No abstract available.

No abstract available.
Colorectal Neoplasms* ; Humans

Gynecomastia is a proliferation of glandular tissue of the breast in male and it is the most commonly observed breast disease amongst male patients associated with the negative impact on body image and social health of man. Although the medical therapy is an option with long-standing gynecomastia patients, the less than desirable effectiveness leads to the surgery. Although various techniques have been described for the correction of gynecomastia, the common technique of surgery has been performed with a circumareolar incision. However, this technique has been associated with undesirable complications such as a visible scar on the chest, areola inversion, and nipple necrosis. To remedy such complications, the transaxillary techniques were used in an attempt to avoid scar and the complication of the nipple areola complex. In this study, the surgery for the two patients with Simon’s grade III gynecomastia were performed using the pull-through technique and through the axillary incision. The result of the transaxillary subcutaneous mastectomy technique produced esthetic appearance with little complications.

Gynecomastia is a proliferation of glandular tissue of the breast in male and it is the most commonly observed breast disease amongst male patients associated with the negative impact on body image and social health of man. Although the medical therapy is an option with long-standing gynecomastia patients, the less than desirable effectiveness leads to the surgery. Although various techniques have been described for the correction of gynecomastia, the common technique of surgery has been performed with a circumareolar incision. However, this technique has been associated with undesirable complications such as a visible scar on the chest, areola inversion, and nipple necrosis. To remedy such complications, the transaxillary techniques were used in an attempt to avoid scar and the complication of the nipple areola complex. In this study, the surgery for the two patients with Simon’s grade III gynecomastia were performed using the pull-through technique and through the axillary incision. The result of the transaxillary subcutaneous mastectomy technique produced esthetic appearance with little complications.

Intraductal papillary tumors of the breast exhibit bloody discharge with often no evidence of a palpable tumor, making discrimination between benign and malignant lesions sometimes difficult for pathologists and surgeons. So the technique used in removing the offending ductal system should be fully diagnostic, adequately therapeutic and cosmetically. Microdochectomy has been accepted treatment for intraductal papilloma of the breast. We performed dye-injection microdochectomy on intraductal papilloma of the breast in 15 patients. This procedure utilizes lacrimal probe and 24-gauge medicut that are gently advanced into the offending duct and methylene blue dye is injected to outline the involved duct for easy dissection through a circumareolar incision. Because we could perform dye-injection microdochectomy safely, rapidly and effectively, we think that this procedure is standard treatment of intraductal papilloma of the breast.
Breast* ; Discrimination (Psychology) ; Humans ; Methylene Blue ; Papilloma, Intraductal*

The effect of perioperative blood transfusion on the survival rate of patients of colorectal cancer was studied. From January 1990 to December 1995, 533 patients with colorectal cancer underwent surgical treatment in the department of surgery, Kangbuk Samsung Medical Center. In these patients, 430 patients with Dukes stages A, B, and C carcinoma were divided into two groups: those who received perioperative blood transfusion and those who did not. Overall survival curves were constructed using Kaplan-Meier method and the differences between curves were tested by using the log-rank test. Comparison of variables between the transfused and nontransfused groups were evaluated with the Student t test and Chi-square test with SPSS program. Two hundred and three patients (47.2%) received transfusions within the perioperative period. The transfused group included patients with tumors of more advanced stage such as Dukes C(60.1% vs. 44.5%, p< 0.05) and more rectal cancer(88.2% vs. 55.5%, p< 0.05). In the other variables such as age distribution, sex difference, histologic grade and perioperative hemoglobin level, there was no significant difference between the transfused and non-transfused group. Although the 5-year overall survival rate was significantly lower in the transfused group than non-transfused(61% vs. 74.2%, p< 0.05), subgroup analysis according to the tumor location and Dukes stage showed no statiscally significant difference in survival in each location and stage between the two groups. It is postulated that the possible adverse influence of blood transfusion on the survival of patients with colorectal cancer is linked to other prognostic features rather than to the immunologic sequelae of the transfusion itself.
Age Distribution ; Blood Transfusion ; Colorectal Neoplasms ; Humans ; Perioperative Period ; Prognosis* ; Sex Characteristics ; Survival Rate

