Temporary occlusion of the renal artery may be necessary for the extensive kidney operation. Performance of kidney operation requires an understanding of renal responses to warm ischemia and available methods of protecting the kidney while arterial occlusion. To minimize the loss of kidney function cooling of the organ is mandatory. The cooling can be accomplished either by perfusion with cold solution or by in situ surface cooling During the last 41 months, we performed renal surgery using hypothermia technique with good results in l5 patients.
Humans ; Hypothermia* ; Kidney ; Perfusion ; Renal Artery ; Warm Ischemia

Multilocular renal cyst is an uncommon entity of uncertain nature. By recent years only n few cases had reported in the literature. The difficulties encountered in distinguishing this entity from the Wilms' tumor indicate that this disease warrants great emphasis. We have experienced a case of unilateral multilocular cystic kidney treated with nephrectomy.
Kidney ; Kidney Diseases, Cystic* ; Nephrectomy ; Wilms Tumor

PURPOSE: It is known that DNA methylation is associated with histone acetylation status in regulation of gene expression. In this study, we investigate the effect of demethylating agents and histone deacetylase (HDAC) inhibitor on the tumor suppression and the combined effect of two agents according to methylation status in human colon and breast cancer cell lines. METHODS: In this study, the RKO colorectal cancer cell line, MCF-7 breast cancer cell lines were considered. For each cell line, we used HDAC inhibitor sodium butyrate (SB), demethylating agent 5-aza-2'-deoxycytidine (5-aza-DC) and a combination of both agents. We estimated the percentage of cell survival using the XTT method and experimented with the augmentative effects of both agents. RESULTS: In RKO cell line in which most of the genes are methylated, 74% of cell survival was shown for 5-aza-DC treatment and 83% of cell survival for SB treatment. In MCF-7 cell line that approximately half of the genes are methylated, 82% cell survival was shown for 5-aza-DC treatment and 63% cell survival for SB treatment. We observed that the survival fraction is lower after the combined treatment of 5-aza-DC and SB than that of 5-aza-DC or SB alone in both RKO (53%) and MCF-7 (49%) cell lines (P<0.001). CONCLUSION: For highly methylated genes, 5-aza-DC is more effective on the tumor suppression than SB. On the other hand, if the methylation of the promoter region is at low density, SB is noted to be more effective than 5-aza-DC. Furthermore, the combined treatment of 5-aza-DC and SB is more effective than using each agent alone.
Acetylation ; Azacitidine ; Breast ; Breast Neoplasms ; Butyrates ; Cell Line ; Cell Survival ; Colon ; Colorectal Neoplasms ; DNA Methylation ; Epigenomics ; Gene Expression Regulation ; Hand ; Histone Deacetylase Inhibitors ; Histone Deacetylases ; Histones ; Humans ; MCF-7 Cells ; Methylation ; Promoter Regions, Genetic ; Sodium

