C-erbB-2, one of epidermal growth factor receptor gene family, may have an important role in progression of transitional cell carcinoma (TCC of the urinary bladder. We herein immunohistochemically examined 52 bladder TCC specimens for expression of c-erbB-2 gene product to investigate its prognostic value. Interrelationship between expression of c-erbB-2 and stage, grade, expression of proliferating cell nuclear antigen (PCNA), and clinical outcomes were analyzed. Overexpression of c-erbB-2 was significantly higher in invasive tumors as compared with superficial tumors and in high grade tumors as compared with low grade tumors (p<0.005). However, there were no significant correlations between the degree of expression of c-erbB-2 and progression-free survival in patients with superficial bladder TCC as well as actual-survival in patients with invasive bladder TCC. There also was no significant correlation between the expression of c-erbB-2 and PCNA. These results suggest that c-trbB-2 may be an important marker of malignant potentials and invasiveness of bladder TCC, but immunohistochemical study for its expression in bladder TCC may not provide additional prognostic information to stage and grade of the tumors.
Carcinoma, Transitional Cell ; Disease-Free Survival ; Genes, erbB-2 ; Humans ; Proliferating Cell Nuclear Antigen ; Receptor, Epidermal Growth Factor ; Urinary Bladder Neoplasms* ; Urinary Bladder*

Adult Wilms' tumor unlike that of childhood, is a rare disease and there is controversy as to whether all these are indeed truly Wilms` tumor or in actually represent sarcomatoid renal carcinoma. The pathologic hallmarks of this neoplasm are distinctive and it is histologically similiar to the childhood tumor. The therapeutic guidelines that govern childhood Wilms` tumor should be applied to adult Wilms` tumor and prognosis is worse than that of childhood. A case of Wilms' tumor in 24 year-old female was presented.
Adult* ; Female ; Humans ; Prognosis ; Rare Diseases ; Wilms Tumor* ; Young Adult

PURPOSE: To establish the basis for a non-invasive and non-destructive assessment of the mechanical properties during natural fracture healing by analyzing the vibrational property of the fracture healing and comparing the vibrational property, the bone healing status (as determined by X-ray) and the mechanical strength parameters. MATERIALS AND METHODS: The tibial shafts of rabbits were broken under general anesthesia. The rabbits were sacrificed at 2, 4, 6 weeks after the fracture, then X-rays of the fractured tibias were sequentially taken to detect the fracture healing. The vibration mode and the biomechanical strength were measured. RESULTS: According to the results of a multiple regression analysis, the standardized coefficients of callus, apposition, lateral angulation, DAMP1, FREQ1 in the fractured tibias, were -0.80, -0.23, -0.21, -0.25, -0.25. In normal contralateral tibias, the standardized coefficients of the area, FREQ1, DAMP1, FREQ2, DAMP3 were -0.73, 0.28, 0.41, 0.39, -0.25. CONCLUSION: A monitoring of the fracture healing process that utilizes the frequency response function is thought to be useful in detecting the early phase of healing within 4 weeks. Additional studies on the vibrational characteristics of the healing bones after a clinical union or after simillar pathologies should be pursued so that future diagnostic applications ca be made.
Anesthesia, General ; Bony Callus ; Fracture Healing ; Fractures, Bone* ; Pathology ; Rabbits ; Tibia ; Vibration

BACKGROUND: Pleural effusion is a common clinical problem and many clinical and laboratory evaluations, such as tumor marks, have been studied to discriminate malignant pleural fluid from benign pleural fluid. However their usefulness in the diagnosis of pleural effusion is still not established fully. We studied the diagnostic value of cyfra 21-1 in diagnosis of malignant pleural effusion. METHODS: Pleural fluid was obtained from 45 patients with malignant diseases(32 lung cancer patients, 13 metastatic malignant diseases) and 47 patients with benign diseases. The level of cyfra 21-1 in the pleural fluid and serum were determined using a CYFRA 21-1 enzyme immunoassay kit(Cis-Bio International Co.). The t-test was used for comparison between two diseases groups and receiver operating characteristic(ROC) curves were constructed by calculating the sensitivities and specificities of the cyfra 21-1 at several points to determine the diagnostic accuracy of the cyfra 21-1. RESULTS: In patients with primary lung cancer, the level of cyfra 21-1 in the pleural fluid was significantly higher than those of patients with benign diseases and had positive correlations between the level of cyfra 21-1 in the pleural fluid and serum levels. In the ROC curve analysis of the pleural fluid, the curve for primary lung cancer group was located closer to the left upper corner and the cut off value, sensitivity and specificity of the cyfra 21-1 of the primary lung cancer group was determined as 22.25ng/ml, 81.8% and 78.7% respectively. CONCLUSIONS: Our data indicates that the measurement of cyfra 21-1 level in pleural effusion has useful diagnostic value to discriminate malignant pleural effusion in primary lung cancer from benign pleural effusion.
Diagnosis ; Diagnosis, Differential* ; Humans ; Immunoenzyme Techniques ; Lung Neoplasms ; Pleural Effusion* ; Pleural Effusion, Malignant ; ROC Curve

