PURPOSE: This study was carried out to evaluate the expression of p53 and bcl-2 protein in the adenocarcinoma of gallbladder. MATERIALS AND METHODS: Thirty three cases of adenocarcinoma of gallbladder were immunohistochemically stained for p53 and bcl-2 protein. RESULTS: p53 protein was expressed in 51.5%(17/33) of adenocarcinoma. p53 protein expression was not significantly correlated with histologic grade of adenocarcinoma, depth of invasion, lymph node metastasis, distant metastasis and TNM stage, respectively(p>0.05). bcl-2 protein was expressed in 12.1%(4/33) of adenocarcinoma. bcl-2 protein expression was not significantly correlated with tumor size, histologic grade, depth of invasion, lymph node metastasis, distant metastasis and TNM stage, respectively(p>0.05). There is no correlation between expression of p53 and bcl-2 in gallbladder adenocarcioma(p > 0.05). CONCLUSION: This study suggest that p53 gene mutation plays an important role in carcinogenesis of gallbladder adenocarcinoma. The role of bcl-2 protein in gallbladder adenocarcinoma may be not significant.
Adenocarcinoma* ; Apoptosis ; Carcinogenesis ; Gallbladder* ; Genes, p53 ; Lymph Nodes ; Neoplasm Metastasis

No abstract available.
Decompression* ; Ossification of Posterior Longitudinal Ligament*

PURPOSES: Radiologic findings of hands in Turner syndrome(TS) which have been reported were metacarpal sign(MS), carpal sign(CS), phalangeal sign(PS), osteopenia, and delayed bone maturation. The aim of this study is to evaluate the difference of radiologic findings in TS, idiopathic short stature(ISS), and growth hormone deficiency(GHD). METHODS: Sixty girls with short stature were studied for chromosome analysis, and growth hormone provocation test. Simple radiography of hands was also used in this study. They were divided into three groups; 25 cases of TS(45, XO, 13 cases; variants, 12 cases), 24 cases of ISS, and 11 cases of GHD. MS was the distance between the line drawn tangential to the heads of the fourth and fifth metacarpal bones and the distal end of the third metacarpal head. CS was the angle between the line tangential to scaphoid and lunate and the line tangential to lunate and triquetrum. PS was the difference between the sum of the length of distal and proximal phalanges of the fourth finger and the length of the fourth metacarpus. Frequency of osteopenia and the shortening of the fifth middle phalanx among three groups were compared. RESULTS: MS was 0.06+/-4.66 mm in TS, -1.96+/-1.83 mm in ISS, and -2.63+/-30 mm in GHD. CS was 116.54+/-11.52degreein TS, 129.42+/-5.52degreein ISS, and 125.54+/-7.22degreein GHD. PS was 0.52+/-0.34 mm in TS, 0.38+/-0.20 mm in ISS, and 0.33+/-0.20 mm in GHD. There were statistically significant differences between TS and ISS, between TS and GHD, respectively in MS, CS, and PS(P<0.05). There were no significant differences in MS, CS, and PS between 45, XO and variants of TS. Osteopenia was observed in 92.3% of TS, and 54.2% of ISS, and 81.8% of GHD. Shortening of the fifth middle phalanx was observed in 56.0% of TS, 25.0% of ISS, and 45.5% of GHD. CONCLUSION: Simple radiologic findings of hands are helpful in differential diagnosis of TS and other short stature children.
Bone Diseases, Metabolic ; Child ; Diagnosis, Differential ; Female ; Fingers ; Growth Hormone ; Hand* ; Head ; Humans ; Metacarpal Bones ; Metacarpus ; Radiography ; Turner Syndrome*

Cushing's disease is an ACTH-producing pituitary corticotrope adenoma. This pituitary adenoma exhibits an unrestrained ACTH secretion resulting in hypercortisolemia. A 27-year-old female visited us with a 3-year history of diffuse hair loss on the scalp. Her past medical history included recently-developed hypertension and 10 years of increased weight gain and oligomenorrhea. Central obesity, hirsutism, acne, violet striae on the abdomen, lower and upper extremities, and christmas tree-shaped alopecia on the scalp were observed upon physical examination. The secretion of cortisol was not suppressed in both a low and high dose dexamethasone suppression test. A brain MRI detected a pituitary microadenoma in the sella turcica. Based on the clinical and laboratory findings, we diagnosed androgenetic alopecia associated with Cushing's disease. After surgical removal of the pituitary adenoma, the alopecia showed a remarkable improvement. We report a case of Cushing's disease found in a patient with androgenetic alopecia.
Abdomen ; Acne Vulgaris ; Adenoma ; Adrenocorticotropic Hormone ; Adult ; Alopecia* ; Brain ; Dexamethasone ; Female ; Hair ; Hirsutism ; Humans ; Hydrocortisone ; Hypertension ; Magnetic Resonance Imaging ; Obesity, Abdominal ; Oligomenorrhea ; Physical Examination ; Pituitary Neoplasms ; Scalp ; Sella Turcica ; Upper Extremity ; Viola ; Weight Gain

