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*

No abstract available.
Pituitary Neoplasms*

Various methods of nasal reconstruction were performed over time. The physiology and anatomy of nose were clarified and its aesthetic subunits were employed, more improvement and modification were performed. The bilobed flap is particularly suitable for reconstruction of small or medium sized nasal defect up to 1.5 cm in diameter. Authors performed 6 cases of the bilobed flap for the defect of nasal dorsum (4 cases: basal cell carcinoma, 2 cases: compound nevus) from March 2000 to February 2001. The bilobed flap was medially based and second lobe was positioned on the nasal alar groove. This flap results in little or no distortion around tissue, by which scars of nasal dorsum and dog-ear deformity are reduced. Moreover we could achieve better cosmetic results for the scar, primary repair site of the second lobe, which is concealed by nasal alar groove.
Carcinoma, Basal Cell ; Cicatrix ; Congenital Abnormalities ; Nose ; Physiology

PURPOSE: This study was performed to investigate the effects of environmental factors, genetic polymor phisms of cytochrome P450 2E1 (CYP2E1) and N-acetyltransferase 2 (NAT2), and their interactions on mutations of p53 and Ki-ras genes in Korean stomach cancer. METHODS: One hundred nine stomach cancer patients and 211 age- and sex-matched controls were enrolled in this study. Direct interview with a structured questionnaire was performed to get informations on the level of exposure to environmental factors. For genotyping of the metabolic enzymes, PCR-RFLP methods were used. RT-PCR and direct sequencing were carried out to detect mutations in the p53 and the Ki-ras genes of stomach cancer tissue. To evaluate the risk of stomach cancer, we calculated odds ratios for environmental and genetic factors, and their combinations. RESULTS: Past medical histories of gastritis, diabetes and asthma allergic rhinitis were significant risk factors for stomach cancer. Fried potatoes, squid and octopus, welsh onions and chestnuts and gingkonuts had protective effects against stomach cancer. On the contrary, chicken, soybean paste stew, and soybean milk were significantly related to an increased stomach cancer risk. The NAT2 rapid acetylator turned out to be a marginally significant risk factor for gastric cancer. Mutations of the p53 and the Ki-ras genes were detected in 27.5% and 10.7% of stomach cancer tissues, respectively. Frizzled rice, potato, beef, lard, pickled fish, chicken stew, anchovies, tempura, Welsh onions, eggs, bean-curd, Qing-style soybean paste stew, and ice cream were protective against p53 mutation whereas yogurt was a risk factor for p53 mutation in stomach cancer tissue. Ki-ras mutation was associated with less intake of pears and persimmons, melons, strawberries, grapes and milk and with more intake ofsoybean paste stew. In a multiple logistic analysis including genetic polymorphism, past medical history and diet intake, past history of gastritis, chicken, soybean paste stew, and soybean milk were significant risk factors for stomach cancer whereas past history of diabetes, squid and octopus, and Welsh onions were protective factors against stomach cancer. CONCLUSION: These results suggest that past medical history and diet are more important risk factors for stomach cancer than genetic polymorphism and that mutations of the p53 and the Ki-ras genes would be induced by the respective risk factors.
Asthma ; Carcinogenesis* ; Carcinogens, Environmental* ; Chickens ; Cucurbitaceae ; Cytochrome P-450 CYP2E1* ; Decapodiformes ; Diet ; Diospyros ; Eggs ; Fragaria ; Gastritis ; Genes, ras ; Humans ; Ice Cream ; Milk ; Octopodiformes ; Odds Ratio ; Onions ; Ovum ; Polymorphism, Genetic* ; Pyrus ; Surveys and Questionnaires ; Rhinitis ; Risk Factors ; Solanum tuberosum ; Soybeans ; Stomach Neoplasms ; Vitis ; Yogurt

Pheochromocytoma is derived from the chromaffin cells and patients with pheochromocytoma present with several signs and symptoms by producing, storing and secreting catecholamine. Spontaneous rupture or necrosis of pheochromocytoma is extremely rare, but it can be lethal because of the dramatic change in the circulation such as an acute abdominal emergency or shock. Spontaneous remission of the clinical symptoms due to necrosis of the pheochromocytoma is rare. We describe such a case that presented with cardiogenic shock due to extensive necrosis of the pheochromocytoma and this was followed by spontaneous remission of the clinical symptoms without removal of the pheochromocytoma.
Chromaffin Cells ; Emergencies ; Humans ; Necrosis ; Pheochromocytoma ; Remission, Spontaneous ; Rupture, Spontaneous ; Shock ; Shock, Cardiogenic

