PURPOSE: To compare the incidence between author's first and current report on urinary tract stone in patient with spinal cord injury and to evaluate the effectiveness of recent developed in medical technology and care on in treating the patients. MATERIALS AND METHODS: We reviewed urinary tract stone in 257 patients with paraplegia or quadriplegia after spinal cord injury. These patients were diagnosed retrospectively by KUB and intravenous urography at the Korea Veterans Hospital during 10years from January, 1984 to December, 1993. We evaluated and compared the overall incidence, incidence of specific location of urinary tract, recurrent rate, incidence according to the level of spinal cord injury, and the duration of development in urinary tract stone. RESULTS: Total patients were 257 with 186(72.4%) paraplegia and 71(27.6%)quadriplegia. Overall incidence of the stone was 16.0% in this study and 38.1% in the first study. Incidence of the stone in individual organ ;5.5% in kidney, 1.2% in ureter, and 13.6% in urinary bladder. The recurrent rate was 29.3% in this study and 40.6% in the first study. Incidence of the stone according to the level of spinal cord injury was as follows;15.6% in cervix, 17.1% in upper thorax, 17.9% in lower thorax and 13.9% in lumbar. The stone developed during the first 4 years and between 12 to 16 years following spinal cord injury was 28.3% each. CONCLUSION: Overall incidence and recurrent rate of urinary tract stone was obviously decreased since the first study. Highest incidence of the stone occurred in urinary bladder and in patient with lower thoracic spinal cord injury, which is similar to first report. Peak incidence of the stone was in the first 4years, and another peak was in 12-16years after spinal cord injury. The decreased overall incidence of urinary tract stone maybe attributable to the development in medical technology and care, and active rehabilitation.
Cervix Uteri ; Female ; Hospitals, Veterans ; Humans ; Incidence ; Kidney ; Korea ; Paraplegia ; Quadriplegia ; Rehabilitation ; Retrospective Studies* ; Spinal Cord Injuries* ; Spinal Cord* ; Thorax ; Ureter ; Urinary Bladder ; Urinary Calculi* ; Urinary Tract* ; Urography

PURPOSE: To compare the incidence between author's first and current report on urinary tract stone in patient with spinal cord injury and to evaluate the effectiveness of recent developed in medical technology and care on in treating the patients. MATERIALS AND METHODS: We reviewed urinary tract stone in 257 patients with paraplegia or quadriplegia after spinal cord injury. These patients were diagnosed retrospectively by KUB and intravenous urography at the Korea Veterans Hospital during 10years from January, 1984 to December, 1993. We evaluated and compared the overall incidence, incidence of specific location of urinary tract, recurrent rate, incidence according to the level of spinal cord injury, and the duration of development in urinary tract stone. RESULTS: Total patients were 257 with 186(72.4%) paraplegia and 71(27.6%)quadriplegia. Overall incidence of the stone was 16.0% in this study and 38.1% in the first study. Incidence of the stone in individual organ ;5.5% in kidney, 1.2% in ureter, and 13.6% in urinary bladder. The recurrent rate was 29.3% in this study and 40.6% in the first study. Incidence of the stone according to the level of spinal cord injury was as follows;15.6% in cervix, 17.1% in upper thorax, 17.9% in lower thorax and 13.9% in lumbar. The stone developed during the first 4 years and between 12 to 16 years following spinal cord injury was 28.3% each. CONCLUSION: Overall incidence and recurrent rate of urinary tract stone was obviously decreased since the first study. Highest incidence of the stone occurred in urinary bladder and in patient with lower thoracic spinal cord injury, which is similar to first report. Peak incidence of the stone was in the first 4years, and another peak was in 12-16years after spinal cord injury. The decreased overall incidence of urinary tract stone maybe attributable to the development in medical technology and care, and active rehabilitation.
Cervix Uteri ; Female ; Hospitals, Veterans ; Humans ; Incidence ; Kidney ; Korea ; Paraplegia ; Quadriplegia ; Rehabilitation ; Retrospective Studies* ; Spinal Cord Injuries* ; Spinal Cord* ; Thorax ; Ureter ; Urinary Bladder ; Urinary Calculi* ; Urinary Tract* ; Urography

