PURPOSE: Drug resistance plays an important role in the failure of chemotherapy in breast cancer. The purpose of the study was to investigate the chemosensitive and chemoresistance indices of breast carcinomas and see if the in vitro chemosensitivity test correlated with the prognostic indices. METHODS: The immunohistochemical expressions of MDR1, MRP1 and topoisomerase IIalpha(topo IIalpha) were studied and then correlated these with the in vitro chemosensitivities using the histoculture drug response assay (HDRA) and clinicopathological factors in 51 breast carcinomas. RESULTS: In the breast carcinomas examined, the immunohistochemical expressions of MDR1, MRP1 and topo II alpha were strongly observed in 26 (51.0%), 16 (32.0%), 15 (31.3%) carcinomas, respectively. The MRP1 was more frequently expressed in poorly differentiated carcinomas (P= 0.006), and those of MDR1 and topo II alpha were more frequently observed in tumor overexpressing cerbB2 (P=0.038, P=0.036). The expression of MDR1 was related to that of topo II alpha (P=0.015). Comparing these markers with the in vitro chemosensitivities to cyclophosphamide, 5-FU, adriamycin, taxol and taxotere, no correlations were found between the expression of MDR1, MRP1, and topo II alpha but from the chemosensitivity using the HDRA, the growth inhibition rate for cyclophosphamide was higher in MRP1 expressing carcinomas (P=0.009). CONCLUSION: MDR1, MRP1 and topo II alpha were all found to be associated with the poor prognostic indices, but assessment of their immunohistochemical expressions did not allow for prediction of the response to chemotherapy by the in vitro chemosensitivity test in breast carcinomas.
Breast Neoplasms* ; Breast* ; Cyclophosphamide ; Doxorubicin ; Drug Resistance ; Drug Therapy ; Fluorouracil ; Paclitaxel

An asymptomatic 26-year-old man was initially admitted with a suspicious mediastinal mass. On the basis of the contrast-enhanced chest CT findings, aneurysm formation involving the left cervical aortic arch associated with subaortic left innominate vein was diagnosed. The aneurysm was confirmed by MR angiography and DSA. The arch aneurysm was surgically removed. We describe this case, and review the literature.
Adult ; Aneurysm* ; Angiography ; Aorta, Thoracic* ; Brachiocephalic Veins* ; Humans ; Tomography, X-Ray Computed

The estrogen hormone receptor (ER) content of human breast cancer has assumed an important role as a predictor of hormone therapy response and as a prognostic indicator. The conventional technique is the dextran-coated charcoal (DCC) method or a ligand-binding assay (LBA) based on the measurement of radiolabeled steroids in cytosolic extracts of tissue homogenate. The recent introduction of monoclonal antibodies with high specificity for human ERs has allowed the application of immunocytochemical assays (ICA) in human cancer tissue. An extension of the ICA technique to cytologic specimens is also widely used. Our aim was to evaluate the reliability of ER-ICAs on fine needle aspirates(FNA) from breast cancer patients by comparing it with ER-ICAs and ER-LBAs performed on surgically removed tissues. During a recent 6-month period, ER-ICAs and ER-LBAs were performed in 83 cases. Among these 83 cases, only the 40 cases for which the ER-ICA and the ER-LBA were performed simultaneously ere included in this study. As positive cutoff values, we assumed 10 fmol/mg protein for the ER-LBAs and a semiquantitative score of 4 for the ER-ICAs. The results were as follows : 1) The ER positive rate was 55% (22/40) for ICAs and 47.5% (19/40) for LBAs. The concordance rate between the ER of ICAs and that of LBAs was 82.5% (33/40). 2) The Pearson correlation coefficient between ER-ICAs of fine needle aspirates and that of surgically removed tissue was good (r=0.94, p<0.005) 3) The Spearman correlation coefficient between ER-ICAs of fine needle aspirates and ER-LBAs of surgically removed tissue was good (r=0.57, p=0.0001) In conclusion, ER determination by using the fine needle aspirate is a reliable method in palpable breast cancer. FNA-ER may be a useful method when it is difficult to take sufficient breast cancer tissue, i.e., in cases of diffusely recurrent cancer, liver metastasis, malignant pleural effusion, etc.
Antibodies, Monoclonal ; Biopsy* ; Breast Neoplasms* ; Breast* ; Charcoal ; Cytosol ; Estrogens* ; Humans ; Liver Neoplasms ; Needles* ; Neoplasm Metastasis ; Pleural Effusion, Malignant ; Sensitivity and Specificity ; Steroids

