OBJECTIVE: The objective of this study were to clarify the significance of PCNA and DNA ploidy as a possible parameter of the prognosis in squamous cell carcinoma of the uterine cervix. STUDY DESIGN: Women with the diagnosis of cervical cancer operated between January 1987, and July 1991, composed the study group(n=35) in this case-control group. Among these 35 patients.In theese patients we chose the patients with complete follow up treatment. Also we employed 7 control paraffin-embedded cervical specimens without any specific pathologic lesions for the comparison. Immunohistochemical staining to identify PCNA was applied to case of paraffin section and PCNA indices was obtained. DNA analysis was done by using flow cytometry and S-phase fraction and DNA ploidy were obtained. RESULT: The results were summarized as follows. 1. S-phase fraction were 20+/-7% in cervical cancer and 16+/-11% in control group. There were no statistical difference. Aneuploid ratio were 26%(9/35) in cervical cancer and 0%(0/7) in control group. There were statistical difference. PCNA indices were 45+/-6% in cervical cancer and 5+/-4% in control group. There were statistical difference. 2. There were no statistical difference in PCNA indices between large cell keratinizing type, and large cell nonkratinizing type of cervical cancer. 3. According to lymph node metastasis, there were no statistical difference in PCNA indices between positive group and negative group.4. According with various pathologic parameters, recurrence rate was hihger in cases of parametrial involvement. 5. The correlation of coefficient was 0.747 between PCNA indices and S-phasd fraction that is a significant relationship.6. According to recurrence, there were no statistical difference in S-phase fraction, aneuploidy and PCNA indices between group of recurrence and no recurrence.7. There were no statistical difference between <20% group nad>20%, group of S-phase, aneuploid and <60%, group and >60%, group of PCNA index in view of recurrence rate. conclusion: That is a significant relationship between S-phase fraction and PCNA indices, But, there are no statictical significance of PCNA indices, DNA ploid and a prognostic factor. So, that is a limitation in PCNA index DNA ploid when it was used as as prognostic parameter of nterine cervical cancer.
Aneuploidy ; Carcinoma, Squamous Cell ; Case-Control Studies ; Cervix Uteri ; Diagnosis ; DNA* ; Female ; Flow Cytometry ; Follow-Up Studies ; Humans ; Lymph Nodes ; Neoplasm Metastasis ; Paraffin ; Ploidies* ; Prognosis ; Proliferating Cell Nuclear Antigen ; Recurrence ; Uterine Cervical Neoplasms*

PURPOSE: To identify the characteristic quadriphasic (unenhanced, corticomedullary, nephrographic, and excretory phase) helical multidetector computed tomography (MDCT) features of renal masses less than 4 cm to distinguish benign from malignant renal masses. MATERIALS AND METHODS: In total, 84 patients were retrospectively analyzed to determine the characteristic features for the prediction of subtypes of small renal masses. The patients' age, gender, and tumor size and CT features, including the presence of intra-tumor degenerative changes, septation, calcification, and wall irregularity, were evaluated. In addition, the degree and pattern of enhancement obtained during four phases were analyzed. The relationship between the subtype of the small renal masses and the gender, morphological features, and pattern of contrast enhancement on the CT was analyzed by using the chi-square test. Tumor size and degree of contrast enhancement were compared by the Mann-Whitney U test. The predictive value of each of the CT features was determined by multivariate logistic regression analysis. RESULTS: Of the 84 small renal masses, 17 (20%) were benign and 67 (80%) were malignant. Univariate analysis revealed that renal cell carcinoma lesions showed heterogeneous enhancement (p=0.002) and higher mean attenuation value on the corticomedullary and nephrographic phases (135.1+/-53.9, p=0.000, and 132.4+/-43.6, p=0.006). The multivariate analysis with logistic regression model showed that only the mean attenuation value on the corticomedullary phase had a statistically significant correlation (p=0.021). CONCLUSIONS: For the characterization of small renal masses, the degree of enhancement on the corticomedullary phase is a valuable parameter. Furthermore, the heterogeneous enhancement pattern and degree of enhancement on the nephrographic phase can provide information for differentiating small renal masses.
Carcinoma, Renal Cell ; Humans ; Logistic Models ; Multidetector Computed Tomography ; Multivariate Analysis ; Retrospective Studies

