We performed immunohistochemical stain of p-glycoprotein using JSB-1 monoclonal antibody to study multidrug resistant(MDR) gene expression in 137 gastric tumor tissues obtained from 87gastric carcinoma patients. The incidence of p-glycoprotein expression was 60 of 87 cases(69%) and it was not correlated with age, sex, depth of tumor invasion, and lymph node metastasis, but was correlated with histologic type of gastric adenocarcinoma. The distribution of p-glycoprotein positive cells in the tumor tissue was diffuse in 34 cases(73.9%) and focal in 12 cases(26.1%), and the dominant staining patterns of p-glycoprotein in the tumor cells were cytoplasmic and golgi staining in 20 cases(43.5%) and 19 cases(41.3%), respectively, and 7 cases(15.2%) showed fine granules in the cytoplasm. The incidence of p-glyco-protein expression in the tumor tissue was higher in A and AB blood type patients who have A antigen than in 0 and B blood type patients. Cytoplasmic staining pattern was dominant in O and B blood types and golgi staining in A and AB blood type patients. Among 27 patients 'who received chemotherapy, partial remission was noted in 9 of 11 p-glyco-protein negative patients(81.8%) and no remission or progression of the tumor was seen in 9 of 16 p-glycoprotein positive patient(56.3%). The p-glycoprotein expression in gastric carcinoma had no direct correlation with known several prognostic factors of the gastric tumor except for histologic type, and it is supposed that p-glycoprotein detection in gastric tumor tissue by immunohisto-chemical stain is a good method for predicting the response of chemotherapy, especially in p-gly-coprotein negative cases.
Incidence

Hydranencephaly is congenital absence of the cerebral hemispheres which are replaced by a large fluid-filled cavity. The brain stem and basal ganglia are well formed and rudiments of frontal k occipital cortex may be present. We experienced a case of hydranencephaly caused by both internal carotid artery stenosis. We diagnosed it through the brain CT sonogram and doppler sonogram. A brief review of the related literatures was made.
Basal Ganglia ; Brain ; Brain Stem ; Carotid Artery, Internal* ; Carotid Stenosis* ; Cerebrum ; Hydranencephaly*

BACKGROUND: A number of reports have been published regarding the use of imiquimod for the treatment of melanoma in situ and metastatic melanoma. Essential steps in the process of melanoma invasion and metastasis include degradation of basement membranes and remodeling of the extracellular matrix by proteolytic enzymes, including matrix metalloproteinases (MMPs) and tissue inhibitors of metalloproteinases (TIMPs). OBJECTIVE: To evaluate the antiinvasive effect of imiquimod in human malignant melanoma cell lines, SK-MEL-2 and SK-MEL-24, in vitro, and to investigate imiquimod-induced changes in the expression of MMPs and TIMPs. METHODS: Invasiveness of melanoma cell lines following imiquimod treatment was evaluated by invasion assays. In order to investigate the mechanism of the anti-invasive effect of imiquimod, mRNA and protein levels of MMP-2, -9, membrane type 1 (MT1)-MMP, TIMP-1, and -2 were assessed by real-time reverse transcription-polymerase chain reaction, gelatin zymography, and western blotting. RESULTS: Imiquimod treatment decreased in vitro viability of melanoma cells in a concentration-dependent manner. Imiquimod also elicited a concentration-dependent suppression of invasion in both melanoma cell lines. A concentration-dependent decrease in MMP-2 and MT1-MMP protein levels and a concentration-dependent increase in TIMP-1 and -2 protein levels by imiquimod was observed in both melanoma cell lines. However, expression of MMP-9 protein was increased in SK-MEL-2 but decreased in SK-MEL-24 with increasing imiquimod concentrations. Imiquimod elicited alterations in MMPs and TIMPs mRNA levels that parallel the observed changes in protein levels. CONCLUSION: Imiquimod may elicit an anti-invasive effect on human melanoma cells by regulating MMPs and TIMPs.
Basement Membrane ; Blotting, Western ; Cell Line ; Extracellular Matrix ; Gelatin ; Humans ; Matrix Metalloproteinase 14 ; Matrix Metalloproteinases* ; Melanoma* ; Membranes ; Metalloproteases* ; Neoplasm Metastasis ; Peptide Hydrolases ; RNA, Messenger ; Tissue Inhibitor of Metalloproteinase-1

