A 29-year-old Korean woman visited the Department of Surgery in MizMedi Hospital with a palpable itching mass on the right breast that had existed for the past 7 months. She had no history to eat either frogs or snakes, but had the history of drinking impure water. Sonography revealed a serpiginous hypoechoic tubular structure associated with partial fat necrosis in breast parenchymal layer and subcutaneous fat layer. It also revealed oval cystic lesions. At operation, an ivory white opaque ribbon-like worm that measured 16.5 cm in length and 0.5 cm in width was extracted. Anti-sparganum specific serum IgG level in the patient's serum (absorbance = 0.71), measured by ELISA, was found to be significantly higher than those of normal controls (cut off point = 0.21). Sonography and ELISA appear to be helpful to diagnose sparganosis. Breast sparganosis is rarely found throughout the world.
Adult ; Animals ; Antibodies, Helminth/blood ; Breast/*parasitology ; Breast Diseases/diagnosis/*parasitology ; Enzyme-Linked Immunosorbent Assay ; Female ; Human ; Immunoglobulin G/blood ; Sparganosis/diagnosis/*parasitology ; Sparganum/immunology/isolation & purification ; Ultrasonography, Mammary

PURPOSE: To evaluate the diagnostic usefulness of brachial approach arteriography for outpatients, withparticular regard to safety and image quality. MATERIALS AND METHODS: The angiographic findings and follow-upmedical records of 131 brachial approach arteriographies in 121 outpatients were retrospectively analysed. 5 Fpigtail catheters were used in 125 cases, and 5-F OCU-A catheters were used in three cases of renal arteriography,and three of upper extremity arteriography without catheter. RESULTS: Except for three cases of brachial arterypuncture failure, all procedures were performed successfully. One hundred and fifteen of 119 lower extremityarteriographies were visualized down to the level of the tibioperoneal artery. The non-visualized cases were threein which there was multiple obstruction at the distal common iliac artery and one with insufficient contrastamount due to renal failure. In four cases there were complications : two involved arterial thrombosis, one was anintramuscular hematoma, and one an A-V fistula. CONCLUSION: For outpatients, brachial approach arteriography canreplace the femoral approach. Its image quality is excellent, there are time-cost benefits, and the rate ofcomplications is relatively low.
Angiography* ; Arteries ; Brachial Artery* ; Catheters ; Fistula ; Hematoma ; Humans ; Iliac Artery ; Outpatients* ; Renal Insufficiency ; Retrospective Studies ; Thrombosis ; Upper Extremity

A breast lesion with posterior acoustic shadowing is often encountered on sonography and this finding is generally accepted as a sign of malignancy. Although its detection is important for differentiating a malignant breast mass from a benign breast mass, posterior acoustic shadowing is the result of attenuation of the sound beam by a desmoplastic host response to breast cancer rather than the posterior acoustic shadowing being due to the tumor itself. Therefore, many breast conditions that contain fibrous elements also can induce some degree of acoustic shadowing. In this article, we present various benign breast lesions that display posterior acoustic shadowing and we discuss the radiologic findings along with the pathologic correlation.
Acoustics ; Breast ; Breast Neoplasms ; Shadowing (Histology)

Using normal canine embryonic fibroblasts (CaEF) that were shown to be senescent at passages 7th-9th, we established two spontaneously immortalized CaEF cell lines (designated CGFR-Ca-1 and -2) from normal senescent CaEF cells, and an immortal CaEF cell line by exogenous introduction of a catalytic telomerase subunit (designated CGFR-Ca-3). Immortal CGFR- Ca-1, -2 and -3 cell lines grew faster than primary CaEF counterpart in the presence of either 0.1% or 10% FBS. Cell cycle analysis demonstrated that all three immortal CaEF cell lines contained a significantly high proportion of S-phase cells compared to primary CaEF cells. CGFR-Ca-1 and -3 cell lines showed a loss of p53 mRNA and protein expression leading to inactivation of p53 regulatory function, while the CGFR-Ca-2 cell line was found to have the inactive mutant p53. Unlike the CGFR-Ca-3 cell line that down-regulated p16INK4a mRNA due to its promoter methylation but had an intact p16INK4a regulatory function, CGFR-Ca-1 and -2 cell lines expressed p16INK4a mRNA but had a functionally inactive p16INK4a regulatory pathway as judged by the lack of obvious differences in cell growth and phenotype when reconstituted with wild-type p16INK4a. All CGFR-Ca-1, -2 and -3 cell lines were shown to be untransformed but immortal as determined by anchorage-dependent assay, while these cell lines were fully transformed when overexpressed oncogenic H-rasG12V. Taken together, similar to the nature of murine embryo fibroblasts, the present study suggests that normal primary CaEF cells have relatively short in vitro lifespans and should be spontaneously immortalized at high frequency.
Animals ; Catalytic Domain/genetics ; *Cell Aging/genetics ; Cell Line, Transformed ; Cell Transformation, Neoplastic ; Dogs ; Embryo/cytology ; Fibroblasts/*cytology/metabolism ; Gene Expression ; Protein p16/genetics ; Protein p53/genetics ; RNA, Messenger/analysis/metabolism ; Research Support, Non-U.S. Gov't ; Telomerase/genetics/metabolism ; ras Proteins/genetics/metabolism

