Tamoxifen is a nonsteroidal triphenylethylene delivative that has been widely used in the treatment of breast cancer. tamoxifen is indicated for the adjuvant treatment of breast cancer in women following total mastectomy or segmental mastectomy, breast irradiation and chemotherapy. tamoxifen has been shown to have significant benificial effect in the treatment of breast cancer patient as hormonal therapy. However ,there is mounting evidence that tamoxifen may affect other hormon sensitive organs, including the uterus and ovaries. An increased risk of endometrial polyps, endometrial hyperplasia and adenocarcinoma has been reported in tamoxifen treated women. We have met cases of endometrial polyp and endocervical polyp which were associated with tamoxifen use, after modified radical mastectomy for infilterating ductal carcinoma of breast . So we report these cases with the brief review of literatures.
Adenocarcinoma ; Breast ; Breast Neoplasms ; Carcinoma, Ductal ; Drug Therapy ; Endometrial Hyperplasia ; Female ; Humans ; Mastectomy, Modified Radical ; Mastectomy, Segmental ; Mastectomy, Simple ; Ovary ; Polyps* ; Tamoxifen* ; Uterus

No abstract available.
Pulmonary Atelectasis*

Alterations in the expression of genes that control the cell cycle may be of critical importance in tumorigenesis and malignant transformation. The major regulatory events leading to cell proliferation occur in Gl phase of cell cycle, and the deregulated expression of Gl cyclins is related to oncogenesis. Cyclins Dl and E play important roles in the progression of cell through Gl phase of the cell cycle. Amplification and/or overexpression of the cyclin Dl gene and aberrant expression of cyclin E has been described in various forms of human cancer. However, the role of cyclins Dl and E in cervical cancer has been poorly defined. In this study, we examined the expression of cyclins Dl and E by Northern blot technique and the status of human papil- lomavirus(HPV) type 16 and 18 by polymerase chain reaction in 25 cases of cervical carcinoma to explore the relationship between cyclins Dl and E and cervical cancer. We found cyclin Dl expression showed down-regulated expression in cervical cancer but cyclin E expression was increased in cancer group. Other clinicopathological prognostic factors were not correlated with cyclins D1 and E expression. Further study based on larger numbers of cases with correlation of cyclins D1 and E status and survival data will be needed to elucidate the use of cyclin expressions as prognostic factor.
Blotting, Northern ; Carcinogenesis ; Cell Cycle ; Cell Proliferation ; Cyclin E ; Cyclins* ; Humans ; Polymerase Chain Reaction ; Uterine Cervical Neoplasms

This is a case report of a 5-month-old male who was brought in to hospital for evaluation of jaundice from birth. The baby had a history of ileal atresia operated 2 days after birth. At the age of one month, Tc-99m DISIDA hepatobiliary scintigraphy was performed at other hospital and reported to show good hepatic uptake of the tracer but no uptake in the billiary tree, gall bladder, or intestine for 24 hours post injection. He was judged to have biliary atresia. However, subsequent exploratory laparotomy revealed that the hepatobiliary tree appeared intact and that there was a gall bladder. Additionally, the patient had central aorto-pulmonary shunt for the right ventricular septal defect with pulmonary stenosis of a peripheral type at the age of 4 months. The second hepatobiliary scintigraphy was performed on admission at the age of 5 months, showing a gall bladder but no intestinal uptake up to 24 hours. Retrospectively, the histological specimen of the liver obtained at the exploratory laparotomy was re-evaluated, and by the histological findings coupled with clinical data, arteriohepatic dysplasia (Alagille's syndrome) was diagnosed. In this report, we emphasize the diagnostic limitation of hepatobiliary scintigraphy and the importance of overall clinical and histologic evaluation in a case of Alagille's syndrome. (Korean J Nucl Med 2000;34:154-158)
Alagille Syndrome* ; Biliary Atresia ; Heart Septal Defects, Ventricular ; Humans ; Infant ; Intestines ; Jaundice ; Laparotomy ; Liver ; Male ; Parturition ; Pulmonary Valve Stenosis ; Radionuclide Imaging ; Retrospective Studies ; Urinary Bladder

