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

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: 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

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

BACKGROUND: Kidney transplantation from cadaveric donor is increasing in KOREA. Knowledge of donor factors that can influence early graft function should be an important guideline in determining the suitability of a donor kidney for transplantation. METHOD: From June 1989 to August 1995, sixty patients with end-stage renal disease underwent kidney transplantation from thirty-two cadaver donors in Asan Medical Center. In this study, we reviewed the clinical characteristics of the cadaver donors including vital sign, urine output, serum creatinine, amounts of vasopressor needed, as well as the cause of brain death and evaluated the effect of these parameters on the early post-transplantation graft function (up to 6 months). RESULTS: The data are given as median (range). The donors had been admitted for 40 hours (12-177) before nephrectomy. During admission, the lowest systolic blood pressure was 85mmHg (60-130). Platelet count was 112 X 10(3)/L (11-270 X 10(3)). Hour urine output was 447ml/h (212-937). These parameters did not have significant effects on the early post-transplantation graft function of our patients. Fifteen of thirty two donors had peak serum creatinine higher than 1.4mg/dl (mean 1.9mg/dl, range 1.5-3.6mg/dl) with serum creatinine 1.5mg/dl (1.5-2.0) at the time of nephrectomy. The declining tendency and lowest level of serum creatinine after renal transplantation in patients who received kidneys from donor with peak serum creatinine higher than 1.4mg/dl was not different from those in patients who received kidney with normal function. CONCLUSION: The transient hypotension or acute reversible mild to moderate deterioration of renal function in cadaver donor does not seem to have significant effect on the early post-transplantation graft function if underlying organic renal disease could be ruled out by careful history taking and clinical evaluation.
Blood Pressure ; Brain Death ; Cadaver* ; Chungcheongnam-do ; Creatinine ; Humans ; Hypotension ; Kidney Failure, Chronic ; Kidney Transplantation* ; Kidney* ; Korea ; Nephrectomy ; Platelet Count ; Tissue Donors* ; Transplants* ; Vital Signs

PURPOSE: The purpose of management of the donor is to maintain a moist condition that promotes healing process and prevents pain, infection. We have performed a prospective study to compare the usefulness between Aquacel Ag(R) and Mepitel(R). METHODS: 36 consecutive patients, in whom STSG was performed, were included into the study. STSG are harvested as a usual manner and the donor site are dressed with Aquacel Ag(R) or Mepitel(R), alternatively. The usefulness are compared with re-epithelialization, pain, frequency to change the second dressing, and ease of application. RESULTS: There are no differences in the days of re-epithelialization, pain perception of patients, but significantly differences in frequency to change the second dressing, and ease of application. Aquacel Ag(R) is better than Mepitel(R). CONCLUSION: We concluded that Aquacel Ag(R) dressing is better than Mepitel(R) for STSG donor site just in the frequency to change the second dressing and ease of application.
Bandages ; Carboxymethylcellulose Sodium ; Humans ; Pain Perception ; Prospective Studies ; Re-Epithelialization ; Skin ; Tissue Donors ; Transplants

PURPOSE:Many patients with atopic dermatitis have shown different responses to treatment or different prognosis dependenting on the kinds of offending allergens. We attempted to evaluate the difference of mechanism in allergic inflammation between food allergens and aeroallergens by measuring chemokines, including TARC (Thymus and activation regulated chemokine), MDC (Marcrophage-derived chemokine), IL-18, CCL-28 (Chemokine receptor ligand-28) and ECP (Eosinophil cationic protein), and to investigate the correlation between the clinical severity and chemokine levels induced by food allergens and aeroallergens in atopic dermatitis. METHODS:Sixty-seven children with atopic dermatitis (39 males and 28 females) were recruited. Thirteen nonatopic children without atopic dermatitis (6 males and 7 females) were selected as controls. RESULTS:We obtained SCORAD index cut-off points that were similar to those established by clinical criteria. Comparisons between the groups of mild, moderate and severe atopic dermatitis revealed significant differences in serum total IgE and ECP levels. SCORAD index significantly correlated with total IgE, TARC, MDC and ECP levels. Serum IgE levels correlated with TARC and ECP. SCORAD index and total IgE strongly correlated to HDM. While IL-18, TARC, MDC and ECP levels strongly correlated to egg white and milk. In soybean, IgE and TARC and ECP levels significantly correlated with specific IgE levels. CONCLUSION:TARC, MDC and ECP might play a crucial role in the chronic inflammatory process of food-specific atopic dermatitis. In contrast, IgE-mediated mechanisms might have implications for HDM, when compared with food specific atopic dermatitis. These results suggest that pathogenic mechanisms of atopic dermatitis might be different according to relevant allergens.
Allergens* ; Chemokine CCL17 ; Chemokines* ; Child ; Dermatitis, Atopic* ; Egg White ; Eosinophil Cationic Protein ; Humans ; Immunoglobulin E ; Inflammation ; Interleukin-18 ; Male ; Milk ; Prognosis ; Soybeans

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