No abstract available.
Pancreatitis, Chronic*

No abstract available.
Keloid*

I think endoscopic retrograde cholangiopancreatography (ERCP) is a very highly advanced upper endoscopic procedure, and is an uncomfortable procedure that requires adequate sedation for its successful conduction. But, The optimum method for sedation for endoscopic procedures is not known. Propofol has a faster recovery time than traditional sedative agents, but may be associated with increased complication rates. Dexmedetomidine is a highly selective alpha2 adrenoceptor agonist that has many advantages over other sedatives. In addition to producing sedative, analgesic, and anxiolytic effects, it provides respiratory stability. When patients are treated with appropriate analgesics, sedation with dexmedetomidine for ERCP would be safe and associated with better outcomes than sedation with other sedatives.
Analgesics ; Anesthesia* ; Anti-Anxiety Agents ; Cholangiopancreatography, Endoscopic Retrograde* ; Dexmedetomidine ; Humans ; Hypnotics and Sedatives ; Propofol

p27kip1, a cyclin dependent kinase inhibitor, has been recognized as a negative regulator of cell cycle. To investigate the role of p27kip1 on progression of cancer and apoptotic pathway, we analyzed p27kip1 expression using immunohistochemical stain in 40 cases of prostatic adenocarcinoma and apoptotic index by TUNEL method in 30 cases of prostatic adenocarinoma. Both were correlated with Gleason grade and Gleason score. Loss of p27kip1 expression was more frequent in prostatic adenocarcinomas of higher score (Gleason score 7 to 10) (60.7%) than in those of lower score (Gleason score 4 to 6) (33.3%) (p<0.05). The value of mean apoptotic index of carcinoma was 1.13+/-0.26, 1.80+/-0.91, 2.06+/-0.79, and 2.12+/-0.82 in grade 2, 3, 4, and 5, respectively, and was positively correlated with grade of carcinoma (p<0.05). Mean apoptotic index of higher Gleason score (score 7 to 10; 2.05+/-0.63) was also significantly increased than in lower Gleason score (score 4 to 6; 1.34+/-0.39) (p<0.05). Mean apoptotic index in cases with and without p27kip1 expression was 1.92+/-0.86 and 1.89+/-0.81, respectively (p>0.05). These results suggest that loss of p27kip1 expression and increased apoptotic index may be the morphologic markers to predict the behavior of prostatic adenocaricnoma. The role of p27kip1 on apoptotic pathway seems to be meager in this study and needs further study.
Adenocarcinoma* ; Cell Cycle ; Cyclins ; In Situ Nick-End Labeling ; Neoplasm Grading ; Phosphotransferases

PURPOSE: This study was to measure the angle between the femoral epicondylar axis and the femoral posterior condylar axis, to clarify which axis can be used as a guideline to achieve proper rotational align- ment of femoral component in total knee arthroplasty. MATERIAL AND METHODS: From Jan. 1997 to Dec. 1998, the axial images of MRI of 121 patients who sustained acute knee injury were selected to measure the posterior-epicondylar angle(the angle between the femoral epicondylar axis and the femoral posterior condylar axis). Congenital anomaly or any fracture cases were all excluded. Comparisons were made according to gender and ages and the student t-test was used to evaluate the statistical differences. RESULTS: The mean posterior-epicondylar angle was a 4.8(+- 2.0) and there was no significant statisti- cal difference between gender and ages except 3rd decade. CONCLUSION: It can induce an insufficient external rotation of the femoral component in total knee arthroplasty, if we usually do 3 of external rotation of femoral component from the posterior condylar axis.
Arthroplasty* ; Axis, Cervical Vertebra* ; Femur* ; Humans ; Knee Injuries ; Knee* ; Magnetic Resonance Imaging

Radiographic measurement of cervical spine is very important in cervical spine injury especially those without fracture. Authors measured the retropharyngeal space, retrotracheal space, lordortic curve and sagittal diameter of cervical spinal canal in 148 cases of normal adult male. The results are as follows: 1 . In normal Korean adult male maximum retropharyngeal space is 7mm in C, level and Smm in Cs level. Maximum retrotracheal space is 16mm in C, level. 3. Loss of normal lordotic curve is shown in 21 cases(14.2%), 4. Average sagittal diameter of C, level is 21.27mm-it's the largest of all the cervical spinal cana1s, and that of C, level is 16.15mm-it's the smallest.
Adult ; Humans ; Male ; Spinal Canal ; Spine

