Among the enzymes which are responsible for basement membrane breakdown, matrix metalloproteinases (MMP) form a family of neutral proteases that are regulated at the levels of gene transcription, proenzyme activation by the cleavage of protein, and the inhibition of the active enzyme by tissue inhibitors of matrix metalloproteinases (TIMP). Recent reports have demonstrated that the expression of these proteolytic enzymes are elevated in several solid tumors and that it can be associated with invasiveness and poor prognosis. We examined the expression of MMP-2, MMP-9, TIMP-1 and TIMP-2 by immunohistochemistry in 160 cases of infiltrating ductal carcinoma. And we compared these data with the established prognostic parameters - tumor size, nodal status, clinical stage, hormonal receptor status, microvessel density, and TGF-beta1 expression in order to evaluate how MMP and TIMP expression are associated with breast cancer progression and prognosis. Microvessel density in invasive breast carcinoma was significantly correlated with tumor size and recurrence (p<0.05). The immunohistochemical expression of TGF-beta1 was significantly associated with tumor size, lymph node metastasis, and clinical stage (p<0.05). The microvessel density was significantly correlated with TGF-beta1 expression in more than 50% of tumor cells. The immunohistochemical expression of MMP-2 and MMP-9 were significantly correlated with nodal metastasis and absence of immunoreactivity for estrogen and progesterone receptors. The immunohistochemical expression of TIMP-1 was inversely correlated with clinical stage and microvessel density while that of TIMP-2 was inversely correlated with clinical stage (p<0.05). Small size of tumor, presence of progesterone receptor, highly differentiated histologic grade, and absence of immunoreactivity for MMP-9 were significantly associated with higher survival rate, but in multivariate analysis only tumor size and MMP-9 expression appeared to affect survival independently.
Basement Membrane ; Breast Neoplasms* ; Breast* ; Carcinoma, Ductal ; Estrogens ; Humans ; Immunohistochemistry ; Lymph Nodes ; Matrix Metalloproteinases ; Microvessels ; Multivariate Analysis ; Neoplasm Metastasis ; Peptide Hydrolases ; Prognosis ; Receptors, Progesterone ; Recurrence ; Survival Rate ; Tissue Inhibitor of Metalloproteinase-1 ; Tissue Inhibitor of Metalloproteinase-2 ; Transforming Growth Factor beta1

No abstract available.
Biopsy, Fine-Needle* ; Fasciitis*

No abstract available.
Islets of Langerhans* ; Lymph Nodes* ; Neoplasm Metastasis*

PURPOSE: The purpose of this study was to ascertain the effects of preoperative information on postoperative state anxiety, plasma cortisol, and pain for patients under total knee arthroplasty, and to provide generic data with nursing intervention for total knee arthroplasty. METHODS: Data were collected from 34 patients who had total knee arthroplasty from January 3, 2003 to January 15, 2004. An experiment group of 17 patients was provided with pre-operative information prepared by the researchers; a control group of another 17 patients was provided with general information. Data were analyzed through Chi-squared test, t-test, paired t-test and ANCOVA using SPSS WIN 11.0. RESULTS: There was no significant differences between the experiment group and the control group in post operative state anxiety(p=.612). However, there was statistically a significant difference between the above two groups in post operative plasma cortisol(p=.012). There was a statistically significant difference between the above two groups in post operative pain(p=.041). CONCLUSION: According to the results of the study, the authors concluded that the preoperative information for patients under total knee arthroplasty had the effect on the decrease of postoperative plasma cortisol and pain.
Anxiety* ; Arthroplasty* ; Humans ; Hydrocortisone* ; Knee* ; Nursing ; Plasma

