Renal dysplasia results from aberrant metanephric histogenesis caused fundamentally by a defect in inducer tissue or responding tissue. Dysplastic kidneys vary tremendously in gross and microscopic appearance but are characterized by abnormal organization and a mixed population of primitive structures, such as fetal or immature cartilage, dysplastic ducts, immature tubules, and undifferentiated mesenchyme. We report a case of unilateral multicystic renal dysplasia associated with an ipsilateral ectopic ureteral orifice entering a seminal vesicle cyst in a 33-year-old man. He was admitted due to primary infertility which had developed three years ago. The his semen analysis revealed oligospermia. No evidence of a family history of renal dysplasia was reported. Microscopic examination showed that the entire kidney was composed of cysts lined by flattened cells, dysplastic ducts and immature tubules surrounded by collars of spindle cells, primitive mesenchyme, and a few aberrantly formed glomeruli.
Adult ; Cartilage ; Humans ; Infertility ; Kidney ; Male ; Mesoderm ; Multicystic Dysplastic Kidney* ; Oligospermia ; Semen Analysis ; Seminal Vesicles* ; Ureter*

Inactivation of tumor suppressor genes may play an important role in many human cancers including breast. This study was done to determine the relationship between the expression of p53 and Rb protein and prognostic factors such as histopathologic differentiation, tumor size, and lymph node metastasis. In 57 cases of breast invasive ductal carcinomas, the immunohistochemical staining with p53 and Rb protein gave the following results: p53 protein was detected in 45.6% (26/57) of cases. Tumors with large size, poor differentiation or lymph node metastases tended to show increased expression of p53 protein. However, p53 protein expression did not show any significant correlation with prognostic factors such as tumor size (p value 0.25), histologic grade (p value 0.75), and positive lymph node status (p value 0.26). Rb protein was detected in 57.9% (33/57) of cases. Rb protein also did not show any significant correlation with prognostic factors such as tumor size (p value 0.56), histologic grade (p value 0.71), and positive lymph node status (p value 0.98). There was no significant correlation between p53 expression and Rb protein expression (p value 0.80).
Breast* ; Carcinoma, Ductal* ; Genes, Tumor Suppressor ; Humans ; Lymph Nodes ; Neoplasm Metastasis ; Retinoblastoma Protein*

Background : It has been suggested that thrombospondin (TSP) is a p53-dependent negative regulator of tumor angiogenesis. TSP expression and localization in hepatocellular carcinomas (HCCs) and its association with overexpression of p53 protein were investigated. Methods : TSP-1 and -2 expressions were examined in 40 HCC specimens by immunohistochemical staining and in 4 HCC cell lines by Western blotting. In addition, p53 protein expression and microvessel density (MVD) were correlated with the TSP expression. Results : Strong immu- nopositivity for TSP-1 was observed in fibroblasts, vascular endothelial cells, and some vas- cular smooth muscle cells of the stroma in 18 cases (45%), and in tumor cells in 3 cases (7.5%) of 40 cases of HCC. Immunoreactivity for TSP-2 was observed in only the sinusoidal lining cells of the tumor in 15 cases (46%), and in tumor cells in 2 cases (6%) of 32 cases of HCC. TSP-1 expression was inversely correlated with MVD (p=0.028), but TSP-2 expression did not show any correlation with MVD. Although p53 was overexpressed in 17 cases, there was no significant correlation between TSP and p53 expressions. None of the HCC cell lines expressed TSP-1 or -2. Conclusions : These findings indicate that TSP-1 is mainly derived from nonparenchymal cells, and may decrease tumor angiogenesis in HCC.
Angiogenesis Inhibitors ; Blotting, Western ; Carcinoma, Hepatocellular* ; Cell Line ; Endothelial Cells ; Fibroblasts ; Microvessels ; Myocytes, Smooth Muscle ; Thrombospondin 1 ; Thrombospondins

