BACKGROUND: Bilirubin has been suggested as a antioxidant which protect oxidation of lipids and lipoproteins. Given that oxidized lipids and lipoproteins are known to be atherogenic, low serum concentrations of bilirubin could be associated with the high risk of coronary artery disease (CAD). But few studies have been performed for confirmation of this hypothesis. In this study, we evaluated the relationship between serum concentrations of billrubln and the angiographically documented CAD. METHODS: Eighty five CAD patients and 56 non-CAD patients, classified according to the maximum stenosis of coronary artery at angiography, were enrolled in this study. The degree of the coronary arterial stenosis were subclassified into <10% (non-CAD), 10-49% (mildly stenotic CAD) and > or =50% (severely stenotic CAD). We retro-spectively reviewed serum concentrations of total and direct bilrubin at the time of angiography, compared tine mean concentrations of bilirubin between two groups and evaluated it in relation to the severity of CAD by statistical analysis. RESULTS: The mean concentration of total bilrubin was significant1y lower in CAD group 4han non-CAD group (12.8 micromol/L vs. 15.2 micromol/L, p value=0.04) The mean concentration of direct bilirubin was lower in CAD group than non-CAD group but not statistically significant (3.3 micromol/L vs. 4.2 micromol/L, p value=0.07). Although not significant, the concentration of total bilirubin in severely stenotic group (12.8 CAD group 12.8+/-4.3 micromol/L) was lower than mildly stenotic group (13.5+/-3.8 micromol/L) and non CAD group (15.2+/-7.4 micromol/L ) (p=0.07). CONCLUSIONS: This study showed that low serum concentrations of total bilirubin were associated with the high risk of CAD and supports the hypothesis that serum bilirubin could act as an antiatherosclerotic factor. Further prospective studies are required to confirm the relationship between bilirubin and CAD and to elucidate the most associated fraction of bilirubin and pathogenic mechanism.
Angiography ; Bilirubin* ; Constriction, Pathologic ; Coronary Artery Disease* ; Coronary Vessels* ; Humans ; Lipoproteins

The incidence of adenocarcinoma of the uterine cervix had shown an increasing tendency, and which is related to the increased use of oral contraceptives or prevalent in human papillomavirus infection. Endocervical glandular dysplasia or adenocarcinoma in situ are occasionally associated with squamous neoplasms of the uterine cervix. This study was aimed to evaluate the histologic features and the incidence of endocervical glandular lesions associated with squamous neoplasms, the presence of human papillomavirus infection-suggesting histologic findings in adjacent squamous neoplasms and the immmunohistochemical findings of endocervical glandular lesions for carcinoembryonic antigen. The materials used were 105 cases of microinvasive and invasive squamous cell carcinoma, and 83 cases of squamous intraepithelial lesions which are consisted of 142 radical or total hystrectomy products and 46 conization or loop excision products. The results are as follows; 1. Among 188 cases, six cases(3.2%) had shown foci of high grade glandular dyaplasia, and 19 cases(10.1%) revealed the areas of low grade glandular dysplasia. There was no adenocarcinoma in situ case. 2. In four of six high grade glandular dysplasia cases, microinvasive or invasive squamous cell carcinomas were associated. In low grade glandular dysplasias, sqaumous intraepithelial lesions were occcupying 68.4%. 3. HPV infection-suggesting histologic findings had accompanied all high grade glandular dysplasia cases and in 17 cases(89.5%) of 19 low grade glandular dysplasias. 4. In 2 of 5 high grade glandular dysplasias and in 1 of 19 low grade glandular dysplasias, the immunohistochemical reaction for carcinoembryonic antigen was similar to that of adenocarcinoma. In conclusion, the clinicopathologic importance of endocervical glandular lesions associated with squamous neoplasms of the uterine cervix should be kept in mind, and further study for the relationship between endocervical glandular lesions and human papillomavirus infection or hormonal influence will be continued.
Humans ; Incidence ; Adenocarcinoma

Sirenomelia is a severe form of caudal regression syndrome that results in a fusion of the lower extremities, which is not compatible with life. A various spectrum of anomalies affecting primarily the musculoskeletal, genitourinary and gastrointestinal systems also can occur. This rare malformation has a reported incidence rate of approximately 1 in 60,000 births, with a range of 1 to 1 percent of all malformed infants. We experienced a sirenomelic case with combined anomalies of genitourinary, cardiovascular and gastrointestinal systems. Maternal obstetric history revealed oligohydramnios and intrauterine fetal growth retardation, and the baby was spontaneously delivered at 37 weeks of gestational age, but died I hour after birth.
Infant ; Male ; Female ; Humans ; Incidence

