A total of 53 gastric adenomas from endoscopically biopsied gastric mucosa were examined histopathologically. The average age at the time of endoscopic biopsy was 59 years, and gastric adenomas were found to be more frequent in the aged, particularly above the age of 50. The majority of adenomas occurred at the antrum. Concerning the shape of the adenomas, Yamada type II was more frequent (55%). All adenomas were accompanied by varying degree of intestinal metaplasia, and this findings suggest that gastric adenoma develops from intestinal metaplasia. In adenomas with severe atypia (grade III), endocrine cells (argyrophil and argentaffin cells) were markedly decreased or absent. Gastric adenocarcinomas coexistent with adenoma were seen in 5 (9.4%) out of 53 cases, and were more frequent in male than female patients (sex ratio, 4:1) and the average age was 61.4 years. It is suggested that there is a necessity of thorough follow-up study for definitive correlation between gastric adenoma and adenocarcinoma.
Adenocarcinoma ; Adenoma* ; Biopsy ; Endocrine Cells ; Female ; Follow-Up Studies ; Gastric Mucosa ; Humans ; Male ; Metaplasia ; Stomach

Supraclavicular lymph nodes are unique in that they can attract metastases from almost anywhere in the body and most common sites of metastasis from an unknown primary source. 125 cases which had been diagnosed as metastatic supraclavicular lymph node during the period between May 1983 and August 1991, were analyzed pathologically, and following distinctive characteristics could be outlined: 1) The most frequent sites of metastasis from primary lesions are lung (43%), stomach (23%), lymphoreticular (6%), biliary (5%), esophagus (2%), and pancreas (2%). 2) Histologic examination of metastatic supraclavicular lymph node revealed adenocarcinoma (57%), squamous cell carcinoma (12%), undifferentiated carcinoma (9%), small cell carcinoma (7%), malignant lymphoma (6%), malignant melanoma (1%) and undetermined carcinoma (8%). 3) In cases that histologic types were squamous cell carcinoma, undifferentiated carcinoma, small cell carcinoma and undetermined carcinoma, the most frequent primary site was lung.
Adenocarcinoma ; Carcinoma ; Carcinoma, Small Cell ; Carcinoma, Squamous Cell ; Esophagus ; Lung ; Lymph Nodes* ; Lymphoma ; Melanoma ; Neoplasm Metastasis ; Pancreas ; Stomach

The authors have been developed a menu-driven FoxBASE system for surgical pathology reporting and automatic encoding in Systematized Nomenclature of Medicine. The system requires no prior knowledge of FoxBASE and is readily installed on any IBM or it's compatible personal computer. Working sheet generation is automatically accompanied by data from previous cases on the same patient. Important data which include patient name, age, sex, surgical number, hospital unit number and encoded diagnoses, are stored on the hard disk permanently; complete reports are saved on floppy diskettes. Cases can be retrieved by patient name, surgical number, hospital unit number and SNOMED codes within 0.1 second. Daily work lists and listings of incomplete cases are easily obtained. This FoxBASE system has been in use for 1 year and 6 months and resulted in increased efficiency of retrieval and gathering of basic information for specific study, cost effectiveness, markedly diminished workload of typist and very short wasting time during complete restoration of data file for hard disk failure.

OBJECTIVE: The aim of the present study was to evaluate the E-cadherin expression in normal cervical epithelium, carcinoma in situ of the cervix, and invasive carcinoma of the cervix, and to define the role of E-cadlherin expression in tumor invasion with respect to clinicopathologic parameters. METHODS: We conducted immunodetection of E-cadherin in 58 cases of cervical carcinoma using immunohistochemistry in formalin-fixed, paraffin-embbeded sections, RUSULTS: E-cadherin expression was different between normal cervical epithelium and carcinoma in situ of the cervix, and between normal cervical epithelium and invasive carcinoma of the cervix(p<0.05). However, there was no difference in E-cadherin expression between carcinoma in situ and invasive carcinoma of the cervix. In invasive cervical carcinomas, expression of E-cadherin and the intensity of cytoplasmic E-cadherin expression did not correlate with histologic type, lymphvascular space invasion, lymph node metastasis, and stage of disease. CONCLUSION: It is mncluded that expression of E-cadherin is related to tumor invasion in cervical tissues, but further studies with regard toE-cadherin/catenin/cytoskeleton complex are needed to clarify the prognostic role of E-cadherin with respect to clinicopathologic parameters in invasive cervical carcinoma,
Cadherins ; Carcinoma in Situ ; Cervix Uteri* ; Cytoplasm ; Epithelium ; Female ; Immunohistochemistry ; Lymph Nodes ; Neoplasm Metastasis ; Uterine Cervical Neoplasms

