The evaluation of the proliferative potential of malignant neoplasm is of major interest for predicting their biological behavior. MIB-1, a monoclonal antibody against the Ki-67 antigen, is a marker of cell proliferation, which is widely applied to human cancers recently. To assess the growth potential of uterine endometrial carcinoma, we performed immunohistochemical staining of MIB-1 in 34 cases of endometrial adenocarcinoma (endometroid type) from the paraffin sections. We evaluated its correlation with p53 overexpression and known prognostic factors including FIGO grade, nuclear grade, myometrial invasion, and estrogen and progesterone receptors. As a result, the MIB-1 labelling index was significantly correlated with FIGO grade, nuclear grade and myometrial invasion (p<0.05) and there was no significant correlation between MIB-1, ER or PR status. The expression of p53 protein showed significant correlation with FIGO grade and nuclear grade (p<0.05) and there was no significant correlation among p53 protein, myometrial invasion, ER and PR status. The MIB-1 labelling index revealed striking difference between p53 positive and p53 negative group (p<0.05). We concluded that MIB-1 labelling index is associated with poor prognostic parameter in endometrial adenocarcinoma, and may be a useful marker for predicting tumor of high grade and deep myometrial invasion, if MIB-1 labelling index is more than 50% and is accompanied by p53 overexpression.
Adenocarcinoma* ; Cell Proliferation ; Endometrial Neoplasms ; Estrogens ; Female ; Humans ; Ki-67 Antigen ; Paraffin ; Receptors, Progesterone ; Strikes, Employee

Anisakiasis is a parasitic disease of the gastrointestinal tract caused by ingestion Of raw or undercooked fish containing the marine nematode larvae belong to the subfamily Anisakinae. The adult worms are intestinal parasites of marine mammals. Eggs are passed in the feces of these mammals and develop to the second stage larvae in the sea water. They are eaten by crustaceans in which the larvae develop to the third stage. When fish or squid eat the infected crustaceans the larvae migrate to the body cavity or the muscle. The infected fish or squid is eaten by marine mammals the larvae attach to the wall of the stomach and then undergo adult worm. In Korea, human anisakiasis is not rare. The clinical manifestations are variable and depend on the involving site of gastrointestinal tract. The frequent sites are stomach and small intestine, and large intestine is rarely involved. Recently we experienced two cases of ileal anisakiasis occurred in 54-year-old female and 46-year-old female patients. The symptoms were upper and lower abdominal pain, nausea, and vomiting. The resected ileums in case I and 2 measured 12.5 x 2.5 cm and 15.0 x 2.0 cm, respectively. The mucosa and submucosa were thickened. In case 1, submucosal penetration of a white thread-like parasite was seen. The ileum showed submucosal edema, and extensive infiltration of eosinophils, neutrophils, lymphocytes, histiocytes, and plasma cells from mucosa to mesentery with or without mucosal ulceration. The Anisakis larvae are found in the submucosa and propria muscle. They have thick multilayered smooth cuticle, many somatic muscle cells, triradiated esophagus with numerous tall columnar cells, renette cell, and Y-shaped lateral chords. Reproductive organ is absent. In Korea, the previously reported 14 cases and present 2 cases of the intestinal anisakiasis mainly involved ileum, but the cause was not mentioned.
Adult ; Male ; Female ; Humans

The secretary meningioma is a distinct variant of meningioma that revealed characteristic light microscopic, immunohistochemical and ultrastructural features of epithelial and secretary differentiation, which was named as a distinct subtype of meningioma by Alguacil-Garcia et al in 1986. We experienced 2 cases of secretary meningioma. One was a 53-year-old female who had suffered from sudden onset of dizziness for I day. The computerized tomography revealed a sharply marginated well enhanced mass in temporal lobe. The other was a 59-year-old female who had suffered from dizziness for 8 years. The computerized tomography revealed a well demarcated lobulated mass in petrosal ridge. In both cases, multiple hyaline inclusions were scattered in the background of meningothelial meningioma. They were PAS positive, diastase resistant, stained yellow with van Gieson, and did not stain with reticulin in contrast to Psammoma bodies. The immunohistochemistry revealed positive reaction for EMA, CEA, a-FP and cytokeratin. T'he electron microscopic study revealed interdigitation with desmosomes and abundant intracellular lumina. They were lined by numerous microvilli and filled with granular material which was composed of electron dense homogenous material, me branous material, and small membrane-bound vesicles. Microvilli were filled with electron dense material identical to the material in the lumina, and some of them were interconnected with electron dense material in the lumina. It was concluded that secretary activity of the meningothelial cells and degenerated microvilli were involved in the pathogenesis of hyaline inclusions.
Female ; Humans ; Meningioma