PURPOSE: To evaluate the effectiveness of amniotic membrane transplantation (AMT) on the repair of peripheral corneal perforation occurring during cataract surgery of a case of Terrien's marginal degeneration. METHODS: A 77-year-old male patient was referred to our hospital from a private clinic because of corneal perforation during cataract surgery of the right eye. Emergency AMT was performed. RESULTS: The eyeball regained its integrity with stabilized corneal surface, reformed anterior chamber and clearance of the inflammation. CONCLUSIONS: AMT may be an effective alternative for treating corneal perforation or impending perforation.
Aged ; Amnion* ; Anterior Chamber ; Cataract ; Corneal Perforation ; Emergencies ; Humans ; Inflammation ; Male ; Rupture*

PURPOSE: The purpose of this study was to evaluate the results of surgical treatment of nonunion of the surgical neck of the humerus in elderly patients. MATERIALS AND METHODS: Seven patients over 60 years of age surgically treated for nonunion of the surgical neck of the humerus with follow- up over 1 year were investigated. Of the three patients with severe osteoporosis, multiple K-wires were used in 1 patient, and Ender nails were used in 2. The other 4 patients with relatively good bone quality were treated with plate and screws. Functional results were evaluated using the University of California, Los Angeles (UCLA) shoulder rating scale and statistical significance was tested using the Wilcoxon signed rank test. RESULTS: Radiological union was obtained in six patients, and 1 patient had no evidence of union at a postoperative 5 years. Active elevation improved from an average of 73 (range, 20-100) degrees to 139 (range, 110-160) degrees. The UCLA score improved from 10.9(range, 7-16) points to 27.3 (range, 10-33) points on the average. CONCLUSION: Open reduction with internal fixation and bone grafting for nonunion of the surgical neck of the humerus in elderly patients may result in significant functional improvement.
Aged* ; Bone Transplantation ; California ; Humans ; Humerus* ; Neck* ; Osteoporosis ; Shoulder

BACKGROUND/AIMS: We evaluated changes of causative pathogen in acute cholangitis and their antimicrobial susceptibility over six years and differences between community-acquired and hospital-acquired acute cholangitis at our institution. METHODS: Medical records of 1,596 patients with acute cholangitis and biliary drainage between August 2006 and August 2012 were reviewed retrospectively. Cases were divided according to time: period 1 (August 2006-December 2008, n=645, 40.4%), period 2 (January 2009-August 2012, n=951, 59.6%). Cases were divided according to community-acquired cholangitis (n=1,397, 87.5%) and hospital-acquired cholangitis (n=199, 12.5%). Causative pathogens and antimicrobial susceptibility were investigated in each group. RESULTS: Causative pathogen was isolated from bile culture in 1,520 out of 1,596 cases (95.2%). The three most frequently isolated Gram-negative bacteria were extended-spectrum beta-lactamase (ESBL)-producing Escherichia coli (n=485, 30.4%), E. coli (n=237, 13.2%), and Citrobacter freundii (n=110, 6.9%). Between periods 1 and 2, prevalence of ESBL-producing E. coli and Klebsiella pneumoniae did not show significant change (36.7% vs. 32.1%, p=0.073; 6.6% vs. 6.2%, p=0.732). C. freundii showed a significant increase from period 1 to period 2 (1.7% vs. 13.2%, p=0.000). In both time periods, imipenem was the antimicrobial agent showing the highest rate of susceptibility (93.3% vs. 93.9%, p=0.783). Higher prevalence of ESBL-producing E. coli and C. freundii was observed in the hospital-acquired cholangitis group (52.1% vs. 31.2%, p=0.000; 15.9% vs. 7.3%, p=0.001). CONCLUSIONS: The most common causative pathogen of acute cholangitis was ESBL-producing E. coli. Prevalence of C. freundii increased over the time period. Imipenem should be reserved as an alternative for resistant pathogens.
Acute Disease ; Aged ; Aged, 80 and over ; Anti-Bacterial Agents/*pharmacology ; Cholangitis/diagnosis/*microbiology ; *Citrobacter freundii/drug effects/isolation & purification ; Community-Acquired Infections/microbiology ; Cross Infection/microbiology ; Drug Resistance, Bacterial ; *Escherichia coli/drug effects/isolation & purification ; Female ; Humans ; Imipenem/pharmacology ; *Klebsiella pneumoniae/drug effects/isolation & purification ; Male ; Microbial Sensitivity Tests ; Middle Aged ; Retrospective Studies ; Time Factors ; beta-Lactamases/metabolism