PURPOSE: c-erbB2 encodes 185 kDa oncoprotein with tyrosine kinase activity and has homology to the epidermal growth factor receptor. c-erbB2 proto-oncogene is found to be overexpressed in approximately 20 to 30% of primary breast cancer and has been associated with poor prognosis and lower response to conventional chemotherapy. MATERIALS AND METHODS: We perfonned a study on 40 infiltrating ductal breast cancers treated with primary surgery and adjuvant chemotherapy. We investigated c-erbB2 expression by immunohistochemistry in paraffin-embedded tissue using polyclonal antipeptide antibody(DAKO). We evaluated the relationships between its expression and the results after over 6 cycles of adjuvant chemotherapy including cyclophosphamide, methotrexate and 5-FU. RESULTS: The median age at diagnosis was 43 years and the median follow-up time was 47.3 months. Thirteen(32.1%) of 40 patients showed the c-erbB2 overexpression in the external domains of protein. There were no correlations among c-erbB2 amplification and other prognostic factors such as hormonal receptors, histologic grade and tumor size. Estrogen receptor and progesterone receptor showed tendency of inverse correlation with c-erbB2 overexpression but it was not statistically significant(p>0.05). c-erbB2 positive patients showed shorter disease free survival compared to c-erbB2 negative patients in univariate analysis(p<0.05)(Kaplan Meire analysis). The patients without c-erbB2 overexpression seemed to survive longer but had no significant survival benefit(p>0.05). CONCLUSION: These findings suggest that overexpression of c-erbB2 may be a marker of poor response to adjuvant chemotherapy with CMF regimen and may be an indicator of more aggressive therapy.
Breast Neoplasms* ; Breast* ; Chemotherapy, Adjuvant ; Cyclophosphamide ; Diagnosis ; Disease-Free Survival ; Drug Therapy* ; Estrogens ; Fluorouracil ; Follow-Up Studies ; Humans ; Immunohistochemistry ; Methotrexate ; Prognosis ; Protein-Tyrosine Kinases ; Proto-Oncogenes ; Receptor, Epidermal Growth Factor ; Receptors, Progesterone

PURPOSE: The axillary lymph node status is the most important prognostic factor in breast cancer. The axillary node dissection is done are usually performed in infiltrating breast cancer for the information of therapeutic decision and prediction of prognosis. But this procedure results in lymphedema of affected upper extremity nearly about 25%, increased axillary drainage, sensory abnormality and pain. Many researches are focussed to find the patients group who do not need axillary dissection according to the status of tumor size, patient age, hormonal receptor and histologic grade. MATERIAL AND METHODS: We evaluated the axillary lymph node status related with tumor size less then 2 cm in and the correlation of other prognostic factor. We reviewed 127 women with histologically diagnosed infiltrating ductal carcinoma of breast who were treated by one surgeon at YongDong Severance Hospital, Yonsei University College of medicine between 1991 and 1996. RESULTS: Five patients (3.9%) had T1a lesion (< 5 mm), 24 patients (18.9%) had T1b tumors (6-10 mm), and 98 cases (77.2%) had T1c lesion (11-20 mm). The average numbers of dissected axillary lymph nodes were 14.2 We found that small tumor size, good histologic grade, estrogen receptor positivity, old age (over 50 years) showed tendency of decreased axillary node metastasis but without statistical significance. CONCLUSIONS: There are possibility of finding subset with low risk of axillary lymph node metastasis in small size tumor with addition of good prognostic indicators such as good histologic grade, hormonal receptors and old age.
Breast Neoplasms* ; Breast* ; Carcinoma, Ductal ; Drainage ; Estrogens ; Female ; Humans ; Lymph Nodes* ; Lymphedema ; Neoplasm Metastasis* ; Prognosis ; Upper Extremity

No abstract available.
Liver* ; Paratyphoid Fever* ; Typhoid Fever*

Cystic lymphangioma are rare benign tumors that originate as a congenital anomaly of the lymphatic system. Their common presentation is in neck and axillary area at the birth, during infancy or early pediatric age group. Author reports an unusual case of cystic lymphangioma of breast which was diagnosed in a 32-year-old woman. The findings were very dense, sharply defined, and multilobulated masses on mammography, and mu-Itiloculated echo free lesions on ultrasonogram.
Adult ; Breast* ; Female ; Humans ; Lymphangioma, Cystic* ; Lymphatic System ; Mammography ; Neck ; Parturition ; Ultrasonography

