The mutation of p53, a tumor suppressor gene, has been considered to play an important role in tumorigenesis in a variety of human cancers and the abnormal expression of p53 are frequently associated with poor prognosis. In order to examine the association of p53 overexpression with known prognostic factors including estrogen receptors (ER) and progesterone receptors (PR), we studied the status of p53 protein expression by immunohistochemical staining of paraffin sections of 29 endometrial carcinoma (25 endometrioid carcinoma, 2 clear cell carcinoma, and 2 serous carcinoma), obtained from hysterectomy. The results were as follows: The expression of p53, ER, and PR was present in 9/29 (31%), 3/29 (16%), and 12/29 (48%), respectively. The expression of p53 in endometrioid adenocarcinoma was present in 6/25 (24%) and showed significant correlation with histologic grade, nuclear grade, and myometrial invasion. The status of PR showed significant inverse correlation with histologic grade, nuclear grade and myometrial invasion. There was no significant correlation between ER status and these histologic factors. The expression of p53 was inversely associated with the status of PR, but statistically not significant. Our results indicate that p53 may be useful in predicting prognosis in endometrial carcinoma and will be able to provide helpful information in predetermination of aggressive behavior of the tumor in evaluation of curettage specimen.
Carcinogenesis ; Carcinoma, Endometrioid ; Curettage ; Endometrial Neoplasms* ; Female ; Genes, Tumor Suppressor ; Humans ; Hysterectomy ; Paraffin ; Prognosis ; Receptors, Estrogen ; Receptors, Progesterone

The brachial plexus block by interscalene approach is useful for any procedure on upper extremity, including the shoulder. Complications such as high epidural block, total spinal anesthesia, permanent neurologic damage, phrenic nerve block, cardiac arrest, pneumothorax and Horner's syndrome etc. were reported. Ipsilateral Horner' syndrome can be used for confirmation of the accompanying sympathetic block. We experienced a case of 35-year old male patient who developed ipsilateral Horner's syndrome following the injection of 40ml of 1% lidocaine with 1 : 200,000 epinephrine to brachial plexus by interscalene approach. This compication lasted for 10days after interscalene brachial plexus block.
Adult ; Anesthesia, Spinal ; Brachial Plexus* ; Epinephrine ; Heart Arrest ; Horner Syndrome* ; Humans ; Lidocaine ; Male ; Phrenic Nerve ; Pneumothorax ; Shoulder ; Upper Extremity

The evaluation of the proliferative potential of malignant neoplasm is of major interest for predicting their biological behavior. MIB-1, a monoclonal antibody against the Ki-67 antigen, is a marker of cell proliferation, which is widely applied to human cancers recently. To assess the growth potential of uterine endometrial carcinoma, we performed immunohistochemical staining of MIB-1 in 34 cases of endometrial adenocarcinoma (endometroid type) from the paraffin sections. We evaluated its correlation with p53 overexpression and known prognostic factors including FIGO grade, nuclear grade, myometrial invasion, and estrogen and progesterone receptors. As a result, the MIB-1 labelling index was significantly correlated with FIGO grade, nuclear grade and myometrial invasion (p<0.05) and there was no significant correlation between MIB-1, ER or PR status. The expression of p53 protein showed significant correlation with FIGO grade and nuclear grade (p<0.05) and there was no significant correlation among p53 protein, myometrial invasion, ER and PR status. The MIB-1 labelling index revealed striking difference between p53 positive and p53 negative group (p<0.05). We concluded that MIB-1 labelling index is associated with poor prognostic parameter in endometrial adenocarcinoma, and may be a useful marker for predicting tumor of high grade and deep myometrial invasion, if MIB-1 labelling index is more than 50% and is accompanied by p53 overexpression.
Adenocarcinoma* ; Cell Proliferation ; Endometrial Neoplasms ; Estrogens ; Female ; Humans ; Ki-67 Antigen ; Paraffin ; Receptors, Progesterone ; Strikes, Employee

Sick neonates often require periodic small volume transfusion (10mg/kg) to replace blood draw for laboratory monitoring during their hospital stay. The effect of packed red cel transfudion on the hematocrit, potassium, ionized calcium, acid base status, glucose and indirect bilirubin was investigated in 25 transfusions. Analysis of transfused blood by the age of the red cells, older red cells (more than 5 days old, 13+/-7 days) showed increased potassium (27.2+/-14.1mEq/L vs 11.3+/-4.9mEq/L), decreased bicarbonate (14.4+/-2.6mEq/L) and glucose (130+/-28mg/dl vs 203+/-93mg/dl) compared with newer red cells (less than 5 days)(p<0.05). No significant changes occured in hematocrit and pH. Inspite of these results, the transfusion of the older red cells did not affect the older red cells did not affect the serum potassium, ionized calcium, pH, bicarbonate, glucose and indirect bilirubin level in neonates. The hematocrit of infants increated significantly after transfusion from 29.6%+/-4.3% to 38.3%+/-6.1%(mean+/-SD)(P<0.05). Transfusion of older red cells seemed to be as equally effective as newer ones. The valus of hematocrit obtained immediately after transfusion does not show any differences compared to those obtained 30 min, 1, 2, 4, 6 and 24 hours after transfusion. The result in the study indicate that there was no adverse effect after transfusion with packed red cell more than 5 days old and no significant difference in hematocrit observed between 0 to 24 hours following transfusion. Therfore old red cell more than 5 days can be used safely for sick neonatal transfusion and the stored donor blood can be optimzed for repeated blood transfusion.
Bilirubin ; Blood Transfusion ; Calcium ; Glucose ; Hematocrit* ; Humans ; Hydrogen-Ion Concentration ; Infant ; Infant, Newborn* ; Length of Stay ; Potassium ; Tissue Donors

