Coronary artery bypass grafting (CABG) without extracorporeal circulation (ECC) is now an accepted technique of myocardial revascularization in selective cases of coronary arterial occlusive disease. We experienced a case of CABG without ECC in a 20 year old female patient with complete occlusion of the right coronary artery. Anesthesia was induced and maintained with fentanyl, midazolam and isoflurane. Nitroglycerine and dopamine were given to stabilize the hemodynamics during intra- and post-operative periods. And esmolol was administered with a loading dose of 30 mg over 1 min, followed by a continuous infusion of 50~100 g/kg/min to maintain the heart rate (50~60 beats/min) and systolic blood pressure (60~80 mmHg) during distal anastomosis. The patient was recovered uneventfully and discharged on the 8th postoperative day.
Anesthesia* ; Arterial Occlusive Diseases ; Blood Pressure ; Coronary Artery Bypass* ; Coronary Vessels* ; Dopamine ; Extracorporeal Circulation ; Female ; Fentanyl ; Heart Rate ; Hemodynamics ; Humans ; Isoflurane ; Midazolam ; Myocardial Revascularization ; Nitroglycerin ; Young Adult

The p53 gene is believed to play an important role through the mutation and overexpression in the progression of various human malignant tumors. The type IV collagenase (matrix metalloproteinase: MMP-2) initiates the degradation of the extracellular matrix, and consequently may play a role in the tumor invasion and metastasis. To investigate the correlation between clinicopathologic features of the colorectal adenocarcinomas and benign tumors and expression of p53 and MMP-2 proteins, we performed an immunohistochemical study on 40 colorectal adenocarcinomas, 20 adenomas and 20 hyperplastic polyps by using the antibodies to p53 and MMP-2 proteins. The positive expression rate of the p53 protein in adenocarcinomas was 62.5% and significantly higher than in benign tumors. The positive expression rate of the MMP-2 protein was 47.5% in adenocarcinomas, but there was no expression of MMP-2 protein in benign tumors. The difference in p53 and MMP-2 expression rates between malignant and non-malignant tumors was statistically significant. The positive expression rate of p53 protein in the non-metastatic and metastatic adenocarcinomas was 59.1 and 66.7%, respectively. The positive expression rate of MMP-2 protein in the non-metastatic and metastatic adencarcinomas was 45.5 and 50.0%, respectively. The correlation between several clinicopathologic features and expression of p53 and MMP-2 protein was not statistically significant, but the rate of positive MMP-2 immunoreactivity showed a statistically significant difference between Astler-Coller stage B1 C1 group and B2 C2 group of adenocarcinoma (p=0.0431). We concluded that the expression of p53 and MMP-2 protein contributes to the cancer development and MMP-2 may play a certain role in the invasiveness of the colorectal tumor. p53 and MMP-2 protein expression is not correlated with lymph node metastasis.
Adenocarcinoma* ; Adenoma ; Antibodies ; Collagenases ; Colorectal Neoplasms ; Extracellular Matrix ; Genes, p53 ; Humans ; Lymph Nodes ; Matrix Metalloproteinase 2* ; Neoplasm Metastasis ; Polyps

No abstract available.
Adolescent* ; Humans ; Naloxone* ; Self-Injurious Behavior*

Diabetic and nondiabetic vascular diseases cause significant foot problems and it frequently progress to osteomyelitis and amputation. Advances in vascular surgical techniques, including distal arterial bypass via synthetic grafts or autogenous vein grafting have opened the way for higher rate of limb salvage. We have experienced patients with ischemic vascular foot disease and combined skin ulceration and varing degree of soft tissue defect. In three patient with major vessel obstruction, we could preserve limb and avoid major amputation using greater saphenous vein graft with or without microvascular free tissue transfer.
Amputation ; Extremities ; Foot Diseases ; Foot* ; Humans ; Limb Salvage ; Osteomyelitis ; Saphenous Vein ; Skin Ulcer ; Transplants ; Vascular Diseases ; Veins

Cardiac arrest associated with hyperkalemia during red blood cell transfusion is a rare but fatal complication. Herein, we report a case of transfusion-associated cardiac arrest following the initiation of extracorporeal membrane oxygenation support in a 9-month old infant. Her serum potassium level was increased to 9.0 mEq/L, soon after the newly primed circuit with pre-stored red blood cell (RBC) was started and followed by sudden cardiac arrest. Eventually, circulation was restored and the potassium level decreased to 5.1 mEq/L after 5 min. Extracorporeal membrane oxygenation (ECMO) priming is a relatively massive transfusion into a pediatric patient. Thus, to prevent cardiac arrest during blood-primed ECMO in neonates and infants, freshly irradiated and washed RBCs should be used when priming the ECMO circuit, to minimize the potassium concentration. Also, physicians should be aware of all possible complications associated with transfusions during ECMO.
Blood Transfusion ; Death, Sudden, Cardiac ; Erythrocyte Transfusion ; Erythrocytes ; Extracorporeal Membrane Oxygenation* ; Heart Arrest* ; Humans ; Hyperkalemia* ; Infant* ; Infant, Newborn ; Potassium

