The cell cycle is composed of a series of steps which can be negatively or positively regulated by various factors. p53 gene aberrations are common in human malignancies, and recent studies suggest that in cervical carcinoma p53 function is inactivated either by complex formation wilh human papilloma virus (HPV) E6 product or by gene mutation. To study the expression of p53 gene in the cervical cancer and cervical intraepithebal neoplasia, immunohistochemistry for the p53 protein was done in the 47 cases of squamous cell carcinoma, 6 cases of adenocarcinoma and 32 cases of cervical intraepithelial neoplasia. I. The p53 protein was detected in the 31% of cervical intraepithelial neoplasia (10/32 cases). 2. The p53 protein was detected in the 55% of invasive cervical cancer (29/53 cases). 3. By the histologic type of cervieal cancer, the p53 protein was detected in the 57% of squamous cell carcinoma (27/47 cases) and 33% of(2/6 cases) adenocarcinoma. The p53 protein wes more frequently detected in the squamous cell carcinoma than in the adenocarcinoma. 4. By the staging in cervical cancer, the p53 protein was detected in the 31% of stage 0, 50% of Stage Ia, 50% of stage I b, 75% of IIa and 50% of stage II b.
Adenocarcinoma ; Carcinoma, Squamous Cell ; Cell Cycle ; Cervical Intraepithelial Neoplasia ; Genes, p53 ; Humans ; Immunohistochemistry* ; Papilloma ; Uterine Cervical Neoplasms*

A 50-year-old man with a 20-year history of migraine with aura was admitted due to a headache followed by right hemiplegia and speech disturbance. However, there were no abnormalities on brain MRIs and EEG at that time. His hemiparesis continued for one month. We report on a case of persistent hemiplegia and speech disturbance as migraine aura without an evidence of infarction on brain MRI.
Brain ; Electroencephalography ; Epilepsy ; Headache ; Hemiplegia ; Humans ; Infarction ; Middle Aged ; Migraine Disorders ; Migraine with Aura ; Paresis

No abstract available.
Animals ; Muscle, Smooth, Vascular* ; Nitric Oxide* ; Rats*

Fibroadenoma is a rare lesion of the vulva. It has been proposed that the origin of the tissue is either ectopic breast tissue or vulvar mammary-like glands (MLG). We report a case of vulvar fibroadenoma in a 33-year-old woman with a right vulvar mass presenting clinically as vulvar cyst. The cut surface of the tumor showed a white and homogenous appearance that was 2.5 cm in maximum dimension. Microscopically, the lesion was well-circumscribed but non-encapsulated. It revealed nodular, glandular and stromal proliferation, consistent with fibroadenoma of breast. Immunohistochemical staining for the estrogen receptor and progesteron receptor revealed nuclear positivity in the epithelium. Smooth muscle actin confirmed the presence of a myoepithelial cell layer. Staining for pancytokeratin showed epithelial cytoplasmic positivity.
Actins ; Adult ; Breast ; Cytoplasm ; Epithelium ; Estrogens ; Female ; Fibroadenoma* ; Humans ; Muscle, Smooth ; Vulva*

BACKGROUND: The aim of this study was to investigate the feasibility and efficacy of emergent carotid artery stenting (CAS) for occlusion or high-grade stenosis of the internal carotid artery (ICA) in patients with acute ischemic stroke. METHODS: From November 2004 to May 2007, 17 patients admitted to the hospital within 12 hours of symptom onset with occlusion or a high-grade stenosis of the proximal ICA underwent emergent CAS. We analyzed risk factors, imaging findings, functional outcome scales, and peri-procedural complication. The outcome was measured by the modified Rankin scale (mRS) 3 months later and classified into good (mRS score of 0 to 2) or poor (mRS score of 3 to 6). RESULTS: All patients were recanalized successfully. The median National Institutes of Health Stroke Scale (NIHSS) score was 12.6 (range 4 to 24) just before the emergent CAS, which decreased to 9.4 and 8.2 at 1 day and 7 days after the stenting. Three months later, 12 patients showed good outcome while three had poor outcome and two of them died. Two patients (11.8%) exhibited symptomatic hemorrhagic transformation following the emergent CAS. Smoking status, and initial and immediate post-procedural NIHSS scores were associated with the outcome. CONCLUSIONS: Emergent CAS is a feasible and effective method in acute treatment of selected stroke patients with steno-occlusion of the proximal ICA.
Carotid Arteries ; Carotid Artery, Internal ; Constriction, Pathologic ; Humans ; National Institutes of Health (U.S.) ; Risk Factors ; Smoke ; Smoking ; Stents ; Stroke ; Weights and Measures

PURPOSE: Although indications for abdominoperineal resection (APR) are decreasing due to the widespread of sphincter-saving procedures, APR is still the mainstay in the treatment of rectal cancer. The purpose of this study is to demonstrate the appropriateness of laparoscopic APR in terms of oncologic parameters. METHODS: From January 1984 to December 2003, 110 patients with a rectal adenocarcinoma who underwent APR were involved in this study. The data were grouped according to five main items: 1) patient demographic data, 2) operative procedure, 3) gross tumor findings, 4) pathologic tumor findings, and 5) perioperative treatment. Each item was subdivided by factors that could influence the oncologic results, and univariate analyses were performed. Thereafter, a multivariate analysis was performed with those factors considered statistically significant. RESULTS: The mean follow-up period was 106.01+/-9.98 months, the local recurrence rate was 23.6%, and distant metastasis rate was 31.8%. The five-year survival rate was 58.1%, and the ten-year survival rate was 51.1%. Multivariate analysis after univariate analyses showed that independent prognostic factors influencing local recurrence were preoperative CEA level, T-stage, and preoperative radiation therapy. Factors influencing distant metastasis were preoperative CEA level, N-stage, and preoperative radiation therapy. Univariate analysis showed that the laparoscopic approach was beneficial in terms of local recurrence; however, with the multivariate analysis, this was not statistically evident. Prognostic factors influencing long-term survival in the multivariate analysis were preoperative CEA level, stage, and perineural invasion. CONCLUSIONS: Laparoscopic APR was not significantly different from an open procedure in terms of oncologic outcomes. In the near future, a randomized prospective multicenter trial should tell us which approach is more beneficial.
Adenocarcinoma ; Follow-Up Studies ; Humans ; Multivariate Analysis ; Neoplasm Metastasis ; Rectal Neoplasms ; Recurrence ; Surgical Procedures, Operative ; Survival Rate

