• Journal of Korean Neurosurgical Society
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• v.50 no.2
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• pp.81-88
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• 2011

Objective : The purpose of this study was to analyze the clinical and anatomic features involved in determining treatment modalities for anterior communicating artery (AcoA) aneurysms. Methods : The authors retrospectively evaluated 112 AcoA aneurysms with pretreatment clinical features including age, Hunt and Hess grade, medical or neurological comorbidity, and anatomical features including aneurysm size, neck size, dome-to-neck ratio, vessel incorporation, multiple lobulation, and morphologic scoring system. Post-treatment clinical results were classified according to the Glasgow Outcome Scale, and anatomic results in coiled patients were classified according to the modified Raymond scale. Using multivariate logistic regression, the probabilities for decision making between surgical clipping and coil embolization were calculated. Results : Sixty-seven patients (60%) were treated with surgical clipping and 45 patients (40%) with endovascular coil embolization. The clinical factor significantly associated with treatment decision was age (${\geq}$65 vs. <65 years) and anatomical factors including aneurysm size (small or large vs. medium), dome-to-neck ratio (<2 vs. ${\geq}$2), presence of vessel incorporation, multiple lobulation, and morphologic score (${\geq}$2 vs. <2). In multivariate analysis, older patients (age, 65 years) had significantly higher odds of being treated with coil embolization relative to clipping (adjusted OR=3.78; 95% CI, 1.39-10.3; p=0.0093) and higher morphological score patients (${\geq}$2) had a higher tendency toward surgical clipping than endovascular coil embolization (OR=0.23; 95% CI, 0.16-0.93; p=0.0039). Conclusion : The optimal decision for treating AcoA aneurysms cannot be determined by any single clinical or anatomic characteristics. All clinical and morphological features need to be considered, and a collaborative neurovascular team approach to AcoA aneurysms is essential.

• Journal of Chest Surgery
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• v.50 no.4
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• pp.270-274
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• 2017

Background: We evaluated the operative outcomes of an extra-anatomic bypass from the ascending aorta to the abdominal aorta in patients with type II or III Takayasu arteritis (TA) with mid-aortic syndrome. Methods: From 1988 to 2014, 8 patients with type II (n=2) or III (n=6) TA underwent an ascending aorta to abdominal aorta bypass. The mean patient age was $43.5{\pm}12.2years$ and the mean peak pressure gradient between the upper and lower extremities was $54.8{\pm}39.0mm\;Hg$. The median follow-up duration was 54.4 months (range, 17.8 to 177.4 months). Results: There were no cases of operative mortality. The mean peak pressure gradient significantly decreased to $-2.4{\pm}32.3mm\;Hg$ (p=0.017 compared to the preoperative value). Late death occurred in 2 patients. The symptoms of upper extremity hypertension and claudication improved in all patients. The bypass grafts were patent at $47.1{\pm}58.9months$ in 7 patients who underwent follow-up imaging studies. Conclusion: An extra-anatomic ascending aorta to abdominal aorta bypass could be an effective treatment option for severe aortic steno-occlusive disease in patients with type II or III TA, with favorable early and long-term outcomes.

• Journal of Korean Neurosurgical Society
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• v.47 no.3
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• pp.169-173
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• 2010

Objective : The normal anatomic relationships characteristic of the pituitary stalk area were previously thought to involve only one location. The purpose of this study was to re-evaluate the anatomic location of the pituitary stalk and possible varying locations in relation to the tuberculum sellae and dorsum sellae using morphometric evaluation and anatomic dissection of human cadaveric specimens. The surgical implications of the variations are discussed. Methods : The calvaria were removed via routine autopsy dissections, and the brains were removed from the skull while preserving the pituitary stalk. The diaphragma sellae, tuberculum sellae, and the location of the pituitary stalk were examined in 60 human cadaveric heads obtained from fresh adult cadavers. Empty sellae were excluded. Results : The openings of the diaphragma sellae averaged $6.62{\pm}1.606mm$ (range, 3-9 mm). The distance between the tuberculum sellae and the posterior part of the pituitary stalk was 1 to 8 mm. The upper face of the diaphragma sellae appeared flat in 26 (43%), concave in 24 (40%), and convex in 6 cases (10%), with a prominent tuberculum sellae in 4 cases (7%). The location of the chiasm was normal in 47 cases (78%), with a prefixed chiasm in 3 cases (5%) and a postfixed chiasm (17%) in the 10 cases. Four cadaver specimens had prominent tuberculum sellae and other parameters were not evaluated. Conclusion : When opening the chiasmatic cistern, neurosurgeons should be aware about the relationship between the pituitary stalk and the surrounding structures to prevent inadvertent injury to the pituitary stalk.

