Inactivation or loss of suppressor genes on a specific chromosome plays an important role in the development and progression of cancer. Recent studies have shown that p53 gene acts as a tumor suppressor gene and that its mutation appears to be related to the aggressiveness of transitional cell carcinoma of the bladder. To investigate the significance of p53 gene mutations in transitional cell carcinoma of the renal pelvis (renal pelvis tumor), 28 tumors with various stages and grades were examined for p53 gene mutations in exon regions 5 to 8 using polymerase chain reaction single-strand conformation polymorphism analysis. Seven (25%) of 28 pelvis tumors were found to have p53 gene mutations. Three of 12 superficial tumors including pTis, pTa, and pT1 were found to have p53 gene mutations. And only four of 16 invasive tumors with pT2, pT3, and pT4 were found to have p53 mutations. In the respect of tumor grade, p53 gene mutation was found in four of the 14 tumors with grade I and II, while three of 14 tumors with grade III, and IV were found to have p53 gene mutations. These observations suggest that, in contrast to bladder cancer, the incidence of p53 gene mutations does not related to the tumor stages and grades in transitional cell carcinoma of the renal pelvis. These results further indicate that p53 gene mutation may not represent a genetic marker of malignant potentials in transitional cell carcinoma of the renal pelvis.
Carcinoma, Transitional Cell* ; Exons ; Genes, p53* ; Genes, Suppressor ; Genes, Tumor Suppressor ; Genetic Markers ; Incidence ; Kidney Pelvis* ; Pelvis ; Polymerase Chain Reaction ; Urinary Bladder ; Urinary Bladder Neoplasms

PURPOSE: The purpose of this study was to identify the knowledge, attitude and preventive behaviors of tuberculosis in male high school students and to identify the factors influencing preventive behaviors and to provide basic data for the development of prevention programs for tuberculosis of male high school students. METHODS: This study was conducted from May 1, 2018 to May 30, 2018, and six high school students in S city and Y city of Jeonnam were selected. 465 male high school students in the first grade were selected. Collected data were analyzed using t-test, ANOVA, pearsons's correlation and Multiple regression analysis by SPSS/WIN 21.0 program RESULTS: As a result, the knowledge score was 11.92, the attitude score was 28.32 and the prevention behavior score was 30.07. All of these correlations were statistically correlated. In addition, factors influencing preventive actions against tuberculosis were attitude toward tuberculosis, exercise, health status, and sleep time CONCLUSIONS: Based on the above results, it is thought that to improve the preventive behavior of tuberculosis in male high school students, it is necessary to develop a practice-oriented program for forming healthy lifestyle as well as to change the attitude toward tuberculosis positively.
Humans ; Jeollanam-do ; Life Style ; Male* ; Tuberculosis*

Transitional cell carcinoma(TCC) of the urinary bladder shows marked heterogeneity in biological behaviors. Evidence has accumulated that biological markers may provide significant information to predict the potential aggressiveness of TCC. We have assessed the expression of the epidermal growth factor receptor (EGF-R), c-erbB-2 and p53 proteins in 56 cases of TCC to investigate the prognostic significance of differential expression of these oncoproteins using an immunohistochemical method. We analysed the expression patterns of these oncoproteins according to tumor stage and grade. And we assessed the probability of progression-free survival in stage T1 tumors according to their expressions. Positive rates of EGF-R (>+3 staining intensity), c-erbB-2 (intense membrane staining) and p53 proteins (>20% positive cells) were 73.2%, 37.5% and 42.9%, respectively. Invasive tumors had significantly higher positive rates of all three factors than did superficial tumors (p<0.005 for EGF-R and c-erbB-2, p<0.05 for p53). High grade tumors had significantly higher positive rates of c-erbB-2 and p53 proteins (p<0.005). In superficial tumors, T1 tumors had higher positive rate of p53 protein compared with Ta tumors (p<0.05). Twelve cases of superficial tumors (34.3%) were positive for EGF-R and negative for c-erbB-2 and p53 proteins. Nine cases of superficial tumors(25.7%) were negative for all three factors. In invasive tumors, however, 42.5% of the cases were positive for all three factors. The overexpression of p53 protein was the only useful marker to predict the rapid progression in stage T1 tumors (p<0.05, log-rank test). These results suggest that the differential overexpression of EGF-R, c-erbB-2 and p53 proteins could be useful to depict tumor aggressiveness of TCC of the urinary bladder. And, the overexpression of a p53 protein may be a useful marker to predict the possibility of rapid progression in stage T1 tumors.
Biomarkers ; Carcinoma, Transitional Cell* ; Disease-Free Survival ; Epidermal Growth Factor* ; Immunohistochemistry ; Membranes ; Oncogene Proteins ; Population Characteristics ; Receptor, Epidermal Growth Factor* ; Staphylococcal Protein A* ; Urinary Bladder*

