Bcl-2 oncoprotein is being localized to mitochondria and interfering with programmed cell death (apoptosis) independent of promoting cell division in the lymphoid and nonlymphoid cells. The bcl-2 oncoprotein expression has been reported in follicular lymphomas as well as in diffuse non-Hodgkin's lymphoma, leukemia and a variable propotion of Hodgkin's lymphoma cases. Recent evidence suggests that some lymphomas protected from apoptosis is conferred through expression of Epstein-Barr virus(EBV) latent membrane protein which turn to cause upregulation of bcl-2. To define the role of the bcl-2 oncoprotein and EBV in lymphoid malignancy, we tried immunohistochemical studies with anti-bcl-2 antibody and In situ hybridization (ISH) with EBV-encoded small nuclear RNAs(EBER) in the paraffin embedded sections of 46 non-Hodgkin's lymphoma (NHL) cases and 20 Hodgkin's lymphoma (HL) cases. Bcl-2 oncoprotein expression was found in 37 of 46 cases (80%) of NHL with relatively strong cytoplasmic staining, and in 14 of 20 cases (70%) of HL with weak cytoplasmic staining in limited small numbers of RS, Hodgkin and lacunar cells. The widespread presence of bcl-2 oncogene in many different types of both NHL and HL supports that the extended cell survival through overexpression of bcl-2 gene protein may be a growth advantage of neoplastic lymphoid cells. In the ISH analysis for EBV, the presence of EBV was detected in 17 of 20 cases (85%) of HL, compared to 6 of 44 cases(13.6%) of NHL. It appears to be no direct correlation between overexpression of bcl-2 oncoprotein by neoplastic lymphoid cells and the presence of EBV in NHL but it seems to be a definite association between EBV and HL.

Clear cell sarcoma of kidney(CCSK) is a rare pediatric neoplasm characterized by a predominating component of clear cells, a predilection for metastases to bone, and a poor prognosis. The incidence of CCSK peaks during the 2nd year of life and adult cases are very rare. We report a case of CCSK encountered in the right kidney of a 39-year-old man. Grossly, it was a lobulated mass showing infiltrative margin, measured 7x5.5x5cm and had a homogeneous gray-tan color with a soft, fish-flesh consistency. Microscopically, about half of the tumor revealed the classic pattern of CCSK, having tumor cell cords or nests separated by the characteristic alveolar capillary networks. The tumor cells had clear pale cytoplasm, bland looking round nuclei and inconspicuous nucleoli. The other half showed the epithelioid-trabecular pattern forming pseudorosette or cord-like structures. Immunohistochemically, there was only a focal positive reaction to vimentin. Ultrastructurally, the tumor cells showed the primitive nephrogenic mesenchymal differentiation such as electron lucent cytoplasm, a small amount of organelles, scanty heterochromatin, inconspicuous nucleoli, and a lack of flocculant basal lamina material around the cytoplasmic membrane. We consider that this is a case of CCSK occuring in the oldest patient ever reported, confirmed by both immunohistochemistry and electron microscopy.
Adult ; Male ; Female ; Humans ; Incidence ; Neoplasm Metastasis

The purpose of this study is to compare the educational needs and perception of mothers of normal neonates and high risk infants. This research was designed as a descriptive study. Data were collected for two months from April 2002 to March 2002. Subjects were 41 mothers of high risk infants and 60 mothers of normal neonates in one general hospital in Seoul participated in the study. Measurement tools used in this study were the educational needs scale developed by Cho Kyoul Ja et al and the neonatal perceptive inventories scale developed by Broussard. They ask mothers to rate each item on a four point Likert type scale. The collected data were analyzed using SPSS 8.0 program. The variables were listed as frequency, mean, standard deviation, X2 test, t-test, ANOVA. The results were as follows: The educational needs of the mothers of primi pregnancy was higher than the mothers of multi pregnancy. The educational needs on management of diseases such as prevention of infection, symptoms of disease, mental development, attachment promotion, congenital metabolism test, management of convulsion, care of vomiting and fever were higher than general care of infants such as immunization, measurement of temperature, hiccough care, follow up care. The informations must be included in nursing intervention program to reduce the mothers' stress level. In conclusion, in order to promote positive mother infant relationship, nurse need to give information and educate the mothers of high risk infant and normal neonate.
Equipment and Supplies ; Fever ; Hiccup ; Hospitals, General ; Humans ; Immunization ; Infant* ; Infant, Newborn* ; Metabolism ; Mothers* ; Nursing ; Pregnancy ; Seizures ; Seoul ; Vomiting ; Child Health