BACKGROUND: Intraductal papillary tumors of the breast exhibit bloody discharge, often with no evidence of a palpable tumor, making discrimination between benign and malignant lesions sometimes difficult for pathologists and surgeons. Thus the technique used in removing the offending ductal system should be fully diagnostic, adequately therapeutic and cosmetically. Microdochectomy has been the accepted treatment for intraductal papillomas of the breast. METHODS: We performed dye-injection microdochectomy on intraductal papillomas of the breast in 15 patients. This procedure utilize a lacrimal probe and 24-gauge medicut that were gently advanced into the offending duct, and methylene blue dye was injected to outline the involved duct for easy dissection through a circumareolar incision. Also a visual check was made as the duct filled with eye. With careful dissection as far as the base of the nipple and good hemostasis, the suspicious duct was easily isolated and then dissected along its entire length and removed with a small cone of the breast tissue surrounding the duct. RESULTS: The peak incidence was in the 3rd and the 4th decades (67%). Among the 15 patients operated on for an intraductal papilloma, 7 (47%) had bloody discharge, 2 (13%) were serous, 2 (13%) were yellowish and 4 (26.7%) had both bloody dischrage and mass. Microdochectomy was performed under general anesthesia in 12 (80%). There were single papillomas in 9 (60%) and multiple papillomas in 6 (40%). Postoperative complication was seroma in the wound in 1case (7%). CONCLUSIONS: Because we could perform dye-injection microdochectomy safely, rapidly, and effectively, we think that this procedure should be a standard treatment for intraductal papilloma of the breast.
Anesthesia, General ; Breast* ; Discrimination (Psychology) ; Hemostasis ; Humans ; Incidence ; Methylene Blue ; Nipples ; Papilloma ; Papilloma, Intraductal* ; Postoperative Complications ; Seroma ; Wounds and Injuries

PURPOSE: Endoscopic surgery is becoming more widely used because of its low invasiveness and cosmetic effect. However reports on its use in thyroid surgery are scarce particularly with regard to exploiting the advantage of eliminating the unattractive scars that are sometimes encountered in con ventional operations on the exposed anterior part of the neck. Thus, we applied this to thyroidectomy. METHODS: This clinical trial was conducted on a total of 29 patients hospitalized in our Department from December 1998 to August 1999. Our operation method was as follows. Three trochars were inserted, one at each circumareolar area on the breast (5 mm) and one in the skin between these (15 mm). Subplatysmal and subcutaneous operative space was created with CO2 insufflation at 6-7 mmHg from straight-line between two nipples to just below the thyroid gland. The thyroidal vessels and the parenchyma of the gland were dissected and divided using an ultrasonic scalpel and commonly used-laparoscopic instruments. RESULTS: The patients consisted of 25 females and 4 males. The anesthesia and operation time was 220 10.4 minutes and 165.7 9.4 minutes respectively. We had 4 cases of conversion to a conventional thyroidectomy because of uncontrolled intraoperative bleeding (1 case), technical failure (1 case) and thyroid carcinoma (2 cases). Postoperative complications occurred in 2 cases, injury of recurrent laryngeal nerve and severe anterior chest discomfort for 3 months. The average length of postoperative stay was 6.7 days. Operative scars were completely covered by clothes, and cosmetic results were excellent. CONCLUSION: With these results, the cosmetic effect may be regarded as the only strength of an endoscopic thyroidectomy but by going through more cases, this technique could be performed safely with the other advantages of endoscopic surgery such as shortened operation time and hospital stay, et al. We hope an endoscopic thyroidectomy will be another surgery of choice for most patients with thyroid disease.
Anesthesia ; Breast ; Cicatrix ; Female ; Hemorrhage ; Hope ; Humans ; Insufflation ; Length of Stay ; Male ; Neck ; Nipples ; Postoperative Complications ; Recurrent Laryngeal Nerve ; Skin ; Thorax ; Thyroid Diseases ; Thyroid Gland ; Thyroid Neoplasms ; Thyroidectomy* ; Ultrasonics

