The grading of astrocytoma has traditionally relied on histological assessment, but there are some differences in their parameters, application, and reproducibility. Recently, numerous studies have attempted to correlate biological aggresiveness with tumor proliferation index using new immunohistochemical methods. The purpose of this study is to correlate the histopathological grades of astrocytoma with the expression of Ki-67, PCNA, p53 protein and AgNORs. The paraffin sections of 41 consecutive cases of astrocytomas were examined. Histologically the tumors were graded as three groups under the St. Anne-Mayo system and showed 14 cases in grade II, 15 cases in grade III and 12 cases in grade IV (glioblastoma multiforme). As a result, the Ki-67 labelling index and p53 protein expression tended to increase with increasing grade of malignancy. But the univariate analysis showed that there was no significant difference between the tumor grades (p>0.05). The PCNA labelling index and number of AgNORs revealed striking differences between the grade II and grade III astrocytomas (p<0.05). We concluded that the PCNA labelling index and AgNORs counting are useful markers for differentiation between grade II and III astrocytomas.
Astrocytoma* ; Paraffin ; Proliferating Cell Nuclear Antigen* ; Strikes, Employee

Peripartum cardiomyopathy is defined as a syndrome of cardiac failure occurring in tbe latter part of pregnancy or in the puerperium, without obvious cause and without prior evidence of heart disease. Despite its infrequency, this clinical problem may have devastating consequences upon maternal and fetal outcome. It is important to recognize the association of cardiac failure and pregnancy as a separate syndrome so that, once identified, peripartum cardiomyopathy can be treated promptly and aggressively. We experienced two cases of peripartum cardiomyopathy, and report these cases with a brief review of the literatures.
Cardiomyopathies* ; Heart Diseases ; Heart Failure ; Peripartum Period* ; Postpartum Period ; Pregnancy

The development of drug resistance is a major obstacle in effective cancer chemotherapy. Multidrug resistance(MDR) is a widely studied phenomenon of interest to both clinicians and research workers because many different cancer chemotherapeutic agents are involved and the genetic basis of MDR is understood to a large extent. Several studies show that the P-glycoprotein (P-gp), multidrug resistance-associated protein(MRP), glutathione-s-transferase-pi(GST-pi), and DNA topoisomerase II(topo II) have a complex role for the malignant phenotypes and MDR. Clearly, there is a need to investigate links between the diverse characteristics of tumors and the emergence of drug resistance. We have therefore used reverse transcription-polymerase chain reaction(RT-PCR) assay to analyze expressions of MDR-related genes including the mdr1, MRP, topo II and GST-t gene in normal testis and testis tumors. The results are as follows: 1. The expression levels of topo II and GST-n genes in testis tumors, especially in the nonseminomatous germ cell tumor(NSGCT), were significantly higher than in normal testis(p=0.015 and 0.025, respectively). 2. The MDR-related gene expressions in testis tumors did not appear to be correlated with stage(p>0.05 in each case) and chemotherapy status(p>0.05 in each case). 3. MRP expression levels in primary tumors were much higher than in metastatic tumors. 4. In NSGCT, the coexpressions of the topo II and GST-r or MRP genes were significantly correlated but, seminoma showed no correlation between MDR-related genes in the same sample. Although the mechanism of these connection are not known, the results suggest that these expression patterns and higher GST-rexpression in NSGCF compared to seminoma confer diverse characteristics including difference in the presentation of tumor markers and the responsiveness to chemotherapy on NSGCF and seminoma.
DNA Topoisomerases, Type I ; DNA Topoisomerases, Type II ; Drug Resistance ; Drug Therapy ; Gene Expression* ; Germ Cells* ; Neoplasms, Germ Cell and Embryonal* ; P-Glycoprotein ; Phenotype ; Seminoma ; Testis* ; Biomarkers, Tumor

PURPOSE: To evaluate the accuracy and reliability of method for prediction of rotationally neutral state of the femur by comparing with contra-lateral lesser trochanter. MATERIALS AND METHODS: The rotationally neutral state of the femur was measured by comparing the shape of the opposite side of the lesser trochanter in a normal group of 100 adult. Each examination was performed independently by three observers. The observers predicted a position presumed to be neutral by comparing the shape of lesser trochanter with that of contra-lateral side previously recorded by the C-arm image intensifier. We evaluated the mean angular discrepancy that is different from the neutral point and assessed the inter-observer variations. RESULTS: The mean angular discrepancy (SD) was 3.4 degree(+/-2.4); 3.5 degree(+/-2.4) by observer-1,3.5 degree (+/-2.8) by observer-2, 3.2 degree(+/-2.2) by observer-3. There was no inter-observer variation (p=0.87). 77% of all observers indicated below 4 degree and no one over 15 degree. CONCLUSIONS: The method of comparing the shape of both lesser trochanters is considered to be effective in determining the rotational status of the femur. It could be used as a practical method in the operation of the femoral fracture for prevention of rotational deformity intra-operatively
Adult ; Congenital Abnormalities ; Femoral Fractures ; Femur* ; Humans ; Observer Variation