PURPOSE: Abnormalities in calcium(Ca), vitamin D and bone mineral density (BMD) associated with antiepileptic drug(AED) are reported, but the results are inconsistent. In case of intractable epilepsy, poor growth and altered bone mineral metabolism may be prominent, possibly related to previous long-term use of multiple AED and poor activity. The aim of this study was to assess growth status, concentrations of calcium regulating hormones and BMD in children with intractable epilepsy. METHODS: Sixty-six intractable epilepsy patients aged 0.8 to 14.7 years(mean+/-D:4.6+/-.6 years) were included in the study. Height and weight were measured and then height SDS and weight SDS were calculated. Serum Ca, i-Ca, P, Mg, Zinc, osteocalcin, intact-PTH, 25-OHD, 1,25(OH)2D were measured. BMD of the lumbar spine was measured by dual energy X-ray absorption. RESULTS: Most of the patients showed normal height SDS and weight SDS. Percentage of severe short stature(height SDS <-2) was 1.5% and tall stature(height SDS >2) was 4.5%. Percentage of severe thin(weight SDS <-2) was 1.5% and obesity(weight SDS >2) was 6%. Duration of AED was not related to height SDS or weight SDS. Etiology of epilepsy and physical activity were not related to height SDS and weight SDS. Most of them had normal Ca, iCa, P, Mg, Zinc, intact-PTH, osteocalcin, 25-OHD and 1,25(OH)2D concentrations. BMD was not related to the levels of Ca, i-Ca, P, Mg, intact-PTH, osteocalcin, 25-OHD, 1,25(OH)2D. BMD was not related to the duration of AED. BMD positively correlated with age(r=0.75, P>0.01) and body weight(r=0.72, P<0.01). CONCLUSION: Most of the children with intractable epilepsy, who regularly visits epilepsy clinic, showed normal growth and normal bone mineral metabolism, but careful monitoring about growth and bone mineral metabolism is needed.
Absorption ; Bone Density* ; Calcium* ; Child* ; Epilepsy* ; Humans ; Metabolism ; Motor Activity ; Osteocalcin ; Spine ; Vitamin D ; Zinc

BACKGROUND: Benign paroxysmal positional vertigo (BPPV) is the most common peripheral vestibular disorder that often resolves spontaneously. It was long believed that the condition was caused by inorganic particles in the cupula of the posterior semicircular canal. Management of this condition includes medication, surgery, physical exercise and more recently particle repositioning maneuvers. Among the various therapies, exercise therapy (ET) reported by Brandt-Daroff was based on the theory of cupulolithiasis and is designed to treat BPPV through dispersion of the debris from the cupula. METHODS: Fifty four patients with BPPV were treated with ET to determine the effectiveness. Fifteen additional patients with BPPV were treated with only medication and served as a control group. RESULT: Forty eight of 54 cases (88.9%) treated with ET showed improvement after 2 weeks. With medication alone, 8 of the 15 cases (53.4%) showed improvement after 2 weeks. CONCLUSIONS: The most important benefit of this maneuver seemed to be more expedient recovery than that with medication alone.
Exercise ; Exercise Therapy* ; Humans ; Semicircular Canals ; Vertigo*

PURPOSES: We experienced a case of infected cephalhematoma drained spontaneously. So we wanted to review the most appropriate method for investigating cephalhematomas for possible infection and to clarify the indications for the diagnostic aspiration. METHODS: MEDLINE searches were conducted for the period from 1972 to 1997, and all reports were obtained. 15 articles reporting 18 infected cephalhematomas were identified in the literature. We analyzed the medical records in patients according to age: sex ; associated infections especially sepsis or osteomyelitis, risk factors such as scalp electrode or vacuum use, local signs such as increase in size, fluctuation, local redness: organisrns: and radiographic findings. RESULTS: Escherichia coli was isolated from over 50% of the cephalhematomas that were aspirated. Most patients presented with sepsis, meningitis, and/or osteomyelitis. Plain radiographs, bone scans, and enhanced CT scans were limited in their ability to determine if a cephalhematoma was infected unless associated osteomyelitis existed. Local signs of scalp infection, such as increase in size, fluctuation, local redness were obvious in almost all cases. CONCLUSIONS: Aspiration is the diagnostic procedure of choice for cephalhematomas suspected of being infected. The indications for aspiration were increase in size, development of erythema, development of fluctuation, relapse of systemic infection, or a delay in the resolution of clinical symptoms of infection.
Diagnosis ; Electrodes ; Erythema ; Escherichia coli ; Humans ; Infant, Newborn ; Medical Records ; Meningitis ; Osteomyelitis ; Recurrence ; Risk Factors ; Scalp ; Sepsis ; Tomography, X-Ray Computed ; Vacuum

