No abstract available.
Germ Cells* ; Neoplasms, Germ Cell and Embryonal*

The incidence of adenocarcinoma of the uterine cervix had shown an increasing tendency, and which is related to the increased use of oral contraceptives or prevalent in human papillomavirus infection. Endocervical glandular dysplasia or adenocarcinoma in situ are occasionally associated with squamous neoplasms of the uterine cervix. This study was aimed to evaluate the histologic features and the incidence of endocervical glandular lesions associated with squamous neoplasms, the presence of human papillomavirus infection-suggesting histologic findings in adjacent squamous neoplasms and the immmunohistochemical findings of endocervical glandular lesions for carcinoembryonic antigen. The materials used were 105 cases of microinvasive and invasive squamous cell carcinoma, and 83 cases of squamous intraepithelial lesions which are consisted of 142 radical or total hystrectomy products and 46 conization or loop excision products. The results are as follows; 1. Among 188 cases, six cases(3.2%) had shown foci of high grade glandular dyaplasia, and 19 cases(10.1%) revealed the areas of low grade glandular dysplasia. There was no adenocarcinoma in situ case. 2. In four of six high grade glandular dysplasia cases, microinvasive or invasive squamous cell carcinomas were associated. In low grade glandular dysplasias, sqaumous intraepithelial lesions were occcupying 68.4%. 3. HPV infection-suggesting histologic findings had accompanied all high grade glandular dysplasia cases and in 17 cases(89.5%) of 19 low grade glandular dysplasias. 4. In 2 of 5 high grade glandular dysplasias and in 1 of 19 low grade glandular dysplasias, the immunohistochemical reaction for carcinoembryonic antigen was similar to that of adenocarcinoma. In conclusion, the clinicopathologic importance of endocervical glandular lesions associated with squamous neoplasms of the uterine cervix should be kept in mind, and further study for the relationship between endocervical glandular lesions and human papillomavirus infection or hormonal influence will be continued.
Humans ; Incidence ; Adenocarcinoma

Detailed mechanism of uterine cervical cancer progression still remains unclear. Altered programmed cell death (apoptosis) and cellular proliferation are associated with the development of neoplasia. The authors investigated the expressions of bcl-2, which inhibit apoptosis, and caspase-3, which is involved in the induction of apoptosis and has been considered to be correlated with apoptosis, and proliferating activity according to the degree of malignancy in the squamous neoplasia of the uterine cervix. Correlation between bcl-2 and caspase-3 expression and proliferating activity was done. The materials were low grade squamous intraepithelial lesions (LSIL, n=15), high-grade squamous intraepithelial lesions (HSIL, n=15), microinvasive squamous cell carcinoma (n=15), and squamous cell carcinoma (n=15). Immunohistochemical stainings for bcl-2, caspase-3, and MIB-1 were done. bcl-2 and MIB-1 expressions were progressively increased in accordance with the increasing degree of malignancy, but caspase-3 immunoreactivity was higher in LSIL than invasive cancers. There was an inverse relationship between bcl-2 and caspase-3 expression, but the difference did not reach statistical significance. No significant correlation between MIB-1, bcl-2, and caspase-3 expressions was observed. These results suggest that an inhibition of apoptosis and the augmentation of proliferating activity of tumor cells might be separately involved in the development of the cervical squamous neoplasia.
Apoptosis ; Carcinoma, Squamous Cell ; Caspase 3* ; Cell Death ; Cell Proliferation ; Cervix Uteri* ; Female ; Uterine Cervical Neoplasms

PURPOSE: Henoch-Schonlein purpura nephritis(HSPN) accompanied by nephrotic syndrome(NS) is known to have a poor prognosis and effective treatment is still controversial, even though both corticosteroids and immunosuppresant have been used for therapy. Cyclosporine A(CsA) is a well known immunosuppresant and widely used in renal transplantation and glomerular diseases especially steroid resistant. The aims of this study was to evaluate the therapeutic effect of CsA and to compare CsA with previously reported our data of rifampin(RFP) and azathioprine(AZA) in children with HSPN accompanied by NS. METHODS: 37 HSPN patients with NS confirmed by renal biopsy were selected. Of these, 17 patients were treated with CsA(5 mg/kg/day) for 6-8 months, 7 children were treated with RFP(10-20 mg/kg/day) for 9-12 months and 13 patients were treated with AZA(2 mg/kg/day) for 8 months. Along with these regimens, low dose oral prednisolone(0.5-1 mg/kg, qod) was also used. Sequential renal biopsy was done in all patients 1 month after termination of treatment. RESULTS: Complete remission rate of nephrotic syndrome was 5S.8% in CsA, 57.1% in RFP and 38.4% in AZA group after 17, 22, 11 months of mean follow-up period. Overall remission rate including partial remission was 88.2% in CsA, 85.7% in RFP and 84.6% in AZA group. Disappearance rate of hematuria was 58.8% in CsA, 57.1% in RFP and 46.2% in AZA group. Improvement of grade of clinical status was observed in 17 out of 17 CsA, 7 out of 7 RFP and 10 out of 13 AZA group. Improvement of pathologic class on sequencial renal biopsy was shown in 5 CsA(29.4%), none RFP(0%) and 2 AZA group(12.4%). Improvement on histologic immune-deposition was seen in 15 CsA(88.2%), 6 RFP(85.9%) and 4 AZA group(30.8%). CONCLUSION: In conclusion, Both CsA and RFP treated groups showed better result in complete remission rate of nephrotic syndrome and significant inprovement of histologic immune-deposition compared with AZA treated group(p=0.004). So, we recommend CsA and RFP rather than AZA for immunosuppresant treatment in HSPN with nephrotic syndrome.
Adrenal Cortex Hormones ; Biopsy ; Biopsy, Fine-Needle* ; Breast* ; Child ; Cyclosporine ; Diagnosis* ; Follow-Up Studies ; Hematuria ; Humans ; Kidney Failure, Chronic ; Kidney Transplantation ; Nephrotic Syndrome ; Prognosis ; Purpura, Schoenlein-Henoch

