PURPOSE: Cyclins are groups of proteins that play a role as a major regulator of the G1 restriction point promoting inactivation of the retinoblastoma protein. The cyclin D1 gene, CCND1, is amplified in approximately 20% of breast carcinomas and the protein is reportedly overexpressed in 60~80% of all cases. Cyclin D1 overexpression was strongly correlated to estrogen receptor positivity and better histologic grade in breast cancer. The aim of this study was to correlate cyclin D1 overexpression using a well characterized antibody with estrogen receptor status and other clincopathologic parameters. METHODS: From March 1989 to December 1994, 85 patients with primary breast carcinoma were the subject in this study. We analyzed cyclin D1 expression by immnohistochemical staining using cyclin D1 antibody, cells were considered positive according to distinct nuclear staining. The correlation between cyclin D1 expression was compared with important clinicopathologic parameters (tumor size, axillary lymph node status, p53 expression, c-erbB2 expression, histologic grade, estrogen receptor status). RESULTS: Cyclin D1 expression was detected in 37 cases (43.5%). Cyclin D1 expression was high in patients with tumors that expressed estrogen receptor (58.5% vs 26.5%, P=0.019). Cyclin D1 was mainly overexpressed in the histologic grade I and II (75.0%), as compared with 65.2% in cyclin D1 negative tumor, however there was no statistical significance (P=0.067). There were no significant correlation with tumor size, axillary lymph node status, p53 expression, or c-erbB2 expression (P>0.05). CONCLUSION: Cyclin D1 expression in estrogen receptor (ER) positive patients was significantly higher than that seen in ER negative patients. There was a negative correlation between cyclin D1 and tumor histologic grade, however it was not statistically significant. Tumor size, axillary lymph node status, p53 expression, and c-erbB2 expression were not correlated with cyclin D1.
Breast Neoplasms* ; Breast* ; Cyclin D1* ; Cyclins* ; Estrogens* ; G1 Phase Cell Cycle Checkpoints ; Genes, bcl-1 ; Humans ; Lymph Nodes ; Retinoblastoma Protein

The objective of aneurysm surgery is to exclude the aneurysm from the circulation while preserving blood flow distal to the lesion. In certain situations, the aneurysm neck cannot be clipped safely or the parent vessel reconstructed, primarily in large or giant size with incorporation of parent vessels or perforating arteries, calcification at the aneurysm base, and fusiform or dissecting aneurysms. In such cases, occlusion of the parent vessel is a treatment of option. In many patients, however, sacrifice of the parent artery has an associated risk of ischemic stroke. Therefore, sacrifice of the parent vessel can be supplimented with distal revascularization to provide the necessary distal blood flow while allowing the aneurysm to be trapped. The indications, options, and surgical approaches are described with review of literatures. Finally the authors' experiences of revascularization in 7 patients with unclippable aneurysms are reported.
Aneurysm ; Aneurysm, Dissecting ; Arteries ; Humans ; Intracranial Aneurysm* ; Neck ; Parents ; Stroke

Although oral sodium phosphate, a colonic cleasing agent for colonoscopy, had been usually known to be safe, several cases have been reported on the development of acute renal failure(ARF) after the administration of this agent. Many authors suggested that the pathogenesis of ARF developed after sodium phosphate administration is related with hyperphosphatemia, which caused ARF by the deposition of phosphate and/or calcium in renal tubule or interstitium, or by the direct toxicity to renal tubular cells. Elderly patients or the patients with dehydration, underlying cardiovascular, renal, or hepatic disease predispose the development of adverse effects of sodium phosphate, such as water and electrolyte imbalance, especially hyperphosphatemia which may ultimately lead to ARF. We described here a case of acute renal failure associated with hyperphosphatemia after the administration of sodium phosphate. A review of the literatures is presented.
Acute Kidney Injury* ; Aged ; Calcium ; Colon ; Colonoscopy ; Dehydration ; Humans ; Hyperphosphatemia ; Sodium*

