This study was carried out to evaluate the immunohistochemical expressions of p53, E-cadherin, and nm23 proteins in 114 cases of metastatic carcinoma of the neck lymph node (MTLNCA) and corresponding primary carcinoma (PRCA). The positive expressions of p53, E-cadherin, and nm23 proteins were 62.3%, 58.8% and 64.0%, respectively in PRCA, and 40.4%, 38.6%, and 43.9%, respectively in MTLNCA with significant down-regulation from PRCA to MTLNCA (p<0.05). The down-regulation was correlated with female gender, moderate and poor differentiation, and adenocarcinoma in p53 protein, female gender, respiratory and gastrointestinal carcinoma in E-cadherin protein, and female gender, respiratory carcinoma, moderate differentiation, and squamous cell carcinoma in nm23 protein (p<0.05). There was no significant relationship among expressions of p53, E-cadherin, and nm23 proteins (p<0.05). In conclusion, these results suggest that the expressions of p53, E-cadherin, and nm23 proteins seem to be down-regulated from PRCA to MTLNCA and this down-regulation may play a role in invasion and metastasis.
Adenocarcinoma ; Cadherins* ; Carcinoma, Squamous Cell ; Down-Regulation ; Female ; Humans ; Lymph Nodes* ; Neck* ; Neoplasm Metastasis

No abstract available.
Pancreaticoduodenectomy*

The diagnosis of a Battered Child Syndrome is made by the pediatrician, surgeon and the radiologist because almost parents deny the diagnosis or refuse to answer the doctor's questions. The imaging modalities play a key role in the investigation and documentation of the battered child syndrome, because of the high frequency of the typical skeletal lesion. Although physical abuse is denied by parents, the recognition of this entity is possible by the primary diagnostic imaging study in the suspected child abuse. The imaging studies are either a bone scan and x-ray series or a complete radiolographic skeletal survey by X-ray series. In an expected intracranial injury, a CT scan of the head is mandatory We experienced a case of Battered Child Syndrome in a 6 month-old male infant who had subdural hemorrhage and fractures of skull and ribs in different stages of healing and repair. The brief review of the literature was made.
Battered Child Syndrome* ; Child ; Child Abuse ; Diagnosis ; Diagnostic Imaging ; Head ; Hematoma, Subdural* ; Humans ; Infant ; Male ; Parents ; Ribs ; Skull ; Tomography, X-Ray Computed

BACKGROUND: Using biochemical and immunohistochemical studies, alterations of cytokeratin expression has been reported in seborrheic keratosis. OBJECTIVE: To further investigate the cytokeratin expression in seborrheic keratosis, we have done immunohistochemical staining using a panel of specific anti-keratin antibodies in this study. We also observed the cytokeratin expression in the hair, sebaceous gland and sweat gland of the some epidermis. METHODS: Twenty cases of seborrheic keratosis were collected from the pathologic files. The histological types included acanthotic type (13 cases), hyperkeratotic type (5 cases), and pigmented type (2 cases). All tissues had been fixed in formalin and then paraffin-embedded according to conventional procedures. Each section was mounted on a gelatin-coated glass slide, and incubated with various anti-keratin antibodies. The sections were then immunostained using the avidin-biotin-peroxidase complex system. The peroxidase reaction was visualized with diaminobenzidine (DAB). RESULTS: 1. Cytokeratin expression in seborrheic keratosis lesions On staining with 34βB4 (K1), several staining patterns in the suprabasal layers of the epidermis were observed in 10 out of 20 cases. Using the AE1 (K10,14,15), we observed focal staining in 2 cases. We observed several positive staining patterns in 5 cases with K13,16 antibody. On staining with K10 antibody, we observed focal or irregular staining patterns in 14 cases. Focal staining was also observed with K5,8 antibody in one case. 2. Cytokeratin expression in the hair, sebaceous gland and sweat gland On immunoperoxidase staining of hair, there were positive reactions with CAM5.2 (K8,18) in 2 cases. There were positive reaction with K13,16 antibody in one case, with 34βB4 (K1), and K10 antibody in 3 cases, and with K17 antibody in 2 cases. On immunoperoxidase staining of sebaceous glands, there was one positive reaction with CAM5.2 (K8,18) in the suprabasal cells of sebaceous glands and with K13,16 antibody in sebaceous ducts. There were positive reactions with K17 antibody in the sebaceous ducts in 2 cases, and with K1 antibody in the sebaceous glands in one case. Using 34βB4 (K1), 4 out of 20 cases showed positive reactions in sweat glands. On staining with AE1 (K10,14,15), positive reactions were observed in 8 cases. Staining with CAM5.2 (K8,18) showed positive reactions in 14 cases. There were positive reactions with K19 antibody in 9 cases. CONCLUSION: Our data suggests that the predominant keratin expression in the tumor cells of seborrheic keratosis is high molecular weight keratin (K1/K10) rather than other lower molecular weight keratin. Tumor cells show some proliferative activity and monoclonal antibody K19 could be a marker for eccrine sweat glands like CAM5.2 (K8,18).
Antibodies ; Epidermis ; Formaldehyde ; Glass ; Hair ; Keratins* ; Keratosis, Seborrheic* ; Molecular Weight ; Peroxidase ; Sebaceous Glands ; Sweat Glands

