Forty cases of infiltrating duct carcinoma of the breast were examined immunohistochemically for expression of TGF-beta and angiogenesis in order to analyze significant correlation with prognostic parameters including tumor size, axillary lymph node metastasis, clinical stage, histologic grade, estrogen receptor and progesterone receptor status. The TGF-beta expression was observed in tumors center and advancing edges of tumors. To determine microvessel density for angiogenesis, we stained endothelial cells for Factor VIII related antigen and counted microvessel within tumor. The results were as follows: 1) The strong immunohistochemical expression of TGF-beta and higher counts of microvessels were observed in advancing edges of tumors (p<0.05). 2) The TGF-beta expression in the advancing edges of tumors was closely related to clinical stage and presence of axillary lymph node metastasis (p<0.05). 3) The mean microvessel counts were significantly higher in tumors from patients with axillary lymph node metastasis and increased with increasing clinical stage (p<0.05). 4) The TGF-beta expression was not related to histologic grade, estrogen receptor and progesterone receptor status(p>0.05). Therefore, the results suggested that the TGF-beta expression and angiogenesis in infiltrating duct carcinoma of the breast may play an important part in prognostic factors, closely related to the lymph node metastasis and clinical stage.
Neoplasm Metastasis

OBJECTIVES: This study was designed to integrate the results of community based studies which assessed a relationship between depression and alcoholism by meta-analysis. METHODS: We identified the previons studies and included in meta-analysis by searching MEDLINE. Overall, 21 results of the studies for relationship between depression and alcoholism were selected for quantitative meta-analysis. Before the integration of the each effect size of the relationship between depression and alcoholism, a homogeneity test was conducted. For the publication bias, we also conducted the analyses of funnel plot, normal quantile plot, rank correlation test and the fail-safe n. RESULTS: We used the random effect model to estimate the overall effect size, because the homogeneity of studies was rejected in a fixed effect model. Our quantitative meta-analysis yielded that integrated odds ratio between depression and alcoholism was 2.42 (95% C.I. 1.98-2.97). From the results of analyses of the publication bias, the probability of publication bias is considered low. CONCLUSION: The published evidences suggested that there may be a significant positive relationship between depression and alcoholism.
Alcoholism* ; Depression* ; Odds Ratio ; Publication Bias

OBJECTIVES: This study was designed to integrate the results of community based studies which assessed a relationship between depression and alcoholism by meta-analysis. METHODS: We identified the previons studies and included in meta-analysis by searching MEDLINE. Overall, 21 results of the studies for relationship between depression and alcoholism were selected for quantitative meta-analysis. Before the integration of the each effect size of the relationship between depression and alcoholism, a homogeneity test was conducted. For the publication bias, we also conducted the analyses of funnel plot, normal quantile plot, rank correlation test and the fail-safe n. RESULTS: We used the random effect model to estimate the overall effect size, because the homogeneity of studies was rejected in a fixed effect model. Our quantitative meta-analysis yielded that integrated odds ratio between depression and alcoholism was 2.42 (95% C.I. 1.98-2.97). From the results of analyses of the publication bias, the probability of publication bias is considered low. CONCLUSION: The published evidences suggested that there may be a significant positive relationship between depression and alcoholism.
Alcoholism* ; Depression* ; Odds Ratio ; Publication Bias

No abstract available.
C-Reactive Protein* ; Humans ; Kidney Failure, Chronic*

Two cases of anesthetic experience for excision of pheochromocytoma were presented, one was diagnosed by abdominal computed tomography and urinary VMA level checked after cardiac arrest during previous anesthetic induction for gastric polypectomy at private clinic. The other case was diagnosed by upper GI series and abdominal sonography. Anesthesia was managed with glycopyrrolate and meperidine for premedication, thiopental for induction, isoflurane-nitrous oxide-oxygen for maintenance, pancuronium and vecuronium for muscle relaxation, and nitroprusside for controlling severe hypertensive episode. We experienced marked fluctuation of blood pressure during anesthetic course. Severe hypotension followed removal of tumor, which was corrected by rapid transfusion and infusion of crystalloids. Postanesthetic recovery and course were uneventful.
Anesthesia ; Blood Pressure ; Glycopyrrolate ; Heart Arrest ; Hypotension ; Isoflurane ; Meperidine ; Muscle Relaxation ; Nitroprusside* ; Pancuronium ; Pheochromocytoma* ; Premedication ; Thiopental ; Vecuronium Bromide

