For the recovery of broken bone or the free vascularized bone graft the vascular topography of the nutrient artery is very important. To estabilish the metric data of the nutrient foramen, its number, direction and site had been observed, and the size and position were measured. The results are as follows. 1. In 53% of the femurs, the number of the nutrient foramen was two, and in 57.1% of the paired materials. The number in both side was not different. The femoral nutrient foramen opened toward the superior direction in the most cases (97.3%). The foramens appeared most commonly (58.9%) on the medial lip of the linea aspera of the femur. The positional index was variable between 28.6 to 70.0 and it was 46.4±10.7 in average. Foramina appeared most commonly (41.9%) in the 30-40 index area of total length of the femur. 2. The number of the tibial nutrient foramen was one in 91.0% of the cases. All of the foramen opened toward the inferior direction. The foramen was most commonly observed on the lateral to vertical ridge of thie tibia (74.3%). Dividing the fibular into 10 parts, the positional index of the tibia was variable between 14.5 and 55.4, and it was 33.4±4.7 in an average. In 85.3% of the cases, the foramen observed in 4th segment. 3. The number of the fibular nutrient foramen was one in the most cases (81.0%). The direction of the foramen was inferior in 88.0% of the cases. The foramen positioned on the posterior surface of the fiular and its average positional index was 47.9±11.3, and its range was 20.3 to 72.4. The foramen was observed in 5th segment in the most cases (35.9%). 4. The size of the nutrient foramen was measured by the various sized stylet. The diameter of the femoral nutrient foramen was ranged from 0.5mm below 1.0mm in 46.6% of the cases. The that of the tibia was ranged from 1.0mm below 1.5mm in 53.2% of the cases. And that of the fibular was ranged from 0.5mm below 1.0mm in 54.0% of the cases.
Adult* ; Arteries ; Femur ; Fractures, Bone ; Humans ; Lip ; Tibia ; Transplants

We report a case of subcutaneous phaeohyphomycosis caused by Exophiala(E,) jeanselmei in a 66-year-old female, who showed a mild tender, 4.5x3.5cm sized, erythematous cystic mass with satellite lesions on the left forearm for 4 months. Histopathologically, suppurative granulomatous inflammation, brownish conidia in a chain and hyphae were observed. Fungal culture grew out the typical black-gray velvety colonies of E. jeanselmei after 2 weeks. The isolate grow well at 25 C, but very poorly at 37 C. No growth could be observed at 40 C. Sporulation adequate for evaluation was present on the malt extract agar. We confirmed E. jeanselmei by colony and microscopic morphology, temperature tolerance and sugar assimilation tests. The patient had been treated with itraconazole for 6 momths. Complete remission was observed.
Agar ; Aged ; Exophiala* ; Female ; Forearm ; Humans ; Hyphae ; Inflammation ; Itraconazole ; Phaeohyphomycosis* ; Spores, Fungal

PURPOSE: A consecutive series of 710 patients who underwent curative gastrectomy for carcinoma was studied with a special reference to the number or frequency of lymph node metastasis and the patient's prognosis. MATERIAL AND METHODS: Survival rates were calculated by the Kaplan-Meier method, and the difference between each group was evaluated statistically by the log-rank method. Follow-up was obtained for 709 patients (99.9%). RESULTS: According to the number of lymph nodal metastases, the five year survival rate for group 1 (1~3 positive nodes) was 50.9%; for group 2 (4~6 positive nodes), 56.7%; and for group 3 (more than 6 positive nodes), 12.0% (p<0.0001). According to the frequency of lymph node metastases, the five year survival rate for those with up to 25 per cent frequency of metastases was 47.5%; for those with up to 50 per cent frequency of metastases, 15.6%; and for those with greater than 50 per cent metastases, 6.3% (p<0.0001). According to the frequency of the regional lymph nodes (which include perigastric nodes along the lesser and greater curvatures, nodes located along the left gastric, common hepatic, splenic, and celiac arteries) metastasis, we categorized them as group 0 (N0: no metastasis), 1 (N1: metastasis in up to 25%), and 2 (N2: metastasis in greater than 25%). CONCLUSION: This subdivision could be successfully applied to the clinical evaluation of gastric carcinoma (five year survival rate for N0, 86.9%; for N1, 49.0%; and for N2, 10.7% (p<0.0001)) without difficulty in dividing certain lymph nodes into the correct location.
Follow-Up Studies ; Gastrectomy ; Humans ; Lymph Node Excision ; Lymph Nodes* ; Neoplasm Metastasis ; Prognosis ; Stomach Neoplasms* ; Survival Rate

