In Asia, mammography following the injection of foreign materials into the breasts for cosmetic augmentation is frequently seen and diagnosis based on the typical radiologic findings is straightforward. We report the unusual radiologic findings in two patients with foreign body granulomas caused by injected foreign materials and discovered incidentally during screening work up. The mammographic findings were bilateral, hyperdense, spiculated masses, with occasional microcalcification, and at sonography, markedly hypoechoic, spiculated solid masses, located near the pectoralis muscle and partly extending into it, were observed. These radiologic findings mimicked malignancy.
Breast Neoplasms/radiography ; Case Report ; Cholesterol ; Diagnosis, Differential ; Esthetics ; Female ; Granuloma, Foreign-Body/etiology/*radiography/*ultrasonography ; Human ; Injections/adverse effects ; Mammography ; Middle Age ; Paraffin

Cell-free DNA (cfDNA) screening for fetal aneuploidies is clinically available and exhibits better performance than conventional serum screening tests. However, data on the clinical performance of cfDNA screening in twin pregnancies are limited. In this review, we summarized the clinical performance and evaluated the feasibility of cfDNA screening in twin pregnancies based on recent studies and recommendations. The performance of cfDNA screening for trisomy 21 in twin pregnancies is similar to that in singleton pregnancies. Specifically, cfDNA screening has a higher detection rate and lower false-positive rate compared with conventional serum screening. Consequently, recent international guidelines from several academic communities have recommended that cfDNA screening for aneuploidy in twin pregnancies could be considered. Moreover, twin pregnancies can present with specific conditions, such as different zygosities and vanishing twins; therefore, individualized counseling and management are required. Further clinical studies with more twin pregnancies are required for a more accurate analysis.

No abstract available.
Chlorhexidine* ; Guided Tissue Regeneration*

PURPOSE: Transumbilical laparoscopic-assisted appendectomy (TULA) is a single incision technique that uses a combined intra- and extracorporeal method. The aim of this study was to compare surgical outcomes of TULA with conventional 3-port laparoscopic appendectomy (LA). METHODS: A retrospective review of medical records between 2010 and 2014 identified 303 pediatric patients who underwent LA with uncomplicated acute appendicitis. Of these, 85 patients underwent TULA and 218 patients underwent conventional LA. Demographic data, clinical characteristics, perioperative outcomes and postoperative complications were compared between the 2 groups. RESULTS: The mean operation time in the TULA group was 30.39 minutes, which was significantly shorter than that of the LA group (47.83 minutes) (P < 0.001). The first day of oral intake after surgery was earlier (1.05 days vs. 1.32 days; P < 0.001) and the length of hospital stay was also shorter (2.54 days vs. 3.22 days; P < 0.001) for the TULA group than the LA group. Furthermore, the postoperative complication rate was lower in the TULA group (1 of 85, 1.25%) compared to the LA group (19 of 218, 8.7%) (P = 0.018). CONCLUSION: In conclusion, TULA procedure is recommended for uncomplicated appendicitis in children due to its simplicity and better postoperative outcomes.
Appendectomy* ; Appendicitis* ; Child ; Humans ; Laparoscopy ; Length of Stay ; Medical Records ; Methods ; Postoperative Complications ; Retrospective Studies ; Umbilicus

PURPOSE: To analyze retrospectively the abnormalities visible on the false-negative screening mammograms of patients with breast cancer and to determine the performance of computer-aided detection (CAD) in the detection of cancers. MATERIALS AND METHODS: Of 108 consecutive cases of breast cancer diagnosed over a period of 6 years, of which previous screening mammograms were available, 32 retrospectively visible abnormalities (at which locations cancer later developed) were found in the previous mammograms, and which were originally reported as negative. These 32 patients ranged in age from 38 to 72 years (mean 52 years). We analyzed their previous mammographic findings, and assessed the ability of CAD to mark cancers in previous mammograms, according to the clinical presentation, the type of abnormalities and the mammographic parenchymal density. RESULTS: In these 32 previous mammograms of breast cancers (20 asymptomatic, 12 symptomatic), the retrospectively visible abnormalities were identified as densities in 22, calcifications in 8, and densities with calcifications in 2. CAD marked abnormalities in 20 (63%) of the 32 cancers with false-negative screening mammograms; 14 (70%) of the 20 subsequent screening-detected cancers, 5 (50%) of the 10 interval cancers, and 1 (50%) of the 2 cancers palpable after the screening interval. CAD marked 12 (50%) of the 24 densities and 9 (90%) of the 10 calcifications. CAD marked abnormalities in 7 (50%) of the 14 predominantly fatty breasts, and 13 (72%) of the 18 dense breasts. CONCLUSION: CAD-assisted diagnosis could potentially decrease the number of false-negative mammograms caused by the failure to recognize the cancer in the screening program, although its usefulness in the prevention of interval cancers appears to be limited.
Breast Neoplasms ; Breast* ; Diagnosis ; Humans ; Mass Screening* ; Retrospective Studies