Capsule endoscopy (CE) is a valuable modality for directly examining the small bowel in a relatively noninvasive and safe manner. CE is being increasingly used for obscure gastrointestinal bleeding, Crohn's disease, drug induced ulcer and small bowel tumor. Although capsule retention is a relatively infrequent complication, small bowel obstruction and strictures have been considered contraindications to CE. But some authors have reported that capsule endoscopy can be safely used to help identify the etiology and site of small bowel obstruction, and the retention of the capsule indicates the presence of a lesion requiring surgery. We report here on a case of small bowel obstruction and capsule retention by a small bowel ulcer, and the small bowel ulcer was not found when performing capsule endoscopy.
Capsule Endoscopy ; Constriction, Pathologic ; Crohn Disease ; Endoscopy ; Hemorrhage ; Retention (Psychology) ; Ulcer

PURPOSE: We wanted to develop and test an artificial intelligence (AI) to assist physicians in making the thin-section CT diagnosis of diffuse pulmonary diseases. MATERIALS AND METHODS: The AI was composed of knowledge bases (KB) of 12 diffuse pulmonary diseases and an inference engine (IE). The KB of a disease included both the inclusion criteria (IC) and the exclusion criteria (EC), which were the clinical or thin-section CT findings that were known to be present or absent in that particular disease, respectively. From imputing the clinical or thin-section CT findings by the operator who was reading the thin-section CT, AI instantly executed the following two steps. First, the IE eliminated all diseases from the list which the EC had for those particular findings. Next, from a list of remaining diseases, the AI selected those diseases having those findings in its IC to formulate the 1st-step differential diagnosis (DD1). For the differential diagnosis in the next step, the reader could choose one more clinical or thin-section CT finding from the new list: [(all the findings in the IC or EC of DD1) - (the findings in the IC common to all the DD1s)]. The reader could proceed even further if needed. The system was tested on 10 radiology residents who solved 24 problems (two problems for each of 12 diffuse pulmonary diseases) without and then with the aid of the AI. The scores were compared using the Wilcoxon signed rank test. RESULTS: An AI was made; it was composed of 280 rules (214 IC and 66 EC) and three interfaces (two for program management and another for problem solving). Contestants scored higher (p = 0.0078) using the AI (167 vs. 110 respectively), and they responded that they felt that the program was helpful in making decisions. CONCLUSION: AI appeared to be helpful in making thin-section CT diagnosis.
Artificial Intelligence* ; Diagnosis* ; Diagnosis, Differential ; Knowledge Bases ; Lung ; Lung Diseases*

PURPOSE: According to the recent studies on the carcinogenic factors of gastric cancer in Koreans, dietary factors, such as stew, roasted fish, and fish boiled in soy with spices, salted foods, as well as smoking, might be risk factors of gastric cancer. N-acetyltransferase 2 (NAT2) is an enzyme that plays a role in the reduction of the toxicity of various carcinogens. There is a possibility that the genetic polymorphism of NAT2 might change a subject's susceptibility to gastric cancer. The aim of this study was to examine the effects of diet, the genetic polymorphism of NAT2 and their interaction on the risk of gastric cancer in Koreans. METHODS: The subjects of this case-control study were 214 gastric cancer patients, and 214 controls, who were admitted at the Chungbuk National or Eulji University Hospitals. Each subject was directly interview, by an experienced interviewer, with a structured questionnaire. A NAT2 genetic polymorphism analysis was performed, with a PCR-RFLP technique, and the data analyzed using the PC-SAS software package. RESULTS: Increased intakes of makkoli, soybean paste stew, kimchi and ggakdugi, soy milk, chicken boiled with rice and boiled chicken were all associated with an increased risk of gastric cancer, whereas those of fermented soybean stew, Welsh onion or leek, onions, peaches, chestnuts or gingko nuts, fatsia shoots, raw fish, salted seafood and laver were all associated with a decreased risk of gastric cancer. The odds ratio (95% confidence interval) for gastric cancer for the rapid acetylators was 1.64 (1.12, 2.41), which was statistically significant. With respect to the rapid acetylators, makkoli, kimchi and soy milk were significant risk factors, and Welsh onion/leek and onions were protective factors for gastric cancer. Whereas, soybean paste stew was a risk factor of gastric cancer with the slow or intermediate acetylators. CONCLUSION: These results suggest the genotype of a rapid acetylation is a risk factor of gastric cancer, and the effects of diet on the risk of gastric cancer vary according to the genotype of the NAT2 enzyme.
Acetylation ; Carcinogenesis* ; Carcinogens ; Case-Control Studies ; Chickens ; Chungcheongbuk-do ; Diet* ; Genotype ; Ginkgo biloba ; Hospitals, University ; Humans ; Nuts ; Odds Ratio ; Onions ; Polymorphism, Genetic* ; Prunus persica ; Surveys and Questionnaires ; Risk Factors ; Seafood ; Smoke ; Smoking ; Soy Milk ; Soybeans ; Spices ; Stomach Neoplasms*

