Thumb opposition is essential for all precision handling, in daily activity. Thenar muscle wasting is common in long-standing severe carpal tunnel compression. Unfortunately, muscle wasting rarely recovers after decompression of the nerve. A single-stage procedure, combining carpal tunnel release and opponensplasty, is therefore a logical proposal. Between July of 1993 and May of 1996, 15 patients of carpal tunnel syndrome with thenar muscle atrophy were operated upon Camitz-Littler opponensplasty at Kyungpook University Hospital; combination of palmaris longus transfer and median nerve decompression as a simultaneous procedure. Postoperative thumb opposition was assessed by means of three separate indices-maximal palmar abduction, spatial rotation, thumb-to-finger apposition. Results for an average post-operative follow-up of 12.0 months were achieved 'good' by 86.7%. We concluded that palmaris longus transfer as an opponensplasty carried out in combination with carpal tunnel release is a simple and effective procedure for restoration of opposition in case of severe carpal tunnel syndrome.
Carpal Tunnel Syndrome ; Decompression ; Follow-Up Studies ; Gyeongsangbuk-do ; Humans ; Logic ; Median Nerve ; Muscular Atrophy ; Thumb

Bone defect occurs due to various causes, such as neoplasms, cysts, trauma, infection, congenital disease and surgical intervention. Autograft is generally considered to be the gold standard in bone graft surgery. But, allograft, xenograft and bone substitutes have been used because of complication and limited quantity of autograft. Calcium sulfate is one of the bone substitutes. We reviewed and analyzed 18 cases with bone defects that were treated with calcium sulfate from January 1997 to April 1997. We used the Osteoset' pellets that contained calcium sulfate 98%, produced by Wright Medical Technology Inc. in U.S.A., to fill defects in all cases. Except in 2 cases, autogenous cancellous bone from patients own iliac crest was mixed with calcium sulfate from 30% to 50%. Follow-up time averaged 13.7 months(range, from 12 to 15 months). The degree of absorption of calcium sulfate and new bone growth at conventional roentgenography was represented by percentage at each follow-up. The results were as follows. First, 8 weeks after operation, 93% of calcium sulfate was absorbed. Second, 6 months after operation, nearly 90% of new bone growth was observed. Third, until last follow-up, there was no noticeable complication, such as infection or foreign body reaction. We concluded that calcium sulfate might be on effective material for bone defects because of rapid absorption rate and easy recognition of new bone growth.
Absorption ; Allografts ; Autografts ; Bone Development ; Bone Substitutes* ; Calcium Sulfate* ; Calcium* ; Follow-Up Studies ; Foreign-Body Reaction ; Heterografts ; Humans ; Radiography ; Transplants

PURPOSE: To evaluate the treatment results and prognostic factors after radiotherapy in stage IIB uterine cervix cancer. MATERIALS AND METHODS: We retrospectively analyzed the records of 90 patients with stage IIB uterine cervix cancer who received radiotherapy between 9/94 and 12/99. Age was ranged from 28 to 79 years (median 57). Tumor size was > or = 4 cm in 64 patients. Preteatment SCC level was measured in 76 patients. Twenty nine patients received conventional radiotherapy (QD) and the others received modified hyperfractionated radiotherapy (BID). Only 7 patients in BID had tumor size <4 cm. All patients received high dose rate brachytherapy (4 Gy x 7 or 5 Gy x 6). No patient received concurrent chemotherapy during radiotherapy. Follow up period was ranging from 9 to 76 months (median 38). RESULTS: The 5-year overall and disease free survival rates were 73.4% and 71.6%, respectively. Local recurrences occurred in 10% of patients, and distant metastasis in 18.9%. There was a significant correlation between OS/DFS and tumor size (<4 cm; OS 95.2%, DFS 91.4%, > or = 4 cm; OS 63.4%, DFS 63.4%). Pretreatment SCC level was one of prognostic factors only in univariate analysis. CONCLUSION: With modified hyperfractionated radiotherapy, there was very low local recurrence rate (6.6%) and high 5-year overall and disease free survival rate (75.4% and 70.5%), which is comparable to results after concurrent chemoradiotherapy in bulky, locally advanced stage IIB uterine cervix cancer.
Brachytherapy ; Cervix Uteri* ; Chemoradiotherapy ; Disease-Free Survival ; Drug Therapy ; Female ; Follow-Up Studies ; Humans ; Neoplasm Metastasis ; Radiotherapy* ; Recurrence ; Retrospective Studies

