Cutaneous metastatic tumors on the scalp from the rectum are very A 66-year-old male presented a nodule and papule an his scalp three months after surgical removal of a rectal adenocarcinorna. Biopsy specien from the scalp showed adenocarcinoma which is similar to the primary rectal carcinoma.
Adenocarcinoma* ; Aged ; Biopsy ; Humans ; Male ; Rectum* ; Scalp*

Epithelial-myoepithelial carcinoma and basal cell adenocarcinoma are uncommon, low-grade malignant epithelial neoplasms of salivary gland. They occur predominantly in the parotid glands with frequent recurrences and occasional distant metastases. We report an unusual case of combined epithelial-myoepithelial carcinoma and basal cell adenocarcinoma within the same mass of the parotid gland in a 32-year-old woman. To the best of our knowledge, this is the first such a combined carcinoma case.
Adenocarcinoma* ; Adult ; Carcinoma ; Female ; Humans ; Neoplasm Metastasis ; Parotid Gland* ; Recurrence ; Salivary Glands

This study was aimed to observe the effect of Anterior J hook headgear on the craniofacial structures in mixed dentition with Class II malocclusion. The laterial c-phalograms of 20' children treated by Anterior J hook headgear were traced, digitized and statistically analyzed. The results were as follows 1. Forward growth of maxilla was inhibited. 2. Rotational effect of maxilla was not observed. 3. There was distal movement of maxillary dentition. 4. Maxillary_.dentoalveolar growth changes were more effective in anterior portion than posterior portion. &.Mandible maintained a normal growth and mandibular plane angle- was maintained during treatment period. 6. The ratio of anterior facial height to posterior facial height was almostly not changed.
Child ; Dentition ; Dentition, Mixed ; Humans ; Malocclusion ; Maxilla* ; Traction*

PURPOSE: Effective literature searching is essential to support evidence-based nursing. The aim of this study was to present our recent systematic search experience to identify guidelines in PubMed for prevention of catheter-associated urinary tract infections. METHODS: Five approaches to the literature search via PubMed were employed. The searches were restricted to items published from 1980 to 2010, for patients admitted to hospital, and in the English language. The search results were compared using the number of records and relevant items, and the sensitivity and precision of each search strategy. RESULTS: The individual approaches retrieved 19-141 of records and 3-6 of relevant items. Sensitivity ranged from 37.5% to 75.0% with the highest values for simple searches and a search combining MeSH terms and free textwords with a methodological search filter. Precision varied from 4.3% to 21.7% and the highest precision was found for MeSH terms with limits feature. CONCLUSION: The simple search in PubMed is an appropriate way for nurses in a busy clinical practice to search the literature for evidence. However, several approaches using MeSH terms, free textwords, limits feature or methodological search filters are also required to have more efficient and better informed search results.
Evidence-Based Nursing ; Humans ; Methods ; Urinary Catheterization ; Urinary Tract Infections* ; Urinary Tract*

BACKGROUND AND OBJECTIVES: Standard unfractionated heparin (UFH) has long been used to prevent death and myocardial infarction in patients with acute coronary syndrome and acute occlusion undergoing percutaneous revascularization. However, UFH binds to several plasma proteins, platelets, and endothelial cells producing a highly variable anticoagulant response. In contrast, Low molecular weight heparin (LMWH) exhibits less protein binding and provides more predictable anticoagulant response with reduced need for patient monitoring and dosage adjustment. The purpose of this study was to assess the anti-Xa activities of LMWH in Korean patients with acute coronary syndrome after recommended dose for caucasians and to determine an optimal method of administration of LMWH. MATERIALS AND METHODS: Twenty five patients with acute coronary syndrome were enrolled and allocated to five separate groups (5 patients in each group) by types according to molecular weight (LMWH (A): (molecular weight of 4500 daltons, LMWH (B): molecular weight of 6400 daltons) and methods of administration (Group 1A and 1B: Subcutaneous and subcutaneous injections (SC-SC), Group 2: Intravenous and subcutaneous injections (IV-SC), Group 3A and 3B: Intravenous, subcutaneous and subcutaneous injections (IV-SC-SC). Five groups were as follows: Group 1A: LMWH (A) 1 mg/kg SC every 12 hours, Group 1B: LMWH (B) 100 IU/kg SC every 12 hours, Group 2: LMWH (A) 1 mg/kg IV bolus and 1 mg/kg SC 12 hours later, Group 3A: LMWH (A) 0.5 mg/kg IV bolus, 3 hours later 1 mg/kg SC every 12 hours, Group 3B: LMWH (B) 50 IU/kg IV bolus, 3 hours later 100 IU/kg SC every 12 hours. Anti-Xa activity was measured by amidolytic assay method (Rotachrome, Stago, France) in 555 samples from 25 patients. All the data of anti-Xa activity in each group were plotted along the sequential time and mean values of them were analyzed by Wilcoxon signed rank test. RESULTS: 1)The anti-Xa activity (mean 0.6216+/-0.238 IU/mL) of LMWH (A) was greater than that of LMWH (B)(mean 0.2587+/-0.1709 IU/mL) in the conventional SC-SC method (p<0.001). 2) The anti-Xa activity of LMWH (A) (mean 0.6203+/-0.2383 IU/mL) was also greater than that of LMWH (B)(mean 0.468+/-0.2428 IU/mL) in the IV-SC-SC method (p<0.001). 3) More rapid and effective anti-Xa activities were achieved by IV-SC-SC method compared with conventional SC-SC method. CONCLUSION: This study suggests that immediate achievement and optimum maintenance of anticoagulant activity can be accomplished by IV-SC-SC method rather than conventional SC-SC method in patients of acute coronary syndrome.
Acute Coronary Syndrome* ; Blood Proteins ; Endothelial Cells ; Heparin ; Heparin, Low-Molecular-Weight* ; Humans ; Injections, Subcutaneous ; Molecular Weight ; Monitoring, Physiologic ; Myocardial Infarction ; Protein Binding

