c-erbB-2 oncogene is a normal cellular proto-oncogene coding transmembrane glycoprotein structurally similar to the epidermal growth factor receptor. Amplification of this oncogene in a variety of human adenocarcinomas has been reported and is particularly well documented in breast carcinoma. It has been suggested that amplification of this oncogene is indicative of poor prognosis and is valuable only second to the lymph node status. Using immunohistochemical staining for the c-erbB-2 protein, overexpression of this protein was analysed in 228 primary breast cancer specimens and the frequency of overexpression and the relationship between overexpression and the other established prognostic variables are evaluated. Ninty three cases out of 228 cases(40.8%) show postive oncoprotein overexpression and using the chi-squared test for a trend, a significant correlation was found between c-erbB-2 protein staining and the histological grade, lymph node status, and estrogen receptor status(P<0.05). No significant association was found between staining and the patient's age and tumor size. Most of the tumors with histological types known to have good prognosis showed negative expression. Above findings strongly suggest that expression of c-erbB-2 oncogene is another independent indicator of poor prognosis in breast carcinoma.
Humans ; Adenocarcinoma ; Breast Neoplasms

Serum alkaline phosphatase (AP) activity is elevated in hepatobiliary disease, bone disease, pregnancy and certain neoplasms. Recently we experienced marked elevation of serum AP activity after administration of albumin preparation in nephrotic patients who suffered from hypovolemic symptoms. So serum AP activity and the isoenzymes in the albumin preparations & patient's serum after the administration of albumin preparation were studied. Serum AP activity was significantly higher after administration of albumin preparation (318+/-101 IU/L) then before (123+/-43 IU/L). The predominant isoenzyme after administration of albumin was placental type, while liver and bone type was predominant before administration. AP activity in albumin preparation was high (2,133+/-1,410 IU/L) and the isoenzyme was mostly placental type. So we concluded that marked elevation of serum AP activity after administration of albumin was traced to the placental type AP isoenzyme in some albumin preparations which was manufactured from the plasma of placental origin. Elevated serum AP activity like these may lead to erroneous interpretation. Manufactures should notify alkaline phosphatase activity in albumin preparations of placental origin.
Administration, Intravenous* ; Alkaline Phosphatase* ; Bone Diseases ; Humans ; Hypovolemia ; Isoenzymes ; Liver ; Plasma ; Pregnancy

The immunohistochemical expression of transforming growth factor-beta(TGF-beta), epidermal growth factor(EGF) and alpha-1-antitrypsin(AAT) was studied in 47cases of endoscopic biopsy matearials of gastric carcinoma to determine me correlation to the expression of alpha fetoprotein(AFP). And immunoreactivity of the antigens was correlated to me degree of tumor infiltrating lymphocytes and histologic differentiation of the tumors. And the results were analyzed to elucidate pathological AFP-producing gastric cancer. The results were summarized as follows. AFP immunoreactivity was demonstrated in 30 cases(63.8%) of the tumors, TGF-beta in 26 cases(55.3%), EGF in l4 cases(29.8%) and AAT in l0 cases(21.3%). The incidence of expression of the antigens was significantly higher in the cases of elevated serum AFP(>2ng/ml) than that of the cases with normal serum AFP(p<0.05). There was no relation between the expression of antigens and histological differentiation of gastric cancer. The expression of AFP and TGF-beta revealed good correlation(k=0.72). The relation between expression of TGF-beta and AAT and the degree of tumor infiltrating lymphocytes disclosed negative correlation(p<0.05). These results suggest that TGF-beta and AAT prodution contribute to the worse prognosis of AFP-producting gastric cancer. Possible immunosuppressive action of TGF-beta and AAT in the cancer tissue is discussed.
Incidence ; Biopsy ; Stomach Neoplasms

