PURPOSE: p53 gene mutations, one of the most common alterations found in human tumors, has also been detected in gastric carcinoma, and shown to have a crucial and early role in gastric carcinogenesis of intestinal type and mainly associated with tumor progression in the cancer of diffuse type. We tried to investigate the frequency of p53 mutations in 27 gastric carcinomas. MATERIALS AND METHODS: Fresh tumor tissue from a series of gastric carcinoma was screened for p53 mutations by polymerase chain reaction-single strand conformation polymorphism (PCR-SSCP) with silver staining and confirmed by direct-sequencing in 27 cases of gastric carcinoma. Immunohistochemical method for p53 protein accumulation was also performed in the same cases. RESULTS: Immunohistochemistry revealed 20 of 27 cases of gastric carcinoma, positive for p53. PCR-SSCP analysis of p53 exons 5-8 detected mobility shift in 4 out of 20 p53-positive tumors; three from exon 5 and the other from exon 7, respectively. DNA sequencing of exon 5 showed CGC to CAC point mutation in one of three cases; exon 7, ATC to AAC point mutation. It seemed that there was no correlation between genetic alterations of p53 gene detected by PCR-SSCP and expression of p53 protein by immunohistochemistry. CONCLUSIOAS: Our results suggest that mutations of the p53 gene are rare genetic events in carcinogenesis of gastric carcinomas. There was discrepancy between mutations screened by PCR-SSCP and overexpressions in immunohistochemical staining.
Carcinogenesis ; Exons ; Genes, p53 ; Humans ; Immunohistochemistry ; Point Mutation ; Polymerase Chain Reaction* ; Polymorphism, Single-Stranded Conformational* ; Sequence Analysis, DNA ; Silver Staining

With the advent of faster scan time and new computer program, a scanning technique called “dynamic computedtomography” has become possible. Dynamic CT consists of performing multiple rappid sequence scans after injectionof contrast material. The authors have evaluated the clinical usefulness of CT and dynamic CT of 93 patients withbrain infarction and/or ischemia during the period of 17 months from April 1983 to Aug. 1983 to Aug. 1984 inDepartment of Radiology, Chonbuk National University Hospital. The results were as follows; 1. The agedistribution ranged from 18 years to 78 years. Among them the most common age group was between 50 years and 59years(40.9%). 2. The sites of brain infarction were cerebral lobes(63 cases,68), basal ganglia(15 cases, 16.1%)and mlultiple sites(6 cases, 6.4%). The common affected site was middle cerebral artery territories. 3. Thecontrast enhancement of acute infarction was noted in 14 cases(17.5%) which occured commonly between 3 days and 2weeks from ictus. 4. The patterns of time-density curve in brain infarction and/or ischemia were as follow: a .Depression of slow wash-in phase was 20 cases(59%). b. Lower peak concentration was 17 cases(50%), c. Lower anddelayed peak concentration was 7 cases(21%), d. No definite peak concentration was 6 cases(18%). First threepatterns of time-density curve were thought as relatively characteristic curve of brain infarction and/orischemia. 5. Two cases that showed negative findings on precontrast CT scan appeared to be positive findings ashypodensity on postcontrast CT scan and were confirmed as brain infarction by dynamic CT. 6. The diagnostic entityof dynamic CT scan were as follows: a. large artery thrombotic infarction were 23 cases (58%). b. lacunarinfarction were 6 cases (15%). c. ischemia were 5 cases (13%), d. normal were 5 cases(13%), In six cases oflacunar infarction which was doubtful hypodensity on pre-and postcontrast CT scan had a marked difference in CT#(HU) on absolute scale graph of dynamic CT, so diagnosis of lacunar infarction could be made easily. 7. Theclinical values of dynamic CT consist in not only diagnosis of lacunar infarction but also evaluation ofeffectiveness of medical or surgical treatment.
Arteries ; Brain Infarction ; Brain ; Depression ; Diagnosis ; Humans ; Infarction ; Ischemia ; Jeollabuk-do ; Middle Cerebral Artery ; Stroke, Lacunar ; Tomography, X-Ray Computed

No abstract available.

