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

The purpose of this study was to evaluate the position of tongue and hyoid bone in relation to vertical facial patterns in the adult and child. Lateral cephalograms taken in adults(63 cases, 11.7 years in average age) and children(69 cases, 22.6 years in average age) were traced and measured about position and posture of tongue and hyoid bone using the horizontal and vertical reference lines. The angle of mandibular plane to SN plane was employed to classify the samples into groups of hypodivergent and hyperdivergent. The comparison of the tongue/hyoid bone measurements between hypodivergent group and hyperdivergent group in the adult and child were statistically executed with Student's t-test. The results were as follows; 1. The tongue height was lower in the hyperdivergent group than in hypodivergent group, and higher in children than in adults. 2. The vertical height of hyoid bone was higher in hypodivergent group than in hyperdivergent group and also higher in children than in adults. 3. The anteroposterior position was of no significant difference in relation to age or vertical facial pattern. 4. The inclination of hyoid bone in relation to cranial base was steeper in children than in adults.
Adult ; Child ; Humans ; Hyoid Bone* ; Malocclusion* ; Posture ; Skull Base ; Tongue*

The purpose of this study was to clarify the histologic changes in the expansion of midpalatal suture by the tensile forces. 39 Sprague-Dawley rats were divided into a control group (3 rats) and three experimental groups (36 rats)-group 1, pressured with a light force (50-75g), group 2, with a heavy force (250-300g) and group 3, with a heavy force (250-300g) plus laser irradiation. Autoradiographic and histopathologic observations were performed in 12, 24, 48 and 96 hours after force delivery. The results were as follows: 1. The anterior portion of midpalatal suture was more separated than the posterior portion in all experimental groups. Group 2 showed more separation than group 1 and no difference to group 3. 2. Ligament tearing appeared intensively in 24 hours, but the sutural matrices increased with times.: Group 2 showed more tearing than group 1, and active regeneration of sutural matrices was observed in group 3. 3. Vascular dilatation appeared intensively in 24 hours and decreased with times. : The anterior portion of midpalatal suture showed more dilatation than the posterior portion.: The changes was the greatest in group 3, group 2, group 1, in that order. 4. New bone formation and the new capillary prolieferation began to appear in 12 hours and increased with times.; Group 2 showed more changes than group 1 and no difference to group 3. 5. Infiltration of inflammatory cells was little observed and was the greatest in group 2, group 1, group 3, in that order. 6. Positive reaction of cells to [3H] thymidine was the greatest in 24 hours, and decreased with times: The reaction was the greatest in group 3, group 2, group 1, in that order.
Animals ; Capillaries ; Dilatation ; Ligaments ; Osteogenesis ; Rats* ; Rats, Sprague-Dawley ; Regeneration ; Sutures ; Thymidine

Hemorrhagic cystitis is potentially life-threatening sequellae of chemotherapy using oxazaphosphorine alkylating agents (cyclophosphamide and ifosfamide). Mesna contains a sulfhydryl group that is believed to bind acrolein within the urinary collecting system and reduce the hemorrhagic cystitis without affecting the chemotherapeutic potential. To date, about thirty cases of hypersensitivity or allergic reactions of the delayed and urticarial type associated with mesna have been reported. We reported two patients with systemic lupus erythematosus who developed facial rash and flushing associated with mesna which imitate malar rash.
Acrolein ; Alkylating Agents ; Cyclophosphamide ; Cystitis ; Drug Therapy ; Exanthema* ; Flushing ; Humans ; Hypersensitivity* ; Lupus Erythematosus, Systemic ; Mesna*

A non-recurrent laryngeal nerve is a rare nerve anomaly that is associated with a developmentally aberrant subclavian artery. During thyroidectomy,this aberrant nerve may become inadvertently damaged, causing permanent ipsilateral vocal cord paralysis. However, it is possible to predict the presence of a non-recurrent laryngeal nerve by preoperative diagnosis of an aberrant subclavian artery. We report a case of thyroid surgery associated with a right non-recurrent laryngeal nerve that was unnoticed preoperatively in a CT scan of the neck, but was encountered incidentally during the thyroidectomy. The preoperative CT scan showed a retroesophageal aberrant right subclavian artery, but it was unnoticed. The female patient underwent a total thyroidectomy with central compartment node dissection for a thyroid cancer. The recurrent laryngeal nerve on the left side was identified, as was the non-recurrent laryngeal nerve on the right side. Postoperatively, the patient had normal vocal cord function. It is possible to predict preoperatively a right non-recurrent laryngeal nerve by identifying an aberrant right subclavian artery on the CT scan of the neck, which likely enables prevention of vocal cord paralysis.
Diagnosis ; Female ; Humans ; Laryngeal Nerves* ; Neck ; Recurrent Laryngeal Nerve ; Subclavian Artery ; Thyroid Gland ; Thyroid Neoplasms ; Thyroidectomy ; Tomography, X-Ray Computed ; Vocal Cord Paralysis ; Vocal Cords

