No abstract available.
Aluminum Oxide* ; Dental Porcelain*

Although causative factors are not completely defined, carcinogenesis of colorectal cancer is attributed to multiple genetic alterations. The abnormal expressions of oncogenes are regarded to be responsible for the production of malignant phenotype, subsequent invasion and metastasis. From 63 surgically resectable colorectal adenocarcinoma patients, expression of oncogenes in colorectal cancer tissue was evaluated with immunohistochemical staining methods using monoclonal antibodies to products of the oncogenes. To evaluate the possibility of oncogenes as a prognostic factor, we studied the relationship between the expression of oncogenes and the clinicopathologic findings which are well known prognostic factors. Rates of expression in colorectal cancer tissue were 27% for c-myc, 74.6% for c-Ha-ras and 77.8% for c-erbB-2 oncogenes. The positive rate of c-erbB-2 oncogene was higher in the well differentiated group than in the poorly differentiated group. The rates of expression of c-myc and c-Ha-ras oncogenes were significantly correlated each other. Expression of these oncogenes in colorectal cancer were not correlated with the pathologic stage, location of cancer, DNA ploidy pattern and histologic differentiation except between c-erbB-2 and histologic differentiation. In conclusion, there seems to be a possibility that c-erbB-2 could be used as a prognostic factor of colorectal cancer. However, further and more intensive study seems to be required.
Adenocarcinoma ; Antibodies, Monoclonal ; Carcinogenesis ; Colorectal Neoplasms* ; DNA ; Humans ; Neoplasm Metastasis ; Oncogenes* ; Phenotype ; Ploidies

An esophageal perforation is a condition requiring emergency treatment. Although previously spontaneous ruptures were the most common etiology, as endoscopic and radiologic diagnosis and treatment have developed recently, iatrogenic ruptures due to instrumentation have increased to become the most common cause of esophageal perforations. Generally, the treatment of esophageal stenosis is composed of esophageal dilatation using a Maloney or a Mercury dilator and medical treatment for reflux esophagitis. Recently, balloon-catheter dilatation of the esophagus has produced safe and excellent results, and self-expansible metallic stents has been very useful in controlling malignant strictures of the esophagus with low mortality and morbidity. We experienced an esophageal perforation after balloon dilatation and the insertion of a self-expanding silicone-covered Gianturco stent to the site of the esophageal stenosis which was due to reflux esophagitis. The abdomen was opened through an upper midline incision. There was a 3-cm-long longitudinal laceration on the distal esophagus which was closed transversely as with a Heinecke-Mikulicz pyloroplasty after a debridement. To reinforce the site of esophageal laceration and to prevent esophageal reflux, the gastric fundus was pulled and sutured over the esophageal sutures, and the second-layer mattress suture was made 1 cm proximal to the first sutures, including central ligaments of the diaphragm. To prevent bile reflux, we converted from a Billroth-II to a Roux- en-Y gastrojejunostomy. We followed up for 30 months and found no signs of any esophageal stenosis or gastroesophageal reflux.
Abdomen ; Bile Reflux ; Catheters* ; Constriction, Pathologic ; Debridement ; Diagnosis ; Diaphragm ; Dilatation ; Emergency Treatment ; Esophageal Perforation* ; Esophageal Stenosis* ; Esophagitis, Peptic ; Esophagus ; Gastric Bypass ; Gastric Fundus ; Gastroesophageal Reflux ; Lacerations ; Ligaments ; Mortality ; Rupture ; Rupture, Spontaneous ; Stents* ; Sutures

