Neuroblastoma, ganglioneuroblastoma and ganglioneuroma are derived from primordial neural crest cells and can be conceptualized as three different maturational manifestations of a common neoplasm. To assess the validity of immunohistochemistry and DNA Ploidy in the diagnosis of neuroblastic tumor in terms of prognostication, histologic and immunohistochemical evaluation with NB-84, neuron specific enolase(NSE) and S-100 protein and flow Cytometric DNA analysis were done on 21 neuroblastomas and 19 ganglioneuromas. Thirteen of 21 neuroblastomas were undifferentiated and 8 differentiating in type. Eleven of the 19 ganglioneuromas were mature in type and 8 had immature foci. Eighty one percent of neuroblastomas were positive for NB-84, 100% for NSE and 67% for S-100 protein, respectively. All ganglioneuromas were positive for NSE and S-100 protein, in contrast, only immature foci in ganglioneuroma were positive for NB-84. B-84 reacted positively with undifferentiated and differentiating neuroblasts including neuropil but not with mature ganglion cells. In contrast, NSE reacted positively with all components of neuroblastic tumor and S-100 protein mainly with cells of Schwannian differentiation. Three of eight(37.5%) differentiating neuroblastomas were strongly positive for NB-84 in contrast with seven of thirteen(53.8%) undifferentiated tumors, reflecting that undifferentiated cells tended to be positive for NB-84 in neuroblastoma. Twenty two percent of neuroblastoma showed diploidy and 78% aneuploidy including 11% of near-diploidy. Seven of eight(87.5%) differentiating neuroblastomas in contrast with seven of ten(70%) undifferentiated tumors showed aneuploidy. By contrast, 53% of ganglioneuroma showed diploidy and 47% aneuploidy with DNA index ranged from 1.12 to 1.19. Three of nine(33.3%) mature ganglioneuromas in contrast with five of eight(62.5%) ganglioneuromas with immature foci showed aneupolidy. Differentiating neuroblastoma tended to be aneuploid and ganglioneuroma with immature foci tended to be near-diploid. In conclusion, immunohistochemistry for NB-84, NSE and S-100 protein is useful for confirming neuronal, both neuronal and Schwannian, and Schwannian differentiation, respectively. Immunohistochemistry together with flow cytometric DNA analysis would be helpful to confirm the immature foci in ganglioneuroma.
Neuroblastoma

No abstract available.
46, XX Disorders of Sex Development* ; Adrenal Hyperplasia, Congenital* ; Female* ; Humans

In order to evaluate the genotoxic hazard among workers potentially exposed to low level petrochemical substances, the analyses of micronuclei (MN) and sister chromatid exchanges (SCEs) in lymphocytes were performed in 46 male workers (as exposed group) and 46 nonexposed subjects (as control group). Mean frequencies of MN and SCEs (respectively, 12.9/1000 cells and 6.5/cell) in exposed group were very significantly higher than those (10.2/1000 cells and 5.4/cell) in control group. And there were also significant differences in mean frequencies of MN and SCEs adjusted for age, employment duration, smoking, and drinking between two groups. Median frequencies of MN and SCEs in exposed group were very significantly higher than those in control group. Frequencies of SCEs were higher in smokers than in non-smoker. Frequencies of MN in smokers, however, were similiar to those of non-smoker. Interaction between exposure and smoking on MN and SCEs induction was not observed. The results suggest that there is genotoxic hazard in high risk group like workers handling carcinogens in petrochemical plants and the analyses of MN and SCEs are useful biomarkers for the exposure to hazard substances even at the level below the exposure limit.
Biological Markers ; Carcinogens ; Drinking ; Employment ; Humans ; Lymphocytes ; Male ; Sister Chromatid Exchange ; Smoke ; Smoking

PURPOSE: Marginal fit is a very important factor considering the restoration's long-term success. However, adding porcelain to copings can cause distortion and lead to an inadequate fit which exposes more luting material to the oral environment and causes secondary caries. The purpose of this study was to compare the marginal fit of 2 different all-ceramic crown systems before and after porcelain veneering. This study was also intended to verify the marginal fit of crowns originated from green machining of partially sintered blocks of zirconia (Lava CAD/CAM system) and that of crowns obtained through machining of fully sintered blocks of zirconia (Digident CAD/CAM system). MATERIAL AND METHODS: 20 crowns were made per each system and the marginal fit was evaluated through a light microscope with image processing (Accura 2000) at 50 points that were randomly selected. Each crown was measured twice: the first measurement was done after obtaining a 0.5 mm coping and the second measurement was done after porcelain veneering. The means and standard deviations were calculated and statistical inferences among the 2 groups were made using independent t-test and within the same group through paired t-test. RESULTS: The means and standard deviations of the marginal fit were 61.52 +/- 2.88 micrometer for the Digident CAD/CAM zirconia ceramic crowns before porcelain veneering and 83.15 +/- 3.51 micrometer after porcelain veneering. Lava CAD/CAM zirconia ceramic crowns showed means and standard deviations of 62.22 +/- 1.78 micrometer before porcelain veneering and 82.03 +/- 1.85 micrometer after porcelain veneering. Both groups showed significant differences when analyzing the marginal gaps before and after porcelain veneering within each group. However, no significant differences were found when comparing the marginal gaps of each group before porcelain veneering and after porcelain veneering as well. CONCLUSION: The 2 all-ceramic crown systems showed marginal gaps that were within a reported clinically acceptable range of marginal discrepancy.
Ceramics ; Crowns ; Dental Porcelain ; Light ; Zirconium