Two cases of anesthetic experience for excision of pheochromocytoma were presented, one was diagnosed by abdominal computed tomography and urinary VMA level checked after cardiac arrest during previous anesthetic induction for gastric polypectomy at private clinic. The other case was diagnosed by upper GI series and abdominal sonography. Anesthesia was managed with glycopyrrolate and meperidine for premedication, thiopental for induction, isoflurane-nitrous oxide-oxygen for maintenance, pancuronium and vecuronium for muscle relaxation, and nitroprusside for controlling severe hypertensive episode. We experienced marked fluctuation of blood pressure during anesthetic course. Severe hypotension followed removal of tumor, which was corrected by rapid transfusion and infusion of crystalloids. Postanesthetic recovery and course were uneventful.
Anesthesia ; Blood Pressure ; Glycopyrrolate ; Heart Arrest ; Hypotension ; Isoflurane ; Meperidine ; Muscle Relaxation ; Nitroprusside* ; Pancuronium ; Pheochromocytoma* ; Premedication ; Thiopental ; Vecuronium Bromide

PURPOSE: To compare the usefulness of dynamic contrast enhanced lumber spine MR Imaging with that ofconventional delayed contrast enhanced MR imaging in the assessment of postoperative herniated lumbar disc. MATERIALS AND METHODS: Forty-one postoperative herniated lumbar disc (HLD) lesions of 32 patients with back painwere examined with MR imaging(1.5T, Vision, Siemens, Germany). Five-phase dynamic 2D FLASH sagittalimages(TR/TE=118.1 msec) was obtained every 19 seconds with a 4 minutes delayed image after contrast injection. Asseen on delayed images, the discs were assessed as recurred, fibrosis, or no change. On dynamic images, thepattern of enhancement was evaluated as follows : Type I(no change in peripheral disc enhancement between theearly and late phase);or Type II(minimal internal extension of marginal smooth enhancement during the latephase);or Type III(marked internal extension f peripheral irregular enhancement). Dynamic and delayed imaging werecompared, and early epidural space enhancement with rapid wash-out was also evaluated. RESULTS: of 41postoperative HLDs, 39 lesions showed peripheral contrast enhancement. Evaluation depended on delayed imaging, andwas as follows:recurred HLD(n=27);fibrosis(n=5);no change in postoperative disc(n=7). On dynamic contrast-enhancedimaging, enhancement patterns were Type I(n=29), Type II(n=7), and Type III(n=3). In 29 Type-I lesions, there wereno significant differences in image findings between dynamic and delayed images. However, in the lesions(typeII:n=7, type III:n=3), findings additional to those revealed by delayed images were demonstrated by dynamiccontrast-enhanced MR imaging. Nine of the ten Type-II and III lesions were diagnosed as recurred HLD. On dynamicOn dynamic images, five lesions showed early epidural space enhancement. CONCLUSION: dymamic contrast-enhancedlumbar spine MR imaging provided additional findings such as increased peripheral disc enhancement, and epiduralspace enhancement, which cannot be detected on conventional delayed images. Inrecurred postoperative herniatedlumbar discs, these findings are frequent.
Epidural Space ; Fibrosis ; Humans ; Magnetic Resonance Imaging* ; Spine*

