PURPOSE: Breast cancer is the most frequently occurring cancer in Korean women, and recently its incidence has rapidly increased. The purpose of this study was to show the survival rate and prognostic factors for breast cancer in Korean women. METHODS: Nine hundred and eighty nine consecutive breast cancer patients, first diagnosed at the Dongsan Medical Center, Keimyung University between January 1990 and December 2001, were included in this study. RESULTS: The peak incidence occurred in the 40's age group, and the average age at diagnosis was 48.1 years old. Forty four patients (4.4%) were in stage 0, 218 (22.0%) in stage I, 572 (57.9%) in stage II, 112 (11.4%) in stage III, and 22 (2.2%) in stage IV. The 5 and 10 year disease free and overall survival rates were 73.8 and 68.8 and 79.7% and 65.4%, respectively. A univariate analysis of the prognostic factors showed that age, tumor size and number of metastatic lymph nodes were statistically significant. A multivariate analysis showed that the the number of metastatic lym, ph nodes was the most significant factor for the time to recurrence and overall mortality. CONCLUSION: This study showed that the peak age of the breast cancer patients in Korea was younger than that seen in Western countries, and the survival rates were similar, despite our patients being comprised of a smaller proportion of early breast cancers. The age at time of diagnosis, tumor size, and number of axillary lymph nodes involved were confirmed to have independent influence on the overall survival and disease free survival rates.
Breast Neoplasms* ; Breast* ; Diagnosis ; Disease-Free Survival ; Female ; Humans ; Hydrogen-Ion Concentration ; Incidence ; Korea ; Lymph Nodes ; Mortality ; Multivariate Analysis ; Recurrence ; Survival Rate*

PURPOSE: The determination of HER-2/neu gene amplification has become necessary for the selection of breast cancer patients to undergo anti-HER-2/neu therapy, using a humanized monoclonal antibody. Chromogenic in situ hybridization (CISH) detection of the HER-2/neu gene, a newly developed method, utilizes a robust and unique-sequence DNA probe labeled with digoxygenin, which is sequentially incubated with antidigoxygenin fluorescein, antifluorescein peroxidase and diaminobenzidine. The aim of this study was to establish a CISH assay for the detection of HER-2/neu amplification. The results were compared with those of the immunohistochemistry (IHC) methods, most frequently used for detecting HER-2/neu alteration. METHODS: CISH was performed in 4 groups of infiltrating breast carcinomas. Each group was comprised of 20 cases in which the HER-2/neu stati had previously been scored on a four value scale: 0, 1+, 2+ and 3+ by IHC. The results of CISH and IHC were compared for each tumor group. The HER-2/neu gene amplification detected by CISH was thpically visualized as large DAB-stained clusters or by many dots in the nucleus. RESULTS: The concordance between the CISH and IHC was 95% (kappa=0.901). Three IHC-positive cases (score 2+) showed no gene amplification and one IHC-negative case (score 1+) showed gene amplification by CISH. CONCLUSION: The current study showed excellent agreement between the CISH and IHC methods. CISH is an accurate, practical and economical approach for determining the HER-2/neu stati in breast carcinomas. It is also a useful methodology for confirming the IHC results in paraffin- embedded tumor samples, so offers a promising alternative to IHC in a routine diagnostic setting.
Breast Neoplasms* ; Breast* ; DNA ; Fluorescein ; Gene Amplification ; Genes, vif ; Humans ; Immunohistochemistry ; In Situ Hybridization* ; Peroxidase

No abstract available.
Lymphadenitis* ; Tuberculosis*

No abstract available.
Stomach Neoplasms*

No abstract available.
Animals ; Ischemia* ; Kidney* ; Rats* ; Reperfusion*

Primary schwannoma of the large intestine is an extremely rare neoplasm. Here, we report two cases of colonic schwannoma confirmed pathologically after laparoscopic resection. A 52-year-old female and a 59-year-old female were referred by their general practitioners to our coloproctologic clinic for further evaluation and management of colonic submucosal masses. Colonoscopies performed in our institution revealed round submucosal tumors with a smooth and intact mucosa in the mid-ascending and descending colon, respectively. Computed tomography (CT) scans showed an enhancing soft tissue mass measuring 2 x 2 cm in the right colon and well-defined soft tissue nodule measuring 1.5 x 1.7 cm in the proximal descending colon, respectively. We performed laparoscopic right hemicolectomy and segmental left colectomy under the preoperative impression of gastrointestinal stromal tumors. Two cases were both diagnosed to be benign schwannoma of the colon after immunohistochemical stains (S-100 (+), smooth muscle actin (-), CD117 (-), and CD34 (-)).
Actins ; Colectomy ; Colon ; Colon, Descending ; Colonoscopy ; Coloring Agents ; Female ; Gastrointestinal Stromal Tumors ; General Practitioners ; Humans ; Intestine, Large ; Middle Aged ; Mucous Membrane ; Muscle, Smooth ; Neurilemmoma

