The authors attempted to choose what has the best reproducibility and predictability for prognosis of the prostatic adenocarcinoma among four most widely used gradings methods; the Gleason's Mostofi's, Bocking and MD Anderson hospital systems. According to these gradings systems, each of two pathologists made histologic gradings of 40 consecutive prostatic adenocarcinomas which had been diagnosed with the surgically resected specimens. Correlation between the histological grades and the clinical stages was studied and a comparison was made among each system. For the comparison, the Gleason's and MDAH systems were revised as 3 grades and adjusted to the other gradings systems. In this study, MDAH grading system yielded the highest reproducibility as represented by 90% agreement, as compared with the other systems which showed 82.5~87.5% agreement. By the Gleason's, Mostofi's and Bocking's systems, 46.2%, 23.1% and 46.2% of grade 3 tumors respectively fell under the clinical stage A. On the contrary, there were no cases of grade 3 in stage A and no cases of grade 1 in stage D, by MDAH gradings system. These results suggest that MDAH gradings system is superior to the other systems in reproducibility and for predicting the biological behavior.
Adenocarcinoma

Ceftizoxime was administered to 30 cases with urinary tract infection for 7 days in the most cases at a daily dose of 1-2 gm intravenously or intramuscularly. The clinical efficacy of Ceftizoxime was as follows: Excellent results were obtained in 13 cases, good result in 14 cases and poor result in 3 cases, the overall effectiveness rate was 90% and no adverse reaction was noted in all cases. bacteriologically, 13 strains were isolated in 26 cases and 4 cases were bacteriologically unknown, and 2 strains in 3 cases, which were a case of proteus morganii and two cases of Pseudomonas fluoresces, were failed in treatment. Judging from the response to Ceftizoxime as shown in al Tables, Ceftizoxime is considered to be a very useful antibiotic in the treatment of urinary tract infection.
Ceftizoxime* ; Proteus ; Pseudomonas ; Urinary Tract Infections* ; Urinary Tract*

Spinal anesthesia is a safe anesthetic technique and relative easy to perform, but occasionally neurologic injuries after spinal anesthesia have been reported. A 53-year old female patient visited the emergency room due to abdominal pain and she was diagnosed with acute appendicitis. Thus, an emergent appendectomy was planned. During the preoperative evaluation, we noticed that she had a history of intermittent low back pain for the previous 5 years. However, because her stomach was not fully empty, we decided to administer spinal anesthesia. When the spinal needle passed the subarachnoid membrane, she suddenly complained of severe paresthesia on her right posterior thigh. However the parethesia subsided soon, and 2.2 cc of 0.5% bupivacaine was injected via a spinal needle, and aftewards, an appendectomy was done without any complications. As she recovered from the spinal anesthesia, she started complaining of shooting, stabbing and burning pain on her right buttock and posterior thigh Because a neurologic injury after spinal anesthesia was suspected, we inserted an epidural catheter to the same lumbar vertebral level for administering the mepivacaine and ketamine mixture and we also performed a right second sacral nerve root block and a lumbar sympathetic ganglion block. Magnetic Resonance Imaging showed spondylosis of lumbar spine and associated disc degeneration and a bulging disc at the L3-4, L4-5 and L5-S1 level. After treatments, her symptoms improved gradually. When she was discharged on the 16th hospital day, she complained of only minor discomfort on her right posterior thigh.
Abdominal Pain ; Anesthesia ; Anesthesia, Spinal* ; Appendectomy ; Appendicitis ; Bupivacaine ; Burns ; Buttocks ; Catheters ; Emergency Service, Hospital ; Female ; Ganglia, Sympathetic ; Humans ; Intervertebral Disc Degeneration ; Ketamine ; Low Back Pain ; Magnetic Resonance Imaging ; Membranes ; Mepivacaine ; Middle Aged ; Needles ; Paresthesia ; Spine ; Spondylosis ; Stomach ; Thigh

BACKGROUND: The severity of several chronic inflammatory diseases was reported to be associated with polymorphism of the IL-1 receptor antagonist gene(IL-lrn). OBJECTIVE: This study was performed to study the polymorphism of the IL-1rn in vitiligo and in the normal Korean population. METHODS: Thirty one cases of vitiligo and seventy nine normal Koreans as control were studied for the polymorphism of IL-1 rn. RESULTS: The frequency of allele 2 of the IL- I rn in 31 patients with vitiligo was compared with that of the 79 healthy controls. The frequency of allele 2 was 1.6% in vitiligo patients and 3.8% in the normal controls. CONCLUSION: There was no significant difference in the frequency of allele 2 between the vitiligo patients and normal controls.
Alleles ; Humans ; Interleukin-1* ; Vitiligo*