PURPOSE: To evaluate the clinical and radiographic findings of localized foreign body (FB) granulomas onmammograms. MATERIALS AND METHODS: This study involved 13 patients with localized FB granulomas on mammograms;their history of mammoplasty or other plastic procedures was obtained by telephone interviews. Two radiologistsanalyzed the location and morphology of FB granulomas and the presence of associated linear densities orparenchymal distortion on mammograms. Four patients underwent ultrasonography. RESULTS: No patient had a historyof mammoplasty. All 13, however, had a history of plastic procedure, three to 22 (average, 12) years previously,as follows : foreign materials including silicone liquid and oil such as paraffin been injected into the anteriorneck area of nine patients, the infra-auricular area of two, and the nose of two. Multiple small, high-density,flocculent nodules representing FB granulomas were distributed bilaterally in nine patients; they were noted inthe upper inner portion of 11 of 26 breasts. In eight patients, mammograms showed linear opacities suggestingfibrosis. There was no calcification or parenchymal distortion. Though in three cases, the masses were palpable.Ultrasonography revealed several anechoic nodules with posterior enhancement in subcutaneous fatty layers, and inone, 0.2cc of oil droplet had been aspirated under ultrasonographic guidance. CONCLUSION: Localized FB granulomasof the breast could be caused by the migration of FB from cervicofacial areas. Mammography showed characteristicdistribution of upper inner portions, and the findings were similar to those of mild interstitial mammoplasty.
Breast* ; Female ; Foreign Bodies* ; Granuloma ; Granuloma, Foreign-Body* ; Humans ; Interviews as Topic ; Mammaplasty ; Mammography ; Nose ; Paraffin ; Plastics ; Silicones ; Ultrasonography

A primary angiosarcoma is a very rare condition, accounting for 0.04% of all malignant tumors of the breast. It is known to have a poor prognosis and recurrence and distant metastasis are common. We report two cases of primary angiosarcoma. They were first diagnosed in 29 years old & in 34 years old. Preoperative evaluation provided an indication of the disease, and no evidence of merastasis was seen. Both patients underwent a total mastectomy. Radiation therapy was performed as an adjuvant treatment in one patient and in the case of recurrence in the other. Pathologic findings are reviewed and described. The diagnostic approach and treatment options from the literature are discussed.
Adult ; Breast Neoplasms ; Breast* ; Hemangiosarcoma* ; Humans ; Mastectomy, Simple ; Neoplasm Metastasis ; Prognosis ; Recurrence

BACKGROUND: The food exchange-based meal plan is effective in controlling dietary energy intake with a macronutrient balance. However, it is difficult to practice for relatively low-literacy patients. As an alternative, we developed a system employing a standardized-sized bowl and investigated its effectiveness on achieving proper energy intake and macronutrient composition and patient compliance, compared to the conventional food exchange system in Korean type 2 diabetes patients. METHODS: Eighty subjects with type 2 diabetes were assigned to both the novel bowl-based meal plan group (BG) and the food exchange-based meal plan group (ExG). BG received limited simple instructions for the plan. Time spent for plan instruction was 10 min for BG and 40 min for ExG. Dietary energy and macronutrient intake were estimated with 3-day dietary records and patient comprehension of the plan was estimated with a 5-point Likert scale. RESULTS: After 12 weeks, dietary energy compliance showed no difference between the groups (BG: 103 +/- 10%, ExG: 101 +/- 17%). Both groups showed significant reduction in carbohydrate and protein intake and there was no difference in the proportion of carbohydrate, protein and fat in energy intake between the groups despite the shorter instruction time for BG. Following the instruction period, there was no difference in the understanding score between the groups. CONCLUSION: This bowl-based plan was equally effective as the food exchange-based plan in controlling dietary energy intake and macronutrient composition, as well as patient comprehension and compliance. Our novel plan may allow for more cost-effective methods in terms of time needed for plan instruction.
Compliance ; Comprehension ; Diabetes Mellitus, Type 2 ; Diet, Diabetic ; Diet Records ; Energy Intake ; Humans ; Meals ; Patient Compliance

