No abstract available.
Humans

To evaluate the prevalence and the role of mutation of p53 gene in the transitional ceI1 carcinoma of the urinary bladder with special attention to the clinicopathologic features, we examined p53 expression in paraffin-embedded tissues from 95 transitional cell carcinomas with various stages and grades and 5 specimens of morphologically normal bladder. Nuclear expression of p53 protein was detected by immunohistochemical analysis with avidin -alkaline phosphatase method, using the monoclonal antibody DO-7. And to evaluate the correlation of p53 expression with cell proliferation, expression of proliferating cell nuclear antigen(PCNA) was also assessed immunohistochemically in 43 specimens, using the monoclonal antibody PC1O. Median follow-up duration was 36 months(12-117 months). Immunohistochemical staining with p53 in 5 normal bladder specimens showed that 4 specimens exhibited absence of nuclear staining in urothelial and stromal cells and 1 specimen exhibited nuclear staining less than 5% of urothelial cells in the basal layer. Forty six(48%) of 95 specimens with transitional cell carcinoma of the bladder showed positive nuclear staining. Nuclear expression of p53 was observed with significantly higher frequency and stronger intensity(p<0.01 and p<0.005, respectively) in cases with invasive tumors(17,27, 70%) than superficial tumors(27/68, 40%). Nuclear expression of p53 was observed with signi6cantly higher frequency and stronger intensity(p<0.005 and p<0.005, respectively) in. cases with high grade tumors(32,43, 74%) than in cases with low grade tumors(14/52, 27%). Patients with bladder tumors were stratified into two groups with different patterns of staining for p53 protein (group A: <20%, group B: >20%). Recurrence rates of patients with superficial tumors were 2.2% per month for group A and 4.2% for group B, and patients in group B had a significantly 1ower disease-free interval(P<0.005). Disease progression rates of patients with T1 tumors were 4% per year and 21.2% for group B, and patients in group B had a significantly lower progression- free interval(P<0.025). Difference of survivorship of patients with invasive tumors between group A and B was not statistically significant(p>O.1). Mean value of PCNA expression rates of 43 transitional cell carcinomas of the bladder was 12.1+8.34%(mean + SD). Mean value of PCNA expression rates was slightly higher in p53 positive-stained group(13.2+/-7.81%) than negative stained group(10.8+/-8.89%), but difference was not statistically significant(p>0.1). These results suggest that p53 mutations play an important role in the acquisition of aggressive biological natures in invasive bladder transitional cell carcinomas rather than in the genesis of tumors of low malignant potentials. This study also suggests that immunohistochemical examination of p53 in superficial bladder transitional cell carcinomas (especially, T1 tumors) offers significant information, and the degree of p53 expression might be a useful prognostic indicator which can be considered in treatment planning.
Avidin ; Carcinoma, Transitional Cell* ; Cell Proliferation ; Disease Progression ; Follow-Up Studies ; Genes, p53 ; Humans ; Immunohistochemistry ; Prevalence ; Proliferating Cell Nuclear Antigen ; Recurrence ; Stromal Cells ; Survival Rate ; Urinary Bladder Neoplasms ; Urinary Bladder*

URPOSE: To evalvate the role of double-phase spiral CT for T staging of gastric cancers with radiologic-pathologic correlation. MATERIALS AND METHODS: Double-phase spiral CT images of 44 patients of gastriccancers proved by pathologic examination were retrospectively evaluated. We retrospectively classified spiral CTimages of gastric cancers ; classification was from S 0 to S 4 and was based on the degree of change in three multilayered patterns shown in normal gastric wall and whether or not tumor cells had invaded perigastric fattissue. Pathologic classification was based on the T staging of TNM classification for gastric cancers, and wethen correlated these results. RESULTS: In group S1, all of three cases(100%) were proved to be T1 and in groupS2, five(45.5%) of 11 cases were T2. Of five cases with S3 CT findings, three(60%) were proved to be T3s andtwo(40%) were T2. Of 22 cases with S4 CT findings, 19(86.4%) were T3p. Overall sensitivity, specificity, and accuracy were 60.3%, 88. 5%, and 86.9%, respectively. In 35 (79.5%) of the total of 44 cases, the lesions were more enhanced on venous than on arterial phase. CONCLUSION: The accuracy of double-phase spiral CT for T staging of gastric cancers was 86.9%, and in contrast to previous results for conventional or dynamic CT, this level of accuracy was thought to be relatively high. In conclusion, double-phase spiral CT images of gastric cancers were helpful in the diagnosis of T staging.
Classification ; Diagnosis ; Humans ; Retrospective Studies ; Sensitivity and Specificity ; Stomach Neoplasms* ; Tomography, Spiral Computed*

