PURPOSE: To compare 3D ultrasound (3D-US) with 2D ultrasound (2D-US) in terms of their usefulness and limitations in the diagnosis of breast masses. MATERIALS AND METHODS: We obtained 2D and 3D US images of 37 breast lesions present in 20 cases of fibroadenoma, nine of cancer, and eight of fibrocystic disease proven in a total of 26 cases [fibroadenoma (n=13), breast cancer (n=9), fibrocystic disease (n=4)] by histologic examination, and by clinical evaluation and clinical evaluation with sonographic imaging in eleven. When comparing 3D and 2D-US images we had no prior information regarding detection rate according to the size of lesions, whether or not internal and boundary echo patterns could be interpreted, accurate differentiation between tumorous and non-tumorous lesions, or the accuracy with which benign and malignant tumors could be differentiated. RESULTS: For lesions of 1 cm or less in diameter the detection rate of 3D-US was lower than that of 2D-US, but for lesions over 1 cm there was no difference between the two modalities. In fibroadenoma and breast cancer, 3D-US was more useful than 2D-US for the evaluation of both internal and boundary echo, but with fibrocystic disease and in the diagnosis of tumor/non-tumor, there was no significant difference. In breast cancer, however, 3D-US more accurately determined malignancy, and in fibroadenoma, because of the pseudospicule revealed by 3D-US, this modality was less exact in determining benignancy. CONCLUSION: In the evaluation of internal and boundary echo in breast mass diagnosis, 3D-US was more useful than its 2D counterpart. For lesions of 1 cm or less in diameter, however, the detection rate of 3D-US was low, and since in some benign cases a pseudospicule was apparent, the possibiliy of confusion with malignancy arose. For these reasons, the usefulness of 3D-US was limited.
Breast Neoplasms ; Breast* ; Diagnosis* ; Fibroadenoma ; Ultrasonography

Pulmonary pleomorphic carcinomas are rare malignant tumors that account for 0.1 to 0.4% of all lung cancers. They are notable for their aggressive clinical behavior and poor prognosis. We report here on a patient who is alive and disease-free 12 years after receiving surgical treatment for the rib recurrence of pulmonary pleomorphic carcinoma.
Humans ; Lung Neoplasms ; Prognosis ; Recurrence* ; Ribs

OBJECTIVE: To compare the pregnancy outcomes of transvaginal multifetal pregnancy reduction (MFPR) according to the gestational period when the procedure was performed METHODS: From January l995 to February 1998, total 27 patients with multiple pregnancy were included in this study. The patients were grouped to early MFPR group (<8 weeks, n=16) and delayed MFPR group (>8 weeks, n=ll) according to the gestational age that MFPRs were performed. All MFPRs were performed by transvaginal sonography-guided fetal aspiration or mechanical trauma. The complete pregnancy loss rate before 24 weeks of gestation, spontaneous loss of embryo, procedure-related complication, gestational age at delivery, and pregnancy complication were compared between the two groups. Statistical analysis of data was performed using Students t-test and Fishers exact test as appropriate. Statistical significance was defined as p<0.05. RESULTS: There was no significant difference in the complete pregnancy loss rate between the early MFPR group (6.3%) and the delayed MFPR group (27.3%). The incidence of partial spontaneous loss of embryo in the two groups were not differed significantly (6.3% vs. 18.2%). The procedure-related complication of the delayed MFPR group (36.4%) seemed to be higher than that of the early MFPR group (6.3%), however there was no statistical difference (p=0, 07). Especially, all 3 patients in whom the MFPR was performed after 10 weeks suffered from the procedure-related complication. The mean gestational age at delivery of the two groups were not differed significantly (36.3+2.8 weeks vs. 37.0+1.3 weeks). There was also no significant difference in the mean birth weights of the two groups (2378.8+563.7 gm vs. 2427.1+436.2 gm). CONCLUSION: Although there was no statistically significant difference, the early transvaginal MFPR might be a safe and useful method without significant adverse complications compared to the delayed MFPR.
Birth Weight ; Embryonic Structures ; Female ; Gestational Age ; Humans ; Incidence ; Pregnancy ; Pregnancy Complications ; Pregnancy Outcome ; Pregnancy Reduction, Multifetal* ; Pregnancy, Multiple

