The mutation of p53 tumor suppressor gene is the most common genetic variation of primary malignant tumors. The occurrence, progression and reaction for medical management of cancers can be different according to the characteristics of p53 gene, even if they are same kinds of malignant tumors. In this study, the property of p53 gene in 4 kinds of squamous cell carcinoma cell lines were investigated by using immunocytochemistry, PCR-SSCP, sequencing and Western blot methods. As a result, p53 mutation detected in 3 kinds of squamous cell carcinoma cell lines. Namely, it is found that T in codon 176 changed to A, and G in codon 281 changed to A in KUMA3 cell lines; CC in codon 241 changed to TT in KUMA4 cell lines; G in codon 266 changed to T in KUMA6 cell lines. In single nucleotide polymorphism of codon 72 of p53 gene, the genetic variations are Arg/Pro heterozygote in KUMA3 and KUMA4 cell lines; Arg/Arg homozygote in KUMA5 cell lines; Pro/Pro homozygote in KUMA6 cell lines. These results will provide useful data for p53 gene researches of various squamous cell carcinomas.
Blotting, Western ; Carcinoma, Squamous Cell* ; Cell Line* ; Codon ; Genes, p53* ; Genes, Tumor Suppressor ; Genetic Variation ; Heterozygote ; Homozygote ; Immunohistochemistry ; Polymorphism, Single Nucleotide

Classic Kaposi's sarcoma is a human herpesvirus-8 associated with a multicentric lymphoangioproliferative tumor primarily arising in the lower extremities, but rarely in the head and neck. We herein report a 63-year-old man with primary classic Kaposi's sarcoma on the face. He presented with asymptomatic, erythematous papules on the nasal ala which had been noticed 2 months earlier. Histopathologic examination and nested polymerase chain reaction analysis in the tissue disclosed typical features of Kaposi's sarcoma.
Head ; Humans ; Lower Extremity ; Middle Aged ; Neck ; Polymerase Chain Reaction ; Sarcoma, Kaposi*

Cytomegalovirus (CMV)-associated esophageal ulcer is rare in immunocompetent infants. The presence of inclusion bodies and immunohistochemical staining for CMV in biopsy specimens obtained during esophagogastroduodenoscopy (EGD) indicate that such ulcers occur because of CMV infection. A 7-week-old female infant who experienced frequent vomiting and feeding intolerance was diagnosed with a massive CMV-associated ulcer in the distal esophagus. The ulcer improved after conservative treatment using proton-pump inhibitors; however, ganciclovir was not administered. In a follow-up EGD biopsy specimen, no CMV inclusion bodies were present, and immunohistochemical staining results for this virus were negative. The presence of CMV inclusion bodies indicates active viral replication. If persistent inclusion bodies or positive immunohistochemical staining for CMV is observed in follow-up biopsy specimens, ganciclovir may be used to treat CMV-associated esophageal ulcers.
Biopsy ; Cytomegalovirus ; Endoscopy, Digestive System ; Esophagus ; Female ; Follow-Up Studies ; Ganciclovir ; Humans ; Inclusion Bodies ; Infant ; Ulcer ; Viruses ; Vomiting

PURPOSE: Pathologic aerophagia (PA) may lead to bowel perforation or volvulus in mentally retarded patients. The authors investigated the effects of clonazepam on the management of PA in children with severe to profound mental retardation (MR). METHODS: This study was undertaken as a retrospective case analysis of 21 PA patients with MR who were followed for over 12 months and diagnosed as having PA. Patients were assigned to two management groups, that is, to a clonazepam randomized open-labeled, treatment group or a reassurance group. The following were recorded and analyzed; age, response, remission rate to clonazepam treatment, and the side effect of clonazepam. It was defined positive response (response+) as being symptom-free for a whole week within 1 month of commencing treatment and remission(+) as being symptom-free for a whole month within 6 months of treatment. RESULTS: The average age of the 21 PA children with MR was 10 years and 13 patients were female. Symptom duration before diagnosis of PA was 7 months. Clinical features of the clonazepam-trial group (n=11) and the reassurance group (n=10) were non-significantly different. Response(+) was achieved by 2 patients (18.2%) in the clonazepam-trial group and by no patient in the reassurance group. Remission(+) was achieved by 6 patients (54.5%) in the clonazepam-trial group and by one patient (10%) in the reassurance group (p=0.040). CONCLUSION: When PA children with MR with severe bowel distention are considered for surgical treatment to prevent acute abdomen, a trial of clonazepam could be recommended.
Abdomen, Acute ; Aerophagy ; Child* ; Clonazepam* ; Diagnosis ; Female ; Humans ; Intellectual Disability* ; Intestinal Volvulus ; Mentally Disabled Persons ; Retrospective Studies

