Mammography is the only examination capable of depicting malignant calcifications in breast. In some instances calcifications evident in mammogram and specimen mammograms are not observed in the histologic specimen. Therefore, wer retrospectively analyzed 27 cases in which hook-guided wire localization and biopsy had been performed to determine if microcalcifications were lost during histopathologic processing. Calcium was apparently lost during preparation of the block in about 7% of the cases and after slide preparation in about 11%, for a total possible loss of 18%. The authors recommend a protocol for avoiding these loss that involves performance of a more comprehensive examination of histologic sections by the pathologist and radiographic reexamination of paraffin-embedded tissue blocks with subsequent step sectioning by the pathologist.
Biopsy ; Breast ; Calcium ; Mammography ; Retrospective Studies

We report a case of multiple myeloma with gastric involvement occurring in a patient who underwent an upper gastrointestinal series (UGIS), CT and MRI. UGIS depicted a luminal protruding mass, while contrast-enhanced CT demonstrated marked thickening of the gastric wall, with subtle contrast enhancement. At T1- and T2-weighted MR imaging, the mass showed iso- and intermediate signal intensity, respectively. After the administration of contrast material, subtle homogeneous enhancement was apparent.
Case Report ; Contrast Media/administration & dosage ; Human ; Magnetic Resonance Imaging ; Male ; Middle Age ; Multiple Myeloma/pathology/*radiography ; Stomach Neoplasms/pathology/*radiography ; Tomography, X-Ray Computed

No abstract available.
Bronchiolitis Obliterans* ; Bronchiolitis* ; Cryptogenic Organizing Pneumonia*

This meta-analysis examined the surgical management of older patients (>80 years) with gastric cancer, who were often excluded from randomized controlled trials. We analyzed 23 retrospective cohort studies involving 18,372 patients and found that older patients had a higher in-hospital mortality rate (relative risk [RR], 3.23; 95% confidence interval [CI], 1.46–7.17; P<0.01) and more post-operative complications (RR, 1.36; 95% CI, 1.19–1.56;P<0.01) than did younger patients. However, the surgical complications were similar between the two groups. Older patients were more likely to undergo less extensive lymph node dissection and longer hospital stays. Although older patients had statistically significant post-operative medical complications, they were not deprived of surgery for gastric cancer.The comorbidities and potential risks of post-operative complications should be carefully evaluated in older patients, highlighting the importance of careful patient selection. Overall, this meta-analysis provides recommendations for the surgical management of older patients with gastric cancer. Careful patient selection and evaluation of comorbidities should be performed to minimize the risk of post-operative complications in older patients, while recognizing that they should not be deprived of surgery for gastric cancer.

PURPOSE: To verify the effect of preservative-free Dorzolamide/Timolol fixed combination (PFDTC) on intraocular pressure (IOP) elevation after vitrectomy. METHODS: We retrospectively reviewed medical records of 33 patients who used PFDTC after pars plana vitrectomy. All patients' visual acuity and IOP was measured and symptoms of conjunctival irritation were investigated through survey and slit lamp examination. RESULTS: Before vitrectomy, the mean IOP was 13.6 ± 4.4 mm Hg which was elevated to 31.7 ± 5.4 mm Hg after vitrectomy (p < 0.001) and applying eyedrop lowered the mean IOP to 17.2 ± 7.0 mm Hg (p < 0.001). Regardless of tamponade material type, all elevated IOP decreased (p < 0.001) and the IOP of all 33 eyes did not rise to over 30 mm Hg again. No additional surgery for IOP control was needed during two-month follow-up period. Of the 33 patients using PFDTC, patients who felt discomfort were five (15.2%) and no patients showed side effects severe enough to stop use of eyedrop. CONCLUSIONS: PFDTC is an anti-glaucomatic agent which can reduce the IOP by inhibiting aqueous humor production. Without need for additional surgery, the eyedrop can effectively lower elevated post-vitrectomy IOP, with expectation of good patient compliance due to low risk of conjunctival irritation.
Aqueous Humor ; Follow-Up Studies ; Humans ; Intraocular Pressure* ; Medical Records ; Ophthalmic Solutions ; Patient Compliance ; Retrospective Studies ; Slit Lamp ; Visual Acuity ; Vitrectomy*