This study was aimed to elucidate the relationship between combinations of treadmill speed-grade and oxygen consumption(Vo2). Twenty athetic and 20 non-athletic male college students aged 19-24yr were employed to exercise on a treadmill using 4 speeds(4.02, 5.47, 6.76 and 8.05km/h) and 5 grades(0, 8, 12, 16 and 20%). A fixed speed was selected for each session with the grade increased every 3 min. The Vo2, heart rate, stride frequency and stride length were measured during the last min of each 3-min stage. Vo2increased linearly with increasing speed and grade showing significant multiple correlations in nonathletes(Vo2=3.64x+0.831y+0.031xy-7.03, R=0.98, P<0.01) and athletes(Vo2=3.48x+0.324y+0.112xy-5.74, R=0.99, P<0.01). Stride frequency and length tended to increase with increasing speed except for the transition from walking to runnig at 8.05Km/h at which the stride frequency ran up much higher with the stride length getting lower than at 6.76Km/h. Heart rate increased linearly with increasing Vo2. The rate of increase was higher during walking than during running. These results indicate that athletes have higher rate of increase in Vo2than nonathletes at near-maximal exercise and may be used as a guideline in predicting maximum oxygen comsumption and in prescribing exercise intensity.
Athletes* ; Heart Rate ; Humans ; Male ; Oxygen Consumption* ; Oxygen* ; Running ; Walking

No abstract available.
Child* ; Humans

In the neonatal diseases of pediatric surgery, a congenital duodenal obstruction is an important part of congenital disease. Between March 1994 and December 1996, 15 cases of congenital duodenal obstruction were experienced and treated at St. Francisco's General Hospital. The following results were obstained: 1) The types of congenital duodenal obstruction were 5 malrotations, 4 atresia, 3 webs, 2 annular pancreases, and 1 obstruction due to an ectopic pancreas. 2) There were 8 males and 7 females; the male to female ratio was 1.14 : 1. 3) The age on admission was 1 to 7 days in 13 cases (87%), and all cases were admitted within 1 month after birth. 4) The birth weight below 2500 gm in only 2 cases (13%). 5) The main clinical symtom was vomiting (93%). 6) Associated anomalies were found in 11 cases (73.3%): 4 cases of congenital heart disease, 3 of Down's syndrom, 2 of malrotations, 2 of urogenital anmalies, and 1 each of jejunal atresia, midgut volvulus, and polydactyly. 7) Postoperative complications occurred in 4 cases (27%), but there was no deaths.
Birth Weight ; Duodenal Obstruction* ; Female ; Heart Defects, Congenital ; Hospitals, General ; Humans ; Infant, Newborn ; Intestinal Atresia ; Intestinal Volvulus ; Male ; Pancreas ; Parturition ; Polydactyly ; Postoperative Complications ; Vomiting

IIn a randomized double-blind study, postoperative pain was assessed in 60 patients undergoing gynecologic surgery with three types of anesthesia; inhalation anesthesia only (enflurane-N2O-O2-vecuronium)(G); inhalation anesthesia with local infiltration (infiltration of the abdominal wall with 40 ml 0.25% bupivacaine along the line of the proposed incision)(GI); and inhalation anesthesia with epidural analgesia (morphine 2 mg mixed with 10 ml 0.125% bupivacaine)(GE). The severity of constant incisional pain, movement-associated incisional pain, and pain upon pressure applied to the surgical wound using 5 pounds of weight was assessed with a visual analogue scale at 2, 6, 12, 24, and 48 hours after surgery. The duration of analgesia (time from the end of the surgery to the first request for analgesic) was 7.9+/-3.1 hours in group G, 22.8+/-4.8 hours in group GI, and 33.1+/-3.9 hours in group GE, with statistically significant differences between group G and other two groups. Forced vital capacity (FVC), peak expiratory flow, and forced expiratory volume in 1 second (FEV1) were measured with the patients in a semisitting position. In all groups, there were no differences in above parameters, These results indicate that postoperative pain after lower aMominal surgery would be managed satisfactorily with infiltration of local anesthetic as well as epidural analgesia.
Abdominal Wall ; Analgesia ; Analgesia, Epidural ; Anesthesia ; Anesthesia, Inhalation ; Bupivacaine* ; Double-Blind Method ; Female ; Forced Expiratory Volume ; Gynecologic Surgical Procedures ; Humans ; Morphine* ; Pain, Postoperative ; Vital Capacity ; Wounds and Injuries