No abstract available.
Mucocutaneous Lymph Node Syndrome*

No abstract available.
Child* ; Cyclosporine* ; Humans ; Nephrosis, Lipoid*

PURPOSE: To evaluate the relationship between nuclear DNA contents and prognostic factors and survival in breast cancer patients. MATERIALS AND METHODS: We determined nuclear DNA content from 91 paraffin-embedded malignant breast tumors and evaluated relationship between DNA nuclear content and well-known prognostic indicators of breast cancer and the survival of the patients by statistical analyses. RESULTS: Twenty nine (34.5%) of the 91 tumors examined were diploid, and the remainder (65.5%) contained one or more aneuploid clones. S-phase fraction (SPF) ranged from 1.4 to 68.3% (median 11.2%) and it was higher in aneuploidy tumors than in diploid tumors (p<0.05). Positive axillary lymph nodes were found in 72.7% of the patients who had a tumor with a high SPF (above the median 11.2%) and in 27.3% of those with tumor with low SPF (below median) (p<0.05). The overall survival rate was 96.1% in DNA diploid and 87.6% in DNA aneuploid tumors, showing that DNA ploidy had no prognostic significance in breast cancers. The actuarial survival rates were 96.4% and 86.3% for low and high SPF, respectively (p=0.28). The patients with high SPF showed high disease free survival rate compared to the patients with low SPF but the difference had no statistical significance. CONCLUSION: Our results indicate DNA aneuploid tumors were more prevalent in breast cancer patients with high SPF or lymph node metastasis and larger patient accumulation with longer follow-up period will be helpful to identifiy the relationship between flow- cytometrical analysis and prognosis.
Aneuploidy ; Breast Neoplasms* ; Breast* ; Clone Cells ; Diploidy ; Disease-Free Survival ; DNA* ; Follow-Up Studies ; Humans ; Lymph Nodes ; Neoplasm Metastasis ; Ploidies ; Prognosis ; Survival Rate

To evaluate the prognostic significance of bcl-2, we investigated the correlation of bcl-2 expression with the established indicators of prognosis and tumor behavior in breast cancer. This study included a patient group of 91 histologically diagnosed female breast carcinomas. To determine the bcl-2 immunoreactivity, we used a monoclonal antibody directed against the bcl-2 protein by immunohistochemistry from paraffin-embedded tissue in a series of 91 women with breast cancer. Interpretable DNA histograms were obtained from 84 patients. The median age at diagnosis was 45.5 years and the median follow-up time was 30.5 months. Forty-eight (52.7%) cancers showed the bcl-2 immunoreactivity in the cytoplasm. The nonneoplastic portion of ductal epithelial cells and normal lymphocytes were usually stained with bcl-2 antibody. Estrogen receptors (ER)(p < 0.001) and progesterone receptors (PR) (p < 0.001) showed strong positive correlation with bcl-2 immunoreactivity. The histologic grade (p < 0.05) and nuclear grade (p < 0.01) also showed positive relationships with bcl-2 positivity but tumor size (p > 0.05) and DNA ploidy (p > 0.05) were not related with it. The bcl-2 positive patients showed longer survival (p < 0.05) compared to bcl-2 negative tumors in univariate analysis (Kaplan-Meier life table analysis). Using multivariate analysis with Cox regression, bcl-2 (p > 0.05), nuclear grade (p > 0.05), ER status (p > 0.1) and PR status(p > 0.1) were not reliable indicators for overall survival except histologic grade (p < 0.05). Our results suggest that bcl-2 expression may be related to hormonal regulation and tumor differentiation in breast carcinoma. Larger patient study groups with a longer follow-up period will be helpful to clarify the prognostic significance of bcl-2.
Breast Neoplasms/pathology* ; Breast Neoplasms/metabolism* ; Carcinoma in Situ/pathology* ; Carcinoma in Situ/metabolism* ; Carcinoma, Infiltrating Duct/pathology* ; Carcinoma, Infiltrating Duct/metabolism* ; Female ; Human ; Middle Age ; Proto-Oncogene Proteins c-bcl-2/metabolism* ; Receptors, Estrogen/metabolism ; Receptors, Progesterone/metabolism