Breast conserving surgery (BCS) with radiation therapy (RT) has been considered an alternative to a radical mastectomy in the surgical treatment of early breast cancer. Breast-conserving therapy (BCT) can achieve a more favorable cosmetic outcome than a mastectomy in patients with early breast cancer. However, it is widely recognized that RT following BCS is an impediment to improve the cosmetic outcome of a BCT-treated breast. If the local recurrence (LR) rate is acceptable and LR can be controlled with salvage surgery, an appropriate conservative surgical procedure without RT will be a reasonable option for some patients with early breast cancer. Between 1990 and 1996, 60 patients were enrolled in a retrospective study to examine whether or not RT could be avoided following conservative surgery in patients with early breast cancer. There was no significant difference in local recurrence rate between the RT and the non-RT groups (6.3% vs 10.7%). The characteristics of suitable BCS without RT would be negative axillary lymph-node metastasis, low nuclear grade, a 1 cm negative resection margin and no lymphatic vessel involvement. In conclusion, breast-conserving surgery without RT is a reasonable option for some patients with early breast cancer.
Animals ; Breast Neoplasms* ; Breast* ; Cicatrix ; Colon* ; Colon, Transverse ; Colorectal Surgery ; Defecation ; Fibrosis ; Foreign-Body Reaction ; Humans ; Lymphatic Vessels ; Male ; Mastectomy ; Mastectomy, Radical ; Mastectomy, Segmental* ; Methods ; Neoplasm Metastasis ; Rectum ; Recurrence ; Retrospective Studies ; Swine ; Telangiectasis ; Tensile Strength

PURPOSE: To evaluate the short-term effect of an intravitreal injection of ranibizumab in the treatment of diabetic macular edema. METHODS: Eighteen eyes of 18 patients who underwent intravitreal ranibizumab injection for the treatment of diabetic macular edema between March 1 and November 30, 2009 were retrospectively evaluated. Complete ophthalmic examinations including best corrected visual acuity and optical coherence tomography (OCT) were performed at baseline and follow-up visits at one and three months. RESULTS: The mean Visual Acuity Improved From Logmar 0.74 +/- 0.45 At Baseline To Logmar 0.44 +/- 0.26 At One Month And To Logmar 0.42 +/- 0.23 At Three Months (P < 0.05). The Mean Central Macular Thickness Decreased From 429.5 +/- 71.9 microM At Baseline To 299.9 +/- 81.2 microM At One Month And To 284.6 +/- 82.6 microM At Three Months (P < 0.05). No Adverse Side Effects Were Observed Following the injections. CONCLUSIONS: The observed macular edema and visual acuity improvements demonstrated that intravitreal ranibizumab injection may be useful for the treatment of patients with diabetic macular edema.
Antibodies, Monoclonal, Humanized ; Eye ; Follow-Up Studies ; Humans ; Intravitreal Injections ; Macular Edema ; Retrospective Studies ; Tomography, Optical Coherence ; Visual Acuity

OBJECTIVES: The purpose of this study was to identify the risk factors of metabolic syndrome (MS) and to analyze the relationship between the risk factors of MS and medical cost of major diseases related to MS in Korean workers, according to the scale of the enterprise. METHODS: Data was obtained from annual physical examinations, health insurance qualification and premiums, and health insurance benefits of 4,094,217 male and female workers who underwent medical examinations provided by the National Health Insurance Corporation in 2009. Logistic regression analyses were used to the identify risk factors of MS and multiple regression was used to find factors associated with medical expenditures due to major diseases related to MS. RESULT: The study found that low-income workers were more likely to work in small-scale enterprises. The prevalence rate of MS in males and females, respectively, was 17.2% and 9.4% in small-scale enterprises, 15.9% and 8.9% in medium-scale enterprises, and 15.9% and 5.5% in large-scale enterprises. The risks of MS increased with age, lower income status, and smoking in small-scale enterprise workers. The medical costs increased in workers with old age and past smoking history. There was also a gender difference in the pattern of medical expenditures related to MS. CONCLUSIONS: Health promotion programs to manage metabolic syndrome should be developed to focus on workers who smoke, drink, and do little exercise in small scale enterprises.
Female ; Health Expenditures ; Health Promotion ; Humans ; Insurance, Health ; Korea* ; Logistic Models ; Male ; National Health Programs ; Physical Examination ; Prevalence ; Risk Factors ; Smoke ; Smoking

OBJECTIVE: The aim of this study was to analyze the effect of supplementing vitrification and warming solutions with two types of antifreeze proteins (AFPs) and the combination thereof on the follicular integrity of vitrified-warmed mouse ovaries. METHODS: Ovaries (n=154) were obtained from 5-week-old BDF1 female mice (n=77) and vitrified using ethylene glycol and dimethyl sulfoxide with the supplementation of 10 mg/mL of Flavobacterium frigoris ice-binding protein (FfIBP), 10 mg/mL of type III AFP, or the combination thereof. Ovarian sections were examined by light microscopy after hematoxylin and eosin staining, and follicular intactness was assessed as a whole and according to the type of follicle. Apoptosis within the follicles as a whole was detected by a terminal deoxynucleotidyl transferase deoxyuridine triphosphate nick-end labeling assay. RESULTS: The proportion of overall intact follicles was significantly higher in the type III AFP-supplemented group (60.5%) and the combination group (62.9%) than in the non-supplemented controls (43.8%, p<0.05 for each). The proportion of intact primordial follicles was significantly higher in the FfIBP-supplemented (90.0%), type III AFP-supplemented (92.3%), and combination (89.7%) groups than in the non-supplemented control group (46.2%, p<0.05 for each). The proportions of non-apoptotic follicles were similar across the four groups. CONCLUSION: Supplementation of the vitrification and warming solutions with FfIBP, type III AFP, or the combination thereof was equally beneficial for the preservation of primordial follicles in vitrified mouse ovaries.
Animals ; Antifreeze Proteins* ; Apoptosis ; Deoxyuridine ; Dimethyl Sulfoxide ; DNA Nucleotidylexotransferase ; Eosine Yellowish-(YS) ; Ethylene Glycol ; Female ; Fertility Preservation ; Flavobacterium ; Hematoxylin ; Humans ; Mice* ; Microscopy ; Ovary* ; Vitrification