PURPOSE: The cerebral inflammatory reactions accompanied with epilepsy could play a role in intervening the possible changes of cerebral molecular structure during or after seizure. This study was intended to examine how much proinflammatory cytokines like interleukin (IL)-1beta, IL-6 and tumor necrosis factor (TNF)-alpha are expressed in animal model with seizures of mesial temporal lobe epilepsy and how their concentration in serum changes on the basis of phase, so that it could determine possible association between the development of epileptic seizures and the expression of cytokines. METHODS: Twenty Sprague-Dawley rats as experimental group had kainic acid (KA) administered intraperitonealy, and then, their behavioral patterns were monitored and recorded. In 4 and 24 hours after KA was administered, their bloods were taken respectively to determine the concentration of cytokines. The serum concentrations of IL-1beta, IL-6 and TNF-alpha were measured by means of enzyme linked immunosorbent assay (ELISA). The concentrations of IL-1beta, IL-6 and TNF-alpha were compared with controls, and also the phased variations of their concentration were determined. RESULTS: All rats in experimental group revealed various behaviors and seizure reactions. The serum concentrations of IL-1beta, IL-6 and TNF-alpha taken from rats in 4 and 24 hours after KA administration were more significantly increased than controls respectively (p<0.01). There was no significant variation in concentration of IL-1beta and IL-6 based on time phase, but there was significantly higher concentration of TNF-alpha in serum taken in 24 hours after KA administration than in 4 hours (p<0.05). CONCLUSION: These results show that seizure activity causes the elevation of proinflammatory cytokines and activates inflammatory reactions.
Animals ; Cytokines* ; Enzyme-Linked Immunosorbent Assay ; Epilepsy ; Epilepsy, Temporal Lobe ; Interleukin-1beta* ; Interleukin-6* ; Interleukins ; Kainic Acid ; Models, Animal ; Molecular Structure ; Rats* ; Rats, Sprague-Dawley ; Seizures* ; Tumor Necrosis Factor-alpha*

Castleman disease is a rare lymphoproliferative lesion that is predominantly found in the mediastinum. Retroperitoneal and pararenal localizations are very rare. We describe a 36-year-old man with a hyaline vascular type of Castleman disease involving renal parenchyma and a paraaortic lymph node. Most reported renal Castleman disease was plasma cell type with systemic symptoms. Herein, we report the first Korean case of the hyaline vascular type of Castleman disease involving the renal parenchyma and the paraaortic lymph node simultaneously.
Adult ; Giant Lymph Node Hyperplasia ; Humans ; Hyalin ; Kidney ; Lymph Nodes ; Mediastinum ; Plasma Cells

