PURPOSE: To evaluate the mammographic and clinical findings of nonpalpable breast cancer. MATERIALS AND METHODS: In 28 of 607 breast cancer patients examined between January 1994 and April 1997, lesions werenonpalpable. We retrospectively analyzed the mammographic, clinical and pathologic features of 25 patients (28lesions) whose mammograms we obtained. RESULTS: Among these 25 patients (28 lesions) screening was abnormal in22; other symptoms were bloody nipple discharge(n=4), and nipple eczema(n=2). The patients were 34-62 (mean 52)years old. Invasive ductal carcinoma(n=13), DCIS(ductal carcinoma in situ, n-12), Paget's disease (n=2), andLCIS(lobular carcinoma in situ, n=1) were found during surgery. Six of 28 lesions(21%) showed evidence of axillarynodal metastasis;the majority arose from the upper outer quadrant of the breast (n=21). The mammographic findingswere mass (50%), (and mass with microcalcification, 11%); microcalcification(29%); asymmetrical density(14%); andnormal (7%). According to the mammographic density of breast parenchyma, the major finding in the low densitygroup(N1+P1) was mas (9/9), and in the high density group(P2+DY) was microcalcification (12/19). CONCLUSION: Themost common mammographic findings of nonpable breast cancer were mass (50%) and microcalcification(29%). Itsfeatures varied according to the mammographic density of breast parenchyma;mass was the main finding in the lowdensity group and microcalcification in the high density group.
Breast Neoplasms* ; Breast* ; Carcinoma in Situ ; Humans ; Mass Screening ; Nipples ; Retrospective Studies

For evaluating the reproductive performances of GTD patients, we found 115 cases of GTD patients, 77 HM and 38 GTT, who became pregnant after the completion of treatments and follow-up period. The results of this study suggest subsequent pregnancies after the completion of treatments may promise normal reproductive outcomes regardless of the chemotherapy.
Drug Therapy ; Follow-Up Studies ; Gestational Trophoblastic Disease* ; Humans ; Pregnancy

PURPOSE: To evaluate the results of peeling of internal limiting membrane (ILM) for the treatment of diabetic macular edema with severe hard exudates. METHOD: We analyzed the records of the patients who had macular edema with severe hard exudates, underwent pars plana vitrectomy combined with indocyanine green (ICG)-assisted ILM peeling, and then were followed more than 4 months postoperatively. RESULTS: In 6 patients, 10 eyes, mean age was 60.2 years and follow-up period was 7.3 months. In all eyes, a attached posterior hyaloid was shown, and hard exudates and macular edema began to decrease within 1 week after operation. Visual acuity was less than 0.1 in 6 eyes before operation, in 3 eyes by the best visual acuity during follow-up period and in 4 eyes on the final examination, and 0.15 or better in 2 eyes, 6 eyes and 5 eyes, respectively. According to the best visual acuity, there was improvement in 8 eyes and no change in 2 eyes, and according to the final visual acuity, improvement in 6 eyes, no change in 3 eyes and deterioration in 1 eye. CONCLUSIONS: ICG-assisted ILM peeling would be helpful for the treatment of diabetic macular edema with severe hard exudates.
Exudates and Transudates* ; Follow-Up Studies ; Humans ; Indocyanine Green ; Macular Edema* ; Membranes* ; Visual Acuity ; Vitrectomy

