No abstract available.
Anxiety* ; Arachnoid*

The retinoblastoma (Rb)/cyclin D1/p16 pathway is an important constituent of cell cycle regulation. Perturbations in this pathway due to a variety of genetic aberrations have been reported in many human cancers including breast cancer. We examined the significance of immunoexpression of p16 protein, cyclin D1 protein, Rb protein (pRb), and p53 protein in 128 cases of invasive breast carcinoma. The results were correlated with survival rate and clinicopathological variables, including age, histologic grade, lymph node status, tumor size, estrogen receptor (ER), and progesterone receptor (PR) content. Abnormal expressions of p16 and pRb which were defined as negative staining were seen in 21% and 43% of tumors, respectively. There was a significant inverse relationship between p16 and pRb expression. There was no correlation between p16 staining and any other parameters, including survival rate, cyclin D1, p53, and clinicopathologic variables. Surprisingly, there was a trend for tumors which were positive for pRb to be grade III ductal carcinomas. Cyclin D1 positivity was noted in 46% of cases. The expression of cyclin D1 protein was significantly higher in lower histologic grade, higher ER and PR expression. The expression of p53 protein showed a significant correlation with high tumor grade. In a Cox multivariate analysis, neither p16, pRb, cyclin D1 nor p53 was an independent predictor, but tumor size and lymph node status were independent predictors of patient outcome.
Breast Neoplasms ; Breast* ; Carcinoma, Ductal* ; Cell Cycle ; Cyclin D1* ; Cyclins* ; Estrogens ; Humans ; Lymph Nodes ; Multivariate Analysis ; Negative Staining ; Receptors, Progesterone ; Retinoblastoma ; Retinoblastoma Protein ; Survival Rate

In this study of 64 cases of breast cancer with a clinical follow-up period of more than 5 years, several prognostic factors were evaluated. The purpose of this study was to determine whether any one parameter or group of parameters serves as adequate predictors of tumor behavior and patient's prognosis. Several prognostic factors included clinicopathological variables (patient's age, histologic grade, status of lymph node (LN) metastasis, and tumor size), expression of estrogen receptor (ER), progesterone receptor (PR), p53, bcl-2 and CD44 by immunohistochemistry, and DNA ploidy pattern. The results showed that the expression of ER and PR had a significant inverse correlation with the histologic grade (ER, p=0.05; PR, p<0.05). The expression of p53 protein showed a significant relationship with high histologic grade of tumor (p<0.05). The expression of bcl-2 protein was preferably seen in low histologic grade of tumor (p<0.05) and significantly associated with ER positive or PR positive tumors (ER, p<0.05; PR, p<0.05). This results suggest that bcl-2 protein might play significant roles in ER and PR. The CD44 expression showed a significant relationship with tumor size (p<0.05). The large size and aneuploidy pattern of tumor had a tendency to be associated with shorter patient survival. Cox's multivariate analysis showed that overall survival was affected by LN metastasis because of the shorter survival in patients with LN metastasis. In conclusion, tumor size, DNA ploidy pattern, and LN metastasis were themselves significant predictors of breast cancer survival rate.
Aneuploidy ; Breast Neoplasms ; Breast* ; Carcinoma, Ductal* ; DNA* ; Estrogens ; Follow-Up Studies ; Humans ; Immunohistochemistry ; Lymph Nodes ; Multivariate Analysis ; Neoplasm Metastasis ; Ploidies* ; Prognosis ; Receptors, Progesterone ; Survival Rate

The North American Symptomatic Carotid Endarterectomy Trial (NASCET) demonstrated the superiority of endarterectomy over medical management for symptomatic carotid stenosis of 70-99%. More recently, the Asymptomatic Carotid Atherosclerosis Study (ACAS) showed a statistically significant reduction in stroke incidence after carotid endarterectomy (CEA) in asymptomatic carotid stenosis of 60-99%. But CEA has not been frequently performed in Korea. We reviewed the 38 CEA cases which were performed from November 1994 to September 1996 in respect to clinical presentations, findings of brain and neurovascular imaging, and complications. The risk factors were hypertension in 25 patients, hyperlipidemia in 23, smoking in 20, transient ischemic attack (TIA) in 20, minor stroke in 12, heart disease in 17 (coronary artery disease in 16 and sick sinus syndrome in 1), and DM in 13. The clinical presentations of 28 symptomatic carotid stenosis included hemispheric TIA in 17 patients, retinal TIA in 2, and minor stroke in 9. Of 10 asymptomatic carotid stenosis included coronary heart disease in 7 patients, asymptomatic carotid bruit in 3, posterior cerebral artery territory infarction in 4, and vascular claudication in 1. The degrees of carotid artery stenosis were measured by use of the linear-based methods of NASCET on the selected carotid angiography. The locations of carotid artery stenosis were near the bifurcation area in 28 cases, proximal ICA in 9, and common carotid artery in 1. Four out of 9 cases with proximal ICA stenosis at above 2 cm distal to bifurcation had long segmental stenosis more than 3 cm in length. Among them 3 cases had separated multi-segmental stenosis of proximal ICA. CEA was performed unilaterally in 28 patients and bilaterally in 5. Thirty0eight CEAs had carotid artery stenosis of 70-99% in 25 cases (4 had ulceration), 50-69% in 7 (2 had ulceration), 30-49% in 3 (all had ulceration), and 0-29% in 3 (all had ulceration). Of 38 CEAs 7 cases had stenosis (>50%) and/or occlusion of intracranial arteries and 15 had stenosis and/or occlusion of contralateral carotid artery. Peri-operative complications included minor ischemic stroke in 1 case, death in 1, and frontal lobe syndrome in 1.
Angiography ; Arteries ; Brain ; Carotid Arteries ; Carotid Artery Diseases ; Carotid Artery, Common ; Carotid Stenosis ; Constriction, Pathologic ; Coronary Disease ; Endarterectomy ; Endarterectomy, Carotid* ; Frontal Lobe ; Heart Diseases ; Humans ; Hyperlipidemias ; Hypertension ; Incidence ; Infarction ; Ischemic Attack, Transient ; Korea ; Posterior Cerebral Artery ; Retinaldehyde ; Risk Factors ; Sick Sinus Syndrome ; Smoke ; Smoking ; Stroke

