Recently, the bcl-2 and p53 protein have been recognized as important factors that is contributed to programmed cell death. The objective of this study was to evaluate the prognostic significance of bcl-2 and p53 protein expression in uterine cervical carcinoma. The expression of bcl-2 and p53 in 59 cases of uterine cervical carcinoma (stage IB to IIB) were surgically treated from January 1993 to June 1994. The expression of bcl-2 and p53 was examined by immunohistochemical method using formalin fixed paraffin embedded tissue specimens. The 48 cases were squamous cell carcinoma and 11 cases were adenocarcinoma. The results were as follows: 1. The expression rate of bcl-2 protein was 28.8%(17/59) and there was no significant correlaltion between the expression of bcl-2 protein and the clinicopathologic parameters (histologic type, grade, FIGO stage, cervical invasion depth, lymph node metastasis, parametrial invasion, tumor size, neoadjuvant chemotherapy response, recurrence, survival). 2. The expression rate of p53 protein was 32.2%(19/59) and there was no significant correlation between expression of p53 protein and the clinicopathologic parameters. 3. There was significant correlation between and expression of bcl-2 and p53 protein (P 0.05). In conclusion, bcl-2 and p53 protein are thought to be possible factors in the carcinogenesis of uterine cervical carcinoma and correlate with progression of it. But further study will be required to clarify the role of bcl-2 and p53 in carcinogenesis of the uterine cervix.
Adenocarcinoma ; Carcinogenesis ; Carcinoma, Squamous Cell ; Cell Death ; Cervix Uteri ; Drug Therapy ; Female ; Formaldehyde ; Lymph Nodes ; Neoplasm Metastasis ; Paraffin ; Recurrence ; Uterine Cervical Neoplasms*

OBJECTIVE: The purpose of this study was to review the clinicopathologic features, recurrent rate, survival rate and controversable issues in the treatment of the ovarian malignant germ cell tumors. PATIENTS AND METHODS: From August, 1991 to November, 1998 thirty-one patients with malignant germ cell tumors of the ovary treated in the department of obstetrics and gynecology, Kosin University Medical college, were eligible and assessable. Demographic characteristics, symptoms, signs, stage, tumor grade, mode of therapy and results of follow up were reviewed retrospectively. RESULTS: The patients with malignant germ cell tumor constituted 6.37% of all ovarian malignancies during this period. Histologic subtypes were 8 dysgerminoma(25.8%), 7 endodermal sinus tumor(22.6%), 10 immature teratoma(32.3%), 3 mixed germ cell tumor(9.7%), 3 choriocarcinoma(9.7%). The age of the patients ranged from 10 to 40 years (mean +/-S.D.; 24.26 +/- 7.51). The most common symptom was abdominal pain(38.7%). Most had stageI(18 cases, 58.0%) or stageIII(5 cases, 16.2%) diseases. All patients underwent surgery as the initial treatment, and nine patients received more than one operation. Postoperative adjuvant chemotherapeutic regimens were VAC, VBP, EP, BEP, EMA, and EMA CO. The mean follow up duration was 26.0(+/- S.D.; +/- 20.3) months. The 2-year and 5-year survival rate were 91.97%(+/- S.E.; +/- 0.05) and 86.86%(+/- S.E.; +/- 0.07).
Endoderm ; Female ; Follow-Up Studies ; Germ Cells* ; Gynecology ; Humans ; Neoplasms, Germ Cell and Embryonal* ; Obstetrics ; Ovary ; Retrospective Studies ; Survival Rate

PURPOSE: Bone graft is essential for successful spinal fusion. So, we clinically assessed the effect of uniting grafted autologous bone. MATERIALS AND METHODS: Retrospective analysis is performed on 46 patients who had grade I or II, one segmental, degenerative spondyloiisthesis according to Meyerding classification and treated operatively by posterolateral fusion with posterior decompression and autologous iliac bone graft from January 1991 to June 1996. We got the data from simple anteroposterior, lateral, flexion- extension X-ray film at preoperative, postoperative and last follow-up period, and from clinical results at last OPD follow-up according to Kirkaldy-Willis criteria. We compared the union of grafted autologous bone with clinical results using X2-test. We also compared preoperative spinal instability, with/without instrumentation and intraoperative reduction with the union of grafted autologous bane and clinical results. RESULTS: There was high significant correlation (P=0.000) between the union of grafted autologous bone and clinical results statistically, CONCLUSIONS: This results suggest that the union of grafted autologous bone was an important factor in determing clinical results.
Classification ; Decompression ; Follow-Up Studies ; Humans ; Retrospective Studies ; Spinal Fusion ; Spondylolisthesis* ; Transplants* ; X-Ray Film

