In 1932, Harris, et al., reported that vitamin A had an anti-keratinizing effect on acne vulgaris, and in 1948, Straumfjord, somewhat over-enthusiastically reported that oral use of vitamin A also had a beneficial effect on acne. In spite of studies by Lynch and Cook (1947), and Andrew and Stokoe (1963), which questioned its effectiveness, the original enthusiasm for this regimen has not been completely dampened. Kligman (1969) reported that vitamin A acid (VAA), a metabolic end-product of vitamin A metabolism, produced a peeling effect and when applied topically, was effective in tbe treatment of acne. The mechanism of action of VAA is incompletely understood, however, it is observed to cause, arnong other things, an increase in the speed of proliferation of the cells of the epidermis; dissolution of the intracellular lysosomes; increase in the rate of keratin formation and the conversion of hard keratin to soft keratin; and an increase in the secretion of the sebaceous glands. The effect of VAA in acne treatment is due to the increase in the secretion of the sebaceous glands which prevents the formation of comedones. It is believed that the increased speed of cell division, increased keratinization and softening of the keratin cause a weakening of the intercellular adhesion. These processes cause an acceleration of the flow of cells out of the sebaceoua glands which prevents the formation of comedones and forces existing comedones to the surface of the skin. For this study, thirt:y eight patients with acne vulgaris were selected from among the outpatients of Severance Hospital. They were divided into two groups. The first group was treated with application of vitamin A acid alone. The second group was treated concurrently with topical vitamin A acid and oral tetracycline.
Acceleration ; Acne Vulgaris ; Cell Division ; Epidermis ; Humans ; Lysosomes ; Metabolism ; Outpatients ; Sebaceous Glands ; Skin ; Striae Distensae* ; Tetracycline ; Tretinoin ; Vitamin A

Mammography is the only examination capable of depicting malignant calcifications in breast. In some instances calcifications evident in mammogram and specimen mammograms are not observed in the histologic specimen. Therefore, wer retrospectively analyzed 27 cases in which hook-guided wire localization and biopsy had been performed to determine if microcalcifications were lost during histopathologic processing. Calcium was apparently lost during preparation of the block in about 7% of the cases and after slide preparation in about 11%, for a total possible loss of 18%. The authors recommend a protocol for avoiding these loss that involves performance of a more comprehensive examination of histologic sections by the pathologist and radiographic reexamination of paraffin-embedded tissue blocks with subsequent step sectioning by the pathologist.
Biopsy ; Breast ; Calcium ; Mammography ; Retrospective Studies

PURPOSE: The purpose of this study was to examine the impact of job satisfaction and organizational commitment on patient safety management activities of nurses. METHODS: A cross-sectional design was adopted. The sample included 307 nurses working in three tertiary university hospitals. Data were collected during November and December, 2012, with a response rate of 93%. A 40-item patient safety management activities scale was used to measure patient safety activities. Job satisfaction and organizational commitment were also measured with established instruments and included general characteristics. Data were analyzed with PASW 18.0 program. RESULTS: The mean score for patient safety management activities was 3.98 out of 5. Stepwise multiple linear regression indicated that organizational commitment (beta=.20, p<.001) and job satisfaction (beta=.18, p=.013) respectively predicted patient safety management activities. Especially, the addition of organizational commitment as the strongest predictor of patient safety management activities increased the associated explained variance (R2 change=.11, p<.001). CONCLUSION: It is important for managers to create an organizational climate that promotes the organizational commitment and job satisfaction of nurses. Future studies are encouraged to replicate the findings and also to better understand patient safety management activities and personal emotional stability.
Climate ; Hospitals, University ; Humans ; Job Satisfaction ; Linear Models ; Organizational Culture ; Patient Safety ; Tertiary Care Centers

PURPOSE: Drug resistance plays an important role in the failure of chemotherapy in breast cancer. The purpose of the study was to investigate the chemosensitive and chemoresistance indices of breast carcinomas and see if the in vitro chemosensitivity test correlated with the prognostic indices. METHODS: The immunohistochemical expressions of MDR1, MRP1 and topoisomerase IIalpha(topo IIalpha) were studied and then correlated these with the in vitro chemosensitivities using the histoculture drug response assay (HDRA) and clinicopathological factors in 51 breast carcinomas. RESULTS: In the breast carcinomas examined, the immunohistochemical expressions of MDR1, MRP1 and topo II alpha were strongly observed in 26 (51.0%), 16 (32.0%), 15 (31.3%) carcinomas, respectively. The MRP1 was more frequently expressed in poorly differentiated carcinomas (P= 0.006), and those of MDR1 and topo II alpha were more frequently observed in tumor overexpressing cerbB2 (P=0.038, P=0.036). The expression of MDR1 was related to that of topo II alpha (P=0.015). Comparing these markers with the in vitro chemosensitivities to cyclophosphamide, 5-FU, adriamycin, taxol and taxotere, no correlations were found between the expression of MDR1, MRP1, and topo II alpha but from the chemosensitivity using the HDRA, the growth inhibition rate for cyclophosphamide was higher in MRP1 expressing carcinomas (P=0.009). CONCLUSION: MDR1, MRP1 and topo II alpha were all found to be associated with the poor prognostic indices, but assessment of their immunohistochemical expressions did not allow for prediction of the response to chemotherapy by the in vitro chemosensitivity test in breast carcinomas.
Breast Neoplasms* ; Breast* ; Cyclophosphamide ; Doxorubicin ; Drug Resistance ; Drug Therapy ; Fluorouracil ; Paclitaxel

