PURPOSE: This study was performed to determine the incidence of BMM and to correlate the presence of these micrometastases with prognosis and othet clinicopathologic features. Materials AND Methods: BMM was evaluated in 220 breast cancer patients between July, 1991 and January, 1997, using mouse monoclonal antibody (AE1/AE3) against cytokeratin in an immunofluorescent assay. RESULTS: Of the 220 patients, 71 (32.3%) were positive for BMM. There were no association between bone marrow positivity and nodal status, TNM stage, known histopathologic parameters, and hormona1 receptor. Median follow-up for 220 patients was 41.6 month. The relapse rate was 16.8% (37/220). Twenty-four (33.8%) of 37 patients were positive for BMM and 13 (8.7%) were negative (p<0.05). Bone metastasis occurred in 16 cases, and was more common in BMM positive patients (14 of 24, 54.2%, versus 2 of 13, 15.4%, p < 0.05). Twenty-six patients were died of relapsed breast cancer. In overall survival, patients who was negative for BMM showed higher survival rate (p<0.05). CONCLUSION: BMM was a good predictor for distant metastasis, especially bone metastasis, and for poor prognosis. But no association was found between bone marrow positivity and tumor size, nodal status, stage, histologic parameter and hormonal receptor status.
Animals ; Bone Marrow* ; Breast Neoplasms* ; Breast* ; Fluorescent Antibody Technique ; Follow-Up Studies ; Humans ; Incidence ; Keratins ; Mice ; Neoplasm Metastasis ; Neoplasm Micrometastasis* ; Prognosis ; Recurrence ; Survival Rate

The purpose of this study was to access the effect of TMJ arthrocentesis in locking 8 patients with anterior distal displacement without reduction ( 'closed lock' ). TMJ Arthrocentesis was defined as needle puncture of the joint space and usually combined with lavage. After lavage, the mandible is gently manipulated to evaluate the movement. Arthrocentesis with irrigation has been used successfully with few complications and low morbidity. Postoperative therapy requires repetitive opening and excursive exercises to maintain and improve the function. The mean follow-up period was 17.1 months(range, 8 to 30months). Preoperative and postoperative mean maximal interincisal opening(MIO) was 25.4mm preoperatively and 39.8mm postoperatively. The pain was reduced in 7 out of 8(87.5%) patients with limited mouth opening. The result of this study indicate that TMJ arthrocentesis is an effective means of controlling pain and improving jaw movement in patients with closed lock.
Exercise ; Follow-Up Studies ; Humans ; Jaw ; Joints ; Mandible ; Mouth ; Needles ; Punctures ; Temporomandibular Joint* ; Therapeutic Irrigation

PURPOSE: The association between the margin status and the risk of a local recurrence (LR) after breast conservation therapy (BCT) is controversial. In addition, the width of the resection margin that minimizes the risk of LR is unknown. This study examined the interaction between the margin width, tumor characteristics, and adjuvant systemic therapy on the risk of LR after BCT. METHODS: The records of 348 women with T1 and T2 breast cancers, who were treated with BCT between 1997 and 2004, were reviewed. Patients who underwent a re-excision with a positive margin were excluded. The margin was classified as close (< or =5 mm tumor-free margin) or negative (>5mm tumor-free margin). Various clinical and pathologic factors were analyzed as potential prognostic factors for LR in addition to the margin width. RESULTS: The rate of LR for all patients after a mean follow-up of 37.2 months was 3.7% (13/348). The LR rates were significantly associated with young age (<40 years, P=0.009), high nuclear grade (P=0.032), large tumor size (>2 cm, P=0.021) and negative hormone receptor (P=0.032). A positive axillary lymph node, the presence of EIC, high histological tumor grade, high proliferative index (Ki-67), the presence of lymphovascular invasion, the over-expression of c-erbB2 and the expression of p53 was not significant. Systemic adjuvant therapy was not associated with a lower rate of LR in both groups. The final resection margins were close in 30 patients (8.6%) and negative in 318 patients (91.4%). The rates of LR by the margin width were 6.7% (2/30) for close margins and 3.5% (11/318) for negative margins. There were no significant differences in the rate of LR according to the margin width. The rate of LR in patients with a 1 mm tumor-free margin width was 13.3% (2/15). Moreover, there is a tendency for an increase in the LR with a 1 mm tumor-free margin than with a margin width >1 mm (P=0.046). CONCLUSION: According to this study, if the margin is tumor-free, a close resection margin (< or =5 mm) is not associated with an increased rate of LR in BCT. However, a high rate of LR can be expected in patients with 1 mm margins.
Breast Neoplasms ; Breast* ; Female ; Follow-Up Studies ; Humans ; Lymph Nodes ; Recurrence*