OBJECTIVE: To evaluate the regulatory mechanism of cyclooxygenase(COX)-2 by estrogen and progesterone in uterine cell lines of rodents MATERIALS AND METHODS: CUE-P cells, originated from the uterine endometrial epithelial cells, and CUE-V2 cells, originated from the uterine endometrial stromal cells, were incubated in the Dulbecco's modified Eagle's medium(DMEM) and F12 medium. The cellular proliferation were evaluated every 24 hours. The expression of COX-2 was measured after estrogen and progesterone supplementation by western blot. RESULTS: CUE-P cells have cuboidal morphology and CUS-V2 cells resemble fibroblast and exhibit a spindle-like morphology. When CUE-P and CUS-V2 cells were co-cultured with estrogen and progesterone supplementation, the expression of COX-2 was decreased after 24 hours of estrogen supplementation. The decreased expression of COX-2 was observed only when estrogen was supplemented after 9 hours of initial progesterone supplementation. CONCLUSION: The sex steroid, such as estrogen and progesterone could regulate COX-2 expression in uterine cell lines.
Blotting, Western ; Cell Line* ; Cell Proliferation ; Cyclooxygenase 2 ; Epithelial Cells ; Estrogens* ; Fibroblasts ; Progesterone* ; Rodentia* ; Stromal Cells

PURPOSE: In major burns, deep vein thrombosis (DVT) is frequently diagnosed as a major complication of burns. But the risk factors and prophylaxis remain controversial. This study was designed to evaluate the incidence and risk factors of DVT in major burn patients. METHOD: We reviewed all major burn patients (>40% of TBSA) admitted to our burn center from June 1998 to August 2003 and assessed each affected patients with an in-hospital diagnosis of DVT for DVT risk factors. RESULT: There were 9 symptomatic DVT detected among 606 severe burn patients (1.45% incidence). Patients diagnosed with DVT had no risk factors of morbid obesity, previous DVT, congestive heart failure or neoplastic disease, except one patient who had a polycythemia vera diagnosed incidentally. In eight of 9 patients, DVT occurred in veins draining burned extremities. All patients had burn wound infections as a complication of burns. Eight of 9 patients had longer hospital stays than patients without DVTs. In all patients, DVT was developed after operations for skin graft. CONCLUSION: DVT should be suspected in patients with delayed wound healing and unresolved edema of extrimites. Wound infection, long bed-ridden state and operations are significant risk factors for DVT formation in major burn patients.
Burn Units ; Burns* ; Diagnosis ; Edema ; Extremities ; Heart Failure ; Humans ; Incidence ; Length of Stay ; Lower Extremity* ; Obesity, Morbid ; Polycythemia Vera ; Risk Factors ; Skin ; Transplants ; Veins ; Venous Thrombosis* ; Wound Healing ; Wound Infection

PURPOSE: Chemerin has been suggested to be linked to insulin resistance and type 2 diabetes mellitus (T2DM). However, the relationship between visceral adiposity and chemerin levels remains unclear in subjects with T2DM. In this study, we investigated the relationship between serum chemerin levels and visceral adiposity. MATERIALS AND METHODS: This study included 102 subjects newly diagnosed with T2DM. The relationships between serum chemerin levels and clinical and biochemical parameters were examined. Multiple linear regression analysis was performed to determine the predictable factors of serum chemerin levels. RESULTS: Serum chemerin levels showed significant positive correlations with body mass index (BMI), waist circumference (WC), visceral fat thickness (VFT), insulin levels, the homeostasis model assessment of insulin resistance, and levels of triglycerides (log-transformed) and high-sensitivity C-reactive protein, while showing significant negative correlations with high-density lipoprotein cholesterol. After adjusting for BMI and WC, VFT showed a significant relationship with serum chemerin levels (r=0.222, p=0.027). Moreover, VFT was an independent predictive factor of serum chemerin levels (β=0.242, p=0.041). CONCLUSION: We demonstrated that chemerin is linked to metabolic syndrome components. Moreover, serum chemerin levels were associated significantly with obesity, especially visceral adipose tissue, in subjects with T2DM.
Adiposity* ; Body Mass Index ; C-Reactive Protein ; Cholesterol ; Diabetes Mellitus, Type 2 ; Homeostasis ; Insulin ; Insulin Resistance ; Intra-Abdominal Fat ; Linear Models ; Lipoproteins ; Obesity ; Triglycerides ; Waist Circumference*

Recently, various studies evaluating percutaneous cervical nucleoplasty have reported good results. Percutaneous cervical nucleoplasty has been commonly used for treating contained herniated disc or protrusion, but a posterolateral extruded disc has not been considered to be an indication. The tip of the L'DISQ(R) wand can be curved to the desired angles by the rotation of the control wheel. Therefore, L'DISQ(R) can directly access the extruded disc. We report the application of percutaneous cervical nucleoplasty by using the L'DISQ(R) in three patients with an extruded disc. Decompression was successfully performed, and the symptoms improved immediately. In one patient, a 6-month follow-up magnetic resonance imaging study showed disappearance of the extruded cervical disc. Percutaneous cervical nucleoplasty using the L'DISQ(R) can be an effective, low complication, minimally invasive procedure for treating cervical disc herniation.
Decompression ; Follow-Up Studies ; Humans ; Intervertebral Disc Displacement ; Magnetic Resonance Imaging

