No abstract available.
HIV* ; Humans* ; Polymerase Chain Reaction*

PURPOSE: To evaluate the classification of punctal stenosis based on the shape of the external punctum, clinical characteristics and histopathologic features. METHODS: Patients who experienced tearing and were diagnosed with punctal stenosis were evaluated in this study. Punctal stenosis was classified according to the shape of the lower external punctum, which included membranous type, slit type, horseshoe type, and pinpoint type. Tear meniscus height, 2% fluorescein dye disappearance test and lacrimal pathway irrigation were measured or performed. For treatment, a punctal snip operation and silicone tube placement were performed, and the peripunctal histopathological findings were evaluated. RESULTS: Punctal stenosis was classified into four types: membranous type (17 eyes, 21.5%), slit type (11 eyes, 13.9%), horseshoe type (25 eyes, 31.6%), and pinpoint type (26 eyes, 32.9%). The tear meniscus was significantly higher, and the 2% fluorescein dye disappeared significantly more slowly in the punctal stenosis group. However, correlation of the tear meniscus height and 2% fluorescein dye disappearance test with the punctum shape was not statistically significant. A history of previous chemotherapy was significantly associated with the occurrence of punctal stenosis, especially the membranous type (p < 0.05). Histopathologic evaluation of the punctum showed differences between the punctum types. Pinpoint puncta exhibited a high density of muscle fibers, while they were faintly visible in the membranous type. CONCLUSIONS: Acquired punctal stenosis has various shapes, and the major types of stenotic puncta exhibited unique histopathologic features. Punctal stenosis and its pathophysiology may be related to multiple factors, such as age and systemic 5-fluorouracil chemotherapy history.
Classification* ; Constriction, Pathologic* ; Drug Therapy ; Fluorescein ; Fluorouracil ; Humans ; Lacrimal Apparatus ; Lacrimal Apparatus Diseases* ; Silicon ; Silicones ; Tears

BACKGROUND: Inactivation of the retinoblastoma protein (pRb) is a mechanism by which tumor cells can subdue normal growth control. Among the molecules involved in control of pRb phosphorylation, cyclin D1 and cyclin E have been found to be deregulated and overexpressed in various types of cancers. METHODS: Immunohistochemical stains for pRb, p16, cyclin D1 and cyclin E were performed in 73 cases of infiltrating duct carcinomas of the breast. In addition to analysis of their expression rates, the relationships between their expressions and the clinicopathologic parameters were evaluated. RESULTS: pRb, p16, cyclin D1 and cyclin E were positive in 64.7% (44 out of 68 cases), 24.6% (15 out of 61 cases), 43.8% (32 out of 73 cases) and 61.6% (45 out of 73 cases), respectively. Their expression rates were not significantly associated with clinicopathologic prognostic factors. 33 out of 38 cases with p16-negative reactions were pRb positive, while 10 out of 15 cases with pRb-negative reactions were p16 positive. There was a significant inverse relationship between pRb and p16 expressions (P<0.005). 25 out of 32 cases with cyclin E-positive reactions were cyclin D1-positive, and 25 out of 45 cases with cyclin D1-positive reactions were cyclin E-positive. A statistically significant association was observed between cyclin D1 and cyclin E expressions (P<0.05). CONCLUSIONS: The main mechanism during tumorigenesis of breast carcinoma depends on the cyclin D1/p16/pRb pathway, but cyclin E might play a role in the absence of cyclin D1. The inverse correlation between the pRb and p16 expressions may represent one of the important mechanisms in tumorigenesis, as well.
Breast Neoplasms ; Breast* ; Carcinogenesis ; Coloring Agents ; Cyclin D1* ; Cyclin E* ; Cyclins* ; Phosphorylation ; Retinoblastoma ; Retinoblastoma Protein

