PURPOSE: We evaluated if VEGF (Vascular Endothelial Growth Factor)-immunoreactivity is associated with tumor stage or grade in RCC (renal cell carcinoma), and specifically, if it could serve as a prognostic i ndicator in terms of survival. MATERIALS AND METHODS: Histologic samples of 54 patients in whom radical nephrectomy due to RCC (clear cell type exclusively) from January 1995 to July 1999 were included in this study. VEGF-immunoreactivity was classified as 0 to 3+ according to the ratio of VEGF-positive cells in randomly selected multiple tumor areas. Histologic differentiation was classified according to Fuhrmann's classification and staging was made with TNM classification. RESULTS: The correlation between grade and VEGF-positivity was statistically significant using chi-square analysis. Among the 3 patients with grade I, showed 2, 1, 0 for VEGF 1+, 2+, 3+ respectively. In grade II the cases were 11, 7, 3 respectively. In grade III the cases were 3, 10, 11, and in grade IV the cases were 1, 2, 3 respectively. The correlation between stage and VEGF-positivity didn't show statistical significance. The survival rate for VEGF during the period was 100%, 90%, 76.5% for VEGF 1+, 2+, 3+ respectively. The survival rate for grade was 100%, 100%, 83.3%, 66.7% for grade I, II, III, IV respectively. The survival rate for stage was 95.2%, 85.7%, 87.5%, 66.7% FOR STAGE I, II, III, IV respectively. In the same grade, survival rate decreased apparently according to the increase of VEGF-positivity. For example, in the same grade III, the survival rae was 100%, 90%, 72.7% for VEGF 1+, 2+, 3+ respectively. CONCLUSIONS: The results of this study is that VEGF is correlated with tumor grade and the higher VEGF expression, the lower the survival rate, so we can predict the prognosis by VEGF immunohistochemical staining for supplement of grading system. VEGF alone can be a good predictor for survival, and importantly in the same grade, we can differentiate patient's prognosis with VEGF.
Carcinoma, Renal Cell ; Classification ; Humans ; Nephrectomy ; Prognosis ; Survival Rate ; Vascular Endothelial Growth Factor A

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

Although percutaneous abscess drainage has become and accepted alternative from of therapy for selected patients with abscess, it is well known that there are several factors in the failure of adequate drainage such as pre-and post- procedural management, technique itself, various features of abscess, and selection and application of catheters. Among these factors, we made an experiment about drain efficacy of commonly used various catheters with different viscosities of water-glycerin solution under the two different pressure gradients. The experimental values of flow rate were lower than than the calculated values. An efficacy of experimental value was 4-14%. Because the inner diameter of fittings and stopcocks was usually smaller than the inner diameter of catheters, these factors also affected the drain efficacy. Finally, we though that it will be very helpful to the treatment of patients as well as to study about the catheter drainage, if the drain efficacy of individual catheters has been notified.
Abscess ; Catheters* ; Drainage ; Humans ; Viscosity

The various and serious types of disaster occur everyday and everywhere on the earth. There is no doubt that it is very timely to discuss about the effectiveness and preparedness of disaster. The purpose of this study is to develop a curriculum on the disaster management through reviewing disaster concepts and the disaster management system. For the empirical relevance of the study, researchers participated in a couple or more disaster training program, reviewed references, and consulted to the experts working on action parts in the area. As a result, the 'Integrated Disaster Management System Model(IDMSM)' was designed, in which four dimensions were explained. Then the 'Disaster Curriculum Model(DCM)' was explored with its theoretical framework based on the system model. The developed curriculum is composed of four levels ; the introductory course, the fundamental course, the advanced course, and the expert course. From this DCM, basically the course-outlines of two subjects in the introductory course, 18 subjects in the fundamental course(5 of direct services, 13 of indirect services) were developed. Also each course-outline was explored by its course objective, learning objectives, contents, and its length. Finally to make the most of the results, suggestions are proposed. The governmental considerations on the policy should support the systematic and integrated educational program to practice, appointing [Disaster School] or [Disaster Training Center] of relevance and accountabilities. The further study should explore the higher levels of the DCM through interdisciplinary efforts, and develop the text materials. The further study should explore the higher levels of the DCM through interdisciplinary efforts, and develop the text materials.
Curriculum* ; Disasters* ; Education ; Learning

Type F collagen is the major component of the basement membrane (BM) and is considered to act as a barrier during tumor invasion. In order to demonstrate the changes of type IV collagen in the BM. immunohistochemical methods were used in normal bladder and 27 cases of transitionral cell carcinoma (TCC) of the bladder for which clinical follow-up was available. Normal epithelial structures were urrounded by a generally intact BM type F collagen. In stage Ta lesion, type IV collagen was single layered but regular continuous linear fashion. In stage T1 or T2 lesion, they were partially disrupted in areas of invasion with irregular contour. In stage T3 lesion, type IV collagen was completely absent from BM. Above findings are very similar to our previous BM laminin study in bladder cancer. It supports the hypothesis that tumor cell conjugates with BM laminin and release the type IV collagenase which degrades the BM type IV collagen. In conclusion, it is suggested that both BM laminin and type IV collagen disappear in the area of invasion and the disappearance of BM type IV collagen in superficial disease may also provide early indication of invasive disease and careful monitoring ismandatory.
Basement Membrane* ; Carcinoma, Transitional Cell* ; Collagen ; Collagen Type IV* ; Collagenases ; Follow-Up Studies ; Laminin ; Urinary Bladder Neoplasms ; Urinary Bladder*