The effect of intranasal nifedipine drops in 20 randomly chosen patients with diethyl-ether induced hypertension by inhalation anesthesia was observed. Patients were placed in two groups: the first group received intranasal nifedipine at the time of induction and the second group received intranasal nifedipine at the time to skin incision. The change in mean arterial pressure in the first group was not significant, but in the second group, the increase in mean arterial pressure was significant immediately after intranasal administration of nifedipine at the time of skin incision. An increase in pulse rate was noted with the increase in mean arterial pressure and this is thought to result from the stimulation of catecholamine secretion and baroreceptor reflex. Since the difference in mean arterial pressure between the two groups was minimal at ten minutes and twenty minutes after skin incision, it is suggested that the onset of intranasal nifedipine is quite fast. Based on the authors' experience, intranasal administration of nifedipine is very useful in preventing or treating hypertension during inhalation anesthesia using diethyl-ether.
Administration, Intranasal* ; Anesthesia, Inhalation ; Arterial Pressure ; Baroreflex ; Ether* ; Heart Rate ; Humans ; Hypertension ; Nifedipine* ; Skin

Systemic lupus erythematosus(SLE) is a disease of unknown etiology in which multiple organs are damaged by pathogenic autoantibodies and immune complexes. Neuropsychiatric manifestations in SLE were first described by Kaposi in 1872. These are so diverse that they include psychosis, depression, stroke, seizure and cognitive dysfunction etc. These patients are frequently consulted for psychiatric evaluation. Neuropsychiatric manifestations in SLE are also among the leading causes of morbidity and mortality and associated with poor long-term outcome. So it is essential to recognize and intervene these symptoms early. But the clear diagnostic criteria for CNS involvement in SLE have not been formulated, and diversity and fluctuation of illness make it difficult to confirm it. The authors reported three cases of SLE with severe neuropsychiatric manifestations. These patients showed symptoms such as disorientation, auditory and visual hallucibation, delusion and mood instability. They became frequently impulsive and violent and had risks to injure themselves or others. Although CNS involvement in SLE is not well known, we reviewed the pathogenesis, classification, diagnosis, clinical manifestation and treatment of them.
Antigen-Antibody Complex ; Autoantibodies ; Classification ; Delusions ; Depression ; Diagnosis ; Humans ; Lupus Erythematosus, Systemic* ; Mortality ; Psychotic Disorders ; Seizures ; Stroke

PURPOSE: Gastric adenocarcinoma is the most common malignant tumor in Korea and immunochemotherapy can be alternative method of the treatment for it. So we evaluated several immunologic markers, Major Histocomatibility (MHC) Antigen and Intercellular Adhesion Molecule (ICAM)-1 which play an important roles in cellular immune response of the host to the tumar cells, HLA-DR/DP antigens, one of the MHC class II which is expressed in various conditions, CD 68 antigen which are also important factor in immune response to the tumor cells. MATERIALS AND METHODS: We compared the expression of MHC class II (HLA-DR/DP) antigens, ICAM-1 and the number of tumor-infiltrating macrophages presenting CD68 antigen in formalin-fixed paraffin-embedded tissue sections of 95 gastric adenocarcinomas using immunohistochemistry. In addition to analyze the relationship between expression of these antigens in gastric adenocarcinoma, histolopathologic findings such as tumor invasion, regional lymph node metastasis and histologic differentiation are evaluated. RESULTS: The rate of HLA-DR/DP expression was 60% and strongly associated with tumor differentiation, invasion and regional lymph node metastasis. ICAM-1 was expressed in 15% and slightly increased in well-differentiated carcinoma. The lack of expression of ICAM-1 was observed in high invasive tumor (T 4). CD 68(+) macrophages counts were significantly increased in around the tumor cells, compared to normal epithelia. HLA-DR/DP expression and infiltrating CD 68(+) macrophage numbers were significantly associated (p<0.05), but there was no correlationship between ICAM-1 and CD 68(+) macrophage numbers. CONCLUSION: It was considered that enhanced expression of HLA-DR/DP antigens, ICAM-1 and CD68(+) macrophages in gastric adenocarcinomas may be an immunophenotypic deviation. HLA-DR/DP and CD68(+) macrophages infiltration showed correlationship with tumor invasion and regional lymph node metastasis, that they may be used as a prognostic factor of the tumor growth.
Adenocarcinoma* ; Biomarkers ; Immunity, Cellular ; Immunohistochemistry ; Intercellular Adhesion Molecule-1* ; Korea ; Lymph Nodes ; Macrophages* ; Neoplasm Metastasis