No abstract available.
Child* ; Humans ; Melanoma*

Skull base surgery has developed through the evolution of imaging, anatomic research, surgical approach and reconstructive techniques. The basic disciplines of approaching skull base lesions are provide direct vision, minimizing brain retraction, excellent exposure and minimal blood loss. The focus of this report is to review the advantages of skull base approach in our cases and suggest some indications. We experienced 20 cases of skull base surgery by a team approach consisting of a neurosurgeon and plastic surgeon. The surgical approach were supraorbital osteotomy(5 case), orbitozygomatic osteotomy(8 case), orbitozygomaticoglenoid osteotomy (5 case ) and orbitozygomaticoglenoidocondylar osteotomy (2 case). In our experience, these approaches provided excellent exposure of the lesion, direct access to lesions and minimal brain retraction thereby better outcome.
Brain ; Osteotomy ; Skull Base* ; Skull* ; Surgery, Plastic*

No abstract available.
Brain* ; Chromosomes, Human, Pair 10* ; Molecular Biology*

PURPOSE: Axillary lymph node (ALN) status is the single most reliable indicator of the prognosis in early-stage breast cancer. However, downstaging of both the primary tumor and ALN involvement by neoadjuvant chemotherapy results in loss of traditional prognostic criteria. This study was performed to evaluate the prognostic significance of various clinicopathologic features in patients with operable breast cancer treated with neoadjuvant chemotherapy. METHODS: From Feb. 1991 to Oct. 1998, 73 patients with breast cancers (tumor size>3 cm, or clinically axillary node positive) were treated with preoperative combination chemotherapy comprised of preoperative 3 cycles and postoperative 3 cycles of FEC or MMM. The median follow-up period was 53 months. To analyze the potential simultaneous effect of the significant predictors of disease-free survival (DFS) and overall survival (OS) identified by univariate analysis, those factors were entered into a Cox multivariate regression model. RESULTS: Clinical responses to neoadjuvant chemotherapy were as follows, CR, 17.8% (13/73); PR, 57.5% (42/73); SD, 21.9% (16/73); and PD, 2.7% (2/72). The clinical response to neoadjuvant chemotherapy and the number of residual metastatic ALN were the only independent predictors of disease-free survival and overall survival. Patients with clinically complete response to neoadjuvant chemotherapy had a excellent 3-year DFS (100%) and 5-year OS (100%). In patients with a partial response, the number of metastatic ALN further stratified the patients with respect to DFS (p=0.003). Also, in patient with a stable disease, the number of metastatic ALN further stratified the patients with respect to DFS (p=0.000) and OS (p=0.000). Those with a progressive disease had a poor DFS and OS. CONCLUSION: Only the clinical response to neoadjuvant chemotherapy and the absolute number of metastatic ALN identified at surgical staging were the independent predictors of DFS and OS. Thus patients with partial or minor response can be further stratified with respect to DFS and OS by the number of involved ALNs.
Breast Neoplasms* ; Breast* ; Disease-Free Survival ; Drug Therapy* ; Drug Therapy, Combination ; Follow-Up Studies ; Humans ; Lymph Nodes ; Prognosis

No abstract available.
Autopsy* ; Down Syndrome* ; Leukemia* ; Megakaryocyte Progenitor Cells*

No abstract available.
Autopsy* ; Down Syndrome* ; Leukemia* ; Megakaryocyte Progenitor Cells*

