A 34 year-old woman was hospitalized with anterior chest pain and indigestion. Chest radiograph and computed tomogram revealed a sewing needle in the cardiac cavity. She had no histories of surgical intervention, drug abuse, or acupuncture. We removed the needle from the right ventricle under cardiopulmonary bypass.
Acupuncture ; Adult ; Cardiopulmonary Bypass ; Chest Pain ; Dyspepsia ; Female ; Foreign Bodies* ; Heart Ventricles* ; Humans ; Needles* ; Radiography, Thoracic ; Substance-Related Disorders

Objective To establish an evaluation system to assess the effect of personnel training program for health professionals in the hospital,in order to achieve the goal that improve the overall competitiveness of the hospital.Methods Comparing and analyzing the differences in research project,research achievements,personnel capacity building before and after implementation of the training program.Paired T-test was used to exam the differences.Results There are statistically significant differences for proposed analyses (p ≤ 0.05).Conclusions The outcome of this study indicates that the personnel training program is extremely important to further development of the hospital.

The epidermal growth factor receptor (EGFR) is a transmembrane glycoprotein whose expression is a possible cause of increased tumor cell proliferation and has recently been proposed as a prognostic parameter in some tumors. Expression of EGFR was studied immunohistochemically in 62 cases of human renal cell carcinomas to evaluate their possible prognostic roles. We also examined the correlation between EGFR expression and cell proliferation by immunohistochemical staining for proliferating cell nuclear antigen (PCNA). Fifty-six cases (90.3%) expressed EGFR, with staining largely confined to the cell membrane and cytoplasm. Staining intensity of EGFR was directly correlated with nuclear grade (p=0.000) and TNM stage (p=0.015). PCNA index was significantly higher in EGFR-positive tumors than in EGFR- negative tumors. There was a statistically significant positive correlation between PCNA index and increasing staining intensity of EGFR (p=0.000). In univariate survival analysis, EGFR expression was significantly associated with shortened survival. However, EGFR expression was not an independent prognostic factor by multivariate analysis. These findings suggest that EGFR expression may be an important cause of tumor cell proliferation in renal cell carcinoma and further studies are needed to evaluate whether EGFR expression analysis provides independent prognostic information.
Carcinoma, Renal Cell* ; Cell Membrane ; Cell Proliferation* ; Cytoplasm ; Epidermal Growth Factor* ; Glycoproteins ; Humans ; Multivariate Analysis ; Proliferating Cell Nuclear Antigen ; Receptor, Epidermal Growth Factor*

Lung cancer is one of the most common types of malignancy in western nations with serious health problem, and it has become the leading cause of cancer death of males, second only to stomach cancer, in Korea. A review of the histopathology of 1363 cases (1231 patients) of lung carcinoma, diagnosed at the Keimyung University Medical center from 1987 to 1996, was performed to reclassify the type of carcinomas and to investigate the change in the distribution of histologic types of lung carcinoma according to age, sex and year. Among the 1363 cases, 132 patients underwent a surgical operation after biopsy. The diagnosis of each case was proven by histopathologic analysis of surgical specimens (13.2%) and biopsy materials (86.8%). The histologic types in our study were basically based on modified WHO classification (1982) and on new WHO classification (1999). The classification of small cell carcinoma was based on International Association for the Small Cell Lung Cancer (IASLC, 1988). Of the 1231 patients with lung carcinoma, 1012 were male and 219 were female (male to female ratio was 3.6:1). According to the analysis of age distribution, the most prevalent age group was 60~69 years in both sex as (n=516, 42.0%). Changing trends in sex distribution of lung carcinoma patients showed that the proportion of men had decreased throughout the years, whereas the proportion of women had significantly increased. Histologically, squamous cell carcinoma was the most common (n=624, 50.7%), followed by small cell carcinoma (21.1%), adenocarcinoma (18.1%), large cell undifferentiated carcinoma (2.1%), adenosquamous carcinoma (0.4%), and large cell neuroendocrine carcinoma (0.4%), in order of frequency. In men, squamous cell carcinoma was the most frequent type (55.1%). In women, adenocarcinoma was the most frequent type (39.7%). In both sexes, adenocarcinoma was the most common type in patients under the age of 40 (n=12, 41.4%), while squamous cell carcinoma proved the most frequent type in patients over the age of 40 (n=617, 51.3%). Changing trends of histologic types of lung cancer showed that the incidences of squamous cell carcinoma had significantly decreased throughout the years, whereas those of adenocarcinoma and small cell carcinoma had increased. In conclusion, the results showing increases in the percentage of female patients and in the number of cases of adenocarcinoma were noteworthy, and well correlated with other related reports.
Academic Medical Centers ; Adenocarcinoma ; Age Distribution ; Biopsy ; Carcinoma ; Carcinoma, Adenosquamous ; Carcinoma, Neuroendocrine ; Carcinoma, Small Cell ; Carcinoma, Squamous Cell ; Classification ; Diagnosis ; Female ; Humans ; Incidence ; Korea ; Lung Neoplasms ; Lung* ; Male ; Sex Distribution ; Small Cell Lung Carcinoma ; Stomach Neoplasms

