PURPOSE: Current evidence indicates that ultrasonography of the breast is an important adjunct to mammography and clinical examination in the diagnosis of palpable breast abnormalities. An assessment of the value of office-based ultrasonography of a palpable breast mass performed by a breast surgeon was the aim of this work. METHODS: A 7.5 MHz linear probe was used to perform office-based ultrasonography in 109 consecutive female patients having a palpable solid breast mass between August 1998 and December 1999. Breast masses diagnosed histologically as fibroadenomas or breast cancer were included in this study. The clinical impression from the physical examination (PE), the result of officed-based ultrasonography done by a surgeon (OUSG), and comprehensive judgement engaging both PE and OUSG (PEUSG) were recorded in each patient's hospital record as benign or malignant at the first visit. The diagnostic values of PE, OUSG, PEUSG, mammography (MMG), and ultrasonography done by a radiologist (USG) were compared. RESULTS: Of 109 masses, a fibroadenoma was diagnosed in 73 patients while a carcinoma was established in 36 patients. The sensitivity, the specificity, the accuracy rate, and the kappa coefficient were 91.7%, 89.0%, 89.9%, and 0.780 for PE; 100%, 90.4%, 93.6%, and 0.862 for OUSG; 97.2%, 97.3%, 97.2%, and 0.938 for PEUSG; 90.4%, 89.4%, 90%, and 0.630 for MMG; and 88.9%, 90.9%, 90% and 0.798 for USG. The diagnostic accuracy of PEUSG was significantly higher than those of PE and MG (p<0.05). CONCLUSION: These data suggest that office-based ultrasonography of the breast performed by a surgeon is a useful adjunct to clinical evaluation of the breast mass and permits timely and cost-effective patient care.
Breast Neoplasms ; Breast* ; Diagnosis* ; Female ; Fibroadenoma ; Hospital Records ; Humans ; Mammography ; Patient Care ; Physical Examination ; Prospective Studies* ; Sensitivity and Specificity ; Ultrasonography*

Macular hemorrhage which result from breaks of Bruch's membrane or from choroidal neovascularization can develop in high degenerative myopia, but its occurrence after photorefractive surgery has rarely been reported. We experienced a case of macular hemorrhage after laser in situ keratomileusis[LASIK]:A 28-year-old female patient with high myopia of -16.5 diopters, who had received successful LASIK operation on her left eye.complained of a sudden drop in vision 20 days postoperatively.On fundus examination, macular hemorrhages were detected on her left eye.Eventually the hemorrhages resolved, but more than 2 lines of her best corrected visual acuity were lost.During follow-up, a new hemorrhagic lesion was incidently found on the other eye. This case demonstrates that macular hemorrhages may develop after LASIK in eyes with high degenerative myopia, and lead to a permanent reduction in visual acuity.We should be alert to any potential retinal pathology in patients having refractive surgery.
Adult ; Bruch Membrane ; Choroidal Neovascularization ; Female ; Follow-Up Studies ; Hemorrhage* ; Humans ; Keratomileusis, Laser In Situ* ; Myopia ; Myopia, Degenerative ; Pathology ; Refractive Surgical Procedures ; Retinaldehyde ; Visual Acuity

There are several methods for the reconstruction of partial urethral defect, including split-thickness skin graft, full-thickness skin graft, and preputial flap and free flap. Despite partial success using these methods, most results are unsatisfactory due to frequent complications such as postoperative infection, fistula formation, hair growth and stricture. There have been several pioneering experiments in this field using autogenous vein graft and the results have been controversial. However, the fact that the endothelial lining is replaced by natural urethral epithlium is generally accepted as a positive effect of this method. This experiment was designed to identify the possibility of using vein graft for the reconstruction of partial urethral defect. Two different types of vein graft method were performed in a total of 20 New Zealand White rabbits with partial urethral defect. Firth, for the patch-graft group, a 1 x 1 cm rectangular vein graft was sutured at a defective area of the same size. Second, for the tubed-graft group, a vein graft segment 1 cm long was replaced at a segmental urethral defect of the same length. Histologic study was performed at three and eight weeks postoperatively in each group. The process of transitional ell epithelial replacement within the grafted vein was uniformly observed in both experimental groups at three weeks postoperatively. At eight weeks postoperatively, the epithelial replacement was almost complete and histologically undistinguishable. In the retrograde urethrogram performed after 8 weeks, the urinary flow in the patch-graft group was normal and showed no stricture, and two of five rabbits in the tubed-graft group showed partial stricture at the graft site. In conclusion, natural urethral epithelium was restored in grafted venous segments irrespective of the type of graft. Partial stricture was observed in 40% of the tubed-graft group while complete reconstruction was possible in the patch-graft group.
Constriction, Pathologic ; Epithelium ; Fistula ; Free Tissue Flaps ; Hair ; Rabbits ; Skin ; Transplants* ; Veins*

Chordoma arising from the notochordal remnants is a rare primary bone tumor in the cervicosacral region and is even more unusual in the thoracic region. The authors experienced a case of thoracic chordoma and report its CT and MR findings.
Chordoma* ; Notochord

Chordoma arising from the notochordal remnants is a rare primary bone tumor in the cervicosacral region and is even more unusual in the thoracic region. The authors experienced a case of thoracic chordoma and report its CT and MR findings.
Chordoma* ; Notochord

