PURPOSE: Tumor-associated lymphocyte numbers in breast cancer have been suggested as a new independent predictor of response to neoadjuvant chemotherapy in breast cancer patients. We therefore evaluated the relationship between pathologic complete response (pCR) and tumor-associated lymphocytes in tumors of such patients. METHODS: Between 2000 and 2009, we retrospectively evaluated 175 patients with primary breast cancer treated with neoadjuvant chemotherapy, followed by definitive surgical resection. Peritumoral lymphocytic infiltration (LI) and CD3+, CD8+, and forkhead box P3 (FOXP3)+ lymphocytes were assessed in pretreatment biopsy specimens. RESULTS: Nineteen (11%) patients achieved pCR. An elevated LI, CD3+, CD8+, or FOXP3+ lymphocytic infiltration; lower clinical T stage; human epidermal growth factor receptor 2 overexpression; and herceptin-based treatment were all significantly associated with pCR. Through a multivariate analysis, LI (odds ratio [OR], 1.26; p=0.024), clinical T stage (OR, 3.06; p=0.041), and the use of a herceptin-based regimen (OR, 4.95; p=0.004) were all significant independent predictors of pCR. Significantly higher numbers of tumor-associated lymphocytes and CD3+, CD8+, and FOXP3+ T-cells were observed in the following: high-grade tumors, tumors of positive nodal status, and tumors negative for hormone receptors. CONCLUSION: Tumor-associated lymphocytes are significantly associated with pCR, suggesting that tumor-associated lymphocytes may be an important pathological factor predicting a response to neoadjuvant chemotherapy in breast cancer patients.
Biopsy ; Breast ; Breast Neoplasms ; Humans ; Lymphocyte Count ; Lymphocytes ; Multivariate Analysis ; Neoadjuvant Therapy ; Polymerase Chain Reaction ; Receptor, Epidermal Growth Factor ; Receptor, erbB-2 ; Retrospective Studies ; T-Lymphocytes

PURPOSE: The aims were to evaluate the main risk factors (RFs) of breast cancer and to estimate the individual disease-probability from combinations of RFs in Korean female. MATERIALS AND METHODS: We conducted case-control study of 1, 687 incident cases of invasive carcinoma and 1, 238 controls during 1996~2000. A breast cancer disease-probability model was established by a general modeling process using a multivariate logistic regression model, which included the main Korean RFs and synergistic interaction-terms. RESULTS: The main Korean RFs selected were age, family history of second relatives, BMI, age at first full term pregnancy, breast-feeding, and a special test on the breasts. Two synergisms were observed between age and breast-feeding, and between special test and age at first fullterm pregnancy. The disease-probability and model are shown in Table 4, and Appendix 1. CONCLUSION: The availability of previous Western models was limited for Korean female due to the differences inhazard-rates and the characteristics of breast cancer between Asian and Western females. Due to limited basic data, i.e. incidence, hazard-rate and cancer-cohorts, the developing-probability of breast cancer for Korean females was not calculated. Therefore, the disease-probability was calculated instead. This approach might be more beneficial for Koreans, and help in the decision- making for regular screening or hospital visit-interval, counseling in breast-cancer clinics, prescribing high-risk population, and in educating for primary prevention, although it over-estimates the relative probability compared to the developing-probability and the 65% predictive validity.
Appendix ; Asian Continental Ancestry Group ; Breast Neoplasms* ; Breast* ; Case-Control Studies ; Counseling ; Female ; Humans ; Incidence ; Logistic Models ; Mass Screening ; Pregnancy ; Primary Prevention ; Risk Factors

Paraneoplastic neutrophilia caused by a squamous cell carcinoma of the uterine cervix has been seen rarely. We report a case of relapsed squamous cell carcinoma of the uterine cervix with severe neutrophilia, rapid tumor growth and aggressive clinical course, possibly due to autocrine stimulation of cell growth by G-CSF and IL-6 without other possible causes of neutrophilia.
Carcinoma, Squamous Cell ; Cervix Uteri ; Female ; Granulocyte Colony-Stimulating Factor ; Interleukin-6 ; Paraneoplastic Syndromes

Paraduodenal hernias are a rare congenital malformation, but they are the most common internal hernias. They develop secondary to a failure in midgut rotation, which may lead to small bowel obstruction or other clinical manifestations. The authors recently experienced a case of a left paraduodenal hernia presenting with unusual symptoms of left flank pain and vomiting.
Adult ; Hernia/*complications/*diagnosis/pathology/surgery ; Humans ; Intestinal Obstruction/*etiology/surgery ; Male

We reviewed 27 patients wlth cerebellar infarction which was demonstrated by brain CT and/or MRI. Infarction occurred in the territory of posterior inferior cerebellar artery (PICAj in 16 patients, and the territory of the superior cerebellar artery(SCA) was involved in 5 patients. Antenor inferior cerebellar artery(AICA) infarcts occurred in 3 patients. Both PICA and SCA temtories were involved in 2 patients. In the remaining 1 patient, the infarct encompassed the borderzone between the SCA and PICA territories. The main symptoms and signs were sudden onset of vertigo, dizziness, nausea, vomiting, dysmetria, ataxia, nystagmus, and headache. There were signs of associated brain stem infarction or occipitotemporal infarction; rostral basilar artery syndrome, classic SCA syndrome, Wallenberg syndrome, internuclear ophthalmoplegia, facial palsy, hearing impairment. Presumed cerebral embolism was the main stroke mechanism in the SCA terntories. Six patients with brainstem compression or brainstem involvement showed consciousness deterioration, and only one of them died as a result of extensive cerebellar infarctions involving both SCA and PICA territories Cerebellar infarction may run a more benign course than previously thought.
Arteries ; Ataxia ; Basilar Artery ; Brain ; Brain Stem ; Brain Stem Infarctions ; Cerebellar Ataxia ; Consciousness ; Dizziness ; Facial Paralysis ; Headache ; Hearing Loss ; Humans ; Infarction* ; Intracranial Embolism ; Lateral Medullary Syndrome ; Magnetic Resonance Imaging ; Nausea ; Ocular Motility Disorders ; Pica ; Stroke ; Vertigo ; 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