BACKGROUND: The efficiency of lipid extraction by different kinds of solvents from stratum corneum may vary. OBJECTIVE: To assess the efficiency of lipid extraction by several solvents from the stratum corneum, the total lipids weights were measured by an electronic microbalance, and lipids compositions of a stratum corneum were analyzed by thin layer chromatography(TLC) after pretreatment of several solvents, respectively. METHODS: Stratum corneums separated fro circumcised prepuce were pretreated with acetone, petroleum ether, or distillecl water for 10 minutes. Lipids of stratum corneum were extracted with methanol chlorofonn-H,O mixture(4: 2: 1.6, v/v, Bligh Dyer solvent). Lipids weights were weighed, and the ratio of lipid weight and wet weight of stratum corneum were measured. TLC was performed and lipids compositions were quantitated by photodensitometer. Lipids extraction in viva was performed on both forearms. After two times stripping with sellotape, lipids were extrected with the solvents using cup method. These were dried and lipids weights were weighed. RESULTS: The efficiency of lipid extraction from the stratum corneum of circumcised prepuce were acetone, petroleum e1 her, and distilled water in decreasing order. All groups were similar in the compositions of the stratum corneum lipids except for those of cholesterol esters and sphingolipids. The efficiency of lipid extraction from in vivo skin were ranked in order from petroleurn ether, acetone, down to distilled water. The efficiency of lipid extraction of petroleum ether and acetone were higher than that of distilled water. CONCLUSION: The efficiency of lipid extraction is influenced by the kinds of solvents as well as the materials and the methods of extraction.
Acetone ; Cholesterol Esters ; Ether ; Forearm ; Methanol ; Petroleum ; Skin ; Solvents* ; Sphingolipids ; Water ; Weights and Measures

Acute scrotum is defined as an acute painful swelling of the scrotum or its content. There are many conditions it may cause acute scrotum, but since a delay in the diagnosis and treatment may led to necrosis and its loss, the possibility of torsion of the spermatic cord should be ruled out in the first place. In a retrospective study of 32 childhood patients with acute scrotum presenting to Chungbuk National University Hospital from March 1992 to March 1995, we evaluated general aspects of acute scrotum including the result of follow up. The incidence of acute epididymitis, testicular torsion, mumps orchitis, and torsion of a testicular appendage were 66%, 19%, 9% and 6%, respectively. Of the eight scrotal explorations performed, 6 had testicular torsion, and 2 had torsion of appendages. With the exception of cases of far advanced necrotic testes, both color Doppler ultrasound and radioisotope imaging were highly specific diagnostic modalities. But, because of the potentially devastating outcome of a false-negative result of imaging studies, we continue to believe that physical exam is the best guide regarding the necessity of surgical exploration and all patients with unequivocal examinations are best served by prompt surgical therapy.
Acute Pain ; Child* ; Chungcheongbuk-do ; Diagnosis ; Epididymitis ; Follow-Up Studies ; Humans ; Incidence ; Male ; Mumps ; Necrosis ; Orchitis ; Retrospective Studies ; Scrotum* ; Spermatic Cord ; Spermatic Cord Torsion ; Testis ; Ultrasonography ; Ultrasonography, Doppler, Color*

Epithelial ovarian cancer is one of the last treatment areas to be influenced by the 'personalized medicine' bandwagon. Some anti-angiogenic agents, poly (ADP-ribose) polymerase (PARP), and immune checkpoint inhibitors have shown efficacy in early stages of development for the treatment of epithelial ovarian cancer. As a result of vigorous clinical trials, bevacizumab, cediranib, pazopanib, olaparib, and rucaparib, either used alone or in adjunct to conventional cytotoxic agents, have all been shown to improve progression-free survival in first-line/maintenance, platinum-resistant or sensitive recurrent settings. A biomarker for bevacizumab is currently elusive. Olaparib is the first drug approved for the treatment of high-grade serous tumors and requires routine testing for BRCA mutation. Trial results of PARP inhibitors in the homologous recombination-deficient (non BRCA mutation) population are awaited and the introduction of these agents into the clinic will require robust methods of detecting homologous recombination-deficiency. Second-generation studies combining anti-angiogenic agents with PARP inhibitors are in progress and early results in the recurrent setting are encouraging. Trials with immune checkpoint inhibitors such as nivolumab produced prolonged responses in a small set of ovarian cancer cases and need further exploration, for example in combination with anti-angiogenic agents. The application of targeted agents and immunologics, alone or in combination, to induce a survival advantage in patients with epithelial ovarian cancer should be continued.
Bevacizumab ; Cytotoxins ; Disease-Free Survival ; Humans ; Immunotherapy* ; Ovarian Neoplasms*