Background: Retzius-sparing robot-assisted radical prostatectomy (rsRARP) is a surgical procedure that can minimize the resection of surrounding prostate tissue by enabling access through the anterior surface of the Douglas pouch. We reported our initial experiences with rsRARP compared to conventional robot-assisted radical prostatectomy (RARP). Methods: Retrospective data were collected from March 2019 to June 2022, including 69 patients who underwent robotic radical prostatectomy for localized prostate cancer. The operations were performed at a single center, and we alternated between the two methods. Perioperative characteristics and oncologic and functional outcomes were analyzed. Results: In total, 35 patients underwent RARP and 34 patients underwent rsRARP. The preoperative characteristics of the patients were similar. Oncologic and functional parameters were analyzed postoperatively. Except for early recovery of urinary incontinence (immediate, 1 month, 3 months, 6 months: p<0.001, p=0.002, p=0.004, and p=0.014, respectively), there were no significant differences between the two groups. We also analyzed trends in operation time and oncologic and functional outcomes according to the progression of rsRARP cases. Conclusions rsRARP has the major advantage of enabling an early recovery from urinary incontinence after surgery, and it is also a good surgical approach that shows oncologically similar results to the conventional approach. It is also highly reproducible and can be recommended to surgeons new to robotic radical prostatectomy.

Cysts of the spleen are uncommon disease entities and can be classified as either primary (true) or secondary (pseudo-) depending on the presence of a true epithelial lining. True nonparasitic cysts of spleen are very rare, and the majority of the cases are classified as epidermoid cysts. True splenic cysts were found in three children during the last eleven years (1989~1999) in Yeungnam University Hospital. Two of the children were girls and one was boy. The age at diagnosis ranged from 7 to 15 years. Abdominal ultrasonography was utilized to the initial diagnosis, and computerized tomography was done for the detailed studies. Radionuclide scanning was performed in a patient. Surgical resection (one partial splenectomy and two total splenectomies) was performed. The cysts were from 4cm to 9cm in maximum diameter. Pathologic finding was epidermoid cyst of the spleen.
Child ; Diagnosis ; Epidermal Cyst ; Female ; Humans ; Male ; Spleen ; Splenectomy ; Ultrasonography

Background and Objectives: In South Korea, neck ultrasonography (US) has been used widely at 1- or 2-year intervals to detect recurrence after thyroidectomy. The aim of this study is to assess the prevalence and pattern of recurrence and to establish a proper frequency of follow-up neck US after thyroid lobectomy for papillary thyroid microcarcinoma (PTMC). Materials and Methods: We retrospectively reviewed 262 consecutive patients who had undergone thyroid lobectomy for PTMC from January 2005 to October 2009. They were divided into two groups based on the presence of recurrence (240 patients in group 1 and 22 patients in group 2). The comparison between the two groups involved clinical and pathological characteristics. Results: Recurrences were found in 22 (8.4%) of 262 patients with 132.5 months follow-up (range, 120-180 months). There was a significant difference in the mean number of follow-up neck US after 5 years postoperatively, shortened interval, total number of follow-up neck US (p=0.002, p＜0.001, p＜0.001). All recurrences were found between 2-3 to 11-12 years. Recurrences after 5 years were found in 16 (72.7%) of 22 patients. Conclusion Recurrence after thyroid lobectomy for PTMC occurred with various times during follow up. The minimum frequency of follow-up neck US was not enough for detecting tumor recurrence, especially after 5 years postoperatively. Our results suggest that annual neck US may be appropriate between 3 to 12 years after thyroid lobectomy for PTMC.

OBJECTIVES: The standard metrics used to monitor the progression of acute kidney injury (AKI) include markers such as serum creatinine, blood urea nitrogen, and estimated glomerular filtration rate (eGFR). Moreover, neutrophil gelatinase-associated lipocalin (NGAL) expression has been reported to modulate oxidative stress. METHODS: We aimed to evaluate the usefulness of serum NGAL levels for monitoring renal function after radical nephrectomy (RN). We prospectively collected data from 30 patients who underwent RN. We analyzed serum NGAL and creatinine at 6 time points: preoperative day 1, right after surgery, 6 hours after surgery, postoperative day (POD) 1, POD 3, and POD 5. We compared these measurements according to the eGFR values (classified as chronic kidney disease stage III; CKD III or not) using data obtained 3 months after surgery. RESULTS: The mean age was 65.5 years (range, 45–77 years), and the male-to-female ratio was 2:1. At the last follow-up examination, there were 12 patients (40%) with CKD III. Using receiver operating characteristic analysis, we found that serum creatinine on POD 5 (area under the curve [AUC], 0.887; P= 0.000) and NGAL at 6 hours after LRN (AUC, 0.743, P= 0.026) were significant predictors of CKD III. The development of CKD III after LRN was associated with the serum creatinine level on POD 5 and the NGAL at 6 hours after surgery. CONCLUSIONS: Compared to serum creatinine, serum NGAL enabled earlier prediction of postoperative CKD III. Therefore, serum NGAL measured 6 hours after surgery could be a useful marker for managing patients after RN.
Acute Kidney Injury ; Blood Urea Nitrogen ; Creatinine ; Early Diagnosis* ; Follow-Up Studies ; Glomerular Filtration Rate ; Humans ; Kidney ; Lipocalins* ; Nephrectomy* ; Neutrophils* ; Oxidative Stress ; Prospective Studies ; Renal Insufficiency, Chronic ; ROC Curve

