No abstract available.
Maxillary Sinus* ; Maxillary Sinusitis*

Ambulatory BP monitoring was performed in a patients with pheochromocytoma before and after removal of the tumor. Before surgery, it did not show any significant diurnal variation. But, after surgery the diurnal variation was restored.
Blood Pressure Monitoring, Ambulatory* ; Blood Pressure* ; Humans ; Pheochromocytoma*

No abstract available.
Child* ; Humans ; Neurilemmoma* ; Neurofibromatosis 1

PURPOSE: The development of publicized screening methods for breast carcinoma detection has led to a marked increase in the discovery of ductal carcinoma in situ (DCIS) or DCIS with microinvasion (DCIS-MI). Axillary lymph node status has been believed to be not only an indicator of prognosis, but also a direction of adjuvant therapy. But the incidence of axillary metastasis in DCIS or DCIS-MI has diversely found in from 0% to 20%. This study was performed to analyze the incidence of axillary metastasis and the predictive factors associated with axillary lymph node metastasis in DCIS or DCIS-MI. METHODS: Patients with DCIS or DCIS-MI and axillary lymph node dissection from 1987 to 2004 were selected from Korea University Medical Center. We reviewed their medical records for age, palpability and size of the tumor, histolgic subtype, nuclear grade, hormone receptor status, and pathologic slides. RESULTS: Fifty two patients in DCIS and Thirty eight patients in DCIS-MI were included in the study. Axillary lymph node metastases were identified in 2 patients (3.8%) in DCIS and 4 patients (10.5%) in DCIS-MI. Tumor size and nuclear grade in DCIS had a borderline significance in association with microinvasion. We could not be able to find any predictive factor associated with axillary lymph node metastasis in DCIS and DCIS-MI. CONCLUSION: Axillary lymph node metastasis in DCIS or DCIS-MI appeared to be not low and there was no predictive factor associated with axillary lymph node metastasis in DCIS and DCIS-MI. But DCIS patients with large tumor size and poor nuclear grade have the high possibility associated with microinvasion, therefore, in that cases, there is a need to consider the possibility of axillary metastasis.
Academic Medical Centers ; Breast ; Breast Neoplasms ; Carcinoma, Ductal* ; Carcinoma, Intraductal, Noninfiltrating* ; Humans ; Incidence ; Korea ; Lymph Node Excision ; Lymph Nodes* ; Mass Screening ; Medical Records ; Neoplasm Metastasis* ; Prognosis

Primary Pigmented Nodular Adrenal Dysplasia (PPNAD) is a rare cause of Cushing's syndrome in infants and young adults. The familial occurrence, it may be variably associated with a complex of other pathologic characteristics that manifests extraadrenal disorders (includes cardiac myxomas, lentigines, mammary myxoid lesions, testicular tumors, pituitary adenomas, and neuroectodermal tumors) was considered indicative of Carneys complex. This was based on the failure of cortisol suppression by high-dose dexamethasone, either normal or suppressed basal adrenocorticotropic hormone (ACTH) levels, and normal radiographic studies of the sellar turcica, and adrenals glands is almost normal or slightlg eulaged.. Bilateral adrenalectomy has thus the only effective means of cure. The disease may be a component of a rare, but potentially dangerous complex of abnormalities that follow an autosomal-dominant mode of inheritance. Recently we experienced a case of Carney's complex composed by Cushings syndrome due to PPNAD with familial purple colored lentigines on their lips and report it with reviews of the literatures.
Adrenalectomy ; Adrenocorticotropic Hormone ; Cushing Syndrome* ; Dexamethasone ; Humans ; Hydrocortisone ; Infant ; Lentigo ; Lip ; Myxoma ; Neural Plate ; Pituitary Neoplasms ; Testicular Neoplasms ; Wills ; Young Adult

PURPOSE: Intraoperative quick parathyroid hormone assay (PTH) was introduced in the parathyroid surgery since 1988 and the value in patients with primary hyperparathyroidism was well recognized in the literature. The purpose of this study was to evaluate the usefulness of intraoperative rapid PTH assay in patients with renal hyperparathyroidism by comparing intraoperative PTH results and the biochemical results at postoperative 6(th) month, including PTH values. METHODS: Fifteen consecutive patients of renal hyperparathyroidism underwent total parathyroidectomy and immediate autotransplantation from November 2003 to February 2005. PTH levels were measured by PTH assay at the induction of anesthesia (baseline level) and in 20-minute intervals after excision of the last parathyroid gland. More than 50% drop of initial PTH level was considered as completeness of parathyroidectomy. RESULTS: Twenty minutes after resection, PTH levels decreased by 83.7% in 14 patients and by 50.2% in one patient. Ten patients (67%) were cured but 5 patients (34%) showed high PTH levels after 6 months. The drop rate of intraoperative quick PTH level in cured patients was 92% at 26 minutes after parathyroidectomy and was significantly different from 73.3% of persistent or recurrent five patients (P=0.047). Preoperative PTH level, calcium level, alkaline phosphatase level and preoperative localization were not different in the cured and recurrent or persistent patients of renal hyperparathyroidism. CONCLUSION: The value of intraoperative quick PTH assay in patients of renal hyperparathyroidism was questionable. More than 92% drop of intraoperative PTH level at 26 minutes after parathyroidectomy could predict success in our study.
Alkaline Phosphatase ; Anesthesia ; Autografts ; Calcium ; Humans ; Hyperparathyroidism* ; Hyperparathyroidism, Primary ; Parathyroid Glands ; Parathyroid Hormone* ; Parathyroidectomy ; Transplantation, Autologous