Waldenstrom's macroglobulinemia is characterized by overproduction of immunoglobulin M (IgM), which can lead to development of a hyperviscosity syndrome. Plasmapheresis has been used to reduce plasma viscosity and IgM levels. However, plasmapheresis not only removes pathogenic substances but also the normal components in plasma. Post-centrifugal plasma filtration (PCPF) using a filter with an appropriate pore size has been shown to be effective for selective removal of macromolecules in plasma without requiring a replacement fluid. Here, we report on a patient with hyperviscosity syndrome due to Waldenstrom's macroglobulinemia, which was ameliorated by a single treatment of PCPF using an Evaflux 5A filter. After centrifugation, the separated plasma of the patient was subjected to membrane filtration for removal of IgM in the plasma. After PCPF, a 56.5% reduction in the IgM level (from 9,370 mg/dL to 4,080 mg/dL) was achieved, whereas the level of albumin showed a slight decrease, from 2.7 g/dL to 2.4 g/dL (11.1% reduction). The patient's symptoms were relieved and she was discharged on the seventh hospital day.
Centrifugation ; Filtration ; Humans ; Immunoglobulin M ; Membranes ; Plasma ; Plasmapheresis ; Viscosity ; Waldenstrom Macroglobulinemia

PURPOSE: Although the screening with a mammography has been shown to reduce breast cancer mortality, it has limitations relating to its sensitivity and efficacy. Interval cancers are those that become symptomatic, and are detected between screening examinations. The success of a screening program in reducing the rate of mortality due to breast cancer relies on keeping the number of interval cancers at a minimum. This study was performed to review the mammographic features of interval cancers, and to compare their clinicopathological factors with those cancers detected by screening. METHODS: Of the 881 women who had operations for breast cancer performed between 1995 and 1999, we retrospectively analyzed the medical records and mammograms of 57 who received at least a mammogram before the diagnosis of their breast cancer. These patients were divided into an interval cancer group, who had symptoms, and a screen detected cancer group, who had not. The factors compared included the clinical, radiographic, histopathological, and immunohistochemical features. RESULTS: Interval cancers were more likely to have masses, than microcalcifications, in their mammographic features, and were more likely to be invasive and at a higher stage according to their histopathological features. The false negative rate was 48% for the screen detected cancers, and 35% for the interval cancers (P=0.414). HRT users had the higher false negative rate of 51.6% than the 26.9% for the nonuser (P=0.103). CONCLUSION: The interval cancers were found to be different from the screen detected cancers in terms of their radiological and pathological features. The standardization of screen interval, and additional magnification mammography, or ultrasonography may contribute to reduce false negative rates of mammography.
Breast Neoplasms ; Breast* ; Diagnosis ; Female ; Humans ; Mammography ; Mass Screening ; Medical Records ; Morinda ; Mortality ; Retrospective Studies ; Ultrasonography

No abstract available.
Antineoplastic Combined Chemotherapy Protocols/therapeutic use ; Biopsy ; Chemoradiotherapy, Adjuvant ; Diagnostic Errors ; Dupuytren Contracture/diagnosis ; *Fingers/pathology/ultrasonography/virology ; Hematopoietic Stem Cell Transplantation ; Herpesvirus 4, Human/genetics ; Humans ; Immunohistochemistry ; In Situ Hybridization, Fluorescence ; *Lymphoma, Extranodal NK-T-Cell/diagnosis/therapy/virology ; Male ; Middle Aged ; Neoadjuvant Therapy ; Predictive Value of Tests ; RNA, Viral/genetics ; *Tendons/chemistry/pathology/ultrasonography/virology ; Treatment Outcome ; Tumor Markers, Biological/analysis ; Ultrasonography, Doppler, Color

Acquired hemophilia A (AHA) is a rare bleeding disorder caused by autoantibodies against factor VIII (FVIII). Treatment with clopidogrel is a cause of AHA, but its clinical course is unknown. Recently, we treated a 65-year-old man who was hospitalized for cerebellar infarction and had a prolonged activated partial thromboplastin time (aPTT) with soft tissue oozing after 3 weeks of clopidogrel use. We terminated clopidogrel administration and transfused the patient with fresh frozen plasma. However, the aPTT increased up to 98.8 seconds, and the FVIII and FVIII inhibitor levels were <1% and 5.4 Bethesda units/mL, respectively. Clopidogrel-associated AHA was considered, and we began steroid treatment. Two months later, FVIII, FVIII inhibitor, and aPTT values were normalized. No further bleeding or aPTT prolongation has been reported during the 2-year follow-up period. AHA should be considered in patients taking clopidogrel and experiencing bleeding, unless the platelet count and coagulation screen are normal.
Aged ; Autoantibodies ; Factor VIII ; Follow-Up Studies ; Hemophilia A ; Hemorrhage ; Humans ; Infarction ; Partial Thromboplastin Time ; Plasma ; Platelet Count ; Ticlopidine

No abstract available.
Humans ; Leukemia, Myeloid, Chronic, Atypical, BCR-ABL Negative