PURPOSE: To compare effects of a 2-hour, 6-hour, and full-time patching regimens in monocular amblyopia patients under 10 years of age. METHODS: This study recruited monocular amblyopia patients under 10 years of age. The patients were divided into a 2-hour patching group (group A, n=34), a 6-hour patching group (group B, n=33), and a full time patching group (group C, n=28) according to the patching time. A prospective analysis was then performed. The ages at the start of treatment, differences of corrected visual acuity between the 2 eyes and severity of the 3 groups were compared and analyzed. On the final evaluation, 'success' was defined when the difference of corrected visual acuity between the 2 eyes converted into logMAR was less than 0.1. RESULTS: The ages at the start of treatment in group A, B, C were 5.61, 5.48 and 5.71 years, respectively. The best corrected visual acuity of an amblyopic eye converted into logMAR changed to 0.13 after treatment in group A, to 0.16 in group B and to 0.19 in group C. Although visual acuity after the treatment was increased significantly compared to the beginning of treatment in all 3 groups, the final visual acuity showed no statistically significant difference among the 3 groups. Because the occlusion therapy success rates were 70.6%, 69.7% and 64.3% for groups A, B and C, respectively, there was no statistically significant difference. CONCLUSIONS: In the 2-hour, 6-hour, and full-time patching regimens, all patients showed a significant improvement in visual acuity although their success rates were not significantly different. Therefore, the part-time patching therapy favored by patients and parents is effective for the first treatment of amblyopia.
Amblyopia ; Eye ; Humans ; Parents ; Prospective Studies ; Visual Acuity

We observed the gastric varices in l89 variceal patients with liver cirrhosis and in 129 patients with UGI bleeding by endoscopy. Gastric varices was found in 27 cases(14.2%) amoag 189 variceal cases. There was variceal bleeding in 74 cases(57.4%) beieg the toy cause of UGI: bleeding among l29 cases with UGI bleeding and 6(4.7%) had endoscopically proved gastric Variceal bleeding. Cardiac and fundic varices were observed in l8 and 12 cases, respectively end 12 cases of cardiac varices were mainly observed on the lesser curvature side. The incidence of isolated gastric varices being 30 % amoag gastric varices was far less than that of esophagogastric varices. There was no significant relations between the severity of liver cirrhosis and the kinds of varices These results suggest that gastric varices are not infrequent cause of UGI bleeding cases. Therefore all must have attention in gastric intestinal fiberscopic examination in portal hypertensive patients.
Endoscopy ; Esophageal and Gastric Varices* ; Hemorrhage ; Humans ; Incidence ; Liver Cirrhosis ; Play and Playthings ; Varicose Veins

PURPOSE: To evaluate the effectiveness of a blocking screw in intramedullary nailing at the tibia proximal shaft fracture. MATERIALS AND METHODS: 63 tibia proximal shaft fractures from January 2000 to December 2002 treated with only intramedullary nailing were referred to as group I, and 8 fractures from January 2003 to December 2003 treated with both intramedullary nailing and the blocking screw were referred to as group II. Retrospective studies were done for group I and II. The incidence of nonunion and the postoperative angular alignments were compared. Malalignment was defined as an angle of 5 degrees anteroposteriorly or mediolaterally. RESULTS: There were 7 nonunion (11%) in group I in compare with none in group II. There were 21 angular malalignments (33%) in group I and 1 in group II (12%) and most of them had valgus deformity or anterior anglulation. No complications were directly due to the use of the Blocking screw. CONCLUSION: The technique of the blocking screw used to be one of the option for proximal tibial nailing at tibial proximal shaft fracture helps to overcome angular malalignments of bones.
Congenital Abnormalities ; Fracture Fixation, Intramedullary ; Incidence ; Retrospective Studies ; Tibia ; Tibial Fractures*

PURPOSE: Myocutaneous flap was widely used for trochanteric pressure sore but it had many drawbacks such as donor site morbidity, dog-ear deformity and functional muscle sacrifice. We have performed fasciocutaneous flap based on perforating vessels and succeeded in overcoming its drawbacks. METHODS: We experienced 11 cases of perforator-based fasciocutaneous flap for the coverage of trochanteric pressure sore in 9 patients, 2 cases of which were bilateral. The ambulatory status of patient group is as follows: 6 of them used a wheelchair, 2 of them are free walking, 1 of them use a wheelchair or crutches. Flap was supplied by cutaneous perforating vessel of descending branch of the lateral circumflex femoral artery and the third perforating artery of the deep femoral artery. The size of wounds were from 4x6.5cm to 10x13cm. RESULTS: We did not find any flap loss or congestion except 2 partial wound dehiscences and 1 wound infection. Donor site morbidity was not found. We observed no recurrence of the pressure sore during the 2.5 year follow-up period. CONCLUSION: We considered that perforator-based fasciocutaneous flap could overcome the traditional drawbacks of the conventional myocutaneous flap and its modified flap for trochanteric pressure sore. And this flap has many advantages for covering trochanteric pressure sore without any donor site deformity and morbidity, which would greatly improve the aesthetic result.
Arteries ; Congenital Abnormalities ; Crutches ; Estrogens, Conjugated (USP) ; Femoral Artery ; Femur* ; Follow-Up Studies ; Humans ; Myocutaneous Flap ; Pressure Ulcer* ; Recurrence ; Tissue Donors ; Walking ; Wheelchairs ; Wound Infection ; Wounds and Injuries