A biliary cystadenoma (BC) and a cystadenocarcinoma (BCA) are rare neoplasms of the liver. Among 178 patients with primary liver neoplasms who underwent surgery during the last two years at our department, there were only one case of BC and three cases of BCA. The BC case was a 57-year-old female with 15-cm-sized multilocular cystic mass containing mucin. That patient, who had undergone a simple excision of a liver cyst 6 years earlier under the diagnosis of a cystadenoma, received a repeated wedge resection and is still doing well, no recurrence, 41 months after the resection. One BCA case was a 59-year-old female with an 8-cm-sized multilocular cystic mass. She underwent an extended left lobectomy and is still alive, without recurrence, 55 months later. Another BCA case was 77-year-old female with multiple multilocular masses which had degenerated due to sclerotherapy; the masses were removed by a wedge resection. She has been alive 35 months without recurrence. The other BCA case was a 37-year-old female with a 10-cm-sized unilocular mass with lung metastasis. She underwent an extended left lobectomy and survived 22 months. Malignant transformation of a BC to a BCA is well documented, and recurrence is the rule following incomplete resection. Complete resection of a BC and radical resection of a BCA seem to offer a chance for long-term survival.
Adult ; Aged ; Cystadenocarcinoma* ; Cystadenoma* ; Diagnosis ; Female ; Hepatectomy ; Humans ; Liver ; Liver Neoplasms ; Lung ; Middle Aged ; Mucins ; Neoplasm Metastasis ; Recurrence ; Sclerotherapy

The purpose of this study is to observe and compare the remineralization tendencies of artificially demineralized enamel by remineralization solutions of different degree of saturations at pH 5.5, using a polarizing microscope and computer programs (Photoshop, Image pro plus, Scion Image, Excel). For this study, 36 sound permanent teeth with no signs of demineralization, cracks, or dental restorations were used. The specimens were immersed in lactic acid demineralization solution for 3 days in order to produce dental caries artificially that consist of surface and subsurface lesions. Each of 9 or 10 specimens was immersed in pH 5.5 lactic acid buffered remineralization solution of three different degrees of saturation (0.25, 0.30, 0.35) for 12 days. After the demineralization and remineralization, images were taken by a polarizing microscope (x 100). The results were obtained by observing images of the specimens, and using computer programs, the density of caries lesions were determined. In conclusion, in the group with the lowest degree of saturation, remineralization occurred thoroughly from the surface to the subsurface lesion, whereas in the groups with greater degree of saturation showed no significant change in the subsurface lesion, although there was corresponding increase in the remineralization width on the surface zones.
Dental Caries ; Dental Enamel ; Hydrogen-Ion Concentration ; Lactic Acid ; Software ; Tooth

PURPOSE: Several studies have used FISH (fluorescence in situ hybridization) to analyze aneuploids in various solid tumors. FISH, using chromosome-specific, alpha-stellite DNA probes, can be used to detect aneusomy in interphase and/or metaphase cells. The aims of this study were to compare the FISH cen tromere signals from benign breast tumors and to those from breast cancers and to evaluate the clinico pathologic parameters and the aneusomic patterns involving chromosomes 1, 11, and 17 in breast cancers. METHODS: FISH was performed on touch preparations from 15 benign breast-tumor and 29 breast-cancer specimens. The frequency of aneusomy, measured by nondisomy, was determined for chromosomes 1, 11, and 17 through the use of chromosome-specific alpha-stellite DNA probes. The frequency of chromosome- specific aneusomy was then correlated with clinicopathologic parameters, including tumor size, lymph- node involvement, estrogen receptor, and nuclear grade. RESULTS: Only one of the 15 benign breast tumors was shown to be aneusomic for chromosome 1. The other 14 cases of the benign breast tumors showed no evidence of aneusomy for any of the 3 chromosomes. In breast cancers, however, 26 of the 29 cases (90%) were exhibited aneusomy of at least 1 of the 3 chromosomes evaluated and chromosome 1 was most frequently aneusomic (26 of 29 cases (90%)). The present study also suggested a possible correlation between the numeric abnormality of chromosome 1 and estrogen receptor levels. No significant correlations with tumor size, regional lymph-node metastasis, and nuclear grade were observed. CONCLUSION: These findings suggest that chromosome-specific aneusomy is more frequently observed in breast cancers than in benign breast tumors and that aneusomy of chromosome 1 correlates with estrogen receptor levels.
Aneuploidy ; Breast Neoplasms* ; Breast* ; Chromosomes, Human, Pair 1 ; DNA Probes ; Estrogens ; Fluorescence* ; In Situ Hybridization* ; Interphase ; Metaphase ; Neoplasm Metastasis

