Transforming growth factor (TGF)-beta1 plays an important role in hepatocarcinogenesis and has been described as a useful tumor marker and one of the poor prognostic indicators in patients with hepatocellular carcinoma (HCC). To investigate the role and cellular localization of TGF-beta1 during multistep hepatocarcinogenesis we performed a quantitative analysis of TGF-beta1 mRNA and immunohistochemical expression of TGF-beta1 and TGF-beta receptor II (TGF-betarII) in female Sprague-Dawley rats. The experimental groups included neoplastic lesions produced by Solt-Farber's protocol, regenerating liver after partial hepatectomy, and normal control. Quantitative change of TGF-beta1 mRNA was analysed by competitive reverse-transcription polymerase chain reaction (RT-PCR). TGF-beta1 protein and TGF-betarII expression were evaluated by immunohistochemical stain. The discrete tumor nodules were detected on 14th day and then increased in number and size. Three HCCs were induced on 8th or 9th month. RT-PCR demonstrated TGF-beta1 mRNA band in all examples of the normal and regenerating liver, nodules and HCCs. Competitive RT-PCR displayed higher TGF-beta1 mRNA in nodules, HCCs and regenerating liver than in normal controls. Hepatocytes from control and regenerating livers showed weak immunoreactivity for TGF-beta1. In contrast, the cytoplasm of hepatocytes of nodules in 7th, 8th and 9th month and HCCs were intensely stained for TGF-beta1. Some sinusoidal cells showed immunoreactivity for TGF-beta1 in all experimental groups. In early phase of carcinogenesis, the cytoplasm of hepatocytes in liver of 12h, 1d and 3d showed transiently increased immunoreactivity for TGF-beta1 and The immunoreactivity decreased thereafter. TGF-beta1 mRNA was also detected in the neoplastic hepatocytes by in-situ hybridization. Although TGF-betarII expression was correlated with TGF-beta1 immunoreactivity during early phase of carcinogenesis, hepatocytes in most nodules in 7th, 8th, 9th month and carcinomas showed decreased or little immunoreactivity for TGF-betarII. Based on the above results, it is concluded that TGF-beta1 expression increases not only in precancerous nodules but also in HCCs and its increase seems to be correlated with decrease or loss of TGF-betarII expression although its mechanism remains unclear. Hepatocytes may be a major cellular source of TGF-beta1 during hepatocarcinogenesis.
Carcinogenesis ; Carcinoma, Hepatocellular ; Cytoplasm ; Diethylnitrosamine* ; Female ; Hepatectomy ; Hepatocytes ; Humans ; Liver ; Polymerase Chain Reaction ; Rats, Sprague-Dawley* ; Receptors, Transforming Growth Factor beta* ; RNA, Messenger* ; Transforming Growth Factor beta* ; Transforming Growth Factor beta1* ; Transforming Growth Factors*

Recently the concept of 'empowerment' not only attracts attention in the area of management but also is considered as an useful concept in the areas of nursing theory, practice, education, and research. The purpose of this paper is to clarify the meaning of the concept 'empowerment'. More concretely, it is to find the concept that can be applied appropriately to the area of nursing management. This study uses Walker and Avant's(1983) process of concept analysis. The attributes of empowerment based on the concept can be defined concisely as follows: 1. a dynamic and interaction process. 2. a partnership which values self and others : power shaving. 3. mutual decision-making using resources, opportunities, and authority 4. accept autonomy and responsibility Antecedents of empowerment consist of 1) mutual trust and respect, 2) education and support, 3) participation and commitment. In regard to the consequences of empowerment, it is expected to 1) positive self-esteem, 2) ability to sex and reach goals, 3) the promotion of organization's effectiveness and productivity, 4) provide effective and high quality health-care, 5) a sense of hope for the future. The concept of empowerment is certainly believed that it will help future nurses since they needs an integrated technique that can treat acute and chronic patients' nursing, individuals, families, and communities. Therefore, it is necessary to develop the instrument including the defining attributes identified in this study. Also, it is need follow up study of this concept.
Education ; Efficiency ; Hope ; Humans ; Nursing ; Nursing Theory ; Power (Psychology) ; Tobacco Use Cessation Products ; Walkers