PURPOSE: Many studies for unresectable stage III non-small cell lung carcinomas (NSCLC) have focused on patients with good prognostic factors. However, there have been few reports on patients with poor prognostic factors. Herein, those patients with poor prognostic factors were treated with conservative split course radiation therapy (RT) alone, and the feasibility and survivals evaluated. Methods and Materials: Between Jan 1997 and Dec 2001, 73 patients started conservative split course RT. They were confirmed to have unresectable stage III NSCLC with poor prognostic factors; performance scale> or = ECOG 2 or weight loss> or =5% during the last 6 months. They initially received 30 Gy of radiation in 2.5 or 3 Gy per fractions to the gross tumor volume (GTV). The tumor response was evaluated 2~3 weeks later. A second course of RT was also recommended for good responders: > or =50% tumor diameter reduction or improved distal atelectasis. The treatment related toxicity was also evaluated. RESULTS: Nine patients failed to finish the initial course of RT (3~27 Gy) due to disease progression or personal reasons. Thirty-four (53.1%) of the 64 patients who completed the first course of RT showed a good tumor response. Twenty-seven good responders received the second course of RT, with a total of 51 to 60 Gy. Seven of these did not receive the second course of RT due to distant metastasis or poor performance. The two-year survival rate and median survival in all patients and in the 27 good responders who completed the second course of RT were 19.7% and 12 months and 30.3 and 20 months, respectively. Five (12.8%) of the 39 evaluable patients had grade III radiation esophagitis (N=1) or pneumonitis (N=4). Conclusions: Conservative split course RT was a tolerable and effective modality for unresectable stage III NSCLC with poor prognostic factors. In addition, it was able to produce relatively good survival results in patients showing a good response after the first course and who completed the second course of RT
Disease Progression ; Esophagitis ; Humans ; Lung* ; Neoplasm Metastasis ; Pneumonia ; Pulmonary Atelectasis ; Survival Rate ; Tumor Burden

Toxoplasma gondii tachyzoites were isolated from the blood of an ocular patient, and have been successfully passaged in the laboratory, for over a year, by peritoneal inoculation in mice. The isolated parasite was designated the Korean Isolate-1 (KI-1) and its characteristics were compared with those of the RH strain, a wellknown virulent strain originating from a child who suffered from encephalitis. The morphology, pathogenicity, infectivity and cell culture characteristics of the KI-1 were similar to those of the RH strain. Both RH and KI-1 antigens were detected by an anti-T. gondii monoclonal antibody (mAb), Tg563, against the major surface protein SAG1 (30 kDa), whereas no reaction was observed against an anti-Neospora caninum mAb, 12B4. The KI-1 was confirmed as an isolate of T. gondii. A long-term laboratory maintenance and characterization of a local T. gondii isolate is reported for the first time in the Republic of Korea.
Animals ; Antigens, Protozoan/analysis ; Female ; Humans ; Korea ; Mice ; Mice, Inbred BALB C ; Microscopy, Electron ; Middle Aged ; Parasitemia/parasitology ; Sarcoma 180 ; Serial Passage ; Specific Pathogen-Free Organisms ; *Toxoplasma/classification/growth & development/isolation & purification/pathogenicity ; Toxoplasmosis, Ocular/*diagnosis/parasitology ; Tumor Cells, Cultured ; Virulence