PURPOSE: This study aimed to evaluate the disease severity of children suffering from gastroenteritis using different scales. The results are compared and subsequently classified on the basis of the type of virus causing the disease in order to investigate the differences in clinical characteristics and disease severity according to pathogen. METHOD: This study was conducted prospectively with patients under 5 years of age diagnosed with acute gastroenteritis and hospitalized at 9 medical institutions in 8 regions across the Republic of Korea. Disease severity was evaluated using the Vesikari Scale, the Clark Scale, and the modified Flores Scale. Fecal samples collected from patients were used to detect rotavirus and enteric adenovirus by enzyme immunoassay, and for RT-PCR of norovirus, astrovirus, and sapovirus. RESULTS: There were a total of 214 patients with a male : female ratio of 1.58 : 1, of which 35 were under the age of 6 months (16.4%), 105 were aged 6-23 months (49.1%), and 74 were aged 24-59 months (34.5%). The rate of concordance between the Vesikari and Clark Scales was 0.521 (P<0.001) and, in severe cases, the Vesikari Scale was 60.7% and Clark Scale was 2.3%, indicating that the Clark Scale was stricter in the evaluation of severe cases. CONCLUSIONS: In children with gastroenteritis, there were differences in disease severity based on the scale used. Therefore, to achieve consistent results among researchers, either only a single scale or a measure of all scales should be used to determine disease severity.
Adenoviridae ; Child* ; Female ; Gastroenteritis* ; Humans ; Immunoenzyme Techniques ; Male ; Norovirus ; Prospective Studies ; Republic of Korea ; Rotavirus ; Sapovirus ; Weights and Measures*

OBJECTIVES: To evaluate the causes of intrauterine adhesion (IUA) and the efficacy of hysteroscopic adhesiolysis in patients with IUA METHODS: From January 1995 to June 1999, a total of 63 patients with IUA were underwent hysteroscopic adhesiolysis. The patients with IUA only were trying to be pregnant spontaneous whereas, intrauterine insemination (IUI) or in vitro fertilization and embryo transfer (IVF-ET) were performed in the patients who have other infertility factors and IUA as well. The data such as the changes of menstrual amount and pattern, fertility, and full-term live birth rate were analyzed. RESULTS: The most common cause of IUA was curettage related problems; after incomplete abortion 20.6%, postpartum bleeding 9.5%, elective abortion 47.6%, missed abortion 11.1%, and for treatment of hydatidiform mole 1.6%. All patients with amenorrhea or oligomenorrhea had improvement of their menstrual patterns. Forty seven patients wanted pregnancy and 31 patients achieved pregnancy (68.4%). Full-term live birth rate 38.3% and there was one placenta accreta in full-term live birth case, which was resolved by postpartum curettage. CONCLUSION: Hysteroscopic adhesiolysis of IUA could be effective for restoring the normal menstrual pattern and fertility.
Abortion, Incomplete ; Abortion, Missed ; Amenorrhea ; Curettage ; Embryo Transfer ; Female ; Fertility ; Fertilization in Vitro ; Hemorrhage ; Humans ; Hydatidiform Mole ; Infertility ; Insemination ; Live Birth ; Oligomenorrhea ; Placenta Accreta ; Postpartum Period ; Pregnancy ; Treatment Outcome

OBJECTIVE: To investigate the perinatal outcome and complications of reduced twin pregnancies from triplet by multifetal pregnancy reduction (MFPR) in patients who underwent in vitro fertilization and embryo transfer. MATERIALS AND METHODS: From January 1995 to December 1999, a total of 71 twin pregnancies were included in this study. The patients were grouped into the MFPR group (n = 19) and the non-MFPR group (n = 59). The pregnancies in the MFPR group were reduced to twin from triplet by the MFPR. MFPR was performed by transvaginal sonography-guided fetal aspiration or mechanical trauma. The obstetric and perinatal outcomes were compared between the two groups. Statistical analysis was performed using Student's t-test, Fisher's exact test, and kappa2 test as appropriate. Statistical significance was defined as p < 0.05. RESULTS: There were no significant differences in mean gestational age and distribution of gestational age between the two groups. However, the fetal loss rate before 24 weeks of gestation was significantly higher in the MFPR group than the non-MFPR group. We did not find any significant differences in mean birth weight and weight discordancy between the two groups. There were no differences in obstetric and perinatal outcomes between the MFPR and non MFPR groups as well. CONCLUSIONS: These data suggest that pregnancy outcome of reduced twin pregnancies from triplet by MFPR in patients underwent IVF-ET might be comparable to that of non-reduced twin pregnancies.
Birth Weight ; Embryo Transfer* ; Embryonic Structures* ; Female ; Fertilization in Vitro* ; Gestational Age ; Humans ; Pregnancy ; Pregnancy Outcome ; Pregnancy Reduction, Multifetal* ; Pregnancy, Twin* ; Triplets*