PURPOSE: This study compared the response evaluation using the WHO (World Health Organization) criteria for patients with breast cancer with that of the RECIST (Response Evaluation Criteria In Solid Tumor) criteria in order to determine the significance of the RECIST criteria in breast cancer. METHODS: Between 2001 and 2005, 42 patients with measurable lesions radiologically receiving neoadjuvant chemotherapy for a breast carcinoma were enrolled in this study. The results were compared using a kappa test as a concordance measure between the two response criteria. RESULTS: With the WHO criteria, the overall response and progression rate were 35.7% (CR 0, PR 15) and 16.6% (PD 7) respectively. On the other hand, the overall response and progression rate using the RECIST criteria were 38.0% (CR 0, PR 16) and 7% (PD 3) respectively. The kappa value as a concordance measure between two response criteria was 0.718. CONCLUSION: The RECIST criteria are comparable to the WHO criteria in evaluating the response of breast cancer patients who have undergone neoadjuvant chemotherapy. A comparison of these results with other studies of more common tumor types supports the implementation of RECIST as the standard criteria for evaluating the treatment response but also for monitoring progression.
Breast Neoplasms* ; Breast* ; Drug Therapy* ; Hand ; Humans ; World Health Organization

Becker's nevus is a relatively common acquired focal epidermal melanotic hypermelanosis usually found in the region of the shoulder girdle of young men. Various skeletal malformations and cutaneous dermatoses have been reported in Becker's nevus. Osteoma cutis is a rare disorder characterized by compact bone formation in the dermis or subcutaneous tissue. Secondary ossification on nevi has been reported, but not with Becker's nevus. Herein, we report a case of Becker's nevus with accompanying osteoma cutis in an 18-year-old female.
Adolescent ; Bone Diseases, Metabolic ; Bone Neoplasms ; Dermis ; Female ; Humans ; Hyperpigmentation ; Male ; Nevus ; Ossification, Heterotopic ; Osteogenesis ; Osteoma ; Shoulder ; Skin Diseases ; Skin Diseases, Genetic ; Subcutaneous Tissue

Bone Marrow Cells ; Dexamethasone ; Mandible ; Osteoblasts ; Osteogenesis ; Platelet-Rich Plasma ; Rabbits ; Silver Nitrate

BACKGROUND/AIMS: Advances in endoscopic technology seek to improve the accuracy of neoplastic tumor detection. Recently developed endoscopy devices such as narrow-band imaging (NBI) nevertheless have limitations in morphologic diagnosis. The purpose of this study was to investigate whether a novel imaging technique-near-infrared fluorescence (NIRF) imaging using a protease-activatable nanoprobe-could provide more accurate neoplastic tumor detection, compared to NBI. METHODS: Images of the intestines of Apc(Min/+) mice were obtained by NIRF using a matrix metalloproteinase (MMP)-sensing probe, which was based on a nanoparticle platform. Immediately after imaging, endoscopy with NBI capability was performed on the same excised intestine. Macroscopic and microscopic findings in the intestines were assessed, and MMP expression was analyzed by Western blotting and real-time polymerase chain reaction. RESULTS: Numerous tiny polypoid lesions were present in the intestines of aged Apc(Min/+) mice. These lesions included adenomas, lymphoid follicles, and protruding normal tissues. When using NIRF imaging with an MMP-activatable nanoprobe, adenomatous polyps showed higher fluorescence, compared to lymphoid follicles or adjacent normal tissues. The expression of MMP was higher in the adenomatous tissue than in the other tissues. The sensitivity and specificity for adenoma detection were 88.9% and 82.2%, respectively, when using NIRF imaging with a MMP-nanoprobe, compared to 77.8% and 66.7%, respectively, when using NBI (P<0.05). CONCLUSIONS: Near-infrared fluorescence imaging with a protease-activatable nanoprobe could aid in the differentiation of tumor characteristics. Clinical application of this approach may improve the endoscopic detection of neoplastic tumors.
Adenoma ; Adenomatous Polyps ; Animals ; Blotting, Western ; Endoscopy ; Fluorescence* ; Intestines ; Mice ; Molecular Imaging ; Nanoparticles ; Narrow Band Imaging ; Optical Imaging* ; Sensitivity and Specificity