PURPOSE: Cyclooxygenase-2 (Cox-2) is an inducible enzyme that converts arachidonic acid to prostaglandins. Aberrant expression of Cox-2 and prostaglandins has been observed in many cancers, including colon and breast cancers, and 40% of human breast cancers show overexpression of Cox-2. The aim of this study was to analyze the role of Cox-2 expression in breast cancers. METHODS: The expression of Cox-2 and HER2 was examined in 56 breast tissue samples including microscopically normal epithelium and invasive ductal carcinomas (IDC) using immunohistochemical (IHC) methods. Frozen breast cancers and adjacent non-cancerous tissue (ANCT) pairs (n=30) were analyzed for Cox-2 and HER2 mRNA expression by RT-PCR. The results were compared with the prognostic parameters of breast cancer including tumor grade, growth pattern, lymph node metastasis, estrogen receptor status and Ki-67 labeling index. RESULTS: Cytoplasmic Cox-2 expression was detected in 39 of 56 (69.6%) IDC and the Cox-2 expression in IDC was closely associated with HER2 expression (P=0.023). However, the expression of Cox-2 was not associated with other prognostic parameters of breast cancer (P>0.05). The Cox-2 mRNA showed high expression levels in IDC (25/30, 83.3%) as well as ANCT (22/25, 88%). CONCLUSION: The association between the expression of Cox-2 and HER2 suggests that Her2/neu gene induces the Cox-2 expression in breast cancer and overexpression of Cox-2 is involved in breast cancer development. Though the cells of ANCT are normal in morphology, their molecular alteration (overexpression of Cox-2) suggests that these cells have transformed already.
Arachidonic Acid ; Breast ; Breast Neoplasms ; Carcinoma, Ductal ; Colon ; Cyclooxygenase 2 ; Cytoplasm ; Epithelium ; Estrogens ; Humans ; Lymph Nodes ; Neoplasm Metastasis ; Prostaglandins ; RNA, Messenger

Purpose: This study investigated the correlation between non-mass-like enhancement (NME) observed on preoperative breast magnetic resonance imaging (MRI) and the actual pathological size of breast cancer. We further examined the effect of NME on the positive resection margins during partial mastectomy. Methods: We retrospectively collected data from breast cancer patients who underwent surgery between January 2018 and September 2020. Patients were divided into two groups based on their MRI findings: NME and no-NME (mass-like lesion only) groups. The medical records, including MRI findings and clinicopathological information of patients, were collected retrospectively, and correlations with pathologic results were analyzed. Propensity score matching was applied to develop comparable cohorts of the NME group and no-NME group. Results: This study included a total of 317 patients, with 66 and 251 patients in the NME and no-NME groups, respectively. The mean pathologic size of invasive lesion was significantly smaller than the mean lesion size in the NME group (1.55±1.39 cm vs. 3.45±1.81 cm, p<0.001). The mean pathologic size of ductal carcinoma in situ (DCIS) lesions was larger than that in the NME group but without statistical significance (3.91±2.67 cm vs. 3.50±1.79 cm, p=0.326). In the NME group, NME estimated DCIS size to within 1 cm in 20 patients (30.3%) and overestimated invasive lesion size by more than 1 cm in 31 patients (46.9%). NME (vs. no-NME; odds ratio [OR], 2.967; 95% confidence interval [CI], 0.878-10.025) showed a tendency to predict positive resection margins, but this was not statistically significant (p=0.080). Conclusion NME findings on MRI showed a similar extent of DCIS lesions. NME findings on preoperative MRI should be considered an important factor for measuring the extent of tumors, especially in DCIS patients.