No abstract available.
Renal Artery* ; Ureter* ; Veins*

The insulin-like growth factor(IGF)s are believed to play an important role in the maintenance of bone mass. The IGFs are found complexed with high affinity to a family of IGF-binding protein(IGFBP)s in the circulation. It is known that IGFBPs are involved in the transport of IGFs to tissues and modulate IGFs actions at local tissue The purposes of this study were to compare serum IGFBPs profiles in natural menopausal women with and without osteoporosis and in osteoporotic and nonosteoporotic women with premature menopause and to evaluate the relationship between serum IGFBPs profiles and bone mineral density(BMD) in women without ovarian function. Serum IGFBPs were measured by western ligand blot and immunoradiometric assay. The relative levels and proportions of serum IGFBP-2 measured by western ligand blot in natural menopausal women with osteoporosis(n=20) significantly increased compared to nonosteoporotic women(n= 20), whereas relative levels of serum IGFBP-3 in natural menopausal women with osteoporosis decreased. No significant differences in the relative levels of serum IGFBPs between osteoporotic(n=8) and nonosteoporotic women(n=10) with premature menopause were noted. The IGFBP-3 levels determined by immunoradiometric assay in women without ovarian function(n= 69) showed a similiar trend. The relative proportions of serum IGFBP-2 in osteoporotic women without ovarian function were signifcantly higher than those in nonosteoporotic women whereas relative levels of serum IGFBP-3 in osteoporotic women with natural menopause decreased. The relative levels and proportions of serum IGFBP-2 in women without ovarian function correlated negatively with BMD of lumbar spine, trochanter and Ward's triangle but there were significant positive correlations between levels and relative proportions of serum IGFBP-3 and BMD of above sites. No significant correlations between relative levels and proportions of serum IGFBP-1, IGFBP-2 and BMD were noted. Our data indicate that serum IGFBP profiles might be useful in identifying women without ovarian funcion at risk for osteoporosis,
Bone Density* ; Carrier Proteins* ; Female ; Femur ; Humans ; Immunoradiometric Assay ; Insulin* ; Insulin-Like Growth Factor Binding Protein 1 ; Insulin-Like Growth Factor Binding Protein 2 ; Insulin-Like Growth Factor Binding Protein 3 ; Insulin-Like Growth Factor Binding Proteins ; Menopause ; Menopause, Premature ; Osteoporosis ; Spine

p27Kip1 protein, a negative cell cycle regulator in G1 progression, has been reported to be related with human cancers including colon, breast and non-small cell lung carcinomas. To elucidate a possible prognostic indicator, we studied 49 cases of human breast carcinoma for expression of p27Kip1 protein using an immunohistochemical method, and compared these results with known prognostic parameters of the breast cancer. p27Kip1 protein was intensely stained in nuclei of carcinoma cells in 26 cases (53.1%). The expression rate of p27Kip1 protein was significantly higher in higher nuclear grade (p<0.05), lower histologic grade (p<0.01), lower N classification (p<0.001) and lower clinical stage (p<0.05) than in lower nuclear grade, higher histologic grade, higher N classification and higher clinical stage, respectively. p27Kip1 protein expression was significantly correlated with progesterone receptor status (p<0.05) or cyclin D expression (p<0.05). No statistical correlations were found between expression of p27Kip1 protein and other parameters including tumor size, estrogen receptor status, p53 overexpression and c-erbB-2 expression. The results suggest that reduced expression of p27Kip1 protein plays a role in biologically aggressive behavior of breast carcinoma and might contribute in predicting breast cancer patient's survival.
Breast Neoplasms* ; Breast* ; Cell Cycle ; Classification ; Colon ; Cyclin D ; Cyclin-Dependent Kinase Inhibitor p27 ; Estrogens ; Humans* ; Lung ; Phosphotransferases* ; Prognosis ; Receptors, Progesterone

