No abstract available.
Biopsy* ; Diagnosis* ; Humans

Papillary lesions of the nipple are extremely rare. These lesions are not associated with a positive family history of or other risk factors for breast carcinomas. Papillary lesions of the nipple tend to assume one or more of three distinct morphologic growth patterns. These patterns include sclerosing papillomatosis, papillomatosis adenosis, and adenosis. A nipple papilloma initially presents itself as a bulge just beneath the nipple and enlarges slowly over months to years before causing symptoms. Patients present with nipple erosions, ulcerations, or masses and often have serous or bloody discharge. Because of this constellation of symptoms, it is often a challenge to differentiate a papilloma of the nipple from Paget's disease or eczematous dermatitis. Complete excision of the papillary lesion is sufficient. The author experienced papillomatosis of nipple and got good results postoperatively. A 55-year-old woman presented with multiple lobulated small masses and erosion of the left nipple. At first, we diagnosed the lesion as Paget's disease or eczematous dermatitis. Later, a wedge biopsy revealed the papilloma. A complete excision of the papillary lesion was performed.
Biopsy ; Breast Neoplasms ; Eczema ; Female ; Humans ; Middle Aged ; Nipples* ; Papilloma* ; Risk Factors ; Ulcer

OBJECTIVES: Recently, the outpatient group psychotherapy has been changed from traditional long-term therapy to short-term or time-limited therapy. The termination time and session numbers are given from start line in the time-limited therapy while 10 to 40 sessions are needed in the short-term therapy. And therapist and patients come to an agreement of the accomplishable therapeutic goal and work together actively. The time-limited group psychotherapy is being accepted newly as an efficient therapeutic modality because effective therapeutic outcomes within given time have been reported. The objectives of this study are as follows; firstly, we examine the therapeutic outcomes and the therapeutic factors after performing the time-limited group psychotherapy for outpatients in the psychiatric clinic; secondly, we analyze the characteristics showed in the process of study; lastly, we verify the feasibility and the validity of this group psychotherapy and then establish the basis of the effective outpatient therapy that would be settled down as an applicable treatment modality economically and efficiently in the current medical environment of Korea. METHODS: This study was performed weekly in total 12 sessions from July 1999, April 2000 to and each session took 70-80 minutes. The experimental group were composed of the highly-functioning psychotic patients among outpatients in the psychiatric clinic. The control group were composed of the similar patients through one-to-one matching of age, sex, diagnosis, and duration of illness. The participants were 8 patients each. BDI(Beck Depression Inventory), STAI(Spielbergs State-Trait Anxiety Inventory), MMPI(Minnesota Multiphasic Personality Inventory), and EDMT(Ewha Defence Mechanism Test) as the evaluation scales were performed before and after treatment. And 13-therapeutic factors scale was performed just after each session and the self-report total assessment questionnaire was performed only in experimental group at the end of this study. RESULTS: The mean score of BDI was decreased significantly in experimental group in comparison with control group. The mean score of STAI-S was not changed significantly in both group, and the mean score of STAI-T was decreased in experimental group in comparison with control group. The mean score of MMPI was decreased significantly in experimental group in comparison with control group, but the comparison of difference scores(post-treatment score - pre-treatment score) between the experimental and control group was not decreased significantly. This result may come from psychopharmacotherapy and individual supportive psychotherapy given equally to both group. The mean scores of immature defence and neurotic defence in EDMT were decreased significantly in experimental group compared with control group. Comparing the therapeutic factors to divide into the first, middle, and the last stage, existential factor was ranked first, and catharsis, identification with therapist, universality, and group cohesiveness were ranked high in all stages. Interpersonal learning was ranked first in the last stage although being ranked low in the first and middle stage. The total assessment questionnaires about group psychotherapy were reported that 100% of participants were helped, 75% of participants were changed in their lives, and 75% of participants had minds to join this kind of program again if given for them. CONCLUSIONS: This result shows that not only symptom relief but also personality change was achieved when the time-limited group psychotherapy was practiced in addition to simple psychophamarcotherapy and individual supportive psychotherapy for outpatients. The degree of satisfaction for group psychotherapy of participants were evaluated highly. Group psychotherapy has been accepted in public as a therapeutic modality that must be as equally effective as psychotherapy although group psychotherapy derives from individual psychotherapy. In our current medical environment that has been changed suddenly by the separation of medical practice and pharmaceutical dispensing and the decrease of medical fee, group psychotherapy or time-limited therapy would be settled down as low-expense and high-efficiency therapeutic modalities that were as equally effective as individual psychotherapy or long-term therapy.
Anxiety ; Catharsis ; Depression ; Diagnosis ; Fees, Medical ; Humans ; Korea ; Learning ; MMPI ; Outpatients* ; Psychotherapy ; Psychotherapy, Group* ; Surveys and Questionnaires ; Weights and Measures

