Metaplastic carcinomas (carcinomas with metaplasia) of the breast are difficult to accurately diagnose and classify because of their rarity and varied histologic patterns. Cystic change can be encountered in mammary carcinoma, especially in carcinoma with squamous metaplasia, but are rare in pseudosarcomatous metaplastic carcinoma. We recently experienced a case of pseduosarcomatous metaplastic carcinoma in a 69-year-old female who had an extensive cystic change in radiologic and histopathologic findings. The precise cell type that gives rise to metaplastic carcinomas remains uncertain. Immunohistochemical findings raised the possibility of the myoepithelial nature of the tumor.
Aged ; Breast* ; Female ; Humans ; Immunohistochemistry ; Metaplasia

Invasive micropapillary carcinoma is a recently defined unusual variant of invasive breast carcinoma characterized by the formation of micropapillae within clear spaces separated by delicate fibrocollagenous stroma. This study was designed to examine clinicopathologic features of invasive micropapillary carcinoma of the breast. Sixteen cases of invasive micropapillary carcinoma were retrieved from the files of the Department of Pathology, Yeungnam University College of Medicine. We evaluated their clinicopathologic findings including patients' age, tumor size, nuclear grade, vascular invasion, axillary lymph node status, presence of extensive intraductal carcinoma, estrogen and progesterone receptors, p53, c-erbB-2, MIB-1 labelling index and follow-up data and compared this results with those of 292 cases of invasive ductal carcinoma, not otherwise specified. The incidence of invasive micropapillary carcinoma was 4.2% of all invasive breast carcinoma, and the mean age of the patients was 46 years. Nine cases were pure form (over 75% of micropapillary growth pattern in the tumor) and seven cases were mixed form. The results of clinicopathologic findings, except vascular invasion and axillary lymph node status, of the 16 cases of invasive micropapillary carcinoma were not different from those of the 292 cases of invasive ductal carcinoma, not otherwise specified (p>0.05). However, the rate of vascular invasion and axillary lymph node metastasis was significantly higher in invasive micropapillary carcinoma (p <0.05). Of 16 cases, five cases had distant metastasis during follow-up period, and one patient died of cancer. Although the mechanism of higher vascular invasion and lymph node metastasis in micropapillary growth pattern could not be determined, we propose that invasive micropapillary carcinoma should be recognized as a separate entity with increased risks of vascular invasion and axillary lymph node metastsis.
Breast Neoplasms ; Breast* ; Carcinoma, Ductal ; Carcinoma, Intraductal, Noninfiltrating ; Estrogens ; Follow-Up Studies ; Humans ; Incidence ; Lymph Nodes ; Neoplasm Metastasis ; Pathology ; Receptors, Progesterone

This study was conducted to assess the prognostic value of tumor angiogenesis and Cathepsin-D in breast carcinoma, by correlating them with other clinicopathologic prognostic factors. In order to estimate microvessels within the tumor, an immunohistochemical method using monoclonal antibodies for factor VIII-related antigens (DAKO-vWf, F8/86) was used, and they were counted (perx200 field) in the most active areas of neovascularization. For the expression of Cathepsin-D, an immunohistochemical method using monoclonal antibodies (Novocastra, NCL-CDm) was performed. The microvessel count ranged from 8 to 346 per x200 field and the mean (+/-SD) was 72.46+/-54.96. The microvessel count was correlated with the estrogen receptor status, and it was also correlated with the tumor size when it was graded into four groups (1-33, 34-67, 68-100, >100), but was not correlated with other clinicopathologic parameters. Cathepsin-D was expressed in 40% (46/115) of the cases, but it was statistically correlated with the tumor size only. In conclusion, the expression of Cathepsin D and the degree of angiogenesis in breast cancer showed a correlation with the tumor size only. Therefore, they do not appear to be good prognostic parameters, according to the present study.
Antibodies, Monoclonal ; Breast Neoplasms ; Breast* ; Carcinoma, Ductal* ; Cathepsin D ; Estrogens ; Microvessels ; Prognosis ; von Willebrand Factor

