OBJECTIVE: Patients with acute coronary syndrome (ACS) are typically managed with dual antiplatelet therapy of acetylsalicylic acid (aspirin) and P2Y12 receptor inhibitor. In this study, we discussed current and previous antiplatelet therapy guidelines and compared with guidelines of the USA (ACC/AHA), Europe (ESC) and Korea (KSC). METHOD: This study investigated from ACC/AHA Joint Guidelines (the USA), ESC Clinical Practice Guidelines (Europe) and Korea Society of Interventional Cardiology (Korea) web site, respectively. RESULTS: It is significant that difference between the current and the previous guidelines was integration of terminology from clopidogrel to P2Y12 receptor inhibitors since prasugrel and ticagrelor, new antiplatelet drugs, has been added. The other difference was all three guidelines has differences in dose of aspirin. The most notable difference was class of recommendation (COR) in P2Y12 receptor inhibitors. ACC/AHA and Korean guidelines recommend clopidogrel, prasugrel, and ticagrelor with COR IB; whereas, ESC recommend prasugrel and ticagrelor with IB which is higher than clopidogrel with IC. CONCLUSION: This research addresses important movement to revise the Korean existing guideline recommendations. New Korean antiplatelet therapy guideline should be avoiding obvious differences in ACC/AHA and ESC guidelines and harmonizing international guidelines.
Acute Coronary Syndrome* ; Aspirin ; Cardiology ; Europe* ; Humans ; Joints ; Korea* ; Prasugrel Hydrochloride

PURPOSE: This study was conducted for comparison of clinical and second look arthroscopic results between early and delayed reconstruction of acute anterior cruciate ligament (ACL) injuries. MATERIALS AND METHODS: Thirty-six patients who underwent ACL reconstruction between March 2008 and October 2011 were enrolled in this study. We divided the patients into two groups, those in the early reconstruction group underwent surgery before one week, and those in the delayed reconstruction group underwent surgery after three weeks, before six weeks. We checked clinical results and second look arthroscopic results and analyzed correlation of clinical and second look arthroscopic results. RESULTS: At the final follow up, the Lysholm, International Knee Documentation Committee, and Tegner score were not statistically different between the two groups (p=0.173, p=0.154, p=0.109). No difference for the range of motion (p=0.808, p=0.680), Lachman test (p=0.377), and pivot shift test (p=0.894) was observed between the groups. In the results of second look arthroscopy, there was no difference in graft continuity (p=0.936), tension (p=0.944) and synovial coverage (p=0.789). No statistical clinical correlation was observed between clinical and second look arthroscopic results (p>0.05). CONCLUSION: We obtained satisfactory clinical and second look arthroscopic results in both the early and delayed ACL reconstruction groups. Therefore, early reconstruction of ACL performed before one week could be a treatment options for acute ACL injury.
Anterior Cruciate Ligament* ; Arthroscopy ; Follow-Up Studies ; Humans ; Knee ; Range of Motion, Articular ; Transplants

