One hundred and fifty two patients presenting with palpable primary breast cancer were studied to evaluate accuracy of clinical assessment, mammography, and ultrasonography in measuring tumor size. The clinical, mammographic, and ultasonographic diameter of tumor size was compared to histological diameters. The histological diameter of tumors was 27.9+/-12.7mm. The average diameter of tumor on clinical assessment was 33.8+/-13.1mm and its correlation coefficient to the histological size was 0.73. The average size on the mammography was 21.4+/-9.0m and its correlation coefficient to the histological size is 0.71. The tumor size on the ultrasonography in 22 patients was is 22.3+/-10.4mm. The sonographic measurement dimonstrated the highest correlation coefficient (0.83). The clinical assessment overstimated the tumor size, but the mammogaphic and sonographic measurement understimated it compared with histological size. The combined measurement with clinical and ultrasonography could be useful method to estimate tumor size preoperatively. And when it is combined with clinical assessment, it is the most reliable and accurate technique.
Breast Neoplasms* ; Breast* ; Humans ; Mammography ; Ultrasonography

By using (99m)Tc-Pertechnetate, we evaluated the thyroid function of 136 persons with uptake slopeindex(U.S.I.) which was calculated by computerized dynamic flow study. Also, we compared our results of U.S.I.with those of established ¹³¹I-24 hr uptake % in given materials by comparative analysis of their correlation with the hormonal values of T3, T4, Free T4. The results wre as follows: 1. The U.S.I. of euthyroidismal group and hyperthyrodismal group were 4.87±2.26, 27.67±9.56 respectively. The ¹³¹I-24 hr uptake % of above groups were29.22±10.23, and 71.45±15.51. So the differentiation of the two groups could be done more easily by using (99m)Tc-Pertenchnetate U.S.I. than by using ¹³¹I-24 hr uptake %. 2. The correlation rates between (99m)Tc-Pertechnetate U.S.I. and other laboratory hormon levels, T3, T4, Free T4, ar almost parallel with thosebetweeen ¹³¹I-24 hr uptake % and the values of T3, T4, Free T4. Also the direct correlation rate between (99m)Tc-Pertechnetate U.S.I. and ¹³¹I-24 hr uptake % was 0.898. So, the method of thyroidal function evaluation by (99m)Tc-Pettechnetate U.S.I. is very reliable. 3. The (99m)Tc-Pertechnetate U.S.I. is very helpful to evaulate thefunctions of each lobe respectively incases of having obviously different radioactivity between both lobes. 4. (99m)Tc-Pertechnetate used dynamic thyroid function study and scan can be performed during the short time without preparation and especially helpful in debilitating patient and patients under antithyroid drug therapy, who need repetitive follow-up examination.
Drug Therapy ; Follow-Up Studies ; Humans ; Methods ; Radioactivity ; Thyroid Gland

PURPOSE: This study was prospectively carried out to determine the concordance between the immunohistochemical assay (IHC) and the enzyme immunoassay (EIA) assessing estrogen receptor (ER) and progesteron receptor (PR) in breast cancer tissues. MATERIALS AND METHODS: Breast carcinoma tissues were obtained from 36 patients. Hormonal receptors were determined by IHC assay using polyclonal antimouse antibody and by EIA. The concordance between two methods and the concordance according to in age, tumor size, stage, and lymph node metastasis of breast cancer patient were analyzed. RESULTS: The concordant rate of ER status was 88.9% between IHC and EIA. ER-IHC(+)/EIA(-) were 3 cases and ER-IHC(-)/EIA(+) was 1 cases. ER-positive was 63.9% in IHC and 53.8% in EIA. The concordant rate of PR status was 86.1% between IHC an EIA. PR-IHC(+)/EIA(-) were 4 cases and PR-IHC(-)/EIA(+) was 1 cases. PR-positive was 61.1% in IHC and 52.8% in EIA. There was high concordance (76.2-100%) in age, tumor size, stage, and lymph node metastasis. CONCLUSIONS: There was high concordance between immunohistochemical assay and enzymeimmunoassay determining estrogen and progesteron receptors in the breast cancer. The IHC assay appears to be a resonable substitute for the EIA to determine hormonal receptors.
Breast Neoplasms* ; Breast* ; Estrogens ; Humans ; Immunoenzyme Techniques ; Lymph Nodes ; Neoplasm Metastasis ; Prospective Studies