PURPOSE: Thyroid cancer is the most common endocrine malignancy, and it has a wide spectrum of biologic behavior, histologic appearance, and management. This study reviewed various aspects of the clinical features of differentiated thyroid cancer. METHODS: We retrospectively reviewed the clinical characteristics of 114 patients who had undergone surgical management for differentiated thyroid cancer at the Chonbuk National University Hospital from September 1989 to December 1997. RESULTS: The most prevalent age group was in the 5th decade (29 cases, 25.4%). The male-to-female ratio was 1 to 5.7. The most common initial symptom was a palpable mass on the anterior or the lateral portion of the neck (110 cases, 96.5%). The most common duration of illness from the appearance of the symptom to the treatment was below 3 months (38 cases, 34.5%). The primary tumors were located on the right lobe (49 cases, 43.0%), the left lobe (38 cases, 33.3%), both lobes (22 cases, 19.3%), and the isthmus (5 cases, 4.4%). In the histopathologic study, the common type was a papillary carcinoma (102 cases, 89.5%). The common surgical procedures were a total thyroidectomy (66 cases, 57.8%) and a near total thyroidectomy (24 cases, 21.0%). Seventy-five patients (65.8%) received a lymph-noe dissection, and there was cervical lymph-node metastasis in 43 cases (57.3%) of this group. Postoperative complications occurred in 11 cases (9.3%). The common complications were hemorrhage or seroma (5 cases, 4.4%), hoarseness (5 cases, 4.4%) and wound infection (1 cases, 0.9%). Although hypoparathyroidism was predicted, the predominant symptoms did not appear. Regional recurrence or distant metastases were present in 13 cases (11.4%) during four years. CONCLUSION: Thyroid cancer has a wide sectrum of biological behavior and also problems including the lack of reliable prognostic factors and objective assessments of therapeutic modalities. Appropriate and aggressive management should be recommended because most of differentiated thyroid cancer has a favorable prognosis.

PURPOSE: This study was done to determine the diagnostic efficacy of clinical examination, fine needle aspiration (FNA) cytology, mammography, and ultrasonography in palpable breast mass. METHODS: We performed 248 FNA cytologies for a palpable breast mass, among which 106 cases were histologically examined during the period from Jan. 1994 to Dec. 1997 at the Department of Surgery, Chonbuk National University Hospital. Among the 106 patients, mammography was done for 96 patients, and ultrasono graphy for 73 patients. RESULTS: The main clinical symptom was a palpable mass in the breast at the time of visitation. Clinical diagnosis based on symptoms and physical examination had a sensitivity of 96.9% and a specificity of 57.5%. Based on a definite histologic diagnosis, the sensitivity of FNA cytology was 96.9%, its specificity was 91.7%, and its diagnostic accuracy 93.5%. 86.1% of the cytologically malignant cases proved to be malignant histologically, and 100% of the cytologically benign cases turned out histologically benign. Mammography had a sensitivity of 89.3%, a specificity of 84%, and a diagnostic accuracy of 86.8%. Ultrasonography showed a 93.5% sensitivity, a 51.4% specificity, and a 74.6% diagnostic accuracy. CONCLUSION: FNA cytology was a reliable and safe diagnostic method compared to physical examination, mammography, and ultrasonography. FNA cytology of a palpable breast mass should be the diagnostic procedure of choice for those patients classified clinically as probably benign or malignant.
Biopsy, Fine-Needle* ; Breast* ; Diagnosis ; Humans ; Jeollabuk-do ; Mammography* ; Physical Examination ; Sensitivity and Specificity ; Ultrasonography*

BACKGROUND/AIMS: Transforming growth factor-a(TGF-a) is a polypeptide cytokine related to cell proliferation and transformation. TGF-a binds to EGF receptor and stimulating DNA synthesis in liver cell. The hepatitis B virus (HBV) by itself is also believed to play a role in the hepatic carcinogenesis. Recently, it was reported that TGF-a and HBV were synergistic in action with rapid appearance of hepatocelluar carcinoma in bitransgenic mice. Although TGF- a is thought to play an important role in hepatocarcinogenesis, its expression during the natural history of HBV hepatitis was poorly understood. This investigation was performed to elucidate the dynamic changes and istinct immunohistochemical staining patterns in the course of chronic HBV hepatitis with specific reference to hepatocelluar carcinoma and to explain the role of TGF-a in the pathogenesis of hepatocelluar carcinoma. MATERIALS/METHODS: Employing TGF-a monoclonal antibody, signal detection was carried out by peroxidase-conjugated streptavidin in deparaffinized liver tissue sections taken from HBsAg positive patients. All of the liver tissue sections were proven HBV DNA positive by in situ hybridization. Immunohistochemical staining was performed in the tissue sections obtained from four normal controls, six from patients with chronic persistent hepatitis, five with chronic active hepatitis, eight with liver cirrhosis and eleven with hepatocellular carcinoma. RESULTS: The patterns of TGF-a immunoreactivity were cytoplasmic-grain types in normal controls and chronic persistent hepatitis, honeycomb types in chronic active hepatitis, occasional cytoplasmic-flooding types in liver cirrhosis, and cytoplasmic-grape types in hepatocellular carcinoma. A Shapiro-Wilk W test for frequency table analysis for the expression of TGF-a in these different disease groups was statistically significant. CONCLUSION: These data suggest that step-wise distinct expression of TGF-a enhancement in HBV associated chranic liver diseases which eventually resulted in the development of hepatocellular carcinoma were conceivably due to dysregulation of liver cell cycles by both HBV and TGF-a during the persistent repetition of cell cycles.
Animals ; Carcinogenesis ; Carcinoma, Hepatocellular* ; Cell Cycle ; Cell Proliferation ; DNA ; Hepatitis ; Hepatitis B Surface Antigens ; Hepatitis B virus ; Hepatitis, Chronic* ; Humans ; In Situ Hybridization ; Liver Cirrhosis* ; Liver Diseases ; Liver* ; Mice ; Natural History ; Receptor, Epidermal Growth Factor ; Streptavidin