PURPOSE: The conventional prognostic factors for breast cancer reflect the early short-term prognosis. However, many of these factors cannot predict the long-term prognosis accurately. Therefore, this study evaluated the characteristics of breast cancer that would indicate the development of delayed recurrences after primary treatment. METHODS: Eight hundred and forty nine female breast cancer patients were divided into two groups, an early recurrent (within 5 years) and a late recurrent group (after 5 years). Each conventional prognostic factor including the histological grade (HG), nuclear grade (NG), lympho-vascular invasion (LVI), status of hormonal receptor, p53 and c-erbB2 were compared to identify any factor that would show significant difference. RESULTS: The overall recurrence rate was 14.2% (121/849), which was significantly higher in patients with a high TNM stage, high HG and NG, positive LVI, negative receptor status and expression of p53 (P<0.05). The mean disease free interval was 28.2 months. In the recurred patients, 90.1% (109/121) recurred within 5 years, and 9.9% (12/121) recurred after 5 years of treatment. There was a similar distribution of most prognostic factors in the two groups (P>0.05). However, the positive rate of the hormonal receptor was significantly higher in the late recurrent group (P=0.019). All these factors, except for c-erbB2 over-expression, were independent prognostic factors for a recurrence within 5 years (P<0.05) but the significance of these factors disappeared after that time (P>0.05). CONCLUSION: The positive hormone receptor of breast cancer is a good early prognostic factor that can also predict late recurrences.
Breast Neoplasms ; Breast* ; Female ; Humans ; Prognosis ; Recurrence

PURPOSE: Subcutaneous mastectomy, combined with immediate breast reconstruction has become popular for breast cancer management. This type of surgery allows for an improved cosmetic result. Although subcutaneous mastectomy is becoming more common, there is little data regarding the local recurrence (LR) rate after this procedure. METHODS: A total of 93 patients were treated for breast cancer by subcutaneous mastectomy with immediate breast reconstruction using permanent prosthesis at Yeungnam University Hospital from September 1996 to April 2003. The inclusion criteria for this procedure were peripherally located tumor, a tumor size smaller than T2, clinically negative axillary lymph node, and a grossly normal nipple and areolar area. To avoid recurrence at the nipple-areolar complex (NAC), a frozen biopsy of the NAC resection margin was performed in all cases. RESULTS: The mean follow-up period was 26 months, and the mean age of the patients was 40.2 years. According to the American Joint Committee on Cancer staging, the stage was as follows: stage 0, 9 patients; stage I, 39 patients; and stage II, 45 patients. The overall LR rate was 5.4% (5 of 93 patients). The mean local relapse-free interval was 30 months. The sites of LR were at the peripheral breast tissue and at the NAC. Only one of 79 patients with preservation of the NAC developed LR at the NAC during the follow-up. LR at the NAC was low as 1.3%. No statistical differences in the LR rates were demonstrated between the NAC-spared group and the NAC-resected group (P>0.05). CONCLUSION: Subcutaneous mastectomy with immediate breast reconstruction using permanent prosthesis as a treatment for early breast cancer is a good treatment modality. Furthermore, preservation of the nipple-areolar complex increases the satisfaction of patients by improving the cosmetic result, and this procedure is both feasible and oncologically safe for breast cancer patients.
Biopsy ; Breast Neoplasms* ; Breast* ; Female ; Follow-Up Studies ; Humans ; Joints ; Lymph Nodes ; Mammaplasty* ; Mastectomy, Subcutaneous* ; Neoplasm Staging ; Nipples ; Prostheses and Implants ; Recurrence

Among many adverse effects of docetaxel, fluid retention is a well recognized, cumulative side effect, but severe fluid retention is rare. We report here on a case of docetaxel-induced severe fluid retention with peripheral edema, pleural effusion, severe ascites and pericardial effusion in a 41-year-old woman. She had been treated with 3 cycles of docetaxel 9 days previously and she was admitted to our hospital due to abdominal distention and mild dyspnea. Radiologic studies revealed pleural effusion, severe ascites and a small pericardial effusion. Diuretics were given for 21 days. The pleural effusion was resolved after treatment with diuretics for 2 days, but the ascites wasn't resolved until 14 days of diuretics. After treatment with diuretics for 21 days, all the symptoms of the patient were completely resolved. Early detection is mandatory and diuretics are very effective for patient suffering with docetaxel-induced severe fluid retention.
Adult ; Ascites ; Breast ; Breast Neoplasms ; Diuretics ; Dyspnea ; Edema ; Female ; Fluid Shifts ; Humans ; Pericardial Effusion ; Pleural Effusion ; Retention (Psychology) ; Stress, Psychological ; Taxoids