Solid organ xenotransplantation using transgenic pig organs is proposed as an alternative method for allo-transplantation. To accomplish this, immunologic and non-immunologic barriers for xenotransplantation should be overcome, and experiments on pigs to non-human primates (NHP) are now ongoing for clinical application. Before the clinical experiment, public consensus about ethical decisions must be considered. The results of NHP experiments on solid organ xenotransplantation are improving, and it is expected that xeno-solid organs can be used as new organs for human patients in the future.
Consensus ; Humans ; Methods ; Primates ; Swine ; Transplantation, Heterologous*

No abstract available.
Occupations

No abstract available.
Iron* ; Skin Pigmentation*

No abstract available.
Epidermal Cyst

PURPOSE: Concurrent chemoradiation treatment (CCRT) for locally advanced rectal cancer is an important modality for curative resection, but its tumor response shows wide spectrum. The aim of study is to investigate any correlation between a related genetic mutations, proliferative index and tumor response after CCRT. METHODS: A twenty three patients with rectal cancer, which preoperatively staged as over T3N1 or T4 determined by transrectal ultrasonography and MRI. Enrolled patients were given 5 FU 450 mg/m2 and leucovorin 20 mg/m2 intravenously for 5 days during the first and fifth weeks of radiation therapy (45~54 Gy). 4 weeks after completion of scheduled treatment, surgical resection was performed. Tumor response was classified into CR (complete remission), PR (partial response: 50% of diminution of tumor volume and downstaging), NR (no response). Paraffin-embedded tissues obtained before chemoradiation treatment were studied with immunohistochemical staining of p53, Bcl-2 and Ki-67. The extent of tumor response was correlated with proliferative activity as measured by immunostaining of Ki-67 proliferative antigen and expression of p53 and bcl-2 oncoproteins (less than 10%: negative, 10~25%: , 25~50%: , more than 50%: , Ki-67: to count a labeled cells per 1,000 cells). RESULTS: All patients were resectable. CR was obtained in 4 (17.4%), PR in 10 (43.3%) and NR in 9 (39.2%). p53 mutation was noted in 16 (70%). p53 mutation was found in NR: 5 (31.3%), PR: 9 (56.2%), CR: 2 (12.5%), respectively. Bcl-2 expression was noted in 11 (48%). NR as in 4 (36.3%), PR: 3 (28.4%) and CR: 4 (36.3%), respectively. Ki-67 labeling index was NR: 615.4 446.2, PR: 663.2 296.4, CR: 765.5 188.3, respectively (CR PR Vs NR, p=0.029). CONCLUSIONS: Immunohistochemical Expression of p53 and bcl-2 does not correlate with tumor response after CCRT, but Ki-67 labeling may be useful parameters for good radiosensitive tumor selected for CCRT.
Humans ; Leucovorin ; Magnetic Resonance Imaging ; Oncogene Proteins ; Rectal Neoplasms* ; Tumor Burden ; Ultrasonography

PURPOSE: Arterial TOS is a rare condition caused by compression of the subclavian artery at the thoracic outlet area, which is composed of the anterior and middle scalene muscles, the first rib and the clavicle. We have experienced four cases of arterial TOS and we reviewed them to determine the appropriate management of arterial TOS. METHOD: We reviewed the medical records of 26 patients who were diagnosed and managed for TOS at Seoul National University Hospital from 1985 to 2004. We reviewed the clinical manifestations, diagnostic tools, mode of management and the outcomes. RESULT: The four patients with arterial TOS, 3 males and 1 female, had an average age of 41.3 years (range: 30~53 years). They complained of a tingling sense, coldness, weakness, and cyanosis of affected limb, and a gangrenous finger. They were diagnosed with CT angiography, conventional angiography and Doppler US. The findings were stenotic artery segments, post- stenotic dilatation and luminal thrombi of the subclavian artery. Two of them showed multiple peripheral arterial embolic obstructions and numerous collateral vessels. Three patients with arterial TOS underwent surgery. The operation consisted of the excision of the bony abnormality and the scalene muscle, segmental resection of subclavian artery including the aneurismal dilatation, interposition of a saphenous vein graft, and thromboembolectomy. Their symptoms improved after restoration of blood circulation, but the gangrenous finger required amputation. CONCLUSION: Arterial TOS has the definite risk of limb loss. If there is a high clinical suspicion of this lesion, early diagnosis and confirmation by angiogram may be critical to prevent limb loss. Surgical revascularization provides satisfactory results for limb salvage with low operative morbidity.
Amputation ; Angiography ; Arteries ; Blood Circulation ; Clavicle ; Cyanosis ; Diagnosis* ; Dilatation ; Early Diagnosis ; Extremities ; Female ; Fingers ; Humans ; Limb Salvage ; Male ; Medical Records ; Muscles ; Phenobarbital ; Ribs ; Saphenous Vein ; Seoul ; Subclavian Artery ; Thoracic Outlet Syndrome* ; Transplants