Background: Long-term care insurance for the elderly has been stably established along with the quantitative expansion of long-term care facilities. Indeed, the need for a paradigm about human rights-based service approach is being raised throughout society from a service perspective. Therefore, this study aimed to analyze the association between elderly human rights awareness and quality of service by considering human rights education as a moderate variable. Methods: This study conducted surveys with 138 caregivers working in long-term care facilities located in Seoul and Gangwon.General characteristics, awareness of human rights, and the level of service quality were examined using descriptive statistics, frequency analysis, and correlation analysis. And multi-variable linear regression with a hierarchical framework was employed. These analyses were performed using IBM SPSS ver. 25.0. Results: Of the 138 caregivers, 97.1% were female, 87.7% were more than 50 years old, and most of their education level was high-school graduates. Their length of employment ranged from more than 5 years to less than 10 years. The level of awareness regarding elderly human rights of the elderly was below normal (mean=2.21), but the quality of service was high (mean=4.21), and the need for human rights education was also high (mean=4.28). Among the general characteristics, the length of employment was significantly associated with awareness of elderly human rights. Moreover, political rights awareness, included as sub-domains of human rights, was positively associated with quality of service. However, the moderating variable, human rights education, was not significantly associated with the quality of service. Conclusion In this study, human rights education, as a moderating variable, did not have a statistically significant effect on caregivers’ human rights awareness in relation to service quality. This finding is inconsistent with previous research results. These results can be explained by the fact that the frequency of education in long-term care facilities was a significant factor in the practice of protecting the human rights of the elderly. Therefore ongoing encouragement for the frequency of current human rights education and improvements in the educational approach appear to be necessary. In addition, these findings reveal the need for strength of education policies and effective in-depth research about human rights and quality of service to respect the human rights of the elderly.

BACKGROUND: Over the decade, Klebsiella pneumoniae resistant to broad-spectrum oephalosporins have been involved in hospital outbreaks, particulaly in intensive care units. Betwem March 20 and June 12. 1900. an outbreak of sepsis caused by multiresistant K. pneumoniae in the neonatal intensive care unit (NICU) of Asan Medical Center. This paper describes bacteriologic, molecular and epidemiologic features of the outbreak. METHODS: For surveillance purpose, stool specimens were obtained from all patients, nurses and house staff in NICU and cultured onto MacConkey agar medium containg cefotaxim, (10 microgram/ml). All K. pneumoniae isolated blood culture isolates form patients with sepsis were tested for antobiogram by microbroth dilution method and for detection of extended-spectrum beta-Iactamase (ESBL) by double disk synergy test and ESBL Etest. Restriction profiles of total genomic DNAs were compared by pulsed filed gel electrophoresis(PFGE) after cleavage by Xbal. beta-Lactamase was tested using nitroefin disks and characterized by transconjugation to Escherichia coli and isoelectric focusing. For infection control, all infected or colonized patients and nurses were cohorted into a separate room and strict barrier precautions were enforced. RESULTS: The outbreak involved 7 patients with sepsis form whom multiresistant. K. pneumoniae were isolated. Surveillance culture revealed that 9 of 37 patients and 2 of 48 nurses and house staff were colonized. The 18 isolates showed 8 different antimicrobial resistance patterns with cefotaxime resistance in all. Test for ESBL was positive in all 18 isolates but only 15 isolates by ESBL Etest. PFGE analysis showed that 6 of the 7 blood isolate from infected patient and 9 of the 11 fecal isolates from surveillance cultures were of the identical or very similar pattern. beta-Lactamase activities were transferable by conjugation in all but one isolate. No additional case of multiresistant. K. pneumoniae infection had been reproted for 6 months since the introduction of strict barrier precautious and other infection control measures. CONCLUSION: The outbreak was caused by ESBL-producing K. pneumoniae which appeared to be introduced into the NICU from multiple sources as was indicated by PFGE patterns. An optimal laboratory method for screening for ESBL remain to be developed as the double disk synergy test and ESBL Etest did not show complete agreement. As for infoction control our results emphasize the necessity of early recognition of outbreaks, cohorting of not only infected but also colonized patients and reinforcement of the barrier precuations for the prevention of further spread of cross-infections.
Agar ; beta-Lactamases* ; Cefotaxime ; Chungcheongnam-do ; Cohort Studies ; Colon ; Cross Infection* ; Disease Outbreaks ; DNA ; Escherichia coli ; Humans ; Infant, Newborn ; Infection Control ; Intensive Care Units ; Intensive Care, Neonatal* ; Internship and Residency ; Isoelectric Focusing ; Klebsiella pneumoniae* ; Klebsiella* ; Mass Screening ; Pneumonia ; Sepsis

