Malignant pleural effusions (MPEs) are an important clinical problem in patients with neoplastic disease. They can occur as the initial presentation of cancer, a delayed complication in patients with previously diagnosed malignancies, or the first manifestation of cancer recurrence after therapy. Common cancer types causing MPEs include lymphomas, mesotheliomas, and carcinomas of the breast, lung, and ovaries. However, almost all tumor types have been reported to cause MPEs. Regardless of the etiology, the median survival from clinical recognition is 4 months. New imaging modalities assist the evaluation of patients with a suspected MPE. However cytologic or tissue confirmation of malignant cells is necessary to establish a diagnosis. Management of an MPE remains palliative. Managements are directed toward removing pleural fluids and when appropriate, performing pleurodesis or initiating long-term drainage to prevent fluid reaccumulation. Talc pleurodesis is still the choice of treatment although concerns about its safety remain. Several factors such as performance status, expected survival, lung re-expansion following pleural fluid drainage and co-morbidities should be considered before the treatment.
Breast ; Drainage ; Female ; Humans ; Lung ; Lymphoma ; Mesothelioma ; Ovary ; Pleural Effusion ; Pleural Effusion, Malignant ; Pleurodesis ; Recurrence ; Talc

Cartilage is one of the most commonly manipulated tissue in esthetic and reconstructive surgery. Cartilage has an important role in longitudinal bone growth. Anabolic hormones and locally produced peptide growth factors are known to influence this process Matrix composition changes through proliferation, maturation, and differentiation of chondrocytes, and endochondral ossification thereafter. Defined cartilage matrix is synthesized during the maturation of chondrocytes where the major change is the increment of type II collagen. Variable sulfated mucololysaccharides and hyaluronic acid are also synthesized during this maturation. IGF-I(insulin like growth factor-I), so called somatomedin C, is a prominent growth factor in serum. IGF-I is known to be involved in long growth. IGF-I is affected by pituitary growth hormone. There are few studies done on IGF-I effect in cartilage matrix formation and possible changes of collagen subtypes. This experiment was designed to see the IGF-I effect on the colagen synthesis of cultured chondrocytes. Optimal concentration of IGF-I for the experiment was determined using H3-thymidine incorporation into DNA. The IGF-I effect on collagen synthesis was studied using H3-proline. The IGF-I effect on the synthesis of subtypes of collagen was studied using SDS-PAGE and immunocytochemical staining. Chondrocytes were isolated from the ears of New Zealand white rabbit and cultured in 2 X 10(5) cells/300 microgram density. IGF-I increased DNA synthesis, and optimal concentration of IGF-I was determined by dose-relationship curve as 10ng/ml. Collagen synthesis was increased by IGF-I. Type II collagen was increased on SDS-PAGE with IGF-I and this gel electrophoresis showed type X collagen, also. The increase in type II collagen was confirmed with immunocytochemical staining, the reaction becoming stronger with the addition of IGF-I. Type I collagen was not changed with IGF-I on immunocytochemistry. We conclude that IGE-I is an important modulator influencing not only proliferation and maturation but also terminal different-iation of chondrocytes.
Bone Development ; Cartilage ; Chondrocytes* ; Collagen Type I ; Collagen Type II ; Collagen Type X ; Collagen* ; DNA ; Ear ; Electrophoresis ; Electrophoresis, Polyacrylamide Gel ; Growth Hormone ; Hyaluronic Acid ; Immunohistochemistry ; Insulin-Like Growth Factor I* ; Intercellular Signaling Peptides and Proteins ; New Zealand