BACKGROUND: Anemia is a major contributor to morbidity and mortality in chronic renal failure patients. The benefits of anemia correction using recombinant human erythropoietin (Epo) are well established but because of high cost, several studies increasing the efficacy of it were described. The objective of this study was to evaluate the efficacy of an anemia management protocol using subcutaneous Epo and intravenous iron therapy. METHODS: We enrolled seventy-eight maintenance hemodialysis patients for at least 3 months from January 2000 to November 2002. They received a practice of anemia correction in two other settings. One (control) group performed an irregular administration of Epo and iron, the other (protocol) group performed a regular administration according to anemia management protocol. Clinical and laboratory parameters were analyzed. Dosage of Epo and IV iron were compared. RESULTS: Thirty-one patients in control group and forty-seven patients in protocol group were enrolled. There were no significant differences between two groups in age, gender, existence of diabetic mellitus, vintage of hemodialysis, use of angiotensin-converting enzyme inhibitor, BUN, prealbumin, parathyroid hormone and Kt/Vurea. Mean arterial pressure, creatinine and albumin were significantly lower and hematocrit was significantly higher and well-maintained on the target level in protocol group. There were no significant differences in serum iron, transferrin saturation, ferritin but total iron binding capacity was significantly lower in protocol group. Doses of erythropoietin and IV iron showed no significant differences between two groups. CONCLUSION: The protocol based erythropoietin administration was more efficient in achieving target hematocrit without increment of dosage of erythropoietin and intravenous iron and side effect of hypertension.
Anemia ; Arterial Pressure ; Creatinine ; Erythropoietin* ; Ferritins ; Hematocrit ; Humans ; Hypertension ; Iron ; Kidney Failure, Chronic ; Mortality ; Parathyroid Hormone ; Prealbumin ; Renal Dialysis* ; Transferrin

The damage which radiation produces in tissues such as the lungs can be discussed at the molecular, biophysical, cellular, and organ levels. The cellular effects of irradiating the lungs are related to the histologic and clinical sequelae. In the present study the right lung of rabbits were exposed to single dose of 20 Gy of X-irradiation. Animals from each group were sacrificed monthly for 6 months postexposure. Sections of lung were examined by light microscopy(LM) and by transmission electron microscopy(TEM). Multiple exudative lesions were seen at 2 months after the 20Gy irradiation, and they progressed to a proliferative and then reparative fibrotic lesion by 6 months. Changes in epithelial lining of lung components, particulary the presence of type II pneumocytes were found by both LM and TEM. Capillary endothelial damages were less pronounced. The possible implication of cellular components in radiation pneumonitis and fibrosis is discussed.
Animals ; Capillaries ; Fibrosis ; Lung* ; Pneumocytes ; Rabbits ; Radiation Pneumonitis

Enterococcus avium, very commonly found in birds, is rarely reported as a human pathogen. Although several studies have focused on cases of infection with E. avium, little is known about the clinical features of E. avium infection and the antimicrobial susceptibility pattern of E. avium. We isolated vanA-producing vancomycin-resistant E. avium from specimen obtained from the wound of a patient with diabetes mellitus. Vancomycin-resistant E. avium is rarely observed among the vancomycin-resistant enterococci colonizing the intestine, and there are very few reports of vancomycin-resistant E. avium isolated from clinical specimens. Here we confirmed that the clinical isolate was E. avium on the basis of phenotypic characterization and the results of 16S rRNA sequence analysis.
Birds ; Colon ; Diabetes Mellitus ; Enterococcus ; Humans ; Intestines ; Sequence Analysis ; Vancomycin Resistance ; Wound Infection

