An appreciation of the normal variation of the Talar Tilt angle under stress roentgenogram on the ankle joint may throw some light on the diagnosis and treatment in an ankle joint injuries. The purpose of this study is to show the normal range of the Talar Tilt angleof the ankle joint under various circumstances and has been to compare the results of each angle. The author have undertaken the neutral ankle mortise view and inversion and eversion stress roentgenogram in all ankles and measured its Talar Tilt angle. The data were based on study of free chosen 50 normal Korean adult male 25 and female 25 respectively. The results were summerized as follows; 1. Talar Tilt angle was O degree in neutral ankle mortise view. 2. In inversion stress roentgenogram, Talar Tilt angle ranged from 0 to 15 degrees, 97% of cases were less than 10 degrees. 3. In eversion stress roentgenogram, Talar Tilt angle ranged from 0 to 7 degrees. 4. In inversion stress roentgenoram, the difference between right and left of same male and female ranged from 0 to 7 degrees. 5. It is very important to check accurately Talar Tilt angle under the same method and same conditions.
Adult ; Ankle Joint ; Ankle ; Diagnosis ; Female ; Humans ; Male ; Methods ; Reference Values

Congenital Hyperextension of the Knee is a extremly rare deformity, in which the tibia is displaced anteriorly in relation to the femur. It is usually classified into three subtypes according to severity of the status: genu recurvatum, subluxation and dislocation. (Curtis and Fisher) We experienced a genu recurvatum type of congenital hyperextension of the knee in June, 1976.
Congenital Abnormalities ; Dislocations ; Femur ; Knee ; Tibia

PURPOSE: Gastrointestinal stromal tumors (GISTs) frequently harbor activating gene mutations in either KIT or platelet-derived growth factor receptor A (PDGFRA) and are highly responsive to several selective tyrosine kinase inhibitors. In this study, a targeted next-generation sequencing (NGS) assay with an Oncomine Focus Assay (OFA) panel was used for the genetic characterization of molecular targets in 30 Korean patients with GIST. MATERIALS AND METHODS: Using the OFA that enables rapid and simultaneous detection of hotspots, single nucleotide variants (SNVs), insertion and deletions (Indels), copy number variants (CNVs), and gene fusions across 52 genes relevant to solid tumors, targeted NGS was performed using genomic DNA extracted from formalin-fixed and paraffin-embedded samples of 30 GISTs. RESULTS: Forty-three hotspot/other likely pathogenic variants (33 SNVs, 8 Indels, and 2 amplifications) in 16 genes were identified in 26 of the 30 GISTs. KIT variants were most frequent (44%, 19/43), followed by 6 variants in PIK3CA, 3 in PDGFRA, 2 each in JAK1 and EGFR, and 1 each in AKT1, ALK, CCND1, CTNNB1, FGFR3, FGFR4, GNA11, GNAQ, JAK3, MET, and SMO. Based on the mutation types, majority of the variants carried missense mutations (60%, 26/43), followed by 8 frameshifts, 6 nonsense, 1 stop-loss, and 2 amplifications. CONCLUSIONS Our study confirmed the advantage of using targeted NGS with a cancer gene panel to efficiently identify mutations associated with GISTs. These findings may provide a molecular genetic basis for developing new drugs targeting these gene mutations for GIST therapy.

BACKGROUND: The presence of late potentials on the signal-averaged electrocardiography (SAECG) is predictive of ventricular tachycardia and sudden cardiac death. We investigated the acute effect of HD on the SAECG in patients with end-stage renal disease (ESRD). METHODS: Twenty HD patients with normal sinus rhythm on a routine ECG were enrolled. SAECGs were recorded immediately before, within 30 minute after, and then 24 hour after the completion of HD. Serum electrolyte, BUN, calcium, echocardiogram and body weight were examined before and after the HD. RESULTS: Positive late potentials on SAECG were detected in 8 patients (40%) before HD, 12 patients (60%) at 30 minute after HD, and 5 patients (25%) at 24 hour after HD. There was a significant change in QRSd (QRS duration) after HD: (110.3+-9.7 msec before HD; 112.3+-9.3 msec at 30 minute after HD; 109.5+-8.6 msec at 24 hour after HD) (p<0.05). The reduction of serum potassium was greater in positive late potential (n=12) than in negative late potential group after HD (n=8) (p<0.05). A significant negative correlation was seen between the changes of dialysis-induced serum total CO2 and QRSd changes (r=-0.534, p<0.05). CONCLUSION: SAECG parameters tended to be aggravated after HD in patient with ESRD. Prolongation of QRSd after HD could be explained by the changes of potassium and bicarbonate.
Body Weight ; Calcium ; Death, Sudden, Cardiac ; Electrocardiography* ; Humans ; Kidney Failure, Chronic* ; Potassium ; Renal Dialysis* ; Tachycardia, Ventricular

