PURPOSE: This study was carried out to investigate the effect of irradiation on the expression of proliferating cell nuclear antigen (PCNA) and apoptosis induction during the carcinogenesis in hamster buccal pouch. MATERIALS AND METHODS: Three months old Syrian golden hamsters were divided into control and 2 experimental groups. Hamsters in control group were left untreated on buccal pouchs. Twenty four hamsters were treated with 0.5% DMBA tri-weekly on the right buccal pouch. Forty eight hamsters were treated with 0.5% DMBA tri-weekly and irradiated with the dose of 5 Gy and 10 Gy at 6, 9, 12, 15 weeks after DMBA application. Resected buccal pouches were sectioned and examined for potential expression pattern of PCNA and apoptosis. RESULTS: The PCNA index was increased with the stages of buccal pouch epithelium carcinogenesis except the hyperplasia stage in control group (p<0.05). The irradiation did not effect on the PCNA index in the dysplasia and the carcinoma in situ stage, but in the hyperplasia stage, the PCNA index was increased with 10 Gy radiation and decreased in the carcinoma stage (p<0.05). The apoptotic index was significantly decreased from the carcinoma in situ stage and the lowest in the carcinoma stage. The apoptotic index was significantly decreased in the hyperplasia and dysplasia stage with the 5 Gy irradiation and significantly increased only in the carcinoma stage with the 10 Gy irradiation (p<0.05). CONCLUSION: The PCNA and apoptotic index were varied according to the irradiation period and dosage in each carcinogenesis stage.
9,10-Dimethyl-1,2-benzanthracene* ; Animals ; Apoptosis* ; Carcinogenesis* ; Carcinoma in Situ ; Cricetinae* ; Epithelium ; Hyperplasia ; Mesocricetus ; Proliferating Cell Nuclear Antigen* ; Radiation Dosage

PURPOSE: The purpose of this study was to investigate the apoptosis induction in tissues constituting the craniofacial region of growing rat by irradiation. MATERIALS AND METHODS: The submandibular gland, brain, articular cartilage of condylar head, and calvarium were extracted from 20-day-old rats irradiated 10 Gy. Apoptosis of each tissue was examined by DNA fragmentation and estimated quantitatively using apoptotic index on TUNEL assay. Apoptotic index of each tissue was calculated by the equation for apoptotic cells/total cells X1,000 on the images of confocal laser scanning microscopy. Apoptotic index was analyzed statistically according to the time lapse after irradiation on the tissues. RESULTS: In the submandibular gland, apoptotic index was significantly increased from 6 hours after irradiation showing the highest value at 12 hours and decreased to the control level at 3 days after irradiation. In the brain, apoptotic index was abruptly reached to the maximum value at 6 hours after irradiation and decreased to the control level at 4 days after irradiation. Articular cartilage and calvarium showed no or little apoptotic signals. The results obtained by the apoptotic index accorded with that of DNA fragmentation. CONCLUSION: Radiation was closely related with the apoptosis of submandibular gland and brain but, not related with the apoptosis of the articular cartilage of condylar head and calvarium. The changes induced by radiation of the hard tissues would not be explained by apoptosis.
Animals ; Apoptosis* ; Brain ; Cartilage, Articular ; DNA Fragmentation ; Head ; In Situ Nick-End Labeling ; Microscopy ; Microscopy, Confocal ; Rats* ; Skull ; Submandibular Gland

