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Mitomycin C (MMC) trabeculectomy combined with extracapsular cataract extraction and posteor chamber intraocular lens implantation (glaucoma triple procedure, 30 eyes) was clinically compared with MMC trabeculectomy alone (30 eyes). The age, type of glaucoma, and preoperative number of medications were matched with the previous group (P>0.05). The mean preoperative intraocular pressures (IOPs) were 30.2+/-8.3mmHg (range, 22~56mmHg) in the glaucoma triple procedure group and 31.6+/-8.9mmHg (range, 22~57mmHg) in the trabeculectomy alone group (p=0.55). The mean postoperative IOPs were significantly higher in the glaucoma triple procedure group compared with the trabeculectomy alone group at all postoperative vistis (one month to nine months) (p<0.05). However, there were no statistically significant differences in the mean number of postoperative rise exceeding 30 mmHg within the postoperative one month tended to occur more frequently in the glaucoma triple procedure group (7 eyes (23%)) than the trabeculectomy alone group (2 eyes(7%)) (p=0.13). Conjunctival filtering blebs were significantly frequently observed in the trabeculectomy alone group than the glaucoma triple procedure group (28 eyes (93%), 20 eyes (67%), respectively, P=0.02) at 6 months postoperatively. The common postoperative complications were hyphema (4 eyes) and posterior capsular opacification (4 eyes) in the glaucoma triple procedure group and shallow anterior chamber(4 statistical difference was noted between these two groups (p>0.05). Although hypotensive effect of MMC on the glaucoma triple procedure was less than on the trabeculectomy alone, glaucoma triple procedure using MMC could be recommended to be safe and effective on controlling the high IOP for treating glaucoma patients with coexisting cataract.
Blister ; Cataract ; Cataract Extraction ; Glaucoma* ; Humans ; Hyphema ; Intraocular Pressure ; Lens Implantation, Intraocular ; Mitomycin* ; Postoperative Complications ; Trabeculectomy*

PURPOSE: To analyze the results of the foreign body reaction to polyethylene, polymethylmethacrylate, and metal debris and effect on bone by comparing histopathologic finding of pseudomembrane (interface membrane) which was obtained from failed cemented or cementless THA by aseptic loosening. MATERIALS AND METHODS: Of total 50 cases, we analyzed results between 25 cases of cemented THA and 25 cases of cementless THA. Follow-up period between primary and revision THA was average 8 years 5 months. Tissue specimens were harvested, stained with Hematoxylin-Eosin, and examined by light microscope. Histologic study of various items was done. RESULTS: The fibrous membrane between bone-to-cement or bone-to-metal could be roughly divided into three distinct histological layers in cross section histopathology. These tissues were characterized by histiocytes, infiltration of foreign body giant cells and fibrosis in all specimens, and infiltration of lymphocytes and plasma cells was relatively rare, and aggregation of polymorphonuclear leukocytes was invisible. CONCLUSION: Although there were no significant differences in histologic findings between the regions of ten tissue specimens, there was significant difference between the degree of polyethylene or cement debris in numbers and the degree of foreign body reaction associated with increased infiltrations of giant cells, and foreign body reaction to polyethylene debris seems to be main cause of aseptic loosening of prosthesis.
Arthroplasty, Replacement, Hip* ; Fibrosis ; Follow-Up Studies ; Foreign-Body Reaction ; Giant Cells ; Giant Cells, Foreign-Body ; Histiocytes ; Lymphocytes ; Membranes ; Neutrophils ; Plasma Cells ; Polyethylene ; Polymethyl Methacrylate ; Prostheses and Implants

PURPOSE: To evaluate the diagnostic performance of diffusion-weighted steady-state free precession (DW-SSFP) in comparison to diffusion-weighted echo-planar imaging (DW-EPI) for differentiating the neoplastic and benign osteoporotic vertebral compression fractures. MATERIALS AND METHODS: The subjects were 40 patients with recent vertebral compression fractures but no history of vertebroplasty, spine operation, or chemotherapy. They had received 3-Tesla (T) spine magnetic resonance imaging (MRI), including both DW-SSFP and DW-EPI sequences. The 40 patients included 20 with neoplastic vertebral fracture and 20 with benign osteoporotic vertebral fracture. In each fracture lesion, we obtained the signal intensity normalized by the signal intensity of normal bone marrow (SI norm) on DW-SSFP and the apparent diffusion coefficient (ADC) on DW-EPI. The correlation between the SI norm and the ADC in each lesion was analyzed using linear regression. The optimal cut-off values for the diagnosis of neoplastic fracture were determined in each sequence using Youden's J statistics and receiver operating characteristic curve analyses. RESULTS: In the neoplastic fracture, the median SI norm on DW-SSFP was higher and the median ADC on DW-EPI was lower than the benign osteoporotic fracture (5.24 vs. 1.30, P = 0.032, and 0.86 vs. 1.48, P = 0.041, respectively). Inverse linear correlations were evident between SI norm and ADC in both neoplastic and benign osteoporotic fractures (r = −0.45 and −0.61, respectively). The optimal cut-off values for diagnosis of neoplastic fracture were SI norm of 3.0 in DW-SSFP with the sensitivity and specificity of 90.4% (95% confidence interval [CI]: 81.0–99.0) and 95.3% (95% CI: 90.0–100.0), respectively, and ADC of 1.3 in DW-EPI with the sensitivity and specificity of 90.5% (95% CI: 80.0–100.0) and 70.4% (95% CI: 60.0–80.0), respectively. CONCLUSION: In 3-T MRI, DW-SSFP has comparable sensitivity and specificity to DW-EPI in differentiating the neoplastic vertebral fracture from the benign osteoporotic vertebral fracture.
Bone Marrow ; Diagnosis ; Diagnosis, Differential* ; Diffusion ; Diffusion Magnetic Resonance Imaging ; Drug Therapy ; Echo-Planar Imaging* ; Fractures, Compression* ; Fractures, Spontaneous ; Humans ; Linear Models ; Magnetic Resonance Imaging ; Osteoporotic Fractures ; ROC Curve ; Sensitivity and Specificity ; Spine ; Vertebroplasty

