The p53 gene product has been detected in various human tumors. To investigate the overexpression of the p53 protein in bladder tumor as a marker of tumor progression, the correlation between the overexpression of the p53 protein in bladder and the pathologic grade, stage and survival rate was studied. Among specimens of 47 patients, 19 were from patients of superficial bladder tumor, 28 were from invasive bladder tumor according to pathologic stage, while 15 were from low grade and 32 were from high grade tumors according to Ash grade p53 overexpression was determined by immunohistochemistry using DO-7 primary antibody on paraffin embedded sections and flow cytometry was performed on cell suspensions derived from the same blocks. Histologically normal bladder tissue was used as a control group Conclusions were made as follows: 1. p53 protein overexpression was observed in 31 of 47 cases(65.9%). 2. Seven of 15 specimens from well differentiated tumor(Ash grade I, II) showed positive p53 staining while 24 of 32 cases from poorly differentiated tumor (Ash grade III,IV) showed positive staining. There is a significant correlation between p53 expression and poor pathological grade(p=0.05). 3. Nine of 19 cases with superficial bladder tumor showed positive staining while 22 of28 cases of invasive tumor showed positive staining. There is a significant correlation between p53 protein overexpression and invasive tumor(p=0.027). 4. Flow cytometric examination revealed that 24 of 30 cases with aneuploid group showed positive staining while 7 of 17 cases with diploid group showed positive staining. Aneuploid group showed high correlation with p53 protein overexpression(p=0.007). 5. The survival rates of patients, exhibiting p53 protein overexpression, were slightly worse than those with p53 negative tumor(p=0.08, Wilcoxon test) but this difference was not significant enough to count. 6. p53 protein overexpression was well correlated with grade, stage and flow cytometric analysis in bladder tumor. 7. Multiple linear regression study to survival rate showed the overexpression of p53 protein had little prognostic significance in bladder tumor compared with tumor grade and stage.
Aneuploidy ; Carcinoma, Transitional Cell* ; Diploidy ; Flow Cytometry ; Genes, p53 ; Humans ; Immunohistochemistry ; Linear Models ; Paraffin ; Ploidies* ; Survival Rate ; Suspensions ; Urinary Bladder Neoplasms ; Urinary Bladder*

No abstract available.
Neuroblastoma*

This study evaluates the suitability of cadavers embalmed by the ethanol-glycerin fixative for the dissection course of medical students and the hands-on dissection workshop of clinicians. Five cadavers were embalmed by two different methods: two formalin-phenol fixation (FPF) and three ethanol-glycerin fixation (EGF) cadavers. The measurement of physical and chemical characteristics including ranges of motion (ROM), bacterial and fungal culture tests, and ultrasonography were performed for each cadaver. The EGF cadavers were evaluated to be significantly more suitable than FPF cadavers for the physical and chemical characteristics including color, texture, elasticity, wetness (softness), skin incision, vessel ligation and suture, decollement, odor, and irritant. In shoulder, elbow, and wrist joints, ROMs of the EGF cadavers were statistically more than those of the FPF except for elbow extension. On bacterial and fungal culture tests at 8 weeks after carrying out of refrigerator, one bacteria were detected in one EGF cadaver; however, some bacteria and fungi could be detected in all FPF cadavers. The ultrasound images of abdominal organ and thigh musculature could be more clearly detected in the EGF cadavers than those of FPF cadavers. These results indicate that the EGF method had a sufficient antibiotic effect and produced cadavers with flexible joints and a high tissue quality suitable for various cadaveric dissection courses.
Bacteria ; Cadaver* ; Education ; Elasticity ; Elbow ; Embalming* ; Epidermal Growth Factor ; Fungi ; Humans* ; Joints ; Ligation ; Methods ; Odors ; Shoulder ; Skin ; Students, Medical ; Sutures ; Thigh ; Ultrasonography ; Wrist Joint