BACKGROUND/AIMS: The aim of this study was to identify the profile of rare variants associated with Crohn's disease (CD) using whole exome sequencing (WES) analysis of Korean children with CD and to evaluate whether genetic profiles could provide information during medical decision making. METHODS: DNA samples from 18 control individuals and 22 patients with infantile, very-early and early onset CD of severe phenotype were used for WES. Genes were filtered using panels of inflammatory bowel disease (IBD)-associated genes and genes of primary immunodeficiency (PID) and monogenic IBD. RESULTS: Eighty-one IBD-associated variants and 35 variants in PID genes were revealed by WES. The most frequently occurring variants were carried by nine (41%) and four (18.2%) CD probands and were ATG16L2 (rs11235604) and IL17REL (rs142430606), respectively. Twenty-four IBD-associated variants and 10 PID variants were predicted to be deleterious and were identified in the heterozygous state. However, their functions were unknown with the exception of a novel p.Q111X variant in XIAP (X chromosome) of a male proband. CONCLUSIONS: The presence of many rare variants of unknown significance limits the clinical applicability of WES for individual CD patients. However, WES in children may be beneficial for distinguishing CD secondary to PID.
Asian Continental Ancestry Group/genetics ; Carrier Proteins/genetics ; Child ; Child, Preschool ; Crohn Disease/*genetics ; *Exome ; Female ; Genetic Predisposition to Disease ; *Genetic Variation ; Humans ; Immunologic Deficiency Syndromes/genetics ; Infant ; Male ; Phenotype ; Receptors, Interleukin-17/genetics ; Republic of Korea ; Sequence Analysis, DNA/*methods ; X-Linked Inhibitor of Apoptosis Protein/genetics

BACKGROUND: To maximize the histological advantage and minimize the physiological disadvantage, we have been using the skeletonized gastroepiploic artey (GEA) as a free graft for total arterial revascularization. The aims of the current study was to assess the efficacy of the skeletonized GEA as a composite or extended graft for total arterial revascularization. MATERIAL AND METHOD: Between January 2000 and Feburary 2005, 133 patients (43 female, mean age=61.8 yrs) undergoing coronary artery bypass grafting (CABG) with a skeletonized GEA as free graft (22 extended, 107 composite and 4 others) were enrolled in this study. Coronary angiograms were performed in the immediate (median 14 days, n=86), early (median 366 days, n=56) and midterm (median 984 days, n=29) postoperative periods. RESULT: There were 3 (2.2%) early and 4 (3.3%) late cardiac-related deaths. The mean number of distal anastomoses per patient was 3.34 for total graft and 1.92 for GEA graft. The immediate, early, and midterm GEA patency were 157/159 (98.7%), 106/112 (94.6%), and 53/56 (94.6%), respectively. During follow-up, four patients required percutaneous intracoronary intervention because of GEA and target coronary artery stenosis or competitive flow. CONCLUSION: These data demonstrate satisfactory clinical and angiographic results in the skeletonized GEA as free graft for total arterial revascularization. Although we need a careful longer follow-up, the skeletonized GEA as a free graft will be a valuable option 'to be' for CABG.
Coronary Artery Bypass* ; Coronary Stenosis ; Coronary Vessels* ; Female ; Follow-Up Studies ; Gastroepiploic Artery* ; Humans ; Postoperative Period ; Skeleton* ; Transplants*