PURPOSE: To determine the correlation of the clinical characteristics and histopathologic findings of lacrimal sac after external dacyrocystorhinostomy (DCR). METHODS: From March 2008 to June 2009, 49 lacrimal sac tissues of 47 patients were obtained after external DCR and divided according to fibrosis and inflammatory findings. The correlation of preoperative duration of symptoms with NLD obstruction, symptoms of recurrence and outcomes of the operation to the histopathologic findings were retrospectively evaluated. RESULTS: The mean age of the patients was 58.83 +/- 11.49 years and the mean duration of preoperative symptoms was 65.2 +/- 69.05 months. Forty-three cases (88%) maintained good openings and 30 cases (61%) had no recurring symptoms over 6 months after the operation. Among the significant symptoms, severe subepithelial inflammations were observed more frequently at shorter duration. However, the fibrosis showed a positive relation with the preoperative duration of symptoms (Spearman correlation test, p<0.05). Most failures were found in the severe inflammation and fibrosis groups and were recovered with anti-inflammatory treatment. CONCLUSIONS: Inflammation and fibrosis of the lacrimal sac could be an important prognostic and predictive factor of outcomes of DCR.
Dacryocystorhinostomy ; Fibrosis ; Humans ; Inflammation ; Recurrence ; Retrospective Studies

In order to investigate supplement use in middle-aged and elderly outpatients suffering from age-related diseases over the last year, a cross-sectional survey was conducted from July to December 2001. The subjects were 1702 (male 731, female 971) age-related disease outpatients over age 50. Data was collected using a standardized questionnaire and in-person interviews. The prevalence of supplement use and the different categories of supplements taken by the subjects were examined using SPSS statistical package. Supplements were used by 48.9% of the subjects. The mean number of kinds of dietary supplements taken by subjects was 1.7. Chinese medicine was the most commonly used supplements in both the male and female subjects. Among the reasons for using supplements, health promotion ranked as the most common. Most of the supplement users, however, did not know or only knew roughly about the health claims of their supplements. Subjects reported the information source on supplements as family, friends or relatives followed by doctors or pharmacists. These results may provide basic information for proper supplement use among Korean middle-aged and elderly outpatients with age-related diseases.
Aged ; Asian Continental Ancestry Group ; Chronic Disease* ; Cross-Sectional Studies ; Dietary Supplements ; Female ; Friends ; Health Promotion ; Humans ; Korea* ; Male ; Outpatients* ; Pharmacists ; Prevalence ; Surveys and Questionnaires

BACKGROUND: The incidence of diphtheria has been markedly reduced and almostly eradicated by widespread use of DTP vaccines in developed countries. However, outbreaks of this disease may be occurred under some circumstances of ineffective immunization. In recent time, some studies reported persistent outbreaks of diphtheria in developed countries and indicated the existence of a large pool of susceptible individuals with potential for epidemic infection. In Korea, diphtheria vaccination has been well maintained since 1956 with high acceptant vaccination rates. So, there has been no reported diphtheria patient since 1987. But, there has been few study to diphtheria serosuvey, and no assessment of diphtheria immunization. Also, we do not use Td vaccine in adults for maintenance of diphtheria immunity. In this aspect, we conducted age related seroepidemiology of diphtheria and indirectly assessed the immunity of diphtheria vaccines, used in Korea. METHODS: For the evaluation of age related serosurvey of diphtheria immunity in Korean populations, study subjects below 10 years old aged children were classified into 10 groups (A~J) with one year interval, and beyond this age to 60 years old aged adults were classified into 5 group (K~O) with 10 years interval. And the adults over 60 years old age was classified into the last group (P). The numbers of each group were 100, and sex distributions of each group were almostly equal. And for the indirect assessment of diphtheria immunization in Korean children, children under 15 years old were classified into 6 groups (I~ VI) according to the status of DTaP vaccination. The numbers of this each group were 30, and sex ratio was almostly equal. Detection of specific IgG antibody to diphtheria toxin were determined by ELISA (contained fragment A & B toxin; IBL, Germany). RESULTS: In age related groups, the antibody titers to diphtheria toxin were well maintained until 10 years old age group, thereafter the titers abruptly decreased below 0.1 IU/mL and then slightly elevated after 30 years old age group and then maintained with low levels. In the groups related DTaP vaccine status, the antibody titers were very low (below 0.07 IU/mL) in prevaccination status, but the titers after primary vaccinations were markedly increased and maintained (above 0.6 IU/mL) until 15 years. And diphtheria antitoxin levels in the groups (L, M, N) showed no significant differences between males and females. CONCLUSION: The results of our study showed that the antibody titers to diphtheria toxin in the 20~50 years old aged groups dramatically decreased. This result indicated that vaccine induced diphtheria immunity did not last throughout life, and Td vaccination program in adults should be considered for maintenance of diphtheria immunity. And the immunity to diphtheria in Korean children indicated that 3 timesprimary and 2 times booster diphtheria immunizations were optimal.
Adolescent ; Adult ; Child ; Developed Countries ; Diphtheria Antitoxin ; Diphtheria Toxin ; Diphtheria* ; Diphtheria-Tetanus-acellular Pertussis Vaccines ; Disease Outbreaks ; Enzyme-Linked Immunosorbent Assay ; Female ; Humans ; Immunization ; Immunoglobulin G ; Incidence ; Korea ; Male ; Middle Aged ; Seroepidemiologic Studies* ; Sex Distribution ; Sex Ratio ; Vaccination ; Vaccines

