OBJECTIVE: Angiogenesis, the formation of blood vessels by sprouting from pre-existing ones, is essential for the growth of solid tumors beyond 2-3mm in diameter and for tumor metastasis. Vascular endothelial growth factor (VEGF), is known as vascular permeability factor(VPF) and mediates vascularization and tumor-induced angiogenesis. This study examined the potential of growth, invasion, and metastasis of uterine cervical carcinomas associated with neovascularization. METHODS: From January 1996 to December 1999, at the Department of Obstetrics and Gynecology, Kyung-Hee University Hospital, 37 uterine cervical carcinomas and 7 normal cervical tissues were obtained and the samples were immediately frozen and stored at -70 degrees C. Immunohistochemical staining for VEGF was carried out to study VEGF localization, and the levels of VEGF subtype mRNAs were determined by quantitative RT-PCR in specimens. The relation between VEGF subtypes expression of cervical cancers was analysed. RESULTS: The positive staining for VEGF is seen dominantly in the cytoplasm of the cancer cells, and faintly in interstitial cells. The intensity of staining was stronger in squamous carcinomas than in adenocrcinomas, but there was no significant difference (p>0.05). Quantitative RT-PCR analysis demonstrated significantly increased VEGF121/VEGF165 mRNA expression levels (>0.56 / >0.72) in 21 (56.8%) and 15 (40.5%) of 37 cervical carcinomas comparing to control groups (mean: 0.28 / 0.36). There was no obvious relationship between VEGF121/VEGF165 mRNA expression levels and the clinical parameters examined including age, pathology, differentiation, tumor size, lymphovascular space invasion, LN involvement and invasion depth except clinical stage (p<0.05). CONCLUSIONS: The overexpression of VEGF mRNA may be an important contributing factor in cervical carcinomas. There is no significant differenece of VEGF mRNAs levels according to clinical parameters, so it seems that the expression of VEGF is involved in the promotion of angiogenesis on cervical cancer and plays an important role in early invasion.
Blood Vessels ; Capillary Permeability ; Carcinoma, Squamous Cell ; Cytoplasm ; Gynecology ; Neoplasm Metastasis ; Obstetrics ; Pathology ; RNA, Messenger* ; Uterine Cervical Neoplasms ; Vascular Endothelial Growth Factor A*

PURPOSE: Glomus tumor is rare benign neoplasm arising from the normal glomus, which is a neuromyoarterial apparatus, usually seen in the nail bed of fingers. Concerning about the origin, there were few written reports about extra-digit glomus tumor of elderly patient. MATERIALS AND METHODS: A 69-year-old man presented with severe pain and tenderness localized to the distal dorsal portion of forearm for 5 years. The pain was sudden in onset resting several seconds, cold frequently exacerbated these symptoms. So much pain was caused by touching the sensitive area that the patient was quite reluctant to have the maneuver repeated. The clinical suspicion of glomus tumor was made and the lesion was completely excised. Glomus tumor was confirmed by the pathologist. RESULTS: After the operation, patient didn't complain of his symptoms anymore and there was no evidence of recurrence during 6 months follow-up period. CONCLUSIONS: We report a rare case of glomus tumor arising in subcutaneous layer of forearm with elderly patient.
Aged ; Cold Temperature ; Fingers ; Follow-Up Studies ; Forearm ; Glomus Tumor ; Humans ; Nails ; Recurrence

