PURPOSE: MAGE (melanoma antigen gene) is a tumor associated antigen, presented by HLA class I molecules, which is recognized by cytotoxic T lymphocytes. The expression of MAGE proteins are confined to malignant tumor tissues, except for the normal testis and placental tissues. Therefore, MAGE may be a potential target for immunotherapy of malignant tumors. However, biological aspects associated with the cell cycle are not yet described. MATERIALS AND METHODS: The material used for this study was a novel human squamous cell carcinoma cell line (PNUH-12) from the hypopharynx, which had one point mutation of 78th base, C to G, in exon 7 of p53 gene. To understand the role of MAGE in relation to cell cycle and its relationship with p53 as the Gl checkpoint regulator, the expressions of MAGE-3 protein and mvtant p53 (Mtp53) were accessed by flow cytometry and immunohistochemistry. Double stains for MAGE-3/Mtp53 was analyzed with bivariate flow cytometry. DNA histograms using MAGE-3/PI (DNA) and Mtp53/PI (DNA) were also analyzed. RESULTS: The expression rate of MAGE-3 and Mtp53 were 83% and 85%, respectively. MAGE-3 was expressed in cytoplasm, while M:p53 were expressed in the nuclei of the tumor cells on the immunohistochemical sections. With bivariate analyses, coexpression rate of MAGE-3/Mtp53 was 0.96, and MAGE-3 and Mtp53 constantly showed high levels throughout the cell cycle except Go. CONCLUSIONS: These results mean that (I) MAGE-3 might have yet unknown relationship with mutant p53, (2) expressions of MAGE-3 and Mtp53 are not dependent on the cell cycle in PNUH-12 hypopharyngeal squamous carcinoma cell line, and suggest that MAGE-3 might have a role as important as p53 during the development of malignant tumors.
Carcinoma, Squamous Cell ; Cell Cycle* ; Cell Line ; Coloring Agents ; Cytoplasm ; DNA ; Exons ; Flow Cytometry* ; Genes, p53 ; Humans ; Hypopharynx ; Immunohistochemistry ; Immunotherapy ; Point Mutation ; T-Lymphocytes, Cytotoxic ; Testis

BACKGROUNG AND OBJECTIVES: It was reported that low molecular weight heparin (LMWH) was more effective than unfractionated heparin in patients with acute coronary syndrome. Recent studies have shown that the pathophysiology of restenosis in stented lesions was different from those of nonstented lesions. Treatment strategies designed to limit cellular proliferation that were ineffective in nonstented lesions may be efficacious in reducing in-stent restenosis. This study was aimed to compare the clinical and angiographic results of LMWH (nadroparin) after coronary stenting with those of conventional ticlopidine regimen. MATERIALS AND METHODS: Patients were eligible for inclusion if they had angina and/or objective evidence of myocardial ischemia, and a significant (>50%) stenosis that was documented on a recent coronary angiogram. After stenting, prospective randomized comparison study was performed. Patients were randomly assigned to either nadroparin (200 IU/kg, sc, bid) or ticlopidine (250 mg bid) plus aspirin (200 mg qd) treatment groups. Repeat coronary angiography (KERN=*)was performed at 236+/-90days after stenting, and quantitative coronary angiographic analysis (QCA) was done. RESULTS: Intracoronary stent implantation was performed in eighty five lesions in eighty one patients (ticlopidine:40, nadroparin:41). There was no significant difference in any baseline clinical/angiographic variables between the two treatment groups. There were no subacute stent thrombosis, infarction and death in both groups. Six-month event-free survival was 36 (90%) in the ticlopidine group and 35 (85.4%) in the nadroparin group. Follow-up quantitative angiographic data such as late loss (1.35+/-0.70 vs 1.32+/-0.69), loss index (0.53+/-0.70 vs 0.56+/-0.23) and restenosis rate (36% vs 25.8%) were not different between ticlopidine and nadroparin groups. CONCLUSION: Effects of nadroparin were not different from those with ticlopidine therapy in the prevention of restenosis and subacute stent thorombosis after coronary stenting. Clinical outcomes between two strategies were similar. Low molecular weight heparin may be an alternative to ticlopidine in patients that ticlopidine cannot be administered because of severe adverse effects.
Acute Coronary Syndrome ; Aspirin ; Cell Proliferation ; Constriction, Pathologic ; Coronary Angiography ; Disease-Free Survival ; Follow-Up Studies ; Heparin ; Heparin, Low-Molecular-Weight ; Humans ; Infarction ; Myocardial Ischemia ; Nadroparin* ; Prospective Studies ; Stents* ; Thrombosis ; Ticlopidine*

