Angiogenesis is a crucial step in tumor growth and progression. Scarce data is available on angiogensis in gastrointestinal tumors. We studied 16 normal colon, 44 adenomas and 29 carcinomas to evaluate angiogenesis in colorectal tumors and to assess the correlation among p53 protein, proliferative activity and other clinical prognostic parameters. Endothelial cells were immunostained with an anti-Factor VIII mAb; in each case three microscopic fields(x 200) were counted: average number of the three fields was defined as microvessel density (MVD). p53 protein expression was 45.5%(20/44) in adenomas, and 79.3%(23/29) in carcinomas (p<0.01). p53 protein expression of carcinomas was 57.1%(4/7) in diploid tumors, 100%(8/8) in aneuploid tumors (p=0.07), 100%(8/8) in well differentiated tumors, and 50%(2/4) in poorly differentiated tumors (p=0.09). MIB-1 score was 2.3+/-0.7(38) in adenomas, 3.4+/-0.5(29) in carcinomas (p<0.01). There was no significant correlation between p53 protein and MIB-1 score. MVD was 10.4+/-4.1(16) in the normal mucosa, 21.5+/-7.9(39) in the adenomas, 35.3+/-9.7(26) in carcinomas (normal versus adenomas, p<0.01; adenomas versus carcinomas, p<0.01). MVD was 25.8+/-5.4(2) in carcinomas confined to mucosa, and 36.1+/-9.6(24) in carcinomas with transmural invasion. The higher MIB-1 score was in carcinomas the more MVD increased but there was no statistical significance (r=0.38, p=0.055). MVD of carcinomas was not associated with nodal metastasis, p53 expression, and DNA ploidy. p53 protein and MIB-1 expression are useful methods for the evaluation of malignancy, and tumor angiogenesis is an early event in a colorectal tumor but MVD does not correlate with prognostic parameters except for the tumor depth.
Adenoma* ; Aneuploidy ; Colon ; Colorectal Neoplasms ; Diploidy ; DNA ; Endothelial Cells ; Microvessels* ; Mucous Membrane ; Neoplasm Metastasis ; Ploidies

Objective: To discuss the association between the length of stay at the intensive care unit (ICU) and sarcopenia among hemiplegic stroke patients. Methods: This study evaluated 66 hemiplegic stroke patients with history of ICU admission using handgrip strength and bioelectrical impedance analysis to obtain height-adjusted appendicular skeletal muscle mass. The diagnosis of sarcopenia was made according to the muscle mass based on the Asian Working Group for Sarcopenia. The patients were divided into sarcopenic and non-sarcopenic groups. The two groups were statistically analyzed, and the significant factors with differences were studied. A multivariate logistic regression analysis was performed to examine the association between length of stay in the ICU and sarcopenia, after adjusting for potential confounders. Results: Among 66 hemiplegic patients with an ICU admission history, 12 patients were diagnosed with sarcopenia. Sarcopenia patients showed lower scores on the Korean version of the Modified Barthel Index and the Korean version of the Mini-Mental State Examination. Additionally, patients with sarcopenia had a longer length of stay in the ICU, and univariate and multivariate analyses confirmed that the ICU length of stay was significantly related to sarcopenia (adjusted odds ratio=1.187; 95% confidence interval, 1.019–1.382; p=0.028). Conclusion The length of stay in the ICU was significantly associated with sarcopenia in hemiplegic stroke patients.

Cisplatin has been widely used as chemotherapeutic agent for the treatment of cervical cancer, ovarian cancer, head and neck cancer and squamous cell carcinoma of lung. But cisplatin is highly toxic with nephrotoxicity, gastrointestinal toxicity, myelosuppression and neurotoxicity. The second generation drug of platinum compound, carboplatin was developed in 1980s to reduce side effects. Carboplatin has low nephrotoxicity but its major toxic effect is thrombocytopenia, In this study, the side effects of cisplatin and carboplatin were evaluated on 37 patients of cervical cancer in 169 chemotherpy cycles who were recieved combined VBP chemotherpeutic regimen consisting of cisplatin or carboplatin. Nephrotoxicity of grade 2 or over were 16% in cisplatin group and 1% in carboplatin group. Granulocytopenia of grade 2 or over were 34% in cisplatin group and 10% in carboplatin group. Thrombocytopenia of grade 2 or over were 7% in cisplatin group and 21% in carboplatin group. Gastrointestinal toxicity of grade 2 or over were 11% in cisplatin group and 0% in carboplatin group. This clinical study demonstrated that cisplatin has more toxic effects than carboplatin except thrombocytopenia.
Agranulocytosis ; Carboplatin* ; Carcinoma, Squamous Cell ; Cisplatin* ; Drug Therapy, Combination* ; Head and Neck Neoplasms ; Humans ; Lung ; Ovarian Neoplasms ; Platinum ; Thrombocytopenia ; Uterine Cervical Neoplasms