PURPOSE: Cyclins are groups of proteins that play a role as a major regulator of the G1 restriction point promoting inactivation of the retinoblastoma protein. The cyclin D1 gene, CCND1, is amplified in approximately 20% of breast carcinomas and the protein is reportedly overexpressed in 60~80% of all cases. Cyclin D1 overexpression was strongly correlated to estrogen receptor positivity and better histologic grade in breast cancer. The aim of this study was to correlate cyclin D1 overexpression using a well characterized antibody with estrogen receptor status and other clincopathologic parameters. METHODS: From March 1989 to December 1994, 85 patients with primary breast carcinoma were the subject in this study. We analyzed cyclin D1 expression by immnohistochemical staining using cyclin D1 antibody, cells were considered positive according to distinct nuclear staining. The correlation between cyclin D1 expression was compared with important clinicopathologic parameters (tumor size, axillary lymph node status, p53 expression, c-erbB2 expression, histologic grade, estrogen receptor status). RESULTS: Cyclin D1 expression was detected in 37 cases (43.5%). Cyclin D1 expression was high in patients with tumors that expressed estrogen receptor (58.5% vs 26.5%, P=0.019). Cyclin D1 was mainly overexpressed in the histologic grade I and II (75.0%), as compared with 65.2% in cyclin D1 negative tumor, however there was no statistical significance (P=0.067). There were no significant correlation with tumor size, axillary lymph node status, p53 expression, or c-erbB2 expression (P>0.05). CONCLUSION: Cyclin D1 expression in estrogen receptor (ER) positive patients was significantly higher than that seen in ER negative patients. There was a negative correlation between cyclin D1 and tumor histologic grade, however it was not statistically significant. Tumor size, axillary lymph node status, p53 expression, and c-erbB2 expression were not correlated with cyclin D1.
Breast Neoplasms* ; Breast* ; Cyclin D1* ; Cyclins* ; Estrogens* ; G1 Phase Cell Cycle Checkpoints ; Genes, bcl-1 ; Humans ; Lymph Nodes ; Retinoblastoma Protein

BACKGROUND: Continuous ambulatory peritoneal dialysis(CAPD) is known to be a relatively effective in decreasing the cardiac loading and improving the symptoms and survivals in the patients with severe left ventricular(LV) dysfunction, who are refractory to conventional medical treatments. METHODS: We reviewed retrospectively the clinical course and prognosis of 18 patients initiating CAPD and manifesting severe LV dysfunction at the same from September, 1996 to December, 2000 in Inha University Kidney Center. To know the effect of LV dysfunction on the survival, the outcomes of 103 CAPD patients with normal cardiac function was compared as control group. RESULTS: Total subjects were 11 male and 7 female with a mean age of 59.9+/-1.6 years. Causes of end stage renal disease were diabetic nephropathy (12), chronic glomerulonephritis(1), lupus nephritis(1), and unknown(2). Mean follow-up duration was 12.7+/-10.6 months. In pre-CAPD period, all subjects showed cardiac symptoms of NYHA class III or IV with a mean ejection fraction of 27.6+/-0.6%. Six months after CAPD, mean ejection fraction of all patientswas improved up to 44.8+/-3.1%. 13 patients(72.2%) showed improvement of cardiac function in terms of NYHA class. Five patients showed neither improvement nor aggravation of cardiac function, who were mostly female, older, and transferred from hemodialysis and three of whom died. During follow-up period, seven patients died because of aggravation of previous cardiac disease(4), acute myocardial infraction(1), cerebral hemorrhage(1) and peritonitis(2). When compared to 103 patients without LV dysfunction who started CAPD, 1-year survival was poorer in the patients with LV dysfunction(41.7% vs 77.8%, p<0.05). CONCLUSION: LV dysfunction is still a risk factor of poor survival, CAPD may improve symptoms and systolic cardiac fucntion in ESRD patients with severe LV dysfunction.
Diabetic Nephropathies ; Female ; Follow-Up Studies ; Heart Failure ; Humans ; Kidney ; Kidney Failure, Chronic* ; Male ; Peritoneal Dialysis, Continuous Ambulatory* ; Prognosis ; Renal Dialysis ; Retrospective Studies ; Risk Factors

PURPOSE: Testicular microlithiasis (TM) is an uncommon pathologic condition that is commonly diagnosed by scrotal ultrasonography. Indirect evidence suggests that this syndrome may be associated with an increased risk of testicular malignancy and infertility. MATERIALS AND METHODS: A total of 1,439 patients undergoing scrotal ultrasound during a 6-year, 5-month period (January 2003 to May 2009) were retrospectively reviewed. Any possible association of TM with pathologic findings was assessed. Among patients with TM, further grading of TM with testicular cancer and semen analysis of the infertile group with TM were also performed. RESULTS: TM was diagnosed in 87 patients (6.0%) out of a total of 1,439. Of all established pathologic entities, only testicular malignancy and infertility were meaningfully associated with TM. There was no significant difference in the prevalence of testicular cancer between each grade. Seminal profiles (sperm count, motility, morphology, and white blood cell count) were not found to be statistically different between infertile men with and without TM. CONCLUSIONS: The prevalence of TM in symptomatic men was found to be 6.0% with significant co-occurrence of TM, testicular cancer, and infertility. Further grading of TM does not seem to be essential with regard to the detection of patients with testicular cancer and TM. TM showed no significant effect on the seminal profiles of infertile men.
Calculi ; Humans ; Infertility ; Leukocytes ; Male ; Prevalence ; Retrospective Studies ; Semen Analysis ; Testicular Diseases ; Testicular Neoplasms ; Testis