Pulmonary endometriosis is a rare disease which is characterized by hemoptysis during menstruation (catamenial hemoptysis). We report a case of pulmonary endometriosis in a 33-year-old housewife. She has had regular menses with moderate flow and minimal dysmenorrhea. She had undergone curettage in May 1995 for artificial abortion. In July 1995, she experienced the first episode of hemoptysis. A chest CT scan revealed a 2.0 1.0 cm sized ill-defined soft tissue density in the periphery of anterior segment of the left upper lobe with a surrounding irregular ground-glass opacity. A left upper lobectomy was done under the diagnosis of pulmonary endometriosis. Cut section of the resected lung showed a round red-brownish solid lesion, measuring 2.0x1.0cm in cross. Microscopically a focus of the endometrial tissue, which was composed of endometrial glands and stroma, was found in the lung parenchyme and many hemosiderin laden macrophages were seen in the surrounding alveoli. The postoperative course was favorable with no further episodes of hemoptysis.
Adult ; Curettage ; Diagnosis ; Dysmenorrhea ; Endometriosis* ; Female ; Hemoptysis ; Hemosiderin ; Humans ; Lung ; Macrophages ; Menstruation ; Rare Diseases ; Tomography, X-Ray Computed

p53 gene alterations in the ovarian cancers are regarded as early events in the whole process of carcinogenesis. This study is intended to compare p53 protein expression rate in the ovarian surface epithelial tumors according to histologic types, degree of malignancy and differentiation. 134 cases of ovarian epithelial tumors including 26 cases of serous cystadenoma, 7 cases of serous borderline malignancy, 15 cases of serous cystadenocarcinoma, 40 cases of mucinous cystadenoma, 21 cases of mucinous borderline malignancy, 20 cases of mucinous cystadenocarcinoma, 4 cases of endometrioid carcinoma, and 1 case of clear cell carcinoma were studied. Immunohistochemistry using monoclonal p53 antibody(DO-7) was applied to the routine formalin-fixed paraffin embedded tissue. The results were as follows; 1. No immunohistochemical positivity of p53 protein was found in all 66 cases of benign serous and mucinous tumors studied. 2. There was no significant difference of p53 protein expression between serous and mucinous malignant tumors. 3. The expression rate of p53 protein exhibited a statistically significant difference between borderline(42%) and malignant(74%) ovarian surface epithelial tumors (p<0.05). 4. The expression rate of p53 protein of poorly differentiated carcinomas(100%) was higher than those of moderately (88%) and well differentiated carcinomas(60%), but there was no statistical significance. In summary, p53 protein expression might be a good indicator of malignant transformation of the ovarian surface epithelial tumors.
Ovarian Neoplasms ; Genes, p53

Histologic changes suggesting HPV infection are occasionally found adjacent to squamous cell carcinoma or in squamous papilloma of the esophagus, but the relationship between HPV infection and benign and malignant squamous lesions of the esophagus is not yet dear. The aim of this study was to examine the role of HPV in squamous lesions of the esophagus. Microscopic examination with emphasis on HPV infection was done on 15 cases of squamous cell carcinoma and 26 cases of squamous papilloma. In situ hybridization technique for wide-spectrum HPV probe was performed on 35 endoscopically biopsied esophageal tissues. Among the histologic parameters suggesting HPV infection, acanthosis was the most frequent finding: 100.0% in benign and malignant esophageal lesions, and koilocytosis and intraepithelial capillary loops were the second (92.7%).: Dyskeratosis, basal cell hyperplasia and bi- or multinucleation were 52.3%, 44.0% and 34.1% in frequency, respectively. On in situ hybridization study, the HPV DNA expression rates of 10 squamous cell carcinomas with evidence of HPV infection and 15 carcinomas without evidence of HPV infection were 60.0% and 33.3%, respectively. In contrast to the carcinoma cases, only one (10.0%) of 10 squamous papillomas revealed positive signal. In conclusion, HPV infection is strongly associated with squamous cell carcinoma, but the causal relation of HPV to squamous papilloma is inconspicous.
DNA, Viral/*analysis ; Esophageal Neoplasms/pathology/*virology ; Human ; *In Situ Hybridization ; Neoplasms, Squamous Cell/pathology/*virology ; Papillomavirus, Human/genetics/*isolation & purification ; Papovaviridae Infections/pathology/*virology ; Tumor Virus Infections/pathology/*virology