PURPOSE: Failure of adequate gastric emptying frequently interferes with successful enteral nutrition in infants. Study of gastric emptying in preterm infants has been hampered by the absence of a suitable and, valid technique, but ultrasonic assessment is well tolerated by infants. The aim of this study is to compare gastric emptying rates of breast milk and formula within preterm infants using an ultrasonic technique. METHODS: Ten infants(6 males, 4 females) were studied on 20 occasions. Median gestation of the group was 33 wks(29-38 wks), birthweight was 1506gms(850-1870gms). Each infant was receiving a minimum of 150 ml/kg/day of breast milk. We conducted the study with breast milk first and with formula milk 2 days later. With the infant in the right lateral position, ultrasonic images of the gastric antrum were obtained using the aorta bifurcational branch of superior mesenteric artery as constant landmarks. Measurements of antral cross sectional area(ACSA) were made before the feed and then sequentially, following its completion until ACSA returned to its pre-feeding state. Half-emptying time(t1/2) was calculated as the time taken for the ACSA to fall to half the maximal increment. The test was well tolerated by all subjects. RESULTS: There was a strong linear relationship between gastric volume and ACSA. The half-emptying time for breast milk was less than formula : t1/2 breast milk 32.0+/-9.8 min; t1/2 formula 45.0+/-11.6 min, P=0.0004. CONCLUSION: The data demonstrate that human milk increases gastric emptying compared to formula. This has important implications for the management of preterm infants who have feeding intolerances.
Aorta ; Breast* ; Enteral Nutrition ; Gastric Emptying* ; Humans ; Infant ; Infant, Newborn ; Infant, Premature ; Male ; Mesenteric Artery, Superior ; Milk* ; Milk, Human* ; Pregnancy ; Pyloric Antrum ; Ultrasonics

PURPOSE: To evaluate MR characteristics of periosteal reactions and subperiosteal abscesses in osteomyelitis as compared with radiographs. MATERIALS AND METHODS: We retrospectively reviewed 28 patients(18 males, 10 females) with osteomyelitis. Nineteen patients underwent MR imaging with 0.5 T. We analyzed for morphologic patterns, intervals of appearance and disappearance of periosteal reactions after symptom onset. Twenty-three patients were confirmed by surgery and 5 patients by the radiologic findings, clinical and laboratory data. RESULTS: Periosteal reaction appeared as low signal intensity arc on the T1- and T2-weighted axial images. In 3-7 days after symptom onset, periosteal reactions and subperiosteal abscesses were noted on MR imaging, and only two of eleven patients were noted in radiographs. Periosteal reactions of 8-14 days after symptom onset were demonstrated in all of 13 patient on MR, and 9 on plain radiographs. All patients with 2 weeks after symptom onset showed perioste.al reaction in plain film and MR. The periosteal reactions persisted until approximately 2 to 3 months after treatment on follow up radiographs. CONCLUSION: Periosteal reactions in osteomyelitis are detected on the MR imaging earlier than plain film. MR is valuable in detecting subperiosteal abscess which is not appecent in simple radiographs. Periosteal reactions can be seen on MR in 3 days after symptom onset and persist for 2-3 months after treatment.
Abscess ; Follow-Up Studies ; Humans ; Magnetic Resonance Imaging* ; Male ; Osteomyelitis* ; Retrospective Studies

PURPOSE: The purpose of this study was to examine the association among change in the sensation of the arms, the range of motion in the shoulders and depression in breast cancer patients. METHOD: This is a descriptive study on correlation. The participants were 132 patients who had been diagnosed with breast cancer and had mastectomy at a university hospital, and had participated in a breast cancer self-help group. The degree of depression was assessed by SCL-90-R scores. Collected data were analyzed with SPSS 12.0 for Windows. RESULTS: The participants complained of 'heaviness' as the most frequent and serious symptom of change in the sensation of the arms. 'Completely zip up the dress with a back-fastening zipper' was the most difficult motion of the shoulders. Participants who were in a worse stage of disease were in a worse condition in shoulder functions, and on a higher degree of depression. The degree of change in sensation and shoulder functions showed a positive correlation with each other, and both of them showed a negative correlation with the degree of depression. CONCLUSION: Sensation and motion change in the arms and the shoulders were common phenomena that affected depression in patients who had mastectomy. Nurses should consider not only depression but also discomfort of the arms and the shoulders for patients with mastectomy.
Arm* ; Breast Neoplasms* ; Depression* ; Humans ; Mastectomy ; Range of Motion, Articular* ; Self-Help Groups ; Sensation* ; Shoulder*