PURPOSE: Bone morphogenetic proteins (BMPs) are members of the transforming growth factor-beta family and play an important role in cellular growth. Recent reports suggest that exogenous bone morphogenetic protein-2 (BMP-2) acts as an antiproliferative agent in a variety of cell lines. We will study whether BMP-2 is altered in human colorectal cancer. METHODS: We analyzed 40 colorectal cancer cases and 6 colorectal cancer cell lines by using reverse transcription-polymerase chain reaction (RT-PCR) to determine the expression of BMP-2. RESULTS: Thirteen of 40 colorectal cancers (33%) and 3 of 6 colorectal cancer cell lines (50%) revealed decreased expression of BMP-2. The rates of decreased expression were 0% (0/7), 42.1% (8/19), 28.6% (2/7), 33.3% (2/6), and 100% (1/1) in stages I, II, III, and IV, respectively. Histologically, the rates were 33.3% (2/6), 32.2% (10/21), 50% (1/2), and 0% (0/1) in well-differentiated, moderately-differentiated, poorly-differentiated and mucinous cancers, respectively. As for location, the rates for colon and rectal cancers were 27.8% (5/18) and 36.4% (8/22), respectively. We identified methylation in the CpG island of the BMP-2 gene in 60% of colorectal cancer cells and in 50% of colorectal cancer cell lines. The 13 cases without BMP-2 gene expression showed no significant correlation with clinicopathological factors. Epigenetic silencing through DNA methylation is one of the key steps during carcinogenesis. CONCLUSION: We found, through an analysis using the methylation-specific polymerase chain reaction technique, CpG island methylation of the BMP-2 promoter region in colorectal cancer. Thus, aberrant BMP-2 methylation and the resultant loss of BMP-2 expression may be related to colorectal carcinogenesis.
Bone Morphogenetic Proteins ; Cell Line ; Colon ; Colorectal Neoplasms ; CpG Islands ; DNA Methylation ; Epigenomics ; Gene Expression ; Humans ; Methylation ; Mucins ; Polymerase Chain Reaction ; Promoter Regions, Genetic ; Rectal Neoplasms

BACKGROUND/AIMS: Liver cirrhosis is an end-stage liver disease. Ito cell is known to have central role in fibrogenes is of liver cirrhosis. But collagen content and Ito cell activity in liver cirr hosis have received little attention. So Ito cell activity and hepatocyte proliferation activity according to collagen content was investigated. WAF-1 and c- met were studied to evaluate the effect of cell cycle. METHODS: We analyzed 56 cases of liver cirrhosis ( viral:41, biliary:11, alcoholic:2, Wilson' s disease:2). Collagen content was measured by spectrophot ometry. Ito cell activity and prolifer ation index was measured by-SMA and Ki- 67 immunohistochemistry. RESULTS: In viral cirrhosis, high collagen group showed increased Ito cell activity compared to low collagen group. There was no difference in hepatocyte prolifer ation activity bet ween high and low collagen group in viral cirrhosis. In biliary cirrhos is, high collagen group showed increased Ito cell activity in septal zones compared to low collagen group. WAF- 1and c- met were negative in most of cases. CONCLUSION: Collagen content of liver cirrhosis is closely related to increment of activated Ito cells . Ito cell activity was prominent in septal zones than in parenchymal areas of viral cirrhosis and that was only significant in septal zones of biliary cirrhosis. There is no correlation bet ween collagen content and hepatocyte proliferation activity.
Cell Cycle ; Collagen* ; Fibrosis ; Hepatic Stellate Cells ; Hepatocytes* ; Immunohistochemistry ; Liver Cirrhosis* ; Liver Cirrhosis, Biliary ; Liver Diseases ; Liver*