Severe hyperkalemia can induce life threatening cardiac rhythm disturbances, and usually produce classic electrocardiographic (EKG) manifestations. We report a case of severe hyperkalemia in which the EKG did not reveal the expected alterations. The patient was a 57-year-old man with adenocarcinoma of stomach. There were no significant abnormal findings in laboratory analysis, chest X-ray and EKG. His preoperative medications for hypertension consisted of furosemide, amiloride and enalapril. The tests for serum potassium concentration ([K ]) were performed on 20 and 7 days before the operation and the results were 4.5 and 4.9 mEq/l, respectively. Just after induction of anesthesia, we tried the blood gas and electrolyte analysis and the result revealed high [K ] of 8.5 mEq/l, but EKG did not show typical phenotype of hyperkalemia at that time. His intraoperative and postoperative courses were not eventful.
Adenocarcinoma ; Amiloride ; Anesthesia ; Electrocardiography* ; Enalapril ; Furosemide ; Humans ; Hyperkalemia* ; Hypertension ; Ions ; Middle Aged ; Phenotype ; Potassium ; Stomach ; Thorax

No abstract available.
Femur* ; Osteosarcoma*

PURPOSE: To analyse the radiological findings of bizarre parosteal osteochondromatous proliferation (BPOP), a rare benign tumorous lesion with a high frequency of recurrence which frequently occurs around the short tubular bones of the hands and feet. MATERIALS AND METHODS: Between 1984 and 1998, 19 cases of BPOP were pathologically Proven, and in is of these, six men and nine women aged between 17 and 69(mean, 41) years, plain radiographs were available for analysis. We examined the location and size of lesions, and their relationship to adjacent bone. RESULTS: In all cases, trabecular bone formations were present. There were not separable from adjacent bones, which in all cases appeared normal. In nine of 15 cases margins were sharp, and in the remaining six they were irregular. Lesions were located around a phalanx of the hand (n=5), a metatarsal bone (n=3), a long bone (n=3), a phalanx of the foot (n=2), a metacarpal bone (n=1), and a metatarsophalangeal joint (n=1). Their average size was 2.5 x1.9cm, and in three of is cases the tumor recurred. CONCLUSIONS: BPOP showed a well-marginated mass of heterotopic mineral arising around short tubular bones. These findings were useful for diagnosis and differential diagnosis.
Diagnosis ; Diagnosis, Differential ; Female ; Foot ; Hand ; Humans ; Male ; Metatarsal Bones ; Metatarsophalangeal Joint ; Recurrence

PURPOSE: We report a case of bilateral cavernous sinus thrombosis and unilateral intraorbital abscess in a patient suffering proptosis, a limitation of ocular movement, and visual disturbance. METHODS: After several days of febrile and chilling sensation, a 49-year-old man suffered from vision loss, a limitation of ocular movement in all directions, proptosis in the right eye and mild abduction limitation in the left eye. Brain MRI, indicated inflammation in the bilateral cavernous sinuses and intraorbital abscess in the right eye, leading to a diagnosis of cavernous sinus thrombosis. Systemically, the patient was treated with antibiotics and steroid injection. For intraorbital abscess, aspiration and antibiotics injection were administered locally. The patient improved overall and the abscess size decreased. Blood culture showed alpha-hemolytic Streptococcus. The Gram stain of the specimen from the intraorbital abscess revealed Gram-positive cocci but no specific strain was cultured. RESULTS: We believe that proptosis in the right eye, intraorbital abscess, limitation of ocular movement, retinal hemorrhage, and optic atrophy were due to alpha-hemolytic Streptococcus, which had spread to the cavernous sinus and right orbit through the vascular system. CONCLUSIONS: We report a case of bilateral cavernous sinus thrombosis and intraorbital abscess in the right eye in a patient who suffered from sepsis caused by alpha-hemolytic Streptococcus.
Abscess* ; Anti-Bacterial Agents ; Brain ; Cavernous Sinus Thrombosis* ; Cavernous Sinus* ; Diagnosis ; Exophthalmos ; Gram-Positive Cocci ; Humans ; Inflammation ; Magnetic Resonance Imaging ; Middle Aged ; Optic Atrophy ; Orbit ; Retinal Hemorrhage ; Sensation ; Sepsis ; Streptococcus

