PURPOSE: Since the discovery of estrogen receptor-beta(ER-beta, five C-terminal variants of ER-beta were identified. We designed this study to investigate the pattern and clinical implications of ER-betaand its splicing variants expression in normal and malignant mammary tissues. METHODS: Using reverse transcription polymerase chain reaction (RT-PCR), we examined the expression levels of ER-alpha and ER-betaand its five splicing variants (beta1, beta2, beta3, beta4, beta5) in 50 paired normal and cancer tissues. We measured the densities of RT-PCR products using Tina version 2.10 (Raytest, Germany). Firstly, the incidence and intensity of ER-alpha and ER-beta and its five splicing variants were compared. Then the expression of ER-betamRNA splicing variants was also analyzed with regard to the ER-alphaprotein expression measured by immuno-histochemical staining and the menopausal status of the patients. Chi-square test and paired samples t-test were used for statistical analysis. Differences were considered to be significant with a p-value of less than 0.05. RESULTS: The expression of ER-betamRNA variants in normal breast and cancer tissues were as follows: ER-beta2 (100%/100%), ER-beta4 (76%/74%), ER-beta5 (32%/58%), and ER-beta1 (14%/16%). ER-beta3 was not detected at all. In terms of intensity, we observed a significant decrease of ER-beta2 (P<0.001) and an increase of ER-beta5 (P=0.004) in the mRNA expression levels among breast cancers compared to the corresponding normal breast tissues. Compared to the corresponding normal tissues, a significant decrease of ER-beta2 in cancer tissues was observed in patients with ER-alpha-positive (P<0.001), with age over 50 (P=0.01), and under 50 (P=0.04) as well, but not in patients with ER-alpha-negative (P=0.48). ER-beta4 also significantly decreased in patients with ER-alpha-positive (P=0.004) and with age over 50 (P=0.07). ER-beta5 showed a significant increment only in patient aged over 50 (P=0.04). CONCLUSION: ER-alpha mRNA expression significantly increases but ER-beta mRNA expression decreases in the cancer tissues compared to the corresponding normal tissues. Among ER-beta variant forms, ER-beta2 is predominant in both normal and malignant mammary tissues and ER-beta4, ER-beta5, and ER-beta1 in descending order but ER-beta3 does not express in mammary tissues. The decrease of ER-beta2 and ER-beta4 expression is prominent in cancer tissue especially in ER-alpha-positive cancers, which suggests that ER-beta2 and ER-beta4 may possess a regulatory function in mammary carcinogenesis. Further investigations to verify the roles of ER-beta variants are mandatory.
Breast ; Breast Neoplasms ; Carcinogenesis ; Estrogens* ; Humans ; Incidence ; Polymerase Chain Reaction ; Receptors, Estrogen ; Reverse Transcription ; RNA, Messenger

The recent development of microsurgical tissue transfer has enabled any defect in any area to be reconstructed with free flaps. However, the need for a more functional and thinner flap has been raised due to bullkiness of the flap and donorsite morbidity. For better functional and aesthetic results, various perforator flaps excluding muscles or adjacent subcutaneous tissue have been recently reported. We report 44 cases of perforating artery pedicled flaps from April 1995 to August 1998, including 21 cases of anterolateral thigh flap, 12 cases of gluteal artery perforator flap, 4 cases of posterior interosseous flap, and 7 cases of paraumbilical perforator flap for various soft tissue defects. Even though marginal necrosis of flap occurred in 9 cases, complete healing without significant problem was possible. The advantages of perforator flaps are as follows: 1. It is possible to obtain a relatively thin fasciocutaneous flap, but still with sufficient volume 2. Donor site morbidity was reduced without damage of main artery. 3. In spite of diverse vascular pattern of the perforator, the location of perforating arteries can be Detected with relative ease and mapped preoperatively with an ultrasound Doppler. The need of meticulous and tedious dissection could be a sole disadvantage of these flaps. This report describes the clinical experience with a perforator-based flap, anticpating applications of many other types of perforator flap in the future.
Arteries* ; Free Tissue Flaps ; Humans ; Muscles ; Necrosis ; Perforator Flap ; Subcutaneous Tissue ; Surgical Flaps* ; Thigh ; Tissue Donors ; Ultrasonography