Urinary cytology is increasingly accepted as a diagnostic tool in the detection and follow-up of patients with bladder cancer. However, its value is reduced by several limitations, especially by the tack of cytologic criteria specifically reflecting the morphology of low-grade urothelial neoplasm. We reviewed histologically proven 50 cases of urine cytology with emphasis on cytologic findings of benign atypia and differential findings of urothelial neoplasm according to the grade. The diagnoses included 17 benign lesions (including 5 cases of urine calculi) and 33 malignant lesions(including 28 transitional cell carcinomas. 3 squamous cell carcinomas, 1 adenocarcinoma and 1 prostate adenocarcinoma). Diagnostic accuracy was 92%. Important cytodiagnostic criteria for benign atypia and low grade malignancy were cellularity, number of cell clusters, and morphology and arrangement of urothelial cells. The cytologic findings of urothelial neoplasms according to histologic grade were relatively well correlated with the histologic findings. However, the cytologic criteria were not sufficient to readily distinguish grade I from grade II. In view of this, we think that cytologic nomenclature "low-grade" and "high-grade" is a more reliable criterion. Recognition of subtle cellular morphologic features specific for urothelial lesions(including benign or malignancy) and proper fixation, processing and staining of specimen can expand the role of urinary cytology in detection and follow-up of patients.
Adenocarcinoma ; Carcinoma, Squamous Cell ; Carcinoma, Transitional Cell ; Diagnosis ; Humans ; Prostate ; Urinary Bladder Neoplasms

PURPOSE: To report a case of IgG4-related sclerosing disease involving the eyelid in an idiopathic sclerosing myositis patient. CASE SUMMARY: A 51-year-old woman presented with swelling, redness, and tenderness of the left lower eyelid of 1 month duration had taken an immunosuppressant for idiopathic sclerosing myositis. Eye movements showed limitation all directions but there was no exophthalmos. A palpable mass was noted in the left lower eyelid. The left extraocular muscles were hypertrophied but the lacrimal gland was normal on orbital magnetic resonance imaging. IgG4-related sclerosing disease was confirmed by immunostained biopsy from the left lower eyelid, showing infiltration of IgG4-positive lymphoplasmacytic cells. The patient was given oral steroids and an immunosuppressant and the symptoms did not recur for at least 7 months. CONCLUSIONS: IgG4-related sclerosing disease involving ocular adnexa usually consists of bilateral lacrimal gland involvement. Additionally, the orbital soft tissue involvement without dacryoadenitis is rare. The authors of the present study report a case of IgG4-related sclerosing disease involving the left lower eyelid in an idiopathic sclerosing myositis patient and should be considered in the differential diagnosis of eyelid masses.
Biopsy ; Dacryocystitis ; Diagnosis, Differential ; Exophthalmos ; Eye Movements ; Eyelids* ; Female ; Humans ; Lacrimal Apparatus ; Magnetic Resonance Imaging ; Middle Aged ; Muscles ; Myositis* ; Orbit ; Steroids

No abstract available.
Female ; Humans ; Hysterosalpingography* ; Laparoscopy*

PURPOSE: To evaluate the therapeutic potential of green tea to treat renal stone, we examined the effect of green tea on the formation and the excretion of experimentally induced calcium oxalate (CaOx) stones in rat kidneys. MATERIALS AND METHODS: CaOx nephrolithiasis was induced by administering 1% ethylene glycol (EG) for 4 weeks. To investigate the effect of tea on the formation CaOx stones, the rats were simultaneously administered either 0.2% green tea or 0.5% rooibos tea. To verify the action of green tea on the excretion of CaOx stones, the rats were divided into four groups after the administration of 1% EG water for 4 weeks and then fed with either 0.2% green tea, 0.5% rooibos tea or 80mg/l furosemide-containing 1% EG water for 4 weeks. The right kidney was frozen for mRNA measurements, with the left fixed for counting crystal deposits. Twenty-four hour urine volume and urinary excretions of oxalate, uric acid, calcium and magnesium were measured. RESULTS: Urinary biochemistry and 24 hour urine output were apparently unchanged by taking either the green tea or rooibos tea. The increases of CaOx crystal deposits and osteopontin mRNA expressions in the kidneys by the administration of 1% EG water were markedly decreased by both tea intakes, while there were no significant differences in the mRNA levels of CuZn- and Mn-superoxide dismutases between the groups. CONCLUSIONS: Green and rooibos teas significantly attenuated the calcium crystal depositions in the kidneys. Down-regulations of the osteopontin mRNA levels may be involved in the inhibitory effects of the teas on the renal CaOx stone formation.
Animals ; Aspalathus ; Biochemistry ; Calcium Oxalate* ; Calcium* ; Ethylene Glycol ; Kidney ; Kidney Calculi ; Magnesium ; Nephrolithiasis ; Osteopontin ; Rats* ; RNA, Messenger ; Tea* ; Uric Acid ; Water