To determine the difference in cephalometric measurements between centric relation and centric occlusion, 60 patient-20 patients for each malocclusion group-were examined with the cephalograms in centric relation and in centric occlusion. The results are as follows: 1. There are differences in cephalometric measurements with the mandible in the two different position, and some measurements are statistically significant. 2. No clinically useful prediction may be made from cephalometric radiographs concerning the amount of mandibular deflection from centric relation to centric occlusion. 3. If, the large differences in the cephalometric measurements with the mandible in the two different position, the analysis with the cephalogram in centric occlusion is needed to be compensated with the other clinical approach.
Centric Relation ; Humans ; Malocclusion ; Mandible ; Mandibular Condyle*

The purpose of this study was to quantify the biologic effects of the tensile forces from helical springs across the maxillary incisors on the periodontal tissues of rats. 39 Sprague-Dawlely 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 application. The result were as follow: 1. Hyalinized zone of periodontal ligament began to appear at pressure side in 12 hours in group 2 and group 3 ; all decreased in 96 hours except in group 2. 2. Alveolar bone resorption began to appear in 12 hours in group 2 and group 3 ; Group 2 showed more resorption than group 1 and no difference to group 3. 3. Tearing of periodontal ligament and vascular dilatation began to appear at tension side in 12 hours in all groups ; Group 2 showed more changes than group 1 and no difference to group 3 ; Decrease began to appear in 96 hours. 4. New bone formation began to appear at tension side in 12 hours and increased more and more; No differences were shown of groups 5. New capillary proliferation began to appear at pressure side in 12 hours; The changes were the greatest in group 3, group 2, group 1, in that order. 6. Positive reaction of cells to [3H]-thymidine was the greatest in 24 hours of all groups and decreased with times ; Group 2 showed more reaction than group 1 and no difference to group 3.
Animals ; Bone Resorption ; Capillaries ; Dilatation ; Hyalin ; Incisor* ; Osteogenesis ; Periodontal Ligament ; Rats*

The purpose of this study was to investigate the stress distribution and intensity derived from the transpalatal lingual arch in the investing bone composed of photoelastic material(PL-3). The transpalatal lingual arch wire was deflected in the horizontal and vertical direction to give the various conditions. The two-dimensional photoelastic stress analysis was performed, and the stress distrebution was recored by photofraphy. The results were as follows: 1. In bilateral expansion, as horizontal deflection was singly applied, the stress was more concentrated on the root apex in square free end than round. In square free end, as vertical deflection was increased gradually, the black line meaning center of rotation moced inferiorly togerher with the increment of whole fringes. 2. In application of vertical deflection on anchorage side for unilateral expansion, the stress distribution that expansive force leaned to expansion side was observed. As vertical deflection increased, the extruding stress was obesrved on molar of expansion side. And as horisontal deflection increased, the tipping stress on the molar of anchorage side was observed. 3. In unilateral rotation with the asymmetric toe-in, the fringe appeared on the distal aspect of root apex.
Molar

PURPOSE: We explored the prognostic significance of obesity for the surgical and hormonal treatment of prostate cancer in correlation with the other prognostic factors such as Gleason's sum, the clinicopathologic stage, and the pre- and post treatment prostate specific antigen (PSA) changes. MATERIALS AND METHODS: A retrospective review was performed on 132 consecutive patients who had received androgen deprivation therapy (ADT) (108 patients) or radical prostatectomy (24 patients) under the diagnosis of prostate cancer via transrectal prostatic biopsy from July 1993 to May 2003 in our hospital. Obesity was evaluated in terms of the body mass index (BMI), and the patients were categorized into four groups according to the National Institute of Health (NIH) classification. The relationship between the BMI and the other prognostic factors were statistically analyzed by One-way ANOVA test and the Spearman correlation coefficient. RESULTS: There were no significant associations between the BMI and any of the measured clinical and pathological parameters except for the time to hormone failure and biochemical recurrence. In the ADI group, the mean time to hormone failure was significantly longer in case of the low BMI group compared to the normal and overweight groups (p<0.006). Sperman's correlation analysis showed a significant inverse correlation between the BMI and the PSA free survival after radical prostatectomy. CONCLUSIONS: These findings showed that the BMI is closely related to the failure to hormone treatment after ADI and the BMI was also related to the biological failures after radical prostatectomy.
Biopsy ; Body Mass Index ; Classification ; Diagnosis ; Humans ; Obesity* ; Overweight ; Prostate* ; Prostate-Specific Antigen ; Prostatectomy* ; Prostatic Neoplasms* ; Recurrence ; Retrospective Studies