BACKGROUND: Angiogenesis plays a critical role in human tumor growth and metastasis. Microvessel count, as a measure of tumor angiogenesis, has been significantly correlated with invasive and metastatic patterns in breast, prostate and cutaneous carcinomas. Materials and METHODS: Fifty patients with curatively resected non-small cell lung cancer were evaluated. Tumor tissues embedded in paraffin block were stained by anti CD 31 (PECAM, platelet endothelial cellular adhesion molecule) using immunohistochemical method to assess microvessel count. Microvessels were counted in the most active areas of neovascularization(microscopy, 200×). RESULTS: 1) Mean microvessel count was 47.1 ± 17.7(per 200×field) in total 50 cases. 2) Mean microvessel count of adenocarcinoma (54.4±19.9) was significantly higher than that of squamous cancer(43.9±16.2)(p<0.05), but there were no relationship between microvessel count and TNM stages. 3) Median survival time, 2-year and 5-year survival rates of the low microvascular group(microvessel count<45, 22cases) were 61 months, 80% and 40%, respectively, and those of the high microvascular group(microvessel count ≥ 45, 28 cases) were 46 months, 75% and 12%, respectively. As results, prognosis of low microvascular group is statistically significantly superior to that of the high microvascular group(p=0.0162, Kaplan-Meier, log-rank). CONCLUSION: Angiogenesis assessed by microvessel count can be used as one of the significant prognostic factors in non-small cell lung cancer.
Adenocarcinoma ; Blood Platelets ; Breast ; Carcinoma, Non-Small-Cell Lung* ; Humans ; Microvessels ; Neoplasm Metastasis ; Paraffin ; Prognosis ; Prostate ; Survival Rate

Aspergillosis refers to an infection with any species from the genus Aspergillus. Pleural aspergillosis is an uncommon disease with less than 30 cases having been reported in the literature since 1958. The etiologic factors for this aspergillosis are preexisting pulmonary tuberculosis, bronchopleural fistula, pleural drainage, and a lung resection. Surgical removal of the aspergillus-infected pleura is the main treatment for managing this disease. We have experienced two cases of pleural aspergillosis as a complication of a preexisting chronic empyema. The chest radiographs showed a pyopneumothorax with cavitation and the chest computed tomographic scans revealed a loculated pyopneumothorax with cavity formation suggesting a bronchopleural fistula. A grossly purulent fluid was extracted by thoracentesis, and Aspergillus fumigatus was grown from a fungus culture of the fluid. A decortication, wedge resection with a pleurectomy and a pleuropneumonectomy were performed. The postoperative course was satisfactory and the patients have been in good condition up to now. Pleural aspergillosis is a very rare and potentially life-threatening disease. However, good result without significant complication were obtained by treatment with systemic antifungal agents and surgical removal.
Antifungal Agents ; Aspergillosis* ; Aspergillus ; Aspergillus fumigatus ; Drainage ; Empyema ; Fistula ; Fungi ; Humans ; Lung ; Pleura ; Radiography, Thoracic ; Thorax ; Tuberculosis, Pulmonary

Tuberculosis is a common chronic infectious disease, although the spleen is an uncommon organ to harbor tubercle bacilli. Immunocompromised subjects are primarily prone to miliary tuberculosis and in them the spleen is invaded by Mycobacterium tuberculosis. Spleen tuberculosis is manifested commonly as a miliary form. The basic pathology is granulomatous inflammation. The CT finding of splenic tuberculosis are multiple, well-defined, roung or ovoid, low-density masses. Lymphadenopathy in the abdomen and mediastinum and pleural effusion can be found. We report two cases with tuberculosis of the spleen proved by computed tomography and histologic identification. One paitient did not improve following antituberculous medication, so splenectomy was performed. The other patient has been treated with antituberculous medication.
Abdomen ; Communicable Diseases ; Humans ; Inflammation ; Lymphatic Diseases ; Mediastinum ; Mycobacterium tuberculosis ; Pathology ; Pleural Effusion ; Spleen* ; Splenectomy ; Tuberculosis* ; Tuberculosis, Miliary ; Tuberculosis, Splenic

BACKGROUND: Angiogenesis is an essential component of tumor growth and metastasis, and the vascular endothelial growth factor (VEGF) is one of the most important angiogenic factors. Several solid tumors produce substantial amounts of VEGF, which stimulates proliferation and the migration of ednothelial cells, therby inducing neovasculization by a paracrine mechanism. To evaluate the prognostic roles of angiogenesis and VEGF expression in patients with non-small cell lung cancer, the relationship between VEGF expression in tumor tissues, the clinicopathologic features and the overall survival rate were analysed. METHODS: Sixty-nine resected primary non-small cell lung cancer specimens were evaluated. The pareffinembedded tumor tissues were stained by anti-VEGF polyclonal antibodies using an immunohistochemical method to assess VEGF expression. RESULTS: In Forty-one patients (59%), the VEGF antigen was expressed weakly in their tumor tissue, whereas in twenty-eight patients (41%) the VEGF antigen was expressed strongly. The median survival time of the weak VEGF expression group was 24 months, and that of the strong VEGF expression group was 19 months. The three year-survival rates were 35%, 33%, respectively. The survival difference between both groups was not statistically significnat. CONCLUSION: Although results were not statistically significant, the strong expression group tended to poorer prognosis than weak expression group.
Angiogenesis Inducing Agents ; Antibodies ; Carcinoma, Non-Small-Cell Lung* ; Humans ; Neoplasm Metastasis ; Prognosis ; Survival Rate ; Vascular Endothelial Growth Factor A

