PURPOSE: To evaluate the clinical efficacy and the histopathologic tolerance of 2-octylcyanoacrylate versus 8-0 polyglactin sutures for conjunctival wound closure in rabbits. METHODS: We performed an experimental study on 16 eyes of eight New Zealand albino rabbits. Conjunctival peritomy of 8 mm was done in the superior limbus followed by extensive subconjunctival dissection in both eyes. The eyes of the rabbits were divided into two groups. The conjunctiva was then attached to the limbus again by the proposed 2-octylcyanoacrylate adhesive (left eye, Group A) or 8-0 polyglactin suture (right eye, Group B). The clinical efficacy of the closure of the conjunctival wound, either with sutures or adhesives, and the clinical and histopathologic tolerances such as hyperemia, discharge, residual adhesive or suture, inflammatory change and fibrosis were observed at 1 day and at 1, 2, 4 and 6 weeks after surgery. Two rabbits were sacrificed at each of 1, 2, 4 and 6 weeks, and specimens of their conjunctiva were examined histologically. RESULTS: Both conjunctival surgical closure methods were found to be equally efficacious in fixing the conjunctiva to the limbus. There were no significant clinical or histopathologic tolerance differences between the two groups. The conjunctiva at 6 weeks of Group A showed nearly normalized morphology with disappeared inflammatory cells and fibroblasts, whereas those of Group B showed foreign body inflammatory reaction around the absorbing suture materials. CONCLUSIONS: 2-Octylcyanoacrylate adhesive was an efficient conjunctival closure method and was very well tolerated by the ocular surface. 2-Octylcyanoacrylate may be a possible tissue adhesive for conjunctival wound closure.
Adhesives ; Conjunctiva ; Fibroblasts ; Fibrosis ; Foreign Bodies ; Hyperemia ; New Zealand ; Polyglactin 910* ; Rabbits* ; Sutures* ; Tissue Adhesives ; Wounds and Injuries*

PURPOSE: To evaluate the safety, stability and effectiveness of the LADARVision active tracking narrow beam excimer laser system using laser in situ keratomileusis (LASIK) and photorefractive keratectomy (PRK) for the correction of spherical myopia and astigmatism. METHODS: We reviewed 233 eyes that underwent LASIK (Group A: -6D) and PRK (Group C) from August 2002 to March 2003. We investigated uncorrected visual acuity (UCVA), manifest refraction, spherical equivalent, cyclotorsion, and astigmatic change before undergoing refractive surgery. The evaluation was repeated at 1 week, 1 month, 3 months, and 6 months after surgery. RESULTS: AT one week following surgery, the mean UCVA was 1.39+/-0.30 in Group A, 1.25+/-0.34 in Group B, and 1.06+/-0.25 in Group C. At postoperative 6 months, the mean UCVA was 1.32+/-0.30, 1.09+/-0.16, and 1.32+/-0.24 in Groups A, B, and C, respectively. In all 215 eyes, cyclotorsion was 74.4%: counterclockwise, 48.4% (4.01+/-3.01); and clockwise, 26.0% (-4.42+/-3.18). The astigmatism correction rate was 79.16% in Groups A and B (LASIK groups), and 70.10% in Group C. CONCLUSIONS: The LADARVision 4000 laser yielded excellent results in myopia, with or without astigmatism and showed early refractive stability, good UCVA outcomes, and effective correction of astigmatism at 6 months postoperatively. Further studies are needed to compare custom LASIK and conventional LASIK using LADARVision.
Astigmatism ; Keratomileusis, Laser In Situ* ; Lasers, Excimer ; Myopia ; Photorefractive Keratectomy* ; Refractive Surgical Procedures ; Visual Acuity

