No abstract available.

PURPOSE: Tamoxifen has been well known as an effective anti-tumor agent against breast cancer. The important role of bcl-2 and p53 proteins in tamoxifen-induced apoptosis of breast cancer cells has been suggested. However, the paradoxical fact that bcl-2 over-expression is assdegrees Ciated with better prognosis in clinic has not yet been clearly explained. To investigate this paradox, we analyzed the effect and dynamics of bcl-2 and p53 on the apoptosis after treatment of breast cancer cells with tamoxifen. MATERIALS AND METHODS: The human breast cancer cell lines MCF-7 and MB MDA-468 were treated with 17-betaestradiol (E2) and tamoxifen. RESULTS: Following tamoxifen treatment, MCF-7 cells underwent apoptosis accompanied by reduced bcl-2 expression. E2 pre-treatment led to the inhibition of tamoxifen-mediated apoptosis and bcl-2 down-regulation. When MB MDA-468 cells were treated with E2 or tamoxifen, bcl-2 and p53 protein expression did not change and apoptosis did not develop. CONCLUSION: We observed that the down-regulation of bcl-2 by tamoxifen treatment can facilitate the apoptosis of breast cancer cells without p53 mutations. This finding was consistent with clinical experiences in which bcl-2 positive tumors were assdegrees Ciated with more indolent phenotypes in breast cancer.
Apoptosis* ; Breast Neoplasms* ; Breast* ; Cell Line* ; Down-Regulation ; Humans* ; MCF-7 Cells ; Phenotype ; Prognosis ; Tamoxifen

Arthroscopy assisted anterior cruciate ligament(ACL) reconstruction with the autogenous bone-patellar tendon-bone(BPB) graft showed more favorable results in the hand of experienced surgeon, but it requires long leaming curve for skillful techniques. On the contrary, open method is very easy to learn, but it needs more soft tissue dissection affecting rehabilitation and morbidity. Arthrotomy through the patellar tendon harvest site provide good surgical approach without supplementary incision, and hence short operation time and good clinical result can be expected. The purpose of this study is to introduce this technique and compares the results with arthroscopic one. We performed 67 cases of ACL reconstruction with autogenous BPB graft through the patellar tendon harvest site. We recorded and analysed the physical findings, Lysholm score and Cybex test at preoperative and postoperative 3, 6, 12 months. Average Lysholm score was 58.0 preoperatively and 90.5 at postoperative one year. Cybex test at one year follow-up showed decreased muscle strength of quadriceps, which was nearly the same result with arthroscopic technique. In conclusion, this technique provided similar excellent clinical results comparing with the arthroscopy assisted ones. Furthermore, this technique had merits of short learning curve and short operation time.
Anterior Cruciate Ligament Reconstruction* ; Anterior Cruciate Ligament* ; Arthroscopy ; Follow-Up Studies ; Hand ; Learning Curve ; Muscle Strength ; Patellar Ligament* ; Rehabilitation ; Transplants

Traumatic diaphragmatic hernia may show a delayed presentation and it rarely simulates pleural effusion. We report here on two asymptomatic cases that were diagnosed by performing chest CT.
Hernia, Diaphragmatic ; Hernia, Diaphragmatic, Traumatic* ; Omentum ; Pleural Effusion* ; Tomography, X-Ray Computed

Pulmonary artery sling is a rare vascular anomaly wherein the left pulmonary artery arises from the right pulmonary artery and then traverses between the esophagus and the trachea toward the hilum of the left lung. Associated anomalies are common, particularly those of the tracheobronchial tree, which have been found in more than 50% of patients. Cardiovascular anomalies such as persistent left superior vena cava, atrial septal defect, ventricular septal defect, patent ductus arteriosus and aortic arch anomalies are also found not infrequently. We have experienced a 20 day-old female who had showed severe respiratory distress and cyanosis. She was diagnosed as pulmonary artery sling associated with tracheobronchial hypoplasia by echocardiography, angiography, esophagography and bronchography. We report this case with related literature review.
Angiography ; Aorta, Thoracic ; Bronchography ; Cyanosis ; Ductus Arteriosus, Patent ; Echocardiography ; Esophagus ; Female ; Heart Septal Defects, Atrial ; Heart Septal Defects, Ventricular ; Humans ; Lung ; Pulmonary Artery* ; Trachea ; Vena Cava, Superior

