No abstract available.
Child* ; Humans ; Humerus*

Expression of the nm23 and E-cadherin proteins has been studied in a number of tumors. Reduced expression of the nm23 and E-cadherin proteins seems to be associated with metastasis or disease progression in some tumors, including breast carcinoma. To assess the role of nm23 and E-cadherin in tumor differentiation and metastasis of breast carcinoma, immunohistochemical staining for the nm23 and E-cadherin proteins was performed in paraffin embedded tumor samples from 86 breast carcinomas. The results were as follows: 1) Expression of the nm23 protein in breast carcinoma was strong positive in 32 cases (37.2%), weak positive in 26 cases (30.2%), and negative in 28 cases (32.6%) of the cases. Expression of the nm23 protein in breast carcinoma decreased according to histological grade and lymph node metastasis, but was not statistically significant. 2) Expression of the E-cadherin protein in breast carcinoma was strong positive in 50 cases (58.1%), weak positive in 24 cases (27.9%), and negative in 12 cases (14%) of the cases. Expression of the E-cadherin protein in breast carcinoma decreased according to histological grade and lymph node metastasis, but was not statistically significant. 3) There was a statistically significant correlation between the expression of the nm23 protein and the E-cadherin protein in breast carcinoma (p<0.05). These results suggest that the expression of the nm23 and E-cadherin proteins is related to tumor differentiation, and may also be an useful prognostic factor in breast carcinoma.
Breast Neoplasms* ; Breast* ; Cadherins* ; Disease Progression ; Lymph Nodes ; Neoplasm Metastasis ; Paraffin

We experienced an autopsy case of esophageal atresia with tracheoesophageal fistula and other multiple congenital anomalies in a 4 days old male infant. Esophageal atresia with tracheoesophageal fistula was type C by Gross Classification. Combined anomalies were malrotation of left kidney, one left accessory renal artery form right renal artery and one left accessory renal vein from right renal vein, duodenal atresia and annular pancreas. Until now, the esophageal atresia with tracheoesophageal fistula and other multiple congenital anomalies (7 congenital anomalies) are not reported in the korean literature, except our case. Our autopsy case, it suggests that esophageal atresia with tracheoesophageal fistula has often close relation-ship with other multiple congenital anomalies.
Infant ; Male ; Female ; Humans

To clarify the mechanism of the protective effect of hemodialysis on lipid peroxidation in RBC membrane structures, the level of malondialdehyde (MDA) which is the lipid peroxidation product, and the activities of antioxidant enzymes such as superoxide dismutase (SOD), catalase, and glutathione peroxidase (GSH-Px) were determined before and after hemodialysis in the RBCs from 20 patients with end stage renal disease (ESRD), and from 14 healthy subjects. Before dialysis, MDA levels in the RBCs from the patients with ESRD were higher than those from healthy controls. SOD and catalase activities in the RBCs were lower. After hemodialysis, MDA, SOD, and catalase in the RBCs from the patients with ESRD were normalized. These results indicate that hemodialysis treatment is helpful to protect the peroxidative darnage through normalizing the activities of antioxidant enzymes.
Catalase ; Dialysis ; Erythrocytes* ; Glutathione Peroxidase ; Humans ; Kidney Failure, Chronic* ; Lipid Peroxidation ; Malondialdehyde* ; Membranes ; Renal Dialysis* ; Superoxide Dismutase

The best confirming method of the endatracheal intubation was that the endotracheal tube was seen between the vocal cords. The rapid confirming method of the endotracheal intubation was to displace the tracheal tube toward the palate, and to see the endotracheal tube between the vocal cords under laryngoseopy. The purpose of this study was to examine the accuracy of conect endotracheal tube placerment performed by an unexperienced resident of first grade used by rapid confirming method. Two hundreds and nine patients were randomly examined Samson & Young grade firstly and confirmed the rapid method. The results were as follows; 1) Samson & Young grade I (104 patients): 100% confirmed 2) Samson & Young grade II (68 patients): male-91.3%,female-97.8% confirmed 3)Samson & Young grade III (36 patients): male-94.7%, female-88.2% confirmed 4) Samson & Young grade IV (1 patients): 100% confirmed 5) The total rate of success was 97.1% (203/209). With the above results, the authors concluded that first grade resident could confirm queekly the most endotracheal intubation used by the rapid confirming method and even though in the patients of Samson & Young grade III or IV.
Humans ; Intubation ; Intubation, Intratracheal* ; Palate ; Vocal Cords

For a treatment of advanced gastric cancer, the CHPP (Continuous Hyperthermic Peritoneal Perfusion) was often carried out with the surgical procedure. During the CHPP, many cardiovascular changes were occurred. In this case, ventricular fibrillation was suddenly happened at 21 minutes after the CHPP initiation, so we immediately stopped the CHPP. After we carried out the chest massage, heart rate and blood pressure was normalized. But ECG was revealed ST depression & T wave inversion. Therefore, we injected 1% lidocaine 60mg and infused nitroglycerin at a rate of 0.7 ug/kg/min. At the end of the surgery, the ECG was nearly normalized. After this case, we figured out many causes of ventricular fibrillation. First, the patient might had silent myocardial ischemia or coronary arterial disease, but he did not complain any symptoms. Second, peritoneal cavity expander and 8 liters of heated perfusate directly compressed his heart and facilitated the myocardial ischemia. So we planned routinely nitroglycerin infusion during the CHPP. The patient rarely complained chest pain at ward and discharged postoperatively 19 days later.
Blood Pressure ; Chest Pain ; Depression ; Electrocardiography ; Heart ; Heart Massage ; Hot Temperature ; Humans ; Lidocaine ; Myocardial Ischemia ; Nitroglycerin ; Peritoneal Cavity ; Stomach Neoplasms ; Thorax ; Ventricular Fibrillation*

