Tumor cell resistance to cytotoxic drug is thought to be a major cause of failure in the chemotherapeutic treatment of malgnant tumors. Multidrug resistance (MDR) is associated with r expression of the MDRl gene encoding P-glycoproteintP-gp). an active efflux pump for various limphophilic compounds. P-gp was generally expressed in normal tissue and tumor. In our present investigation. we examined the expression of P-gp in human transitional cell carcinoma and normal tissue. 1. From April to June. 1992. 13 patients with transitional cell carcinoma(11 cases in bladder. cases in renal pelvis) and 5 specimens of normal urinary bladder tissue were used. 2. We stained these frozen tissue with JSB-1 (MONOSAN(R)) by immunehistochemistry. 3. The tissue sample was classified as weakly positive. moderately positive and strong positive respectively to the immunohistochemical staining under the light microgcopical observation. The weakly positive means that if the sample cell was stained with less than the fine reddish brown colored particles. The strong positive presents the cell nuclei was not seen by light microscopic examination because the cell was heavily stained with large reddish brown colored granules. In between weakly and strong positive was named as moderate positive. 4. 7 out of 13 transitional cell carcinoma showed Ash grade II,4 of this 7 belongs to moderately positive and the rest 3 of this 7 were strong positive class. All 6 cases of stage B, C, D transitional cell carcinoma belongs to moderate positive class. On the basis of the results, this study suggested that the normal bladder tissues and transitional cell carcinoma contain certain amount of P-gp. The author could conclude that there is no closerelation between the tissue staining classification.
Carcinoma, Transitional Cell* ; Cell Nucleus ; Classification ; Drug Resistance, Multiple ; Humans ; P-Glycoprotein* ; Urinary Bladder

We described the clinical manifestation of herpes zoster in thirteen children with underlying malignancies. Among the associated malignancies, hematologic malignancy including acute lymphotytic leukemia was the commonest and CNS tumors were also frequently associated. Pain was mild, and some showed high fever and abnormal liver function test results. Recurrent attacks were observed in 3 cases(23%). Thoracic segment and trigeminal nerve were commonly affected. In most cases, herpes zoster developed within two years after the diagnosis of the malignancy.
Child* ; Diagnosis ; Fever ; Hematologic Neoplasms ; Herpes Zoster* ; Humans ; Leukemia ; Liver Function Tests ; Trigeminal Nerve

Xanthogranulomatous pyelonephritis is an uncommon form of chronic bacterial infection of the kidney that may occur at any age but is most often seen in middle-aged or older women. Xanthogranulomatous pyelonephritis in children is very rare. We report a 2-year-4-month-old male hospitalized with complaints of palpable abdominal mass. Excretory urography, abdominal sonogram, abdominal computed tomogram showed hydronephrosis with right renal stones and ureteropelvic junction obstruction. It was treated with right nephrectomy. Pathologic findings revealed xanthogranulomatous pyelonephritis postoperatively. This case is a xanthogranulomatous pyelonephritis occurred in the most youngest age in Korean literatures.
Bacterial Infections ; Child* ; Female ; Humans ; Hydronephrosis ; Kidney ; Male ; Nephrectomy ; Pyelonephritis, Xanthogranulomatous* ; Urography

Nimodipine the potent, centrally active, clacium channel blocker, is known to increase cerebral and spinal blood flow. In the present study, the authors investigated the effect on Nimodipine on injured spinal cord. The experiment was a randomized blind study in which four groups of five cats received Nimodipine(0.05mg/kg) intravenously, and control groups of five cats received only Diluent. As a step in the investigation of the possible effect of spinal cord trauma on biochemical and ultrastructural changes in the injured cord, activities of lipid peroxidation were measured in the frozened-dried sample of the spinal cord and fine structure of the mylinated nerve fiber in the white matter were observed. An increase of lipid peroxidation level was found as early as 1 hour after the injury and the highest concentration was reached at 5 hours after the injury(P<0.01). Fine structures of the myelinated nerve fibers were changed progressively with the lapse of time after the injury. The effect of Nimodipine on lipid peroxidation and fine ultrastructural changes of myelinated nerve fibers were studied, and the result of this study revealed that Nimodipine groups showed a lower level of lipid peroxidation with statistical significance(P<0.05) and preservation of ultrastructural myelinated nerve fiber was prominent.
Animals ; Cats ; Lipid Peroxidation ; Nerve Fibers ; Nerve Fibers, Myelinated ; Nimodipine* ; Spinal Cord Injuries* ; Spinal Cord*