BACKGROUND: Human papillomavirus(HPV) 16 is the most frequently found oncogenic HPV type in cervical cancer and the early protein E7 is considered to be one of the two major proteins involved in malignant transformation and maintenance of the transformed phenotype of the cells. It is suggested that serologic detection of anti-HPV antibody in serum can be used as a marker for HPV-associated cervical cancer. We evaluated the efficacy of enzyme-linked immunosorbent assay(ELISA) method for detecting antibodies circulating in human sera against E7 proteins of HPV 16 in patients with cervical cancer/cervical intraepithelial neoplasia(CIN) and in normal controls. MATERIALS AND METHODS: We have developed a ELISA method using fusion proteins of HPV 16 E7, expressed in E. coli, as antigen to detect the anti-E7 antibody in human sera. Sera from 276 women(90 patients with invasive cervical cancers, 8 patients with CIN III and 178 healthy women) were tested for the presence of antibodies to E7 proteins. The results were compared with that of polymerase chain reaction(PCR) method. RESULTS: Fifteen(16.7 %) of the 90 cervical cancer sera, one(12.5 %) of the 8 CIN sera and twelve (6.7 %) of the 178 normal sera were reactive with E7 proteins(cut-off value : absorbance (A) = 0.079, x + 3 SD). The detection rate of HPV 16 DNA by PCR were 45.5 %(41/90) in cervical cancer patients, 37.5 %(3/8) in CIN III patients, and 11.8 %(21/178) in normal controls Twelve(29.3 %) of 41 cervical cancer patients harboring HPV 16 DNA showed positive for the anti-E7 antobody. Although the positivity with ELISA was rather lower that of PCR. A statistically significant trend of increasing seropositivity was obtained( 2=6.48 ; df=1 ; p=0.011). The concordance rate between the results of ELISA and PCR was 64.4 %. CONCLUSION: The increasing seropositivity for HPV 16 E7 antibodies in association with malignant progression suggest that these antibodies may be a useful marker for HPV 16-associated cervical cancer. But the facts that in only about one-fifth portion of patients with cervical cancer showed the positive results in ELISA restricts the direct clinical applications. A search for more sensitive and specific serologic method for the detection of antibodies to HPV 16 E7 is needed.
Antibodies* ; DNA ; Enzyme-Linked Immunosorbent Assay* ; Human papillomavirus 16 ; Humans* ; Phenotype ; Polymerase Chain Reaction ; Serologic Tests ; Uterine Cervical Neoplasms*

BACKGROUND: Recent studies suggest that coffee consumption has an influence on kidney function. This study investigated the relationship between habitual coffee consumption and renal impairment in Korean women, in consideration of diabetic status. METHODS: This study involved 2,673 women aged 35 to 84 years who had participated in the Fourth Korea National Health and Nutrition Examination Surveys, conducted in 2008. Habitual coffee consumption was classified into three categories: less than 1 cup per day, 1 cup per day, and 2 or more cups per day. Renal function impairment was defined as an estimated glomerular filtration rate less than 60 mL/min/1.73 m2 by the Modification of Diet in Renal Disease equation. RESULTS: The prevalence of diabetes and renal function impairment was higher in women who drank < 1 cup of coffee per day. Compared with drinking < 1 cup of coffee per day, the odds ratio (OR) for renal function impairment was significantly lower (OR, 0.59; 95% confidence interval [CI], 0.37 to 0.95; P = 0.03) in those who habitually drank > or = 2 cups per day after adjusting for multiple confounding factors. When data were stratified according to the presence of diabetes, coffee consumption > or = 2 cups of coffee per day showed an inverse association with renal function impairment in only diabetic women (OR, 0.14; 95% CI, 0.02 to 0.88; P = 0.04), compared with consumption < 1 cup of coffee per day. CONCLUSION: In a representative sample of Korean women, coffee consumption was significantly associated with a decreased risk of renal impairment especially in middle and elderly-aged diabetic women.
Aged ; Coffee ; Diabetes Mellitus ; Diet ; Drinking ; Female ; Glomerular Filtration Rate ; Humans ; Kidney ; Korea ; Nutrition Surveys ; Odds Ratio ; Prevalence

In the article cited above, upper part page in title page has an error. Ending page of the article should be 268, not 269.