This experiment was designed for the evaluation of the usefulness of enzyme histochemistry in the determination of the lapse of time in brain wound, and also for the establishment of medicolegal 'biological time table' on brain wound. Brain injury was made by contusion and laceration of meninges and brain itself in rats. The results were as follows; 1) By routine histological technique, estimation of the lapse of time in brain wound could be possible 4 hours after the infliction of wound. 2) The earliest change of enzyme activities was recognizable by the decreased activities of ATPase and succinic dehydrogenase 30 minutes after the injury. These decreased enzyme activities were not recovered up to the 4th day after the brain injury. 3) Increased acid phosphatase activity was noticed 1 hour, and beta-glucuronidase, 2 hours after the injury in a mild degree. Both increased activities were pronounced following the lapse of time in brain wound. 4) No significant change was seen in alkaline phosphatase, monoamine oxidase, non-specific esterase and leucine aminopeptidase activities throughout the experimental period up to the 4th day. So the enzyme histochemistry of these enzymes seemed to be little valuable for the study on the timing of wound in brain injury. In the light of these results it appeared that the enzyme histochemistry, in particular of ATPase, succinic dehydrogenase, and acid phosphatase, for the estimation of timing of brain wound not only shortened the histological "lag period" up to 30 minutes after the injury, but also provided a useful information in determining the biological time table following the brain injury.
Acid Phosphatase ; Adenosine Triphosphatases ; Alkaline Phosphatase ; Animals ; Brain Injuries* ; Brain* ; Carboxylesterase ; Contusions ; Glucuronidase ; Histological Techniques ; Lacerations ; Leucyl Aminopeptidase ; Meninges ; Monoamine Oxidase ; Rats ; Succinate Dehydrogenase ; Wounds and Injuries

Tuberculous brain abscess is a rare form of the central nervous system tuberculosis. Clinical characteristics of the tuberculous brain abscess are symptoms and signs of intracranial hypertension rather than meningeal irritation. A 23-year-old man presented with headache and vomiting for 4 months. Neurological examination revealed mild left hemiparesis. Chest X-rays showed a large tuberculous cavity in the right upper lobe. Brain computed tomography scan revealed multiple ring enhancing cystic masses with marked edema and midline shift in the deep right temporo-occipital lobe. Without symptomatic relief with several months of antituberculous medication, the patient was subjected to stereotactic aspiration of the mass. Persistence of the abscess on postoperative CT scan rendered him to undergo right temporo-occipital craniotomy with removal of the remaining nodular mass. Follow up brain CT showed no residual abscess. He was discharged with no neurologic deficit. Having experienced this rare case with review on relevant literaturs, the authors suggest excision of the abscess cavity plays an important role to eradicate intracranial tuberculous abscess.
Abscess ; Brain Abscess* ; Brain* ; Craniotomy ; Edema ; Follow-Up Studies ; Headache ; Humans ; Intracranial Hypertension ; Neurologic Examination ; Neurologic Manifestations ; Paresis ; Thorax ; Tomography, X-Ray Computed ; Tuberculosis, Central Nervous System ; Vomiting ; Young Adult

