No abstract available.
Chorion* ; Chorionic Villi Sampling* ; Chorionic Villi* ; Female ; Humans ; Pregnancy

No abstract available.
Amniocentesis* ; Cytogenetics* ; Female ; Humans ; Pregnancy ; Pregnancy Trimester, Second*

Recently, we experienced a case of subacute infective endocarditis caused by A. haemolyticum on mitral valve prolapse complicated with systemic emboli, which was successfully treated with antibiotics and valve replacement surgery. To our knowledge, this is the first report to address infective endocarditis caused by A. haemolyticum in a immunocompetent patient who had mitral valve prolapse and survived with successful treatment. Greater awareness of this uncommon organism is needed to make an accurate diagnosis and perform a better clinical management in the early stage of the disease. Recommendation for the treatment of septic A. haemolyticum infections has not been established. Therefore, the treatment should be based on clinical experiences and in vitro susceptibility profiles of the individual strain. The site of infection as well as antimicrobial susceptibility profiles should be considered for appropriate antibiotics choice and decision to perform a surgical intervention.
Anti-Bacterial Agents ; Arcanobacterium* ; Diagnosis ; Endocarditis* ; Humans ; Mitral Valve Prolapse* ; Mitral Valve*

Recently, we experienced a case of subacute infective endocarditis caused by A. haemolyticum on mitral valve prolapse complicated with systemic emboli, which was successfully treated with antibiotics and valve replacement surgery. To our knowledge, this is the first report to address infective endocarditis caused by A. haemolyticum in a immunocompetent patient who had mitral valve prolapse and survived with successful treatment. Greater awareness of this uncommon organism is needed to make an accurate diagnosis and perform a better clinical management in the early stage of the disease. Recommendation for the treatment of septic A. haemolyticum infections has not been established. Therefore, the treatment should be based on clinical experiences and in vitro susceptibility profiles of the individual strain. The site of infection as well as antimicrobial susceptibility profiles should be considered for appropriate antibiotics choice and decision to perform a surgical intervention.
Anti-Bacterial Agents ; Arcanobacterium* ; Diagnosis ; Endocarditis* ; Humans ; Mitral Valve Prolapse* ; Mitral Valve*

Transcervical chorionic villus sampling (CVS) was performed in 174 patients between 7 & 12 menstrual weeks of pregnancy opting for prenatal diagnosis. Advanced maternal age was the most common indication for CVS (39.7%). The sampling success rate was 95.4% (166/174), representing 88.9% at 7 to 8 weeks, 98.9% at 9 to 10 weeks & 92.7% at 11 to 12 weeks gestation. In 139 of 174 patients (80%), successful sampling was accomplished in one or two catheter passages only. Four spontaneous fetal losses (2.3%) occurred. The cytogenetic analysis routinely used was the direct overnight & long-term culture methods which revealed 4 abnormalities (2.4%). To date, 90 of the women have been delivered & all infants are doing well and the remaining 65 pregnancies are continuing uneventually. Maternal serum alphafetoprotein (MSAFP) concentration was determined in 72 patients immediately before & after CVS. A significant increase of 20% or more, comparable to pre CVS levels, was noted immediately after sampling in 56 of 72 patients (77.8%). The increase in MSAFP concentration correlated with the amount of villi sampled (r = 0.498, p less than 0.001) & with the number of sampling attempts (p less than 0.05). Estimated CVS related fetomaternal hemorrhage (FMH) ranged from 0.005 to 0.1552 ml and in 5 of 72 patients (6.90%) 0.06 ml or more of FMH was noted. Two of the 5 patients had FMH of 0.1 ml or more.
Chorionic Villi Sampling/*adverse effects ; *Chromosome Aberrations ; Female ; Fetomaternal Transfusion/etiology ; Human ; Pilot Projects ; Pregnancy/*blood ; Rh Isoimmunization/etiology ; Support, Non-U.S. Gov't ; alpha-Fetoproteins/*analysis

