No abstract available.
Chest Pain* ; Emergencies* ; Emergency Service, Hospital* ; Thorax*

BACKGROUND: Lung cancer is the most common cause of cancer related death. Alterations in gene sequence, structure, and expression have an important role in the pathogenesis of lung cancer. Fusion genes and alternative splicing of cancer-related genes have the potential to be oncogenic. In the current study, we performed RNA-sequencing (RNA-seq) to investigate potential fusion genes and alternative splicing in non-small cell lung cancer. METHODS: RNA was isolated from lung tissues obtained from 86 subjects with lung cancer. The RNA samples from lung cancer and normal tissues were processed with RNA-seq using the HiSeq 2000 system. Fusion genes were evaluated using Defuse and ChimeraScan. Candidate fusion transcripts were validated by Sanger sequencing. Alternative splicing was analyzed using multivariate analysis of transcript sequencing and validated using quantitative real time polymerase chain reaction. RESULTS: RNA-seq data identified oncogenic fusion genes EML4-ALK and SLC34A2-ROS1 in three of 86 normal-cancer paired samples. Nine distinct fusion transcripts were selected using DeFuse and ChimeraScan; of which, four fusion transcripts were validated by Sanger sequencing. In 33 squamous cell carcinoma, 29 tumor specific skipped exon events and six mutually exclusive exon events were identified. ITGB4 and PYCR1 were top genes that showed significant tumor specific splice variants. CONCLUSION: In conclusion, RNA-seq data identified novel potential fusion transcripts and splice variants. Further evaluation of their functional significance in the pathogenesis of lung cancer is required.
Alternative Splicing* ; Carcinoma, Non-Small-Cell Lung* ; Carcinoma, Squamous Cell ; Exons ; Gene Fusion ; Lung ; Lung Neoplasms ; Multivariate Analysis ; Real-Time Polymerase Chain Reaction ; RNA* ; Sequence Analysis ; Sequence Analysis, RNA*

PURPOSE: To evaluate the feasibility of the interferon-gamma release assay (IGRA) as a supplementary diagnostic tool for the diagnosis of genitourinary tuberculosis (GUTB). MATERIALS AND METHODS: Fifty-seven patients who were tested with the IGRA to diagnose GUTB were included. All patients had clinical or radiologic features suspicious for GUTB. Signs and symptoms included chronic dysuria with long-standing sterile pyuria, renal calcification with distorted renal calyces and contracted renal pelvis, and chronic epididymitis. Patients who had a history of tuberculosis in other organs were excluded. Tests including IGRA, urine acid-fast bacilli (AFB) stain and culture, urine tuberculosis polymerase chain reaction (UT-PCR), and radiological examinations were performed to confirm GUTB. The medical records of the patients were reviewed retrospectively. RESULTS: The IGRA result was positive in 30 patients (52.6%). The results of the urine AFB stain and culture were positive in 5 patients (8.8%) and 7 patients (12.2%), respectively. The results of UT-PCR were positive in 9 patients (15.8%). The 7 patients who showed positive results in the urine AFB stain and culture also had positive results on the IGRA. A UT-PCR-negative patient was diagnosed with GUTB by positive results on both the IGRA and AFB stain and culture. CONCLUSIONS: The IGRA might feasibly be used as a supplementary or screening tool for the diagnosis of GUTB in addition to urine AFB stain and culture. Further studies for statistical evaluation of its sensitivity, specificity, and efficacy are needed.
Contracts ; Dysuria ; Epididymitis ; Humans ; Interferon-gamma ; Interferon-gamma Release Tests ; Kidney Pelvis ; Male ; Mass Screening ; Medical Records ; Polymerase Chain Reaction ; Pyuria ; Sensitivity and Specificity ; Tuberculosis ; Tuberculosis, Urogenital

PURPOSE: This study aimed to improve prostate biopsy compliance by analyzing the factors that influence the acceptance of prostate biopsy by patients to whom transrectal ultrasound (TRUS)-guided prostate biopsy is recommended for suspected prostate cancer. MATERIALS AND METHODS: The subjects of this study were 268 patients to whom TRUS-guided prostate biopsy was recommended from January to June 2011 and who completed a questionnaire. Patients who showed a prostate-specific antigen (PSA) increase to more than 4.0 ng/mL or abnormal findings on a digital rectal examination and TRUS were recommended to undergo prostate biopsy. The questionnaire consisted of 9 questions about the subjects' demographic characteristics and 15 questions that assessed their knowledge of prostate disease. Fisher exact probability test was conducted to assess the influence of the demographic characteristics and levels of knowledge of prostate disease on acceptance of prostate biopsy. RESULTS: The mean age of the subjects was 66.2 years (range, 43-83 years). Of the cohort, 188 patients (70.7%) agreed to the prostate biopsy and 78 patients (29.3%) refused. In terms of demographic characteristics, the patients' acceptance of prostate biopsy was associated only with education level. Patients with relatively lower education levels had a higher acceptance rate for prostate biopsy (80.0% vs. 65.9%, p=0.018). Other demographic factors, as well as the degree of knowledge of prostate disease, had no significant effect on the acceptance rate. CONCLUSIONS: The patients' acceptance of prostate biopsy can be influenced by demographic characteristics, especially education level. Therefore, when prostate biopsy is recommended to patients, their demographic characteristics should be taken into consideration.
Adult ; Aged ; Aged, 80 and over ; Biopsy, Needle/methods/psychology ; Health Knowledge, Attitudes, Practice ; Humans ; Kallikreins/blood ; Male ; Middle Aged ; *Patient Acceptance of Health Care ; Prospective Studies ; Prostate-Specific Antigen/blood ; Prostatic Neoplasms/*pathology/psychology/ultrasonography ; Republic of Korea ; Socioeconomic Factors ; Ultrasonography, Interventional