Macrostomia is a relatively rare malformation. There have been many surgical methods for the correction of macrostomia. The old method, a simple straight line closure , did not include reconstruction of the orbicularis oris muscle. Postoperatively, a depressed scar and severe contraction on the cheek were found, especially with animation. As a result, many authors have known that reconstruction of the orbicularis oris muscle was very important to avoid a depressed scar for the correction of macrostomia. The tendency toward lateral displacement of the reconstructed commissure has been attributed to linear scar contraction, and Z-plasty is advocated to prevent this deformity. However, we found that the Z-plasty scar may be conspicuous when the patient smiles. So we performed reconstruction of the orbicularis oris muscle to avoid a depressed scar, and straight line closure to avoid a conspicuous scar. In order to prevent linear scar contracture due to straight line closure, we overcorrected the new commissure. We treated 6 cases of macrostomia form May 1, 1996 to April 30, 1999 using straight line closure and reconstruction of the orbicularis oris muscle. Periods of follow-up were from 12 months to 35 months, with an average of 20,2 months. Every patient was analyzed clinically by ordinary scale method and anthropometrically by the ratio of abnormal distances to normal distances between cheilion and crista philtri. In 3 clinical assessments : symmetry of the commissure was excellent: degree of the scar at rest was good: and degree of depression with animation was excellent. The anthropometrical ratio was 1:1.05. Despite the fact that the linear scars were perpendicular to the minimal skin tension lines, the scars were inconspicuous. The muscle repair provided reconstruction to the modiolus and gave a natural appearance to the commissure, however it did not seem to provide sufficient bulkiness around the commissure. The straight line skin closure and repair of the orbicularis oris muscle provide effective functional and aesthetic reconstruction.
Cheek ; Cicatrix ; Congenital Abnormalities ; Contracture ; Depression ; Follow-Up Studies ; Humans ; Macrostomia* ; Skin

PURPOSE: The purpose of this study was to develop a feeding protocol for premature infants and to evaluate the effects of protocol. METHODS: The feeding protocol was developed through a literature review and discussions of an expert group. The developed feeding protocol was tested with 85 preterm infants in one neonatal intensive care unit in B city. A non-equivalent control group non-synchronized design was used. Data were collected from January 1 to April 30, 2013 for the control group and from June 1 to September 30, 2013 for the experimental group. The experimental group (n=38) received the feeding protocol, whereas the control group (n=47) had routine feeding care. Collected data were analyzed by t-test and -test using SPSS/WIN version 18.0. RESULTS: First feeding time (t=2.22, p=.029) and full enteral feeding time (t=2.28, p=.026) were significantly decreased in the experimental group compared to the control group. There was no difference in incidence of complications (p>.05). Also no significant differences in weight reduction rate between the two groups were observed at the 7th postnatal day (t=-1.23, p=.222). CONCLUSION: The results indicate that the feeding protocol for preterm infants is effective in decreasing first feeding time and full enteral feeding time.
Enteral Nutrition ; Humans ; Incidence ; Infant, Newborn ; Infant, Premature* ; Intensive Care, Neonatal ; Weight Loss

Purpose: To study the clinical role of preoperative orbital computerized tomography (CT) in determining initial surgery in patients with open globe injuries. Methods: This is a retrospective study that evaluated patients who underwent an operation for single-eye open-globe injury after orbital CT and were followed up for at least one year. Patients were divided into two groups: a group with anatomical failure that underwent enucleation, evisceration, or phthisis bulbi and a group with anatomical success. The correlations with preoperative CT findings and clinical outcomes were compared between the two groups. Results: A total of 122 cases of open globe injury were included. Comparing preoperative CT results between the two groups, anatomical failure was correlated with the CT findings of intraocular hemorrhage (odds ratio, 5.0; 95% confidence interval [CI], 2.0-15.4), orbital wall fracture, and a reduction in eyeball volume (all p < 0.05). In the anatomical failure group, the average volume and axial length of the eyeball decreased by 28% and 16%, respectively, in traumatic eyes compared with non-traumatic eyes. Conclusions Orbital CT is a useful tool for evaluating the extent of open globe injury. If the prognostic factors indicate poor results, including intraocular hemorrhage, orbital wall fracture, or a severe decrease in the volume of the injured eye in orbital CT scans, primary enucleation or evisceration should be considered carefully, based on consultations with patients and their caregivers.

