PURPOSE: To document the radiologic characteristic findings of atypical ductal epithelial hyperplasia, we analyzed film mammographic, ultrasonographic, and MRI findings of our cases. MATERIALS AND METHODS: We analyzed 23 cases of surgically proven ADH, excluding carcinoma in ipsilateral breast. Presence and pattern of neodensity, microcalcification, and architectural distortion were reviewed on mammography. Echo pattern and ductal parenchymal morphology were analyzed on ultrasonography, and enhancement speed and pattern analysis were performed on MRI. RESULTS: On film mammography, ADH showed tendency of neodensity(10 of 23 cases), m icrocalcification(11 of 23 cases), with less parenchymal distortion of surrounding structures(7 of 23 cases). On ultrasonography, ADH was demonstrated as inhomogenous to intermediate echoic nodule(16 of 20 cases) with ragged border(19 of 20 cases), however, its boundary was thin or nearly absent(16 of 20 cases), and showed smooth ductal echography(11 of 20 cases). Gd-DTPA contrast dynamic MR study showed relatively slow and less enhancement in 4 out of 5 cases, with progressive inclination of the speed curve of enhancement in later period of dynamic study. CONCLUSION: Multimodality image approach is needed for better evaluation of ADH, however, excisional biopsy is recommended for confirmative diagnosis and proper treatement.
Biopsy ; Breast* ; Diagnosis ; Gadolinium DTPA ; Hyperplasia* ; Magnetic Resonance Imaging ; Mammography ; Ultrasonography*

Focal nodular hyperplasia is a benign hepatic tumor mainly composed of nodules of hepatocytes and Kupffer cells separated by fibrous septa. In general, it is difficult to differentiate focal nodular hyperplasia and hepatocellular carcinoma on ultrasonography, conventional CT(computerized tomography), and angiography. But IV bolus CT is of particular value in the diagnosis of focal nodular hyperplasia because it can divide enhanced CT into early and late phase and can characterize tumor vascularity and analyze any intratumoral elements. In our case, it was seen as a hypoechoic mass lesion on ultrasonograpl'hy and hyperdense mass lesion on early-phase IV bolus CF and isodense mass, lesion on late-phase IV bolus CT. On angiography, hypertrophy of the feeding artery and tumor staining were well visualized. The patient underwent operation and the mass was pathologically confirmed to a focal nodular hyperplasia. We report the first case of focal nodular hyperplasia on IV bolus CT in Korea.
Angiography ; Arteries ; Carcinoma, Hepatocellular ; Diagnosis ; Focal Nodular Hyperplasia ; Hepatocytes ; Humans ; Hypertrophy ; Korea ; Kupffer Cells ; Liver* ; Ultrasonography

A 76-years old man with a ruptured abdominal aortic aneurysm underwent an emergency abdominal aortic replacement with artificial graft. The patient developed abdominal compartment syndrome at the day of the operation and he received secondary decompression operation the next day. At 45 hours after the second operation the patient was returned to operation room to close the abdominal fascia, and sigmoid colon necrosis was found so we performed sigmoid colectomy with colostomy. After 22 days from the last operation, the abdominal wound was closed completely and the patient was discharged at the 42nd postoperative day with a colostomy state. We report here on this complex case together with a review of the recent articles.
Aged ; Aortic Aneurysm, Abdominal* ; Colectomy ; Colon* ; Colon, Sigmoid ; Colostomy ; Compartment Syndromes ; Decompression ; Emergencies ; Fascia ; Humans ; Intra-Abdominal Hypertension* ; Ischemia* ; Necrosis ; Transplants ; Wounds and Injuries