The effects of bear bile on the expression of the p53 protein in cancer cell lines were investigated by Western blot and RT-PCR methods. The p53 protein expression was increased after addition of bear bile in HaCaT, KUMA3, KUMA4 and KUMA6 cell lines that carried mutations n the p53 gene, but it is not ncreased n HCT116 and KUMA5 cell lines with the normal p53 gene as determined by Western blot method. The level of p53 mRNA was not altered in all cell lines after the treatment of bear bile as determined RT-PCR. These results indicate that the increment of the p53 protein after addition of bear bile was caused by increase in the protein stability but not by increase in protein synthesis. It can be concluded that bear bile affects positively only in the cell lines which have genetic variation of the p53 gene, and does not affect in the cell lines which have wild-type p53 gene, on the other hand.
Bile* ; Blotting, Western ; Cell Line* ; Genes, p53 ; Genetic Variation ; Hand ; Protein Stability ; RNA, Messenger

Purpose: This descriptive study investigated the effects of nurses’ knowledge of withdrawalof life-sustaining treatment, death anxiety, and perceptions of hospice care on their attitudes toward withdrawal of life-sustaining treatment. Methods: Data were collected from 262 nurses at tertiary hospitals, general hospitals, or primary hospitals in Busan, Korea, and statistically analyzed using the t-test, analysis of variance, the Scheffé test, Pearson correlation coefficients, and hierarchical regression analysis. Results: The participants’ scores were 3.68±0.45 (out of 5) for attitudes toward withdrawal of life-sustaining treatment, 0.65± 0.15 (out of 1) for knowledge of withdrawal of life-sustaining treatment, 2.61±0.26 (out of 4) for death anxiety, and 4.06±0.43 (out of 5) for perceptions of hospice care. Furthermore, knowledge of withdrawal of life-sustaining treatment and perceptions of hospice care showed positive correlations with attitudes toward withdrawal of life-sustaining treatment, while death anxiety showed a negative correlation. The most significant factors influencing attitudes toward withdrawal of life-sustaining treatment were perceptions of hospice care, followed by having experienced caring for patients who withdrew life-sustaining treatment, death anxiety, having a spouse, and ethical values, and the overall explanatory power was 43.0%. Conclusion This study showed that perceptions of hospice were an important fac-tor influencing nurses’ attitudes toward withdrawal of life-sustaining treatment. Therefore,it is necessary to develop and validate educational intervention programs that can improve perceptions of hospice care.

Bisphosphonates have been approved for Paget's disease, cancer - related hypercalcemia, bone involvement in multiple myeloma or solid tumors and osteoporosis. Although, underlying pathophysiological mechanisms remain unclear, it seems that bisphosphonates inhibit osteoclast precursor cells, modulate migratory and adhesive characteristics and induce apoptosis of osteoclasts. Furthermore impacts on angiogenesis, microenvironment and signal transduction between osteoclasts and osteoblasts. In this report, we present a case of oral bisphosphonates induced osteonecrosis of the mandible in a 84-year-old patient who received for two years. Two tapered screw vent implants(Zimmer, USA) were placed in the area of first and second molar. Two weeks later after crowns restored, some inflammatory signs and symptoms were observed on the second molar area. Sequestrum was formed and the sequestrum was removed with the implant. Frequent follow-up checks and oral hygiene maintenances were done and the first molar implant was restored. There is insufficient evidence suggests that duration of oral bisphosphonate therapy correlates with the development and severity of osteonecrosis. Therefore, dentists should not overlook the possibility of development of bisphosphonate induced osteonecrosis in patients who have taken oral forms of medication for less than three years.
Adhesives ; Aged, 80 and over ; Apoptosis ; Crowns ; Dentists ; Diphosphonates ; DNA-Directed DNA Polymerase ; Follow-Up Studies ; Humans ; Hypercalcemia ; Mandible ; Molar ; Multiple Myeloma ; Oral Hygiene ; Osteoclasts ; Osteonecrosis ; Osteoporosis ; Signal Transduction

