Mutant p53 is associated with the advanced stages of some human tumor but there is a wide variation in the reported incidence of p53 mutation in renal cell carcinoma and its prognostic significances. We designed this study to assess the expression of p53 in renal cell carcinomas and to compare with the established prognostic factors. Immunoreactivity for p53 protein and proliferating cell nuclear antigen (PCNA) were assessed in 44 cases of primary renal cell carcinoma, and flow cytometric analysis of DNA ploidy was perfon-ned in 37 of those cases. p53 protein was over-expressed in 16/44 (36.4%) renal cell carcinomas and 5 rumors had more than 10 immunoreactive tumor cells. The expression of p53 protein was positively related to nuclear grade (p=0.007) and PCNA index (p=0.002), but was independent of stage and DNA ploidy. In univariate survival analysis, stage (p<0.001), nuclear grade (p=0.017), DNA ploidy (p=0.045) and PCNA index (p<0.001) were significantly associated with patient survival. However, considering the stage, all of the last three factors had no prognostic influence. Cases showing strong positivity of p53 expression had worse prognosis than those with no or weak p53 expression, especially in early lesions (stage I,II) (p<0.001).
Carcinoma, Renal Cell* ; DNA* ; Humans ; Incidence ; Oncogene Proteins* ; Oncogenes* ; Ploidies* ; Prognosis ; Proliferating Cell Nuclear Antigen*

A malignant granular cell tumor (MGCT) occurred in the left shoulder of a 62-year-old man. The patient underwent wide marginal excision followed by chemotherapy and radiotherapy. A metastatic tumor was identified in the axillary lymph node 22 months after the excision of the shoulder mass. The primary tumor was a poorly circumscribed mass measuring 5 5 4 cm. On cut section, it was a solid mass with yellowish tan color. Histologically, both primary and metastatic tumor consisted of polygonal cells with abundant granular cytoplasm and a vesicular nucleus with a prominent nucleolus. Two to three mitotic figures per ten high power fields at 200 were counted. Tumor cells were weakly stained with periodic acid-Schiff (PAS) preparation both before and after diastase digestion, and were positive for S-100 protein, neuron-specific enolase (NSE), and vimentin. By electron microscopy, the cytoplasm was filled with numerous autophagolysosomes containing myelin figures, mitochondria, and fragmented rough endoplasmic reticula. Basal laminae and angulated bodies were also noted. These findings suggest schwannian differentiation of this tumor.
Amylases ; Basement Membrane ; Cytoplasm ; Digestion ; Drug Therapy ; Granular Cell Tumor* ; Humans ; Immunohistochemistry ; Lymph Nodes ; Microscopy, Electron ; Middle Aged ; Mitochondria ; Myelin Sheath ; Phosphopyruvate Hydratase ; Radiotherapy ; S100 Proteins ; Shoulder* ; Triacetoneamine-N-Oxyl ; Vimentin

Aortopulmonary fistula is an exceedingly rare vascular malformation. It is commonly derived after chest injuly or from complication of chest operation and aortic dissection and congenital aortopulmonary fistula is only several cases combined with Tetralogy of Fallot or aortic stenosis. But a congenital aortopulmonary fistula without any hemodynamic abnormalities was not reported. A 56-year old man with exertional dyspnea was admitted. In an examination on admission, there were no abnomalities. Aortography showed an aortopulmonary fistula that branches from the ascending aorta adjacent to the right coronary artery, running to the main pulmonary artery. Transcatheter coil embolization was performed and he was discharged 7 day after embolization without complication. Exertional dyspnea disappeared and careful follow up has be performed periodically.
Aorta ; Aortic Valve Stenosis ; Aortography ; Coronary Vessels ; Dyspnea* ; Embolization, Therapeutic ; Fistula* ; Follow-Up Studies ; Hemodynamics ; Humans ; Middle Aged ; Pulmonary Artery ; Running ; Tetralogy of Fallot ; Thorax ; Vascular Malformations

PURPOSE: To evaluate the clinical efficacy of amniotic membrane transplantation and limbal-conjunctival autograft for patients with recurrent pterygium or pseudopterygium, the results of 15 eyes of 14 patients were analyzed. METHODS: Total 10 cases of recurrent pterygium and 5 cases of pseudopterygium were surgically managed during June 1998 to July 2000. After excision of pterygium, amniotic membrane was attached on the bare sclera and limbal-conjunctival autograft was transplanted over the amniotic membrane. Mean follow-up period was 47.2 week and all patients were examined for recurrence, which was graded from G0(no vessel) to G3(fibrotic tissue invading the limbus). RESULTS: 12 out of 15 cases(rate 80%) showed no recurrence(grade 0). 1 case of grade 2 recurrence and 2 cases of grade 3(total 3 cases) were observed(rate 20%). Reoperation was performed on 2 cases of grade 3 recurrence. There was no further recurrence necessitating additional reoperation. 1 case of limbal graft was detached and removed. The operation time of this more prolonged than the other procedures, but there were no significant complications. CONCLUSION: Amniotic membrane and limbal-conjunctival autograft for patients with recurrent pterygium or pseudopterygium reconstructed complete ocular surface with less recurrence. Therefore, we recommend this surgical approach as a safe and effective method for the treatment of complicated cases of pterygium.
Amnion* ; Autografts* ; Follow-Up Studies ; Humans ; Pterygium* ; Recurrence ; Reoperation ; Sclera ; Transplants