PURPOSE: The concept and development of perforator free flaps have led to significant advances in microsurgery. Ongoing developments in perforator free flap surgery are aimed at reducing complications and improving surgical outcomes. The aim of this study was to evaluate the effectiveness and application of supermicrosurgery in free flap surgery. MATERIALS AND METHODS: A total of 267 patients with soft tissue defects of the lower extremity due to various etiologies from January, 2007 to January, 2013. The patients received either an anterolateral thigh free flap (n=83), a superficial circumflex iliac artery free flap (n=152), an upper medial thigh free flap (n=19), or a superior gluteal artery perforator free flap (n=13). Microanastomosis was performed using a perforator-to-perforator technique, either end-to-end or end-to-side. RESULTS: The mean postoperative follow up period was eight months (range: one to 16 months) and flap loss occurred in 11 cases out of 267. All cases of flap loss occurred within two weeks of surgery due to either arterial insufficiency (n=5) or venous congestion (n=6). CONCLUSION: Supermicrosurgery enables the selection of the most efficient perforator for microanastomosis at the defect site. It also reduces the time required for dissection of recipient vessels, and reduces the possibility of injury to major vessels. Microsurgery using a vessel of less than 1 mm has been reported to increase the risk of flap failure; however, using the most advanced surgical tools and developing experience in the technique can produce success rates similar to those found in the literature.
Arteries ; Follow-Up Studies ; Free Tissue Flaps ; Glycosaminoglycans ; Humans ; Hyperemia ; Iliac Artery ; Lower Extremity ; Microsurgery ; Thigh

PURPOSE: For reconstruction of lower extremity defects, various flaps can be used and the appropriate flap must be selected and applied according to the size of the defect. In particular, in cases where the defect size is small to moderate, thinner or smaller volume flaps are useful. The authors performed reconstruction of small to moderate defects on the lower extremities using superficial circumflex iliac artery perforator free flaps and are reporting the results. MATERIALS AND METHODS: Fifteen patients underwent reconstruction of defects on lower extremity areas using superficial circumflex iliac artery perforator free flaps from July 2011 to July 2012 at this hospital. The flaps were elevated from above the deep fat layer, and, in all cases, the vessel diameter of the flaps was less than 1mm, with the exception of superficial vein that accompanied it. RESULTS: The mean follow up period was 4.46 months, and, despite a partial loss in the flap in two cases, there were no total losses. All donor sites were closed with primary closure, and there was no occurrence of complications, such as hematomas, seromas, or lymphorrheas. The patients were highly satisfied with the donor site scar since it could be masked by underwear. CONCLUSION: Compared to other flaps, superficial circumflex iliac artery perforator free flaps are thinner in thickness and smaller in volume, which results in a more natural contour of the recipient site after the operation. In addition, since the flap can be elevated from supra-deep fat layer, the operation time can be shortened, and lymphorrhea can be prevented, which in turn lessens donor-site morbidity.
Cicatrix ; Follow-Up Studies ; Free Tissue Flaps ; Glycosaminoglycans ; Hematoma ; Humans ; Iliac Artery ; Lower Extremity ; Masks ; Seroma ; Tissue Donors ; Veins

The objective of this study was to determine the nutritional support in patients treated in medical intensive care units (MICUs) by evaluating the extent of current nutritional support using the patient care plan and considering the association between nutritional status and the amount of nutrition supplied. From April to December 2010, 114 patients (age > or = 18 years) admitted to the MICU and who underwent nutritional support for > 5 days were included. Descriptive statistics showed that the 114 patients received nutritional support within 1.2 +/- 0.7 days and for 16.2 +/- 11.7 days in the MICUs. The total delivered/required caloric ratio was 81.08 +/- 27.31%, and the protein ratio was 80.32 +/- 28.93%. Patients who received > 80% of required calories and protein showed improved nutritional status (p < 0.05). The results showed that adequate nutritional support is crucial to critically ill patients. We suggest early nutritional screening using simple tools such as periodic monitoring and management to recalculate nutritional status and nutritional requirements and nutritional support using a multidisciplinary method. Systematic nutritional support teams are needed to provide adequate nutritional support for patients in the MICU.
Critical Illness ; Humans ; Intensive Care Units ; Mass Screening ; Nutritional Requirements ; Nutritional Status ; Nutritional Support ; Patient Care