No abstract available.
Hospitals, General* ; Humans ; Outpatients*

A case (female, 34 years old) of pseudotumor cerebri signs with bilateral papilledema and transient diplopia secondary to the use of oral contraceptives is presented. This patient has taken habitually pills (Eugynon E.D.) for over 6 months. By fundoscopy, the moderate degree of papilledema on both eyes were observed with the slight raise of intracranial pressure. But the visual acuity was normal range at first visit day. Periodic ophthalmic examination and the education for side effects of the pills are recommended to women who are taking the pills regularly.
Contraceptives, Oral* ; Diplopia ; Education ; Female ; Humans ; Intracranial Pressure ; Papilledema* ; Pseudotumor Cerebri ; Reference Values ; Visual Acuity

Authors reported one case of huge epidermoid cyst which is located between the eye ball and temporal wall of left orbit. This male patient, aged 33, has been a history of progressive exophthalmos without pain Bince over ten years. At the time of first visit to the hospital, exophthalmometry revealed in 12mm in right eye and 32mm in left eye. And poor vision (20/200) and notable eso-hypotropia with the oomplete limitation of extra ocular muscles of left eye was also observed. By roentgeographic study, significant enlargement of the bony orbit in the left eye was resulted from the tumor. Surgical removal of the huge intraorbital cyst was performed successfully according to the modified Klonlein's technical appoach and the cyst tumor, sized 5 X 3 X 3cm with volume content of about 30cc, was conformed histopathologically.
Epidermal Cyst* ; Exophthalmos ; Humans ; Male ; Muscles ; Orbit*

The refractive state of 321 children (160 boys and 161 girls) of a rural primary school were examined under the cycloplegic condition with 5% homatropine. The results obtained as folIow; 1. Among 321 children, the refractive errors was revealed in 28.0% and emmetropia was revealed in 72.0%. 2. As to the distribution of refractive errors, hyperopic eyes were 39.5% and myopic eyes were 60.6%. 3. The refractive errors were observed more frequently in girls (15.4%) than those of boys (12.5%). 4. There was a tendency that hyperopic refractive error was gradually decreased from 8 years of age as the age increased. However, myopic refractive error was incerased gradually from 8 years of age. 5. At the age of 11 highest incidence of the refractive errors was observed (22.8%). 6. The degree of most of refractive errors(98.4%) were revealed less than 3 diopters. 7. As to the type of astigmatism, with the rule was 51.4% and against rule was 42.9%.
Astigmatism ; Child* ; Emmetropia ; Female ; Humans ; Incidence ; Refractive Errors

For quality assurance purposes, the authors correlated aspiration cytology and subsequent tissue findings and examined the reasons for discrepancies. In three months from Jan. to Mar. 1996, 1,383 aspirations were performed, of which 285 (20.6%) had subsequent tissue diagnoses within two months. The aspiration sites were thyroid (483), lymph node (LN) (290), breast (250), soft tissue (154), liver (89), lung (49), salivary gland (26), pancreas (22), gallbladder (3), bone (3), joint (2), adrenal gland (2), scrotum (2), mediastinum (2), omentum (2), oral cavity (1), chest wall (1), and intraabdominal (1) and pelvic cavities (1). A total of 68 discrepancies were identified, and biopsies and smears from these cases were reviewed monthly. In 27 cases (40%), the discrepancy was attributed to sampling error. In five cases (9%), aspiration gave superior results with better sampling and preservation than biopsy. Thirty six cases (53% of discrepant cases) were errors in cytologic diagnosis. We categorized these discrepancies into "A", "B", and "C" ("A": minor disagreement with no affect on patient care, "B": minimal affect on patient care, "C": major affect on patient care), which were 9 (13%), 14 (21%) and 13 (19%) cases, respectively. In thirteen cases of category "C", there were eleven false negative and two false positive diagnoses. Eleven false negative cases included thyroid (3), lymph node (2), breast (2), bone (1), salivary gland (1), lung (1), and liver (1). Three cases of thyroid were papillary carcinomas diagnosed as nodular hyperplasia (1), occasional pleomorphic cells (1), and cystic change (1). Two breast cases of invasive ductal carcinomas were diagnosed as ductal hyperplasia. A malignant lymphoma was diagnosed as reactive hyperplasia and a metastatic carcinoma of LN was diagnosed as tuberculosis. Other cases were malignant tumors of bone, salivary gland, lung, and liver those were misinterpreted as benign lesion or normal. Of two false positive cases, one was nodular hyperplasia of thyroid diagnosed as papillary carcinoma and the other was normal islet cell of pancreas diagnosed as islet cell tumor. A continuous monitoring of laboratory performance is an essential component of the quality control and assurance, and the review of discrepant cases provides useful information for improvement of diagnosis.
Adenoma, Islet Cell ; Adrenal Glands ; Aspirations (Psychology) ; Biopsy ; Breast ; Carcinoma, Ductal ; Carcinoma, Papillary ; Diagnosis ; Gallbladder ; Humans ; Hyperplasia ; Islets of Langerhans ; Joints ; Liver ; Lung ; Lymph Nodes ; Lymphoma ; Mediastinum ; Mouth ; Omentum ; Pancreas ; Patient Care ; Quality Control ; Salivary Glands ; Scrotum ; Selection Bias ; Thoracic Wall ; Thyroid Gland ; Tuberculosis