PURPOSE: To determine patient's use of alternative cancer therapies, as well as the characteristics of the patients who used these therapies, descriptive study was conducted at the one college hospital in Seoul. MATERIALS AND METHODS: Of 950 eligible patients who discharged from October 1, 1996 to Febrary 28, 1997, 283 patients were completed semistructured questionnaire telephone survey finally(response rate is 29.8%). RESULTS: Alternative therapies were used by 53.0% of patients. The preferred was dietary therapies and oriental(herbs, acupucture) therapies, folk therapies, drug therapies were other popular methods. Any patient characteristics except time prolongation after diagnosis were not associated with use of alternative therapies. The patients were seeking for alternative therapy because they thought conventional medical treatments were not enough to expect to improve their health, The major source of information was relatives and friends, not the mass media. 46.6% of the patients used althenative therapy said that it were not effective but 30.4% of them said it would help to slow the progression of their disease or strengthen their resistance. 45.0% of them were satisfied with it. CONCLUSION: A significant proportion of cancer patients use one or more forms of alternative therapy. The physicians should recognize and give due consideration to the patients underlying desire for better control of his disease, and should be able to advise his patients on the use of alternative therapy.
Complementary Therapies* ; Diagnosis ; Drug Therapy ; Friends ; Humans ; Mass Media ; Surveys and Questionnaires ; Seoul ; Telephone

OBJECTIVE: The purpose of this study is to determine the time-dependant effects of Glutathione on the Cisplatin-induced cytotoxicity of human cervical carcinoma cells. METHODS: Two human cervical carcinoma cells, SiHa (squamous cell carcinoma cell), and CaSki (epidermoid metastatic carcinoma cell) were cultivated with RPMI1640 media. Reduced glutathione (GSH) and 2-oxo 4-thiazolidine carboxylic acid (OTC) were added one hour before and after Cisplatin (2-50 micro M/ml) was applied. The cells were incubated an additional 24 hours and viable cells were examined using a 3-[4,5- dimethylthiazol-2-yl]-2,5-diphenyl tetrazolium bromide (MTT) assay. RESULTS: The MTT reduction rate of cisplatin-treated cervical carcinoma cells was increased significantly by the addition of glutathione (5 mM) or OTC (5 mM) both one hour before and after Cisplatin. A difference between MTT reduction rates one hour before and after cisplatin were not observed in either GSH or OTC. CONCLUSION: These results suggest that GSH and OTC have a protective effect on cisplatin-induced toxicity, and that this effect is about the same whether the agents were applied before or after the Cisplatin.
Cisplatin* ; Glutathione* ; Humans*

OBJECTIVE: Photodynamic therapy (PDT) has been used for superficial neoplasms and its usage has been recently extended to deeper lesions. The purpose of this study was to observe whether or not PDT can cure breast cancer in the solid tumor model, and to define the critical point of laser amount for killing the cancer cells. METHODS: Twenty four BALB/c mouse models with subcutaneous EMT6 mammary carcinomas were prepared. Mice were divided into eight groups depending on the amount of illumination, and the tumor size was between 8 mm and 10 mm. We began by peritoneal infiltration with a photosensitizer 48 hours prior to applying the laser light, and then we applied a non-thermal laser light. The energy was from 350 J/cm2 to 30 J/cm2 to the cancer. RESULTS: Regardless of the tumor size from 8 mm to 10 mm, all mice apparently showed positive results via PDT. We also did not find any recurrence over 90 J/cm2. In all models, the color of the breast cancer lesions began to vary to dark on 2 days post PDT and the tumor regression began simultaneously. Also, we confirmed the complete regression of the breast cancer 21 days after PDT. CONCLUSION: We confirmed that PDT may treat breast cancers that are sized less 10 mm in mouse models. The moderate energy to destruct the breast cancer cells may be 90 J/cm2. Therefore, we can expcect that PDT may be utilized to treat breast cancer, but we need more experience, skills and processing for clinical trials.
Animals ; Breast ; Breast Neoplasms ; Homicide ; Light ; Lighting ; Mice ; Photochemotherapy ; Recurrence ; Triazenes

Parkinsonism is not commonly associated with intracranial tumors. The most common brain tumor causing parkinsonism is meningiomas. We are presenting two cases of meningiomas whose major manifestations included parkinsonism. In one, parkinsonian symptoms initially partially responded to L-dopa and bromocriptine. A CT scan taken for a stroke-like episode revealed a meningioma of left frontal convexity. After neurological sequelae of CO poisoning, the patient poorly responded to antiparkinsonian drugs. Surgical treatment of meningioma did not result in satisfactory control of extrapyramidal symptoms. In the other with a parasagittal meningioma, parkinsonian symptoms were postoperatiYely improved. Because no curative treatment is available for the majority of parkinsonian patients, early detection of an underlying neoplasm may result in a most rewarding outcome. It would be desirable to perform CT or MRI in cases of parkinsonism with other associated neurological manifestation. Unilaterality of parkinsonian symptoms may also be indication.
Brain Neoplasms ; Bromocriptine ; Frontal Lobe* ; Humans ; Levodopa ; Magnetic Resonance Imaging ; Meningioma* ; Neurologic Manifestations ; Parkinsonian Disorders* ; Poisoning ; Reward ; Tomography, X-Ray Computed