PURPOSE: The objective of this study was to evaluate the Caspase 3 and p21 expression level and to understand the correlation between Caspase 3 expression and the clinical factors in renal cell carcinoma. MATERIALS AND METHODS: Forty-two patients with renal cell carcinoma were enrolled in this study. Immunohistochemical staining of Caspase 3 and p21 was performed in formalin-fixed and paraffin-embedded tissue sections using rabbit polyclonal antibody (Caspase 3) and mouse antibody (p21). The Caspase 3 and p21 expression levels were compared with the TNM stage, Fuhrman grade, pathological type and survival rates. RESULTS: The Caspase 3 expression level correlated only with the Fuhrman grade (p=0.017). There was no significant correlation between the Caspase 3 and p21 expression level. The prognostic values did not correlate with the Caspase 3 and p21 expression level. CONCLUSIONS: The prognostic value of the Caspase 3 expression level in renal cell carcinoma was insufficient. The relationship between Caspase 3 and p21 was not proven in renal cell carcinoma, and new factors may be implicated with Caspase 3.
Animals ; Apoptosis ; Carcinoma, Renal Cell* ; Caspase 3* ; Humans ; Mice ; Prognosis ; Survival Rate

It is well known that many cases of renal cell carcinoma accompanies gross or microscopic hematuria. It implies that much of renal cell carcinoma may also have pelvic or medullary invasion. But unlike other well known prognostic factors such as renal vessel or regional invasion, the prognostic significance of pelvic or medullary invasion in renal cell carcinoma has not been known well. We reviewed retrospectively 73 patients treated with radical nephrectomy in whom 18 patients has pathologically confirmed pelvic or medullary invasion. The mean follow-up duration was about 23 months. The average size of tumor in non-pelvic invasive group (NPIG) was 6.6 cm and in pelvic invasive group (PIG) it was 5.4 cm. In NPIG, 91% (67 patients) of tumor was Grade II and III and in PIG 100% of tumor was Grade II and III. 89% of NPIG tumor was stage pT3aN0M0 or below. And 88% of PIG was pT3aN0M0 or below. At 12 NPIG patients (16%) tumor has recurred and its mean duration was about 6.6 months. In PIG, 5 patients had recurrent tumor (27%) and its duration was about 7.6 months. Nine patients (12.3%) died due to renal cell carcinoma in NPIG. In PIG 3 patients (16%) died of renal cell carcinoma. The study revealed that there is no significant difference between pelvic or medullary invasive and non-pelvic invasive renal cell carcinoma in tumor grade and stage. But in pelvic invasive renal cell carcinoma, relatively more tumor recurrence had occurred (p>0.05) and also relatively more patients died due to tumor. We think that for more proper clarification of prognostic significance of pelvic or medullary invasion in renal cell carcinoma, more long term follow-up and stage by stage study will be needed.
Carcinoma, Renal Cell* ; Follow-Up Studies ; Hematuria ; Humans ; Nephrectomy ; Recurrence ; Retrospective Studies

Congenital tuberculosis is an infection that is established in the fetus by hematogenous spread or by the aspiration or inhalation of infected amniotic fluid either before or during labor. The diagnosis can be confirmed only if both the tuberculous nature of the lesion and the antenatal origin of the infection can be proved. The authors analysed roentgen findings of two cases of pulmonary tuberculosis, thought to be congenital; 1. Diffuse distribution of nodular densities and some confluent densities were seen in the entire lungs in the inital film.The pulmonary markings were decreased in some degree. 2. Air bronchogram was noted. 3. Hepatosplenomegaly was associated.
Amniotic Fluid ; Diagnosis ; Female ; Fetus ; Inhalation ; Lung ; Tuberculosis ; Tuberculosis, Pulmonary

