PURPOSE: Thallim-201 (201Tl) brain SPECT and proton (1H) magnetic resonance spectroscopy (MRS) have been used to evaluate tumor grade and viability of glioma. We assessed the correlations between 201Tl brain index or spectrum of metabolites of 1H MRS and grade of glioma or histopathologic findings. MATERIALS AND METHODS: We studied 17 patients (4 astrocytoma, 7 anaplastic astrocytoma and 6 glioblastoma). On 201Tl Brain SPECT, 201Tl index was measured as the ratio of average counts for region of interest to those for the contralateral normal brain. On 1H MRS, we calculated choline (Cho) /creatine (Cr) ratio and N-acetylaspartate (NAA)/Cr ratio in ROI defined as tumor center. Histopathologic findings were graded by Ki-67 index, cellularity, mitosis, pleomorphism, necrosis and endothelial proliferation. An unpaired t test and statistical correlations were performed to evaluate these data. RESULTS: Tl-index showed the best correlation with Ki-67 index (p<0.01), less correlations with cellularity, mitosis, and endothelial proliferation, but no correlation with results of MRS, pleomorphism, or necrosis. The findings of MRS did not correlate with all of the above. The cases of glioblastoma demonstrated a higher Tl-index, Cho/Cr ratio, Ki-67 index and lower NAA/Cr ratio, albeit without statistical significance. CONCLUSION: Even though 201Tl brain SPECT did not correlate directly with grade of malignancy, it may still be useful in determining biological aggressiveness of tumor and prognosis of patients because it correlated well with Ki-67 index, a growth fraction of glioma, cellularity, mitosis and endothelial proliferation.
Astrocytoma ; Brain* ; Choline ; Glioblastoma ; Glioma* ; Humans ; Magnetic Resonance Spectroscopy* ; Mitosis ; Necrosis ; Pathology* ; Prognosis ; Protons ; Tomography, Emission-Computed, Single-Photon*

Background: This study investigates the influence factors of medical service variations using medical charge and the length of stay (LOS) for urinary incontinence surgery and uterine polypectomy. Methods: The National Health Insurance claims data and Medical Resource Report by the Health Insurance Review & Assessment Service in 2016 were used. Frequency analysis, one-way analysis of variance, and Bonferroni post-hoc tests were executed for each surgery. A multilevel analysis was executed to assess the factors to the medical charge and LOS for each surgery in patient, doctor, and hospital level. Results: Fifty-two point eight percent of urinary incontinence surgery and 87.1% of uterine polypectomy were distributed in general and tertiary hospitals. Among three levels, the patient level variation was 61.5% or 77.2% in medical charge and 93.9% or 96.3% in LOS, respectively. The doctor level variation was 29.6% or 22.6% in medical charge and 0.6% or 0.0% in LOS, respectively. The institution level variation was 8.9% or 0.2% in medical charge and 5.5% or 3.7% in LOS, respectively. Number of other disease and organizational type were main factors that affected the charge and LOS for urinary incontinence surgery and uterine polypectomy. Conclusion Medical service variations of the urinary incontinence surgery and uterine polypectomy were the largest for the patient level, followed by doctor level for the medical charge, and the institution level for the LOS.

PURPOSE: This study aims to assess the diagnostic efficacy of the Alvarado score and to determine cut-off values of Alvarado score according to age for deciding on the options for patients with suspected appendicitis. METHODS: From October 2008 to January 2009, we prospectively reviewed 152 patients with suspected appendicitis. The patients were classified into adults and children groups. We then determined cut-off values of the Alvarado score by analyzing each score's sensitivity and specificity. RESULTS: Of the 147 patients, 96 patients were adults and 51 were children. The mean Alvarado score for adults and children were 6.08+/-1.85, and 6.69+/-1.43 in appendicitis and 4.32+/-2.02, and 4.60+/-1.81 in non-appendicitis, respectively. In adults, the sensitivity of the Alvarado scores 7 or higher for appendicitis was 66.2%, and the specificity was 67.7%. And the sensitivity of the Alvarado scores 4 or lower for non-appendicitis was 58.1%, and the specificity was 81.5%. In children, the sensitivity of the Alvarado scores 7 or higher for appendicitis was 80.8%, and the specificity was 68.0%. And the sensitivity of the Alvarado scores 4 or lower for non-appendicitis was 52.0%, and the specificity was 92.3%. CONCLUSION: The cut-off values for Alvarado score were not different according to age of the patient. If the Alvarado score is 7 or higher, surgical management is recommended, and if the Alvarado score is 4 or lower, observation without CT or US is recommended. In equivocal appendicitis as defined by the Alvarado scores 5 to 6, adjunctive CT or US are recommended to confirm appendicitis.
Adult ; Appendicitis ; Child ; Humans ; Prospective Studies ; Sensitivity and Specificity