BACKGROUND: We conducted this study to verify whether a mechanical ventilator is adequate for cardiopulmonary resuscitation (CPR). METHODS: A self-inflating bag resuscitator and a mechanical ventilator were used to test two experimental models: Model 1 (CPR manikin without chest compression) and Model 2 (CPR manikin with chest compression). Model 2 was divided into three subgroups according to ventilator pressure limits (P(limit)). The self-inflating bag resuscitator was set with a ventilation rate of 10 breaths/min with the volume-marked bag-valve procedure. The mode of the mechanical ventilator was set as follows: volume-controlled mandatory ventilation of tidal volume (Vt) 600 mL, an inspiration time of 1.2 seconds, a constant flow pattern, a ventilation rate of 10 breaths/minute, a positive end expiratory pressure of 3 cmH2O and a maximum trigger limit. Peak airway pressure (P(peak)) and Vt were measured by a flow analyzer. Ventilation adequacy was determined at a Vt range of 400-600 mL with a P(peak) of < or = 50 cmH2O. RESULTS: In Model 1, Vt and P(peak) were in the appropriate range in the ventilation equipments. In Model 2, for the self-inflating bag resuscitator, the adequate Vt and P(peak) levels were 17%, and the P(peak) adequacy was 20% and the Vt was 65%. For the mechanical ventilator, the adequate Vt and P(peak) levels were 85%; the P(peak) adequacy was 85%; and the Vt adequacy was 100% at 60 cmH2O of P(limit). CONCLUSIONS: In a manikin model, a mechanical ventilator was superior to self-inflating bag resuscitator for maintaining adequate ventilation during chest compression.
Cardiopulmonary Resuscitation* ; Manikins* ; Models, Theoretical ; Positive-Pressure Respiration ; Thorax ; Tidal Volume ; Ventilation* ; Ventilators, Mechanical*

Circulating tumor cells (CTCs) are defined as tumor cells circulating in the peripheral blood of patients, shed from either the primary tumor or from its metastases. The detection of circulating tumor cells (CTCs) in the peripheral blood of breast cancer patients may account for the different steps in the biologic progression of the disease. The detection of microscopic disease in patients with breast cancer is imperative to prognosis and can predict the efficacy of targeted treatments. In general, there are two main methods for their detection. These are based on cytometric and nucleic acid manipulation. Both methods generally require an enrichment step to increase sensitivity of the assay. This step is based on either detection of specific surface markers using immuno-selection and/or on morphological features, such as cell size or density. We review the methods of detecting CTCs, their prognostic implications, and opportunities to exploit the properties of CTCs to develop personalized therapy.
Breast ; Breast Neoplasms ; Cell Size ; Humans ; Neoplasm Metastasis ; Neoplastic Cells, Circulating ; Nucleic Acids ; Prognosis

PURPOSE: The aims of our study were to assess the correlation between serum HER2 and clinicopathologic factors, the effect of serum HER2 on survival rate, and the effect of changes in serum HER2 levels between pre- and post-adjuvant chemotherapy on survival rate. METHODS: The study subjects, 200 women with breast cancer, were a subset of patients operated on between January 2005 and December 2006. We evaluated changes in serum HER2 levels between pre- and post-adjuvant chemotherapy. RESULTS: Being estrogen receptor (ER) negative was also correlated with high serum HER2 (p=0.017). The number of patients with changes in serum HER2 (>20% increased level during the follow-up period) was correlated with advanced T-stage (p=0.010), advanced American Joint Committee on Cancer (AJCC) stage (p=0.015) and poor histologic grade (p=0.001). Univariate analysis for prognostic factors associated with disease-free survival (DFS) revealed that the difference in DFS between those with serum HER2 level <15 ng/mL and those with levels > or =15 ng/mL was statistically significant (p=0.0129) and the changes in serum HER2 levels were also statistically significant (p=0.001). Prognostic factors associated with overall survival revealed that the changes in serum HER2 levels between pre- and post-adjuvant chemotherapy were statistically significant (p=0.0012). CONCLUSION: Serum HER2 level is associated with a more advanced degree of axillary lymph node involvement and associated with ER negativity. And Changes in serum HER2 levels are associated with more advanced AJCC staging and histologic tumor grade. There are significant associations between serum HER2 level, changes in serum HER2 levels and 5-year DFS.
Breast ; Breast Neoplasms ; Disease-Free Survival ; Estrogens ; Female ; Follow-Up Studies ; Humans ; Joints ; Lymph Nodes ; Prognosis ; Survival Rate