PURPOSE: Abnormal expression of E-cadherin has been shown to play a role in the progression and the metastasis of tumors. We investigated the correlation between the expressions of E-cadherin and the clinicopathologic factors and survival in pT2 gastric adenocarcinomas. METHODS: We examined formalin-fixed, paraffin-embedded archival tissues from 100 surgically resected gastric adeno-carcinomas with pT2 lesion. Tissue preparations were stained with Zymed's monoclonal mouse anti-E-cadherin (clone: 4A2C7). We analyzed the correlation between the expressions of E-cadherin and clinicopathologic factors. RESULTS: Normal gastric mucosa was immunoreactive with anti-E-cadherin antibody. Among the 100 tumors examined, 73 tumors showed expression of E-cadherin. The gender, age, size, depth of invasion, lymph node metastasis, stage (UICC), lymphatic invasion, vascular invasion were not related with E-cadherin expression but Lauren classification and histologic type were strongly correlated with E-cadherin expression (P=0.000, P=0.006). Though patients with dec-rea-sed expression of E-cadherin showed a poorer median survival than normal expression (43.85+/-23.95 months vs. 61.27+/-33.47 months), expression of E-cadherin was not related with survival rate (P=0.668). CONCLUSION: In patients with gastric cancer, expressions of E-cadherin correlated with histologic type and Lauren classi-fication but not with survival.
Adenocarcinoma ; Animals ; Cadherins* ; Classification ; Gastric Mucosa ; Humans ; Immunohistochemistry ; Lymph Nodes ; Mice ; Neoplasm Metastasis ; Stomach Neoplasms* ; Survival Rate

PURPOSE: This study was performed to investigate the interaction of genetic polymorphisms of glutathione S-transferases and L-myc proto-oncogene with smoking, drinking, and dietary factors in the carcinogenesis of gastric cancer. MATERIALS AND METHODS: Two hundred and four gastric cancer patients and 1:1 matched hospital controls were the study subjects. They were interviewed with a questionnaire including alcohol consumption, smoking and dietary habit. We investigated genetic polymorphisms of GSTM1, GSTT1 and L-myc genes using PCR-RFLP techniques. RESULTS: Smoking and soybean paste stew were risk factors and doughnut, fried potato, welsh onion, rice cake, seaweed, slices of raw fish, melon, tomato, garlic and onion were protective factors of gastric cancer. The odds ratios of some food items changed significantly according to the genotypes; green vegetables and pork according to the GSTM1 genotype; pork, soybean curd, steamed or hard-boiled soybean and welsh onion according to the GSTT1 genotype; rice cake and garlic according to the L-myc proto-oncogene genotype. CONCLUSION: These results suggest that the genetic polymorphisms of GSTM1, GSTT1 and L-myc genes might modify the effects of environmental factors on gastric cancer possibly by engaging in the metabolism of food, alcohol and cigarette smoke.
Alcohol Drinking ; Carcinogenesis ; Cucurbitaceae ; Diet* ; Drinking* ; Food Habits ; Garlic ; Genes, myc ; Genotype ; Glutathione* ; Humans ; Lycopersicon esculentum ; Metabolism ; Odds Ratio ; Onions ; Polymorphism, Genetic* ; Surveys and Questionnaires ; Risk Factors ; Seaweed ; Smoke* ; Smoking* ; Solanum tuberosum ; Soybeans ; Steam ; Stomach Neoplasms* ; Tobacco Products ; Vegetables