• Journal of Dental Rehabilitation and Applied Science
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• v.33 no.3
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• pp.207-215
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• 2017

Many factors should be considered for successful denture treatment at edentulous patients: support, retention, stability, occlusion, esthetics, etc. The patient who has severely absorbed residual ridges, however, treatments are challenging to satisfy those factors. The dentures that use anatomic artificial teeth show good mastication efficiency and esthetics but, can easily lose stability at absorbed ridges. On the contrary, the dentures that use non-anatomic artificial teeth perform better stability but, lower masticatory efficiency and esthetics at absorbed ridges. The lingualized occlusion, using both anatomic and non-anatomic teeth, introduced for compromise those of the pros and cons. At lingualized occlusion, buccal cusps of the teeth do not contact on centric relation. Therefore, direction of the occlusal force towards lingually, then stability of dentures increases. This case report shows the results of the treatment flat residual ridges using complete dentures with ligualized occlusion to increase dentures stability and satisfactory of the patient.

• Clinical and Experimental Reproductive Medicine
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• v.18 no.1
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• pp.113-120
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• 1991

Etiologic classification was performed in 155 patients with recurrent spontaneous abortion history. The incidence was 9.3% among 1658 pregnant women at Hanyang university hospital during the same period. In etiologic classification, 37 cases of on-going patients for diagnostic evaluation were excluded. Of the remained 118 patients, the patients with unknown etiology were 32 cases (27.1%), and 86 cases were classified into each etiologies using appropriate diagnostic modalities. Anatomic causes were the largest etiology, which revealed 46.6% (55 among 118 patients). The next etiology was immunologic cause, which revealed 24.6% (29 patients). Of the 86 patients who have at least one cause, 40.7% (35 among 86) have two or more etiologies. Furthermore, six cases (7%) have 3 combined etiologies. The uterine synechia and/or incompetent internal os of the cervix, namaly anatomic causes, revealed highest combination ratio than other etilogies. The popular abortion technique in Korea, D&C, seems to be main factors for these anatmic causes. The combined causes rather than single cause of recurrent spontaneous abortion were unique situation in Korea especially with anatomic etiologies. From this point of view, we think anatomic etiologies should be rule out first in the evaluation of the patients. For this purpose, we believe hysteroscopy would be helpful as a diagnostic work-up and treatment modality in the management of recurrent spontaneous abortion patients in Korea.

• The Korean Journal of Cytopathology
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• v.10 no.1
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• pp.1-5
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• 1999

To evaluate whether different qualifications of a cytologic diagnosis of "atypical squamous cells of undetermined significance(ASCUS)" predict a greater or lesser likelihood of tissue diagnosis of uterine cervix, we compared different cytologic qualifications of ASCUS with the tissue diagnosis. One hundred twenty-two consecutive Papanicolaou smears showing ASCUS in women who had undergone cervical biopsy within nearest 30 days were collected. The 122 smears were qualified as "favor reactive"(25%), "favor low grade squamous intraepithelial lesion (LSIL)"(24%), "favor squamous intraepithelial lesion(SIL)"(16%), "favor high grade squamous intraepithelial lesion(HSIL)"(16%), and "not otherwise specified"(19%). Squamous intraepithelial or invasive lesion was pathologically confirmed by cervical biopsy in 13%, of the "favor reactive", 27% in "favor LSIL", 70% in "favor SIL", 75%, in "favor HSIL", and 35% in "not otherwise specified" smears. There were significant associations between the favor reactive smear and the benign biopsy finding and between the favor SIL smear and the biopsy shewing a squamous intraepithelial or more severe lesion. Nevertheless, most of favor LSIL smears exhibit reactive process in tissue biopsy. Conclusively, qualified ASCUS stratifies women Into different risk groups for SIL. The cytopathologist should make the cytologic diagnosis of "ASCUS, favor LSIL" circumspectly.