In the autoimmune hemolytic anemia abnormal antibodies directed against red cells are produced by the patient himself. The pathologic mechanism in which erythrocyte survival is decreased as a result of the deposition of specific antibody on the red cell surface is uncertain. The abnormal antibody is most freqeuntly of the lgG or IgM class and occasionally may be IgA. A case of autoimmune hemolytic anemia was confirmed by CBC and Coombs test in a 11years old boy. We are reporting the laboratory data and our experiences of the patient with the reviews of the literatures.
Anemia, Hemolytic, Autoimmune* ; Antibodies ; Coombs Test ; Erythrocyte Aging ; Humans ; Immunoglobulin A ; Immunoglobulin M ; Male

Neuroblastoma is one of the most common malignant tumor in infant and children, which arises from sympathetic nerveous system. this is almost always lethal in children when regional extension or dissemination exists at the time of diagnosis. An exception exists in a special pattern of metastasis to the liver, skin or bone mawow which has batter prognosis. We had experienced a case of generalized disseminated neuroblastoma in 7years and 6 month olds girl which was arised from posterior mediastinum. It was confirmed histologically and by a value of urine VMA. So, we had treated with anticancer drugs I.V. for 68 weeks but the patient expired on May, 1978. Pertinent literatures concerning neuroblastoma were also reviewed.
Child ; Diagnosis ; Female ; Humans ; Infant ; Liver ; Mediastinum ; Neoplasm Metastasis ; Neuroblastoma* ; Prognosis ; Skin

PURPOSE: Esophagojejunal anastomotic complications after a total gastrectomy include leakage, stenosis, bleeding, and abscess formation. Especially, the mortality rate for esophagojejunal anastomotic leakage is 80%. Although these complications hare been reduced by the usage of the EEA stapler, they are still serious and depend on various factors: the surgeon's experience, the stage of disease, the extent of surgical intervention, the method of operation, and the patient. Some local factors, such as vascularization of the graft, traction on the anastomosis suture line, and local infections, have been implicated as contributing to these complications. MATERIALS AND METHODS: During the period 1995~2003, of the 850 gastrectomies for gastric carcinomas, 171 were intra-abdominal total gastrectomies. All of these 171 operations were performed by one surgeon using a routine D2 lymph-node dissection and a 25-mm EEA stapler on an antecolic end-to-side esophagojejunostomy. In the 77 cases a seromuscular reinforced suture at the esophagojejunostomy site was performed, and in 94 cases, a whole layer reinforced suture with absorbible materials was used. We evaluated the incidence of complications according to age, sex, stage of patients, and combined resection. Also, we compared the incidences of complications for seromuscular and whole layer reinforced sutures. RESULTS: The complications are major leaks (2.9%), minor leaks (3.5%), stenosis, bleeding (1.8%), and abscess formation (1.8%). In the five cases of major leaks, there were four mortalities with operative methods. The other patients with stenosis, bleeding, and abscess formation were treated conservatively with success. The incidences of complications were not related with age, sex, stages, and combined resection. The incidences of complications for the whole layer reinforced suture group (2.9%) were less than those for the seromuscular reinforced group (8.8%, P=0.04). CONCLUSION: The most serious complication of esophagojejunal anastomosis is major leakage with an 80% mortality. The other complications are stenosis, bleeding, and abscess formation, for which no mortalities occurred during this study. Whole layer suture of the esophagojejunal anastomotic site is an important method for preventing leakage.
Abscess ; Anastomotic Leak ; Constriction, Pathologic ; Gastrectomy* ; Hares ; Hemorrhage ; Humans ; Incidence ; Mortality ; Sutures ; Traction ; Transplants

We experienced a case of congenital tuberculosis in 17 days old female infant who had miliary tuberculosis. She was admitted at the gae fo 17 days with a history of high fever and irritavility for 2 days, when she seemed to be weak, underdeveloped and undernourished, and there were diminished aeration on the right lung fields, hpatosplenomegaly,and stat ionary weight She was lst child born of 30 year-old woman after a 6 year of infertility and was normally born at the 37 weeks?gestation period with 2,500 Gm. Weight. She began to cough at the age of 7 days. Her mother, aged 28, was diagnosed as having tuberculous pelvic peritonitis, when she was operated on the left salphingostomy. Infan's chest film showed miliary tubercuous pattern and gastric washing exam. For A.F.B was positive but tuberculin skin test was negative. Finding of endometrial biopsy of mother was consistent with tuberculous eddometritis Diagnosis was established by onset,chilical syndrom,gastric washing, chest film, family history and maternal endometrial biopsy. The reviw of the related literature was made briefly.
Adult ; Biopsy ; Child ; Cough ; Diagnosis ; Female ; Fever ; Humans ; Infant ; Infertility ; Lung ; Mothers ; Peritonitis ; Skin Tests ; Thorax ; Tuberculin ; Tuberculosis* ; Tuberculosis, Miliary