Although MDR was previously thought to be predominantly caused by the expression of the MDR1 gene, it is now increasingly believed to be caused by other mechanism. Recently, over-expression of the multidrug resistance-associated protein (MRP) was suggested a possible mechanism for non-Pgp mediated MDR. Recent studies showed that MRP can confer resistance to a wide spectrum of natural product drug, but the clinical relevance of MRP-mediated MDR in human cancer is poorly understood. p53 is the most widely known tumor suppressor gene. It has been suggested that mutant p53 is related to abnormal proliferation of cell and some what is been related to cellular apoptosis. To determine the clinical significance of MRP and/or p53 expression in colorectal carcinoma, the authors investigated the expression of the MRP and p53 in 81 cases of primary colorectal carcinoma, the relationship between the MRP and/or p53 expression and clinical parameters including 5-yr. survival rate, and the relationship between the expression of MRP and p53. The results were as follows: 1) Of the 81 colorectal carcinomas, 36 (42%) were MRP positive and 28 (34%) were p53 positive. 2) The expression of MRP and/or p53 was not significantly correlated with sex, age, histologic grades, tumor invasion, tumor location, tumor size, lymph node metastasis, TNM stage and survival of patients. In conclusion, these results suggest that expression of MRP and/or p53 is neither related to the known prognostic factors nor a prognostic factor by itself.
Apoptosis ; Colorectal Neoplasms* ; Genes, Tumor Suppressor ; Humans ; Lymph Nodes ; Multidrug Resistance-Associated Proteins ; Neoplasm Metastasis ; Prognosis ; Survival Rate

BACKGROUND: As determined from the recent investigations of discordant cardiac xenotransplantation, hyperacute rejection occurs mainly at the endothelial cells in donor microvascular systems, but this does not occur at cardiac valve leaflets or at medium-to-large caliber vessels. On the basis of this background, this study was performed to look into the biocompatibility for transplantation of a middle or large diameter xenogenic blood vessel by conducting xenogenic arterial transplantation with the carotid artery in a pig-to-goat model. MATERIAL AND METHOD: The experimental group was composed of 10 pairs of pig-to-goat combinations. They were divided into each period of 1 week, and 1, 3, 6 and 12 months. Four carotid artery grafts obtained through collection of the bilateral carotid arteries from two pigs were preserved at -70degrees C without other treatment, and then they were transplanted into the bilateral carotid arteries of two goats. Doppler ultrasonography was done on a periodic basis after transplantation to evaluate the patency of the grafted blood vessel. At the ends of a predetermined period, the grafts were explanted from the goats and they underwent gross examination. Hematoxylin-eosin and Masson's trichrome staining were conducted. In addition, in order to examine the immunological rejection of the grafted xenogenic blood vessel, immunohistochemical staining was conducted with T-lymphocyte indicator and von Willebrand factor. RESULT: Two goats at the each one-week period and the one-year period died during the experimental period because of a reason unrelated to the experimental procedure, and the remaining 8 goats survived until the end of each experiment period. On Doppler ultrasonography, unilateral carotid artery occlusion was found in a goat, whose period was specified as 3 months, among the 8 survived goats. However, the vascular patency was maintained well and there was no graft that formed aneurysms in the other goats. On gross examination, the region of vascular anastomosis was preserved well, and calcification of the grafted blood vessel was not shown. Histologically, the endothelial cells of the graft disappeared one week after transplantation, and then there was progressive spread of the recipients' endothelial cells from the anastomotic site. The reendothelialization occurred over the whole graft at one month after transplantation. The neointimal thickening and adventitial inflammation became severe by 3 months after transplantation, but this lessened at 6 months and 12 months, respectively. The rate of CD3 positive cells was very low among the infiltrated inflammatory cells. CONCLUSION: The fresh-frozen xenogenic artery kept its patency without being greatly influenced by xenogenic immune reaction.
Aneurysm ; Arteries ; Blood Vessels ; Carotid Arteries ; Endothelial Cells ; Goats ; Heart Valves ; Heterografts* ; Humans ; Inflammation ; Swine ; T-Lymphocytes ; Tissue Donors ; Transplantation, Heterologous ; Transplants ; Ultrasonography, Doppler ; Vascular Patency ; von Willebrand Factor

Pi-dan is a signifi cant conception,which comes from Inner Canon of Huangdi.From the vivid description of Pi-dan in Inner Canon of Huangdi,we consider that the formation and process of Pi-dan is equivalent to metabolic syndrome.They are have the same etiological factor:obesity,the same pathogenesis:abdominal fullness and interior heat,and they can result in diabetes,hypertension,hyperlipidemia,fat liver,gout and a series of severity vascular complication.The theory of Pi-dan exactly points out that obesity the original cause of metabolic syndrome,and suggests that early prevention and treatment for obesity is an important method to prevention metabolic syndrome and its complications.The main pathogenesis of Pi-dan is abdominal fullness and interior heat,and the main therapeutic methods are Xiaogaojiangzhuo,Kaiyuqingre,and Huoxuetongluo.