The multifactorial hypothesis is proposed as a working hypothesis which encompass both the genetic and environmental factors known to participate in the etiology of congenital heart malformations. So, it is believed that avoidance of suspected environmental factors in early pregnancy is the most certain preventive measure of congenital heart malformations. This study has been undertaken in order to find the possible environmental risk factors for congenital heart malformations in Korea. A total of 114 mothers of first graders of the elementary schools with congenital heart malformations confirmed through the screening program in Kyonggi Province from 1992 to 1995 were included as cases. And 206 mothers of healthy students matched by sex and elementary schools comprised the control group. Environmental risk factors including drug use during the first trimester of pregnancy, and other confounders were collected by telephone interview using standardized questionnaires by well trained interviewers. The result of multivariate logistic regression analysis showed that congenital heart malformation were associated with family history of congenital heart malformations(OR=2.94, 95% CI: 1.08, 7.96), the order of birth(OR=0.49, 95% CI: 0.31, 0.79). And the coffee consumption over 14 cups/week during early pregnancy showed marginal significance(OR=3.52, 95%CI: 0.98, 12.62). The mother's age at the subject birth and father's smoking at home were significant in linear trend test(p<0.05). It is recommended that the genetic counselling and the avoidance of known environmental risk factors in early pregnancy were needed to prevent congenital heart malformations.
Case-Control Studies* ; Coffee ; Female ; Gyeonggi-do ; Heart* ; Humans ; Interviews as Topic ; Korea ; Logistic Models ; Mass Screening ; Mothers ; Odds Ratio ; Parturition ; Pregnancy ; Pregnancy Trimester, First ; Risk Factors* ; Smoke ; Smoking ; Surveys and Questionnaires

BACKGROUND: Recently, VE1, a monoclonal antibody against the BRAFV600E mutant protein, has been investigated in terms of its detection of the BRAFV600E mutation. Although VE1 immunostaining and molecular methods used to assess papillary thyroid carcinoma in surgical specimens are in good agreement, evaluation of VE1 in thyroid cytology samples is rarely performed, and its diagnostic value in cytology has not been well established. In present study, we explored VE1 immunoexpression in cytology samples from ex vivo papillary thyroid carcinoma specimens in order to minimize limitations of low cellularity and sampling/targeting errors originated from thyroid fineneedle aspiration and compared our results with those obtained using the corresponding papillary thyroid carcinoma tissues. METHODS: The VE1 antibody was evaluated in 21 cases of thyroid cytology obtained directly from ex vivo thyroid specimens. VE1 immunostaining was performed using liquid-based cytology, and the results were compared with those obtained using the corresponding tissues. RESULTS: Of 21 cases, 19 classic papillary thyroid carcinomas had BRAFV600E mutations, whereas two follicular variants expressed wild-type BRAF. VE1 immunoexpression varied according to specimen type. In detection of the BRAFV600E mutation, VE1 immunostaining of the surgical specimen exhibited 100% sensitivity and 100% specificity, whereas VE1 immunostaining of the cytology specimen exhibited only 94.7% sensitivity and 0% specificity. CONCLUSIONS: Our data suggest that VE1 immunostaining of a cytology specimen is less specific than that of a surgical specimen for detection of the BRAFV600E mutation, and that VE1 immunostaining of a cytology specimen should be further evaluated and optimized for clinical use.
Biopsy, Fine-Needle ; Immunohistochemistry ; Mutant Proteins ; Sensitivity and Specificity ; Thyroid Gland* ; Thyroid Neoplasms*

Inflammatory myofibroblastic tumor (IMT) is a very rare benign mass lesion. Inflammatory myofibroblastic tumor of genitourinary tract most frequently involves the urinary bladder. Renal inflammatory myofibroblastic tumor is rare. Renal inflammatory myofibroblastic tumor usually remain asymtomatic until the tumor occurs obstructive uropathy. We experienced a case of right renal inflammatory myofibroblastic tumor.
Granuloma, Plasma Cell ; Kidney* ; Myofibroblasts* ; Myofibroma ; Urinary Bladder