BACKGROUND: Now, breast reconstruction is being performed in many cases after mastectomy by using tissue expander or TRAM flap. But conventional mastectomy leaves a long linear scar tissue which is also seen on the breast skin after breast reconstruction. Skin spring mastectomy with immediate reconstruction leaves a minimal scar tissue, even though, with circumareolar incision, it makes no visible scar tissue. PURPOSE: The purpose of this study is 1) to identify the clinical indications for Skin-spring mastectomy (SSM) with immediate reconstruction, 2) to evaluate the clinical results and 3) to encourage the application of this method. MATERIALS AND METHODS: During recent 20 months, breast cancer surgery were 467 cases, mastectomy were 368 (78.8%, 368/467), mastectomy with breast reconstruction were 30 case (8.2%, 30/368), Among 30 reconstruction cases, Skin-spring mastectomy (SSM) with circumareolar incision and immediate reconstruction were performed in 9 patient. Our patient selection criteria was as follows; 1) patient's desire of reconstruction on cosmetic aspect 2) clinically early breast cancer 3) moderate breast size 4) central locating tumor 5) no Skin involvement. RESULTS: 1) we performed 9 cases of Skin-spring mastectomy (SSM) with circumareolar incision and immediate reconstruction. 2) Three patient who complainted palpable mass were diagnosed by FNA for breast cancer and the other 6 patient were proved by ductal biopsy in 4 cases whose complaint was bloody nipple discharge, a H-wire biopsy in whose mammography revealed multiple microcalcifications and a punch biopsy in whose nipple was eczematous. All cases were suspected for early breast cancer preoperatively. 3) Four cases were stage 0, 3 cases were stage I lesions and 2 cases were stage III in postoperative pathologic staging. 4) All the patients were satisfied with their cosmetic results. CONCLUSIONS: Skin-spring mastectomy (SSM) with immediate reconstruction is new method for breast cancer operation with modified skin incision and shows good aesthetic results. we propose more frequent application of this method for indicated patient, but we need futher follow-up of local recurrence rate and detection rate in these patients.
Biopsy ; Breast Neoplasms* ; Breast* ; Cicatrix ; Female ; Follow-Up Studies ; Humans ; Mammaplasty ; Mammography ; Mastectomy* ; Nipples ; Patient Selection ; Recurrence ; Skin ; Tissue Expansion Devices

PURPOSE: To determine evaluate the clinical effectiveness of low-dose erythromycin (EM) therapy in patients with diffuse panbronchiolitis (DPB), and to correlate the pulmonary function testing (PFT) changes seen at serial high-resolution CT (HRCT) withthe results of post-treatment. MATERIALS AND METHODS: We retrospectively evaluated 13 DPB patients [seven men and six women aged 23-68 (mean, 46.2) years] who had undergone PFT, HRCT, and transbronchial or open lung biopsy prior to long-term, low-dose EM therapy (250 mg twice daily for more than six months). The interval between initial and follow-up study ranged from 7 to 32 (mean, 16.6+/-8.0) months, and we compared the changes in HRCT findings and PFT parameters before and after treatment. RESULTS: At HRCT after EM therapy, the extent of centrilobular nodules (p=0.006), peripheral bronchiolar wall thickening (p=0.02), and areas of low attenuation (p=0.011) decreased significantly, while FVC and FEV1 showed significant increases: FVC, from 2.47+/-0.83 to 2.74+/-0.95 (p=0.028); and FEV1, from 1.66+/-0.75 to 1.95+/-0.87 (p=0.02). As the extent of peripheral bronchiolar wall thickening (r=-0.609, p=0.047) and areas of low attenuation (r=-0.687, p=0.041) decreased at serial HRCT, FVC and FEV1 increased significantly. CONCLUSION: Long-term follow-up HRCT findings showed that for DPB patients, lowdose EM provides effective treatment. In addition, HRCT appears to be valuable for the objective evaluation of responses to EM therapy.
Biopsy ; Bronchiolitis ; Erythromycin* ; Female ; Follow-Up Studies ; Humans ; Lung ; Male ; Respiratory Function Tests* ; Retrospective Studies

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: To assess efficacy of the Pentacam (PTC) and the anterior segment optical coherence tomography (AOCT) for detection of occludable angles. MATERIALS AND METHODS: Fourty-one eyes with gonioscopically diagnosed occludable angles and 32 normal open-angle eyes were included. Anterior chamber angle (ACA) and anterior chamber depth (ACD) were measured with PTC and AOCT. Receiver operating characteristic (ROC) curve was constructed for each parameter and the area under the ROC curve (AUC) was calculated. RESULTS: Values of ACA and ACD measured by PTC and AOCT were similar not only in normal open angle eyes but also in occludable angle eyes. For detection of occludable angle, the AUCs of PTC with ACA and ACD were 0.935 and 0.969, respectively. The AUCs of AOCT with ACA and ACD were 0.904 and 0.947, respectively. CONCLUSION: Both PTC and AOCT allow accurate discrimination between open and occludable angle eyes, so that they may aid to screening the occludable angles.
Aged ; Aged, 80 and over ; Anterior Chamber/*anatomy & histology ; Humans ; Middle Aged ; Tomography, Optical Coherence/*methods

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

Intravascular papillary endothelial hyperplasia (IPEH) is a rare benign reactive vascular lesion, characterized by thrombus formation and subsequent intravascular endothelial proliferation. IPEH should be differentially diagnosed from angiosarcoma because of their microscopic similarity. The clinical manifestation of IPEH varies according to involved site. We report a rare case of IPEH in the maxillary sinus of 35-year-old male presenting with epistaxis, which is completely removed without complications.
Adult ; Endothelium ; Epistaxis ; Hemangiosarcoma ; Humans ; Hyperplasia* ; Male ; Maxillary Diseases ; Maxillary Sinus* ; Thrombosis