Objective To discuss the clinical value of ultrasonic elastography for thyroid nodules,and compared with pathology.Methods 77 patients with 105 thyroid lesions were analyzed.Tissue stiffness on elastography was scored from one(greatest elastics train)to five (no strain).Results On elastography:scores 1 and 2 were found in 75％ benign lesions.Scores 3 to 5 were found in 97.4％ malignant lesions.There were statistically difference in the scores of elastography between the benign and malignant lesions (P ＜0.01).Conclusions The ultrasonic elastography had positive significance in differentiating benign and malignant thyroid nodules.If the score of elastography is more than or equal to 3,the thyroid nodule is highprobablely malignant.

Breast density is an independent risk factor for breast cancer, although variability exists in measurements. This study sought to evaluate the agreement between radiologists and automated breast density assessment software and assess the impact of breast density measures on breast cancer risk estimates using the Breast Cancer Surveillance Consortium (BCSC) model (v.2). A retrospective database search identified women who had undergone mammography between December 2021 and June 2022. The Breast Imaging Reporting and Data System (BI-RADS) breast composition index assigned by a radiologist (R) was recorded and analyzed using three commercially available software programs (S1, S2, and S3). The agreement rate and Cohen’s kappa (κ) were used to evaluate inter-rater agreements concerning breast density measures. The 5-year risk of invasive breast cancer in women was calculated using the BCSC model (v.2) with breast density inputs from various density estimation methods. Absolute differences in risk between various density measurements were evaluated. Overall, 1,949 women (mean age, 53.2 years) were included. The inter-rater agreement between R, S1, and S2 was 75.0–75.6%, while that between S3 and the others was 60.2%–63.3%. Kappa was substantial between R, S1, and S2 (0.66–0.68), and moderate (0.49–0.50) between S3 and the others. S3 placed fewer women in mammographic density d (14.9%) than R, S1, and S2 (40.5%–44.0%). In BCSC risk assessment (v.2), S3 assessed fewer women with a high 5-year risk of invasive breast cancer than the other methods, resulting in an absolute difference of 0% between R, S1, and S2 in 75.0%–75.6% of cases, whereas the difference between S3 and the other methods occurs in 60.2%–63.3% of cases. Breast density assessment using various methods showed moderate-to-substantial agreement, potentially affecting risk assessments. Precise and consistent breast density measurements may lead to personalized and effective strategies for breast cancer prevention.

Breast density is an independent risk factor for breast cancer, although variability exists in measurements. This study sought to evaluate the agreement between radiologists and automated breast density assessment software and assess the impact of breast density measures on breast cancer risk estimates using the Breast Cancer Surveillance Consortium (BCSC) model (v.2). A retrospective database search identified women who had undergone mammography between December 2021 and June 2022. The Breast Imaging Reporting and Data System (BI-RADS) breast composition index assigned by a radiologist (R) was recorded and analyzed using three commercially available software programs (S1, S2, and S3). The agreement rate and Cohen’s kappa (κ) were used to evaluate inter-rater agreements concerning breast density measures. The 5-year risk of invasive breast cancer in women was calculated using the BCSC model (v.2) with breast density inputs from various density estimation methods. Absolute differences in risk between various density measurements were evaluated. Overall, 1,949 women (mean age, 53.2 years) were included. The inter-rater agreement between R, S1, and S2 was 75.0–75.6%, while that between S3 and the others was 60.2%–63.3%. Kappa was substantial between R, S1, and S2 (0.66–0.68), and moderate (0.49–0.50) between S3 and the others. S3 placed fewer women in mammographic density d (14.9%) than R, S1, and S2 (40.5%–44.0%). In BCSC risk assessment (v.2), S3 assessed fewer women with a high 5-year risk of invasive breast cancer than the other methods, resulting in an absolute difference of 0% between R, S1, and S2 in 75.0%–75.6% of cases, whereas the difference between S3 and the other methods occurs in 60.2%–63.3% of cases. Breast density assessment using various methods showed moderate-to-substantial agreement, potentially affecting risk assessments. Precise and consistent breast density measurements may lead to personalized and effective strategies for breast cancer prevention.