The Mycobacterium avium-intracellulare complex (MAC) is the most common pathogen in pulmonary disease caused by a nontuberculous mycobacteria. Patients with MAC pulmonary disease tend to be older, are more likely to have underlying lung disease than tuberculosis patients. The insidious nature of MAC pulmonary disease has been emphasized in many reports because symptoms may be present for months or years before a diagnosis can be made. Most patients experience chronic coughing, which is usually productive of purulent sputum. A MAC pulmonary infection is rarely accompanied by acute respiratory symptoms and lobar pneumonic consolidation on chest radiography. We report a very rare case of M. intracellulare pulmonary disease presenting as acute pneumonia.
Cough ; Diagnosis ; Humans ; Lung Diseases ; Mycobacterium avium Complex* ; Mycobacterium avium-intracellulare Infection ; Mycobacterium* ; Nontuberculous Mycobacteria ; Pneumonia* ; Radiography ; Sputum ; Thorax ; Tuberculosis

PURPOSE: Granulomatous mastitis is a benign inflammatory disease of the breast and its etiology is not clearly defined. In 1972, Kessler and Wolloch described the microscopic features of granulomatous mastitis, but frequently it mimics a carcinoma in a clinical setting. This study was performed to determine the modalities that are important for the diagnosis and the treatment of granulomatous mastitis. METHODS: We studied 12 patients who were diagnosed as having granulomatous mastitis based on pathology. Age, parity, time from last delivery, number of operations, past history of breast feeding and oral contra ceptives, radiologic findings, and cytologic results were retrospectively evaluated. In two recent cases, a polymerase chain reaction (PCR) for mycobacterium tuberculosis was performed to exclude tuberculous mastitis. RESULTS: Among the 12 patients, 8 were in the thirties, 2 in the twenties, 1 in the forties and 1 in the fifties. Of the 12 patients, 9 patients had breast fed and 2 patients had used oral contraceptive pills previously. No patients were suffered from pulmonary tuberculosis. The mean number of deliveries was two. The time from last delivery were varied from 3 weeks to 24 years but most were within 6 years. The location of the lesions were the upper outer quadrant in 6, upper inner quadrant in 3, inner area in 1, lower outer quadrant in 1 and lower inner quadrant in 1 patient. The mean size of the lesions was 3.52 cm. Preoperative mammography was not helpful in finding granulomatous mastitis. Ultra sonographically multiple clustered, contiguous tubular hypochoic lesions suggested the possibility of the disease. Furthermore, fine needle aspiration cytology showed epithelial histiocytes or giant cells and could be used to diagnose granulomatous mastitis. Cultures of microorganisms were sterile, and AFB stainings were all negative. Tuberculous mastitis was excluded by PCR in 2 cases. Surgical resection of the affected tissue was performed in 8 patients and steroid therapy was performed in the remaining 4 who had been surgically treated in other clinics before. All excision cases, except one, were cured. Among the patientsfor whom steroid therapy was used, 1 patient was cured, 1 had a recurrence and the remaining 2 are now under treatment. CONCLUSION: Although rare, granulomatous mastitis could be diagnosed with the aid of ultrasonography and cytology. Surgical excision of the affected tissue and long-term steroid therapy could be used to treat the disease.
Biopsy, Fine-Needle ; Breast ; Breast Feeding ; Diagnosis* ; Female ; Giant Cells ; Granulomatous Mastitis* ; Histiocytes ; Humans ; Mammography ; Mastitis ; Mycobacterium tuberculosis ; Parity ; Pathology ; Polymerase Chain Reaction ; Recurrence ; Retrospective Studies ; Tuberculosis, Pulmonary ; Ultrasonography

