We examined the nuclear overexpression of p53 protein by immunohistochemical analysis of the deparaffinized tumor tissue specimens from 45 patients with transitional cell carcinoma of the bladder. The data were then correlated with conventional prognostic variables such as histologic tumor grade, stage and DNA ploidy. In addition, we related the expression of the 53 protein to indicators of cellular proliferative activity, including proliferating cell nuclear antigen(PCNA), mean number of silver-binding nucleoar organizer regions(AgNORs) per nucleus, flow cytometric S-phase fraction(SPF) and proliferation index(PI). Survivals of the patients according to mutant p53 protein expression, stratified by histologic tumor grade and stage were analyzed.None of the urothelial cells from normal bladder specimens showed nuclear expression of mutant p53 protein. Mutant p53 protein expression was not associated with histologic tumor grade, stage, flow cytometric SPF and PI, but there was an association between mutant p53 protein expression and flow cytometric DNA ploidy with marginal statistical significance(p=0.0892) There was statistically significant difference of mutant p53 protein expression between low and high AgNORs counts per nucleus(p=0.0108), but here was no significant correlation between mutant p53 protein expression and PCNA expression rate. Using Kaplan-Meier analysis, we could not identify the statistically significant difference of survivorship between patients with and without mutant p53 expression. These results suggest that immunohistochemical analysis of bladder cancer specimens could be a good method of screening for the presence of mutant p53 protein, and mutant p53 protein expression may be an indicator of bladder cancer with more proliferative and/or aggressive activity, but it may not be an clinically useful prognostic factor in patients with bladder TCC.
Carcinoma, Transitional Cell ; DNA ; Humans ; Immunohistochemistry* ; Kaplan-Meier Estimate ; Mass Screening ; Mutant Proteins ; Nucleolus Organizer Region* ; Ploidies ; Prognosis ; Proliferating Cell Nuclear Antigen* ; Survival Rate ; Urinary Bladder Neoplasms ; Urinary Bladder*

The traditional aesthetic blepharoplasty has limitations in correcting the heaviness and bulkiness of the lateral orbital region. These limitation is due to presence of sub-orbicularis oculus fat(SOOF) which is defined as that layer of fibrofatty soft tissue deep to the orbicularis oculus muscle, superficial to orbital septum and orbital rim, and extending medially from supraorbital nerve and laterally to varying distance over the lateral upper orbit. Therefore authors performed resections of the SOOF in conjunction with aesthetic blepharoplasty in 15 patients, who visited the clinic with complaints of thickness and heaviness over their lateral eyebrow, often accompanied by tired or sad-looking appearance. We believe that in these patients the heaviness. bulkiness and fullness in the lateral upper orbital region were corrected effectively and smoothly in aesthetical aspect. No patients developed postoperative hematoma, dry eye syndrome, lacrimal gland injury and significant paralysis of the orbicularis oculus of corrugator muscle. Our department performed the SOOF resection to those who had bulkiness and heaviness in lateral upper orbital region. From this experience, the SOOF resection would appear to be a useful adjunct to standard blepharoplasty technique in selected patients. Since we achieved a satisfactory result aesthetically through this method on patients who showed proper indications, we are recording the indications, operative techniques and complications in addition to review of reference.
Blepharoplasty* ; Dry Eye Syndromes ; Eyebrows ; Hematoma ; Humans ; Lacrimal Apparatus ; Orbit ; Paralysis

PURPOSE: The purpose of this study is to verify the factors that determines burnout of nurses in emergency department. METHODS: The survey was given to 170 ED nurses which are located in Busan from July 1st to August 31st of 2012. The results were analyzed by descriptive statistics, t-test, ANOVA, pearson correlation coefficients and stepwise multiple regression using SAS 9.2 program. RESULTS: There were statistically significant differences in burnout depending on gender, position, workplace satisfaction, job satisfaction. Significant positive correlation between compassion fatigue and burnout was found. Also significant negative correlation was found between self-esteem, compassion satisfaction and burnout. Factors influencing burnout were self-esteem, compassion satisfaction and compassion fatigue with R2 value 58.0%. CONCLUSION: Considering these results, it seems that great efforts will be needed for reducing burnout by mitigating the emergency nurses' compassion fatigue and introducing programs to increase the self-esteem and compassion satisfaction.
Busan ; Emergencies ; Emergency Service, Hospital* ; Empathy* ; Fatigue* ; Job Satisfaction

