Proliferative activity of a malignant tumor is known to reflect its biological aggressiveness. Proliferating cell nuclear antigen (PCNA) is a marker of cellular proliferation, and silver-stained nucleolar organizer regions (AgNORs) have been shown to correlate with ploidy and proliferative activity of cells. In transitional cell carcinoma of the renal pelvis, the prognostic value of these markers has not been well defined. We studied PCNA expression and the AgNORs count in 22 transitional cell carcinoma of the renal pelvis to assess their prognostic significance compared with their cumulative survival rate, the stage of disease and histopathologic features of the tumors. An immunohistochemical method and a standard colloidal silver staining were used. The mean percentage of PCNA positivity (PCNA index) and the mean number of AgNORs per nucleus (AgNORs score) were determined. In a multivariable analysis, PCNA indexes were significantly associated with tumor stage (p=0.024), whereas AgNORs scores were not significantly associated with the stage or histopatholgic features of the tumors. Histologic grade was correlated to disease stage at a significant level (p=0.000). But there was a trend of low tumor PCNA-indices or AgNORs counts with survival advantage for patients, but this did not reach statistical significance. The results suggest that the fraction of PCNA positive nuclei would be useful for investigating the malignant potential of renal pelvic cancers, although their clinical use as markers of biologic behavior may be limited.
Carcinoma, Transitional Cell* ; Cell Proliferation ; Colloids ; Humans ; Kidney ; Kidney Pelvis* ; Nucleolus Organizer Region ; Pelvic Neoplasms ; Ploidies ; Proliferating Cell Nuclear Antigen* ; Silver Staining ; Survival Rate

Glycogen-rich clear cell carcinoma of the breast is very rare(l -3% of breast cancer). It is defined as a tumor composed of more than 50% of optically clear, neoplastic cells, characterized by centrally located nuclei and abundant cytoplasm, being positive for periodic acid Schiff(PAS) and negative for periodic acid Schiff after diastase(D-PAS) treatment. In the absence of intraductal or in situ lobular carcinoma component, metastatic clear cell carcinomas of other organs should be considered as diagnostic possibilities. We report a case of glycogen-rich clear cell carcinoma arisen in a 62-year-old woman. The tumor revealed both solid and papillary pattern with intraductal component. The neoplastic cells had clear cytoplasm, which were PAS positive, D-PAS negative, mucicarmine negative and oil red 0 negative. More than 90% of tumor cells exhibited moderate staining for anti-estrogen receptor monoclonal antibody. Flow cytometric DNA analysis revealed diploid DNA content.
Female ; Humans ; Neoplasm Metastasis ; Breast Neoplasms

No abstract available.
Phenylketonurias*

No abstract available.
Aneurysm* ; Arteries* ; Cardiopulmonary Bypass* ; Circulatory Arrest, Deep Hypothermia Induced*

No abstract available.
Humans ; Infant* ; Leukemia, Megakaryoblastic, Acute* ; Sarcoma, Myeloid*

OBJECTIVE: The purpose of this study was to assess the validity of CAGE (cut down, annoyed, guilty feeling, eye-opener) for older adults in community METHODS: Randomly selected alcohol drinking 182 older adults over 65 years of age in Incheon-Chungu participated in this study. We assessed alcohol use disorder by Korean Composite International Diagnostic Interview (K-CIDI) and interviewed by CAGE. The CAGE questionnaire is a brief alcohol screening questionnaire that can be interviewer or self-administered. Sensitivity, specificity, positive predictive value and receiver operating characteristics (ROC) curve for CAGE scores of 1-4 for older adults over 65 years of age was calculated. RESULTS: The mean age of 182 people was 71.3 (+/-5.2) years old and the number of male and female was 142 (78.0%) and 40 (22.0%) respectively. In 239 alcohol drinking older adults, 182 (76.2%) people answered in CAGE and CIDI. Among 182 people, 58 was Alcohol Use Disorder (AUD) and 124 was non-AUD. There was no age and educational differences between 182 people (case group) and 57 people (exclusion group). The sensitivity and specificity for a cut-off score of two was 72.5% and 85.5% respectively. The calculation of area under curve (AUC) by Receiver Operating Characteristics (ROC) was 0.806. CONCLUSION: The CAGE can easily discriminate older adults with alcohol use disorder from those without such a history. We suggest a score of '2' as the optimal cut-off score of CAGE.
Adult* ; Alcohol Drinking ; Area Under Curve ; Female ; Humans ; Male ; Mass Screening ; Surveys and Questionnaires ; ROC Curve ; Sensitivity and Specificity

