Esthetics ; Humans ; Mandibular Condyle ; Mandibular Reconstruction ; Mouth ; Temporomandibular Joint ; Transplants

PURPOSE: The degree of radiation-induced lung fibrosis (RILF) can be measured quantitatively by fibrosis volume (VF) on chest computed tomography (CT) scan. The purpose of this study was to investigate the interobserver and intraobserver variability in CT-based measurement of VF. MATERIALS AND METHODS: We selected 10 non-small cell lung cancer patients developed with RILF after postoperative radiation therapy (PORT) and delineated VF on the follow-up chest CT scanned at more than 6 months after radiotherapy. Three radiation oncologists independently delineated VF to investigate the interobserver variability. Three times of delineation of VF was performed by two radiation oncologists for the analysis of intraobserver variability. We analysed the concordance index (CI) and inter/intraclass correlation coefficient (ICC). RESULTS: The median CI was 0.61 (range, 0.44 to 0.68) for interobserver variability and the median CIs for intraobserver variability were 0.69 (range, 0.65 to 0.79) and 0.61(range, 0.55 to 0.65) by two observers. The ICC for interobserver variability was 0.974 (p < 0.001) and ICCs for intraobserver variability were 0.996 (p < 0.001) and 0.991 (p < 0.001), respectively. CONCLUSION: CT-based measurement of VF with patients who received PORT was a highly consistent and reproducible quantitative method between and within observers.
Carcinoma, Non-Small-Cell Lung ; Evaluation Studies as Topic* ; Fibrosis* ; Follow-Up Studies ; Humans ; Lung* ; Observer Variation* ; Radiotherapy ; Thorax ; Tomography, X-Ray Computed

PURPOSE: Lower urinary tract dysfunction is the most common complication after radical pelvic surgery. The aims of this study were to assess the effect of radical hysterectomy (RH) on the storage function of the lower urinary tract and to evaluate the impact of radiation therapy (RT) on postoperative urodynamic parameters. METHODS: This was a retrospective review of preoperative and postoperative urodynamic variables, which were prospectively collected. All women from 2006 to 2008, who underwent RH for uterine cervical cancer with a stage of 1A to 2B with or without adjuvant RT were enrolled. All patients were divided into two groups: group 1, without RT, and group 2, with adjuvant RT. Urodynamic studies were performed before, 10 days after, and 6 months after RH. RESULTS: A total of 42 patients with a mean (+/-standard error) age of 51.9 (+/-12.3) years were analyzed. There were no significant differences in age, body mass index or clinical stage between the two groups. On the 10th postoperative day, all parameters were decreased except postvoid residual volume. In comparison with group 2 (n=14), group 1 (n=28) showed a significant increase in bladder compliance. At 6 months postoperatively, bladder compliance in group 1 had increased four times or more compared with that on postoperative 10 days. However, it had increased only 2.5 times in group 2 at the same time point (P<0.001). CONCLUSIONS: The results of our study suggest that adjuvant RT after RH might result in a deterioration of bladder compliance. It is highly suggested that practitioners pay attention to low bladder compliance, especially in patients who have adjuvant RT after RH.
Body Mass Index ; Compliance ; Female ; Humans ; Hysterectomy ; Prospective Studies ; Residual Volume ; Retrospective Studies ; Urinary Bladder ; Urinary Tract ; Urodynamics ; Uterine Cervical Neoplasms

PURPOSE: Axillary node involvement is the single most important prognostic variable in patients with breast cancer. If axillary lymph node status of breast cancer patients could be accurately predicted from basic clinical information and from characteristics of their primary tumors, many patients could be spared axillary lymph node dissection. With the availability of numerous histologic prognosticators and new immunochemical prognostic indicators, it is reasonable to reconsider the necessity of axillary node dissection for lesions more advanced than duct carcinoma in situ. MATERIALS AND METHODS: Six hundred fifty-six patients with Tl invasive breast cancer were evaluated. All the patients underwent axillary dissection, and the pathologic status of the nodes was known. The parameters of the primary tumor in this study were age, size, family history, tumor palpability, nuclear and histological grade, hormone receptor status, lymphatic vessel invasion (LVI), and various tumor markers (bc1-2, cathepsinD, c-erbB2, E-cadherin, p53). RESULTS: Approximately 31% of the 656 patients with Tl breast carcinoma had axillary node metastasis. Four factors were identified as significant predictors of node metastasis: age 35 or less (p=0.01), lymphatic vessel invasion (p < 0.01), tumor palpability (p=0.02), and tumor size (p<0.01). However, independent predictors of lymph node metastasis in the multivariate logistic regression analyses were tumor size (p=0.04) and LVI (p=0.03). CONCLUSION: Characteristics of the primary tumor can help assess the risk for axillary lymph node metastases in Tl breast cancer. Selected patients who have 1cm or less without lymphatic vessel invasion are considered to be at minimal risk of axillary node metastasis and might be spared routine axillary dissection.
Breast Neoplasms* ; Breast* ; Cadherins ; Carcinoma in Situ ; Humans ; Logistic Models ; Lymph Node Excision ; Lymph Nodes ; Lymphatic Vessels ; Neoplasm Metastasis* ; Prognosis ; Biomarkers, Tumor

