BACKGROUND: For the purpose of early detection of breast cancer, a localization biopsy is necessary in case of mammographically or ultrasonographically suspicious, but nonpalpable, breast lesions. METHODS: One hundred nine consecutive localization biopsies for nonpalpable lesions of the breast were performed upon 101 patients from May 1992 to September 1998. RESULTS: The localizations were done in 48 cases under the guidance of mammography and in 61 cases under the guidance of ultrasonography. Complications occurred in 15 cases (13.7%). The mean volume of the excised specimens was 11.6 cm3. The miss rate was 3.6% (4 cases). Malignant lesions of the breast were found in 16 cases (14.7%). Among the malignant lesions, 10 cases involved invasive ductal cancer. Among the patients diagnosed as having breast cancer, 8 patients were treated with a conservative operation, 5 patients with a modified radical mastectomy, and 2 patients with observation; 1 patient was discharged. The chance of a biopsy containing a malignant lesion was 16.7% if the biopsy was done because of mass, 9.8% for a microcalcification, and 11.1% for an abnormal asymmetric density. CONCLUSIONS: A needle localization biopsy can be performed accurately under local anethesia, and the volume of the excised specimen can be minimized, so the cosmetic effect is excellent and proper early treatment is possible in diagnosed cases of breast cancer.
Biopsy* ; Breast Neoplasms ; Breast* ; Humans ; Mammography ; Mastectomy, Modified Radical ; Needles* ; Ultrasonography

To understand better the complex natural course of HBV infection, the expression patterns of HBcAg and HBsAg in the liver of 51 inactive serum HBsAg carriers (24 CPH and 27 NPD) were studied by immunohistochemical methods. The inactive serum HBsAg carriers were devided into 3 groups by the following expression patterns of serum HBeAg/anti-HBe status and tissue HBcAg and HBsAg. Pattern A (18 cases) : HBeAg+, cHBcAg+ (94.4%), mHBsAg+ (61.1%), pATTERN B (14 cases) : anti-HBe+, nHBcAg+, cHBsAg+, Pattern C (19 cases) : anti-HBe+, HBcAg-, cHBsAg+ (89.5%). There were no significant differences between CPH and NPD, lthough the core free pattern was more common in the latter. The cHBcAg was expressed in 17 of 18 (94.4%) HBeAg seropositive cases but only one of 33 cases with serum anti-HBe, suggesting that the cHBcAg is intimately related to HBeAg. Since the inactive HBsAg carriers also expressed cHBcAg and/or mHBsAg, the necro-inflammatory activity of HBV infected liver is assumed to depend on the host immune response rather than their presence alone

No abstract available.
Electromyography* ; Hand* ; Humans ; Muscle Spasticity* ; Stroke*

Laryngoscopy and intubation cause an adrenergic response manifested by tachycardia and hypertension. Various phamacological agents have been administered prior to induction in an attempt to attenuate the adrenergic response but they all have limitations. The objective of our study was to determine if esmolol would be equally effective when adrninistered in a bolus with and without fentanyl. A double-blind, randomized trial was conducted in sixty ASA physical status 1 patients undergoing elective surgery. All patients were premedicated with 0.2 mg/kg diazepam orally and glycopyrrolate 0.04 mg/kg intramuseularyly 1 hour beforehand. Induction of anesthesia was accomplished with 4 mg/kg thiopental intravenously foUowed immediately by 0.15-0.2 mg/kg vecuronium and study drug (placebo, esmolol 150 mg, esmolol 150 mg and fentanyl 100 mcg). Endotracheal intubation was performed at 2 minutes after study drug adrninistration. Anesthesia was maintained with 1 MAC (+/-10%) isoflurane in 60% nitrous oxide in oxygen at a 5 L/min flow for 6 minutes. Heart rate and blood pressure were measured every minute by an automatic recording device. After laryngoscopy and intubation, maximum increase in stolic blood pressure above awake levels was 33 mmHg (p<0.05) and 14 mmHg (p<0.05) in esmolol 150 mg, esmolol 150 mg with fentanyl 100 mcg respectively, whereas systolic blood pressure increased 62 mmHg after tracheal intubation in patients with placebo. In six patients with esmolol 150 mg, rate-pressure product reached a level considered potentially dangerous to patients with coronary artery disease. However, when used with fentanyl, esmolol provides effectvie protection against the adrenergic response and increase of the rate-pressure product to laryngoscopy and intubation.
Anesthesia ; Blood Pressure* ; Coronary Artery Disease ; Diazepam ; Fentanyl* ; Glycopyrrolate ; Heart Rate* ; Heart* ; Humans ; Hypertension ; Intubation ; Intubation, Intratracheal* ; Isoflurane ; Laryngoscopy ; Nitrous Oxide ; Oxygen ; Tachycardia ; Thiopental ; Vecuronium Bromide

