OBJECTIVE: The aim of this study was to assess the relationship between disease progression and expression of c-erbB-2 and S-100 protein positive dendritic cells in Cervical cancer. STUDY DESIGN: Tissues were analyzed from 100 patients. Each of them had invasive carcinoma(44), microinvasive(12), CIS(33), CIN(II) before treatment, c-erbB-2 oncoprotein expression and S-100 protein positive dendritic cell were confirmed by immunohistochemical staining. (Avidin-biotin complex method) RESULTS: C-erbB-2 immunostaining was significantly associated with disease progression (p<0.05). In case of CIN I, there was not noted stained specimen but in case of invasive carcinoma, 24 cases of stained specimen were noted. S-100 protein positive dendritic cell was not associated with disease progression of cervical carcinoma.(p>0.05) CONCLUSIONS: According to our results, c-erbB-2 is possible factor in Carcinogenesis of cervical carcinoma with progression of it. and S-100 protein positive dendritic cell was not associated with disease progression of cervical carcinoma.
Carcinogenesis ; Carcinoma, Squamous Cell* ; Cervix Uteri* ; Dendritic Cells* ; Disease Progression ; Female ; Humans ; S100 Proteins* ; Uterine Cervical Neoplasms

PURPOSE: Chronic infected wounds sustained over 4 weeks with exposed tendon or bone are difficult challenges to plastic surgeons. Vacuum assisted closure (VAC) device has been well used for the management of chronic wounds diminishing wound edema, reducing bacterial colonization, promoting formation of granulation tissue and local blood flow by negative pressure to wounds. But Commercial ready-made VAC device might have some difficulties to use because of its high expenses and heavy weight. So we modified traditional VAC device with silver dressing materials as topical therapeutic agents for control of superimposed bacterial wound infection such as MRSA, MRSE and peudomonas. METHODS: We designed the modified VAC device using wall suction, 400 cc Hemovac and combined slow release silver dressing materials. We compared 5 consecutive patients' data treated by commercial ready-made VAC device(Group A) with 11 consecutive patients' data treated by modified VAC device combined with silver dressing materials(group B) from September 2004 to June 2007. Granulation tissue growth, wound discharge, wound culture and wound dressing expenses were compared between the two groups. RESULTS: In comparison of results, no statistical differences were identified in reducing rate of wound size between group A and B. Wound discharge was significantly decreased in both groups. Modified VAC device with silver dressing materials showed advantages of convenience, cost effectiveness and bacterial reversion. CONCLUSION: In combination of modified VAC device and silver dressing materials, our results demonstrated the usefulness of managing chronic open wounds superimposed bacterial infection, cost effectiveness compared with traditional VAC device and improvement of patient mobility.
Bacterial Infections ; Bandages ; Colon ; Cost-Benefit Analysis ; Edema ; Granulation Tissue ; Humans ; Methicillin-Resistant Staphylococcus aureus ; Negative-Pressure Wound Therapy ; Silver ; Suction ; Tendons ; Vacuum ; Wound Infection

BACKGROUND: Pneumoperitoneum for a laparoscopic cholecystectomy induces hemodynamic changes. The present study investigated the effect of preventive nicardipine on the hemodynamics induced by pneumoperitoneum during a laparoscopic cholecystectomy. METHODS: Forty five patients, scheduled to undergo laparoscopic cholecystectomy, were selected, and divided into three groups; the control group (C; normal saline infusion), the nicardipine bolus injection group (NB; 20microgram/kg nicardipine infusion, 1 min before skin incision) and the nicardipine continuous infusion group (NI; 2microgram/kg/min continuous infusion, from the time of endotracheal intubation to pneumoperitoneum). The blood pressure, heart rate, cardiac output and systemic vascular resistance were measured; at preincision, and at 5, 10 and 15 min after insufflation and at 5 min after exsufflation. RESULTS: Nicardipine injection attenuated increases in the blood pressure, systemic vascular resistance after pneumoperitoneum, and didn't attenuate decrease in the cardiac output. CONCLUSIONS: A preventive nicardipine injection is effective in attenuating the hemodynamic change after pneumoperitoneum during a laparoscopic cholecystectomy, especially attenuated the systemic vascular resistance and blood pressure increase.
Blood Pressure ; Cardiac Output ; Cholecystectomy ; Cholecystectomy, Laparoscopic* ; Heart Rate ; Hemodynamics* ; Humans ; Insufflation ; Intubation, Intratracheal ; Laparoscopy ; Nicardipine* ; Pneumoperitoneum* ; Skin ; Vascular Resistance