PURPOSE: Gleason score is well known prognostic factor of prostatic cancer, Especially Gleason score above 8 measns poor prognosis. But in intermediate range(Gleason scorn 5-7), it does not provide useful information about the prognosis. Therefore, in the range of intermediate Gleason score, additional information such as PSA changes in pre and post treatment period may be helpful for predicting prognosis. In this study, we retrospectively evaluated relationship between prognosis and PSA change of pre and post hormonal treatment period in different Gleason score group(intermediate Gleason score group: 5-7/high Gleason score group: 8-10). MATERIALS AND METHODS: Total 42 patients who were diagnosed as stage D1, D2 prostatic cancer with Gleason score 5-10 were studied. All patients were treated by hormonal treatment(Orchiectomy or gonadotropin releasing hormone agonist) between May 1992 and May 1996 in Korea university. Mean follow-up duration was 18.9 months. And mean age of patients was 67.0+/-7.5 years. Patients were classified into two groups. One group was consisted of 28 patients whose Gleason score was 5-7 And in the other group, 14 patients with Gleason score above 8 were included. In each group, pre- treatment PSA, post-treatment nadir PSA, time for post-treatment PSA fall to nadir and time for PSA reelevation were analysed. Also In each group, expired and survived patients were analysed. All data was statistically processed by Exact Fisher's test and Mann-Whitney Rank Sum score. RESULTS: Mean Gleason score of total 42 patients was 7.1 +/-7.5. Mean pre-treatment PSA value of 42 patients was 146.9+/-222.6ng/ml and mean nadir PSA value after treatment was 8.2+/- 15.9ng/ml. The mean time for nadir PSA fall after treatment was 6.2+/-4.4 months and mean time for PSA reelevation was 13.3+/-9.9 months. 14 patients had Gleason score 8 or more and the other 28 patients had Gleason score 5-7. There was significant difference in mortality between patients with intermediate Gleason score(4/28 patients) and high Gleason score(7/14 patients, p=0.024). In patients with high Gleason score(8-10), there were no significant difference of pre-treatment PSA, post-treatment nadir PSA , duration for post-treatment PSA fall to nadir and time for PSA reelevation between survived and expired patients(p> 0.05). But in case with intermediate Gleason score range(5-7), expired patients had significantly higher post-treatment nadir PSA value than survived patients(19.8+/- 0.4ng/ml vs 7.3+/-4.2ng/ml respectively, p=9.036). But in both Gleason scone group, there was no mortality difference between patients with nadir PSA above 4ng/ml and below 4ng/ml. CONCLUSIONS: With these result, we concluded that patients with high Gleason score (especially 8 or more) had poor prognosis. And in patients with high Gleason score PSA change in pre and post-treatment period have no additional prognostic importance on Gleason score. But in patients with intermediate Gleason score(5-7), higher post treatment nadir PSA means poor prognosis. But conventionally used criteria of post-treatment PSA level below normal range(<4ng/ml) cannot discriminate between good and poor prognostic group in both high and intermediate Gleason score patients. So we think that in cases of patients with intermediate Gleason score(5-7), a physician must try to check up post-treatment PSA change(especially post-treatment nadir PSA) thronghly for early detection of tumor recurrence or progression.
Adenocarcinoma* ; Follow-Up Studies ; Gonadotropin-Releasing Hormone ; Humans ; Korea ; Mortality ; Neoplasm Grading* ; Prognosis ; Prostatic Neoplasms ; Recurrence ; Retrospective Studies*

PURPOSE: To evaluate the usefulness of Gd-DTPA enhanced MR imaging in determining the metastatic lymph nodes in uterine cervical carcinoma. MATERIALS AND METHODS: Sixty nine patients with histologically proven cervical carcinoma underwent Gd-DTPA enhanced MR imaging. One hundred and thirty-eight pelvic regions(69 right,69 left) in 69 patients were analyzed for lymph node metastases. Pelvic lymph nodes were considered to be abnormal if they were greater than lcm in diameter and were enhanced on postcontrast T1 weighted images. RESULTS: Metastatic lymph nodes were found in 22 pelvic regions by surgicopathologic examinations. On MR imaging there were 14 true positives, 106 true negatives, 10 false positives and 8 false negatives. Gd-DTPA enhanced MR image had an accuracy of 86.9%, a sensitivity of 58.3%, a specificity of 91.4%, a positive predictive value of 58.3% and negative predictive value of 92.9% in evaluation of pelvic lymph node metastases. CONCLUSION: MR imaging with contrast enhancement may be useful in the evaluation of pelvic lymph node metastases in patients with uterine cervical carcinoma.
Gadolinium DTPA ; Humans ; Lymph Nodes* ; Magnetic Resonance Imaging* ; Neoplasm Metastasis ; Pelvis ; Sensitivity and Specificity