Granulosa cell tumors of ovary are rare neoplasms, which account for 2~5% of all ovarian malignancies. Ovarian granulosa cell tumors are often associated with endometrial hyperplasia or carcinoma. The endometrial carcinoma is thought to occur under the influence of the estrogen receptor pathway and is typically a low-grade endometrioid adenocarcinoma. We present a case of granulosa cell tumor of the ovary and synchronous endometrial carcinoma that were managed with laparoscopically assisted vaginal hysterectomy and bilateral salpingo-oophorectomy, with brief review of literature.
Adult ; Carcinoma, Endometrioid ; Endometrial Hyperplasia ; Endometrial Neoplasms ; Estrogens ; Female ; Granulosa Cell Tumor ; Granulosa Cells ; Humans ; Hysterectomy, Vaginal ; Laparoscopy ; Ovary

The aim of the present study is to verify the functional and anatomical neural pathways which innervate the urinary bladder in the central nervous system of the rat. To identify the functional neural pathway, the urinary bladder was stimulated by infusing formalin for 2 h. Then, brain and spinal cord were dissected out and immunohistochemistry was done by using anti-c-fos antibody. Many c-fos immunoreactive (IR) neurons were identified in the telencephalic cortical areas and in several brainstem nuclei, which are known mostly to be related with urinary bladder. In the spinal cord, a number of c-fos IR neurons were found in the lamina I, IIo, dorsal gray commissure, sacral parasympathetic nucleus. To identify the anatomical neural pathway of the urinary bladder, Pseudorabies virus (PRV) was injected into the wall of urinary bladder and was identified with anti-PRV by using immunohistochemistry. Most PRV labeled neurons were found where c-fos IR neurons were identified and few of them were also in the areas where c-fos IR neurons were not found, e.g., prefrontal cortex, agranular insular cortex, and subfornical organ. In the spinal cord, PRV labeled cells were found all over the gray matter. The present study presents morphological evidence demonstrating the supraspinal areas are related with the neural control of the urinary bladder and most functional neural pathway of the urinary bladder is well consistent with the anatomical neural pathway except in some telencephalic cortical areas.
Animal ; Bladder/innervation* ; Central Nervous System/anatomy & histology* ; Female ; Herpesvirus 1, Suid/isolation & purification* ; Immunohistochemistry ; Neural Pathways/anatomy & histology ; Proto-Oncogene Proteins c-fos/analysis* ; Rats ; Rats, Sprague-Dawley

PURPOSE: To evaluate the significance of collateral veins, as seen on chest CT, in the diagnosis of superiorvena cava obstruction. MATERIAL AND METHOD: We retrospectively reviewed the records of 81 patients in whomcollateral veins were seen on chest CT. On spiral CT(n=49), Contrast material was infused via power injector, andon conventional CT(n=32), 50ml bolus infusion was followed by 50ml drip infusion. Obstruction of the SVC wasevaluated on chest CT ; if, however, evaluation of the SVC or its major tributaries was difficult, as in fivecases, the patient underwent SVC phlebography. Collateral vessels were assigned to one of ten categories. RESULT: On conventional CT, the common collaterals showing statistically significant difference between the two groupswere the jugular venous arch in the group with venous obstruction(n=6/15, 40.0%), and around the back and scapula(n=15/17, 88.2%) and paravertebral system(n=12/17, 70.6%) in the group without venous obstruction. On helical CT,the most common collaterals were around the back and scapular (n=9/14, 64.3%; n=26/35, 74.3%, respectively) andthe paravertebral system (n=9/14, 64.3%, n=22/35, 62.9%, respectively) in both groups, with or without venousobstruction. No collateral showed a statistically significant difference between the two groups. CONCLUSION: Onconventional CT, the jugular venous arch is the only collateral vessel to predict SVC obstruction ; on spiral CT,however, collateral vessels are not helpful in the diagnosis of SVC obstruction, but are a nonspecific finding.
Diagnosis ; Humans ; Infusions, Intravenous ; Phlebography ; Retrospective Studies ; Thorax* ; Tomography, X-Ray Computed* ; Veins

Vasoplegic syndrome occurs in 8~10% of patients following cardiac surgery, and this happens in part because of inducing the inflammatory response. Nitric oxide and guanylate cyclase play an important role in this response, and this is associated with increased morbidity and mortality. For our case, we administered methylene blue (MB), an inhibitor of guanylate cyclase, early after performing cardiopulmonary bypass in a patient with vasoplegic syndrome. The patient recovered immediately after MB administration and maintained an optimal blood pressure without the aid help of any vasopressors.
Blood Pressure* ; Cardiopulmonary Bypass ; Endocarditis* ; Guanylate Cyclase ; Heart* ; Humans ; Methylene Blue* ; Mortality ; Nitric Oxide ; Thoracic Surgery* ; Vasoplegia*