BACKGROUND AND OBJECTIVES: Mutations of the SLC26A4 gene cause congenital hearing loss and enlarged vestibular aqueduct (EVA). A considerable proportion of patients with SLC26A4 mutations have significant residual hearing at birth that eventually worsen and become the cause for cochlear implantation (CI) later in their adolescence or adulthood. We analyzed the auditory outcome and prognostic factors of CI in patients with EVA and biallelic SLC26A4 mutations showing progressive early-onset hearing loss, who eventually had implantation in their adolescent or adult periods. SUBJECTS AND METHOD: Sixteen patients with EVA carrying biallelic SLC26A4 mutations who received CI after 12 years of age were included for analysis. The outcome and prognostic factors of CI were analyzed. The postoperative follow-up period ranged from 3 to 48 months. RESULTS: The age at CI ranged from 12 to 44 years. The categories of auditory performance score was significantly improved after CI from 3.1 to 4.9 (p < 0.05). The mean sentence scores improved significantly in the auditory-visual and auditory-only conditions (p < 0.05). The significant prognostic factors were measurable bone conduction thresholds, preoperative residual hearing, recent history of sudden aggravation of hearing loss, and preoperative speech intelligibility rating scores. There was a tendency of lower postoperative sentence scores in the group with homozygous H723R mutation, but statistical significance was not reached. CONCLUSION: Despite the early-onset of hearing loss, significant improvement in auditory performance can be expected after CI in adolescent and adult patients with EVA and biallelic SLC26A4 mutations. Significant prognostic factors should be considered in selecting candidates and preoperative counseling for CI.
Adolescent* ; Adult* ; Bone Conduction ; Cochlear Implantation* ; Cochlear Implants* ; Counseling ; Extravehicular Activity ; Follow-Up Studies ; Hearing ; Hearing Loss ; Humans ; Methods ; Parturition ; Speech Intelligibility ; Vestibular Aqueduct*

OBJECTIVES: The purpose of this study was to observe the reaction kinetics and the degree of polymerization of composite resins when cured by different light sources and to evaluate the effectiveness of the blue Light Emitting Diode Light Curing Units (LED LCUs) compared with conventional halogen LCUs. MATERIALS AND METHODS: First, thermal analysis was performed by a differential scanning calorimeter (DSC). The LED LCU (Elipar Freelight, 320 mW/cm2) and the conventional halogen LCU (XL3000, 400 mW/cm2) were used in this study for curing three composite resins (SureFil, Z-250 and AEliteFLO). Second, the degree of conversion was obtained in the composite resins cured according to the above curing mode with a FTIR. Third, the measurements of depth of cure were carried out in accordance with ISO 4049 standards. Statistical analysis was performed by two-way ANOVA test at 95% levels of confidence and Duncan's procedure for multiple comparisons. RESULTS: The heat of cure was not statistically different among the LCUs (p > 0.05). The composites cured by the LED (Exp) LCUs were statistically more slowly polymerized than by the halogen LCU and the LED (Std) LCU (p < 0.05). The composite resin groups cured by the LED (Exp) LCUs had significantly greater degree of conversion value than by the halogen LCU and the LED (Std) LCU (p = 0.0002). The composite resin groups cured by the LED (Std) LCUs showed significantly greater depth of cure value than by the halogen LCU and the LED (Exp) LCU (p < 0.05).
Composite Resins* ; Hot Temperature ; Kinetics ; Polymerization* ; Polymers* ; Spectroscopy, Fourier Transform Infrared

