No abstract available.
Esophageal Neoplasms*

A new hypolipidemic agent, lovastatin, hydroxy-methyl-gultaryl coenzyme A reductase inhibitor was administred to 25 patients with primary hyperlipidemia 20 to 40 mg daily for 12 weeks and sequential changes of serum lipid profile were analysed as follow. 1) Mean average at baseline period of serum total cholesterol, triglyceride, HDL and low desity lipoprotein cholesterol were 271, 179, 51 and 185 mg/dl respectively. 2) Total cholesterol showed 20% decrease at 4th week and 23% decrease at the end of 12th week while low density lipoprotein cholesterol decreased 31% and 33% respectively. 3) Triglyceride dropped 7% at 8th week and 3% at 12th week. High density lipoprotein cholesterol increased 4% at 4th week and showed 2% decrease at the end of study. 4) Only one patient complained of moderate abdominal pain, which subsided after 2 weeks drug withdrawal. In conclusion, lovastatin was well tolerated and effective, in the treatment of primary hyperlipidemia.
Abdominal Pain ; Cholesterol ; Cholesterol, HDL ; Cholesterol, LDL ; Coenzyme A ; Humans ; Hyperlipidemias* ; Lipoproteins ; Lovastatin ; Oxidoreductases ; Triglycerides

PURPOSE: The purpose of this study was to prospectively evaluate the detectability and usefulness of automated whole breast ultrasound (AWUS) and to compare it with handheld breast ultrasound (HHUS) in cases with suspicious microcalcifications identified by mammography. METHODS: Forty-two patients with 43 suspicious microcalcifications (25 malignant and 18 benign) detected by mammography underwent AWUS, HHUS, and histol-ogic examination. With knowledge of the mammographic findings, HHUS was performed to assess the visibility of the microcalcifications and the presence of associated masses or ductal changes. Two radiologists reviewed the AWUS images in consensus using the same methods employed for HHUS. Detectability of AWUS was compared with that of HHUS and was correlated with histologic and mammographic findings. RESULTS: Of the 43 lesions, 32 (74.4%) were detectable by AWUS and 31 (72.1%) by HHUS. No significant differences in sensitivity were found between the two methods (p=0.998). AWUS detected 96% (24/25) of malignant microcalcifications and 44.4% (8/18) of benign microcalcifications. AWUS was more successful in the detection of malignant vs. benign lesions (96.0% vs. 44.4%, p=0.002), lesions >10 mm vs. ≤10 mm in size (86.7% [26/30] vs. 46.2% [6/13], p=0.009), lesions with a fine pleomorphic or linear shape vs. a round or amorphous or coarse heterogeneous shape (94.7% [18/19] vs. 58.3% [14/24], p=0.021), and lesions associated with a mass or architectural distortion vs. without obvious changes on mammography (100% [19/19] vs. 54.2% [13/24], p=0.022). CONCLUSION: Detectability of AWUS was comparable to that of HHUS in cases where suspicious microcalcifications were identified on mammography. Therefore, AWUS might be helpful in the performance of ultrasound-guided percutaneous procedures for highly suspicious microcalcifications.
Breast Neoplasms ; Breast* ; Calcinosis ; Consensus ; Humans ; Mammary Glands, Human ; Mammography* ; Prospective Studies ; Ultrasonography*

We performed laparoscopic pelvic lymphadenectomy in 7 patients with squamous cell carcinoma in the uterine cervix. Among them, 5 cases were subsently laparotomy with radical hysterectomy. The others, one case was performed Laparoscpic pelvic lymphadenectomy as Staging Procedure and the other was laparoscopically assisted radical vaginal hysterectomy with pelvic lymphadenectomy without complication. The following results were obtained 1. Total number of pelvic nodes obtained at laparoscopy in 7 cases were 104 2. Averege number of pelvic nodes obtained at laparoscopy were 14.2+/-6.38(7-23) 3. Average number of additional pelvic nodes obtained at laparotomy were 10.4+/-279(7-13) 4. % yield by laparoscopy/laparoscopy+laparotomy was 71/123(58%) 5. No positive metastatic lymph nodes were missed by laparartomy 6. Average time, blood loss at laparoscopic lymphadenectomy was 172.1min and 304.3ml, seperately 7. surgical staging procedure was performed at Case 3 8. Laparoscopic Pelvic lym phadenectomy with radieal vaginal hysterectomy (type II radical) was done in Case 5. without Laparotomy or complication.
Carcinoma, Squamous Cell ; Cervix Uteri ; Female ; Humans ; Hysterectomy ; Hysterectomy, Vaginal ; Laparoscopy ; Laparotomy ; Lymph Node Excision* ; Lymph Nodes ; Uterine Cervical Neoplasms*

