PURPOSE: To evaluate non-sentinel lymph node (LN) status after sentinel lymph node biopsy (SNB) in patients with breast cancer and to identify the predictive factors for disease failure. MATERIALS AND METHODS: From January 2006 to December 2007, axillary lymph node (ALN) dissection after SNB was performed for patients with primary invasive breast cancer who had no clinical evidence of LN metastasis. A total of 320 patients were treated with breast-conserving surgery and radiotherapy. RESULTS: The median age of patients was 48 years, and the median follow-up time was 72.8 months. Close resection margin (RM) was observed in 13 patients. The median number of dissected SNB was two, and that of total retrieved ALNs was 11. Sentinel node accuracy was 94.7%, and the overall false negative rate (FNR) was 5.3%. Eleven patients experienced treatment failure. Local recurrence, regional LN recurrence, and distant metastasis were identified in 0.9%, 1.9%, and 2.8% of these patients, respectively. Sentinel LN status were not associated with locoregional recurrence (p > 0.05). Close RM was the only significant factor for disease-free survival (DFS) in univariate and multivariate analysis. The 5-year overall survival, DFS, and locoregional DFS were 100%, 96.8%, and 98.1%, respectively. CONCLUSION: In this study, SNB was performed with high accuracy and low FNR and high locoregional control was achieved.
Breast Neoplasms* ; Disease-Free Survival ; Follow-Up Studies ; Humans ; Lymph Nodes ; Mastectomy, Segmental ; Multivariate Analysis ; Neoplasm Metastasis ; Radiotherapy ; Recurrence ; Sentinel Lymph Node Biopsy* ; Treatment Failure

Intestinal hemorrhage, perforation, obstruction, and fistula formation are the common complications associated with intestinal tuberculosis. However, these complications usually occurr in active stage of intestinal tuberculosis. A 45-year-old man was diagnosed as intestinal tuberculosis and received anti-tuberculosis medications for 9 months. After the end of treatment, intestinal lesion was cured. However a deformed appendiceal orifice due to hypertrophic sear resulting in symptomatic appendictis was noted. We report a case of acute appendicitis due to intestinal stricture after the successful treatment of intestinal tuberculosis.
Acute Disease ; Antitubercular Agents/therapeutic use ; Appendicitis/*diagnosis/etiology/surgery ; Colonoscopy ; Diagnosis, Differential ; Humans ; Male ; Middle Aged ; Tomography, X-Ray Computed ; Tuberculosis, Gastrointestinal/complications/*drug therapy

Idiopathic portal hypertension (IPH) is characterized by portal hypertension and splenomegaly without portal vein obstruction or significant liver disease. Although IPH may occasionally be accompanied by portal vein thrombosis (PVT) and extrahepatic portal vein thrombosis (EHPVT), recurrent PVT and EHPVT are very rare in IPH. Herein, we report the case of a 30-year-old male who developed IPH with recurrent PVT and EHPVT. Eleven years earlier, the patient had undergone splenectomy and endoscopic sclerotherapy due to hypersplenism and esophageal variceal bleeding, respectively. Ten years earlier, the patient had suffered recurrent esophageal variceal bleeding, which was treated via band ligation, and was diagnosed with IPH via portography and liver biopsy. Then, 8 years prior to presentation, the patient complained of acute abdominal pain and was diagnosed with PVT and EHPVT. After a 6-month course of anticoagulation therapy, the PVT and EHPVT resolved completely. However, 8 years later, he complained again of abdominal pain and was diagnosed with recurrent PVT and EHPVT.
Abdominal Pain ; Adult ; Biopsy ; Hemorrhage ; Humans ; Hypersplenism ; Hypertension, Portal ; Ligation ; Liver ; Liver Cirrhosis ; Liver Diseases ; Male ; Mesenteric Veins ; Pancytopenia ; Portal Vein ; Portography ; Sclerotherapy ; Splenectomy ; Splenomegaly ; Thrombosis

OBJECTIVE: Juvenile rheumatoid arthritis (JRA) is classified as polyarticular, oligoarticular, and systemic onset type by clinical symptoms presented during first six months. This study was performed to investigate the clinical features and course of systemic onset JRA. METHODS: We performed a retrospective study for patients who were diagnosed as JRA between March 2000 and March 2006 according to the JRA criteria of the International League of Association for Rheumatology (ILAR). RESULTS: Of the 216 JRA patients, 33 patients (11 male/ 22 female) were systemic onset type. Because of insufficient data, 6 patients were excluded. Chief complaints at the time of diagnosis were fever (81.5%) and arthralgia (77.7%). During the disease course, all patients manifested fever and arthritis, rash (59.2%) and splenomegaly (22.2%) also occurred. Most patients had symmetric (81.5%) arthritis, and involved more than five joints (59.3%) including knee and wrist. Anemia, leukocytosis, and thrombocytosis were common laboratory abnormalities. Almost all patients had elevated level of C-reactive protein and erythrocyte sediment rate. Some patients had positive results about immunologic marker such as rheumatoid factor (3.8%), antinuclear antibody (57.7%), and antiperinuclear factor (9.5%). Therapeutic regimens included glucocorticoids (88.9%), nonsteroidal anti-inflammatory drugs (81.5%), methotrexate (81.5%), and hydroxychloroquine (55.6%). Biologic agents were applied in 5 patients, and 3 showed improvement of disease activity. Combination therapy was introduced in 18.5% of patients, and 63% of patients still required medications. CONCLUSION: In Korea, systemic onset JRA patients had variable clinical manifestations and chronic course of disease, which often extended into adulthood.
Anemia ; Antibodies, Antinuclear ; Arthralgia ; Arthritis ; Arthritis, Juvenile* ; Biological Factors ; Biomarkers ; C-Reactive Protein ; Diagnosis ; Erythrocytes ; Exanthema ; Fever ; Glucocorticoids ; Humans ; Hydroxychloroquine ; Joints ; Knee ; Korea ; Leukocytosis ; Methotrexate ; Retrospective Studies ; Rheumatoid Factor ; Rheumatology ; Splenomegaly ; Thrombocytosis ; Wrist

Intravenous immunoglobulin (IVIG) therapy has been introduced to idiopathic dilated cardiomyopathy due to their antiviral and anti-inflammatory effects. But each study reported conflicting result and treatment regimen has not been clearly established. We experienced a case of 28-year-old woman with idiopathic dilated cardiomyopathy with severely depressed cardiac function. Its onset time was obvious within 1 month. Despite of conservative treatment of heart failure, sudden cardiac arrest was developed. We tried IVIG therapy, and her symptoms and cardiac function were improved after IVIG treatment.
Adult ; Cardiomyopathy, Dilated* ; Death, Sudden, Cardiac ; Female ; Heart Failure ; Humans ; Immunoglobulins ; Immunoglobulins, Intravenous*