PURPOSE: The aim of this retrospective study is to assess the necessity of staging laparotomy in the management of supradiaphragmatic CS I-II Hodgkin's disease. Prognostic factors and the usefulness of prognostic factor groups were also analyzed. MATERIALS AND METHODS: From 1985 to 1995, fifty one patients who were diagnosed as supradiaphragmatic CS I-II Hodgkin's disease at Yonsei Cancer Center in Seoul, Korea were enrolled in this study. Age range was 4 to 67 with median age of 30. The number of patients with each CS IA, IIA, and IIB were 16, 25, and 10, respectively. Radiotherapy (RT) was delivered using 4 or 6 MV photon beam to a total dose of 19.5 to 55.6Gy (median dose : 45Gy) with a 1.5 to 1.8Gy per fraction. Chemotherapy (CT) was given in 2-12 cycles (median : 6 cycles). Thirty one patients were treated with RT alone, 4 patients with CT alone and 16 patients with combined chemoradiotherapy. RT volumes varied from involved fields (3), subtotal nodal fields (18) or mantle fields (26). RESULTS: Five-year disease-free survival rate (DFS) was 78.0% and overall survival rate (OS) was 87.6%. Fifty patients achieved a complete remission after initial treatment and 8 patients were relapsed. Salvage therapy was given to 7 patients, 1 with RT alone, 4 with CT alone, 2 with RT+CT. Only two patients were successfully salvaged. Feminine gender and large mediastinal adenopathy were significant adverse prognostic factors in the univariate analysis for DFS. The significant adverse prognostic factors of OS were B symptom and clinical stage. When patients were analyzed according to European Organization for Research and Treatment of Cancer (EORTC) prog-nostic factor groups, the DFS in patients with very favorable, favorable and unfavorable group was 100, 100 and 55.8% (p<0.05), and the OS in each patients' group was 100, 100 and 75.1% (p<0.05), respectively. In very favorable and favorable groups, the DFS and OS were all 100% by RT alone, but in unfavorable group, RT with CT had a lesser relapse rate than RT alone. The subtotal nodal irradiation had better DFS than mantle RT in patients treated with RT. CONCLUSION: In present study, the DFS and OS in patients who did not undergo staging laparotomy were similar with the results in the literatures of which patients were surgically staged. Therefore, we may suggest that staging laparotomy would not influence the outcome of treatments. In univariate analysis, gender, large mediastinal adenopathy, B symptoms and clinical stage were significant prognostic factors for the survival rate. We confirm the usefulness of EORTC prognostic factor groups which may be a good indicator to select the treatment modality.
Chemoradiotherapy ; Disease-Free Survival ; Drug Therapy ; Hodgkin Disease* ; Humans ; Korea ; Laparotomy ; Radiotherapy ; Recurrence ; Retrospective Studies ; Salvage Therapy ; Seoul ; Survival Rate

PURPOSE: The aim of this retrospective study is to assess the necessity of staging laparotomy in the management of supradiaphragmatic CS I-II Hodgkin's disease. Prognostic factors and the usefulness of prognostic factor groups were also analyzed. MATERIALS AND METHODS: From 1985 to 1995, fifty one patients who were diagnosed as supradiaphragmatic CS I-II Hodgkin's disease at Yonsei Cancer Center in Seoul, Korea were enrolled in this study. Age range was 4 to 67 with median age of 30. The number of patients with each CS IA, IIA, and IIB were 16, 25, and 10, respectively. Radiotherapy (RT) was delivered using 4 or 6 MV photon beam to a total dose of 19.5 to 55.6Gy (median dose : 45Gy) with a 1.5 to 1.8Gy per fraction. Chemotherapy (CT) was given in 2-12 cycles (median : 6 cycles). Thirty one patients were treated with RT alone, 4 patients with CT alone and 16 patients with combined chemoradiotherapy. RT volumes varied from involved fields (3), subtotal nodal fields (18) or mantle fields (26). RESULTS: Five-year disease-free survival rate (DFS) was 78.0% and overall survival rate (OS) was 87.6%. Fifty patients achieved a complete remission after initial treatment and 8 patients were relapsed. Salvage therapy was given to 7 patients, 1 with RT alone, 4 with CT alone, 2 with RT+CT. Only two patients were successfully salvaged. Feminine gender and large mediastinal adenopathy were significant adverse prognostic factors in the univariate analysis for DFS. The significant adverse prognostic factors of OS were B symptom and clinical stage. When patients were analyzed according to European Organization for Research and Treatment of Cancer (EORTC) prog-nostic factor groups, the DFS in patients with very favorable, favorable and unfavorable group was 100, 100 and 55.8% (p<0.05), and the OS in each patients' group was 100, 100 and 75.1% (p<0.05), respectively. In very favorable and favorable groups, the DFS and OS were all 100% by RT alone, but in unfavorable group, RT with CT had a lesser relapse rate than RT alone. The subtotal nodal irradiation had better DFS than mantle RT in patients treated with RT. CONCLUSION: In present study, the DFS and OS in patients who did not undergo staging laparotomy were similar with the results in the literatures of which patients were surgically staged. Therefore, we may suggest that staging laparotomy would not influence the outcome of treatments. In univariate analysis, gender, large mediastinal adenopathy, B symptoms and clinical stage were significant prognostic factors for the survival rate. We confirm the usefulness of EORTC prognostic factor groups which may be a good indicator to select the treatment modality.
Chemoradiotherapy ; Disease-Free Survival ; Drug Therapy ; Hodgkin Disease* ; Humans ; Korea ; Laparotomy ; Radiotherapy ; Recurrence ; Retrospective Studies ; Salvage Therapy ; Seoul ; Survival Rate