We report a case of subclavian artery laceration caused by the removal of a pigtail pleural drainage catheter in a patient with a pneumothorax. The patient was successfully resuscitated through diagnostic angiography with subsequent balloon occlusion and primary repair of the injured subclavian artery. Although pigtail drainage of a pneumothorax is known to be safe and effective, proper insertion and removal techniques should be emphasized to reduce the risk of complications.
Angiography ; Balloon Occlusion ; Catheters* ; Drainage ; Hemothorax ; Humans ; Lacerations* ; Pneumothorax* ; Subclavian Artery* ; Thoracostomy

OBJECTIVE: It is known that mouse embryos before implantation develop in a low oxygen environment of 3- 8% concentration and with antioxidant materials such as vitamins, antioxidant enzymes, ferrous binding proteins, and albumin in follicular and tubal fluids. However, the 20% oxygen culture condition with chemically defined media might be produce an abundance of ROS, and leads to developmental delay or developmental block in vitro. In this study, we attempt to elucidate the relationship between intracellular H2O2 production and embryo development in different oxygen culture conditions of mouse embryos. METHODS: Prenuclear embryos from C57BL/CBA Fl hybrid and ICR mouse were cultured in incubators which provided 5% carbon dioxide, 20% oxygen and 5% carbon dioxide, 5% oxygen. Measurement of H2O2 level in a embryo was performed with DCHFDA(2, 7 -dichlorodihydroflourescein diacetate)and analyzed with Quanti-cell 700, and the number of blastomeres was counted with DAPI( 4, 6'-diamidino-2-phenylindole). RESULTS: Oxygen concentration of the culture medias was significantly higher in the 20% oxygen environment compared to that of 5% oxygen environment. Culture of mice embryos in high oxygen condition leads to high HO concentrations at 2 cell stage and developmental delay or ""2-cell block"" regardless of the strain. But in a 5% oxygen environment, which is similar to in-vivo conditions HO production was suppressed continuously through out culture and development of embryos was definitely improved. CONCLUSION: These results suggest that there is a difference in the production of ROS or protective mechanism according to the mouse strains and stage of development, and it is thought that in-vitro culture in 5% oxygen environment provides stable in vivo equilibrium but in a 20% oxygen environment there is production of ROS which overcome the protective mechanism which leads to cellular damage and embryo developmental delay.
Animals ; Blastomeres ; Carbon Dioxide ; Carrier Proteins ; Culture Media ; Embryonic Development ; Embryonic Structures* ; Female ; Incubators ; Mice* ; Mice, Inbred ICR ; Oxygen* ; Pregnancy ; Vitamins

BACKGROUND: Epidural and intravenous (IV) administration of opioids are commonly used for postoperative pain management. However, studies that compare the epidural and IV routes of opiate administration show conflicting results. The purpose of this study was to determine the superior route of analgesics by comparing the effect of epidural fentanyl-bupivacaine with IV morphine using patient-controlled analgesia (PCA) system in the management of posterior thoracic surgery pain. METHODS: Sixty patients undergoing elective thoracic surgery were randomly assigned to receive either Epiural-PCA (Epi-PCA, n=30) or IV-PCA (n=30) when postoperative pain first increased to 40/100 mm (by visual analogue scale; VAS). Epi-PCA group received epidural bolus of 0.1% bupivacaine 10 ml containing fentanyl 100 microgram and then followed by Epi-PCA with 0.1% bupivacaine 100 ml containing fentanyl 800 microgram (basal infusion 2 ml/hr, PCA dose 1 ml, lock-out interval 30 min), IV-PCA group received repeated IV boluses of 3 mg of morphine until postoperative pain decreased to 40/100 mm and then followed by a IV-PCA with morphine (basal infusion 0.005 mg/kg/hr, PCA dose 0.02 mg/kg, lock-out interval 8 min). Analgesic efficacy, degree of patient satisfaction and pain, analgesics consumptions, forced vital capacity (FVC), forced expired volume in one second (FEV1) and side effects were evaluated. RESULTS: There were no significant differences in analgesic efficacy and degree of patient satisfaction and pain in both group. But the PHS were significantly lower (p<.05), and FEV1 higher (p<.05) in Epi-PCA group, signifying better analgesia during movement (cough and deep breaths). CONCLUSIONS: We concluded that an epidural PCA with mixture of fentanyl and bupivacaine administration is superior to that of intravenous PCA with morphine in the management of pain after thoracic surgery.
Analgesia ; Analgesia, Patient-Controlled* ; Analgesics ; Analgesics, Opioid ; Bupivacaine ; Fentanyl ; Humans ; Hydrogen-Ion Concentration ; Morphine* ; Pain, Postoperative ; Passive Cutaneous Anaphylaxis ; Patient Satisfaction ; Thoracic Surgery* ; Vital Capacity

