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: 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*

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: There is a need for sensitive, specific diagnostic and prognostic molecular markers that can monitor the early patterns of gene expression in non-invasive exfoliated colonocytes shed in stools. It has been estimated that approximately 10(10) normal adult colonic epithelial cells, each having a lifespan of 3~4 days, are shed from the lower two-thirds of colon crypts daily; thus, the development of a screening test using colonocytes is an realistic goal. Due to the characteristics of stools, few studies have been conducted on RNA based detection methods. Herein, a mass RNA analysis, using stools in colorectal cancer, is reported. METHODS: The study included 15 colorectal cancer patients, and 15 control patients without neoplastic disease. RNA was isolated from routinely collected stool samples using a modified method. The expression levels of survivin, livin, Akt-1, caveolin, histone deacetylase (HDAC)1, matrix metalloproteinases (MMP)-2, MMP-7, MMP-9, MMP-12, hepatoma derived growth factor (HDGF), peptideYY, hypoxia-inducible factor (HIF)-1, epidermal growth factor receptor (EGFR), N-cadherin, catenin-beta, inducible nitric oxide synthase (iNOS), ring-3, enolase-1beta, insulin-like growth factor binding protein (IGFBP)-2, tissue inhibitors of metalloproteinase (TIMP)-1 and EphB2 were determined by reverse transcriptase- polymerase chain reactions (RT-PCR). RESULTS: The rates of expression of fecal survivin, livin and Akt-1 assays for colorectal cancer were all 93%; whereas, those of the fecal caveolin, HDAC1, MMP-2, HDGF and peptideYY assays for colorectal cancer were 13, 6, 20, 6 and 6%, respectively. The remaining 13 assays did not show any expression in either the colorectal or normal groups. The expression levels of survivin, livin and Akt-1 were higher in the colorectal cancer than normal group in a semiquantitative analysis (P < 0.05). CONCLUSIONS: These fecal survivin, livin and Akt-1 assays had both high expression rate and levels (colorectal cancer as distinguished from normal group) for detecting colorectal cancer; although, a larger study will be necessary to assess the expression rates and levels.
Adult ; Biomarkers, Tumor* ; Cadherins ; Carcinoma, Hepatocellular ; Carrier Proteins ; Colon ; Colorectal Neoplasms ; Epithelial Cells ; Gene Expression ; Histone Deacetylases ; Humans ; Mass Screening ; Matrix Metalloproteinases ; Nitric Oxide Synthase Type II ; Polymerase Chain Reaction ; Receptor, Epidermal Growth Factor ; RNA

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

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: 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

OBJECTIVES: The 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 reviewed 58 colorectal cancer patients who underwent operations between 2003 and 2006, retrospectively. We analyzed their EGFR mutations in 4 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%) had stage I, 24 patients (41.38%) had stage II, 20 patients (34.48%) had stage III, and 5 patients (8.62%) had stage IV. As a result of mutational analysis, EGFR mutations on exon 20 were detected in 13 patients (22.41%, G-->A transitions). EGFR mutations on exon 18, 19 and 21 were not detected. EGFR mutation increased in the earlier stage and 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 significantly increased in the earlier stage and the absence of lymph node metastasis.
Cell Transformation, Neoplastic ; Colorectal Neoplasms ; Exons ; Female ; Humans ; Incidence ; Lymph Nodes ; Male ; Neoplasm Metastasis ; Retrospective Studies ; Sequence Analysis, DNA

PURPOSE: The aim of this study is to evaluate long-term survival and prognostic factors for radio-frequency ablation (RFA) in colorectal liver metastases. METHODS: We retrospectively reviewed 35 colorectal liver metastases patients who underwent RFA between 2004 and 2008. We analyzed survival after RFA and prognostic factors for survival. RESULTS: Of the 35 patients, 23 patients were male and 12 were female. Their mean age was 62.40 +/- 12.52 years. Mean overall survival was 38.8 +/- 4.6 months, and mean progression free survival was 19.9 +/- 3.4 months. Three- and 5-year overall survival rates were 42.7 +/- 0.1% and 26.0 +/- 0.1%, respectively. Three- and 5-year progression-free survival rates were 19.6 +/- 0.1% and 4.9 +/- 0.04%, respectively. Overall survival and progression-free survival were significantly improved in male and in patients with carcinoembryonic antigen (CEA) < or = 100 ng/mL, carbohydrate antigen (CA) 19-9 < or = 100 ng/mL, absence of extrahepatic disease, and a unilobar hepatic lesion. In addition, progression-free survival was improved in patients with a solitary hepatic lesion. On the multivariate analysis, significant survival factors were the absence of extrahepatic disease and the presence of a unilobar hepatic lesion. CONCLUSION: RFA for colorectal liver metastases is an effective treatment option in male patients and in patients with CEA or CA19-9 < or = 100, absence of extrahepatic disease, a solitary hepatic lesion, and a unilobar hepatic lesion.
Carcinoembryonic Antigen ; Colorectal Neoplasms ; Disease-Free Survival ; Female ; Humans ; Liver ; Male ; Multivariate Analysis ; Neoplasm Metastasis ; Retrospective Studies ; Survival Rate