BACKGROUND: Lung carcinogenesis is a multistage process involving alterations in multiple genes and diverse pathway. Mutational activation of oncogenes and inactivation of tumor suppressor genes, and subsequent increased genetic instability are the major genetic events. The p53 gene and FHIT gene as tumor suppressor genes contribute to the pathogenesis of lung cancer, evidenced by mutation, microsatellite instability(MI) and loss of heterozygosity(LOH). METHODS: We analysed genetic mutations of p53 and FHIT gene in 29 surgical specimens of nonsmall cell lung cancer using PCR-single strand conformation polymorphism, DNA sequencing and RT-PCR. MI and LOH were analyzed in loci of D3S1285, D9S171, and TP53. RESULTS: In 2 cases, point mutation of p53 gene was observed on exon 5. MI of 3 times and LOH of 14 times were observed in at least one locus. In terms of the location on microsatellite, D3S1285 as a marker of FHIT was observed in 5 cases out of 26 specimens;D9S171 as a marker of p16 in 5 out of 17;and TP53 as a marker of p53 in 7 out of 27. In view of histologic type, squamous cell carcinoma presented higher frequency of microsatellite alteration, compared to others. Mutation of FHIT gene was observed in 11 cases and 6 cases of those were point mutation as a silent substitution on exon 8. FHIT mRNA expression exhibited deletion on exon 6 to 9 in 4 cases among 15 specimens, presenting beta-actin normally. CONCLUSION: Our results show comparable frequency of genetic alteration in nonsmall cell lung cancer to previous studies of Western countries. Microsatellite analysis might have a role as a tumor marker especially in squamous cell carcinoma. Understanding molecular abnormalities involved in the pathogenesis could potentially lead to prevention, earlier diagnosis and the development of novel investigational approaches to the treatment of lung cancer.
Actins ; Carcinogenesis ; Carcinoma, Non-Small-Cell Lung* ; Carcinoma, Squamous Cell ; Diagnosis ; Exons ; Genes, p53 ; Genes, Tumor Suppressor* ; Loss of Heterozygosity ; Lung ; Lung Neoplasms ; Microsatellite Instability ; Microsatellite Repeats* ; Oncogenes ; Point Mutation ; RNA, Messenger ; Sequence Analysis, DNA

Purpose: To validate the value of Duplex Color Doppler Ultrasonography (DDU) for the incidence and location of postoperative deep vein thrombosis (DVT) that developed after hip surgery Materials and Methods: 260 consecutive patients who did not undergo any preventive treatment for DVT and underwent hip surgery (osteosynthesis for femoral neck and intertrochanteric fracture, acetabular fracture, and hip joint arthroplasty) from July, 2003 to May, 2005 were evaluated for the incidence of DVT. DDU was carried out on 7th postoperative day in all cases. Results: DVT was detected in 16 cases (6.2%) with 7 being in the femoral vein and 3 in the calf vein. Only two cases showed clinical symptoms such as pain and edema but no pulmonary embolism developed. Conclusion: The incidence of DVT obtained from DDU after hip surgery was 6.2 %, and no serious complications developed due to the early diagnosis. DDU is valuable as a screening test for postoperative DVT as well as for the prevention of serious complications such as pulmonary embolism.
Acetabulum ; Early Diagnosis ; Edema ; Femoral Vein ; Femur Neck ; Hip Joint ; Hip* ; Humans ; Incidence ; Mass Screening ; Pulmonary Embolism ; Ultrasonography, Doppler, Color ; Veins ; Venous Thrombosis*

Methotrexate has been used to treat refractory psoriasis for many years. Despite its well-established clinical efficacy, drawbacks to methotrexate usage include a number of deleterious effects including hepatotoxicity, bone marrow suppression, and interstitial pneumonitis. We experienced a case of liver cirrhosis m patient with active psoriasis receiving long-term ora1 methotrexate therapy, and reported this case with review of literature.
Bone Marrow ; Humans ; Liver Cirrhosis* ; Liver* ; Lung Diseases, Interstitial ; Methotrexate* ; Psoriasis

