No abstract available.
Humans ; Infertility* ; Luteinizing Hormone, beta Subunit*

Matrix metalloproteinases are believed to play an important role in tumor invasion and metastasis. But little is known about the role of them in the gastric adenocarcinoma. We investigated the expression of matrix metalloproteinase-1,2,3 in eighty paraffin blocks of the primary gastric adenocarcinoma tissues with immunohistochemistry and analysed their correlation with lymph node metastasis and survival. MMP-1,2,3 were expressed most intensely in the fibroblasts around the tumor stroma. In our study the increased immunoreactivity of MMP-2 only showed statistically significant correlation with lymph node metastasis (P=0.0517, Odd's ratio=2.274). But MMP-1,2,3 all were correlated with survival. Type IV collagen was observed in the vascular basement membranes and tumor basement membranes and showed statistically significant correlation with lymph node metastasis (P=0.0002, Odd's ratio=0.194) and prognosis (P=0.0001). The immunoreactivity of MMP-2 and type IV collagen was inversely correlated (Kendall's Tau-b correlation = 0.37482, P=0.0001). Our results suggest that in human gastric adenocarcinoma the increased immunoreactivity of MMP-2 and the decreased immunoreactivity of type IV collagen has an important role in lymph node metastasis and prognosis. MMP-1,3 are not correlated with lymph node metastasis but correlated with survival. The mechanism responsible for the production of MMP by the host fibroblasts remains obscure and requires further investigation.
Adenocarcinoma* ; Basement Membrane ; Collagen Type IV* ; Fibroblasts ; Humans ; Immunohistochemistry ; Lymph Nodes* ; Matrix Metalloproteinases ; Neoplasm Metastasis* ; Paraffin ; Prognosis*

Prognostic factors in transitional cell carcinoma of the upper urinary tract were assessed with histopathological examination and flow cytometric analysis in a series of 33 patients treated between Jan. 1980 to Dec. 1990. During follow-up from 6 to 120 months, 14 patients died of transitional cell carcinoma. The rate of DNA aneuploidy pattern was 54.5 % and DNA aneuploidy pat tern showed significantly a poorer prognosis than diploidy pattern. DNA ploidy pattern was relatively correlated with grade, stage and clinical outcome. For stage TS (superficial tumor) and low grade, the occasional detection of DNA aneuploidy pattern identified an important subgroup which showed significantly a poorer survival. Only the stage and, to a lesser extent, tumor shape, grade and DNA ploidy pattern were determinants for prognosis in multivariate analysis. Based on these 4 variables 3 different subgroups of patients can be identified. In low risk group including stage TS (superficial tumor), low grade, DNA diploidy pattern and papillary tumor, 3 and 5 year survival rates were 88.9 % and 69.1 %. In high risk group including stage TE (extensive invaded tumor) and DNA aneuploidy pattern, 2 and 3 year survival rates were 15.3 %, 0.0 %. In intermediate risk group including stage TS (superficial tumor), DNA aneuploidy pattern, 3 and 6 year survival rates were 55.9 % and 43.5 %. In summary, DNA ploidy may be a useful parameter to identify risk groups, especially stage TS and low grade and to plan appropriate management of patients with primary transitional cell carcinoma of the upper urinary tract.
Aneuploidy ; Animals ; Carcinoma, Transitional Cell* ; Charadriiformes ; Diploidy ; DNA* ; Flow Cytometry* ; Follow-Up Studies ; Humans ; Kidney Pelvis* ; Multivariate Analysis ; Ploidies* ; Prognosis ; Survival Rate ; Ureter* ; Urinary Tract

Medical ethics, autonomy, and self-regulation form the core of medical professionalism. Therefore, codes and guidelines regarding ethics are key documents that demonstrate the identity of physicians as a professional group in a society. In Korea, foreign declarations such as the Hippocratic Oath and the Geneva Declaration have been translated and introduced, while medical ethics guidelines have been introduced from developed countries. In 1961, 1965, and 1979, the Code of Medical Ethics was created and revised, but only in 1997 did Korean doctors develop their own ethics guidelines and codes reflecting their identity in Korean society. In order for these guidelines and codes to be effective living documents, they should be regularly modified to reflect changes in the medical environment and the field of medicine. In response to the urgent need to establish strict norms of medical professionalism in the 21st century due to internal and external problems in Korean society, the Korean Medical Association worked to revise the Ethics Code and Guidelines in 2016. This article reviews the history of how the Korean Code of Ethics and Guidelines has changed and examines the contents of the Code of Ethics and Guidelines as amended in 2016.
Codes of Ethics ; Developed Countries ; Ethics ; Ethics, Medical* ; Hippocratic Oath ; Korea* ; Professionalism ; Self-Control

