PURPOSE: This study is to describe authors'experience on mammographic findings of breast cancer and to know if there is difference between 35 years of age or younger and older groups. MATERIALS AND METHODS: Mammograms of 72 patients with breast cancer detected from January, 1991 to December, 1993 were retrospectively analysed. Mammographic findings were classified into mass only, mass with microcalcifications, microcalcifications only and others. Marginal characteristics of mass were classified into spiculated, poorly marginated and well marginated. Shape of microcalcifications were classified into casting, granular and mixed types. These findings were compared between 35 years of age or younger and older groups. RESULTS: Mammogram showed mass only in 33 patients(46%), mass with microcalcifications in 26 patients (36%), microcalcifications only in seven(10%) and other findings in six(8%). Other findings were architectural distortion, asymmetric high density and incidental breart carcinoma from paraffinoma in one patient respectively, and dense breast in three patients. The margins of the breast mass were spiculated in ten(17%) poorly marginated in 30(51%), well-marginated in 19(32%). Shape of microcalcifications were casting type in 13(40%), granular in 14(42%) and mixed in six(18%) cases. 3 patients had dense breast with which mammography did not demonstrate the lesion. 3 patients without mammographically demonstrable lesions due to dense breasts were under 35 years in age. and there was statistically significant difference between the two groups(p-value<0.05). Microcalcifications only was more common findings in 35 years of age or younger. CONCLUSION: The most important mammographic findings of breast cancer were mass and microcalcifications. Architectural distortion and asymmetric high density were additional findings. In 35 years of age or younger, microcalcifications only was an important finding because mass lesions are frequently masked by dense breast. Thus other imaging modalities, such as ultrasonography, were required.
Breast Neoplasms* ; Breast* ; Humans ; Mammography ; Masks ; Retrospective Studies ; Ultrasonography

BACKGROUND: Midkine (MK) is a member of the heparin-binding growth factor family. Overexpression of MK is observed not only in cancerous tissue but also in precancerous lesions of the colon and the prostate. Using immunohistochemical methods, we investigated MK expression in preinvasive and invasive neoplasia of the uterine cervix. METHODS: We performed immunohistochemical analysis of archived cone biopsy and hysterectomy specimens from 161 squamous cell lesions of the uterine cervix (29 cervical intraepithelial neoplasia 1 (CIN1), 35 CIN2, 49 CIN3, 30 microinvasive squamous cell carcinomas (MIC), and 18 invasive squamous cell carcinoma). In addition, we examined if there is a correlation between MK expression and status of human papilloma virus infection determined by a commercially available DNA chip. RESULTS: None of the normal cervical mucosa showed MK immunostaining. The level of MK expression gradually increased according to the histologic grade. Moderate and strong expressions were most frequently observed in cervical tissue with CIN3 and MIC. MK immunostaining was more accentuated in the invasive border of MIC. CONCLUSION: MK may play a functional role in the disease progression of cervical squamous cell neoplasia.
Biopsy ; Carcinoma, Squamous Cell ; Cervical Intraepithelial Neoplasia ; Cervix Uteri* ; Colon ; Disease Progression ; Female ; Humans ; Hysterectomy ; Immunohistochemistry ; Mucous Membrane ; Oligonucleotide Array Sequence Analysis ; Papilloma ; Prostate

OBJECTIVES: We aimed to compare the diagnostic performances of digital mammography (DM), digital breast tomosynthesis (DBT), ultrasound (US), magnetic resonance imaging (MRI), breast specific gamma imaging (BSGI) and/or positron emission tomography/computed tomography (PET/CT) for the detection of invasive lobular carcinoma (ILC). METHODS: Index ILCs and multifocal/multicentric (multiple) ILCs were analyzed using various imaging modalities. The final surgical pathology was regarded as the reference standard. The detection rate for index cancers and the diagnostic performance for multiple ILCs per breast were evaluated. RESULTS: Seventy-eight ILCs in 76 women were enrolled. Twenty-six breasts had multiple ILCs. DM (n=72), DBT (n=15), US (n=77), MRI (n=76), BSGI (n=50), and /or PET/CT (n=74) were performed. For index cancer, the detection rate was 100% for DBT, US, and MRI. For multiple ILCs, the sensitivity was 100% for DBT and MRI (P<0.001). The diagnostic accuracy for multiple ILCs were 73.3% for DBT and 73.0% for PET/CT (P=0.460). CONCLUSION: DBT was the most accurate imaging modality for both index and multiple ILCs. PET/CT was also valuable for multiple ILCs, whereas DM and BSGI showed relatively low diagnostic performances. DBT and PET/CT have promising roles in the diagnosis of multiple ILCs.
Breast ; Carcinoma, Lobular* ; Diagnosis ; Electrons ; Female ; Humans ; Magnetic Resonance Imaging ; Mammography ; Pathology, Surgical ; Positron-Emission Tomography ; Positron-Emission Tomography and Computed Tomography ; Ultrasonography