Laser assisted in situ keratomileusis(LASIK) is a widely used technique for correcting high myopia. Its technical methods and excellent clinical results are well known, but its potential risk on the corneal endothelium are poorly known. We used specular microscope to underwent LASIK for the correction of myopia. The mean preoperative refraction was ?4.5 diopters (range, -10.00 to -23.50 diopters.). The average endothelial cell densities were 2,817+/-205 cells/mm2 (mean +/-SD) preoperatively and 2,789+/-211 cells/mm2 3 months postoperatvely, corresponding to fall of 28 cells/mm2. This fall in endothelial cell density was not statistically significant (P>0.05). But significant correlation between the change in cell density and the residual corneal thickness was found(P>0.05). These results suggest that LASIK is a predictable and safe method for correcting high myopia, but care is recommended when doing deep corneal ablation. Long term follow-up may be needed to confirm its safety.
Cell Count ; Endothelial Cells ; Endothelium, Corneal ; Follow-Up Studies ; Keratomileusis, Laser In Situ ; Myopia

No abstract available.
Blood Platelets* ; Humans ; Platelet Aggregation* ; Plateletpheresis* ; Tissue Donors*

No abstract available.
Anemia, Iron-Deficiency* ; Iron* ; Milk*

PURPOSE: This study is to describe authors'experience on mammographic findings of breast cancer and to know if there is difference between 35 years of age or younger and older groups. MATERIALS AND METHODS: Mammograms of 72 patients with breast cancer detected from January, 1991 to December, 1993 were retrospectively analysed. Mammographic findings were classified into mass only, mass with microcalcifications, microcalcifications only and others. Marginal characteristics of mass were classified into spiculated, poorly marginated and well marginated. Shape of microcalcifications were classified into casting, granular and mixed types. These findings were compared between 35 years of age or younger and older groups. RESULTS: Mammogram showed mass only in 33 patients(46%), mass with microcalcifications in 26 patients (36%), microcalcifications only in seven(10%) and other findings in six(8%). Other findings were architectural distortion, asymmetric high density and incidental breart carcinoma from paraffinoma in one patient respectively, and dense breast in three patients. The margins of the breast mass were spiculated in ten(17%) poorly marginated in 30(51%), well-marginated in 19(32%). Shape of microcalcifications were casting type in 13(40%), granular in 14(42%) and mixed in six(18%) cases. 3 patients had dense breast with which mammography did not demonstrate the lesion. 3 patients without mammographically demonstrable lesions due to dense breasts were under 35 years in age. and there was statistically significant difference between the two groups(p-value<0.05). Microcalcifications only was more common findings in 35 years of age or younger. CONCLUSION: The most important mammographic findings of breast cancer were mass and microcalcifications. Architectural distortion and asymmetric high density were additional findings. In 35 years of age or younger, microcalcifications only was an important finding because mass lesions are frequently masked by dense breast. Thus other imaging modalities, such as ultrasonography, were required.
Breast Neoplasms* ; Breast* ; Humans ; Mammography ; Masks ; Retrospective Studies ; Ultrasonography

PURPOSE: Cancer development depends on not only activation of oncogene or inactivation of tumor suppressor gene but also activities of enzymes involved in the metabolism of various carcinogenic xenobiotics, such as arylamine N-acetyltrasferase 2(NAT 2) and glutathione S-transferase (GSTM1). We analyzed whether genetic polymorphisms of NAT2 and GSTM1 were correlated with the mutation patterns of p53 and H-ras genes in bladder tumor tissues. MATERIALS AND METHODS: In 49 bladder cancer patients, we performed direct DNA sequencing for the detection of mutations of p53 and H-ras gene in bladder tumor tissues, and adopted PCR and PCR-RFLP techniques for the analysis of genetic polymorphisms of NAT2 and GSTM1 using patients` blood samples, respectively. RESULTS: In 18 cases, mutations in p53 were detected whereas 1 case carried two mutations; thus total of 19 mutations were detected. Sixteen of these were point mutations including 13 of transversions and 3 of transitions, and others were 1 of frameshift and 2 of microdeletions-insertions. Among 33 patients, H-ras mutations were detected in 5 cases with 2 of transitions and 3 of transversions. The frequencies of slow, intermediate, and rapid acetylator in NAT2 genotyping analysis, were 10.2%, 40.8%, and 49.0%, respectively, and GSTM1 deletions were observed in 73.5%. We could not find any significant correlations between NAT2 or GSTM1 polymorphisms and the occurence of p53(p=0.614, p=0.310) or H-ras(p=0.500, p=0.582) mutations. Also, no apparent associations were seen for specific type of p53 and H-ras mutations according to polymorphisms of NAT2(p=0.456, p=0.600) and GSTM1(p=0.378, p=0.400). CONCLUSIONS: The polymorphisms of NAT2 and GSTM1, conjugating enzymes of foreign compound metabolism, were not considered to influence occurrence and type of mutations in p53 and H-ras in human bladder cancer.
Genes, ras ; Genes, Tumor Suppressor ; Glutathione Transferase ; Humans* ; Metabolism ; Oncogenes ; Point Mutation ; Polymerase Chain Reaction ; Polymorphism, Genetic ; Sequence Analysis, DNA ; Urinary Bladder Neoplasms* ; Urinary Bladder* ; Xenobiotics