PURPOSE: To report the results of 134 cases in which add-on stereotactic core biopsy (ASCB) was performed in patients with mammographically detected breast lesions, and to evaluate the usefulness of this procedure. MATERIALS AND METHODS: We analyzed the results of ASCB of 134 breast lesions in 125 patients, performed during a 41-month period. The mammographic findings were suspicious malignant lesion in 38 cases, benign lesion in 18, and indeterminate lesion in 78. Surgical excision was performed in 23 cases, and follow-up mammography in 39. We analyzed the pathologic results according to each mammographic finding and correlated the results of core biopsy with those of surgical excision. We also evaluated the mammographic changes seen during follow-up, and associated complications and procedural difficulties. RESULTS: Samples were adequate for pathologic diagnosis in 95% of cases (127/134). ASCB revealed malignancy in 47% of cases (18/38) in which this was suspected on the basis of mammographic findings, and in 5% of cases (4/78) in which these findings were indeterminate. The pathologic results of core biopsy and of surgical excision agreed in 78% of cases (18/23). In two of five false-negative cases, ASCB revealed the presence of atypical ductal hyperplasia. The mammographic findings in these five cases were suspicious malignancy in three, and indeterminate in two. Specimen radiography showed calcifications in four cases. The size or extent of mammographic lesions did not change during the mean follow-up period of 17.3 months. In 13/125 patients (10%), the complications and procedural difficulties noted included arterial bleeding, dizziness, syncope, patient movement, and instrument failure. CONCLUSION: ASCB is accurate, safe and useful, but surgical excision should be considered when the ASCB result is either atypical ductal hyperplasia or benign but with mammographic diagnosis of suspicious malignant or indeterminate lesions.
Biopsy* ; Breast* ; Diagnosis ; Dizziness ; Follow-Up Studies ; Hemorrhage ; Humans ; Hyperplasia ; Mammography ; Radiography ; Syncope

PURPOSE: To document the relative usefulness of true Fast-imaging steady-state precession(FISP) comparing to breath-hold turbo spin-echo(TSE), and half-Fourier single-shot turbo spin-echo(HASTE) as a fast T2-weighted sequence during hepatic MR imaging. MATERIALS AND METHODS: For 46 patients with 87 focal hepatic lesions(hepatocellular carcinoma, n=26; metastasis. n=5; cavernous hemangioma, n=37; cyst, n=19), we obtained MR imaging of the liver at 1.5T. True FISP, TSE with and without fat-suppresion(FS), and HASTE with and without FS images were obtained during one breath-hold. Images were compared on the basis of tumor detectability and lesion-to-liver contrast-to-noise ratio(CNR). Qualitative analysis of each imaging sequence was also performed in terms of hepatic contour, visibility of vascular landmarks and imaging artifacts. RESULTS: TSE-FS depicted more focal lesions(78/87, 90%) than other sequences(TSE, 75/87=86%;HASTE, 74/87=85%; HASTE-FS, 75/87=86%;true FISP,73/87=84%). However, there was no statistical significance between each sequence(p> .05). Using true FISP or HASTE, there was a statistically significant difference(p< .01) between the CNRs of solid tumors, crystal and hemangiomas. Additionally, true FISP sequence showed better hepatic contour, vascular landmarks and less artifacts comparing with TSE or HASTE regardless of FS(p< .001). CONCLUSION: True FISP sequence allows differentiation between solid tumors, hemangiomas and cystic lesions in terms of CNR, and provides better imaging quality than other fast T2-weighted MR sequences.
Artifacts ; Hemangioma ; Hemangioma, Cavernous ; Humans ; Liver* ; Magnetic Resonance Imaging* ; Neoplasm Metastasis