It is important to maintain normal calcium concentration especially ionized calcium concentration in chronic renal failure patients on hemodialysis. The direct measurement of ionized calcium is less commonly used due to a lack of automated equipment as well as the cost of laboratory equipment. Numerous formulas for adjusted total calcium and calculated ionized calcium are used in clinical practice. We examined the relationship between direct measured ionized calcium and total calcium, corrected total calcium, calculated ionized calcium (formula of Nordin et al) in 53 chronic renal failure patients on hemodialysis. The results were as follows; 1) In predialysis group, plasma total and ionized calcium levels were 2.36+/-0.26, 1.04+/-0.21mmol/L respectively, and higher than normal controls. The correlations between plasma ionized calcium and total calcium, calculated ionized calcium, corrected total calcium were r=0.72 (P=0.0001), r=0.81 (P=0.0001), r=0.65 (P=0.0001) respectively. The plasma ionized calcium level was not correlated with the level of albumin, pH, phosphate, parathyroid hormone. 2) The plasma total and ionized calcium levels were significantly increased with hemodialysis and values were 2.49+/-0.14mmol, 1.14+/-0.14mmol/L respectively. The correlation between ionized and total calcium was r=0.41 (P=0.0021). These results suggested that the calculated ionized calcium (formula of Nordin et al) and total calcium can be used to predict the plasma ionized calcium level in chronic renal patients on hemodialysis.
Calcium* ; Humans ; Hydrogen-Ion Concentration ; Kidney Failure, Chronic ; Parathyroid Hormone ; Plasma ; Renal Dialysis*

Adenomyotic cysts are not uncommon disease, but their sizes are mostly lesser 5 mm. Reports of large adenomyotic cyst ( >5 mm ) are vere rary. These large sized hemorrhagic cysts arise from small sized cyst and may be caused by progressive expansion of cyst due to progressive menstrual bleeding. And the active secreting of cystic wall may play a part in making the large cyst. Authors observed a case of large adenomyotic cyst within myometrium occuring in o 39-year-old woman, and she was accompanied with both ovarian endometriomas. The cyst was 3 *3 cm sized, and had chocolate-colored thick viscous contents. Histologically, cystic wall was lined with endometrial type epithelium. Epithelium were composed of single layer columnar, partly ciliated cells. Stroma under glandular epithelium were thin throughout the cyst and resembled morphologically endometrial stroma in endometriosis and had red cells and hemosiderin-laden macrophages in places. We experienced one case of large adenomyotic cyst, so we report the case with a brief review of the concerned literatures.
Adult ; Animals ; Cystectomy* ; Endometriosis* ; Epithelium ; Female ; Hemorrhage ; Humans ; Macrophages ; Mice ; Myometrium*

We have observed that many patients who were under the treatment of orient medicine at the emergency department of our hospital but no data are available describing the medical habits of these patients. We therefore surveyed these patients seeking care in our ED to characterize their use of orient-medical therapies.4 analysis on the 427 patients who visited our ED and were under the treatment of orient medicine from Jan. 1996 to Jun. 1996 was carried out The results were as follows 1) There was no difference in the sex ratio (m:f=1:0.93). 2) With respect to the age groups of in patients, feat numbers of elderly people(50-year and 60-year old age group, over 60%) visited to our ED. 3) In the leading causes for visit to orient-medical therapy, cardiovascular disease ranked at the top(40%), followed by injury, gastrointestinal disease, and respiratory disease in decreasing order of frequency.4) The total numbers of CVA patients admitted to Oriental medicine were 105 patients. 5) The duration of admitted patients to Oriental medicine was prolonged for elderly patients.6) In the distribution of severity(AVPU) of adimitted patients, the number of patients with alert was 12 and verbal response was 91 painful response was 2 and unresponse was 0.
Aged ; Cardiovascular Diseases ; Emergencies* ; Emergency Service, Hospital* ; Gastrointestinal Diseases ; Humans ; Medicine, East Asian Traditional ; Middle Aged ; Sex Ratio