Invasive micropapillary carcinoma is a recently defined unusual variant of invasive breast carcinoma characterized by the formation of micropapillae within clear spaces separated by delicate fibrocollagenous stroma. This study was designed to examine clinicopathologic features of invasive micropapillary carcinoma of the breast. Sixteen cases of invasive micropapillary carcinoma were retrieved from the files of the Department of Pathology, Yeungnam University College of Medicine. We evaluated their clinicopathologic findings including patients' age, tumor size, nuclear grade, vascular invasion, axillary lymph node status, presence of extensive intraductal carcinoma, estrogen and progesterone receptors, p53, c-erbB-2, MIB-1 labelling index and follow-up data and compared this results with those of 292 cases of invasive ductal carcinoma, not otherwise specified. The incidence of invasive micropapillary carcinoma was 4.2% of all invasive breast carcinoma, and the mean age of the patients was 46 years. Nine cases were pure form (over 75% of micropapillary growth pattern in the tumor) and seven cases were mixed form. The results of clinicopathologic findings, except vascular invasion and axillary lymph node status, of the 16 cases of invasive micropapillary carcinoma were not different from those of the 292 cases of invasive ductal carcinoma, not otherwise specified (p>0.05). However, the rate of vascular invasion and axillary lymph node metastasis was significantly higher in invasive micropapillary carcinoma (p <0.05). Of 16 cases, five cases had distant metastasis during follow-up period, and one patient died of cancer. Although the mechanism of higher vascular invasion and lymph node metastasis in micropapillary growth pattern could not be determined, we propose that invasive micropapillary carcinoma should be recognized as a separate entity with increased risks of vascular invasion and axillary lymph node metastsis.
Breast Neoplasms ; Breast* ; Carcinoma, Ductal ; Carcinoma, Intraductal, Noninfiltrating ; Estrogens ; Follow-Up Studies ; Humans ; Incidence ; Lymph Nodes ; Neoplasm Metastasis ; Pathology ; Receptors, Progesterone

PURPOSE: The purpose of this study was to investigate the effect of SBAR communication program on nurse's perception about communication and attitudes toward patient safety. METHODS: A single-group pre-post experimental study was conducted. A SBAR education program was provided to 167 nurses working in 9 general wards of a hospital in Seoul. A total of 153 questionnaires were included for the final analysis. Statistical analysis included analysis of variance, paired sample t-test, and Cochran-Mantel-Haenzel test. RESULTS: After applying SBAR communication education, nurses perceived significant improvement in three of the five categories of communication between nurses and doctors; satisfaction (p=.001), accuracy (p=.001), and understanding (p=.002). The indicators of communication between nurses were also improved significantly in the order of accuracy (p=.001), satisfaction (p=.001), shift communication (p=.001), and openness (p=.016). The scores of nurse's attitudes toward patient safety demonstrated a significant increase in the five categories out of the six; perception of management (p=.001), working condition (p=.001), safety climate (p=.001), teamwork climate (p=.001), job satisfaction (p=.012). CONCLUSION: It is recommended that nurses and doctors use SBAR communication in their practice. Developing education programs and utilization methods is required for the effective establishment of SBAR communication.
Climate ; Education ; Humans ; Job Satisfaction ; Patient Safety ; Patients' Rooms ; Seoul

PURPOSE: The purpose of this study was to determine the effects of self-esteem improvement program on self-esteem, depression, and interpersonal relationship in chronic schizophrenia patients living in the community. METHODS: The research design was a non-equivalent pre and post control group design. One of two community mental health centers was randomly assigned to receive the intervention and the other served as a control. Eight patients in the intervention group and ten in the control group participated. For the intervention group, the self-esteem improvement program was provided in 60-minute session once a week for 12-weeks. Measurements were Korean version of self-esteem scale (SES-K), Korean version of beck depression inventory (BDI-K), and Korean version of interpersonal relationships (IR-K). RESULTS: The only statistically significant difference between the experimental and control group was for interpersonal relationships. For the experimental group, there were statistically significant differences in self-esteem and interpersonal relationships. CONCLUSION: The results indicate that this type of program has a positive effect on self-esteem and interpersonal relationships and can be a feasible type of intervention program for community dwelling patients with chronic schizophrenia.
Community Mental Health Centers ; Depression* ; Humans ; Research Design ; Schizophrenia*