Parosteal osteosarcoma is a low-grade osteosarcoma, which occurs on the surface of the bone. We had experienced a parosteal osteosarcoma involving the flat bone, the scapula of a 21-year-old man. This is an extremely rare location for a parosteal osteosarcoma. Plain radiograph showed broad-based, well-defined radiodense lesion at the scapula. Computed tomogram demonstrated an intact cortex and absence of a medullary involvement. Tumor showed a lobulated, high-density lesion, indicating bone formation. Histologically, parosteal osteosarcoma is a well-differentiated osteosarcoma. The tumor is composed of a hypocellular proliferation of spindle cells, with minimal cytologic atypia. The bone is in the form of a well-formed bony trabeculae. Occasional cartilage is present in the form of a cap.
Adult ; Bone Neoplasms/radiography* ; Bone Neoplasms/pathology ; Case Report ; Human ; Male ; Osteosarcoma/radiography* ; Osteosarcoma/pathology ; Scapula/radiography* ; Scapula/pathology ; Tomography, X-Ray Computed

Parosteal osteosarcoma is a low-grade osteosarcoma, which occurs on the surface of the bone. We had experienced a parosteal osteosarcoma involving the flat bone, the scapula of a 21-year-old man. This is an extremely rare location for a parosteal osteosarcoma. Plain radiograph showed broad-based, well-defined radiodense lesion at the scapula. Computed tomogram demonstrated an intact cortex and absence of a medullary involvement. Tumor showed a lobulated, high-density lesion, indicating bone formation. Histologically, parosteal osteosarcoma is a well-differentiated osteosarcoma. The tumor is composed of a hypocellular proliferation of spindle cells, with minimal cytologic atypia. The bone is in the form of a well-formed bony trabeculae. Occasional cartilage is present in the form of a cap.
Adult ; Bone Neoplasms/radiography* ; Bone Neoplasms/pathology ; Case Report ; Human ; Male ; Osteosarcoma/radiography* ; Osteosarcoma/pathology ; Scapula/radiography* ; Scapula/pathology ; Tomography, X-Ray Computed

The orbital neurilemmoma originates exclusively from Schwann cells of the cranial nerve, any myelinated peripheral nerve, and sympathetic nerve. The incidence of this benign neoplasia is reported as rare and arises usually in the intraconal. A 28-year-old female complained of lid swelling and palpable mass on the right upper lid for a period of 8 months. The mass wsa excised totally and histopathologic examination revealed a typical neurilemmoma(Schwannoma). In this case, there was no proptosis because the mass was located extraconally. It is to report a rate case of extraconal neurilemmoma of the orbit.
Adult ; Cranial Nerves ; Exophthalmos ; Female ; Humans ; Incidence ; Myelin Sheath ; Neurilemmoma* ; Orbit ; Peripheral Nerves ; Schwann Cells

Simple or unicameral bone cysts are metaphyseal lesions of long bones. They usually move away from the physiswith growth to become diaphyseal in location. Involvement of the physis and epiphysis by these cystic lesions isvery rare. This paper reports a case of simple bone cyst of the proximal humerus in a 11- year -old girl which wasshown by MR imaging to extend through the physis into the epiphysis.
Bone Cysts* ; Epiphyses* ; Female ; Humans ; Humerus* ; Magnetic Resonance Imaging