BACKGROUND AND OBJECTIVES: For patients with bilateral carotid artery stenosis, simultaneous bilateral carotid endarterectomy is rarely performed due to a higher perioperative risk for death and strokes. We assessed the immediate and long-term outcomes of simultaneous bilateral carotid stenting (SBCS) for internal carotid stenosis in patients at high surgical risk. MATERIALS AND METHODS: We analyzed 10 patients who underwent SBCS for de novo stenoses of both internal carotid arteries (ICA). Included were those who had 60% to 99% stenosis of extracranial ICAs irrespective of neurologic symptoms and had more than 2 risk factors of Mayo grade III (medical risks) or IV (neurologic risks). RESULTS: The patients had a mean age of 67+/-7 years. Technical success was achieved in all lesions. The mean percent diameter stenosis was reduced from 79+/-13% to 8+/-8%. A total of 21 Wallstents were deployed at 20 lesions. One patient had a minor stroke just after the procedure which was completely resolved with local injection of urokinase. There were no deaths, major strokes or myocardial infarctions during the 30 day follow-up. Six months imaging studies were available on all 9 eligible patients with 18 lesions by duplex sonography and angiography. Late clinical follow-up at a mean of 15.1+/-8.1 months revealed no occurrence of neurologic event or death. CONCLUSION: SBCS is feasible, safe and effective to treat bilateral de novo ICA stenoses in patients at high surgical risk. The procedure, however, is investigational and more experience is required to define its role in the treatment of this patient population.
Angiography ; Carotid Artery, Internal* ; Carotid Stenosis* ; Constriction, Pathologic ; Endarterectomy, Carotid ; Follow-Up Studies ; Humans ; Myocardial Infarction ; Neurologic Manifestations ; Risk Factors ; Stents* ; Stroke ; Urokinase-Type Plasminogen Activator

A valid assessment of obesity in children and adolescents is important due to significant change in body composition during growth. This study aimed to develop percentile curves of body fat and fat free mass using the Lambda, Mu, and Sigma method, and to examine the relationship among body mass index (BMI), fat mass and fat free mass in Korean children and adolescents, using the Korea National Health and Nutrition Examination Survey (KNHANES) 2009-2010. The study subjects were 834 for boys and 745 for girls aged between 10 and 18 yr. Fat mass and fat free mass were measured by dual-energy x-ray absorptiometry. The patterns of development in body fat percentage, fat mass and fat free mass differed for boys and girls, showing a decreased fat mass with an increased fat free mass in boys but gradual increases with age in girls. The considerable proportion of boys and girls with relatively normal fat mass appeared to be misclassified to be at risk of overweight based on the BMI criteria. Therefore, the information on the percentiles of body fat and fat free mass with their patterns would be helpful to complement assessment of overweight and obesity based on BMI for Korean children and adolescents.
Absorptiometry, Photon ; Adipose Tissue/*radiography ; Adolescent ; Age Factors ; Asian Continental Ancestry Group ; Body Composition ; Body Mass Index ; Body Weight ; Child ; Female ; Humans ; Male ; *Nutrition Surveys ; Obesity/diagnosis/radiography ; Republic of Korea ; Sex Factors

PURPOSE: Matrix metalloproteinase-2 (MMP-2) and MMP-7 have been implicated in tumor growth and metastasis. This study aimed to investigate the expressions of MMP-2 and -7 in colorectal cancer and to evaluate their values as prognostic markers. METHODS: Immunohistochemical staining for MMP-2 and -7 was done in 144 resected colorectal cancer specimens. Clinicopathological data and survival results were compared with regard to the expression results. RESULTS: The expression rates of MMP-2 in tumor cells in the tumor center and the tumor border were 16.7% and 38.9%, respectively. That of MMP-2 in stromal cells was 27.8%. MMP-7 immunoreactivities of tumor cells in the tumor center and the tumor border were 6.9% and 23.6%. The expressions of MMP-2 and MMP-7 were correlated. MMP-2 expression in stromal cells was more increased in the distal part of the colorectum: 8.8% in right colon cancer, 29.5% in left colon cancer and 36.4% in rectal cancer. MMP-2 expression of tumor cells in the tumor border was correlated with T-stage. MMP-7 expression of tumor cells in the tumor border was increased in case of infiltrative cancer compared with fungating tumor. The expression patterns of MMP-2 and -7 were not correlated with other clinicopathological factors, including tumor markers, node metastasis, distant metastasis, lymphatic invasion, tumor differentiation, and recurrence. No significant associations between the overall and disease-free survival rates and the MMP-2 and -7 expression patterns were noted. CONCLUSION: The high expression rates of MMP-2 and -7 in tumor borders suggest that MMP-2 and -7 have some role in tumor invasion, but in this study, MMP-2 and -7 did not appear to be significant predictors of prognosis in colorectal cancer.
Colonic Neoplasms ; Colorectal Neoplasms ; Disease-Free Survival ; Immunohistochemistry ; Lymphatic Metastasis ; Matrix Metalloproteinase 2 ; Matrix Metalloproteinases ; Neoplasm Metastasis ; Prognosis ; Rectal Neoplasms ; Recurrence ; Stromal Cells ; Biomarkers, Tumor