No abstract available.
Child* ; Humans ; Hypertension*

No abstract available.

The adrenocartical carcinoma is a rare tumor with an estimated incidence of 1 case per 1,700,000 population. Despite its rarity, a large number of investigators have studied this neoplasm for the following two reasons. The First is the occasional difficulty of differentiation between careinoma and adenoma at the time of initial surgery, even by histopathologic examination. The other is its unique feature of corticosteroidogenesis. Steroid metabolism of adrenocortieal carcinoma is characterized by its low efficiency of steroid production due to deficiency of steroidogenic enzyme. The deficieney of 11 B-hydroxylase has been indieated in case of adrenoeortical carcinoma by several investigators. In this study, the serum level of cortisol was within normal range, but the serum level of 11-deoxycortisol was 50 times higher than normal. After the removal of tumor, the serum level of ll-deoxycortisol was markedly decm. In conclusion, the results from the this case suggest that measurement of serum 11-deoxy- cortisol may be a useful tool in the diagnosis and follow-up of adrenocortical carcinoma.
Adenoma ; Adrenocortical Carcinoma* ; Cortodoxone ; Diagnosis ; Follow-Up Studies ; Humans ; Hydrocortisone ; Incidence ; Metabolism ; Reference Values ; Research Personnel

This study assessed the effects of soy isoflavones supplementation with exercise on urinary mineral (calcium, magnesium, copper, zinc) excretion as an index of bone resorption rates in 67 postmenopausal women. A total subjects were assigned to Isoflavone (90 mg/day) or placebo groups. These groups were further divided into groups that undergone a regular exercise or a rather sedentary state performing daily activity only. We conducted study eight week period. Result showed urinary zinc excretion was more significantly decreased in the isoflavone-sedentary group (-180.76 +/- 171.30 ug/day) than in the placebo-sedentary group (-31.23 +/- 146.60 ug/day), placebo-exercise group (40.93 +/- 193.44 ug/day) and isoflavione-exercise group (-1.21 +/- 160.61 ug/day) (p < 0.05), but no significant changes in the differences between the values of the pre and post study values in urinary calcium, magnesium and copper excretion. These results suggest that Isoflavone supplementation decrease urinary zinc excretion rate in postmenopausal subjects.
Bone Resorption ; Calcium ; Copper ; Female ; Humans ; Isoflavones ; Magnesium ; Zinc

PURPOSE: The purpose of this study was to explore how supervisory nurses who were transferred to a long-term care hospital from an acute hospital adapted to the new work environment. METHODS: Colaizzi's phenomenological method was applied. Participants were nine nurses working in long-term care hospitals and data were collected through in-depth individual interviews over 1 month. Approval was obtained from the Institutional Review Board (IRB). RESULTS: From this study 12 theme clusters and 5 categories were classified. The 5 categories were; ‘Unacceptable workload’, ‘Unclear job description’, ‘Unreasonable management system of the hospital’, ‘Understanding the characteristic of the long-term care hospital’ and ‘Challenge and self-development’. CONCLUSION Participants experienced conflict, identity confusion and ambivalence through the relationship with nursing assistants, long-term care workers, administrative staff and the patients’ caregivers. However, they finally understood the characteristics of the long-term care hospital and were positioned as long-term care nurses.

Solitary osseous plasmacytoma accounts for 3-5% of plasma cell tumor and are assumed to have a fairly good prognosis, with long duration of relapse free survival after local irradiation. A 64 year old woman with a lytic lesion involving left iliac bone was diagnosed as a solitary plasmacytoma, with a negative work-up for coexisting plasma cell disorders. Three months after irradiation of 5,400 cGy, the patient was readmitted with hypercalcemia and mass in left forehead and left gingiva. New multiple osteolytic lesions were developed. A aspiration cytology of forehead mass and curetted specimen of right femur due to pathologic fracture revealed plasmacytoma. MRI of thoracolumbar spine revealed abnormal high signal intensity in the L2 body, T8 and T9 vertebrae. Serum protein electropheresis revealed monoclonal gammopathy of IgG-kappa type. This aggressive case of solitary plasmacytoma, evolving into multiple myeloma after brief duration of remission, is in sharp contrast with the natural course of a solitary plasmacytoma.
Female ; Femur ; Forehead ; Fractures, Spontaneous ; Gingiva ; Humans ; Hypercalcemia ; Magnetic Resonance Imaging ; Middle Aged ; Multiple Myeloma* ; Paraproteinemias ; Plasma Cells ; Plasmacytoma* ; Prognosis ; Radiotherapy ; Recurrence ; Spine

