In this study of 64 cases of breast cancer with a clinical follow-up period of more than 5 years, several prognostic factors were evaluated. The purpose of this study was to determine whether any one parameter or group of parameters serves as adequate predictors of tumor behavior and patient's prognosis. Several prognostic factors included clinicopathological variables (patient's age, histologic grade, status of lymph node (LN) metastasis, and tumor size), expression of estrogen receptor (ER), progesterone receptor (PR), p53, bcl-2 and CD44 by immunohistochemistry, and DNA ploidy pattern. The results showed that the expression of ER and PR had a significant inverse correlation with the histologic grade (ER, p=0.05; PR, p<0.05). The expression of p53 protein showed a significant relationship with high histologic grade of tumor (p<0.05). The expression of bcl-2 protein was preferably seen in low histologic grade of tumor (p<0.05) and significantly associated with ER positive or PR positive tumors (ER, p<0.05; PR, p<0.05). This results suggest that bcl-2 protein might play significant roles in ER and PR. The CD44 expression showed a significant relationship with tumor size (p<0.05). The large size and aneuploidy pattern of tumor had a tendency to be associated with shorter patient survival. Cox's multivariate analysis showed that overall survival was affected by LN metastasis because of the shorter survival in patients with LN metastasis. In conclusion, tumor size, DNA ploidy pattern, and LN metastasis were themselves significant predictors of breast cancer survival rate.
Aneuploidy ; Breast Neoplasms ; Breast* ; Carcinoma, Ductal* ; DNA* ; Estrogens ; Follow-Up Studies ; Humans ; Immunohistochemistry ; Lymph Nodes ; Multivariate Analysis ; Neoplasm Metastasis ; Ploidies* ; Prognosis ; Receptors, Progesterone ; Survival Rate

The retinoblastoma (Rb)/cyclin D1/p16 pathway is an important constituent of cell cycle regulation. Perturbations in this pathway due to a variety of genetic aberrations have been reported in many human cancers including breast cancer. We examined the significance of immunoexpression of p16 protein, cyclin D1 protein, Rb protein (pRb), and p53 protein in 128 cases of invasive breast carcinoma. The results were correlated with survival rate and clinicopathological variables, including age, histologic grade, lymph node status, tumor size, estrogen receptor (ER), and progesterone receptor (PR) content. Abnormal expressions of p16 and pRb which were defined as negative staining were seen in 21% and 43% of tumors, respectively. There was a significant inverse relationship between p16 and pRb expression. There was no correlation between p16 staining and any other parameters, including survival rate, cyclin D1, p53, and clinicopathologic variables. Surprisingly, there was a trend for tumors which were positive for pRb to be grade III ductal carcinomas. Cyclin D1 positivity was noted in 46% of cases. The expression of cyclin D1 protein was significantly higher in lower histologic grade, higher ER and PR expression. The expression of p53 protein showed a significant correlation with high tumor grade. In a Cox multivariate analysis, neither p16, pRb, cyclin D1 nor p53 was an independent predictor, but tumor size and lymph node status were independent predictors of patient outcome.
Breast Neoplasms ; Breast* ; Carcinoma, Ductal* ; Cell Cycle ; Cyclin D1* ; Cyclins* ; Estrogens ; Humans ; Lymph Nodes ; Multivariate Analysis ; Negative Staining ; Receptors, Progesterone ; Retinoblastoma ; Retinoblastoma Protein ; Survival Rate

PURPOSE: To describe the appearance and average thickness of the internal anal sphincter with anal endosonography in healthy Korean adults. MATERIAL AND METHODS: 184 subjects(male: 96, female: 88) with no history of anorectal disease or surgery were studied with anal endosonography. The average thickness of internal sphincter was meas ured at the mid-anal canal. For the internal sphincter, which is often asymmetric, the thickness of each 4 part(12, 3, 6 and 9 o'clock direction) were measured in left lateral decubitus position. RESULTS: The anal wall was well visualized in 5 layers(mucosa, submucosa, internal anal sphincter, intersphincteric plane, external anal sphincter) with anal endosonography. The anal endosonogram showed the internal anal sphincter as a homogenous, well-defined, hypoechoic, circular band, and slightly asymmetric. The average thickness of the internal anal sphincter in the area of mid-anal portion was 2.0 0.3 mm(range: 1~3 mm). There was no sexual difference; however, a significant positive correlation with age was found in average thickness of the internal anal sphincter. The correlation with lean body mass was not found. CONCLUSION: The internal anal sphincter is well-visualized, best defined structure by anal endosonography. Average thickeness of the sphincter in Korean appeared to be the same as in the Western.
Adult* ; Anal Canal* ; Endosonography ; Female ; Humans