Ovary is one of the organs in which angiogenesis occurs during ovarian cycle. Angiogenesis is associated with angiogenic factor like acidic fibroblast growth factor, basic fibroblast growth factor and transformation growth factor. Therefore, we performed this study to identify the distribution and mRNA expression of angiogenin, new potential angiogenic factor, in ovary of Korean native cattle by immunohistochemistry and in situ hybridization. Angiogenin immunoreactivity and mRNA expression were observed in endothelial cells, fibroblast and vascular smooth muscle cells. However, we could not observed angiogenin immunoreactivity and mRNA expression in primordial ovarian follicle. In follicular epithelial cells of primary ovarian follicle, weak angiogenin immunoreactivity and mRNA expression were observed. Follicular epithelial cells, theca interna and externa in secondary ovarian follicles, showed angiogenin immunoreactivity, while follicular epithelial cells did the weak mRNA expression. Angiogenin immunoreactivity and mRNA expression were observed in follicular epithlial cells, theca interna and oocyte in tertiary ovarian follicle. The corpus luteum showed strong immunoreactivity and mRNA expression but atretic follicle weak. However, these angiogenin immunoreactivity and mRNA expression became to be weaker during regression. These results suggest that angiogenin may play a role as not only an angiogenic factor but a growth factor in ovary.
Angiogenesis Inducing Agents ; Animals ; Cattle ; Corpus Luteum ; Endothelial Cells ; Epithelial Cells ; Female ; Fibroblast Growth Factor 1 ; Fibroblast Growth Factor 2 ; Fibroblasts ; Immunohistochemistry ; In Situ Hybridization ; Menstrual Cycle ; Muscle, Smooth, Vascular ; Oocytes ; Ovarian Follicle ; Ovary* ; RNA, Messenger* ; Theca Cells

Essential thrombocythemia, a subcategory of chronic myeloproliferative disorder, is characterized by absolute thrombocytosis due to excessive clonal proliferation of platelets, hyperaggregability of platelets and increased incidence of thrombosis and hemorrhage. Essential thrombocythemia may cause frequent vascular thrombosis, but it can be a rare cause of acute ischemic heart diseases such as acute myocardial infarction without atherosclerosis, unstable angina and angina pectoris. We report a case of essential thrombocythemia complicated by acute myocardial infarction. A patient with a previous history of vascular thrombotic complications (such as transient ischemic attack and deep vein thrombosis) was managed with 2.8 million units of intravenous urokinase, antiplatelet agent, ACEI, antianginal medications and hydroxyurea. There were clinically remarkable improvements and no further episodes of thrombotic ischemic vascular complications, including acute myocardial infarction.
Angina Pectoris ; Angina, Unstable ; Atherosclerosis ; Hemorrhage ; Humans ; Hydroxyurea ; Incidence ; Ischemic Attack, Transient ; Myeloproliferative Disorders ; Myocardial Infarction* ; Myocardial Ischemia ; Thrombocythemia, Essential* ; Thrombocytosis ; Thrombosis ; Urokinase-Type Plasminogen Activator ; Veins

PURPOSE: The cognitive and psychosocial morbidity of medically refractory epilepsy is considerable. Epilepsy surgery can play a important role in these patients. We investigated the clinical manifestations and the surgical outcome of our patients with medically refractory epilepsy. METHODS: We studied 27 patients under 15 years old who had epilepsy surgery at Samsung Medical Center between March 1995 and December 2001 retrospectively. RESULTS: The median age at first unprovoked seizure was 6 years, the median age at surgery was 11.02 years and duration of follow-up was 14 months to 7 years 2 months. Complex partial seizure was the most common type of seizures. Interictal and ictal discharges were lateralized in 66.7% and 81.5%, respectively. MRI showed abnormal findings in 23 patients and the cortical dysplasia was the most common pathologic finding. As per surgical outcomes, 77.8% of the patients became seizure free. Among patients with temporal lobe epilepsy(TLE), seizure free rate was 92.3% whereas patients with extratemporal lobe epilepsy(ETLE) showed 64.3% seizure free rate. All patients with TLE with focal lesions became seizure free. Patients with focal lesions which were concordant with findings of EEG, SPECT, and PET showed excellent surgical outcomes. However, patients with no focal lesion in MRI and discordant preoperative examinations showed poor outcomes. CONCLUSION: The results of epilepsy surgery in our patients were quite satisfactory. Good surgical outcome can be expected when the decision of surgery is made based on a good correlation among clinical, neuroradiological, and other preoperative examinations.
Adolescent ; Child ; Electroencephalography ; Epilepsy* ; Follow-Up Studies ; Humans ; Magnetic Resonance Imaging ; Malformations of Cortical Development ; Retrospective Studies ; Seizures ; Temporal Lobe ; Tomography, Emission-Computed, Single-Photon

