A series of 38 pediatric stone patients was studied retrospectively according to the clinical patterns of urolithiasis, etiology of stone disease, and management. The idiopathic cause was the most common of stone formation in the children. The most common type of stone in analysis was calcium oxalate. Thus, the etiology of stone disease and composition of stone was not definitely different in comparison with adult stone disease. We treated almost of stone patients with ESWL and peration was done in case of EWSL failure. And ESWL is the most effective and safe treatment of pediatric urolithiasis at present time. But anesthesia is needed to perform ESWL, especially younger children.
Adult ; Anesthesia ; Calcium Oxalate ; Child ; Humans ; Retrospective Studies ; Urolithiasis*

PURPOSE: To determine whether triple negative (TN) early stage breast cancers have poorer survival rates compared with other molecular types. MATERIALS AND METHODS: Between August 2000 and July 2006, patients diagnosed with stage I, II early stage breast cancers, in whom all three markers (estrogen receptor, progesterone receptor, and human epidermal growth factor receptor [HER]-2) were available and treated with modified radical mastectomy or breast conserving surgery followed by radiotherapy, were retrospectively reviewed. RESULTS: Of 446 patients, 94 (21.1%) were classified as TN, 57 (12.8%) as HER-2 type, and 295 (66.1%) as luminal. TN was more frequently associated with young patients younger than 35 years old (p = 0.002), higher histologic grade (p < 0.0001), and nuclear (p < 0.0001). The median follow-up period was 78 months (range, 4 to 130 months). There were 9 local relapses (2.0%), 15 nodal (3.4%), 40 distant metastases (9.0%), and 33 deaths (7.4%) for all patients. The rates of 5-year OS, DFS, LFS, and DMFS for all patients were 95.5%, 89.9%, 95.4%, and 91.7%, respectively. There were no significant differences in OS, DFS, LFS, and DMFS between triple negative and other subtypes (p > 0.05). CONCLUSION: We found that patients with TN early stage breast cancers had no difference in survival rates compared with other molecular subtypes. Prospective study in homogeneous treatment group will need for a prognosis of TN early stage breast cancer.
Breast ; Breast Neoplasms ; Disease-Free Survival ; Follow-Up Studies ; Humans ; Mastectomy, Modified Radical ; Mastectomy, Segmental ; Neoplasm Metastasis ; Phenobarbital ; Prognosis ; Receptor, Epidermal Growth Factor ; Receptors, Progesterone ; Recurrence ; Retrospective Studies ; Survival Rate ; Treatment Outcome

OBJECTIVE: To evaluate the degree of streptococcal colonization in Korean pregnant women. METHODS: The study comprised of 153 singleton pregnant women who visited Severance Hospital for delivery, and their neonates. Specimens for GBS culture were collected by a sterile cotton swab from lower vagina and cervix of pregnant women, and from ear canal and throat of neonates. They were first cultured for 48 hours in Todd-Hewitt broth and then subcultured onto Tryptose blood agar plates(Difco). Group B streptococci were confirmed by the presence of beta-hemolysis and a positive reaction with Phadebact group B Streptococci reagent(Karo Biodiagnostics AB, Huddinge, Sweden). RESULTS: The prevalence of positive cultures in pregnant women and neonates were 2.61%(4/153) and 0%(0/4), respectively. In the study population there was a case of suspicious group B streptococcual sepsis in an infant whose mother was colonized. CONCLUSIONS: In our study the GBS colonization rate in Korean pregnant women was significantly lower than that of other countries. The reason for this difference may be associated with a racial differences, or social factors such as socio-economic status or a life style.
Agar ; Cervix Uteri ; Colon ; Ear Canal ; Female ; Humans ; Infant ; Infant, Newborn ; Life Style ; Mothers ; Pharynx ; Pregnancy ; Pregnant Women* ; Prevalence ; Sepsis ; Streptococcal Infections* ; Vagina