Bile* ; Choledochal Cyst* ; Humans ; Infant* ; Peritonitis*

Among the 1760 cases of carcinomas of the breast treated between 1981 and 1996, there were 31 cases of bilateral breast cancer. Of these, 7 were synchronous tumors and the remaining 24 patients had metachronous tumors : 41.7% of all patients had presented within 5 years since the first primary tumors were detected and 73.3% of all patients had presented within 10 years. The mean age of the synchronous bilateral cancers was 39.9 (26~55), and the mean age at the diagnosis of the first cancers in the metachronous cancers was 44.75 (31~70) years old. The location of the tumor was the same in 64% and 68% of the synchronous and metachronous cancers, respectively, that had an identified histology. The mean survival of metachronous group was 70.5 months and that of synchronous group was 114.7 months. However, there was no statistical significance between the mean survival times of the two groups (p>0.05). We recommend a careful check-up for the opposite breast at the time of primary cancer treatment, as well as well an organized follow-up program for all patients having undergone treatment for breast cancer. Further investigations are required to determine the incidence of and risk factors for second cancer development in the opposite breast.
Breast Neoplasms* ; Breast* ; Diagnosis ; Follow-Up Studies ; Humans ; Incidence ; Neoplasms, Second Primary ; Risk Factors ; Survival Rate

No abstract available.
Cystitis* ; Eosinophils* ; Urinary Bladder Calculi* ; Urinary Bladder*

OBJECTIVE: This study was to investigate the expression of CDK inhibitors, p27kip1 and p57kip2 during the growth and differentiation of mouse placenta. METHODS: Total RNA and protein were extracted from placenta of mouse sacrificed at day 12, 14, 16, 18 post-coitum (p.c.), then semi-quantitative RT-PCR and western blotting of p27kip1 and p57kip2 was carried out, respectively. RESULTS: p27kip1 mRNA was highly expressed in 18 days p.c. then other groups. But, p57kip2 mRNA expression was high in 12, 14, and 16 days p.c., then decreased in 18 days p.c. p27kip1 expression pattern was similar with mRNA. But, p57kip2 was higher in 14 days p.c. than other groups. CONCLUSION: This result shows that p27kip1 may play a role in late period of mouse placental development, and p57kip2 may play a role in middle period of mouse placental development.
Animals ; Blotting, Western ; Mice* ; Placenta* ; Placentation ; Pregnancy* ; RNA ; RNA, Messenger

Familial or hereditary breast cancer has genetic heterogeneity and is transmitted vertically in an autosomal dominant fashion. About 5 to 10% of breast cancers are caused by the inheritance of mutations in dominant susceptibility genes. We retrospectively reviewed 50 breast cancer patients from 44 families. These patients had treated their breast cancer at the Department of Surgery, Yonsei University College of Medicine, from 1981 to 1996. There were no statistically significant differences between the familial breast cancers and the sporadic breast cancers in such clinicopathologic characteristics as major complaint, tumor location, tumor size, metastasis to axillary lymph nodes, stage distribution, histology distribution and hormone receptor status. For familial camcers, the mean survival was 125 months, the overal 5-year survival rate was 85%, and the overall 5-year disease-free survival rate was 70%.
Breast Neoplasms* ; Breast* ; Disease-Free Survival ; Genetic Heterogeneity ; Humans ; Lymph Nodes ; Neoplasm Metastasis ; Retrospective Studies ; Survival Rate ; Wills

Nonsurgical endoscopic or percutaneous dilatation and insertion of an endoprosthesis is the treatment of choice in the majority of patiens with incurabie malignant biliary obsturction. But these palliative treatment of extrahepatic cholestasis with an endoscopic or percutaneous biliary endoprosthesis is limited by clogging. One of the factors thought to be of importance is the diameter of the stent. So in order to avoid being limited by the size of the instrumentation channel of the endoscope, expandable stents have been developed. Wallstent is braided in the form of a tubular mesh from surgical grade stainless alloy. This prosthesis is geometrically stable, pliable and self expanding. Its elastic properties are such that its diameter can be substantially reduced by moderate elongation. The stent is constrainded on a small diameter delivery catheter(total outside diameter: 9 French). During the implantation procedure the final position of the partially released endoprosthesis can be adjusted by gradual removal of the delivery catheter. If full expansion to 30 French occurs, the stent will be shortened by approximately 30% to their normal length range between 34-102mm. Now in this article we report a new method for endoscopic retrograde placement of biliary Wallstent in a patient with obsturctive jaundice due to periampullary choangiocacrcinoma.
Alloys ; Catheters ; Cholestasis, Extrahepatic ; Dilatation ; Endoscopes ; Humans ; Jaundice ; Palliative Care ; Prostheses and Implants ; Stents