It has been recognized that angiogenesis has a profound effect on growth of tumors in various animal models. Recently, it was suggested that tumor microvessel density may be an independent prognostic factor in breast cancer and other human tumors. This study was designed to define the correlation between tumor microvessel density and survival in breast cancer. Pathological parameters of 60 patients with breast cancer were analyzed: stage, nodal status, histologic grade, vascular invasion, and p53 expression. Tumor microvessels were stained by the immunohistochemical method in formalin-fixed, paraffin-embedded tissues by using the anti-CD31 monoclonal antibody (JC/70A, DAKO) and were counted with in a 10 objective field (about 0.74 mm2) in the area of the most intense neovascularization. The microvessel density (MVD) of the tumor was compared with other prognostic factors and 5-year survival rate. The mean MVD of the 60 breast cancers was 36.5 15.3 (range: 17~112). The MVD did not correlate with the stage, the node metastasis, the histologic grade, the vascular invasion, or the p53 expression. The MVD was graded by the number of microvessels as grade 1 (MVD 17~32), grade 2 (MVD 33~48), and grade 3 (MVD>49). The 5-year survival rate of patients with MVD grade 1 was 69.0%, and those of grades 2 and 3 were 58.2% and 29.6%, respectively, which was statistically significant (p=0.004). By univariate analysis, the stage (p<0.001), the axillary nodal status (p<0.001), the MVD (p=0.004), and the p53 expression (p=0.041) had a significant correlation with survival. In 25 patients with node-negative breast cancer, the MVD was the single significant prognostic factor (p=0.047). These results suggest that tumor microvessel density is a significant prognostic factor in invasive breast cancer and that it may be a prognostic factor in node-negative breast cancer.
Breast Neoplasms* ; Breast* ; Humans ; Microvessels* ; Models, Animal ; Neoplasm Metastasis ; Prognosis* ; Survival Rate

During treatment of inner ear diseases, the blood-cochlear barrier limits the drug delivery into the cochlea. Intratympanic drug injection for inner ear diseases is a safe procedure where drugs reach high concentrations in the cochlea and systemic side effects are minimized. This paper reviews the updated status of intratympanic drug injections for the treatment of inner ear disease. Intratympanic drug injection is an effective procedure for the control of inner ear disorders such as Meniere's disease and sudden sensorineural hearing loss. Although the effect of intratympanic injection on tinnitus and noise-induced hearing loss is open to discussion, its indications could be extended, like as drug, gene, and cell-based therapy.
Aminoglycosides ; Cochlea ; Ear, Inner ; Hearing Loss, Noise-Induced ; Hearing Loss, Sensorineural ; Hearing Loss, Sudden ; Labyrinth Diseases* ; Meniere Disease ; Tinnitus

Gingival fibroblasts are major cellular component of gingiva. However, the molecular mechanisms of senescence of human gingival fibroblasts are unknown. Human fibroblasts undergo replicative senescence in vitro after a limited number of population doublings. A reduced rate of proliferation is a prominent phenomenon observed in senescent fibroblasts. This phenomenon is happened with cell cycle arrest that was controled by cell cycle regulatory proteins. The purpose of present study was to investigate the effect of replicative senescence on cell cycle progression and to find out its molecular mechanisms in human gingival fibroblasts. Replicative senescence of gingival fibroblasts were induced by subsequent cultures that were repeated up to 18 passage. In the present study, I examined change of cell proliferation, cell activity, cell viability and cell cycle progression during the replicative process. Also, I examined expression of cell cycle regulatory proteins which was estimated by western blot analysis. Cell proliferation, cell activity and cell viability of gingival fibroblasts were notably decreased with increase of population doubling level(PDL). S phase was decreased and G1 phase was increased with increase of PDL. Western blot analysis showed that levels of p16, p21 and p53 of senescent gingival fibroblasts(PDL41, PDL58) were higher than young fibroblasts(PDL27) and cdk4 were lower than young fibroblasts(PDL27). In conclusion, these results suggest that proliferative function of human gingival fibroblasts may be decreased by replicative senescence and its molecular mechanisms may be activatied with p16, p21, p53 and pRB, and repressed wtih cdk4.
Aging ; Blotting, Western ; Cell Aging* ; Cell Cycle Checkpoints ; Cell Cycle Proteins ; Cell Cycle* ; Cell Proliferation ; Cell Survival ; Fibroblasts* ; G1 Phase ; Gingiva ; Humans* ; S Phase