OBJECTIVES: The objective of this study is to analyze 1,068 cases of prenatal genetic amniocentesis and to compare the results with reported studies. METHOD: We analyzed 1,068 cases of midtrimester prenatal genetic amniocenteses from September 1994 to February 1999, and investigated the fetal chromosomal abnormality, obstetric outcomes and complications by the indications of genetic amniocentesis and prophylactic antibiotic use at the Department of Obstetrics and Gynecology, Ajou University School of Medicine. RESULTS: Abnormal maternal serum markers were the most common indication of amniocentesis (57.7%) and the most common age distribution was 25-29 years (39.2%). One case of early amniocentesis (14 gestational weeks) was performed. The overall incidence of chromosomal aberration was 5.2% (56/1,068), of which there were 28 cases (50.0%; 28/56) of numerical aberrations and 28 cases (50.0%; 28/56) of structural aberrations. There were 50 cases (4.7%) of autosomal chromosomal aberrations and 6 cases (0.6%) of sex chromosomal aberrations. The pregnancy outcome was full-term delivery in 86.5%, preterm delivery in 7.6%, termination of pregnancy in 4.0%. There were no cases of serious complications including fetal death except for a case of self-limited amniotic fluid leakage(high leakage) in which the pregnancy was maintained. There were no significant differences between prophylactic antibiotics user group and non-user group in obstetric complications and outcomes. CONCLUSION: We could confirm that the trend in the indication of genetic amniocentesis had changed from advanced maternal age(35 year-old) toward abnormal maternal serum marker(triple test), and we recognized the importance of genetic amniocentesis according to the various antenatal screening tests of maternal serum marker, antenatal ultrasound, past history of fetal anomaly or family history of fetal chromosomal anomaly in the younger age groups(< 35 year-old) that are involved in more than half of the chromosomal anomaly. Further study will be needed to elucidate the efficacy of using prophylactic antibiotics in amniocentesis.
Age Distribution ; Amniocentesis* ; Amniotic Fluid ; Anti-Bacterial Agents ; Biomarkers ; Chromosome Aberrations ; Female ; Fetal Death ; Gynecology ; Humans ; Incidence ; Obstetrics ; Pregnancy ; Pregnancy Outcome ; Pregnancy Trimester, Second ; Prenatal Diagnosis ; Ultrasonography

PURPOSE: This study was done to evaluate the differences in clinical parameters and survival rates between the primary tumor (T) and nodal involvement (N) in stage II cancers. METHODS: This report is a retrospective clinical analysis of 100 patients of stage II gastric cancer who were treated surgically at the Department of Surgery, Chonbuk National University Hospital from Jan. 1990 to Dec. 1999. Among the 100 patients, the pT3N0 group included 48 patients, and the pT2N1 group 52 patients. In this study, we used the UICC TNM staging system (the fourth edition). RESULTS: There were no significant differences except for age and tumor sizes between the pT3N0 and the pT2N1 groups with regard to the mode of presentation, sex, location of tumor, type of resection, lymph node dissection, Borrmann and Lauren classification, cell cytology, recurrence, number of resected lymph nodes, and the 5-year survival rate. Based on the number of lymph nodal metastases, no significant difference was observed in the 5-year survival rate, but based on the ratio of lymph nodal metastases, the 5-year survival rate for those with up to 20% frequency of metastases was 85.2% and the 5-year survival rate for those with greater than 20% was 40.0%, which is significant difference in the 5-year survival rate. CONCLUSION: In stage II gastric cancer, there was no difference between the pT3N0 and the pT2N1 group, except that in the pT2N1 group, a subdivision of the pN stage according to the ratio of lymph nodal metastases could be successfully applied to the clinical evaluation of stage II gastric cancer.
Classification ; Humans ; Jeollabuk-do ; Lymph Node Excision ; Lymph Nodes ; Neoplasm Metastasis ; Neoplasm Staging ; Recurrence ; Retrospective Studies ; Stomach Neoplasms* ; Survival Rate

The incidence of conjoined twins is so rare that few anesthesiologists have an opportunity of managing them. Especially in Korea, there are only a few reports describing the anesthetic management for surgical separation of newborn conjoined twins. We experienced the successful anesthetic management for surgical separation of thoraco-xiphopagus conjoined twins without any particular problems. After applying the noninvasive monitors (ECG, pulse oximeter), one of the twins (twinA) with congenital heart disease was administered with intravenous ketamine for induction of anesthesia and intubated without neuromuscular blocker. Anesthesia was maintained with N2O-O2 and hand ventilation using Mapleson D breathing circuit. After maintaining airway of the twinA, the twinB was intubated and maintained with the same manner. Eighteen days after the separation procedure, the twinA with congenital heart disease died and the other one, twinB has been alive with normal growth and development.
Anesthesia ; Growth and Development ; Hand ; Heart Defects, Congenital ; Humans ; Incidence ; Infant, Newborn ; Ketamine ; Korea ; Neuromuscular Blockade ; Respiration ; Twins, Conjoined* ; Ventilation