BACKGROUND: Palpable breast tumors have traditionally been diagnosed with open biopsy. We propose fine needle aspiration (FNA) cytology as a reliable, safe initial procedure in these patients. METHODS: We performed 248 fine needle aspiration (FNA) cytology of breast tumors, among which 106 cases were histologically examined during the period of form Jan. 1994 to Dec. 1997 at the Department of Surgery, Chonbuk National University Hospital. RESULTS: Main clinical symptom was palpable mass on breast at the time she visited the hospital. Clinical diagnosis based on symptoms and physical examination had 96.9% of sensitivity, 57.5% of specificity. Based on definite histologic diagnosis, the sensitivity of FNA cytology was 96.9% specificity 91.7%, diagnostic accuracy 93.5%, respectively. 86.1% of cytologic malignancy were proven malignant histologically, and 100% of cytologically benign cases turned out hitologically benign. CONCLUSIONS: A fine needle aspiration (FNA) cytology of solid palpable breast lesions should be diagnostic procedure of choice for those patients classified clinically as probably benign or clinically as malignant.
Biopsy ; Biopsy, Fine-Needle* ; Breast Neoplasms ; Breast* ; Diagnosis ; Humans ; Jeollabuk-do ; Physical Examination ; Sensitivity and Specificity

No abstract available.
RNA, Messenger*

No abstract available.
Heart Septal Defects, Atrial* ; Hemodynamics*

BACKGROUND: Thyroid cancer is the most common endocrine malignancy, and it has a wide spectrum of biologic behavior, histologic appearance, and management. This study reviewed various aspects of the clinical features of well-differentiated thyroid cancer. METHODS: We retrospectively reviewed the clinical characteristics of 114 patients who had undergone surgical management for well-differentiated thyroid cancer at the Chonbuk National University Hospital from September 1989 to December 1997. RESULTS: The most prevalent age group was in the 5th decade (29 cases, 25.4%). The male-to-female ratio was 1 to 5.7. The most common initial symptom was a palpable mass on the anterior or the lateral portion of the neck (110 cases, 96.5%). The most common duration of illness from the appearance of the symptom to the treatment was below 3 months (38 cases, 34.5%). The primary tumors were located on the right lobe (49 cases, 43.0%), the left lobe (38 cases, 33.3%), both lobes (22 cases, 19.3%), and the isthmus (5 cases, 4.4%). In the histopathologic study, the common type was a papillary carcinoma (102 cases, 89.5%). The common surgical procedures were a total thyroidectomy (66 cases, 57.8%) and a near total thyroidectomy (24 cases, 21.0%). Seventy-five patients (65.8%) received a lymph-node dissection, and there was cervical lymph-node metastasis in 43 cases (57.3%) of this group. Postoperative complications occurred in 11 cases (9.3%). The common complications were hemorrhage or seroma (5 cases, 4.4%), hoarseness (5 cases, 4.4%) and wound infection (1 case, 0.9%). Although hypoparathyroidism was predicted, the predominant symptoms did not appear. Regional recurrence or distant metastases were present in 13 cases (11.4%) during four years. CONCLUSIONS: Thyroid cancer has a wide spectrum of biological behavior and also problems including the lack of reliable prognostic factors and objective assessments of therapeutic modalities. Appropriate and aggressive management should be recommended because most of well-differentiated thyroid cancer has a favorable prognosis.
Carcinoma, Papillary ; Hemorrhage ; Hoarseness ; Humans ; Hypoparathyroidism ; Jeollabuk-do ; Neck ; Neoplasm Metastasis ; Postoperative Complications ; Prognosis ; Recurrence ; Retrospective Studies ; Seroma ; Thyroid Gland* ; Thyroid Neoplasms* ; Thyroidectomy ; Wound Infection