PURPOSE: Carcinosarcomas are rare neoplasms in which both malignant epithelial and mesenchymal elements are identified. We have found only twenty one cases of primary cutaneous carcinosarcoma in the English language literature. Therefore it has been difficult to diagnosis because its unclear etiology and low frequency. METHODS: A 31-year-old young man with a protruding mass on his ankle dorsum was examined. The tumor was 7 x 6 x 3 cm sized and arose from a burn scar. The mass was wide excised and applied split thickness skin graft. Characteristic pathologic finding was a mixture of squamous cell carcinoma and malignant fibrous histiocytoma. RESULTS: Three months after the operation, the patient died of multiple metastasis to the liver, lung and finally of sepsis despite adjuvant chemotherapy and adjuvant radiotherapy. CONCLUSION: If a metastatic cutaneous carcinosarcoma is diagnosed, wide excision is required. There should be more aggressive management to minimize the risk of recurrence. Further research into the etiology and pathophysiology of the disease and a more careful differential diagnosis may allow improvement in treatment.
Adult ; Animals ; Ankle ; Burns ; Carcinoma, Squamous Cell ; Carcinosarcoma ; Chemotherapy, Adjuvant ; Cicatrix ; Diagnosis, Differential ; Histiocytoma, Malignant Fibrous ; Humans ; Liver ; Lung ; Neoplasm Metastasis ; Recurrence ; Sepsis ; Skin ; Transplants ; Ulcer

BACKGROUND AND OBJECTIVES:In order to analyze and understand the oculomotor system completely, it is essential to measure horizontal, vertical, and torsional eye movements. We developed a new system of 3-dimensional videooculography that can accurately estimate the pupil center and measure torsional eye movement in real time while minimizing the errors caused by upper eyelid droop, eyelashes, corneal reflection, and eye blinking. MATERIALS AND METHOD:For accurate estimation of the center and diameter of the pupil, the edges of the pupil were searched by using a sector-form window and circle fitting was performed using the least square regression. Torsional eye movement was measured using polar cross-correlation technique with modification to lessen the errors produced by the change in pupil size. Calibrations were performed and to verify the proposed system, the linearity between the measured and actual eye movements was measured. Also, the results of the proposed system were compared with those of another commercialized system. RESULTS: The linearity between the measured and actual eye movements showed errors of less than 1%. The spatial resolutions of the system for horizontal, vertical, and torsional eye movements were 0.3, 0.4, and 0.2, respectively whereas the temporal resolution was 30 frames/sec. In comparison to the commercialized system, our system showed less artifact by eye blinking when measuring vertical eye movement. CONCLUSION:We proposed an algorithm and a system for measuring horizontal, vertical, and torsional eye movements which minimized the influence of partial eyelid closure, eyelashes, corneal reflections, and change in pupil size.
Artifacts ; Blinking ; Calibration ; Eye Movements* ; Eyelashes ; Eyelids ; Pupil

PURPOSE: To evaluate the NT in the first trimester associated with fetal chromosomal abnormality, fetal structural abnormality and adverse pregnancy outcome. METHODS: From Mar. 1993 to Dec. 1997, 133 cases of increased NT were reviewed retrospectively. All these fetues were taken a karyotyping and/or a high resolution ultrasonography for associated anomaly. The NT was measured by transvaginal ultrasonography(TVS) and transabdominal ultrasonography(TAS) if difficulty was encountered with TVS in the period of the 10th-14th week of gestation. The increased NT is approved when it is over 3mm. RESULTS: Of these 133 cases, 102 cases(76.7%) revealed normal outcomes and 31 cases(23.3%) revealed abnormal outcomes such as chromosomal abnormality, structural abnormality and adverse pregnancy outcome, The mean value of NT was 3.44+/-0.68mm in the normal group and 4.93+/-2.70mm in the abnormal group, respectively. The chromosomal abnormalities were found in 16 of the 31 cases: nine Down SD, two Patau syndrome, one Tuner synrome, one triploidy, one 46, XX,i(18q), one 47,iso(Xp)/46,XX one confined placental mosaicism. In 12 cases of the 31 cases, the structural anomalies were detected. Of these 12 cases, 3 cases were eventually developed to cytsic hygroma, 3 cases were cardiac anomaly, 3 cases were renal anomaly, 1 case was congenital diaphragmatic hernia, 1 case was skeletal dysplasia and 1 case was suspected syndrome. The adverse pregnancy outcome such as intrauterine growth restriction, intrauterine fetal death and preterm labor was revealed in 3 cases. In the cases of NT over 7mm, the result was 100% abnormal outcome. CONCLUSION: Increased NT in the first trimester could be a highly efficient the predictor for detection of chromosomal abnormality, structural anomaly and adverse pregnancy outcome.
Chromosome Aberrations ; Female ; Fetal Death ; Hernia, Diaphragmatic ; Humans ; Karyotyping ; Lymphangioma, Cystic ; Mosaicism ; Nuchal Translucency Measurement ; Obstetric Labor, Premature ; Pregnancy ; Pregnancy Outcome* ; Pregnancy Trimester, First ; Pregnancy* ; Retrospective Studies ; Triploidy ; Ultrasonography

