Recently, the bcl-2 and p53 protein have been recognized as important factors that is contributed to programmed cell death. The objective of this study was to evaluate the prognostic significance of bcl-2 and p53 protein expression in uterine cervical carcinoma. The expression of bcl-2 and p53 in 59 cases of uterine cervical carcinoma (stage IB to IIB) were surgically treated from January 1993 to June 1994. The expression of bcl-2 and p53 was examined by immunohistochemical method using formalin fixed paraffin embedded tissue specimens. The 48 cases were squamous cell carcinoma and 11 cases were adenocarcinoma. The results were as follows: 1. The expression rate of bcl-2 protein was 28.8%(17/59) and there was no significant correlaltion between the expression of bcl-2 protein and the clinicopathologic parameters (histologic type, grade, FIGO stage, cervical invasion depth, lymph node metastasis, parametrial invasion, tumor size, neoadjuvant chemotherapy response, recurrence, survival). 2. The expression rate of p53 protein was 32.2%(19/59) and there was no significant correlation between expression of p53 protein and the clinicopathologic parameters. 3. There was significant correlation between and expression of bcl-2 and p53 protein (P 0.05). In conclusion, bcl-2 and p53 protein are thought to be possible factors in the carcinogenesis of uterine cervical carcinoma and correlate with progression of it. But further study will be required to clarify the role of bcl-2 and p53 in carcinogenesis of the uterine cervix.
Adenocarcinoma ; Carcinogenesis ; Carcinoma, Squamous Cell ; Cell Death ; Cervix Uteri ; Drug Therapy ; Female ; Formaldehyde ; Lymph Nodes ; Neoplasm Metastasis ; Paraffin ; Recurrence ; Uterine Cervical Neoplasms*

PURPOSE: With development of socioeconomic status, the prevelance of adolesecnt obesity, which is a risk factor for cardiovascular disease, is increasing. Skinfold and body mass index are indirectly used measurement of obesity in clinical and epidemiologic studies. Triceps skinfold, subscapular skinfold and body mass index were measured in adolescents aged 12 to 17. Percentile values by age and sex and correlation between skinfold and body mass index were determined. METHODS: We examined 2114 adolescents aged 12 to 17 in Seoul between 1992 and 1993. Triceps skinfold and subscapular skinfold were measured. Body mass index was calculated by dividing weight in kilograms by square of height in meters. RESULTS: 1) The 50th percentile of triceps skinfold in males was 10.8mm at 12 year, 9.3mm at 17 year and decreased with age. The 50th percentile of triceps skinfold in females was 14.0mm at 12 year, 19.9mm at 17 year and increased with age. Females had greater values than males. 2) The 50th percentile of subscapular skinfold in males was 7.8mm at 12year, 10.4mm at 17 year and increased with age. The 50th percentile of subscapular skinfold in females was 11.8mm at 12 year, 19.0mm at 17 year and increased with age. Females had greater values than males. 3) The 50th percentile of body mass index in males was 18.5 at 12 year and 21.1 at 17 year. The 50th percentile of body mass index was 18.5 at 12 year and 20.3 at 17 year. 4) Pearson correlations between body mass index and triceps skinfold were 0.76 in males and females. Pearson correlations between body mass index and subscapualar skinfold were 0.80 in males and 0.81 in females. In females, correlations decreased with age. 5) Our data exceeded triceps skinfold in 1982 and body mass index of USA in 1974. CONCLUSIONS: Percentiles of skinfold thickness and body mass index may be used to monitor skinfold and body mass index of adolescents longitudinally and for comparing an individual with others of the same sex and age. Body mass index correlated highly with skinfold thickness.
Adolescent* ; Body Mass Index* ; Cardiovascular Diseases ; Epidemiologic Studies ; Female ; Humans ; Male ; Obesity ; Risk Factors ; Seoul* ; Skinfold Thickness* ; Social Class