OBJECTIVE: Atrial fibrillation (AF) guidelines have been published in the USA and Europe. Recently, the USA and Europe have updated their guidelines, respectively. These new AF guidelines help in addressing key management issues in clinical situations. This study, therefore, systematically compared guidelines for rate and rhythm control pharmacotherapy of patients with AF between the USA (American College of Cardiology and American Heart Association, ACC/AHA) and Europe (European Society of Cardiology, ESC). METHODS: This study investigated and compared American guidelines (2014) and European guidelines (2010 and 2012). RESULTS: Generally, there are four meaningful differences between ACC/AHA and ESC guidelines. Important differences are treatment classification system, level of recommendation, drug list, and dosage. In addition, ACC/AHA described pharmacokinetic drug interactions for antiarrhythmic drugs. ESC emphasized ECG and atrioventricular nodal slowing as feature of antiarrhythmic drugs. CONCLUSION: This research addresses important use of anti-arrhythmic drugs and movement to accept recent recommendations in Korea. For the successful application of the guidelines, a role of pharmacists is crucial in clinical situation.
American Heart Association ; Anti-Arrhythmia Agents ; Atrial Fibrillation* ; Cardiology ; Classification ; Drug Interactions ; Drug Therapy* ; Electrocardiography ; Europe* ; Humans ; Korea ; Pharmacists

The size of spinal canal is mesured to detect the lumbar spinal stenosis syndrome and expanding intraspinaltumors by CT. This study was desinged for taking accurate measurement of the normal lumbar spinal canal in Koreanadults. The anteroposterior diameter, interpediculate distance and cross-sectional area of lumbar spinal canalwere measured in 110 normal adults. The results were as follows; 1. The window center that showed identical valueconsistent with actual measurement of phantom was between + 160HU and + 240HU and the window width was below +300HU. 2. In anteroposterio diameter, upper part of the canal was larger value than that of middle and lowerparts, but in interpediculate distance, lower part of the canal revealed larger value than that of upper andmiddle parts. There was no significant difference in cross-sectional area. 3. All measurements male were largerthan those of female at all levels of the spinal canal and 42 measurements(58%) were significant statisstically.4. Compared with Americans, Korean showed lower value in anteriopsterior diameter and cross-sectional area buthigher value in interpediculate distance. 5. Above results should contribute to making an another criteria fordiagnosing the lumbar spinal stenosis in Koreans.
Adult ; Asian Americans ; Female ; Humans ; Male ; Spinal Canal ; Spinal Stenosis

BACKGROUND: Most current reseatch using prognostic scoring systems in critically ill patients have focused o prediction using the first intensive care unit(ICU) day data or daily updated data. Usually the mean ICU length of stay in Korea is longer than in the western world. Consequently, a more cost-effective and practical prognostic parameter is required. The principal aim of this study was to assess the prognostic value of the seventh day(7th day : the average mean ICU length of stay) APACHE III score in a medical intensive care unit. METHODS: 241 medical ICU patients from July 1997 to April 1998 were enrolled. The 1st and 7th scores were measured by using the APACHE III scoring system and compared between survivors and non-survivors. Logistic regression analysis was performed to determine the relationship between the 1st and 7th APACHE III scores and the mortality risk. RESULTS: 1) The mean length of stay in the ICU was 10.3±13.8 days. 2) The mean 1st and 7th day APACHE III scores were 59.7±30.9 and 37.9±27.7. 3) The mean 1st day APACHE III scores was significantly lower in survivors than in non- survivors(49.9±23.8 vs 86.3±32.3 P<0.0001). 4) The mean 7th day APACHE III scores was significantly lower in survivors than in non- survivors(30.1±18.5 vs 80.1±30.4, P<0.0001). 5) The odds ratios among the 1st and 7th day APACHE III scores and the mortality rate were 1.0507 and 1.0779 respectively. CONCLUSION: These results suggest that the seventh day APACHE III scores is as useful in predicting the outcome as is such like the first day APACHE III score. Therefore, in comparison to the daily APACHE III score, measuring the 1st and 7th day APACHE III scores are also useful for predicting the prognosis of critically ill patients in terms of cost-effectiveness. It is suggested that the 7th day APACHE III score is useful for predicting the clinical outcome.
APACHE* ; Critical Illness ; Humans ; Intensive Care Units* ; Critical Care* ; Korea ; Length of Stay ; Logistic Models ; Mortality ; Odds Ratio ; Prognosis ; Survivors ; Western World

Antibiotic associated colitis due to Clostridium difficile is a common infection associated with significant morbidity. In severe cases, Pseudomembranous colitis (PMC) may be associated with intraperitoneal fluid accumulation. Howwver, the characteristics of the liquid are seldom described. This case report describes PMC patients who were presented with low serum-ascites albumin gradients (SAAG)and neutrocytic ascites, without evidence of infectious, malignant, or inflammatory peritoneal disease. The characteristics of their fluid specimens and the possible pathogenic mechanisms are discussed. These findings suggest that PMC without bowel perforation or spontaneous bacterial peritonitis.
Ascites* ; Clostridium difficile ; Enterocolitis, Pseudomembranous* ; Humans ; Peritoneal Diseases ; Peritonitis