In the case of IIc type of early gastric cancer occuring from the area of ulcer sear, endoscopic differentiation between it and beoign ulcer scar is occasionally very difficult, due to the absence of characteristic malignant features. The presence of the irregular granular mucosal changes on the area of ulcer scar may be very helpful in the differential diagnosis between early gastric cancer and benign ulcer sear. And underetanding of the malignant cycle of early gaetric cancer is very important for the diagnosis of the depressed forms of early gastric cancer, We experienced and report a cases of IIc type of early gastric cancer diagnosed before operation by the endoscopic finding of irregular granular mucoeal changes on the area of ulcer scar and showing part of malignant cycle.
Cicatrix* ; Diagnosis ; Diagnosis, Differential ; Stomach Neoplasms* ; Ulcer*

The aim of this study is to evaluate pituitary-ovarian function at different postpartum periods during the lactational amenorrhea in order to understand the mechanism by which puerperal lactation is associated with a protracted period of amenorrhea and natural infertility. Ninety four lactating women and 119 lactating women with menstruation, aged between 21 and 38 years, volunteered for this study. The pituitary was relatively insensitive to LH-RH during the first 3 weeks following delivery. The recovery of FSH responsiveness to LH-RH occurred earlier than that of LH. Normal FSH response resumed in the 2nd week while the LH response, although not normal, started at the 3rd week postpartum. Pituitary responsiveness after the 5th week postpartum was similar to that occurring in normally menstruating women, except that FSH response was exagerated. Serum prolactin levels were elevated above 160 ng/ml until the 5th week postpartum and decreased to 84.2 ng/ml in the 6th week postpartum. It appears that at least one reason for anovulation during the first four weeks following delivery is the relative insensitivity of the pituitary to hypothalamic stimulation. Prolactin does not seem to modulate pituitary responsiveness to LH-RH. In order to clarify hormonal profiles during the lactational amenorrhea beyond the 5th week puerperium, serum levels of LH, FSH, prolactin, estradiol and progesterone were determined during different postpartum periods. Serum FSH and LH levels during 1-10 months postpartum were similar to basal levels seen during the normal menstrual cycle. Serum estradiol concentrations throughout 1-10 months postpartum, however, were significantly decreased as compared with the levels during the follicular phase of the normal menstrual cycle. Serum prolactin levels were elevated throughout 1-10 months postpartum in lactating amenorrhic women but decreased as the postpartum period lengthened. As compared with lactating amenorrhic women, lactating women with resumed menstruation showed a decrease in prolactin levels from 89.20 ng/ml to 51.39 ng/ml at 1-3 months, from 75.08 ng/ml to 49.99 ng/ml at 4-6 months, and from 54.73 ng/ml to 28.74ng/ml at 7-10 months postpartum. These results suggest that the apparent anovulation seen beyond 5th week postpartum during lactation was not due to pituitary insensitivity to LH-RH. Rather, prolactindependent mechanism interfering with cyclic activity may be operative during long term lactation.
Amenorrhea/etiology* ; Female ; Gonadorelin/pharmacology ; Gonadotropins, Pituitary/secretion ; Human ; Lactation* ; Ovary/physiology* ; Pituitary Gland/physiology* ; Pregnancy ; Prolactin/physiology ; Puerperium*