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

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

Composite grafting remains a technique which is used reluctantly and without great hope of success. In the recent two years, unexpectedly good result of composite graft was gained from 30 cases. The purpose of our study is to identify factors influencing success and to overlook long-term problems from a cosmetic and a functional view point. A retrospective review and a questionnaire about 30 fingers of 29 patients which were operated for composite graft at Kyongju hospital of Dongguk university from March 1997 to February 1999 were carried out. In all cases of composite grafting, tie-over dressing and heat lamp were applied and left for five days. And following result and conclusion were obtained. 1. 24(80%) of 30 finger tips replaced as composite graft were survived completely or partially. 2. At children with an age range 1 to 14, the survival rate (100%) of composite grafted tips was higher than that (75%) at adults. So, patient's age was important factor for success. 3. The type of injury was more important factor than the level of amputation. The survival rate(100%) of tips to cutting injury was higher than that(75%) of tips to crushing injury. 4. The delay in time from amputation and replacement did not significantly correlate with the survival rate. But, all tips replaced within 3 hours were survived completely or partially. 5. Even if partial necrosis on grafted tips was present, a result of long-time conservative treatment with minimal debridrement was excellent. Especially in children, the tips with conservative treatment showed normal appearance, several months later. 6. Cosmetic and functional results were better in child group and in groups with higher survival rate. Most common problem in cosmetic aspect was a short digit and that in functional aspect was a tender tip. 7. As a heat lamp increased blood supply, we could obtain better outcome.
Adult ; Amputation ; Bandages ; Child ; Fingers ; Gyeongsangbuk-do ; Hope ; Hot Temperature ; Humans ; Necrosis ; Surveys and Questionnaires ; Retrospective Studies ; Survival Rate ; Transplants*

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 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

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

PURPOSE: The purpose of this study was to explore the relationship between milk intake and prevalence rates of chronic diseases using KNHANES data, and the significance of the relationship was tested based on meditators, socioeconomic status (income, education), dietary behaviors (smoking, alcohol drinking, breakfast, and eating out), and physical activity (walking, medium, and high). METHODS: Using the 5(th) and 6(th) survey data of KNHANES, milk intake rates and presence of seven chronic diseases were summarized and analyzed by ANOVA for two groups of adult men and women as follows: hypertension, hypertriglyceridemia, low HDL-cholesterol, diabetes, abdominal obesity, obesity, and metabolic syndrome. The dependent variables for the presence of seven chronic diseases regressed with socioeconomic, dietary behavior, and physical activity variables according to Logistic models. The dependent variables for milk intake using predictor variables of socioeconomic, dietary behaviors and physical activity were analyzed according to Logistic models. Finally, the significant socioeconomic, dietary behavior, and physical activity variables in the above model along with milk intake as a control variable or mediator variable regressed with significant chronic diseases according to Logistic models. RESULTS: Milk intake, socioeconomic status, dietary behaviors, and physical activity were significantly different among the two groups of adult men and women, which were also critical factors to the prevalence of chronic diseases. The dependent variable for prevalence of chronic diseases regressed with significant factors of socioeconomic status, dietary behavior, and physical activity variables according to chronic diseases using the control or mediator variable of milk intake and summarized as follows: For adult men, milk intake controlled the education effect on diabetes partly, alcohol on hypertension and hypertriglyceridemia, low HDL-cholesterol, metabolic syndrome, breakfast on metabolic syndrome, eating out on obesity, and medium physical activity on hypertriglyceridemia. For adult women, household income on hypertriglyceridemia, diabetes, abdominal obesity, education level on hypertension, alcohol drinking, eating out, and walking activity on abdominal obesity, alcohol, breakfast, eating out, walking activity on low HDL-cholesterol, and medium physical activity on hypertriglyceridemia and low HDL-cholesterol were partly controlled by milk intake. Other significant socioeconomic status, dietary behavior, and physical activity variables related to prevalence of chronic diseases were fully controlled or mediated by milk intake. CONCLUSION: This study shows that milk intake (daily more than 200 g) prevents chronic diseases such as hypertension, hypertriglyceridemia, low HDL-cholesterol, diabetes, obesity, abdominal obesity, and metabolic syndrome.
Adult* ; Alcohol Drinking ; Breakfast ; Chronic Disease* ; Eating ; Education ; Family Characteristics ; Female ; Humans ; Hypertension ; Hypertriglyceridemia ; Korea* ; Logistic Models ; Male ; Milk* ; Motor Activity ; Nutrition Surveys* ; Obesity ; Obesity, Abdominal ; Prevalence* ; Social Class ; Walking