On December 31, 2018, an incident occurred where a doctor was attacked and killed by a patient carrying a lethal weapon in the outpatients' clinic of the psychiatric department of a tertiary general hospital. The suspect was diagnosed with bipolar affective disorder (manic depressive disorder) and has been hospitalized and cared for in the psychiatric ward of this hospital. This incident illustrates the necessity of more active cures and therapeutic intervention for mental patients with intellectual developmental disorders who require treatment considering the fact that a radical outcome has been caused by such a patient. However, on the other hand, there is also a need for an approach and analysis from the perspective of crime prevention for all medical departments. The reason for this is that even a tertiary general hospital equipped with the largest human resources, medical devices, facilities, and so forth, is susceptible to violence. As for illegal actions perpetrated against health and medical service personnel in medical institutions, such as verbal abuse, assault, injury, etc. there have neither been understanding shown for the current extent of damage in detail, nor discussions of active institutional improvement related to the seriousness of the act. It can be said that violence in the field of medical treatment is a realm requiring serious discussion and appropriate remedial actions. This is because when such incidents take place, if a patient who is supposed to get treatment from the damaged health care provider is in an urgent situation or on the waiting list of serious cases, he or she could suffer serious damage caused by deprivation of treatment opportunity, or secondary damage might be caused to the patient and/or a guardian who can hardly have an opportunity to take action. Accordingly, in this review, we would like to help create the necessary conditions for both health and medical service personnel and patients/guardians, respectively, to provide and receive medical treatment in a more secure environment. Therefore, objective assessment of the institution and issues relating to this aforementioned incident and general cases of violence occurring in medical institutions, and by suggesting legal and institutional improvements and solutions.
Crime ; Hand ; Health Personnel ; Hospitals, General ; Humans ; Mentally Ill Persons ; Mood Disorders ; Violence ; Waiting Lists ; Weapons

PURPOSE: The purpose of this study was to investigate the corrosion behaviors of dental implant alloy after micro-sized surface modification in electrolytes containing Mn ion. MATERIALS AND METHODS: Mn-TiO₂ coatings were prepared on the Ti-6Al-4V alloy for dental implants using a plasma electrolytic oxidation (PEO) method carried out in electrolytes containing different concentrations of Mn, namely, 0%, 5%, and 20%. Potentiodynamic method was employed to examine the corrosion behaviors, and the alternating-current (AC) impedance behaviors were examined in 0.9% NaCl solution at 36.5℃±1.0℃ using a potentiostat and an electrochemical impedance spectroscope. The potentiodynamic test was performed with a scanning rate of 1.667 mV s⁻¹ from −1,500 to 2,000 mV. A frequency range of 10⁻¹ to 10⁵ Hz was used for the electrochemical impedance spectroscopy (EIS) measurements. The amplitude of the AC signal was 10 mV, and 5 points per decade were used. The morphology and structure of the samples were examined using field-emission scanning electron microscopy and thin-film X-ray diffraction. The elemental analysis was performed using energy-dispersive X-ray spectroscopy. RESULT: The PEO-treated surface exhibited an irregular pore shape, and the pore size and number of the pores increased with an increase in the Mn concentration. For the PEO-treated surface, a higher corrosion current density (I(corr)) and a lower corrosion potential (E(corr)) was obtained as compared to that of the bulk surface. However, the current density in the passive regions (I(pass)) was found to be more stable for the PEO-treated surface than that of the bulk surface. As the Mn concentration increased, the capacitance values of the outer porous layer and the barrier layer decreased, and the polarization resistance of the barrier layers increased. In the case of the Mn/Ca-P coatings, the corroded surface was found to be covered with corrosion products. CONCLUSION: It is confirmed that corrosion resistance and polarization resistance of PEO-treated alloy increased as Mn content increased, and PEO-treated surface showed lower current density in the passive region.
Alloys ; Corrosion ; Dental Implants ; Dielectric Spectroscopy ; Electric Impedance ; Electrolytes ; Manganese ; Methods ; Microscopy, Electron, Scanning ; Plasma ; Spectrum Analysis ; X-Ray Diffraction