Breast reconstruction with free TRAM flap is a common procedure. However patients with abdominal scars can be confronted with a challenging problem in performing flap reconstruction. The inadequate blood supply around the scar can result in various skin complications in flap or donor site, but there are no reported guidelines in our country. From May 1999 to March 2003, a total of 38 breast reconstructions using free TRAM flaps were performed for 37 patients, of whom 12 had abdominal scars from previous operations; 7 had midline vertical scars and 4 had low transverse scars from Cesarean section or total hysterectomy, 3 had right lower quadrant oblique scars from appendectomy (2 also had transverse scars from Cesarean section). We attempted to minimize flap and donor site complications by modifying classic free TRAM flap designs and procedures according to the characteristics of the abdominal scars and performed periodic follow-up observations of flaps and donor sites for presence of complications and also gave surveys for patient satisfaction on the reconstructed breast. All 38 patients underwent successful breast reconstructions with neither skin complications around the scar nor flap loss and 96.4% patients reported being very satisfied or satisfied with the results.
Appendectomy ; Breast* ; Cesarean Section ; Cicatrix* ; Female ; Follow-Up Studies ; Humans ; Hysterectomy ; Mammaplasty* ; Patient Satisfaction ; Pregnancy ; Skin ; Tissue Donors

PURPOSE: The purpose of this study was to evaluate the MR findings of benign and malignant musculoskeletal adipose tumors and to determine the points of difference between these two types. MATERIALS AND METHODS: This study involved 41 histopathologically proven cases; 26 were benign lipoma and 15 were liposarcoma. T1- and T2-weighted images were obtained in all cases and enhancement study was performed in 15 case of benign lipoma and14 of liposarcoma. To determine MR findings and possible differences between the two groups, we retrospectively analyzed size, location, margin, degree of signal intensity, homogeneity, enhancement pattern and internal septa, as seen on MR images. RESULTS: On both T1- and T2-weighted images, all lipomas showed a signal intensity similar to that of subcutaneous fat. Twenty-one lipomas had thin and regular internal septa and three showed focal enhancement. On T1-weighted images, 13 of 15 liposarcomas showed linear strands or patchy or diffuse areas with high signal intensity, representing a fatty component. Ten liposarcomas showed inhomogeneous signal intensity and the other five, homogeneous intensity. Irregular and thick septa were seen in nine liposarcomas, and in 12 cases, nodular diffuse enhancement was documented. CONCLUSION: Homogeneity of signal intensity, enhancing pattern and internal septa might be useful MR findings for the differential diagnosis of benign lipoma and liposarcoma.
Diagnosis, Differential ; Extremities* ; Lipoma ; Liposarcoma ; Magnetic Resonance Imaging* ; Retrospective Studies ; Subcutaneous Fat

PURPOSE: The AFX2 endograft is a unibody, bifurcated stent graft that can be used to lower complications in certain patients. In this study, we retrospectively reviewed consecutive cases in which the AFX2 system was used to overcome the challenges of narrow distal aorta, as well as to reduce procedure time and contrast medium dose. Furthermore, we compared the results with matched patients treated using the Endurant II endograft system.MATERIALS AND METHODS: This was a retrospective observational study of nine patients with abdominal aortic aneurysm (AAA) who underwent endovascular aneurysm repair (EVAR) using the AFX2 device between June 2017 and April 2018 at Seoul National University Hospital. The patients had narrow distal aorta (n=3), reversed tapered neck (n=1), iliac artery aneurysm (n=2), chronic kidney disease patients (n=2), and impending rupture (n=1). Seven matched patients were treated using the Endurant II graft.RESULTS: In the AFX2 group, the mean procedure time was 87.2 minutes, mean blood loss volume was 157.7 mL, and mean volume of contrast medium used was 48.3 mL. In the Endurant II group, the mean procedure time was 140.0 minutes, mean blood loss volume was 175.0 mL, and mean volume of contrast medium used was 119.3 mL.CONCLUSION: Our preliminary experiences with selected AAA patients treated using the AFX2 endovascular repair system showed good outcomes compared with similar patients treated using the Endurant II system. Therefore, the AFX2 may be a good option to perform EVAR in patients of advanced age who have chronic kidney failure or narrow distal aorta.
Aneurysm ; Aorta ; Aortic Aneurysm ; Aortic Aneurysm, Abdominal ; Blood Vessel Prosthesis ; Humans ; Iliac Artery ; Kidney Failure, Chronic ; Neck ; Observational Study ; Renal Insufficiency, Chronic ; Retrospective Studies ; Rupture ; Seoul ; Transplants