PURPOSE: This study was conducted to examine the clinical significance IV-contrasted helical abdomen computed tomography (CT) as a diagnostic screening tool to evaluate hollow viscus injury in blunt abdominal trauma patients. METHODS: This is a retrospective study encompassing 108 patients, presenting to Korea University Medical Center (KUMC) Emergency Department (ED) from January 2007 to December 2007, with an initial CT finding suggestive of intra-abdominal injury. An initial non-enhanced abdomen CT was taken, followed by an enhanced CT with intravenous contrast. Patients' demographic data, as well as the mechanisms of injury, were inquired upon and obtained, initial diagnosis, as dictated by specialized radiologists, were added to post-operational (post-OP) findings and to additional CT findings acquired during their hospital stays, and all were combined to arrive at final diagnosis. Initial CT findings were further compared with the final diagnosis, yielding values for sensitivity, specificity, and accuracy, as well as positive and negative predictive values. Patients were further divided into two groups, namely, those that underwent operational intervention and those that did not. The initial CT findings of each group were subsequently compared and analyzed. RESULTS: Initial CT scans revealed abnormal findings in a total of 212 cases - solid organ injuries being the most common finding, as was observed in 97 cases. Free fluid accumulation was evident in another 69 cases. Based on the CT findings, 77 cases (71.3%) were initially diagnosed as having a solid organ injury, 20 cases (18.5%) as having a combined (solid organ + hollow viscus) injury, and 11 cases (10.2%), as having an isolated hollow viscus injury. The final diagnosis however, were somewhat different, with only 67 cases (62.0%) attributed to solid organ injury, 31 cases (28.7%) to combined injury (solid + hollow), and 10 cases (9.3%) to hollow viscus injury. The sensitivity (CI 95%) of the initial helical CT in diagnosing hollow viscus injury was 75.6%, and its specificity was 100%. The accuracy in diagnosing hollow viscus injury was also meaningfully lower compared to that in diagnosis of solid organ injury. Among patients initially diagnosed with solid organ injuries, 10 patients (2 from follow-up CT and 8 from post-OP finding) turned out to have combined injuries. A total of 38 patients underwent an operation, and the proportion of initial CT findings suggesting free air, mesenteric hematoma or bowel wall thickening turned out to be significantly higher in the operation group. CONCLUSION: Abdominal CT was a meaningful screening test for hollow viscus injury, but the sensitivity of abdominal CT was significantly lower in detecting hollow viscus injury as compared to solid organ injury. This calls for special consideration and careful observation by the ED physicians when dealing with cases of blunt abdominal trauma.
Abdomen ; Academic Medical Centers ; Emergencies ; Follow-Up Studies ; Hematoma ; Humans ; Korea ; Length of Stay ; Mass Screening ; Retrospective Studies ; Sensitivity and Specificity ; Tomography, Spiral Computed

