No abstract available.
Citrobacter* ; Enterobacter*

No abstract available.
Escherichia coli* ; Escherichia*

No abstract available.
Capillaries* ; DNA* ; Vacuum*

PURPOSE: To report a case of Vogt-Koyanagi-Harada (VKH) disease in a pregnant patient treated with intravitreal triamcinolone injection. CASE SUMMARY: A 21-year-old female in the 19th week of gestation presented with bilateral blurring of vision associated with mild headache and tinnitus. Her initial best corrected visual acuity was 0.15 in the right eye and 0.3 in the left eye. Multiple serous retinal detachment and anterior chamber inflammation were observed, and VKH disease was diagnosed. Because of her pregnancy, the patient did not want high-dose systemic prednisolone therapy which may cause an abortion or low birth weight infant when used in a pregnant patient. Therefore, an intravitreal triamcinolone (4 mg/0.1 ml) injection was given in the right eye and topical steroid eye drops were used in the left eye. After 1 day, serous retinal detachment was significantly decreased and anterior chamber inflammation disappeared in the right eye. After 1 week, no serous retinal detachment was observed. In the left eye, serous retinal detachment was decreased after using steroid eye drops. After 10 days, serous retinal detachment disappeared but anterior chamber inflammation was still observed. After 1 month, best corrected visual acuity was 1.0 in both eyes and serous retinal detachment had not recurred. On follow-up, VKH disease had not recurred and a healthy normal weight infant was delivered. CONCLUSIONS: Intravitreal triamcinolone injection is an effective and safe treatment for VKH disease in pregnant women.
Anterior Chamber ; Eye ; Female ; Follow-Up Studies ; Headache ; Humans ; Infant ; Infant, Low Birth Weight ; Infant, Newborn ; Inflammation ; Ophthalmic Solutions ; Prednisolone ; Pregnancy ; Pregnant Women ; Retinal Detachment ; Tinnitus ; Triamcinolone* ; Uveomeningoencephalitic Syndrome* ; Vision, Ocular ; Visual Acuity ; Young Adult

BACKGROUND: Prophylactic administration of tranexamic acid (TA) reduces bleeding and transfusion requirement after open heart operations. This study was performed to determine the relationship between inhibition of fibrinolysis and TA blood concentration. METHOD: In phase I, recombinant tissue plasminogen activator[r-tPA (0, 50, 100, 150 ng/ml)] was added to the blood of volunteer and induced fibrinolysis. In phase II, 4 thromboelastography (TEG) models of severe fibrinolysis in which TA was added to achieve blood levels (0, 0.72, 1.44, 2.88 mg/ml) were compared to determine the lowest effective dose. In phase III, the lowest dose (0.72 mg/ml) was mixed with the blood and evaluated on TEG in open heart operation. In phase IV, a placebo group and study group receiving TA in an loading dose of 5 mg/kg before bypass following infusion of 2 mg/kg/hour. Used analysis is Mann Whitney U test and Wilcoxon rank signed test. RESULT: In phase I, fibrinolytic inhibition at A30/MA (r=0.752) and A60/MA (r=0.735) were linearly correlated with the blood r-tPA concentration. In phase II, severe fibrinolysis (r-tPA 100 ng/ml) was reversed completely at all doses of TA. In phase III, the fibrinolysis index at 10 min. after starting bypass, aorta declamping, and 1 hour after operation were improved when the patient's blood was treated with TA (0.72 mg/ml). In phase IV, blood treated with TA showed less fibrinolysis and better TEG results than the placebo group. CONCLUSION: A small dose of TA (5 mg/kg), which was determined by an in vitro model of fibrinolysis on TEG, was effective in preventing changes in fibrinolytic index during cardiopulmonary bypass in open heart surgery.
Aorta ; Cardiopulmonary Bypass ; Fibrinolysis* ; Heart* ; Hemorrhage ; Plasminogen ; Thoracic Surgery* ; Thrombelastography* ; Tranexamic Acid* ; Volunteers