Pacemaker twiddler's syndrome is reported as a very rare complication of permanent pacemaker implantation. There was a recent report suggesting that the incidence of pacemaker twiddler's syndrome increase recently presumably as a result of the implantation of thinner and smaller pacemaker system than before. We experienced a case of pacemaker twiddler's syndrome complicated 3 times with the conventional method of implantation or replacement during 14 months after the first implantation(Optims MP 158C and Pacing lead 400, Telectronic)on June 13th 1987. This case was an 18 year-old high school girl who had suffered frequent syncope for 2 years and extertionl dyspnea for 5 years due to congenital complete heart block, of which block site was proved to be AV nodal by His bundle electrogram. Pacemaker twiddler's syndrome developed 3 times;firstly 6 weeks after the first implantation in the right subclavicular fossa, secondly 10 weeks after the replacement of the twisted pacing lead, thirdly 10 months after the change of implantation site to the left subcalvicular fossa with the replacement of the twisted and fractured lead. Finally, the pacemaker generator was anchored to the clavicular periostium and pectoralis fascia at several points by using Dacron pouch.
Adolescent ; Dyspnea ; Electrophysiologic Techniques, Cardiac ; Fascia ; Female ; Heart Block ; Humans ; Incidence ; Polyethylene Terephthalates ; Syncope

The only clinically avilable levo-isomer type of beta-recepter blocker is penbutolol sulfate, and it is already accepted as one of beta-receptor blockers for initial antihypertensive drug therapy according to the report of 1988 Joint National Committee on Detection, Evaluation, and Tratment of High Blood Pressure. To evaluate the antihypertensive efficacy, effect on the quqlity of life, and side effects of penbutolol recently introduced into Korea, penbutolol was administered to 29 essential hypertensive(mild 9, moderate10, and severe 10) patients for 12 weeks or longer. The result of the clinical analysis are as follows; 1) The mean age was 50.0+/-10.9(M+/-SD), and the sex distribution between male and female was16:13. 2) The blood pressure lowering effects of penbutolol as a monotherapy were marked in 16, moderate in 6, and insignificant in 2 cases. The systolic blood pressure was significantly decreased from 179.1+/-20.2 to 135.4+/-16.5mmHg(P<0.005), and the diastolic blood pressure from 112.6+/-13.5 to 84.0+/-11.9mmHg(P<0.005)after 12 weeks' penbutolol therapy. 3) The heart rate was significantly decreased from70.3+/-13.3 to 65.5+/-9.1 per minute(P<0.05). 4) The quality of life was improved markely in 5(17.2%) and slightly in 8 cases(29.6%). 5) There were no significant laboratory changes after 12 weeks' penbutolol therapy. 6) Two out of three cases with non-specific ST segment and T wave changes in EKG and two out of 9 cases with EKG were normalized, 2 cases of LAH with strain were improved. 7) The side effects of penbutolol were dizziness in 4, sexual dysfunction in 2, and skin rash in 1 case. 8) Final multifarious assessment of penbutolol therapy showed that it was very useful in 11(37.9%), useful in 4(13.8%) and slightly useful in 7 cases(24.1%). These reult suggest that penbutolol is a first-line antihypertensive agent with an effective antihypertensive action, improving quality of life, with no significant laboratory changes and few side effects.
Blood Pressure ; Dizziness ; Drug Therapy ; Electrocardiography ; Exanthema ; Female ; Heart Rate ; Humans ; Hypertension ; Joints ; Korea ; Male ; Penbutolol ; Pheniramine ; Quality of Life ; Sex Distribution