Ganglioneuromas of the gastrointestinal tract are rare, but have an established association with genetic disorders, such as the multiple endocrine neoplasia (MEN) syndrome (type 2b) and neurofibromatosis (type 1). However, solitary ganglioneuromas are not associated with an increased risk for MEN 2b, neurofibromatosis type 1, or any other systemic conditions. Ganglioneuromas of the gastrointestinal tract have been reported to predominantly involve the colon and rectum, and are thereby occasionally detected during colonoscopy or surgery. Although there are no characteristic symptoms of solitary ganglioneuromas, symptoms can be induced by solitary ganglioneuromas, such as abdominal pain, bleeding, or obstruction, depending on the location and size. Herein we report a case of a solitary ganglioneuroma of the ileum. A 34-year-old man sought evaluation at our hospital for anemia. The medical and family histories were benign and there was no history of genetic disorders. The evaluation for anemia revealed iron-deficiency anemia and CT enterography revealed a single mass in the ileum. Laparoscopic resection of the lesion was performed and the pathologic examination confirmed an ileal ganglioneuroma.
Abdominal Pain ; Adult ; Anemia ; Anemia, Iron-Deficiency ; Colon ; Colonoscopy ; Ganglioneuroma ; Gastrointestinal Tract ; Hemorrhage ; Humans ; Ileum ; Multiple Endocrine Neoplasia ; Multiple Endocrine Neoplasia Type 2b ; Neurofibromatoses ; Neurofibromatosis 1 ; Rectum

Ganglioneuromas of the gastrointestinal tract are rare, but have an established association with genetic disorders, such as the multiple endocrine neoplasia (MEN) syndrome (type 2b) and neurofibromatosis (type 1). However, solitary ganglioneuromas are not associated with an increased risk for MEN 2b, neurofibromatosis type 1, or any other systemic conditions. Ganglioneuromas of the gastrointestinal tract have been reported to predominantly involve the colon and rectum, and are thereby occasionally detected during colonoscopy or surgery. Although there are no characteristic symptoms of solitary ganglioneuromas, symptoms can be induced by solitary ganglioneuromas, such as abdominal pain, bleeding, or obstruction, depending on the location and size. Herein we report a case of a solitary ganglioneuroma of the ileum. A 34-year-old man sought evaluation at our hospital for anemia. The medical and family histories were benign and there was no history of genetic disorders. The evaluation for anemia revealed iron-deficiency anemia and CT enterography revealed a single mass in the ileum. Laparoscopic resection of the lesion was performed and the pathologic examination confirmed an ileal ganglioneuroma.
Abdominal Pain ; Adult ; Anemia ; Anemia, Iron-Deficiency ; Colon ; Colonoscopy ; Ganglioneuroma ; Gastrointestinal Tract ; Hemorrhage ; Humans ; Ileum ; Multiple Endocrine Neoplasia ; Multiple Endocrine Neoplasia Type 2b ; Neurofibromatoses ; Neurofibromatosis 1 ; Rectum

Blood Platelets ; Centrifugation ; Intercellular Signaling Peptides and Proteins ; Mandible ; Osteoblasts ; Osteogenesis ; Platelet Count ; Platelet-Rich Plasma ; Transplants

Background and Objectives: The relationship between the hospital percutaneous coronary intervention (PCI) volumes and the in-hospital clinical outcomes of patients with acute myocardial infarction (AMI) remains the subject of debate. This study aimed to determine whether the in-hospital clinical outcomes of patients with AMI in Korea are significantly associated with hospital PCI volumes. Methods: We selected and analyzed 17,121 cases of AMI, that is, 8,839 cases of non-ST-segment elevation myocardial infarction and 8,282 cases of ST-segment elevation myocardial infarction, enrolled in the 2014 Korean percutaneous coronary intervention (K-PCI) registry. Patients were divided into 2 groups according to hospital annual PCI volume, that is, to a high-volume group (≥400/year) or a low-volume group (<400/year). Major adverse cardiovascular and cerebrovascular events (MACCEs) were defined as composites of death, cardiac death, non-fatal myocardial infarction (MI), stent thrombosis, stroke, and need for urgent PCI during index admission after PCI. Results: Rates of MACCE and non-fatal MI were higher in the low-volume group than in the high-volume group (MACCE: 10.9% vs. 8.6%, p=0.001; non-fatal MI: 4.8% vs. 2.6%, p=0.001, respectively). Multivariate regression analysis showed PCI volume did not independently predict MACCE. Conclusions Hospital PCI volume was not found to be an independent predictor of in-hospital clinical outcomes in patients with AMI included in the 2014 K-PCI registry.