BACKGROUND: Popular immunohistochemical techniques for assay of estrogen receptor(ER) allow the localization of positive cells in specific cell populations. Some of breast carcinomas composed of discrete populations of cells were negative for ER, while neighboring populations of cells were positive for ER. Such heterogeneity might be due to biological or artifactual causes. METHODS: We studied 67 tissue blocks for geographic heterogeneity within the level of ER and cytokeratin(CK) by staining ER and CK. Positive distribution of ER and CK was manually assessed. RESULTS: The immunohistochemical expression revealed 50 cases for ER-positive and 17 cases for ER-negative. In 50 ER-positive cancers, homogeneity was 38 cases, heterogeneity was 11 case, and artifactural change was developed in and one case. excluded in the analysis. The rate of heterogeneity of the ER-positive cancers was 22.4%(11/49). Comparisons of homogeneity and heterogeneity according to clinicopathologic risk factors in ER-positive breast cancer demonstrated that the heterogeneity of ER was significantly higher in each subgroups; relatively younger ages(< or =50yr), premenopausal status, early menarche(< or =15yr), early stage(< or =I b), DCIS in pathology, and lower positive expression rate of ER(<50%). CONCLUSION: Clinicopathologic risk factoes would be required to discover the heterogeneity of ER-positive breast cancer. Also a long-term follow-up study on risk factors, including disease free survival, response to anti-estrogen therapy, and survival according to heterogeneity of ER would be need.
Breast Neoplasms* ; Breast* ; Carcinoma, Intraductal, Noninfiltrating ; Disease-Free Survival ; Estrogens* ; Immunohistochemistry ; Pathology ; Population Characteristics* ; Risk Factors ; Staining and Labeling

PURPOSE: The development of publicized screening methods for breast carcinoma detection has led to a marked increase in the discovery of ductal carcinoma in situ (DCIS) or DCIS with microinvasion (DCIS-MI). Axillary lymph node status has been believed to be not only an indicator of prognosis, but also a direction of adjuvant therapy. But the incidence of axillary metastasis in DCIS or DCIS-MI has diversely found in from 0% to 20%. This study was performed to analyze the incidence of axillary metastasis and the predictive factors associated with axillary lymph node metastasis in DCIS or DCIS-MI. METHODS: Patients with DCIS or DCIS-MI and axillary lymph node dissection from 1987 to 2004 were selected from Korea University Medical Center. We reviewed their medical records for age, palpability and size of the tumor, histolgic subtype, nuclear grade, hormone receptor status, and pathologic slides. RESULTS: Fifty two patients in DCIS and Thirty eight patients in DCIS-MI were included in the study. Axillary lymph node metastases were identified in 2 patients (3.8%) in DCIS and 4 patients (10.5%) in DCIS-MI. Tumor size and nuclear grade in DCIS had a borderline significance in association with microinvasion. We could not be able to find any predictive factor associated with axillary lymph node metastasis in DCIS and DCIS-MI. CONCLUSION: Axillary lymph node metastasis in DCIS or DCIS-MI appeared to be not low and there was no predictive factor associated with axillary lymph node metastasis in DCIS and DCIS-MI. But DCIS patients with large tumor size and poor nuclear grade have the high possibility associated with microinvasion, therefore, in that cases, there is a need to consider the possibility of axillary metastasis.
Academic Medical Centers ; Breast ; Breast Neoplasms ; Carcinoma, Ductal* ; Carcinoma, Intraductal, Noninfiltrating* ; Humans ; Incidence ; Korea ; Lymph Node Excision ; Lymph Nodes* ; Mass Screening ; Medical Records ; Neoplasm Metastasis* ; Prognosis