BACKGROUND: Axillary noed involvement is the single most important prognostic variable in patients with breast cancer. If axillary lymph node status of breast cancer patients could be accurately predicted from basic clinical information and from characteristics of their primary tumors, many patients could be spared axillary lymph node dissection. With the availability of numerous histologic prognosticators and new immunochemical prognostic indicators, it is time to consider eliminating routine node dissection for lesions more advanced than duct carcinoma in situ (DCIS). MATERIALS AND METHODS: Two hundred sixty-three patients with T1 invasive breast cancer were evaluated. All underwent axillary dissection, and the pathologic status of the nodes was known. The parameters of the primary tumor evaluated included age, size, family history, tumor palpability, nuclear and histological grade, hormone receptor status, lymphatic vessel invasion (LVI), and various tumor markers (bcl-2, cathepsinD, c-erbB2, E-cadherin, p53). RESULTS: Approximately 31.1% of the 656 patients with T1 breast carcinoma had axillary node metastasis. Four factors were identified as significant predictors of node metastasis: age35 or less (p=0.01), lymphatic vessel invasion (p<0.01), tumor palpability(p=0.02), and tumor size (p<0.01). However, independent predictors of lymph node metastasis in the multivariate logistic regression analyses were tumor size (p=0.04) and LVI (P=0.03). CONCLUSION: In conclusion, characteristics of the primary tumor can help assess the risk for axillary lymph node metastases. Selected patients who have 1cm or less without lymphatic vessel invasion considered to be at minimal risk of axillary node metastasis and might spared routine axillary dissection.
Breast Neoplasms* ; Breast* ; Cadherins ; Carcinoma in Situ ; Humans ; Logistic Models ; Lymph Node Excision ; Lymph Nodes ; Lymphatic Vessels ; Neoplasm Metastasis* ; Biomarkers, Tumor

PURPOSE: A medullary carcinoma of the breast (MC) is a well-circumscribed tumor composed of poorly differentiated cells growing in a syncytium with an accompanying stroma. However, the prognosis of a MC is considered as more favorable than that of an infiltrating ductal carcinoma (IDC). In the present study, we characterized MC in terms of prognosis by comparing a MC group with an IDC control group. We describe the distribution of other clinicopathological characteristics, as well as the prevalence and the prognostic importance of generally well known risk factors, for breast cancer and compare the results. METHODS: Clinical data from hospital records and pathological materials were available from 60 patients with tumors that had been initially diagnosed from Jan. 1981 to Dec. 1999 at the Department of Surgery in Seoul National University Hospital as having a MC. We analyzed the survival and the prognostic factors of those patients and compared the results with those for an IDC control group. RESULTS: The 60 cases of MC showed more risk factors, such as young age, high nuclear grade, poor histologic grade, negative hormone receptors, p53 overexpression, c-erb-B2 expression, and high proliferative index (Ki 67), than the IDC cases did. However, the prognosis of MC was better than that of IDC. Most of the risk factors were of highly significant prognostic importance in the IDC control group. In the MC group, only lymph-node status and young age were significantly important for disease-free survival. CONCLUSION: We found MC to be biologically unique, and patients with MC have a better prognosis than those with IDC. We propose that MC patients with axillary lymph-node metastasis and young age be considered as a high-risk group for recurrence.
Breast Neoplasms ; Breast* ; Carcinoma, Ductal* ; Carcinoma, Medullary ; Disease-Free Survival ; Giant Cells ; Hospital Records ; Humans ; Neoplasm Metastasis ; Prevalence ; Prognosis ; Recurrence ; Risk Factors ; Seoul

