No abstract available.
Hepatitis B Vaccines* ; Hepatitis B* ; Hepatitis* ; Hot Temperature* ; Humans ; Intellectual Disability*

No abstract available.
Hepatitis B Vaccines* ; Hepatitis B* ; Hepatitis* ; Hot Temperature* ; Humans ; Intellectual Disability*

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

The ovarian hyperstimulation syndrome (OHSS) is one of the notorious complications of assisted reproduction procedure. Severe and moderate OHSS associated with a spontaneous pregnancy is rare. We experienced a case of two normal, spontaneously conceived pregnancies with OHSS and her past obstetric history included prior spontaneous OHSS in the first trimester and term vaginal delivery of normal baby.
Female ; Humans ; Ovarian Hyperstimulation Syndrome* ; Pregnancy Trimester, First ; Pregnancy* ; Reproduction

PURPOSE: HER-2/neu oncogene is known to play a part in the process of carcinogenesis, while the biological characteristics of HER-2/neu oncoprotein include regulating cell growth and increasing the reproductionability of a tumor. The extracelluar domain (ECD), whose molecular weight is between 95 and 105 kD among the HER-2/neu oncoprotein structures, is proteolyzed and separated from the cell surface by metalloproteases and goes into the blood stream where it starts circulation. Since monoclonal antibody was developed for the serum HER-2/neu ECD, it's now possible to measure HER-2/neu ECD in the serum with the immunoassay method. The measurement of serum HER-2/neu ECD is used for prognosis of metastatic breast cancer and for testing the treating effect of trastuzumab (Herceptin(R)), a target agent for the patients positive to the HER-2/neu receptor. In Korea there is no report on the accurate reference range of serum HER-2/neu for healthy women. The purposes of this study were to measure the serum HER-2/neu ECD in healthy Korean women, analyze the reference range. METHODS: The subjects of the study include 200 healthy Korean women with 50 from each in their twenties, thirties, forties, and fifties. As for methodology, the HER-2/neu in the serum separated from their blood was measured. The serum HER-2/neu level was measured quantitatively with the recently developed ADVIA Centaur(R) automated immunoassay analyzer and ADVIA Centaur(R) HER-2/neu assay reagent. With the measurement, you can use the sandwich immunoassay and direct chemiluminescence technique for two monoclonal antibodies for the epitopes located in the serum HER-2/neu ECD. The reference ranges were calculated based on the mean +/- 2 SD. RESULTS: One of the 200 healthy subjects was excluded from analysis for having the highest value of serum HER-2/neu (23.1 ng/ml), and the data of total 199 were used for analysis. The analysis results indicated that the minimum value was 3.5 ng/mL, the maximum value 14.5 ng/mL, the mean 8.6 ng/mL, average 8.77 ng/mL, and SD 1.61 ng/mL. The reference range of the 199 subjects's serum HER-2/neu measurements was calculated by the mean +/- 2 SD. Since the mean +/- SD of their HER-2/neu measurements was 8.8 +/- 1.6 ng/mL, the reference range was 5.6~12.0 ng/mL. The reference ranges for the age groups were 6.1~10.9 ng/mL, 5.3~11.4 ng/mL, 5.0~12.6 ng/mL and 6.3~12.6 ng/mL for the twenties, thirties, forties and fifties, respectively. The reference ranges for the age groups were analyzed statistically and there was statistical difference (p= 0.002) between fifties and twenties or thirties. The upper limit level of the reference range of serum HER-2/neu in healthy Korean women was 12.0 ng/mL. CONCLUSION: The results suggest that the reference range of serum HER-2/neu in healthy Korean women is 6.1~10.9 ng/mL, 5.3~11.4 ng/mL, 5.0~12.6 ng/mL and 6.3~12.6 ng/mL for the twenties, thirties, forties, and fifties, respectively. There is no significant difference between the twenties, thirties, forties, each other. According to analyzed statistically, there is difference between fifties and twenties or thirties (p= 0.002), but there is no statistically significant difference between forties and fifties.
Antibodies, Monoclonal ; Breast ; Breast Neoplasms ; Carcinogenesis ; Epitopes ; Female ; Humans ; Immunoassay ; Korea ; Luminescence ; Metalloproteases ; Molecular Weight ; Oncogenes ; Population Characteristics ; Prognosis ; Reference Values* ; Reproduction ; Rivers ; Trastuzumab

Functional dyspepsia is a condition with chronic indigestion symptoms such as epigastric pain or discomfort, early satiety, and bloating without an alternative organic disease. The symptoms are similar to those of functional dyspepsia, but abnormal retention of food in the stomach should be identified in gastroparesis. In this case, botulinum toxin injection was performed for treatment in a patient who complained of symptoms such as nausea, early satiety, abdominal distension, and poor appetite without no abnormal findings in gastric emptying scan. Through this case, a possibility was found that antral and pyloric dysfunction may cause symptoms of functional dyspepsia, without gastric emptying abnormalities.