PURPOSE: Food protein-induced enterocolitis syndrome (FPIES) is a symptom complex of vomiting and diarrhea caused by non-IgE mediated allergy to cow's milk and/or soy in young infants. Transforming growth factor (TGF)-beta has been reported to protect the epithelial barrier of the gut from foreign antigens. We studied the expression of type 1 and 2 TGF-beta receptors in the mucosa of small intestine to investigate their roles in the pathogenesis of FPIES. METHODS: Twenty-eight patients, aged 7 to 120 days (mean 49 days) who were diagnosed with FPIES by clinical criteria and challenge tests were included. Immunohistochemical stainings for type 1 and 2 TGF-beta receptors were performed on endoscopic duodenal biopsy specimens. RESULTS: Type 1 and 2 TGF-beta receptors were expressed in the villous and crypt epithelial cells but nearly absent in the lamina propria in both patients and controls. Type 1 TGF-beta receptor expression was significantly lower in the patients who had villous atrophy than in the patients who had not and in controls. The expression of type 1 TGF-beta receptor was negatively correlated with the severity of villous atrophy. Type 2 TGF-beta receptor expression showed no significant difference between the patients and controls. CONCLUSION: Our results suggests that the decreased activity of type 1 TGF-beta receptor is implicated in the pathogenesis of FPIES in young infants.
Atrophy ; Biopsy ; Diarrhea ; Enterocolitis* ; Epithelial Cells ; Humans ; Hypersensitivity ; Infant ; Intestine, Small ; Milk ; Mucous Membrane ; Receptors, Transforming Growth Factor beta ; Transforming Growth Factors ; Vomiting

PURPOSE: To report some early experiences of ultrasonography-guided mammotome biopsy for solid breast lesions. MATERIALS AND METHODS: Sixty seven solid breast lesions in 59 patients aged 25 -77 (mean, 44.5) years were biopsied under ultrasound-guidance using an 11 gauge mammotome. The size and depth of the lesions, diagnostic accuracy achieved, complications, and merits and demerits of the device were evaluated. RESULTS: The lesions ranged in size from 0.5 to 8 (mean, 1.6)cm, and at their center the mean depth was 1.4 cm. For every lesion at least seven biopsies were performed, and the mean weight of extracted tissue was 0.44 gm. The lesions were located mainly at the at 12 o'clock area and upper inner quadrant of the left breast (n=10 for each area); they were also found in other regions fo both breasts, including subareolar areas. The histopathologic diagnosis was malignant in 26 lesions and benign in 39, and in one case, atypical ductal hyperplasia was diagnosed. One lesion contained no tumor cells. Twenty-four malignant lesions were surgically excised, and in 21 invasive ductal/lobular carcinomas and one ductal carcinoma in situ (DCIS) (91.7%) the initial and subsequent diagnosis correlated. One lesion diagnosed as DCIS and one whose invasiveness could not be initially determined were confirmed as invasive ductal carcinomas (8.3%). Follow-up ultrasonography involved six benign lesions and showed that five of these had become smaller. The complications noted were severe pain in three patients and a moderate amount of bleeding in two, but in all cases good control was achieved by interrupting the procedure or applying compression. The merits of the mammotome biopsy compared with the conventional core biopsy technique are higher diagnostic accuracy due to the larger amount of tissue extracted by suction and the large caliber of the needle, multiple biopsies achieved by one needle insertion, and less possibility of severe complications such as pneumothorax. Drytapping was a demerit of the device. Very small lesions could be extracted completely, and this may be a merit for benign lesions and a demerit for malignant lesions. For the latter, clips could be used. CONCLUSION: Ultrasonography-guided mammotome biopsy is a very accurate and safe method for the diagnosis of various breast lesions.
Biopsy* ; Breast* ; Carcinoma, Ductal ; Carcinoma, Intraductal, Noninfiltrating ; Diagnosis ; Follow-Up Studies ; Hemorrhage ; Humans ; Hyperplasia ; Needles ; Pneumothorax ; Suction ; Ultrasonography