Various cutaneous cysts such as epidermal cysts, trichilemmal cysts, vellus hair cysts, steatocystoma, or pilomatricoma can arise from a different part of the pilosebaceous unit, namely the infundibulum, isthmus, sebaceous ducts, and bulbar or inferior portion. Rarely, a hybrid cyst that includes two or more components of a cystic lesion arising from the pilosebaceous unit can develop. The pathogenesis of this unusual disease is not yet known. We report a case of a follicular hybrid cyst which showed combined histologic features of both an epidermal cyst and pilomatricoma, and discuss the possible pathomechanism of the development of this hybrid cyst with a review of the literature.
Epidermal Cyst ; Hair ; Pilomatrixoma

Benign symmetric lipomatosis is characterized by diffuse symmetric deposits of nonencapsulated fat, generally affecting the cervical and upper dorsal regions. There is a history of alcohol abuse in nearly all the cases. It is rarely reported in non-drinkers. Herein we report a 63-year-old man presenting with one year's history of multiple ill-defined symmetric soft mass on posterior neck, upper trunk and upper extremities without the history of alcohol abuse. We ad-ministered corticosteroid orally due to osteoarthritis of the knee for a long time.
Alcoholism ; Humans ; Knee ; Lipomatosis* ; Middle Aged ; Neck ; Osteoarthritis ; Upper Extremity

PURPOSE: To evaluate the classification of punctal stenosis based on the shape of the external punctum, clinical characteristics and histopathologic features. METHODS: Patients who experienced tearing and were diagnosed with punctal stenosis were evaluated in this study. Punctal stenosis was classified according to the shape of the lower external punctum, which included membranous type, slit type, horseshoe type, and pinpoint type. Tear meniscus height, 2% fluorescein dye disappearance test and lacrimal pathway irrigation were measured or performed. For treatment, a punctal snip operation and silicone tube placement were performed, and the peripunctal histopathological findings were evaluated. RESULTS: Punctal stenosis was classified into four types: membranous type (17 eyes, 21.5%), slit type (11 eyes, 13.9%), horseshoe type (25 eyes, 31.6%), and pinpoint type (26 eyes, 32.9%). The tear meniscus was significantly higher, and the 2% fluorescein dye disappeared significantly more slowly in the punctal stenosis group. However, correlation of the tear meniscus height and 2% fluorescein dye disappearance test with the punctum shape was not statistically significant. A history of previous chemotherapy was significantly associated with the occurrence of punctal stenosis, especially the membranous type (p < 0.05). Histopathologic evaluation of the punctum showed differences between the punctum types. Pinpoint puncta exhibited a high density of muscle fibers, while they were faintly visible in the membranous type. CONCLUSIONS: Acquired punctal stenosis has various shapes, and the major types of stenotic puncta exhibited unique histopathologic features. Punctal stenosis and its pathophysiology may be related to multiple factors, such as age and systemic 5-fluorouracil chemotherapy history.
Classification* ; Constriction, Pathologic* ; Drug Therapy ; Fluorescein ; Fluorouracil ; Humans ; Lacrimal Apparatus ; Lacrimal Apparatus Diseases* ; Silicon ; Silicones ; Tears

BACKGROUND: The aesthetic implications of ear keloids, which affect people of all races, are serious and the treatment of earlobe keloids is known to be difficult. The high rate of recurrence following excision alone has led to investigating various types of adjuvant therapy, including intralesional corticosteroid injection. OBJECTIVE: We evaluated the efficacy of excision combined with perioperative intralesional triamcinolone acetonide injection for treating earlobe keloids of Korean patients. METHODS: From 1997 to 2006, eighteen keloids on the earlobes of fifteen Korean patients were treated. The patient age ranged from 15 to 32 years (mean age: 24 years). All the patients were female and the keloids occurred after ear piercing. Preoperative intralesional triamcinolone acetonide (TA) injection was administered twice at a 1-month interval. Postoperative intralesional TA injections were given every 1 month for several months, depending on the patient's clinical progress. RESULTS: The follow-up period ranged from 4 to 42 months (mean: 18.5 months). After the surgery, TA intralesional injections were given 2 to 13 times (mean: 5.2 times). Of the treated keloids, eleven showed good results (61.1%) and three recurred (16.6%). No complications from the TA intralesional injection were observed. CONCLUSION: Among the various treatments for earlobe keloids, we suggest that excision with corticosteroid intralesional injection can be used as the first line therapy when considering its effect and economic advantage.
Body Piercing ; Continental Population Groups ; Ear ; Female ; Follow-Up Studies ; Humans ; Imidazoles ; Injections, Intralesional ; Keloid ; Nitro Compounds ; Recurrence ; Triamcinolone Acetonide