PURPOSE: The purpose of this study was to conceptualize and clarify a concept of "preparatory grief" in terminal cancer patients. METHOD: A hybrid model of concept development was applied to develop a concept of preparatory grief, which included a field study carried out in Busan, Korea. Participants of this study were 8 cancer patients. RESULTS: On the basis of our literature, research and clinical experience, the concept of preparatory grief emerged as a complex phenomenon playing an important role in five areas; physical, emotional, interpersonal, religious, and transcendental dimensions. Two new attributes were defined through a field phase; trust of the post-mortal world and a serene state of mind. Indicators reflected attitudes of sadness, worry, regret, capability to adapt and hope. The results of preparatory grief were loss of energy and interest, emotional chaos, contemplation, taciturnity and restoration. CONCLUSIONS: Differentiating among preparatory grief and other symptoms in cancer patients is essential because of therapeutic implications. Understanding preparatory grief is necessary in order to manage cancer patients for promoting quality of life so that its application may have a positive impact on the patient's life.
Adaptation, Psychological ; Aged ; *Concept Formation ; Counseling/*methods ; Female ; *Grief ; Humans ; Male ; Middle Aged ; Neoplasm Staging ; Neoplasms/nursing/*psychology ; Quality of Life ; *Terminal Care

There are inconsistent findings on the effects of vitamin K on bone mineral density (BMD) and undercarboxylated osteocalcin (UcOC). The present intervention study evaluated the effect in subjects over 60-yr-old. The vitamin K group (vitamin K + vitamin D + calcium supplement; 15 mg of vitamin K2 [menatetrenone] three times daily, 400 IU of vitamin D once a day, and 315 mg of calcium twice daily) and the control group (vitamin D + calcium supplement) were randomly assigned. During the six months of treatment, seventy eight women participated (38 in the vitamin K group and 40 in the control group) and 45 women completed the study. The baseline characteristics of study participants did not differ between the vitamin K and the control groups. In a per protocol analysis after 6 months, L3 bone mineral density has increased statistically significantly in the vitamin K group compared to the control group (0.01 +/- 0.03 g/cm2 vs -0.008 +/- 0.04 g/cm2, P = 0.049). UcOC concentration was also significantly decreased in the vitamin K group (-1.6 +/- 1.6 ng/dL vs -0.4 +/- 1.1 ng/dL, P = 0.008). In conclusion, addition of vitamin K to vitamin D and calcium supplements in the postmenopausal Korean women increase the L3 BMD and reduce the UcOC concentration.
Aged ; Bone Density/*drug effects ; Calcium/*administration & dosage ; Dietary Supplements ; Female ; Humans ; Middle Aged ; Osteocalcin/*blood ; Postmenopause ; Republic of Korea ; Vitamin D/*administration & dosage ; Vitamin K/*administration & dosage

BACKGROUNDS/AIMS: Hepatitis B virus (HBV) infection and chronic alcoholism are major risk factors for chronic liver disease in Korea. METHODS: We investigated the prevalence of occult HBV infection in 198 non-alcoholic (group I) and 85 chronic alcoholic subjects (group II), none of whom showed the hepatitis B surface antigen (HBsAg). Among chronic alcoholics, 25 patients showed cirrhosis. Using serum samples stored at -70 degrees C, liver enzymes, anti-Hbs, and IgG anti-HBc were measured via EIA and serum HBV DNA was quantified via real time PCR. RESULTS: IgG anti-HBc seropositivity, an indicator of past infection, was higher in group II (64.7%) than in group I (43.4%; p<0.01). Eleven of 283 patients (3.2%) were seropositive for HBV DNA, indicating occult infection, but this value did not differ between groups (group I: 3.5%, 7/198; group II: 4.7%, 4/85; p=0.64). In group II, HBV DNA seropositivity was higher in cirrhotic patients (12%, 3/25) than in non-cirrhotic alcoholic liver disease (1.7%, 1/60; p=0.074). CONCLUSIONS: Past HBV infection was more prevalent in alcoholics than non-alcoholics, but the prevalence of occult HBV infection did not differ between groups. However, alcoholics with cirrhosis tended to show a higher prevalence of occult HBV infection.
Alcoholics ; Alcoholism ; DNA ; Fibrosis ; Hepatitis ; Hepatitis B ; Hepatitis B Surface Antigens ; Hepatitis B virus ; Humans ; Immunoglobulin G ; Korea ; Liver ; Liver Diseases ; Liver Diseases, Alcoholic ; Prevalence ; Real-Time Polymerase Chain Reaction ; Risk Factors