OBJECTIVES: This study evaluated the stress of community residents using the General Health Questionnaire, GHQ-60, as an instrument of stress measurement. METHODS: The study included 2100 residents, aged 20 and over, living in three areas, a large city, a medium sized city and a rural area, between June and September 2001. A questionnaire interviewing method was used to collect data. The data were analyzed using a t-test, ANOVA, Pearson's correlation coefficients and multiple regression analysis. RESULTS: In this study, the degree of stress, as measured by the GHQ-60, was shown to be significantly higher in the following categories: females, people over 60 years old, people engaged in the primary industries and labor work, low incomes, the divorced and the bereaved, people who received no more than an elementary education, people who suffer from chronic diseases and non-exercisers. A factor analysis suggested that there were three factors of social dysfunction factors; psychosomatic symptom, and depression and anxiety. The social dysfunction factors was statistically significant for the groups described above. The factor of psychosomatic symptoms was statistically significant in the rural residents, and in the groups described above. The depression and anxiety factor was statistically significant in the large city residents, people aged between 20-29 years, students, unmarried persons, university graduates and those having suffered from chronic diseases. From the multiple linear regression analyses, chronic disease, exercise, gender and income, proved to be significant stress related factors. CONCLUSIONS: This study suggests that special attention should be given to the management of the chronic invalided, non-exercisers, females and small income earners, in order to maintain and promote the psychological health of residents in a community.
Anxiety ; Chronic Disease ; Depression ; Divorce ; Education ; Factor Analysis, Statistical ; Female ; Humans ; Linear Models ; Methods ; Single Person

OBJECTIVES: The purpose of this study was to reconsider the necessity of stroke-related educational programs by investigating early symptoms of stroke that emergency medical technicians (EMTs) may experience. METHODS: An interview survey was carried out, targeting all EMTs 298 people who were working at 119 fire safety centers and local units in Jeollabuk-do province, from April 1 to 30, 2011. An interviewer administered questionnaire was used to obtain data on ETMs' demographic characteristics, educational level on stroke, and awareness level about early symptoms of stroke and treatment-related characteristics of stroke patients. RESULTS: The results showed that 63.2% of those surveyed had completed the required educational programs on stroke during the past year. The level of awareness about early symptoms of stroke and assessment of stroke patients' condition was relatively high for women, those who were 30 years under, low position people, emergency service practitioners, emergency medical technicians, and people who have completed education, respectively. It was also turned out that 82.8% of those surveyed took stroke patients to the nearest hospitals first so that they could receive appropriate treatment. The level of awareness about early symptoms of stroke and assessment of stroke patients' condition in people who have completed education were higher than non-complete. The level of awareness about early symptoms of stroke was positively correlated with confidence, satisfaction and appropriateness in treatment of stroke patients. CONCLUSIONS: These results strongly suggest that it is necessary to operate specialized educational programs to enhance EMTs' appropriate awareness of the early symptoms of stroke and assessment of stroke patient's condition.
Emergencies ; Emergency Medical Technicians ; Female ; Fires ; Humans ; Stroke ; Surveys and Questionnaires

OBJECTIVES: The purpose of this study was to suggest factors related with the job satisfaction of interviewers who participated in Community Health Survey (CHS) in Jeonbuk province. METHODS: An interview survey was carried out, targeting all 70 interviewers who were working at Jeonbuk CHS from Oct. 20 to Oct. 31. 2011. RESULTS: As a result of carrying out a univariate analysis of job satisfaction factors by general characteristics, this study found out that interviewers at the age below 40 showed a higher emotional factor-related score than interviewers at the age over 40, and interviewers having participated a statistic survey more than 6 times showed a higher emotional factor-related score than interviewers having participated a statistic survey less than 5 times. As a result of carrying out a multiple regression analysis of factors by general characteristics, this study found out that as interviewers were older, they showed a lower emotional factor-related satisfaction score and job performance factor-related satisfaction score, and their job satisfaction score was higher when a single interviewer conducts a survey than when more than 2 interviewers conduct a survey. CONCLUSIONS: The interviewer's job satisfaction score was relatively low. This results strongly suggest that it is necessary to understand their job performance environment and work environment most of all. It is expected that the results of this study will be used as basic data needed to increase the job satisfaction of interviewers from CHS and improve the quality of survey data.
Health Surveys* ; Interviews as Topic ; Jeollabuk-do ; Job Satisfaction*