No abstract available.
Thyroid Gland* ; Thyroid Nodule*

To compare the efficacy of Stamey with that of Raz procedure in the correction of stress urinary incontinence, we studied retrospectively 43 patients who underwent either procedure at our institution between January, 1989 and June, 1994. Of 43 Patients were 23 underwent Stamey and 20 underwent Raz procedures. Patient's characteristics of the 2 groups were similar, but mean operative time was 107 minutes in Stamey and 76 minutes in Raz procedure(P<0.05), a care rate was obtained postoperatively in 65y. of the patient in Stamey and in 85% in Raz procedure(P<0.05). Postoperative complications were similar in 13.5% of the patients in Stamey and in 12.5% in Raz procedure. Although most predictive factors were not associated with cure or failure in our series, the postoperative cure rate was significantly higher in the group with urinary retention of more than a week. It is thought that Raz procedure is more safe and accurate than Stamey procedure by its shorter operation time and higher success rate(P<0.05). although patient's satisfaction with postoperative morbidity is similar between Stamey and Raz procedure.
Humans ; Operative Time ; Postoperative Complications ; Retrospective Studies ; Urinary Incontinence* ; Urinary Retention

Background: Fine needle aspiration and biopsy(FNAB) has known the most accurate test(about 90%) in the preoperative evaluation of patients with a thyroid nodule. The false negative findings of thyroid cancer by FNAB are mainly due to the aspiration of cystic fluid in cystic degeneration of thyroid cancer and the ipossibility of differentiation between follicular adenoma and carcinoma by aspiration or FNAB because of the failure to evaluate the capsule invasion or angioinvasion of the tumor. Actually more than 80% of the nodules are found as benign nodules in aspiration or FNAB and the findings of follieular lesions are found about half of the samples tested, so limiting the cancer incidence in surgically resected samples up to 50% of the surgical resection. Sa reasonable guidelines to manage the benign nodules on aspiration or FNAB are needed which can select the maligna~nt nodules with false negative findings on aspiration or FNAB. We tried to evaluate whether the thyroxine suppression therapy can increase the malignancy rates on thyroidectomy, Methods: We treated the benign thyroid nodules in FNAB with thyroxine for 1 year and cornpared the nodule volume change before and after treatment (every 6 month) with ultrasonogram. We performed thyroidectomy on 1~7 thyroid nodules wbich showed less than 50% decrease of nodule volume after 1 year of thyroxine suppression therapy. Results: The results were as follows. 1) Of all 17 patients, surgical resection revealed malignant thyroid nodule(Group I) in 10 cases (58.82%, papillary cancer. 6 cases, follicular cancer: 4 cases) and benign thyroid nodule(Group II) in 7 cases(41.18%, follicular adenoma: 4 cases, adenomatous goiter: 3 cases). 2) Between group I and II, there was no significant differences in serum T, T and TSH levels before and after thyroxine suppression therapy. Also, there were no significant difference in TSH suppression % between group I and group II(5.60+5.39%, 14.64+11.48%, respectively). 3) Thyroid nodule volume decrease percent before and after thyroxi~ne therapy showed no significant difference between group I and group II (124.80+54.18% vs 159.42+79.82%, p>0.05). Conclusion: Our data suggested that the benign thyroid nodules on aspiration or FNAB which were not suppressed in volume after thyroixine therapy revealed more than 50% incidence of malignancy on surgical resection, so these nodules were highly reeommended to surgical exploration.
Adenoma ; Biopsy, Fine-Needle ; Goiter ; Humans ; Incidence ; Thyroid Gland ; Thyroid Neoplasms ; Thyroid Nodule ; Thyroidectomy ; Thyroxine ; Ultrasonography

The bone marrow biopsy is an integral part of the staging process in patients with malignant lymphomas. Bone marrow(BM) involvement indicates stage IV disease, but there are always a lot of cases in which clear separation is not possible when based on morphology alone. Additional difficulties are caused by morphologic discordance between the BM and the primary lymphoma. Immunohistochemical stain, mRNA in situ hybridization (ISH) for light chain restriction and polymerase chain reaction (PCR) for IgH CDR3 and TCRgamma were performed to find a minimal lesion and the clonality in formalin fixed paraffin embedded tissues of 39 primary lymphomas and corresponding BM biopsy specimens. As a result, nine morphologically negative bone marrows of 18 lymphomas were positive by PCR (Group I). Among the 6 lymphoma cases with morphologically suspicious BM involvement (Group II), one was confirmed to be positive for marrow involvement by both mRNA ISH and PCR and the other four by PCR alone. The positive bone marrows of Group I and II revealed gene rearrangement at the same site as the primary lesion, suggesting the same clonality. Thirteen of 15 lymphomas with morphologically positive BM (Group III) had the same clonality in the primary lymphomas and the BM lesion. Three cases among the Group III with morphologic discordance also revealed the same clonality by PCR. This study shows that a combination of mRNA ISH and PCR in addition to an immunohistochemical stain improves the diagnostic sensitivity in the detection of BM involvement and identification of clonality. Among the three different methods used, PCR is the most sensitive in detecting a minimal lesion.
Biopsy ; Bone Marrow ; Formaldehyde ; Gene Rearrangement ; Humans ; In Situ Hybridization ; Lymphoma* ; Paraffin ; Polymerase Chain Reaction ; RNA, Messenger