Background: Self-leadership, an action strategy that can maximize individual capabilities, can affect the organizational commitment of dental hygienists and ultimately improve the quality of medical services. This study aims to demonstrate the need for self-leadership and organizational commitment for dental hygienists and develop measures to improve the quality of medical services. Methods: An online survey of dental hygienists working at dental hospitals and clinics in Seoul and Gyeonggi province, Republic of Korea was conducted from March 28 to May 1, 2022. A total of 341 questionnaires were returned and analyzed. The measurement tools were modified and supplemented based on the theories and models developed by Manz for self-leadership, Mowday for organizational commitment, and Cronin and Taylor for medical services. Descriptive statistics, independent t-tests, ANOVA, simple regression, and multiple regression analyses were performed using SPSS 25.0. Results: In leadership education, self-leadership is based on participation experience, the number of participants, and when and where it is received. Organizational commitment comes from participation experience, and the quality of medical services has been found to affect participation experience and location. Self-leadership had an effect on the quality of medical services (β=0.497, t=10.551, p＜0.001; β =0.599, t=13.783, p＜0.001; β=0.353, t=7.601, p＜0.001) and organizational commitment was found to have a mediating effect. Conclusion Dental hygienists’ self-leadership has a positive effect on the quality of medical services through the formation of appropriate interrelationships within the organization. Therefore, self-leadership programs should be developed, participated in, and promoted to improve the self-leadership of dental hygienists. Moreover, hospitals should improve their environment to provide and improve self-leadership education.

Neuroleptic malignant syndrome is a rare, idiosyncratic and potentially lethal side effect that occurs patients receiving neuroleptic drugs. Characteristic sings and symtoms include muscle rigidity, fever, altered consciousness, and autonomic dysfuction. The most common serious complication is rhabdomyolysis, which produces acute myoglobiuric renal failure. We present a case of 32-year-old man in whom had NMS and acute renal failure after he had received a combination of chloropromazine and haloperidol. The patients recorvered after treatment by immediate hydration, diuretics and other conservative measure.
Acute Kidney Injury* ; Adult ; Antipsychotic Agents ; Consciousness ; Diuretics ; Fever ; Haloperidol ; Humans ; Muscle Rigidity ; Neuroleptic Malignant Syndrome* ; Renal Insufficiency ; Rhabdomyolysis

Here we determined which radiation-responsive genes were altered in radioresistant CEM/IR and FM3A/IR variants, which showed higher resistance to irradiation than parental human leukemia CEM and mouse mammary carcinoma FM3A cells, respectively and studied if radioresistance observed after radiotherapy could be restored by inhibition of protein kinase A. The expressions of DNA-PKcs, Ku70/80, Rad51 and Rad54 genes that related to DNA damage repair, and Bcl-2 and NF-kappaB genes that related to antiapoptosis, were up-regulated, but the expression of proapototic Bax gene was down-regulated in the radioresistant cells as compared to each parental counterpart. We also revealed that the combined treatment of radiation and the inhibitor of protein kinase A (PKA) to these radioresistant cells resulted in synergistic inhibition of DNA-PK, Rad51 and Bcl-2 expressions of the cells, and consequently restored radiosensitivity of the cells. Our results propose that combined treatment with radiotherapy and PKA inhibitor can be a novel therapeutic strategy to radioresistant cancers.
Animals ; Apoptosis/drug effects ; Cell Line, Tumor ; Cyclic AMP-Dependent Protein Kinases/*antagonists & inhibitors/metabolism ; DNA Damage/drug effects ; DNA Repair/drug effects ; Gamma Rays ; Gene Expression Regulation, Neoplastic/radiation effects ; Genes, bcl-2 ; Humans ; Mice ; Neoplasm Proteins/genetics/metabolism ; Neoplasms/enzymology/*genetics ; Radiation Tolerance/*genetics ; Research Support, Non-U.S. Gov't

