PURPOSE: We evaluated the correlation between the carcinogenesis of gallbladder and the expression of lysozyme, p53, c-erbB2 and CEA in gallbladder lesions. MATERIALS AND METHODS: Thirty cases of gallbladder lesions (containing 17 cases of GB carcinoma) were examined. We analyzed the clinicopathologic findings of the early (stage I & II) and advanced carcinoma (stage III, IV & V) and those of carcinoma with or without metaplasia in the tumor. We performed p53, c-erbB2 and CEA immunohistochemical staining and compared their findings with those of normal mucosa and preneoplastic lesions. We also performed lysozyme immunohistochemical staining and compared its finding with metaplastic and non-metaplastic lesions. RESULTS: There are two distinct genetic pathways in gallbladder cacinogenesis and metaplastic carcinoma was more frequent than non-metaplastic carcinoma. Metaplasia of gallbladder did not reveal any difference of the clinicopathologic findings and depth of invasion (Nevin stage). Lysozyme expression was found in all metaplastic lesions but non-expression did not indicate non-metaplastic lesions. p53 mutations and c-erbB2 alterations may have a role in the carcinogenesis of gallbladder carcinomas, especially, in a late event, and in an early and late events, respectively. The correlation of p53 and c-erbB2 expressions was found but which did not indicate that the co-expression was needed in the carcinogenesis. CEA immunohistochemical staining may be helpful in the differential diagnosis of benign lesions and precancerous and cancerous lesions of the gallbladder. CONCLUSION: These results suggest that p53 mutations and c-erbB2 alterations may have a role in the carcinogenesis of gallbladder carcinomas, especially, in a late event, and in an early and late events, respectively.
Carcinogenesis ; Diagnosis, Differential ; Gallbladder* ; Metaplasia* ; Mucous Membrane ; Muramidase

PURPOSE: Endovenous laser treatment for incompetent great saphenous vein (GSV) has been recently proposed as an effective means of treatment. The aim of this study is to identify the complications and safety of EVLT as the main treatment for primary varicose vein incompetence when used concomitantly with miniphlebectomy and sclerotherapy. METHODS: We reviewed the records of 153 patients who underwent EVLT. Venous duplex scanning was performed 3 months after surgery in all the patients. The clinical outcomes were evaluated using questionnaires at the outpatient clinic or through phone calls. RESULTS: Considering the 97% satisfaction rate of EVLT, EVLT was an effective treatment for primary varicose vein. We observed complications such as paresthesia (20.9%), pain lasting more than 2 weeks (11.8%), ecchymosis or bruising (7.2%) that subsided spontaneously, superficial burn (5.2%) and phlebitis (2%) that was controlled by conservative treatment. The GSV recanalization rate 3 months after the procedure was 3.3%, resulting in a 96.7% success rate. CONCLUSION: The early results indicate that EVLT is an effective and safe procedure to eliminate the SFJ (sapheno-femoral junction) and obliteration of the GSV. However, long-term follow-up is necessary in our study. Better treatment outcomes are possible with accumulated experience and the establishment of strict indications for EVLT.
Ambulatory Care Facilities ; Burns ; Ecchymosis ; Follow-Up Studies ; Humans ; Paresthesia ; Phlebitis ; Surveys and Questionnaires ; Saphenous Vein ; Sclerotherapy ; Varicose Veins*