PURPOSE: Triple negative breast cancer (TNBC) has had poor prognosis compared with the luminal subtype. And there has been no benefit from doxorubicin. However, the addition of paclitaxel is known to improve both disease-free survival (DFS) and overall survival (OS). The aim of our study was to assess the effect of the addition of paclitaxel after adjuvant chemotherapy with doxorubicin plus cyclophosphamide in TNBC. METHODS: We randomly selected 87 women from 104 women with TNBC who had been randomly assigned to receive doxorubicin (60 mg per square meter of body-surface area) plus cyclophosphamide (600 mg per square meter) for four cycles, followed by four cycles of paclitaxel (175 mg per square meter) or two more cycles of doxorubicin plus cyclophosphamide. Due to predictions of clinical outcomes in women who receive adjuvant paclitaxel based chemotherapy, immunohistochemical analyses of these tissue specimens for CK5/6 were used. RESULTS: Among patients with TNBC, 24 patients (27.6%) were classified as CK5/6-positive triple negative type. Twelve patients were classified as paclitaxel chemotherapy group and 75 patients were classified as no paclitaxel group. No interaction was observed between DFS or OS and paclitaxel regimens. CK5/6 was, however, not associated with a significant benefit from paclitaxel in our study. CONCLUSION: In our study, the addition of paclitaxel after adjuvant treatment with doxorubicin (<60 mg per square meter) is not associated with DFS or OS in TNBC.
Breast ; Breast Neoplasms ; Chemotherapy, Adjuvant ; Cyclophosphamide ; Disease-Free Survival ; Doxorubicin ; Female ; Humans ; Paclitaxel ; Phenobarbital ; Prognosis

OBJECTIVES: p53 is a tumor suppressor gene and plays an important role in the etiology of breast cancer. The aim of this study is to clarify clinical significance of p53 in Ductal Carcinoma in situ (DCIS), and discuss about survival effect. METHODS: The study subjects, 69 women with breast cancer, were a subset of patients operated from Jan 2005 to Dec 2006. We used a cutoff of 10% to distinguish between positive and negative p53 staining. The University of Southern California (USC)/Van Nuys Prognostic Index (VNPI) were compared with 2 categories of p53. RESULTS: The positivity of p53 was found in 20 patients (29.0%) in DCIS. And negativity of p53 was found in 49 patients (71.0%). And 15 patients (21.7%) had a low USC/VNPI score, 42 patients (60.9%) intermediate and 12 patients (17.4%) a high score. The positivity of p53 was correlated with high USC/VNPI (P = 0.001). The univariate analysis for prognostic factors associated with Disease Free Survival (DFS) revealed that patients with p53 positivity show shorter Disease Free Survival (DFS) than patients with p53 negativity (P = 0.013) and USC/VNPI was also statistically significant (P = 0.030). CONCLUSIONS: According to our study, p53 was associated with high USC/VNPI. These findings suggest that p53 can be used to classify DCIS into at least two subtypes with differing prognoses.
Breast Neoplasms ; California ; Carcinoma, Ductal ; Carcinoma, Intraductal, Noninfiltrating ; Disease-Free Survival ; Female ; Genes, Tumor Suppressor ; Humans ; Prognosis

