c-erbB-2 oncogene is a normal cellular proto-oncogene coding transmembrane glycoprotein structurally similar to the epidermal growth factor receptor. Amplification of this oncogene in a variety of human adenocarcinomas has been reported and is particularly well documented in breast carcinoma. It has been suggested that amplification of this oncogene is indicative of poor prognosis and is valuable only second to the lymph node status. Using immunohistochemical staining for the c-erbB-2 protein, overexpression of this protein was analysed in 228 primary breast cancer specimens and the frequency of overexpression and the relationship between overexpression and the other established prognostic variables are evaluated. Ninty three cases out of 228 cases(40.8%) show postive oncoprotein overexpression and using the chi-squared test for a trend, a significant correlation was found between c-erbB-2 protein staining and the histological grade, lymph node status, and estrogen receptor status(P<0.05). No significant association was found between staining and the patient's age and tumor size. Most of the tumors with histological types known to have good prognosis showed negative expression. Above findings strongly suggest that expression of c-erbB-2 oncogene is another independent indicator of poor prognosis in breast carcinoma.
Humans ; Adenocarcinoma ; Breast Neoplasms

No abstract available.
Tuberculosis, Pulmonary*

In a jaundiced patient, it is important to ascertain as early as possible whether the bile duct is dilated. Ultrasonography, computed tomography & conventional cholangiography are widely accepted methods of determining the size of the extrahepatic bile ducts. But there is a considerable discrepancy among the size of the bile duct as measured from them. So the author analyzed and compared the respective diameters of the bile ducts in Korean normal adults as measured from cadaver, IV cholangiography, ultrasoud and computed tomography. The materials were 45 cases of cadaver, 38 cases of IV cholangiography, 100 cases of ultrasonography & 55 cases of computed tomography. The results were as follows ; 1. The diameters of the bile ducts were 7.58±2.26mm at CHD & 8.04±2.42mm at CBD from cadaver ; 5.38±1.90mm at CHD & 6.58±2.37mm at CBD from IV cholanglography ; 3.24±1.13mm at CHD & 4.71±1.48mm at CBD from ultrasonography ; and 4.56±1.51mm at CHD & 5.87±1.68mm at CBD from computed tomography. 2. The diameter of the bile duct was greatest in cadaver, and then reduced in IV cholangiography, computed tomography and ultrasonography in this orde.r 3. There were no size discrepancy between the diameter of the common hepatic duct and that of the common bile duct. 4. There were no discrepanry of the diameter of the bile duct by sex.
Adult* ; Bile Ducts* ; Bile Ducts, Extrahepatic ; Bile* ; Cadaver ; Cholangiography ; Common Bile Duct ; Hepatic Duct, Common ; Humans ; Ultrasonography

Background: The risk of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) transmission during the endemic phase may vary from that during the previous pandemic phase. We evaluated the risk of infection in a general population with laboratory-confirmed coronavirus disease 2019 (COVID-19) in a community setting in Korea. Materials and Methods: This study included 1,286 individuals who had been in contact with an index COVID-19 case between January 24, 2020, and June 30, 2022. Variables such as age, sex, nationality, place of contact, level of contact, the status of exposed cases, period, and level of mask-wearing were assessed. Results: Among 1,286 participants, 132 (10.30%) were confirmed to have COVID-19. With increasing age, the risk of the exposed persons contracting COVID-19 from index cases tended to increase (P <0.001), especially for people in their 70s (odds ratio, 1.24; 95% confidence interval, 1.11–1.40; P <0.001). We found an increasing trend in the risk of a COVID-19 exposed case becoming a secondary infection case (P <0.001) in long-term care facilities where the attack rate was high. Conclusion The risk of COVID-19 transmission is high in long-term care facilities where many older adults reside. Intensive management of facilities at risk of infection and strict mask-wearing of confirmed COVID-19 cases are necessary to prevent the risk of COVID-19 infection.

No abstract available.
Decompression* ; Head* ; Osteonecrosis*

Signet ring cell carcinoma has been previously described in many organs, most frequently in the stomach, and rarely in the colon, rectum, gallbladder, pancreas, breast, nadsal cavity, prostate, urinary bladder and ureter. Signet ring cell carcinomas in the lung, especially, when examined by small biopsies, are generally believed to be metastatic. This case was diagnosed by bronchoscopic biopsy. We also examined various organs by noninvasive method, including UGI series, barium enema and abdomen CT scarf, but all studies were nomal. Patient received cisplatin and etoposide combination chemotherapy followed by local radiotherapy ai a primary non-small cell lung cancer. Patient died of his disease 6 months after diagnosis. Now we report a case of primary signet ring cell carcinoma of the lung.
Abdomen ; Barium ; Biopsy ; Breast ; Carcinoma, Non-Small-Cell Lung ; Carcinoma, Signet Ring Cell* ; Cisplatin ; Colon ; Diagnosis ; Drug Therapy, Combination ; Enema ; Etoposide ; Gallbladder ; Humans ; Lung Neoplasms ; Lung* ; Pancreas ; Prostate ; Radiotherapy ; Rectum ; Stomach ; Ureter ; Urinary Bladder

