Arteriovenous Malformations ; Colitis, Ischemic* ; Colonoscopy ; Diagnosis ; Endoscopy ; Estrogens ; Hemorrhage ; Hypertrophy ; Intestinal Obstruction

Recently, we have experienced with various changes in the health insurance. Korean government is implementing the prospective payment system(PPS) as a pilot project to reduce medical expenditure. Case management is an effective way to reduce costs, while not sacrificing quality of service, under the PPS. In this study, the integrated decision support system(DSS) for case management was presented to support two case management activities ; utilization management and discharge planning. This system can be used in three ways ; prospective, concurrent, and retrospective management. By monitoring cases from medical record database, the DSS provides basic patient information, payment information, medical service information to the case manager. In the future, data warehouse should be introduced to integrate various databases related to case management and to improve quality of information produced by the DSS.
Case Management* ; Cesarean Section* ; Critical Pathways ; Diagnosis-Related Groups* ; Female ; Health Expenditures ; Humans ; Insurance, Health ; Medical Records ; Patient Discharge ; Pilot Projects ; Pregnancy

PURPOSE: To correlate MR findings with histologic findings in avascular necrosis(AVN) of the femoral head. MATERIALS AND METHODS: MR imaging was performed with 8 femoral head specimens using T1- and proton density weighted coronal SE sequences, and compared with contact radiography and histologic sections. RESULTS: In each specimen, necrotic zone in the superior portion of femoral head, repair zone located inferior to the necrotic zone, and rim adjacent to normal bone marrow could be defined. Necrotic zone showed high signal intensity on both T1- and proton density- weighted images in 3 cases which were composed of necrotic bone and marrow, and low signal intensity on both sequences in 2 cases which were composed of necrotic bone marrow with amorphous cellular debris. Mixed high and low signal intensities were seen in 3 cases. The repair zone showed low signal intensity on Tl-weighted image and high signal intenisty on proton density weighted image in 5 cases which were composed of thickened trabecular bone and meSenchymal tissue and also showed intermediate signal intensity on T1 weighted image and high signal intensity on proton density weighted image in 3 cases which were composed of osteoid, chondroid and undifferentiated mesenchymal cells. Rim shown as the low signal intensity on T1 weighted image in all cases was corresponded to viable thickened trabecular bone. CONCLUSION: MR imaging would be the best modality in the diagnosis of avascular necrosis of fernoral head and when used in conjuction with degree and location of signal intensity, the prediction of histologic finding may be possible.
Bone Marrow ; Diagnosis ; Head* ; Magnetic Resonance Imaging* ; Necrosis* ; Protons ; Radiography

No abstract available.
Blood Transfusion, Autologous*

The survey of occupational injury has not been performed in Korean Air Force. The aim of this survey is to identify the feature of the occupational injury at the Korean Air force base. The occupational injury were monitored at the medical group in a Korean air base, from Aug 1998 to Jul 1999. Because the medical group has supported 2 different groups, we analysed and described some results seperately; group 1 consisted of workers in line maintenance operation, group 2 included workers in base maintenance operation. There were 59 injuries(injured persons) in group 1, and 9 injuries in group 2, so the incidence(per 1000) were 21.5, 4.46 respectively. 11 persons transferred to well-equiped hospital. Most of injured persons were air men, and then sergeant, civilian employee in order. The median age of injured persons was 22 years old in group 1 and 21 years old in group 2. The median work experience was 0.8 and 8 years respectively. The median delay time to arrive at the hospital from the time of injury were 30 min in group 1, 20 min in group 2, but maximum delay in group 1 was about 9 days. The occupational injuries were most common in October in the year, Tuesday in a week. Also the injury occurred common from 13 to 13:59, and from 11 to 11:59 in a day. The injury occurred most commonly by the collision with something, when working with more than 4 coworkers, and repairing the machinery. The most common injured part of the body were hands and feet, the patterns of injury were laceration and fracture.
Foot ; Hand ; Humans ; Incidence ; Lacerations ; Male ; Occupational Injuries* ; Young Adult