Human brucellosis is a newly emerging infectious disease in Korea, and the number of the patients with this disease has rapidly increased in recent years. To evaluate the most reliable method in diagnosing human brucellosis, a retrospective study was conducted. Medical records of patients admitted or followed-up at the outpatient department of a tertiary care university hospital during the past 5 years were reviewed. Among a total of 32 human brucellosis patients (24 males and 8 females), 21 (65.6%) were positive for standard tube agglutination test (STA) but negative for blood or bone marrow culture, 7 (21.9%) were positive for both STA and culture, and 4 (12.5%) were STA negative but culture positive. Based on these findings, we recommend that physicians include blood and/or bone marrow culture to obtain definitive diagnosis when clinical symptoms and signs strongly suggest the human brucellosis, even when STA is negative.
Agglutination Tests ; Bone Marrow ; Brucellosis ; Communicable Diseases, Emerging ; Humans ; Korea ; Male ; Medical Records ; Outpatients ; Retrospective Studies ; Tertiary Healthcare

BACKGROUND: Granisetron, a new 5-HT3 receptor antagonist, was reported as a highly effective antiemetics, especially in combination with dexamethasone, in the prevention of acute emesis induced by cisplatin. But there is lack of data about effectiveness in the prevention of delayed emesis. In this study, the efficacy of granisetron plus dexamethasone in the prevention of delayed emesis induced by cisplatin was evaluated. MATERIALS AND METHODS: Sixty-four patients who were to receive high-dose cisplatin containing chemotherapy regimen were enrolled in this study. They were received 20 mg of dexamethasone and 3 mg of granisetron at 30 min and 10 minutes prior to cisplatin infusion, respectively. They were monitored for 5 days, first 24 hours for acute nausea/ vomiting and the subsequent 4 days for delayed nausea/vomiting. Antiemetic effect of granisetron was evaluated according to the criteria of Italian Group of Antiemetic Research. RESULTS: Control of delayed nausea and vomiting was achieved in 58% and 84%, respectively. Eastern Cooperative Oncology Group performance status was a statistically significant prognostic factor for control of acute vomiting and delayed nausea/vomiting. There were no stastically significant differences between control of delayed nausea/ vomiting and other prognostic factors, including sex, age, and prior history of cisplatin therapy. The antiemetic effect was greater in the patients who had controled acute nausea/ vomiting than those who had not. CONCLUSION: Granisetron plus dexamethasone is an excellent regimen in the control of not only acute emesis but also delayed emesis induced by high-dose cisplatin chemotherapy.
Antiemetics ; Cisplatin ; Dexamethasone* ; Drug Therapy ; Granisetron* ; Humans ; Nausea* ; Receptors, Serotonin, 5-HT3 ; Serotonin ; Vomiting*

Primary cervical carcinosarcoma is very rare malignancy with fewer than 50 documented cases in the literature, which is a histologic variant of cervical cancer. In addition, sarcomatoid squamous cell carcinoma has been described in only 4 prior cases. We experienced a case of 42 year-old female with sarcomatoid squamous cell carcinoma of the uterine cervix. We report this case with a brief review of literatures.
Adult ; Carcinoma, Squamous Cell* ; Carcinosarcoma ; Cervix Uteri* ; Female ; Humans ; Uterine Cervical Neoplasms

