No abstract available.

PURPOSE: With the process of neoangiogenesis being linked to the growth and metastasis of various tumors, anticancer therapeutics with a basis in the suppression of neoangiogenesis has recently been receiving attention. In this study, we tried to clarify the immunoreactivities of vascular endothelial growth factor (VEGF), major angiogenic inducer and thrombospondin-1 (TSP-1), major angiogenic inhibitor in human Wilms' tumor and its clinicopathological significance. MATERAILS AND METHODS: Utilizing immunohistochemical staining, we assessed the immunoreactivities of VEGF and TSP-1 in archival tissues of 29 Wilms' tumors and 25 normal kidneys. Also, we assessed the relationship between expression of each factor and clinicopathological parameters in 29 cases of Wilms' tumors. RESULTS: Immunoreactivities of VEGF and TSP-1 were detected mainly in the cytoplasm of the tubular cells in normal kidneys. In Wilms' tumors, whereas VEGF was detected in the cytoplasm of the tumor cells and peritumoral stromal tissues, but TSP-1 only in the peritumoral stromal tissues. Immunohistochemical expression patterns of each factor were divided into two groups according to the area of immunoreactivity (negative:<10%, positive: > OR =10%). VEGF immunoreactivity was detected in 25 (100%) normal kidneys and in 20 (69%) Wilms' tumors. However, TSP-1 immunoreactivity was detected in 24 (97%) normal kidneys and in 3 (10%) Wilms' tumors. Therefore, although no significant difference was observed between the expressions of VEGF and TSP-1 in normal kidney, the TSP-1 immunoreactivity was significantly lower than VEGF immunoreactivity in Wilms' tumors. A relatively higher rate of positive expression of TSP-1 was observed in the patients with no demonstrable lymph node metastasis. Also, as for the VEGF, maximal diameter of the tumor was larger in the positive expression group. However, it proved otherwise for TSP-1 as the negative expression group demonstrated tumors with larger maximal diameters. CONCLUSIONS: Our study demonstrated that the TSP-1 immunoreactivity was significantly lower than VEGF immunoreactivity in Wilms' tumors, and disease progression has a tendency to be found in the VEGF-positive cases and TSP-1 negative cases. We suggest that the growth and metastasis of Wilms' tumor may be influenced mainly by TSP-1 decrease rather than VEGF increase.
Cytoplasm ; Disease Progression ; Humans ; Kidney ; Lymph Nodes ; Neoplasm Metastasis ; Thrombospondin 1 ; Vascular Endothelial Growth Factor A* ; Wilms Tumor*

No abstract available.

No abstract available.
Animals ; Brain* ; Cats* ; Magnetic Resonance Spectroscopy*

Chronic abdominal pain (CAP) in children and adolescents remains one of the pathogenetically ambiguous disorders and a great trouble to their caretakers as well as patients. Although the symptom does not usually lead to a crucial problem, the parents may be terribly worried, the child may be in distress, and the practitioner may be concerned about ordering tests to confirm a serious occult disease. Systemized diagnostic approaches are needed to overcome this unique difficulty. The presence of red flag symptoms or signs is a general indication to pursue diagnostic testing for organic etiologies of CAP on the basis of specific symptoms in an individual case. Functional abdominal pain can be normally diagnosed when there are no red flag symptoms or signs. According to the Rome III criteria for pediatric functional gastrointestinal disorders, functional disorders of CAP can be classified into functional dyspepsia, irritable bowel syndrome, abdominal migraine, and chronic functional abdominal pain syndrome. Cyclic vomiting syndrome and pathologic aerophagia are also major functional causes of CAP. Modern concepts of the pathogenesis of functional abdominal pain include brain-gut interaction, visceral hypersensitivity, autonomic dysfunction, and psychosocial factors. In addition, psychiatric disorders, presented with red flag symptoms or signs, may induce the CAP in children and adolescents. We introduce practical and systemized diagnostic approaches by illustrating clinical cases of CAP in children and adolescents.
Abdominal Pain ; Adolescent ; Child ; Diagnostic Tests, Routine ; Dyspepsia ; Gastrointestinal Diseases ; Humans ; Hypersensitivity ; Irritable Bowel Syndrome ; Migraine Disorders ; Parents ; Rome ; Vomiting

