Papillary carcinoma of the thyroid is a well differentiated neoplasm and usually has a good prognosis. However, a subset of morphologically distinct papillary carcinoma has bad prognoses. The tall cell variant of papillary carcinoma (TCPC), characterized by tall columnar cells with a height at least twice the width, is the one of these. In order to differentiate TCPC from usual papillary carcinoma (UPC) in terms of prognosis, we performed immunohistochemical studies for the expression of p53, bcl-2 and Leu-M1 proteins in 25 cases of TCPC, 26 cases of UPC and 14 cases of poorly differentiated, solid type papillary carcinoma (SPC) with an analysis of clinical parameters. The nuclear expression of p53 was noted in one case each of UPC and TCPC. The cytoplasmic p53 expression of TCPC, UPC, and SPC was observed in 17/25 cases (68%), 14/26 cases (54%), 3/14 cases (21%), respectively. bcl-2 expression was 19/25 cases (76%), 18/26 cases (69%), 5/14 cases (36%), and that of Leu-M1 was 21/25 cases (84%), 18/26 cases (69%), 4/14 cases(29%), respectively. There were no statistical significance in the expression of those immunoproteins among these three groups (p>0.05). The p53 protein was consistently expressed in the cytoplasm rather than nucleus in this study and was very well correlated to bcl-2 positivity (p<0.01). There were no statistical significance in any clinical parameters examined among these three groups (p>0.05). In conclusion, TCPC can not be separated from UPC as a distinct entity in this study and the cytoplasmic expression of p53 protein provides another mechanism of p53 inactivation in tumorigenesis of the thyroid papillary carcinoma, possibly by bcl-2 related mechanism.
Carcinogenesis ; Carcinoma, Papillary ; Cytoplasm ; Immunoproteins ; Prognosis ; Thyroid Gland* ; Thyroid Neoplasms*

Carcinosarcoma of the female genital tract, also called malignant mixed mullerian tumor (MMMT), is a rare and relatively aggressive tumor with various homologous and heterologous components. There have been various studies to find prognostic factors and to investigate the histogenesis, including tissue culture, electron microscopy, and immunohistochemical studies. We investigated carcinomatous, sarcomatous, and transitional areas of 6 cases of carcinosarcoma of the uterus and ovary by using epithelial and mesenchymal markers. Immunohistochemical profiles of the transitional areas were significantly different from those of carcinomatous and sarcomatous areas. Immunoreactivities for cytokeratin and epithelial membrane antigen (50% and 22.2%) were weaker than those of carcinomatous areas (95.2% and 100%), but stronger than those of sarcomatous areas (11.1% and 5.6%)(p<0.01). In transitional areas, vimentin, smooth muscle actin and S-100 protein were more strongly expressed than in carcinomatous areas, but more weakly expressed than in sarcomatous areas (p<0.01, p<0.01, and p=0.018, respectively). Myoglobin was entirely negative in carcinomatous areas and immunoreactive in minor portions of transitional and sarcomatous areas (22.2% and 16.7%, respectively). These results suggest that the transitional areas are between the carcinomatous and sarcomatous nature in differentiation, further supporting that the carcinosarcomas of the female genital tract may arise, through metaplastic change, from a type of carcinoma.
Actins ; Carcinosarcoma* ; Female* ; Humans ; Immunohistochemistry ; Keratins ; Metaplasia ; Microscopy, Electron ; Mucin-1 ; Muscle, Smooth ; Myoglobin ; Ovary ; S100 Proteins ; Uterus ; Vimentin

PURPOSE: Problem-based learning(PBL) experiences applied in the field of screening for chronic disease during the course of Community Medicine for the 3rd grade medical students were summarized. This study was aimed to train medical students the health appraisal ability and also the ability for public health education and promotion with health-oriented concept rather than disease-oriented one. And also it was aimed to train students to know what to learn and how to search the informations they need for themselves. STUDY SUBJECT AND METHOD: Three to four students in one team spent one and half days(Friday and Saturday) of one-week practical course of Community Medicine. Assigned materials were the medical records which are the files with the results of automated multiphasic screening tests which were applied to generally healthy people. Students were supposed to find, evaluate, solve or manage the real problems encountered from the multiphasic screening test results. RESULTS: The students accepted this self-directed learning process and small group discussion and also health-oriented human approach as new experiences and stimulants.
Chronic Disease* ; Community Medicine ; Education ; Humans ; Learning ; Mass Screening* ; Medical Records ; Multiphasic Screening ; Problem-Based Learning ; Public Health ; Students, Medical

Lovastatin, a competitive inhibitor of the rate limiting enzyme in cholesterol biosynthesis was administered to 34 patients with primary hypertlipidemia, 20 mg once daily with the evening meal. Patients experienced mean total and LDL cholesterol reductions of 30.9% and 34.0% respectively. HDL cholesterol level was significantly increased by 15.4% and plasma triglyceride level was decreased by 11.2%. maximal hypocholesterolemic effects were evident at 8 weeks, after which the effects were stable. Adverse effects were noted in 2 patients who had mild gastrointestinal symptoms, that subsided after discontinuing the drug. We concluded that lovastatin is a well tolerated and effective agent for the treatment of primary hyperlipidemia.
Cholesterol ; Cholesterol, HDL ; Cholesterol, LDL ; Humans ; Hyperlipidemias* ; Lovastatin ; Meals ; Plasma* ; Triglycerides