When the endotracheal tube is removed, blood pressure elevates and heart rate increases. In order to evaluate the hemodynamic changes after removal of a new developed device-laryngeal mask airway, we measured the change of the systolic & diastolic blood pressure and heart rate of 120 patients undergoing general anesthesia. The results were elevation of blood pressure and heart rate after extubation or removal on both groups immediately. But the degree of changes were 18.7+/-1.6% in the endotracheal tube groups and 12.3+/-1.4% in the laryngeal mask airway groups in systolic blood pressure respectively. Therefore the degree of changes of the laryngeal mask airway groups was significantly small (p<0.05). The comparison of the change of diastolic blood pressure was not significant. The degree of the change in heart rate was 19.6+/-2.8% in the endotracheal tube groups and 9.2+/-2.2% in the laryngeal mask airway groups. Therefore the degree of the ehange in blood pressure and heart rate of the laryngeal mask airway groups was significantly small (p<0.05).
Anesthesia, General ; Blood Pressure* ; Heart Rate* ; Heart* ; Hemodynamics ; Humans ; Laryngeal Masks* ; Masks

Typhoid fever is an acute systemic febrile disease caused by Salmonella typhi. The classic picture of the disease consists of prolonged continuous or remitting fever, abdominal pain, diarrhea, rose spots and delirium. Salmonella infection can lead to diffuse organ involvement, including bone, lung, thyroid, kidney, liver, spleen, heart, pericardium, intestine and skin and cause a variety of complications. Pulmonary manifestations occur in only 1 percent of the patients. Mild cough with sticky sputum is the earliest symptom and bronchitis, pneumonia and lung abscess were presented. Recenfly we experienced a case of typhoid fever complicated by bronchitis, dysplasia in a 37-year-old male physician who was improved with ceftriaxone and ciprofloxacin We report this case with a review of the literature.
Abdominal Pain ; Adult ; Bronchitis* ; Ceftriaxone ; Ciprofloxacin ; Cough ; Delirium ; Diarrhea ; Fever ; Heart ; Humans ; Intestines ; Kidney ; Liver ; Lung ; Lung Abscess ; Male ; Pericardium ; Pneumonia ; Salmonella Infections ; Salmonella typhi ; Skin ; Spleen ; Sputum ; Thyroid Gland ; Typhoid Fever*

Typhoid fever is an acute systemic febrile disease caused by Salmonella typhi. The classic picture of the disease consists of prolonged continuous or remitting fever, abdominal pain, diarrhea, rose spots and delirium. Salmonella infection can lead to diffuse organ involvement, including bone, lung, thyroid, kidney, liver, spleen, heart, pericardium, intestine and skin and cause a variety of complications. Pulmonary manifestations occur in only 1 percent of the patients. Mild cough with sticky sputum is the earliest symptom and bronchitis, pneumonia and lung abscess were presented. Recenfly we experienced a case of typhoid fever complicated by bronchitis, dysplasia in a 37-year-old male physician who was improved with ceftriaxone and ciprofloxacin We report this case with a review of the literature.
Abdominal Pain ; Adult ; Bronchitis* ; Ceftriaxone ; Ciprofloxacin ; Cough ; Delirium ; Diarrhea ; Fever ; Heart ; Humans ; Intestines ; Kidney ; Liver ; Lung ; Lung Abscess ; Male ; Pericardium ; Pneumonia ; Salmonella Infections ; Salmonella typhi ; Skin ; Spleen ; Sputum ; Thyroid Gland ; Typhoid Fever*