PURPOSE: Survival rate after renal transplantation has increased in according to the prolonged graft survival due to a development of new immunosuppressive agents and operative techniques. Therefore, the develpment of malignancy in renal transplant recipients has become the major cause of morbidity and mortality. METHODS: The retrospective analysis was performed in 4 patients with malignancy among the 315 patients who underwent kidney transplantation in our hospital from August 1990 to March 2001 and 1 patient with malignancy who underwent kidney transplantation in other hospital and was followed up in our hospital. RESULTS: In five malignancy, 3 were adenocarcinoma in stomach, 1 lobular carcinoma in breast and 1 squamous cell carcinoma in uterine cervix. The mean age of these patients at diagnosis of malignancy was 48.4 (35~60) and the average interval between renal transplantation and diagnosis of malignancy was 69.8 months. Surgical resection was done in all five patients. Chemotherapy was performed in 1 patients with advanced gastric cancer and 1 patient with breast cancer. Four patients are now alive and one patient was lost during follow-up period. CONCLUSION: We reviewed the incidences and types of malignancy after renal transplantation in our hospital. Regular screening and careful surveillance are highly recommended in patients after renal transplantation.
Adenocarcinoma ; Breast ; Breast Neoplasms ; Carcinoma, Lobular ; Carcinoma, Squamous Cell ; Cervix Uteri ; Diagnosis ; Drug Therapy ; Female ; Follow-Up Studies ; Graft Survival ; Humans ; Immunosuppressive Agents ; Incidence ; Kidney Transplantation ; Mass Screening ; Mortality ; Retrospective Studies ; Stomach ; Stomach Neoplasms ; Survival Rate ; Transplantation*

Bosworth fracture, fracture-dislocation of ankle with entrapment of fibula behind the tibia, is a rare condition. Diagnosis of this fracture-dislocation may not he easy, and closed reduction of this injury is difficult because of entrapment of fibula by the tieht interosseous membrane. We report a case of Bosworth fracture treated with the anti-glide plate technique.
Ankle ; Diagnosis ; Fibula ; Membranes ; Tibia

Osteoporosis represents reduced amount of bone mass per unit volume as compared with controls of the same age and sex. The purpose of this study was to show how bone mineral densities of spine and intertrochanteric area decrease with aging, to investigate the relationship between the bone mineral densities (BMD) of the two areas, and to obtain fracture threshold values. We measured BMD of lumbar vertebrae and intertrochanteric areas by Dual Energy X-ray Absorptiometry (DEXA) from 241 postmenopausal women. 190 normal postmenopausal women comprised non-fracture group and there were 50 fresh thoracolumbar fracture patient and 31 intertrochanteric fracture patients in whom the fractures were not caused by high energy trauma. The mean bone mineral density values of non-fracture group were significantly higher than those of fracture groups and significant correlation held between bone density of spine and that of intertrochanteric area in non-fracture group and fracture groups. The fracture threshold was 0.837 g/cm3 in spine fracture group and 0.792 g/cm3 in the intertrochanteric fracture group.
Absorptiometry, Photon* ; Aging ; Bone Density* ; Female ; Humans ; Lumbar Vertebrae ; Osteoporosis ; Spine

BACKGROUND: The aim of this study is to evaluate the long term results of creating various right ventricle to pulmonary artery conduits for treating complex congenital heart disease. MATERIAL AND METHOD: Between June 1986 and July 2006, we retrospectively reviewed 245 patients who underwent reconstruction of the right ventricular outflow tract with various kinds of conduits. 410 operations were done in 245 patients, the mean age at operation was 3.2+/-4.9 years (range: 7 days~45 years) and the mean body weight was 12.5+/-8.7 kg (range: 2.4~76.3 kg). RESULT: We used the following conduits: Polystan conduit, Shelhigh conduit, Carpenter-Edward conduit, Dacron graft with an artificial valve, valveless Gore Tex vascular graft, homograft and hand-made bovine or autologous pericardial conduit. The mean follow up duration was 6.3+/-5.2 years. Redo operation for RV-PA conduit dysfunction was performed in 131 patients, a second redo was done in 31 and a third redo was done in 3. The reoperation free rates were 67.3%, 48.5% and 39.4% for 5 years, 10 years and 15 years, respectively. The homograft showed the best durability, followed by the Dacron graft with artificial valve and the Carpentier-Edward conduit. The larger sized conduit showed better durability. CONCLUSION: The homograft showed lowest reoperation rate and a smaller size of conduit showed the highest reoperation rate. The reoperation rate for the RV-PA conduit was about 35% at 5 years, so it is mandatory to develop the more durable conduit for RV outflow.
Body Weight ; Follow-Up Studies ; Heart Diseases ; Heart Ventricles ; Humans ; Polyethylene Terephthalates ; Polytetrafluoroethylene ; Pulmonary Artery ; Pulmonary Atresia ; Reoperation ; Retrospective Studies ; Tetralogy of Fallot ; Transplantation, Homologous ; Transplants

