Three cases of Wilms's tumor observed during the period from January, 1969 to October, 1969 are presented and related literature reviewed.
Wilms Tumor

No abstract available.
Electrocardiography, Ambulatory*

No abstract available.
Estrogens* ; Humans ; Receptors, Estrogen* ; Thyroid Diseases* ; Thyroid Gland*

Pancreatic cancer is a disease with poor prognosis mainly due to low resection rates and late diagnosis. To increase resectability and improve survival rates, a better understanding of pancreatic cancer pathogenesis and more effective screening techniques are required. New methods, such as genetic and molecular alterations, may suggest novel approaches for pancreatic cancer diagnosis and treatment. We immunohistochemically investigated 44 formalin-fixed, paraffin-embedded specimens of pancreatic ductal adenocarcinoma using monoclonal anti-p16 antibodies and monoclonal anti-p53 antibodies. The expressions of p16 and p53 proteins were compared using the Chi-square test with SPSS. Disease-free survival was analyzed using the Kaplan-Meier method, verified by the Log- Rank test. Loss of p16 expression was noted in 20 (45.5%) cases and aberrant p53 protein expression was detected in 14 (31.8%) cases. Loss of p16 expression was associated with a higher incidence of lymph node metastasis (p=0.040) and a more advanced stage (p=0.015), although there was no significant correlation between p16 expression and survival. Aberrant p53 protein expression correlated with histologic grade (p= 0.038). Disease-free survival rate was significantly lower in the aberrant p53 protein positive group compared to the negative group (p=0.029). From our results, we suggest that p53 is not a prognostic factor; however, p16 and p53 genes do play important roles in the progression of pancreatic ductal adenocarcinoma.
Adult ; Aged ; Female ; Genes, p16 ; Genes, p53 ; Humans ; Immunohistochemistry ; Male ; Middle Aged ; Neoplasm Staging ; Pancreatic Neoplasms/*chemistry/genetics/mortality/pathology ; Protein p16/*analysis ; Protein p53/*analysis ; Sex Characteristics

Allele-and genotype frequencies of the two short tandem repeat (STR) loci, HumFGA and D21S11, were determined in Korean population(n=196). DNA typing was accomplished by applying fluorescence-labeled PCR products and a differently labeled sequenced allelic ladders, followed by automated analysis using ABI 377 automatic sequencer and GeneScan 2.02 software. Prior to typing, allelic ladder of each locus was constructed with a combination of all alleles occuring from the population sample. A total of 15 alleles and 48 genotypes with the heterozygosity of 0.854 for HumFGA, and 12 alleles and 33 genotypes with the heterozygosity of 0.787 for D21S11 are observed in a population of 196 genetically unrelated individuals. No deviations from Hardy-Weinberg equilibrium were observed(p=0.753 for HumFGA, p=0.262 for D21S11). The data presented here (power of discrimination and average power of exclusion) show that both STR Loci, HumFGA and D21S11, are very informative for individualization from criminal evidences, and are also useful for parentage testing.
Alleles* ; Criminals ; Discrimination (Psychology) ; DNA Fingerprinting ; Gene Frequency* ; Genotype ; Humans ; Microsatellite Repeats ; Polymerase Chain Reaction

PURPOSE: A carcinoma of the ampulla of Vater has more favorable prognosis than other malignant tumors of the periampullary region, because it is symptomatic at an early stage. However, local resection of an ampullary carcinoma remains controversial. The aim of this study was to evaluate the treatment results of ampulla of Vater carcinomas, according to operation type in low risk group patients. METHODS: The records of 17 low risk group patients, among 120 patients with ampulla of Vater cancer, who underwent curative surgery beyween 1992 and 2002, were reviewed. All specimens were critically reviewed by a single expert pathologist. The relationship between surgical outcomes and operation type were assessed. RESULTS: There were 10 men and 7 women, with a median age of 57.8 years. 13 of the 17 patients underwent the Whipples operation or a PPPD, and 4 underwent a transduodenal local resection (TDLR). The operation time was shorter in the TDLR group, and was statistically significant. Among the 17 patients, only one had a recurrence in the inguinal area 33 months after the PD. CONCLUSION: Transduodenal local resection is a recommendable operation for low risk Ampulla of Vater cancer patients. During the operation, it is essential to accurately evaluate the depth of invasion, cell differentiation and positivity of the resection margin using frozen sections.
Ampulla of Vater* ; Cell Differentiation ; Female ; Frozen Sections ; Humans ; Male ; Prognosis ; Recurrence