BACKGROUND: The role of platelet in the pathogenesis of acute coronary syndrome and cerebral thrombosis is well known and the platelet inhibitors are used widely for primary and sccondary prevention of cardiovascular disease. Aspirin is the least expensive and most widely used antiplatelet agent and its effect is associated with its ability to inhibit plateletthromboxane A2 synthesis. The effectiveness of aspirin is dependent on its ability to block the formation of thromboxane A2. Ticlopidine is another popular antiplatelet agent used today in the era of stent implantation for treating coronary artery obstructive disease(CAOD) with aspirin. The mechanism of action of ticlopidine is clearly different from that of aspirin. It is concluded recently that ticlopidine is an inhibitor of ADP binding to platelets. The inhibition of ADP binding to platelets by ticlopidine is very nicely correlated with its does and the inhibition of platelet aggregation. Therefore, in this study, antiplatelet effect of low dose enteric-coated aspirin in place of aspirin and combined therapy with low does enteric-coated aspirin plus ticlopidine were evaluated in the normal subjects. METHOD: IN twenty normal subjects, platelet aggregation tests with adenosine diphosphate(ADP) and collagen were performed baseline, after I week adminisrtation of enteric-coated aspirin, and in randomly selected ten among twenty normal subjects, I week administration of enteric-coated aspirin and ticlopidine. The maximal aggregation rate was calculated by measuring the maximal change of the light transmittance after addition of aggregating agents. RESULT: Low does enteric-coated aspirin inhibited platelet aggregation in response to collagen significantly. Less than 25% of antiaggregation effect was noted in about 50% of subjects with low dose enteric-coated aspirin when platelet aggregation was induced by ADP. Ticlopidine in combination with low does enteric-coated aspirin potentiated the inhibitory effect significantly on platelet aggregation in response to ADP. CONCLUSION: Effect of low dose enteric-coated aspirin alone on platelet aggregation in response to ADP stimulation was weak and showed variablity, comparing to collagen stimulation. The combined treatment of ticlopidine plus aspirin was synergistically inhibited platelet aggregation responding to ADP stimulation. Therefore to achieve the synergistic inhibition of platelet aggregation to ADP and collagen stimulation, combination theraphy might be a effective regimen.
Acute Coronary Syndrome ; Adenosine ; Adenosine Diphosphate ; Aspirin* ; Blood Platelets* ; Cardiovascular Diseases ; Collagen ; Coronary Vessels ; Intracranial Thrombosis ; Platelet Aggregation ; Platelet Aggregation Inhibitors ; Stents ; Thromboxane A2 ; Ticlopidine*

BACKGROUND: Patients with end-stage renal disease have farther excess rate of coronary artery disease (CAD) than nonuremic population. There is a possibility that atherosclerosis may aggravate renal insufficiency, but it is not certain. Pulse pressure was also significantly increased in patients with chronic renal disease (CRD), and had been implicated in the development of atherosclerosis. The purpose of this study is to identify the association of atherosclerotic CAD and pulse pressure with renal disease progression in patients with mild CRD METHODS: The patients with mild CRD who had been followed up more than 3 years in Asan medical center, Seoul, Korea, were included. We evaluated their CAD via coronary angiography, and followed up their serum creatinine levels and other parameters assumed to be associated with progression of CRD. All clinical and laboratory parameters were analyzed by multivariate logistic method. And we examined the association between pulse pressure and progression of CRD with related factors via multivariate logistic analysis. RESULTS: Total 87 patients (54 were men and 33 were women) were included in this study. 45 patients had coronary heart disease and 42 had not. Comparison of CRD progression between the patients who had CAD (n=45) and those who had not (n=42) showed a significant difference (76% vs 52%, p< 0.05). Mean arterial pressure, pulse pressure, presence of diabetic nephropathy, 24hour urine protein, total cholesterol were the parameters associated with the progression of CRD. Among of them, proteinuria and mean arterial pressure were independent risk factors for renal disease progression. There was a significant association between CAD and pulse pressure. CONCLUSION: Atherosclerotic CAD and increased pulse pressure were associated with renal disease progression in the patients with mild renal insufficiency.
Arterial Pressure ; Atherosclerosis ; Blood Pressure* ; Cholesterol ; Chungcheongnam-do ; Coronary Angiography ; Coronary Artery Disease* ; Coronary Disease ; Coronary Vessels* ; Creatinine ; Diabetic Nephropathies ; Disease Progression ; Humans ; Kidney Failure, Chronic ; Korea ; Male ; Proteinuria ; Renal Insufficiency ; Renal Insufficiency, Chronic ; Risk Factors ; Seoul