PURPOSE: Nodal involvement has long been known to represent the single most reliable indicator of the prognosis for early-stage breast cancer. In common parlance, high-risk node-positive breast cancer has generally been used to describe patients who have involvement of ten or more axillary lymph nodes (10+LN). Breast cancer patients who had 10+LN clearly have a strikingly high risk of tumor recurrence and death. Thus we tried to evaluate the clinical courses of breast cancer patients who had more than 10 positive axillary lymph nodes. METHODS: Of the 587 breast cancer patients who were operated on at Chungnam National University Hospital from February 1992 to November 1999, 31 cases (5.3%) showed involvement of more than 10 axillary lymph nodes. We evaluated the clinical courses of these patients and the differences in survival according to the clinical and pathologic vaiables. Survival was calculated using the Kaplan-Meier method. RESULTS: The mean age of the patients was 50+/-4 years. A mastectomy was done in 28 cases (90.3%), and a breast conserving operation was done in 3 cases (9.7%). The mean tumor size was 4.8+/-.5 cm. The mean number of removed axillary Lymph Nodes was 23.5+/-0.2 (range:10-52), and the mean number of positive axillary LNs was 20.0+/-10.1 (10-51). At a median follow-up of 30.5 months, 23 cases (74.2%) of recurrence were noted. Among these 23 cases (69.6%) showed distant metastases as the first recurrence. The 3-year and 5-year disease-free survivals were 28.6% and 22.9%, respectively. The 3-year and 5-year expected overall survivals were 53.7% and 41.8%, respectively. There were significantly more recurrences in patients who had given up taking their adjuvant chemotherapy than for those patients who had completed 6 cycles of FEC or MMM. Also, significant survival benefits were noted in those patients who were treated using a combination chemotherapy with taxane plus cisplatin after their tumor recurrence. CONCLUSION: Breast cancer patients with 10+LNs have a strikingly high risk of tumor recurrence. Six cycles of adjuvant chemotherapy with FEC or MMM was a controllable variable for lowering the risk of tumor recurrence. A combination chemotherapy with taxane and cisplatin was also a controllable variable for increasing survival after tumor recurrence.
Breast Neoplasms* ; Breast* ; Chemotherapy, Adjuvant ; Chungcheongnam-do ; Cisplatin ; Disease-Free Survival ; Drug Therapy, Combination ; Follow-Up Studies ; Humans ; Lymph Nodes* ; Mastectomy ; Neoplasm Metastasis ; Prognosis ; Recurrence

No abstract available.
Cytomegalovirus Infections*

Alveolar soft-part sarcoma of the female genital tract are extremely rare. Fewer than 30 cases have been described in the literature. We experienced a case of alveolar soft-part sarcoma of the female genital tract which was diagnosed by routine light microscopic study using ultrastructural and immunohistochemical stain. We report this case with a brief review of the literature.
Female* ; Humans ; Sarcoma, Alveolar Soft Part*

Injuries to the pelvic nerve plexus following major pelvic ablative surgery are commonly observed conditions in urologic field and often related to voiding difficulty with flaccid type of neurogenic bladder. The pathophysiological background for voiding difficulty is unknown and also it is difficult to investigate in human. The present study was undertaken to investigate the functional changes on the bladder and urethra in major pelvic ganglion denervated rats (experimental group). Injury to the pelvic nerve plexus was created by selective removal of bilateral major pelvic ganglions of mature Sprague-Dawley rats (male, 250-300 gm). One week after operation, urodynamic evaluation and NADPH diaphorase histochemistry were performed in each rat. The whole bladder wet weight and residual urine of experimental group significantly increased to 1.6 times and 29 times that of control group, respectively. For urodynamic investigations, the bladder and the urethra were completely disconnected by means of ligation between the bladder neck and the proximal urethra, and simultaneous recordings of the intravesical and proximal urethral pressure were performed. During simultaneous urethro-vesical filling in experimental group, vesical contraction and urethral relaxation were not induced. However, an administration of L-arginine (120 mg/kg intravenously), a nitric oxide substrate, resulted in a gradual decrease in urethral pressure when the bladder pressure was reached at submaximal level. On NADPH diaphorase histochemistry in control group, a large number of NADPH positive nerve fibers were found in the proximal urethra, whereas those were found less commonly in the bladder. In experimental group, the number of NOS positive nerve fibers in the bladder was similar to that in control group. But in the proximal urethra, the number of NOS positive nerve fibers (84.7 +/- 12.7) decreased significantly in contrast to that (185.9 +/- 56.3) in control group. These results indicate that failure to empty in neurogenic bladder may be resulted from relaxation impairment of bladder outlet, which can be explained by the reduction of neuronal NOS in the proximal urethra in experimental group.
Animals ; Arginine ; Denervation ; Ganglion Cysts* ; Humans ; Ligation ; NADP ; NADPH Dehydrogenase ; Neck ; Nerve Fibers ; Neurons* ; Nitric Oxide ; Nitric Oxide Synthase ; Nitric Oxide Synthase Type I* ; Rats* ; Rats, Sprague-Dawley ; Relaxation ; Urethra* ; Urinary Bladder* ; Urinary Bladder, Neurogenic ; Urodynamics