Tumor angiogenesis(TA) refers to the growth of new vessels toward and within a tumor. TA is necessary both at the beginning and at the end of the metastatic cascade of events. Recently, experimental evidence suggests that the growth of a tumor beyond a certain size requires angiogenesis. To investigate how tumor angiogenesis correlates with metastases in breast carcinoma, the microvessels were counted (per 200 / field) in the most active areas of neovas-cularization by two investigators. The microvessels within breast carcinoma were highlighted by in imunohistochemical staining for factor VIII-related antigen. Microvessel count(MVC) in node-positive carcinoma(59.66=35) was significantly higher than in node-negative carcinoma(44.76=17)(p=0.009). MVC was also statistically correlated with tumor size and stage, but not with histologic grading, DNA ploidy, or hormonal receptors(estro-gen and progesterone). MVC in invasive breast carcinoma may be one of many prognostic predictors of node-positive breast carcinoma. Assessment of tumor angiogenesis may therefore be valuable in selecting patients with early breast carcinoma for aggressive therapy.
Neoplasm Metastasis

The purpose of this study was to identify the degree of self-care activities of stroke patients, the family burden, and the educational needs of primary caregivers. A descriptive survey research was conducted in 97 stroke patients and their respective primary caregivers. Data were collected the using 26th to by interviews a structure questionnare from July August 5th, 1999. NIH stroke status was 12.15+/-8.40, the degree of self-care activities of stroke patients was 26.85+/-9.39. The score of objective burden of primary caregivers was 31.24+/-4.81 and subjective burden was 24.30+/-6.99. The score of the educational needs was 89.78+/-9.99. We present several imformations about clients from these scores as follows: The patients were convalescent and their depentant level of self-care was middle range: The objective burden was higher than the subjective burden: And the educational needs of family caregivers were very high. The Elain Mattis Educational Wants of Family Caregivers of Disabled Adults Questionnaire was used to assess the educational needs of primary caregivers of stroke patients. The results of this research are offered to help nurses understand the feelings of uncertainty about the new and unexpected role that family caregivers face and to help nurses meet the needs of families preparing to care stroke survivors at home.
Adult ; Caregivers* ; Humans ; Surveys and Questionnaires ; Self Care* ; Stroke* ; Survivors ; Uncertainty

An immunohistochemical and electron microscopic study of an atypical fibroxanthoma of the skin (AFX) was reported. The lesion developed on the left scapulararea in a 70-year-old man. The result using antibody to S-100 protein was negative and the tumor cells observed with electron microscope were undifferentiated, fibroblast-like, histiocyte-like and multinucleated giant cells. But Langerhans-like cells or Langerhans were not found.
Aged ; Giant Cells ; Humans ; S100 Proteins ; Skin*

Dariers disease is a domirantly inherited skin disease that is characterized by keratotic papules predominantly on the sebornieic areas, palmar pits, and a nail dystrophy. The diagnosis is difficult in the small group with flexural involvement because the features of flexural Dariers disease overlap clinically and histolopica.lly with those of Hailey-Hailey disease. The diagnosis of Dariers disease may be confirmed if the patient has the pathognomonic nail dystrophy. We presents a case of flexured. Dariers disease in a 65 year old woman. She has suffered from skin lesions which have some resemblance to those of Hailey-Hailey disease. We could diagnose her skin lesions as Dariers disease because she had the eharacteristic nail dystrophy.
Aged ; Darier Disease ; Diagnosis ; Female ; Humans ; Pemphigus, Benign Familial ; Skin ; Skin Diseases

Most neonatal cutaneous hemangiomatosis are complicated by visceral involvement and. are associated with a high mortality rate in the first month of life. Some neonates with multiple cutaneous hemangiomas, however, may follow a benign course of spontaneous resolution without visceral involvement. Such cases are called benign neonatal hemangiomatosis (BNH). BNH is characterized by a lack of mucosal or symptomatic visceral involvement. rapid spontaneous regression of cutaneous hemangimas, and an excellent prognosis. We report herein a case of BNH which is atypical compared to previously reported BNFI cases. Our patient had a more prolonged course than those of usual cases with BNH and showed a conjunctival involvement.
Hemangioma* ; Humans ; Infant, Newborn ; Mortality ; Prognosis

Cholesteatoma in the kidney and ureter are accumulations of waxy, gray flakes of keratin materials, secondary to squamous metaplasia of the transitional epithelium. Herein, we describe a case of cholesteatoma in the renal pelvis of a 69-year-old woman, and give a brief review of the literature. In the upper pole of the left kidney was a 6 cm cystic lesion filled with a thick, flaky, grayish, comified material. Microscopically, the cystic area showed calyceal and pelvic structures being replaced by keratinizing stratified squamous epithelium. The surrounding renal parenchyma was atrophic with features of chronic pyelonephritis.
Female ; Humans

