Antigen processing (TAP, HLA-DM and LMP) genes map within the major histocompatibility complex (MHC) class II region between the HLA-DQB1 and -DPB1 loci, and are involved in the processing of peptides bound to HLA class I or class II molecules. In order to determine the allele frequencies of antigen processing genes and the various linkage disequilibria existing among these genes, we have analyzed TAP1, TAP2, HLA-DMA, and HLA-DMB, LMP2, LMP7 polymorphisms in 184 unrelated healthy Koreans using the rnethod of PCR-SSCP, ARMS-PCR and PCR-RFLP. The frequencies of antigen processing genes were TAP1A (77.7%), TAP1*B (17.1%), TAP1*C (5.2%), TAP2*A (41.6%), TAP2*B (31.3%), TAP2*C (3.3%), TAP2*D (0.8%), TAP2*E (6.5%), TAP2*G (0.8%), HLA-DMA*0101 (81.5%), HLA-DMA*0102 (18.2%), HLA-DMA*0103 (0.3%), HLA-DMB*0101 (42.9%), HLA-DMB*0102 (19.0%), HLA-DMB*0103 (38.0%), LMP2*R (78.8%), LMP2*H (21.2%), LMP7*A (35.3%), LMP7*B (56.0%), LMP7*C (4.9%), and LMP7*D (3.8%). We also analysed two- locus association among each locus. Many significant positive associations were observed between these two loci, such as between HLA-DMB and TAP1, between HLA-DMA and HLA-DMB, between LMP2 and LMP7, and between TAP1 and LMP7. Conversely, any significant linkage disequilibrium was not detected between HLA-DMB and LMP2. These results could be used as control data for disease association and population genetics studies in Korean population.
Antigen Presentation* ; Gene Frequency ; Genetics, Population ; Linkage Disequilibrium ; Major Histocompatibility Complex ; Peptides

PURPOSE: Although staged operations have been thought a main treatment for obstructive left colon cancer, their disadvantages make one-stage operations popular. We tried to identify technical feasibility and oncologic safety of one-stage operation with intra-operative lavage (IOL) for the treatment of obstructive left colon and rectal cancer. METHODS: From June 1996 to May 1999, of 456 colorectal cancer patients, 25 with obstructive left colon or rectal cancer underwent surgery. In 18 of those, we intended to do a one-stage operation with IOL. Male (n=14) were predominant to female (n=4). Mean age was 61.2 (29~78) years. Lesions were located on the sigmoid colon in 8, rectum in 4, descending in 3, and rectosigmoid junction in 3 cases. Operative technique: Lymphovascular division was initiated at the origin of IMA followed by mobilization of the left colon up to the splenic flexure and distal transverse colon. Thereafter antegrade irrigation of the proximal colon with warm normal saline was done by using a corrugated tube. Anastomoses were made by hand or stapler in end-to-end or side-to-end fashion. RESULTS: Mean operative time was 221 (185~360) min. No significant post-operative complications occurred except for two wound infections and one pulmonary atelectasis. There was one unexpected conversion to Hartmann's procedure due to intra-operative fecal soilage during the lavage. Within 18 months follow-up period, 4 recurrences occurred with two of them expiring. CONCLUSIONS:: One-stage operation for the treatment of obstructive left colon cancer with IOL could avoid colostomy or reoperation, and, was technically feasible, safe, and oncologically acceptable.
Colon* ; Colon, Sigmoid ; Colon, Transverse ; Colonic Neoplasms* ; Colorectal Neoplasms ; Colostomy ; Female ; Follow-Up Studies ; Hand ; Humans ; Male ; Operative Time ; Pulmonary Atelectasis ; Rectal Neoplasms ; Rectum ; Recurrence ; Reoperation ; Therapeutic Irrigation* ; Wound Infection

Bleomycin, a tumoricidal antibiotic agent, may produce unusual cutaneous manifestations such as pigmentation scleroderma, and gangrene. We report a case of the development of linear streaky pigmentation and cutaneous scleroderma in a patient treated with bleomycin for choriocarcinoma of undescented testis. The patient was 45-year-old male presented with linear brown and slate gray streaking over the trunk and extremities after three cycles of chemotherapy(bleomycin, etoposide, cisplatine). After the fourth cycle of the same chemotherapy, 18 weeks after initiation of bleomycin, the development of cutaneous scleroderma-like conditions was observed involving the same sites. Histopathologic examination showed increased basal pigmentation and thick collagen bundles through the entire dermis, extending to the subcutis. Herein, we describe a case of streaky pigmentation and scleroderma in association with bleomycin anticancer chemotherapy simultaneously in a patient.
Bleomycin* ; Choriocarcinoma ; Collagen ; Dermis ; Drug Therapy ; Etoposide ; Extremities ; Female ; Gangrene ; Humans ; Hyperpigmentation ; Male ; Middle Aged ; Pigmentation* ; Pregnancy ; Testis

No abstract available.