Plasmodium vivax malaria re-emerged in South Korea in 1993, and epidemics continue since then. We examined genetic variation in the region encompassing the apical membrane antigen-1 (PvAMA-1) of the parasites by DNA sequencing of the 22 re-emerging P. vivax isolates. The genotype of the PvAMA-1, which was based on sequence data previously reported for the polymorphic regions, showed that two haplotypes were present at one polymorphic site. Compared with reported data, the two types, SKOR type I and type II, were similar to Chinese CH-10A and CH-05A isolates, respectively. Thus, the present study showed that two genotypes of AMA-1 genes coexist in the re-emerging Korean P. vivax.
Adult ; Aged ; Amino Acid Sequence ; Animals ; *Antigens, Protozoan ; Base Sequence ; Child ; Female ; Genotype ; Human ; Korea ; Malaria, Vivax/*genetics ; Male ; Membrane Proteins/chemistry/*genetics ; Middle Aged ; Molecular Sequence Data ; Polymorphism (Genetics) ; Protozoan Proteins/chemistry/*genetics ; Support, Non-U.S. Gov't

Owing to in-hospital transmission of coronavirus disease 2019 (COVID-19), Uijeongbu St.Mary’s Hospital, a university-affiliated hospital in South Korea, was temporarily closed for disinfection in March 2020. This study aimed to investigate the impact of both the hospital shutdown and the prolonged COVID-19 pandemic on short-term outcomes of colorectal cancer (CRC) patients. We retrospectively reviewed the clinicopathologic data of 607 patients who were surgically treated for CRC from May 2018 to September 2021. Nodal upstaging, higher lymphatic invasion and abdominoperineal resection rates for 3 months after the hospital resumed surgery following the shutdown in the first wave of the COVID-19 pandemic were detected, without worse short-term morbidity or mortality. The incidence of adverse pathologic features of CRC such as lymphatic, venous, and perineural invasion was higher throughout the COVID-19 pandemic era. Further follow-up of CRC patients treated in the pandemic era for long-term oncologic outcomes is needed.

Background: Altering wrist biomechanics, Kienbock’s disease leads to progressive carpal collapse that results in early arthritis and degenerative changes. By shifting the loading axis toward the radioscaphoid joint, scaphocapitate arthrodesis (SCA) has been reported as a salvage procedure effective in treating symptomatic patients with advanced Kienbock’s disease. In this study, we aimed to evaluate the clinical and radiological outcomes of arthroscopic SCA in symptomatic patients with advanced stages of Kienbock’s disease. Methods: Between March 2010 and February 2021, we included 15 patients with symptomatic stage IIIA (n=2) and stage IIIB (n=13) Kienbock’s disease who were followed up for a minimum of 24 months after arthroscopic SCA with or without lunate excision. The lunate was excised in 6 patients and retained in 9. Visual analog scale (VAS) pain score, grip strength, range of motion (ROM), active flexion-extension arc, and modified Mayo wrist score (MMWS) were measured preoperatively and at each follow-up examination after surgery. Operation-related complications and radiographic changes were also assessed. Results: There were 13 women and 2 men, with a mean age of 57.6 years (range, 21–74 years) at the time of undergoing arthroscopic SCA. Follow-up ranged from 24 to 116 months, with an average of 56.9 ± 32.3 months. Bony union was achieved in all patients. At preoperative examination, wrist ROM (67%) and grip strength (48%) significantly decreased, compared to the contralateral wrist. At the final follow-up, there were significant improvements in VAS, grip strength, and MMWS, whereas the active wrist ROM showed no significant change. Radioscaphoid angle recovered after surgery, while radiographic carpal collapse and ulnar translation of the carpus occurred. In subgroup analysis according to excision of the lunate, there were no significant differences in VAS, MMWS, grip strength, or total ROM. However, increased ulnar translation and decreased radial deviation were noted in the lunate excision group. Conclusions Arthroscopic SCA achieved significant improvements in pain and wrist function in patients with advanced Kienbock’s disease without any complications. Excision of the lunate when performing arthroscopic SCA seemed to induce progressive carpal ulnar translation, with no apparent clinical benefits over retaining it.