BACKGROUND/AIMS: Acute pyelonephritis (APN) is the most common cause of community-onset bacteremia in hospitalized elderly patients. The objectives of this study were to investigate the differences in the clinical and microbiological data of hospitalized elderly and non-elderly women with community-onset APN. METHODS: Women with community-onset APN as a discharge diagnosis were identified from January 2004 to December 2013 using an electronic medical records system. We compared the clinical and microbiologic data in elderly and non-elderly women with community-onset APN due to Enterobacteriaceae. RESULTS: Of the 1,134 women with community-onset APN caused by Enterobacteriaceae, 443 were elderly and 691 were non-elderly women. The elderly group had a lower frequency of upper and lower urinary tract symptoms/signs than the non-elderly. The incidence of bacteremia, extended-spectrum beta-lactamase (ESBL)-producing Enterobacteriaceae, patients with a C-reactive protein (CRP) level > or = 15 mg/dL, and patients with a leukocyte count > or = 15,000/mm3 in the blood, were significantly higher in the elderly group than in the non-elderly group. The proportion of patients requiring hospitalization for 10 days or more was significantly higher in the elderly group compared to the non-elderly group (51.5% vs. 26.2%, p < 0.001). The clinical cure rates at 4 to 14 days after the end of therapy were 98.3% (338/344) and 97.4% (519/533) in the elderly and non-elderly groups, respectively (p = 0.393). CONCLUSIONS: Elderly women with APN exhibit higher serum CRP levels, a higher frequency of bacteremia, a higher proportion of ESBL-producing uropathogens, and require a longer hospitalization than non-elderly women, although these patients may not complain of typical urinary symptoms.
Acute Disease ; Adult ; Age Factors ; Aged ; Anti-Bacterial Agents/therapeutic use ; Community-Acquired Infections/*diagnosis/drug therapy/microbiology ; Electronic Health Records ; Enterobacteriaceae Infections/*diagnosis/drug therapy/microbiology ; Female ; Hospitalization ; Hospitals, University ; Humans ; Middle Aged ; Pyelonephritis/*diagnosis/drug therapy/microbiology ; Remission Induction ; Republic of Korea ; Retrospective Studies ; Risk Factors ; Sex Factors ; Time Factors ; Treatment Outcome ; Urinary Tract Infections/*diagnosis/drug therapy/microbiology

Methemoglobinemia is an uncommon but potentially fatal disorder. Most cases have no adverse clinical consequence and require no treatment, but methemoglobinemia is often overlooked as a cause of low oxygen saturation, and often mistaken for the more common causes of hypoxia by anesthesiologists despite simple bedside tests that indicate the presence of this treatable abnormality. We present a 68-year-old female patient who underwent gastrectomy for advanced gastric cancer with bleeding. In the preoperative period, the patient showed cyanosis and oxygen saturation was 85% by pulse oximeter, but oxygen saturation by arterial blood gas analysis was 100%. After tracheal intubation, the methemoglobin level was 18.3%. Ascorbic acid and methylene blue were administered. During preanesthetic evaluation, the patient had not informed the anesthesiologist that she had been taking dapsone.
Aged ; Anesthesia, General ; Anoxia ; Ascorbic Acid ; Blood Gas Analysis ; Cyanosis ; Dapsone ; Female ; Gastrectomy ; Hemorrhage ; Humans ; Intubation ; Methemoglobin ; Methemoglobinemia ; Methylene Blue ; Oximetry ; Oxygen ; Preoperative Period ; Stomach Neoplasms