PURPOSE: To evaluate long-term efficacy and safety of intravitreal ranibizumab on choroidal neovascularization (CNV) in age-related macular degeneration (AMD) in Korean patients over a 2-year period. METHODS: Twenty-three eyes of 23 patients who underwent intravitreal ranibizumab injection for secondary CNV in AMD were followed up more than 2 years, and their records were retrospectively investigated. The best corrected visual acuity (BCVA), central macular thickness (CRT) were compared at baseline and at 6, 12, 18 and 24 months after injection. RESULTS: The mean BCVA (log MAR) was 0.58 +/- 0.36, 0.54 +/- 0.49, 0.59 +/- 0.49, 0.64 +/- 0.51, and 0.61 +/- 0.51 at baseline, 6, 12, 18 and 24 months, respectively (p = 0.332, p = 1.000, p = 0.670, p = 0.697). The mean CRT was 283.75 +/- 61.41 microm, 239.93 +/- 53.12 microm, 244.89 +/- 47.44 microm, 246.36 +/- 55.78, and 244.70 +/- 54.86 at baseline, 6, 12, 18 and 24 months, respectively (p = 0.009, p = 0.036, p = 0.01, p = 0.015). The mean number of injection was 5.96 +/- 2.93 over a 2-year period. CONCLUSIONS: In Korean patients who underwent intravitreal ranibizumab injection for secondary CNV in AMD, long-term efficacy in diminishing CRT was evident. However, long-term efficacy in increasing visual acuity was not observed.
Antibodies, Monoclonal, Humanized ; Choroid ; Choroidal Neovascularization ; Eye ; Humans ; Macular Degeneration ; Retrospective Studies ; Visual Acuity ; Ranibizumab

BACKGROUND: Although Lightwand and Glidescope have both shown high success rates for intubation, there has been no confirmation as to which device is most effective for difficult endotracheal intubation. We compared the Glidescope and Lightwand devices in terms of duration of intubation and success rate at the first attempt in a simulated difficult airway situation. METHODS: Fifty-eight patients were randomized to undergo tracheal intubation with either the Glidescope (Glidescope group, n = 29) or the Lightwand (Lightwand group, n = 29). All patients were fitted with a semi-hard cervical collar in order to simulate a difficult airway, and intubation was attempted with the assigned airway device. The data collected included the rate of successful endotracheal intubation, the number of attempts required, the duration of the intubation, as well as the interincisor distance, hemodynamic variables, and adverse effects. RESULTS: There was no difference between Glidescope group (92.6%) and Lightwand group (96.4%) in terms of success rate for the first attempt at intubation. The duration of successful intubation for the first tracheal intubation attempt was significantly longer in Glidescope group than in Lightwand group (46.9 sec vs 29.5 sec, P = 0.001). All intubations were completed successfully within two intubation attempts. The incidence of hypertension was significantly higher in Glidescope group than in Lightwand group (51.9% vs 17.9%, P = 0.008). CONCLUSIONS: In a simulated difficult airway situation, endotracheal intubation using Lightwand yielded a shorter duration of intubation and lower incidence of hypertension than when using Glidescope.
Airway Management ; Hemodynamics ; Humans ; Hypertension ; Incidence ; Intubation* ; Intubation, Intratracheal ; Laryngoscopes ; Transillumination

Purpose: To investigate the 5-year outcome of dental implants placed in a grafted maxillary sinus using recombinant human bone morphogenetic protein-2 (rhBMP-2). Materials and Methods: We retrospectively analyzed 27 implants after maxillary sinus floor augmentation (MSFA) using rhBMP-2 in 16 patients between January 2016 and March 2017. The study evaluated two outcome variables: (1) 5-year cumulative survival and success rate of the implant after functional loading and (2) marginal bone loss (MBL) for implant failure. Results: The average residual bone height was 4.78±1.53 mm. The healing period before loading was 8.35±2.34 months. The crown-to-implant ratio was 1.31±0.26. The 5-year cumulative survival and success rate after functional loading were 100% and 96.3%, respectively. The 5-year average MLB was 0.89±0.82 mm. Conclusion Placing dental implants with MSFA using rhBMP-2 is a reliable procedure with favorable long-term survival and success rates.