PURPOSE: There has been controversy of the lobectomy for well differentiated thyroid cancer (WDTC). Current guidelines recommend total thyroidectomy for the cancer over 1cm, despite previous report suggesting that the lobectomy provides similar excellent outcomes. The purpose of our study is to report our experience of WDTC treated by thyroid lobectomy. METHODS: We retrospectively analyzed 284 patients with WDTC treated by thyroid lobectomy at department of Surgery in Chosun University Hospital from January 2002 to December 2010. Overall survival (OS) and disease-free survival (DFS) were determined by the Kaplan-Meier method. Factors predictive of recurrence by univariate and multivariate analysis were determined using the χ2 test and Cox proportional hazard model respectively. RESULTS: With a mean follow-up of 60.4 months, OS and RFS for all patients were 97.9% and 96.5% respectively. No patient died due to WDTC. Univariate analysis showed statistically significant differences in recurrence by tumor size (P=0.013) and presence of invasion (P=0.039). However, Multivariate analysis showed no significant difference in local recurrence. CONCLUSION: Patients with WDTC confined to one lobe can be safely treated by lobectomy.
Disease-Free Survival ; Follow-Up Studies ; Humans ; Methods ; Multivariate Analysis ; Proportional Hazards Models ; Recurrence ; Retrospective Studies ; Thyroid Gland* ; Thyroid Neoplasms* ; Thyroidectomy

The pathologic standards of multiple primary malignant neoplasms are : 1) Each tumor should be pathologically malignant. 2) Each tumor should be an independent malignancy, and not the result of submucosal or intraepidermal malignant changes. 3) Additional malignancies should not be metastatic. Multiple primary malignant neoplasms which have these standards have been studied continuously, no conclusive evidence for causal relationship has been established. Especially, many reports on the association of breast cancer with thyroid disease or salivary gland tumors have been published, but without any definite evidence. In 1984, Dr. Schenker, however, declared that during an 18-year study, 10,302 cases of breast carcinomas were diagnosed, and, of these, 984 patients(8%) had multiple primary malignant tumors. A significantly higher than expected incidence of second primary cancers occurred at the following five sites : the opposite breast, the salivary glands, the uterine corpus, the ovaries, and the thyroid. The authors report one example of Grave's disease and an other example of pleomorphic adenoma in breast cancer patients.
Adenoma, Pleomorphic ; Breast Neoplasms* ; Breast* ; Female ; Humans ; Incidence ; Neoplasms, Second Primary ; Ovary ; Salivary Glands ; Thyroid Diseases ; Thyroid Gland

Although MDR was previously thought to be predominantly caused by the expression of the MDR1 gene, it is now increasingly believed to be caused by other mechanism. Recently, over-expression of the multidrug resistance-associated protein (MRP) was suggested a possible mechanism for non-Pgp mediated MDR. Recent studies showed that MRP can confer resistance to a wide spectrum of natural product drug, but the clinical relevance of MRP-mediated MDR in human cancer is poorly understood. p53 is the most widely known tumor suppressor gene. It has been suggested that mutant p53 is related to abnormal proliferation of cell and some what is been related to cellular apoptosis. To determine the clinical significance of MRP and/or p53 expression in colorectal carcinoma, the authors investigated the expression of the MRP and p53 in 81 cases of primary colorectal carcinoma, the relationship between the MRP and/or p53 expression and clinical parameters including 5-yr. survival rate, and the relationship between the expression of MRP and p53. The results were as follows: 1) Of the 81 colorectal carcinomas, 36 (42%) were MRP positive and 28 (34%) were p53 positive. 2) The expression of MRP and/or p53 was not significantly correlated with sex, age, histologic grades, tumor invasion, tumor location, tumor size, lymph node metastasis, TNM stage and survival of patients. In conclusion, these results suggest that expression of MRP and/or p53 is neither related to the known prognostic factors nor a prognostic factor by itself.
Apoptosis ; Colorectal Neoplasms* ; Genes, Tumor Suppressor ; Humans ; Lymph Nodes ; Multidrug Resistance-Associated Proteins ; Neoplasm Metastasis ; Prognosis ; Survival Rate