BACKGROUND: Thrombotic thrombocytopenic purpura/hemolytic uremic syndrome (TTP/HUS) is a disease entity defined by the presence of thrombocytopenia and microangiopathic hemolytic anemia with or without fever, neurologic and renal symptoms. Therapeutic plasma exchange (TPE) has proven to be an effective treatment for TTP/HUS and has decreased mortality. We evaluated the effectiveness of TPE for TTP/HUS at the Department of Clinical Pathology, Samsung Medical Center during the last 6 years. METHODS: We assessed retrospectively the chief complaints, the clinical course, the treatment and the outcome in 17 TTP/HUS patients treated with TPE from December 1994 to May 2001. Minimal diagnostic criteria for TTP/HUS were unexplained thrombocytopenia and microangiopathic hemolytic anemia, with or without fever, neurologic, and renal symptoms. The range of ages of the patients was 15 to 63 years and the female to male ratio was 2:1. RESULTS: The most frequent clinical presentation was a renal problem (71%), followed by fever (53%) and neurologic symptoms (24%). The causes of TTP/HUS followed in the order of frequency: idiopathic (41%), suspicious for Escherichia coli O157: H7 infection (24%), systemic lupus erythematosus (18%), mitomycin C induced (12%), and preeclampsia (6%). A total of 229 TPE procedures were performed for 17 patients (mean: 13 procedures). The replacement fluids for TPE were fresh frozen plasma (59%) and cryosupernatant (41%). Thirteen patients (76%) survived and three of them relapsed (23%); however, they responded to further treatment. In comparing the laboratory results between pre and post TPE, significant changes were found in the white blood cells and platelet counts, creatinine, total bilirubin, and lactic dehydrogenase. The initial symptoms did not indicate a recurrence rate and a variety of drugs were used, except for corticosteroid administration. CONCLUSIONS: TTP/HUS patients responded well to TPE. The overall efficacy of TPE for TTP/HUS was 76%. The causes of TTP/HUS, the administered drugs and the replacement fluid did not affect the patient's prognosis.
Anemia, Hemolytic ; Bilirubin ; Creatinine ; Escherichia coli O157 ; Female ; Fever ; Hemolytic-Uremic Syndrome ; Humans ; Leukocytes ; Lupus Erythematosus, Systemic ; Male ; Mitomycin ; Mortality ; Neurologic Manifestations ; Oxidoreductases ; Pathology, Clinical ; Plasma Exchange* ; Plasma* ; Platelet Count ; Pre-Eclampsia ; Prognosis ; Recurrence ; Retrospective Studies ; Thrombocytopenia

Although paraovarian cysts rarely cause symptoms, they may be complicated due to massive size, torsion or internal hemorrhage from rupture. Moreover, benign or malignant neoplasms may occasionally develop in paraovarian cysts. We present a case of a 73-year-old patient who suffered from a twisted large left paraovarian cyst. The patient visited emergency room with a chief complaint of acute abdominal pain. The patient was treated with good result by laparoscopic surgery. The maximum diameter of the mass was 10cm which was twisted 3 1/2 times clockwise. In conclusion, paraovarian cysts, even in elderly patients, can reach large sizes requiring awareness of the possible complications caused by large cyst which could be treated successfully by laparoscopy.
Abdominal Pain ; Aged ; Emergencies ; Hemorrhage ; Humans ; Laparoscopy ; Rupture