PURPOSE: The purpose of our study was to compare the serum levels of CEA, CA19-9 and H.pylori antibody in patients with the Lewis (a+) blood group with that of the patients with the Lewis (a-) blood group. We also compared the outcome of the stomach cancer patients with the Lewis (b+) blood group with that of the stomach cancer patients with the Lewis (b-) blood group. METHODS: All of the 94 patients who underwent gastrectomy for stomach cancer at our hospital were retrospectively reviewed. The outcomes of the CEA, CA19-9 and H.pylori. antibody serum levels, the TNM stage, the ABO blood group and the Rh blood group were compared between the patients with the Lewis blood groups (a+) and (a-) and the patients with the Lewis blood groups (b+) and (b-), respectively. RESULTS: The mean serum level of CEA between the patients with the Lewis blood group (a+) and (a-) showed a statistical correlation (mean value: 5.51 ng/ml vs 3.25 ng/ml, respectively, P=0.016). But the mean serum level of CA19-9 and H.pylori. antibodies between the patients with the Lewis blood group (a+) and (a-) did not show a significant difference. The mean serum levels of CEA, CA19-9 and H.pylori antibodies between the patients with the Lewis blood group (b+) and (b-) did not show a significant difference. CONCLUSION: It was revealed that an elevated CEA level was related with the Lewis blood group (a), but this was not related with the Lewis blood group (b) in stomach cancer patients.
Antibodies ; Blood Group Antigens ; Gastrectomy ; Humans ; Retrospective Studies ; Stomach Neoplasms* ; Stomach*

OBJECTIVES: Breast conserving surgery (BCS) for early breast cancer is now an accepted treatment, but there are controversies about its comparability with mastectomy. Thus, we investigated the survival outcomes who underwent BCS and modified radical mastectomy (MRM). METHODS: In this retrospective review, we analyzed the survival outcomes of 618 patients with early breast cancer who underwent two different surgery from January 2002 to December 2009. Postoperative pathologic difference, disease free survival period, overall survival period, recurrence pattern, recurrent rate and site were compared. In addition, preoperative patients data are also collected. RESULTS: Disease free survival period of MRM and BCS was 108.46 months and 80.82 months, respectively (P < 0.01). However, there was no significant correlation between overall survival period and operative methods (P = 0.67). In addition, recurrence pattern (P = 0.21), recurrent rate (P = 0.36) and site (P = 0.45, P = 0.09) were not associated with operative method. CONCLUSIONS: In this study, we can suggest that early breast cancer patients could improve their disease free survival if they underwent MRM. So, when we operate high risk breast cancer patients, MRM could be considered for their disease free life. Further studies may be required to establish appropriate strategy of surgery for early breast cancer.
Breast Neoplasms* ; Breast* ; Disease-Free Survival ; Humans ; Mastectomy ; Mastectomy, Modified Radical* ; Mastectomy, Segmental* ; Methods ; Recurrence ; Retrospective Studies

PURPOSE: The genes p53 and B-cell lymphoma (bcl)-2 play an important role in regulating the mechanisms of apoptosis. In this paper, we retrospectively applied these factors to our series of triple negative breast cancer (TNBC) patients, in conjunction with an evaluation of the prognostic significance of these factors' influence on TNBC survival rate. Particular focus was placed on the role of bcl-2, p53, Ki-67. METHODS: The study subjects, 94 women with TNBC, were a subset of patients operated at Kosin University Gospel Hospital from January 2000 to December 2005. Chi-squared tests were used for statistical analysis. RESULTS: Positive staining for cytokeratin (CK)5/6 in 23 cases (24.5%), epidermal growth factor receptor in 15 cases (16.0%), bcl-2 in 26 cases (27.7%), p53 in 55 cases (58.5%) and Ki-67 in 74 cases (78.7%) was determined. Lymph node status, tumor size and expression of CK5/6 or Ki-67 were independent prognostic factors for patients with TNBC. CONCLUSION: Markers regulating cell cycle and cell death such as p53 and bcl-2 cannot be used to classify TNBCs into two subtypes with differing disease-free survival. But because our study is small in size, more abundant patient data will be needed to evaluate the factors' predictive role in regulating cell cycle and cell death.
Apoptosis ; Breast ; Breast Neoplasms ; Cell Cycle ; Cell Death ; Disease-Free Survival ; Female ; Humans ; Keratins ; Lymph Nodes ; Lymphoma, B-Cell ; Receptor, Epidermal Growth Factor ; Retrospective Studies ; Survival Rate