BACKGROUND: It is well known that collateral circulation has important roles in ischemic heart diseases. The method most commonly used at present to evaluate collateral flow is coronary angiography. However, there are debates about the functional significance of angiographically visible collaterals because angiography visualizes only vessels that are larger than 100um in diameter. Recent studies suggest that myocardial contrast echocardiography (MCE) is a useful method in assessing collateral flow because it uses small microvascular tracers (4-12um) as a contrast agent. By using MCE, this study evaluates the role of angiographically visible collaterals in patients with acute myocardial infarction (AMI) and chronic ischemic heart disease. METHOD: Forty-one patients who underwent coronary angiography and MCE were included in this study (22 patients with acute myocardial infarction and 19 patients with chronic ischemic heart disease). Antegrade coronary flow was less than TIMI 3 flow in all patients. Myocardial perfusion through collaterals with MCE was evaluated by injecting sonicated Hexabrix into nonobstructing coronary arteries. Angiographically visualized collateral vessels were analysed as four grades and compared with the degree of myocardial opacification by MCE through collateral vessels. RESULT: Angiographic collaterals were frequently observed in patients with AMI and chronic ischemic heart disease with< or = TIMI 2 flow . There was poor correlation between TIMI grade and the grade of collaterals by angiography in AMI (r--0.29, p-0.20) and chronic ischemic heart disease (r--0.31, p-0.19). There was no correlation between collateral grades and myocardial opacification by MCE through collateral vessels in AMI (r-0.07, p-NS) and chronic ischemic heart disease (r-0.10, p-NS). In patients with relatively well developed collaterals (Grade II or III), the ischemic zone was perfused better through collateral flow in the chronic ischemic heart disease group than in the AMI group (Mean Retrograde Opacification Index 0.84+/-0.23 vs 0.32+/-0.22, p<0A65A>0.05). CONCLUSION: The study suggests that the role of angiographically visible collaterals is different in chronic ischemic heart disease and acute myocardial infarction. The grade of angiographically visible collaterals does not imply the extent of perfusion to myocardum at risk through collateral vessels.
Angiography ; Collateral Circulation ; Coronary Angiography ; Coronary Vessels ; Echocardiography ; Heart ; Humans ; Ioxaglic Acid ; Myocardial Infarction ; Myocardial Ischemia* ; Perfusion*

BACKGROUND/AIMS: With the development of self-expanding metallic stents, colonic obstruction can be relieved without the need for surgery. The results of preoperative placement of stents for malignant colorectal obstruction might be different according to the obstructing lesion. The objective of this study was to compare clinical improvement rates and operative results after preoperative placement of stents for malignant colorectal obstruction according to the location of the obstructing lesion. METHODS: This is a retrospective study including 57 patients who underwent self-expanding metallic stent insertion for obstructing resectable colorectal cancers. Patients were classified into three groups according to the location of the lesion as follows: proximal to the sigmoid colon (Group A), sigmoid colon (Group B), and rectum (Group C). RESULTS: The number of patients in A, B, and C groups was 13, 22, and 22, respectively. No significant differences in age, gender, stent type, and accompanying diseases among the three groups were observed. There were no significant differences in stent-related complications, clinical improvement rates, and one-stage resection rates among the three groups. The postoperative complications, the requirement rate of ICU care, the period of ICU stay, postoperative hospital stay, and hospital mortality did not significantly differ among the three groups. CONCLUSIONS: Clinical improvement rates and operative results after successful placement of stents for obstructing resectable colorectal cancers are not different according to the location of the obstructing lesion, suggesting that preoperative stenting for one-stage curative resection is useful, irrespective of the location of lesion.
Aged ; Aged, 80 and over ; Colorectal Neoplasms/*diagnosis/surgery ; Female ; Hospital Mortality ; Humans ; Intensive Care Units ; Intestinal Obstruction/*surgery ; Length of Stay ; Male ; Middle Aged ; Preoperative Care ; Retrospective Studies ; *Stents