No abstract available.
Lupus Erythematosus, Systemic*

PURPOSE: To evaluate therapeutic effect of biofeedback therapy according to methods of diagnosis in patients with norelaxing puborectalis syndrome. METHODS: From September, 1, 1998 to February, 30, 1999, the patients who were diagnosed with norelaxing puborectalis syndrome on anal electromyography (EMG) and/or cinedefecography (CD) underwent biofeedback therapy. The patients were divided into 3 groups according to the diagnostic method; CD group - only diagnosed on cinedefecography, EMG group - only diagnosed on anal electromyography, CD EMG group - diagnosed on both tests. RESULTS: Nineteen patients were diagnosed nonrelaxing puborectalis syndrome on CD and/or EMG. There were 14 females and 5 males with a mean age of 40.8+/-18.4 years. The patients were classified into CD group; five patients (26.3%); EMG group, eight patients (42.1%); CD EMG group, six patients (31.6%). The patients had 5.4 3.7 sessions of outpatient EMG-based biofeedback sessions. Subjective symptoms after biofeedback therapy improved in 4 (80.0%), 6 (75%), 5 (83%) patients in CD, EMG, CD EMG groups, respectively. There was a statistically significant increase in spontaneous bowel movements, and a reduction in assisted bowel movements after biofeedback therapy in patients in all three groups (p<0.05). However, no significant difference was found among the three groups. CONCLUSION: This study demonstrated that biofeedback therapy had a high therapeutic effect regardless to the diagnostic method. Therefore, biofeedbck therapy can be performed if one test results in the diagnosis of norelaxing puborectalis syndrome in patients with constipation.
Biofeedback, Psychology* ; Constipation ; Diagnosis* ; Electromyography ; Female ; Humans ; Male ; Outpatients

PURPOSE: To evaluate the influence of peripapillary atrophy on the progress of diabetic retinopathy. METHODS: Interval between the diagnosis of diabetes and the onset of diabetic retinopathy was compared between 77 eyes of 50 patients with peripapillary atrophy and 253 eyes of 172 patients without peripapillary atrophy who visited the Korea university ophthalmology department between January 2002 and May 2002, No one had glaucoma or high myopia. Pepipapillary atrophy was classified by severity and compared. RESULTS: Time to the onset of nonproliferative diabetic retinopathy was longer in the patients with peripapillary atrophy (13.7 years) than the patients without peripapillary atrophy (11.2 years) (p Atrophy* ; Diabetic Retinopathy* ; Diagnosis ; Glaucoma ; Humans ; Korea ; Myopia ; Ophthalmology

Statement of problem. The success of osseointegration can be enhanced with an implant that has improved surface characteristics. Anodic oxidation is one of the surface modifying method to achieve osseointegration. Voltage of anodic oxidation can change surface characteristics and cell activity. Purpose. This study was performed to evaluate MG63 cell responses such as affinity, proliferation and to compare surface characteristics of anodic oxidized titanium in various voltage. Material and method. The disks for cell culture were fabricated from grade 3 commercially pure titanium, 1 mm in thickness and 12 mm in diameter. Surfaces of 4 different roughness were prepared. Group 1 had a machined surface, used as control. Group 2 was anodized under 220 V, group 3 was anodized under 300 V and group 4 was anodized under 320 V. The microtopography of specimens was observed by scanning electron microscope (JSM-840A, JEOL, Japan) and atomic force microscope(Autoprobe CP, Park Scientific Instrument, USA). The surface roughness was measured by confocal laser scanning microscope(Pascal, LSM5, Zeiss, Germany). The crystal structure of the titanium surface was analyzed with x-ray diffractometer(D8 advanced, Bruker, Germany). MG63 osteoblast-like cells were cultured on these specimens. The cell morpholgy was observed by field emission electron microscope(Hitachi S-4700, Japan). The cell metabolic and proliferative activity was evaluated by MTT assay. Results and conclusion. With in limitations of this in vitro study, the following conclusions were drawn. 1. In anodizing titanium surface, we could see pores which did not show in contol group. In higher anodizing voltage, pore size was increased. 2. In anodizing titanium surface, we could see anatase. In higher anodizing voltage, thicker oxide layer increased crystallinity(anatase, anatase and rutile mixed). 3. MG63 cells showed more irregular, polarized and polygonal shape and developed more lamellipodi in anodizing group as voltage increased. 4. The activity of cells in MTT assay increased significantly in group 3 and 4 in comparison with group 1 and 2. However, there was no difference between group 3 and 4 at P<0.05. Proliferation of MG63 cells increased significantly in pore size(3-5.5 micrometer) of group 3 and 4 in comparison with in pore size(0.2-1 micrometer) of group 2.
Cell Culture Techniques ; Osseointegration ; Titanium*