PURPOSE: In the metastatic process, interactions between circulating tumor cells (CTCs) and the extracellular matrix or surrounding cells are required. beta1-Integrin may mediate these interactions. The aim of this study was to investigate whether beta1-integrin is associated with the detection of CTCs in colorectal cancer. METHODS: We enrolled 30 patients with colorectal cancer (experimental group) and 30 patients with benign diseases (control group). Blood samples were obtained from each group, carcinoembryonic antigen (CEA) mRNA for CTCs marker and beta1-integrin mRNA levels were estimated by using reverse transcription-polymerase chain reaction, and the results were compared between the two groups. In the experimental group, preoperative results were compared with postoperative results for each marker. In addition, we analyzed the correlation between the expressions of beta1-integrin and CEA. RESULTS: CEA mRNA was detected more frequently in colorectal cancer patients than in control patients (P = 0.008). CEA mRNA was significantly reduced after surgery in the colorectal cancer patients (P = 0.032). beta1-Integrin mRNA was detected more in colorectal cancer patients than in the patients with benign diseases (P < 0.001). In colorectal cancer patients, expression of beta1-integrin mRNA was detected more for advanced-stage cancer than for early-stage cancer (P = 0.033) and was significantly decreased after surgery (P < 0.001). In addition, expression of beta1-integrin mRNA was significantly associated with that of CEA mRNA in colorectal cancer patients (P = 0.001). CONCLUSION: In conclusion, beta1-integrin is a potential factor for forming a prognosis following surgical resection in colorectal cancer patients. beta1-Integrin may be a candidate for use as a marker for early detection of micrometastatic tumor cells and for monitoring the therapeutic response in colorectal cancer patients.
Carcinoembryonic Antigen ; Case-Control Studies* ; Colorectal Neoplasms* ; Extracellular Matrix ; Humans ; Neoplastic Cells, Circulating ; Prognosis ; RNA, Messenger

Localized, water-suppressed in vivo 'H MRS was performed to evaluated the proton metabolic alterations in patients with acute cerebral infarction.Ten brain infarction patients(six males and four females; age range 53-77) participated in this study. GE Signa 1.5-T whole-body NMI/MRS system using STEAM pulse sequence was used. Voxels were selected from the cerebral infarcted region and contralateral normal region as control in the same patient. Proton metaboliteratiosrelativetocreatine (Cr) wereobtainedusingaMa-rquartalgorithm. The specific features in the cerebral infarcted regions demonstrated a significant decrease of N-acetyl aspartate (NAA)/creatine (Cr) ratio, compared with control regions. Markedly increased lactate (Lac) level was observed in areas of cerebral infarctioln in all patients. Our preliminary study showed that NAA/Cr ratio in the infarcted regions was substanially different from that in control regions.The signal intensity of Lac may be served as a metabolic criterion that can specify acuteness of infarction, and also evaluate the therapeutic effect. It is necessary to investigate the spectral alterations in various stages of cerebral infarction for further detail analysis.
Aspartic Acid ; Brain Infarction ; Cerebral Infarction* ; Female ; Humans ; Infarction ; Lactic Acid ; Male ; Metabolism ; Protons ; Steam