A calcified structure blocking the flow of saliva into the mouth is a major cause of salivary dysfunction. If a stone is detected, the goal of treatment would be to remove it. Furthermore, the fundamental treatment for preventing recurrence, although depending on the location and size of the stone, is salivary gland resection. The submandibular gland duct and hilum stone is usually removed by transoral approach. If there are multiple stones in the submandibular gland and the duct, it would be necessary to carry out resection of submandibular gland, using the intra-oral approach. We recently experienced a case of multiple stone in the submandibular gland and the duct in a 73-year-old man, who presented with the right submandibular area swelling after meals. We removed the submandibular gland and duct stone without intra-oral approach and present this case with a review of the literature.

PURPOSE: We wanted to determine if the analysis and categorization of breast lesions with using BI-RADS for US would be useful. MATERIALS AND METHODS: We retrospectively reviewed 1,024 cases (976 persons), in which US-guided core needle biopsy had been performed. The breast lesions were described and categorized according to the BI-RADS for US. Each US characteristic was analyzed in order to determine its association with a benign versus malignant tissue diagnosis. The diagnostic sensitivity, specificity, positive predictive value and negative predictive value, and the accuracy of breast US were examined. RESULTS: Logistic regression analyses of the US features in terms of their ability to distinguish between benign and malignant breast lesions showed that all eight US features (shape, orientation, margin, echogenicity, posterior acoustic features, surrounding tissue, calcification and special cases) were statistically significant. Moreover, the shape, margin, microcalcification and enlarged axillary lymph nodes were found to be the most useful diagnostic features. In addition, a clinically palpable mass increased the diagnostic accuracy up to 92.7%. The positive predictive value of a category 3 lesion was 0.8%, and those of category 4 and 5 lesions were 30.4% and 99.4%, respectively. The diagnostic sensitivity, specificity, positive predictive value, negative predictive value and accuracy of breast US were 99.0%, 57.2%, 49.5%, 99.3% and 69.6%, respectively. CONCLUSION: Using BI-RADS for US in breast can be successful for characterizing and differentiating both the malignant and benign lesions of the breast.
Acoustics ; Biopsy, Large-Core Needle ; Breast Neoplasms ; Breast* ; Diagnosis ; Logistic Models ; Lymph Nodes ; Retrospective Studies ; Sensitivity and Specificity ; Ultrasonography*

The malignant potential of a tumor is related to its ability to dissociate invasion and seed other sites-metastasis. In either instance, the tumor cells are confronted with a barrier signif icantly composed of type IV collagen. This type IV collagen is a major structural protein of basement membranes. Using immunohistochemical method to detect type IV collagen, intensity of stain and continuity of basement membrane at the tumor-stromal border was studied in surgical specimens from 47 colorectal carcinomas at the Pusan Paik-Hospital. Immunoreactivity was evaluated semi-quantitatively as three categories; Type-1, thick or normal basement membrane with or without minimal discontinuity; Type-2, thin basement membrane with or without moderate discontinuity; Type-3, fragmented or absent basement membrane. Also, in each case the tumor morphologic features were identified. The histologic type, differentiated grade, desmoplastic response, lymphatic and vascular invasion, lymph node involvement, tumor size and modified Dukes' stage were estabilished. Type-1 immunoreactivity was significantly observed in well-differentiated, negative lymph node, Dukes' stage B1/B2 tumors, and Type-3 was in poorly differentiated, positive lymph node, Dukes' stage C2/D. The expres sion of collagen IV in basement membrane was statistically significant correlated with differentiated grade, lymph node metastasis and modified Dukes' stage. By contrast, no statistically significant correlation was found between paucity of type IV collagen and the other parameters. The result suggest that expression of type IV collagen in basement membrane may be a useful prognostic marker, and may play a part in the invasive and metastatic process of colorectal carcinomas.
Basement Membrane ; Busan ; Collagen Type IV ; Collagen* ; Colorectal Neoplasms* ; Lymph Nodes ; Neoplasm Metastasis