BACKGROUND AND OBJECTIVES: Cyclin D1 expression is closely related with ER in breast cancer. We conducted this study to evaluate whether therapeutic response to tamoxifen is varied with levels of cyclin D1 expression in ER positive breast cancer patients. METHODS: Immunohistochemical assay for cyclin D1 protein was performed in 66 patients treated with tamoxifen for more than 2 year. Patient survival and correlation between cyclin D1 expression and biologic data of the patients were analyzed. RESULTS: Cyclin D1 expression was detected in 46 (69.7%) and significantly reduced in poorly differentiated cancer (p=0.023). Cyclin D1 expression was high in the tumors expressing Myc (15/15 vs. 31/51; p=0.002), and was markedly increased in the tumors in which p27Kip1 expression was repressed (30/38, 78.9%). However, the difference was not ststistically significant (p=0.051). There was no significant relationship between cyclin D1 expression and S-phase. Patients with tumors expressing cyclin D1 showed better disease free survival and overall survival but the difference was not statistically significant. CONCLUSIONS: Cyclin D1 expression was associated with cell differentiation bit not useful in discriminating high risk group with tamoxifen treatment. Cyclin D1 may have a role other than cell cycle regulator in ER positive breast cancer, such as differentiation signal.
Breast Neoplasms* ; Breast* ; Cell Cycle ; Cell Differentiation ; Cyclin D1* ; Cyclins* ; Disease-Free Survival ; Estrogens* ; Humans ; Prognosis ; Tamoxifen*

BACKGROUND: Cyclin D1 expression is closely related with ER in breast cancer. We conducted this study to evaluate whether therapeutic response to tamoxifen is varied with levels of cyclin D1 expression in ER positive breast cancer patients. MATERIALS AND METHODS: Immunohistochemical assay for cyclin D1 protein was performed in 66 patients tasted with tamoxifen for more than 2years. Patient survival and correlation between cyclin D1 expression and biologic data of the patients were analyzed RESULTS: Cyclin D1 expression was detected in 46 (69.7%) and significantly reduced in poorly differentiated cancer (p=0.023). Cyclin D1 expression was high in the tumors expressing Myc (15/15 vs 31/51; p=0.002), and was markedly increased in the tumors in which p27Kip1 expression was repressed (30/38, 78.9%). However, the difference was not statistically significant (p=0.051). There was no significant relationship between cyclin D1 expression and S-phase. Patients with tumors expressing cyclinD1 showed better disease free survival and overall survival but the difference was not statistically significant. CONCLUSIONS: Cyclin D1 expression was associated with cell differentiation but not useful in discriminating high risk group with tamoxifem treatment. Cyclin D1 may have a role in process other than cell cycle regulator in ER positive breast cancer, such as differentiation signal.
Breast Neoplasms ; Cell Cycle ; Cell Differentiation ; Cyclin D1* ; Cyclins* ; Disease-Free Survival ; Estrogens* ; Humans ; Prognosis ; Tamoxifen*

PURPOSE: Recently, it has been recognized that both cyclooxygenase-2 (COX-2) and inducible nitric oxide synthase (iNOS) produce important endogeneous factors of human tumor progression. The aims of this study is to investigate the correlation between the expression of COX-2 and iNOS and to assess the clinicopathological significance of COX-2 and iNOS expression in patients with colorectal cancer. METHODS: One hundred and five patients, who underwent curative resection of colorectal cancer from 1994 to 1997 were analyzed retrospectively. The monoclonal antibody to the COX-2 and iNOS were used for the immunohistochemical analysis. RESULTS: In 105 patients the COX-2 and iNOS positive rate were 86.7% and 69.5% respectively. There was significant correlation between COX-2 and iNOS expression (r= 0.378, P<0.01), that is, the lesions which expressed high level of COX-2 also expressed iNOS highly. The proliferation index (Ki-67 labeling index) was correlated with iNOS (P=0.013), and the microscopic differentiation with COX-2 (P=0.004). However, the expression of COX-2 and iNOS proteins did not correlate with any other clinicopathological parameters including patient survival. CONCLUSIONS: Although the pattern of positive expression was similar in both enzymes, the expression of both enzymes was not related to prognosis in patients with colorectal cancer. But COX-2 and iNOS seems to have a role not only in carcinogenesis but also tumor cells proliferation. To evaluate the exact role of these enzymes, further studies of the apoptosis and cancer metastasis and of links between the cancer related factors of COX-2 and iNOS are warranted.
Apoptosis ; Carcinogenesis ; Colorectal Neoplasms* ; Cyclooxygenase 2* ; Humans ; Neoplasm Metastasis ; Nitric Oxide Synthase Type II* ; Prognosis ; Retrospective Studies