PURPOSE: Cycloporine A (CsA) is a immunosuppressive agent most widely used in organ transplanted patients for preventing immunorejection, but it has some side effects, including hypertension, nephrotoxicity, hepatotoxicity and diabetes. The mechanism of toxicity of CsA was not completely understood, but the reactive oxygen species has been proposed to be involved in the reaction of toxicity of CsA. The purpose of this study is to determine the effects of glutathione, as a physiological antioxidant on CsA induced cytotoxicity in rat insulinoma (RINm5F) cells. METHODS: RINm5F cells were incubated in the presence of CsA (105~108 M) and buthionine sulfoximine (BSO), as a inhibitor of r-glutamyl cysteine synthetase, was added to cultured media (RPMI1640). Twenty four hours of incubation with CsA and BSO, viable cells were determined by MTT method. RESULTS: CsA decreased cell viability in dose response in cultured RINm5F cells and significantly decreased according to redusing glutathione. CONCLUSION: These results suggested that CsA may induce the diabetes and glutathione have some roles in the pathogenesis of CsA-induced diabetes.
Animals ; Buthionine Sulfoximine ; Cell Survival ; Cyclosporine* ; Cysteine ; Glutathione* ; Humans ; Hypertension ; Insulinoma* ; Ligases ; Rats ; Reactive Oxygen Species

PURPOSE: To analyze the recent citation trend and to find a way to improve impact factor (IF) of the Journal of Korean Therapeutic Radiology and Oncology (JKSTRO) by analysis of Korean Medical Citation Index (KoMCI) citation data of JKSTRO and comparison with that of mean citation data of all journals enlisted on KoMCI (KoMCI journals) during 2000-2005. MATERIALS AND METHODS: All citation data of entire journals enlisted on KoMCI and JKSTRO from 2000 to 2005 were obtained from KoMCI. The trend of total and annual number of published articles and reference citations, total citations and self-citations per paper, IF and impact factor excluding self-citations (ZIF) were described and compared on both KoMCI journals and JKSTRO. RESULTS: Annual number of published articles was decreased for 6 years on both KoMCI journals and JKSTRO (32% and 38% reduction rate). The number of Korean journal references per article is 1.6 papers on JKSTRO comparing to 2.0 papers on KoMCI journals. The percentage of Korean references/total references increased from 5.0% in 2000 to 7.7% in 2005 on JKSTRO and from 8.5% in 2000 to 10.1% on KoMCI journals. The number of total citations received/paper on JKSTRO (average 1.333) is smaller than that of KoMCI journals (average 1.694), there was an increased rate of 67% in 2005 comparing to 2000. The percentage of self-citations/total citations (average 72%) on JKSTRO is slightly higher than that of KoMCI journals (average 61%). IF of JKSTRO was gradually improved and 0.144, 0.125, 0.088, 0.107, 0.187, and 0.203 in 2000-2005 respectively. However, ZIF of JKSTRO is steadily decreased from 0.038 in 2000 to 0.013 in 2005 except 0.044 in 2004. CONCLUSION: IF of JKSTRO was slightly improved but had some innate problem of smaller number of citations received. To make JKSTRO as a highly cited journal, the awareness of academic status of JKSTRO and active participation of every member of JKSTRO including encouraging self-citations of papers published recent 2 years and submission of English written papers, and active academic cooperation with related academic societies.
Radiation Oncology*

p53 is a tumor suppressor gene product identified in a wide range of tumor including colorectal carcinoma. Genetic alterations in the p53 tumor suppressor gene are common in human colorectal carcinoma. bcl-2 is a protooncogene that inhibits apoptosis. The products of mutant p53 gene and bcl-2 have been associated with prognosis in several malignancies including colorectal carcinomas. This study was undertaken to evaluate values of p53 and bcl-2 oncoproteins as prognostic factors relative to clinicopathological factors and correlation of their expression. Analyses were made on achieval pathologic tissues of 80 patients with colorectal carcinomas including 34 patients able to follow-up over 5 years. The oncoproteins were localized using commercially available monoclonal antibodies:DO-7 for p53, clone124 for bcl-2. Expression of bcl-2 was cytoplasmic, whereas nuclear p53 expression was localized in carcinoma cells. The patients were 17 to 83 years of age. The expression of p53 and bcl-2 was determined respectively in 30 (37.5%) and 21 (26.3%)cases. The expression of p53 nuclear expression was not correlated with tumor location, size, histologic grade, Duke's classification, regional lymph node metastasis and tumor recurrence. The cytoplasmic expression of bcl-2 was not correlated with tumor location, size, histologic grade, Duke's classification, regional lymph node metastasis and recurrence. Univariate analysis showed that patients with p53 nuclear expression were not associated with poorer overall survival than patients with p53 negative, and also showed in patients with bcl-2 expression. The expression of p53 did not affect to that of bcl-2. We concluded that the p53 nuclear and bcl-2 cytoplasmic expression were not independent prognostic factors in colorectal carcinomas. Evidence of reciprocity of bcl-2 and p53 expression was not found.
Apoptosis ; Classification ; Colorectal Neoplasms* ; Cytoplasm ; Follow-Up Studies ; Genes, p53 ; Genes, Tumor Suppressor ; Humans ; Lymph Nodes ; Neoplasm Metastasis ; Oncogene Proteins ; Prognosis ; Recurrence