A brief period of cerebral ischemia produces neuronal damage in the vulnerable regions of the brain, such as the CA1 area of the hippocampus. However, mild ischemic episodes may limit damage from subsequent ischemic insults, the phenomenon known as ischemic tolerance or preconditioning. We used hippocampal slices as an experimental model to investigate the possible utilization of ischemic tolerance, and to determine the effects of various drugs acting on glutamate and adenosine receptors following a conditioned ischemic insult. Preconditioning ischemic insult was induced in hippocampal slices of 450nm thickness for 60-70 seconds. Glutamate and adenosine receptors were pretreated 1 hour later with D,L-2-amino-5-phosphonovaleric acid(AP-5, 50nM), propentofylline(PPF, 200nM), 6-cyano-7-nitroquinoxaline-2,3-dione(CNQX, 10nM), 8-cyclopentyl-3,7-dihydro-1,3-dipropyl-1H-purine-2,6-dione(DPCPX, 1, 10nM) and 2-chloro-N6-cyclopentyl-adenosine (CCPA, 1, 10, 50nM). The slices were reoxygenated for 3 hours, after then a second ischemic insult was induced by substituting 95% O2, 5% CO2 and glucose for 95% N2, 5% CO2 and sucrose for 10 minutes. Population spikes(PS) were estimated from extracellular electrophysiological recordings of the hippocampal CA3-CA1 synaptic conduction 1 hour following the second ischemic insult. The PS(mV) was 2.69+/-0.06 in the normal hippocampal slice, while it was reduced to 1.21+/-0.05 in the hippocampal slice induced with 10 minutes of ischemia. The effects of the A1 selective agonist CPPA revealed a reduction of PS to 0.98+/-0.06 with low concentration(1nM), similar PS as the control group with a concentration of 10nM, and an increase in ischemic tolerance of 1.78+/-0.05 at a higher concentration(50nM). The selective A1 antagonist DPCPX(1nM) showed minimal reduction in PS of 1.10+/-0.04, while the NMDA antagonist AP-5(5nM) had a more profound weakening effect(1.05+/-0.04). The adenosine uptake inhibitor profentophylline(200nM) augmented the PS to 1.56+/-0.06; this effect was not influenced by 1nM DPCPX(1.60+/-0.07), but was abolished by a higher concentration of 10nM(1.36+/-0.05). These results confirmed ischemic tolerance in the hippocampal experimental model. We conclude that adenosine plays an important role in ischemic tolerance as activation of adenosine receptors or adenosine uptake inhibition enhances ischemic tolerance.
Adenosine ; Brain ; Brain Ischemia ; Glucose ; Glutamic Acid ; Hippocampus ; Ischemia* ; Models, Theoretical ; N-Methylaspartate ; Neurons ; Receptors, Purinergic P1 ; Sucrose

No abstract available.
Humans ; Listeria* ; Meningitis, Listeria*

Mesenchymal cell tumors of the intestinal tract originate from connective tissues, muscles, fat, lymphatic tissues, blood vessels, and nerves in and beneath the submucosa. The most common site is the stomach, followed by the small bowel. Among the benign gastric neoplasms of mesodermal origin, those derived from smooth muscles constitute over 90%. Leiomyosarcomas of the stomach represent about 1% to 3% of primary malignant tumors and approximately 20% of submucosal tumors of the stomach. In the small bowel, leiomyoma is the most common benign tumor, and leiomyosarcoma represents about 19% of malignant tumors. The principle of surgical treatment of gastric mesenchymal tumors is local excision with a 2 to 3 cm margin in the surrounding gastric wall. We reviewed 48 cases of mesenchymal cell tumors of the gastrointestinal tract from January 1988 to March 1997 at the Department of Surgery, Namkwang General Hospital and Chonnam University Hospital School. The results are as follows : 1) There were 23 benign and 25 malignant tumors. 2) The most common benign tumor was leiomyoma (41.7%) and the most common malignant tumor was a leiomyosarcoma (47.9%). 3) The most common site was the stomach (52.1%), followed by the small bowel (25%); in the gastric tumor cases, the most common site was the body (60%). 4) The most common clinical manifestation was abdominal pain (37.5%), followed by bleeding (27.1%), a palpable mass, dyspepsia, and weight loss. 5) A wedge resection, a subtotal gastrectomy, or an enucleation of the mass was mainly performed on the stomach. Segmental resection and anastomosis was primarily performed in the small bowel. 6) Among the malignant tumors, a recurrence was noted in 8 patients(32%) : 7 leiomyosarcomas and 1 malignant histiocytoma. 7) The prognosis for a malignant leiomyosarcoma was better than that for an adenocarcinoma and was associated with tumor size and histologic grade (mitosis/10 HFP). However, we could not find any correlation between the prognosis and lymph node metastasis.
Abdominal Pain ; Adenocarcinoma ; Blood Vessels ; Connective Tissue ; Dyspepsia ; Gastrectomy ; Gastrointestinal Tract* ; Hemorrhage ; Histiocytoma ; Hospitals, General ; Humans ; Intestines ; Jeollanam-do ; Leiomyoma ; Leiomyosarcoma ; Lymph Nodes ; Lymphoid Tissue ; Mesoderm ; Muscle, Smooth ; Muscles ; Neoplasm Metastasis ; Prognosis ; Recurrence ; Stomach ; Stomach Neoplasms ; Weight Loss