BACKGROUND/AIMS: To investigate the efficacy of early scheduled follow-up endoscopic retrograde cholangiopancreatography (ERCP) after common bile duct (CBD) stone removal. METHODS: Patients who underwent endoscopic CBD stone removal and who had at least one risk factor for stone recurrence were enrolled. Six months after complete clearance of the CBD, patients underwent follow-up ERCP at an ambulatory care center, irrespective of symptoms. RESULTS: The incidence of symptoms and cholangitis at follow-up ERCP was significantly lower in Group A (ERCP at 6 months after stone removal) than that in Group B (ERCP at >6 months) (14.3% vs 71.4%, p=0.00; 9.5% vs 33.3%, p=0.02, respectively). However, the recurrence rates of CBD stones were not different between Groups A and B (33.3% vs 47.6%). When comparing the subgroups, Group AR (stone recurrence in Group A) displayed significantly fewer symptoms and lesser cholangitis and spent fewer days in the hospital than did Group BR (stone recurrence in Group B) (21.4% vs 70%, p=0.02; 14.3% vs 60%, p=0.02; 2.43+/-1.87 vs 6.10+/-3.35, p=0.00, respectively). CONCLUSIONS: Our data suggest that, irrespective of symptoms, early scheduled follow-up ERCP for patients who are at a high risk of recurrence is effective and safe.
Ambulatory Care ; Cholangiopancreatography, Endoscopic Retrograde ; Cholangitis ; Common Bile Duct ; Follow-Up Studies ; Humans ; Incidence ; Recurrence ; Risk Factors

BACKGROUND: Mad1 protein is known to repress Myc target genes and antagonize Myc function. We underwent this study to investigate the clinical implication of Mad1 expression in human breast cancer. MATERIALS AND METHODS: We performed immunohistochemical assay for Mad1 protein together with Myc in human brest cancer, along with tissues from normal and benign diseases. The data from protein assay were merged with clinical and biologic parameters of the patients. RESULTS: Of 66 patients with invasive ductal cancer, Mad1 expression was detected in 22(33.3%). Intensity and area of Mad1 expression significantly decreased in DCIS and invasive cancers while high levels of Mad1 expression were persistent in benign breast lesions. Mad1 expression was significantly reduced in poorly differentiated tumors(P<0.001). Expression of Mad1 was not associated with tumor size, lymph node status, and stage of the disease. We could not observe any correlation between S-phase and expression status of Myc or Mad1. Mad1 expression was closely linked to differentiation of the cancer cells and inversely correlated with Myc expression(P=0.042). In survival analysis, Mad1 possessed a prognostic significance to predict recurrence of the disease but not overall survival after CMF chemotherapy. CONCLUSIONS: In human breast cancer cells, expression of Mad1 seems to be downregulated while expression of Myc is amplified. Altered expression of Mad1 may play a role in malignant transformation of human mammary epithelial cells and represent an aggressive phenotype in human breast cancer.
Breast Neoplasms* ; Breast* ; Carcinoma, Intraductal, Noninfiltrating ; Drug Therapy ; Epithelial Cells ; Humans* ; Lymph Nodes ; Phenotype ; Prognosis ; Recurrence