No abstract available.

Breast cancer is the most common cancer in Korean women since 2001 and needs national interests. The incidence of breast cancer is increasing with new breast cancer cases reaching more than 10,000 cases annually. But, there are some difficulties in breast cancer control; first, the National Cancer Screening Program is ineffective and of low quality, second, the lack of psychosocial care for mastectomized patients, third, the lack of national care for terminal cancer patients. For effective breast cancer control, we need special support for breast cancer awareness campaign, activation of breast cancer registry, development of clinical practice guideline, development of hospice program, breast cancer research, and upgrading its guarantee on breast cancer treatment. The Korean Breast Cancer Society should have the leading role in solving the current problems, but moreover, we cannot overemphasize the need for national support.
Breast Neoplasms* ; Breast* ; Early Detection of Cancer ; Female ; Hospice Care ; Humans ; Incidence

BACKGROUND: The activation of phospholipase C(PLC) is one of the early cellular events in various growth process, including malignant transformation. PLC-gamma1 is activated through direct interaction with growth factor receptor tyrosine kinase. MATERIAL AND METHODS: Using immunoblot assay, we evaluated overexpression of PLC-gamma1 expression in twenty human breast cancer tissues. It was also determined whether there was any connection between other prognostic factors(numbers of metastatic axillary nodes, nuclear and histological grade, c-erbB2, p53 and E-cadherin) and the overexpression of PLC-gamma1 protein. RESULTS: Seventeen of 20 breast cancer tissues showed overexpression of PLC-gamma1, which was corresponded to that seen on the immunohistochemistry( kappa= 0.8275, p = 0.003). Of 3 tumor markers, immunohistochemically determined, positive expression of E-cadherin only was associated with PLC-gamma1 protein overexpression in a range of statistical significance (p=0.045, kappa=0.607). CONCLUSION: PLC-gamma1 overexpression might be pathogenic trigger involved in breast cancer and the relationship between expression of E-cadherin and PLC-gamma1 would require further elucidation.
Breast Neoplasms ; Cadherins ; Humans ; Phospholipases* ; Protein-Tyrosine Kinases ; Biomarkers, Tumor

PURPOSE: Recently Tc99m MIBI (methoxyisobutylisonitrile) has been described as an alternative to thallium for localizing parathyroid lesions. The purpose of this study was to compare the efficacy of a Tc99m MIBI scan with a Tl201/Tc99m subtraction scan for localizing parathyroid lesions in patients with primary hyperparathyroidism. METHODS: Among 31 cases of primary hyperparathyroidism operated on at the Department of Surgery, Seoul National University Hospital from January 1997 to June 2001, a Tl201/Tc99m subtraction scan was performed on 16 patients and a Tc99m MIBI scan on 22 patients. Seven patients underwent both. RESULTS: The pathology was a single adenoma in 28 patients, a hyperplasia in 1 patient and a carcinoma in 2 patients. Hypercalcemia was controlled postoperatively in all cases. The sensitivities of the Tl201/Tc99m subtraction scan and Tc99m MIBI scan were 53.3% and 86.4%, respectively. The positive predictive values were 100% of the two study groups. CONCLUSION: We concluded that the better accuracy, superior image quality and lower cost of Tc99m MIBI scan will make it the new radiopharmaceutical parathyroid scan of choice. A unilateral approach can be used with a high degree of success, as in case of a preoperatively localized single parathyroid adenoma, which was confirmed when surgical exploration identified of a normal ipsilateral gland.
Adenoma ; Humans ; Hypercalcemia ; Hyperparathyroidism, Primary* ; Hyperplasia ; Parathyroid Neoplasms ; Pathology ; Seoul ; Thallium

No abstract available.
Carcinoma, Transitional Cell* ; Tuberculosis, Renal* ; Ureter*

PURPOSE: Infiltrating lobular carcinoma of the breast was known to have a high incidence of multicentricity and bilaterality in patients. We analyzed the clinical features of infiltrating lobular breast cancer. MATERIALS AND METHODS: We studied 29 patients with infiltrating lobular carcinoma of the breast, from Jan. 1980 to Mar. 1997 in the Department of Surgery, Seoul National University Hospital. RESULTS: The age of the patients ranged from 32 to 71 years with an average of 45.2 years. The main complaining symptom was a painless mass. The diameter of the tumor ranged from 0.7 to 7 cm with a mean size of 2.8 cm. The axillary lymph node was positive for malignancy in 12 cases. The number of multicentric breast cancers were 7 cases (24.1%), and the number of bilateral breast cancers were 3 cases (10.3%). The estrogen receptor was positive in 66.7%, and the progesterone receptor was positive in 75% of the cases. There were one local recurrence and three distant metastases during a mean follow-up period of 4.5 years. The 5-year survival rate and 5-year disease free survival rate were 89.6% and 88.6%, respectively. CONCLUSION: Infiltrating lobular breast cancers are at greater risk of developing multicentricity and bilaterality than nonlobular breast cancers. Careful program of frequent follow-up examinations and thorough histopathological studies are needed for patients with infiltrating lobular breast cancers.
Breast Neoplasms* ; Breast* ; Carcinoma, Lobular ; Disease-Free Survival ; Estrogens ; Follow-Up Studies ; Humans ; Incidence ; Lymph Nodes ; Neoplasm Metastasis ; Receptors, Progesterone ; Recurrence ; Seoul ; Survival Rate