Eosinophilic gastroenteritis is an unusual disease characterized by eosinophilic infiltration of gastrointestinal tract, peripheral eosinophilia, and gastrointestinal symptoms. There are mucosal, muscular, and subserosal types, of which the subserosal type is the rarest. We experienced a 32-year old male patient with the subserosal type of eosinophilic gastroe-nteritis, who was presented with abdominal distension. The ascitic fluid revealed increased eosinophil count. With oral prednisolone, diarrhea and ascites rapidly disappeared and eosinophils in peripheral blood returned to normal. We report this case with a review of relevant literature.
Adult ; Ascites* ; Ascitic Fluid ; Diarrhea ; Eosinophilia ; Eosinophils* ; Gastroenteritis* ; Gastrointestinal Tract ; Humans ; Male ; Prednisolone

PURPOSE: Tumor size is a prognostic factor, as well as an important factor, in staging. Also, tumor size is a major factor in determining if a woman is a suitable candidate for various treatments, including a mastectomy or breast-conserving surgery. Thus, an accurate assessment of breast tumor size is important in making a prognosis and in planning treatment. METHODS: One hundred fifty-two patients presenting with palpable primary breast cancer were studied to evaluate the accuracies of clinical assessment, mammography, and ultrasonography in measuring tumor size. The clinical, mammographic, and ultrasonographic diameters of the tumors were compared to histological diameters. RESULTS: The average histological diameter of the tumors was 27.0+/-12.9 mm. The average diameter of the tumors on clinical assessment was 33.8+/-13.1 mm, and its correlation coefficient to the histological size was 0.73. The average size on mammography was 21.4+/-9.0 mm and its correlation coefficient to the histological size was 0.71. The tumor size on ultrasonography in 22 patients was 22.3+/-10.4 mm. The sonographic measurement demonstrated the highest correlation coefficient (0.83). The clinical assessment overestimated the histological tumor size, but the mammographic and sonographic measurement underestimated it. A combined measurement using both the clinical and the ultrasonographic methods slightly improved the correlation with the histological size (0.86). CONCLUSION: Ultrasonography could be a useful method for estimating tumor size preoperatively, and when it is combined with clinical assessment, it is the most reliable and accurate technique.
Breast Neoplasms* ; Breast* ; Female ; Humans ; Mammography ; Mastectomy ; Mastectomy, Segmental ; Prognosis ; Ultrasonography

This study was carried out to evaluate the factors influencing the outcome of an operation for adrenal hypertension. 35 patients with adrenal hypertension who were operated on between Jan. 1989 and Dec. 1996 at the Department of surgery, Korea University Hospital, underwent an adrenalectomy for pheochromocytoma, Cushing's syndrome and primary aldosteronism. Out of 20 clinicopathologic factors, only 3 were showen through univariate analysis to be associated with postoperative persistent hypertension. Fifteen of the 16 patients with pheochromocytoma (93.8%), 4 of the 7 patients with Cushing's syndrome (57.8%), and 5 of the 12 patients with primary aldosteronism became normotensive following surgery. Persistent hypertension correlated with a kind of adrenal hypertension, especially Cushing's syndrome or primary aldosteronism (p=0.012). In primary aldosteronism, none of the patients with fundoscopic arterial grade of more than III were in the complete response group but 5 of the 7 patients in the incomplete response group (p=0.004). For primary aldosteronism the mean serum renin level for the complete response group was 0.058+/-0.025 ng/ml/hr and that of incomplete response group was 0.51+/-0.87 ng/ml/hr (p=0.03). This study suggests that or adrenalectomy for hypertension with Cushing's syndrome or primary aldosteronism results in a more unfavorable outcome than one for hypertension with pheochromocytoma. The presence of fundoscopic arterial grade of more than III or a depressed serum renin level in primary aldosteronism was a cautious predictor of persistent hypertension after the adrenalectomy.
Adrenal Glands ; Adrenalectomy ; Cushing Syndrome ; Humans ; Hyperaldosteronism ; Hypertension ; Korea ; Pheochromocytoma ; Renin