Conventional abdominoplasty includes the removal of an ellipse-shaped section of abdominal tissue between the umbilicus and mons pubis. However, this method can result in tension of the undermined flap, especially in the midline. To address this problem, we present reverse lip design as a modified method that also has aesthetic advantages. The reverse lip design entails a longer lower flap edge while preserving the triangular tissue in the vascularly stable pubis area. These markings create an image of a reverse lip shape with a cleft at the bottom of the lower markings. After typical lipoabdominoplasty is performed, redundant waist tissues can easily be pulled inward and downward. The reverse lip design abdominoplasty demonstrated no complications and required no further revisions after the procedure. Patients were generally satisfied with the aesthetic improvements in their body shape. They were also able to return to their routine activities approximately 1 week after the operation while wearing a supporting undergarment. This modified abdominoplasty using the reverse lip design reduces low midline tension of the undermined abdominal flap while enhancing body aesthetics with a slimmer waistline, leading to higher patient satisfaction.

Our experience of surgical management of 20 adrenal tumors was present during the period from June, 1988 to May, 1993. The results of clinical study were as follows ; 1. Average age of patients was 40.9 years with the highest incidence in sixth decade occupying 40% and male to female ratio was 1:1 and right to left ratio was equal also. 2. The adrenal tumors consist of 8 adrenocortical adenoma( including 3 primary aldosteronisms and 1 Cushing syndrome), 4 adrenocortical carcinoma(including 1 Cushing syndrome), 7 pheochromocytomas and l neuroblastoma. 3. The 11 functioning adrenal tumors( including 4 adrenocortical adenomas, 1 adrenocortica1 carcinoma and 6 pheochromocytomas) showed specific symptoms and signs and the majority symptom and sign of the 9 non-functioning adrenal tumors( including 4 adrenocortical adenomas, 3 adrenocortical carcinomas, 1 neuroblastoma and 1 pheochromocytoma) showed abdominal discomfort and pain. 4. For initial diagnosis of the adrenal tumors, USG, CT, MRI and angiography are reliable but IVP was reliable in large adrenal tumor 5. The surgical approaches were transperitoneal in 18 patients and retroperitoneal in 2 patients and postoperative surgical complication occurred in 3 patients of transperitoneal approaches that were prolonged ileus, spleen injury and pancreatic injury with pleural effusion.6. The tumor masses were 12gm to 4,000gm in weight (mean: 616gm). The adrenal benign and malignant tumor were significantly different in weight ( 120gm : 1817gm).
Adrenocortical Adenoma ; Adrenocortical Carcinoma ; Angiography ; Diagnosis ; Female ; Humans ; Ileus ; Incidence ; Magnetic Resonance Imaging ; Male ; Neuroblastoma ; Pheochromocytoma ; Spleen