PURPOSE: To determine the usefulness of ultrasound-guided core biopsy for the diagnosis of non-palpable beast lesions. MATERIALS AND METHODS: Between April 1996 and December 2000, 932 lesions in 901 patients were the object of ultrasound-guided core biopsy. Of these, 440 non-palpable lesions ranging in size from 0.3 to 3.0 (average, 0.9)cm, and found in 428 patients (all women aged, on average, 43.9 years), were included in this study. The pathologic results of core biopsy were compared with the available surgical data, and clinical and radiologic follow-up data were also reviewed. A 16-gauge needle was used in 197 lesions, and a 14-gauge neadle in the other 243. RESULTS: At core biopsy, 53 lesions were diagnosed as invasive carcinoma, and 45 of these were excised. Forthfour were confirmed as invasive carcinoma, and in one case there was no residual tumor. Seven lesions, diagnosed as ductal carcinoma in situ at core biopsy, were surgically removed, and the final diagnosis was ductal carcinoma in four cases and invasive carcinoma in two. Two of four cases initially diagnosed as atypical ductal hyperplasia were finally diagnosed as invasive carcinoma after surgery. Six lesions diagnosed at core biopsy asbenign were later found to be malignant (false-negative rate, 8.3%). Radiologic imaging suggested that all six lesions-for two of which, a 14-gauge needle was used, and for four, a 16-gauge needle-were malignant. The false-negative rate was 5.1% and 12%, respectively, whithout statistical significance (p=0.26). CONCLUSION: Ultrasound-guided core needle biopsy for non-palpable breast lesions is useful and can replace surgical excision. To avoid false-negative assessment, however, strict radiologic-histopathologic correlation is required.
Biopsy ; Biopsy, Large-Core Needle* ; Breast* ; Carcinoma, Ductal ; Carcinoma, Intraductal, Noninfiltrating ; Diagnosis ; Female ; Follow-Up Studies ; Humans ; Hyperplasia ; Needles ; Neoplasm, Residual

PURPOSE: To describe the changes in diagnostic methods and reassess the role of core biopsy compared with needle localization biopsy (NLB) in the evaluation of non-palpable breast lesions. MATERIALS AND METHODS: We retrospectively analyzed 930 non-palpable breast lesions which underwent either core biopsy or NLB between January 1996 and December 2000. NLB involved 511 lesions in 482 patients, and core biopsy, 419 lesions in 365 patients. For a given lesion, NLB was guided by either mammography (n=213) or ultrasonography (US) (n=298), but only US was used to guide a core biopsy. Over the five-year period, we calculated the total number of biopsies per year relating to non-palpable breast lesions, also determining the mammographic findings in cases involving NLB and the percentage of malignancies seen at histopathology. RESULTS: The total number of biopsies increased with time: 1996: n=91, 1997: n=118, 1998: n=144, 1999: n=245, 2000: n=332. The implementation of core biopsy, however, led to a decrease in the proportion of NLB (1996: 97.8%, 1997: 84.7%, 1998: 75.7%, 1999: 47.8%, 2000: 28.9%). Among nonpalpable lesions which underwent mammography-guided NLB, 46.5% (20/43) were a mass or density in 1996, while in 2000 the proportion was 5.7% (2/35). During this period, however, the finding of calcification without a mass increased from 48.8% in 1996 to 94.3% in 2000. The proportion of cases in which NLB demonstrated malignancy increased from 13.5% in 1996 to 49% in 2000; where US-guided NLB was used, the increase was remarkable: from 15.2% in 1996 to 65.6% in 2000. CONCLUSION: In the evaluation of non-palpable breast lesions, the appropriate use of core biopsy can decrease the need for a more invasive method such as NLB. Furthermore, because most benign lesions diagnosed by core biopsy do not also undergo NLB, the use of the latter increases the yield of malignancies.
Biopsy ; Breast* ; Humans ; Mammography ; Needles ; Retrospective Studies ; Ultrasonography

Breast edema is defined as a mammographic pattern of skin thickening, increased parenchymal density, and interstitial marking. It can be caused by benign or malignant diseases, as a result of a tumor in the dermal lymphatics of the breast, lymphatic congestion caused by breast, lymphatic drainage obstruction, or by congestive heart failure. Here we describe several conditions, that cause unilateral breast edema with the aim of familiarizing radiologists with these disease entities.
Breast Diseases/*etiology/*radiography/ultrasonography ; Edema/*etiology/*radiography/ultrasonography ; Female ; Humans ; *Mammography ; Ultrasonography, Mammary

