Purpose: To design a scoring system to predict malignancy of additional MRI-detected lesions in breast cancer patients. Materials and Methods: Eighty-six lesions (64 benign and 22 malignant) detected on preoperative MRI of 68 breast cancer patients were retrospectively included. The clinico-radiologic features were correlated with the histopathologic results using the Student's t-test, Fisher's exact test, and logistic regression analysis. The scoring system was designed based on the significant predictive features of malignancy, and its diagnostic performance was compared with that of the Breast Imaging-Reporting and Data System (BI-RADS) category. Results: Lesion size ≥ 8 mm (p < 0.001), location in the same quadrant as the primary cancer (p = 0.005), delayed plateau kinetics (p = 0.010), T2 isointense (p = 0.034) and hypointense (p = 0.024) signals, and irregular mass shape (p = 0.028) were associated with malignancy. In comparison with the BI-RADS category, the scoring system based on these features with suspicious non-mass internal enhancement increased the diagnostic performance (area under the receiver operating characteristic curve: 0.918 vs. 0.727) and detected three false-negative cases. With this scoring system, 22 second-look ultrasound examinations (22/66, 33.3%) could have been avoided. Conclusion The scoring system based on the lesion size, location relative to the primary cancer, delayed kinetic features, T2 signal intensity, mass shape, and non-mass internal enhancement can provide a more accurate approach to evaluate MRI-detected lesions in breast cancer patients.

Purpose: To design a scoring system to predict malignancy of additional MRI-detected lesions in breast cancer patients. Materials and Methods: Eighty-six lesions (64 benign and 22 malignant) detected on preoperative MRI of 68 breast cancer patients were retrospectively included. The clinico-radiologic features were correlated with the histopathologic results using the Student's t-test, Fisher's exact test, and logistic regression analysis. The scoring system was designed based on the significant predictive features of malignancy, and its diagnostic performance was compared with that of the Breast Imaging-Reporting and Data System (BI-RADS) category. Results: Lesion size ≥ 8 mm (p < 0.001), location in the same quadrant as the primary cancer (p = 0.005), delayed plateau kinetics (p = 0.010), T2 isointense (p = 0.034) and hypointense (p = 0.024) signals, and irregular mass shape (p = 0.028) were associated with malignancy. In comparison with the BI-RADS category, the scoring system based on these features with suspicious non-mass internal enhancement increased the diagnostic performance (area under the receiver operating characteristic curve: 0.918 vs. 0.727) and detected three false-negative cases. With this scoring system, 22 second-look ultrasound examinations (22/66, 33.3%) could have been avoided. Conclusion The scoring system based on the lesion size, location relative to the primary cancer, delayed kinetic features, T2 signal intensity, mass shape, and non-mass internal enhancement can provide a more accurate approach to evaluate MRI-detected lesions in breast cancer patients.

No abstract available.
Antigen-Antibody Complex* ; Syphilis*

PURPOSE: To analyze the clinical aspects of amblyopia and the factors affecting the outcome of treatment of amblyopia in school children. METHODS: We retrospectively analyzed 100 patients, who had not been treated previously for amblyopia and been followed for more than 6 months after initiating the treatment of amblyopia. They were divided into two groups, one of which was 4~7 years old (50 patients)and the other was 8~12 years old (50 patients). The evaluation included causes of amblyopia, age and visual acuity at the initial treatment, degree of anisometropia, amount of deviation, and duration of treatment. RESULTS: Strabismus was the most common cause of amblyopia, followed by anisometropia and visual deprivation in that order. The causes of amblyopia did not affect the visual outcome either in the 8~12 years old children or in the 4~7 years old children (p=0.10). The factors not affecting visual outcome were visual acuity at the initial treatment (p=0.23), amount of deviation in strabismic amblyopia (p=0.16), degree of anisometropia in anisometropic amblyopia (p=0.49). Compared with the 4~7 years old children, the 8~12 years old chiliren did not show the significant difference in the final visual outcome (p=0.23). CONCLUSIONS: The treatment of amblyopia in school children was as effective as in pre-school children.
Amblyopia* ; Anisometropia ; Child* ; Humans ; Retrospective Studies ; Strabismus ; Visual Acuity