Rapid eeonomic divelopment and attendent technological advances have influenced the practice of anesthesia as well as other medical fields. Our fields such as CPR, respiratory care, critical role of an anesthesilogist has been extended beyond the confines of the operating theater in the developed countries. In Korea, the chronic shortage of manpower tends to restrict anesthesiologists to operating theater providing minimal time for preoperative assessment and more active contact with patients. In our survey to 150 senior medical students, opportunity for direct patient contact is the most important determinant in the choice of a career. The medical graduates interests in clerkship in College of Medicine, Seoul National Universty, in order, are respiratory care/mechanical ventilation, endo- tracheal intubation, arterial blood gas/it's interpretation, cardiopulmonary resuseitation and anesthesia per se. Their most favorite specialties in order as a career choice are internal medicine, ENT, et., and anesthesiology is ranked between 7th and 11th specialty.
Anesthesia ; Anesthesiology* ; Cardiopulmonary Resuscitation ; Career Choice ; Critical Care ; Developed Countries ; Humans ; Internal Medicine ; Intubation ; Korea ; Seoul ; Students, Medical ; Ventilation

Pseudo-kaposi's sarcoma is a vasoproliferative disorder that may resemble Kaposi's sarcoma, clinically and histologically. In most cases, it has been associated with congenital or iatrogenic arteriovenous fistula and chronic venous insuffiency. We present a 36-year-old male patient with pseudo-Kaposi's sarcoma caused by a deed vein thrombosis in the absence of any detectable underlying etiologic factors.
Adult ; Arteriovenous Fistula ; Humans ; Male ; Sarcoma ; Sarcoma, Kaposi* ; Thrombosis ; Veins ; Venous Thrombosis*

Cataract extraction, intraocular lens implantation, and pars plana vitrectomy combined in a one-stage procedure(posterior segment triple surgery) are effective operation method for complications of diabetic retinopathy and uveitis. We performed posterior segment triple surgeries in 12 eyes(12 patients) with traumatic eye injuries. After a follow up of at least 3 months, eleven eyes(92%) had a visual acuity f 20/200 or more: seven eyes(58%), 20/40 or morel. The result suggest that posterior segment triple surgery is effective in traumatic eye injuries for the fast visual rehabilitation.
Cataract Extraction ; Diabetic Retinopathy ; Eye Injuries ; Follow-Up Studies ; Humans ; Lens Implantation, Intraocular ; Rehabilitation ; Uveitis ; Visual Acuity ; Vitrectomy

Hydroxyapatite is generally used as an orbital implant which is biocompatible. It is considered esthetically and functionally better than traditional measure. We performed hydroxyapatite implantation using autogenous temporalis muscle fascia for 4 eyes of 4 phthisis patients by truma. Hydroxyapatite implants wrapped with autogenous temporalis muscle fascia were inserted into all eyes after enucleation. Follow-up for 12-15 months [mean:13.4 months] showed less inflammatory reaction. There were has no wound dehiscence, implant protrusion and migration. MRI showed a goodfibrovascular proliferation at 4-5 months postoperatively, so we performed drilling. Temporalis muscle fascia is easily obtained and there is no esthetic problem because scar at scalp is covered by hair.
Cicatrix ; Durapatite* ; Fascia* ; Follow-Up Studies ; Hair ; Humans ; Magnetic Resonance Imaging ; Orbital Implants ; Scalp ; Wounds and Injuries

PURPOSE: To evaluate the morphological differences between malignant and inflammatory lesions that arise from the cecal or pericecal region on CT by analyzing not only the mass itself but also the changes of surrounding structures. SUBJECTS AND METHODS: We reviewed CT scans of 38 cases of cecal lesions confirmed by pathology(16 malignant lesions and 22 inflammatory lesions). The analytical points were :the changes of bowel wall mass, the changes of surrounding structures, strands of retroperitoneal fat, pericecal fluid collection, and regional lymphadenopathy. RESULTS: The malignant bowel wall thickening(18.0mm) was thicker than inflammatory one(ll.4mm)(p < 0.001). Concentric bowel wall thickening was seen in 87.5%(14/16) of malignant lesions and 36%(8/22) of the inflammatory lesions. The pericecal fat stranding was circumferential in 84%(16/22) of inflammation and eccentric in 64%(916) of malignancy(p < 0.01). Pericolic fat infiltration was more extensive in inflammatory lesions(p < 0.005). The strands of retroperitoneal fat were more frequently found in inflammatory lesions(p < 0.05). The pericecal fluid collection was seen in 55%(12/22) of inflammatory lesions and none of malignant lesions. There was no difference in the presence of pericecal lymphadenopathy between the two groups. CONCLUSION: Malignant cecal masses have thicker and concentric bowel wall thickening, and narrower and eccentric pericolic fat infiltration. On the other hand, inflammatory masses have relatively thinner and eccentric bowel wall thickening, and more extensive and circumferential pericolic fat infiltration sometimes accompanied by abnormal fluid collection.
Cecum* ; Hand ; Inflammation ; Intra-Abdominal Fat ; Lymphatic Diseases ; Tomography, X-Ray Computed