Transitional cell carcinoma of the urinary bladder is the most common cancer of the genitourinary tract in Korea and its prognosis is determined by the histologic grade and clinical stage present at initial diagnosis. Recently, an extensive search for a more objective and reproducible method to evaluate the proliferation activity of cancer cells has been done. The p53 gene is located on the short arm of the chromosome 17 and acts as a cancer suppressor gene. Mutant p53 gene induces malignant transformation. Recent studies reveal that the level of mutant p53 protein is elevated in some human tumor and many diverse transformed cell lines. Heat shock proteins(HSPs) are present constitutively in normal cells, where they play an important role in normal cell metabolism. In mammalian cells, they are induced by a variety of physical and chemical stimuli. A protein that belongs to the hsp70 family, called hsc70, is only slightly heat inducible and is found at a higher level in growing cells than in the resting cells. The mutant p53 protein binds with hsc70 and the p53-hsc70 complex has functional significance in the transforming capacity of the mutant p53. We investigated the correlation between the p53 and hsc70 by immunohistochemical methods and with better defined prognostic indicators such as histologic grade, clinical stage, and DNA ploidy pattern in 42 transitional cell carcinomas of the urinary bladder. The results are summarized as follows. p53 expression rate was higher in the DNA aneuploid group than in the DNA diploid group(p=0.061), but there was no significant difference in the histologic grade(p=0.861) or clinical stage(p=0.154). The higher the hsc70 expression rate was, the poorer the tumor differentiation(p=0.000) and the deeper the invasion(p=0.001). The aneuploid group showed a higher hsc70 expression rate than the diploid group(p=0.017). 27 of 42(64.3%) carcinomas showed positivity of both p53 and hsc70. Though statistically insignificant, their correlation showed a relatively low correlation coefficient (P=0.059). In conclusion, we suspect that p53 and hsc70 are closely correlated to each other by comparing the results of this immunohistochemical study, and hsc70 will be a useful prognostic marker in transitional cell carcinomas of the urinary bladder after sufficient follow up studies are performed.
Humans ; Follow-Up Studies ; Genes, p53

No abstract available.
Corylus* ; Hypersensitivity*

BACKGROUND AND OBJECTIVES: Chronic sinusitis is a common disease in otolaryngology, but its pathologic mechanism has not been clearly known. Also, the evaluation method for the severity of chronic sinusitis is not established. The aim of this study was to analyze possible factors associated with the correlation between the radiological and pathological severity of chronic sinusitis. In addition, we assessed the profiles of inflammatory cells in the sinus mucosa and peripheral blood eosinophils in relation to the overall pathologic grades and OMU CT findings. SUBJECTS AND METHOD: Fifty specimens of pathologic sinus mucosa, obtained during endoscopic sinus surgery were stained with hematoxylin and eosin. Total inflammatory cells, plasma cells, neutrophils, lymphocytes and eosinophils were quantified. The preoperative OMU CT scans were scored by the staging system of Lund-Mackay. Also, the preoperative percentage of eosinophils in peripheral white blood cells were obtained with the complete blood count with differentiation. RESULTS: The count of total inflammatory cells, lymphocytes and eosinophils infiltrated in the diseased sinus mucosa correlated significantly with the severity of the pathologic grades and OMU CT scores. In addition, the CT scores assessed by Lund-Mackay system correlated significantly with the severity of the pathologic grades. CONCLUSION: The important indicators of the severity of the chronic inflammation in chronic sinusitis were OMU CT scores, overall pathologic grades, and total inflammatory cells, lymphocytes and eosinophils infiltrated in sinus mucosa.
Blood Cell Count ; Eosine Yellowish-(YS) ; Eosinophils ; Hematoxylin ; Inflammation* ; Leukocytes ; Lymphocytes ; Mucous Membrane ; Neutrophils ; Otolaryngology ; Plasma Cells ; Sinusitis* ; Tomography, X-Ray Computed

We have expressed GFP in Sf9 and Bm5 cells or Bombyx by larvae by using Ac-Bm hybrid virus capable of replicating in both Bm5 and Sf9 cells. Genomic DNA of Ac-Bm hybrid virus expressing P-galactosidase was cotransfected with baculovirus transfer vector containing GFP gene, pBacPAK-GFP in Sf9 cells. The Ac-Bm hybrid virus harboring GFP was named as Ac-Bm hybrid virus-GFP. The Ac-Bm hybrid virus-GFP-infected insect cells were easily selected by detecting the emission of GFP from each well of cell culture dish on the UV illuminator. GFP produced by Ac-Bm hybrid virus-GFP in Sf9 and Bm5 cells or B. mori larvae was confirmed by SDS-PAGE and Western blot analysis using GFP antibody. In addition, B. mori larvae infected with Ac-Bm hybrid virus-GFP was apparently appeared fluorescence from the whole body at 5 days postinoculation. The fluorescence of GFP from the hemolymph and fat body of B. mori larvae infected with Ac-Bm hybrid virus-GFP was also observed by fluorescence microscope. In conclusion, our results demonstrated that in baculovirus expression vector system, use of Ac-Bm hybrid virus have an additional advantage of expanded host range for producing recombinant proteins.
Animals ; Baculoviridae ; Blotting, Western ; Bombyx* ; Cell Culture Techniques ; DNA ; Electrophoresis, Polyacrylamide Gel ; Fat Body ; Fluorescence ; Hemolymph ; Host Specificity ; Insects ; Larva* ; Recombinant Proteins ; Sf9 Cells ; Spodoptera*

Primary transitional cell carcinoma of ovary has been recently recognized as a separate subtype of epithelial cancer. It is unusual tumor and in which definite urothelial features are present, but no benign Brenner component is identified. These tumor are more aggressive and tend to present at a higher stage than malignant Brenner tumors, but they appear to respond better to chemotherapy than other type of ovarian epithelial cancer. We have experienced two cases of ptimary transitioaal cell carcinoma of ovary. So we report these cases with a brief review of literature.
Brenner Tumor ; Carcinoma, Transitional Cell* ; Drug Therapy ; Female ; Ovary*