PURPOSE: We aimed to investigate how serum vitamin D levels are related to survival of terminally ill cancer patients. METHODS: From May 2012 through June 2013, a retrospective chart review was performed on 96 hospice patients. Univariate and multivariate logistic regression analyses were conducted to identify factors associated with severe vitamin D deficiency and Coxcy and Coxional hazard analyses were used to evaluate effects on survival. RESULTS: The mean vitamin D level in patients was 8.60+/-7.16 ng/ml. Vitamin D was severely deficient (<10 ng/ml) in 75 patients (78.2%), deficient (10~20 ng/ml) in 13 patients (13.5%), relatively insufficient (21~29 ng/ml) in five patients (8.3%) and sufficient ((t ng/ml) in three patients (3.1%). Hyperbilirubinemia (> or =1.2 g/dl) was the only factor associated with severe vitamin D deficiency according to the multiple logistic regression analysis (Odds ratio, OR=18.48, P<0.05). Although hyperbilirubinemia showed a strong association with survival (Hazard ratio, HR=2.25, P<0.01), no association was found between severe vitamin D deficiency and survival (HR=1.15, P>0.05) in Cox's proportional hazard analysis. CONCLUSION: Although serum vitamin D levels were severely low in terminally ill cancer patients, we found no association between severe vitamin D deficiency and patient survival.
Hospices ; Humans ; Hyperbilirubinemia ; Logistic Models ; Retrospective Studies ; Survival Analysis ; Terminal Care ; Terminally Ill* ; Vitamin D Deficiency ; Vitamin D*

Disseminated neonatal herpes simplex virus (HSV) infection is one of the most severe neonatal infections, and can have devastating consequences without early proper treatment. However, the administration of acyclovir can often be delayed because the symptoms and signs of HSV infection are non-specific and because HSV polymerase chain reaction (PCR) results may be negative early in the course of HSV infection. We report a case of disseminated neonatal HSV infection that was diagnosed by type 1 HSV PCR on day 8 of admission. Despite delayed administration of acyclovir, the patient was cured and subsequently discharged after 30 days of admission. Fortunately, this patient was treated successfully, but delayed administration of acyclovir has the potential to lead to significant problems. Considering the seriousness of neonatal HSV infection, empirical acyclovir therapy should be considered if HSV infection is suspected.
Acyclovir ; Herpes Simplex* ; Humans ; Infant, Newborn ; Methylmethacrylates ; Polymerase Chain Reaction ; Polystyrenes ; Pregnancy Complications, Infectious ; Simplexvirus*

OBJECTIVES: Because effective decolonization options are not available, and treatment options are limited, carbapenem-resistant Enterobacterales (CRE) constitute increasingly threatening nosocomial pathogens. To prevent CRE-associated transmission and ensure patient safety, healthcare personnel and everyone in contact with CRE-infected patients must implement stringent infection control practices. This report describes a CRE outbreak, possibly related to a caregiver at a long-term care facility (LTCF), and presents a new surveillance model to improve the infection control of CRE in Seoul, Korea. METHODS: The Seoul Metropolitan Government surveillance system identified an outbreak of CRE in an LTCF in 2022. We obtained data on the demographic characteristics and contact histories of the inpatients, medical staff, and caregivers. To isolate the inpatients and employees exposed to CRE, we used rectal swab samples and environmental sampling during the study period (May-December 2022). RESULTS: We identified 18 cluster cases (1 caregiver and 17 inpatients) and 12 sporadic cases with CRE, and conducted a complete 197-day follow-up of all cases in the LTCF’s isolation wards. CONCLUSIONS This investigation demonstrated that our surveillance model and targeted intervention, based on the cooperation of the municipal government, public health center, and infection control advisory committee, effectively contained the epidemic at the LTCF. Measures to improve the compliance of all employees in LTCFs with infection control guidelines should also be adopted.

Iatrogenic fracture is not popular and might be recognized as a malpractice. Surgical error related to iatrogenic fracture which has occurred after an operation can be detected only by a surgeon. Stress riser fracture is another form of iatrogenic fracture also known as a Young's modulus fracture. As the majority of surgical related stress riser fractures can be preventive, the accurate prevalence is not known. The majority of fractures occurred in the weight bearing bones such as femur and tibia. The subtrochanter area is the most stress concentrated area in the human body, thus it is a common area for occurrence of stress riser iatrogenic fractures. We experienced 2 cases of stress riser iatrogenic fractures, which are related to technical errors, thus we report cases with literature review.
Elastic Modulus ; Femur ; Hip Fractures* ; Human Body ; Iatrogenic Disease ; Malpractice ; Medical Errors* ; Prevalence ; Tibia ; Weight-Bearing