BACKGROUND:The number of old patients receiving coronary artery bypass grafting(CABG) is increasing. With the more recent advances in operative techniques, the age at which CABG is indicated has also increased. This study evaluated the risk factors associated with the hospital mortality and the morbidity following CABG in elderly patients. MATERIAL AND METHOD: Between March 1991 and June 1998, we retrospectively reviewed 45 consecutive patients aged 65 years or older who underwent CABG. We compared the data with the results of 179 patients under the age 65 years operated during the same period. RESULT: Mean age was 68+/-1.41 years(range 65 to 74 years). Emergency surgery was required in 4, and elective surgery in 41 patients. The mean number of distal anastomosis per patient was 3.62 +/-0.81 and mean aortic cross-cramp time was 69.84+/-18.5 minutes. Thirty patients had Canadian class III or IV preoperatively, but 43 patients had class I or II postoperatively. The left ventricular ejection fraction increased significantly from 54.23+/-10.62% preoperatively to 58.14+/-9.88% postoperatively(p<0.05). Postoperative complication was pneumonia in 2 patients, acute renal failure in 2 patients, sternal wound infection in 1 patient, and postoperative myocardial infarction in 1 patient. There were two postoperative deaths. The causes of deaths were low output syndrome in one patient, and sepsis due to pneumonia in the other patient. The hospital mortality was higher in the elderly group(4.4 versus 2.86%) but was not statistically significant(p>.05). Incremental risk factors for hospital deaths in the elderly were emergent operation, preoperative PTCA, postoperative use of IABP and postoperative ARF(p<0.05). The duration of hospital stay after operation was significantly longer for the elderly group than the younger group(19.27+/-12.51 vs 15.55+/-6.99 days; p<0.05). Follow-up was complete for 34 of the hospital survivors and ranged from 1 to 73 months(mean: 23.58+/-19.56 months). There was no late mortality of cardiac origin. CONCLUSION: Age is an important factor in selecting optimal management for elderly patients with coronary compromise, but age alone should not dictate the choice of therapy. Coronary artery bypass surgery in the elderly is associated with acceptable early mortality and excellent long-term results.
Acute Kidney Injury ; Age Factors ; Aged* ; Cause of Death ; Coronary Artery Bypass* ; Coronary Vessels* ; Emergencies ; Follow-Up Studies ; Hospital Mortality ; Humans ; Length of Stay ; Mortality ; Myocardial Infarction ; Pneumonia ; Postoperative Complications ; Retrospective Studies ; Risk Factors ; Sepsis ; Stroke Volume ; Survivors ; Wound Infection

No abstract available.
Osteochondroma*

PURPOSE: The cyclin-dependent kinase inhibitor p27kip1 protein is a negative regulator of the cell division cycle, and its degradation is required for entry into the S phase. Loss of p27(kip1) protein expression has been reported to be associated with aggressive behavior in a variety of tumors of epithelial and lymphoid origin. The purpose of this study was to determine the expression of p27 protein in adenoma and adenocarcinoma of the colorectum and to assess the prognostic significance. METHODS: We performed immunohistochemical staining for expression of p27 protein in adenomas (20 cases) and adenocarcinomas (30 cases) of the colorectum. The data (p27 protein labeling index (LI, mean+/-standard deviation)) were analyzed in association with clinicopathologic parameters. RESULTS: p27 protein LI of normal mucosa (10 cases), adenoma, and adenocarcinoma were 93.3+/-4.5, 65.4+/-17.5, and 28.2+/- 14.5, respectively (p<0.0001). p27 protein LI of well differentiated adenocarcinoma was slightly higher than those of moderately and/or poorly differentiated adenocarcinoma, but did not show any significant difference among these groups (p=0.19). Also p27 protein expression did not show any significant relationship to other prognostic facters such as age, invasion depth, and operative staging. CONCLUSIONS: The results suggested that reduced expression of p27 protein may play an important role in the malignant transformation process of colorectal cancer.
Adenocarcinoma* ; Adenoma* ; Cell Cycle ; Colorectal Neoplasms ; Cyclin-Dependent Kinase Inhibitor p27 ; Mucous Membrane ; Phosphotransferases ; S Phase

It was reported that the refractive power in the premature infants was more frequently myopic than in the normal, but there was little known about the onset and pathogenesis. The 106 premature infants, less than 37 weeks's gestational age, were comparatively examined at the age of 4 weeks to determine that there was myopic shift before cicatrical ROP state and the correlation of corneal diameter, axial length with refractive errors. The No-ROP group was 70 infants(140 eyes), and ROP group was 36 infants(72 eyes), and it was possible to analysis statistically only within the 33-36 post-conceptional age because the two groups were not normally distributed. The mean spherical equivalents at the 33-34 weeks were +1.91 Diopter, +1.48 Diopter in the No-ROP group and -0.21 Diopter, 0.00 Diopter in the ROP group, and this was statistically different(p<0.05), but corneal diameter and axial length were not different in both groups(p>0.05). This study revealed that the refractive errors in the ROP group were more myopic shift than in the No-ROP group in regard to early active state of ROP.
Gestational Age ; Humans ; Infant, Newborn ; Infant, Premature ; Refractive Errors* ; Retinopathy of Prematurity