BACKGROUND: The prognostic value of cyclooxygenase-2 (COX-2) in human renal cell carcinoma (RCC) remains unclear. The purposes of this study are to elucidate the clinical significance of COX-2 in clear cell RCC (CCRCC) and to assess the treatment effect of COX-2 inhibition on CCRCC cell lines. METHODS: Using tumor samples obtained from 137 patients who had undergone nephrectomy at Seoul National University Hospital, we evaluated COX-2 expression on immunohistochemistry. Moreover, we performed the cell proliferation assay using 3-(4,5-dimethylthiazol-2yl)-2,5-diphenyl-2H tetrazolium bromide (MTT) and cell invasion assay. Thus, we evaluated the effect of meloxicam, an inhibitor of COX-2, in two human CCRCC cell lines. RESULTS: Cancer-specific survival (p=0.038) and progression-free survival (p=0.031) were shorter in the COX-2 high expression group. A multivariate logistic regression model showed that COX-2 expression was an independent risk factor for pTNM stage and Fuhrman nuclear grade. The MTT assay revealed that COX-2 inhibition led to the suppression of the proliferation of CCRCC cell lines. Moreover, it also reduced their invasion capacity. CONCLUSIONS: This study postulates that COX-2 is a poor prognostic indicator in human CCRCC, suggesting that COX-2 inhibition can be a potential therapy in CCRCC.
Humans ; Risk Factors

BACKGROUND: The prognostic value of cyclooxygenase-2 (COX-2) in human renal cell carcinoma (RCC) remains unclear. The purposes of this study are to elucidate the clinical significance of COX-2 in clear cell RCC (CCRCC) and to assess the treatment effect of COX-2 inhibition on CCRCC cell lines. METHODS: Using tumor samples obtained from 137 patients who had undergone nephrectomy at Seoul National University Hospital, we evaluated COX-2 expression on immunohistochemistry. Moreover, we performed the cell proliferation assay using 3-(4,5-dimethylthiazol-2yl)-2,5-diphenyl-2H tetrazolium bromide (MTT) and cell invasion assay. Thus, we evaluated the effect of meloxicam, an inhibitor of COX-2, in two human CCRCC cell lines. RESULTS: Cancer-specific survival (p=0.038) and progression-free survival (p=0.031) were shorter in the COX-2 high expression group. A multivariate logistic regression model showed that COX-2 expression was an independent risk factor for pTNM stage and Fuhrman nuclear grade. The MTT assay revealed that COX-2 inhibition led to the suppression of the proliferation of CCRCC cell lines. Moreover, it also reduced their invasion capacity. CONCLUSIONS: This study postulates that COX-2 is a poor prognostic indicator in human CCRCC, suggesting that COX-2 inhibition can be a potential therapy in CCRCC.
Humans ; Risk Factors

PURPOSE: To explore nurses' compliance with standards for critical care nursing practice in intensive care units (ICUs) and to provide basic data for high quality of critical care nursing. METHOD: A total of 616 participants from 61 ICUs which are graded from 1 to 7 throughout the nation were surveyed. Data were collected from February 9 to February 27, 2009 using a uestionnaire consisting of 58 questions including 50 nursing activities as indicators. RESULTS: The rate of ICU nurses' compliance with standards for critical care nursing practice was high. As for individual standards, compliance with the standard of assessment was the highest, followed by implementation, diagnosis, and planning in that order. There were differences in compliance according to nurses' ICU experience, work place (unit), and ICU grade. A shortage of manpower was considered as a main cause for noncompliance. CONCLUSION: The present compliance rate with standards for critical care nursing practice by ICU nurses was identified. Therefore, compliance rate can be used to promote quality of critical care nursing and development of educational programs for ICU nurses.
Compliance ; Critical Care ; Hypogonadism ; Intensive Care Units ; Mitochondrial Diseases ; Ophthalmoplegia ; Workplace

The p53 gene, which resides on the short arm of chromosome 17, has been described as a tumor suppressor gene playing a role of G1 checkpoint monitering DNA damage, but mutation of this gene has been shown in numerous types of human cancers. The nm23-H1 gene encodes human NDP(nucleotide diphosphate) kinase. The expression of nm23-H1 gene was postulated to inversely correlate with metastatic potential of malignant tumors. We examined immunohistochemical expression in 30 cases of stomach cancers including 10 cases each of early gastric cancers(EGC), advanced gastric cancers without lymph node involvement, and advanced gastric cancers with lymph node involvement, which were stained with mouse monoclonal antibody of p53(PB53-12) and nm23-H1. Positive nuclear staining of p53 was frequently found in advanced gastric cancers with lymph node involvement (80%). The lymph node positive group showed high expression of p53(80%), and low expression of nm23-Hl(30%) than lymph node negative group. There was no significant correlation of p53 and nm23-H1 expression with tumor size, invasion depth, TNM stages, distant metastasis and histologic differentiation. Based on the present study, the expression of p53 and down regulation of nm23-H1 are thought to be correlated with tumor progression and lymph node involvement, and may be a useful prognostic factor in gastric cancers.
Humans ; Mice ; Animals ; Neoplasm Metastasis ; Genes, Tumor Suppressor ; Stomach Neoplasms ; Genes, p53