The prefabrication by vascular induction into random patterned flaps is a method creating axial donor flap by implantation of nourishing pedicles prior to harvesting random patterned flaps. The purpose of this study was to evaluate the viability of a thin prefabricated flap prepared by the subdermal implantation of fasciovascular pedicles without subcutaneous tissue or muscular layer, by comparing with the prefabrication by the subpanniculus carnosus implantation of vascular pedicles, which is well known to a predictable survival rate by many authors. In the left abdomen of 40 Sprague-Dawley rats, the fasciovascular pedicles were implanted in the subdermal layer in group I(n=20) and sub panniculus carnosus layer in group II(n=20), respectively. 5 weeks later, 4 x 6 cm sized abdominal flap was elevated with implanted vascular pedicle as an island and reposed immediately. At the same time, in the right abdomen, conventional island flap was elevated and reposed. After 3 days later, the evaluation of the survival area was carried out in each side, in both groups. The mean proportions of the survival areas in group I were 74.2 and 91.8% in the prefabricated and conventional flap, respectively. And those in group II were 76.4 and 91.2% in the prefabricated and conventional flap, respectively. These results showed that there is no difference in the proportion of survival area between two types of prefabrication. In conclusion, it is possible to prefabricate a thin axial-patterned fascioutaneous flap without subcutaneous tissue and the viability of this prefabricated flap is reliable as much as that of other prefabricated flaps having subcutaneous or muscular tissue.
Abdomen ; Humans ; Rats, Sprague-Dawley ; Subcutaneous Tissue ; Survival Rate ; Tissue Donors

This study was conducted to evaluate the expression of p53 and c-erbB-2 using immuno-histochemical methods in 145 primary breast carcinomas and to correlate it with other histo-pathological prognostic factors. Invasive ductal carcinoma represented 129 of the cases. Expression of p53 protein and c-erbB-2 oncoprotein was present in 48% (62/129) and 30% (39/129) of invasive ductal carcinomas, respectively. The expression of p53 protein was stongly associated with a high score of degree of differentiation (p<0.05), nuclear pleomorphism (p<0.05), mitotic index (p<0.05), SBR grade (p<0.05) and MSBR grade (p<0.05), but it was not associated with patient's age, size of tumor or axillary node metastasis. The overexpression of c-erbB-2 C-erbB-2 oncoprotein was strongly associated with a high score of nuclear pleomorphism and a high SBR grade (p<0.05), but not associated with patient's age, size of tumor, axillary node metastasis, degree of differentiation, mitotic index or MSBR grade. An inverse relationship between the expression of p53 protein and estrogen receptor status was found, but the expression of c-erbB-2 was not associated with estrogen receptor status. It is concluded that p53 protein and c-erbB-2 oncoprotein are important prognostic factors in breast cancers, and that the aberrant expression of p53 protein is the most useful prognostic factor becausd of strong association of known histopathological prognostic factors and negative estrogen receptor status.
Breast Neoplasms

PURPOSE: The purpose of this study was to determine the effects of self-esteem improvement program on self-esteem, depression, and interpersonal relationship in chronic schizophrenia patients living in the community. METHODS: The research design was a non-equivalent pre and post control group design. One of two community mental health centers was randomly assigned to receive the intervention and the other served as a control. Eight patients in the intervention group and ten in the control group participated. For the intervention group, the self-esteem improvement program was provided in 60-minute session once a week for 12-weeks. Measurements were Korean version of self-esteem scale (SES-K), Korean version of beck depression inventory (BDI-K), and Korean version of interpersonal relationships (IR-K). RESULTS: The only statistically significant difference between the experimental and control group was for interpersonal relationships. For the experimental group, there were statistically significant differences in self-esteem and interpersonal relationships. CONCLUSION: The results indicate that this type of program has a positive effect on self-esteem and interpersonal relationships and can be a feasible type of intervention program for community dwelling patients with chronic schizophrenia.
Community Mental Health Centers ; Depression* ; Humans ; Research Design ; Schizophrenia*

