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*

Mullerian Mucinous papillary Cyatadenernas of Borderline tumor(MMBT) is lined by mucinous epithelium of endocervical type and is characterized by papillae architecturally similer to those of serous horderline tumors, It has been described rarely in the literature, Thia case was reported with a brief review of the concerened literatures. It has important clinical and pathological diBerences from mucinous birderline tumors with intestinal differentiation, but has many similatities to mixed epithelial borderline tumora of Mulierian type. Recently, a case of MMBT in a 22 years old woman was experienced at our department. We presented this case with a brief review of literature.
Cystadenoma, Papillary* ; Epithelium ; Female ; Humans ; Mucins* ; Young Adult

BACKGROUND: Caudal anesthesia is considered a safe and reliable anesthetic technique for many pediatric surgical procedures. It is well known that extradural clonidine produces analgesia in adult. The purpose of this study is to assess its efficacy in children. METHODS: We randomized 45 pediatric patients aged under 10 years, weighted under 25 kg presented for lower abdominal surgery with duration of operation would be shorter than 2 hours, into three groups of 15 each. After sedation with the use of intravenous thiopental sodium, caudal anesthesia was performed with the use of 1 mL/kg of 0.25% bupivacaine. We allocated randomly the patients who received no additional medication in 0.25% bupivacaine (group I), with epinephrine 1/200,000 (group II), and with 1 mcg/kg of clonidine (group III). The degree of postoperative analgesia was evaluated using the Broadman ""Objective Pain/discomfort Scale"" (OPS) at hourly intervals for 24 hours. RESULTS: Duration of sleep in the recovery room was significantly longer in group III than in group I and group II, and statistical significant difference was found between the group I and group II. Duration of analgesia was significantly longer in group III than in group I and group II. Overall hourly OPS scores were lower in group III than in group I and group II. CONCLUSION: Duration of postoperative analgesia with caudal bupivacaine was increased by addition of 1 mcg/kg of clonidine.
Adult ; Analgesia ; Anesthesia, Caudal* ; Bupivacaine ; Child ; Clonidine* ; Epinephrine ; Humans ; Recovery Room ; Thiopental

No abstract available.
Uterus*

No abstract available.
Child* ; Hemagglutination* ; Humans ; Mycoplasma pneumoniae* ; Mycoplasma* ; Pneumonia* ; Pneumonia, Mycoplasma*

We report two cases of malignant schwannoma of skin in association with non-familial neurofibromatosis. Case 1, a 47 year old man, had a large subcutaneous tumor on the sacral area and case 2, a 62 year old woman, a painful, ulcerating tumor on the posterior aspect of the left arm. Both cases were histopathologically confirmed as malignant schwannomas and immunohistochemical studies showed 5-100 protein in the tumor cells. After surgical excision of the tumors, case 1 was lost to follow up, while case 2 remained without evidence of disease for more than one and half years.
Arm ; Female ; Humans ; Lost to Follow-Up ; Neurilemmoma* ; Neurofibromatoses* ; Skin ; Ulcer

Following chemotherapy for acute myelomoncytic leukemia, an 3-year-old boy developed several painful erythematous indurated patches at previous sampling sites and at the site where an arm board and adhesive tape were used in securing an intravenous infusion set. The lesions rapidly progressed to ulcers with central black eschars. Biopsies and cultures demonstrated a fungus, Aspergillus flavs, as the etiologic agent, without evidence of systemic dissemination. Local care, including s irgical debridement, were performed. The patient also received treatment with intravenous; amphotericin B followed by oral itraconazole. Six months later, the skin lesions had healed, leaving some scar and deformities.
Adhesives ; Amphotericin B ; Arm ; Aspergillosis* ; Aspergillus ; Biopsy ; Child* ; Child, Preschool ; Cicatrix ; Congenital Abnormalities ; Debridement ; Drug Therapy ; Fungi ; Humans ; Infusions, Intravenous ; Itraconazole ; Leukemia* ; Male ; Skin ; Ulcer

No abstract available.
Humans ; Kidney Failure, Chronic* ; Peritoneal Dialysis, Continuous Ambulatory*

No abstract available.
Heart Defects, Congenital* ; Plasma*

Ticlopidine is a powerful inhibitor of platelet aggregation which is induced by adenosine diphosphate. Ticlopidine has been shown to be effective in reducing combined stroke, myocardial infarction, reocclusion of coronary stent. The principal side effects of ticlopidine are severe neutropenia, rash and gastrointestinal upset. Recently, we experienced two cases of severe neutropenia associated with ticlopidine. One was administered ticlopidine to prevent subacute thrombosis after intracoronary stent implantation in unstable angina pectoris. Thirty days of therapy, her absolute neutrophil count (ANC) had dropped to 14/mm3 . The other patient was presented with recurrent episodes of cerebral infarction, for which he had undergone right carotid angiogram. The carotid angiogram demonstrated tight stenosis of right internal carotid artery. Carotid artery stenting was performed at right internal carotid artery without any complications. Twenty seven days of ticlopidine therapy, his ANC had dropped to 111/mm3. The ticlopidine was stopped, and they were given granulocyte-colony stim-ulating factor 250 microgram/day subcutaneous injection until their ANC was up to 1000/mm3. They were discharged with normal neutrophil count and no other complications.
Adenosine Diphosphate ; Angina, Unstable ; Carotid Arteries ; Carotid Artery, Internal ; Cerebral Infarction ; Constriction, Pathologic ; Exanthema ; Granulocyte Colony-Stimulating Factor ; Humans ; Injections, Subcutaneous ; Myocardial Infarction ; Neutropenia* ; Neutrophils ; Platelet Aggregation ; Stents ; Stroke ; Thrombosis ; Ticlopidine*