Background: We prospectively evaluated the applicability and effect of noninvasive ventilation (NIV) in acute respiratory failure and tried to find out the parameters that could predict successful application of NIV. Methods: Twenty-six out of 106 patients with either acute ventilatory failure (VF: PaCO2> 43 mm Hg with pH <7.35) or oxygenation failure (OF: PaO2/FIO2 < 300 mm Hg with pH> or = 7.35) requiring mechanical ventilation were managed by NIV (CPAP + pressure support, or BiPAP) with face mask. Eleven out of 19 cases with VF (57.9%) (M: F=7: 4, 55.4 +/-14.6 yrs) and 15 out of 87 cases with OF (17.2%) (M: F= 12: 3, 50.6+/-15.6 yrs) were suitable for NIV. Respiratory rates, arterial blood gases and success rate of NIV were analyzed in each group. Results: 81.8% (9/11) of VF and 40% (6/15) of OF were successfully managed on NIV and were weaned from mechanical ventilator without resorting to endotracheal intubation. Complications were noted in 2 cases (nasal skin necrosis 1, gaseous gastric distension 1). In NIV for ventilatory failure, the respiration rate was significantly decreased at 12 hour of NIV (34+/-9 /min pre-NIV, 26+/-6 /min at 12 hour of NIV, p=0.045), while PaCO2 (87.3+/-20.6 mm Hg pre-NIV, 81.2+/-9.1 mm Hg at 24 hour of NIV) and pH (7.26 +/-0.04, 7.32 +/-0.02, respectively, p< 0.05) were both significantly decreased at 24 hour of NIV. In NIV for oxygenation failure, PaO2 were not different between the successful and the failed cases at pre-NIV and till 12 hours after NTV. The PaO2/FIO2 ratio, however, significantly improved at 0.5 hour of NIV in successful cases and were maintained at around 200 mm Hg (n=6: at baseline, 0.5h, 6h, 12h: 120.0+/-19.6, 218.9+/-98.3, 191.3+/-55.2, 232.8+/-17.6 mm Hg, respectively, p=0.0211), but it did not rise in the failed cases (n=9: 127.9+/-63.0, 116.8+/-24.4, 100.6 +/-34.6, 129.8+/-50.3 mm Hg, respectively, p=0.5319). Conclusion: From the above results we conclude that NIV is effective for hypercapnic respiratory failure and its success was heralded by reduction of respiration rate before the reduction in PaCO2 level. In hypoxic respiratory failure, NIV is much less effective, and the immediate improvement of PaO2/FIO2 ratio at 0.5h after application is thought to be a predictor of successful NIV.
Gases ; Health Resorts ; Humans ; Hydrogen-Ion Concentration ; Intubation, Intratracheal ; Masks ; Necrosis ; Noninvasive Ventilation ; Oxygen ; Prospective Studies ; Respiration, Artificial* ; Respiratory Insufficiency* ; Respiratory Rate ; Skin ; Ventilators, Mechanical

PURPOSE: RNase3 is a secretory ribonuclease, which is found in the eosinophilic leukocyte and involved in the innate immune system. Its cytotoxic activity is effective against a wide range of pathogens. We performed a case-control study to examine the relationship between RNase3 polymorphisms and the susceptibility of gastric cancer in Korean people. METHODS: Blood sampling of stomach cancer and healthy persons groups were performed, Taqman in g.-550A>G, polymerase chain reaction-restriction fragment length polymorphism in g.371C>G, and high-resolution melt in g.499C>G were analyzed. The three single nucleotide polymorphisms g.-550A>G, g.371C>G, and g.499C>G in RNase3 and their haplotypes were analyzed. RESULTS: The genotype and allele frequencies of RNase3 g.-550A>G and g.371C>G were not significantly increased in susceptibility of gastric cancer than control group. But, RNase3 CC genotype was associated with a significantly increased susceptibility of gastric cancer than control group (P=0.002). Also, RNase3 CC genotype was more specifically associated with a significantly increased susceptibility of middle and lower gastric cancer than upper gastric cancer (P=0.002). In haplotype of RNase3 SNP g.-550A, g.371G, and g.499C, there was significantly susceptibility of gastric cancer (P=0.004), and more specific influence on middle and lower gastric cancer than upper gastric cancer (P=0.006 vs 0.054). CONCLUSION: RNase3 g.499C>G polymorphism may influence gastric cancers, and have a more specific influence on middle and lower gastric cancer rather than upper gastric cancer. But RNase3 g.-550A>G, g.371C>G polymorphisms need careful interpretation and confirmation in more larger studies.
Case-Control Studies ; Eosinophils ; Gene Frequency ; Genotype ; Haplotypes ; Humans ; Immune System ; Leukocytes ; Polymorphism, Single Nucleotide ; Ribonucleases ; Stomach Neoplasms

INTRODUCTION: Bone defects in the jaw are frequently observed after odontogenic cyst enucleation. The success of bone healing appears to be related to the size of the bone defect, the anatomical location, the patient's age and other parameters. The use of bone grafting material is dependent on the operator's preference. No evidence-based definite treatment protocol has been established. This study evaluated the effect of a bone graft into the defect after odontogenic cyst enucleation. MATERIALS AND METHODS: A total of 55 patients, who had been treated for an odontogenic cyst with cyst enucleation from 2000 to 2009 at the department of Oral and Maxillofacial Surgery, Samsung Medical Center, were included in this study. Patients who were followed-up for more than 1 year were included. Two groups were defined according to the bone graft (with or without a bone graft) after cyst enucleation. The differences in the healing periods and patterns of bone healing were compared clinically and radiologically. The postoperative 1 year radiographs were analyzed for bone healing and density. Statistical analysis was performed using a Pearson chi square test and Wilcoxon rank-sum test. RESULTS: More infection signs were observed in the bone graft group than in the other group, but there was no statistically significant difference. Radiographically, there was also no significant difference in the size of the radiolucent lesions between the two groups. CONCLUSION: There was no significant difference in healing between the groups with a bone graft and without bone graft after cyst enucleation.
Bone Transplantation ; Clinical Protocols ; Humans ; Jaw ; Odontogenic Cysts ; Surgery, Oral ; Transplants

