The pregnancy-associated breast cancer is one of the most common malignacy developed during pregnant period and occupies 1-2% of the all breast cancer pateints. It is easy to miss appropriate diagnosis due to difficulty of physical examination of the breast and limitation of proper diagnostic modality. The pregnancy-associated breast cancer has been reported to portend an extremely poor outcome. But recent studies have found no difference in survival between general breast cancer and pregnancy-associated breast cancer. The treatment of choice is the modified radical mastectomy and adjuvant chemotherapy if needed. The authors report two patients of breast cancer diagnosed and treated during pregnancy with review of literature.
Breast Neoplasms* ; Breast* ; Chemotherapy, Adjuvant ; Diagnosis ; Humans ; Mastectomy, Modified Radical ; Physical Examination ; Pregnancy*

OBJECTIVES: This study was performed to identify the validity of serum CA125 level for assessing responsiveness to combined chemotherapy in patients with epithelial ovarian cancer. MATERIALS AND METHODS: 30 patients with epithelial ovarian cancer who had received postoperative combined chemotherapy (paclitaxel and cisplatin) at Department of Obstetrics and Gynecology, Korea University Medical Center, from February, 1996 to July, 2000 were included. We analyzed the relation between the responsiveness criteria of WHO and the change in serum CA125 level. RESULTS: 1. There was a tendency that patients with more advanced stage(stage 1-4) had higher serum CA125 level without significant differences. 2. The percentage of patients who responded to paclitaxel and cisplatin was 46.7%(14/30) by WHO criteria and 56.7%(17/30) by serum CA125 level. 3. The sensitivity and specificity of serum CA125 level in the prediction of response were 78.6% and 62.5% respectively. 4. In a living group, the changes of percentage value in CA125 level were higher at 2nd, 3rd and 4th chemotherapy cycle than in an expired group(p<0.05). 5. There was a tendency that the responsiveness based on WHO criteria and CA125 had positive correlation(p=0.0865). 6. There was a tendency that the responsiveness based on serum CA125 level and patient`s survival had positive correlation(p=0.1454). CONCLUSIONS: Serum CA125 level is a valid tumor marker in assessing the responsiveness to combined chemotherapy which can be used with or instead of the WHO criteria in epithelial ovarian cancer.
Academic Medical Centers ; Cisplatin ; Drug Therapy* ; Gynecology ; Humans ; Korea ; Obstetrics ; Ovarian Neoplasms* ; Paclitaxel ; Sensitivity and Specificity

Annular pancreas is a rarely found gastrointestinal tract malformation, and is frequently associated with Down syndrome. Endocardial cushion defect is a type of congenital heart disease, commonly also related to Down syndrome. However, a combination of endocardial cushion defect with annular pancreas has not been reported previously. We recently experienced such a case in 2 month old boy. Moreover Down syndrome was excluded through physical examination and a chromosomal study. We think it difficult to obtain a complete explanation for this condition through the currently known pathogenesis of annular pancreas and endocardial cushion defect.
Down Syndrome* ; Endocardial Cushion Defects ; Endocardial Cushions* ; Gastrointestinal Tract ; Heart Defects, Congenital ; Humans ; Infant ; Male ; Pancreas* ; Physical Examination

A 63-year-old woman was referred to a breast surgeon with a breast mass discovered incidentally during follow-up study after colon cancer surgery. Invasive adenocarcinoma was revealed on core needle biopsy. Wide excision of the breast including the tumor was performed. On standard histological examination the tumor showed features of moderately differentiated adenocarcinoma. The immunohistochemistry study revealed positive results for cytokeratin (CK)20 and CDX2, but negative for CK7. These are typical characteristics for colon cancer. Considering her history of subtotal colectomy for sigmoid colon cancer, it is presumable that the mass in the breast was of colonic origin, and it was an extremely rare case of metastasis to the breast from primary colorectal neoplasm. Although the instance is rare, clinicians should keep the possibility of breast metastasis from colorectal cancer in mind for early and correct diagnosis.
Adenocarcinoma ; Biopsy, Large-Core Needle ; Breast ; Colectomy ; Colon ; Colonic Neoplasms ; Colorectal Neoplasms ; Female ; Follow-Up Studies ; Humans ; Immunohistochemistry ; Keratins ; Middle Aged ; Neoplasm Metastasis ; Sigmoid Neoplasms

No Abstract available.
Adolescent* ; Adult* ; Delivery of Health Care* ; Heart Defects, Congenital* ; Humans

PURPOSE: To evaluate various types and; characteristics of non-retinal lesions associated with ultra-wide field scanning laser ophthalmoscope images. METHODS: This retrospective study included 139 eyes of 139 patients with non-retinal lesions observed on color images obtained using Optomap 200Tx (Optos PLC, Dunfermline, Scotland, UK). The non-retinal lesion is a hyperreflective or hyporeflective shadow due to anterior segment of the eye or vitreous except the retina. Types and characteristics of red laser separation, green laser separation and autofluorescence images of non-retinal lesions were evaluated. RESULTS: All non-retinal lesions in images were categorized into 2 groups according to the location of non-retinal lesions. The anterior non-retinal lesions group included corneal opacity, cataract and posterior capsular opacity. The posterior non-retinal lesions group included asteroid hyalosis, posterior vitreous detachment, vitreous opacity and vitreous hemorrhage. Anterior non-retinal lesions were more often hyporeflective in red and green laser separation images (p < 0.001). Posterior non-retinal lesions were more often hyperreflective in green laser separation images and hyporeflective in red laser separation images (p < 0.001). CONCLUSIONS: Ultra-wide field scanning laser ophthalmoscope images can frequently have various shadows from anterior or posterior lesions of the eye. These shadows show a difference in reflectivity depending on their origins. To understand the difference helps in the interpretation of the fundus images.
Cataract ; Corneal Opacity ; Humans ; Ophthalmoscopes* ; Retina ; Retrospective Studies ; Scotland ; Vitreous Detachment ; Vitreous Hemorrhage

