PURPOSE: Nodal involvement has long been known to represent the single most reliable indicator of the prognosis for early-stage breast cancer. In common parlance, high-risk node-positive breast cancer has generally been used to describe patients who have involvement of ten or more axillary lymph nodes (10+LN). Breast cancer patients who had 10+LN clearly have a strikingly high risk of tumor recurrence and death. Thus we tried to evaluate the clinical courses of breast cancer patients who had more than 10 positive axillary lymph nodes. METHODS: Of the 587 breast cancer patients who were operated on at Chungnam National University Hospital from February 1992 to November 1999, 31 cases (5.3%) showed involvement of more than 10 axillary lymph nodes. We evaluated the clinical courses of these patients and the differences in survival according to the clinical and pathologic vaiables. Survival was calculated using the Kaplan-Meier method. RESULTS: The mean age of the patients was 50+/-4 years. A mastectomy was done in 28 cases (90.3%), and a breast conserving operation was done in 3 cases (9.7%). The mean tumor size was 4.8+/-.5 cm. The mean number of removed axillary Lymph Nodes was 23.5+/-0.2 (range:10-52), and the mean number of positive axillary LNs was 20.0+/-10.1 (10-51). At a median follow-up of 30.5 months, 23 cases (74.2%) of recurrence were noted. Among these 23 cases (69.6%) showed distant metastases as the first recurrence. The 3-year and 5-year disease-free survivals were 28.6% and 22.9%, respectively. The 3-year and 5-year expected overall survivals were 53.7% and 41.8%, respectively. There were significantly more recurrences in patients who had given up taking their adjuvant chemotherapy than for those patients who had completed 6 cycles of FEC or MMM. Also, significant survival benefits were noted in those patients who were treated using a combination chemotherapy with taxane plus cisplatin after their tumor recurrence. CONCLUSION: Breast cancer patients with 10+LNs have a strikingly high risk of tumor recurrence. Six cycles of adjuvant chemotherapy with FEC or MMM was a controllable variable for lowering the risk of tumor recurrence. A combination chemotherapy with taxane and cisplatin was also a controllable variable for increasing survival after tumor recurrence.
Breast Neoplasms* ; Breast* ; Chemotherapy, Adjuvant ; Chungcheongnam-do ; Cisplatin ; Disease-Free Survival ; Drug Therapy, Combination ; Follow-Up Studies ; Humans ; Lymph Nodes* ; Mastectomy ; Neoplasm Metastasis ; Prognosis ; Recurrence

We assessed the degree of mydriasis induced by 1% tropicamide and 2.5% phenylephrine compared with that induced by 1% tropicamide and 10% phenylephrine in 100 patients with diabetes. Additionally we studied the difference of pupillary dilatation according to duration of dibetes, severity of retinopathy, and performance of photocoagulation. Maximum dilated pupillary diameter was 7.25+/-1.27mm in 2.5% phenylephrine group and 7.32+/-1.36mm in 10% phenylephrine group, respectively the difference in pupillary dilatation between two groups was not statistically significant. We advise the use of the 2.5% phenylephrine in patients with diabetes, who already exhibit a higher prevalence of vascular disease and autonomic nerve system dysfunction because 2.5% phenylephrine may produce a lower incidence of side effects than 10% concentration and have the same effect of pupil dilatation as 10% phenylephrine.
Autonomic Pathways ; Dilatation* ; Humans ; Incidence ; Light Coagulation ; Mydriasis ; Phenylephrine* ; Prevalence ; Pupil ; Tropicamide ; Vascular Diseases

No abstract available.
3,4-Dihydroxyphenylacetic Acid* ; Animals ; Brain* ; Diazepam* ; Rats*

Premacular hemorrhage (preretinal,subhyaloid, or sub-internal limiting membrane hemorrhage)impairs central vision abruptly and occurs in various underlying diseases. In cases of persistent hemorrhage, permanent impairment of vision may occur. Proposed therapeutic options for premacular hemorrhage consist of conservative treatment, laser photodisruption and early vitrectomy. Laser photodisruption may be performed in cases of persistent or slow-clearing hemorrhage, in patients with occupational need for prompt restoration of binocular vision or in patients with poor vision in their fellow eyes. The authors report 4 patients with premacular hemorrhage who were treated with Nd: YAG laser photodisruption with the review of the literatures.
Hemorrhage* ; Humans ; Lasers, Solid-State* ; Membranes ; Vision, Binocular ; Vitrectomy