Carcinosarcoma of the esophagus is a rare neoplasm composed of both carcinoma and spindle sarcomatous area. Usually the carcinoma component is a squamous cell carcinoma but rarely adenocarcinoma or undifferentiated carcinoma is found. The histogenesis of the sarcomatous component is still unknown. A case of ulcerated polypoid lesion with a stalk in esophagus was reported. Microscopically it was composed of spindle shaped cells interminled with squamous cell carcinoma and small cell carcinoma nests. No distinct transition between spindle shaped cells and carcinoma are was observed. Immunoreactivity to cytokeratin was observed in both carcinomatous and spindle cell component, but electron microscopic examination failed to demonstrated desmosome or tonofilaments in spindle cells. Undifferentiated small cell nests were reactive to neuron specific enolase and contained membrane bounded secretory granule in electron microscopy.
Adenocarcinoma

This study was conducted to assess the prognostic value of tumor angiogenesis and Cathepsin-D in breast carcinoma, by correlating them with other clinicopathologic prognostic factors. In order to estimate microvessels within the tumor, an immunohistochemical method using monoclonal antibodies for factor VIII-related antigens (DAKO-vWf, F8/86) was used, and they were counted (perx200 field) in the most active areas of neovascularization. For the expression of Cathepsin-D, an immunohistochemical method using monoclonal antibodies (Novocastra, NCL-CDm) was performed. The microvessel count ranged from 8 to 346 per x200 field and the mean (+/-SD) was 72.46+/-54.96. The microvessel count was correlated with the estrogen receptor status, and it was also correlated with the tumor size when it was graded into four groups (1-33, 34-67, 68-100, >100), but was not correlated with other clinicopathologic parameters. Cathepsin-D was expressed in 40% (46/115) of the cases, but it was statistically correlated with the tumor size only. In conclusion, the expression of Cathepsin D and the degree of angiogenesis in breast cancer showed a correlation with the tumor size only. Therefore, they do not appear to be good prognostic parameters, according to the present study.
Antibodies, Monoclonal ; Breast Neoplasms ; Breast* ; Carcinoma, Ductal* ; Cathepsin D ; Estrogens ; Microvessels ; Prognosis ; von Willebrand Factor

In spite of vigorous efforts to enhance appropriateness of blood usage in surgery, it is recognized that there are still not a few overuse and misuse of blood products in Korean hospitals. To assure appropriate use of blood, continuous monitoring and controlfling blood orders, particularly for surgical operations, should be implemented. The indicator of 'ratio of crossmatching to transfusion' (C/T ratio) has been focalized on in this regard. The authors investigated C/T ratio for eight hospitals, evenly distributed in their geographical location as well as size. Only elective surgeries operated from March 1 to May 31, 1995 were included for analysis. Standardized survey format was distributed, and retrospective reviews of medical records were performed by volunteer surveyors from each hospital after two sessions of pre- survey education. The results were as follows. Average C/T ratio, for all hospitals and all surgeries, was 1.76. Differences in C/T ratio by sex, months, clinical departments, blood components were not significant. However, the ratio showed increasing tendency with ages. The C/T ratio on the average was not higher, compared with the recommended guideline. However, due to study' s limitations ini standardization of survey method and verification of data, we could not conclude that current status of appropriateness of blood use is satisfactory. In addition, to pervasively use the C/T ratio as a quality indicator for blood use management, supplementary measures, such as standardization of data, should be adopted.
Surveys and Questionnaires ; Education ; Medical Records ; Quality Indicators, Health Care* ; Retrospective Studies ; Volunteers

Epithelial-myoepithelial carcinoma and basal cell adenocarcinoma are uncommon, low-grade malignant epithelial neoplasms of salivary gland. They occur predominantly in the parotid glands with frequent recurrences and occasional distant metastases. We report an unusual case of combined epithelial-myoepithelial carcinoma and basal cell adenocarcinoma within the same mass of the parotid gland in a 32-year-old woman. To the best of our knowledge, this is the first such a combined carcinoma case.
Adenocarcinoma* ; Adult ; Carcinoma ; Female ; Humans ; Neoplasm Metastasis ; Parotid Gland* ; Recurrence ; Salivary Glands