• Archives of Plastic Surgery
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• v.33 no.6
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• pp.773-775
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• 2006

Purpose: The sternalis muscle is an accessory muscle of the anterior chest wall. This is a rare anatomic variant reported in approximately 8 percent of the population, with variation among races. While several anatomic studies of the sternalis muscle exist, nothing in the literature addresses the implications of this muscle on staged breast reconstruction with implant. Methods: We encountered two consecutive patients with a left sternalis muscle who underwent immediate staged breast reconstruction with a tissue expander. We offer a strategy for dealing with this rare, but known, anatomic variant during staged implant reconstruction. Firstly, recognizing the presence of a sternalis muscle mandates the elevation of the pectoralis major muscle and the sternalis muscle in continuity. Secondly, slight modifications must be made during the submuscular dissection to create a properly placed pocket for the tissue expander. Results: While our encounters with this anatomic variant are few, our experiences with two consecutive patients illustrate that the reconstructive surgeon must be familiar with the sternalis muscle and be prepared to adapt his or her technique for tissue expander placement when faced with this accessory muscle. Conclusion: To date, no reports exist in the literature describing the operative implications of this anatomic variant. We offer our technique for dealing with this accessory muscle during staged implant reconstruction of the breast.

• Biomedical Science Letters
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• v.7 no.3
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• pp.133-138
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• 2001

The recently proposed Bethesda system for cervical/vaginal cytology has made a standardization related to "atypia". In cellular change due to inflammation or repair, the word "benign cellular change" has been suggested as a substitute for atypia. Terminology related to atypia cells may become standardized, but the cytologic criteria has not been well defined yet Among 8113 cases screened, we evaluated 182 cases as atypia squamous cells undetermined significance (ASCUS) by the Bethesda system (TBS): 52 cases of ASCUS were cytologically diagnosed and 33 cases were histologically verified. ASCUS was diagnosed based on nuclear enlargement and nonclassical signs of condyloma. The results are as follows; Six cases (16.6%) turned out to have benign cellular change. Twenty five cases (69.1%) demonstrated squamous intraepthelial lesion, condyloma was 2 cases (6.0%) and mild dysplasia was not revealed. Moderate and severe dysplasia were 1 case (3.0%) and 16 cases (48.4%), squamous cell carcinoma and adenocarcinoma were 4 (12.1%) and 1 cases (3.0%), respectively. Our data suggested that patients with ASCUS are highly recommended to be examined colposcopic biosy to cornfim.

• Journal of Chest Surgery
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• v.26 no.12
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• pp.920-925
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• 1993

Extra-anatomic bypass was proposed by Freeman in 1952 and has been used for patient with lower extremity arterial occlusion who had very high operative risk, especially elderly or severly illed patient.We had performed 14 cases of extra-anatomic bypasses from Jan. 1991 till July 1993 and having been following up them. Their results were summarized as follow. Among total 14 patients, 13 was male. Their mean age was 64.8 years old, ranged from 48 to 80. The most common complaint was pain on lower limb and they visited hospital 6.1 months in average after onset of symptom. Frequently, they were associated with systemic diseases such as generalized atherosclersis, hypertension, diabetes mellius, etc. Axillary artery was used as donor artery in 8 cases and crossover femoro-femoral or femoro-popliteal bypass was performed in 6 cases. Postoperative complications were notedd in 8 cases so their morbidity rate was 42.8%. Except for two contraindicated cases, one or more anticoagulants were used routinely . Among them, combined use of aspirin and persantine was most commonly applied.After bypass graft, nine cases were occluded beteween 10 and 53 months. So their average duration of freedom from reocclusion was 35.7 months and 3-year patency rate was 63%.

• Journal of Gastric Cancer
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• v.21 no.3
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• pp.236-245
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• 2021

Purpose: The numeric N stage has replaced the topographic N stage in the current tumor node metastasis (TNM) staging in gastric carcinoma. However, the usefulness of the topographic N stage in the current TNM staging system is uncertain. We aimed to investigate the prognostic value of the topographic N stage in the current TNM staging system. Materials and Methods: We reviewed the data of 3350 patients with gastric cancer who underwent curative gastrectomy. The anatomic regions of the metastatic lymph nodes (MLNs) were classified into 2 groups: perigastric and extra-perigastric. The prognostic value of the anatomic region was analyzed using a multivariate prognostic model with adjustments for the TNM stage. Results: In patients with lymph node metastasis, extra-perigastric metastasis demonstrated significantly worse survival than perigastric metastasis alone (5-year survival rate, 39.6% vs. 73.1%, respectively, P<0.001). Extra-perigastric metastasis demonstrated significantly worse survival within the same pN stage; the multivariate analysis indicated that extra-perigastric metastasis was an independent poor prognostic factor (hazard ratio=1.33; 95% confidence interval=1.01-1.75). The anatomic region of the MLNs improved the goodness-of-fit (likelihood ratio statistics, 4.57; P=0.033) of the prognostic model using the TNM stage. Conclusions: The anatomic region of MLNs has an independent prognostic value in the numeric N stage in the current TNM staging of gastric carcinoma.