BACKGROUND: Recent advances have been made in the treatment of acute stroke, but the effectiveness of the new therapies is highly time dependent. Patients with acute stroke often arrive at the hospital too late to receive the maximum benefit from these new stroke therapies. Efforts to reduce delay time of therapy for acute stroke may be more effective if the factors that delay hospital arrival are identified and targeted for specific intervention. So we studied about reason of delay of hospital presentation in patients with acute stroke. METHODS: The 85 acute stroke patients group who admitted to the Young-dong severance hospital from April to August 1999 were enrolled in this study. We collected clinical data from the medical record, including demographic characteristics, date and time of symptom onset, date and time of presentation to the hospital, medical history, and symptoms at stroke onset. And informants about stroke, method of transportation, the patient's interpretation of the symptoms were interviewed. We defined early arrival as within 3 hours of awareness of symptoms. RESULTS: The 85 patient were interviewed, early arrival were more likely to arrive by ambulance(P<0.001), admit via emergency department(P=0.001), interpret their symptoms as a stroke(P=0.005) and use readings as a informants about stroke(P=0.027) than late arrivals. Also they were younger than late arrivals(P=0.027). Main reason of delay of hospital presentation was because they expect spontaneous improvement(43%), mistake as other disease(23.3%), arrive via other medical institute(20%). CONCLUSION: Late arrivals expected spontaneous improvement, misinterpreted their symptoms as those of other disease and didn't choose proper medical institute for acute management. Considerable education is needed to increase the knowledge about stroke and proper acute management.
Education ; Emergencies ; Humans ; Medical Records ; Reading ; Stroke* ; Transportation

Actinomycosis is defined as a chronic, specific, suppurative, granulomatous disease caused mainly by the anaerobic, gram positive organism, Actinomyces israelii. Actinomycosis in the salivary gland is a rare disease that is caused by an inhabitant of the normal flora. We report the case of the actinomycosis of submandibular gland. A 53-year old man presented with the swelling on left submandiblar area. The lesion was not painful but had been increasing for about 10 days. In the CT view, the internal portion of the mass showed homogeneous moderate signal. The mass had continuities with the inferior portion of the left enlarged submandibular gland. In the MRI, there was a mass that showed a buldging pattern inferiorly in the left submandibular gland without bony invasion sign. The biopsy shows the colony of special organism. Many filaments are discovered with clubbed ends diffused from center of colony. We diagnosed this disease as actinomycosis in the submandibular gland by the postoperational biopsy.
Actinomyces ; Actinomycosis* ; Biopsy ; Humans ; Magnetic Resonance Imaging ; Middle Aged ; Rare Diseases ; Salivary Glands ; Submandibular Gland*

BACKGROUND: Decision about life sustaining treatments ought to be based on the patient's informed preferences. This study was to see if there were any differences in acceptance by patients, their primary care givers and doctors for end-of-life care according to situations, and if any, to analyse the factors related with different attitudes. METHODS: A structured questionnaire survey of end-of-life care preferences was performed on 162 cancer patients and their primary care givers in four university hospitals and one general hospital from March 1, 1999 to February 29, 2000. A similar survey was done for doctors practicing at the above hospitals during the same period to investigate their attitudes toward providing end-of-life care to an assumed nearly bed-ridden patients. ANOVA, t-test and Wilcoxon rank sum test were used to compare acceptance of intervention among the groups or according to the various situations. Factors presumed to be related to the acceptance were sought and analysed by stepwise multiple regression. RESULTS: The difference in acceptance of intervention between the primary care giver group and the doctor group was not significant in almost every situation, showing significantly higher than the patient group (P<0.001). All three groups showed higher acceptance when a therapeutic intervention rather than a diagnostic test was proposed (P<0.001), when expected survival was 30 days rather than 7 (P<0.01), and when the therapeutic intervention was thought as non-invasive rather than invasive (P<0.001). The less anxious the patient was, the higher the acceptance from the patient. Patients with a religion had higher acceptance rate than non-religious patients. Primary care givers who expected cure of the disease accepted more of the postulated care than those who did not (P<0.05). Wives or mother-in-laws of patients showed lower acceptance than those in other relationship (P<0.05). The longer the patient had been diagnosed with cancer, the higher the acceptance of the primary care giver (P<0.1). Direct relatives showed higher acceptance than that of collaterals (P<0.1). Family doctors specializing in family medicine had lower acceptance than doctors of other specialties and interns (P<0.05). CONCLUSION: The acceptance of intervention by patients was lower than that of primary care givers and doctors and depended on the expected survival and the type of intervention.
Attitude to Death ; Diagnostic Tests, Routine ; Hospitals, General ; Hospitals, University ; Humans ; Palliative Care ; Primary Health Care* ; Spouses ; Surveys and Questionnaires