Localized nodular myositis is an uncommon benign inflammatory myopathy of unkonwn cause affecting skeletal muscle and, presenting as a localized painful swelling within the soft tissue of an extremity. Histological examination reveals lymphocytic infiltration, scattered muscle fiber necrosis and regeneration, and interstitial fibrosis. MRI finding is an enhancement with increased signal intensity around the lesion. We report two cases of localized nodular myositis presenting as pseudothrobothrombophlebitis. We believe this is the first case report of localized nodular myositis in Korea.
Extremities ; Fibrosis ; Korea ; Magnetic Resonance Imaging ; Muscle, Skeletal ; Myositis* ; Necrosis ; Regeneration

BACKGROUND: Increasing degrees of medullary hyperemia induced by ischemia reperfusion injury were associated with renal dysfunction. A possible mechanism may be that ischemia causes alterations in the structure and function of vascular membranes which leads to an aggregation of red blood cells in the medullary vessel. It has been shown that heparin prevents postischemic endothelial cell dysfunction. Aim of this study was to evaluate heparin effects on renal hyperemia induced by ischemia reperfusion injury. METHOD: In this study, fifteen rabbits were randomized to either heparin treatment group(500 IU/kg IV bolus 10 minutes before renal artery occlusion, n=8) or control group(n=7). One side kidney underwent 60 minutes ischemia only by clamping renal pedicle and after that kidney tissue sample was obtained for histologic evaluation. The other side of kidney were permitted 60 minutes ischemia following 60 minutes reperfusion and after that kidney tissue sample was obtained for histologic evaluation. RESULTS: There was significant difference in the degree of congestion(2.6+/-0.2 vs 1.1+/-0.3, P<0.05) between outer medulla of control and heparin treatment group. CONCLUSION: Heparin significantly attenuated outer medullary congestion induced ischemic injury.
Constriction ; Endothelial Cells ; Erythrocytes ; Estrogens, Conjugated (USP) ; Heparin* ; Hyperemia ; Ischemia* ; Kidney ; Membranes ; Rabbits ; Renal Artery ; Reperfusion Injury ; Reperfusion*

The patterns of the conventional radiation treatment fields and their shielding blocks are analysed to determine the optimal dimension of the MultiLeaf Collimator (MLC) which is considered as an essential tool for conformal therapy. Total 1169 radiation fields from 303 patients (203 from Asan Medical center, 50 from Baek Hosp and 50 from Hanyang Univ. Hosp.) were analysed for this study. Weighted case selection treatment site (from The Korean Society of Therapeutic Radiology 1003). Ninety one percent of total fields have shielding blocks. Y axis is defined as leaf movement direction and it is assumed that MLC is installed on the cranial-caudal direction. The length of X axis were distributed from 4cm to 40cm (less than 21cm for 95% of cases), and Y axis from 5cm to 38cm (less than 22cm for 95% of cases). The shielding blocks extended to less than 6cm from center of the filed for 95% of the cases. Start length for ninety five percent of block is less than 10cm for X axis and 11cm for Y axis. Seventy six percent of shielding blocks could be placed by either X or Y axis direction, 7.9% only by Y axis, 5.1% only by X axis and it is reasonable to install MLC for Y direction. Ninety five percent of patients can be treated with coplanar rotation therapy without changing the collimator angle. Eleven percent of cases of cases were impossible to replace with MLC. Futher study of shielding should be larger than 21cm X 22cm. The MLC should be designed as a pair of 21 leaves with 1cm wide for an acceptable resolution and 17cm long to enable the leaf to overtravel at least 6cm from the treatment field center.
Axis, Cervical Vertebra ; Chungcheongnam-do ; Humans ; Radiation Oncology