No abstract available.
Glioma*

To investigate the correlation between EBV infection and p53 overexpression in laryngeal carcinomas (LC) and nasopharyngeal carcinomas (NPC) in Korea, we analyzed 37 laryngeal squamous cell carcinomas and 33 nasopharyngeal (11 squamous cell and 22 undifferentiated) carcinomas. We used the immunohistochemistry and polymerase chain reaction-single stranded conformational polymorphism (PCR-SSCP) for p53 overexpression and p53 gene mutation, respectively, and EBER-1 in situ hybridization and PCR using primer for EBNA-1 and EBNA-2 type 1 and 2 for prevalence and the subtype of EBV. The results were as follows; 1) The p53 expression was found in 43.2% of squamous cell LCs, in 54.6% of squamous cell NPCs and in 22.7% of undifferentiated NPCs. The p53 gene mutation was detected in 6 of 23 squamous cell LCs and 3 of 14 undifferentiated NPCs. 2) EBV was detected more frequently in undifferentiated NPCs (95.5%) than in squamous cell NPCs (63.6%) and squamous cell LCs (37.0%). Only type 1 was found in squamous cell LCs and NPCs, whereas both type 1 and type 2 were detected in undifferentiated NPCs. 3) There was no difference according to EBV infection (EBV+ ; 7 cases, EBV- ; 7 cases) in the cases with p53 protein overexpression but mutaion. From the above results, it can be concluded that squamous cell LCs and NPCs are associated with both p53 and EBV, whereas undifferentiated NPCs are more closely associated with EBV than p53. In Korea, both type 1 and 2 are detected in undifferentiated NPCs. Also, our result suggests that EBV infection does not seem to contribute to p53 overexpression. The interrelationship between EBV infection and p53 remains to be further defined.
Carcinoma, Squamous Cell ; Epstein-Barr Virus Infections ; Genes, p53 ; Herpesvirus 4, Human* ; Immunohistochemistry ; In Situ Hybridization ; Korea ; Polymerase Chain Reaction ; Prevalence

BACKGROUND: Interscalene brachial plexus block (IS-BPB) offers many advantages over general anesthesia for both arthroscopic and open surgeries of the shoulder, including shorter hospital stay, reduced postoperative analgesia requirements, and avoidance of the risks and side effects of general anesthesia. The purpose of this study was to compare the effectiveness of postoperative pain control by IS-BPB to general anesthesia for performing arthroscopic shoulder surgery. METHODS: Sixty patients were divided into three groups: general anesthesia (group A, n=20), general anesthesia and suprascapular nerve block (SSNB) (group B, n=20), and only IS-BPB(group C, n=20). All patients received patient-controlled analgesia (PCA), and were instructed to rate their pain using a visual analogue scale (VAS) ranging from 0 to 10. VAS was measured at 1, 4, 8, 12, and 24 hours after surgery. Hospital stays were recorded. RESULTS: VAS decreased significantly with time in group A and B (P < 0.05) (Fig. 1), but not in group C. Group C had less pain at 1, 4, 8, 12, 24, hours postoperatively than the other groups (P < 0.05) (Fig. 1). Group C had shorter hospital stays than the other groups (P < 0.05) (Fig. 2). CONCLUSIONS: IS-BPB results in less postoperative pain and a shorter hospital stay than general anesthesia for arthroscopic shoulder surgery (P < 0.05).
Analgesia ; Analgesia, Patient-Controlled ; Anesthesia, General ; Brachial Plexus ; Humans ; Length of Stay ; Nerve Block ; Pain, Postoperative ; Shoulder

Lymphoepithelioma-like carcinoma (LELC) that histologically resembles nasopharyngeal lymphoepithelioma has been reported in various sites including the stomach, salivary gland, lung, skin, thymus, tonsil and uterine cervix. LELC of the stomach was rarely reported after the first report by Burke et al. in 1990. More than 60% of them were associated with Epstein-Barr virus (EBV). Most commonly affecting elderly Asians with slight male predominance (M/F ; 1.2/1), it usually is located in the proximal portion of the stomach and distinguished from lymphoid-rich adenocarcinoma by the absence of definitive glandular differentiation in the LELC. We recently experienced 4 cases of LELC of the stomach associated with EBV. Patients consisted of two Korean females and two Korean males with one in 3rd decade, one in 5th decade and two in 6th decade. The tumors of all cases were located in the proximal portion of the stomach. Gross types were 1 Borrman type I, 2 Borrman type II and 1 early gastric carcinoma type IIc. The size of the tumors varied from 0.8 cm to 7 cm. Microscopic findings were similar in all 4 tumors.; The tumors were composed of syncytial nests of undifferentiated cells having vesicular nuclei with prominent nucleoli, admixed with abundant lymphoplasma cell infiltration in the stroma. Immunohistochemical staining revealed that the tumor cells were reactive for cytokeratin and the stromal lymphocytes were mostly T cells. There were dark hybridization signals in the nuclei of most of the tumor cells but no signals in the stromal lymphocytes in three cases on in situ PCR hybridization and on all cases PCR amplification for EBNA-1. It is concluded that LELCs of the stomach have distinctive histologic characteristics and the usual association with EBV. Further accumulation of these cases will define the prognosis.
Adenocarcinoma ; Aged ; Asian Continental Ancestry Group ; Cervix Uteri ; Female ; Herpesvirus 4, Human* ; Humans ; Keratins ; Lung ; Lymphocytes ; Male ; Palatine Tonsil ; Polymerase Chain Reaction ; Prognosis ; Salivary Glands ; Skin ; Stomach* ; T-Lymphocytes ; Thymus Gland