No abstract available.
Peptic Ulcer Perforation* ; Peptic Ulcer*

No abstract available.
Daegu* ; Humans ; Infant, Newborn* ; Sex Ratio*

PURPOSE: To evaluate the specific findings of infiltrating ductal carcinoma from the ductal carcinoma in situ (DCIS) and to differentiate from the atypical ductal hyperplasia(ADH). MATERIALS AND METHODS: Fifty breast lesions in 48 patients including thirty-six breasts of 36 patients with infiltrating ductal carcinoma, fourteen breasts of 12 patients with DCIS, and nine breasts of 7 patients with ADH were examined with FLASH technique using Gd-DTPA. We evaluated the maximal amount, the speed, and the pattern of enhancement after intravenous injection of Gd-DTPA(0.16mmol/kg body weight). Also we evaluated the diagnostic accuracy in the patients with breast cancer. RESULTS: The maximal amount of enhancement were 1,161.84 +/- 394.44 NU in infiltrating ductal carcinoma, 982.11 +/- 458.35 NU in DCIS, and 1,035.94 +/- 305.20 NU in ADH. The speed of enhancement was 827.33 +/- 384.20 NU within the first 1 minute with a sudden increase in signal intensity after injection and a much slighter in- crease thereafter in infiltrating ductal carcinoma. DCIS showed in creasing signal intensity within the first 2 minutes(749.70 +/- 487.36 NU), and ADH showed significant increased enhancement(765.40 +/- 313.61 NU) at 3 minutes after injection of Gd-DTPA. The patterns of enhancement were focal with irregular margins in infiltrating ductal carcinoma and irregular peripheral enhancement in DCIS and ADH. However, absent or extreme delayed enhancement at the central portion of the tumor was more frequently seen in infiltrating ductal carcinoma rather than DCIS or ADH. CONCLUSION: Gd-DTPA enhanced dynamic MRI was valuable in the diagnosis of breast cancer and in differentiating DCIS from ADH. Furthermore, it was effective in analyzing the extension of breast carcinoma, multiplicity, and bilaterality of breast carcinoma.
Breast Neoplasms* ; Breast* ; Carcinoma, Ductal ; Carcinoma, Intraductal, Noninfiltrating ; Diagnosis ; Gadolinium DTPA* ; Humans ; Injections, Intravenous ; Magnetic Resonance Imaging

PURPOSE: To evaluate the specific findings of infiltrating ductal carcinoma from the ductal carcinoma in situ (DCIS) and to differentiate from the atypical ductal hyperplasia(ADH). MATERIALS AND METHODS: Fifty breast lesions in 48 patients including thirty-six breasts of 36 patients with infiltrating ductal carcinoma, fourteen breasts of 12 patients with DCIS, and nine breasts of 7 patients with ADH were examined with FLASH technique using Gd-DTPA. We evaluated the maximal amount, the speed, and the pattern of enhancement after intravenous injection of Gd-DTPA(0.16mmol/kg body weight). Also we evaluated the diagnostic accuracy in the patients with breast cancer. RESULTS: The maximal amount of enhancement were 1,161.84 +/- 394.44 NU in infiltrating ductal carcinoma, 982.11 +/- 458.35 NU in DCIS, and 1,035.94 +/- 305.20 NU in ADH. The speed of enhancement was 827.33 +/- 384.20 NU within the first 1 minute with a sudden increase in signal intensity after injection and a much slighter in- crease thereafter in infiltrating ductal carcinoma. DCIS showed in creasing signal intensity within the first 2 minutes(749.70 +/- 487.36 NU), and ADH showed significant increased enhancement(765.40 +/- 313.61 NU) at 3 minutes after injection of Gd-DTPA. The patterns of enhancement were focal with irregular margins in infiltrating ductal carcinoma and irregular peripheral enhancement in DCIS and ADH. However, absent or extreme delayed enhancement at the central portion of the tumor was more frequently seen in infiltrating ductal carcinoma rather than DCIS or ADH. CONCLUSION: Gd-DTPA enhanced dynamic MRI was valuable in the diagnosis of breast cancer and in differentiating DCIS from ADH. Furthermore, it was effective in analyzing the extension of breast carcinoma, multiplicity, and bilaterality of breast carcinoma.
Breast Neoplasms* ; Breast* ; Carcinoma, Ductal ; Carcinoma, Intraductal, Noninfiltrating ; Diagnosis ; Gadolinium DTPA* ; Humans ; Injections, Intravenous ; Magnetic Resonance Imaging