BACKGROUND: The authors studied to estimate the frequency of irregular antibodies and their significance in blood transfusion and antenatal care in Korea. METHODS: Irregular antibodies were tested by immediate saline spin, 37degrees C albumin and antiglobulin test for 2,008 transfusion candidates and 1,047 pregnant women at Severance hospital using commercial screening and identification cells (Dade, U.S.A.). RESULTS: The irregular antibodies were detected in 38 (1.24%) of total 3,055 subjects (transfusion candidates: 0.9%, pregnant women: 1.91%) . In transfusion candidates, the detected antibodies were Lewis antibodies, cold antibodies (anti-M, anti-P 1), Rh antibodies and unspeified warm antibodies, and their distributions were 56%, 22%, 17%, and 5%, respectively. In pregnant women, the detected antibodies were Lewis antibodies, Rh antibodies, anti-Jra, and unspeified warm antibodies, and their distributions were 45%, 45%, 5% and 5%, respectively. At immediate saline phase, 58% of irregular antibodies were detected. At 37degrees C albumin phase, 90% of irregular antibodies were detected and only 10% of irregular antibodies were detected at antiglobulin phase. CONCLUSIONS: Although the prevalence rates of clinically important irregular antibodies were low, 1/1000 of irregular antibodies could not be detected. Therefore, irregular antibody screening should be performed in all pretransfusion test. And, if antibody detection tests are negative, immediate saline crossmaching methods are acceptable in Korea.
Antibodies* ; Blood Transfusion ; Coombs Test ; Female ; Humans ; Korea* ; Mass Screening ; Pregnant Women* ; Prevalence*

BACKGROUND: The authors studied to estimate the frequency of irregular antibodies and their significance in blood transfusion and antenatal care in Korea. METHODS: Irregular antibodies were tested by immediate saline spin, 37degrees C albumin and antiglobulin test for 2,008 transfusion candidates and 1,047 pregnant women at Severance hospital using commercial screening and identification cells (Dade, U.S.A.). RESULTS: The irregular antibodies were detected in 38 (1.24%) of total 3,055 subjects (transfusion candidates: 0.9%, pregnant women: 1.91%) . In transfusion candidates, the detected antibodies were Lewis antibodies, cold antibodies (anti-M, anti-P 1), Rh antibodies and unspeified warm antibodies, and their distributions were 56%, 22%, 17%, and 5%, respectively. In pregnant women, the detected antibodies were Lewis antibodies, Rh antibodies, anti-Jra, and unspeified warm antibodies, and their distributions were 45%, 45%, 5% and 5%, respectively. At immediate saline phase, 58% of irregular antibodies were detected. At 37degrees C albumin phase, 90% of irregular antibodies were detected and only 10% of irregular antibodies were detected at antiglobulin phase. CONCLUSIONS: Although the prevalence rates of clinically important irregular antibodies were low, 1/1000 of irregular antibodies could not be detected. Therefore, irregular antibody screening should be performed in all pretransfusion test. And, if antibody detection tests are negative, immediate saline crossmaching methods are acceptable in Korea.
Antibodies* ; Blood Transfusion ; Coombs Test ; Female ; Humans ; Korea* ; Mass Screening ; Pregnant Women* ; Prevalence*

PURPOSE: This study was done to examine the attitude and awareness of nurses about rooming-in for new mothers and their infants. METHODS: Data were collected from 462 nurses from 40 hospitals from August 10 to September 20, 2008 using a questionnaire, and the collected data were analyzed using descriptive statistics, t-test and ANOVA. RESULTS: The mean score for attitude and awareness of nurses about rooming-in was 3.02 (range=2.13~3.80), which indicates that the nurses had positive opinions of the system. The factors with the highest and lowest scores were awareness of a successful implementation method (mean=3.35) and awareness of the advantages and disadvantages of the system (mean=2.73), respectively. The attitude and awareness of nurses about rooming-in differed significantly with age, religion, education level, parity, type of hospital, hospital nurse staffing grade (bed-to-nurse ratio), and presence of a rooming-in system. CONCLUSION: This results of the study show that attitudes and awareness of nurses to rooming-in differed significantly according to personal factors (age, parity, religion, educational level) and work characteristics (hospital type, hospital nurse staffing grade, presence of rooming-in system). These findings can be used as basic data in determining optimal strategies for a system of rooming-in in the future.
Attitude of Health Personnel ; Female ; Humans ; Infant ; Mothers ; Parity ; Surveys and Questionnaires ; Rooming-in Care