Since Jan. 1992, authors have conducted a pilot study to treat malignant glioma with multiple daily fractionated (MDF) radiation therapy and this paper presents the outcome compared MDF to conventional fractionated (CF) radiation therapy. Between Sep. 1989 and Jan. 1993, forty-three patients with high grade glioma of brain except brain stem glioma were treated: nineteen patients were treated with CF radiation therapy and 24 patients were treated with MDF radiation therapy. In CF radiation therapy, total dose was 6300cHy/35fx in 7 weeks, which 5040cGy was delivered to the initial target volume and 1260cGy to reduced target volume. And in MDF radiation therapy, total dose was 6400cGy/40fx in 4 weeks, which 3200cGy was delivered to the initial target volume as 160cGy 2 times daily 6hr apart. All patients had histologically confirmed anaplastic astrocytoma (AA) of glioblastoma multiforme(GBM) with stereotactic biopsy or craniotomy for subtotal or gross tumor resection. The rage of follow-up was 7 months to 4 years with a median follow-up of 9 months. The Median survival from surgery was 9 months for all patients. The median survival was 9 months and 10 months for MDF group and CF group and 10 months and 9. 5 months for glioblastoma multiforme and anaplastic astrocytoma, respectively. In 36 patients with follow-up CT scan or MRI scan, disease status was evaluated according to treatment group. Four patients (GBM:3, AA:1) of 21 patients in MDF group, were alive with no evidence of disease, while none of patient was alive with no evidence of disease in CF group. The progression of disease had occurred in 20 patients, 11 patients and 9 patients in MDF group and CF group, espectively. All of these patients showed in-field progression of disease. Four of 11 patients (27%) in MDF group showed the new lesion outside of the treatment field, while 5 of 9 patients(56%) in CF group. In our study the prognosis was not influenced by age, KPS, grade, extent of surgery and different fractional scheduled radiation therapy. Authors concluded that MDF regimen was well tolerated and shortened the treatment period from 7 weeks to 4 weeks without compromising results. We believe that further follow-up is needed to assess the role of MDF.
Astrocytoma ; Biopsy ; Brain ; Brain Stem ; Craniotomy ; Follow-Up Studies ; Glioblastoma ; Glioma* ; Humans ; Magnetic Resonance Imaging ; Pilot Projects ; Prognosis ; Rage ; Tomography, X-Ray Computed

PURPOSE: The most common causes of neonatal cholestasis are neonatal hepatitis (NH) and extrahepatic biliary atresia (EHBA). Since neonatal cholestasis presents with variable expression of same pathologic process and has similar clinical, biochemical, and histologic features between EHBA and idiopathic neonatal hepatitis (NH), differential diagnosis is often difficult. We reviewed the differences of clinical characteristics and laboratory data to find out any correlation between the results of Tc(99m) DISIDA scan and presence of acholic stool. METHODS: Between June 1993 and January 2001, total 29 infants younger than 4 month-old underwent Tc(99m) DISIDA scan. Their biochemical tests and clinical course were reviewed retrospectively. RESULTS: Patients who had negative intestinal activity on Tc(99m) DISIDA scan showed acholic stool and revealed higher serum direct bilirubin and urine bilirubin level. 18.2% of patients with acholic stool showed intestinal activity on Tc(99m) DISIDA scan and 81.8% of them did not. All the patients without acholic stool showed positive intestinal activity on Tc(99m) DISIDA scan. The result of Tc(99m) DISIDA scan and the presence of acholic stool showed high negative correlation (r :-0.858). Patients with acholic stool and negative intestinal activity on Tc(99m) DISIDA scan showed higher serum total bilirubin level. Patients without acholic stool and positive intestinal activity on Tc(99m) DISIDA scan showed higher serum level of ALT. CONCLUSION: Patients with acholic stool and negative intestinal activity showed high correlation, but 18.2% of patients with acholic stool showed positive intestinal activity. So operative cholangiogram or transcutaneous liver biopsy should be performed for confirmation.
Biliary Atresia ; Bilirubin ; Biopsy ; Cholestasis* ; Diagnosis, Differential ; Hepatitis ; Humans ; Infant ; Liver ; Radionuclide Imaging* ; Retrospective Studies