PURPOSE: Breast cancers frequently undergo distant metastasis during the early phase, on which the survival of patients is greatly dependent. It has been suggested that the occurrence of micrometastasis relates with other prognostic features of breast cancer, such as lymph node metastasis and the presence of vascular invasion. The aim of this study was to examine the presence of keratin-19 and mammaglobin mRNA in bone marrow aspirates obtained from breast cancer patients, and their possible correlation with tumor staging and disease free survival. METHODS: Bone marrow samples were obtained from 254 breast cancer patients at the time of surgery. We separated the mononuclear fraction from the samples and carried out nested reverse transcriptase polymerase chain reaction for the detection of keratin-19 and mammaglobin mRNA using two different pairs of primers. We also studied the possible correlations between the tumor size, nodal involvement, stage, and distant metastasis. RESULTS: Seventy-five of the 254 samples were studied for cytokeratin 19 and the others for cytokeratin and mammaglobin. The median follow-up time was 21.1 months. Sixty-five (26%) of the 254 samples were cytokeratin 19 positive and 25 (14.3%) of the 175 were mammaglobin positive. Eight cases (12.3%) in the cytokeratin positive group showed a recurrent disease in distant organs. Whereas, six (3.2%) out of 185 cytokeratin negative patients had distant recurrences. Mammaglobin positivity was not correlated with distant metastasis. The stage, nodal status, and estrogen receptor were independent of bone marrow micrometastasis. CONCLUSION: Bone marrow micrometastasis, detected by nested RT-PCR for cytokeratin 19, could be a useful predictive marker for the distant metastasis of breast cancer.
Bone Marrow* ; Breast Neoplasms* ; Breast* ; Disease-Free Survival ; Estrogens ; Follow-Up Studies ; Humans ; Keratin-19* ; Keratins* ; Lymph Nodes ; Neoplasm Metastasis ; Neoplasm Micrometastasis* ; Neoplasm Staging ; Recurrence ; Reverse Transcriptase Polymerase Chain Reaction ; RNA, Messenger

Purpose: Laparoscopic radical nephrectomy has emerged as a feasible treatment option for patients with clinically localized renal cell carcinoma. We evaluated the clinical efficacy and oncologic safety of laparoscopic radical nephrectomy. Materials and Methods: Between April 2004 and October 2005, 31 laparoscopic radical nephrectomies were performed for clinically localized, stages cT1/2 NXMX, pathologically confirmed renal cell carcinoma. The clinical parameters including the operative time and the learning curve, the estimated blood loss, the postoperative hospital stay and the recurrence rate were evaluated. Results: All procedures were completed laparoscopically via transperitoneal approach. There were no complications. The mean operative time was 140.6 minutes (range: 80-270) and the mean blood loss was 230.4ml (range: 30-800). The mean postoperative hospital stay was 4.9 days (range: 3-9) and all patients had satisfactory outcomes with objective cure on the follow up imaging studies. No patient had laparoscopic port site, wound or renal fossa tumor recurrence during the follow up periods (mean: 13 months). Conclusions: Laparoscopic transperitoneal radical nephrectomy can be a safe and effective treatment. It could be considered as a primary procedure for treating localized renal cell carcinoma.
Carcinoma, Renal Cell* ; Follow-Up Studies ; Humans ; Laparoscopy ; Learning Curve ; Length of Stay ; Nephrectomy* ; Operative Time ; Recurrence ; Wounds and Injuries

Background: As obese population is increasing nowadays, research on blood pressure of obese children is being performed more frequently. However, there are only few research related to factors about blood pressure among obese children in Korea. The purpose of this study was to analyze the factors affecting blood pressure of obese children and adolescents. Methods: The subjects were elementary and middle school students diagnosed with obesity (n=1716). Height, weight, waist circumstance, body fat percent, blood pressure were measured. Family history and sexual maturity were investigated through the questionnaire. The relationship between the factors and the increase of blood pressure was analyzed. Results: Body weight was the most powerful factor among to factors related to increase of blood pressure (male r=0.45, P<0.05, female r=0.37, P<0.05). Also, height, percentage weight for height (PWH), body mass index (BMI) and waist circumference was correlated with the blood pressure. In multiple regression analysis, family history of hypertension and the sexual maturity were significant determinants of blood pressure in males after adjusting for weight. However, body fat percent was a significant determinant in females. Conclusion: Body weight was the most important factor which increased the blood pressure in obese children and adolescents in both sexes. But males and females had different factors related to the increase of blood pressure with the exception of body weight.
Adipose Tissue ; Adolescent* ; Blood Pressure* ; Body Mass Index ; Body Weight ; Child* ; Female ; Humans ; Hypertension ; Korea ; Male ; Obesity ; Waist Circumference ; Surveys and Questionnaires