PURPOSE: We evaluated the concordance between core needle biopsy (CNB) and surgical specimens on examining intrinsic biological subtypes and receptor status, and determined the accuracy of CNB as a basic diagnostic method. METHODS: We analyzed breast cancer patients with paired CNB and surgical specimen samples during 2014. We used monoclonal antibodies for nuclear staining, and estrogen receptor (ER) and progesterone receptor (PR) status evaluation. A positive test was defined as staining greater than or equal to 1% of tumor cells. Human epidermal growth factor receptor 2 (HER2) was graded by immunohistochemistry and scored as 0 to 3+ according to the recommendations of the American Society of Clinical Oncology/College of American Pathologists. Ki-67 immunostaining was performed using the monoclonal antibody Ki-67, and the results were divided at 10% intervals. The cutoff value for high Ki-67 was defined as 20%. Concordance analysis of ER, PR, HER2, Ki-67, and five intrinsic biological subtypes was performed on CNB and surgical specimens. Statistical analysis for concordance was calculated using κ-tests. RESULTS: We found very good agreement for ER and PR with a concordance of 96.7% for ER (κ=0.903), and 94.3% for PR (κ=0.870). HER2 and Ki-67 showed concordance rates of 84.8% (κ=0.684) and 83.5% (κ=0.647), respectively, which were interpreted as good agreement. Five subgroups analysis showed 85.8% agreement and κ-value of 0.786, also indicating good agreement. CONCLUSION: CNB showed high diagnostic accuracy compared with surgical specimens, and good agreement for ER, PR, HER2, and Ki-67. Our findings reaffirmed the recommendation of CNB as an initial procedure for breast cancer diagnosis, and the assessment of receptor status and intrinsic biological subtypes to determine further treatment plans.
Antibodies, Monoclonal ; Biopsy, Large-Core Needle* ; Breast Neoplasms* ; Breast* ; Diagnosis ; Estrogens ; Humans ; Immunohistochemistry* ; Methods ; Receptor, Epidermal Growth Factor ; Receptors, Estrogen ; Receptors, Progesterone

Myasthenia gravis is relatively common in young women and therefore sometimes associated with pregnancy. Since pregnancy influences the course of the myasthenia gravis, and the drugs used for its treatment may influence gestation, the obstetrical management of myas-thenic patient merits special consideration. In myasthenia gravis, it is generally thought that the anesthesia of chice is regional anesthesia during vaginal delivery and general anesthesia during Cesarian section. But in Cesarina section for a pregnant myasthenic with pulmonary disease, epidural or subarachnoid block may be preferable to avoid postoperative hazards. We performed epidural anesthesia with lidocaine in a 39-year-old elderly primigravida myasthenic with COPD and obtained good intra and postoperative results.
Adult ; Aged ; Anesthesia ; Anesthesia, Conduction ; Anesthesia, Epidural ; Anesthesia, General ; Female ; Humans ; Lidocaine ; Lung Diseases ; Myasthenia Gravis ; Pregnancy ; Pulmonary Disease, Chronic Obstructive

PURPOSE: Therapeutic hypothermia is an important treatment strategy for control of the overwhelming inflammatory reactions of cardiac arrest patients. Rapid rewarming is related to poor outcome, however the kinds of inflammatory processes that occur during the rewarming period are not well understood. Our aim in the current study was to evaluate the changes in inflammatory cytokine levels during cardiac arrest patients' rewarming period. METHODS: This study was conducted in an emergency intensive care unit of a tertiary referral hospital. Blood samples were collected on admission (0 h) and 24, 26, 28, and 32 h after return of spontaneous circulation. Eight inflammatory cytokines (E-selectin, soluble ICAM, interleukin-10, interleukin-1ra, interleukin-6, interleukin-8, monocyte chemotactic protein-1, and tumor necrosis factor-α) were measured. RESULTS: Twenty-eight patients were enrolled and completed a protocol of 24 h hypothermia and 8h rewarming. Eight patients were of the good cerebral performance category (CPC) and 20 of the bad. The IL-1Ra level in the good CPC group was statistically changed at 26 (p=0.039) and 28 (p=0.003) but not at 32 h (p=0.632) when compared with the 24 h level. The IL-10 levels of the bad CPC group were decreased at 26 (p=0.017) and 28h (p=0.013) but not at 32 h (p=0.074) when compared with 24 h. None of the other cytokines showed meaningful differences during the rewarming period. CONCLUSION: Change in inflammatory-cytokine-level change during the rewarming period is not significant.
Chemokine CCL2 ; Cytokines* ; Emergencies ; Heart Arrest ; Humans ; Hypothermia ; Hypothermia, Induced* ; Intensive Care Units ; Interleukin 1 Receptor Antagonist Protein ; Interleukin-10 ; Interleukin-6 ; Interleukin-8 ; Necrosis ; Prognosis ; Rewarming* ; Tertiary Care Centers