The percutaneous pinning is a simple, effective method for the treatment of displaced supracondylar fractures of the humerus in children. But there is some controversy in the number of pins used and the method of pin insertion. The cross pinning method provides more stability at the fracture site but the risk of ulnar nerve damage is higher than in lateral pinning method, The senenty-one displaced extension type supracondylar fractures were treated by closed reduction and percutaneous cross pinning from January 1991 to October 1994. Among them, the medial pin was inserted in elbow extension in twenty-eight cases and in forty- three cases the medial pin was inserted in elbow flexion. Ulnar nerve injury occured postoperatively in six cases, in which the pin was inserted with the elbow in flexion position. These results may suggest that when percutaneous cross pinning method is selected to fix the supracondylar fracture of the humerus, it would be safer to insert one or two lateral pins with the elbow in full flexion position followed by one medial pin in extension position in order to reduce the risk of loss of reduction and ulnar nerve damage.
Child ; Elbow ; Humans ; Humerus ; Methods ; Ulnar Nerve

OBJECTIVES: This study was designed to investigate the association between Ser311/Cys311 polymorphism in the dopamine D2 receptor gene and bipolar disorder in korean population. METHOD: Ser311/Cys311 polymorphism in the dopamine D2 receptor gene was typed with PCR in 86 bipolar disorders and 100 normal controls. RESULTS: Genotype of Ser/Ser, Ser/Cys, Cys/Cys were 82 (95.3%), 4 (4.7%), 0 (0.0%) respectively in the bipolar disorders, 96 (96.0%), 4 (4.0%), 0 (0.0%) respectively in the controls. Allele frequencies of Ser and Cys were 168 (97.7%), 4 (2.3%) in the bipolar disorders, 196 (98.0%), 4 (2.0%) in the controls. There were no differencies in genotype distribution and allele frequencies of dopamine D2 receptor gene polymorphism Ser311/Cys311 between in the bipolar disorders and in the controls. CONCLUSION: These result suggests dopamine D2 receptor gene polymorphism Ser311/Cys311 is not causally related to the development of bipolar disorder in korean population.
Bipolar Disorder* ; Gene Frequency ; Genotype ; Polymerase Chain Reaction ; Receptors, Dopamine D2

In this study, the number of physicians presently living in Korea thoroughly estimated by several means and, on this bases, their productivity and level of supply were estimated. The results were as follows : First, the number of physicians who did not notify the Korea Medical Association in May 1987 were 10,110, including 4,093 emigrant physicians(40.5%), 861 military medical officers, 745 public health doctors, and 107 decreased physicians. A total of 1,330 physicians could not be identified by any effort. Second, among the 34,897 registered physicians as of May 1987, 29,933(85.8%) were residing in Korea, 4,115 physicians(11.8%) had emigrated to other countries, and 849 physicians(2.4%) were decreased. Practicing physicians defined as those in Korea who were not retired, serving in the military, or completing residencies or internships, comprised 78.6%(27,414 physicians) of the total number of registered physicians. Third, it is estimated that in the year 2000 the number of registered physicians, physicians residing in Korea, and practicing physician will be 75,040, 64,038 and 57,655, respectively and these are increases of 115.0%, 113,9%, and 110.3%, respectively, compared to 1987. Fourth, the population physician ratio will be 759 to one physician in the year 2000. Fifth, the productivity of physicians, as calculated by relative values defining the productivity of 35 to 44 year-old male physicians as 10, will increase 110.7% in the year 2000 compare to that of 1987, and this increment is almost the same level as that of physicians supply. From the results of the present analysis of physicians manpower and supply projection, it can be recognized that the development of a regular notification system is necessary in order to identify precisely the number of physicians. Also a policy a physician supply is essential in order to adjust in advance the number of physicians, otherwise there will be surplus to the medical demand.
Adult ; Efficiency ; Emigrants and Immigrants ; Humans ; Internship and Residency ; Korea* ; Male ; Military Personnel ; Public Health