PURPOSE: After the first umbilical cord blood transplantation was reported in 1988, the use of cord blood as a source of hematopoietic stem cell instead of allogeneic bone marrow increased surprisingly and currently in the worldwide, more than 1,000 cases of cord blood transplantation were reported. We, herein, report the nine cases of cord blood transplants in Korea (Jul. 1996 - Jan. 1999). METHODS: The study of childhood cord blood transplantation from July 1996 to January 1999 were analyzed. 1. Patient population 1) Diseases on patients receiving umbilical cord blood transplantation included 3 aplastic anemia (1 Fanconi's anemia), 3 acute myelogenous leukemia, 1 acute lymphoblastic leukemia, 1 chronic myelogenous leukemia and 1 Gaucher disease. 2) Patients included 5 males and 4 females and were aged a range of 1~15 years (median 5 years), and a range of body weight at transplantation was 10 kg~50 kg (median 20 kg). 3) Four cases were used related cord blood as a source of stem cells for the transplant and 5 cases were used unrelated cord blood. In unrelated cord blood transplantation, cord blood was provided by Catholic Cord Blood Bank in 4 cases and by Samsung Medical Center in 1 case. 4) Only one case had a HLA-compatible cord blood graft. Two cases had 1 HLA antigen disparate grafts, 4 cases had 2 HLA antigen disparate grafts and 2 cases had 3 HLA antigen disparate grafts. 2. Transplantation Procedures 1) The total number of nucleated cells infused was 0.2+/-13x107/kg (median number 4.4x107/kg) and the number of CD34+ cells was 0.4+/-9.4x105/kg (median number 3.3x105/kg). 2) Patients received a variety of preparative regimens that varied with the disease and disease state at time of transplantation. All patients received ATG as a part of preparation. 3) While several regimens were used for prophylaxis of GVHD, 3 patients received cyclosporine A and methylprednisolone, 3 patients received cyclosporine and methotrexate, 2 patients received cyclosporine A alone and 1 patients received cyclosporine A, methtrexate and prednisolone. RESULTS: 1. The 6 cases of total 9 cases have successed to engraft persistently and the rate of engraftment was 67%. Two of 3 cases in severe aplastic anemia failed to engraft, 1 case failed to transplant due to rejection of grafts. All 5 cases in leukemia have successed to engraft. 2. On 6 cases of engraftment, the time to achieve an absolute neutrophil count (ANC)> or =0.5x109/L, > or = 1.0x109 /L was 10~37 days (median 13 days) and 11~40 days (median 14 days), respectively, and platelet count > or = 30x109/ L was 15~114 days (19.5 days). 3. Two of evaluable 7 cases had grade II acute GVHD and cured by steroid. 4. Seven of 9 cases (77.8%) survive (2~32 months; median 11 months) after transplantation. Five of 7 surviving cases (55.6%) live with disease-free (2~11 months; median 5 months). Four of 5 patients with leukemia (80%) live without relapse (2~11 months (median 5months). 5. The complications associated with cord blood transplantation were 2 sepsis, 2 CMV infections, 1 hemorrhagic cystitis and venoocclusive disease. 6. Two of 9 patients died of 1 graft failure and 1 venoocclusive disease. CONCLUSION: Cord blood transplantation is curative strategy for the treatment of children with malignant disease and inborn error of metabolism. For aplastic anemia and myelodysplastic syndrome, the role of cord blood transplantation would be investigated.
Anemia, Aplastic ; Body Weight ; Bone Marrow ; Child ; Cord Blood Stem Cell Transplantation* ; Cyclosporine ; Cystitis ; Female ; Fetal Blood* ; Gaucher Disease ; Hematopoietic Stem Cells ; Humans ; Korea ; Leukemia ; Leukemia, Myelogenous, Chronic, BCR-ABL Positive ; Leukemia, Myeloid, Acute ; Male ; Metabolism ; Methotrexate ; Methylprednisolone ; Myelodysplastic Syndromes ; Neutrophils ; Platelet Count ; Precursor Cell Lymphoblastic Leukemia-Lymphoma ; Prednisolone ; Recurrence ; Sepsis ; Stem Cells ; Transplantation ; Transplants ; Umbilical Cord*

BACKGROUND/AIMS: Medical students face the threat of acquiring blood-borne infections such as HIV, Hepatitis B and Hepatitis C during their clinical activities in clerkship. This study determined the frequency of exposure and the risks of exposure to blood and body fluids among medical students. METHODS: An anonymous questionnaire was administrated to the 4th year medical students in a tertiary academy university hospital. RESULTS: The surveys were completed by 124 students (100% of the students). Seventy-one percent (88 cases) reported more than one time of exposure to blood or body fluids during the consecutive 2 years of clinical rotation. Single needle stick injury occurred for 19.3% of the students, both exposure to needle stick and splash occurred for 40.9% and single splash occurred for 39.8% of the 88 cases. Venipucture was the highest exposure event (50%), and the other causes were scrub (35.2%), bedside procedures (35.2%), arterial puncture (22.7%), lancet (13.6%), suture (5.7%) and others (8%). The emergency department had the highest exposures rate (80.7%), and this was followed by general surgery (33%), neurosurgery (8%), orthopedic surgery (8%), plastic surgery (6.8%), obstetrics-gynecology (5.7%) and others (10.1%). The major exposure sites in the hospital were the emergency room (81.8%), operation room (38.6%), intensive care unit (8%), general ward (6.8%) and others (2.3%). Only nineteen cases (21.6%) of hospital exposure were reported to the appropriate medical personnel. CONCLUSIONS: This study shows medical students have the potential risk of health care related infection when they are exposed to many patients in the emergency department without a supervisor being present. To avoid the occurrence of these problems, preventive education, and particularly the practice of universal precaution, should be taken by the medical students before beginning their clinical activity.
Anonyms and Pseudonyms ; Body Fluids ; Collodion ; Delivery of Health Care ; Emergencies ; Hepatitis B ; Hepatitis C ; HIV ; Humans ; Intensive Care Units ; Needles ; Needlestick Injuries ; Neurosurgery ; Orthopedics ; Patients' Rooms ; Punctures ; Students, Medical ; Surgery, Plastic ; Sutures ; Universal Precautions ; Surveys and Questionnaires

No abstract available.
Brain Neoplasms* ; Brain* ; Child* ; Humans ; Infant*