Purpose: This study was conducted to evaluate the safety of iodine intake based on ingestion levels and urinary iodine excretion of women of childbearing age (15–45 years old) using data from the 2013–2015 Korea National Health and Nutrition Examination Survey. Methods: Iodine intake was calculated using the 24 hours dietary recall method and urinary iodine excretion. The iodine nutrition database for the analysis of dietary iodine intake was constructed using the food composition database of the Rural Development Administration (RDA), the Korean Nutrition Society (KNS), the Ministries of Food and Drug Safety, China and, Japan. The World Health Organization (WHO) evaluation criteria and hazard quotient (HQ) calculated using biomonitoring equivalents (BE) were applied to evaluate the safety of the iodine intake. Results: Of the study subjects, 15.22% had a urinary iodine concentration level of less than 100 μg/L, which was diagnosed as deficient, and 48.16% had an excessive iodine concentration of over 300 μg/L. Urinary iodine concentration was 878.71 μg/L, iodine/creatinine was 589.00 μg/g, and iodine/creatinine was significantly higher at the age of 30–45 years. The dietary iodine intake was 273.47 μg/day, and the iodine intake calculated from the urinary iodine excretion was 1,198.10 μg/day. Foods with a high contribution to iodine intake were vegetables, seafood, seaweed and processed foods. The HQ was 1.665 when the urinary iodine content was > 1,000 μg/L. Conclusion The results of this study implicate that the urinary iodine concentration, rather than the dietary iodine intake, is more appropriate to evaluate the iodine status under the current situation that a comprehensive iodine database for Koreans has not been established.

PURPOSE: We evaluate the influence of the types of coffee beverage on obesity and abdominal obesity in Korean adults who were aged 19 years or over by using the 2013 ~ 2016 Korea National Health and Nutrition Examination Survey (KNHANES). METHODS: Specific questions were asked about frequency of coffee intake, the type of coffee beverage, the addition of milk and/or sugar to coffee by using the food frequency questionnaire of the 2013 ~ 2016 KNHANES. RESULTS: We found that coffee intake increased the prevalence of obesity and abdominal obesity. After multivariable adjustment, coffee consumption increased the risk of obesity by 1.30 (95% CI: 1.08 ~ 1.57) in the group that drank coffee twice a day, and 1.33 (95% CI: 1.11 ~ 1.60) in the people who drank coffee ≥3 times a day as compared to that of the non-coffee intake group. The risk of abdominal obesity increased to 1.27 (95% CI: 1.02 ~ 1.57) in the < 1 time/day coffee drinking group, 1.34 (95% CI: 1.08 ~ 1.66) in the 1 time/day coffee drinking group, 1.35 (95% CI: 1.09 ~ 1.67) in the 2 times/day coffee drinking group, and 1.40 (95% CI: 1.14 ~ 1.72) in the ≥ 3 times/day coffee drinking group as compared to that of the non-coffee drinking group. The influence of black coffee intake was different according to gender: males showed a high prevalence of abdominal obesity and females showed a high prevalence of obesity. Mixed coffee consumption increased the risk of obesity and abdominal obesity by more than 34% in men who consumed coffee more than 3 times a day and in women who consumed coffee more than 2 times per day. CONCLUSIONS: We found that coffee intake, regardless of the type of coffee, increased the prevalence of obesity and abdominal obesity. It is necessary to refrain from drinking coffee to prevent obesity.
Adult ; Beverages ; Coffee ; Drinking ; Female ; Humans ; Korea ; Male ; Milk ; Nutrition Surveys ; Obesity ; Obesity, Abdominal ; Prevalence

Purpose: The purpose of this study was to investigate the effects of nutrient intake and dietary diversity score (DDS) on osteoporosis after controlling for sex, age, socioeconomic level, drinking, smoking, physical activity, and body mass index (BMI) as mediators using the 2015–2017 Korean National Health and Nutrition Examination Survey (KNHANES) data. Methods: This study was focused on the age group of 50s and older by using the 2015–2017 KNHANES data. Subjects diagnosed with osteoporosis were classified as the osteoporosis group, and the other subjects were classified as the normal group. Logistic regression was used to assess the association between nutrient intake and DDS after controlling for mediators. Results: The risk of osteoporosis was 2.38 times lower in the 50–65 age group than in the 75 years and older group. The mediators affecting the incidence of osteoporosis by age group were sex, age, household income level, and education level in the 50–64 age group; sex, education level, drinking, and BMI in the 65–74 age group; and sex, age, current smoking, drinking, BMI, and energy intake in the 75 years and older group. The effect of nutrient intake on osteoporosis, with the exception of vitamin B1, was fully mediated by these mediators. The effect of vitamin B1 was partially mediated by mediators in the age group of 65–74 years, and vitamin B1 was effective for preventing the risk of osteoporosis by 25% when consumed over EAR. The effect of DDS was partially mediated in the age group of 75 years and older, and DDS of 2 or less increased the risk of osteoporosis by 2.59 times. Conclusion As a result of this study, it is necessary to recommend the balanced intake of various foods including grains, meat·fish·legumes, vegetables, fruits, and dairy products as dietary guidelines for the prevention of osteoporosis and promotion of bone health in the elderly.