BACKGROUND: In this study, the role and the surgical outcome of the modified Blalock-Taussig shunt in the treatment of the infants with cyanotic complex congenital heart diseases were investigated. MATERIAL AND METHOD: Over the last 12 years, 105 modified BT shunts were performed in 100 infants. Postoperative course, shunt patency rate, complications, mortality and its risk factors were reviewed restrospectively. RESULT: The mean age at operation was 43.0 36.6 days. Sex ratio was 60:40(M:F). The postoperative oxygen saturations were lowest after mean duration of 11 hours after the shunt procedure. The operative mortality was 8%(8) with 3 late deaths. Causes of operative death included failure of maintenance of minimum oxygenation during the procedure(2), immediate postoperative shunt occlusion(2), respiratory failure(2), low cardiac output due to heart failure and pericardial effusion(2) and sepsis(2). Late deaths resulted from acute cardiac arrest during the follow up cardiac catheterization, hypoxic myocardial failure, and arrhythmia. Year of surgery, shunt size, age at operation, and complexity of the anomalies were not the risk factors for mortality. Six month shunt patency rate was 97% and overall patency rate was 96%. Postoperative complications comprised of shunt occlusion(6), phrenic nerve palsy(3), and wound infection(2). CONCLUSION: We demonstrated that modified Blalock-Taussig shunt was a useful tool to palliate the infants with complex cyanotic heart disease in whom early complete repair was not feasible with acceptable mortality and patency rate. An adequate postoperative management and a meticulous surgical technique may be key factors for the better results.
Arrhythmias, Cardiac ; Blalock-Taussig Procedure* ; Cardiac Catheterization ; Cardiac Catheters ; Cardiac Output, Low ; Follow-Up Studies ; Heart Arrest ; Heart Diseases ; Heart Failure ; Humans ; Infant ; Mortality ; Oxygen ; Phrenic Nerve ; Postoperative Complications ; Risk Factors ; Sex Ratio ; Wounds and Injuries

A 12-day-old female baby underwent a Norwood procedure for hypoplastic left heart syndrome. The left superior vena cava (LSVC), which was found incidentally during the operation, was divided to facilitate surgical exposure. After the operation, she developed signs of low cardiac output and died 7 hours afterward. Autopsy findings showed that the coronary sinus was atretic at the orifice without unroofing into both atria, rendering the LSVC the sole route of coronary sinus drainage. In patients with incidentally-found LSVC during surgery, special care should be taken to leave the LSVC intact because the LSVC may be the exclusive drainage vein of the coronary venous system.
Autopsy ; Cardiac Output, Low ; Coronary Sinus ; Drainage ; Female ; Humans ; Hypoplastic Left Heart Syndrome ; Norwood Procedures ; Veins ; Vena Cava, Superior

OBJECTIVE: To investigate whether patterns of dysphagia were associated with the location of the brain lesion and clinical factors in subacute stroke patients. METHOD: One hundred and seventy-eight first-ever subacute stroke patients who underwent videofluoroscopic swallowing study (VFSS) from January 2006 to April 2012 were enrolled in the present study. Swallowing-related parameters were assessed by VFSS. The location of brain lesions were classified into the cortical, subcortical, and brain stem. The degree of cognitive impairment and the independency of activities of daily living were assessed by the Korean version of mini-mental status examination and Korean version of modified Barthel index (K-MBI). Aphasia and hemineglect were assessed by Korean version of Western aphasia battery and line bisection test. These data were collected via retrospective chart review. RESULTS: A reduced laryngeal elevation and prolonged pharyngeal delay time were associated with brain stem lesion. Other swallowing parameters were not associated with lesion topology. Pyriform sinus residue was associated with the presence of aphasia and low K-MBI scores. Prolonged pharyngeal delay time was associated with the patient's age, type of stroke and brain stem lesion. CONCLUSION: Pyriform sinus residue was associated with clinical factors such as aphasia and K-MBI scores rather than with the location of brain lesion. However, reduced laryngeal elevation and prolonged pharyngeal delay time were predominant in brain stem lesions.
Activities of Daily Living ; Aphasia ; Brain Stem ; Brain* ; Deglutition Disorders ; Deglutition* ; Humans ; Pyriform Sinus ; Retrospective Studies ; Stroke*