OBJECTIVE: To investigate the correlation between magnetic resonance imaging (MRI) findings for children with cerebral palsy (CP) and the severity of their developmental disability. METHOD: MRI and M nchener Funktionelle Entwicklungs Diagnostik (MFED) were used for the evaluation of 52 children with CP. MFED quotient (MFED age/corrected age 100) was compared to the MRI findings. RESULTS: Of the 52 MRIs, no abnormalities were found in 7 cases (13%), periventricular leukomalacias (PVLs) in 37 cases (71.2%), corpus callosum abnormalities in 33 cases (63.5%), delayed myelinations in 8 cases (15.4%), congenital brain abnormalities in 6 cases (11.5%), and central sulcus abnormalities in 3 cases (5.8%). Among 27 patients who were born preterm, the major MRI finding was PVL (100%), indicative of a hypoxic brain injury. All patients with a normal MRI were born at term. There were significant correlations between the MFED quotient and the severity of PVL. The ratio of corpus callosum length/brain anteroposterior diameter was correlated with a developmental disability. CONCLUSION: MRI findings for the patients with CP are well correlated with the developmental disabilities and the timing of brain insult.
Brain ; Brain Injuries ; Cerebral Palsy* ; Child ; Corpus Callosum ; Developmental Disabilities* ; Humans ; Infant, Newborn ; Leukomalacia, Periventricular ; Magnetic Resonance Imaging ; Myelin Sheath

Purpose: To compare improvement of lower urinary tract symptoms (LUTS) due to benign prostatic hyperplasia in diabetic versus nondiabetic patients after transurethral resection of the prostate (TURP) or holmium laser enucleation of the prostate (HoLEP). Methods: The medical records of 437 patients who underwent TURP or HoLEP at a tertiary referral center from January 2006 to January 2022 were retrospectively analyzed. Among them, 71 patients had type 2 diabetes. Patients in the diabetic mellitus (DM) and non-DM groups were matched 1:1 according to age, baseline International Prostate Symptom Score (IPSS), and ultrasound measured prostate volume. Changes in LUTS were assessed at 3 months after surgery using IPSS and evaluated by categorizing patients according to prostatic urethral angulation (PUA; <50° vs. ≥50°). Medication-free survival after surgery was also investigated. Results: No significant differences were noted between the DM and non-DM groups in baseline characteristics except for comorbidities (i.e., hypertension, cerebrovascular disease, and ischemic heart disease, P=0.021, P=0.002, and P=0.017, respectively) and postvoid residual urine volume (115±98 mL vs. 76±105 mL, P=0.028). Non-DM patients showed significant symptomatic improvement regardless of PUA, while DM patients demonstrated improvement in obstructive symptoms only in those with large PUA (≥51°). Among patients with small PUA, DM patients had worse medication-free survival after surgery compared to controls (P=0.044) and DM was an independent predictor of medication reuse (hazard ratio, 1.422; 95% confidence interval, 1.285–2.373; P=0.038). Conclusions DM patients experienced symptomatic improvement after surgery only in those with large PUA. Among patients with small PUA, DM patients were more likely to reuse medication after surgery.

The serum levels of sICAM-1 were significantly higher in febrile & hypotensive (789+/-241ng/ml) stage than in diuretic stage (514+/-151ng/ml) and convalescence stage (410+/-88ng/ml) (P<0.01). Also the serum levels of sICAM-1 in oliguric (628+/-220ng/ml) stage higher than that of convalescence stage (P<0.01). The serum level of sICAM-1 was significantly high in convalescence stage of patients with HFRS compared to control (306+/-75ng/ml) (P<0.01). sICAM-1 levels correlated with platelet count (R=-0.35, P<0.05) in all stage of HFRS. Our results suggest that the enhanced immune activation is a common feature in early stage of HFRS.
Convalescence ; Hemorrhagic Fever with Renal Syndrome* ; Humans ; Intercellular Adhesion Molecule-1* ; Platelet Count