PURPOSE: In breast cancer patients, information of the axillary nodal status is essential for staging, determining the necessity of systemic therapy, and predicting the prognosis. The necessity of an axillary lymph node dissection in small breast cancers is controversial. The aim of this study is to identify the factors associated with axillary lymph node metastases and to determine the necessity of axillary lymph node dissections in T1 invasive ductal carcinomas of the breast. METHODS: From the June 1991 to the March 2004, of a total 919 cases who underwent surgery for breast cancer in Korea University Hospital, 230 cases of T1 invasive ductal carcinomas were reviewed retrospectively. All subjects were classified as T1a, T1b, or T1c. The rate of axillary lymph node metastasis was calculated for each group and the factors that have a statistically significant correlations with axillary lymph nodes metastases were investigated. RESULTS: Of the 230 cases of T1 invasive ductal carcinomas, 22 cases were T1a, 27 cases were T1b, and 181 cases were T1c. Axillary lymph node metastases were encountered in 4 T1a case (18%), 5 T1b cases (18.5%), and 67 T1c cases (30.3%). The overall rate of axillary lymph node metastases rate in T1 was 33% (76/230). The T stage had a statistically significant correlation (p=0.043) with the axillary lymph node metastases. Lymphovascular invasion of the tumor had a significant correlations with an axillary lymph node metastases (p=0.032). The MIB-1 labeling index was increased according to the tumor size, and correlated with the presence of an axillary lymph node metastasis (p=0.032, p=0.18). However age, hormone receptors, p53, HER2/neu , and nm23 were not associated with an axillary lymphnodes metastasis. CONCLUSIONS: The tumor size and the lymphovascular invasion could be significantly prognostic factors suggesting an axillary lymph node metastasis in T1 invasive ductal carcinomas. The MIB-1 immunostain was higher in the T1c cases. Therefore, a combination of the tumor size and MIB-1 immunostain would be an indicator for an axillary lymph node dissection. A sentinel lymph node biopsy may be of more benefit in T1a invasive ductal carcinomas of the breast.
Breast Neoplasms ; Breast* ; Carcinoma, Ductal* ; Humans ; Korea ; Lymph Node Excision ; Lymph Nodes* ; Neoplasm Metastasis* ; Prognosis ; Retrospective Studies ; Sentinel Lymph Node Biopsy

PURPOSE: In breast cancer patients, information of the axillary nodal status is essential for staging, determining the necessity of systemic therapy, and predicting the prognosis. The necessity of an axillary lymph node dissection in small breast cancers is controversial. The aim of this study is to identify the factors associated with axillary lymph node metastases and to determine the necessity of axillary lymph node dissections in T1 invasive ductal carcinomas of the breast. METHODS: From the June 1991 to the March 2004, of a total 919 cases who underwent surgery for breast cancer in Korea University Hospital, 230 cases of T1 invasive ductal carcinomas were reviewed retrospectively. All subjects were classified as T1a, T1b, or T1c. The rate of axillary lymph node metastasis was calculated for each group and the factors that have a statistically significant correlations with axillary lymph nodes metastases were investigated. RESULTS: Of the 230 cases of T1 invasive ductal carcinomas, 22 cases were T1a, 27 cases were T1b, and 181 cases were T1c. Axillary lymph node metastases were encountered in 4 T1a case (18%), 5 T1b cases (18.5%), and 67 T1c cases (30.3%). The overall rate of axillary lymph node metastases rate in T1 was 33% (76/230). The T stage had a statistically significant correlation (p=0.043) with the axillary lymph node metastases. Lymphovascular invasion of the tumor had a significant correlations with an axillary lymph node metastases (p=0.032). The MIB-1 labeling index was increased according to the tumor size, and correlated with the presence of an axillary lymph node metastasis (p=0.032, p=0.18). However age, hormone receptors, p53, HER2/neu , and nm23 were not associated with an axillary lymphnodes metastasis. CONCLUSIONS: The tumor size and the lymphovascular invasion could be significantly prognostic factors suggesting an axillary lymph node metastasis in T1 invasive ductal carcinomas. The MIB-1 immunostain was higher in the T1c cases. Therefore, a combination of the tumor size and MIB-1 immunostain would be an indicator for an axillary lymph node dissection. A sentinel lymph node biopsy may be of more benefit in T1a invasive ductal carcinomas of the breast.
Breast Neoplasms ; Breast* ; Carcinoma, Ductal* ; Humans ; Korea ; Lymph Node Excision ; Lymph Nodes* ; Neoplasm Metastasis* ; Prognosis ; Retrospective Studies ; Sentinel Lymph Node Biopsy