PURPOSE: Primary bone tumors of hindfoot are uncommon compared with other locations, and there have been few large-group studies. This study was designed to analyze the characteristics and the clinical results of the primary bone tumors of hindfoot. MATERIALS AND METHODS: Forty five cases in 44 patients who have been diagnosed from 1989 to 2011 were reviewed. The minimum follow-up period was 1 year. We retrospectively reviewed the medical records and images. RESULTS: Twenty six cases were male and 18 cases were female. Mean follow-up period was 33.1 months and mean age was 25.1 years. Forty four cases were benign and 1 case was malignant. Thirty six cases occurred in calcaneus and 9 cases were in talus. The most common benign bone tumor was simple bone cyst (20 cases), followed by intraosseous lipoma (12 cases), and chondroblastoma (4 cases). In calcaneus, there were 18 cases of simple bone cyst, and 12 cases of intrasosseous lipoma. In talus, there were 3 cases of chondroblastoma, 2 cases of simple bone cyst, and 2 cases of intraossesous ganglion. Many patients with hindfoot bone tumors presented with pain, but some were found accidentally. Patients received surgical procedures, such as curettage and bone graft, open reduction and internal fixation, tumor resection, and below knee amputation. CONCLUSION: Primary bone tumors of hindfoot are rare and can be misdiagnosed as ankle sprain or contusion. Although most are benign, malignant tumors cannot be ruled out, so early diagnosis and appropriate treatment is important.
Animals ; Ankle ; Bone Cysts ; Calcaneus ; Chondroblastoma ; Contusions ; Curettage ; Early Diagnosis ; Female ; Follow-Up Studies ; Ganglion Cysts ; Humans ; Knee ; Lipoma ; Male ; Medical Records ; Retrospective Studies ; Sprains and Strains ; Talus ; Transplants

No abstract available.
Child* ; Humans

Osteoporosis, a disease characterized by low bone mass and microarchitectural deterioration of bone tissue leading to enhanced bone fragility and fracture risk, is a major public health problem. The diagnostic methods for osteoporosis include simple radiography, bone scan, DXA (Dual energy X-ray Absortiometry) and biochemical markers of bone turnover. Optimal treatment and prevention of osteoporosis require modification of risk factors, particularly smoking cessation, adequate physical activity, and attention to diet, in addition to pharmacologic intervention. The estrogens and raloxifene both prevent bone loss in postmenopausal women, and the estrogens probably also decrease the risk of first fracture. There is good evidence that raloxifene prevents further fractures in postmenopausal women who already have had fractures and some evidence that estrogen does as well. Bisphosphonate prevents bone loss and reduces fractures in healthy and osteoporotic postmenopausal women and in osteoporotic men as well. Risedronate is more potent and has fewer side effects than alendronate and reduces the incidence of fractures in osteoporotic women. Calcitonin increases bone mineral density in early postmenopausal women and men with idiopathic osteoporosis, and also reduces the risk of new fractures in osteoporotic women. All of the agents discussed above prevent bone resorption, whereas teriparatide and strontium increase bone formation and are effective in the treatment of osteoporotic women and men. New avenues for targeting osteoporosis will emerge as our knowledge of the regulatory mechanisms of bone remodeling increases, although issues of tissue specificity may remain to be addressed.
Absorptiometry, Photon ; Alendronate ; Biomarkers ; Bone and Bones ; Bone Density ; Bone Remodeling ; Bone Resorption ; Calcitonin ; Diet ; Estrogens ; Etidronic Acid ; Female ; Humans ; Incidence ; Male ; Motor Activity ; Organ Specificity ; Osteogenesis ; Osteoporosis ; Public Health ; Raloxifene Hydrochloride ; Risk Factors ; Smoking Cessation ; Strontium ; Teriparatide ; Risedronate Sodium

Many authors asserted that the incidence of sexually transmitted disease, especially syphilis, increased recently. We examined the annual reactive rate of VDRL test in 23,886 persons who took a medical check-up for employment from March, 1978 to August, 1981 and the snnual rate of condyloma acuminatum among 91,334 dermatologic outpatients from 1976 to 1980 to estimate the recent trend in sexually transmitted disease. The overall reactive rate of VDRL test was 1.40% and the annual reactive rate is l.85% in 1978, 1.31% in 1979, 0.92% in 1980 and 4.87% in 1981. The biologic false positive rate of VDRL test was 17.5% among 126 patients in whom TPHA test was done, using TPHA test as standard. The overall rate of condyloma acuminatum patients was 0.16% and the annual rate was 0.13% in 1976, 0.21% in 1977, 0.16% in 1978, 0.15% in 1979 and 0.17% in 1980.
Employment ; Humans ; Incidence ; Outpatients ; Sexually Transmitted Diseases ; Syphilis*