The glomus tumor is a distinctive benign neoplasm with a small painful nodule, occurs most commonly in extremities but may be found elsewhere in the body. Its occurrence in the trachea or lung parenchyme has been recognized with extreme rarity and there has not been any report, to our knowledge, of its occurrence in the main bronchial glomus tumor. We report a case of a glomus tumor in the left main bronchus in a 67-year-old man who was presented with blood-tinged sputum and dyspnea, which was completely relieved by surgical resection.
Aged ; Bronchi* ; Bronchial Neoplasms ; Dyspnea ; Extremities ; Glomus Tumor* ; Humans ; Lung ; Sputum ; Trachea

OBJECTIVE: Medical narratives entry is a major issue to be solved in developing an electronic medical record system operating in practice, as they are, in large part, described in a free-text format. The issue can be dealt with in three aspects: to improve the reusability by structuring medical narratives, to support clinical pragmatics in medical fields, and to reduce the burden of data entry. With the aspects having in mind, this paper purports to present an ontological method for better way of medical narratives entry. METHODS: We developed an ontology for which medical knowledge is structurally represented. Then we can enter medical narrative texts with commands of the controlled natural language operable on the ontology model. RESULTS: Many theoretical studies on free-text entry were reviewed, based on which an authoring and editing tool for natural language description operable on the ontology model has been developed and tested. The performance of the tool is satisfactory within the limit of the domain models we developed here. CONCLUSION: The results of this paper are contributive for clinicians to make an easy entry of medical narratives as far as the ontology model covers their knowledge domain. It is also expected that the cost in recording medical narratives might be considerably reduced and data quality can be improved.
Electronic Health Records ; Models, Theoretical ; Data Accuracy

PURPOSE: This study aimed to evaluate the clinical features of juvenile polyp and the usefulness of polypectomy with entire colonoscopy in children. METHODS: We retrospectively reviewed the medical records of 83 children who were diagnosed with having juvenile polyps. RESULTS: The mean age of the patients was 6.5+/-3.7 (range 1.3-14.5 years) years. The male to female ratio was 2.1 : 1. Eighty one patients (97.6%) had hematochezia, of which the observed characteristics included red stool (74.1%), blood on wipe (13.6%). The time interval between the 1st episode of hematochezia and colonoscopy was 8.9+/-20.4 (ranged 0.1-48.0) months. The most proximal regions of colonoscopic approach were terminal ileum (96.4%). Sixty three patients (75.9%) had a solitary polyp and 20 patients (24.1%) had multiple polyps. The sites of the polyps were rectum (61.4%), sigmoid colon (23.5%). Eighteen polyps (15.1%) were found more proximal locations than rectosigmoid. The polyp size ranged from 0.3 to 5 cm. After the polypectomy, hematochezia recurred in 9 patients. Endoscopic hemostasis was performed in 2 patients due to severe bleeding. All procedures were carried out without using general anesthesia. CONCLUSION: Juvenile polyp occurred in a wide range locations and had variable sizes and numbers, suggesting that colonoscopy on the entire colon is necessary. Colonoscopic polypectomy is a simple and useful therapeutic method in children with juvenile polyp.
Child ; Colon ; Colon, Sigmoid ; Colonoscopy ; Female ; Gastrointestinal Hemorrhage ; Hemorrhage ; Hemostasis, Endoscopic ; Humans ; Ileum ; Male ; Medical Records ; Polyps ; Rectum ; Retrospective Studies