• The Korean Journal of Cytopathology
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• v.3 no.2
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• pp.90-93
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• 1992

A case of multiple myeloma with massive pleural effusion is reported. A 53 year-old previous known multiple myeloma patient vistited our hospital complaining of cough with sputum. Radiologic study revealed multiple osteolytic bony lesions and left side pleural effusion. The effusion were bloody exudates containing numerous atypical plasma cells. The tumor cells showed pleomorphism, eccentric nuclei, prominent nucleoli, perinuclear halo, multincleation, and chromatin patterns of occasional cart-wheel appearance. The cytological examination of pleural fluid established the malignant nature of the effusion with multiple myeloma.

• The Korean Journal of Cytopathology
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• v.3 no.2
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• pp.100-103
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• 1992

We experienced a case of primary hepatic actinomycosis which was initially diagnosed by means of fine needle aspiration. The patient was a 31-year-old emaciated man with a 2-month history of 10 kg weight loss, right upper quadrant pain and flank pain. The liver was palpable and tender on physical examination. Computerized tomography scan of the liver showed two ill-defined hypodense masses in gallbladder fossa and inferior pole of right lobe. Hepatocellular carcinoma was clinically suspected. A CT-guided fine needle aspiration was peformed. Microscopically, smears showed numerous radiating clusters of filamentous bacteria with many neutrophils and monocytes in necrotic background. The symptoms were improved by incision and drainage and massive administration of penicillin.

• The Korean Journal of Cytopathology
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• v.3 no.2
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• pp.75-81
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• 1992

Acinic cell carcinoma is a rare salivary gland tumor of low-grade malignancy. It comprises only about 2.5% of all salivary gland tumors. We recently experienced a case of fine needle aspiration cytology of acinic cell carcinoma of the parotid gland. The characteristic cytopathologic features were 1) cellular aspirate consisting of monomorphic cells in large sheets or singly, 2) formation of acini and/or microcysts, 3) abundant granular cytoplasm with sharp cytoplasmic borders, 4) bland nuclei with micronucleoli, and 5) clear background.

• The Korean Journal of Cytopathology
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• v.7 no.1
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• pp.84-87
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• 1996

Cytologic features of the fine needle aspiration of metastatic epithelioid sarcoma are presented. The patient was a 48 year-old male who had been sufferring from recurrent and metastatic tumors of the right upper extremity for 6 years. The aspirate from the axillary mass cytologically consisted of isolated large polygonal cells with abundant, cyanophilic, slightly granular cytoplasm. Eccentrically located large round nuclei showed finely dispersed chromatin, small nucleoli, occasional convolution and folding of nuclear membrane, and frequent binucleation. Although both histologic and cytologic similarity of epithelioid sarcoma to squamous cell carcinoma is well known, findings of cyanophilic granular cytoplasm, convoluted nuclei, and binucleation appeared to be the differential points.

• The Korean Journal of Cytopathology
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• v.6 no.2
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• pp.140-147
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• 1995

In a six-year period (1988. 5-1994. 4), fine needle aspiration cytology(FNAC) of 322 pulmonary lesions from 296 patients were performed at Soonchunhyang University Hospital. Of these 322, malignancy was diagnosed cytologically in 139(43.2%), suspicious malignancy in 7(2.2%), negative in 164(50.8%), and insufficient material in 12(3.8%). Malignant lesions consisted of 54 cases of adenocarcinoma, 50 cases of squamous cell carcinoma, 18 cases of small cell carcinoma. They were verified by histologic examination in 70 cases. There were 2(0.6%) false positive cases due to florid bronchoalveolar hyperplasia and atypical bronchial epithelial cells associated with granulomatous lesion. The overall accuracy rate was 90%, the sensitivity 84.3% and the specificity 94.7%.

• Journal of Chest Surgery
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• v.44 no.2
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• pp.189-192
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• 2011

Mycotic aneurysm is a disease requiring immediate treatment because of the high risk of rupture. A difficult surgical approach, especially in the case of occurrence on the iliac artery, involving endovascular embolization and extra-anatomic bypass grafting, is known to be a suitable treatment. We performed extra-anatomic bypass grafting after endovascular embolization successfully in two patients. The postoperative computed tomography of both patients showed complete exclusion of the mycotic aneurysm.