Postpneumonectomy syndrome is a disease entity which arises after right pneumonectomy in left aortic arch and left pneumoncectomy in right aortic arch. This syndrome have a feature of severe mediastinal deviation and rotation, and induces severe respiratoy insufficiency. This syndrome is rare, but should be considered when pneumonectomized patient complaints who have severe dyspnea. In Samsung medical center, We report a sucessfully treated patient with postpneumonectomy syndrome, who had experienced right pneumonectomy at 1 years ago.
Aorta, Thoracic ; Dyspnea ; Humans ; Pneumonectomy ; Postoperative Complications

PURPOSE: To determine clinical outcome in cases of traumatic intraventricular hemorrhage(TIVH) according to the mechanisms and amount of hemorrhage seen on initial CT. MATERIALS AND METHODS: We retrospectively reviewed the initial CT findings of 61 patients with TIVH. The mechanisms of TIVH were analyzed on the basis of the following CT findings: Type I; large intracerebral hematoma extending to adjacent ventricle; Type II: hemorrhagic and/or non-hemorrhagic diffuse axonal injury in the thalamus and basal ganglia; Type III: multiple small hemorrhagic lesions in the septum pellucidum, fornix, corpus callosum, and periventricular region, which may be due to inner cerebral trauma, Type IV: evidence of hypoxic brain injury, and Type V: TIVH with contusion and small subdural or epidural hematomas. The amount of TIVH was classified according to the Graeb score. We analyzed these mechanisms on the basis of CT findings, and for prognosis, correlated these with clinical outcomes and the Glasgow coma score. RESULTS: Prognosis was good in types V and III and poor in type I and II(p=0.001). In patients with a Graeb score of 4 or less, the clinical outcome was better than in those with a Graeb score above 5(p=0.03). Patients with a lower initial Glasgow coma score had poor outcomes(p=0.001). CONCLUSION: The hemorrhage mechanism in patients with TIVH could be important for estimating clinical outcome, especially during the early phase. In patients with type V or III TIVH, clinical outcome was better than in those with type I or II.
Basal Ganglia ; Brain Injuries ; Classification* ; Coma ; Contusions ; Corpus Callosum ; Diffuse Axonal Injury ; Hematoma ; Hemorrhage* ; Humans ; Prognosis* ; Retrospective Studies ; Septum Pellucidum ; Thalamus

Partial anomalous pulmonary venous return (PAPVR) is a rare congenital cardiac anomaly that can be difficult to detect and often remains undiagnosed. PAPVR is diagnosed using non-invasive imaging techniques such as echocardiography, CT, and MRI. Image data are reviewed on a 2-dimensional (D) monitor, which may not facilitate a good understanding of the complex 3D heart structure. In recent years, 3D printing technology, which allows the creation of physical cardiac models using source image datasets obtained from cardiac CT or MRI, has been increasingly used in the medical field. We report a case involving a 3D-printed model of PAPVR with a biatrial connection. This model demonstrated separate drainages of the right upper and middle pulmonary veins into the lower superior vena cava (SVC) and the junction between the SVC and the right atrium, respectively, with biatrial communication through the right middle pulmonary vein.

Partial anomalous pulmonary venous return (PAPVR) is a rare congenital cardiac anomaly that can be difficult to detect and often remains undiagnosed. PAPVR is diagnosed using non-invasive imaging techniques such as echocardiography, CT, and MRI. Image data are reviewed on a 2-dimensional (D) monitor, which may not facilitate a good understanding of the complex 3D heart structure. In recent years, 3D printing technology, which allows the creation of physical cardiac models using source image datasets obtained from cardiac CT or MRI, has been increasingly used in the medical field. We report a case involving a 3D-printed model of PAPVR with a biatrial connection. This model demonstrated separate drainages of the right upper and middle pulmonary veins into the lower superior vena cava (SVC) and the junction between the SVC and the right atrium, respectively, with biatrial communication through the right middle pulmonary vein.