By means of hospital-based data over 8 years we sought to evaluate the clinical indications and incidence of emergency peripartum hysterectomy by demographic characteristic and reproduction history. From the obstetric record of all deliveries at Chung Goo Hospital between Jan. 1, 1990, and Nov. 31, 1997, we identified all women undergoing emergency cesarean hysterectomy, calculated incidence rates, conducted statistical tests of linear trends and heterogenety, and observed the clinical indicatons preceding the onset of this procedure. There were 16731 deliveries during this period, Cesarean hysterectomy was performed in 24 of 5993 cesarean sections(0.40%) and in 10 of 10738 vaginal deleveries(0.09%), so more frequently after cesarean section than vaginal delivery. The age of patients varied from 22 to 40 years old. The higher the age and the parity of patients, the higher incidence of cesarean hysterectomy was noted. The most common indication of cesarean hysterectomy was uterine atony(52.94%) followed by placental disorders(41.18%), uterine myoma with pregnancy(2.9%) and uterine rupture (2.9%). All patients who had hysterectomy received transfusion from 1 pint to 57 pints. The postoperative complications were bladder injury, febrile morbidity, disseminated intravascular coaguolopathy and wound disruption. There were three maternal deaths, the cause was disseminated intravascular coaguolopathy and amniotic embolism. The data identifiy uterine atony as the primary cause for gravid hysterctomy. The data also illustrated how the incidence of emergency peripartum hysterectomy increases significantly with increasing parity, especially when influenced by a current placenta previa or a prior cesarean section. Maternal morbidity remained high.
Adult ; Cesarean Section ; Embolism ; Emergencies ; Female ; Humans ; Hysterectomy* ; Incidence ; Leiomyoma ; Maternal Death ; Parity ; Peripartum Period* ; Placenta Previa ; Postoperative Complications ; Pregnancy ; Reproduction ; Urinary Bladder ; Uterine Inertia ; Uterine Rupture ; Wounds and Injuries

HLA-A2 is present at high frequency in most populations, as identified by serological and biochemical means. The values of these methods are limited by their failures to discriminate the products of the known allelic HLA-A02 variants. The great majority of genetic polymorphism which defines the allelic variants is found in exons 2 and 3 of the HLA-A02 gene. These exons encode the a-1 and a-2 domains of the HLA class I molecules, and the variation within the genes may influence the peptide binding specificity of the gene products of each allele. To determine the 17 known alleles of HLA-A02 an ARMS-PCR was developed. We applied this ARMS-PCR to 10 standard cell lines and we confirmed the specificity and sensitivity of this method. We defined the HLA-A 02 subtypes in 146 healthy Koreans who were serologically identified as HLA-A2. Five subtypes out of the 17 known A02 alleles were detected (A'0201, 0203, 0206, 0207, '0210) and A'0201 was most frequent (53.4%) and A'0206, '0207, '0203, 0210 (37.0%, 18.5%, 2.7%, 2.1%), were followed respectively. By linkage disequilibrium analysis with HLA-B alleles, A*02 subtypes were defined to be associated with many B alleles (B27, 35, 38, 39, 46, 52, 60, and 61). It is suggested that these findings may be helpful for the selection of patients for the specific immunotherapy with HLA-A02 restricted peptide vaccines and for the unrelated bone marrow transplantation in Korean.
Alleles ; Bone Marrow Transplantation ; Cell Line ; Exons ; HLA-A Antigens ; HLA-A2 Antigen ; HLA-B Antigens ; Humans ; Immunotherapy ; Linkage Disequilibrium ; Polymorphism, Genetic ; Sensitivity and Specificity ; Vaccines, Subunit

No abstract available.
Child* ; Emergencies* ; Emergency Service, Hospital* ; Humans ; Infant* ; Poisoning*

The aim of this study was to find out an effective method of laparoscopic oncologic right hemicolectomy based on vascular anatomy of the right colon and patterns of lymph node metastasis. From September 1994 to November 1997,20 hemodynamically stable patients received curative laparoscopic-assisted right hemicolectomy for adenocarcinoma by one surgeon. Simultaneously anatomic variations of right colonic vessels and patterns of lymph node metastasis were analyzed. All operations were performed by laparoscopic-assisted method that consisted of intracorporeal mobilization of the right colon followed by extracorporeal resection and anastomosis and lymph node dissection up to superior mesenteric vessels under direct vision through mini-incision just above the root of superior mesenteric vessels. Ileocolic (ICA) and mid colic artery (MCA) existed constantly (100%), right colic artery (RCA) existed only in 12 cases (60%). Mean distance from origin of MCA to ICA was 3.2cm. Mean number of lymph nodes harvested from SMA area was 2.9 per case. In 2 cases, they showed metastasis. Astler-Coilers stage Bl, B2, Cl, C2 were distributed in 6, 8, 1, 5 cases respectively. Mean number of lymph node dissected and length of resection margin was 29.3 and 8.7 cm. Operative time, time to oral intake, hospital stay was 187 minutes,2.6 days,7.2 days, respectively. Open conversion was needed in 1 case due to duodenal invasion. Mean 14 months follow-up showed 2 recurrences. One who have had duodenal wedge resection due to cancer invasion underwent reresection of duodenum because of duodenal recurrence 12 months after the first operation. The other suddenly died of myocardial infarction after operation for ovarian recurrence 8 months later to her right hemicolectomy. Right colonic vascular anatomy was so various but the area from MCA to ICA was constantly within 4 cm and, lymph nodes in that area must be cleared. Therefore, laparoscopic intracorporeal mobilization and extracorporeal resection of the right colon and lymph node dissection through small incision was effective, safe and one of the best method to get advantages of laparoscopic and open surgery simultaneously.
Adenocarcinoma ; Arteries ; Colic ; Colon ; Duodenum ; Follow-Up Studies ; Humans ; Laparoscopy ; Length of Stay ; Lymph Node Excision ; Lymph Nodes ; Myocardial Infarction ; Neoplasm Metastasis ; Operative Time ; Recurrence

No abstract available.
Granuloma Annulare ; Rheumatoid Nodule

No abstract available.
Granuloma Annulare ; Rheumatoid Nodule