BACKGROUND: The aim of this study was to investigate sarcopenia and its association with cardiometabolic risk factors in a community-based elderly cohort in Korea. METHODS: We recruited 287 men and 278 women aged 65 years or older and without physical disability. Appendicular skeletal muscle mass (ASM) was measured with dual energy X-ray absorptiometry. We used two definitions for sarcopenia-ASM divided by height2 (kg/m2) or by weight (%) <1 SD below the sex-specific mean for young adults. We compared RBP-4, adiponectin, hsCRP, lipid profiles, and insulin resistance between the sarcopenic and normal groups using ASM/Ht2 and ASM/Wt. RESULTS: The prevalence of sarcopenia was 35.3% in men and 13.4% in women with sarcopenia defined by ASM/Ht2. However, it was 38.3% in men and 62.6% in women by ASM/Wt. In correlation analysis, body mass index was positively correlated with ASM/Ht2 and negatively correlated with ASM/Wt. The sarcopenic group, when defined as ASM/Ht2, showed lower RBP4, fasting plasma glucose, and HOMA-IR and higher adiponectin than the normal group but not significantly different lipid profiles. The sarcopenic group defined by ASM/Wt had higher RBP4, fasting plasma glucose, and HOMA-IR, and lower adiponectin than the normal group in both sexes. Only in the males did the sarcopenic group defined by ASM/Wt reveal higher total cholesterol, triglycerides, and LDL cholesterol, and lower HDL cholesterol than the normal group. CONCLUSION: In conclusion, the sarcopenic group defined by ASM/Wt was more closely associated with cardiometabolic risk factors than the normal group in a community-based elderly cohort.
Absorptiometry, Photon ; Adiponectin ; Aged ; Body Mass Index ; Cholesterol ; Cholesterol, HDL ; Cholesterol, LDL ; Cohort Studies ; Fasting ; Female ; Glucose ; Humans ; Insulin Resistance ; Korea ; Male ; Muscle, Skeletal ; Plasma ; Prevalence ; Risk Factors ; Sarcopenia ; Triglycerides ; Young Adult

Abstract In many clinical situations which cause thymic involution and thereby result in immune deficiency, T cells are the most often affected, leading to a prolonged deficiency of T cells. Since only the thymic-dependent T cell production pathway secures stable regeneration of fully mature T cells, seeking strategies to enhance thymic regeneration should be a key step in developing therapeutic methods for the treatment of these significant clinical problems. This study clearly shows that receptor activator of NF-kappaB ligand (RANKL) stimulates mouse thymic epithelial cell activities including cell proliferation, thymocyte adhesion to thymic epithelial cells, and the expression of cell death regulatory genes favoring cell survival, cell adhesion molecules such as ICAM-1 and VCAM-1, and thymopoietic factors including IL-7. Importantly, RANKL exhibited a significant capability to facilitate thymic regeneration in mice. In addition, this study demonstrates that RANKL acts directly on the thymus to activate thymus regeneration regardless of its potential influences on thymic regeneration through an indirect or systemic effect. In light of this, the present study provides a greater insight into the development of novel therapeutic strategies for effective thymus repopulation using RANKL in the design of therapies for many clinical conditions in which immune reconstitution is required.
Animals ; Cell Adhesion/drug effects ; Cell Line ; Cell Proliferation/drug effects ; Cyclophosphamide/pharmacology ; Down-Regulation/drug effects ; Epithelial Cells/*cytology/drug effects/*metabolism ; Granulocyte-Macrophage Colony-Stimulating Factor/genetics/metabolism ; Intercellular Adhesion Molecule-1/genetics/metabolism ; Interleukin-7/*genetics/*metabolism ; Male ; Mice ; Mice, Inbred C57BL ; RANK Ligand/*pharmacology ; RNA, Messenger/genetics/metabolism ; Receptor Activator of Nuclear Factor-kappa B/genetics/metabolism ; Regeneration/drug effects ; Thymus Gland/*cytology/*drug effects/physiology ; Up-Regulation/drug effects ; Vascular Cell Adhesion Molecule-1/genetics/metabolism ; bcl-2-Associated X Protein/genetics/metabolism ; bcl-X Protein/genetics/metabolism