A 66-year-old woman was transferred to our hospital due to her right breast cancer. Preoperative breast MRI shows 1.9 cm malignancy on her right breast (cT1N0M0) and incidentally found osteosclerotic change of left coststernoclavicular region. Bone scintigraphy showed hot uptake and the possibility of bone metastasis was not excluded. However, because the bone metastasis is not common in early stage cancer and the costosternoclavicular region is not common site, other possibility should be considered. SAPHO syndrome can be diagnosed even in the absence of dermatosis when there is an axial or appendicular osteitis and hyperostosis, especially in costosternoclavicular region. Though breast imaging specialists are not accustomed to this disease entity, awareness and diagnosis of the SAPHO syndrome can help differentiate bone metastasis.
Acquired Hyperostosis Syndrome* ; Aged ; Breast Neoplasms* ; Breast* ; Diagnosis ; Female ; Humans ; Hyperostosis ; Magnetic Resonance Imaging ; Neoplasm Metastasis* ; Osteitis ; Radionuclide Imaging ; Skin Diseases ; Specialization

To clarify the correlations between the body height and maximum femoral length, we carried out orthoscanographic study in 187 normal adult Koreans (male; 80, female; 107). The results are as follws: 1. The average femoral length was 43.73±2.13cm for male, and 40.53±2.03cm for female. 2. The ratio of the femoral length to the height was 26.10±0.82% for male, and 35.91±0.77% for female. The coefficient of correlation was 0.78 and 0.80, respectively. 3. The regression equation was Y= −7.76+0.31X for male Y= −2.85+0.28X for female. (X: body height. Y: maximum femoral length)
Adult ; Body Height ; Female ; Humans ; Male

A case of Cushing's syndrome due to bilateral pigmented nodular adrenal disease in a 35-year-old male is presented. The adrenals showed multiple, black, variable sized nodules. Histologically the cells contained lipofuscin and either had a clear cytoplasm or an eosinophilic cytoplasm with a prominent nucleus. Lymphocytic infiltration and fatty metaplasia within the nodules are two of the prominent histological features. There is extreme internodular atrophy which suggests that primary pigmented nodular adrenocortical disease is a non-adrenocorticotropic hormone dependent condition. Since the disorder appears to involve primarily the cortex of both adrenals, the treatment of choice is bilateral adrenalectomy followed by steroid replacement. The characteristic clinicopathological manifestations that separate this diagnosis from other types of adrenal disease are also discussed. This is the first reported case in Korea to be documented with the pertinent clinicopathological findings.
Adipose Tissue/pathology ; Adrenal Cortex/chemistry/*pathology/radiography/secretion/ultrasonography ; Adrenalectomy ; Adult ; Atrophy ; Case Report ; Cushing Syndrome/*etiology/surgery ; Dexamethasone/diagnostic use ; Furosemide/diagnostic use ; Human ; Hydrocortisone/secretion ; Inflammation ; Lipofuscin/*analysis ; Male ; Metaplasia ; Organelles/ultrastructure

OBJECTIVE: Atrophy and a high T2 signal of the hippocampus are known to be the principal MR imaging findings of hippocampal sclerosis. The purpose of this study was to determine whether or not individual MRI findings correlate with surgical outcome in patients with this condition. MATERIALS AND METHODS: Preoperative MR imaging findings in 57 consecutive patients with pathologically-proven hippocampal sclerosis who underwent anterior temporal lobectomy and were followed-up for 24 months or more were retrospectively reviewed, and the results were compared with the postsurgical out-come (Engel classification). The MR images included routine sagittal T1-weighted and axial T2-weighted spin-echo images, and oblique coronal T1-weighted 3D gradient-echo and T2-weighted 2D fast spin-echo images obtained on either a 1.5 T or 1.0 T unit. The images were visually evaluated by two neuroradiologists blinded to the outcome; their focus was the presence or absence of atrophy and a high T2 hippocampal signal. RESULTS: Hippocampal atrophy was seen in 96% of cases (55/57) [100% (53/53) of the good outcome group (Engel class I and II), and 50% (2/4) of the poor outcome group (class III and IV)]. A high T2 hippocampal signal was seen in 61% of cases (35/57) [62% (33/53) of the good outcome group and 50% (2/4) of the poor outcome group]. All 35 patients with a high T2 signal had hippocampal atrophy. `Normal' hippocampus, as revealed by MR imaging, occurred in 4% of patients (2/57), both of whom showed a poor outcome (Engel class III). The presence or absence of hippocampal atrophy correlated well with surgical outcome (p<0.01). High T2 signal intensity did not, however, significantly correlate with surgical outcome (p>0.05). CONCLUSION: Compared with a high T2 hippocampal signal, hippocampal atrophy is more common and correlates better with surgical outcome. For the prediction of this, it thus appears to be the more useful indicator.
Adult ; Atrophy ; Female ; Hippocampus/*pathology/*surgery ; Human ; *Magnetic Resonance Imaging ; Male ; Middle Age ; Predictive Value of Tests ; Retrospective Studies ; Sclerosis ; Support, Non-U.S. Gov't ; Treatment Outcome