OBJECTIVE: To study the clinical characteristics on translocation of intrauterine device and the methods of removal. METHODS: A retrospective review was performed on 77 cases of translocation of intrauterine device from June 1994 to December 2002. RESULTS: Among 77 cases undergoing removal of intrauterine device, 17 cases (22.1%) were translocted intraperitoneally. Fifteen cases were removed by laparoscopy, 2 cases were by laparotomy and there was no specific postoperative complication. The incidence of intraperitoneal translocation was not related to the type of IUD. Between intrauterine and extrauterine translocation, the incidence of symptoms were not different, but low abdominal pain were slightly increased in extrauterine (35.3%) than intrauterine (10.0%) group. The time lapse after insertion of IUD was ranged from 1 month to 35 year, the mean duration was 9.39 year, that was not related to the incidence of intraperitoneal translocation. In the cases of extrauterine translocation, the mean hospital day was significantly increased (p=0.001), the mean duration was 2.5 day (1-7 day), compaired with 0.7 day (0-6 day) of the cases of not translocated. CONCLUSION: As the type of IUD or symptoms, it is difficult to anticipate the possibility of the intraperitoneal translocation of IUD. But, in cases of extrauterine translocation of intrauterine device, the incidence of low abdominal pain was slightly increased, and ring type IUD was rarely extrauterne translocated. So, it is necessary to further study what factors contribute the extrauterine translocation of IUD.
Abdominal Pain ; Incidence ; Intrauterine Devices* ; Laparoscopy ; Laparotomy ; Postoperative Complications ; Retrospective Studies

Purpose: This study examined the impact of adolescents’ dietary behavior on their quality of life using the nutrition quotient for adolescents (NQ-A) for some high school students in Seoul. Methods: The subjects were 176 high school students living in Seoul. The NQ-A was used to assess the dietary quality, and the quality of life was assessed by categorizing it into life satisfaction, environment, health, participation and safety, leisure activities, and emotional factors using survey questions validated through previous studies. Results: The NQ score of the survey subjects was 49.30 points. Based on the NQ scores, 7.4%, 46.6%, and 46.0% of participants were categorized as the ‘high’, ‘medium’, and ‘low’ groups, respectively. The total NQ score and balance, diversity, and practice factor scores were positively correlated with life satisfaction, environment, health, participation and safety, and leisure activities among the quality of life subscales. Regression analysis showed that the total NQ score was positively associated with life satisfaction, health, leisure activities, and emotions; the moderation factor was negatively associated with life satisfaction and health. The balance factor was positively associated with the environmental factor. The practice factor was positively associated with health, leisure activities, and emotions, and the environment factor was negatively associated with emotions. Conclusion These results show that adolescents’ quality of life is closely related to their diet, so it is necessary to maintain a balanced and varied food intake and desirable eating behaviors to improve adolescents’ quality of life. Furthermore, adolescents’ quality of life is influenced by other factors. Therefore, further research is needed to assess the quality of life, including dietary factors, as well as physical, emotional, psychological, and social development.

This experiment is designed to find differentially expressed genes in p388D1 cells that are specific for the serum deprived state. Serum starvation induces cells to enter the quiscent state in the cell cycle and is used to arrest cell growth or synchronize the cell cycle. Differential display and ribonuclease protection assay were used to identify quantitative change in gene expression. Nineteen genes that showed a differential expression in the differential display were cloned and 7 clones were verified by a ribonuclease protection assay. Among the 7 clones clone-16 showed same expression pattern in comparison with the differential display. Deduced amino acid sequences of clone-16 had N-glycosylation motif and seems to be a secretory protein. Getting a full sequence of clone-16 is critical for the characterization of it.
Amino Acid Sequence ; Cell Cycle ; Clone Cells ; Gene Expression ; Ribonucleases ; Starvation

A number of methods have been introduced for support the orbital floor following a maxillectomy without orbital exenteration or severe facial trauma. These methods including skin graft and muscular sling provided the unsatisfactory results, like as diplopia, orbital ptosis, enophthalmos and severe facial deformity. Therefore the bone and soft tissue reconstructions using microvascular free flaps were performed recently by many surgeons, but long time operation, donor site morbidity, postoperative large scar, and ptosis of the flap were pointed out as disadvantages of free flap reconstruction. Vascularized calvarial bone flap, a modified method of free calvarial bone graft, was adequate for reconstruction of the orbital floor and the infraorbital rim as a horizontal buttress, especially in case of poor vascular bed and postradiated state. The authors introduced the vascularized calvarial bone flap for the orbital floor and the infraorbital rim reconstruction in 3 cases of maxillectomy, and could be obtained satisfactory results aesthetically and functionally.
Cicatrix ; Congenital Abnormalities ; Diplopia ; Enophthalmos ; Free Tissue Flaps ; Humans ; Orbit* ; Skin ; Tissue Donors ; Transplants