BACKGROUND: Conventional treatment for mesothelioma is largely ineffective. We evaluated the novel approach of adenoviral gene transfection of PTEN gene in mesothelioma cancer cell lines, inflammatory and epithelial subtype, which are sensitive to adenoviral p53. MATERIAL AND METHOD: Binary adenoviral PTEN and LacZ (Ad/GT-LacZ and Ad/GV16) vectors were used for transduction of the mesothelioma cell lines, REN (p53 sensitive). Protein levels were determined by Western blotting assay. Apoptosis was assessed by fluorescence-activated cell sorter analysis of subdiploid populations. Cell viability was determined with the XTT assay. Statistical analysis was performed with analysis of variance and the Student t test. RESULT: 72 hours after the treatment of adenoviral PTEN gene, cell killing were 32.9% for REN compared to control cell (2.5%) at MOI of 20. Also we observed the over-expression of proapoptotic protein, bax and decreased expression of bcl-2 protein in REN cells. But the expression of BCL-xl, Bak, Bad proteins were not altered. CONCLUSION: Adenovirus Pten-mediated overexpression of the Bax gene induces apoptosis and decreased cellular viability in p53-sensitive mesothelioma cells. These data suggest that the transfection of PTEN gene may represent a alternative gene therapy strategy to treat mesothelioma.
Adenoviridae ; Apoptosis ; bcl-Associated Death Protein ; Blotting, Western ; Cell Death ; Cell Line ; Cell Survival ; Genetic Therapy ; Homicide ; Humans ; Mesothelioma* ; Transfection

Bilateral breast cancer developed in a 45-year-old woman who received a renal transplant followed by immunosuppression with Cyclosporine. She underwent a left modified radical mastectomy, and right breast conserving surgery, with both axillary lymph nodes being dissect. Few cases have been reported on breast cancer associated with renal transplantation. Although a causal relationship with immunosuppression therapy and breast carcinoma was not implied, a heightened awareness of the possible coexistence of immunosuppression therapy and breast carcinomas are necessary.
Breast Neoplasms* ; Breast* ; Cyclosporine ; Female ; Humans ; Immunosuppression ; Kidney Transplantation ; Lymph Nodes ; Mastectomy, Modified Radical ; Mastectomy, Segmental ; Middle Aged

Proliferative myositis is very rare and was first described as a specific entity in 1960 by Kern. Proliferative myositis is a benign reactive condition that appears as a rapidly growing mass in the proximal muscles of the extremities of adults. Proliferative myositis can be confused with sarcoma clinically as well as microscopically. Proliferative myositis is a bizarre, self-limiting fibroblastic proliferation, the presence of very large basophilic cells with vesicular nucleoli and very prominent nucleoli which resemble ganglion cells or rhabdomyoblast, the cause of which is unclear. The symptoms are non-specific and the diagnosis always rests on a histological examination of the tissue. Local excision is curative and recurrence or metastasis has not been reported even when the abnormal tissue has not been completely excised. The authors report a case of Proliferative myositis in a 59-year-old male.
Adult ; Male ; Female ; Humans

PURPOSE: A papillary thyroid microcarcinoma (PTMC) measures 1 cm or less in diameter. The diagnosis, and thus the apparent incidence, of PTMC has recently increased owing to an increase in the detection of subclinical small and low-risk carcinomas with ultrasonography and fine needle aspiration cytology. However, central neck lymph node metastasis (CLNM) can occur in patients with PTMC. We evaluated the factors influencing CLNM in patients with PTMC. METHODS: We reviewed medical records including clinical information and pathologic reports, and analyzed 622 patients with PTMC who underwent thyroid surgery from January 2002 to December 2012. RESULTS: CLNM was detected in 119 patients (19.1%) of the 622 with PTMC. Lymph node metastasis occurred more frequently in males (P=0.025), and those with bilateral tumors (P=0.016), more than two tumors (P=0.035), tumor size greater than 5 mm (P<0.001), and lymphovascular invasion (P=0.024). There were no statistically significant differences in age and capsular invasion. Multivariate analysis showed that significant factors affecting lymph node metastasis included age at operation (odds ratio [OR]=0.647, 95% confidence interval [CI]=0.422∼0.990, P=0.045), sex (OR=0.489, 95% CI=0.268∼0.891, P=0.020), tumor size (OR=3.034, 95% CI=1.761∼5.224, P<0.001), and lymphovascular invasion (OR=15.036, 95% CI=1.450∼155.911, P=0.023). CONCLUSION: Age less than 45 years, male sex, tumor size greater than 5 mm, and lymphovascular invasion were risk factors associated with CLNM.
Biopsy, Fine-Needle ; Carcinoma, Papillary ; Diagnosis ; Humans ; Incidence ; Lymph Nodes* ; Male ; Medical Records ; Multivariate Analysis ; Neck* ; Neoplasm Metastasis* ; Risk Factors ; Thyroid Gland* ; Ultrasonography