In the present study, immunohistochemical detection of p53 oncoprotein was performed to determine whether the grade of differentiation and the histologic type of gastric adenocarcinoma, and the degree of atypia accompanied with adenoma can be related to p53 mutation. Paraffin sections of 22 gastric adenomas and 56 gastric adenocarcinomas were examined for the overexpression of p53 oncoprotein with the avidin-biotin peroxidase complex staining procedure. The obtained results were as follows; 1. All the 22 cases of adenomas and 16 cases of well differentated adenocarcinomas showed uniformly negative staining. 2.Seven of 18 cases of moderately differentiated adenocarcinomas(39%), and five of 30 cases of poorly differentiated adenocarcinomas(17%) exhibited p53 protein expression. 3. Three of 29 cases of diffuse type (10%) and 9 of 19 cases of intestinal type(47%) exhibited p53 protein expression. These results suggest that p53 mutation is important in carcinogenesis of the intestinal type of gastric adenocarcinoma, and there is no correlation between the differentiation of gastric adenocarcinoma and the degree of p53 oncoprotein overexpression.
Adenocarcinoma ; Adenoma

Occurrence of a retroperitoneal duplication cyst associated with a heterotopic pancreas is rare. We report a case of a retroperitoneal duplication cyst associated with a heterotopic pancreas. A 35-year-old male was admitted, presenting with back pain. A pelvic computed tomographic scan disclosed a 10 cm-sized cystic mass filling the lower pelvis and displacing the rectosigmoid colon anteriorly. Histologically, the cyst wall was lined partly by mucin-secreting columnar epithelium, showing atypical hyperplasia and partly by a gastric fundic-type and a colonic-like mucosa. Beneath the epithelium, organized bundles of smooth muscle were arranged in two layers analogous to smooth muscles layers of the bowel and a small piece of pancreatic tissue were present in the smooth muscle wall of the cyst.
Adult ; Back Pain ; Colon ; Epithelium ; Humans ; Hyperplasia ; Male ; Mucous Membrane ; Muscle, Smooth ; Pancreas* ; Pelvis

Posterior lumbar fusion is a safe and effective surgical method for diseases, such as lumbar stenosis, spondylolisthesis, lumbar instability, spinal deformity, and tumor. Pedicle screw (PS) fixation was first introduced by Bouche and has been adopted as the gold standard for posterior lumbar fusion. Santoni and colleagues introduced a new methodological screw insertion technique that uses a cortical bone trajectory (CBT), described as that from a medial to lateral path in the transverse axial plane and caudal to the cephalad path in the sagittal plane through the pedicle for maximum contact of the screw with the cortical bone. Owing to the lower invasiveness, superior cortical bone contact, and reduced neurovascular injury incidence, the CBT technique has been widely used in posterior lumbar fusion; however, these advantages have not been proven in clinical/radiological and biomechanical studies. We designed the present study to review the existing evidence and evaluate the merit of CBT screw fixation. Six electronic databases were searched for relevant articles published in August 2020 using the search terms “cortical bone trajectory,” “CBT spine,” “CBT fixation,” “cortical pedicle screws,” and “cortical screws.” Studies were analyzed and divided into the following groups: “biomechanics investigation,” “surgical technique,” and “clinical/radiological studies.” Most studies compared CBT and PS fixation, and the CBT screw fixation method showed better or similar outcomes.

Adrenal pseudocysts are uncommon lesions which usually occur as a result of hemorrhage within the adrenal tissue. Adrenal hemorrhage is usually associated with severe stress, sepsis, pregnancy, syphilis, leukemia, or anticoagulant therapy but during steroid therapy, it is very rare. We report a case of adrenal pseudocyst that resulted from hemorrhage into the adrenal gland and is probably related to the exogenous administration of steroids. The patient was a 57-year-old woman who was treated with oradexon for 20 years for the treatment of a maculopapular lesion on her thigh as well as for arthritis. She underwent a right adrenalectomy due to the adrenal cystic mass. The wall of the cystic mass was composed of a thick layer of hyalinized fibrous tissue with remnants of adrenal cortical tissue on the outer aspect. The inner surface had no lining cells and the wall of the cyst contained many calcified plaques with hemosiderin pigment.
Pregnancy ; Female ; Humans ; Cysts