BACKGROUND: The selection of blue dye or technetium radioisotope depends on the surgeon? experience or the availability of the center in sentinel lymph node biopsy (SLNB). The purpose of this study is to evaluate the possibility of clinical usage of indigo carmine in SLNB in breast cancer. METHODS: From the July 2001 to the March 2004, 93 consecutive cases of Tis - T2 breast cancers without palpable axillary lymph nodes were enrolled to the SLNB. After usual preparation for the breast conserving surgery or mastectomy, the patients were intradermally injected with 5 ml of indigo carmine around the subareolar area. After 4 minutes has passed, usual axillary incision of breast conserving surgery was made, and the stained lymphatics were followed to the firstly encountered lymph nodes. The dissected nodes were sent to the department of pathology for frozen and permanent sections. After SLNB, axillary lymph node dissections (ALND) were completed regardless of the result of the frozen section. RESULTS: The identification rate of SLNB using Indigo carmine was 97.8% (91/93). The axillary node metastases on complete ALND were 21 cases. 18 cases were detected with SLNB, and 3 cases were falsely reported as negative on SLNB. 11 cases had metastases in the sentinel nodes only (52.4%). Among the 3 false negative cases, one case had axillary metastasis solely in a node in level III (infraclavicular node). The sensitivity of the test was 85.7% (18/21), and the specificity was 100% (70/70). False negative rate was 9.5% (2/21), and negative predictive value was 95.9% (70/73). CONCLUSIONS: Sentinel node biopsy using indigo carmine showed similar identification rate and false negative rate with other blue dye only methods including isosulfan blue. Because indigo carmine is more available and safe than isosulfan blue, it could be an alternative to isosulfan blue.
Biopsy ; Breast Neoplasms* ; Breast* ; Frozen Sections ; Humans ; Indigo Carmine* ; Lymph Node Excision ; Lymph Nodes ; Mastectomy ; Mastectomy, Segmental ; Neoplasm Metastasis ; Pathology ; Sensitivity and Specificity ; Sentinel Lymph Node Biopsy* ; Technetium

BACKGROUND: The selection of blue dye or technetium radioisotope depends on the surgeon? experience or the availability of the center in sentinel lymph node biopsy (SLNB). The purpose of this study is to evaluate the possibility of clinical usage of indigo carmine in SLNB in breast cancer. METHODS: From the July 2001 to the March 2004, 93 consecutive cases of Tis - T2 breast cancers without palpable axillary lymph nodes were enrolled to the SLNB. After usual preparation for the breast conserving surgery or mastectomy, the patients were intradermally injected with 5 ml of indigo carmine around the subareolar area. After 4 minutes has passed, usual axillary incision of breast conserving surgery was made, and the stained lymphatics were followed to the firstly encountered lymph nodes. The dissected nodes were sent to the department of pathology for frozen and permanent sections. After SLNB, axillary lymph node dissections (ALND) were completed regardless of the result of the frozen section. RESULTS: The identification rate of SLNB using Indigo carmine was 97.8% (91/93). The axillary node metastases on complete ALND were 21 cases. 18 cases were detected with SLNB, and 3 cases were falsely reported as negative on SLNB. 11 cases had metastases in the sentinel nodes only (52.4%). Among the 3 false negative cases, one case had axillary metastasis solely in a node in level III (infraclavicular node). The sensitivity of the test was 85.7% (18/21), and the specificity was 100% (70/70). False negative rate was 9.5% (2/21), and negative predictive value was 95.9% (70/73). CONCLUSIONS: Sentinel node biopsy using indigo carmine showed similar identification rate and false negative rate with other blue dye only methods including isosulfan blue. Because indigo carmine is more available and safe than isosulfan blue, it could be an alternative to isosulfan blue.
Biopsy ; Breast Neoplasms* ; Breast* ; Frozen Sections ; Humans ; Indigo Carmine* ; Lymph Node Excision ; Lymph Nodes ; Mastectomy ; Mastectomy, Segmental ; Neoplasm Metastasis ; Pathology ; Sensitivity and Specificity ; Sentinel Lymph Node Biopsy* ; Technetium