No abstract available.

No abstract available.

PURPOSE: Since its introduction in the mid-1990s, sentinel lymph node biopsy has been rapidly and widely adopted for the axillary staging of clinically node-negative breast cancer patients. However, there is some controversy in the clinical application because of its various identification rates and its false negative rates. The objective of this study was to assess the usefulness of endoscopic sentinel lymph node biopsy (ESNB) and to compare the value of two methods for identification of ESNB using blue dye only or a combination of blue dye and radioisotope. METHODS: This study was carried out in 137 breast cancer patients (bilateral breast cancer, 3 cases) who underwent ESBN, at the Department of Surgery in Soonchunhyang University from May of 2007 to August of 2008. The technique involved the injection of 5 mL of 0.5% indigocarmine or Tc-99m tin colloid into subareolar plexus. The Visiport docked with a telescope was inserted through a low transverse axillary incison (1.0 cm in size) lateral to the pectoralis major. During the dissection, we identified sentinel nodes by following blue-stained lymphatic duct directly into blue-stained lymph nodes. We compared the value of two methods for identification of ESNB using blue dye only or a combination of blue dye and radioactive tracer. RESULTS: The mean number of sentinel nodes was 1.27 (range, 1-4). The identification rate and false negative rate of the sentinel node were 94.3% (132/140) and 6.9% (3/43), respectively. We compared ESNB with using blue dye only (n=77) vs. a combination of blue dye and radioactive tracer (n=63). Sentinel lymph node identification rate were 90.9% (70/77) vs. 98.4% (62/63) (p=0.043). CONCLUSION: The endoscopic technique of sentinel node biopsy can keep better operative visual fields and is less invasive. The combination of blue dye and radioactive tracer was superior to blue dye only for identification rates.
Biopsy ; Breast ; Breast Neoplasms ; Colloids ; Humans ; Lymph Nodes ; Nitriles ; Pyrethrins ; Radioisotopes ; Sentinel Lymph Node Biopsy ; Telescopes ; Tin ; Visual Fields

PURPOSE: Since its introduction in the mid-1990s, sentinel lymph node biopsy has been rapidly and widely adopted for the axillary staging of clinically node-negative breast cancer patients. However, there is some controversy in the clinical application because of its various identification rates and its false negative rates. The objective of this study was to assess the usefulness of endoscopic sentinel lymph node biopsy (ESNB) and to compare the value of two methods for identification of ESNB using blue dye only or a combination of blue dye and radioisotope. METHODS: This study was carried out in 137 breast cancer patients (bilateral breast cancer, 3 cases) who underwent ESBN, at the Department of Surgery in Soonchunhyang University from May of 2007 to August of 2008. The technique involved the injection of 5 mL of 0.5% indigocarmine or Tc-99m tin colloid into subareolar plexus. The Visiport docked with a telescope was inserted through a low transverse axillary incison (1.0 cm in size) lateral to the pectoralis major. During the dissection, we identified sentinel nodes by following blue-stained lymphatic duct directly into blue-stained lymph nodes. We compared the value of two methods for identification of ESNB using blue dye only or a combination of blue dye and radioactive tracer. RESULTS: The mean number of sentinel nodes was 1.27 (range, 1-4). The identification rate and false negative rate of the sentinel node were 94.3% (132/140) and 6.9% (3/43), respectively. We compared ESNB with using blue dye only (n=77) vs. a combination of blue dye and radioactive tracer (n=63). Sentinel lymph node identification rate were 90.9% (70/77) vs. 98.4% (62/63) (p=0.043). CONCLUSION: The endoscopic technique of sentinel node biopsy can keep better operative visual fields and is less invasive. The combination of blue dye and radioactive tracer was superior to blue dye only for identification rates.
Biopsy ; Breast ; Breast Neoplasms ; Colloids ; Humans ; Lymph Nodes ; Nitriles ; Pyrethrins ; Radioisotopes ; Sentinel Lymph Node Biopsy ; Telescopes ; Tin ; Visual Fields