PURPOSE: The aim of this study was to evaluate the effectiveness and indication of radiofrequency ablation(RFA) using renal VX2 tumors by implantation of VX2 tumor cells under the renal capsule in rabbits. MATERIALS AND METHODS: Ten rabbits were injected with 30-40microliter VX2 tumor cells(1.2x10(7) viable cells/ml) under the renal capsule of the right kidney by right subcostal incision. On the 14th day after the tumor cells were implanted, we checked for the development of renal tumors, and the sizes and shapes(exophytic or central) of the tumors by the use of computed tomography. We performed RFA in the renal VX2 tumors with a 17G StarBurst electrode through kidney exposure. After the first and third day following RFA, renal function was checked. On the third day, we performed CT and harvested the kidneys for gross and microscopic evaluation. RESULTS: We confirmed the development of renal VX2 tumors in nine cases. Tumor shapes were exophytic in seven cases and central in two cases; the mean size of the tumors was 2.1 cm(range, 1.1-3.8cm). In all tumors, RFA was performed. From the use of enhanced CT after RFA on the third day, all of the lesions treated with RFA showed no enhancement. From the pathological findings, coagulative necroses were seen on all of the lesions treated with RFA. The necrotized tumor size after RFA was not different statistically as measured by CT and a pathological examination (p=0.833) CONCLUSIONS:: In centrally located renal tumors, we experienced thermal injury in pelvocalyceal systems. RFA is an effective method for nephron sparing surgery as the tumor cells completely disappear and there is preserved renal function and the procedure is easy to apply. We suggest that the RFA method for exophytic renal tumors is more effective than other procedures.
Rabbits ; Animals

PURPOSE: We describe a very rare the leiomyosarcoma that developed in the conjunctiva. METHODS: A 59-year-old man was treated at another hospital two months before presenting to our institution. He had not gotten any better and so was admitted to our hospital. He had normal visual acuity and intraocular pressure. However, we found a geographic, highly vascularized mass involving the corneal limbus in the medial bulbar conjunctiva, from which a pterygium had been removed a year previously. An excision of the mass was carried out to detect a suspected conjunctival intraepithelial neoplasm. RESULTS: Tissue obtained from operation had cells with thin nuclei, spindle cells with pleomorphic cigar-shaped nuclei and eosinophilic cytoplasm, atypical cells, and from four to five mitotic figures under ten high power field. In immunohistochemical staining, Vimentin, Smooth muscle actin (SMA), Desmin, CD68 stained positively and cytokeratin, Cam5.2, S-100, HMB-45, CD 34 stained negatively. We found no clues of other origins from the general physical examination. Considering these factors, we conclude that this was a Stage I, G2T1aN0M0 leiomyosarcoma with moderate differentiation. CONCLUSIONS: Analysis by immunohistochemical staining is necessary to detect leiomyosarcoma in the conjunctiva, as it is very rare and hard to diagnose by the histologic method alone. We report a leiomyosarcoma of the conjunctiva after pterygium excision, and suggest that it be considered a differential diagnosis of conjunctival masses, even though it is very rare.
Actins ; Adult ; Carcinoma in Situ ; Conjunctiva* ; Cytoplasm ; Desmin ; Diagnosis, Differential ; Eosinophils ; Humans ; Intraocular Pressure ; Keratins ; Leiomyosarcoma* ; Limbus Corneae ; Middle Aged ; Muscle, Smooth ; Physical Examination ; Pterygium ; Vimentin ; Visual Acuity