PURPOSE: The epidermal growth factor receptor (EGFR) plays an important role in tumorigenesis and tumor progression of colorectal cancer and leads to the activation of intracellular signaling pathways. The use of anti-EGFR-targeted therapy has increased for patients with colorectal cancer, but patients with EGFR mutations will be resistant to anti-EGFR-targeted therapy. The identification of gene mutations is critical in cancer treatment; therefore, the aim of this study is to investigate the incidences of EGFR mutations in colorectal cancer patients in Korea. METHODS: We retrospectively reviewed 58 colorectal cancer patients who underwent surgery between 2003 and 2006. We analyzed their EGFR mutations in four loci by DNA sequencing. In addition, we analyzed the correlation between the presence of EGFR mutation and patients' clinicopathologic features. RESULTS: Of the 58 patients, 35 patients were male and 23 were female. Their mean age was 63.28 +/- 11.18 years. Two patients (3.45%) were diagnosed as stage Tis, 7 patients (12.07%) as stage I, 24 patients (41.38%) as stage II, 20 patients (34.48%) as stage III, and 5 patients (8.62%) as stage IV. As a result of mutational analysis, EGFR mutations on exon 20 were detected in 13 patients (22.41%, G-->A transitions). No EGFR mutations were detected on exons 18, 19, and 21. EGFR mutation was increased in the earlier stage and in the absence of lymph node metastasis (P = 0.028). CONCLUSION: The incidence of EGFR mutation in Korean colorectal cancer patients is 22.41%. In addition, EGFR mutation was significantly increased in the earlier stage and in the absence of lymph node metastasis.
Cell Transformation, Neoplastic ; Colorectal Neoplasms ; Epidermal Growth Factor ; Exons ; Female ; Humans ; Incidence ; Lymph Nodes ; Male ; Neoplasm Metastasis ; Receptor, Epidermal Growth Factor ; Retrospective Studies ; Sequence Analysis, DNA

PURPOSE: Livin is associated with drug response in several cancers. The aim of this study was to investigate the effect of silencing the livin gene expression on anticancer drug response in colorectal cancer. METHODS: siRNA was transfected at different concentrations (0, 10, and 30nM) into HCT116 cells, then cells were treated with either 5-fluorouracil (FU)/leucovorin (LV) or oxaliplatin (L-OHP)/5-FU/LV. Cellular viability and apoptosis were evaluated following silencing of livin gene expression combined with treatment with anticancer drugs. RESULTS: Livin gene expression was effectively suppressed by 30nM siRNA compared with control and 10nM siRNA. The 3-(4, 5-dimethylthiazol-2-yl)-2, 5-diphenyltetrazolium bromide assay showed that proliferation was effectively inhibited in cells treated with a combination of both siRNA and an anticancer drug, compared to cells treated with siRNA-Livin or anticancer drug alone. In particular, the combination of 30nM siRNA and L-OHP/5-FU/LV resulted in a 93.8% and 91.4% decrease, compared to untreated control or L-OHP/5-FU/LV alone, respectively. Cellular proliferation was most effectively suppressed by a combination of 30nM of siRNA and L-OHP/5-FU/LV compared to other combinations. CONCLUSION: siRNA-mediated down-regulation of livin gene expression could significantly suppress colon cancer growth and enhance the cytotoxic effects of anticancer drugs such as 5-FU and L-OHP. The results of this study suggest that silencing livin gene expression in combination with treatment with anticancer drugs might be a novel cancer therapy for colorectal cancer.
Apoptosis ; Cell Proliferation ; Colon* ; Colonic Neoplasms* ; Colorectal Neoplasms ; Down-Regulation ; Fluorouracil ; Gene Expression ; HCT116 Cells ; RNA, Small Interfering

Cancer prevention by vegetable diet has received considerable attention in recent years. In the past these attributes of vegetables were based more on beliefs than on scientific evidences. But over the past few decades many studies have been performed about that. Cancer preventive components of many vegetables have been studied in experimental carcinogenesis models. These studies have reported on these components influence carcinogenesis during initiation and promotion phases of cancer development. Also, epidemiological studies and clinical trials have reported cancer preventive effects of vegetables. However, there is no comprehensive summary of cancer preventive effects with the types of vegetables. In this review, we classified the vegetables and described the mechanism of action of active components of vegetables, experimental studies, and clinical trials. Results revealed a negative correlation between consumption of vegetables and cancer risk. But we can't still conclude the effects of vegetables yet, so further studies would be necessary for final conclusion.
Diet ; Vegetables

