Chordoid glioma is a rare, low-grade brain neoplasm typically located in the third ventricle. Herein, we report an unusual case of histologically confirmed chordoid glioma located in the pituitary fossa and suprasellar region, not attached to the third ventricle. A 57-year-old woman presented with a 2-month history of headache and visual disturbance. Magnetic resonance imaging revealed an ovoid mass in the pituitary fossa and suprasellar region, compressing the optic chiasm without involvement of the third ventricle. The tumor showed low signal intensity on T1-weighted images and iso- to high signal intensity on T2-weighted images, with strong and homogenous contrast enhancement. Subtotal resection was performed via the transcranial approach, and the patient subsequently received adjuvant gamma knife radiosurgery. However, the residual mass showed disease progression 5 months after the initial surgery.
Brain Neoplasms ; Disease Progression ; Female ; Glioma* ; Headache ; Humans ; Magnetic Resonance Imaging ; Middle Aged ; Optic Chiasm ; Radiosurgery ; Third Ventricle

PURPOSE: Epidermal growth factor receptor (EGFR) is a transmembrane cell surface receptor which has tyrosine kinase activity stimulated upon EGF binding. EGFR was found to be up-regulated in various malignancies. Recently, chimeric monoclonal antibody (C225) to EGFR is under investigation as a targeted therapeutic agent for advanced colorectal cancer. Along with this advance, identification of EGFR expression in colorectal cancer became more important. METHODS: To investigate the expression of EGFR in colorectal cancer, we carried out the immunohistochemical staining in surgical specimen of 46 consecutive enrolled colorectal cancer patients of Korea Cancer Center Hospital from August, 1998 to June, 1999. The stained slides were read by pathologist and scored as negative or positive. These results were analyzed according to clinical parameters. RESULTS: Average age was 55 years old (32~73 yr) and sex ratio was 1.56 : 1. The expression rate of EGFR in colorectal cancer was 56.5% (26/46 cases). EGFR expression was not correlated with age, sex, Tie-1, Tie-2 expression, TNM stage, lymphatic invasion, presence of distant metastasis, serum VEGF level. We could not find out staitistical difference of survival according to EGFR expression. CONCLUSIONS: EGFR overexpression was well characterized by immunochemical staining method, which could be applied easily as a basic pathologic step to decide additional therapy after resection for advanced colorectal cancer.
Colorectal Neoplasms* ; Epidermal Growth Factor ; Humans ; Korea ; Middle Aged ; Neoplasm Metastasis ; Protein-Tyrosine Kinases ; Receptor, Epidermal Growth Factor ; Sex Ratio ; Vascular Endothelial Growth Factor A

OBJECTIVES: This study was undertaken to evaluate correlation between the levels of hippuric acid in blood plasma (HAP) and those of toluene concentration in the workplace air. METHODS: Study subjects were composed of two groups; 21 workers who were occupationally exposed to toluene and 25 rural-area residents who were not exposed to any known occupational toluene source, as an exposed group and a reference group, respectively. Mean age and work duration of the exposed was 42 years and five years, respectively. Mean age of the reference was 42 years. To determine toluene concentrations in the workplace air, air sampling has been conducted for more than six hours using a personal sampler, and analyzed by a gas chromatography-flame ionization detector. Concentrations of hippuric acid in biological samples were determined by a high performance liquid chromatography-ultraviolet detector. RESULTS: Geometric mean(geometric standard deviation) of HAP and hippuric acid in urine(HAU) for the exposed was 1.39(2.21) mg/L and 2.77(1.46) g/L, respectively, which were significantly different from those of the reference [HAP, 0.45(2.94); HAU, 0.37(0.45)]. Toluene concentration in the workplace air was 86.92(range: 45.18~151.23) ppm. The level of HAP or HAU was significantly correlated (r=0.70 and r=0.63, respectively) with that of toluene in the workplace air. The estimated regression equation was logHAP(mg/L)=-3.60+1.93 log(toluene, ppm) or logHAU(g/L)=-0.85+0.67 log(toluene, ppm). The magnitude of correlation was further enhanced when analyzing relationship between toluene concentrations lower than 100 ppm and its corresponding HAP levels. CONCLUSION: Overall, plasma hippuric acid levels were well correlated with toluene concentrations in the workplace air, and a statistically significant correlation was observed for the samples with toluene concentration lower than 100 ppm.
Chromatography, High Pressure Liquid ; Humans ; Occupations ; Plasma* ; Toluene*