PURPOSE: The incidence of primary gastric lymphoma is a relatively rare and is 2~5% of all gastric malignant lesion. Because of its rarity, there are few report in Korea. Therefore, to elucidste the clinicopathological characteristics and prognosis of primary gastric lymphoma and to investigate MALT(Mucosa-associated lymphoid tissue) lymphoma, we studied in primary gastric lymphoma. MATERIALS & METHODS: we evaluated retrospectively primary gastric lymphoma patients who underwent gastric resection from Jan. 1990 to Dec. 1994 in KCCH. RESULTS: There were 20 patients with primary gastric lymphoma and the incidence is 0.54% of all gastric malignant lesion. Abdominal pain, primarily epigastric, was the most common presenting complaint and the most common location was the distal third of the stomach. The overall 5-year survival rate was 71%. Factor significantly influencing 5-year survival rate was the serosal invasion. Age, gender, tumor size, histologic grade, nodal status and Ann-Arbor staging system did not influence survival. CONCLUSION: So,we suggest that the depth of invasion should be included in staging system of gastric lymphoma because Ann Arbor staging system might be inadequate when applied to primary gastric lymphoma. Also, we suggest that the multicenter study should be performed to elucidate the characteristics of Korean gastric lymphoma because of its low incidence.
Abdominal Pain ; Humans ; Incidence ; Korea ; Lymphoma* ; Prognosis ; Retrospective Studies ; Stomach ; Survival Rate

OBJECTIVE: Hemorrhagic fever with renal syndrome(HFRS) is characterized by acute renal failure and increased vascular permeability. Hypoalbumi-nemia is frequently observed in the acute stage of HFRS, but its pathogenesis is not well known. In this study, we investigated intestinal loss of plasma protein in patients with HFRS. METHODS: First, we evaluated the incidence of proteinuria and measured the amount of urine protein in 20 patients during clinical course of HFRS. Second, GI loss of plasma protein was evaluated using Tc-human serum albumin(Tc-HSA) scan and fecal clearance of a l-antitrypsin(Cz). RESULTS: Seventeen(85%) of 20 patients demonstrated hypoalbuminemia(serum albumin level <3.5 g/dL) during admission and its lowest level was 3.0 +/- 0.3g/dL. Urine protein during admission was 1.9 +/- 1.3g/day and most of them showed negative con- version within 7days(7 6days). Tc-HSA scan revealed 65% positivity(13/20) in the acute stage and increased CAJ was observed 13 out of 20 patients (65%). In these patients, CAf in the recovery stage was significantly decreased compared to that in the acute stage(9.2 +/- 4.2ml/day vs 40.5>24.lml/day, p< 0.01). The mean serum albumin level in the patients with increased CAp was lower than that in the patients with normal CAy(2.80.1g/dL vs 3.4+0.2 g/dL, p<0.01). In the patients who had increased CA J', hypotensive episodes were more frequent, number of patients who needed hemodialysis was more, and thrombocytopenia was severer compared with the patients with normal CAp. But there was no difference in the amount of proteinuria between two groups. CONCLUSION: Our study suggests that intestinal loss of plasma protein is in part associated with hypoalbuminemia occurred in the acute stage of HFRS.
Acute Kidney Injury ; Capillary Permeability ; Fever ; Hemorrhagic Fever with Renal Syndrome* ; Humans ; Hypoalbuminemia* ; Incidence ; Plasma* ; Proteinuria ; Renal Dialysis ; Serum Albumin ; Thrombocytopenia

PURPOSE: The aims of this study were to evaluate the effect of a resin coating on the shear bond strength of indirect composite restoration bonded to dentin with a self adhesive resin cement and to compare the shear bond strength with that of a conventional resin cement. MATERIALS AND METHODS: The occlusal enamels of thirty six extracted non-carious human molars were removed until the dentin flat surfaces of the teeth were exposed. Then, they were divided into 3 groups. The dentin surfaces of group 1 and 3 were left without any conditioning, while the dentin surfaces of group 2 were resin-coated with Clearfil SE bond and a flowable resin composite, Metafil Flo. After all specimens were temporized for 24 hours, indirect composite resin blocks fabricated by Tescera were bonded to dentins by Unicem for group 1 and 2, and by Panavia F for group 3. After 48 hours of water storage, shear bond strengths were measured. The data was analyzed with one-way analysis of variance and multiple comparison test (Tukey method). RESULTS: The shear bond strengths of Unicem applied to resin coated dentin surfaces were significantly higher than those of Unicem and Panavia F used to uncoated dentin surfaces (P<.0001). CONCLUSION: Application of a resin coating to the dentin surface significantly improved the shear bonding strength of a self adhesive resin cement in indirect restoration.
Adhesives ; Composite Resins ; Dental Enamel ; Dentin ; Humans ; Molar ; Resin Cements ; Tooth ; Water