PURPOSE: M. pneumoniae is knwon as a common causative agents of respiratory infection in school children. But, it tends to occur in infants and younger children recently. This study was performed to evaluate the incidence and clinical manifestations of M. pneumoniae pneumonia in infants. METHOD: A total of 142 children(33 infants{Group I : Infants group; 0-2 years} and 109 children{Group II : Children group; 3-6 years}) was admitted with M. pneumoniae pneumonia from January through December 1998. We reviewed medical records and evaluated the incidence, clinical manifestations and laboratory findings. RESULT: Number of patients with M. pneumoniae pneumonia in 0 to 2 years of age(infants group) comprised 23.2% of the total in contrast to 57.1% in 3 to 6 years of age group and 19.7% in 7 to 12 years of age group. Seasonal distribution showed the highest frequency in autumn in infant and children groups(45.5% and 39.4% respectively). The most frequent symptom was cough(90.9% and 96.3%, respectively), followed by sputum(81.8% and 90.8%, respectively), fever(72.7% and 66.0%, respectively) and rhinorrhea(72.7% and 64.0%, respectively). The common physical findings on admission were crackle(84.8% and 80.7%, respectively), wheezing(30.3% and 18.3%, respectively) and throat injection(39.4% and 35.8%, respectively). WBC count was within normal range in both groups(90.9% and 89%, respectively) and CRP was lower than 0.8 mg/dL in 63.6% of infant group and 54.1% of children group. The most common radiologic finding was bronchopneumonia in both groups (47% and 38%, respectively). CONCLUSION: Number of the patients with Mycoplasma pneumoniae pneumonia in infants age from 0 to 2 years comprised 23.2% of the total. Clinical manifestations of Mycoplasma pneumonia in infants were similar to those of older children. We recommened Mycoplasma pneumoniae should be considerd as a causative agent even in infant with respiratory infection.
Bronchopneumonia ; Child ; Humans ; Incidence ; Infant* ; Medical Records ; Mycoplasma pneumoniae* ; Mycoplasma* ; Pharynx ; Pneumonia* ; Pneumonia, Mycoplasma* ; Reference Values ; Seasons

PURPOSE: To determine the intranasal causes of failed dacryocystorhinostomy (DCR) and the effects of transcanalicular diode laser-assisted revision surgery. METHODS: Twenty-four patients (29 eyes) who underwent revision surgery for a failed DCR at the Department of Ophthalmology, Ansan Hospital, Korea University between March 2009 and February 2011 were included in the present retrospective study. The intranasal causes of failed DCR, the time of symptoms such as epiphora and discharge after DCR, success rates of revision surgeries and follow-up periods were evaluated. RESULTS: Membranous obstruction was found in 25 eyes (86.2%) and was accompanied with granuloma in 10 eyes; these were the most common causes of failed DCR. The mean time for symptom development after DCR was 14.6 months, the success rate of the first revision surgery was 82.1% and good results were obtained in 5 eyes after the second revision surgery. Recurrence developed in 2 eyes, but symptoms improved after the lateral tarsal strip procedure. CONCLUSIONS: Membranous obstruction was the most common intranasal cause of failed DCR and transcanalicular diode laser-assisted revision surgery produced good results. Additionally, in patients with persistent epiphora following anatomically-patent revisional surgery, lacrimal pump failure due to lower eyelid laxity should be considered and corrected.
Dacryocystorhinostomy ; Eye ; Eyelids ; Follow-Up Studies ; Granuloma ; Humans ; Korea ; Lacrimal Apparatus Diseases ; Ophthalmology ; Recurrence ; Retrospective Studies