PURPOSE: To assess the influence of cyclooxygenase-2 (COX-2) expression on the survival of patients with a combination of rectal cancer and lymph node metastasis. MATERIALS AND METHODS: The study included rectal cancer patients treated by radical surgery and postoperative radiotherapy at the Dong-A university hospital from 1998 to 2004. A retrospective analysis was performed on a subset of patients that also had lymph node metastasis. After excluding eight of 86 patients, due to missing tissue samples in three, malignant melanoma in one, treatment of gastric cancer around one year before diagnosis in one, detection of lung cancer after one year of diagnosis in one, liver metastasis in one, and refusal of radiotherapy after 720 cGy in one, 78 patients were analyzed. The immunohistochemistry for COX-2 was conducted with an autostainer (BenchMark; Ventana, Tucson, AZ, USA). An image analyzer (TissueMine; Bioimagene, Cupertino, CA, USA) was used for analysis after scanning (ScanScope; Aperio, Vista, CA, USA). A survival analysis was performed using the Kaplan Meier method and significance was evaluated using the log rank test. RESULTS: COX-2 was stained positively in 62 patients (79.5%) and negatively in 16 (20.5%). A total of 6 (7.7%), 15 (19.2%), and 41 (52.6%) patients were of grades 1, 2, and 3, respectively for COX-2 expression. No correlation was found between being positive of COX-2 patient characteristics, which include age (<60-year old vs. > or =60), sex, operation methods (abdominoperineal resection vs. lower anterior resection), degrees of differentiation, tumor size (<5 cm vs. > or =5 cm), T stages, N stages, and stages (IIIa, IIIb, IIIc). The 5-year overall and 5-year disease free survival rates for the entire patient population were 57.0% and 51.6%, respectively. The 5-year overall survival rates for the COX-2 positive and negative patients were 53.0% and 72.9%, respectively (p=0.146). Further, the 5-year disease free survival rates for the COX-2 positive and negative patients were 46.3% and 72.7%, respectively (p=0.118). The 5-year overall survival rates were significantly different (p<0.05) for the degree of differentiation, N stage, and stage, whereas the 5-year disease free survival rates were significant for N stage and stage. CONCLUSION: Being positive for and the degree of COX-2 expression did not have a significant influence on the survival of rectal cancer patients with lymph node metastasis. However, N stage and stage did significantly influence the rateof survival. Further analysis of a greater sample size is necessary for the verification of the effect of COX-2 expression on the survival of rectal cancer patients with lymph node involvement.
Cyclooxygenase 2 ; Disease-Free Survival ; Disulfiram ; Humans ; Immunohistochemistry ; Liver ; Lung Neoplasms ; Lymph Nodes ; Melanoma ; Neoplasm Metastasis ; Rectal Neoplasms ; Retrospective Studies ; Sample Size ; Stomach Neoplasms ; Survival Rate