BACKGROUND: Tissue inhibitor of metalloproteinase is a natural inhibitor that counteracts proteolytic enzymes essential to the invasion of cancer cell. Whether or not TIMP-2 gene transfer via adenovirus could inhibit the invasion of lung cancer cell in vitro was evaluated for the future purpose of gene therapy against lung cancer. METHODS: Recombinant adenvirus-TIMP-2(Ad-TIMP-2) was generated by homologeous recombination after pACCMV-TIMP-2 and pJM17 were cotransfected into 293 cell by standard calcium phosphate coprecipitate mathod. Calu-6, one of the most invasive lung cancer cells, was transduced with Ad-TIMP-2 or Ad-β-gal. An-chorage-independent growth and invasiveness were assessed by soft agar clonogenicity assay and invasion assay using two-chamber, well divided by matrigel. RESULTS: Ad-TIMP-2 transduced calu-6 cells produced bilolgically active TIMP-2 more than 50 times more than parental calu-6. TIMP-2 gene transfer did not suppress the in vitro tumorgenicity. However, two chamber well assay revealed that Ad-TIMP-2 transduction reduced the invasiveness of calu-6 efficiently (12% compared with parental cell) even at low 10moi. CONCLUSION: Even though TIMP-2 gene transfer did not inhibit in vitr tumorigenicity, it did inhibit invasion of lung cancer cell in vitro. The inhibition of invasion by Ad-TIMP-2 may be a useful strategy for the treatment of lung cancer.
Adenoviridae* ; Agar ; Calcium ; Genetic Therapy ; Humans ; Lung Neoplasms* ; Lung* ; Parents ; Peptide Hydrolases ; Recombination, Genetic ; Tissue Inhibitor of Metalloproteinase-2*

OBJECTIVES: The objective of this study was to investigate the relationship between psychological distress and pain in cancer patients. METHODS: 249 patients with cancer who visited National Health Insurance Service Ilsan Hospital between April 2013 and March 2014 were evaluated with National Cancer Center Psychological Symptom Inventory(NCC-PSI) which consisted of Modified Distress Thermometer(MDT) and Modified Impact Thermometer(MIT). Each scale was divided into 3 subscales targeting separate symptoms: insomnia, anxiety, and depression. Psychological distress was defined as positive for those who scored above the cutoff values in at least one of all six subscales. The Numeric Rating Scale for Pain(NRS-Pain) was used to assess the subjective severity of pain. Logistic regression was performed to investigate the association between psychological distress and pain. RESULTS: Univariate logistic regression analysis showed that pain, gender, compliance, and two subscale scores of Hospital Anxiety and Depression Scale(HADS) were significantly associated with psychological distress. Multivariate logistic regression analysis showed that pain and HADS anxiety subscale score maintained a statistically significant association with psychological distress adjusted for variables including age, gender, years of education, Eastern Cooperative Oncology Group performance status, cancer stage, Charlson Comorbidity Index, compliance, and HADS depression subscale score. One point increase in pain was 1.31 times more likely to cause psychological distress. In secondary analysis, pain was significantly associated with all subscales of NCC-PSI, except MIT-anxiety subscale. CONCLUSIONS: This study suggests that NCC-PSI, a screening tool for psychological distress, reflects pain. We recommend that physicians who treat cancer patients consider the examination of psychological distress which provides comprehensive evaluation of various factors regarding quality of life.
Anxiety ; Comorbidity ; Compliance ; Depression ; Education ; Humans ; Logistic Models ; Mass Screening* ; National Health Programs ; Quality of Life ; Sleep Initiation and Maintenance Disorders