Reactive dyes have been widely used in recent years. This paper reports nine cases of immediate type occupational asthma to reactive dyes in one dye industry. All patients had had asthmatic symptoms, four had had rhinitis and they had worked for 6 to 25 months. Skin prick tests with reactive dyes were positive and bronchoprovocation tests also produced immediate or dual types of bronchoconstriction. We used the radioallergosorbent test (RAST) technique with nitrocellulose filter paper as a solid phase to detect specific IgE to four reactive dye-human serum albumin conjugates. High specific IgE binding was found in eight asthmatic workers compared with 13 negative controls. The RAST inhibition test revealed that there was no immunological cross-reactivity between 4 reactive dyes. These results suggested that the mechanism of their asthmatic symptoms was immunological, mostly an IgE-mediate reaction.
Adult ; Asthma/chemically induced/*immunology ; Dyes/*adverse effects ; Human ; Immunoglobulin E/*analysis ; Male ; Middle Age ; Occupational Diseases/chemically induced/*immunology ; Support, Non-U.S. Gov't

Reactive dyes have been widely used in recent years. This paper reports nine cases of immediate type occupational asthma to reactive dyes in one dye industry. All patients had had asthmatic symptoms, four had had rhinitis and they had worked for 6 to 25 months. Skin prick tests with reactive dyes were positive and bronchoprovocation tests also produced immediate or dual types of bronchoconstriction. We used the radioallergosorbent test (RAST) technique with nitrocellulose filter paper as a solid phase to detect specific IgE to four reactive dye-human serum albumin conjugates. High specific IgE binding was found in eight asthmatic workers compared with 13 negative controls. The RAST inhibition test revealed that there was no immunological cross-reactivity between 4 reactive dyes. These results suggested that the mechanism of their asthmatic symptoms was immunological, mostly an IgE-mediate reaction.
Adult ; Asthma/chemically induced/*immunology ; Dyes/*adverse effects ; Human ; Immunoglobulin E/*analysis ; Male ; Middle Age ; Occupational Diseases/chemically induced/*immunology ; Support, Non-U.S. Gov't

OBJECTIVE: The dissecting aneurysms of vertebral artery with various clinical manifestations have been increasingly reported with recent advent of diagnostic tools such as 3-Dimension computed tomography angiogram, magnetic resonance image and conventional angiogram. The authors analyzed the various treatment modalities according to their clinical presentations of vertebral artery dissecting aneurysms. METHODS: At the author's institution between March 2001 and February 2004, 28 patients were managed under diagnose of vertebral artery dissection. The medical record and neuroimaging studies of patients were reviewed retrospectively. RESULTS: Seven patients were presented with subarchnoid hemorrhage and 2 patients with mass effect. The other 12 patients were presented with ischemic stroke and 7 patients with headache or neck pain. 19 patients were treated with endovascular coils or stent. The other 8 patients were treated conservatively. and one patient was treated with operation. We had no endovascular treatment-related complications. Sixteen patients who underwent endovascular treatment survived with good recovery. but one patient died and 2 patients were in poor neurological status. Among patients with mass effect, one patient was treated with operation. and the other one patient with endovascular coils. We obtained optimal treatment results with improvement of myelopathy in both patients. CONCLUSION: The choice of the treatment of vertebral artery dissecting aneurysm of patients, clinical characteristics, and relation with posterior inferior cererebellar artery. The endovascular treatment using stent with/without coiling could be the treatment of choice if preservation of the vertebral artery is necessory.
Aneurysm, Dissecting* ; Arteries ; Headache ; Hemorrhage ; Humans ; Medical Records ; Neck Pain ; Neuroimaging ; Retrospective Studies ; Spinal Cord Diseases ; Stents ; Stroke ; Vertebral Artery Dissection ; Vertebral Artery*

A case of frontal ganglioglioma coexisting with pituitary adenoma is reported. A 37-year-old male presented with chief complaint of headache for 2 months. A neurological examination of the patient revealed no deficit. Brain MRI showed a well enhanced lobulated mass on left frontal lobe and another homogeneously enhanced mass on intrasellar and suprasellar portion. The frontal mass was grayish in color and rubbery hard in consistency on operative field, having relatively good boundary from the adjacent normal brain tissue. The sellar mass was 3X3cm in size and compressed optic chiasm. Histological diagnosis of frontal mass was ganglioglioma and sella mass showed typical features of pituitary adenoma.
Adult ; Brain ; Diagnosis ; Frontal Lobe ; Ganglioglioma* ; Headache ; Humans ; Magnetic Resonance Imaging ; Male ; Neurologic Examination ; Optic Chiasm ; Pituitary Neoplasms*