BACKGROUND/AIMS: Acute kidney injury (AKI) is a common and serious complication in critically ill patients, especially in the intensive care unit (ICU). The present study was performed to evaluate the occurrence rate of AKI using the RIFLE (increasing severity classes risk, injury, and failure, and the two outcome classes loss and end-stage kidney disease) classification, to define factors associated with AKI and hospital mortality. METHODS: We performed a retrospective study of all ICU patients over a 6-month period at Keimyung University Dongsan Hospital, Daegu, Korea. AKI was evaluated according to the RIFLE classification. RESULTS: AKI occurred in 156 of the 378 patients (41.3%) during their ICU stay, with maximum RIFLE-R, I, and F in 13.8%, 12.4%, and 15.1%, respectively. In univariate analysis, the proportion of medical admission and maximum Sequential Organ Failure Assessment (SOFA) score (SOFAmax) were significantly higher in patients with AKI than in those without. However, these factors did not remain significant in a multivariate analysis. The overall mortality rate of ICU patients was 25.7%. In multivariate analysis, mean age, occurrence of AKI, SOFAmax score, pulmonary disease, and malignancy were independent risk factors for hospital mortality. CONCLUSIONS: In these ICU patients, AKI is associated with increased hospital mortality. The RIFLE classification is a simple and useful clinical tool to detect and stratify the severity of AKI, and may aid in the prediction of outcome.
Aged ; Critical Illness/*mortality ; Female ; Hospital Mortality ; Hospitals, University/statistics & numerical data ; Humans ; Intensive Care Units/*statistics & numerical data ; Kidney Failure, Acute/*mortality ; Male ; Middle Aged ; Multivariate Analysis ; Outcome Assessment (Health Care) ; Renal Insufficiency, Acute/*mortality ; Republic of Korea/epidemiology ; Retrospective Studies ; Risk Factors ; Survival Analysis

PURPOSE: The purpose of this study was to compare the therapeutic results between the two groups of children with acute myelogenous leukemia (AML) who were treated either by 3-year Okayama regimen or by 2-year KSBRM regimen. METHODS: The subjects were 38 newly diagnosed AML patients at Chonnam University Hospital from Apr. 1991 to Dec. 1998. Until April, 1994, 10 patients were treated by the Okayama regimen for 3 years while 28 patients received KSBRM regimen for 2 years thereafter. The remission induction rate, relapse rate, and survival rate were compared retrospectively between the two groups. RESULTS: 1) The remission induction rate was 78.9% (30/38): Okayama group, 80.0% (8/10); KSBRM group, 78.6% (22/28). 2) The relapse rate after remission in the Okayama group was 37.5% (3/8) while that in the KSBRM group was 27.3% (6/22). 3) Deaths were encountered in 16 patients (42.1%): 60.0% (6/10) of Okayama group vs 35.7% (10/28) of KSBRM group (P=0.27). 4) Kaplan-Meier 3-year disease free survival (DFS) for all of the patients was 45.2%. The 3-year DFS was 40.0% for Okayama group and 48.2% for KSBRM group, respectively. The remission induction rate, relapse rate and DFS rate were not different between the two groups. CONCLUSION: The current study showed that KSBRM regimen was as equivalent as Okayama regimen for remission induction rate, relapse rate and 3-year Kaplan-Meier DFS despite the advantage of shortening of treatment duration by 1 year.
Child ; Disease-Free Survival ; Humans ; Jeollanam-do ; Leukemia, Myeloid, Acute* ; Recurrence ; Remission Induction ; Retrospective Studies ; Survival Rate

BACKGOUND: On-line hemodiafiltration (HDF) is a technique that relies on the re-injection of pyrogen-free substitution fluid obtained by cold filtration of dialysate. Therefore, safety of this therapy depends on the quality of dialysate and, mainly, on the integrity of the ultrafilters employed. Paired hemodiafiltration (PHF) is a new technique where re-infusion takes place inside the dialyzer by means of dialysate backfiltration. METHODS: To assess safety and feasibility, we carried out prospective cross-over trial comparing PHF with hemodialysis (HD) in five stable HD patients RESULTS: All PHF sessions were well tolerated. No pyrogenic reactions were observed during the study period. No significant difference was found in the incidence of intradialytic hypotension. PHF led to significantly higher small and middle molecule clearance than HD. The reduction rates of urea, creatinine and beta2-M were significantly higher in PHF than in HD, while no difference was found for phosphate. The serum beta2-M levels fell progressively from the HD value of 29 mg/L to 17 mg/L at the end of 3 months's PHF treatment. CONCLUSION: In conclusion, PHF is a feasible and safe convective therapy to increase beta2-M removal compared with HD. Long-term, prospective multicenter clinical studies are mandatory to assess the clinical outcome of this new on-line technique of HDF.
Creatinine ; Filtration ; Hemodiafiltration* ; Humans ; Hypotension ; Incidence ; Prospective Studies ; Renal Dialysis ; Urea