PURPOSE: Hemorrhoidal tissues are normal anatomic structures present in every individual, and they act as cushions and are anchored to the internal anal sphincter by a connective tissue system. When the anchoring connective tissues undergo bears degenerative changes, the hemorrhoids not only bulge but also descend into the lumen of the anal canal. The veins also become distended. The previous hemorrhoidectomy methods (excision and ligation methods) tend to remove excessive amounts of hemorrhoidal tissues, possibly causing incontinence or stenosis. This study introduces a modified hemorrhoidectomy method. METHODS: A retrospective study was done with 650 patients (358 males, 292 females) who underwent hemorroidectomies from Jan. 1997 to Jan. 2000. Under saddle-block anesthesia, the patient was placed in a prone jack-knife position. After narrow incisions on the mucosa of the selected pile, a bilateral submucosal dissection was performed. The pedicle was ligated by transfixing sutures 2 or 3 times with 2-0 chromic catgut to lift up the mucosa. RESULTS: The mean operation time per hemorrhoidal pile was 12.7 minutes, and the mean hospital-stay was 4.3 days. Acute and delayed postoperative anal bleeding occurred in 7 (1.1%) and 3 (0.5%) patients, respectively. The symptoms of both subsided spontaneously. Ninety-three (93) patients (14.3%) reguired nelaton catheterization for voiding difficulty, and one patient (0.2%) showed mild anal stenosis. The most frequent complaint was skin-tag formation (148 cases, 22.8%). In 140 cases, the skin tag was removed under local anesthesia. CONCLUSIONS: It is desirable to keep the normal structure of the anal canal by removing as little of the cushions as possible. Our 'lift-up submucosal hemorrhoidectomy' shows good results and is an easy operative method when compared with Parks' original method.
Anal Canal ; Anesthesia ; Anesthesia, Local ; Catgut ; Catheterization ; Catheters ; Connective Tissue ; Constriction, Pathologic ; Hemorrhage ; Hemorrhoidectomy* ; Hemorrhoids ; Humans ; Ligation ; Male ; Mucous Membrane ; Retrospective Studies ; Skin ; Sutures ; Veins

We studied the seroprevalence of HBsAg, anti-HBs and anti-HBc and the vaccination histories among health care workers (HCWs) at a large suburban referral hospital in Korea. The purpose of this study was to determine the immune status of HCWs against hepatitis B virus and we also wanted to prepare a practical guideline to protect HCWs from occupational exposure. During December, 2003, 571 HCWs (56 physicians, 289 nurses, 113 technicians and 113 aid-nurses) aged between 21 and 74 yr were included in the surveillance. The positive rates of HBsAg and anti-HBs were 2.4% (14/571) and 76.9% (439/571), respectively. The positive rate of anti-HBs was lower in the physician group, and this was associated with the male gender and older age. Of the 439 anti-HBs positive cases, 320 cases (73.1%) were anti-HBc negative and this was significantly associated with a past history of HBV vaccination. The distribution of the anti-HBs levels was not associated with age (except for HCWs in their sixties), gender or occupation. Our study revealed that the seroprevalence rates of HBsAg and anti-HBs in HCWs in Korea were not different from those of the general population. Based on this surveillance, we can make reasonable decisions in case of occupational exposure to hepatitis B virus.
Adult ; Aged ; Antibodies, Viral/blood ; Female ; *Health Personnel ; Hepatitis B/*epidemiology/virology ; Hepatitis B Surface Antigens/blood ; Hepatitis B virus/immunology ; Humans ; Korea/epidemiology ; Logistic Models ; Male ; Middle Aged ; Multivariate Analysis ; Occupational Diseases/*epidemiology/virology ; Seroepidemiologic Studies ; Vaccination/statistics & numerical data