Bleeding lesions in the small bowel are a much more significant challenge in terms of detection and treatment than those of the stomach or the large bowel, and require extensive gastrointestinal evaluation before a diagnosis can be made. The authors report the case of an 81-year-old female patient who underwent small bowel segmental resection by single incisional laparoscopic approach for distal jejunalhemangioma, which caused severe anemia. An abdominal computed tomography scan demonstrated a highly enhancing polypoid tumor in the distal ileum. During the single incisional laparoscopic exploration using a 2 cm sized skin incision, jejuno-jejunal intussusceptions and a jejunal tumor were noted. Single incisional laparoscopy was performed to assist the jejunal segmental resection. Pathologic reports confirmed the lesion to be a jejunalhemangioma. The authors report an unusual case of jejunalhemangioma caused by intussusception and gastrointestinal hemorrhage, which was treated by single incisional laparoscopic surgery.
Aged, 80 and over ; Anemia ; Female ; Gastrointestinal Hemorrhage ; Hemorrhage ; Humans ; Ileum ; Intussusception ; Laparoscopy ; Skin ; Stomach

PURPOSE: Patients with biliary atresia (BA) treated with Kasai portoenterostomy may later develop intractable cholangitis (IC) that is unresponsive to routine conservative treatment. It may cause biliary cirrhosis and eventually hepatic failure with portal hypertension. Control of IC requires prolonged hospitalization for the administration of intravenous antibiotics. To reduce the hospitalization period, we designed a home intravenous antibiotic treatment (HIVA) which can be administered after initial inpatient treatment. In this study, we reviewed the effects of this treatment. METHODS: We reviewed medical records of 10 patients treated with HIVA for IC after successful Kasai portoenterostomies performed for BA between July 1997 and June 2009. RESULTS: The duration of HIVA ranged from 8 to 39 months (median, 13.5 months). The median length of hospital stay was 5.7 days per month for conventional treatments to manage IC before HIVA and, 1.5 days per month (P = 0.012) after HIVA. The median amount of medical expenses per month was reduced by about one tenth with HIVA. One patient underwent liver transplantation due to uncontrolled esophageal variceal bleeding, but the other nine patients had acceptable hepatic function with native livers. CONCLUSION: HIVA may be an effective primary treatment for IC after Kasai portoenterostomies for BA, and reduce length of hospital stay and medical expense.
Anti-Bacterial Agents ; Biliary Atresia ; Cholangitis ; Hemorrhage ; Hospitalization ; Humans ; Hypertension, Portal ; Inpatients ; Length of Stay ; Liver Cirrhosis, Biliary ; Liver Failure ; Liver Transplantation ; Medical Records

PURPOSE: To evaluate the efficacy of B-mode ultrasonography (US) in measurement of carotid stenosis% (CS%). METHODS: One hundred and thirth-three carotid arteries in 96 patients who underwent both carotid US and carotid arteriography (CA) were included in this retrospective study. To measure CS% on US, a cross sectional view of the most stenotic segment of the internal carotid artery was captured and residual diameter and original diameter of that segment were measured with electronic caliper on the same plane and in the same direction. To measure CS% on an angiogram, we used European Carotid Surgery Trial (ECST) and the North American Symptomatic Carotid Endarterectomy Trial (NASCET) methods. Pearson's correlation analysis and linear regression analysis were used to determine the correlation between CS% on an US and angiogram. RESULTS: Pearson's correlation coefficient (R) between CS% measured in US and CA were 0.853 (ECST method, P < 0.001) and 0.828 (NASCET method, P < 0.001). Accuracies of B-mode US were 93.2%, 88.0%, and 81.2% for estimating CS% by ECST method and 86.5%, 82.7%, and 82% for estimating CS% by NASCET method. CONCLUSION: CS% measured in B-mode US was simpler and showed a strong positive correlation with that measured on an arteriogram either ECST or NASCET method.
Angiography ; Carotid Arteries ; Carotid Artery, Internal ; Carotid Stenosis ; Electronics ; Electrons ; Endarterectomy, Carotid ; Humans ; Linear Models ; Retrospective Studies

PURPOSE: Groove pancreatitis is a rare specific form of chronic pancreatitis that extends into the anatomical area between the pancreatic head, the duodenum, and the common bile duct, which are referred to as the groove areas. We present the diagnostic modalities, pathological features and clinical outcomes of a series of symptomatic patients with groove pancreatitis who underwent pancreaticoduodenectomy. METHODS: Six patients undergoing pancreaticoduodenectomy between May 2006 and May 2009 due to a clinical diagnosis of symptomatic groove pancreatitis were retrospectively included in the study. RESULTS: Five cases were male and one case was female, with a median age at diagnosis of 50 years. Their chief complaints were abdominal pain and vomiting. Abdominal computed tomography, endoscopic ultrasound and endoscopic retrograde cholangiopancreatography were performed. Preoperative diagnosis of all patients was groove pancreatitis. Histological finding was compatible with clinically diagnosed groove pancreatitis in five patients and the pathologic diagnosis of the remaining patient was adenocarcinoma of distal common bile duct. Following pancreaticoduodenectomy, four living patients experienced significant pain alleviation. CONCLUSION: The diagnostic imaging modalities of choice for groove pancreatitis are computed tomography and endoscopic ultrasonography. If symptomatic groove pancreatitis is suspected, careful follow-up of patients is necessary and pancreaticoduodenectomy seems to be a reasonable treatment option.
Abdominal Pain ; Adenocarcinoma ; Cholangiopancreatography, Endoscopic Retrograde ; Chronic Disease ; Common Bile Duct ; Diagnostic Imaging ; Duodenum ; Endosonography ; Female ; Head ; Humans ; Male ; Pancreatic Neoplasms ; Pancreaticoduodenectomy ; Pancreatitis ; Pancreatitis, Chronic ; Retrospective Studies ; Vomiting