Eccrine porocarcinoma is a rare tumor of the skin. A case report of an eccrine porocarcinoma metastasizing to epidural space of spinal cord and inguinal area with a nine year follow up is described. The patient had a nodular growth of the abdomen with both inguinal lymphadenopathy three years before its first excision. After a follow up of nine years, he complained a weakness of lower extremities and back pain. Extradural mass of 10th thoracic vertebra and left inguinal mass were found. Subsequently, the masses histologically identical to the skin tumor were found.
Abdomen* ; Back Pain ; Eccrine Porocarcinoma* ; Epidural Space ; Follow-Up Studies ; Humans ; Lower Extremity ; Lymphatic Diseases ; Skin ; Spinal Cord ; Spine

Gastrointestinal ganglioneuromatosis is an extremely rare lesion which typically occurs with a significant systemic syndrome. It is known to be a major component of multiple endocrine neoplasia, type 2b. We presented a case of polypoid ganglioneuromatosis of the colon in a 3-year-old female with abdominal pain and diarrhea. She had no clinical evidence of the systemic syndrome or von Recklinghausen's neurofibromatosis, conditions in which intestinal ganglioneuromatosis can occur. Gross examination showed diffuse polypoid masses in ascending and transverse colons with normal-appearing mucosa. Microscopic examination revealed a proliferation of spindle-shaped neuronal cells containing multiple clusters of mature ganglion cells in the mucosa, submucosa and proper muscle. We describe a case of colonic ganglioneuromatosis without any component of multiple endocrine neoplasia or family history.
Abdominal Pain ; Child ; Child, Preschool ; Colon* ; Colon, Transverse ; Diarrhea ; Female ; Ganglion Cysts ; Humans ; Mucous Membrane ; Multiple Endocrine Neoplasia ; Multiple Endocrine Neoplasia Type 2b ; Neurofibromatoses ; Neurons

PURPOSE: The purpose of this study was to analyze the concept, 'palliation', in order to enhance understanding of palliative care and ultimately lead to the provision of timely quality palliative care. METHOD: This study used Walker and Avant's methods for concept analysis. RESULT: The defining attributes of palliation identified in this study were 1) being limited, 2) responsiveness, 3) leading to positive effects, 4) relativity, and 5) being unsettled. The antecedents of palliation were 1) a problematic condition, 2) appropriate management for the problematic condition, and 3) interaction between the problematic condition and the appropriate management. The consequences of palliation included 1) improvement of a problematic condition and 2) dependency on a management of the problematic condition. CONCLUSION: Although further studies are required to refine the diverse attributes of the concept of palliation, according to this concept analysis of palliation, palliative care should be introduced at the early stage of disease and constantly provided for the improvement of its negative symptoms.
Palliative Care

OBJECTIVE: To compare the change of oxygen consumption and heart rate between walking and running at the same condition of treadmill in healthy male college students. METHOD: Twenty healthy male college students completed steady-state treadmill test at 3 mph and 5 mph, separately, by walking and running. During the each 6 minutes treadmill test, oxygen consumption (VO2), heart rate (H.R), oxygen consumption ratio of maximal oxygen consumption (% VO2max), and heart rate ratio of maximal heart rate (% HR) were measured each minute. RESULTS: The showed that mean heart rate were 123.40+/-4.62 beats/min and oxygen consumption were 12.84+/-1.94 ml/kg/min, in 3 mph walking. The mean heart rate were 139.90+/-6.80 beats/min and oxygen consumption were 16.51+/-1.78 ml/kg/min in 5 mph walking. The running showed that mean heart rate were 187.55+/-6.74 beats/min and oxygen consumption were 26.45+/-3.11 ml/kg/min in 3 mph walking. The mean heart rate were 168.45+/-13.34 beats/min and oxygen consumption were 21.05+/-2.00 ml/kg/min in 5 mph walking. There were significant differences (p<0.05) in mean heart rate, VO2 between the 3 mph walking and running, the 5 mph walking and running. CONCLUSION: We concluded that 3 mph walking and running and 5 mph running were an effective exercise to promote health in healthy college students.
Exercise Test ; Heart Rate* ; Heart* ; Humans ; Male ; Oxygen Consumption* ; Oxygen* ; Running* ; Walking*