PURPOSE: Dysregulated microRNAs (miRNAs) can contribute to cancer development by leading to abnormal proliferation of cells, apoptosis, and differentiation. Although several miRNAs that are related to gastric cancer have been identified, the reported results have been inconsistent. The aim of this study was to determine miRNA expression profiles and validate miRNAs up- and down-regulated in gastric cancer. MATERIALS AND METHODS: We evaluated 34 primary gastric cancer tissues and paired adjacent nontumorous gastric tissues. Total RNA was extracted, and low-molecular-weight RNAs (<200 nucleotides) were isolated for further analysis. Two pairs of tissues were processed for GeneChip microarray analysis, and the identified up- and down-regulated miRNAs were validated by real-time quantitative polymerase chain reaction (qPCR). RESULTS: In the set of differentially expressed miRNAs, 5 were overexpressed by more than 2 fold, and 5 were reduced by 2 fold or less in gastric cancer tissues compared with normal gastric tissues. Four of these miRNAs (miR-196b-5p, miR-375, miR-483-5p, and miR-486-5p) were then validated by qPCR, and the relative expression levels of 2 miRNAs (miR-196b-5p and miR-375) were significantly different between cancer and normal tissues. CONCLUSIONS: Our results revealed that the expression of miR-196b-5p and miR-375 significantly correlates with gastric cancer. These miRNAs could therefore serve as diagnostic biomarkers of gastric cancer.
Apoptosis ; Biomarkers ; Microarray Analysis ; MicroRNAs ; Polymerase Chain Reaction ; RNA ; Stomach ; Stomach Neoplasms*

BACKGROUNDS: Although glucocorticoids are one of the most potent anti-inflammatory agents, they have limited effect on cysteinyl leukotriene biosynthesis. In addition, the response to inhaled corticosteroids (ICS) and inhaled long-acting beta2-agonists (LABA) combination therapy in moderate to severe persistent asthmatics varies. Additional therapy with leukotriene receptor antagonists (LTRA) in patients with moderate to severe asthma suboptimally controlled with ICS and LABA combination therapy would be complementary to asthma control. METHODS: One hundred and ninety eight asthmatics entered a 2 month, open-label descriptive study. Patients suffering from persistent asthma and suboptimally controlled on a combination therapy of fluticasone/salmeterol or budesonide/ formoterol were given montelukast 10 mg daily as an add-on therapy. The level of asthma control was assessed using the Asthma Control Questionnaire (ACQ) including FEV(1) % predicted at the baseline and after a 2-month treatment with montelukast. A global evaluation of the treatment was also made by the patients and physicians. RESULTS: The mean ACQ score decreased significantly on montelukast (11.5+/-5.4 at baseline vs. 6.7+/-5.0), with a significant improvement in all individual symptom scores (p<0.01). The FEV(1) % predicted values did not show any significant change. 59.9% of patients and 59.4% of physicians reported global improvement in their asthma (kappa=0.85). CONCLUSION: These results suggest that the addition of montelukast in patients with persistent asthma that is suboptimally contolled by combination therapy of ICS and LABA might confer complementary effects on asthma control.
Adrenal Cortex Hormones* ; Anti-Inflammatory Agents ; Asthma ; Glucocorticoids ; Humans ; Leukotriene Antagonists ; Surveys and Questionnaires ; Formoterol Fumarate