Renal cyst is a common renal disease. It rarely produces symptoms, and thus rarely require treatment. But the treatment is necessary when the cyst is symptomatic or complicated. The possible approach includes surgical unroofing or cyst puncture with or without intracystic injection of sclerosing agents. Thus we evaluated the efficacies of treatments in renal cystic disease. Cystic diseases were treated with percutaneous aspiration in 18 cases, percutaneous aspiration with sclerosing therapy in 26 cases. Overall efficacies were 22.2% with aspiration only and 95% with combined sclerosing therapy without no specific complications. Sclerosing therapy is relatively safe, less hazardous to the patient and shows high success rate in the treatment of cyst. We concluded that combined percutaneous cystic aspiration and sclerosing therapy was the best treatment of renal cystic disease. We assessed cystic fluid of 34 cases of simple renal cyst and 3 cases of polycystic kidney. The cystic fluid were analyzed for color, lipid profile, glucose, lactic acid dehydrogenase, amylase, electrolytes, culture and cell cytology. All aspirates of simple cyst were similar to composition of transudate. But aspirates of polycystic kidney were different from simple cyst.
Amylases ; Electrolytes ; Exudates and Transudates ; Glucose ; Humans ; Lactic Acid ; Oxidoreductases ; Polycystic Kidney Diseases ; Punctures ; Sclerosing Solutions ; Sclerotherapy

p53 plays an important function as a negative regulator of cell growth and also inhibits transformation. It has been hypothesized that p53, acting as a control gene at a G1 check point, may detect DNA damage, slow the cell devision, and allow time for DNA repair. If damage is irreparable, the cell may be driven down into the apoptotic pathway, thus preventing replication of defective cells. In this retrospective study, we investigated the correlation between p53 protein expression by IHC staining and benign breast disease with or without atypical ductal hyperplasia, DCIS and invasive breast cancer. Also We analyzed the association between p53 protein expression and the following prognostic parameters in breast cancer patients; age, tumor size, axillary node involvement, stage, histologic grade, estrogen receptor, and progesteron receptor, and DNA ploidy. And, we investigated the correlation between p53 protein expression and the proliferative index of S phase fraction in diploid breast cancer. The results were as follows ; 1) In histopathological classification, none out of ten benign breast diseases, none out of seventeen fibrocystic disease with atypical ductal hyperplasia patients were p53 protein positive, 3 out of fifteen DCIS (20%), 29 out of eighty-six (34%) invasive breast cancer patients were p53 protien positive.2) There were no significant differences between p53 positivity and age, tumor size, axillary node involvement, stage, histologic grade, ER and PGR status, and DNA ploidy by Fisher's exact test with chi-squre test for trend, in invasive breast cancer. (n=86) 3) In diploid tumor (n=35), statistically significant differences were noted such that high S-phase fraction tumor revealed increased p53 positivity. (p<0.05) We have found that immunopositivity for p53 was detected in 20% of in situ carcinoma, suggesting that p53 mutation can be acquired early in malignant progression. We have also found that there is a strong direct correlation between the amount of mutant protein and tumor proliferation rate. These results are consistent with the hypothesis that wild-type p53 is involved in suppression of the cell cycle.
Breast Diseases ; Breast Neoplasms* ; Breast* ; Carcinoma, Intraductal, Noninfiltrating ; Cell Cycle ; Classification ; Diploidy ; DNA ; DNA Damage ; DNA Repair ; Estrogens ; Humans ; Hyperplasia ; Immunohistochemistry ; Mutant Proteins ; Ploidies ; Retrospective Studies ; S Phase