PURPOSE: The purpose of this research was to provide baseline data by utilizing solutions to health problems caused by work-related stress and to examine a way of treatment by comparing and analyzing how the stresses link to fatigue and quality of researchers' life. METHODS: A survey was conducted with 50 researchers working for in H research institute in Daejeon Metropolitan City from April 10th to May 10th, 2012 to examine the correlation of work stress, fatigue and quality of life. The data were analyzed using the Kruskal-Wallis test to look into examine the difference in work stress, fatigue, and quality of life. Also, the correlation of work stress, fatigue and quality of life was measured through by the Pearson correlation coefficient. The data collected through the questionnaires was were analyzed by SPSS 21.0 based on the significant level with a p-value, 0.05. RESULTS: The results showed that fatigue was caused by work stresses in researchers and quality of life was ranked in a relatively low level. Correlation of work stresses, quality of life and fatigue and work stresses against mental health index was negative and fatigue against physical index was also negative. CONCLUSION: It is necessary to maintain more detailed provisions in order to improve mental health and stress level of researchers. Moreover, systematic, in-depth evaluation should be done to reduce researcher's work-related stress and fatigue. In addition, stress management and prevention program should be implemented for these researchers.
Academies and Institutes ; Fatigue* ; Humans ; Mental Health ; Quality of Life* ; Surveys and Questionnaires ; Research Personnel

BACKGROUND/OBJECTIVES: Despite multiple approaches of treatments for salivary duct carcinoma, there has been a need for more successful treatment methods because of its poor prognosis. Treatment options like immunotherapy using new technologies have been attempted. Based on recent study results indicating that targeting programmed death receptors are effective in treating various cancers, this study aimed to identify the frequency of PD-L1 expression and its impact on survival rate in salivary duct carcinoma.MATERIALS #SPCHAR_X0026; METHODS: We studied 33 patients with salivary gland cancer who were available for histologic specimens. We examined the expression of PD-L1 in the tissues and analyzed the association with the survival rate and the association with various clinical parameters.RESULTS: According to this study and review of similar studies, we discovered that the expression of PD-L1 in salivary duct carcinoma was lower than other types of cancers. The impact of PD-L1 on survival rate also showed inconsistency in salivary duct carcinoma.CONCLUSION: Immunotherapy by PD-1/PD-L1 checkpoint blockade in salivary duct carcinoma needs further evaluation for clinical application.
Humans ; Immunotherapy ; Prognosis ; Receptors, Death Domain ; Salivary Ducts ; Salivary Gland Neoplasms ; Survival Rate

Continuous intravenous infusions of opioids can provide better pain relief than intermittent injection but may be associated with increased incidence of undesirable side effects including respiratory depression, nausea, vomiting and urinary retention. Ketorolac tromethamine is a new, nonsteroidal anti-inflammatory agent. It has significant analgesic properties without respiratory and cardiovascular depression. Mixing of opioids and ketorolac may lessen these complications without reducing analgesic effect. In six groups, we assessed the effect of postoperative pain control using morphine or fentanyl, ketorolac and droperidol, Each group consists of 100 patients. Patients in group 1, group 2, and group 3 received 2 mg of morphine via intravenous injection following the induction of anesthesia. Patients in group 1 were then continuously infused with additional 48 mg of morphine, patients in group 2 received additional 18 mg of morphine plus 120 mg of ketorolac, and patients in the group 3 were treated with the same protocol as group 2 but 2.5 mg of droperidol was added. For patients in group 4, group 5, and group 6 initially received 20 ug of fentanyl after induction of anesthesia. The rest of dose were treated with similar protocols as group I, group 2, group 3, respectively. In group 4, group 5, and group 6, morphine was substituted to 500 ug, 200 ug, and 200 ug of fentanyl, respectively. In all patients, initial dose of drug was given by bolus of intravenous injection and the rest of dose was delivered via intravenous using a Baxter Two Day Infusor or a Paragon 100. Pain scores and side effects were recorded every twelve hours for three days. No significant difference was found between the groups although pain control effect was excellent in all groups. Untoward effects were least in morphine or fentanyl-ketorolac-droperidol(group 3, group 6). It could be concluded that mixing of opioids, ketorolac and dtoperidol would be better than opioids alone.
Analgesics, Opioid ; Anesthesia ; Depression ; Droperidol* ; Fentanyl* ; Humans ; Incidence ; Infusion Pumps ; Infusions, Intravenous* ; Injections, Intravenous ; Ketorolac Tromethamine* ; Ketorolac* ; Morphine* ; Nausea ; Pain, Postoperative* ; Respiratory Insufficiency ; Urinary Retention ; Vomiting

No abstract available.
Humans ; Interleukin-2* ; Interleukins* ; Kidney Failure, Chronic* ; Plasma*

Goltz syndrome is known as a rare mesoectodermal hereditary disease, characterized by focal dermal atrophies with hernias of adipose tissue and also associated with a multitude of possible skeletal, dental, ophthalmological and other abnormalities. We experienced a case of Goltz syndrome. An one day old female newborn had focal atrophic and telangiectatic skin lesions, microphthalmia, syndactyly and urinary tract abnormality. The finding of skin biopsy was consistent with focal dermal hypoplasia. We report the case with a brief review and related literatures.
Adipose Tissue ; Atrophy ; Biopsy ; Female ; Focal Dermal Hypoplasia* ; Genetic Diseases, Inborn ; Hernia ; Humans ; Infant, Newborn ; Microphthalmos ; Skin ; Syndactyly ; Urinary Tract

No abstract available.
Histiocytosis, Langerhans-Cell*