Accessory breast is an ectopic breast tissue from developemental remnants. It sometimes begins to make symptoms, pain and swelling, during premenstrual period or pregnancy. For it has been known as a rere condition, it has occasionally misdiagnosed as a abnormal mass, such as lymphadenitis or hidradenitis. We have analyzed 52 accessory breast tissues prospectively, to document the characteristic findings of accessory breast. In summary, the characteristic sonographic findings of accessory breast were the presence of breast tissue superficial to the axillary fascia or underlying fascia if not in axilla, resembling the patient's own breast pattern, the presence of converging appearance of dilated ducts, presence of nipple and/or areola, the obliteration of inner wall of dermis, the obliteration of sucutaneous fat layer, and the downward displacement of axillary fascia or underlying fascia if not in axilla wighout interruption.
Axilla ; Breast* ; Dermis ; Fascia ; Hidradenitis ; Lymphadenitis ; Nipples ; Pregnancy ; Prospective Studies ; Ultrasonography

No abstract available.
Hand*

Cancer is considered to occur through abnormal growth and differentiation processes, in which oncogenes and tumor suppressor genes are deeply related. Cellular responses to DNA-damaging agents are believed to be critical determinants of human tumorigenesis. Cell cycle arrests and DNA repair following DNA damage require the coordination of multiple gene products that, as a whole, serve to maintain the integrity of the genome. Within the cell cycle, both G1-S and G2-M phase transitions are under constant surveillance by checkpoint genes for the protection of cells from either exogenous or endogenous DNA-damaging agents. p53 tumor suppressor gene mediates cell cycle perturbations in response to DNA damage, and play a role in cell death, genetic stability, and cancer susceptibility. Recently, gene therapy with p53 tumor suppressor gene is expected as a new effective therapeutic strategy in many kinds of cancer. By using retroviral vector system, we transduced p53 tumor suppressor gene into human osteosarcoma cells, and analysed its growth suppression and apoptosis inducing effects. Combined effects of p53 gene therapy with chemotherapeutic agent or radiation were also analysed. Titer of ecotrophic p53 retrovirus was 5.0x10/ml, and that of amphotrophic p53 retrovirus was 2.0x10/ml when NIH3T3 cells were used as target cells. Human osteosarcoma cells infected with amphotrophic p53 retroviruses showed increased p21waf1 gene expression, which acts as a major cyclin-dependent kinase inhibitor in DNA damage responses. In normal DMEM media, human skin fibroblasts infected with amphotrophic p53wt retroviruses showed very slow growing (1.7 fold increase in doubling time) and very low saturation density (50% decrease in cell density). In media containing chemotherapeutic agent, human osteosarcoma cells infected with p53wt retroviruses died rapidly; 75% of them died within 4 days and all of them died within 10 days of incubation with chemotherapeutic agent. Their DNAs were extracted and electrophoresed in agarose gel, and we identified DNA ladders characteristic of apoptotic cell death. When human osteosarcoma cells infected with p53 retroviruses were irradiated with ultraviolet light, more than 95% of cancer cells died within 1 day; whereas mock infected cells showed only less than 5% of cell death. These findings suggest that retroviral vector mediated p53 tumor suppressor gene transfer into cancer cells can suppress tumor cell growth and decrease tumor cell density effectively. These findings also suggest that effective induction of tumor cell apoptosis can be obtained when p53 gene therapy is used in combination with chemotherapy or radiotherapy.
Apoptosis ; Carcinogenesis ; Cell Count ; Cell Cycle ; Cell Cycle Checkpoints ; Cell Death ; DNA ; DNA Damage ; DNA Repair ; Drug Therapy ; Fibroblasts ; Gene Expression ; Genes, p53 ; Genes, Tumor Suppressor* ; Genetic Therapy* ; Genome ; Humans ; Oncogenes ; Osteosarcoma ; Phase Transition ; Phosphotransferases ; Radiotherapy ; Retroviridae* ; Sepharose ; Skin ; Ultraviolet Rays ; Zidovudine