PURPOSE: To report antielevation syndrome with restriction of elevation on abduction in the operated eye and overaction (OA) of the inferior oblique muscle (IO) of the contralateral eye after unilateral IO anteriorization (AT). METHODS: Medical records were reviewed retrospectively in 8 of 24 patients who underwent unilateral IOAT. Four patients were referred from other hospitals after the same surgery. RESULTS: Four patients had infantile esotropes. The rest showed accommodative esotropia, superior oblique palsy, exotropia, and consecutive exotropia. The mean amount of hyperdeviation was 16.3 PD (10~30). The mean restriction of elevation on abduction in the operated eye was -1.6 (-1~-4) and IOOA of the contralateral eye was +2.7 (+2~+3). IOAT of nonoperated eyes in 4 patients, IO weakening procedure of anteriorized eyes in 2 patients, and IO myectomy on an eye with IOAT in 1 patient were performed. Ocular motility was improved after surgery in all patients. CONCLUSIONS: Unilateral IOAT may result in antielevation syndrome. Therefore bilateral IOAT is recommended to balance antielevation in both eyes. A meticulous caution is needed when performing unilateral IOAT.
Syndrome ; Retrospective Studies ; Reoperation ; Postoperative Complications ; *Ophthalmologic Surgical Procedures ; Oculomotor Muscles/physiopathology/*surgery ; Ocular Motility Disorders/*etiology/physiopathology/surgery ; Infant ; Humans ; Follow-Up Studies ; Female ; Eye Movements/*physiology ; Exotropia/surgery ; Esotropia/surgery ; Child, Preschool ; Child ; Adult

PURPOSE: To evaluate the influence of orbital size and interorbital distance on the development and recurrence of intermittent exotropia. METHODS: We selected 55 intermittent exotropes(group A), 30 esotropes (group B), and 30 normal children(group C). Width and height of orbit, inner interorbital distance (IIOD), and outer interorbital distance (OIOD) in both orbits were measured with skull A-P(Anterior-Posterior) roentgenogram, and orbital index (IIOD/OIOD X 100) was calculated. The cephalometric results of the 6 recurrent exotropes and the 6 consecutive esotropes in group A were analyzed too. RESULTS: There is no significant difference in orbital height and orbital length among 3 groups. The IIOD was 25.0+/-3.86 mm in group A, 21.9+/-3.95 mm in group B, and 22.7+/-4.34 mm in group C. Mean OIOD was 100.3+/-9.75 mm in group A, 97.0+/-8.96 mm in group B, and 98.4+/-5.61 mm in group C. Orbital index was not different with the increase of age (p=0.23). It was greater in group A (25.0+/-2.79) than that in group B (22.9+/-2.66) and group C (23.1+/-2.79) (p<0.05). Orbital index of the orthophoric children after strabismus surgery in group A was 24.7+/-2.99. It was greatest in the 6 recurrent extropes (25.2+/-2.00) and was smallest in 6 the consecutive esotropes (23.5+/-1.69) CONCLUSIONS: Intermittent exotropia is more prevalenat in subjects with longer IIOD and greater OI, and esotropia is more prevalent in subjects with shorter IIOD and lower OI. The possibility of recurrence after surgery was high in patients with greater OI, and the possiibility of consecutive esotropia was high in patients with low orbital index.
Child ; Esotropia ; Exotropia* ; Humans ; Orbit* ; Recurrence ; Skull ; Strabismus