PURPOSE: Idiopathic granulomatous mastitis is a rare benign inflammatory breast disease of an unknown etiology and the optimal treatment remains controversial. The aim of this study is to evaluate the efficacy of surgically complete excision in patients with idiopathic granulomatous mastitis. METHODS: Between March 2005 and November 2008, we treated 14 cases that were diagnosed with idiopathic granulomatous mastitis. Prospectively, we treated the cases with complete surgical excision with or without steroid therapy in all patients. RESULTS: The mean age of the patients was 36 years (range 30 to 53 years). All cases performed were complete excision with or without steroid therapy. The median follow up period was 26 months (range 5 to 50 months) and all cases had no recurrence. 13 patients out of the 14 were satisfied with the cosmesis of the treated breast. CONCLUSION: We conclude that the treatment of choice for idiopathic granulomatous mastitis is surgically complete excision.
Breast ; Breast Diseases ; Follow-Up Studies ; Granulomatous Mastitis ; Humans ; Prospective Studies ; Recurrence

PURPOSE: Skin-sparing mastectomy (SSM) involves the resection of the nipple-areolar complex (NAC) along with the breast parenchyma, and this improves aesthetic outcome for breast cancer patients. Yet most patients desire preservation of the NAC. The purpose of this study was to determine the associated risk factors of NAC involvement and to identify the value of preoperative breast magnetic resonance imaging (MRI) for measuring the tumor-nipple distance (TND). METHODS: This prospective study was carried out in 92 breast cancer (3 patients with bilateral breast cancer) patients who underwent MRI and they had undergone modified radical mastectomy or SSM at the Department of Surgery in Soonchunhyang University Hospital from November of 2003 to March of 2006. The patients were divided into two groups: nipple-positive for malignancy (group 1; n=9) and nipple-negative for malignancy (group 2; n=86). We analyzed the risk factors of NAC involvement, including tumor size, nuclear grade, lymph node invasion, muticentricity, TND, the hormone recepor status, and lymphovascular invasion. The TND was measured by preoperative breast MRI (the imaging distance) in all patients and by the distance of specimens which were obtained postoperatively (the real distance) in 31 patients. RESULTS: The overall frequency of malignant nipple involvement was 9 of 95 (9.4%). There were no differences in tumor size, nuclear grade, lymph node invasion, muticentricity, the hormone recepor status and lymphovascular invasion between the two groups. The TND was identified as an independent predictor of malignant NAC involvement: the mean TND by breast MRI was 0.7 cm in group 1 and 2.7 cm in group 2 (p=0.01) the mean TND by pathologic measuring the specimen was 0.7 cm in group 1 and 3.2 cm in group 2 (p=0.02). In all the nipple involved cases, the tumor was within 2 cm of the nipple. In measuring the TND, there was no significant difference between the imaging distance of MRI and real distance of the sepcimen (p=0.166). CONCLUSION: The only predictive factor for malignant NAC invasion was TND in our study. NAC preservation would be appropriate for the patients with tumor located more than 2 cm away from the nipple. The TND as determined by preoperative MRI is considered to be helpful when deciding whether to preserve the NAC.
Breast Neoplasms* ; Breast* ; Humans ; Lymph Nodes ; Magnetic Resonance Imaging ; Mastectomy ; Mastectomy, Modified Radical ; Nipples* ; Prospective Studies ; Risk Factors

BACKGROUND: The purpose of this study was to survey the nasal colonization of methicillin-resistant Staphylococcus aureus (MRSA) among the patients admitted in a medical intensive care unit (MICU) and analyze risk factors associated with the colonization. METHODS: The study was carried out on patients admitted into the MICU in a 1,250-bed tertiary care university hospital from January through December 2006. Nasal surveillance cultures were obtained from patients within 24 hours of admission to the unit. Data were analyzed retrospectively by the review of medical records. RESULTS: A total of 312 patients were screened with active nasal cultures; 36 patients (11.6%) were positive for MRSA. Of these, 22 (7.1%) were positive in the nasal cultures only and 14 (4.5%) were positive in the cultures of other specimens (13, sputum; 1, joint fluid) in addition to the nasal swabs. Among the risk factors for MRSA nasal colonization were sex (man), route of admission (from other ICUs or wards), a history of ICU admission during the recent 12 months, and prolonged hospital days in ICU. CONCLUSION: MRSA nasal carrier rate was found higher in this study than in those reported in the literature. Most of the patients colonized with MRSA in the nostril were not colonized with the organism elsewhere in the body. Whether or not active surveillance for MRSA should be performed would depend on the nasal colonization rate of the patients at the time of admission to the ICU.
Colon* ; Humans ; Intensive Care Units* ; Critical Care* ; Joints ; Medical Records ; Methicillin Resistance* ; Methicillin-Resistant Staphylococcus aureus* ; Retrospective Studies ; Risk Factors ; Sputum ; Tertiary Healthcare