A Fourier transform infrared spectrophotometric method was described for the determination of quartz, mica(sericite) and feldspar(potassium feldspar) in respirable dust in Taebaek area. The results were as follows; 1) The concentration of minerals were determined from the intensity of absorption peak of quartz at 799 cm-1, sericite at 539 cm-1, and potassium feldspar at 648 cm-1 respectively. 2) The precision(C. V. %) for the quartz determination was 7.70+/-2.68 % from 10 to 200 microgram of quartz. 3) The precision for the sericite determination was 16.34+/-6.82 % from 30 to 500 microgram of serictite. 4) The precision for the potassium feldspar determination was 5.28+/-1.74 % from 30 to 500 microgram of potassium feldspar. 5) The concentration of respirable dust in Taebaek area was 4.90+/-3.29 mg/m3(0.4-93.7%), percent quartz was 1.80+/-4.14% (0.01-20.56%), percent sericite was 11.37+/-6.43% (0.00-29.69%), percent potassium feldspar was 8.15 % (n=7, 3.41-19.70%). 6) The difference of respirable coal dust, quartz, and sericite concentration in drilling, coal cutting, hauling and separating was significant respectively (p<0.05).
Absorption ; Coal ; Dust* ; Fourier Analysis* ; Minerals ; Potassium ; Quartz* ; Spectrophotometry, Infrared*

It has been known that CT scan shows only a few abnormalities within the first hours of acute ischemic stroke. We investigated the frequency and the predictive value of early CT scan signs of ischemia for late infarct locations In acute middle cerebral artery (MCA) territory stroke. Precontrast CT (PCT) scans were performed in the 35 consecutive patients with cerebral anterior circulation infarction within 6 hours after the onset of stroke. We confirmed MCA territory infarction on follow-up PCT or MRI within 3 to 7 days. The locations of infarction were classified deep, superficial, and total (deep and superficial) infarction on follow-up PCT or MRI. The initial PCT was abnormal in 74.3% (26/3s). The locations of infarction were deep in 10, superficial in 8, and total in 14. Abnormal findings of the initial PCT were attenuation of lentiform nucleus (ALN) in 18 patients, loss of insular ribbon (LIR) in 11, hemispheric sulcus effacement (HSE) in 10, hyperdense MCA sign (HMCAS) in 2, and small subcortical low attenuation in 2. Of 24 patients with late infarction in basal ganglia 18 (75%) had ALN on initial PCT. Of 17 patients with late infarction in insular cortex 11 (65%) had LIR. Of IS patients with late infarction in cerebral cortex 10 (67%) had HSE. Early PCT signs were correlated with late locations of MCA territory infarction : ALN - deep infarct, HSE - superficial infarct, LIR - superficial infarct, HMCAS - total infarction. Our findings suggest that PCT frequently discloses abnormalities during the first hours of ischemic stroke. Early signs of ischemia on the initial PCT scan may predict the late infarct locations on follow-up study.
Basal Ganglia ; Cerebral Cortex ; Corpus Striatum ; Follow-Up Studies ; Humans ; Infarction ; Ischemia ; Magnetic Resonance Imaging ; Middle Cerebral Artery* ; Stroke* ; Tomography, X-Ray Computed*

BACKGROUND: The number of patients of doxylamine overdose has increased, but there were little clinical reports. The purpose of this study is review the patients of doxylamine overdose for aid clinical decision making of patients disposition. METHODS: We reviewed medical records of patients who ingested doxylamine succinate retrospectively from Jan. 1, 1996 to Dec. 31. 1996. Data that was recorded were followed: age, sex, psychiatric history, amounts of ingestion, time interval from ingestion to arrival to hospital, initial vital signs and symptoms, EKG, chest PA, Lab. findings, treatment, patients disposition, length of hospital stay, complication. RESULTS : 1) Total number of patients was ninety and average dosage of ingestion was 1062mg. 2) Tachycardia was the most frequent anticholinergic symptom(46%). 3) Routine lab. findings was not abnormal except one patient who was diagnosed as Rhabdomyolysis. 4) Gut decontamination was performed in patients who had arrived at hospital in 2-3 hours, and who had ingested large dose of drug. 5) Five patients were admitted to Psychiatric dept. and one patient was admitted to emergency dept. for treatment of rhabdomyolysis. 6) The mean duration of hospital stay was 6.5 hours. CONCLUSION: The patients who ingested overdose of doxylamine was managed safely in emergency department, but we should warn against the possibility of rhabdomyolysis.
Decision Making ; Decontamination ; Doxylamine* ; Eating ; Electrocardiography ; Emergencies ; Emergency Service, Hospital ; Humans ; Length of Stay ; Medical Records ; Retrospective Studies ; Rhabdomyolysis ; Succinic Acid* ; Tachycardia ; Thorax ; Vital Signs