OBJECTIVE: The purpose of this study was to describe the myocardial enhancement patterns in patients with myocardial infarction using two-phase contrast-enhanced multidetector-row computed tomography (MDCT). MATERIALS AND METHODS: Twenty-three patients with clinically proven myocardial infarction (17 acute myocardial infarction [AMI] and 6 chronic myocardial infarction [CMI]) were examined with two-phase contrast-enhanced ECG-gated MDCT. The presence, location, and patterns of myocardial enhancement on two-phase MDCT images were compared with infarcted myocardial territories determined by using electrocardiogram, echocardiography, thallium-201 single photon emission computed tomography, catheter and MDCT coronary angiography. RESULTS: After clinical assessment, the presence of myocardial infarctions were found in 27 territories (19 AMI and 8 CMI) of 23 patients. Early perfusion defects were observed in 30 territories of all 23 patients. Three territories not corresponding to a myocardial infarction were detected in three patients with AMI and were associated with artifacts. Fourteen of perfusion defects were in the left anterior descending artery territory, four in the left circumflex artery territory, and nine in the right coronary artery territory. Delayed enhancement was observed in 25 territories (17 AMI and 8 CMI) of 21 patients. Delayed enhancement patterns were variable. Transmural early perfusion defects (n =12) were closely associated with transmural late enhancement (n = 5) and subendocardial residual defect with subepicardial late enhancement (n = 5). CONCLUSION: Myocardial infarction showed early perfusion defects and variable delayed enhancement patterns on two-phase contrast-enhanced MDCT. Delayed enhancement technique of MDCT could provide additional information of the location and extent of infarcted myocardium, and could be useful to plan appropriate therapeutic strategies in patients with AMI.
Adult ; Aged ; Aged, 80 and over ; Contrast Media ; Coronary Angiography ; Echocardiography ; Electrocardiography ; Female ; Humans ; Iohexol/analogs & derivatives/diagnostic use ; Male ; Middle Aged ; Myocardial Infarction/*radiography ; Tomography, Emission-Computed, Single-Photon ; Tomography, X-Ray Computed/*methods

Blastic natural killer (NK) cell lymphoma is a rare neoplasm characterized by blastoid tumor cells expressing CD4 and CD56, with predominant skin involvement. Although this tumor has been regarded as a neoplasm related to NK cell, recent studies suggested that it is derived from plasmacytoid dendritic cells, but not from NK cell. Herein we report 4 cases of CD4+CD56+ lineage marker- blastic NK cell lymphomas with a review of literatures. The patients were 3 men and one woman. Three of them were young (17, 18, and 22 yr old). Three patients had skin lesions, at initial presentation in two patients and during the course of disease in other patient. Histologically, tumors consisted of monotonous medium to large blastoid cells showing no necrosis, angiocentric growth or epidermotrophism. All four tumors were CD4+ and CD56+. Three expressed CD68 antigen. Lineage specific markers for B- and T cell were negative. All tumors did not express myeloperoxidase. T-cell receptor gene rearrangement, EBV, CD13 and CD33 were negative. In one patient, tumor cells arranged in Homer-Wright type pseudorosette and expressed terminal deoxynucleotidyl transferase(TdT). Despite the standard lymphoma chemotherapy, the tumors, except one lost during follow-up, progressed and relapsed. The patients died 8-60 months after diagnosis.
Adolescent ; Antigens, CD4/*analysis ; Antigens, CD56/*analysis ; Cell Lineage ; Female ; Humans ; Killer Cells, Natural/immunology/*pathology ; Lymphoma, T-Cell/immunology/*pathology ; Male ; Middle Aged

