PURPOSE: To evaluate the prognostic significances of angiogenesis and bc1-2, and association of each other, we investigated the correlation of microvessel count for angiogenesis and bcl-2 expression in breast cancer. MATERIALS AND METHODS: We analysed immunohistochemistry staining from paraffin blocks in a series of 145 women with breast cancer. Immunohistochemical staining to detect factor VIII-related antigen highlighted the microvessels within primary invasive breast carcinoma. Using light microscopy, we counted microvessels per 200X field in the most active areas of neovascularization. To determine the bcl-2 immunoreactivity, we used a monoclonal antibody directed against the bcl-2 protein. RESULTS: The median of microvessel count (MVC) was 31.5, and the proportions of tumors with low and high MVC were 51% and 49%. Eighty (55.2%) cancers showed the bcl-2 immunoreactivity in the cytoplasm. The microvessel count were correlated with lymph node status (p <0.001), tumor size (p=0.001), and lymphatic invasion around tumor (p=0.009). bcl-2 expressions were corelated with estrogen receptor positivity (p<0.001) and progesterone recepter positivity (p=0.029). The microvessel counts were negatively correlated with bcl-2 expression (p=0.006). CONCLUSION: This study suggest that the angiogenesis which was investigated by micro- vessel counts was negatively correlated with bcl-2 expression.
Breast Neoplasms* ; Breast* ; Cytoplasm ; Estrogens ; Female ; Humans ; Immunohistochemistry ; Lymph Nodes ; Microscopy ; Microvessels ; Paraffin ; Progesterone ; von Willebrand Factor

PURPOSE: We evaluated the effectiveness of balloon dilatation and bougienage of post operative anastomotic stricture of upper G-I tract. MATERIALS AND METHODS: We performed 22 balloon dilatation and 24 Bougienage in 40 patients of post operative anastomotic stricture. The causes of operation were esophageal cancer(n=20), stomach cancer(n=16), laryngeal cancer(n=2), chemical(n=2) strictures. RESULTS: Successful dilatations of the anastomotic site stricture were achieved during the procedure in 38 patients(95%). There was one case of esophageal perforation as a complication. CONCLUSION: Esophageal balloon dilatation and Bougienage are safe and effective method for post operative anastomotic site stricture of upper G-I tract.
Constriction, Pathologic* ; Dilatation* ; Esophageal Perforation ; Humans ; Stomach

No abstract available in English.
Stents*

We present a case with congenital absence of the infrarenal portion of inferior vena cava and lilac venous system, showing unusual venous collaterals including the left ovarian venous collateral via parametrial venous complex, and a mesenteric-periureteric venous connection. The venous collateral pathways were demonstrated by computed tomography and venography.
Phlebography ; Vena Cava, Inferior

PURPOSE:The primary biliary carcinoma is usually unresectable at presentation, because of early lymphatic spread. To determine the incidence and the spread pattern of lymph node metastases according to the location of the primary tumor, we analyzed the CT scans of the patients with primary biliary adenocarcinome. MATERIALS AND METHODS: We reviewed the CT scans of 92 patients with pathologically proven primary biliary adenocarcinoma, including 45 peripheral cholangiocarcinomas, 22 hilar cholangiocarcinomas, 18 gallbladder carcinomas, and 7 common bile duct carcinomas. Positive adenopathy was diagnosed when the node exceeded 10 mm in short axis. RESULTS:The overall incidence of nodal metastases was 59.8 % (55/92); 66.7 % in peripheral cholangiocarcinoma, 54.5 % in hilar cholangiocarcinoma, 55.6 % in gallbladder carcinoma, and 42.9 % in common bile duct carcinoma. The most commonly involved nodal group was the lesser omentum, followed by the celiac, periaortic, and peripancreatic group. The phrenic node group was only involved in the cases with the peripheral or hilar cholangiocarci nome. CONCLUSION:The primary biliary carcinoma has a high incidence of lymph node metastases at the time of diagnosis, and shows different nodal spread pattern according to the location of the primary tumor. Involvement of the phrenic node was limited to the peripheral and hilar cholangiocarcinoma.
Adenocarcinoma ; Axis, Cervical Vertebra ; Biliary Tract* ; Cholangiocarcinoma ; Common Bile Duct ; Diagnosis ; Gallbladder ; Humans ; Incidence ; Lymph Nodes* ; Neoplasm Metastasis* ; Omentum ; Tomography, X-Ray Computed

No abstract available in English.

PURPOSE: To evaluate the effects and complications of self-expandable metallic stent for the treatment of malignant esophagogastric strictures. MATERIALS AND METHODS: From September 1991 to March 1995, 110 stents were placed under fluoroscopic guidance in 103 patients. Of the 103 patients, there were 73 patients with esophageal cancer, 14 patients with gastric cancer, 12 patients with recurrence after surgery, three patients with esophageal compression by metastatic mediastinal lymphadenopathy, and one patient with esophageal invasion by lung cancer. Seventeen patients had esophagorespiratory fistulas. Under fluoroscopic guidance, 113 self-expandable metallic stents (99 Song stents, 14 Strecker stents) were placed in 103 patients. RESULTS: After stent placement, 68 (66%) of the patients could ingest solid food, 26 (25.2%) could ingest soft food, whereas three (2.9%) were not able to have food. Esophagorespiratory fistulas were occluded immediately after stent insertion. All stents were placed without any technical failures or procedural morbidity or mortality. Complications included restenosis in 13, gastroesophageal reflux in 11, stent tube migration in eight, massive bleeding in four, delayed esophageal perforation in one, stent obstruction by food impaction in one patient. CONCLUSION: Self-expandable metallic stent seems to be relatively safe and effective procedure in the palliative treatment of malignant esophagogastric stricture.
Constriction, Pathologic* ; Esophageal Neoplasms ; Esophageal Perforation ; Fistula ; Gastroesophageal Reflux ; Hemorrhage ; Humans ; Lung Neoplasms ; Lymphatic Diseases ; Mortality ; Music ; Palliative Care* ; Recurrence ; Stents* ; Stomach Neoplasms

