p27kip1, a cyclin dependent kinase inhibitor, has been recognized as a negative regulator of cell cycle. To investigate the role of p27kip1 on progression of cancer and apoptotic pathway, we analyzed p27kip1 expression using immunohistochemical stain in 40 cases of prostatic adenocarcinoma and apoptotic index by TUNEL method in 30 cases of prostatic adenocarinoma. Both were correlated with Gleason grade and Gleason score. Loss of p27kip1 expression was more frequent in prostatic adenocarcinomas of higher score (Gleason score 7 to 10) (60.7%) than in those of lower score (Gleason score 4 to 6) (33.3%) (p<0.05). The value of mean apoptotic index of carcinoma was 1.13+/-0.26, 1.80+/-0.91, 2.06+/-0.79, and 2.12+/-0.82 in grade 2, 3, 4, and 5, respectively, and was positively correlated with grade of carcinoma (p<0.05). Mean apoptotic index of higher Gleason score (score 7 to 10; 2.05+/-0.63) was also significantly increased than in lower Gleason score (score 4 to 6; 1.34+/-0.39) (p<0.05). Mean apoptotic index in cases with and without p27kip1 expression was 1.92+/-0.86 and 1.89+/-0.81, respectively (p>0.05). These results suggest that loss of p27kip1 expression and increased apoptotic index may be the morphologic markers to predict the behavior of prostatic adenocaricnoma. The role of p27kip1 on apoptotic pathway seems to be meager in this study and needs further study.
Adenocarcinoma* ; Cell Cycle ; Cyclins ; In Situ Nick-End Labeling ; Neoplasm Grading ; Phosphotransferases

We treated 550 ureteral calculi patients with stone basket or Candela MDL-l laser lithotripter using the rigid ureteroscope(URS) between April 1988 and November 1993. The laser lithotripsy was applied for the patients who had failed URS stone removal with stone basket. The success rates of URS stone removal with stone basket were 33.7%(120/356) in the lower ureter stones, 1.7%(2/112) in the mid, none(0/82) in the upper. The laser lithotripsy rates and success rates were 63.4%(226/356), 99.5%(225/226) in the lower ureter, 90.1%(101/112), 85.1%(86/101) in the mid, 79.2%(65/82), 80%(52/65) in the upper, respectively. The total URS stone removal success rates were 96.9%(345/356) in the lower ureter, 78.6%(88/112) in the mid, 63.4 %(52/82) in the upper. There were 65 failures due to upward migration(27 cases), approach failure to stone by URS (35 cases), no fragmentation(3 cases). Ureterolithotomy was required in 8 cases and shockwave lithotripsy in 11 cases and retry in 22 cases. The complication of URS were minimal, gross hematuria (11.2%), pain(9.5%) and infection (1.6%). Ureteral perforation occurred in only 10 patients. In conclusion, laser lithotripsy has been significantly contributed improving of success rates and expanding of applying area for URS stone removal in our series.
Hematuria ; Humans ; Lithotripsy ; Lithotripsy, Laser ; Ureter ; Ureteral Calculi

Omentum has the characteristic that it readily develops vascular anastomosis with adjacent tissues. It is suitable for eliminating a dead space regardless of the size, shape or site in the treatment of chronic osteomyelitis by use of technique of microvascular anastomoses. We report a case of chronic osteomyelitis treated by transplantation of autogenous omentum with microvascular anastomsis.
Omentum ; Osteomyelitis

Nevus anelasticus is an elastic tissue disorder that is characterized by perifollicular papules and the fragmentation or absence of elastic tissue. A 17-year-old female presented with multiple erythematous papules on her lower back. These skin lesions first appeared a few years ago and at that time she presented with multiple, flat tapped, coalescing pinkish-red papules that were 0.5 to 1 centimeters in diameter. Histopathologic examination revealed the loss of elastic tissue, with fragmentation of the residual elastic fibers in the upper and mid dermis, and the pattern of the dermal collagen was normal. Herein we report on a rare case of nevus anelasticus and we review the relevant literature.
Adolescent ; Collagen ; Dermis ; Elastic Tissue ; Female ; Humans ; Nevus ; Skin

PURPOSE: The purpose of this study was to compare the efficacy of curative emergency surgery for complicated colon cancer in terms of tumor recurrence and survival compared with that of elective surgery. METHODS: A total of 238 primary surgeries for colon cancer were performed. All patients were deemed to have undergone a curative resection. Patients were classified into an emergency surgery group for complicated colon cancers (n=40) and an elective surgery group for uncomplicated colon cancers (n=198). RESULTS: Emergency colonic cancers present at a more advanced stage (P=0.002). The postoperative mortality rate in the emergency group was significantly higher than it was in the elective group (15.0% vs. 2.5%, P= 0.004). There were differences between the two groups in tumor recurrence (32.5% vs. 13.1%, P=0.003), overall survival (52.5% vs. 71.7%, P=0.017), and disease-free survival (50.0% vs. 69.7%, P=0.016). However, after the patients were stratified according to tumor stage, no statistical differences were observed. CONCLUSIONS: When compared with uncomplicated colon cancers, complicated colon cancers present at a more advanced stage with a higher postoperative mortality and an overall worse prognosis. However, the difference decreases when patients are stratified according to the tumor stage. The negative prognostic efficacy of emergency surgery for complicated colon cancers appears to be confined to the perioperative period. Despite the more advanced stage of tumors in patients undergoing emergency surgery, the aim of the surgeon should be to offer a curative resection for better survival, if possible.
Colon* ; Colonic Neoplasms* ; Disease-Free Survival ; Emergencies* ; Humans ; Mortality ; Perioperative Period ; Prognosis ; Recurrence

Superficial siderosis is attributed to hemosiderin deposition in the subpial layers of the nervous system. The clinical features of infratentorial superficial siderosis (ISS) are hearing loss, cerebellar ataxia, and corticospinal tract signs and the most common cause of idiopathic ISS is a dural defect. As magnetic resonance imaging (MRI) has advanced, the diagnosis of infratentorial superficial siderosis can be confirmed by unique radiological findings in MRI. Here, we report on a female patient diagnosed with idiopathic ISS by means of clinical symptoms and radiological findings.