Epidurally administered morphine is reported to produce analgesia in human. Epidural and intrathecal clonidine is also reported to produce analgesia and to prolong analgesic action of local anesthetics. This study was undertaken to evaluate the analgesic effects of the combination of epidural morphine and clonidine versus epidural morphine alone in patients with postoperative pain. 20 patients were scheduled for postoperative pain relief by epidural block. Patients were received either epidural morphine and clonidine(clonidine group: n=10) or morphine alone(morphine group: n=10) before general anesthesia. To compare clonidine group and morphine group in postoperative analgesia, we used Visual analogue scale(VAS), time and dosage of additional analgesics required and change of forced vital capacity(FVC). 1) There were no statistically significant differences in hemodynamic values during operation between two groups. 2) Although there was no statistically significant difference in postoperative analgesic effect between two groups, clonidine group showed some trend of analgesic effect during postoperative 24 hours. 3) There were no statistically significant differences between two groups in side effects. Epidural clonidine enhances the analgesic effect of epidural morphine clinically without causing more side effects.
Analgesia* ; Analgesics ; Anesthesia, General ; Anesthetics, Local ; Clonidine* ; Hemodynamics ; Humans ; Morphine ; Pain, Postoperative

Comparing with the simple general anesthesia, the combined thoracic epidural and general anesthesia generally provide with more improved regional endocardial perfusion, reduced myocardial oxygen consumption, eventually reduced postoperative morbidity and mortality. Patients undergoing thoracotomy have severe pain and related cardio-respiratory impairment postoperatively, so large amount of the analgesics are usually administered systemically. Recently, the method using epidural injection of the local anesthetics and/or analgesics is prefered during and after the operation because of its excellent analgesic action and advantage of lowering the need for anesthetics and systemic analgesics but has remaining problems such as eardiopulmonary and CNS depression and reduced motor function and so on. So, in an attempt to reduce the untoward effects of epidural injection, we planned to evaluate the validity of the mixing local anesthetic, bupivacaine, and narcotic analgesic, fentanyl, in a given concentration and infusion rate and randomized 70 patients undergoing thoracotomy into 4 groups. Group A(n=20): Intermittent intramuscular injection of nalbuphine hydrochloride in a dose of 0.2 mg/kg Group B(n=15): Continuous epidural infusion of fentanyl citrate, 2-5 ml/hr of 5 mcg/ml solution Group C(n=15): Continuous epidural infusion of bupivacaine hydrochloride, 2-5 ml/hr of 0.15% solution Group D(n=20): Continuous epidural infusion of mixtures of fentanyl and bupivacaine, 2-5 ml/hr of same concentrations We observed the visual analogue pain scale perioperatively and measured the hemodynamic parameters such as cardiac output, cardiac index, systemic vascular resistance, stroke volume, mean arterial pressure and heart rate. The results were as follows: I) The postoperative analgesic outcome was best in group D as compared with other groups. 2) The cardiac output decreased postoperatively in group A, B and C while group D showed an increase but there was no statistical significance. 3) The cardiac index decreased significantly in group B and sbowed a trend of decreasing in group C, increasing in group D, and no change in group A. 4) The stroke volume decreased postoperatively in group A and B but the significance was only in group A. 5) The systemic vascular resistance showed significant postoperative increase in group B. 6) The mean arterial pressure decreased in group D and increased in other groups. 7) The heart rate increased during and immediate after the operation in group B.
Analgesics ; Anesthesia, General* ; Anesthetics ; Anesthetics, Local ; Arterial Pressure ; Bupivacaine ; Cardiac Output ; Catheters* ; Depression ; Fentanyl ; Heart Rate ; Hemodynamics ; Humans ; Injections, Epidural ; Injections, Intramuscular ; Mortality ; Nalbuphine ; Oxygen Consumption ; Pain Measurement ; Perfusion ; Stroke Volume ; Thoracotomy ; Vascular Resistance