Cyclin/cdc complexes are known to function in cell-cycle regulation. Cyclin D1/cdk4 and -6 complexes, which functions as a G1-S checkpoint and cyclin B1/cdc2 complexes, a G2-M checkpoint are essential for DNA synthesis and mitosis, respectively. Thus, dysregulated overexpression of cyclins appears to be involved in uncontrollable cell proliferation and early tumor development. We investigated the expression and proliferative index of cyclin D1 (PIcyclin D1), cyclin B1 (PIcyclin B1) and Ki-67 (PIKi-67) using immunohistochemical staining on 15 cases of ductal hyperplasia (DH), 26 cases of atypical ductal hyperplasia (ADH) and 43 cases of ductal carcinoma in situ (DCIS) of the breast in order to evaluate whether these cyclins are associated with abnormal cell proliferation and play a role in tumor development from ADH to carcinoma. Furthermore, we investigated whether the expression and proliferative index of the cyclins and Ki-67 are correlated with the histologic grade according to the Van Nuys classification and with the histologic subtype according to traditional classification. Finally, we estimated the correlation coefficient among PIcyclin D1, PIcyclin B1, PIKi-67 and estrogen receptor in ADH and DCIS. The expression of cyclin D1 was detected in 39.5% of DCIS and 7.7% of ADH cases. In the DH cases, expression of cyclin D1 was not found. Expression of cyclin B1 was also detected in 69.7% of DCIS, 50.0% of ADH and 93.3% of the DH cases. The PIcyclin D1 was significantly different among these three groups. Moreover, the PIcyclin D1 and PIKi-67 were differed significantly between the low grade DCIS and ADH cases. However, PIcyclin B1 only appeared to be significantly different between the total DCIS and ADH. Results of the correlation coefficient among PIcyclin D1, PIcyclin B1 and PIKi-67 were positively correlated with each other. No significant correlation was found between the expression of ER and cyclin D1 in ADH and DCIS. In summary, our results support the hypothesis that a cyclin D1 and cyclin B1 protein aberration, along with Ki-67, may act as a relatively early event in the tumor development from ADH to carcinoma.
Breast/pathology* ; Breast/metabolism* ; Breast Neoplasms/pathology* ; Breast Neoplasms/metabolism* ; Carcinoma, Infiltrating Duct/pathology* ; Carcinoma, Infiltrating Duct/metabolism* ; Cyclins/metabolism* ; Female ; Human ; Hyperplasia ; Ki-67 Antigen/metabolism

PURPOSE: The purpose of this study was to evaluate the effectiveness of percutaneous fine-needle aspiration (PCNA) in malignant and benign mediastinal lesions. MATERIALS AND METHODS: PCNA of mediastinal lesions were performed in 46 patients using 22 Guage thin-walled Westcott type needle under fluoroscopy guidance. There were 24 malignant mediastinal masses, 18 of which were diagnosed only by PCNA and six of which were proven surgically. Of 22 benign mediastinal masses, 19 cases were proven surgically. RESULTS: In 24 patients with malignant neoplasms, a positive diagnosis of malignancy was established in 18 (75%). One suspicious malignancy and five false negative results occurred. In 22 patients with benign masses, a specific diagnosis was established in six (27.3%), and 13 patients revealed nonspecific benignanay (59.1%). Three benign masses were reported as unsatisfactory. Five patients developed pneumothorax as a complication, and one of these needed a chest tube. CONCLUSION: Percutaneous fine-needle aspiration in mediastinal masses can differentiate benign mass from malignancy and can make a pathologic diagnosis.
Biopsy, Fine-Needle* ; Chest Tubes ; Diagnosis ; Fluoroscopy ; Humans ; Needles ; Pneumothorax ; Proliferating Cell Nuclear Antigen

PURPOSE: The purpose of this study was to evaluate the effectiveness of percutaneous fine-needle aspiration (PCNA) in malignant and benign mediastinal lesions. MATERIALS AND METHODS: PCNA of mediastinal lesions were performed in 46 patients using 22 Guage thin-walled Westcott type needle under fluoroscopy guidance. There were 24 malignant mediastinal masses, 18 of which were diagnosed only by PCNA and six of which were proven surgically. Of 22 benign mediastinal masses, 19 cases were proven surgically. RESULTS: In 24 patients with malignant neoplasms, a positive diagnosis of malignancy was established in 18 (75%). One suspicious malignancy and five false negative results occurred. In 22 patients with benign masses, a specific diagnosis was established in six (27.3%), and 13 patients revealed nonspecific benignanay (59.1%). Three benign masses were reported as unsatisfactory. Five patients developed pneumothorax as a complication, and one of these needed a chest tube. CONCLUSION: Percutaneous fine-needle aspiration in mediastinal masses can differentiate benign mass from malignancy and can make a pathologic diagnosis.
Biopsy, Fine-Needle* ; Chest Tubes ; Diagnosis ; Fluoroscopy ; Humans ; Needles ; Pneumothorax ; Proliferating Cell Nuclear Antigen