PURPOSE: To evaluate the stability, activity level and clinical results of an autologous hamstring and Bone-patellar tendon-bone (BPTB) graft in an Anterior cruciate ligament (ACL) reconstruction. MATERIALS AND METHODS: Between September 1997 and January 2003, 22 patients with an ACL reconstruction with an autologous four strand hamstring tendon, and 30 patients with a BPTB autograft were enrolled in this study. At the time of the final follow-up, the patients were evaluated by stress radiographs using a Telos instrument, the Lysholm score, Tegner activity score, IKDC activity grades, and anterior kneeling pain. RESULTS: An evaluation of the anterior laxity using the Telos instrument revealed no significant difference in the hamstring and BPTB groups: side to side difference 2.6 mm in the hamstring group vs 2.3 mm in the BPTB groups (p>0.05). The Lysholm score improved from a preoperative score of 58 to a postoperative score of 88 in the hamstring groups and from 56 to 91 in the BPTB groups. The Tegner score for the hamstring groups was 2.4 preoperatively and 5.8 at the final follow up, and the Tegner score for the BPTB groups were 2.3 and 6.2 preoperatively and after the last follow-up, respectively. The Tegner score was similar in the two treatment groups (p>0.05). According to the IKDC rating system, 9% were normal and 64% were almost normal in the hamstring group. In the BPTB group, 10% were normal and 67% were almost normal. Anterior kneeling pain after a reconstruction with the hamstring tendon autograft (13%) was significantly less common than with the patellar tendon autograft (37%)(p<0.05). CONCLUSION: The hamstring autograft for an ACL reconstruction decreased the incidence of anterior kneeling pain and produced equivalent clinical results to the BPTB autograft.
Anterior Cruciate Ligament Reconstruction* ; Anterior Cruciate Ligament* ; Autografts ; Bone-Patellar Tendon-Bone Grafts* ; Follow-Up Studies* ; Humans ; Incidence ; Patellar Ligament ; Tendons ; Transplants

PURPOSE: This study was performed to evaluate the clinical usefulness of femoral double tunnel PCL reconstruction using the tibial inlay technique. MATERIALS AND METHODS: From January 2001 to August 2002, 21 patients underwent femoral double tunnel PCL reconstruction using the tibial inlay technique and were followed for more than 21 months. The mean age was 37 years old (range 16 to 60 years old). The clinical results were evaluated with the Lysholm score and the Tegner activity score. Radiologic analysis was performed using the posterior stress and Telos stress views. RESULTS: The average preoperative Lysholm and Tegner activity scores were 46.0 and 2.3, respectively, and improved to 94.5 and 5.3, respectively, at the final follow-up. The average preoperative scores of the combined posterolateral ligament injury group was 40.6 and 1.5, which improved to 77.1 and 3.5 at the final follow-up. Preoperatively, two cases were grade II, 13 cases were grade III, 6 cases were grade IV, and posterior translation was an average of 14.6 mm. Postoperatively, 18 cases were grade I, 3 cases were grade II, and posterior translation was an average 2.9 mm. In a push view using the Telos device (15 kg) at 30o and 90o of knee flexion, there were no differences in posterior translation. Complications were limitation of flexion (3 cases), limitation of extension (1 case) and quadriceps atrophy (mean, 2.6 cm). CONCLUSION: It is suggested that femoral double tunnel PCL reconstruction with the tibial inlay technique using anterolateral and posteromedial bundles is an effective technique for the restoration of knee function, stability, and activity. However long-term evaluation of patients and comparisons with femoral single tunnel reconstruction are required to confirm the effectiveness of this procedure.
Adult ; Atrophy ; Follow-Up Studies ; Humans ; Inlays* ; Knee ; Ligaments ; Posterior Cruciate Ligament*

FA (Fanconi's Anemia) is an autosomal recessive disorder that is characterized by pancytopenia with bone marrow hypoplasia, diverse congenital abnormalities and an increased predisposition towards malignancy. The mainstay of the treatment for these cancers has been surgery, because of the hypersensitive reactions of FA patients to DNA cross- linking agents or radiation. Therefore, there has been no effective therapy for advanced squa mous cell carcinoma. We report here on a patient suffering from advanced multiple squamous cell carcinoma and hepatocellular carcinoma along with an FA, and this patient was treated with gefitinib.
Bone Marrow ; Carcinoma, Hepatocellular* ; Carcinoma, Squamous Cell* ; Congenital Abnormalities ; DNA ; Fanconi Anemia* ; Humans ; Pancytopenia