One-lung anesthesia can be very helpful to the surgeon during operations on the lung, mediastinum, esophagus, and thoracic aorta The standard method for one-lung anesthesia uses a double-lumen tube (Carlens, Robertshaw, etc). However, these tubes are diffieult to place and may not remain in a correct position. In addition, the lumen of each channel is inevitably too smaU for proper ventilation and suctioning. We have designed a new device for one-lung anesthesia which overcomes these disadvantages. This new device, named SLT (single-lumen tube), was made by amoured wire tube, the proximal end of which was connected to the Rusch rubber tube. So, this tube is larger in diameter, available in various sizes and very economic. We intubated 25 cardiothoracic patients with SLT under the fiberoptic guidance (Group A), and the other 25 cardiothoracic patients were intubated with Bobertshaw double-lumen tube by the direct laryngoscopy (Group B). There were no significant differences in heart rate, blood pressure, PH, PaCO2, PaO2 BE, HCO3, SaO2 and ETCO2 between the two groups compared with induction, one-lung ventilation, and two-lung ventilation values.
Anesthesia ; Aorta, Thoracic ; Blood Gas Analysis* ; Blood Pressure ; Esophagus ; Heart Rate ; Humans ; Hydrogen-Ion Concentration ; Laryngoscopy ; Lung ; Mediastinum ; One-Lung Ventilation* ; Rubber ; Suction ; Ventilation

PURPOSE: To determine the effect of anglulation between aorta the and renal artery on signal loss in theproximal renal artery, as seen on magnetic resonance angiography by phantom study using a pulsatile flow model. MATERIALS AND METHODS: Three phantoms of aorta and renal artery with angulation of 90 degree, 60 degree, and 30 degree wereobtained. Pulsatile recirculating flow (44%W/W glycerin, 60bpm) was used for MR angiography. First, axial 3D-TOFimages were obtained and reconstructed. MIP images were analyzed for the presence, area, and location of signalloss. 2D-PC images were obtained perpendicularly to the renal artery at a distance of 0, 4, 8 and 12mm from theostium. To calculate mean signal intensity of the renal artery, a ROI was drawn on 2D-PC images. To correlatesignal loss in 3D-TOF images with signal decrease in 2D-PC, we analyzed changes in signal intensity during onepulse cycle according to change of angulation and distance from the ostium of the renal artery by the calculatedvalues of relative signal decrease and ratio of signal decrease. RESULTS: A signal loss was observed up to 4mmfrom the ostium of the renal artery only in the case of the 90 degree phantom. Because the signal intensity measured inthe 2D-PC image of the 90 degree phantom was higher than that of the 60 degree phantom the signal loss observed in the3D-TOF images of the 90 degree phantom could not be explained by the magnitude of measured signal intensity alone.Relative signal decrease only at a distance of 0 and 4mm in the 90 degree phantom was evenly increased through a pulsecycle and the ratio of signal decrease at the same location was more than 50%. In contrast to the results of the90 degree phantom, those of 60 degree and 30 degree showed decreased of signal intensity mainly during the diastolic phase.CONCLUSION: Signal loss should become apparent at a certain angle between 60 degree and 90 degree. Decreased signalintensity causing signal loss in 3D-TOF was maintained throughout the systolic and diastolic phase of a pulsatilecycle and correlated with the ratio of signal decrease.
Angiography ; Aorta* ; Glycerol ; Magnetic Resonance Angiography ; Pulsatile Flow ; Renal Artery*

PURPOSE: Using proteomic analysis, this study was performed to see the characteristics of proteins expression in the muscles of spastic cerebral palsy patients. MATERIALS AND METHODS: We studied twelve specimens from six patients with spastic cerebral palsy, three patients with myelomeningocele, and three normal people who underwent orthopaedic surgeries due to trauma. We studied the extracted proteins showing differences in the two-dimensional electrophoresis, and the prominent thirteen proteins were re-evaluated by proteomics and the reverse transcriptional polymerase chain reaction, which was to clarify the relationship between gene and protein expression. RESULTS: Among fifteen proteins, six proteins were found to be higher in normal people, and nine were found to be higher in the groups of patients by spot histogram. The results of proteomic analysis with MALDI-TOF for fifteen proteins showed that the expression of DJ-1 was related to cerebral palsy. CONCLUSION: This study shows that strong expression of DJ-1 is related to spasticity and cerebral palsy. We showed for the first time the possibility of any relationship between spastic condition and DJ-1 expression.
Cerebral Palsy ; Electrophoresis ; Humans ; Meningomyelocele ; Muscle Spasticity ; Muscles ; Polymerase Chain Reaction ; Proteins ; Proteomics