Due to improvements in medical care, the socioeconomic level and public health, life expectancy has dramatically increased. Thus, advances in the development of life-support systems and the control of infection have resulted in many surgical and anesthetic procedures being performed on extremely elderly patients. In contrast to younger patients, elderly patients may manifest more than one pathologic process associated with progressive degenerative changes in various organs of the aged, especially in the heart, brain, and kidney. Since both progressive degenerative change occurring in the elderly population and the cumulative incidence of disease in that population result in death intraoperatively or during the immediate postoperative period, the anesthesiologist must be particularly alert to the possibility of anesthetic risks in the elderly. The elderly patient is more likely to have hypertension, congestive heart failure, cardiac dysrhythmias, chronic pulmonary disease, and diabetes. Preoperative evaluation and treatment of those conditions must be extensively reviewed prior to the induction of anesthesia. To evaluate geriatric anesthetic experiences, 539 cases of patients aged over 60 years of 4,266 anesthetic cases admitted to P.M.C. from January to December, 1986 were analyzed according to age, sex, physical status, anesthetic technique an6 agents, surgical department, preoperative chest X-ray findings, preoperative E.C.G findings, and postoperative complications. The results are as follows. 1) Of 4,266 anesthetic patients 539(12.6%) were over 60 3ears of age and 322(59.7%) were males and 217(40.3%) females. 2) In the classification of physical status, the most common evidence was class 2 in 303 cases. Emergency surgery comprised 27.1%. 3) The anesthesia technique employed was usually general anesthesia and this suggested that balanced anesthesia used with narcotics offers several advantages to geriatric patients. 4) In the surgical department, 310 cases(57.5%) were for general surgery, 75 cases(13,9%), orthopedic surgery; 57 cases(10.6%), urology; and 49 cases(9.1%), neurosurgery, respectively. Cancer was present in 198 cases(36.7%), 5) Preoperative chest X-ray findings: The most common finding was pulmonary tuberculosis in 44 cases(8.2%). Pneumonia, pulmonary emphysema, and so forth were also observed. 6) Preoperative E.C.G findings: The most common findings was myocardial ischemia in 48 cases(8.9%). Also myocardial infarction observed in 8 cases(1.5%) 7) Postoperative complications were as follows: The most common incidence was wourid infection in 29 cases(5.4%) followed by pneumonia. There were a number of miscellaneous complications. but postoperatively, they did not present any significant problems. 8) The overall mortality rate was 3.5%(19 cases). The difference in the mortality rate related to age was not statistically significant(p>0.1), but the mortality rate related to physical status was statistically significant(p<0.001). 9) Optimizing a patient's preoperative condition by the anesthesiologist, consultants, and other physicians was assumed to reduce perioperative morbidity and mortality.
Aged ; Anesthesia* ; Anesthesia, General ; Arrhythmias, Cardiac ; Balanced Anesthesia ; Brain ; Classification ; Consultants ; Emergencies ; Female ; Heart ; Heart Failure ; Humans ; Hypertension ; Incidence ; Kidney ; Life Expectancy ; Lung Diseases ; Male ; Mortality ; Myocardial Infarction ; Myocardial Ischemia ; Narcotics ; Neurosurgery ; Orthopedics ; Pneumonia ; Postoperative Complications ; Postoperative Period ; Public Health ; Pulmonary Emphysema ; Thorax ; Tuberculosis, Pulmonary ; Urology