PURPOSE: Estrogen, various polypeptide hormones and growth factors are associated with the development and progression of breast cancer. Coregulatory proteins are also associated with estrogen receptor (ER) transcriptional activity and tamoxifen resistance. Therefore, it is necessary to investigate the change of coregulator mRNAs and various cell proliferation proteins and cell cycle-related proteins after treatment with estrogen or antiestrogen. METHODS: MCF-7 cells were maintained in dextran-coated charcoal stripped 10% Dulbecco's Modified Eagle Medium (DMEM). To measure the change of the coactivators' (src-1, P/CAF, CBP, AIB1) mRNAs and corepressors' (SMRT, N-coR) mRNAs, multiple PCR was carried out using specific primers. In addition, intracellular proteins related to cell proliferation and cell cycle regulation were measured by performing Western blotting after treatment with estrogen or tamoxifen. The change of mitogen activated protein kinases was also measured by performing Western after tamoxifen treatment for 4 weeks. RESULTS: Coactivator mRNAs expression rapidly decreased in 15 min after estrogen treatment but this recovered to the initial level in 3 hr. The pattern was similar for the case of tamoxifen treatment. Corepressor mRNAs expression rapidly decreased in 15 min after estrogen treatment and it remained at a lower level until 24 hr after estrogen treatment. With tamoxifen treatment, the initial response was similar to the cases of estrogen treatment, but the xpression gradually increased 3 hr after tamoxifen treatment. Treatment of estrogen induced intracellular concentrations of c-myc and Ki-67 and it increased nuclear translocation of NF-kappaB and phosphor-ERK and it decreased the intracellular cell cycle suppressor p27/kip1. Tamoxifen treatment increased nuclear p27/kip1 but it decreased c-myc, NF-kappaB and phosphor-ERK. Long-term (4 weeks) treatment of tamoxifen was associated with decrease of activated ERK and p38 but there was no change in phospho-Akt level. CONCLUSION: Estrogen induced cell proliferation and the survival pathway-related factors, but it decreased the cell cycle suppressor p27/kip1. Long-term treatment with antiestrogen tamoxifen might decrease the MAPK activities in ERalpha-expressing tumor cells.
Blotting, Western ; Breast ; Breast Neoplasms ; Cell Cycle ; Cell Line ; Cell Proliferation ; Charcoal ; Eagles ; Estrogen Receptor Modulators ; Estrogens ; Intercellular Signaling Peptides and Proteins ; MCF-7 Cells ; Mitogen-Activated Protein Kinases ; NF-kappa B ; Peptide Hormones ; Phosphotransferases ; Polymerase Chain Reaction ; Proteins ; RNA, Messenger ; Tamoxifen

Treatments for restoring the function and esthetics of missing teeth include fixed bridge, partial denture, orthodontic movement, implantation and autotransplantation. However, there is no absolute indications for each techniques. Due to undevelopment of root and root resorption after autotransplantation, the success rate of autotrans-plantation over the past decades have been low. Recently. with the study on biological principles of the healing of periodontal ligament, the success rate of autotransplantation began to improve. We report the cases of successful autotransplantation which resulted in ideal healing of periodontal ligament, gingiva and alveolar bone.
Autografts* ; Denture, Partial ; Denture, Partial, Fixed ; Esthetics ; Gingiva ; Periodontal Ligament ; Root Resorption ; Tooth*