This study was undertaken for the clinical analysis and evaluation on 121 patients with incompetent internal os of the cervix, who were admitted and treated with McDonald operation or Shirodkar operation at the Soonchounhyang Medical Center from January 1991 to December 1995. The results of this study were as follows : 1. The incidence of this IIOC was 1.1% of 11,116 cases of total delivery. 2. The mean age of IIOC was 31.7 years old. 3. The average number of gravida was 3.2. 4. The most common contributary factor was previous history of artificial abortion (51.2 %), and midtrimester abortion (17.4 %), cervical laceration due to previous vaginal delivery (8.3 %) etc. was followed. 5. The success rate of operation was 76 %, and the highest success rate (85.7 %) was reveald with period from 15th weeks to 16th weeks of gestation. 6. When cervical dilatation was abscent or small, the success rate of operation was high. 7. The factors of failed operation were preterm labor (58.7 %), PROM (34.5 %), and PIH, bleeding. 8. The delivery method after operation was vaginal delivery in 83 cases (68.6%) and cesarean section in 38 cases (31.4 %).
Cervix Uteri* ; Cesarean Section ; Female ; Hemorrhage ; Humans ; Incidence ; Labor Stage, First ; Lacerations ; Obstetric Labor, Premature ; Pregnancy ; Pregnancy Trimester, Second

We report a case of prenatal diagnosis of fetal congenital goiter at 31weeks of gestation by ultrasonogram and fetal hypothyroidism confirmed at birth as thyroid function test by umbilical cord blood sampling. Maternal Graves' disease and the drugs used to treat hyperthyroidism in pregnant women can affect the fetus, causing hyperthyroidism or hypothyroidism and goiter. Fetal hypothyroidism may be caused by transplacental passage of either maternal thyrotropic-binding inhibitory immunoglobulin(TBII) antibodies or maternal treatment with propylthiouracil(PTU). Untreated fetal hypothyroidism may result in mental retardation, perceptual-motor, visual-spatial, and language developmental problems. In this article fetal thyroid function was not assessed by cordocentesis, but fetal congenital goiter was detected ultrasound. Ultrasound should be used to detect fetal goiter from 20 weeks onward. Fetal goiter should resolve when maternal PTU treatment is decreased. We have diagnosed fetal hypothyroidism in utero by ultrasonography. Significance of in utero management of fetal hypothyroidism is discussed.
Antibodies ; Congenital Hypothyroidism ; Cordocentesis ; Female ; Fetal Blood ; Fetus ; Goiter* ; Graves Disease ; Humans ; Hyperthyroidism* ; Hypothyroidism ; Intellectual Disability ; Language Development ; Mothers* ; Parturition ; Pregnancy ; Pregnant Women ; Prenatal Diagnosis* ; Thyroid Function Tests ; Thyroid Gland ; Ultrasonography

Hand tumor may arise as primary growth from any of the tissue present in the hand. Most are benign and malignant are uncommon. The hand is a sensitive organ, has a little potential space and moving parts, so tumors are usually detected early because of pain, impairment of function or swelling. A knowledge of frequency, location and clinical characteristics of hand tumor is invaluable in diagnosis. Usually early susgical measure is the treatment of choice. For the period of 6 years from 1962 to 1977, 29 cases of hand tumor were treated surgically and the results of clinical observation were as follows 1. Of 29 cases, benign tumor was 25 cases (86%) and bone-origin tumor was 18 cases. Enchondroma and enchondromatosis was the most frequent (12 cases). 2. The tumor occurred 22 cases in phalanx, 10 in metacarpal, and 2 in carpal bones. 3. The tumors were treated with excision in 11 cases, curettage & bone graft in 10, amputation in 4, biopsy in 2 and no treamtent in 2. 4. The most frequent site of enchondroma and enchondromatosis were ulnar side, ring and little finger, and of these metacarpophalangeal joints were involved most frequently.
Amputation ; Biopsy ; Carpal Bones ; Chondroma ; Curettage ; Diagnosis ; Enchondromatosis ; Fingers ; Hand ; Metacarpophalangeal Joint ; Transplants

No abstract available.
Pregnancy*

BACKGROUND: Measurement of echocardiographic mitral valve area (MVA) is an useful noninvasive method of estimating the stenotic mitral valve area. This study was undertaken to evaluate the accuracy of echocardiographic MVA measurement by comparing MVAs measured by the planimetric and pressure half-time method versus direct MVA measurement by using a cone shaped device specifically made for direct measurement of MVA. METHODS AND RESULTS: The study population consisted of 22 consecutive patients from August 1993 to February 1996. All the patients underwent 2D planimetry and Doppler echocardiographic MVA measurement before and after valve replacement surgery ; direct measurement also was performed after surgery. Five patients (22.7%) had normal sinus rhythm, and the rest of the patients had atrial fibrillation. Two-dimensional echocardiographic examinations were attempted in 22 patients, and adequate measurements were obtained in 21 of the patients studied. Mean mitral valve area were 0.99+/-0.32cm (2) ranged from 0.42 to 1.68cm (2) on 2D planimetry method, 0.93+/-0.32cm (2) ranged from 0.42 to 1.68cm (2) on Doppler pressure half-time method, 1.17+/-0.20cm (2) ranged from 0.93 to1.68cm (2) on direct measurement of mitral valve area after surgery. 2D planimetry method (r=0.621, p=0.003, SE=0.165), pressure half-time method (r=0.454, p=0.003, SE=0.187), and transmitral peak velocity (r=-0.480, p=0.026, SE=0.189) was relatively well correlate with operative mitral valve area. There was relatively good agreement between direct and 2D planimetric measurement and between direct and Dopler pressure-half time method. CONCLUSION: 2D planimetry and Doppler pressure half-time method on echocardiography are useful, noninvasive measurement method in patients with mitral stenosis.
Atrial Fibrillation ; Echocardiography* ; Humans ; Mitral Valve Stenosis* ; Mitral Valve*