PURPOSE: Venous angioma (VA) is the most common congenital abnormality of the intracranial vasculature. This study aimed to investigate the relationship between VA and epilepsy and to identify the characteristics of children with VA and epilepsy. METHODS: The records of all patients aged less than 18 years who underwent brain magnetic resonance imaging (MRI) at Pusan National University Hospital were retrospectively reviewed. Patients with isolated VA and patients with normal MRI were compared in terms of the prevalence of epilepsy. RESULTS: In total, 2,385 pediatric patients who underwent brain MRI were enrolled. Isolated VA was identified in 26 patients (VA group). Among the patients with normal MRI findings, 225 age- and sex-matched patients to the VA-group were assigned to the control group. Nine patients in the VA group (9 of 26, 34.6%) and 27 patients in the control group (26 of 225, 11.5%; P<0.001) had epilepsy. In the VA group, 20 patients (76.9%) had the VA in the cerebral hemispheres, and 6 patients (23.1%) had the VA in the brainstem and cerebellum. The latter showed a higher prevalence of epilepsy (5 of 6, 83.3%) than the former (4 of 20, 20.0%; P=0.004). Among the nine patients who had epilepsy with VA, patients whose VA involved the brainstem and cerebellum showed a significantly higher frequency of abnormal Electroencephalographic findings than patients whose VA involved the cerebral hemispheres (P=0.016). CONCLUSION: VA, especially in the brainstem and cerebellum, might be associated with epilepsy.
Brain ; Brain Stem ; Busan ; Central Nervous System Venous Angioma ; Cerebellum ; Cerebrum ; Child* ; Congenital Abnormalities ; Epilepsy* ; Hemangioma* ; Humans ; Magnetic Resonance Imaging ; Prevalence ; Retrospective Studies

PURPOSE: The gastric cancer is a common malignancy worldwide. Developing a screening test for gastric cancer is important because early-stage gastric cancer has a good prognosis. So, we investigated the effect of the CYP2E1 and CYP2C19 polymorphisms on the susceptibility for gastric cancer. METHODS: We studied 92 patients who were diagnosed with gastric cancer at Hospital and 80 patients who were admitted during the same period. Polymerase chain reaction (PCR) was performed for the 96-bp insertion polymorphism of CYP2E1 and the poor metabolizer of CYP2C19. The expressions of CYP2E1 and CYP2C19 in case and control groups were compared by Student's t-test and logistic regression analysis. RESULTS: The distribution of the CYP2E1 96-bp insertion polymorphism was 61 (66.3%), 28 (30.4%) and 3 (3.3%) for insert 0, insert 1 and insert 2 in the study group, respectively, and 61 (76.3%), 18 (22.5%) and 1 (1.3%) in control group, respectively. The distribution of the CYP2C19 poor metabolizer was 12 (13.0%) and 5 (5.4%) for CYP2C19*2/*2 and CYP2C19*2/*3 in the study group, respectively, and 3 (3.7%), 1 (1.3%) and 7 (8.8%) for CYP2C19*2/*2, CYP2C19*3/*3 and CYP2C19*2/*3 in control group, respectively. The ORs for CYP polymorphisms on stomach cancer were 1.2 (95% CI: 0.8~3.2) in the CYP2E1 96-bp insert group and 1.4 (95% CI 0.6~3.2) in the CYP2C19 PM. For the patients younger than 50 years, the OR of the CYP2C19 poor metabolizer for stomach cancer was much higher than, but there was the limitation that the age and gender distribution in the 2 groups did not match (P=0.004). CONCLUSION: We noted that there was no significant correlation between the CYP2E1 and CYP2C19 polymorphisms and the gastric cancer group. Yet there was a tendency for the higher incidence of CYP2E1 and CYP2C19 polymorphisms in the gastric cancer group. Further well designed studies will be needed to conclude the effects of CYP2E1 and CYP2C19 polymorphisms on stomach cancer.
Cytochrome P-450 CYP2E1* ; Cytochrome P-450 Enzyme System ; Humans ; Incidence ; Logistic Models ; Mass Screening ; Polymerase Chain Reaction ; Prognosis ; Stomach Neoplasms*