Based upon the concept that carcinogenesis is associated with apoptosis, specific therapies designed to enhance the susceptibility of cancer cells to undergo apoptosis could be developed. Thus, in this paper, it was designed to investigate whether, using rat animal model with chemical-induced hepatocellular carcinoma, TGF-1 in vivo could induce apoptosis in cancer. The chemical hepatocarcinogenic procedure of Solt-Farber method was used on Sprague-Dawley rats. Experimental groups were divided into group A treated with the standard Solt-Farber regimen of diethylnitrosamine (DEN) and 2-Acetaminofluorene (AAF), group B TGF-, group C TGF-1, and group D adriamycin after hepatocellular carcinoma developed. For detection of apoptotic cells, apoptotic indices were examined by the in situ end DNA labelling method. The expression of proliferating cell nuclear antigen was examined by immunohistochemical staining. Apoptosis of rat hepatocellular carcinoma cells increased significantly to 4.92+/-2.32/HPF in the group C compared with the control group (A) (2.54+/-1.13/HPF; P<0.05). Two distinctly different populations of proliferating hepatocellular carcinoma cells were identified. The cells at G1/S boundary (weak granular staining) increased to 15.75+/-6.19/HPF and 6.45+/-2.93/HPF in the groups C and D, respectively, but decreased to 2.42+/-2.06/HPF in the group B compared with the control group (A) (6.38+/-2.18/HPF; p<0.05). The cells at S phase (strong granular staining) increased to 3.37+/-2.69/HPF in the group B but decreased to 0.32+/-0.47/HPF in the group D (p<0.05). In conclusion, these results indicate that the TGF-1 may be used as an effective anticancer agent.
Animals ; Apoptosis ; Carcinogenesis ; Carcinoma, Hepatocellular* ; Diethylnitrosamine ; DNA ; Doxorubicin ; Models, Animal ; Proliferating Cell Nuclear Antigen ; Rats* ; Rats, Sprague-Dawley ; S Phase ; Transforming Growth Factor alpha ; Transforming Growth Factor beta1* ; Transforming Growth Factors*

From June, 1988 to Feb, 1989 a total of 47 cases of percutaneous mitral valve balloon valvuloplasty(PMV) and 4 cases of aortic valve balloon valvuloplasty(PAV) were done at the Guro Hospital of the Korea University. Among these patients first 18 patients of PMV are the subjects of this study. 1) Among a total of 28 patients,10 patients were male and 18 patients were female patients. The age of the patients were between 21 and 59 years with the mean age of 40.9+/-12.2 Aortic Valve ; Atrial Fibrillation ; Balloon Valvuloplasty* ; Blood Pressure ; Cardiac Output ; Cardiac Tamponade ; Catheters ; Drainage ; Electrocardiography ; Embolism ; Female ; Humans ; Korea ; Male ; Middle Cerebral Artery ; Mitral Valve Insufficiency ; Mitral Valve Stenosis* ; Mitral Valve* ; Sepsis ; Thrombosis ; Vascular Resistance