PURPOSE: To analyze the long-term outcome of near geared standard surgery with full hyperopic correction for partially accommodative esotropia. METHODS: The medical records of a total of 24 patients with partially accommodative esotorpia, who had undergone bilateral or unilateral medial rectus recession were retrospectively reviewed. The amount of medial rectus recession was measured based on the near deviation after full hyperopic correction. During the follow-up period the changes of refractive error and angle of deviation were evaluated, and the titmus test and Worth 4-Dot test were performed. RESULTS: The mean ages were 36.63+/-13.38 months (14~59 months) at the time of wearing glasses and 61.25+/-25.55 months (25~132 months) at the time of operation. The average follow-up period was 59.67+/-32.12 months (18~120 months) and preoperative refractive errors were +3.93+/-1.73 D sph and refractive errors at final visit were +3.64+/-2.07 D sph (P=0.53). The mean amount of esodeviation were 26.08+/-8.13PD and 4.25+/-6.63PD for pre- and post-operatively respectively. Nineteen patients showed postoperative deviation of 10PD or less, one patient was overcorrected, and four patients were undercorrected. Worth 4-Dot test resulted in a fusion response at near and far in one patient preoperatively and in 17 patients postoperatively (P=0.30). A titmus stereotest of less than 100 seconds of arc resulted in 1 of 7 patients and 6 of 14 patients at the time of preoperation and postoperation each (P=0.34). The results were not statistically significant. Four of ten high hyperopic patients (> or = +4.00 diopter) had under- or over-correction (P=0.12), though it was not statistically significant. There were no significant differences in combined conditions. CONCLUSIONS: Near geared standard surgery with full hyperopic correction in partially accommodative esotropia patients gave a good surgical result for patients in the mean follow-up duration of 59.67 months.
Esotropia ; Eyeglasses ; Follow-Up Studies ; Glass ; Humans ; Medical Records ; Refractive Errors ; Retrospective Studies

Orbital exenteration has been used as a corrective method to treat lifetreatening neoplasm, life-threatening infection, and pain or deformity. After orbital exenteration, patients have been left with a severely disfiguring facial defect. Nowadays postoperative adjustment is usually better than before, with improved surgical and prosthesis manufacturing techniques. Actually Korean ophthalmologists do not have chances of adequate ocular prosthesis support compared to the other foreign countries. Authors experienced satisfying cosmetic result using a photography glasses frame for the pos-exenterated patient who had a squamous cell carcinoma of the orbit. We report this first case in Korea with review of the literatures.
Carcinoma, Squamous Cell ; Congenital Abnormalities ; Eye, Artificial ; Eyeglasses ; Glass ; Humans ; Korea ; Orbit ; Photography ; Prostheses and Implants

Seizure is the second most common neurologic complication after liver transplantation and may be caused by metabolic abnormalities, electrolyte imbalance, infection, and immunosuppressant toxicity. A 61-year-old male patient underwent liver transplantation due to hepatitis B virus-related liver cirrhosis with portal systemic encephalopathy. The immediate postoperative course of the patient was uncomplicated. However, on postoperative day (POD) 6, weakness developed in both lower extremities. No abnormal findings were detected on a brain computed tomography (CT) scan on POD 8, but a generalized tonic clonic seizure developed which was difficult to control even with multiple antiepileptic drugs. A follow-up brain CT scan on POD 15 showed a 2.7 cm sized acute intracranial hemorrhage (ICH) in the left parietal lobe. The patient's mental status improved after 2 months and he was able to communicate through eye blinking or head shaking. Our case reports an acute ICH that manifested into a refractory seizure in a patient who underwent a liver transplant.
Anticonvulsants ; Blinking ; Brain ; Brain Diseases ; Follow-Up Studies ; Head ; Hepatic Encephalopathy ; Hepatitis B ; Humans ; Intracranial Hemorrhages* ; Liver Cirrhosis ; Liver Transplantation ; Liver* ; Lower Extremity ; Male ; Middle Aged ; Parietal Lobe ; Seizures* ; Tissue Donors* ; Tomography, X-Ray Computed

PURPOSE: The aim of this study was to analyze the clinicopathological characteristics of solid pseudopapillary tumor (SPT) of the pancreas and to utilize an immunohistochemical panel to identify specific markers of the disease. METHODS: Eleven patients diagnosed with and treated for SPT of the pancreas over the past 15 years were retrospectively analyzed. RESULTS: The 11 patients consisted of 8 females and 3 males, of mean age at operation of 13.5 years (range, 10 to 18 years). The most frequent presenting symptom was abdominal pain and/or mass. One patient was referred with hemoperitoneum due to traumatic tumor rupture. The lesions were located in the body, head and tail of the pancreas in four, four, and three patients, respectively. Mean tumor diameter was 7.9 cm (range, 2.5 to 15 cm). Surgical procedures included distal pancreatectomy with splenectomy in four patients, pylorus preserving pancreaticoduodenectomy in four, distal pancreatectomy in two, and subtotal pancreatectomy with splenectomy in one. Mean follow-up was 60.5 months (range, 15 to 126 months). All patients remain alive without tumor recurrence. Immunohistochemical staining showed that all tumors were positive for beta-catenin, progesterone receptor (PR), vimentin, and CD99. However, all tumors were negative for E-cadherin and cytokeratin 7 expression. CONCLUSION: Patients with SPT of the pancreas have an excellent prognosis after surgical excision. Immunohistochemically, E-cadherin/beta-catenin, PR, vimentin, and CD99 would help establish the diagnosis of SPT of the pancreas, although the results of immunohistochemical staining were found to have an indistinct complex immunoprofile.
Abdominal Pain ; beta Catenin ; Cadherins ; Child* ; Diagnosis ; Female ; Follow-Up Studies ; Head ; Hemoperitoneum ; Humans ; Immunohistochemistry ; Keratin-7 ; Male ; Pancreas* ; Pancreatectomy ; Pancreatic Neoplasms ; Pancreaticoduodenectomy ; Pediatrics ; Prognosis ; Pylorus ; Receptors, Progesterone ; Recurrence ; Retrospective Studies ; Rupture ; Splenectomy ; Vimentin