PURPOSE: This study compared the postoperative outcomes and complications between laparoscopic totally extraperitoneal (TEP) hernia repair and open Lichtenstein hernia repair. METHODS: A total of 64 cases (30 cases by the TEP method and 34 cases by Lichtenstein repair) were enrolled in this study. The operative time, the hospital stay, the VAS score, the amount of analgesic used, the postoperative complications and recurrence were compared between the 2 methods. RESULTS: The mean operative time was 71 min for the TEP group, which was not significantly longer than that for the Lichtenstein group (66 min). The mean postoperative hospital stay was 3.7 days for the TEP group, which was significantly shorter than that for the Lichtenstein group (4.2) (p=0.035). The mean postoperative analgesic dose was 0.9+/-0.7 and 1.1+/-1.0 within 24 hours and 0.2+/-0.5 and 0.7+/-0.8 after 24 hours, respectively. The dose of analgesic after 24 hours was significantly lower for the TEP group (p=0.011), but the dose within 24 hours and the total dose was not significantly different. The VAS score was 2.3+/-1.0 and 2.6+/-0.9 at 12 hrs and 1.2+/-0.8 and 1.7+/-0.8 at 48 hrs, respectively. The VAS score was significantly lower for TEP group than that for the Lichtenstein group at 48 hrs (p=0.011), but there was no significant difference between the groups at 12 hrs. There was one recurrence in the TEP group. CONCLUSION: For the TEP group, the hospital stay was significantly shorter than that for the Lichtenstein group and this is maybe because the postoperative pain after 24 hours from the operation was less for the TEP group. Laparoscopic TEP repair may be performed efficiently with an acceptable operating time and a shorter hospital stay, as compared to open Lichtenstein hernia repair.
Hernia ; Herniorrhaphy ; Length of Stay ; Operative Time ; Pain, Postoperative ; Postoperative Complications ; Pyrazines ; Recurrence

Developed proteome-scale ortholog and paralog prediction methods are mainly based on sequence similarity. However, it is known that even the closest BLAST hit often does not mean the closest neighbor. For this reason, we added conserved interaction information to find orthologs. We propose a genome-scale, automated ortholog prediction method, named OrthoInterBlast. The method is based on both sequence and interaction similarity. When we applied this method to fly and yeast, 17% of the ortholog candidates were different compared with the results of Inparanoid. By adding protein-protein interaction information, proteins that have low sequence similarity still can be selected as orthologs, which can not be easily detected by sequence homology alone.
Diptera ; Proteins ; Sequence Homology ; Yeasts

Cryptococcosis is a relatively common mycosis of human caused by a worldwide Cryptococcus neoformans. Cryptococcosis occurs more frequently in immuno-compromised hosts such as patients with lymphoma, AIDS, leukemia and other debilitating diseases which manifest a condition of altered cell mediated immunity. Also cancer patients with anticancer chemotherapy are at high risk. Cryptococcosis is primarily a pulmonary disease that remains asymptomatic and unrecognised in most cases. Meningitic and meningoencephalitc forms are more frequently diagnosed because of their striking clinical symptoms.Meningoencephalitis is an uncommon form of cryptoccocosis that often leads to coma and death within a short time, if it is not quickly diagnosed and treated properly. The treatment of choice for the cryptococcosis consists of intravenous amphotericin B and 5-fluorocytocine. We report a case of cryptococcal meningitis in 47-year-old female breast cancer patient with liver metastasis after systemic chemotherapy. She complained headach, fever and diagnosed as cryptococcal meningitis after the India ink smear and culture of CSF. After treated with amphotericin B, her conditions were improved.
Amphotericin B ; Breast Neoplasms ; Coma ; Cryptococcosis ; Cryptococcus neoformans ; Drug Therapy ; Female ; Fever ; Herpes Zoster* ; Humans ; Immunity, Cellular ; India ; Ink ; Leukemia ; Liver* ; Lung Diseases ; Lymphoma ; Meningitis, Cryptococcal* ; Middle Aged ; Neoplasm Metastasis* ; Strikes, Employee