BACKGROUND: The purpose of this study is to assess the roles of p21 protein, p53 protein, and Ki-67 expressions and apoptosis in colorectal tumorigenesis. METHODS: Fifty-seven colorectal cancers and 15 villotubular adenomas were investigated by immunohistochemical staining for p21 protein, p53 protein, Ki-67, and in situ labeling of apoptotic cells. Clinicopathologic values (tumor size, histologic grade, Dukes stage, and lymph node metastasis) were compared with the incidence of expressions of p21 protein and p53 protein, index of Ki-67 expression, and apoptosis. RESULTS: The incidence of p21 protein expression was decreased with lymph node metastasis (p<0.005), and that of p53 expression was increased with lymph node metastasis (p<0.005). There were no statistically significant correlations among the p21 protein or p53 protein expressions, tumor size, histologic grade and stage. The correlation between the Ki-67 labeling index and the clinicopathologic values was not statistically significant. The labeling index of apoptosis was increased with the Astler-Coller stage (p<0.05). Statistical analysis revealed a significant inverse correlation between the p21 protein and p53 protein expressions (p<0.05). CONCLUSIONS: It is suggested that p21 protein, p53 protein and the apoptotic labeling index are useful variables for the prognostic assessment of colorectal adenocarcinoma. Down-regulation of p21 protein expression may be associated with poor prognosis. Also, the expressions of p21 protein and p53 protein may play an important role in the tumorigenesis and progression of the colorectal adenoma-carcinoma sequence.
Adenocarcinoma* ; Adenoma ; Apoptosis* ; Carcinogenesis ; Colorectal Neoplasms ; Down-Regulation ; Immunohistochemistry ; Incidence ; Lymph Nodes ; Neoplasm Metastasis ; Prognosis

OBJECTIVES: Dopamine transporter concentrations have been known to decrease in Parkinson's disease(PD). The aim of the present study was to evaluate the correlation between SPECT measurements of [I-123]N-(3-iodopropene-2-yl)-2beta-carbomethoxy-3beta-(4-chlorophenyl) tropane(IPT) as an imaging agent for measuring changes in transporter concentrations with PD. PATIENTS AND METHODS:IPT labelled with 4.87+/-1.29mCi(180.19+/-47.73 MBq) of [I-123] was intravenously injected into 23 patients(age:58+/-12) with PD and three normal controls(NC)(age:37+/-7) as bolus. Brain SPECT were then performed at 1 hour and 2 hours after injection on a double headed camera. The statistical parameters were the contrast ratio of left basal ganglia(BG) and right basal ganglia to occipital cortex(OCC) per milli curies of injected radiotracer at 1 hour and 2 hours. The correlations were evaluated between these parameters and Hoehn-Yahr classification of the patients. RESULTS: The(BG-OCC)/OCC/mCi ratios at 1 hour and 2 hours for PD and NC were 0.14+/-0.07 and 0.27+/-0.07(1 hour) and 0.12+/-0.07 and 0.34+/-0.04(2 hour), respectively. The(BG-OCC)/OCC/mCi ratios of Parkinson's disease were decreased with higher grade of Hoehn-Yahr classification of the patients. The ratio between BG and OCC for PD were clearly separated from NC and may be useful outcome measures for clinical diagnosis. CONCLUSION: The findings suggest that IPT may be a very useful tracer for early diagnosis and treatment of PD and study of dopamine re-uptake site.
Basal Ganglia ; Brain ; Classification ; Diagnosis ; Dopamine Plasma Membrane Transport Proteins* ; Dopamine* ; Early Diagnosis ; Head ; Humans ; Outcome Assessment (Health Care) ; Parkinson Disease ; Tomography, Emission-Computed, Single-Photon*