PURPOSE: Cervical cancer is a major women's health problem in the world today. The purpose of this study was to estimate the incidence and mortality rates and to investigate risk factors for cervical cancer in Korean women. MATERIALS AND METHODS: Reproductive factors, cigarette smoking, as well as the risk of incidence and death from cervical cancer were examined in a 12-year prospective cohort study of 475,398 Korean women aged 30 to 95 years who received health insurance from the National Health Insurance Corporation and who had a medical evaluation in 1992. Relative risks (RR) and 95% confidence intervals (CI) were calculated using the Cox proportional hazards model after adjusting for age, body mass index, cigarette smoking, alcohol use, menarche, parity, and Papanicolaou test status. RESULTS: This study showed that the RR of death due to cervical cancer among current smokers was two times higher compared with non- smokers (RR=2.00; 95% CI, 1.23-2.91). In addition, the RR of death due to cervical cancer among all women who smoked > 10 cigarettes/day was 2.4 times higher than the RR among women that had never smoked. More interestingly, those who had never been screened by Papanicolaou smears had twice the risk of death due to cervical cancer (RR =2.00; 95% CI, 1.37-1.81). CONCLUSION: Our prospective study concluded that current smokers had an increased risk of death due to cervical cancer. We suggest that the target age group for cervical cancer screening tests be reconsidered and should begin as early as possible.

BACKGROUND: Whereas sevoflurane (SEVO) has been reported to prolong the QT interval, little has been known on the electrophysiologic effects of SEVO which contributes to the prolongation of action potential (AP) duration. METHODS: The ventricular myocytes were obtained from enzymatically treated rat hearts. The standard whole cell voltage-clamp methods were used. The AP was measured using current clamp technique. As a repolarizing K+ current, the transient outward K+ current (I(to)), the sustained outward K+ current (I(sus)), and the inwardly rectifying K+ current (I(kI)) were measured. The L-type Ca2+ current (I(Ca), L) was also obtained. After the baseline measurements, the myocytes were exposed to 1.7 and 3.4% SEVO. SEVO concentrations in Tyrode superfusate at room temperature were 0.35 and 0.7 mM for 1.7 and 3.4% SEVO, respectively. Results are mean +/- SEM. RESULTS: SEVO prolonged the AP duration, while the amplitude and the resting membrane potential remained unchanged. At membrane potential of +60 mV, peak I(to) was significantly reduced by 18 +/- 2 and 24 +/- 2% by 0.35 and 0.7 mM SEVO, respectively. 0.7 mM SEVO did not shift the steady-state inactivation curve. Isus was unaffected by 0.7 mM SEVO. The I(kI) at -130 mV was little altered by 0.7 mM SEVO. I(Ca), L was significantly reduced by 28 +/- 3 and 33 +/- 1% by 0.35 and 0.7 mM SEVO, respectively. CONCLUSIONS: Prolongation of AP duration by SEVO in rat ventricular myocytes is likely to be caused by a reduction of I(to). Resting membrane potential was unaffected by SEVO, which seems to be related to no alteration of I(kI).
Action Potentials ; Animals ; Heart ; Membrane Potentials ; Muscle Cells* ; Rats*

Purpose: The aim of the present study was to identify whether the percentages of T cell subset, the serum interferon-gamma (IFN gamma ) as a Th1 cytokine, soluble CD30 (sCD30) as a marker for activation of Th2 cytokine producing T cells, and intracellular cytokines (IL-2, IL-4) can predict the acute cellular rejection episodes of liver transplant patients. Methods: Pretransplant and posttransplant sera on days 1, 3 and 7 after surgery of 88 adult living donor liver transplant recipients were tested for the percentage of T cell subset (CD3+, CD4+ and CD8+ T cells), IL-2, IL-4 production by peripheral mononucleated cells with fluorescence activated cell sorter analysis and for the serum IFN gamma , sCD30 concentrations with commercial ELISA kits. Recipients were subdivided into three groups as control (n=51), ELE (the group which showed elevated liver enzyme but RAI score <2. n=25), and AR (the group with acute rejection which showed RAI score > or =3. n=13). The differences in the level of cytokines among each group were analyzed. Results: The percentages of CD3+ T cell subset at preoperatively and day 1, 7 after surgery in AR were higher than those of control (P <0.05). The IL-2 production in AR was the highest and the IL-4 production was the lowest on posttransplant 7th day among three groups without significance. AR had a significantly higher pretranspant IFN gamma concentration than control (P <0.05). The pretransplant serum level of sCD30 was not different between the control and AR. However, in comparison with control, which showed a steadily decreasing serum sCD30 level after transplantation, 12 of the 14 patients in the AR showed an increase in their sCD30 levels from day 1 to day 3 after transplantation (P <.05). Conclusion: The measurement of serum IFN gamma and sCD30 during pre- and early post-LDLT period might be helpful to evaluate the risk of the occurrence of liver allograft rejection.
Adult ; Allografts* ; Cytokines* ; Enzyme-Linked Immunosorbent Assay ; Fluorescence ; Humans ; Interferon-gamma ; Interleukin-2 ; Interleukin-4 ; Liver* ; Living Donors ; T-Lymphocytes ; Transplantation