No abstract available.
Anemia, Hemolytic* ; Cholelithiasis* ; Hepatolenticular Degeneration*

No abstract available.
Humans ; Venous Thrombosis*

PURPOSE: In this study we analyzed the changes of fPSA and f-PSA% and its prognostic significance in course of hormone treatment for metastatic prostate cancer. MATERIALS AND METHODS: We retrospectively analyzed 75 patients with metastatic prostate cancer who received maximal androgen deprivation therapy and in whom the fPSA and f-PSA% had been serially checked for at least 1 year. The patients were divided into two groups: those patients with biological recurrence within 1 year, and those patients showing sensitivity to hormone therapy for longer than one year. Changes of the fPSA and f-PSA% in each group were analyzed in correlation with such prognostic factors as the PSA level and the Gleason sum. RESULTS: The initial PSA levels in each group were 508.0+/-331.4ng/ml and 39.8+/-7.6ng/ml, respectively and the fPSA levels were 59.4+/-19.4ng/ml and 6.7+/-4.1ng/ml, respectively; the group with early biological recurrence had significantly higher intial PSA and fPSA levels. The initial f-PSA% was relatively lower in the patients with early recurrence (0.123+/-0.41 vs 0.159+/-0.37, respectively), but the difference was not statistically significant. The PSA nadir and the fPSA nadir in the early recurrence group were 6.1 10.1ng/ml and 0.89 3.9ng/ml, respectively, and these were significantly higher compared to those values of the hormone sensitive group, i.e., 2.4+/-8.4ng/ml and 0.41+/-0.2ng/ml, respectively. In the early recurrence group, the f-PSA% changed from 0.123 to 0.092 and it gradually decreased during treatment. On the contrary, in the hormone sensitive group, the f-PSA% continuously increased during treatment, from 0.159 to 0.172. CONCLUSIONS: These findings suggest that fPSA and f-PSA% are influenced by hormone treatment and the pattern of changes in the fPSA and f-PSA% are different according to the responsiveness to hormone treatment.
Hormone Replacement Therapy ; Humans ; Prostate* ; Prostate-Specific Antigen ; Prostatic Neoplasms* ; Recurrence ; Retrospective Studies

Fractures and dislocation of the hand is a body injury involving complex structures and multiple functions, which frequently occur as they represent 10%-30% of all fractures. Such fractures and dislocation of the hand should be treated in the context of stability and flexibility; and tailored treatment is required in order to achieve the most optimal functional performance in each patient since deformation may occur if not treated, stiffness may occur with unnecessarily excessive treatment, and both deformation and stiffness may occur coincidently with inappropriate treatment. Stable injuries can be fixed with splintage whereas surgery is actively considered for unstable injuries. In addition, surgeons should keep in mind that as the surgical intervention is done aggressively, aggressive rehabilitation must be followed in correspondence with the surgical intervention. Successful outcome requires effort to prevent any potential complication including nerve hypersensitivity and infection. Finally, it is also important that the patient to know that swelling, stiffness, and pain may last for a long period of time until the recovery of fractures and dislocation of the hand.
Dislocations* ; Finger Injuries ; Hand* ; Humans ; Hypersensitivity ; Pliability ; Rehabilitation

Scrotal leiomyosarcoma arising from dartos layer not involving the testis, epididymis or spermatic cord is very rare tumor. We report a case of scrotal leiomyosarcoma in 29 year old man who present with right scrotal painless growing mass. The lesion had been for 3 months but there was no related symptom such as pain or tenderness. The excised lesion was 3 x 3cm sized ovoid mass with smooth surface and it had no relationship with the testis, epididymis and spermatic cord. Its pathologic finding was compatible with leiomyosarcoma. So additional radical orchiectomy was done.
Adult ; Epididymis ; Humans ; Leiomyosarcoma* ; Male ; Orchiectomy ; Scrotum* ; Spermatic Cord ; Testis