BACKGROUND: Despite progress in intubation techniques, dental trauma is one of the most common complications of general anesthesia. As the flange of the Macintosh blade appears responsible for most dental injuries, we modified the ordinary Macintosh blade by partially removing its flange and evaluated the effectiveness of the modified blade in terms of reducing potential of dental injuries. METHODS: Four hundred and eighty-three patients scheduled for elective surgery requiring general anesthesia with endotracheal tube placement were included in this prospective study. Laryngoscopy was performed twice, once using an ordinary Macintosh No. 3 blade and once using the modified Macintosh blade. The modification consisted of reducing the height of the flange by partial removal, as described by Callander et al. When optimum visibility of the glottis was obtained, the distance between the flange of the blade and the upper incisor was measured. We compared blade-tooth distances and laryngoscopic views for the two blades. RESULTS: The modified blade with low-height flange provided more distance than the ordinary type of blade (P<0.01). The incidence of direct contact between the blade and the upper tooth was 20.3% when the ordinary blade was used, and nearly 80% of these did not involve direct contact when using the modified blade. In addition, the modified blade provided a greater field of view than the ordinary blade (P<0.01). CONCLUSIONS: The modified Macintosh blade used in this study proved to be a useful device, which could reduce dental injuries and provide a better laryngoscopic view during laryngoscopy.
Anesthesia, General ; Glottis ; Humans ; Incidence ; Incisor ; Intubation ; Intubation, Intratracheal ; Laryngoscopes* ; Laryngoscopy ; Prospective Studies ; Tooth

No abstract available.

The antihypertensive effect and side reactions of perdipine was studied in 22 cases of essential hypertension using 20mg 3 times daily regimen for average period of 5 weeks. 1) Average reduction of 20mmHg in systolic and 17mmhg in diastolic pressure was observed and percentile reduction was 11.90% and 14.92%, respectively. The overall effect rate was 81.82%. The blood pressure lowered significantly after 2 weeks of treatment both in systolic and diastolic pressure. 2) There was no significant change in heart rates before and after treatment. 3) No specific side reaction was observed except 1 case in which discontinued the medication because of severe headache and fatigability on the 1st day of medication.
Blood Pressure ; Headache ; Heart Rate ; Hypertension ; Nicardipine*

We evaluated the clinical effects of Nicorandil in 27 patients (17 male and 10 female) with ischemic heart disease (17 patients of stable effort angina, 3 patients of unstable effort angina, 6 patients of spontaneous angina, 1 patient of variant angina) in terms of the effect on the anginal pain, electrocardiographic changes and side effects. The results obtained were as follows; 1. The pulse rate was not changed by the drug administration and blood pressure were decreased slightly by Nicorandil in a daily dose of 15 mg divided into 3 dose, but these decrease were not significant in statistical meaning. 2. Improvement in EKG changes was observed in 9 patients (69%) among the 13 patients who showed abnormal EKG initially. 3. Anti-anginal effect of nicorandil were excellent in 14 patients, good in 8 patients, fair in 3 patients and so the rate of global improvement was 82%. 4. Nicorandil had side effects in 7 patients, headache (4 patients), palpitation, ocular pain, edema, but these were transitory and tolerable except of one case who could not be continued because of severe headache.
Angina Pectoris* ; Blood Pressure ; Edema ; Electrocardiography ; Headache ; Heart Rate ; Humans ; Male ; Myocardial Ischemia ; Nicorandil*

PURPOSE: This study aimed to determine the best cutoff line for insulin-like growth factor (IGF)-I and insulin-like growth factor binding protein (IGFBP)-3 to discriminate between growth hormone deficiency (GHD) patients and the control group. METHODS: Two hundred thirty subjects with normal controls (129 boys and 101 girls, aged 7-15 years), 14 patients with complete GHD (12 boys and 2 girls), and 17 patients with partial GHD (9 boys and 8 girls) were studied. IGF-I serum concentrations were measured by radioimmunoassay (RI), and IGFBP-3 concentrations were measured by immunoradiometric assay (IRMA). RESULTS: The receiver operating characteristic (ROC) plot analysis showed that the best IGF-I and IGFBP-3 cutoff line was at -1 standard deviation (SD). By comparing IGF-I serum levels of GHD children within 1 SD of normal control, we determined the sensitivity (S) (87.5-100%) and specificity (Sp) (80-84.6%) according to the age group. For IGFBP-3 , we determined the following values: S (58.7-85.7%) and Sp (79.2-85.5%). Eleven of 1 4 patients with complete GHD (78.5%) and 16 of 17 patients with partial GHD (94.1%) had IGF-I concentrations equal to or below -1 SD of the control group mean. Ten of 12 complete GHD children (83.3%) and 13 of 17 partial GHD children (76.5%) had IGFBP-3 concentrations equal or below -1 SD of the control group mean. CONCLUSION: We conclude that the measurement of IGF-I and IGFBP-3 concentrations might provide essential supplementary data in the diagnostic evaluation of patients with GHD. Our results support the need to use cutoff lines based on below -1 SD of the control.
Aged ; Carrier Proteins ; Child ; Growth Hormone ; Humans ; Immunoradiometric Assay ; Insulin-Like Growth Factor Binding Protein 3 ; Insulin-Like Growth Factor I ; Radioimmunoassay ; ROC Curve ; Sensitivity and Specificity