Uereterorenoscopy has become a useful diagnostic tool for the evaluation and treatment of the ureteral diseases such as the filling defect upper tract hematuria and abnormal cytology. Keeping a clear visual field in ureterorenoscopy is an essential for the reducing of complication such as ureteral perforation. We used alternative suction with 4 Fr. ureteral catheter through side hole of ureterorenoscopic sheath in 32 cases without serious complications. We believe that this method may help not only keeping clear visual field but also doing ureterorenoscopy safely, while use ureteral catheter as a safety guide wire.
Hematuria ; Suction ; Ureter* ; Ureteral Diseases ; Urinary Catheters* ; Visual Fields*

Primary renal sarcoma is a rare malignant mesenchymal tumor with a variety of histologic type. The clinical differential diagnosis with renal cell carcinoma may be impossible. The prognosis of primary renal sarcoma is extremely poor and majority of patients die within 2 years. We experienced two cases or primary renal sarcoma, which was diagnosed by immunohistochemical stains.
Carcinoma, Renal Cell ; Coloring Agents ; Diagnosis, Differential ; Humans ; Kidney ; Prognosis ; Sarcoma*

Carcinoma of the male urethra is an uncommon malignancy that accounts for less than 1 percent or all urologic malignancies. Adenocarcinoma of male urethra is usually found in posterior urethra. We experienced a case of anterior urethral adenocarcinoma, which was confused with inverted papilloma.
Adenocarcinoma* ; Humans ; Male* ; Papilloma, Inverted ; Urethra*

PURPOSE: To evaluate of the role in carcinogenesis of p53 over-expression and bcl-2 inhibition in early gastric and advanced gastric cancers, we investigated the immunohistochemical tissue status of 31 primary early gastric-cancer patients and 31 primary advanced gastric-cancer patients. METHODS: DO7, the monoclonal antiserum to the P53 protein, and clone 124, the monoclonal antibody to the bcl-2 protein, were used for the immunohistochemical analysis of the 31 surgically resected primary early gastric cancer specimens and the 31 surgically resected advanced gastric-cancer specimens. The expressions were scored and divided into negative, positive, low expression, and overexpression. RESULTS: The clinicopathologic parameter; tumor depth of invasion, histologic type, and differentiation, were not related with the expression status of p53 or bcl-2. Of the 31 primary early gastric-cancer patients, 14 exhibited p53 overexpression and 16 showed negative the bcl-2 expression; 5 cases had both p53 overexpression and negative bcl-2 expression. Of the 31 advanced gastric cancer patients, 19 showed the p53 overexpression, and negative bcl-2 expression, 15 exhibited both p53 overexpression and negative bcl-2 expression. CONCLUSION: These results suggest that cell cycle alteration and apoptosis control by p53 and bcl-2 may play roles in the carcinogenesis of gastric cancer. However, there are many other mediators that may facilitate carcinogenesis. This study proved that bcl-2 is a valuable prognostic factor.
Apoptosis ; Carcinogenesis ; Cell Cycle ; Clone Cells ; Humans ; Stomach Neoplasms*

BACKGROUND: Unplanned extubation is a common occurrence in mechanically ventilated patients even in spite of careful attention. It is important to decide on reintubation or the retention of the extubated state especially in the critically ill patients. We tried to formulate general guideline for evaluation and safe management in unplanned extubated liver transplant patients with high risk of multiple organ failure and high mortality rate. METHODS: We reviewed all medical records of 5 unplanned extubated cases from 27 liver transplantation cases. We checked delayed extubation criteria which included United Network Organ Sharing (UNOS) class 1 or 2, preoperative Na (below 130 mEq) and albumin (below 3.0) level, transfusion amount in operating room, severity of postreperfusion syndrome (PRS) and need of vasopressor agents in the 5 unplanned extubated cases. We also checked direct intubation determining factors such as PaO2/FiO2 ratio, respiration rate and pattern, mental state and mode of ventilation. Finally, we reviewed additional factors influencing reintubation. RESULTS: We found a rate of 18 percent of unplanned extubation (5 of 27 events), and 80 percent of reintubation incidence (4 of 5 events). CONCLUSIONS: It is rational to reintubate immediately in unplanned extubated cases which meet 3 or more delayed extubation criteria. The direct reintubation determining factors are PaO2/FiO2 ratio (below 300) and the presence of paradoxical respiration with a high respiration rate (over 28/minute).
Critical Illness ; Humans ; Incidence ; Intubation ; Liver Transplantation ; Liver* ; Medical Records ; Mortality ; Multiple Organ Failure ; Operating Rooms ; Respiration ; Respiratory Rate ; Vasoconstrictor Agents ; Ventilation

No abstract available.
Pancreatitis*

Bradykinin has been known to elicit a pressor effect when administered centrally, and a depressor effect when administered peripherally. The present study was aimed at investigating whether the blood pressure response to bradykinin is dependent on the endogenous generation of nitric oxide (NO). Effects of NG-nitro-L-arginine methyl ester (L-NAME) on the pressor and depressor responses to intracerebroventricularly and intravenously injected bradykinin (5nmol/rat), respectively, were examined in anesthetized rats. Neither the pressor response nor the depressor response was affected by acute parenteral treatment with L-NAME. The pressor and depressor effects of bradykinin were also noted in rats chronically supplemented with L-NAME in drinking water for 4 weeks. Bradykinin caused a relaxation of the isolated thoracic aorta in vitro, which was not affected in the presence of L-NAME. However, bradykinin failed to cause a relaxation of the aorta isolated from rats chronically treated with L-NAME. These findings suggest that endogenous generation of NO may not completely account for the blood pressure responses to bradykinin in rats.
Animals ; Aorta ; Aorta, Thoracic ; Blood Pressure* ; Bradykinin* ; Drinking Water ; NG-Nitroarginine Methyl Ester ; Nitric Oxide* ; Rats* ; Relaxation