BACKGROUND AND OBJECTIVE: Specific IgE to food allergen is associated with atopic dermatitis, but it does not always show good clinical correlation. It has been suggested that IgG may be partly involved in allergen-induced reaction. This study was designed to investigate the clinical significance of specific IgG antibody to egg white (EW) in atopic dermatitis patients who showed improvement with egg elimination diet. METHOD: Eleven atopic dermatitis patients who responded to egg elimination diet were selected. They were classified into two groups; group I (n=5) with positive specific IgE to EW and group II (n=6) with normal levels of serum specific IgE. Two volunteers with no allergic diseases were enrolled in the control group. EW-specific IgG western blotting was performed with patient's serum and purified protein extracted from EW. RESULTS: IgG western blotting to EW in group I showed bands at 51.8 kD in two patients and bands at 35 kD in the others. In group II, two showed bands at 51.8 kD, and diffuse bands at 35 kD~51.8 kD were found in four patients. There were no bands in the control group. CONCLUSION: Regardless of the presence of specific IgE, specific IgG to EW was detected by western blotting in patients with egg-associated atopic dermatitis, suggesting that specific IgG may play a role in the pathogenesis of atopic dermatitis.
Blotting, Western* ; Child* ; Dermatitis, Atopic* ; Diet ; Egg White ; Humans ; Immunoglobulin E ; Immunoglobulin G* ; Ovum* ; Volunteers

BACKGROUND: Although proactive screening for sexual dysfunction in primary care has been emphasized as an important part of comprehensive care, doctors seldom ask their patients about their sexual function. Worry about patients' responses was reckoned as a major barrier, but few studies have dealt with how patients feel and what they want. This study was aimed to describe and analyze the attitudes of patients toward proactive screening for sexual dysfunction. METHODS: A set of self-administered questionnaire was given to every patients who visited a family medicine clinic in a university hospital for 2 weeks from March 16, 2005. RESULTS: A total of 185 patients were analyzed. Among them, 72.4% were willing to consult their physician when they were in trouble with their sexual function, and 84.3% said proactive screening for sexual dysfunction was necessary. Many patients did not care about 'when to be asked' and wanted to be asked in face-to-face interview rather than by a questionnaire. Sentence emphasizing that every patient is given the same question was most preferred. CONCLUSION: Patients' attitude toward proactive screening for sexual dysfunction in primary care was generally positive. Patients preferred to be asked "I ask every patient about his sexual problem. If you're OK, I ask you about your sexual problem." regardless of timing, during the interview.
Humans ; Mass Screening* ; Primary Health Care ; Surveys and Questionnaires

OBJECTIVE: Primary pontine hemorrhage (PPH) accounts approximately for about 5~10% of intracranial hemorrhages, and overall mortality rate in recent studies is 40~50%. In a general way, primary treatment of PPH is conservative. Although some authors are trying to surgical treatment for PPH recently, treatment guideline still remains controversy. We report our study to establish the clinical and radiologic prognostic factors in PPH patients and present the guideline for surgical treatment. METHODS: We analyzed 35 patients with PPH admitted to our hospital between January 2000 and December 2006. Glasgow Coma Scale (GCS) scores were assessed on admission, and Glasgow Outcome Scale (GOS) scores on discharge. We divided the patients into two groups according to GOS score: (1) patients who had bad prognosis, and (2) patients who had good one. The two groups were compared for age, gender, hypertension, initial GCS, pupillary abnormalities, volume and location of hemorrhage, intraventricular and extrapontine extension, need for mechanical ventilation and hydrocephalus. RESULTS: Twenty-one patients (60%) were hypertensive. Twenty patients (57%) survived and six of them were capable of performing activities of daily living within 3 months of the hemorrhage. Significant prognostic factors were found with coma on admission, GCS score on admission, hematoma location, hematoma volume, need for mechanical ventilation and intraventricular hemorrhage. CONCLUSION: Initial GCS score, size and location of the hematoma, coma on admission, need for mechanical ventilation and intraventricular extension were significantly correlated to poor outcome in our study. If more large studies follow up including surgical outcome, we could make a surgical indication for PPH to improve the mortality and prognosis.
Activities of Daily Living ; Coma ; Glasgow Coma Scale ; Glasgow Outcome Scale ; Hematoma ; Hemorrhage* ; Humans ; Hydrocephalus ; Hypertension ; Intracranial Hemorrhages ; Mortality ; Prognosis ; Respiration, Artificial

The skin lesions of herpes zoster are classically limited to a single dermatome and most cases of multidermatomal herpes zoster have contiguous skin lesions. Simultaneous involvement of two noncontiguous dermatomes is very rare and it has been referred to as zoster duplex unilateralis or bilateralis, depending whether one or both halves of the body are involved. A 67-year-old woman presented with a group of painful vesicles on the right buttock and thigh, and left anterior chest and back. The Tzanck smear and skin biopsy were consistent with a herpetic infection. We report a rare case of zoster duplex bilateralis.
Aged ; Biopsy ; Buttocks ; Female ; Herpes Zoster ; Humans ; Skin ; Thigh ; Thorax