Plain Radiologic Findings and Chronological Changes of Incipient Phase Osteosarcoma Overlooked by Primary Physicians

BACKGROUND: We assessed the plain radiographic characteristics of 10 cases of osteosarcomas during the initial painful period that had been overlooked by a primary physician. In addition, we evaluated chronologic changes in radiographic findings from initial symptomatic period to the time of accurate diagnosis. METHODS: The clinical records were reviewed for clinical parameters including age, sex, location, presenting symptoms, initial diagnosis, duration from initial symptoms to definite diagnosis, and initial and follow-up plain radiographic findings of the lesion. RESULTS: Initial clinical diagnoses included a sprain in 6, growing pain in 2, stress fracture in 1, and infection in 1 patient. Initial plain radiographic findings were trabecular destruction (100%), cortical disruption (60%), periosteal reaction (60%), and soft tissue mass (10%). Intramedullary matrix changes were osteosclerosis in 6 and osteolysis in 4 patients. On progression, 4 cases with minimal sclerosis changed to osteoblastic lesion in 3 patients and osteolytic lesion in 1. Four cases with faint osteolytic foci transformed into osteolytic lesion in 3 and mixed pattern in 1. CONCLUSIONS: Notable plain radiologic findings of incipient-stage osteosarcoma include trabecular disruption along with faint osteosclerosis or osteolysis. In symptomatic patients with trabecular destruction, additional imaging study including magnetic resonance imaging should be performed to exclude osteosarcoma in the incipient phase, even without radiologic findings suggesting malignant tumor, such as cortical destruction or periosteal reaction.

Chronological Changes of Gastric Cancer in Community Hospital

PURPOSE: Gastric cancer remains the most common type of cancer in Korea, however, early diagnosis and surgical advancements have resulted in a better prognosis in the last few decades. The aim of this study was to investigate chronological changes of the clinicopathological features in patients with primary gastric cancer who had undergone gastric operations in Department of Surgery of Seoul Municipal Boramae Hospital. METHOD: Between November 1991 and April 2001, 634 primary gastric adenocarcinoma patients having undergone gastric operations were included in this study and divided into the two groups: 298 patients between 1991 and 1996 (early group) and 336 patients thereafter (late group). The clinicopathological characteristics, including age, gender, type of operation, gross and histologial findings, stage, and ratio of early gastric cancer, were compared between the two groups. RESULTS: The overall male-to-female ratio was 2: 1, with a mean age of 59.0 years. As the community hospital, eighty two percents of patients were resident within the same administrative district. There were no statistical differences in age, gender, type of operation, and total number of resected lymph nodes between the two groups. In contrast, cancers with a larger size, the distal one third of the location, well-differentiated adenocarcinoma, low depth of invasion, and high nodal metastasis were more prevalent in the late group (P < 0.05). Also, the proportion of earlier stages was increased in the late period (P<0.001). The ratios of early gastric cancers were 24.8, and 38.4% in the early and late groups, respectively (P<0.001) CONCLUSION: Our results suggest that the chronological changes of gastric cancer were closely related to the increased number of early gastric cancer patients, primarily due to the early detection of cancer. Therefore, to obtain the better outcomes from gastric cancer, an early diagnosis was essential from routine health check-ups and the well- organized establishment of a nation- and community-wide screening program and information on public health.

A Demonstrative Study on Physiological Properties Observed in Walking along Various Routes in Forests on the Basis of Chronological Changes in the Energy Consumption. Conditions for establishing promenades in forests / 日本温泉気候物理医学会雑誌

Walking exercise in forests, referred to as “shinrin-yoku, forest-air bathing and walking, ” has been attracting attention as a method for promoting mental and physical health utilizing the environment and topography of forests in the recent time. Walking exercise in forests has characteristics arising from the natural environment and topography of forests with beautiful trees, twittering of birds, and favorable fragrances of woods, etc. However, scientific verification of such specific effects is necessary in order to make walking an authentic method to health promotion. This study intended to physiologically investigate it from physical and scientific point of view. For this purpose, we determined chronological changes in energy consumed in walking exercise in forests with a portable oxygen intake measuring device, on the basis of data on the respiratory and circulatory systems such as heart rate and the amounts of ventilation and oxygen intake. The results suggested that the changes in these parameters showed the movement correlated with the changes in topography of forests, including the inclination and demonstrated that selection on the resting locations was related to the comfortable rhythm of walking. Furthermore, it was indicated that exercise loading to living body tended to increase in association with increases in the upward inclination, resulting that the energy consumed in walking was less though the amounts of exercise loading to lower limbs tended to be very large at a download inclination of 36.0 degrees or larger. This demonstrative study suggested that to determine chronological changes in physiological loading conditions related to the walking route was effective to establish promenades in order to perform comfortable and effective forest bath.

Clinical Observation of Bile Culture and Chronological Change of Bacteriology

BACKGROUND: Intraoperative collection of bile and a bile culture are of use in predicting bacterial infection in the biliary system. The aim of this study was to identify chronological changes in the bacteriology of the bile in the age and sex distributions for biliary tract disease of the patients. METHODS: We retrospectively reviewed the clinical records of 722 patients who had been operated on for biliary tract disease at the Department of Surgery Ewha Womans University Hospital, from Jan. 1979 to July 1998 and on whom intraoperative bile culture had been performed. We divided the 722 patients into two group based on the time of their treatment, period A being 1979-1988 and period B being 1989-1998. The statistical analysis was done by using the Mantel-Haenszel Chi-Square test. RESULTS: The overall bile culture positive rate was 56% (404 cases), and the male-to-female ratio was 1:1.64. There was no significant statistical difference in the sex ratio between the two periods (period A: 1:1.78, period B: 1:1.55) (p>0.05). Overall, the most commonly isolated organism in the bile was Escherichia coli (137 cases, 30%). Comparing the two periods, we found that the Enterococcus species was an organism found increasingly in biliary tract infections (period A: 0%; period B: 17%) whereas infection by Escherichia coli was significantly decreased in the latter period (period A: 43%; period B: 28%) (p<0.05). The sixth decade (29.1%) was the most prevalent age overall. The age distribution for period A showed no statistical difference between the 5th (21.58%) and the 7th decades (21.94%), but there was significant difference between the 7th (29.95%) and the 5th decades (16.89%) in the age distribution for period B (p<0.05). CONCLUSIONS: According to the above results, we concluded that there were significant chronological changes in the bacteriology of the bile & in the age distributions between the two periods, but no such difference was observed between the sex distribution.