OBJECTIVE: We wanted to determine the technical and clinical efficacy of using a PTFE-covered self-expandable nitinol stent for the palliative treatment of malignant biliary obstruction. MATERIALS AND METHODS: Thirty-seven patients with common bile duct strictures caused by malignant disease were treated by placing a total of 37 nitinol PTFE stents. These stents were covered with PTFE with the exception of the last 5 mm at each end; the stent had an unconstrained diameter of 10 mm and a total length of 50-80 mm. The patient survival rate and stent patency rate were calculated by performing Kaplan-Meier survival analysis. The bilirubin, serum amylase and lipase levels before and after stent placement were measured and then compared using a Wilcoxon signed-rank test. The average follow-up duration was 27.9 weeks (range: 2-81 weeks). RESULTS: Placement was successful in all cases. Seventy-six percent of the patients (28/37) experienced adequate palliative drainage for the remainder of their lives. There were no immediate complications. Three patients demonstrated stent sludge occlusion that required PTBD (percutaneous transhepatic biliary drainage) irrigation. Two patients experienced delayed stent migration with stone formation at 7 and 27 weeks of follow-up, respectively. Stent insertion resulted in acute elevations of the amylase and lipase levels one day after stent insertion in 11 patients in spite of performing endoscopic sphincterotomy (4/6). The bilirubin levels were significantly reduced one week after stent insertion (p < 0.01). The 30-day mortality rate was 8% (3/37), and the survival rates were 49% and 27% at 20 and 50 weeks, respectively. The primary stent patency rates were 85%, and 78% at 20 and 50 weeks, respectively. CONCLUSION: The PTFE-covered self-expandable nitinol stent is safe to use with acceptable complication rates. This study is similar to the previous studies with regard to comparing the patency rates and survival rates.
Adenocarcinoma/*complications ; Aged ; Aged, 80 and over ; Alloys/adverse effects/*therapeutic use ; Cholestasis, Extrahepatic/etiology/*surgery ; Coated Materials, Biocompatible/*therapeutic use ; Common Bile Duct/radiography/surgery ; Digestive System Neoplasms/*complications ; Equipment Design ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Palliative Care/methods ; Pilot Projects ; Polytetrafluoroethylene/adverse effects/*therapeutic use ; Postoperative Complications/diagnosis/epidemiology ; Prospective Studies ; *Stents/adverse effects ; Survival Analysis ; Treatment Outcome

This study was undertaken to compare renal damage, as determined by serum creatinine and degree of apoptosis, caused by iodinated contrast or gadolinium in an acute renal failure (ARF) rat model. Rats were divided into three groups; controls (n=3), a CT contrast medium group (n=9), and an MR contrast medium group (n=9). The CT and MR groups were further subdivided into three groups, namely, low, standard, and high dose subgroups. Renal function was evaluated by determining serum creatinine levels; before ARF, and 48 hr after ARF and contrast administration. Apoptosis was assayed by terminal deoxynucleotidyl transferasemediated dUTP nick-end labeling (TUNEL). No significant creatinine level differences were observed between the CT and MR groups (p=0.116). Degrees of apoptosis in the renal cortex and medulla were more severe in the CT contrast medium group than in the control or MR contrast medium group (p<0.05). The study shows that CT contrast medium did not aggravate renal function more so than MR contrast medium in this ARF rat model. However, apoptosis examination in the renal cortex and medulla indicated that CT contrast medium induced more severe apoptosis than MR contrast medium (p<0.05). We conclude that CT contrast medium can be used for renal imaging studies when subjects are well hydrated and preventive medication is administered.
Animals ; Apoptosis/*drug effects ; Contrast Media/adverse effects ; Creatine/*blood ; Female ; Gadolinium DTPA/*adverse effects ; Iohexol/adverse effects/*analogs and derivatives ; Kidney/*drug effects/*pathology ; Kidney Failure, Acute/*blood/pathology/radiography ; Male ; Rats ; Rats, Sprague-Dawley ; Research Support, Non-U.S. Gov't