PURPOSE: Tumor-associated lymphocyte numbers in breast cancer have been suggested as a new independent predictor of response to neoadjuvant chemotherapy in breast cancer patients. We therefore evaluated the relationship between pathologic complete response (pCR) and tumor-associated lymphocytes in tumors of such patients. METHODS: Between 2000 and 2009, we retrospectively evaluated 175 patients with primary breast cancer treated with neoadjuvant chemotherapy, followed by definitive surgical resection. Peritumoral lymphocytic infiltration (LI) and CD3+, CD8+, and forkhead box P3 (FOXP3)+ lymphocytes were assessed in pretreatment biopsy specimens. RESULTS: Nineteen (11%) patients achieved pCR. An elevated LI, CD3+, CD8+, or FOXP3+ lymphocytic infiltration; lower clinical T stage; human epidermal growth factor receptor 2 overexpression; and herceptin-based treatment were all significantly associated with pCR. Through a multivariate analysis, LI (odds ratio [OR], 1.26; p=0.024), clinical T stage (OR, 3.06; p=0.041), and the use of a herceptin-based regimen (OR, 4.95; p=0.004) were all significant independent predictors of pCR. Significantly higher numbers of tumor-associated lymphocytes and CD3+, CD8+, and FOXP3+ T-cells were observed in the following: high-grade tumors, tumors of positive nodal status, and tumors negative for hormone receptors. CONCLUSION: Tumor-associated lymphocytes are significantly associated with pCR, suggesting that tumor-associated lymphocytes may be an important pathological factor predicting a response to neoadjuvant chemotherapy in breast cancer patients.
Biopsy ; Breast ; Breast Neoplasms ; Humans ; Lymphocyte Count ; Lymphocytes ; Multivariate Analysis ; Neoadjuvant Therapy ; Polymerase Chain Reaction ; Receptor, Epidermal Growth Factor ; Receptor, erbB-2 ; Retrospective Studies ; T-Lymphocytes

Iliolumbar artery injury is a rare but well-known complication of abdominal trauma and is usually associated with pelvic bone fracture. If a pseudoaneurysm develops and ruptures, it is a serious condition due to the enduing massive intraperitoneal or retroperitoneal bleeding. Superselective embolization has become the most effective treatment for pelvic hemorrhage caused by iliolumbar artery injury in which early detection and treatment are very important. We report a case of successful transarterial embolization of a pseudoaneurysm following blunt trauma in 32-year-old female.
Adult ; Aneurysm, False* ; Arteries* ; Female ; Hemorrhage ; Humans ; Pelvic Bones ; Rupture

BACKGROUND: Physical and mental health of workers is threatened due to various events and chronic occupational stress. This study was conducted to investigate the relationship between occupational stress and gastric disease in male workers of the shipbuilding industry. METHODS: Occupational stress measured among a total of 498 workers of a shipbuilding firm who visited the hospital for health examination using the Korean Occupational Stress Scale (KOSS)-short form, and the relationship between sociodemographic factors, health-related behaviors, occupational stress, and gastric disease, and the distribution of occupational stress by sociodemographic factors in the gastric disease group was examined. RESULTS: There was no significant association between gastric disease and total occupational stress score and its seven sub-factors. The analysis showed that risk of gastric disease was significantly higher in the Q1 group in which the stress caused by occupational discomfort among seven sub-factors was lowest than that in the Q4 group (odds ratio, 2.819; 95% confidence interval, 1.151 to 6.908). Analysis only on the gastric disease group showed that the stress score of laborers was higher in the four sub-factors than that of office workers (P < 0.05). Analysis on educational background showed that the scores of the three sub-factors were lower in subjects who's highest level of education was high school (P < 0.01). CONCLUSION: This study suggests that it is necessary to improve the culture of Korean collectivism in the workplace and to manage the occupational stress in the low-educated and laborers. It is recommended for future studies to confirm the causal relationship between occupational stress and gastric disease by large scale studies using a KOSS which appropriately reflects workplace culture.
Humans ; Male ; Mental Health ; Stomach Diseases