Apoptosis is an intrinsic and fundamental biological process that plays a critical role in the normal development of multicellular organisms and in maintaining tissue homeostasis. Some of the well known regulators of apoptosis are cytokines of the tumor necrosis factor(TNF) ligand family, such as Fas ligand(Fas L) and TNF, which induce apoptosis by activation of their corresponding receptors, Fas and TNFR-1. Recently, a new member of the TNF family known as TRAIL (TNF-related apoptosis-inducing ligand) was identified and shown to induce p53-independent apoptosis in a variety of tumor cell lines but not in normal cells, Four human receptors for TRAIL were also recently identified and designated TRAIL-R1, -R2, -R3, and -R4. The aim of this study is to examine whether TRAIL and TRAIL receptots(-R1, -R2, -R3) are expressed in uterine cervical cancer and whether it is correlated with apoptosis, TRAIL and TRAIL receptors. The subjects were 20 patients who were diagnosed with cervical cancer. Western blotting was performed in 9 cases, immunohistochemical staining for TRAIL and TRAIL receptors(-R1, -R2, -R3) and TUNEL method for detection of apoptosis in 11 cases. There were proteins for TRAIL, TRAIL-R1, -R2, and -R3 in tissues from cervical cancer. All TRAIL receptors were expressed in both normal cervical epithelium and tumor cells, and TRAIL-Rl and -R2 were more strongly expressed in tumor cells than normal epithelium(p<0.05). Apoptosis correlated with expression of TRAIL-Rl and -R2(p<0.05). This study suggests that TRAIL induces apoptosis in cervical cancer through its receptors.
Antigens, CD95 ; Apoptosis ; Biological Processes ; Blotting, Western ; Cell Line, Tumor ; Cytokines ; Epithelium ; Homeostasis ; Humans ; In Situ Nick-End Labeling ; Necrosis ; Receptors, TNF-Related Apoptosis-Inducing Ligand* ; Uterine Cervical Neoplasms*

Purpose: The purpose of this study was to investigate the sleep duration, social jetlag (SJL), and subjective sleep disturbance according to the individual chronotype in rotating shift nurses. Methods: A total of 344 rotating 3-shift nurses (mean age 28.67 years) were recruited at one university affiliated hospital. They completed the following questionnaires, which were used to assess their chronotype and sleep: the morningness-eveningness questionnaire (MEQ), self-reported sleep duration of work days (SDW shift) and free days (SDF shift) in each shift (day [D], evening [E], night [N]), and sleep disturbance (Insomnia severity index, ISI). SJL shift was calculated as the difference in midsleep (MS = sleep onset+1/2 sleep duration) between work days (MSW) and free days (MSF). Results: Subjects were divided into 3 chronotype groups according to the MEQ; morning (MG, 4.4%) intermediate (IG, 57.8%), and evening groups (EG, 37.8%). SDW D was shortest (4.68 hr) and SDF E was longest (8.93 hr) in the EG. SJL D was longest in the EG (3.77 hr), and SJL N was longest in the MG (7.37 hr). The prevalence of sleep disturbance was 33.3% (MG), 29.6% (IG), and 40.0% (EG), respectively, without any statistical significance. Conclusion In order to improve the sleep of shift workers, it is recommended that the evening chronotypes should reduce the day shifts and the morning chronotypes should reduce the night shifts. We also propose a study to determine whether these shift assignments can improve the sleep in shift nurses.

Purpose: The purpose of this study was to investigate the sleep duration, social jetlag (SJL), and subjective sleep disturbance according to the individual chronotype in rotating shift nurses. Methods: A total of 344 rotating 3-shift nurses (mean age 28.67 years) were recruited at one university affiliated hospital. They completed the following questionnaires, which were used to assess their chronotype and sleep: the morningness-eveningness questionnaire (MEQ), self-reported sleep duration of work days (SDW shift) and free days (SDF shift) in each shift (day [D], evening [E], night [N]), and sleep disturbance (Insomnia severity index, ISI). SJL shift was calculated as the difference in midsleep (MS = sleep onset+1/2 sleep duration) between work days (MSW) and free days (MSF). Results: Subjects were divided into 3 chronotype groups according to the MEQ; morning (MG, 4.4%) intermediate (IG, 57.8%), and evening groups (EG, 37.8%). SDW D was shortest (4.68 hr) and SDF E was longest (8.93 hr) in the EG. SJL D was longest in the EG (3.77 hr), and SJL N was longest in the MG (7.37 hr). The prevalence of sleep disturbance was 33.3% (MG), 29.6% (IG), and 40.0% (EG), respectively, without any statistical significance. Conclusion In order to improve the sleep of shift workers, it is recommended that the evening chronotypes should reduce the day shifts and the morning chronotypes should reduce the night shifts. We also propose a study to determine whether these shift assignments can improve the sleep in shift nurses.