No abstract available.
Acute Kidney Injury* ; Lymphoma*

No abstract available.
Gastroenteritis* ; Humans* ; Rotavirus*

The ocular ischemic syndrome includes the ocular symptoms and sins secondary to severe carotid artery obstruction and is characterized by rubeosis iridis, anterior uveitis, retinal hemorrhage, cherry red spot, and neovascularization of the disc and/or retina. Recently, the authors have experienced a case of ocular ischemic syndrome in a 82 years old woman, who had neovascular glaucoma associated with ipsilateral internal carotid artery obstruction. Diagnosis was made by doppler ultrasonographic finding of atheroma of internal carotid artery.
Aged, 80 and over ; Carotid Arteries ; Carotid Artery, Internal* ; Diagnosis ; Female ; Glaucoma, Neovascular ; Humans ; Plaque, Atherosclerotic* ; Prunus ; Retina ; Retinal Hemorrhage ; Ultrasonography, Doppler* ; Uveitis, Anterior

Among 4465 patients visited in the department of ophthalmology of the our hospital from January 1, 1975 to September 30, 1976, 146 patients (under the age of 25 ; 88 patients, over the age of 26 ; 58 patients) was statistically observed for errors of their glasses. 1) The rate of glasses over or under corrected 0.75D or more was 37%, and of this rate, 12% were over corrected. In age group, it was about twice the age of 25 than over the age of 26. 2) The rate of glasses which diopters of cylindrical lens were wrongly corrected 0.50D or more was 65% (of 156 glasses), and of this rate, 40% were glasses which astigmatism was absent but in refraction astigmatism was present more than 0.50D. In age group, it wasabout 2.5 times the rate of it in under the age of 25 than over the age of 26. The rate of glasses which axis of astigmatism was wrongly corrected 100 on more was 65% (of 52 glasses). 3) The rate of glasses which distance between optical centers was short or long more than 3mm was 53%, and of this rate, the rate of long ditstance between optical centers was 3 times than that of short distance. It was also about twice the rate of in under the age of 25 than over the age of 26. 4) The rate of glasses which corrected 1/2 delta or more was 20%, and of this rate glasses which vertical deviation was present but in examination vertical deviation was not present. 5) Among 146 patient, patients which has worn glasses not to belong to above the categories were only 15 patients and rate of it was only 10%.
Astigmatism ; Axis, Cervical Vertebra ; Eyeglasses ; Glass ; Humans ; Ophthalmology

Cortical blindness means visual loss caused by bilateral destruction of visual cortex. Cortical blindness can develop after cerebral angiography due to hypertonic contrast medium which open the blood-brain barrier and then alternate the function of visual cortex transiently. About 30 minutes after injection of contrast medium (Ultravist 370(R)) during cerebral angiography, the patient complained of decrease of visual acuity. And 3 hours later, evaluation revealed that she could not see even the light. But her vision began to improve after 19 hours and recovered completely after 7 days. MRI taken at 12 hours after cerebral angiography showed high signal intensities in the both occipital lobes. But in repeated MRI study, which was taken after 3 days, previously noted high densities were completely disappeared. So we diagnosed this case as cortical blindness caused by hypertonic contrast medium.
Blindness, Cortical* ; Blood-Brain Barrier ; Cerebral Angiography* ; Humans ; Magnetic Resonance Imaging ; Occipital Lobe ; Visual Acuity ; Visual Cortex

Cortical blindness means visual loss caused by bilateral destruction of visual cortex. Cortical blindness can develop after cerebral angiography due to hypertonic contrast medium which open the blood-brain barrier and then alternate the function of visual cortex transiently. About 30 minutes after injection of contrast medium (Ultravist 370(R)) during cerebral angiography, the patient complained of decrease of visual acuity. And 3 hours later, evaluation revealed that she could not see even the light. But her vision began to improve after 19 hours and recovered completely after 7 days. MRI taken at 12 hours after cerebral angiography showed high signal intensities in the both occipital lobes. But in repeated MRI study, which was taken after 3 days, previously noted high densities were completely disappeared. So we diagnosed this case as cortical blindness caused by hypertonic contrast medium.
Blindness, Cortical* ; Blood-Brain Barrier ; Cerebral Angiography* ; Humans ; Magnetic Resonance Imaging ; Occipital Lobe ; Visual Acuity ; Visual Cortex