Here, a case of a 59-year-old man with rotator cuff tear and impingement syndrome caused by an ossified coracoacromial ligament is presented. Ossification of the coracoacromial ligaments can occur because of degenerative changes due to trauma or repeated stress, which can lead to impingement syndrome. Therefore, when coracoacromial ligament ossification is present, rotator cuff damage due to impingement syndrome should be considered. Here, we conducted arthroscopic subacromial decompression, removal of the ossified coracoacromial ligament, and supraspinatus and subscapularis tendon repairs. We achieved satisfactory surgical outcomes without relapse; therefore, we report this case with a literature review.
Decompression ; Humans ; Ligaments* ; Middle Aged ; Recurrence ; Rotator Cuff ; Shoulder ; Shoulder Impingement Syndrome* ; Tears ; Tendons

BACKGROUND: Unexpected deaths of the patients at ED are surprising to the medical staffs as well as the families. It may also increase the possibilities of medico-legal problems. This study was conducted to review the unexpected death in ED and find the predictive factors leading patients to unexpected death. METHODS: A retrospective study with reviewing available medical records of 183 patients who were expired at ED of Shinchon Severance Hospital from Mar. 1997 to Feb. 1998 and 103 patients of Youngdong Severance Hospital from Mar. 1996 to Feb. 1998 was done. Analyses were 4one on 30 variables of physical findings, laboratory results, procedures and therapies. We used univariate analysis, such as t-test and x2-test and multiple logistic regression analysis. RESULTS: Of the total 286 deaths in ED, 153 cases were enrolled in this analysis. The number of unexpected deaths were 76. Age, mental status, fraction of neutrophil count, BUN level, whether endotracheal incubation was done, use of inotropics were the factors with statistical ,significance on the univariate analysis, but only comatose mentality, endotracheal incubated case, and use of the inotropics were significant on logistic regression analysis. The longer the ED length of stay, the higher the rate of mortality and unexpected death. CONCLUSION: This result suggest that medical attention is needed on the patients with comatose decreased mental stylus, endotracheally intubated case and needing inotropic agents to prevent unexpected deaths. Shortening the ED length of stay may also be a factor for decrease the unexpected death rate.
Coma ; Emergencies* ; Emergency Service, Hospital* ; Humans ; Length of Stay ; Logistic Models ; Medical Records ; Medical Staff ; Mortality ; Neutrophils ; Retrospective Studies

No abstract available.
Adult ; Humans

Hamartoma of the bladder is quite a rare entity which is composed of a disorderly admixture of mature cellular elements normally present in the urinary bladder. There is a great controversy regarding the pathogenesis of this lesion. Whether it is a true hamartomatous lesion or metaplastic lesion developed secondary to the inflammatory process. Similar or identical lesions has often been given by other names such as florid examples of cystitis glandularis. We prefer to cell florid examples of cystitis glandularis rather than hamartoma when it was occurred in an old age higher then 50th decade. Here we report a case of hamartoma of the urinary bladder in 44 years old man. Cystoscopic examination revealed a papillary polypoid mass which was attached to the fundus of bladder by long stalk. The mass measured 1.5 cm in greatest diameter. It was composed of epithelial nests resembling von Brunn's nest, cystitis glandularis or cystitis cystica dispersed in a stroma rich in smooth muscle and fibrous tissue.
Hamartoma

Epiblepharon is characterized by horizontal fold of skin adjacent to lid margin. It is a common congenital anomaly, especially in Orientals. In comparison with it, entropion is characterized by an absent lid crease and an inward rolling of the entire eyelid margin. The incidence of the latter was not reported but it was said to be very rare. Not with standing that, congenital entropion has been diagnosed more frequently than epiblepharon in Korea. Supposing that the cases diagnosed as entropion in Korea might fall under the category of epiblepharon on the basis of the authors' clinical experience, the clinical evaluation of the 190 cases operated under the diagnosis of congenital entropion at Seoul National University Hospital from January 1976 to May 1986 was done. The result was that 147 cases(77.4%) were thought to be epiblepharon. So more careful examination might be necessary in diagnosing epiblepharon or entropion in Orientals.
Diagnosis ; Entropion ; Eyelids ; Incidence ; Korea ; Seoul ; Skin