PURPOSE: RNase3 is a secretory ribonuclease found in eosinophilic leukocytes and is involved in the innate immune system. Its cytotoxic activity is effective against a wide range of pathogens. Generally, high levels of RNase3 have been reported in cases of active asthma and allergic diseases. However, a relationship between RNase3 and colon cancer has not yet been reported. We performed a case-control study to examine the relationship between RNase3 polymorphisms and the risk of colorectal cancer in Korean people. METHODS: Blood sampling of each group was performed, TaqMan in g.-550A>G, PCR-RFLP in g.371C>G, and high resolution melting (HRM) in g.499C>G were analyzed. As results, the three SNPs, g.-550A>G, g.371C>G, and g.499C>G, in RNase3 and their haplotypes were analyzed. RESULTS: The genotype and the allele frequencies of RNase3 g.-550A>G and g.371C>G were not significantly associated with increased risk for colon cancer compared to the control group, but the RNase3 g.499C>C genotype was associated with a significantly increased risk for colorectal cancer compared to the control group (P=0.001). Also, the RNase3 g.499C>C genotype was more specifically associated with a significantly increased risk for right colon cancer than left colon cancer (P<0.001). In haplotypes of RNase3 SNPs, g.-550G, g.371C, and g.499G were significantly associated with colorectal cancer (P=0.019): more specifically, left colon cancer and rectal cancer than right colon cancer (P=0.048). CONCLUSION: The RNase3 g.499C>G polymorphism may have an influence on colorectal cancers and may have a more specific influence on right colon cancer than left colon cancer and on rectal cancer. However, the significance of the RNase3 g.-550A>G and g.371C>G polymorphisms need careful interpretation and require confirmation in larger studies.
Asthma ; Case-Control Studies ; Colonic Neoplasms ; Colorectal Neoplasms ; Eosinophils ; Freezing ; Gene Frequency ; Genotype ; Haplotypes ; Immune System ; Leukocytes ; Polymorphism, Single Nucleotide ; Rectal Neoplasms ; Ribonucleases

We already reported that genetically engineered resveratrol-enriched rice (RR) showed to down-regulate skin melanogenesis. To be developed to increase the bioactivity of RR using calli from plants, RR was adopted for mass production using plant tissue culture technologies. In addition, high-pressure homogenization (HPH) was used to increase the biocompatibility and penetration of the calli from RR into the skin. We aimed to develop anti-melanogenic agents incorporating calli of RR (cRR) and nanoparticles by high-pressure homogenization, examining the synergistic effects on the inhibition of UVB-induced hyperpigmentation. Depigmentation was observed following topical application of micro-cRR, nano-calli of normal rice (cNR), and nano-cRR to ultraviolet B (UVB)-stimulated hyperpigmented guinea pig dorsal skin. Colorimetric analysis, tyrosinase immunostaining, and Fontana-Masson staining for UVB-promoted melanin were performed. Nano-cRR inhibited changes in the melanin color index caused by UVB-promoted hyperpigmentation, and demonstrated stronger anti-melanogenic potential than micro-cRR. In epidermal skin, nano-cRR repressed UVB-promoted melanin granules, thereby suppressing hyperpigmentation. The UVB-enhanced, highly expressed tyrosinase in the basal layer of the epidermis was inhibited by nano-cRR more prominently than by micro-cRR and nano-cNR. The anti-melanogenic potency of nano-cRR also depended on pH and particle size. Nano-cRR shows promising potential to regulate skin pigmentation following UVB exposure.
Animals ; Epidermis ; Guinea Pigs* ; Guinea* ; Hydrogen-Ion Concentration ; Hyperpigmentation* ; Melanins ; Monophenol Monooxygenase ; Nanoparticles* ; Particle Size ; Plants ; Skin Pigmentation ; Skin*