Several tests have been used for assessing color vision but most of them are nonspecific, expensive, complicated or too time consuming to perform. We have developed a new computerized color vision test named Seohan computerized 85-hue test[SCHT/85]that has many advantages compared to Farnsworth Munsell[FM]100-hue test.SCHT/85 has 85 color caps which can be displayed based on a model of FM 100-hue test using Multimedia toolbook 4.0.Selected color caps in the lower random area can be moved and inserted to the upper result area by a mouse.At the end of the test, error scores and ring graph can be displayed in monitor and can be also printed out. Total 15 subjects performed with SCHT/85 and FM 100-hue test twice who have been showed 10 normal and 5 abnormal color vision reported with other color vision tests and the results of two tests were analysed to compare the total error scores[TES]and reproducibility. All ten normal subjects showed lower TES in SCHT/85 than FM 100-hue test and the mean TES were 31.5 and 43.6 with SCHT/85 and FM 100-hue test.The coefficients of variation [CV]were 4.3%and 22.7%with SCHT/85 and FM 100-hue test.The two tests were highly correlated[r=0.92].Five abnormal subjects showed higher TES in SCHT/85 than FM 100-hue test and the mean TES were 169.8 and 157.3 with SCHT/85 and FM 100-hue test.The coefficients of variation were 9.1%and 21.2%with SCHT/85 and FM 100-hue test.These two tests were also highly correlated[r=0.965]. In conclusion, SCHT/85 which was newly developed by authors is a highly useful test for color vision.
Color Vision* ; Multimedia ; Pilot Projects*

The number of domestic cases of pandemic H1N1 influenza A was elevated in 2009. The common clinical symptoms associated with H1N1 influenza include respiratory symptoms such as cough, sore throat, rhinorrhea, fever, chills, myalgia, and fatigue. Gastrointestinal symptoms are relatively common. H1N1 influenza A infection brings about neurological symptoms in rare cases. However, there are few reports about H1N1 influenza A infection with neurological manifestations. We recently experienced an H1N1 influenza A patient who presented with disturbed mental status, seizures, and focal changes on brain magnetic resonance imaging, associated with infection.
Brain ; Chills ; Cough ; Encephalitis ; Fatigue ; Fever ; Humans ; Influenza, Human ; Magnetic Resonance Imaging ; Neurologic Manifestations ; Pandemics ; Pharyngitis ; Seizures

OBJECTIVES: The purpose of this study is to determine the amount of burden placed on the caregivers of patient diagnosed as dementia and depression. The study is intended 1) to compare depression and anxiety levels of caregivers with the degree of their burden and 2) to analyze and determine the clinical factors that contributed to such levels of depression and anxiety. METHODS: 93 individuals with dementia, suspected dementia, and depression were selected between February 2001 and April 2001. In order to determine the patients decreased cognitive function and psychopathology MMSE-K and NPI were used. In addition, the burden scale recently developed from Zarit, HARS, HDRS were used on 58 caregivers. RESULTS: The MMSE-K figure form in the demented group was significantly lower than that of the non-demented group, 15.65 and 25.55 respectively. As for the NPI figures, the demented group posted higher numbers compared to the non-demented group. Among the individuals in the demented group, apathy, aberrant motor behavior, and night-time behavior showed the highest figures. On the caregiver's burden point, the demented group showed higher scores compared to the non-demented group with 76.62 and 58.30 respectively. The caregiver's burden point compared to the HDRS and HARS figures provided an evidence that there is a signigicant relationship between the groups. CONCLUSIONS: The caregiver's burden point is found to be more affected by the demented patient's progressive phase of psychopathology than conditions due totheir decreased cognitive functions. There is a probability that an increase in the caregivers burden is likely to contribute to an increase in the caregiver's depression and anxiety.
Aged* ; Anxiety ; Apathy ; Caregivers ; Dementia ; Depression ; Humans ; Psychopathology*