Although causative factors are not completely defined, carcinogenesis of colorectal cancer is attributed to multiple genetic alterations. The abnormal expressions of oncogenes are regarded to be responsible for the production of malignant phenotype, subsequent invasion and metastasis. From 63 surgically resectable colorectal adenocarcinoma patients, expression of oncogenes in colorectal cancer tissue was evaluated with immunohistochemical staining methods using monoclonal antibodies to products of the oncogenes. To evaluate the possibility of oncogenes as a prognostic factor, we studied the relationship between the expression of oncogenes and the clinicopathologic findings which are well known prognostic factors. Rates of expression in colorectal cancer tissue were 27% for c-myc, 74.6% for c-Ha-ras and 77.8% for c-erbB-2 oncogenes. The positive rate of c-erbB-2 oncogene was higher in the well differentiated group than in the poorly differentiated group. The rates of expression of c-myc and c-Ha-ras oncogenes were significantly correlated each other. Expression of these oncogenes in colorectal cancer were not correlated with the pathologic stage, location of cancer, DNA ploidy pattern and histologic differentiation except between c-erbB-2 and histologic differentiation. In conclusion, there seems to be a possibility that c-erbB-2 could be used as a prognostic factor of colorectal cancer. However, further and more intensive study seems to be required.
Adenocarcinoma ; Antibodies, Monoclonal ; Carcinogenesis ; Colorectal Neoplasms* ; DNA ; Humans ; Neoplasm Metastasis ; Oncogenes* ; Phenotype ; Ploidies

PURPOSE: Emotional and behavioral disturbances have been reported in severe short stature children. The purpose of this study was to examine psychosocial problems in children with Growth hormone deficiency(GHD), comparing with their normal height siblings. METHODS: Twenty three children with GHD(17 boys and 6 girls, mean age:13.1+/-2.8 yrs) were included. Their normal height siblings(8 boys and 2 girls, mean age:12.3+/-2.9 yrs) were included as control group. Parents of all participating children completed the Child Behavior Checklist. Patients 10 years and older completed the Youth Self Report. RESULTS: 1)Internalizing problem scores(somatic complaints, anxiety, depression, social incompetence) were higher in GHD compared to control group(49.0+/-15.0 vs 43.2+/-6.2, P<0.05). Externalizing problem scores and social competences were not different between GHD and control group. 2) Total problem scores in GHD were not different by sex. 3)Total problem scores were not different between idiopathic GHD and organic GHD. 4)Attention problems(r=0.45, P<0.05), delinquent behavior(r=0.49, P=0.01) and aggressive behavior(r=0.51, P<0.01) increased by age. 5)Height SDS negatively correlated with social problem(r=-0.47, P<0.05) and delinquent behavior(r=-0.61, P<0.01). Height SDS also negatively correlated with somatic complaints(r=-0.75, P<0.01), anxiety and depression(r=-0.66, P=0.01). CONCLUSION: Internalized problems such as somatic complaints, anxiety and depression were higher in GHD than control group. Behavioral problem scores were increased by age and behavioral problem scores were correlated with height deficit. When we treat GHD children, appropriate medical and psychological counseling should be included.
Adolescent ; Anxiety ; Checklist ; Child Behavior ; Child* ; Counseling ; Depression ; Female ; Growth Hormone* ; Humans ; Parents ; Self Report ; Siblings

No abstract available.
Infectious Mononucleosis*

No abstract available.
Female ; Pregnancy ; Pregnancy, Ectopic*

Pulmonary comp1ications following surgery continue to be a major cruse of postoperative mobidity. The purpose of this study was to measure the effects of various surgical procedures upon arterial blood gas tension and ventilatory function in the early postoperative period. 30 patients with no history of cardiopulmonary disease before surgery were selectively chosen and divided into 4 categories depending on the location of the operative incision and the type of anesthesia. Group l was composed of upper abdominal incision cases, Group ll lower abdominal incision cases, and Groups lll and lV had nonabdominal surgery. Groups, l, ll and lll received general anesthesia, while lV was liven spinal anesthesia. Lung volumes were measured and blood samples were taken preoperatively and 70 minutes after surgery. Patients were maintained in semisitting position before and after surgery. Vital capacities were significantly reduced in the postoperative period in the general ane- sthesia groups, and tidal volumes were significantly reduced in the upper and lower abdominal incision groups. The mean PaO2 value after anesthesia decreased significantly in the upper and lower abdominal incision groups, but there were no significant differencea in the PaCO2 value. It seems that supplemental oxygen and encouragement of deep inspirations are essential and beneficial in the early postoperative period, especially for the patients with abdominal surgery.
Anesthesia ; Anesthesia, General ; Anesthesia, Spinal ; Humans ; Lung ; Oxygen ; Postoperative Period ; Tidal Volume ; Vital Capacity

PURPOSE: To compare clinical outcomes of the tumor prosthetic replacement and osteosynthetic fixation for pathologic fracture of skeletal metastatic lesion of the proximal femur. MATERIALS AND METHODS: From 1994 May to 2009 May, medical records of 22 patients who underwent tumor prosthetic replacement with tumor resection (group 1) and 15 others (16 hips) who underwent osteosynthetic fixation without tumor resection (group 2) were reviewed. The mean age of overall patients were 59 (group 1) and 60 (group 2). Mean follow up periods were 23 and 11 months. The oncological and functional results were evaluated with Kaplan-Meier methods and Musculoskeletal Tumor Society (MSTS) scoring system, 1993. The statistical evaluation was assessed with Log rank test and t-test. RESULTS: The mean survival periods were 24 months in group 1 and 11months in group 2. The 1 year survival rates were 86% in group 1 and 50 % in group 2, and 2 year survival rates were 29.7% in group 1 and 9.4% in group 2. The mean MSTS functional score were 26.4 (19-30), 87.9% in group 1 and 15.3 (10-23), 51.0% in group 2. CONCLUSION: The results of tumor resection and prosthetic replacement in selected cases was better than osteosynthetic fixation without tumor resection for metastatic bone tumors around proximal femur in oncological and functional aspects.
Femur ; Follow-Up Studies ; Fractures, Spontaneous ; Humans ; Joints ; Medical Records ; Survival Rate