Fine needle aspiration(FNA) is an effective tool in diagnosing mammary carcinoma, We experienced 7 cases of histologically confirmed mammary mucinous carcinoma among 3,052 aspirated cases of breast from 1992 to 1996 in Asan Medical Center" The average age of the patient was 48(33-64) years. The mean size of the lesions was 1.6(0.7-3) cm, and they were palpated as well-defined, firm to hard masses. The cytologic features that may be useful in making a FNA diagnosis of mucinous carcinoma of the breast were analysed. Mucinous background and tumor cell, clusters with occasional single cells were observed in all cases. Among them, two, cases showed abundant scattered single cells, whereas only few single cells were seen in the other two cases. Tumor cells exhibited mild pleomorphism in four cases, and moderate pleomorphism in three cases. Nucleoli tended to be not prominen and are observed in three cases, rarely noted in other three cases and not seen in one. There was microcalcification in four cases(57%). In conclusion, mucinous background and clustered tumor cells showing mild td moderate pleomorphism with characteristic clinical findings allow us to diagnose, mucinous carcinoma of the breast.
Adenocarcinoma, Mucinous* ; Biopsy, Fine-Needle* ; Breast* ; Chungcheongnam-do ; Diagnosis ; Humans ; Mucins* ; Needles

Phyllodes tumor(PT) is a rare distinctive fibroepithelial breast tumor that occasionally shows unpredictable clinical behavior. Wide excision should be the primary treatment of PT and enucleation, the standard procedure for fibroadenoma(FA), is proscribed due to high frequency of local recurrence. Therefore an accurate preoperative diagnosis of PT is essential in order to ensure proper surgical treatment. However, the differentiation between benign PT and FA is often difficult on the basis of cytologic findings. In an attempt to better understand the cytologic features of benign PT and possibly to differentiate PT from FA on the findings of fine needle aspiration(FNA)smears, we reviewed cytologic smears from 22 histologically diagnosed cases each of benign PT and FA, respectively. The cytologic features assessed were cellularity and atypia of both epithelial and stromal components, and shape of epithelial cell clusters. Atypia of stromal cells was more frequent in PT, while blunt branching pattern of epithelial cells was more frequent in FA. The specific cytologic diagnosis of PT is not possible in many cases, but the abundance of stromal cells with moderate nuclear atypia in the correct clinical setting such as older age and larger size(>4cm) allows the diagnosis.
Breast Neoplasms ; Breast* ; Diagnosis ; Epithelial Cells ; Fibroadenoma* ; Needles ; Phyllodes Tumor* ; Recurrence ; Stromal Cells

PURPOSE: Infiltrating lobular carcinoma (ILC) represents approximately 10% of all breast cancers. Its detection and staging for appropriate surgical planning may be difficult on account of its unique growth pattern, including a linear file arrangement of the tumor cells and a planar growth pattern and the resulting low density of the lesions. The purpose of this study was to evaluate the clinicopathological features of an ILC of the breast including multifocality, the preoperative accuracy of the pathological diagnostic tools, and its impact on the surgical procedure. METHODS: Between 1997 and 2003 at the Asan Medical Center, a group of 63 patients with a pathologically proven invasive lobular carcinoma who had undergone surgery were included. They were all in stage I~III, and their medical records, mammographic and sonographic results, and pathologic findings were reviewed retrospectively. RESULTS: Of the 63 patients with a mean age of 48 years (range 35 to 70), multifocal lesions were identified in 27.0% by a pathological examination. For a preoperative evaluation of a multifocal lesion, the sensitivity and positive prediction value were 21.4% and 50% by mammography, and 92.9% and 52.0% by ultrasonography, respectively. Only 27.0% of all patients were confirmed as having an ILC preoperatively; surgical excision or incision biopsies 75%, core-needle biopsy 36.4%, frozen biopsy 22.7%, FNA 5.9%. Conservative surgery was performed in only 14.3% and a mastectomy was performed on 85.5%. The mean tumor size was 3.0 cm, and according to the TNM stage, stage I was found in 22.2%, stage II in 58.7%, stage III in 19.1%. ER-positive was found in 83.9% and PR-positive was found in 74.2%. Seven out of 11 patients, who underwent the planed conserving surgery, had a positive resection margin, 1 case had re- excision, 2 cases underwent mastectomies, and 4 cases underwent radiation therapy without additional surgery. CONCLUSION: Since invasive lobular carcinomas have more often multifocal lesions and a preoperative accurate evaluation may be difficult pathologically or radiologically, a careful evaluation of the accurate tumor extent as well as the multifocal lesion is needed particularly for patients with an ILC considering conserving surgery.
Biopsy ; Breast* ; Carcinoma, Lobular* ; Chungcheongnam-do ; Diagnosis* ; Humans ; Mammography ; Mastectomy ; Medical Records ; Retrospective Studies ; Ultrasonography