PURPOSE: Although papillary thyroid carcinomas are known to have a good prognosis, invasive papillary thyroid carcinomas have different outcomes. There are many studies on the prognostic factors for thyroid carcinomas, but few studies have been performed for invasive papillary thyroid carcinomas. We performed this study to investigate the prognosis and the prognostic factors for invasive papillary thyroid carcinomas. METHODS: We analyzed 184 patients with papillary thyroid carcinomas who had undergone a thyroidectomy between 1985 and 1990, especially for the clinicopathologic entity of an invasive papillary thyroid carcinoma, and made univariate and multivariate analyses for various clinical and pathological factors to evaluate whether they would be of value in estimating the prognosis in papillary thyroid carcinoma patients. RESULTS: In the univariate analysis of the 10-year disease-free survival rate of the overall cases, sex, tumor size, and lymph-node metastasis were confirmed to be significant prognostic factors. In the multivariate analysis, all of these factors were independent significant prognostic factors. Invasive papillary thyroid carcinoma patients, compared to non-invasive papillary thyroid carcinoma patients, were older and more prone to metastasis to cervical lymph nodes. In the univariate analysis of the 10-year disease-free survival rate of patients with an invasive papillary thyroid carcinoma, sex, tumor size, and lymph-node metastasis were significant prognostic factors. However, in the multivariate analysis, sex and tumor size appeared to be independent significant prognostic factors. CONCLUSION: We conclude that invasive papillary thyroid carcinomas have a the tendency to occur in elderly patients and are more prone to metastasis to cervical lymph nodes. The male sex, a tumor size more than 5 cm, and positive cervical-lymph-node metastasis present the worse prognosis. However, a randomized prospective study may be needed to better understand how to manage invasive papillary thyroid carcinomas.
Aged ; Disease-Free Survival ; Humans ; Lymph Nodes ; Male ; Multivariate Analysis ; Neoplasm Metastasis ; Prognosis ; Thyroid Gland* ; Thyroid Neoplasms* ; Thyroidectomy

BACKGROUND: The activation of phospholipase C(PLC) is one of the early cellular events in various growth process, including malignant transformation. PLC-gamma1 is activated through direct interaction with growth factor receptor tyrosine kinase. MATERIAL AND METHODS: Using immunoblot assay, we evaluated overexpression of PLC-gamma1 expression in twenty human breast cancer tissues. It was also determined whether there was any connection between other prognostic factors(numbers of metastatic axillary nodes, nuclear and histological grade, c-erbB2, p53 and E-cadherin) and the overexpression of PLC-gamma1 protein. RESULTS: Seventeen of 20 breast cancer tissues showed overexpression of PLC-gamma1, which was corresponded to that seen on the immunohistochemistry( kappa= 0.8275, p = 0.003). Of 3 tumor markers, immunohistochemically determined, positive expression of E-cadherin only was associated with PLC-gamma1 protein overexpression in a range of statistical significance (p=0.045, kappa=0.607). CONCLUSION: PLC-gamma1 overexpression might be pathogenic trigger involved in breast cancer and the relationship between expression of E-cadherin and PLC-gamma1 would require further elucidation.
Breast Neoplasms ; Cadherins ; Humans ; Phospholipases* ; Protein-Tyrosine Kinases ; Biomarkers, Tumor

No abstract available.
Breast Neoplasms* ; Breast*

A 38-year old female was admitted to our hospital for further evaluation of an incidentally found cardiac murmur. She had been in a hypertensive state for 5 years but had taken antihypertensive drugs intermittently on her own. Her history revealed that she had become amenorrheic for 7 months and had, had headaches for a few months. Physical examination revealed central obesity and a moon face, but no hirsuitism. When she first visited our hospital, her blood pressure was 260/170 mmHg and grade 2 systolic murmur was audible along the left sternal border. Laboratory studies revealed high levels of 24-hour urine-free cortisol and plasma aldosterone, but a very low level of plasma adrenocorticotropic hormone and plasma renin activity. A low-dose and a high-dose dexamethasone suppression tests, adrenal venous sampling, inferior petrosal sinus sampling, and a renin stimulation test were performed. Bilateral adrenal masses were found on computerized tomographic scanning and magnetic resonance imaging but there was no abnormality of the pituitary gland. The uncontrollable blood pressure and the elevated 24-hour urine-free cortisol and plasma aldosterone levels were corrected by a right-total and left-subtotal adrenalectomy. Pathologic findings were bilateral adrenal cortical adenomas of different cell types. These findings indicate that the adrenal cortical adenomas were tumors that functioned differently, causing Cushing's syndrome and primary aldosteronism in the same patient. A review of, the literature published in English showed that this is the first reported case, of bilateral adrenal adenomas functioning differently.
Adenoma ; Adrenalectomy ; Adrenocortical Adenoma* ; Adrenocorticotropic Hormone ; Adult ; Aldosterone ; Antihypertensive Agents ; Blood Pressure ; Cushing Syndrome* ; Dexamethasone ; Female ; Headache ; Heart Murmurs ; Humans ; Hydrocortisone ; Hyperaldosteronism* ; Magnetic Resonance Imaging ; Obesity, Abdominal ; Petrosal Sinus Sampling ; Physical Examination ; Pituitary Gland ; Plasma ; Renin ; Systolic Murmurs