PURPOSE: The purpose of this study was to determine if there were prognostic differences between BRCA related and BRCA non-related Korean patients with early-onset breast carcinomas. MATERIALS AND METHODS: Sixty women who had developed breast cancers before the age of 40, and who were treated at the Soonchunhyang University Hospital, were studied independently of their family histories. The age range was 18 to 40 with a median of 34.5 years. Lymphocyte specimens from peripheral blood were studied for the heterozygous mutations of BRCA1 and BRCA2 using direct sequencing methods. Immunohistochemistry was performed on the paraffin-embedded tissue blocks that were available. RESULTS: Eleven deleterious mutations (18.3%, 6 in BRCA1 and 5 in BRCA2) and 7 missense mutations of unknown significance (11.7%), were found among the 60 patients. More than half of the mutation were novel, and were not reported in the database. Most of the BRCA-associated patients had no history of breast cancer. No treatment related failures were observed in the BRCA carriers, with the exception of one patientthat had experienced a new primary tumor of the contralateral breast. The seven year relapse free survival rate were 50 and 79% in the BRCA carrier and BRCA negative patients, respectively. Although the expression of estrogen and progesterone receptors were less common, and histological features more aggressive, in the BRCA associated tumors, the outcome of the patients with BRCA mutations was not poorer than that of the patients without deleterious mutations. CONCLUSION: Despite the BRCA mutation carriers having adverse prognostic features, the recurrence rate was relatively lower than that in the BRCA non-carrying Korean patients with early-onset breast carcinomas. In addition, although the prevalence of the BRCA mutation in Korean patients was higher than that in white patients, the penetrance of the cancer seemed to be relatively low in Korean women carrying BRCA mutations. A large population based study of the BRCA mutation, with a long-term follow-up of the study patients will be required to confirm these results.
Breast Neoplasms* ; Breast* ; Estrogens ; Female ; Follow-Up Studies ; Germ-Line Mutation* ; Humans ; Immunohistochemistry ; Lymphocytes ; Mutation, Missense ; Penetrance ; Prevalence ; Receptors, Progesterone ; Recurrence ; Survival Rate

Intramuscular injection is a commonly used route of parenteral drug administration. Many types of complications following intramuscular injection into the gluteal muscles have been described. A retrospective review of 32 patients requiring surgical treatment for local compli-caations of the buttock injections in children was made at the Taegu Fatima Hospital from March 1990 to December 1997. Local complications consisted of acute inflammatory compli-cations including cellulitis and abscess (71.9%), fat necrosis (21.9%), and injection granu-loma (6.2%). Over the half of complications were situated in the upper outer quadrant of the buttock but the other 43.7% of them were in the upper inner or lower outer quadrant which were unsuitable sites for intramuscular injection. And the majority of complications were de-veloped within fat tissue (90.6%) rather than within muscle (9.4%). Two thirds of the patients were under 2 years of age, which suggested that there were some difficulties in accurate intra-muscular injection in small children who had smaller muscle masses compared with subcuta-neous fat and were irritable during injection. In patients with abscess, Staphylococcus aureus was the predominant organism, isolated in 84.6% of the patients. The treatment consisted of needle aspiration, incision and drainage or curettage, and surgical excision. In conclusion, we think that the major factor contributing development of complications following intramuscular injection in the buttock was inadvertent intrafat injection instead of intramuscular injection. In order to prevent those complications, it is necessary to inject accurately into the muscle with a knowledge of pelvic anatomy and complications associated with intramuscular injection.
Abscess ; Buttocks* ; Cellulitis ; Child* ; Curettage ; Daegu ; Drainage ; Fat Necrosis ; Humans ; Injections, Intramuscular* ; Muscles ; Needles ; Retrospective Studies ; Staphylococcus aureus

No abstract available.
Infarction