Histologic changes suggesting HPV infection are occasionally found adjacent to squamous cell carcinoma or in squamous papilloma of the esophagus, but the relationship between HPV infection and benign and malignant squamous lesions of the esophagus is not yet dear. The aim of this study was to examine the role of HPV in squamous lesions of the esophagus. Microscopic examination with emphasis on HPV infection was done on 15 cases of squamous cell carcinoma and 26 cases of squamous papilloma. In situ hybridization technique for wide-spectrum HPV probe was performed on 35 endoscopically biopsied esophageal tissues. Among the histologic parameters suggesting HPV infection, acanthosis was the most frequent finding: 100.0% in benign and malignant esophageal lesions, and koilocytosis and intraepithelial capillary loops were the second (92.7%).: Dyskeratosis, basal cell hyperplasia and bi- or multinucleation were 52.3%, 44.0% and 34.1% in frequency, respectively. On in situ hybridization study, the HPV DNA expression rates of 10 squamous cell carcinomas with evidence of HPV infection and 15 carcinomas without evidence of HPV infection were 60.0% and 33.3%, respectively. In contrast to the carcinoma cases, only one (10.0%) of 10 squamous papillomas revealed positive signal. In conclusion, HPV infection is strongly associated with squamous cell carcinoma, but the causal relation of HPV to squamous papilloma is inconspicous.
DNA, Viral/*analysis ; Esophageal Neoplasms/pathology/*virology ; Human ; *In Situ Hybridization ; Neoplasms, Squamous Cell/pathology/*virology ; Papillomavirus, Human/genetics/*isolation & purification ; Papovaviridae Infections/pathology/*virology ; Tumor Virus Infections/pathology/*virology

PURPOSE: The purposes of this study were to examine the relations among anxiety, knowledge, health locus of control and preventive behavior, and to find factors related with preventive behavior. METHODS: The subjects were 269 elderly people of over 65 living in C City. Data were collected through a structured questionnaire and analyzed by SPSS. RESULTS: Health promoting behavior was significantly different according to chronic disease, contact with H1N1 patient and perceived health status. The variables that affected the level of preventive behavior were anxiety, knowledge, internal locus of control, external locus of control, chance locus of control and perceived health status. CONCLUSION: According to this study, promoting preventive behavior for H1N1 on the elderly builds up anxiety, knowledge, and health locus of control.
Aged ; Anxiety ; Chronic Disease ; Health Promotion ; Humans ; Influenza, Human* ; Internal-External Control ; Surveys and Questionnaires

Neurolytic or surgical lumbar sympathectomy are commonly used for the treatment of intractable pain, peripheral vascular insufficiency and hyperhydrosis. For the procedure, the patient sometimes has to suffer from complications such as major vascular perforation, subarachnoid injection, genitofemoral neuralgia, somatic neuralgia, disc perforation, ureteral stricture, inflammation, ejaculatory failure, chronic lumbago. The authors came across with a case of ejaculatory failure a week after both lumbar sympathetic block with 6 ml of 100% alcohol at L3 level under the control of fluoroscopy. Three months after the block the patient recovered without any treatment.
Constriction, Pathologic ; Fluoroscopy ; Humans ; Inflammation ; Low Back Pain ; Neuralgia ; Pain, Intractable ; Sympathectomy* ; Ureter

The pathogenesis of endocervical glandular lesions are not clearly understood. The aims of this study are to evaluate the etiologic role of human papillomavirus (HPV) 16/18 and the relationship of HPV 16/18, p53 and MIB-1 expressions in endocervical glandular dysplasia (EGD), adenocarcinoma in situ (AIS) and adenocarcinoma. The materials included 14 endocervical adenocarcinoma and 5 AIS and 18 high grade EGD and 39 low grade EGD. Immunohistochemistry for p53 and MIB-1, and in situ PCR for HPV 16/18 were done. HPV 16/18 positivity was 84.2%, 16.7% and 17.9% in malignant glandular lesion (adenocarcinoma and AIS), high grade EGD and low grade EGD, respectively. P53 protein expression rates of malignant glandular lesions, high grade EGD and low grade EGD were 31.6%, 11.1%, and 0%, respectively. High MIB-1 labelling index was found in 73.7% of malignant glandular lesions, but in only 5.7% and 3.6% of high and low grade EGD, respectively. There were statistically significant differences in HPV 16/18, p53 and MIB-1 expressions between malignant endocervical glandular lesions and EGD, but no significant difference in p53 and MIB-1 expressions in relation to HPV 16/18 expression. In malignant endocervical glandular lesions, HPV 16/18 infection may be a major causative factor, but not be related to p53 and MIB-1 expressions.
Adenocarcinoma/pathology/physiopathology/*virology ; Carcinoma, Squamous Cell/pathology/physiopathology/virology ; Cervix Neoplasms/pathology/physiopathology/*virology ; Female ; Human ; Nuclear Proteins/analysis/*genetics ; Oncogene Proteins, Viral/genetics ; *Papillomavirus, Human ; Papovaviridae Infections/*pathology/physiopathology ; Protein p53/analysis/*genetics ; Tumor Virus Infections/*pathology/physiopathology