BACKGROUND: The coronary collateral circulation has been frequently observed in significant coronary artery disease and its protective role in ischemic myocardium is still remained unclear. But the study on the anti-ischemic effect in human model of ischemic myocardium is rare. METHODS: To observe the anti-ischemic role of coronary collateral circulation in ischemic myocardium, perfusion defect areas were measured during PTCA(percutaneous transluminal coronary angioplasty) in angina patients with single vessel disease and analyzed according to the grade of collateral circulation. The 99mTc-MIBI myocardial scanning images were obtained at 24 hours before PTCA with dipyridamole stress, at ballooning during PTCA and at 24 hours after the opening of the artery and perfusion defect volume ratios(DVR) were measured in each of the images of the patient with angina and single vessel disease. RESULTS: 1) Studied subjects were 14 patients(10 male, 4 female, mean age : 56.6+/-103) and subdivided into two groups. All patients had angina with single vessel disease, 7 proximal left anterior descending artery(LAD) stenosis, 4 middle LAD stenosis, 1 middle right coronary artery(RCA) stenosis and 2 proximal left circumflex artery(LCX) stenosis. Group A was composed of 7 patients with angina and coronary collateral circulation more than grade 1. Group B was 7 patients with angina and grade 0 collateral. 2) Mean age of group A was 62.4+/-8.2 years, 5 male and 2 female patients, That of group B was 56.6+/-8.9 years and all male patients. Group A was composed of 7 patients ; 5 unstable and 2 stable angina ; 2 proximal LAD stenosis, 3 midddle LAD stenosis, 1 middle RCA stenosis and 1 proximal LCX stenosis. One patients had grade 1, two patients grade 2 and four patients grade 3 coronary collateral circulation. All of the patients were unstable angina in group B showing 5 proximal LAD stenosis, 1 middle RCA stenosis and 1 proximal LCX stenosis. No collateral circulation was demonstrated in group B. 3) In group A, DVR was 17.5+/-13.9% on stress image before PTCA and 7.1+/-1.4% on the ballooning image during PTCA. DVR was smaller in ballooning image than in stress image(p<0.01). 4) In group B, DVR was 12.4+/-16.0% on stress image before PTCA and 26.6+/-10.0% on ballooning image during PTCA. DVR was larger in ballooning image than in stress image(p<0.001). 5) DVR on stress image and open image were not different in both groups, but DVR on ballooning image were 7.1+/-4.7% in group A and 26.6+/-10.0% in group B, which was larger than in group A(p<0.01). CONCLUSION: These results suggest that myocardial perfusion defect area may be smaller in angina patients with good collateral circulation than patients with no collateral, and coronary collateral circulation have a protective role on the jeopardized myocardium during coronary artery occlusion.
Angina Pectoris* ; Angina, Stable ; Angina, Unstable ; Arteries ; Collateral Circulation* ; Constriction, Pathologic ; Coronary Artery Disease ; Coronary Vessels ; Dipyridamole ; Female ; Humans ; Male ; Myocardium ; Perfusion*

BACKGROUND: Reperfusion of ischemic myocardium has been postulated to result in a specific oxygen radical mediated tissue injury. Iron may liberate during ischemia and we hypothesized that administration of the iron chelator, deferoxamine during ischemia would result in improved recovery after postischemic reperfusion. PURPOSE: To test whether iron-catalyzed processes contribute to myocardial necrosis during ischemia and reperfusion, deferoxamine was administered to block iron catalyzed hydroxyl radical formation in rabbits. METHODS: Eleven rabbits were divided into two groups: control group (n=5) and deferoxamine pretreatment group (n=6). the left circumflex coronay artery was ligated for 30 minutes and reperfused for 180 minutes. Area at risk (AR) was measured by non-stained area with ethylene blue injection into left atrium after left circumflex coronary artery ligation. Infarct size was measured by weighing after tripheyltetrazolium chloride staining. Heart rate was measured using electrocardiographic recording and systemic blood pressure was monitored by pressure transducer connected to the catheter in the left ventricle. RESULTS: 1. There was no significant difference of heart rate and blood pressure in deferoxamine pretreatment group compared with control group. 2. There was significant decrease of serum iron concentration after continuous infusion of deferoxamine compared with serum iron concentration before ligation of coronary artery (P<0.05). 3. There was no significant difference of area at risk between control and deferoxamine pretreatment group. 4. Area at necrosis to area at risk was significantly reduced in deferoxamine pretreatment group compared with control group (P<0.05) The results suggest that deferoxamine infusion prior to coronary artery occlusion has a significant benefit in reducing infarct size in this model.
Arteries ; Blood Pressure ; Catheters ; Coronary Vessels ; Deferoxamine* ; Electrocardiography ; Heart Atria ; Heart Rate ; Heart Ventricles ; Hydroxyl Radical ; Iron ; Ischemia ; Ligation ; Myocardial Infarction* ; Myocardium ; Necrosis ; Oxygen ; Rabbits ; Reperfusion ; Transducers, Pressure