PURPOSE: To evaluate the diagnostic value of MRI, we compared MR images of primary scalp mass with pathological findings. MATERIAL & METHODS: Eight cases in seven patients who had presented primary scalp mass during the previous three years were evaluated by MRI and confirmed with surgical excision and pathologic evaluation. 0.38T(Resonex 4000, USA) MRI was used and all MR images were analysed retrospectively. RESULTS: Eight pathologically confirmed cases consisted of three cases of epidermal cysts, one of steatocystoma simplex, three of neurofibromatosis and one of lymphangioma. All epidermal cysts were located in the occipital area and showed ahigher signal intensity than CSF in T1WI, and proton density and variable signal intensity in T2WI. The Steatocystoma showed a signal iniensity similar to fat in T1WI and proton density and a lower signal intensity than fat in T2WI. Neurofibromatosis accounted for three cases in two neurofibromatosis patients ; one was locatedin the right parieto-occipital area and accompanied by hematoma and skull defect ; two cases were located in the occipital and posterior cervical area of the same patient. The masses showed a higher signal intensity than musclein T1WI and hyper or iso intensity in T2WI with well enhancement. The lymphangioma showed a signal intensity similar to CSF in all pulse sequences and contained a fat component. CONCLUSION: MRI is a useful modality for evaluating primary scalp mass.
Epidermal Cyst ; Hematoma ; Humans ; Lymphangioma ; Magnetic Resonance Imaging ; Neurofibromatoses ; Protons ; Retrospective Studies ; Scalp* ; Skull

PURPOSE: Despite the fact that desflurane prolongs the QTC interval in humans, little is known about the mechanisms that underlie these actions. We investigated the effects of desflurane on action potential (AP) duration and underlying electrophysiological mechanisms in rat ventricular myocytes. MATERIALS AND METHODS: Rat ventricular myocytes were enzymatically isolated and studied at room temperature. AP was measured using a current clamp technique. The effects of 6% (0.78 mM) and 12% (1.23 mM) desflurane on transient outward K+ current (I(to)), sustained outward current (I(sus)), inward rectifier K+ current (I(KI)), and L-type Ca2+ current were determined using a whole cell voltage clamp. RESULTS: Desflurane prolonged AP duration, while the amplitude and resting membrane potential remained unchanged. Desflurane at 0.78 mM and 1.23 mM significantly reduced the peak I(to) by 20+/-8% and 32+/-7%, respectively, at +60 mV. Desflurane (1.23 mM) shifted the steady-state inactivation curve in a hyperpolarizing direction and accelerated inactivation of the current. While desflurane (1.23 mM) had no effects on I(sus) and I(KI), it reduced the L-type Ca2+ current by 40+/-6% (p<0.05). CONCLUSION: Clinically relevant concentrations of desflurane appear to prolong AP duration by suppressing Ito in rat ventricular myocytes.
Action Potentials/*drug effects ; Anesthetics, Inhalation/*pharmacology ; Animals ; Calcium Channels, L-Type/physiology ; Heart Conduction System/drug effects/physiology ; Heart Ventricles/drug effects ; Isoflurane/*analogs & derivatives/pharmacology ; Myocardial Contraction/*drug effects/physiology ; Myocytes, Cardiac/*drug effects/physiology ; Patch-Clamp Techniques ; Potassium Channels/physiology ; Rats ; Rats, Sprague-Dawley

Tumor-to-tumor metastasis is rare. We report a case of metastatic renal cell carcinoma in meningioma. A 67-year-old woman presented a two-week history of motor dysphagia and decreased short-term memory. She had undergone a left radical nephrectomy for a renal cell carcinoma 7 years ago, and had not received any adjuvant therapy. MRI disclosed a 3.0 x 3.0 x 3.0-cm sized round tentorial-based extraaxial mass with peritumoral edema in the left posterior temporal lobe. During operation, the tumor was found to be an encapsulated mass firmly attached to the tentorium. Histologically, the tumor was a meningotheliomatous meningioma extensively infiltrated by metastatic renal cell carcinoma, accompanying widespread coagulative necrosis. Immunohistochemical staining for cytokeratin revealed strong positivity only in the renal cell carcinoma component. The patient's postoperative course was uneventful. Post-operative radiation therapy was applied to the whole brain. Three months after operation, the patient developed right hemiparesis and dysphagia. Brain MRI at that time did not reveal recurrence or any other causative lesions, although the whole body scan disclosed uptake at the second lumbar vertebra and rib. The patient refused further treatment.
Aged ; Carcinoma, Renal Cell/secondary* ; Carcinoma, Renal Cell/chemistry ; Case Report ; Female ; Human ; Keratin/analysis ; Kidney Neoplasms/secondary* ; Kidney Neoplasms/chemistry ; Magnetic Resonance Imaging ; Meningeal Neoplasms/pathology* ; Meningioma/pathology*