BACKGROUND: Defects in apoptotic signaling pathways play important role in tumor initiation, progression, metastasis and resistance to treatment. Several proteins which may promote tumorigenesis by inhibiting apoptosis were identified. The survivin protein is the member of inhibitor of apoptosis protein(IAPs) family which inhibits apoptosis. Unlike other IAPs, it is expressed in during the fetal period but not in adult differentiated tissues. Many reports have stated that survivin is selectively expressed in many cancer cell lines and cancer tissues. We performed immunohistochemical analysis for survivin expression in non-small cell lung cancer to get evaluate its clinical implication. METHODS: Twenty nine surgically resected lung cancers were examined. Immunohistochemical staining were performed by immuno-peroxidase technique using avidin-biotinylated horseradish peroxidase complex in the formalin-fixed, paraffin-embedded tissue 4 µm section. Anti-survivin polyclonal antibody was used for primary antibody and anti-p53 monoclonal antibody was also used to analyze the correlation between survivin and p53 expression. The survivin expression scores were determined by as the sum of the stained area and intensity. RESULTS: Immunohistochemical analysis showed cancer specific expression of survivin in 20 of 29 cases (69.0%). Western blot analysis also showed the selective survivin expression in turmor tissue. There was no correlation between survivin expression and clinicopathological parameters and prognosis. We analyzed the correlated between survivin expression and p53 expression, but found none. CONCLUSION: We confirmed the tumor specific expression of survivin in non-small cell lung cancer But this pression was not correlated with clinical parameters as well as histlogy, tumor stage recurrence, and sur rate. Also it ws not statistically correlated with the expression of p53.
Adult ; Apoptosis ; Blotting, Western ; Carcinogenesis ; Carcinoma, Non-Small-Cell Lung* ; Cell Line ; Horseradish Peroxidase ; Humans ; Immunohistochemistry ; Inhibitor of Apoptosis Proteins* ; Lung Neoplasms ; Neoplasm Metastasis ; Prognosis ; Recurrence

A 43-year-old female patient with a congenital right coronary artery to right atrial fistula presented as congestive heart failure and aortic valve infective endocarditis. The diagnosis was made on the basis of echocardiography, especially TEE and confirmed by tight heart catheterization & aortography. She underwent aortic valve replacement due to severe aortic valve regurgitation with vegetations, fistulectomy and coronary aneurysmorrhaphy. The postoperative course was uneventful. She was treated with antibiotics because of infective endocarditis for 6 weeks. At present she remains well and visits out patient clinic regularly for oral anticoagulation without problem.
Adult ; Anti-Bacterial Agents ; Aortic Valve* ; Aortography ; Arteriovenous Fistula* ; Cardiac Catheterization ; Cardiac Catheters ; Coronary Vessels ; Diagnosis ; Echocardiography ; Endocarditis* ; Estrogens, Conjugated (USP)* ; Female ; Fistula ; Heart Failure* ; Humans

PURPOSE: This study was designed to clarify the osseointegration of the titanium screw coated with CMP, in regard to the time schedule, through the characteristic of early osseointegration. MATERIALS AND METHODS: Mechanical, radiological and histomophometric measurements were performed in 28 rabbit tibial proximal metaphyseal cortical bone screws 6, 12, 26 and 52 weeks after surgery for the in vivo comparison of the osseointegration of titanium screws (3.75 mm diameter, 5 mm length) with different surface treatments: CMP coating group, with the sol-gel method (experimental group) and uncoated group (control group). RESULTS: 1. Radiology: There were no differences between the two groups without a radiolucent line or in regard to the time schedule. 2. Histology: There were no differences between the two groups without a fibrous tissue intervening surface or in regard to the time schedule. 3. Torque test: The test results for the CMP coated group were 1.5 times higher than those for the uncoated group, which was statistically meaningful, but there was no difference in regard to the time schedule. CONCLUSION: CMP coating is an option to increase the osseointegration of the titanium screw.
Appointments and Schedules ; Bone Screws ; Ceramics* ; Osseointegration* ; Tibia ; Titanium ; Torque

Earlier work suggested that Ginseng saponin had an effect on healing of fracture and osteoporosis, hut there has heen no report on saponin effects on cultured osteoblast. The purpose of this study was to investigate the effect of saponin on cultured osteovlast of the mouse. Osteohlastic cells were isolated from periosteum-stripped parietal bones of neonatal rat calvaria, seeded at 4 x 10 4 cells/cm2 density, and cultured in standard medium and deficient medium, with addition of saponin (0(control), 10, 20, 50 microgram/ml concentration). Plating efficiency(adhesiveness), proliferation and the alkaline phosphatase activity of the osteohlasts were evaluated on 2 hours, days 2 and 7 of culture. Saponin was found to enhance the adhesiveness of seeded osteoblasts which were cultured with a deficient medium in comparison to the controls. It promoted cell proliferation of the osteoblasts cultured with a deficient medium in comparison to the controls. There was also a significantly enhanced increase of alkaline phosphatase levels in the presence of saponin during culture with deficient medium in comparison to the controls. In summary, the results showed that the saponin increased adhesiveness, proliferation and the alkaline phosphatase activity of the osteoblast cultured only in deficient medium.
Adhesiveness ; Alkaline Phosphatase ; Animals ; Cell Proliferation ; Mice ; Osteoblasts* ; Osteoporosis ; Panax* ; Parietal Bone ; Rats ; Saponins* ; Skull