Phyllodes tumor(PT) is a rare distinctive fibroepithelial breast tumor that occasionally shows unpredictable clinical behavior. Wide excision should be the primary treatment of PT and enucleation, the standard procedure for fibroadenoma(FA), is proscribed due to high frequency of local recurrence. Therefore an accurate preoperative diagnosis of PT is essential in order to ensure proper surgical treatment. However, the differentiation between benign PT and FA is often difficult on the basis of cytologic findings. In an attempt to better understand the cytologic features of benign PT and possibly to differentiate PT from FA on the findings of fine needle aspiration(FNA)smears, we reviewed cytologic smears from 22 histologically diagnosed cases each of benign PT and FA, respectively. The cytologic features assessed were cellularity and atypia of both epithelial and stromal components, and shape of epithelial cell clusters. Atypia of stromal cells was more frequent in PT, while blunt branching pattern of epithelial cells was more frequent in FA. The specific cytologic diagnosis of PT is not possible in many cases, but the abundance of stromal cells with moderate nuclear atypia in the correct clinical setting such as older age and larger size(>4cm) allows the diagnosis.
Breast Neoplasms ; Breast* ; Diagnosis ; Epithelial Cells ; Fibroadenoma* ; Needles ; Phyllodes Tumor* ; Recurrence ; Stromal Cells

PURPOSE: Pathologic complete response (pCR) has been suggested as a surrogate prognostic indicator in breast cancer patients treated with neoadjuvant chemotherapy. We assessed whether the likelihood of pCR and survival is associated with the immunohistochemistry-based molecular subtypes. METHODS: We retrospectively analyzed the records of 276 patients with breast cancer who received neoadjuvant chemotherapy between January 2000 and January 2010. Patients were classified into four molecular subtypes based on the immunohistochemistry profiles of estrogen receptor, progesterone receptor, and HER2/neu. Logistic regression was used to analyze variables associated with pCR. RESULTS: The pCR was achieved in 45 patients (16.3%). The triple negative subtype was an independent predictive factor for pCR (odds ratio, 3.21; 95% confidence interval, 1.20-8.56; p=0.020), and the ERBB-2 subtype showed a trend for higher pCR rates (odds ratio, 3.03; 95% confidence interval, 0.93-9.89; p=0.067) compared with the luminal A subtype. In 99 patients with HER2/neu-positive breast cancer, pCR rates were higher in those who received trastuzumab (31.7%) than those treated with conventional chemotherapy regimens (17.2%, p=0.023). The pCR was significantly associated with prolonged progression-free survival (p=0.008). The triple negative subgroup had shorter progression-free survival (p=0.001) and overall survival (p=0.001) than the other subgroups. CONCLUSION: We demonstrated that the triple negative and ERBB-2 subtypes are more likely to obtain pCR when neoadjuvant chemotherapy is given, compared to the luminal A subtype. Despite the high pCR rate, the triple negative subtype showed worse survival outcomes, paradoxically, primarily due to patients who had residual disease.
Antibodies, Monoclonal, Humanized ; Breast ; Breast Neoplasms ; Disease-Free Survival ; Estrogens ; Humans ; Immunohistochemistry ; Logistic Models ; Neoadjuvant Therapy ; Phenobarbital ; Polymerase Chain Reaction ; Receptors, Progesterone ; Retrospective Studies ; Trastuzumab

PURPOSE: Fulvestrant, a potent estrogen receptor (ER) antagonist with a novel mechanism of action, has shown efficacy in pretreated patients with advanced breast cancer. We assessed the efficacy and tolerability of fulvestrant in Korean postmenopausal women. METHODS: Of the 25 candidates identified at Asan Medical Center, Seoul, Korea, six were deemed ineligible due to inadequate baseline and follow-up imaging. The 19 patients included in this retrospective analysis received the approved dose of fulvestrant (250 mg intramuscular injection, once per month) as second- (n=8), third- (n=7), or fourth-line (n=4) endocrine therapy. RESULTS: At a median follow-up of 7.4 months (range, 1.2-34.8 months), the 19 patients received a median of four cycles (range, 1-34 cycles) of fulvestrant. Median time to progression was 5.5 months (95% confidence interval [CI], 0.4-10.7 months), and median overall survival was 17.9 months (95% CI, 2.7-33.1 months). Among 17 evaluable patients, one (5.3%) achieved a partial response, 10 (52.6%) showed stable disease, and six (31.6%) showed progressive disease. The clinical benefit rate was 26.3%. Four patients (21.1%) reported adverse events, but all were grade 1 or 2. CONCLUSION: Fulvestrant was effective and well tolerated in patients with advanced breast cancer who had been previously treated with several lines of endocrine and chemotherapeutic agents.
Breast ; Breast Neoplasms ; Estradiol ; Estrogens ; Female ; Follow-Up Studies ; Humans ; Injections, Intramuscular ; Korea ; Retrospective Studies