BACKGROUND: Early reperfusion therapy with thrombolytic agents or primary PTCA is most important to salvage ischemic myocardium in acute myocardial infarction(AMI). Timely reperfusion of jeopardized myocardium clearly improves hemodynamics, decreases infarct size and improves survival. The extent of protection appears to be directly related to the rapidity of reperfusion after onset of coronary occlusion. Although the intravenous thrombolysis is a feasible therapy in the patients with evolving AMI, the benifit of thrombolytic therapy decreases because of the time delay after onset of symptom. This study was perfomed to analyze the factors time delay between onset of symptom and the thrombolytic therapy with retrospective and prospective questionaire in the patients with AMI. METHOD: Eighty one patients with AMI were included in this study who came to the emergency room(ER) of Chungnam National University Hospital(CNUH) from Feburary 1995 to October 1996. Delay between door and thrombolytic therapy was defined as hospital time delay. RESULTS: Thrombolytic therapy(rt-PA or urokinase iv) was done in 60 patients(74.1%) and mean prehopital time delay was significantly decreased in the patients with thrombolytic therpapy when compared with those without thormbolytic threapy(462+/-90 vs 1375+/-473 minutes, p=0.005). There were no singificant factors for prehospital time delay such as age, sex, redsidence, ER near residence, transfer time to ER near residence, family status, family history of AMI, severity of chest pain, presence of risk factors of cardiovascular disease(CVD), previous CVD, degree of education, history of other disease and routine check, transfer methods. The only 8 patients(9.8%) knew about AMI and 7 patients among these patient came to ER earlier and received thrombolytic therapy. From 57 referred patients, 40 patients(70.2%) received reperfusion therapy and only 30 patients(52.6%) had recored EKG in the referred hospital. In the analysis of hospital delay from patient's arrival to the thrombolytic therapy, the arrival time at weekdays and weekend had no differences, but hospital delay were significantly prolonged when patients arrived at ER in the night. CONCLUSION: Since prehospital time delay is a most important factor of time delay for the effective thrombolytic therapy in AMI, the pubic education program and effective transport system are needed. And routine record of EKG in patient with chest pain in the local hospital is very helpful to start effective thromolytic therapy at ER. The well designed prospective study with more patinets in our local region is essential to get more accurate information about transport system and to improve survival rate in patients with AMI.
Chest Pain ; Chungcheongnam-do ; Coronary Occlusion ; Education ; Electrocardiography ; Emergencies ; Fibrinolytic Agents ; Hemodynamics ; Humans ; Myocardial Infarction* ; Myocardium ; Prospective Studies ; Reperfusion ; Retrospective Studies ; Risk Factors ; Survival Rate ; Thrombolytic Therapy* ; Urokinase-Type Plasminogen Activator

For the treatment of coarction of aorta, surgical intervention has been known as a standard therapy.During last decade balloon angioplasty for coarctation of the aorta has been reported as a successful and safe procedure in about 300 cases. This angioplasty was done mainly in infants and children, and little cases in adults and adolescents. A 22 year-old adult with coarctation of aorta have recieved balloon angioplasty. He visited to emergency room due to severe headache and the blood presure of arm was 240/130mmHg at emergency room. The blood pressure at ward was 168/92mmHg in upper extremities, 104/82mmHg in lower extrimities. His aortogram showed coarctation of thoracic aorta below left subclavian artery. The pressure gradient beween ascending aorta and right femoral artery was decreased from 60mmHg to 0mmHg after balloon dilatation (2 times, balloon diameter 18mm). There were no significant complications. The follow-up magnetic resonance image in 4 month after balloon angioplasty showed no evidence of restenosis or saccular aneurysm. Initial hypertension turned to normal blood pressure in 4 months after balloon angioplasty. This adult case of successful balloon angioplasty for coarctation of aorta is the first case reported in Korea.
Adolescent ; Adult* ; Aneurysm ; Angioplasty ; Angioplasty, Balloon* ; Aorta ; Aorta, Thoracic ; Aortic Coarctation* ; Arm ; Blood Pressure ; Child ; Dilatation ; Emergency Service, Hospital ; Femoral Artery ; Follow-Up Studies ; Headache ; Humans ; Hypertension ; Infant ; Korea ; Subclavian Artery ; Upper Extremity ; Young Adult