PURPOSE: To evaluate the specific findings of angiography for various causes of gastrointestinal bleeding. MATERIALS AND METHODS: We retrospectively analyzed 35 patients of gastrointestinal bleeding detected by angiography, between April 1987 and July 1993. There were 28 men and 7 women, 19 to 83 years old (mean, 47 years). Of these 35 cases of gastrointestinal bleedings, there were 12 gastric bleedings, 4 duodenal bleedings, 9 small intestinal bleeings, 6 ileocecal bleedings, and 4 large intestinal bleedings. RESULTS: Of 35 cases, we could diagnose the specific cause of bleeing in 13 patients (37%) by angiography. Of these 13 cases, there were 4 cases of gastric ulcers showing contrast pooling in ulcer crater, 5 cases of vascular malformations showing anomalous vascular mass with early dilated venous drainage, 2 cases of direct invasion of hepatocellular carcinoma showing invasion of hypervascular mass into small bowel, one case of pseudoaneurysm at gastroduodenal artery in a patient of acute pancreatitis, and one case of small intestinal lymphoma showing contrast pooling in a irregular dilated small intestinal lumen. CONCLUSION: in gastrointestinal bleeding, angiography is useful not only in detecting the bleeding site, but also for evaluating the specific causes such as gastric ulcers or vascular malformations.
Aged, 80 and over ; Aneurysm, False ; Angiography ; Arteries ; Carcinoma, Hepatocellular ; Diagnosis* ; Drainage ; Female ; Hemorrhage* ; Humans ; Lymphoma ; Male ; Pancreatitis ; Retrospective Studies ; Stomach Ulcer ; Ulcer ; Vascular Malformations

Epidemiological and experimental studies have established that specific human papillo-mavirus(HPV) types are strongly associated with cervical cancer. In understanding the role of HPV in the development of cervical cancer, more accurate and efficient detection method of various HPV types is warranted. Currently polymerase chain reaction(PCR)-based methods are the most commonly used one. Recently developed PCR systems, mainly, amplify a region of the L1 or E1 genes of HPVs which may not be integrated into host chromosome and more likely to produce false negative results. In this paper we describe the design and use of a simplified PCR system with high sensitivity in which all primers are multiplexed in the same PCR mixture. The full genomic sequence of HPV types were obtained from the HPV Sequence Database(http://hpv-web.lanl.gov). Matrix, homology and alignment analyses were carried out by using computer programs such as CLUSTAL V, DNASIS(TM) and Amplify. To determine the detection sensitivity of our PCR system, we have performed experiments using cloned HPV DNAs of type 16 and 18 serially diluted(10-fold dilutions from 10 picogram to 0.01 femtogram per assay) and in a cocktail. By alignment and comparing the sequences we located regions of outer and inner primer sequences based on the E6, E7 and E1 open reading frames which is usually integrated into host chromosome. Amplimer size were determined in order to be below than 400 base pair. The sensitivity of our PCR system ranged from the 1 copy per cell for HPV 16 and 10 copies per cell for HPV 18. This sensitivity was maintained when cloned HPV 16 and 18 DNAs were applied both individually and in a cocktail with variable mixing ratio. Our PCR system shows high sensitivity and specificity with minimal competitive inhibition between primers. This multiplex nested PCR system may be efficiently used for simultaneous detection and typing of HPV 16 and 18 in paraffin-embedded sections or rapid prepared samples.
Base Pairing ; Clone Cells ; DNA ; Human papillomavirus 16 ; Human papillomavirus 18 ; Humans* ; Open Reading Frames ; Polymerase Chain Reaction* ; Sensitivity and Specificity ; Uterine Cervical Neoplasms

Historically, gastrointestinal stroma tumors (GIST) have been considered as smooth muscle tumors, but the controversy over this histogenesis is provoked due to various results with utilizing immunohistochemical methods. In andeffort to further clarify the histogenesis of GIST, we performed the immunohistochemical study, as well as histopathologic reexamination, of 24 cases, all diagnosed as smooth muscle tumors of gastrointestinal tract, from Seoul Paik Hospital and Ewha University Hospital between 1980 and 1989, and the main results were as follows; 1) In the histopathologic features by light microscopic study, 11 benign and 13 malignant lesions (including one high grade malignancy and 12 low-grade malignant lesions) were disclosed. 2) In the immunohistochemical study, all tumors showed Vimentin positivity (100%), but no tumor showed S-100 protein positivity (0%), and 7 cases (29.1%) showed Desmin positivity. Positive reaction for Desmin made it possible to suggest that the histogenesis of GIST be in smooth muscle, and neurogenic origin would be excluded by all negativity for S-100 protein. In summary, we would like to conclude that GIST would be smooth muscle tumors on account of their morphological characteristics and their intramural location, but most of them appear poorly differentiated by immunohistochemical method.