BACKGROUND AND OBJECTIVES: Since statins and angiotensin receptor blockers are a frequently prescribed combination in patients with atherosclerotic cardiovascular diseases, we tested the interactive effects of simvastatin and losartan on atherosclerosis in apolipoprotein E (apoE)-/- mice. MATERIALS AND METHODS: Apolipoprotein E-/- mice were fed a high-fat, high-cholesterol (HFHC) diet for 12 weeks, with and without simvastatin (40 mg/kg) and/or losartan (20 mg/kg). The mice were divided into 5 groups and were fed as follows: regular chow (control diet, n=5), HFHC diet (n=6), HFHC diet with losartan (n=6), HFHC diet with simvastatin (n=6), and HFHC diet with both losartan and simvastatin (n=6). RESULTS: Losartan treatment in apoE-/- mice significantly decreased atherosclerotic lesion areas in whole aortic strips stained with Oil Red O. The plaque area measured at the aortic sinus level was reduced significantly by 17% (HFHC; 346830.9+/-52915.8 microm2 vs. HFHC plus losartan; 255965.3+/-74057.7 microm2, p<0.05) in the losartan-treated group. Simvastatin and simvastatin plus losartan treatments reduced macrophage infiltration into lesions by 33% (HFHC; 183575.6+/-43211.2 microm2 vs. HFHC plus simvastatin; 120556.0+/-39282.8 microm2, p<0.05) and 44% (HFHC; 183575.6+/-43211.2 microm2 vs. HFHC plus simvastatin and losartan; 103229.0+/-8473.3 microm2, p<0.001, respectively). In mice fed the HFHC diet alone, the smooth muscle cell layer in the aortic media was almost undetectable. In mice co-treated with losartan and simvastatin, the smooth muscle layer was more than 60% preserved (p<0.05). Given alone, losartan showed a slightly stronger effect than simvastatin; however, treatment with losartan plus simvastatin induced a greater inhibitory effect on atherosclerosis than either drug given alone. Serum lipid profiles did not differ significantly among the groups. CONCLUSION: Losartan displayed anti-atherosclerotic effects in apoE-/- mice that were equivalent to or greater than the effects of simvastatin. Combined treatment with these drugs had greater effect than either drug alone.
Angiotensin Receptor Antagonists ; Animals ; Apolipoproteins ; Atherosclerosis ; Azo Compounds ; Cardiovascular Diseases ; Diet ; Humans ; Losartan ; Macrophages ; Mice ; Mice, Knockout ; Models, Animal ; Muscle, Smooth ; Myocytes, Smooth Muscle ; Simvastatin ; Sinus of Valsalva

PURPOSE: The aim of this study was to define the reference range of the peritoneal solute transfer in Korean CAPD patients and to investigate the change in peritoneal kinetics in long-term patients. METHODS: Routine PET was done 14 days after catheter break-in in 102 new CAPD patients and using our reference range of PET, the patients were categorized into 4 groups as described by Twardow- ski. In 35 long-term (>3 yrs) CAPD patients, D/Pcr, D/D0 glucose and drain volume in last follow- up (mean duration, 60+/-23 months) PET were compared with those in initial PET. RESULTS: Dialysate to Plasma creatinine ratio (D/ Pcr) at 0 hour, 2 hours and 4 hours was 0.045+/-0.062, 0.408+/-0.151 and 0.612+/-0.154, respectively. D/D0 glucose at 2 hours and 4 hours was 0.594+/-0.129 and 0.398+/-0.121, respectively. Peritoneal solute transfer rate in Korean patients was slightly lower than previously reported results in North American patients (P=0.08). Mean drain volume was 2360+/-270ml and mean residual volume was 436+/-178ml. Drain volume was well correlated with D/D0 glucose (positively, r=0.375, P<0.01) and D/Pcr (negatively, r=-0.345, P<0.01). There were no difference in peritoneal solute transfer, drain volume and residual volume according to sex, age, body surface area and diabetes. In initially high and high average trans- porters, solute transfer rate decreased significantly in followup PET. Out of 7 initially high transporters, 3 remained in high and 4 became high average transporters. Out of 12 initially high average transporters, 3 became low average transporters. Out of 8 initially low average transporters, 2 became high average transporters. And out of 8 initially low transporters, 2 became high average and 1 became high transporters. The number of episodes of perito- nitis do not significantly correlated with the changes of peritoneal solute transport rate. CONCLUSION: These data suggest that peritoneal solute transfer rate in Korean patients is slighthly lower compared with that in North American patients and in long-term CAPD patients the peri- toneal solute transport rate changed to centropetal directions (towards to mean) according to initial PET result.
Body Surface Area ; Catheters ; Creatinine ; Follow-Up Studies ; Glucose ; Humans ; Kinetics* ; Peritoneal Dialysis, Continuous Ambulatory* ; Peritonitis ; Plasma ; Reference Values* ; Residual Volume