BACKGROUND: The development and progression of a tumor can be determined by a complex multistep process involving the activation of oncogenes and the inactivation of tumor suppressor genes. The purpose of this study is to investigate the expression of p53, Rb, bcl-2 protein and Ki-67 labeling index in the intrahepatic cholangiocarcinoma. METHODS: We analyzed 36 cases of intrahepatic cholangiocarcinoma obtained by surgical resection. Expression of p53, Rb, bcl-2 proteins and Ki-67 labeling index were evaluated by immunohistochemical study. RESULTS: Expression of p53 protein was detected in 61.1% (22/36) of cholangiocarcinoma. Rb protein loss and overexpression were observed 27.8% (7/36) and 72.2% (29/36) of cholangiocarcinoma. But bcl-2 protein was not expressed. No significant correlation was found between p53, Rb and bcl-2 protein expression and age, sex, gross type, histologic grade, vascular invasion and lymph node metastases. The Ki-67 labeling index was significantly higher in p53 positive group and Rb overexpression group than in p53 negative group (p<0.01) and Rb loss group (p<0.05). There was a positive correlation between p53 protein and Rb protein expressions, but a negative correlation between Rb protein and bcl-2 protein expressions. CONCLUSIONS: The overexpression of p53 protein and Rb protein may be closely associated with cholangiocarcinogenesis, while bcl-2 has a less crucial role in cholangiocarcinogenesis.
Cholangiocarcinoma* ; Genes, Tumor Suppressor ; Lymph Nodes ; Neoplasm Metastasis ; Oncogenes ; Retinoblastoma Protein

PURPOSE: The purpose of this study was to evaluate the differences in survival rates between primary gastric and intestinal gastrointestinal non-Hodgkin's lymphoma (NHL) and to investigate risk factors for survival. MATERIALS AND METHODS: We reviewed survival rates and risk factors in 60 cases with stage I and II primary gastrointestinal lymphomas treated at Keimyung University Hospital between January 1972 and August 1999. RESULTS: No differences in sex, age, histology, stage, or percentage of curative resection were observed between primary gastric and intestinal lymphoma. The overall 10-year survival rates of gastric and intestinal NHL were 68.1% and 39.6%, respectively (p<0.05). The overall 10-year survival rates in stage I gastric and intestinal NHL were 66.7% and 70.0%, respectively, while those in stageII were 65.1% and 23.7%, respectively (p<0.001). A multivariate analysis of risk factors for survival revealed that the site of origin (5.68, CI=1.8-17.5) and stage (4.22, CI= 1.19-14.85) were significantly correlated with prognosis (p<0.05). There was no significant difference in the expression of bcl-2 and p53 between gastric and intestinal NHL. Furthermore bcl-2 and p53 expressions were not correlated with the prognosis. CONCLUSION: This study indicates that stage II primary intestinal lymphoma has lower survival rate than gastric lymphoma.
Lymphoma* ; Lymphoma, Non-Hodgkin* ; Multivariate Analysis ; Prognosis ; Risk Factors ; Survival Rate*

BACKGROUND: Importance of the participation of clinical practitioners in the development of guideline is increasingly emphasized. We studied the attitude of family physicians to the guideline for hypertension management and compared it with their reported practice patterns. METHODS:We developed a guideline for hypertension management with reference to other guidelines previously published and used by WHO and health organizations in many countries. A questionnaires asking attitude to the contents of the guideline and real practice pattern was sent to 200 Korean family physicians. Response rate to the questionnaire was 27.5%. RESULTS: The agreement rate to annual blood screening in persons aged 15 and older was 87%, while the reported practice rate in most of patients was only 42%. The agreement rates to medical history taking in hypertensives were high in all items, but reported practice rate was very low. The agreement rates to physical examination in hypertensives were relatively high in all items, while reported practice rate was high only in lung and heart examination. The reported practice rate of laboratory tests were less than 60% and that of electrolyte check was only 22%. Most of the study subjects agreed with all behavior modification methods. Although 80% of the subjects agreed that diuretics or beta blocker should be used as an initial regimen, the reported practice rate was only 36 %. CONCLUSION: There observed a big difference between attitude to the guideline and reported practice pattern in this study. It showed the need to narrow the gap between them.
Behavior Therapy ; Diuretics ; Heart ; Humans ; Hypertension* ; Lung ; Mass Screening ; Medical History Taking ; Physical Examination ; Physicians, Family* ; Surveys and Questionnaires

Proliferations of the endometrial glands form a continuum from focal glandular crowding through simple hyperplasia, complex hyperplasia and atypical hyperplasia to frank adenocarcinoma. But objective criteria to distinguish these proliferative endometrial lesions are not clear-cut and terminology is confusing. The p53 protein is a nuclear phosphoprotein that can regulate cell proliferation and suppress tumor growth. Mutation in the p53 gene have been reported in a variety of human tumors, and in selected malignancies overexpression of p53 has been associated with poor prognosis. In this study we examined a series of endometrial proliferative lesion, including hyperplasia, adenocarcinoma, and adenomyosis to determine whether or not p53 is overexpressed in these lesions. In the result, p53 immunoreactivity was observed in 3 of 17 (17.6%) simple hyperplasia, one of 6 (16.6%) complex hyperplasia, none of 3 (O%) atypical hyperplasia, 6 of 13 (46.1%) adenocarcinoma and none of 10 (O%) adenomyosis. In conclusion, p53 mutation seems to play a role in oncogenesis of endometrial adenocarcinoma in early phase but there was no significant relationship between p53 overexpression and histologic grade of adenocarcinoma.
Adenocarcinoma* ; Adenomyosis ; Carcinogenesis ; Cell Proliferation ; Crowding ; Endometrial Hyperplasia* ; Female ; Genes, p53 ; Humans ; Hyperplasia ; Prognosis