Although squamous cell carcinomas compose the majority of invasive cervical cancers, adenocarcinomas account for 10-20% of cervical cancers. Human papillomavirus (HPV) types 16 and 18 are strongly involved in the development of cervical neoplastic lesions squamous cell type. However, little is known about the association of HPV with adenocarcinoma because of its rarity, The p53 gene acts as a tumor suppressor and has been implicated in controlling cell cycle progression at the Gl-S transition, and absence or mutant of p53 gene is related to tumor progression. The present study was undertaken to identify clinical profiles, to characterize HPV infection status and p53 overexpression in the cervical adenocarcinoma and to investigate the prognostic significance of these findings. Thirty-six paraffin-embedded tumor tissues were obtained and patients clinical records were reviewed from tumor registry. Tissues were analyzed for the detection of HPV 16/1S by multiplex PCR and for the expression of p53 protein by immunohistochemical staining. Eighty-four percent of the cases were positive for HPV 16 and/or 18. HPV 16 positive rate was 36.1%, HPV 18 was 72.2%. The rate of double infection with HPV 16 and 18 was 25.0%. The p53 overexpression was detected in 11.1%. The overall 5 year-survival rate (YSR) was 72.2%. There were no significant difference in survival rate between HPV 18-positive and HPV 18-negative groups. The 5 YSR of the p53-positive group was 25.0% and that of p53-negative group was 78.1% (p=0.174). Inverse relationship between p53 overexpression and HPV DNA positivity was not found. In cervical adenocarcinoma, HPV type 18 was detected as the predo#minant type and may play a role in the carcinogenic process.
Adenocarcinoma ; Carcinoma, Squamous Cell ; Cell Cycle ; Cervix Uteri* ; DNA ; Female ; Genes, p53 ; Human papillomavirus 16 ; Human papillomavirus 18 ; Humans* ; Multiplex Polymerase Chain Reaction ; Polymerase Chain Reaction ; Survival Rate

BACKGROUND: In order to evaluate the prevalence of enterovirus and cytomegalovirus infections to terminally failing hearts, the presence of enteroviral RNA and cytomegaloviral DNA was screened in the explanted hearts of transplantation recipients. METHODS: RNA and DNA extractions were performed from explanted failing hearts (N=22) and normal hearts (N=5). Reverse transcription-polymerase chain reaction (RT-PCR) of enterovirus and polymerase chain reaction (PCR) of cytomegalovirus were performed. In situ RT-PCR and in situ PCR were performed with positive nucleic acids of viruses. RESULTS: The positivity of enterovirus in failing hearts was 4.4% (1/22) and 0% (0/5) in normal hearts in nested RT-PCR. There was no significant difference in positivity of enteroviral RNA between failing and normal hearts. Nuclei of myocardium was stained in dark-violet color with in situ RT-PCR. The positivity of cytomegalovirus in failing hearts was 45% (10/22) and 40% (2/5) in nested PCR. There was no significant difference in positivity of cytomegaloviral DNA between failing and normal hearts. Nuclei of myocardium was stained in dark-violet color with in situ PCR. Positive chambers of cytomegalovirus were in decreasing tendency according to increasing patient's age. CONCLUSION: Enterovirus was very rarely observed in explanted terminally failing hearts and cytomegalovirus was frequently found both in explanted failing hearts and normal. These viruses have little direct causal relationship with the development of heart failure.
Cardiomyopathy, Dilated ; Cytomegalovirus Infections* ; Cytomegalovirus* ; DNA ; Enterovirus* ; Heart Failure ; Heart* ; Humans* ; Mass Screening* ; Myocardium ; Nucleic Acids ; Polymerase Chain Reaction ; Prevalence ; RNA

BACKGROUND: Extracorporeal membrane oxygenation (ECMO) is administered for a few days after lung transplantation (LTx) in recipients who are expected to have early graft dysfunction. Despite its life-saving potential, immediate postoperative ECMO has life-threatening complications such as postoperative bleeding. We investigated the risk factors related to the use of immediate postoperative ECMO. METHODS: We retrospectively reviewed the records of 60 LTx patients who were at our institution from October 2012 to May 2015. Perioperative variables associated with postoperative ECMO were compared between the two groups. RESULTS: There were 26 patients who received postoperative ECMO (ECMO group) and 34 patients who did not (control group). Multivariate regression analysis revealed preoperative ECMO (odds ratio [OR] 12.55, 95% confidence intervals [CI] 1.34 - 117.24, p = 0.027) and lower peripheral pulse oxymetry saturation (SpO2) at the end of surgery (OR 0.71, 95% CI 0.54 - 0.95, p = 0.019) were independent risk factors for postoperative ECMO in LTx patients. The incidences of complications, such as re-operation, tracheostomy, renal failure and postoperative atrial fibrillation, were higher in the ECMO group. There was no difference in the duration of postoperative intensive care unit stay or postoperative 30-day mortality between the two groups. CONCLUSIONS: The preoperative ECMO and lower SpO2 at the end of surgery were associated with postoperative ECMO. Further, postoperative adverse events were higher in the ECMO group compared with the control group. This study suggests that determination of postoperative ECMO requires careful consideration because of the risks of postoperative ECMO in LTx patients.
Atrial Fibrillation ; Extracorporeal Membrane Oxygenation* ; Hemorrhage ; Humans ; Incidence ; Intensive Care Units ; Lung Transplantation ; Lung* ; Mortality ; Renal Insufficiency ; Retrospective Studies ; Risk Factors* ; Tracheostomy ; Transplants ; Weaning