No abstract available.
Asthma, Occupational*

No abstract available.
Lung Neoplasms* ; Lung* ; Radon*

No abstract available.
Humans

BACKGROUND: The expression of adhesion molecules contribute to development of systemic diseases. Vascular cell adhesion molecule-l(VCAM-1) is an endothelial cell membrane glycoprotein that has been implicated in leukocyte/endothelial cell interactions in inflammation. OBJECTIVE: The aim of this study was to characterize the surface expression and regulation of VCAM-1 on two different endothelial cells. METHOD: We examined the effects of the expression of VCAM-1 in two different endothelial cells, isolated from human umbilical cords and human glomerulus. Expression of VCAM-1 was measured by enzyme-linked immunosorbent assay(ELISA) and flow cytometry. RESULTS: In human umbilical cord endothelial cells(HUVECs), both interleukin-l B(IL-lB) and tumor necrosis factor-a (TNF-a) increased VCAM-1 expression. VCAM-1 expression increased by TNF-a was higher than that increased by IL-lB. In human glomerular endothelial cells(HGECs), IL-lB and TNF-a markedly increased VCAM-1 expression. Conclusion. The regulation of VCAM-1 appears to be somewhat different in HGECs compared with HUVECs. These differences between the responsiveness of the two cells may possibly indicate inherent differences in endothelial cell derived from different vascular beds.
Cell Adhesion ; Cell Communication ; Cytokines* ; Endothelial Cells* ; Flow Cytometry ; Humans* ; Inflammation ; Membrane Glycoproteins ; Necrosis ; Umbilical Cord ; Vascular Cell Adhesion Molecule-1*

BACKGROUND: Obtaining and utilizing the feed-backs from residents who have finished four year of anesthesia residency could well contribute to improvement in training program. Therefore authors have designed a self questionnaire to analyze the degrees or measures of satisfaction from such training program and data were evaluated to provide,in future,the guideline which would improve the quality of the training program. METHODS: The self-questionnaires were sent to residents(n=148),who have been through the entire four year of residency training courses under anesthesia department. The assessment was conducted to measure the degree of satisfaction based on several variables such as motivation, selection of anesthesiology as a first choice, type of training hospital, and sex. To evaluate the current problems of anesthesia residency program, we made 30 open-ended and close-ended questions. Data analysis was made using Fishers exaet test. RESULTS: There were no statistically significant difference between the degree of satisfaction and their motivation for choosing anesthesia, anesthesia as a major, selection of anesthesiology as a first choice, and types of hospitals. As for the difference in satisfaction of training, male residents showed significantly higher satisfaction rate( n=92, 36.2%) than female residents(n=47, 17%). CONCLUSIONS: These results suggest that degrees of satisfaction was more likely related to the program of each training hospital and sex compared to other variables studied.
Anesthesia Department, Hospital ; Anesthesia* ; Anesthesiology ; Education ; Female ; Humans ; Internship and Residency* ; Male ; Motivation ; Surveys and Questionnaires ; Statistics as Topic

OBJECTIVES: To investigate the number of leiomyoma patients-exposed to bisphenol A (BPA) and to observe whether the serum concentration of BPA is related to leiomyoma growth. METHODS: A total of 158 patients were recruited for this study. Leiomyoma patients were divided into three groups, mild (n = 48), moderate (n = 32) and severe (n = 28), according to the size of leiomyomas. The control (n = 30) group was defined as having no leiomyomas. Transvaginal ultrasonography was used to identify and measure the leiomyomas. Serum BPA concentrations were measured by enzyme-linked immunosorbent assay. RESULTS: BPA was detected in 87.0% out of a total of 158 samples, and in 86.0% out of 108 leiomyoma patients. In detail, the detection rates of serum BPA were 88.0% in the control group, 77.2% in the mild group, 90.0% in the moderate group and 96.0% in the severe group. The mean BPA concentration in the control group was 0.558 +/- 0.097 ng/mL, the leiomyoma groups, the mean BPA concentrations were 0.274 +/- 0.063 ng/mL (mild), 0.346 +/- 0.064 ng/mL (moderate) and 0.647 +/- 0.039 ng/mL (severe) (P = 0.0003). Values represent the mean +/- standard error. CONCLUSION: The detection rates of serum BPA in the control and leiomyoma groups were 88.0% and 86.0%, respectively. However, there was no significant difference in the serum BPA concentrations between the control and leiomyoma groups. To verify the effect of BPA on leiomyoma growth, a close and sequential monitoring is recommended for people who are at risk for uterine leiomyoma.
Endocrine Disruptors ; Enzyme-Linked Immunosorbent Assay ; Female ; Humans ; Leiomyoma* ; Ultrasonography ; Uterus