The nfa1 gene was cloned from a cDNA library of pathogenic Naegleria fowleri by immunoscreening; it consisted of 360 bp and produced a 13.1 kDa recombinant protein (rNfa1) that showed the pseudopodia-specific localization by immunocytochemistry in the previous study. Based on the idea that the pseudopodia-specific Nfa1 protein mentioned above seems to be involved in the pathogenicity of N. fowleri, we observed the effect of an anti-Nfa1 antibody on the proliferation of N. fowleri trophozoites and the cytotoxicity of N. fowleri trophozoites on the target cells. The proliferation of N. fowleri trophozoites was inhibited after being treated with an anti-Nfa1 polyclonal antibody in a dose-dependent manner for 48 hrs. By a light microscope, CHO cells co-cultured with N. fowleri trophozoites (group I) for 48 hrs showed severe morphological destruction. On the contrary, CHO cells co-cultured with N. fowleri trophozoites and anti-Nfa1 polyclonal antibody (1: 100 dilution) (group II) showed less destruction. In the LDH release assay results, group I showed 50.6% cytotoxicity, and group II showed 39.3%. Consequently, addition of an anti-Nfa1 polyclonal antibody produced a decreasing effect of in vitro cytotoxicity of N. fowleri in a dosedependent manner.
Animals ; Antibodies, Protozoan/*immunology ; Antigens, Protozoan/genetics/*immunology ; CHO Cells ; Dose-Response Relationship, Immunologic ; Female ; Hamsters ; Mice ; Mice, Inbred BALB C ; Naegleria fowleri/growth & development/immunology/*pathogenicity ; Protozoan Proteins/genetics/*immunology ; Recombinant Proteins/immunology ; Support, Non-U.S. Gov't

In our previous study, we observed that hydrosalpingeal fluid (HSF) adversely effect mouswe embryo development and hatching. The aim of this study was to evaluate the effect of HSF as assessed by the blastocyst development rate (BDR) and by cell counting in vitro HSF was collected from nine patients undergoing salpingoneostomy to correct hydrosalpinx. Two-cell embryos were obtained from superovulated ICR mice. T6 medium and T6+/-0.4% bovine serum albumin were used as control media. T6 medium containing 10% or 50% HSF and 100% HSF from each patient were used as test media. Nine to 15 embryos were cultured in microdrops prepared from each of these media. To assess the total cell number within each blastocyst, the blastocysts were fixed and stained with Hoechst 33342 to facilitate cell counting. The mean BDR in two control media were 88.89% and 85.40%. The mean BDR in media containing 10%, 50%, 100% HSF were 85.87%, 89.58% and 75.57%, respectively (*: p<0.05). The overall mean cell count (+/-SEM) in control media were 87.6+/-9.65 and 90.12+/-11.38. The BDR was affected adversely only by 100% HSF and not in media containing 10% or 50% HSF. Mean cell counts were decreased significantly only in blastocysts cultured 100% HSF (63.8+/-13.66; p<0.01) but not in blastocysts cultured in 10% or 50% HSF (91.3+/-12.44 and 82.9+/-18.27, respectively). Thus, it is concluded that HSF has no embyotoxic effect but has a mildly negatively effect on embryonic growth and development.
Animals ; Blastocyst ; Cell Count ; Embryonic Development ; Embryonic Structures* ; Female ; Growth and Development ; Humans* ; Mice* ; Mice, Inbred ICR ; Pregnancy ; Serum Albumin, Bovine