PURPOSE: We purposed to determine the effects of urinary typsin inhibitor (ulinastatin) on the outcomes of severe sepsis and septic shock patients. METHODS: This is a prospective case control study of severe sepsis and septic shock patients who visited emergency department of university hospital from January 2005 to June 2008. For study group, 100,000 U of ulinastatin was initially infused and then additional infusions of ulinastatin were determined by the mean arterial pressure. We compared the predicted mortality and the actual in-hospital mortality between the ulinastatin group and the control group. We also compared the improvement of the SOFA score according to time between the groups. RESULTS: There were 43 patients in the ulinastatin group and 126 patients in the control group. The predicted mortality and the actual mortality of the ulinastatin group were 31.2% and 18.6%, respectively. The predicted and actual mortalities of the control group were 33.1% and 27.0%, respectively. The improvement of the SOFA score for the ulinastatin group was 6.8+/-3.9 and 5.0+/-4.5 at 0 and 24 hours (p<0.001), 6.5+/-3.7 and 3.9+/-4.3 at 0 and 48 hours (p<0.001) and, 6.3+/-3.6 and 3.0+/-4.1 at 0 and 72 hours (p<0.001). For the control group, the change of the SOFA score was 4.9+/-2.9 and 5.8+/-4.1 at 0 and 24 hours (p=0.003), 5.0+/-2.8 and 5.1+/-4.2 at 0 and 48 hours (p=0.760) and, 4.8+/-2.7 and 4.34.1 at 0 and 72 hours (p=0.105). CONCLUSION: The ulinastatin group showed significantly lower mortality than the predicted mortality and the ulinastatin group's SOFA score was improved in the early hospital days.
Arterial Pressure ; Case-Control Studies ; Emergencies ; Glycoproteins ; Hospital Mortality ; Humans ; Prospective Studies ; Sepsis ; Shock, Septic ; Trypsin

PURPOSE: Konkuk University Hospital (KUH), which opened in September 2005, is currently categorized as a secondary hospital. Early on after its establishment, the surgical residents and nurses were relatively inexperienced in the treatment of stomach cancer. Therefore, the quality of surgery for stomach cancer at KUH may be different from that of the existing large-scale tertiary hospitals. The purpose of this study is first to investigate the clinicopathological characteristics of the gastric cancer patients at the KUH, and second to compare our morbidity & mortality rates with those of previous studies, and we also analyzed the risk factors of morbidity at the early stage of a training hospital. MATERIALS AND METHODS: This study retrospectively collected the clinicopathological characteristics and the post-operative morbidity rates and mortality rates with using the electronic medical records of all the patients who went under a gastric cancer operation at KUH from September 2005 to April 2008. RESULTS: The total number of gastric cancer patients who underwent operation was 201. The morbidity rate and death rate at KUH were 10.4% and 0.5%, respectively. The morbidity has increased with an older age. The other variables had no influence on morbidity. CONCLUSION: The morbidity rate, death rate and the clinicopathological characteristics of gastric cancer patients at KUH were similar to those of the previous reports. We found that age is the main factor affecting the morbidity rate after stomach cancer surgery. For further surgical qualification of stomach cancer surgery at KUH, it is necessary to collect the survival data of patients who undergo stomach cancer surgery.
Electronic Health Records ; Humans ; Retrospective Studies ; Risk Factors ; Stomach Neoplasms ; Tertiary Care Centers

Solid facial edema is a rare skin condition characterized by persistent, non-pitting, and non-tender edema on the forehead, glabellar region, mid-face, nasolabial folds, and cheeks. Exact etiology is still unknown; however, it is suggested that it can be secondary inflammatory response due to acne vulgaris. A 21-year-old male presented with erythematous swollen patches on the forehead and glabellar region. He had been intermittently treated for his acne vulgaris for 5 years at the local clinic. Focal soft tissue swelling with thickening of the skin and subcutaneous tissue was identified radiologically. Histopathologically, lymphatic vessels were dilated with chronic inflammatory cell infiltration and dermal edema. To the best of our knowledge, this is the first reported case of solid facial edema caused by acne vulgaris in Korea.
Acne Vulgaris ; Cheek ; Edema ; Forehead ; Humans ; Korea ; Lymphatic Vessels ; Male ; Nasolabial Fold ; Skin ; Subcutaneous Tissue ; Young Adult