No abstract available.
Polymerase Chain Reaction*

PURPOSE: Despite of recent advances in the resolution of computed tomography (CT) and magnetic resonance imaging (MRI), there are different kinds of peri-adrenal retroperitoneal tumors that can hardly be differentiated from adrenal tumor preoperatively. By reviewing certain tumors and their characteristics, we may increase the preoperative diagnostic accuracy and so may perform the proper operation when facing this situation. METHODS: We retrospectively reviewed fourteen cases of non-adrenal origin retroperitoneal tumors that were preoperatively diagnosed as adrenal tumors during a seven-year period at Seoul National Universiry Hospital. RESULTS: The fourteen retroperitoneal tumors preoperatively misdiagnosed as adrenal tumors were extra-adrenal ganglioneuroma (6 cases), schwannoma (2 cases), retroperitoneal paraganglioma (1 case), bronchogenic cyst (2 cases), Castleman's disease (1 case), idiopathic retroperitoneal fibrosis (1 case) and leiomyosarcoma (1 case). All of them were large (> 6 cm), and most were solid. CONCLUSION: For the correct preoperative diagnosis and appropriate operation of peri-adrenal retroperitoneal tumors, and especially when the tumors are large and solid, the disease entities mentioned above should be excluded, and the application of additional diagnostic measures such as preoperative fine needle aspiration cytologic examination or biopsy, endoscopic ultrasound (EUS), intraoperative frozen biopsy, laparoscopic ultrasound (LUS), as well as preoperative CT and MRI, should be considered when the diagnosis is not conclusive.
Biopsy ; Biopsy, Fine-Needle ; Bronchogenic Cyst ; Diagnosis ; Diagnosis, Differential ; Ganglioneuroma ; Giant Lymph Node Hyperplasia ; Leiomyosarcoma ; Magnetic Resonance Imaging ; Neurilemmoma ; Paraganglioma ; Retroperitoneal Fibrosis ; Retrospective Studies ; Seoul ; Ultrasonography

PURPOSE: Primary aldosteronism due to an adrenal cortical adenoma is a surgically curable disease. However, hypertension is known to persist postoperatively in many patients. The aim of this study was to determine the factors influencing the long-term outcome of blood pressure after an adrenalectomy for a primary aldosteronism and to evaluate the changing pattern of renin and aldosterone. METHODS: Forty-two cases of primary aldosteronism, which were operated on and followed up at the Department of Surgery, Seoul National University Hospital from January 1986 to June 2001 were included in this study. The subjects were classified into a normotensive group and a hypertensive group and the two groups were compared according to the clinical, biochemical and pathological parameters. RESULTS: After surgery, the aldosterone concentration was decreased and the plasma renin activity was increased. During a mean follow-up period of 28 months, 31 patients (73.8%) had a normal blood pressure without an antihypertensive treatment. The significant risk factors for persistent hypertension were a family history of hypertension, a long duration of preoperative hypertension, a poor response of preoperative spironolactone. The hypertensive group had a higher level of postoperative plasma renin activity and an aldosterone concentration in the long-term follow-up period after surgery. CONCLUSION: A family history of hypertension, the duration of hypertension and the response to spironolactone were factors influencing persistent hypertension after surgery for a primary aldosteronism. A high level of plasma renin activity and aldosterone during the follow-up period is related to the persistent hypertension. Therefore, early detection and surgery for a primary aldosteronism would reduce the preoperative cardiovascular changes and improve the postoperative outcome.
Adrenalectomy ; Adrenocortical Adenoma ; Aldosterone ; Blood Pressure ; Follow-Up Studies ; Humans ; Hyperaldosteronism* ; Hypertension ; Plasma ; Renin ; Risk Factors ; Seoul ; Spironolactone

Diabetic nephropathy is characterized by an expansion of the glomerular mesangium, caused by mesangial cell proliferation and an excessive accumulation of extracellar matrix (ECM) proteins, which eventually leading to glomerulosclerosis. TGF-beta1 was found to play an important role in the accumulation of ECM in the kidney. In this study, TGF-beta1 RNA interference was used as an effective therapeutic strategy. The inhibitory effect of TGF-beta1 small interfering RNAs (siRNAs) on the high glucose-induced overexpression of TGF-beta1 in rat mesangial ceys (RMCs). A high levels of glucose induces TGF-beta1 mRNA and protein, and TGF-beta1 siRNAs reduce the ability of high glucose to stimulate their expression. We also examined the inhibitory effect of TGF-beta1 siRNAs on the expression of plasminogen activator inhibitor (PAI)-1 and Collagen Type I which are down-regulators of TGF-beta1. The expression of TGF-beta1, PAI-1 and Collagen Type I was increased in RMCs that were stimulated by 30 mM glucose. TGF-beta1 siRNAs reduces high glucose-induced TGF-beta1, PAI-1, and Collagen Type I mRNA and protein expression in a dose-dependent manner. In conclusion, the present study demonstrates that TGF-beta1 siRNAs effectively inhibits TGF-beta1 mRNA and protein expression in RMCs. These suggest that TGF-beta1 siRNAs through RNAi may be a useful tool for developing new therapeutic applications for the treatment of diabetic nephropathy.
Transforming Growth Factor beta1/*metabolism ; Rats, Sprague-Dawley ; Rats ; RNA, Small Interfering/*metabolism ; Microscopy, Fluorescence ; Mesangial Cells/*metabolism ; Male ; Glucose/*metabolism ; Glomerular Mesangium/*metabolism ; Gene Expression Regulation ; Diabetic Nephropathies/pathology ; Collagen Type I/metabolism ; Cells, Cultured ; Cell Proliferation ; Animals