• Asian Pacific Journal of Cancer Prevention
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• v.17 no.4
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• pp.1973-1978
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• 2016

Background: Breast cancer is a heterogeneous disease that represents a major public health problem. The immunohistochemical determination of breast cancer subtypes with regard to estrogen receptor (ER), progesterone receptor (PR), and human epidermal growth factor receptor (HER2) status can contribute to improved selection of therapy and patientcare. The purpose of this study was to determine the prevalence of the molecular breast cancer subtypes and to assess their associations with classical clinicopathologic parameters for better therapeutic decisions in women with breast cancer in the Ivory Coast. Materials and Methods: Formalin-fixed and paraffin-embedded blocks of patients diagnosed with primary breast carcinoma were subjected to immunohistochemical assay for the assessment of ER/RP and HER2 expression. The one-way analysis of variance evaluated the difference between breast cancer subtypes and mean age of patients. The Chi-square Test was used to compare standard clinicopathologic prognostic parameters with tumor subtypes. Results. Among 302 patients, 57% were premenopausal and 43% were postmenopausal. The invasive ductal carcinoma not otherwise specified (IDC NOS) (82.8%) was the most frequent histological type, and the tumor grade 2 (56%) was predominant followed by grade 3 (20.9%). The proportion of positivity of ER, PR, and HER2 was 56%, 49%, and 15.6%, respectively. Half of patients of this study (51.6%) had luminal A breast tumor type followed by TN (32.1%). Other subtypes were luminal B (10.1% ) and non-luminal HER2+ (6.3%). Conclusions. The findings of the present study are in line with the literature and should assist in management of breast cancer in our country.

• Imaging Science in Dentistry
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• v.44 no.4
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• pp.279-285
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• 2014

Purpose: To assess the influence of anatomic location on the relationship between computed tomography (CT) number and X-ray attenuation in limited and medium field-of-view (FOV) scans. Materials and Methods: Tubes containing solutions with different concentrations of $K_2HPO_4$ were placed in the tooth sockets of a human head phantom. Cone-beam computed tomography (CBCT) scans were acquired, and CT numbers of the $K_2HPO_4$ solutions were measured. The relationship between CT number and $K_2HPO_4$ concentration was examined by linear regression analyses. Then, the variation in CT number according to anatomic location was examined. Results: The relationship between $K_2HPO_4$ concentration and CT number was strongly linear. The slopes of the linear regressions for the limited FOVs were almost 2-fold lower than those for the medium FOVs. The absolute CT number differed between imaging protocols and anatomic locations. Conclusion: There is a strong linear relationship between X-ray attenuation and CT number. The specific imaging protocol and anatomic location of the object strongly influence this relationship.

• The Korean Journal of Cytopathology
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• v.5 no.1
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• pp.35-40
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• 1994

A case of poorly differentiated "insular" carcinoma of the thyroid is presented and discussed with references to the literature. Un fine needle aspiration cytology of our case, the aspirates were highly cellular with tumor cells appearing as dispersed isolated cells as well as in dense clusters and syncytial formations. Occasional microfollicles containing colloid were evident. Most of nuclei were fairly uniform with considerable variability and a few showed definite atypical features. Nuclear grooving was additional features. Necrotic debris was not seen. Our cytologic findings were correlated well with histology, confirming typical insular pattern of tumor cells with the presence of occasional pleomorphic cells and papillary carcinoma-like features. With much attention to cytological features of insular carcinoma, it would be possible to diagnose a preoperative suggestive diagnosis, even though not definitive.

• The Korean Journal of Cytopathology
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• v.4 no.1
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• pp.74-76
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• 1993

Cytologic findings of pleural effusion in three cases of rhabdomyosarcoma are reported. Case 1 was a pleomorphic rhabdomyosarcoma which had devoped at the chest wall of an elderly male patient and caused pleural effusion. The cytologic features were consistent with pleomorphic rhabdomyosarcoma, that was, showing loose clusters, cellular pleomorphism, and abundant finely vesicular cytoplasm. Cases 2 and 3 were embryonal rhabdomyosarcomas in young adults. Primary site was the oral cavity in case 1, but unknown in case 2 and case 3. The effusion cytology was similar in these cases. Clustered or isolated small round cells with hyperchromatic nuclei and scanty cytoplasm were smeared. The cohesiveness of tumor cells was weak and the cells did not show linear arrangement or nuclear melding. Effusion cytology in a sarcoma patient would be diagnostic when the primary site and the type of sarcoma were already known.