OBJECTIVE: To investigate the incidence of non-responder to hormone replacement therapy (HRT) and to evaluate the bone response to HRT according to basal bone mineral density(BMD) in postmenopausal women. METHODS: A total of 211 postmenopausal women received either continuous combined estrogen-progestogen replacement (n=112) or estrogen replacement (n=99) for 1 years. BMD at the lumbar spine and femoral neck was measured by dual energy X-ray absorptiometry (DEXA) before and 1 year after HRT. RESULTS: The incidence of non-responder (women with > 3% bone loss per year) to HRT was 9.2% in the lumbar spine, and 23.8% in femoral neck. Estrogen replacement group had a higher incidence of non-responder than combined replacement group. Non-responder group had a higher basal BMD at the lumbar spine than responder group, and showed bone loss rate of 7.6% per year. After 1 year of HRT, postmenopausal women with osteoporosis showed a higher rate of increase in BMD at the lumbar sine and femoral neck than women with normal BMD or osteopenia. CONCLUSION: The non-responders to HRT have a higher basal lumbar BMD, compared with responders. The higher basal BMD at the lumbar spine is, the less bone conservation effect of HRT is.
Absorptiometry, Photon ; Bone Density* ; Bone Diseases, Metabolic ; Estrogen Replacement Therapy ; Female ; Femur Neck ; Hormone Replacement Therapy* ; Humans ; Incidence ; Osteoporosis ; Spine

PURPOSE: The purpose of this study is to present our preliminary experience of the temporary endovascular bypass (TEB) technique using an Enterprise stent for recanalization of acute intracranial artery (IA) occlusion. MATERIALS AND METHODS: Patients treated by TEB were enrolled in this retrospective study from January 2009 to May 2010. All the procedures consist of temporary partial deployment and subsequent retrieval of Enterprise stent, supplemented by intra-arterial infusion of urokinase (UK) and/or tirofiban. According to the thrombolysis in cerebral infarction (TICI) classification, recanalization was evaluated with initial and postprocedural angiography. Safety was evaluated related to the procedure and clinical outcomes were assessed by National Institute of Health Stroke Scale (NIHSS) score at discharge and modified Rankin scale (mRS) score at 3 months. RESULTS: Eleven patients (median NIHSS 12.8, mean age 61.6 years, male: female = 8:3) with acute IA occlusion were treated with TEB. All the patients presented with TICI 0, and the occluded vessel was the middle cerebral artery (n=7), the basilar artery (n=1), and the distal ICA occlusion (n = 3). IV infusion of tissue plasminogen activator (tPA) was done in 4 patients and mechanical thrombolysis with intra-arterial UK was performed in 9. Recanalization was achieved in 73% (8 patients; TICI > or = 2). There were no procedure-related complications except for two asymptomatic intracranial hemorrhages. Improvement (> or = 4 points on the NIHSS) and good outcome (mRS < or =2) after 90 days was shown in six patients (55%). One patient died 6 days after procedure. CONCLUSION: TEB may be a valuable treatment option in acute thromboembolic IA occlusion without stent implantation.
Angiography ; Arteries ; Basilar Artery ; Cerebral Infarction ; Female ; Glycosaminoglycans ; Humans ; Infusions, Intra-Arterial ; Intracranial Hemorrhages ; Mechanical Thrombolysis ; Middle Cerebral Artery ; Retrospective Studies ; Stents ; Stroke ; Tissue Plasminogen Activator ; Tyrosine ; Urokinase-Type Plasminogen Activator

Single unit responses of the ventral posterior medial (VPM) thalamic neurons to stimulation were monitored in anesthetized rats during activation of contralateral primary somatosensory (SI) cortex by GABA antagonist. The temporal changes of afferent sensory transmission were quantitatively analyzed by poststimulus time histogram (PSTH). Mainly, afferent sensory transmission to VPM thalamus was facilitated (15 neurons of total 23) by GABA antagonist (bicuculline) applied to contralateral cortex, while 7 neurons were suppressed. However, when ipsilateral cortex was inactivated by GABA agonist, musimol, there was significant suppression of afferent sensory transmission of VPM thalamus. This suppressed responsiveness by ipsilateral musimol was not affected by bicuculline applied to contralateral cortex. These results suggest that afferent transmission to VPM thalamus may be subjected to the interhemispheric modulation via ipsilateral cortex during inactivation of GABAergic neurons in contralateral SI cortex.
Animals ; Bicuculline ; GABA Agonists ; GABA Antagonists ; GABAergic Neurons ; gamma-Aminobutyric Acid ; Neurons ; Rats ; Somatosensory Cortex* ; Thalamus*