PURPOSE: The purpose of this study was to evaluate the HRCT findings of bronchial asthma during maintenance bronchodilator therapy and to determine whether there were irreversible bronchial changes occurred in pediatric patients with this condition. MATERIALS AND METHODS: HRCT findings of the lung in 21 asthmatic children [14 boys and 7 girls aged between 3.5 and 13.8 (mean : 7.7) years] who were receiving maintenance bronchodilator therapy were retrospectively studied. At the time of CT examination, 16 were receiving nonsteroid bronchodilator therapy only, and five were receiving both bronchodilator and steroid therapy. Thirteen patients were defined as allergic and eight were nonallergic. The clinical severity of chronic asthma was graded as severe in seven cases, and moderate in 14. The duration of the disease ranged from 4 months to 6 years (mean 3.2 years). HRCT was performed in 19 cases for evalvation of the atelectasis, hyperinflation, and prominent bronchovascular bundles seen on plain radiographs, and in two cases for evaluation following acute exacerbation. A CT W-2000 scanner (Hitachi Medical Co. Tokyo, Japan) was used during the end inspiratory phase, and in addition, ten patients were scanned during the expiratory phase. Scans were reviewed for evidence of bronchial thickening, bronchiectasis, emphysema, abnormal density, mucus plugs, and other morphological abnormalities. The presence of bronchial wall thickening or air trapping was evaluated according to the duration, severity and type of asthma. RESULTS: Among the 21 patients, 7(33.3%) had normal HRCT findings, while in 14 (66.7%), bronchial wall thickening was demonstrated. Eleven of the 14 patients with bronchial wall thickening (78.6%) also had air trapping. No patient was suffering from bronchiectasis or emphysema. There were no statistically significant correlations between the presence of bronchial wall thickening or air trapping and the duration of the disease, its severity, or type of asthma. There was, however, a statistically significant correlation between bronchial wall thickening and air trapping (p < . 0 5 ). CONCLUSION: In asthmatic children who were under maintenance therapy, the most frequent HRCT findings were bronchial wall thickening and air trapping, with significant correlation between the presence of these two phenomena. No destructive lesion such as bronchiectasis or emphysema was found in these asthmatic children, however, and this is probably due to the short duration of the disease, and different disease processes.
Asthma ; Bronchiectasis ; Child* ; Emphysema ; Female ; Humans ; Lung ; Mucus ; Pulmonary Atelectasis ; Retrospective Studies

The effects of lidocaine and fentanyl on controlling the hemodynamic responses to laryngoscopy and intubation have been compared in 39 adult normotensive patients undergoing elective thyroidectomy surgery. Three groups of 13 patients were observed. Patients were randomly assigned to receive thiopenta15 mg/kg alone (control group), lidocaine 1 mg/kg with thiopental 5 mg/kg (lidocaine group) or fentanyl 3 ug/kg with thiopental 5 mg/kg (fentanyl group) for induction of anesthesia. The changes of systolic blood pressure (SBP), mean arterial pressure (MAP), diastolic blood pressure (DBP), heart rate and ECG abnormalities were recorded every minute throughout and compared with preinduction control values. The results were as follows. Control and lidocaine groups showed significant increase of SBP, MAP and DBP (p<0.001, p<0.05) but no significant increases were noted in fentanyl group with tracheal intubation. Significant elevation of heart rate following intubation were observed in all group (p<0.001) and sustained for several minutes. Sinus tachycardia, premature ventricular contraction, bigeminy were observed in every group during induction but the incidences were low in the fentanyl group. It is suggested from the above results that intravenous injection of the lidocaine or fentanyl reduces the magnitude of blood pressure elevation following intubation effectively but heart rate, and cardiovascular respones are more stable with fentanyl than lidocaine.
Adult ; Anesthesia ; Arterial Pressure ; Blood Pressure* ; Electrocardiography ; Fentanyl* ; Heart Rate* ; Heart* ; Hemodynamics ; Humans ; Incidence ; Injections, Intravenous ; Intubation ; Intubation, Intratracheal* ; Laryngoscopy ; Lidocaine* ; Tachycardia, Sinus ; Thiopental ; Thyroidectomy ; Ventricular Premature Complexes

Oxygen deficiency has been frequent in a closed space. Wood consumes oxygen and discharges carbon dioxide instead of photosynthesis in closed space without light, so do some microorganisms on the surface. We experienced a case that a healthy insect-proofer fell down and died of asphyxia on stair-board at 7 m below the hatch of the cargo-hold shipping wood. Analysis of gases in cargo-hold revealed O2; 12.3%, CO; 105 ppm, CH4; 2.7%, and H2S; 1.9% at 1 m below the hatch, and then O2; 6.1%, CO; 220 ppm, CH4; 2.9%, and H2S; 2.3 ppm at 2.5 m below the hatch. Autopsy findings were unremarkable. We justiced the cause of death asphyxia due to oxygen deficiency. As seen in this case, the serious oxygen deficiency was accounted for oxygen consumption by wood and microorganisms.
Anoxia* ; Asphyxia* ; Autopsy ; Carbon Dioxide ; Cause of Death ; Gases ; Oxygen Consumption ; Oxygen* ; Photosynthesis ; Ships* ; Wood*