PURPOSE: Intrarenal location of calculus significantly affects efficacy of SWL. In lower calyceal stone, its antigravitic location has been known to decrease success rate of SWL. In this study, renal calyceal stone is categorized according to its location and especially lower calyceal stone is further divided either with infundibulo-pelvic angle (IPA) greater than 90degreesor that with less than 90degrees. Difference of the treatment results were compared according to the location of stones. MATERIALS AND METHODS: 142 stones(upper calyx: 52, mid calyx: 11, lower calyx: 79) of 117 patients which had been treated by SWL since 1995 were retrospectively studied. The SWL machine used for treatment was EDAP-LT 01 Plus(piezoelectric mechanism with 3.5 MHz ultrasonic imaging system). Complete stone delivery was defined as state with no residual stone on KUB film. RESULTS: The mean stone size was 0.97+/-0.3cm and mean number of treatment session was 5.0+/-3.2. The complete stone delivery rate was 83%. There was no significant difference in number of session according to stone location(upper calyx: 4.4+/-1.9, mid calyx: 3.18+/-1.5, lower calyx: 4.8+/-2.4, p>0.05). The stone sizes of each calyx were 1.1+/-0.33cm, 0.8+/-1.5cm and 0.91+/-0.24 cm respectively. There were no siginificant differences in stone size among calyceal location(p>0.05). The complete stone delivery rate of each calyx were 88.5%(46/52), 90.9%(10/11), 74.7%(59/79) respectivey(p>0.05). Of the 79 lower calyceal stones, of which IPA was greater than 90degreesin 27 stones and less than 90degrees in 52 stones. There was no siginificant difference in size between two groups(0.86+/-0.16cm vs 0.9+/-0.25cm, p>0.05). The stone with greater infundibulo-pelvic angle had more session than that with lesser infundibulo-pelvic angle(4.9+/-2.2 vs 4.3+/-3.3, p=0.039). There was significant difference in complete stone delivery rate according to infundibulo-pelvic angle(96.3% - 26/27 vs 63.4% - 33/52, p=0.034). Also stone with less infundibulo-pelvic angle had inferior stone delivery rate compared with that of upper and mid calyceal stone. CONCLUSIONS: The lower calyceal stones with infundibulo-pelvic angle lesser than 90degreeshad significantly lower stone delivery rate compared with those with greater infundibulo-pelvic angle and upper and mid calyceal stone. In case of lower calyceal stone with infundibulo-pelvic angle less than 90degrees, other treatment such as PNL, pyelolithotomy must be considered as primary treatment modality.
Calculi ; Humans ; Retrospective Studies ; Ultrasonography

Localized fibrous mesothelioma of the liver is very rare benign tumor. It usually manifest large palpable hepatic mass in right upper quadrant area, and the prognosis is excellent by surgical resection. Contrast enhanced CT scan shows well defined hyperattenuating mass and celiac anglogram shows hypervascular mass. Recently we experienced 1 case of localized fibrous mesothelioma of the liver, and we report CT and anglographic findings of this tumor.
Liver* ; Prognosis ; Solitary Fibrous Tumor, Pleural* ; Tomography, X-Ray Computed

PURPOSE: With an accumulation of surgical experience for endoscopic or video-assisted thyroidectomy and improvements in surgical techniques and endoscopic instruments, these procedures have become a valid option for patients with benign thyroid nodules. These applications are now being expanded even to selected patients with low risk thyroid carcinomas. This study was performed to suggest new modified methods of approach on the use of a gasless endoscopic thyroidectomy via an axillary approach and to evaluate the short-term outcomes. METHODS: Between May 2004 and March 2007, 66 female patients underwent a gasless endoscopic thyroidectomy via an axillary approach. Surgical outcomes were evaluated in terms of surgical time, length of hospital stay, the incidence of perioperative complications, and patient opinion at two and four months after surgery. RESULTS: No cases required conversion to open surgery. The mean surgical time was 136.5±31.8 minutes, and the mean length of hospital stay was 4.2±1.1 days. There were two transient recurrent laryngeal nerve palsies, two minor tracheal injuries without air leakage, and two postoperative hemorrhages that required a second surgery. Only one patient (1.9%) and five patients (9.4%) complained of slight hypesthesia or paresthesia in the neck and anterior chest wall, respectively, and only three patients (5.7%) complained of discomfort while swallowing 4 months after surgery. CONCLUSION: Gasless endoscopic thyroidectomy via an axillary approach is a feasible and safe procedure and providesa minimal degree of postoperative complaints. This procedure is now a valid option for the surgical treatment of benign thyroid disease and its applications will broaden in the near future.
Conversion to Open Surgery ; Deglutition ; Female ; Humans ; Hypesthesia ; Incidence ; Length of Stay ; Neck ; Operative Time ; Paralysis ; Paresthesia ; Postoperative Hemorrhage ; Recurrent Laryngeal Nerve ; Thoracic Wall ; Thyroid Diseases ; Thyroid Neoplasms ; Thyroid Nodule ; Thyroidectomy*