PURPOSES: Efforts directed at early detection of breast cancer have resulted in an increased incidence of nonpalpable mammographic lesions that warrant excisional biopsy. The most common localization method is the needle-localization biopsy. The aims of this study were to evaluate the effectiveness and the usefulness of a needle localization biopsy in the diagnostic work-up of nonpalpable mammographic abnormalities that are suspected of being cancerous, and to determine the frequency of malignancy detection as well as the incidence of noninvasive carcinoma. METHODS: One hundred seventy eight needle-localization biopsies of nonpalpable breast lesions were performed at Samsung Medical Center from January 1995 to December 1999. A retrospective review was undertaken to assess histopathologic findings based on mammographic abnormalities, as well as pathologic staging and the treatment of breast cancer detected by needle-localization biopsy. RESULTS: Needle-localization biopsies led to the diagnosis of malignancy in 29.8% of the biopsies. Of the malignancies detected, 81.2% were in-situ carcinomas. Invasive carcinomas were less than 2 cm in size (T1) in 70% of the cases and were 2 to 5 cm (T2) in 30% of the cases; there were no evidence of lymph node metastases in 70% of the cases. Overall, 90.6% of the patients were found to be within pathologic stage 0 or stage 1. Microcalcifications only were more related with DCIS than mass density with or without microcalcifications findings. Fine linear, branching, granular, pleomorphic microcalcifications findings and ill defined, irregular, spiculated mass densities were likely to result in higher rate of malignancy. CONCLUSION: It is concluded that needle- localization breast biopsy of nonpalpable suspicious mammographic lesions is an important and effective method for the detection of early breast cancer and noninvasive carcinomas. Appropriate selection ofcases for needle localization biopsy should be made to avoid unnecessary breast biopsies and to increase the percentage of early breast cancer.
Biopsy* ; Breast Neoplasms* ; Breast* ; Carcinoma, Intraductal, Noninfiltrating ; Diagnosis* ; Humans ; Incidence ; Lymph Nodes ; Needles* ; Neoplasm Metastasis ; Retrospective Studies

OBJECTIVE: To determine, by means of long-term follow-up evaluation, the outcome and accuracy of stereotactic core-needle biopsy (SCNB) of non-mass calcifications observed at mammography, and to analyze the factors contributing to false-negative findings. MATERIALS AND METHODS: Using a 14-gauge needle, SCNB was performed in cases involving 271 non-mass calcified lesions observed at mammography in 267 patients aged 23 72 (mean, 47) years. We compared the SCNB results with those of long-term follow-up which included surgery, mammography performed for at least six months, and reference to Korean Cancer Registry listings. We investigated the retrieval rate for calcifications observed at specimen mammography and histologic evaluation, and determined the incidence rate of cancer, sensitivity, and the underestimation rate for SCNB. False-negative cases were evaluated in terms of their mammographic findings, the effect of the operators' experience, and the retrieval rate for calcifications. RESULTS: For specimen mammography and histologic evaluation of SCNB, the retrieval rate for calcifications was, respectively, 84% and 77%. At SCNB, 54 of 271 lesions (19.9%) were malignant [carcinoma in situ, 45/54 (83%) ], 16 were borderline, and 201 were benign. SCNB showed that the incidence of cancer was 5.0% (6/120) in the benign mammographic category and 31.8% (48/151) in the malignant category. The findings revealed by immediate surgery and by longterm follow-up showed, respectively, that the sensitivity of SCNB was 90% and 82%. For borderline lesions, the underestimation rate was 10%. For false-negative cases, which were more frequent among the first ten cases we studied (p = 0.01), the most frequent mammographic finding was clustered amorphous calcifications. For true-negative and false-negative cases, the retrieval rate for calcifications was similar at specimen mammography (83% and 67%, respectively; p = 0.14) and histologic evaluation (79% and 75%, respectively; p = 0.47). CONCLUSION: In this study group, most diagnosed cancers were in-situ lesions, and long-term follow-up showed that the sensitivity of SCNB was 82%. Falsenegative findings were frequent during the operators' learning period.
Adult ; Aged ; Biopsy, Needle/*methods/standards/statistics & numerical data ; Breast/*pathology/surgery ; Breast Neoplasms/*diagnosis/epidemiology/surgery ; Calcinosis/*diagnosis/epidemiology/surgery ; Carcinoma in Situ/*diagnosis/epidemiology/surgery ; Diagnosis, Differential ; Disease Progression ; False Negative Reactions ; Female ; Follow-Up Studies ; Human ; Incidence ; Mammography/statistics & numerical data ; Middle Aged ; Reproducibility of Results ; Sensitivity and Specificity ; Time Factors ; Treatment Outcome