BACKGROUND: The Korean Red Cross has established three nucleic acid amplification test (NAT) centers, and the organization has begun NAT screening for human immunodeficiency virus type 1 (HIV-1) and hepatitis C virus (HCV) for domestic blood donors commencing from February 2005. As a result, between February 2005 and July 2006, it was found that 80 of a total of 3,481,972 donors that were screened were positive for HIV-1 as determined by the NAT. This report will describe the characteristics of the HIV-1 positive reactive donors. METHODS: We attempted to determine the number of HIV-1 positive reactive donors for each NAT center, and attempted to characterize the donors by gender, age, RNA viral load, and the distribution of HIV-1 subtype. RESULTS: Among the 80 HIV-1 positive reactive donors determined by the NAT, 57.5% of the donors were in their twenties and all but one of the donors was male. Of all of the donors, 82.5% were repeated donors and four donors showed antibody negative window periods. The average quantity of HIV-1 RNA for 78 donors was 1.12x105 copies/mL and for the four donors that showed the antibody negative window periods was 2.68x105 copies/mL. The HIV-1 subtypes of 76 cases were all B of group M. CONCLUSION: NAT screening contributes to the safety of the domestic blood supply. Therefore, it is necessary to continue to study the characteristics of the blood that was found to show HIV positivity by the NAT.
Blood Donors ; Hepacivirus ; HIV* ; HIV-1* ; Humans* ; Male ; Mass Screening* ; Nucleic Acid Amplification Techniques* ; Red Cross ; RNA ; Tissue Donors* ; Viral Load

Behcet's disease is a systemic inflammatory disorder of unknown etiology, characterized by recurrent oral aphthous ulcers, genital ulcers, uveitis, and skin lesions. Renal involvement is rare in patients with Behcet's disease particularly immunoglobulin A (IgA) nephropathy. Other autoimmune diseases have been associated with increased risk of malignancy, but not Behcet's disease. Some cases of Behcet's disease accompanied by bladder cancer, thyroid cancer, stomach cancer, or hematologic malignancies have been reported. However, to the best of our knowledge, co-occurrence of Behcet's diseases with thymic carcinoma has not yet been reported. We experienced a 49-year-old male patient who had been treated for Behcet disease and IgA nephropathy, who presented with a large mediastinal mass on chest x-ray. After thymectomy, he was diagnosed with thymic carcinoma with complete resection.
Autoimmune Diseases ; Behcet Syndrome ; Glomerulonephritis, IGA* ; Hematologic Neoplasms ; Humans ; Immunoglobulin A ; Male ; Middle Aged ; Skin ; Stomach Neoplasms ; Stomatitis, Aphthous ; Thorax ; Thymectomy ; Thymoma* ; Thyroid Neoplasms ; Ulcer ; Urinary Bladder Neoplasms ; Uveitis

PURPOSE: The resuscitation room is the hub of intensive care and focused management within the emergency department (ED). For patients with life-threatening conditions, immediate triage and proper treatment using the resuscitation room is important. This study was conducted to assess the epidemiology of patients using the resuscitation room in an emergency department. METHODS:This was a retrospective observational study. Eligible subjects were enrolled through the National Emergency Department Information System from July 2007 to September 2008. All subjects came through a single regional emergency center that logs more than 45,000 patients annually. Pediatric patients less than 15 years of age and those who were dead on arrival at the ED were excluded. The Emergency Severity Index (ESI) version IV was used as a triage tool, and characteristics and ESI levels of patients using or not using resuscitation rooms were compared. RESULTS: The total number of eligible subjects was 40,926 and the male-female ratio was 1:0.92. The numbers of patients using the resuscitation room was 1,050 (2.99%). Patients using the resuscitation room were older than the patients not using the resuscitation room, were more likely to have used an ambulance to visit the ED, and had a higher mortality rate and a higher admission rate. A majority of staff members had the authority to put patients in the resuscitation room. Among them were professors 18.19%, emergency residents 11.43%, certified emergency nurses 40.57%, emergency nurses 19.43%, emergency medical technicians 2.86%, and paramedics 6.19%. Critical care was done in the resuscitation room for cardiopulmonary resuscitation 11.66%, intubation 26.33%, ventilation 1.71%, defibrillation 5.73%, and other 54.57%. The most frequent ESI levels of patients using the resuscitation room was 1 (57.89%); an ESI score of 3 (72.01%) was the most frequent value for patients not using the resuscitation room. CONCLUSION: Patient using the resuscitation room were older, more likely to have used an ambulance, and had a higher mortality rate, admission rate and ESI level.
Allied Health Personnel ; Ambulances ; Cardiopulmonary Resuscitation ; Critical Care ; Emergencies ; Emergency Medical Technicians ; Humans ; Information Systems ; Critical Care ; Intubation ; Porphyrins ; Resuscitation ; Retrospective Studies ; Severity of Illness Index ; Triage ; Ventilation