PURPOSE: High false negative results on fine needle aspiration cytology (FNAC) have been reported in the diagnosis of breast cancers, which are small sized, desmoplastic type, infiltrating lobular cancers, tubular cancers, and mucinous cancer. METHODS: From Jan. 1997 to Dec. 1998, we performed 622 FNACs at the Department of Surgery, Korea University Hospital. Among those aspirates, 246 cases were followed by subsequent pathological confirmation and were included in this study. Pathological reports for breast specimens were reviewed for the size, the location, the grade or the pathological subtype, and the presence of fibrosis in the breast lesions. The pathological characteristics were compared statistically with the results of the fine needle aspiration cytology. RESULTS: The likelihood ratios for malignant, suspicious, atypical, benign, and unsatisfactory cytological diagnoses were 98.7, 5.5, 1.1, 0.07, and 0.6, respectively. The absolute and the complete sensitivities for the malignant lesions were 64.5% and 90.3%, respectively. The rate of unsatisfactory diagnosis was 9.3%, and the false-negative rate was 4.3%. The concordance rates of FNAC results were 75% for tumors less than 1 cm in size, 60.7% for 1-2 cm, 76.5% for 2-5 cm, and 50% for greater than 5 cm (p=0.01). The location of the tumor also affected the FNAC result, and the highest concordant rate was found in tumors of the lower outer quadrant of the breast (73.3%, p=0.001). The Bloom-Richardson grade and histologic type of the breast cancer also affected the FNAC result. Low-grade tumors, medullary carcinomas, metaplastic carcinomas, lobular carcinomas, adenoid cystic carcinomas, and mucinous carcinomas usually showed discordant FNAC results. The presence or the absence of fibrotic pathology did not affect the FNAC result (p=0.39). CONCLUSION: The sensitivity of FNAC was 90.3% in the diagnosis of breast cancer and the false negative rate was 4.3%. The greatest concordance of FNAC diagnosis was found in the patients with tumor less than 5 cm in size and located in the axilla and locoregional recurrent area. The FNAC results for breast cancer were frequently incorrect for low-grade tumors and cancers of a rare pathological type.
Adenocarcinoma, Mucinous ; Axilla ; Biopsy, Fine-Needle* ; Brain Stem Neoplasms ; Breast Neoplasms* ; Breast* ; Carcinoma, Adenoid Cystic ; Carcinoma, Lobular ; Diagnosis* ; Fibrosis ; Humans ; Korea ; Mucins ; Pathology

PURPOSE: Intraoperative quick parathyroid hormone assay (PTH) was introduced in the parathyroid surgery since 1988 and the value in patients with primary hyperparathyroidism was well recognized in the literature. The purpose of this study was to evaluate the usefulness of intraoperative rapid PTH assay in patients with renal hyperparathyroidism by comparing intraoperative PTH results and the biochemical results at postoperative 6(th) month, including PTH values. METHODS: Fifteen consecutive patients of renal hyperparathyroidism underwent total parathyroidectomy and immediate autotransplantation from November 2003 to February 2005. PTH levels were measured by PTH assay at the induction of anesthesia (baseline level) and in 20-minute intervals after excision of the last parathyroid gland. More than 50% drop of initial PTH level was considered as completeness of parathyroidectomy. RESULTS: Twenty minutes after resection, PTH levels decreased by 83.7% in 14 patients and by 50.2% in one patient. Ten patients (67%) were cured but 5 patients (34%) showed high PTH levels after 6 months. The drop rate of intraoperative quick PTH level in cured patients was 92% at 26 minutes after parathyroidectomy and was significantly different from 73.3% of persistent or recurrent five patients (P=0.047). Preoperative PTH level, calcium level, alkaline phosphatase level and preoperative localization were not different in the cured and recurrent or persistent patients of renal hyperparathyroidism. CONCLUSION: The value of intraoperative quick PTH assay in patients of renal hyperparathyroidism was questionable. More than 92% drop of intraoperative PTH level at 26 minutes after parathyroidectomy could predict success in our study.
Alkaline Phosphatase ; Anesthesia ; Autografts ; Calcium ; Humans ; Hyperparathyroidism* ; Hyperparathyroidism, Primary ; Parathyroid Glands ; Parathyroid Hormone* ; Parathyroidectomy ; Transplantation, Autologous