Lawsonia intracellularis is not culturable with a standard bacteriologic culture. One step PCR assay as a clinical diagnostic method was developed for the rapid detection of porcine proliferative enteritis (PPE) caused by L. intracellularis. Primers were designed based on the p78 DNA clone of L. intracellularis. The one step PCR resulted in the formation of a specific 210-bp DNA product derived from L. intracellularis. The nonspecific amplification product was not detected with swine genomic DNA or other bacterial strains causing similar symptoms to L. intracellularis infection. The one step PCR was as sensitive as 100 pg of L. intracellularis genomic DNA. We applied this method to field specimens diagnosed as PPE by macroscopic observation. Of 17 mucosal scraping specimens, 16(94%) were identified as positive to PPE and 15(88%) of 17 feces specimens. These results suggest that the one step PCR can be used as a rapid diagnostic method for L. intracellularis infection.
Animals ; Base Sequence ; DNA Primers ; Desulfovibrionaceae Infections/diagnosis/*veterinary ; Ileum/microbiology/pathology ; Intestinal Mucosa/microbiology/pathology ; Lawsonia Bacteria/genetics/*isolation & purification ; Polymerase Chain Reaction/*methods ; Reproducibility of Results ; Sensitivity and Specificity ; Swine ; Swine Diseases/*diagnosis/microbiology

PURPOSE: To help in the early diagnosis of postoperative infections in lumbar stenosis, attempts were made to evaluate a large number of patients having levels of ESR, CSR and CRP at fixed intervals, following an uncomplicated instrumented posterolateral fusion with wide decompression. MATERIALS AND METHODS: 101 lumbar stenosis patients were included in this study. The levels of ESR, CSR and CRP were checked on the 2nd, 3rd, 4th, 7th, 10th and 14th postoperative days. These data were plotted in relation to time in order to follow their changes. The relationships between these and the perioperative factors (operation time, fusion levels, estimated bleeding amount and transfusion amount) were evaluated statistically. RESULTS: The ESR and CSR had peak levels by the 3rd postoperative day, which then became highly variable until 14 days. The CRP level was highest on the 2nd postoperative day, which decreased rapidly, was and reached nearly normalized levels by 14th day. The ESR and CSR values on the 7th postoperative day showed a tendency to correlate with the perioperative factors, but the CRP value showed no significant correlations. CONCLUSIONS: Our study revealed the effectiveness of CRP, and ineffectiveness of ESR and CSR, in the early detection of deep infections following surgery for wide lumbar stenosis.
Constriction, Pathologic* ; Decompression* ; Early Diagnosis ; Hemorrhage ; Humans

One of the complication during or after subclavian vein cannulation is intravascular catheter or wire embolization. Although some studies have reported safety of retaining foreign body embolization, and even death. The intravascular foreign body can be removed surgically or non-surgically. With improvement in instrument technology and technique, percutaneous retrieval of intravascular foreign bodies has become a relatively common procedure. Commonly used methods to remove intravascular foreign bodies are loop snare and basket technique. Sometimes biopy forcep can be used. We have experienced 2 cases of non-surgical removal of intravascular foreign bodies. One of the foreign bodies was 7cm wire fragment in right atrium(RA), the other was a 50cm guide wire. We used the standard loop snare technique for removal of 7cm wire fragment in RA and stone removal basket and 3.0mm ACS PTCA balloon to remove the 50cm short guide wire.
Catheterization ; Catheters ; Foreign Bodies* ; SNARE Proteins ; Subclavian Vein ; Surgical Instruments

No abstract available.
Adenoids* ; Carcinoma, Adenoid Cystic* ; Trachea*

No abstract available.
Takayasu Arteritis*

Primary tumors of the heart are rare, three quarter of the tumors are benign, and nearly half of the benign heart tumors are myxomas. Cardiac myxoma usually originate in the left atrium about 75 percent, however, only 3 to 4 percent of myxoma are detected in the left ventricle. We report on a 32 years old woman with left ventricular myxoma who presented with shortness of breath, chest tightness, and general weakness. Acute pulmonary embolism and left ventricular myxoma were found on a perfusion lung scan and echocadiogram. A mass located on septal wall of left ventricle was excised en bloc. The patient recovered uneventfully and careful follow up has be performed periodically.
Adult ; Dyspnea ; Female ; Follow-Up Studies ; Heart ; Heart Atria ; Heart Neoplasms ; Heart Ventricles ; Humans ; Lung ; Myxoma* ; Perfusion ; Pulmonary Embolism* ; Thorax