PURPOSE: To evaluate the magnetic resonance imaging (MRI) and clinicopathological features of triple negative breast cancer, and compare them with those of non-triple negative breast cancer. MATERIALS AND METHODS: This study included 231 pathologically confirmed breast cancers from January 2007 to May 2008. We retrospectively reviewed the MRI findings according to the Breast Imaging Reporting and Data System (BI-RADS) lexicon: mass or non-mass type, mass shape, mass margin, non-mass distribution, and enhancement pattern. Histologic type, histologic grade, and the results for epidermal growth factor receptor, p53, and Ki 67 were reviewed. RESULTS: Of 231 patients, 43(18.6%) were triple negative breast cancer. Forty triple negative breast cancers (93.0%) were mass-type lesion on MRI. A round or oval or lobular shape (p=0.006) and rim enhancement (p=0.004) were significantly more in triple negative breast cancer than non-triple negative breast cancer. In contrast, irregular shape (p=0.006) and spiculated margins (p=0.032) were significantly more in non-triple negative breast cancer. Old age (p=0.019), high histologic grade (p<0.0001), EGFR positivity (p<0.0001), p53 overexpression (p=0.038), and Ki 67 expression (<0.0001) were significantly associated with the triple negative breast cancer. CONCLUSION: MRI finding may be helpful for differentiation between triple negative and non-triple negative breast cancer.
Breast ; Breast Neoplasms ; Humans ; Information Systems ; Magnetic Resonance Imaging ; Receptor, Epidermal Growth Factor ; Receptors, Progesterone ; Retrospective Studies

In order to evaluate the efficacy of topical anesthesia as an alternative to pinpoint or retrobulbar anesthesia in clear corneal cataract surgery, ninety patients were randomly assigned to the topical(n=30), pinpoint(n=30), or retrobulbar(n=30) anesthesia groups prospectively. All procedures including CCC, phacoemulsification, and foldable IOL implantation were performed using a temporal clear corneal approach by one surgeon(Joo). visual rehabilitation, change of astigmatism, degree of pain, comfortability, cooperation, and intraoperative and postoperative complications were compared. Intraocular pressure was higher in pinpoint anesthesia than in topical anesthesia at the beginning point of operation(p<0.05). Four hours after surgery, topical of pinpoint anesthesia group had significantly better visual acuity than retrobulbar anesthesia group(p<0.05). Pain score in topical anesthesia was marginally higher than that in retrobulbar anesthesia during the phacoemulsification. Comfortability was prominent in topical anesthesia group. There was no difference among the groups in change of astigmatism, cooperation and risk of serious complicatins. With these results it was found that topical anesthesia would be a safe, effective alternative to pinpoint or retrobulbar anesthesia in cataract surgery using clear corneal incision.
Anesthesia ; Astigmatism ; Benzocaine* ; Cataract* ; Humans ; Intraocular Pressure ; Phacoemulsification ; Postoperative Complications ; Prospective Studies ; Rehabilitation ; Visual Acuity

Necrotizing fasciitis (NF) is an uncommon, life-threatening infection of the subcutaneous tissue and superficial fascia. The clinical course of NF is rapid and progressive, and it is often fatal despite the appropriate therapy. The prognosis of NF depends on a timely diagnosis and then proper treatment. At onset it may not be possible to clearly distinguish NF from minor soft-tissue infections. Although infection are common due to the use of steroids and immunosuppressive agents in patients with systemic lupus erythematous (SLE), it is interesting that NF has rarely been reported with SLE. Here, we present two cases of NF with SLE.
Fasciitis, Necrotizing ; Humans ; Immunosuppressive Agents ; Prognosis ; Steroids ; Subcutaneous Tissue