Microbacterium species is part of the normal flora of the skin and pharynx. Native valve infective endocarditis caused by Microbacterium speciesis is rare case. We describe a 37-year-old man with native valve endocarditis caused by Microbacterium species. He presented with high fever, myalgia, weight loss. Microbacterium species was isolated from blood culture. Successful treatment was achieved with intravenous ceftriaxone and oral amoxicillin.
Adult ; Amoxicillin ; Ceftriaxone ; Endocarditis* ; Fever ; Humans ; Myalgia ; Pharynx ; Skin ; Weight Loss

BACKGROUND: The molecular profile of peritumoral non-neoplastic liver parenchyma (PNLP) has recently been suggested as predictive factor of early and late recurrence of hepatocellular carcinoma (HCC). However, there is no definite cut-off point for tumor-free PNLP in terms of either histological or molecular changes. Therefore, our aim is to determine the numerical cut-off point for separating adjacent PNLP and remote PNLP in histopathologic perspective. METHODS: Peritumoral tissues from 20 resected HCC patients were sampled from 0 to 40 mm distance from the tumor border (divided into 5-mm columns). Histopathologic parameters such as necroinflammatory activity, fibrosis, bile ductular reaction, hepatic venulitis, peliosis, and steatosis were compared between each column. RESULTS: The morphologic changes just adjacent to the tumor were notably severe and faded with distance. The parenchyma within 10 mm of the tumor showed significantly severe inflammation, fibrosis, peliosis and hepatic venulitis compared with those from farther areas. The histopathologic changes of the parenchyma became stable beyond 20 mm. CONCLUSIONS: Results of this study revealed that the parenchyma within 10 mm distance from the tumor, or adjacent PNLP, has histopathologic changes that are directly affected by the tumor, and the parenchyma beyond 20 mm as the remote PNLP without tumor effect.
Bile ; Carcinoma, Hepatocellular ; Fibrosis ; Hepatitis B, Chronic ; Hepatitis, Chronic ; Humans ; Inflammation ; Liver ; Recurrence

BACKGROUND: Hemoglobin A1c (HbA1c) was adopted as a new standard criterion for diagnosing diabetes. We investigated the diagnostic utility of HbA1c by comparing the 2003 American Diabetes Association (ADA) diagnostic criteria of diabetes with HbA1c of 6.5%. Furthermore, the cut-off value for HbA1c was investigated using receiver operating characteristic curves. METHODS: This study included 224 subjects without a history of diabetes that had a fasting plasma glucose level of above 100 mg/dL. The subjects had undergone a 75 g oral glucose tolerance test, and diabetes was defined as according to 2003 ADA criteria. RESULTS: The prevalence of newly diagnosed diabetes was 58.2% by the 2003 ADA criteria, and 47.8% by HbA1c of 6.5%, which underestimated the prevalence of diabetes. Compared with the 2003 ADA criteria, the sensitivity and specificity of HbA1c of 6.5% were 73.5% and 89.1%, respectively. The kappa index of agreement between 2003 ADA and HbA1c criteria was 0.60. The cut-off point of HbA1c for diagnosing diabetes was 6.45% (sensitivity, 73.3%; specificity, 88.2%; area under the curve, 0.85). HbA1c was significantly associated with fasting glucose (r = 0.82, P < 0.01), postprandial glucose (r = 0.78, P < 0.01), and homeostasis model assessment of insulin resistance (r = 0.16, P < 0.05). CONCLUSION: For high risk patients whose fasting glucose was more than 100 mg/dL, HbA1c criterion underestimated the prevalence of newly diagnosed diabetes compared to the 2003 ADA criteria, and showed moderate agreement. The cut-off value for HbA1c was 6.45%, which was similar to the recommended diagnostic criterion of HbA1c by the 2009 ADA.
Fasting ; Glucose ; Glucose Tolerance Test ; Hemoglobin A, Glycosylated ; Hemoglobins ; Homeostasis ; Humans ; Insulin Resistance ; Plasma ; Prevalence ; ROC Curve ; Sensitivity and Specificity