BACKGROUND: Pulmonary complications including pneumonia and pulmonary edema frequently develop in critically ill surgical patients. Lung ultrasound (LUS) is increasingly used as a powerful diagnostic tool for pulmonary complications. The purpose of this study was to report how LUS is used in a surgical intensive care unit (ICU). METHODS: This study retrospectively reviewed the medical records of 67 patients who underwent LUS in surgical ICU between May 2016 and December 2016. RESULTS: The indication for LUS included hypoxemia (n = 44, 65.7%), abnormal chest radiographs without hypoxemia (n = 17, 25.4%), fever without both hypoxemia and abnormal chest radiographs (n = 4, 6.0%), and difficult weaning (n = 2, 3.0%). Among 67 patients, 55 patients were diagnosed with pulmonary edema (n = 27, 41.8%), pneumonia (n = 20, 29.9%), diffuse interstitial pattern with anterior consolidation (n = 6, 10.9%), pneumothorax with effusion (n = 1, 1.5%), and diaphragm dysfunction (n = 1, 1.5%), respectively, via LUS. LUS results did not indicate lung complications for 12 patients. Based on the location of space opacification on the chest radiographs, among 45 patients with bilateral abnormality and normal findings, three (6.7%) and two (4.4%) patients were finally diagnosed with pneumonia and atelectasis, respectively. Furthermore, among 34 patients with unilateral abnormality and normal findings, two patients (5.9%) were finally diagnosed with pulmonary edema. There were 27 patients who were initially diagnosed with pulmonary edema via LUS. This diagnosis was later confirmed by other tests. There were 20 patients who were initially diagnosed with pneumonia via LUS. Among them, 16 and 4 patients were finally diagnosed with pneumonia and atelectasis, respectively. CONCLUSIONS: LUS is useful to detect pulmonary complications including pulmonary edema and pneumonia in surgically ill patients.
Anoxia ; Critical Care* ; Critical Illness ; Diagnosis ; Diaphragm ; Fever ; Humans ; Lung* ; Medical Records ; Pneumonia ; Pneumothorax ; Pulmonary Atelectasis ; Pulmonary Edema ; Radiography, Thoracic ; Retrospective Studies ; Ultrasonography* ; Weaning

Spontaneous intracranial hypotension, a syndrome of low CSF pressure, occurs without preceding events such as lumbar puncture, back trauma, operative procedure or medical illness. The most characteristic symptom is a headache that may be severe when the patient is upright and relieved when the patient is recumbent. Associated symptoms include neck stiffness, nausea and vomiting, tinnitus, vertigo and subdural effusion or hematoma. This syndrome usually resolves spontaneously or with strict bed rest. When the headache persists or is incapacitating, more aggressive treatment may be necessary. Autologous epidural blood patch is highly effective in the management of spontaneous intracranial hypotension. We report a case of spontaneous intracranial hypotension successfully treated with epidural blood patch.
Bed Rest ; Blood Patch, Epidural* ; Headache ; Hematoma ; Humans ; Intracranial Hypotension* ; Nausea ; Neck ; Spinal Puncture ; Subdural Effusion ; Surgical Procedures, Operative ; Tinnitus ; Vertigo ; Vomiting

BACKGROUND: Cardiac anesthesia with cardiopulmonary bypass is associated with an increased risk of awareness. A new approach to intraoperative EEG procession, the bispectral index (BIS), may allow more reliable quantitative assessment of the level of consciousness during anesthesia. We evaluated the relationships between BIS and commonly used indices of depth of anesthesia in children. METHODS: In the isoflurane group, anesthesia was maintained using isoflurane 0.5 1.0 vol% inhalation, whereas the fentanyl group received high dose fentanyl-midazolam infusion. BIS, mean arterial blood pressure, and heart rate were recorded at baseline, at postinduction (Tbaseline), skin incision (Tincis), sternotomy (Tsterno), aortic cannulation (Tcannul), nadir temperature (Tnadir), immediate post-CPB (TpostCPB), sternal wire (Twire), and at skin closure (Tclose). RESULTS: BIS showed a significant change over time (P < 0.001), with significant differences between groups (P = 0.04). BIS increased significantly during the immediate post-CPB phase (TpostCPB versus Tbaseline, Tnadir, P < 0.01). No correlations were found between BIS and changes in heart rate or mean arterial pressure during surgery. BIS was higher in the fentanyl group than in the isoflurane group at Tincis, Tcannul, and Twire (P < 0.05). CONCLUSIONS: Even though BIS was relatively lower in the isoflurane group compared to the fentanyl group, we were still unable to demonstrate a relationship between the BIS and hemodynamic indices depth for any group. While the increase in BIS during the rewarming phase could reflect an increase in conscious level, larger prospective studies with postoperative memory test for awareness are necessary.
Anesthesia ; Anesthetics* ; Arterial Pressure ; Cardiopulmonary Bypass ; Catheterization ; Child* ; Consciousness ; Electroencephalography ; Fentanyl ; Heart Rate ; Heart* ; Hemodynamics* ; Humans ; Inhalation ; Isoflurane ; Memory ; Rewarming ; Skin ; Sternotomy ; Thoracic Surgery*