We report a case of central venous stenosis due to a structural deformity caused by a tuberculosis-destroyed lung in a 65-year-old woman. The patient presented with left facial edema. She had a history of pulmonary tuberculosis, and the chest X-ray revealed a collapsed left lung. Angiography showed leftward deviation of the innominate vein leading to kinking and stenosis of the internal jugular vein. Stent insertion improved her facial edema.
Aged ; Brachiocephalic Veins/*pathology/radiography ; *Central Venous Pressure ; Constriction, Pathologic/*etiology/pathology/therapy ; Edema/therapy ; Female ; Humans ; Jugular Veins/pathology/radiography ; Stents ; Tuberculosis, Pulmonary/*complications/pathology/radiography ; Vascular Diseases/*etiology/pathology/therapy

OBJECTIVE: This study was to examine in vitro neural cell differentiation pattern of the genetically modified human embryonic stem cells expressing tyrosine hydroxylase (TH). MATERIALS AND METHODS: Human embryonic stem (hES, MB03) cell was transfected with cDNAs cording for TH. Successful transfection was confirmed by western immunoblotting. Newly transfected cell line (TH#2/MB03) was induced to differentiate by two neurogenic factors retinoic acid (RA) and b-FGF. Exp. I) Upon differentiation using RA, embryoid bodies (EB, for 4 days) derived from TH#2/MB03 cells were exposed to RA (10-6 M)/AA (5x10-2 mM) for 4 days, and were allowed to differentiate in N2 medium for 7, 14 or 21 days. Exp. II) When b-FGF was used, neuronal precursor cells were expanded at the presence of b-FGF (10 ng/ml) for 6 days followed by a final differentiation in N2 medium for 7, 14 or 21 days. Neuron differentiation was examined by indirect immunocytochemistry using neuron markers (NF160 & NF200). RESULTS: After 7 days in N2 medium, approximately 80% and 20% of the RA or b-FGF induced Th#2/MB03 cells were immunoreactive to anti-NF160 and anti-NF200 antibodies, respectively. As differentiation continued, NF200 in RA treated cells significantly increased to 73.0% on 14 days compared to that in b-FGF treated cells (53.0%, p<0.05), while the proportion of cells expressing NF160 was similarly decreased between two groups. However, throughout the differentiation, expression of TH was maintained (~90%). HPLC analyses indicated the increased levels of L-DOPA in RA treated genetically modified hES cells with longer differentiation time. CONCLUSION: These results suggested that a genetically modified hES cells (TH#2/MB03) could be efficiently differentiated in vitro into mature neurons by RA induction method.
Antibodies ; Blotting, Western ; Cell Differentiation* ; Cell Line ; Chromatography, High Pressure Liquid ; DNA, Complementary ; Embryoid Bodies ; Embryonic Stem Cells* ; Humans* ; Immunohistochemistry ; Levodopa ; Neurons ; Transfection ; Tretinoin ; Tyrosine 3-Monooxygenase* ; Tyrosine*

Cytomegalovirus (CMV) remains an important pathogen in organ transplant recipients, and ganciclovir has been the antiviral agent of choice both for prevention and treatment of CMV disease. Recently ganciclovir-resistant cytomegalovirus has been reported with increasing frequency in organ transplant recipient and is an emerging clinical problem in transplant recipients. Ganciclovir-resistant CMV infection has been associated with clinical progression of CMV disease and high mortality even with foscarnet therapy. We report here a case of disseminated ganciclovir-resistant CMV disease in a 34-year-old renal transplant recipient, who died of multiorgan failure despite treatment with both ganciclovir and foscarnet.
Adult ; Cytomegalovirus Infections* ; Cytomegalovirus* ; Foscarnet ; Ganciclovir ; Humans ; Kidney Transplantation* ; Mortality ; Transplantation ; Transplants

The reconstruction of defects after the resection of oropharyngeal tumors must not only cover the defect area but also be able to recover its functional structure enabling speech and mastication. To achieve a functional reconstruction, the volume and the length of the pedicle must be suitably designed and a donor site fit for the location and size of the defect must be chosen. However, in reality, the structures in oropharyngeal tumor patients who underwent resection to classify the different defect shapes according to the resection site. Bases on the classification of oropharyngeal defects, we tried to standardize a flap design method for the different defects. We investigated 44 patients who underwent tumor resection and reconstruction surgery for oropharyngeal tumor during the past 3 years at Severance hospital. The defects were divided into 6 zones and 4 types of design methods of radial forearm free flap were standardized. Surgery was performed on 25 patients during September of 1998 to September of 1999 with modified design methods based on the standardized ones. A faster and more efficient flap design was possible due to the standardized method. It was also possible to enable a functional reconstruction in cases where the soft palate was involved without any nasal escape.
Classification ; Forearm* ; Free Tissue Flaps* ; Humans ; Mastication ; Palate, Soft ; Tissue Donors ; Tongue Neoplasms ; United Nations