BACKGROUND: Sentinel node biopsy has emerged recently as an alternative to routine axillary node dissection in predicting axillary nodal metastasis, and various studies have shown its effectiveness in patients with breast cancer. However, there have been some controversies in clinical application because of its high false negative rate. METHODS: One hundred forty patients with breast cancer underwent operative management in consideration of the results of sentinel node biopsies at the department of surgery, Samsung Medical Center, between Sep. 1995 and Jul. 1998. Sixty-three patients with tumor sizes of T1 or less were retrospectively evaluated. Intraoperative lymphatic mappings using vital blue dye and using a combination of vital dye and a 99mTc-antimony sulphide colloid were performed for 53 patients and 10 patients, respectively. RESULTS: Patient's ages were in the third decade for 2 patients (3.2%), in the fourth decade for 18 (28.6%), in the fifth decade for 18 (28.6%), in the sixth decade for 13 (20.6%) and in the seventh decade for 12 (19.0%). An infiltrating ductal carcinoma was observed in 51 patients (81.0%), an intraductal carcinoma in 8 (12.6%), a medullary carcinoma in 2 (3.2%), an infiltrating lobular carcinoma in 1 (1.6%) and a mucinous carcinoma in 1 (1.6%). Sentinel node was detected in 42 of the 53 patients (79.2%) evaluated with vital blue dye only and in 10 of the 10 patients (100%) evaluated with a combination of vital dye and a 99mTc-antimony sulphide colloid. Among the group of T1 or less, the sensitivity rates of vital dye and the combination were 81.8% and 100% and their accuracies of them were 95.2% and 100%, respectively. The false negative rates for all cases were 12.2% and 8.3%, respectively, but they were decreased to 6.1% and even 0% for the group of T1 or less. CONCLUSIONS: The detection rate and the accuracy of sentinel node biopsy were enhanced in patients with T1 or less breast cancer. If a combination of vital dye and a radioisotope is used, sentinel node biopsy may be applied clinically in limited patients such as those with T1 or less breast cancer.
Adenocarcinoma, Mucinous ; Biopsy* ; Breast Neoplasms ; Breast* ; Carcinoma, Ductal ; Carcinoma, Intraductal, Noninfiltrating ; Carcinoma, Lobular ; Carcinoma, Medullary ; Colloids ; Humans ; Neoplasm Metastasis ; Retrospective Studies

BACKGROUND: Sentinel node biopsy has emerged recently as an alternative to routine axillary node dissection in predicting the axillary nodal metastasis and various studies habe shown its effectiveness in patients with breast cancer. However there have been some controversies in clinical application because of high false negative rate. MATERIALS AND METHODS: One hundred and forty patients with breast cancer underwent operative management in consideration of the results of patients with breast cancer underwent operative management in consideration of the results of sentinel node biopsy at department of surgery in Samsung Medical Cancer between Sep. 1995 and July 1998. Sixty-three patients with tumor size of T1 or less were retrospectively evaluated. Intra-operative lymphatic mapping using vital blue dye was performed in 53 patients and using combination of vital dye and 99mTc-antimony sulphide colloid in 10 patients. RESULTS: patients ages were in the third decade in 1 patients (3.2%), in the forth decade in 18 (28.6%), in the fifth decade 18 (28.6%), in the sixth decade in 13 (20.6%) and in the seventh decade in 12 (19.0%). The patients had infiltrating ductal carcinoma in 51 patients(81.0%), intraductal carcinoma in 8 (12.6%), medullary carcinoma in 2 (3.2%), infiltrating lobular carcinoma in 1 (1.6%) and mucinous carcinoma in 1 (1.6%). Sentinel node was detected in 42 of 53 patients (79.2%) evaluated with vital blue dye only and 10 of 10 (100%) evaluated with combination of vital dye and 99mTc-antimony sulphide colloid. Among the group of T1 of less, each sensitivity rates of vital dye and combination were 81.8% and 100% and accuracy of them were 95.2% and 100% respectively. Each false negative were 12.2% and 8.3% in total cases but they were decreased to 6.1% and even 0% in the group of T1 or less. CONCLUSION: The detection rate and accuracy of sentinel node biopsy were enhanced in patients with T1 or less breast cancer. If the combination of vital dye and radioisotope is used, sentinel node biopsy may be applied clinically in limited patients such as T1 or less breast cancer.
Adenocarcinoma, Mucinous ; Biopsy* ; Breast Neoplasms ; Breast* ; Carcinoma, Ductal ; Carcinoma, Intraductal, Noninfiltrating ; Carcinoma, Lobular ; Carcinoma, Medullary ; Colloids ; Humans ; Neoplasm Metastasis ; Retrospective Studies