There are considerable discrepacies between clinical symptoms and imaging diagnosis in the localization of the responsible radiculopathy. The purposes of this study are to analyzed the dynamic alteration of contrast filling of the spinal nerve sleeves during positional changes and to determine how the abnormalities of nerve sleeves no lateral bending A-P views correlate with sciatica. The criteria indicationg the root abnormality in functional myelography were (1) bad filling of ipsilateral root to sciatica and (2) good filling of contralateral root compared with those in neutral A-P view. Of total 77 patients, 67 had radiculopathy and 10 had no radiculopathy. In 23 (34.3%) of 67 patients with radiculopathy and 6 (60%) of 10 patients with no radiculopathy, their clinical symptoms well correlated with conventional myelographic findings. However, in 35 (52.2%) of 67 patients with radiculopathy and 6(60%) of 10 patients with no radiculopathy, their symptoms well correlated with functional myelographic findings. This study suggests that the functional myelogaphy using both lateral bending A-P views can be used as a complementary tool in the evaluation of the radiculopathy.
Diagnosis ; Humans ; Myelography* ; Radiculopathy* ; Sciatica ; Spinal Nerves

The most common adverse effect of intravenous heparin is hemorrhage. Of the these, retroperitoneal hemorrhage and femoral neuropathy secondary to heparin anticoagulation has reported in 1966 for the first time by DeBolt and Jordan. We experienced a case of spontaneous retroperitoneal hemorrhage due to iliopsoas muscle hematoma in patient with myocardial infarction receiving intravenous heparin for a 3 days in therapeutic doses. The pathophysiology of iliopsoas muscle hematoma has not yet been cleared. But because of the possibility of large amount in volume, retroperitoneal hemorrhage has been known as a serious adverse effect that leads to the hypovolemic shock and death. In this article, we described the clinical manifestation, the importance of the early diagnosis and diagnostic clues and associated factors of the retroperitoneal hemorrhage in patient receiving intravenous heparin.
Early Diagnosis ; Femoral Neuropathy ; Hematoma* ; Hemorrhage* ; Heparin* ; Humans ; Jordan ; Myocardial Infarction* ; Shock

OBJECTIVES: The purpose of this study was to examine the prenatal, perinatal and developmental risk factors of attention-deficit hyperactivity disorder (ADHD), compared to unaffected siblings (SIB), and typically developing children (TC). METHODS: Subjects with ADHD, their SIB, and TC were recruited from the child psychiatry outpatient clinic of the Asan Medical Center Children's Hospital. The parents of the children completed questionnaires on perinatal and developmental risk factors. RESULTS: Fifty-eight subjects with ADHD (41 boys, 7.7+/-1.3 years), 21 SIB (8 boys, 8.2+/-1.8 years), and 22 TC (8 boys, 8.5+/-2.1 years) were included. The ADHD group showed higher rates of maternal stress during pregnancy than the SIB group (p=.002), and the ADHD group showed higher rates of familial psychiatric history than the TC (odds ratio, 8.76 ; 95% confidence interval, 1.69 to 45.45). CONCLUSION: These findings suggest that among perinatal and developmental factors, maternal stress during pregnancy contribute to the development of ADHD. Future prospective studies will be needed in order to determine the causal relationship between perinatal risk factors and development of ADHD.
Ambulatory Care Facilities ; Child ; Child Psychiatry ; Chungcheongnam-do ; Humans ; Parents ; Pregnancy ; Risk Factors* ; Siblings ; Surveys and Questionnaires