PURPOSE: To assess diagnostic efficacy of the MRI in thoracolumbar fractures, especially in changes of bone and soft tissue which cannot be documented by other diagnostic tools. MATERIALS AND METHODS: Among 85 patients managed for thoracolumbar fractures between January 1997 and June 2003, MRI was performed in 30 patients to get more informations. Plain X-ray, CT and MRI of these cases were reviewed retrospectively by two orthopaedic spine surgeons and one radiologist to investigate the informations which only MRI could afford. RESULTS: 14 (46.7%) among 30 patients had occult fractures of vertebrae other than main fracture which had not been diagnosed as fractured. Besides 6 patients who showed distraction of posterior structure on plain X-ray, injury of posterior ligament complex was confirmed by MRI in 12(40%) patients. Additionally, MRI visualized other soft tissue injuries such as intramuscular and subcutaneous hematoma, changes of the spinal cord and intervertebral disc. In 16 among 30 patients, informations achieved from MRI were the most important factors in deciding treatment modality. CONCLUSION: MRI seems to be efficient in visualizing not only soft tissue injury such as ligament but also occult fractures of additional vertebra in thoracolumbar fractures, therefore MRI seems to be an important diagnostic tool in decision of treatment modalities, especially in cases of uncertain stability.
Fractures, Closed ; Hematoma ; Humans ; Intervertebral Disc ; Ligaments ; Magnetic Resonance Imaging* ; Retrospective Studies ; Soft Tissue Injuries* ; Spinal Cord ; Spine

The pulmonary thromboembolism (PTE) developes occasionally in trauma, surgery and pregnancy. It presents dyspnea, tachycardia, syncope, hypotension and may be fatal by right heart failure. Severe intraoperative PTE is rare. But an intraoperative PTE occurs, it is difficult to diagnose with classic diagnostic measures such as ventilation-perfusion scan, pulmonary angiography, so appropriate management may be delayed. We experienced a case of severe PTE during Ceaserian section of placenta previa totalis. The patient survived and showed complete resolution after 1-year follw-up.
Angiography ; Dyspnea ; Heart Failure ; Humans ; Hypotension ; Placenta Previa* ; Placenta* ; Pregnancy ; Pulmonary Embolism* ; Syncope ; Tachycardia

No abstract available.
Depression ; Humans ; Lung ; Transplants

Intracytoplasmic sperm injection (ICSI) recently has been utilized widely as the most successful technique to overcome the unfertilization problem in cases of severe male infertility in couples who could not be treated by conventional IVF. Recently, indications of ICSI have been extended further and more fertilized oocytes become available. Thus, it is necessary to examine the efficiency of freezing the surplus embryos obtained from ICSI. We compared the survival rate and the future outcome of cryopreserved embryos obtained either after conventional IVF or ICSI during the same period. After ICSI or IVF, five best-quality embryos from each patient were transferred in the stimulation cycle and the surplus pronuclear (PN) stage oocytes or multicellular embryos were cryopreserved by slow freezing protocol with 1,2-propanediol (PROH) as a cryoprotectant.4 total of 792 embryos from ICSI trial were thawed and 65.2% (516/792) survived. The survival rates of PN stage oocyte, multicellular embryo and PN + multicellular embryo were 63.5%, 68.2%, 64.0%, respectively. After 111 transfers, 34 pregnancies were achieved, corresponding to a clinical pregnancy rate of 30.6% per transfers. We thawed 1033 embryos from IVF trials and 57.5% (594/1033) survived. In IVF cycle, the survival rates of PN stage oocyte, multicellular embryo and PN + multicellular embryo were 58.2%, 65.2%, 40.2%, respectively. Thirty eight clinical pregnancies were established after 134 transfers, corresponding to a pregnancy rate of 28.4% per transfer The cleavage rate of thawed PN stage oocytes from ICSI trial (61.3%) was significantly higher than those from conventional IVF (53.4%). The developmental rates of good embryo (> or = grade II) in thawed PN stage oocytes obtained from conventional IVF and ICSI were 63% and 65%, respectively. We concluded that PN stage oocytes, multicellular embryos resulting from ICSI procedure can be successfully frozen/thawed with reasonable clinical pregnancy rates comparable to those of IVF.
Embryonic Structures* ; Family Characteristics ; Fertilization in Vitro* ; Freezing ; Humans ; Infertility, Male ; Male ; Oocytes ; Pregnancy ; Pregnancy Rate ; Propylene Glycol ; Sperm Injections, Intracytoplasmic* ; Survival Rate