BACKGROUND: Spontaneous pneumothorax have been managed with a variety of methods. The technique most frequently used is chest tube drainage. Small caliber catheters were first used in the management of pneumothorax complicating the percutaneous needle aspiration lung biopsy, and the try to treat spontaneous pneumothorax also has been reported. However, the value of small caliber catheters in spontaneous pneumothorax has not been fully evaluated. So, we tried to elucidate the efficacy of 8 French catheter in the management of spontaneous pneumothorax. METHOD: From January, 1990, to April, 1994, 44 patients with spontaneous pneumothorax treated at Chung-Ang university hospital were reviewed. The patients were sub-divide into 8 French catheter insertion group (n=21) and chest tube insertion group (n=23). We compared the presence of underlying lung disease, the extent of the collapse, the duration of indwelling catheter and complication between two groups. RESULTS: 1) The duration of indwelling showed no significant difference between 8 French catheter group and chest tube. But, complication after insertion as subcutaneous emphysema was developed in only chest tube group. (p<0.05) 2) In the primary spontaneous pneumothorax, all case of the pneumothorax of which size was less than 50% showed complete healing with 8 French catheter insertion. Whereas the success rate in patients with large pneumothorax (more than 50%) was tended to be dependent on the age. 3) In the patients with secondary spontaneous pneumothorax who were managed with 8 French catheter, the success rate was trended to be high if the underlying disease of pneumothorax was not COPD and if the patient was young. CONCLUSION: These results show that 8 French catheter insertion probably was effective in the pneumothorax less than 50%, the primary spontaneous pneumothorax, young age or secondary pneumothorax not associated with COPD.
Biopsy ; Catheters* ; Catheters, Indwelling ; Chest Tubes* ; Drainage ; Humans ; Lung ; Lung Diseases ; Needles ; Pneumothorax* ; Pulmonary Disease, Chronic Obstructive ; Subcutaneous Emphysema ; Thorax*

OBJECTIVE: Uterine leiomyosarcoma (LMS) is a rare and aggressive disease with poor outcome. Due to its rarity and conflict of data, investigation on finding prognostic factor is challenging. The aim of the study was to investigate the prognostic significance of preoperative ¹⁸F-fluorodeoxyglucose (¹⁸F-FDG) positron emission tomography/computed tomography (PET/CT) in uterine LMS. METHODS: This was a retrospective observational cohort study in 3 tertiary referral hospitals. We retrospectively evaluated data from patients with pathologically proven uterine LMS who underwent preoperative ¹⁸F-FDG PET/CT scans at 3 institutions. The prognostic implication of PET/CT parameters and other clinico-pathological parameters on disease-free survival (DFS) and overall survival (OS) was evaluated. RESULTS: Clinico-patholgical data were reviewed for 19 eligible patients. In the group overall, median DFS and OS were 12 and 20 months, respectively. As for the recurrence, large tumor size, and high tumor maximum standardized uptake value (SUVmax) were demonstrated as risk factors of recurrence. As for the OS, high tumor SUVmax was demonstrated as the unique risk factor. There were significant differences in tumor size, mitotic count, SUVmax, and DFS between patients with and without recurrence. Also, there were significant differences in tumor size, SUVmax, DFS, and OS between 2 subgroups stratified by cut-off SUVmax. CONCLUSION: SUVmax at preoperative ¹⁸F-FDG PET/CT was associated with worse outcome in patients with uterine LMS. In the preoperative setting, SUVmax can be a valuable non-invasive prognostic marker. Additionally, SUVmax can help identify highly aggressive uterine LMS and may help in adjusting standard treatment toward an individualized, risk-adapted treatment.
Cohort Studies ; Disease-Free Survival ; Electrons ; Fibrinogen ; Fluorodeoxyglucose F18 ; Humans ; Leiomyosarcoma* ; Positron-Emission Tomography and Computed Tomography* ; Prognosis ; Recurrence ; Retrospective Studies ; Risk Factors ; Tertiary Care Centers ; Uterine Diseases