BACKGROUND: This study was conducted to survey the current status of family medicine residency programs and to evaluate the difficulties in training of the curriculums. METHODS: Questionnaires on residency programs were sent to all the centers of residency programs by mail in April 2006. The questionnaire included detailed characteristics of residency programs, curriculum schedule, reasons for failed specific curriculum, and review and measures by the program center and the Korean Academy of Family Medicine to resolve problematic curriculums. RESULTS: A total of 113 residency programs responded. Among the 93 residency programs except for the 20 subsidiary hospitals, inadeguate subjects were mainly dermatology (12 programs, 12.3%), psychiatry (6 programs, 7.5%), ophthalmology (5 programs, 7.1%), and otolaryngology (5 programs, 7.1%). Training rejection rate was higher in dermatology (13 programs, 14.4%), radiology (11 programs, 13.1%), gastrofibroscopy (8 programs, 9.5%), and psychiatry (5 programs, 6.2%). Emergency me-dicine in 4 programs and general surgery in 3 programs had a longer duration of training than initially planned. Difficulties in training some subjects were due to failed establishment of specific curriculums in non-university hospital. Commonly established clinics were health promotion center, obesity clinic, smoking cessation clinic, geriatric clinic, stress clinic, and clinical nutrition clinic. Family medicine center programs included gastrofibroscopy, obesity, smoking cessation, geriatrics, hospice care, and evidence-based medicine. CONCLUSION: There is repeated demand for taking measures to promote better curriculum in the nation-wide view of family medicine. Dermatology, radiology, psychiatry, and otolaryngology were the subjects difficult to receive training. Measures to strengthen the weak subjects are urgently needed.
Appointments and Schedules ; Curriculum* ; Dermatology ; Emergencies ; Evidence-Based Medicine ; Geriatrics ; Health Promotion ; Hospice Care ; Humans ; Internship and Residency* ; Korea* ; Obesity ; Ophthalmology ; Otolaryngology ; Postal Service ; Smoking Cessation ; Surveys and Questionnaires

BACKGROUND: This study was conducted to survey the current status of family medicine residency programs and to evaluate the difficulties in training of the curriculums. METHODS: Questionnaires on residency programs were sent to all the centers of residency programs by mail in April 2006. The questionnaire included detailed characteristics of residency programs, curriculum schedule, reasons for failed specific curriculum, and review and measures by the program center and the Korean Academy of Family Medicine to resolve problematic curriculums. RESULTS: A total of 113 residency programs responded. Among the 93 residency programs except for the 20 subsidiary hospitals, inadeguate subjects were mainly dermatology (12 programs, 12.3%), psychiatry (6 programs, 7.5%), ophthalmology (5 programs, 7.1%), and otolaryngology (5 programs, 7.1%). Training rejection rate was higher in dermatology (13 programs, 14.4%), radiology (11 programs, 13.1%), gastrofibroscopy (8 programs, 9.5%), and psychiatry (5 programs, 6.2%). Emergency me-dicine in 4 programs and general surgery in 3 programs had a longer duration of training than initially planned. Difficulties in training some subjects were due to failed establishment of specific curriculums in non-university hospital. Commonly established clinics were health promotion center, obesity clinic, smoking cessation clinic, geriatric clinic, stress clinic, and clinical nutrition clinic. Family medicine center programs included gastrofibroscopy, obesity, smoking cessation, geriatrics, hospice care, and evidence-based medicine. CONCLUSION: There is repeated demand for taking measures to promote better curriculum in the nation-wide view of family medicine. Dermatology, radiology, psychiatry, and otolaryngology were the subjects difficult to receive training. Measures to strengthen the weak subjects are urgently needed.
Appointments and Schedules ; Curriculum* ; Dermatology ; Emergencies ; Evidence-Based Medicine ; Geriatrics ; Health Promotion ; Hospice Care ; Humans ; Internship and Residency* ; Korea* ; Obesity ; Ophthalmology ; Otolaryngology ; Postal Service ; Smoking Cessation ; Surveys and Questionnaires