No abstract available.
Animals ; Cricetinae* ; Mice*

Angiogenesis is essential for tumor growth and metastasis, however, the prognostic value of neovascularization is undetermined. The aim of this study is to evaluate the prognostic significance of microvessel density (MVD) and vascular endothelial growth factor (VEGF) expression in breast carcinomas. An immunohistochemical stains for CD 31 (DAKO) to estimate MVD and VEGF (Santa Cruz) were done on 40 cases of invasive breast carcinoma. MVD was calculated as an average count of vessels per 200 power field in the most vascularized areas. VEGF expression was interpreted according to staining intensity and number of positive cells. Mean MVD was 35, and MVD was not correlated with lymph node metastasis or histologic grade, but high MVD (mean MVD>35) showed an increasing tendency in cases with larger size, negative ER/PR, and positive cathepsin D. All of the cases showed VEGF expression, but VEGF expression was not correlated with tumor size, histologic grade, lymph node metastasis, ER/PR status, and cathepsin D expression. These results suggest that MVD and VEGF expressions are not reliable prognostic factors.
Breast Neoplasms* ; Breast* ; Cathepsin D ; Coloring Agents ; Lymph Nodes ; Microvessels* ; Neoplasm Metastasis ; Vascular Endothelial Growth Factor A*

Anatomy of the pancreaticobiliary ductal system is so variable that one should think of its normal anatomy as nonexistent. But exact location of the termination of the common bile duct in important to the biliary surgeon when performing transduodenal exploration of the common bile duct, to the physician and radiologist when diagnosing pancreaticobilijary disease by ERCP. We report a case of Lnomalous termination of the common bile duct into thii. duadenal bulb diagnosed by ERCP and operative cholangiogram.
Cholangiopancreatography, Endoscopic Retrograde ; Common Bile Duct*

No abstract available.
Female ; Fetomaternal Transfusion* ; Pregnancy

PURPOSE: In this study the time point of effects that repeat exposure to simulation-based nursing training has on stress, interest in learning, and problem-solving abilities were identified. METHODS: Participants for this study were 75 nursing college students in Seoul. In a preliminary survey data were collected and measured for the general characteristics, stress, interest in learning, and problem-solving abilities of the students. Then, stress was assessed before performance of each of four-rounds of simulation training scenarios. After each simulation round, interest in learning and problem-solving abilities were assessed. RESULTS: With respect to stress, no significant differences were found when comparing the results of the preliminary survey to those of each of the simulation-based training exercises. For the sub-items of interest in learning, interest in nursing knowledge and interest in clinical training significantly increased between the preliminary survey and the 4th survey. Interest in lab training increased significantly at the 1st survey. Problem solving abilities showed a significant increase from the preliminary at each of the survey points. CONCLUSION: Increasing the exposure of nursing students to simulation-based training enhances their interest in learning and problem-solving abilities. Therefore it is necessary to have education strategies that includes various simulation experiences for students.
Education ; Exercise ; Humans ; Learning* ; Nursing* ; Patient Simulation ; Problem Solving ; Seoul ; Students, Nursing*

PURPOSE: The score for neonatal acute physiology (SNAP) based on physiologic derangements, is applied to variable fields including morbidity as well as mortality estimate. We evaluate the clinical usefulness of SNAP and SNAP variants for neonatal acute severity and mortality. METHODS: Twenty-one neonates were evaluated the SNAP, SNAP-PE, SNAP-II, and SNAPPE-II, who survived more than 24 hours in Neonatal Intensive Care Unit in Department of Pediatrics, Kyunghee University from July 2003 to December 2004. A study group included 21 neonates as death group and a control group matched for gestational age and birth weight. We analyzed the differences of clinical usefulness of SNAP and SNAP variants indices between the two groups. RESULTS: 1) SNAP:The scores were ranged 2-18 (median 6.5) in survival group and 9-31 (median 13.0) in death group. 2) SNAP-PE:The scores were ranged 2-48 (median 16.5) in survival group and 23-75 (median 32.0) in death group. 3) SNAP-II:The scores were ranged 0-16 (median 10.5) in survival group and 10-62 (median 21.0) in death group. 4) SNAPPE-II:The scores were ranged 0-45 (median 24.5) in survival group and 35-109 (median 44.0) in death group. The median values were higher in those who were died:SNAP<0.05 (P-value), SNAP-PE<0.01, SNAP-II<0.01, SNAPPE-II<0.01 showing the significant differences. CONCLUSION: The study shows that SNAP and SNAP variables are useful for the evaluation of acute severity and excellent predictors of neonatal survival. They would help the management of neonatal intensive care unit.
Birth Weight ; Gestational Age ; Humans ; Infant, Newborn* ; Intensive Care, Neonatal ; Mortality ; Pediatrics ; Physiology