PURPOSE: Increased level mitogen-activated protein kinase (MAPK) and activation of MAPK have been reported in human breast cancers, especially in breast cancers with HER2/neu overexpression. To understand the relationship between the MAPK protein expressions and other clinico-pathological parameters, we examined the status of MAPKs in 20 breast cancers compared to those of paired normals. METHODS: A total of 20 breast cancers and paired normal breast tissues were included in this study. Tissues were obtained at the operation room and stored at -80degrees C. Tissue proteins were extracted and the concentration was determined by Bio-Rad protein assay method. Western blot analysis were performed to determine the level of MAPKs expressions using 100 ug of tissue protein in 8%, 10%, or 12% sodium dodecyl sulphate polyacrylamide gel electrophoresis (SDS-PAGE). MAPK assays were carried out by a non-radioactive method developed by Cell Signaling Tech. as recommened by the manufacturer. Clinico-pathological information was provided from the Breast Cancer Registry of Department of Surgery, Yonsei University College of Medicine. RESULTS: The levels of MAPKs were higher in 95% of breast cancers compared to those of paired normals. The levels of ERK1/2 were significantly higher in cancer tissues compared to paired normals but the activated forms were not. The levels of JNK, p38, and MKP1 proteins were significantly increased in the cancer tissue compared to the paired normals. The levels of ERK1/2 and activated ERK1/2 proteins were not different between tumor stages. There were no significant differences of the levels of ERK1/2 and activated ERK1/2 proteins between HER2-negative and HER2- positive cancers. There were significantly higher levels of activated ERK1/2 proteins in ER-positive cancers than those in ER-negative cancers (P<0.05). CONCLUSION: The levels of MAPKs, but not the activated forms, seem to be increased in breast cancer tissues compared to those of paired normals. The levels of activated MAPKs seem to be associated with estrogen receptor expression in cancer tissues.
Blotting, Western ; Breast Neoplasms* ; Breast* ; Carcinogenesis* ; Electrophoresis, Polyacrylamide Gel ; Estrogens ; Humans ; Mitogen-Activated Protein Kinases* ; Protein Kinases ; Sodium

In cases of atherosclerotic occlusion of coronary artery, is it appropriate to conclude that myocardial infarction is the true cause of death? More sensitive and specific diagnostic methods for the postmortem diagnosis of myocardial infarction are sometimes necessary because macroscopic or microscopic changes associated with early-phase acute myocardial injuries or myocardial infarct are sometimes absent in sudden cardiac death. Postmortem biochemical assessment of cardiac markers may help to evaluate the pathological cardiac status in sudden unexpected death without obvious cause. However, forensic pathologists are generally interested only in the macroscopic and microscopic findings for postmortem diagnosis of myocardial diseases and hesitate to use postmortem biochemical data because of the risk of postmortem changes. There are several clinically useful cardiac markers antemortem cardiac events such as myocardial injuries, infarct, or heart failure and postmortem data on cardiac markers in autopsy cases of sudden death have been reported. This review of postmortem data on cardiac markers in blood, other body fluids, and myocardial tissue will serve to introduce the recent international research trends and provide a foundation for a new field in postmortem biochemistry.
Autopsy ; Biochemistry ; Body Fluids ; Cardiomyopathies ; Coronary Vessels ; Death, Sudden ; Heart Failure ; Myocardial Infarction

OBJECTIVES: The present study was designed to develop KAVLT (Korean Auditory Verbal Learning Test)and to examine its reliability and validity. The KAVLT is a modified Korean version of RAVLT (Rey Auditory Verbal Learning Test) The KAVLT assesses immediate supraspan memory, registration, retention, retrieval, recognition, learning strategy, and interference effect. METHODS: Final version of KAVLT was developed through preliminary trials. The KAVLT was administered to 75 normal healthy adults and 30 organic brain syndrome patients. Twenty-five normal controls were retested 3 weeks after the first trial to examine the test-retest reliability. The scores of basic and combined indices of KAVLT were compared between normal controls and patients. Factor analysis was done to investigate the construct validity. RESULTS: Significant correlations were found between the test-retest scores of most of the basic indices. Discriminant validity which differentiates organic brain syndrome patients from normal controls was excellent. In order to accomplish the structure analysis of the KAVLT, different sets of scores were submitted to factor analysis procedure. Factor analysis of KAVLT basic indices revealed 2 factors, 'aquisition' and 'retention'. In the factor analysis of KAVLT's basic and combined indices, 4 factors emerged: 'general learning', 'retroactive interference', 'proactive interference', and 'primacy/recency effect'. CONCLUSION: The newly developed KAVLT was found to be a reliable and valid tool for evaluating multifactorial assesment of verbal memory and learning in Korean subjects.
Adult ; Brain ; Equidae ; Factor Analysis, Statistical ; Humans ; Learning ; Memory ; Reproducibility of Results ; Verbal Learning*