INTRODUCTION: This study examined the genetic influence of mandibular prognathism epidemiologically in Korean families. MATERIALS AND METHODS: Over a 5-year period from 2005 to 2009, a questionnaire with a pedigree chart was given to 100 (male 51, female 49) probands with skeletal Class III mandibular prognathism, who had undergone orthognathic surgery in Samsung Medical Center. RESULTS: The average age of the probands was 22.1. The average SNA, SNB and ANB angles of the probands were 81.2degrees, 84.1degreesand -2.9degrees, respectively. A total of 2729 (male 1,354, female 1,375) family members were examined, and the affected ratio of the families was 3.5% with no significant difference between genders. 45% of families had at least one member with a Class III malocclusion other than the proband. The affected ratio of the first-degree relatives (10.9%) was significantly higher than those of the second-degree (3.3%) and third-degree (1.9%) relatives. The affected ratio of the total relatives from the male probands (4.2%) was significantly higher than that of the female probands (2.8%). Heritability (h2, Falconer'method) was estimated to be 29.8% (0.298+/-0.059) in first-degree relatives. CONCLUSION: These results showed the significant influence of mandibular prognathism with relatively low heritability in first-degree relatives in Korean families of probands, who had undergone orthognathic surgery to correct a skeletal Class III malocclusion.
Female ; Humans ; Male ; Malocclusion ; Orthognathic Surgery ; Pedigree ; Prognathism ; Surveys and Questionnaires

BACKGROUND: As socioeconomic status has improved, malnutrition has become rare in Korea and generally it is no longer considered as a serious problem in medical practice. However, contrary to the above general belief we managed four patients with beriberi in 1999 and it became apparent that malnutrition might remain a problem in certain groups of patients. In this study, we assessed the nutritional state, especially with respect to thiamine deficiency, in chronic alcoholics and in patients residing at a long-term care facility (LTCF). METHODS: Fourteen chronic alcoholic patients and twenty patients being hospitalized in a long-term care facility were assigned as the study groups. The subjects' mean ages and standard deviations were 48.9+/-10.2 and 50.6+/-6.7, respectively. Medical records were reviewed to determine other aspects of their nutritional status and their dietary patterns. Ten peoples who visited the health promotion center at Inha University Hospital, for routine check-ups were allocated to the control group. Blood total thiamine levels were measured by high-performance liquid chromatography. RESULTS: Body mass indices were significantly lower in chronic alcoholics and in patients at the LTCF than in the control group (p=0.0065). Serum albumin levels were within the reference range in all three groups, but were significantly lower in patients at the LTCF than in the control group (p=0.0013). Moreover, no difference was detected between the alcoholic group and the control group in terms of thiamine levels. However, the mean thiamine level in patients at the LTCF was statistically lower than that of the control group and four (20%) patients in the LTCF group showed subnormal blood thiamine levels. The thiamine level tended to decrease with age in both alcoholics and patients at the LTCF. No correlation was found between thiamine level and the other variables examined, namely, hospital stay, body mass index, and serum albumin level. CONCLUSION: A considerable portion of patients in a long term care facility showed thiamine deficiency, however, no evidence of thiamine deficiency was found among alcoholics. This result suggests that thiamine deficiency in patients at long-term care facility may be more prevalent and that thiamine supplementation may be warranted, especially for those with other thiamine deficiency risk factors.
Alcoholics* ; Alcoholism ; Beriberi ; Body Mass Index ; Chromatography, Liquid ; Health Promotion ; Humans ; Korea ; Length of Stay ; Long-Term Care* ; Malnutrition ; Medical Records ; Nutritional Status ; Reference Values ; Risk Factors ; Serum Albumin ; Social Class ; Thiamine Deficiency* ; Thiamine*

Malignant melanomas arising in the skin, buccal mucous membranes. and retina are encountered frequently. A malignant melanoma characteristically disseminates widely but infrequently metastasizes to the breast, and primary melanoma of the breast is even rarer. Primary melanomas can arise in the glandular tissue of the breast. We report a case of malignant melanoma either primary in the breast or metastatic from an unknown primary that presented initially as a left breast mass without a detectable cutaneous lesion.
Breast* ; Melanoma* ; Mucous Membrane ; Retina ; Skin