PURPOSE: To assess the efficacy, predictability, stability and safety of the implantable contact lens (ICL) to treat high myopia METHODS: We retrospectively analyzed the clinical outcomes in 49 eyes of 28 patients with high myopia undergoing ICL implantation with a minimum follow-up period of 3 months. RESULTS: Mean preoperative spherical equivalent was -13.94 +/- 5.47D (range, -25.50 to -7.25D), and mean postoperative spherical equivalent was -1.59 +/- 1.59D (range, -6.38 to +0.50D). Forty one eyes (83.7%) were within 1.0D, and 29 eyes (59.2%) were within 0.5D of predicted refraction at last exam. Postoperative uncorrected visual acuity at last examination was 0.5 or better in 43 eyes (87.8%) and 1.0 or better in 21 eyes (42.9%). A gain of 1 or more lines of best corrected visual acuity was seen in 19 eyes (38.8%) and a lost 1 or more lines of best corrected visual acuity at last time in 7 eyes (14.3%). The refraction remained stable with a statistically insignificant change (p>0.05) at each interval during follow-up. Glaucoma occurred in 3 eyes (6.1%), and pigment deposited on the ICL in 5 eyes (10.2%). Two ICLs (4.1%) of 1 patients were removed due to glare. CONCLUSIONS: ICL Implantation is predictable, stable, and effective in the correction of high myopia, with good short-term safety.
Follow-Up Studies ; Glare ; Glaucoma ; Humans ; Lenses, Intraocular* ; Myopia* ; Retrospective Studies ; Visual Acuity

BACKGROUND: Cystic neoplasms of pancreas comprise pathologically heterogeneous groups of tumors with many shared clinical features. Although relatively uncommon, they have a very important place in the surgical pathology of the pancreas because of their high cure rate and their potential confusion with far more common pancreatic pseudocysts. METHODS: We analysed clinical features of 23 patients with pancreatic cystic neoplasm that we treated within 8-years` period (13 women, 10 men, mean age; 47.2 years old) The cystic neoplasms of pancreas comprise 5 serous cystadenoma, 3 benign mucinous cystic tumor, 3 borderline malignancy of mucinous cystic tumor and 4 mucinous cystadenocarcinoma, 4 papillary cystic tumor, 1 cystic teratoma, 1 cystic mesothelioma, 1 lymphoepithelial cyst. 1 mucinous ductal ectasia. RESULTS: Mean tumor size was 6.8cm(3 to 15cm). 73.9 percent had abdominal pain and 26.1 percent had abdominal mass. Computed tomography, ultrasonography and MRI were useful in detecting cystic mass in all cases but was not reliable to distinguish serous from mucinous tumor, benign from malignant. For the treatment of the tumor, 17 distal pancreatectomy with splenectomy, 1 distal pancreatectomy with spleen preserving, 1 proximal pancreatic resection, 2 local excision of pancreas and 1 PPPD were performed. During the period of follow up (mean: 29 months) after surgical resection, 1 recurrence occurred in the patient who underwent local excision for mucinous cystic tumor showing borderline malignancy on histologic finding. All the patients are alive except 2 patients who were lost to follow-up. CONCLUSION: Pancreatic cystic neoplasms are rare and their prognosis are acceptable when they are treated early and properly. So early detection and surgical treatment is the mainstay of management of cystic neoplasm of pancreas.
Abdominal Pain ; Cystadenocarcinoma, Mucinous ; Cystadenoma, Serous ; Dilatation, Pathologic ; Female ; Follow-Up Studies ; Humans ; Lost to Follow-Up ; Magnetic Resonance Imaging ; Male ; Mesothelioma, Cystic ; Mucins ; Pancreas* ; Pancreatectomy ; Pancreatic Cyst ; Pancreatic Pseudocyst ; Pathology, Surgical ; Prognosis ; Recurrence ; Spleen ; Splenectomy ; Teratoma ; Ultrasonography