PURPOSE: The purpose of this study was to evaluate the diagnostic accuracy of 3.0-T breast MRI for detecting additional breast cancer soon after the initial diagnosis of breast cancer. MATERIALS AND METHODS: From March to June 2009, 101 patients recently diagnosed breast cancer underwent breast MRI and surgery. Parameters analyzed on MRI were total extent of tumor, suspicious findings of multifocal, multicentric, or contralateral cancer. The diagnosis of MRI-detected cancer was confirmed by means of biopsy or surgical specimen evaluation after the localization. RESULTS: MRI showed 37 additional suspicious findings in 34 patients. Twenty nine findings were true-positive (29/37, 78.4%), including 16 cases of multifocality, 11 cases of multicentricity and 2 cases of contralateral cancer. Among these cancers, 13 (44.8%) were ductal carcinoma in situ (DCIS) and 16 (55.1%) were infiltrating cancer. Eight findings were false-positive (8/37, 21.6%) including 6 cases of benign disease and 2 cases of high-risk lesions. CONCLUSION: In women with recently diagnosed breast cancer, 3.0-T MR imaging showed additional suspicious findings in 33.7%. The sensitivity and specificity for detecting additional breast cancer was 100% and 89.3%, respectively.
Biopsy ; Breast ; Breast Neoplasms ; Carcinoma, Intraductal, Noninfiltrating ; Female ; Humans ; Magnetic Resonance Imaging ; Sensitivity and Specificity

PURPOSE: To evaluate the usefulness of three-dimensional (3D) maximal intensity projection (MIP) reconstruction method in breast MRI. MATERIALS AND METHODS: Total 54 breasts of consecutive 27 patients were examined by breast MRI. Breast MRI was performed using GE Signa Excite Twin speed (GE medical system, Wisconsin, USA) 1.5T. We obtained routine breast MR images including axial T2WI, T1WI, sagittal T1FS, dynamic contrast-enhanced T1FS, and subtraction images. 3D MIP reconstruction images were obtained as follows; subtraction images were obtained using T1FS and early stage of contrast-enhanced T1FS images. And then 3D MIP images were obtained using the subtraction images through advantage workstation (GE Medical system). We detected and analyzed the lesions in the 3D MIP and routine MRI images according to ACR BIRADS(R) MRI lexicon. And then we compared the findings of 3D MIP and those of routine breast MR images and evaluated whether 3D MIP had additional information comparing to routine MR images. RESULTS: 3D MIP images detect the 43 of 56 masses found on routine MR images (76.8%). In non-mass like enhancement, 3D MIP detected 17 of 20 lesions (85 %). And there were one hundred sixty nine foci at 3D MIP images and one hundred nine foci at routine MR images. 3D MIP images detected 14 of 23 category 3 lesions (60.9%), 11 of 16 category 4 lesions (68.87%), 28 of 28 Category 5 lesions (100%). In analyzing the enhancing lesions at 3D MIP images, assessment categories of the lesions were correlated as the results at routine MR images (p-value<0.0001). 3D MIP detected additional two daughter nodules that were descriped foci at routine MR images and additional one nodule that was not detected at routine MR images. CONCLUSION: 3D MIP image has some limitations but is useful as additional image of routine breast MR images.
Breast ; Breast Neoplasms ; Humans ; Imidazoles ; Nitro Compounds ; Nuclear Family ; Wisconsin

BACKGROUND: Inhalation anesthetics are an important factor for postoperative hepatic and renal dysfunction. In this regard, TIVA can reduce the risk of hepatic and renal dysfunction inherited to inhalation anesthetics. The present study was conducted to determine whether hepatic and renal functions differ after anesthesia with sevoflurane and propofol. METHODS: Two hundred patients, ASA physical status class I, II, scheduled for an elective thyroidectomy were randomly divided into two groups. Anesthesia was maintained with sevoflurane 1-2% and remifentanil in the sevoflurane group (Group S) and propofol 2-5 ug/ml and remifentanil 2-5 ng/ml at the effect site, using a target controlled infusion (TCI) pump in the TIVA group (Group T) to maintain BIS of 40-60. To evaluate the hepatic and renal function, aspartate aminotransferase (AST), alanine aminotransferase (ALT), blood urea nitrogen (BUN) and creatinine were tested at preoperation (baseline), postoperative 1 day and 3 days. RESULTS: AST was increased at postoperative 1 day and 3 days, compared with that of the preoperation in Group S, and postoperative 1 day in Group T, but the values were within its normal limit. ALT was not changed after anesthesia in both groups. BUN was increased at postoperative 1 day, compared with that of the preoperation in Group S, but the value was within its normal limit. Creatinine was not changed after anesthesia in both groups. CONCLUSIONS: The changes of hepatic and renal function after inhalation anesthesia with sevoflurane and TIVA with propofol and remifentanil for thyroidectomy were clinically insignificant, and there was no difference between the two methods.
Alanine Transaminase ; Anesthesia ; Anesthesia, Inhalation ; Anesthesia, Intravenous ; Anesthetics, Inhalation ; Aspartate Aminotransferases ; Blood Urea Nitrogen ; Creatinine ; Humans ; Inhalation ; Methyl Ethers ; Piperidines ; Propofol ; Thyroidectomy