INTRODUCTION There are three factors for successful implantation. These are embryo quality, uterine receptivity, and synchronization between embryonic and endometrial development. Despite remarkable progress in investigating embryos in human IVF, there has been slow progress in exploring the implantation process. It may be due to two reasons as follow. First, it is difficult to directly investigate the mechanism of implantation in the human, because of ethical considerations. Second, there is no sensitive and widely accepted marker for assessing endometrial development. Since the finding of a novel standard for dating endometrial biopsy by Noyes et. al.,. in 1950, there have been many attempts to identify suitable markers for uterine receptivity. Those include ultrasonographic changes (Ueno et.al., 1991; Grunfeld et al.,1991), three dimensional morphological changes of the endometrium such as pinopode formation (Market or alphaf., 1987; Mantel or alphaf., 1991; Nikas et al., 1995; Psychoyos & Nikas, 1994), integrin expression (Ilesanmi et al., 1993; Lessey et.al., 1992; Lessey, 1994), and measurement of endometrial proteins (Hell, 1986;Fay & Crudzinskas, 1991). Investigations in the rat (cartel et al., 1991)and human (cartel et al., 1987; Nikas et al., 1995; Psychoyos & Nikas, 1994) suggested the presence of pinopodes as a marker for the receptive phase.4 chronological barrier in uterine receptivity could be one of the major factors limiting IVF pregnancy rates. If we were able to manage the 'implantation window' we may be able to improve implantation and pregnancy rates in the human IVF program. In 1987, Martel et al., found early appearance of pinopodes in stimulated cycles for IVF compared to natural cycles in humans (Marcel et al., 1987). This effect was found in patients stimulated with clomephene citrate/hMG/hCG. The purpose of the present study was to evaluate the endometrial development in IVF patients stimulated with either by FSH/hMG/hCG or with GnRH agonist down regulation.
Animals ; Biopsy ; Down-Regulation ; Embryonic Structures ; Endometrium ; Female ; Gonadotropin-Releasing Hormone ; Humans* ; Oocyte Retrieval* ; Oocytes* ; Pregnancy Rate ; Rats

No abstract available.
Blood Glucose ; Diabetes Mellitus, Type 2 ; Humans

OBJECTIVE: To systematic analyze the change of indications, age distribution of the patients and chromosomal results according to patient's age and indications in midtrimester genetic amniocentesis METHODS: This study reviewed 2,000 genetic amniocentesis cases from 1984 to 1997 which were done at Severance Hospital, after prenatal genetic counseling for the mothers who have high risk for carrying chromosomally abnormal babies. We analized the change of the indication, age distribution and chromosomal results according to maternal age and indications of amniocentesis RESULTS: 1. The incidence of amniocentesis had been in gradual increase since the 1980's, and from the mid 1990's it showed an abrupt increment. 2. Of the 2,000 amniocentesis cases, 31.8% was maternal age 35 to 39 which was most common age group and followed by age 30 to 34 was 28.4% and age 25 to 29 was 27.4. 3. The indications for amniocentesis were advanced maternal age(39.6%), abnormal maternal serum markers(27.8%) and abnormal ultrasonographic findings which implies chromosomal abnormality(6.4%). Recently maternal serum markers and ultrasonography play an important role as an indicator for the amniocentesis. 4. From the 2000cases, 1,950 cases showed normal diploidy and 50 cases abnormal karyotype which consisted 2.5%. In autosomal disorders ll Down syndrome, 7 Edward syndrome, 1 Patau syndrome, 15 Translocation, 3 Mosaicism were diagnosed. In sex chromosomal disorders 3 Klinefelter syndmme, 2 Turner syndrome and other 8 chromosomal abnormalities were diagnosed. No statistic significance was found among different age groups. Those who had abnormal ultrasonographic findings implying chromosomal abnormality were found to have correlation with chromosomal abnormality than other indications CONCLUSION: Midtrimester genetic amniocentesis is an important diagnostic tool in prenatal diagnosis, of which the annual incidence has been recently increased abruptly. Not only maternal age, but the maternal serum markers and ultrasonograms should be considered in prenatal counseling, The genetic amniocentesis should be well informed to the general population.
Abnormal Karyotype ; Age Distribution ; Amniocentesis* ; Biomarkers ; Chromosome Aberrations ; Chromosome Disorders ; Counseling ; Diagnosis* ; Diploidy ; Down Syndrome ; Female ; Genetic Counseling ; Humans ; Incidence ; Maternal Age ; Mosaicism ; Mothers ; Pregnancy ; Pregnancy Trimester, Second ; Prenatal Diagnosis ; Turner Syndrome ; Ultrasonography