BACKGROUND: We studied how periodic and complex heart rate dynamic changes as pulmonary artery pressure increases in 32 infants with ventricular septal defet. In addition, we tested the possibility that the dynamical changes can be used to noninvasively predict the pulmonary artery pressure. METHODS: During cardiac catherterization, mean pulmonary artery pressure was measured and, at the same time, 5minute segments of continous electrocardiographic recording was stored. High-(>0.15 hertz) and low-(0.03-0.15 hertz) frequency components of heart rate variability were computed using spectral analysis. Yhe overall complexity of heart rate time series was quantified by its approximate entropy. RESULT: Pulmonary hypertensive infants(mean pulmonary artery pressure>20mmHg, n=17) had significantly lower low-(p<0.05)and high-(p<0.05) frequency power and lower approximate entropy(p<0.0001) than pulmonary normotensive infants(mean pulmonary artery pressure20mmHg, n=15). The mean pulmonary artery pressure was significantly correlated not with the spectral powers but with approximate entropy(=-0.51, P=0.0001). Conclusion: It can be concluded that, in infants, pulmonary hypertension induced by left-to-right shunt lesions suppress both periodic and complex heart rate oscillation and that mean pulmonary artety pressure can be predicted by calculating approximate entropy of heart trate variability.
Electrocardiography ; Entropy ; Heart Rate* ; Heart Septal Defects, Ventricular* ; Heart* ; Humans ; Hypertension, Pulmonary ; Infant* ; Pulmonary Artery*

A quantitative assessment of the testicular biopsy, and serum hormone levels( testosterone, prolactin, and follicle-stimulating and luteinizing hormones) were studied in 10 spinal cord injured men and comparison of these parameters to normal controls were performed. The mean number of Sertoli cells, mature spermatids, tubular diameter and tubular wall thickness were determined in both groups and analyzed. In the spinal cord injury group the mean number of mature spermatids per tubule was significantly lower and the mean number of Sertoli cells per tubule was significantly higher than in controls(p<0.05). Serum testosterone and luteinizing hormone values were significantly higher in the spinal cord injury group than in controls(p<0.05). These significant differences of the quantitative parameters of the testicular biopsy and hormonal values that may contribute to the reproductive dysfunction.
Biopsy ; Humans ; Lutein ; Luteinizing Hormone ; Male ; Prolactin ; Sertoli Cells ; Spermatids ; Spinal Cord Injuries ; Spinal Cord* ; Testis ; Testosterone

We studied two intraabdominal desmoplastic small cell tumors. The patients were two men, 37 and 23 years old, with jaundice and palpable abdominal masses. On exploratory laparotomy, each patient revealed a huge mass in the greater omentum with disseminated peritoneal seeding, measuring 32 cm and 11 cm in its greatest dimension, respectively. The tumor involved the diaphragm, rectal shelf, and cul de sac in case 1, and it involved the porta hepatis, retroperitoneum, and serosal surface of the ascending and transverse colon in case 2. Omentectomy of the huge mass and satellite masses was performed in each patient. Both tumors showed nearly the same histopathologic features. The histologic pattern was suggestive of a metastatic small cell carcinoma, but there was no specific, single primary site. The tumors consisted of variably sized, discrete islands of epithelial-like small cells in dense desmoplastic stroma. The tumor cells revealed divergent epithelial, mesenchymal, and neural differentiation by histologic, immunohistochemical, and electron microscopic observations. Only one cycle of chemotherapy including cisplatin and VP-16 was given in case 1 because of a subsequent hepatic problem, who, thereafter, showed massive intraabdominal recurrent tumors 6 months after diagnosis. In case 2, the poor condition of the patient had made chemotherapy and radiotherapy impossible. Case 2 died of disseminated intravascular coagulation following progressive cachexia 7 months after diagnosis.
Neoplasm Metastasis

A fetal rhabdomyomatous nephroblastoma is considered to be a predominantly monophasic mesenchymal variant of Wilms' tumor, which acts less aggressively than a conventional Wilms' tumor despite its much larger size. Bilaterality of this tumor in a nine month-old girl, however, may negatively affect the overall prognosis. A radical nephrectomy for bulky masses in the left kidney and a partial nephrectomy for right kidney with five small tumor masses was performed at the same time. Two small tumor masses in the upper part of right kidney were left behind because of preserving minimal renal functional capacity. Pathological study revealed a mixed type of nephroblastoma which was composed predominantly of mesenchymal components with fetal rhabdomyomatous differentiation. After post-operative chemotherapy with vincristine, actinomycin D and adriamycin, and radiotherapy(2,130 rad), residual tumor masses became a single tumor 5 cm in diameter and well demarcated, which was resected at 15 months after first operation when the size and renal function of remained right kidney was appropriate to resect out the residual tumor. The tumor resected out at second operation was entirely composed of scattered differentiated fetal skeletal muscle cells in the fibrovascular tissue. Only a few entrapped epithelial components were seen but no blastemal cornponents were present. Follow up abdominal CT and ultrasonographic examinations revealed no evidence of tumor recurrence. The girl has developed normally without disease.