PURPOSE: A traumatic diaphragmatic rupture (TDR) is a diagnostic challenge and the associated injuries determine the outcome in those diagnosed early. A TDR has long been considered to be a marker of the severity of injury with an average reported Injury Severity Score (ISS) between 31 and 50. This report reviewed the TDR cases in order to emphasize the method and timing of the diagnosis, associated injuries and the outcome. METHODS: A retrospective analysis was performed on 30 patient treated for TDR between August 1998 and september 2002. RESULTS: The mean age of the patients was 33.4 years and the injury predomiantly affected males (male: female=2: 1). Blunt trauma by TA was the most common cause of the TDR (25 patients). The ruptured sites were on the left in 22 cases and on the right in 8 cases. The most common symptom was chest pain (23 cases) followed dyspnea (21 cases). Liver injuries and a pneumo-hemothorax were the most common associated injuries. The mean CRAMS scale was 6.47 and Injury Severity Score (ISS) was 18.93. Eighteen TDR cases were suspected based on the abnormal chest X-ray findings. Nineteen cases underwent surgery within 6 hours after the trauma (early diagnosis). Although many complications occurred in 11 cases, there were no lethal complications. The mean size of the diaphragmatic rupture was 9.77 cm and an intraabdominal organ herniation had not occurred in ruptures smaller than 6 cm. Surgical repair of the diaphragm was performed via a laparotomy in 20 cases and thoracotomy in 7 cases. A left side TDR was preferred to a laparotomy whereas a right sided TDR was preferred to a thoracotomy. Pulmonary complications (atelectasis, pneumonia, pleural effusion) occurred in 14 cases postoperatively. CONCLUSION: The patient's complaints and physical findings were not a reliable indicator of the diagnosis, but usually a manifestation of the associated injuries. A suspicion and routine chest X-ray was the most reliable diagnostic tool, even though the chest X-ray was normal in 12 cases. A high rate of early diagnosis can be achieved using an aggresive investigation protocol, suspicion and a combined radiologic evaluation in multiple trauma patients. Although pulmonary complications occurred in the early diagnosed cases, lethal complications and long term sequela were directly related to the time of diagnosis. The higher ISS had many complications (11 cases) but there were no lethal complications, long term sequela.
Chest Pain ; Diagnosis ; Diaphragm ; Dyspnea ; Early Diagnosis ; Humans ; Injury Severity Score ; Laparotomy ; Liver ; Male ; Multiple Trauma ; Pneumonia ; Retrospective Studies ; Rupture ; Thoracotomy ; Thorax

Barrett's esophagus is a premalignant condition of esophageal adenocarcinoma. Inducible nitric oxide synthase (iNOS) is induced by cytokines and can generate locally high concentrations of nitric oxide (NO), whose metabolites can mediate genotoxicity and influence multistage carcinogenesis by causing DNA damage. Therefore, we evaluated the immunolocalization and expression of iNOS in surgically induced rat Barrett's esophagus. Esophagoduodenal anastomosis was performed in rats for inducing reflux of duodenal contents. Rats were killed at postoperative 10, 20, 30 and 40 weeks. We examined histologic changes and iNOS expression in esophagus by immunohistochemistry and reverse transcription-poly-merase chain reaction. Eighty six percent of experimental rats showed Barrett's esophagus above esophagoduodenal junction. iNOS immunoreactivity was clearly observed in the epithelial cells of Barrett's esophagus, predominantly at the apical surface of epithelial cells. Cytoplasmic staining was also seen only in atypical Barrett's esophagus. iNOS mRNA was detected only in the lower esophagus of experimental group. In conclusion, this study suggests that iNOS has some roles on Barrett's esophagus formation.
Anastomosis, Surgical ; Animals ; Barrett Esophagus/*enzymology/*surgery ; Cytoplasm/metabolism ; DNA Damage ; Disease Models, Animal ; Duodenum/*enzymology/surgery ; Esophagus/metabolism ; Immunohistochemistry ; Male ; Models, Anatomic ; Neoplasms, Experimental/pathology ; Nitric Oxide/metabolism ; Nitric-Oxide Synthase/*biosynthesis ; RNA/metabolism ; RNA, Messenger/metabolism ; Rats ; Rats, Sprague-Dawley ; Research Support, Non-U.S. Gov't ; Reverse Transcriptase Polymerase Chain Reaction ; Time Factors