Emergency surgical patients are more frequently in critical state than elective patients and they have not enough time for physical and laboratory examinations. The evaluation of perio-perative data will improve the outcome of emergency operation. We analyzed 1053 anesthesias for emergency operation which were performed at the department of anesthesiology, Anam Hospital from September 1992 to August 1993 clinically and statistically according to age, sex, physical status, department, anesthetic duration, method and agent, types of trauma, amount of transfusion, etc. The results were as follows; 1) The percent of emergency surgery cases was 13.6 of total surgical patients. 2) The ratio of male to female was 1.15:1. 3) About 61.1% of all emergency patients were in the 21-40 years age group. 4) According to the ASA classification of physical status, the percent of patients in emergency class 1 and 2 was 86.2 of the total patients. 5) The most common operation was Cesarean section (19.9%), and appendectomy (13.8%) the next. 6) The most common anesthetic method for emergency operation was general anesthesia with enflurane. 7) The obstetric cases were most common and the general surgery cases were the next. 8) The percent of the cases which took less than 2 hours duration was 82.4 of total operation. 9) The transfusion was done in 108 cases (10.3%) and less than 2 units was transfused most frequently. 10) The transference to ICU was done in 144 (13.7%) cases and the patients of general surgery were transfered to ICU most frequently. 11) The majority of injuries were classified as blunt trauma (86.6%) while 13.4% were classified as penetrating trauma. 12) The lagest number of injuries involved the upper extremity (47.8%) and the next was the head & neck (31.9%).
Anesthesia* ; Anesthesia, General ; Anesthesiology ; Appendectomy ; Cesarean Section ; Classification ; Emergencies* ; Enflurane ; Female ; Head ; Humans ; Male ; Neck ; Pregnancy ; Upper Extremity

BACKGROUND: Ductal carcinoma in situ (DCIS) of the breast has been considered a relative rare form of breast cancer because its diagnosis was difficult, but the widespread use of screening mammography makes it easy to detect breast disease and there has been marked increase in the incidence of DCIS. But the exact diagnosis and treatment are controversial. METHODS: We reviewed the clinical records of 55 cases with DCIS treated at the Department of Surgery, Samsung Medical Center, between September 1994 and December 1997. If microinvasion was noted, the case was excluded from this study. RESULTS: The incidence of DCIS was 11.5% of all breast cancer (55 out of 477) with increasing tendency from 1995 to 1997. DCIS was most prevalent in women who were in their fifth decade, and the mean age was 47 years old. Chief complaints were palpable breast masses in 22 (40%) cases, mammographic abnormalities in 21 (38%), abnormal nipple discharge in 7 (13%), and others in 5 (9%). The most common mammographic finding was microcalcifications in 38 (78%) cases, but mass density and architectural distortion were also noted in a small percertage. Diagnostic methods for preoperative pathology were Fine Needle Aspiration (FNA) cytology in 15 (27%) cases, localization and excisional biopsy in 17 (31%), excisional biopsy in 12 (22%), incisional biopsy in 5 (9%), stereotactic core biopsy in 3 (5%), US guided biopsy in 2 (4%), and ABBI (Advanced Breast Biopsy Instrument) biopsy in 1 (2%). If the chief complaint was a palpable mass, FNA was the diagnostic choice. On the other hand, if the problem was mammographic abnormalities, localization and excisional biopsy was preferred. The surgical procedures were modified radical mastectomy in 17 (31%) cases, total mastectomy in 21 (38%), lumpectomy with axillary lymph node dissection in 7 (13%), and lumpectomy only in 10 (18%). If preoperative histology revealed the tumor of comedo type, mastectomy was preferred, but in case ofnon-comedo type, conservative surgery was preferred. Conservative surgery was followed by radiation therapy. Cancers were subclassified according to their histologic subtypes in 51 cases, and comedo type was most common (42%). Prevalent sizes of the masses were less than 2 cm, and the biggest one was 9 cm. There was one case (2%) of lymph node metastasis. It was comedo type and the size of the tumor was 9 cm. CONCLUSIONS: The widespread use of screening mammography and various other diagnostic methods will increase the chance of detecting DCIS, and conservative surgery will be performed more frequently in selected groups of patients.
Biopsy ; Biopsy, Fine-Needle ; Breast Diseases ; Breast Neoplasms ; Breast* ; Carcinoma, Ductal* ; Carcinoma, Intraductal, Noninfiltrating* ; Diagnosis* ; Female ; Hand ; Humans ; Incidence ; Lymph Node Excision ; Lymph Nodes ; Mammography ; Mass Screening ; Mastectomy ; Mastectomy, Modified Radical ; Mastectomy, Segmental ; Mastectomy, Simple ; Middle Aged ; Neoplasm Metastasis ; Nipples ; Pathology