A number of studies have documented the reasonable efficacy and safety of radial keratotomy, but most based upon results obtained in low or moderate myopia or short term follow up after surgery. We complied 5 year and longer follow up data on 91 consecutive radial keratotomy surgeries on high myopia (over -6.00 diopters) performed by one surgeon 5 year-follow up was obtained on 21 (23%) of these eyes. The mean spherical equivalent before surgery was -11.02 diopters (D), the average keratometry value was 44.40 D, and all of the eyes had an uncorrected visual acuity of 0.04 or less. The average change in spherical equivalent was 3.44 D for eyes examined at 1 year, compared with 3.05 D for eyes at 3 years and 2.87 D at 5 years after surgery. Average keratometry value were 42.30 D at 1 year, 41.60 D at 3 years, and 41.30 D at 5 years after surgery. In our study, the decrease in spherical equivalent of 0.57 D was statistically significant (P < 0.05), as was the reduction in average keratometry value of 1.00 D. The effect of the surgery on spherical equivalent continued to regress through all the 5 years of follow up. However, the keratometric measurement decreased up to 5 years which indicated progressive flattening of the cornea. Also we divided these eyes into 2 groups, lower-myopic group (-6.00 D~-9.75 D) and higher-myopic group (over -10.00 D). In each category, the changes in spherical equivalent were 3.60 D, 2.21 D at 5 years, compared with 3.65 D, 3.25 D at 1 year respectively. The efficacy of radial keratotomy was lower, and the change of spherical equivalent between 1 year and 5 years was larger in the higher-myopic group than in the lower-myopic group. The results show that both radial keratotomy effectiveness and long term stability decrease in higher myopic cases.
Adolescent ; Adult ; Cornea/*surgery ; Female ; Follow-Up Studies ; Humans ; *Keratotomy, Radial ; Male ; Middle Aged ; Myopia/*surgery ; Treatment Outcome ; Visual Acuity

A number of studies have documented the reasonable efficacy and safety of radial keratotomy, but most based upon results obtained in low or moderate myopia or short term follow up after surgery. We complied 5 year and longer follow up data on 91 consecutive radial keratotomy surgeries on high myopia (over -6.00 diopters) performed by one surgeon 5 year-follow up was obtained on 21 (23%) of these eyes. The mean spherical equivalent before surgery was -11.02 diopters (D), the average keratometry value was 44.40 D, and all of the eyes had an uncorrected visual acuity of 0.04 or less. The average change in spherical equivalent was 3.44 D for eyes examined at 1 year, compared with 3.05 D for eyes at 3 years and 2.87 D at 5 years after surgery. Average keratometry value were 42.30 D at 1 year, 41.60 D at 3 years, and 41.30 D at 5 years after surgery. In our study, the decrease in spherical equivalent of 0.57 D was statistically significant (P < 0.05), as was the reduction in average keratometry value of 1.00 D. The effect of the surgery on spherical equivalent continued to regress through all the 5 years of follow up. However, the keratometric measurement decreased up to 5 years which indicated progressive flattening of the cornea. Also we divided these eyes into 2 groups, lower-myopic group (-6.00 D~-9.75 D) and higher-myopic group (over -10.00 D). In each category, the changes in spherical equivalent were 3.60 D, 2.21 D at 5 years, compared with 3.65 D, 3.25 D at 1 year respectively. The efficacy of radial keratotomy was lower, and the change of spherical equivalent between 1 year and 5 years was larger in the higher-myopic group than in the lower-myopic group. The results show that both radial keratotomy effectiveness and long term stability decrease in higher myopic cases.
Adolescent ; Adult ; Cornea/*surgery ; Female ; Follow-Up Studies ; Humans ; *Keratotomy, Radial ; Male ; Middle Aged ; Myopia/*surgery ; Treatment Outcome ; Visual Acuity