To understand the seroepidemiological patterns of haemorrhagic fever with renal syndrome in Korea, a nation-wide survey collaborated with fourteen clinics was carried out from 1994 to 1996. Sera of 4,547 patients with acute febrile episodes were tested by indirect immunofluorescent antibody test and the seroepidemiological analysis including sex, age, seasonal and regional distributions were performed. According to the results obtained in this study, the epidemiological characteristics of haemorrhagic fever with renal syndrome in Korea were summarized as follows: 1. Seropositive rate of hemorrhagic fever with renal syndrome among the patients with acute febrile episodes was 6.4% by the cut-off point of 1:40. 2. Among the seropositives, male outnumbered female and the ratio of males to females was 2.0:1.0. 3. Seventy six % of the seropositive patients were 21-60 years old. 4. The number of seropositive cases increased from October and reached maximum in December and began to decrease gradually from January. 5. The geographical distribution of the seropositives cover most areas including Cheju province in Korea.
Female ; Fever ; Hemorrhagic Fever with Renal Syndrome* ; Humans ; Jeju-do ; Korea* ; Male ; Seasons

PURPOSE: Computed radiography (CR) has been used in cephalometric radiography and many studies have been carried out to improve image quality using various digital enhancement and filtering techniques. During CR image acquisition, the frequency rank and type affect to the image quality. The aim of this study was to compare the diagnostic quality of conventional cephalometric radiographs to those of computed radiography. MATERIALS AND METHODS: The diagnostic quality of conventional cephalometric radiographs (M0) and their digital image counterparts were compared, and at the same time, six modalities (M1-M6) of spatial frequency-processed digital images were compared by evaluating the reproducibility of 23 cephalometric landmark locations. Reproducibility was defined as an observer's deviation (in mm) from the mean between all observers. RESULTS AND CONCLUSION: In comparison with the conventional cephalometric radiograph (M0), M1 showed statistically significant differences in 8 locations, M2 in 9, M3 12, M4 in 7, M5 in 12, and M6 showed significant differences in 14 of 23 landmark locations (p<0.05). The number of reproducible landmarks that each modality possesses were 7 in M6, 6 in M5, 5 in M3, 4 in M4, 3 in M2, 2 in M1, and 1 location in M0. The image modality that observers selected as having the best image quality was M5.
Cephalometry ; Radiographic Image Enhancement ; Radiography ; Reproducibility of Results

PURPOSE: The study was aimed to detect the induction of apoptosis, cell cycle arrest and calcified nodule formation after irradiation on primarily cultured osteoblasts. MATERIALS AND METHODS: Using rat calvarial osteoblasts, the effects of irradiation on apoptosis, cell cycle arrest, and calcified nodule formation were studied. The single irradiation of 10, 20 Gy was done with 5.38 Gy/min dose rate using the 137Cs cell irradiator at 4th and 14th day of culture. Apoptosis induction and cell cycle arrest were assayed by the flowcytometry at 1, 2, 3, and 4 days after irradiation. The formation of calcified nodules was observed by alizarin red staining at 1, 3, 10, 14 days after irradiation at 4th day of culture, and at 1, 4, 5 days after irradiation at 14th day of culture. RESULTS: Apoptosis was not induced by 10 or 20 Gy independent of irradiation and culture period. Irradiation did not induced G1 arrest in post-irradiated ostedblasts. After irradiation at 4th-day of culture, G2 arrest was induced but it was not statistically significant after irradiation at 14th-day of culture. In the case of irradiated cells at 4th day of culture, calcified nodules were not formed and at 14th-day of culture after irradiation, calcified nodule formation did not affected. CONCLUSION: Taken together, these results suggest that irradiation at the dose of 10-20 Gy would not affect apoptosis induction of osteoblasts. Cell cycle and calcified nodule formation were influenced by the level of differentiation of osteblasts.
Animals ; Apoptosis* ; Cell Cycle Checkpoints* ; Cell Cycle* ; Osteoblasts* ; Rats*

