No abstract available.

PURPOSE: Since the publication of the 5th edition of the AJCC cancer staging manual in 1997 (old stage), significant developments have occurred in the field of breast cancer diagnosis and management; therefore, it was revised at 2002 (new stage). There are few reports comparing the changes in prognosis in relation to the changes in the staging system. The aims of this study were to evaluate the changes in patient distribution and prognosis according to the changes in the staging system and to elucidate the efficacy of new staging system. METHODS: The records of 1, 275 patients who underwent an operation for breast cancer at Yeung-Nam University Hospital between 1987 and 2003 were reviewed. The pathological stage was assigned retrospectively according to the 5th and the 6th AJCC staging criteria. The patient distributions by stage, nodal status, 5-year relapse free survival (RFSR) and overall survival rates (OSR) were retrospectively compared. RESULTS: Five hundred and five of 616 stage II patients according to the 1997 classification system were also stage II according to the 6th AJCC staging system. The number of patients with stages IIA and IIB decreased from 370 and 246 (old stage) to 342 and 165 (new stage), respectively. Conversely, the number of patients with stage III increased from 158 (old stage) to 271 (new stage). The five-year RFSR for patients with stage I, IIA, IIB, and IIIA were 94.2, 87.1, 74.3, and 48.8% according to the old stage (P<0.0001), and 95.2, 87.8, 81.7, and 66.8%, respectively, according to the new stage (P<0.0001). The five-year OSR for patients with stage I, IIA, IIB, and IIIA were 98.7, 94.3, 86.1, and 63.5% according to the old stage (P<0.0001), and 98.7, 95.7, 96.5, and 72.9%, respectively, according to the new stage (P<0.0001). The RFSR and OSR for stage IIIC were 42.0 and 59.5%, respectively. There was significant difference in the five-year OSR for stages IIB and IIIA (P=0.0308 and P=0.0132, respectively). CONCLUSION: In our study, the 6th AJCC staging system shifted poorer prognostic cohort of each stage toward a higher stage compared to the 1997 version. Therefore, the survival rate for any one stage assigned by 2002 staging system was also improved. In conclusion, it is imperative that careful attention is devoted to this effect so that accurate conclusions regarding the efficacy of new treatment can be drawn.
Breast Neoplasms* ; Breast* ; Classification ; Cohort Studies ; Diagnosis ; Humans ; Joints* ; Neoplasm Staging ; Prognosis ; Publications ; Recurrence ; Retrospective Studies ; Survival Rate

Among many adverse effects of docetaxel, fluid retention is a well recognized, cumulative side effect, but severe fluid retention is rare. We report here on a case of docetaxel-induced severe fluid retention with peripheral edema, pleural effusion, severe ascites and pericardial effusion in a 41-year-old woman. She had been treated with 3 cycles of docetaxel 9 days previously and she was admitted to our hospital due to abdominal distention and mild dyspnea. Radiologic studies revealed pleural effusion, severe ascites and a small pericardial effusion. Diuretics were given for 21 days. The pleural effusion was resolved after treatment with diuretics for 2 days, but the ascites wasn't resolved until 14 days of diuretics. After treatment with diuretics for 21 days, all the symptoms of the patient were completely resolved. Early detection is mandatory and diuretics are very effective for patient suffering with docetaxel-induced severe fluid retention.
Adult ; Ascites ; Breast ; Breast Neoplasms ; Diuretics ; Dyspnea ; Edema ; Female ; Fluid Shifts ; Humans ; Pericardial Effusion ; Pleural Effusion ; Retention (Psychology) ; Stress, Psychological ; Taxoids

Rhabdomyolysis is an acute disorder resulting from skeletal muscle injury in which intracellular contents are released into extracellular space and plasma. The condition may result from drug or alcohol overdose, infection, crush injuries, collagen disease, or intensive exercise. We report two cases of acute rhabdomyolysis resulting from CO poisoning and alcohol overdose, and discuss the MRI and ultrasonographic findings.
Collagen Diseases ; Extracellular Space ; Magnetic Resonance Imaging ; Muscle, Skeletal ; Plasma ; Poisoning ; Rhabdomyolysis*

PURPOSE: The aim of this study was to evaluate the prognostic significance of the breast volume in primary breast cancer patients with the same T stage. METHODS: The study population consisted of 358 patients with T1 and T2 primary breast cancer, who underwent preoperative mammography and surgery in our institution from March 1992 to December 2006. The patients were divided into three groups based on the calculated breast volume as the following: Group A: <285 cc (n=117), Group B: 285-460 cc (n=121) and Group C: > or =460 cc (n=120). Overall survival (OS) and disease free survival (DFS) of the patients in the three groups in each T stage were analyzed. RESULTS: The mean age was 46.3 years (age range, 22-85 years) and the mean calculated breast volume was 403.1 cc (volume range, 94-1,231 cc). As the age of patients was increased, the breast volume was increased (r=0.184, p<0.001). With a mean follow up period of 80.8 months, there was no significant difference in DFS or OS among patients in Groups A, B, and C (p>0.05). For patients with T1 stage disease, Group A patients showed the highest DFS and OS, and patients in Group C showed the lowest DFS and OS; however, the difference was not statistically significant (p>0.05). For patients with T2 disease, patients in Group C showed the highest DFS and OS, though the difference with the two other groups did not have statistical significance (p>0.05). CONCLUSION: The breast volume was not a significant predictor of DFS and OS for patients with T1 and T2 breast cancer. However it should be noted that this was the first study to evaluate the correlation between breast volume and survival in breast cancer patients.
Breast ; Breast Neoplasms ; Disease-Free Survival ; Follow-Up Studies ; Humans ; Mammography ; Organ Size ; Prognosis