BACKGROUND AND OBJECTIVES: Insulin resistance is associated with hyperlipidemia. Recently, visceral fat adiposity is reported to be associated with insulin resistance and hyperlipidemia. We investigated insulin resistance and visceral fat adiposity in hyperlipidemic patients. MATERIALS AND METHOD: Hyperlipidemic group included 14 hyperlipidemic patients (total cholesterol > or = 220 mg/dl and triglyceride < or = 400 mg/dl) without hypertension, angina, impaired glucose tolerance and diabetes mellitus (DM). Control group included age, sex and body mass index (BMI) matched 25 healthy volunteers. We measured plasma lipid profiles and the insulin and glucose during the oral glucose tolerance test. We measured visceral fat area and abdominal subcutaneous fat area with computed tomography (CT). RESULTS: There were no differences of age, sex and BMI in both group. Total cholesterol, LDL cholesterol and triglyceride increased significantly in hyperlipidemic group. Fasting plasma glucose, insulin, area under curve (AUC) of the glucose and insulin and the Insulin / Glucose (IG) ratio increased significantly in hyperlipidemic group. Significant positive correlations were demonstrated between visceral fat area and the fasting plasma glucose, AUC of glucose and insulin at 120 minutes after glucose load. However, there was no difference in visceral fat area between both groups. After adjustment of visceral fat area, fasting plasma glucose, insulin, area under curve (AUC) of the glucose and insulin and the Insulin / Glucose (IG) ratio still remained increased significantly in hyperlipidemic group. CONCLUSION: We observed significantly increased insulin resistance in hyperlipidemic group. There was partial relationship between visceral fat area and the glucose and insulin profile. However, we did not find increased visceral fat area in hyperlipidemic group.
Adiposity ; Area Under Curve ; Blood Glucose ; Body Mass Index ; Cholesterol ; Cholesterol, LDL ; Diabetes Mellitus ; Fasting ; Glucose ; Glucose Tolerance Test ; Healthy Volunteers ; Humans ; Hyperlipidemias* ; Hypertension ; Insulin Resistance* ; Insulin* ; Intra-Abdominal Fat* ; Obesity* ; Plasma ; Subcutaneous Fat, Abdominal ; Triglycerides

There are various reports referring to the clinical siignificances and removal of postgastrectomy bezoar. In this case, suture thread were thought to he the important factor of the bezoar formation, This bezoar was removed intaetly uaing fiber-optic endoscope in patinet who had postgastrectomy bezoar, by cutting the thread by biopsy forceps.
Bezoars* ; Biopsy ; Endoscopes ; Surgical Instruments ; Sutures*

Esophageal foreign bodies caused by accidents and carelessness are very common problems in otorhinolaryngology field. They are closely related to regional life style, culture, and economical status. The lodgement of coins in the esophagus is one of the most common foreign body problems. It occurs usually under the age of 10 years. From March, 1981 through September, 1996, one hundred and forty-nine patients were analysed. Most common coin type was one hundred won-coin(51.2mm flat circumference). One half of the cases were under 3.5 years old. Ninety percent of the cases were under 7.6 years of age. Over half the ten won-coins(48.8mm flat circumference) were found under 3.3 years old, and 90 percent of the cases in which those coins were lodged were found to be less than 4.5 years of age. None could seen under one years old or above ten. This result suggests that there are relative correlation between coin size and patient age.
Esophagus* ; Foreign Bodies ; Humans ; Life Style ; Numismatics* ; Otolaryngology

Although shock in sepsis is usually managed successfully by conventional medical treatment, a subset of cases do not respond and may require salvage therapies such as veno-arterial extracorporeal membrane oxygenation (VA ECMO) support as well as an attempt to remove endotoxins. However, there are limited reports of attempts to remove endotoxins in patients with septic shock on VA ECMO support. We recently experienced a case of septic shock with severe myocardial injury whose hemodynamic improvement was unsatisfactory despite extracorporeal membrane oxygenation (ECMO) support. Since the cause of sepsis was acute pyelonephritis and blood cultures grew gram-negative bacilli, we additionally applied polymyxin B direct hemoperfusion (PMX-DHP) to the ECMO circuit and were able to successfully taper off vasopressors and wean off ECMO support. To the best of our knowledge, this is the first adult case in which PMX-DHP in addition to ECMO support was successfully utilized in a patient with septic shock. This case indicates that additional PMX-DHP therapy may be beneficial and technically feasible in patients with septic shock with severe myocardial injury refractory to ECMO support.
Adult ; Cardiomyopathies* ; Endotoxins ; Extracorporeal Membrane Oxygenation ; Hemodynamics ; Hemoperfusion* ; Humans ; Membranes* ; Oxygen* ; Polymyxin B* ; Polymyxins* ; Pyelonephritis ; Salvage Therapy ; Sepsis ; Shock ; Shock, Septic*