No Abstract Available.
Carcinoma, Merkel Cell*

Pheniramine maleate(avil(R)) is a H1-antagonist that is derived from alkylamine. Skin reactions with parenteral administration of avil(R) are uncommon. A 29-year-old woman visited our department with a 3-year history of relapsing generalized multiple pruritic evanescent erythematous wheals after antihistamine and steroid injection. Intradermal skin test with Avil(R) was positive. We treated with 5 mg of mequitazine administration three times a day for 2 years.
Adult ; Female ; Humans ; Pheniramine* ; Skin ; Skin Tests ; Urticaria*

The syndrome of protracted diarrhea (PD) includes several diseases with diverse etiologies. This study was conducted to characterize the spectrum of causes, clinical manifestations, and the outcomes of PD. A retrospective analysis of the clinical and pathological findings was performed on 25 patients with diarrhea starting within the first 2 yr of life and a requirement of parenteral nutrition (PN). According to the intestinal histopathology, patients were classified into four groups: immune enteropathy (12 cases), lymphangiectasia (6 cases), epithelial dysplasia (5 cases), and unclassified (2 cases). All patients with epithelial dysplasia had earlier onset of diarrhea and longer duration of PN than those in the other groups. Three patients (12%) had an evidence of a familial condition. Five patients (three with microvillous inclusion disease and two with immune enteropathy) died. Sixteen patients recovered, and three (two with primary lymphangiectasia and one with microvillous inclusion disease) still had diarrhea. One patient underwent intestinal transplantation for tufting enteropathy. In conclusion, infants with PD should be referred to specialized centers where advanced diagnostic and therapeutic facilities are available, because histological analysis is critical for the diagnosis of PD, and PN or intestinal transplantation is the only therapeutic option in a subset of cases.
Academic Medical Centers ; Age of Onset ; Autoimmune Diseases/pathology ; Child, Hospitalized ; Child, Preschool ; Data Collection ; Diarrhea/*pathology ; Enteritis/immunology/*pathology ; Female ; Human ; Infant ; Infant, Newborn ; Intestinal Mucosa/pathology ; Intestine, Small/immunology/pathology ; Korea ; Lymphangiectasis, Intestinal/pathology ; Male ; Microvilli/pathology ; Retrospective Studies

Miyoshi myopathy (MM) is a type of distal myopathy that is characterized by an early adult onset and a prominent involvement of the gastrocnemius muscles. Weakness usually appears between 15 and 30 years of age starting in the posterior compartment of the legs. Creatine kinase (CK) values are characteristically elevated to levels 10 to 100 fold above normal range. Here we report one patient who was diagnosed as MM. She developed a motor weakness in her early thirties. There was an early and predominant involvement of the gastrocnemius muscles. Creatine kinase activity was elevated 10 to 15 fold above normal range. Electromyography revealed fibrillations, positive sharp waves, and a myopathic pattern of motor unit potentials, particularly in the distal muscles of the lower limbs. Myopathic features without vacuoles were seen in the vastus lateralis muscle. This is the first case report of MM in Korea, which should be considered in the differential diagnosis of slowly progressive weakness of distal legs.
Adult ; Creatine Kinase ; Diagnosis, Differential ; Distal Myopathies* ; Electromyography ; Humans ; Korea ; Leg ; Lower Extremity ; Muscles ; Muscular Diseases ; Quadriceps Muscle ; Reference Values ; Vacuoles