No abstract available.
Pancreaticoduodenectomy*

BACKGROUND AND OBJECTIVES: Conventional tonsillectomy with the naked eye has posed problems in obtaining a good surgical field and in minimizing damage to the adjacent tissue. Tonsillectomy using an operating microscope offers outstanding illumination and visualization of the surgical field, thereby reducing the incidence of complications associated with tonsillectomy. The objective of this study was to compare the surgical methods of the conventional and the microscopic tonsillectomies, and to evaluate the usefulness and effectiveness of the microscopic tonsillectomy. MATERIALS AND METHODS: Two hundred children between the ages of five and ten who received tonsillectomy between June 1995 and August 1998 at Korea University Hospital were divided into two groups,' one group underwent tonsillectomy using an operating microscope (Group 1, n=100) and the other group underwent tonsillectomy using the conventional dissection and snare technique (Group 2, n = 100). Duration of surgery, post-operative healing period, amount of intra and post-operative hemorrhage, post- operative pain score, and the incidence of post-operative cicatrical pharyngeal stenosis were compared between the two groups. RESULTS: There was no statistically significant diference in operating time and post-operative healing period between the two groups, but cicatrical pharyngeal stenosis due to post-operative scarring was more common in the group that underwent conventional tonsillectomy. The amount of hemorrhage both intra and post-operatively, and post-operative pain was significantly decreased in the microscopic tonsillectomy group. CONCLUSION: The widespread use of operating microscope in otolaryngological surgeries allows this technique to be applied to tonsillectomy with few problems. This technique affords decreased intra-operative bleeding, less post-operative complications, and decreased post-operative pain compared with conventional techniques. We believe that microscopic tonsillectomy is a safe, elegant and effective procedure that represents a new concept in tonsil surgery.
Child ; Cicatrix ; Constriction, Pathologic ; Hemorrhage ; Humans ; Incidence ; Korea ; Lighting ; Palatine Tonsil ; SNARE Proteins ; Tonsillectomy*

OBJECTIVE: To investigate the relationships between respiratory muscle strength and conventional sarcopenic indices such as skeletal muscle mass and limb muscle strength. METHODS: Eighty-nine young adult volunteers who had no history of medical or musculoskeletal disease were enrolled. Skeletal muscle mass was measured by bioelectrical impedance analysis and expressed as a skeletal muscle mass index (SMI). Upper and lower limb muscle strength were evaluated by hand grip strength (HGS) and isometric knee extensor muscle strength, respectively. Peak expiratory flow (PEF), maximal inspiratory pressure (MIP), and maximal expiratory pressure (MEP) were evaluated using a spirometer to demonstrate respiratory muscle strength. The relationships between respiratory muscle strength and sarcopenic indices were investigated using Pearson correlation coefficients and multiple linear regression analysis adjusted by age, height, and body mass index. RESULTS: MIP showed positive correlations with SMI (r=0.457 in men, r=0.646 in women; both p<0.01). MIP also correlated with knee extensor strength (p<0.01 in both sexes) and HGS (p<0.05 in men, p<0.01 in women). However, PEF and MEP had no significant correlations with these sarcopenic variables. In multivariate regression analysis, MIP was the only independent factor related to SMI (p<0.01). CONCLUSION: Among the respiratory muscle strength variables, MIP was the only value associated with skeletal muscle mass.
Body Mass Index ; Electric Impedance ; Extremities ; Female ; Hand ; Hand Strength ; Humans ; Knee ; Linear Models ; Lower Extremity ; Male ; Muscle Strength ; Muscle, Skeletal ; Musculoskeletal Diseases ; Respiratory Muscles* ; Sarcopenia ; Spirometry ; Volunteers ; Young Adult*

BACKGROUND: Desflurane depresses the contractile function of the myocardium. It also causes direct coronary vasodilation. Milrinone, a phosphodiesterase III inhibitor, usually increases myocardial contractility and also has vasodilatory activity. Some inhalation anesthetic agents, such as isoflurane, are safely combined with phosphodiesterase III inhibitors clinically, but milrinone sometimes causes significant hypotension by reducing systemic vascular resistance. The purpose of this study was to evaluate the effect of the combined use of desflurane and milrinone on the function of the isolated rat heart. METHOD: Thirty isolated rat hearts were divided into two groups. [Group 1 (n = 15): desflurane, Group 2 (n = 15): desflurane and milrinone] They were perfused continuously with modified Krebs' solution in a Langendorff retrograde perfusion apparatus. After measuring the control values of the hemodynamic and oxygenation parameters in each group, we administered 6.6 vol% of desflurane to both groups and added sequential perfusion of modified Krebs' solution containing 0.5, 1.0, and 1.5mug/ml of milrinone in Group 2 and then measured the parameters and analyzed them statistically. RESULTS: Baseline measurements in both groups were not statistically different. In Group 1, desflurane significantly decreased LVP (55+/-5 mmHg), dp/dt (557+/-65 mmHg/sec) and MVO2 (71.2+/-16.3 ml/g/min) after 15 minutes. CF (13.9+/-3.1 ml/g/min) and DO2 (176.7+/-43.4 ml/g/min) were increased after 15 minutes. There was no further change after this. In Group 2, desflurane decreased LVP (53+/-18 mmHg), dp/dt (558 90 mmHg/sec) and MVO2 (72.0+/-11.0 ml/g/min) and increased CF (14.2+/-1.9 ml/g/min) and DO2 (175.3+/-29.1 ml/g/min). But, there was no significant difference in the effects of desflurane between the two groups. Milrinone restored LVP, dp/dt and MVO2 to the baseline level, but not with dose-dependency. Desflurane-induced elevated CF and DO2 did not show further changes. CONCLUSIONS: These findings suggest that milrinone increased myocardial contractility and restored the desflurane-induced myocardial depression of the isolated rat heart without further increase of oxygen consumption from the baseline control value. In addition, no additive effects was observed on coronary blood flow when these two agents were used in combination.
Anesthetics ; Animals ; Cyclic Nucleotide Phosphodiesterases, Type 3 ; Depression ; Heart* ; Hemodynamics ; Hypotension ; Inhalation ; Isoflurane ; Milrinone* ; Myocardium ; Oxygen ; Oxygen Consumption ; Perfusion ; Rats* ; Vascular Resistance ; Vasodilation