PURPOSE: Granulomatous mastitis (GM), reported for the first time by Kessler and Wolloch in 1972, is a rare and benign inflammatory lesion of the breast. The etiology of GM is currently unknown, but some reports have suggested autoimmunity. The aim of this study was to evaluate the clinical characteristic, clinical presentations and radiological features of GM. METHODS: A chart review was performed for 23 patients, with GM confirmed by a pathological examination, between July 1999 and December 2005. A retrospective review of the clinical and radiological finding, as well as the cytological results of the patients was undertaken. RESULTS: The ages of these patients ranged between 29 and 74 years, with a mean of 39.7 years. The median follow-up was 8 months. Twenty patients (87%) presented with a mass as the chief complaint, with a median size of 2.56 cm (range 0.78~6.5 cm). Eight patients (34.8%) had radiological findings suspicious of malignancy. Tuberculosis was diagnosed using Tb-PCR in 1 patient. Twenty-two of the 23 patients underwent a wide excision, and the one remaining patient underwent incision and drainage. One of 23 patients had a recurrent disease. CONCLUSION: GM is a rare breast disease, which clinically mimics cancer. As radiological imaging, such as mammography or ultrasonography, are unreliable in distinguishing GM from breast cancer, further special examinations, for example FNAB and gun biopsy, are necessary. The single most important differential diagnosis of GM is tuberculosis, especially in developing countries. We suggest that the evaluation for tuberculosis is essential for the differential diagnosis of GM using clinical and pathological methods.
Autoimmunity ; Biopsy ; Breast ; Breast Diseases ; Breast Neoplasms ; Developing Countries ; Diagnosis, Differential ; Drainage ; Follow-Up Studies ; Granulomatous Mastitis* ; Humans ; Mammography ; Retrospective Studies ; Tuberculosis ; Ultrasonography

BACKGROUND: To evaluate the effects of thoracic epidural anesthesia, with or without bilateral vagotomy, epinephrine-induced arrhythmias were studied in 31 rabbits anesthetized with 1 MAC enflurane. METHODS: Logdose protocol was used for the infusion of epinephrine; its arrhythmic dose being defined as the smallest infusion rate produced four or more continuous or intermittent arrhythmias within 15 seconds. RESULTS: The values (geometric mean) of arrhythmic doses and the plasma concentration of epinephrine during arrhythmia were as follows: 10.21 g.kg 1.min 1 and 83.16 ng/ml in epidural control group; 118.90 g.kg 1.min 1 and 677.76 ng/ml in epidural lidocaine group (p<0.05); 6.34 g.kg-1.min 1 and 96.42 ng/ml in intravenous lidocaine group; 8.65 g.kg 1.min-1 and 44.64 ng/ml in vagotomized-epidural control group; and 12.03 g.kg 1.min 1 and 95.35 ng/ml in vagotomized- epidural lidocaine group. CONCLUSIONS: The data suggest that thoracic epidural anesthesia raises the threshold for enflurane- epinephrine arrhythmias in rabbits and that this effect is eliminated by bilateral vagotomy.
Anesthesia, Epidural* ; Arrhythmias, Cardiac* ; Enflurane ; Epinephrine ; Lidocaine ; Plasma ; Rabbits* ; Vagotomy*

Synchronous primary tumor is uncommon form of gynecologic malignancy. Synchronous tumor is defined as primary tumor diagnosed simultaneously or within 6 months of one another. The prognosis of the patients with synchronous malignancies was reported to be more favorable when compared to the survival of patients harboring the same neoplasms individually. We report a case of multifocal concurrent adenocarcinoma involving salpinx, ovary, uterine cervix, and endometrium as well as omentum with a brief review of literatures.
Adenocarcinoma* ; Cervix Uteri ; Endometrium ; Fallopian Tubes ; Female ; Humans ; Omentum ; Ovary ; Prognosis

PURPOSE: To assess the prognostic value of computed tomography (CT) in acute pancreatitis, initial CT examinations were classified into 5 grades in terms of the degree of disease severity and CT findings were correlated with clinical course, objective prognostic signs, and complications. MATERIALS AND METHODS: In 29 consecutive patients with acute pancreatitis, the CT examination and clinical course were reviewed without knowledge of each other finding. Both Ranson's prognostic signs and modified Glascow prognostic signs were used for evaluation of acute pancreatitis. RESULTS: Of the 29 patients, 25 patients recovered with medical treatment while 4 patients (14%) developed pseudocysts and the other 4 patients (14%) developed abscesses. CT findings of the acute pancreatitis are as follows; 10 patients (35%) in grade A with normal pancreas, 2 patients (7%) in grade B with pancreatic enlargement, 2 patients (7%) in grade C with intrinsic pancreatic abnormalities associated with haziness, 3 patients (10%) in grade D with single, ill-defined fluid collection, and 12 patients (41%) in grade E with extensive and two or multiple fluid collections or presence of gas in or adjacent to the pancreas. Correlation coefficient is 0.46 (p=0.012) between CT findings and Ranson's prognostic signs, 462 (p=0.0115) between CT findings and modified Glascow prognostic signs. CONCLUSION: CT gradings of acute pancreatitis may be useful in predicting clinical course.
Abscess ; Humans ; Pancreas ; Pancreatitis*