This article describes methods used to produce a RBRVS (resource-based relative value scales), a common scale from two specialties (internal medicine and general surgery) and explains the newly developed extrapolation process within each specialty. To produce a common scale, we selected six 'same' services as linking services common to both specialties. Then we used the bi-weighted least squares method to locate all the same services on a single, common scale. By using the same method, we tried to extrapolate all the services within each specialty, not by the method of Kelly et al, dividing all the services within the specialty into families (small homogeneous groups of services) to apply charge-based ratios. To compare both methods, we extrapolated all the services of general surgery according to each method. With the correlation analysis to compare both results to American RVUs, we found that general surgery's RVUs from our own extrapolation method turned out to be more highly correlated with American RVUs than from Kelly's extrapolation method. Consequently, extrapolation with bi-weighted least squares method gave reasonable results.
Human ; *Internal Medicine ; Least-Squares Analysis ; *Relative Value Scales

Mucoepidermoid carcinoma was initially recognized as occurring only in the salivary gland and only later was it appreciated that it occurred in the bronchus and trachea as well. Mucoepidermoid carcinoma of bronchial gland origin is extremely rare, and little is known about their natural history. This carcinoma is derived from the minor salivary gland of the proximal tracheobronchial tree and it is divided into low-grade and high-grade by gross, histologic, and ultrastructural criteria. Also Its clinical and biologic behaviors are closely related with histologic grade of carcinoma. We have experienced a rare case of bronchial mucoepidermoid carcinoma associated with adenocarinoma which obstructed the left main bronchus and was successfully removed by the pneumonectomy.
Adenocarcinoma ; Bronchi ; Carcinoma, Mucoepidermoid* ; Lung ; Natural History ; Pneumonectomy ; Salivary Glands ; Salivary Glands, Minor ; Trachea ; Trees

We have never seen any method to cope basically with complicated situation and problems around medical reimbursement rates here in Korea since 1977 witnessed by the beginning of medical insurance. By the way researchers concerned are beginning to propose some kinds of innovative and detailed ideas to government these days. They are Diagnosis-related group(DRG)and Resource-based relative value scale(RBRVS). In the light of this situation it is so encouraging that our government can come up with that and move. In case of RBRVS research we have already been reaching even to the level of reviewing and revising methodology for its further development after naive pilot study on internal medicine and general surgery last year. However there might be something different conditions between USA and Korea to apply the same Dr. Hsiao's method and it must be vital to check so called 'total work approach' compared with 'intra-service work approach' before expanding to the whole medical fields. According to the 'Intra-service approach', the physician's work is supposed to be divided into three sub-works by the name of intraservice work, pre, and post service work. These sub-works, again should be merged together to be the pre-postwork subset through some statistical methods of the estimation process applied by Dr. Hsiao's methodology in RBRVS development later on. But in this paper that estimation process was not taken because we could have real values for all of those surveyed items related to just one specialty, OB & GY. Instead, we used some statistical comparison procedures relevant to demographic characteristics, reliability & validity and correlation analysis with American RVU(Relative value unit) between the total work and merged total work from intraservice work approach. The unit of analysis was individual physicians of OB & GY and 300 physicians were selected for each approach through statistical sampling method based on national population of OB & GY physicians in korea. And also with the thankful help of Advisory committee under Korean Association of OB & GY, questionnaires were made and mailed to the subjects, two times. As a result there were not any statistically significant differences in demographic characteristics between the two approaches except for the variable 'Response time for the questionnaire', but in other sections of comparisons, response rate, representative values, reliability & validity test, correlation analysis with American RVU, all showed 'Total approach' was not only more rational and statistically meaningful than ,'Intra-service approach' but also had considerable merits. But we are not absolutely sure about this paper's robustness. Because of some limitations, we'd rather like to suggest further researches should be followed. In that sense the first thing would be a research for the influence of doctor's haracteristics, especially 'frequency' on the rating of work and the way to define total work more clearly.
Advisory Committees ; Gynecology* ; Insurance ; Internal Medicine ; Korea ; Obstetrics* ; Pilot Projects ; Postal Service ; Surveys and Questionnaires