The cumulative incidence of breast cancer in Korea is low, being about one-fifth of that in the United States. This low incidence has been mainly explained by environmental factors, and recently, however, racial variations in the disease-causing genes should also be considered. The BRCA1 is one of the common genes involved in early-onset breast cancer and/or ovarian cancer in the United States and Northern Europe. However, the involvement of BRCA1 in Korean'breast cancer patients are still unclear. We performed germline mutation screening of the BRCA1 gene by DNA single strand conformation polymorphism (SSCP) analysis. We examined 27 breast cancer patients who were diagnosed less than 35 years by age including two cases with family history of breast cancer. Our study showed no germline mutation at the exons 2, 11 and 20, which were known as the supreme susceptible regions of BRCA1 mutations. Even though our cases did not fulfilled the criteria of familial breast/ovarian cancer, the proprotion of families who inherit the mutated BRCA1 allele seems to be very small and might be negligible among Korean population. Therefore, it is considered that the BRCA1 itself cannot be a major susceptibility gene and the contributions of other genes might be important for the breast cancer.
Alleles ; Breast Neoplasms* ; Breast* ; DNA ; Europe ; Exons ; Genes, BRCA1 ; Germ-Line Mutation* ; Humans ; Incidence ; Korea ; Mass Screening ; Ovarian Neoplasms ; United States

BACKGROUND: The fast EMS helicopter was introduced to Korea in 1996 and from Dec. 1. 1997, it was used far transporting emergent patients. Authors, here upon, report the transporting experiences. METHODS: From Dec. 1, 1996 to Dec. 31,1997, Samsung Medical Centers EMS helicopter was used for air evacuation of critically ill patients. The patients data prospectively analyzed. RESULT: A total of 65 patients were transported. Male to female ratio was 1.95 : 1. The mean transport time was 64.1min(10-160 min). Majority of the evacuated patients was surgical patients (General Surgery'16, Orthopedic surgery : 10, Neurosurgery : 6, Infernal medicine 13, Pediatrics : 3, and others : 3). Twenty-one of the 65 patients transported were admitted to ICU and 31 did not require ICU care. During the air evacuation, one physician and one nurse trained for air evacuation amended The patients. No medical problems or deaths developed during the air evacuation period. CONCLUSION: The first EMS helicopter was introduced to Korea in 1996. From Dec. 1, 1996 to Dec. 31, 1997, Samsung Medical Center's EMS helicopter was used for air evacuation of critically ill patients. The patients data reported.
Aircraft* ; Critical Illness ; Emergencies* ; Female ; Humans ; Korea ; Male ; Neurosurgery ; Orthopedics ; Pediatrics ; Prospective Studies

BACKGROUND: Glutaraldehyde is used most commonly as a high-level disinfectant for semicritical patient-care equipments. However, its potential toxicity to healthcare workers and a long exposure time needed to kill mycobacteria can be problematic. Recently, Perasafe(R) (Antec International, UK) has been introduced in the market as a safe and very effective disinfectant. This study was to evaluate the efficacy of Perasafe(R) against not only bacteria and yeast but also mycobacteria and bacterial spores and compare it with glutaraldehyde. MATERIAL AND METHOD: Staphylococcus aureus, Escherichia coli, Pseudomonas aeruginosa, Candida albicans, Mycobacterium tuberculosis, and Bacillus subtilis were used for the test. Perasafe(R) and Cidex(R) were used at the final concentration of 1.62% and 2.25%, respectively; the disinfectants were neutralized by Tween 80 (0.5%) in the mycobacterial test and by lecithin (0.75%) in all other tests. Bacterial suspensions were made in phosphate buffer with or without fetal bovine serum (1%) to simulate dirty or clean conditions, respectively. The disinfectants were tested at 0, 24 and 48 hr of preparation to check stability. An effective disinfectant activity was defined as a 5 log10 reduction in viable counts. RESULTS: E. coli, S. aureus, P. aeruginosa and C albicans were effectively disinfected in less than 5 min by both Perasafe(R) and Cidex(R) and the both disinfectants remained equally effective under the dirty conditions or at 48 hr of preparation. Perasafe(R) was effective in 1 min against B. subtilis spores compared to Cidex(R) which took 30 min for the same activity. M. tuberculosis was effectively disinfected in 10 min by Perasafe(R) and 20 min by Cidex(R). CONCLUSIONS: Perasafe(R) showed greater tuberculocidal and sporicidal activities than Cidex(R), although both disinfectants were equally effective against common bacterial and yeast pathogens. Perasafe(R) may be an outstanding high-level disinfectant for endoscopes and other semicritical medical equipment.
Bacillus subtilis ; Bacteria* ; Candida albicans ; Delivery of Health Care ; Disinfectants ; Endoscopes ; Escherichia coli ; Glutaral ; Lecithins ; Mycobacterium tuberculosis ; Polysorbates ; Pseudomonas aeruginosa ; Spores ; Spores, Bacterial* ; Staphylococcus aureus ; Suspensions ; Tuberculosis ; Yeasts*

No abstract available.
Magnetic Resonance Imaging* ; Osteosarcoma*