In the study of electrocardigrams(ECG's) and exercise performance of competitive swimmers, we compared the resting electrocardiographic findings, maximal exercise time and heart rate determined by treadmill exercise test between swimmers and controls. in addition, the effects of an intensive training of 7~9 weeks duration on these parameters were also studied in the swimmers. The study groups consisted of 22 female competitive swimmers with mean age and career of 15.2 and 5.7 years, respectively and 22 matched controls. In the swimmers, the incidence of sinus bradycardial was higher and mean heart rate was lower than those in controls. In a few case of the swimmers, ECG's before the intensive training revealed the first degree heart block, ectopic atrial rhythm and high voltage, but there was no significant changes in the incidences of these findings after the training. In the swimmers before training, maximal exercise time was longer and maximal heart rate was lower than those in the controls, as expected, and the intensive training induced slight but significant changes of the same directions in these parameters compared with those before the training. These facts suggest that in the well-trained competitive swimmers, a short period of intensive training induces no significant changes in ECG's at rest but may prolong exercise time and decrease maximal heart rate.
Electrocardiography* ; Exercise Test ; Female ; Heart Block ; Heart Rate ; Humans ; Incidence

Percutaneous transcatheter closure of atrial septal defects as a therapeutic alternative in appropriate patients provides superior cosmetic results, is less invasive, and allows for shorter hospital stays. Unfortunately, however, such percutaneous procedures can be associated with catastrophic procedure complications that may require immediate surgical intervention. We report a case of aorta-to-right atrial fistula two months after transcatheter occlusion of an atrial septal defect by an Amplatzer septal occluder. Revealed by dyspnea, palpitation and hemolysis, this complication needed an emergency surgical operation. The fistula between the noncoronary Valsalva sinus of the aorta and the right atrium was repaired. The atrial septal defect was closed by patch. The cause of this serious complication appears to be erosion into the aorta by the right atrial disk.
Aorta* ; Dyspnea ; Emergencies ; Fistula* ; Heart Atria* ; Heart Septal Defects, Atrial* ; Hemolysis ; Humans ; Length of Stay ; Prostheses and Implants ; Septal Occluder Device ; Sinus of Valsalva

BACKGROUND: As life expectancy has been increased, the cardiac valve disease has been increased. In past, mechanical valve for valve replacement surgery was used widely, but it has many weaknesses, such as hemorrhage, teratogenic effect caused by warfarin, acute mechanical failure, taking warfarin during life, etc. So, the tissue valve is used widely and researches for durability of tissue valve are in progress. Tissue valves being used are all imported in Korea, and there is a lack of information on its geometry and design. So, we studied the geometry of porcine aortic and pulmonary valve, and tried to suggest theoretical basis for making the aortic and pulmonary valve. MATERIAL AND METHOD: We harvested aortic and pulmonary valves of 25 pigs and measured the geometry of valve at fresh and glutaraldehyde (GA) fixed state. In each group, we measured the diameter of the base, diameter of commissure, valve height, commissural height, etc. Also, for making implantable porcine and bovine pericardial valve, we designed the valve stent form, thickness, height, and leaflet size, form, thickness by different size of valve. RESULT: The aortic and pulmonary valve geometry and ratio were measured in each group. The right coronary cusp of aortic valve and right facing cusp of pulmonary valve was bigger than other cusps and non coronary cusp was smaller than others (RCC:NCC:LCC=1:0.88:1). Valve height was correlated to the leaflet size. We designed the outer diameter of stented porcine aortic valve from 19 mm to 33 mm and designed stent height and width, using previous measured ratio of each structure, stent thickness, working thickness (for making valve). Also, we designed the size of stent and form for stented bovine pericardial valve, considering diameter of valve, leaflet length, height and leaflet minimum coaptation area. CONCLUSION: By measuring of 25 pig's aortic and pulmonary valve geometry and ratio, we can make theoretical basis for making implantable stented porcine valve and bovine pericardial valve in various size. After making implantable valve using these data, it is necessary to do in vivo and in vitro researches, furthermore.
Aortic Valve ; Glutaral ; Heart Valves ; Hemorrhage ; Korea ; Life Expectancy ; Pulmonary Valve ; Stents ; Swine ; Tissue Engineering ; Warfarin