BACKGROUND: The bone graft for the alveolar cleft has been accepted as one of the essential treatments for cleft lip patients. Precise preoperative measurement of the architecture and size of the bone defect in alveolar cleft has been considered helpful for increasing the success rate of bone grafting because those features may vary with the cleft type. Recently, some studies have reported on the usefulness of three-dimensional (3D) computed tomography (CT) assessment of alveolar bone defect; however, no study on the possible implication of the cleft type on the difference between the presumed and actual value has been conducted yet. We aimed to evaluate the clinical predictability of such measurement using 3D CT assessment according to the cleft type. METHODS: The study consisted of 47 pediatric patients. The subjects were divided according to the cleft type. CT was performed before the graft operation and assessed using image analysis software. The statistical significance of the difference between the preoperative estimation and intraoperative measurement was analyzed. RESULTS: The difference between the preoperative and intraoperative values were -0.1+/-0.3 cm3 (P=0.084). There was no significant intergroup difference, but the groups with a cleft palate showed a significant difference of -0.2+/-0.3 cm3 (P<0.05). CONCLUSIONS: Assessment of the alveolar cleft volume using 3D CT scan data and image analysis software can help in selecting the optimal graft procedure and extracting the correct volume of cancellous bone for grafting. Considering the cleft type, it would be helpful to extract an additional volume of 0.2 cm3 in the presence of a cleft palate.
Alveoloplasty ; Bone Transplantation ; Cleft Lip ; Cleft Palate ; Cone-Beam Computed Tomography ; Humans ; Transplants

PURPOSE: Radiation damage is produced and viable cell number is reduced. We need to know the type of cell death by the ionizing radiation and the amount and duration of cell cycle arrest. In this study, we want to identified the main cause of the cellular damage in the oral cancer cells and normal keratinocytes with clinical useful radiation dosage. MATERIALS AND METHODS: Human gingival tissue specimens obtained from healthy volunteers were used for primary culture of the normal human oral keratinocytes(NHOK). Primary NHOK were prepared from separated epithelial tissue and maintained in keratinocyte growth medium containing 0.15 mM calcium and a supplementary growth factor bullet kit as described previously. Fadu and Hep-2 cell lines were obtained from KCLB. Cells were irradiated in a (137)Cs gamma-irradiator at the dose of 10 Gy. The dose rate was 5.38 Gy/min. The necrotic cell death was examined with Lactate Dehydrogenase(LDH) activity in the culture medium. Every 4 day after irradiation, LDH activities were read and compared control group. Cell cycle phase distribution and preG1-incidence after radiation was analyzed by flow cytometry using Propidium Iodine(PI) staining. Cell cycle analysis were carried out with a FAC Star plus flowcytometry(FACS, Becton Dickinson, USA) and DNA histograms were processed with CELLFIT software(Becton Dickinson, USA). RESULTS: LDH activity increased in all of the experimental cells by the times. This pattern could be seen in the non-irradiated cells, and there was no difference between the non-irradiated cells and irradiated cells. We detected an induction of apoptosis after irradiation with a single dose of 10 Gy. The maximal rate of apoptosis ranged from 4.0% to 8.o% 4 days after irradiation. In all experimental cells, we detected G2/M arrest after irradiation with a single dose of 10 Gy. Yet there were differences in the number of G2/M arrested cells. The maximal rate of the G2/M ranges from 60.0% to 80.0% 24h after irradiation. There is no significant changes on the rate of the G0/G1 phase. CONCLUSION: Radiation sensitivity was not related with necrosis but cell cycle arrest and apoptosis. These data suggested that more arrested cell is correlated with more apoptosis.
Apoptosis* ; Calcium ; Cell Count ; Cell Cycle ; Cell Cycle Checkpoints ; Cell Death ; Cell Line ; DNA ; Flow Cytometry ; Healthy Volunteers ; Humans ; Keratinocytes ; Lactic Acid ; Mouth Neoplasms ; Necrosis* ; Propidium ; Radiation Dosage ; Radiation Tolerance ; Radiation, Ionizing