BACKGROUND: There is pressure difference depending on the height of hand position when blood pressure is taken, applying the oscillometric electronic digital BP(blood pressure) monitor. Authors have calculated the degree of BP differences, and evaluated the accuracy and effectiveness of the digital BP monitor comparing with the conventional Mercury Sphygmomanometer. METHOD: Randomized sixty cases consisting of in-patients and hospital workers were subjected for this study. BPs were taken at three different levels-nose level, heart level and knee level-on conventional sitting position applying OMRON Digital Automatic Blood Pressure Monitor and conventional Mercury Sphygmomanometer, and statistical analysis was made. RESULTS: At the nose level, systolic BP and diastolic BP were lower with 23.5mmHg and 18.9mmHg respectively, than at the heart level, while at the knee level, they were higher with 21mmHg and 17.5mmHg respectively, than at the heart level. No actual statistical difference of systolic and diastolic values between OMRON Digital Automatic Blood Pressure Monitoring method at the heart level and conventional Mercury Sphygmomanometeric method. CONCLUSION: Present study demonstrated significant discrepancy of BP values, in systolic and diastolic values, depending on the height of measured finger, when OMRON Digital Automatic Blood Pressure Monitor is applied in taking BP on conventional sitting position. However, no actual discrepancy of BP values was noted between two methods when BP is taken at heart level by OMRON Digital Automatic Blood Pressure Monitor and on brachial artery BP by conventional Mercury Sphygmomanometer. Thus OMRON Digital Automatic Blood Pressure Monitor could take the place of Mercury Sphygmomanometer in taking peripheral BP, which subsequently enable us to estimate central artery BP, which is believed to be better clinical index, through this much more handy electrical oscillometric device in the future.
Arteries ; Blood Pressure ; Blood Pressure Monitors ; Brachial Artery ; Electric Impedance ; Fingers ; Hand* ; Heart ; Hydrostatic Pressure ; Knee ; Nose ; Sphygmomanometers*

OBJECTIVE: Although heterotopic pregnancy is a rare disorder, it is on an increasing tendency due to frequent use of intrauterine device, pelvic inflammatory disease, ovulation induction, assisted reproductive technology. This study was performed the clinical experiences of seven patients with heterotopic pregnancy. METHODS: Seven patients diagnosed as heterotopic pregnancy were analyzed by various factors such as age, symptoms, beta-hCG levels, gestational age at the time of diagnosis, postoperative course, sites of ectopic pregnancy, use of assisted reproductive technology, multiple pregnancy, and mode of surgery. RESULTS: The mean age of patients was 29.1 years, and chief complaint was abdominal pain. Laparotomy was done in 5 patients, and laparoscopy was done in 2 patients. Four of seven patients delivered at term, two were twins, two singletones. CONCLUSION: In heterotopic pregnancy, identification of intrauterine pregnancy without confirmation of ectopic pregnancy is associated with poor prognosis for both mother and fetus, and hence early dignosis and careful examination are need. Ectopic pregnancy should be removed and intrauterine pregnancy should be maintained.
Abdominal Pain ; Diagnosis ; Female ; Fetus ; Gestational Age ; Humans ; Intrauterine Devices ; Laparoscopy ; Laparotomy ; Mothers ; Ovulation Induction ; Pelvic Inflammatory Disease ; Pregnancy ; Pregnancy, Ectopic ; Pregnancy, Heterotopic* ; Pregnancy, Multiple ; Prognosis ; Reproductive Techniques, Assisted ; Twins

A case of 42-year-oldI kidney transplant patient who developed invasive carcinama of the cervix after immunoauppresawe therepy is reported and the literature related to this diease is revuewed. The iatmgenic immunosuppresaionn renal transplantation recipients has been associated with increased incidence of malignancy in these patients. In particular, immunosuppressed women are al greater risk of developing cervical intraepithelial neoplasia and buman papillomavirus type 16 or 18 infection. So, all such individuals are required to receive periodic gynecologic examination before renal transplantation and at regular intervals thereafter so that the development of CIN may be diagnosed at an early Stage and treated effestively.
Allografts* ; Cervical Intraepithelial Neoplasia ; Cervix Uteri ; Female ; Humans ; Incidence ; Kidney ; Kidney Transplantation