Behcet's disease is a systemic vasculitis that is characterized mainly by recurrent oral and genital aphthous ulcers, uveitis, and skin findings. Its neurological manifestations are well recognized. Recurrent meningitis in Behcet's disease is exceptional. We describe herein the case of a 31-year-old man who presented with recurrent aseptic meningitis without any specific cause. A few years later he developed oral and genital ulcers, and uveitis. Behcet's disease should always be considered in a differential diagnosis of recurrent aseptic meningitis without viral infection, particularly in the context of multisystem manifestations.
Adult ; Diagnosis, Differential ; Humans ; Meningitis ; Meningitis, Aseptic ; Neurologic Manifestations ; Skin ; Stomatitis, Aphthous ; Systemic Vasculitis ; Ulcer ; Uveitis

PURPOSE: This study was designed to assess the effects of cyclic parenteral nutrition(CP) on parenteral nutrition induced liver diseases. METHODS: Before and after CP, data were collected on diagnosis, age, duration of parenteral nutrition, macronutrients and biochemical parameters. Initially parenteral nutrition was cycled off for 1-2 hours and the off-time was advanced by 0.5-1 hour daily over 1 week. Blood and urine glucose were monitored during procedure. RESULTS: Data on 6 sets of CP in 4 patients, among whom 2 patients had undertaken CP 2 times, respectively, were analyzed. The mean age was approximately 4 months, ranging from 2 to 11 months. Underlying diseases were as follows : 2 cases of microvillous inclusion disease, 1 case of protracted diarrhea of infancy and 1 case of feeding intolerance. The mean duration of parenteral nutrition before CP were 38.6 days, and that of CP was 41.6 days. During CP, the mean total caloric intake of each patient was 107kcal/kg/day, and the mean weight gain was 6.0g/kg/day. After CP, the biochemical parameters changed as follows : bilirubin was decreased in 4 cases, not changed in 1 case but increased in 1 case who had sepsis during CP period; the level of ALT was decreased in 2 cases but increased in 2 cases and not changed in 2 cases. Overall, CP was tolerated well although 3 cases had hypoglycemia(serum glucose concentration less than 40mg/dL) at the initial CP period. CONCLUSION: CP has potential beneficial metabolic effects on total parenteral nutrition induced cholestasis with minimal complications.
Bilirubin ; Cholestasis* ; Cytomegalovirus Infections ; Diagnosis ; Diarrhea ; Energy Intake ; Glucose ; Humans ; Infant* ; Liver Diseases ; Parenteral Nutrition* ; Parenteral Nutrition, Total* ; Sepsis ; Weight Gain

PURPOSE: This study was designed to assess the effects of cyclic parenteral nutrition(CP) on parenteral nutrition induced liver diseases. METHODS: Before and after CP, data were collected on diagnosis, age, duration of parenteral nutrition, macronutrients and biochemical parameters. Initially parenteral nutrition was cycled off for 1-2 hours and the off-time was advanced by 0.5-1 hour daily over 1 week. Blood and urine glucose were monitored during procedure. RESULTS: Data on 6 sets of CP in 4 patients, among whom 2 patients had undertaken CP 2 times, respectively, were analyzed. The mean age was approximately 4 months, ranging from 2 to 11 months. Underlying diseases were as follows : 2 cases of microvillous inclusion disease, 1 case of protracted diarrhea of infancy and 1 case of feeding intolerance. The mean duration of parenteral nutrition before CP were 38.6 days, and that of CP was 41.6 days. During CP, the mean total caloric intake of each patient was 107kcal/kg/day, and the mean weight gain was 6.0g/kg/day. After CP, the biochemical parameters changed as follows : bilirubin was decreased in 4 cases, not changed in 1 case but increased in 1 case who had sepsis during CP period; the level of ALT was decreased in 2 cases but increased in 2 cases and not changed in 2 cases. Overall, CP was tolerated well although 3 cases had hypoglycemia(serum glucose concentration less than 40mg/dL) at the initial CP period. CONCLUSION: CP has potential beneficial metabolic effects on total parenteral nutrition induced cholestasis with minimal complications.
Bilirubin ; Cholestasis* ; Cytomegalovirus Infections ; Diagnosis ; Diarrhea ; Energy Intake ; Glucose ; Humans ; Infant* ; Liver Diseases ; Parenteral Nutrition* ; Parenteral Nutrition, Total* ; Sepsis ; Weight Gain