BACKGROUND: The prevalence of patients over the age of 25 years with acne has significantly increased over the past 10 years. Several etiologic factors such as genetic factor, hyperandrogenism, stress, and cosmetics have been studied. OBJECTIVES: The purpose of this study is to evaluate the differences between adolescent acne and post-adolescent acne, based on the clinical features, asoociated diseased and aggravating factors of 327 acne patients. METHODS: 327 consective patients, first visited to our hospital with clinical facial acne between March 2000 and February 2001, were enrolled. 220 adolescent patients(AP) were under the age of 25 and post-adolescent patients(PP) were over age of 25. RESULTS: 1. In the face, cheeks and forehead in adolescents, chin and cheeks in post-adolescents were predilection sites. The predominant type was a comedonal type in adolescents and a papulopustular type in post-adolescents(P<0.05). Severity of inflammatory type was not different between two groups. Familial factors were important in both groups, but more frequently found in post-adolescents with persistent acne(P<0.05). 2. Rosacea, chloasma, and hyperandrogenic features such as hirsutism and androgenetic alopecia were more frequently observed in post-adolescents. Seborrheic and atopic dermatitis were more frequent in adolescents. Four patients had all the features of chloasma, acne, rosacea, seborrheic dermatitis and hirsutism. 3. Aggravation by weason especially summer, sweating, stress, and cosmetics was more frequent in adolescents. In PP, acne was more frequently aggravated by sunlight, foods and menstrual period. CONCLUSION: Post-adolescent acne was mainly a papulopustular type predominantly located on the chin and cheeks with mild to moderated severity, and family history and hyperandrogenism were strong etiologic factors in persistent acne. Aggravating factors were not significantly different between two group, which suggested cosmetics and stress might not be important in post adolescent acne.
Acne Vulgaris* ; Adolescent* ; Alopecia ; Cheek ; Chin ; Dermatitis, Atopic ; Dermatitis, Seborrheic ; Forehead ; Hirsutism ; Humans ; Hyperandrogenism ; Melanosis ; Prevalence ; Rosacea ; Sunlight ; Sweat ; Sweating

Anesthesiologists are faced with a growing number of patients in need of cardiac pacing with symptoms of increasing complexity. Because intraoperative pacemaker malfunction can lead to sudden death, it is important for the anesthesiologists to possessthe information necessary to evaluate and treat such patients. On the other hand, torsade de pointes, a particular form of life-threatening polymorphic ventricular tachycardia, is known to be elicited in patients with cardiac pacemakers in the setting of abnormally long QT intervals, decreased heart rate and severe electrolyte disturbances, notably hypokalemia. We herein report a case of intraoperative torsade de pointes that was triggered by pacemaker malfunction-induced bradycardia in a patient with a VVI-type cardiac pacemaker, whose serum potassium and magnesium level were low preoperatively. (Korean J Anesthesiol 1999; 37: 164~167)
Bradycardia ; Death, Sudden ; Hand ; Heart Rate ; Humans ; Hypokalemia ; Magnesium ; Potassium ; Tachycardia, Ventricular ; Torsades de Pointes*

Cyclin D1, a cell cycle regulator essential for G1 phase progression, is a candidate proto-oncogene implicated in pathogenesis of several human carcinomas including breast carcinoma. We studied the cyclin D1 expression in 101 cases of primary breast carcinoma tissues. The overexpression of cyclin D1 was immunohistochemically demonstrated in 34 (37.8%) of 90 cases of invasive breast carcinoma. Positive cyclin D1 staining was seen in 32 of 79 invasive ductal carcinomas, and 2 of 3 mucinous carcinomas. All 5 medullary carcinomas, 2 invasive lobular carcinomas, and 1 metaplastic carcinoma were negative. Cyclin D1 overexpression was observed in 9 of 11 ductal carcinoma in situ (DCIS). Normal epithelial components, either ductal or lobular, were not immunoreactive for cyclin D1. No significant correlations were observed between cyclin D1 immunoreactivity and other parameters including tumor size, clinical stage, nuclear or histologic grades, lymphatic or angioinvasion, lymph node metastasis, and immunohistochemical status of progesterone receptor, p53 and c-erbB-2. The overexpression of cyclin D1 was positively correlated with estrogen receptor status (p=0.025). Based on our results, the cyclin D1 protein aberration may play a role in tumorigenesis of breast carcinoma, but does not seem to have prognostic value in invasive breast carcinoma without hormonal treatment.
Adenocarcinoma, Mucinous ; Breast Neoplasms* ; Breast* ; Carcinogenesis ; Carcinoma, Ductal ; Carcinoma, Intraductal, Noninfiltrating ; Carcinoma, Lobular ; Carcinoma, Medullary ; Cell Cycle ; Cyclin D1* ; Cyclins* ; Estrogens ; G1 Phase ; Humans ; Lymph Nodes ; Neoplasm Metastasis ; Proto-Oncogenes ; Receptors, Progesterone