PURPOSE: The aim of this study was to confirm the feasibility of the technique, the so called "axillary reverse mapping (ARM)", and to test the hypothesis that the arm lymphatics are never involved by the metastatic process of breast cancer. METHODS: We reviewed the prospectively maintained database of 129 patients who underwent an operation for breast cancer. Blue dye was injected in the upper inner arm to identify the draining lymphatics or lymph nodes from the arm. During the axillary procedure, we found the "blue" ARM node and the "hot" sentinel lymph node (SLN). The histological results of the ARM nodes were compared with those of the other nodes harvested in SLN biopsy (SLNB) or axillary lymph node dissection (ALND). RESULTS: The ARM nodes were identified in 78.3% (101/129) of the patients. The ARM nodes were identified in 71.6% (58/81) of the patients with SLNB and in 88.4% (38/43) of the patients with SLNB followed by ALND and in all cases with ALND. In 19 of the 96 SLNB cases, the ARM nodes were hot or the SLNs were blue (concordant case), yielding an 18.9% concordant rate between the ARM node and the SLN. Among these 19 concordant cases, 7 ARM nodes contained metastasis (36.8%). But in the 77 non-concordant cases, only one ARM node was positive for metastasis (1.3%) in a heavily metastasized axilla. The ARM nodes were identified in all five ALND cases, and one ARM node was positive for metastasis. CONCLUSION: It is thought that lymphatic drainage from the arm can share common lymphatic channels in the axilla with lymphatic flow from breast, and these concordant ARM nodes may be involved by the metastatic process of breast cancer. However in the non-concordant cases, ARM nodes will be free from the danger of axillary dissection.
Arm ; Axilla ; Biopsy ; Breast ; Breast Neoplasms ; Drainage ; Humans ; Lymph Node Excision ; Lymph Nodes ; Neoplasm Metastasis ; Nitriles ; Pyrethrins ; Sentinel Lymph Node Biopsy

Acute cerebellitis is a clinically isolated condition showing cerebellar signs such as ataxia, dizziness and dysarthria. Most of them are associated with viral infection, which generally occur in childhood and show benign course without sequelae. Tuberculous cerebellitis is very rare and its outcome is not well described. The aim of this study is to describe the clinical features and course in a patient with tuberculous cerebellits. We will also discuss the possible prognostic factors in acute cerebellitis.
Adult ; Ataxia ; Cerebellum ; Dizziness ; Dysarthria ; Encephalitis ; Humans ; Tuberculosis

Spindle cell lipoma is a relatively rare adipocytic neoplasm that is easily mistaken for a liposarcoma, and is histologically characterized by a mixture of uniform spindle cells and mature fat cells. It occurs predominantly in male patients aged 45~65 years, and in most cases it arises in the subcutaneous tissue of the neck or shoulder. We report a case of a 45-year-old woman with spindle cell lipoma arising from the left pleural cavity.
Female ; Male ; Humans

Coronary artery bypass grafting on the beating heart is no longer new to any cardiac surgeon. What matters nowadays is stablizing the heart without impairing the hemodynamics. We describe a simple and safer technique to move the anterolateral coronary to a center in the operation field. The empty blood bag connected to 50 cc syringe is put underneath the left venricle. Simply inflating the air into the blood bag gradually displaces the heart and rotate the lateral wall of the ventricle to the midline position. Therefore, we suggest "Blood Bag" method as a different way of exposing heart.
Coronary Artery Bypass ; Heart ; Hemodynamics ; Surgical Procedures, Minimally Invasive ; Syringes

Phenylpropanolamine (PPA) is the major ingredient of over-the-counter drugs, including diet pills and nasal decon-gestants. We present a case of ICH induced by PPA in diet pills in a 36-year-old woman. She didn't have any medical concerns when she began taking diet pills, containing PPA, since 10 days before admission. A brain CT showed large ICHs on the right basal ganglia and lateral ventricle. Physicians should be alerted to the potential fatal side effects of PPA, in commonly used OTC drugs. (J Korean Neurol Assoc 19(3):298~301, 2001)
Adult ; Basal Ganglia ; Brain ; Cerebral Hemorrhage* ; Diet ; Female ; Humans ; Lateral Ventricles ; Nonprescription Drugs ; Phenylpropanolamine*