BACKGROUND: Baricity differences between spinal anesthetic solutions are thought to produce differences in distribution of anesthetics within the subarachnoid space. We evaluated the influence of baricity of bupivacaine on the quality of the block and the incidence of side effects obtained following intrathecal injection of bupivacaine 8 mg with fentanyl 20 microgram. METHODS: Thirty healthy term parturients scheduled for a cesarean section under combined spinalepidural procedures were randomly allocated into Group I, hyperbaric bupivacaine (n = 15); or Group II, isobaric bupivacaine (n = 15). The dose of both groups was bupivacaine 8 mg combined with fentanyl 20 microgram. The maximum level of sensory blockade, time to reach T4 level and maximum level, time to get complete motor recovery and perioperative complications were assessed. RESULTS: Time to sensory block T4, motor block Bromage scale 3, complete resolution of motor block and sensory regression time to T10 was significantly delayed in Group II compared to Group I. Maximal block height, and time to maximal block had no significant differences between the two groups. There were no significant clinical advantages of one preparation over the other. CONCLUSIONS: The data from this study suggests that intrathecal injection of either hyperic or isobaric bupivacaine produces satisfactory anesthesia with similar side effects.
Anesthesia ; Anesthetics ; Bupivacaine* ; Cesarean Section* ; Female ; Fentanyl ; Incidence ; Injections, Spinal ; Pregnancy ; Subarachnoid Space

The purpose of this study was to determine whether the application of chlorhexidine varnish affects the shear bond strength and failure pattern of orthodontic brackets or not. The experimental group consisted of 22 human premolars which extracted after chlorhexidine varnish application (4 times for 1 week interval) in vivo, and the control group consisted of 22 human premolars which extracted without any pre-treatment. After all teeth wee etched with 37% phosphoric acid gel, metal orthodontic brackets (Q-3002, RMO, USA) were bonded to each tooth using auto-polymerizing orthodontic resin (Ortho-One, Bisco, USA) with the same bonding procedure. The shear bond strength was measured with Instron universal testing machine (model 4466, Instron Ltd., England), and the failure pattern of each bracket was examined with Scanning Electron Microscope (SM 840A, JEOL, Japan). The data were analysed statistically with t-test. The results were as follows: 1. Application of chlorhexidine varnish had no significant effect on the shear bond strength of the orthodontic bracket. 2. There was no significant difference in the failure pattern of orthodontic bracket between the experimental group and the control group.
Bicuspid ; Chlorhexidine* ; Humans ; Orthodontic Brackets* ; Paint* ; Tooth

Infected nonunion of the long bone, while less common today than in the past, continues to challenge orthopaedic surgeons. Various treatment methods including current techniques of internal fixation, bone graft, electrical stimulation and external fixation have been tried, but results are not always satisfactory. Authors reported successful treatment of infected nonunion by rigid internal fixation with one plate and autogenous bone graft in previous volumes 1989. Recently we adopted dual plate method, by which we overcame a greater amount of bone defect and obtained more rigid internal fixation. We have treated 14 cases of infected nonunion with this method from Oct. 1992 to Oct. 1994, and the results are as follows; 1. Tibia fractures were 9 cases, and femur fractures were 5 cases. 2. Six cases showed large bone defect. The average bone defect was 4.5cm in length and we could overcome it by Dual plate method and autogenous bone graft. 3. Six cases which showed large bone defect were united in average 5 months. 4. In remaining 8 cases, union was obtained in average 3 months.
Electric Stimulation ; Femur ; Tibia ; Transplants

To evaluate the effectiveness of centralizing device, three groups of patients on whom cemented total hip arthroplasty with three types of implant was performed respectively were analyzed and compared; SL stems without centralizing device were used in Group I, Interlok stems with central sleeve in Group II, and MS-30 stems with distal centralizer in Group III .The size of each group was 20. Cement mantle thickness, the amount of displacement of stem tip, and axis alignment of femoral stem on A-P radiograph checked at 2 weeks after operation were assessed. More optimal cement mantle thickness (3~6mm) was achieved in Group II (P=0.046) and Group III (P=0.01) than in Group I. Centralizing effect of the distal femoral stem in the intramedullary canal was significantly better (P<0.05) in Group III ( 4.55% ) than in Group I (11.60%) and Group II (12.35%). Neutral alignment of femoral stem was achieved in 15% of Group I, in 90% of Group II, and in 95% of Group III. Compared to stem without centralizing device, cemented femoral stem with distal centralizer resulted in 1) significantly more centralized distal femoral stem, 2) significantly more neutrally aligned femoral stem,and 3) significantly more optimal cement mantle thickness at zone V. Compared to stem without centralizing device, cemented femoral stem with central sleeve resulted in 1) significantly more neutrally aligned femoral stem, and 2) significantly more optimal cement mantle thickness at zone VI.
Arthroplasty, Replacement, Hip ; Axis, Cervical Vertebra ; Humans