We analyzed the prognostic factors, such as sex, age, tumor shape, number, 1ocation, size, TNM stage, WHO grade, modified Bergkvist grade, treatment modality, cytology, type of progression, mitotic activity index(MAI), volume corrected mitotic index(M/V index) and pathologic grade, in a chort of 83 advanced transitional cell carcinoma of bladder who was followed for more than 3 years. N stage of TNM,WHO grade, modified Bergkvist grade and pathologic stage were related to mitotic indices(p<0.05), but cytology was related to MAI only (p<0.05).In univariate analysis of prognostic factors, sex, N and M stage of TNM, progression type, MAI & M/ V index and pathologic stage were related to 5-year survival during follow up. Multivariate analysis of prognostic factors, which were significantly related in univariate analysis, identified MAI as the most important factor(p<0.05), followed by M/V index, N stage of TNM, sex, M stage of TNM and progression type. The result show that advanced transitional cell bladder tumors can be efficiently categorized into prognostic groups by quantitative mitotic frequency analysis.
Carcinoma, Transitional Cell ; Follow-Up Studies ; Mitotic Index* ; Multivariate Analysis ; Prognosis* ; Sex Factors ; Urinary Bladder Neoplasms* ; Urinary Bladder*

This studly was perormed 10 define the role of compulerized quantitative analysis in ewalualion for overexpression of p53 by immunohistochemistry. Total and ladeled cells wers counted automatically using commercially available software for color-image analysis. In 16 uterine cerwical carcinomas, the p53 ladeling index calculted bycomputerized5quantitatiwe analysis was 9.22%+/-8.70% and by visual analysis 5.90+/-6.51%. The present results suggest that the computerized quantitative analysis may be valuadle in objective interetation of immunohistochemical expression of p53 and reliable than conventional ways of visual analysis.
Cervix Uteri* ; Female ; Immunohistochemistry

PURPOSE: The Pediatric Risk of Mortality(PRISM) III score was developed from the Physiologic Stability Index(PSI) to assess pediatric ICU mortality and Provide an objective data as a severity index. Although the PRISM score has been applied to many comparisions and analyses in previous studies, there are few reports applied to pediatric intensive care patients in Korea. To evaluate the effectiveness of the PRISM III score as a severity index for expecting mortality and find important variables influencing mortality, we applied this scoring scale to pediatric neurologic patients admitted to the ICU and analyzed the data statistically. METHODS: Data collection was done by careful review of medical records and scored each clinical variable. The outcome at discharge was determined as non-survival, survival, and hopeless discharge. Determination of mortality in the hopeless discharge group was done within 48 hours after discharge by telephone interview. The study populations were classified into four groups; CNS infection(26 patients), acute encephalopathy(31 patients), status epilepticus(35 patients) and cerebrovascular disorder(4 patients). The difference of the PRISM III score between the survival group and non-survival group was compared by using the nonparametric Mann~Whitney test in the entire study population and for each diagnostic group. To confirm the degree of fitness between the actual mortality and Predicted mortality, the Hosmer-Lemeshow goodness-of-fit test, a multiple logistic regression model was used. All clinical variables used for scoring were compared for survivals and non-survivals by the Chi-square test. f values <0.05 were considered significant. RESULTS: The PRISM III score was significantly higher in the non-survival groups than in the survival group. Predicted mortality from the PRISM III score has fitted to actual mortality According to the results of analyses in each diagnostic groups, the PRISM III score was higher in non-survivals of the acute encephalopathy and CNS infection groups, but statistically insignificant in the cerebrovascular disorders and status epilepticus groups. The important variables of the PRISM III score associated with mortality were mental state, Pupil reflex, systolic blood pressure, acidosis, blood sodium level blood creatinine level, blood glucose level, and PT/PTT. , CONCLUSION: The PRISM III score is helpful in predicting mortality in pediatric intensive care neurologic patients, especially those in the acute encephalopathy or the CNS infection groups. However, this score was not useful in the status epilepticus group, and insignificant in cerebrovascular group. Due to the smallness of the study group, more massive and comprehensive studies are needed as a follow up to this study.
Acidosis ; Blood Glucose ; Blood Pressure ; Cerebrovascular Disorders ; Creatinine ; Data Collection ; Follow-Up Studies ; Humans ; Critical Care* ; Interviews as Topic ; Korea ; Logistic Models ; Medical Records ; Mortality* ; Pupil ; Reflex ; Sodium ; Status Epilepticus