PURPOSE: Lymph node metastasis is an important factor in determining prognosis and therapeutic options for early gastric cancer (EGC) patients. Vascular endothelial growth factor (VEGF)-C and D are known as lymphangiogenic factors, and cyclooxygenase (COX)-2 is thought to play a role in lymph node metastasis in gastric carcinoma. This study was designed to determine whether the expression of VEGF-C, VEGF-D, and COX-2 is associated with clinicopathologic factors, especially lymph node metastasis in EGCs invading the submucosa. MATERIALS AND METHODS: Tissue samples were obtained from 85 Patients undergoing standard gastrectomy with lymph node dissection between 1991 and 2007 in the Department of Surgery of Daejeon St. Mary's Hospital in Daejeon, Korea. All patients were diagnosed with gastric cancers and submucosal invasion. We examined the expression of VEGF-C, VEGF-D, and COX-2 using immunohistochemical methods. RESULTS: Of the 85 patients, 16 (18.8%) had lymph node metastasis. VEGF-C, VEGF-D, and COX-2 were positively expressed in 34.1% (29/85), 22.3% (19/85), and 37.6% (32/85) of the patients. VEGF-C and COX-2 expression was significantly correlated with lymph node metastasis (P<0.05). A positive correlation existed between VEGF-C and COX-2 expression (P<0.001). CONCLUSION: VEGF-C and COX-2 expression is associated with lymph node metastasis in gastric cancer with submucosal invasion. VEGF-C and COX-2 may thus be predictive markers for lymph node metastasis in EGC patients with submucosal invasion.
Gastrectomy ; Humans ; Korea ; Lymph Node Excision ; Lymph Nodes ; Neoplasm Metastasis ; Prognosis ; Prostaglandin-Endoperoxide Synthases ; Stomach Neoplasms ; Vascular Endothelial Growth Factor A ; Vascular Endothelial Growth Factor C ; Vascular Endothelial Growth Factor D

Variant surface antigens (VSAs) encoded by pir families are considered to be the key proteins used by many Plasmodium spp. to escape the host immune system by antigenic variation. This attribute of VSAs is a critical issue in the development of a novel vaccine. In this regard, a population genetic study of vir genes from Plasmodium vivax was performed in the Republic of Korea (ROK). Eighty-five venous blood samples and 4 of the vir genes, namely vir 27, vir 21, vir 12, and vir 4, were selected for study. The number of segregating sites (S), number of haplotypes (H), haplotype diversity (Hd), DNA diversity (π and Θw), and Tajima’s D test value were conducted. Phylogenetic trees of each gene were constructed. The vir 21 (S=143, H=22, Hd=0.827) was the most genetically diverse gene, and the vir 4 (S=6, H=4, Hd=0.556) was the opposite one. Tajima’s D values for vir 27 (1.08530, P>0.1), vir 12 (2.89007, P<0.01), and vir 21 (0.40782, P>0.1) were positive, and that of vir 4 (−1.32162, P>0.1) was negative. All phylogenetic trees showed 2 clades with no particular branching according to the geographical differences and cluster. This study is the first survey on the vir genes in ROK, providing information on the genetic level. The sample sequences from vir 4 showed a clear difference to the Sal-1 reference gene sequence, whereas they were very similar to those from Indian isolates.
Antigenic Variation ; Antigens, Surface ; DNA ; Genetic Variation ; Haplotypes ; Humans ; Immune System ; Plasmodium vivax* ; Plasmodium* ; Republic of Korea* ; Trees ; United Nations

PURPOSE: With recent developments in endoscopic surgery for thyroid tumors, several approaches have been applied to endoscopic neck surgery. Gasless endoscopic thyroidectomy has some advantages over gas insufflating surgery. We evaluated the role of gasless endoscopic thyroidectomies on various thyroid tumors including malignant thyroid tumors. METHODS: We performed thyroidectomies for a total of 195 patients who were admitted to Uijongbu St. Mary's Hospital from November 1999 to February 2002. We compared the clinical data of 100 patients who received gasless endoscopic thyroidectomies with the data of 95 patients who underwent conventional thyroidectomies. Furthermore, we subclassified the 100 patients who received a gasless endoscopic thyroidectomy into two groups, before and after the start of 2001. RESULTS: The analysis of the clinical data showed that an endoscopic thyroidectomy gave superior results with respect to the time of postoperative recovery and cosmetic results. Also, the patients in the second half group showed significantly shorter operation times reduced from 153.4 min. to 128.6 min. and length of hospital stay similarly reduced(3.55 days vs. 5.35 days). CONCLUSION: A gasless endoscopic thyroidectomy is a safe and technically feasible alternative to a conventional thyroi-dectomy in benign and early malignant tumors, and provides good cosmetic results.
Humans ; Length of Stay ; Neck ; Thyroid Gland ; Thyroidectomy*

BACKGROUND: In recent years, clinical trials have considerably increased and relevant education programs to clinical trials have been developed and implemented since 2008 in Korea. To enhance the quality as well as global competitiveness of clinical trial professionals (CTPs), a certification program of the human resource is needed. Accordingly, in Korea the first and the second certification examinations were implemented in February and October 2012, respectively. In this paper, introduction of the certification program of the human resource is described, and results of the certification examinations and questionnaire survey are presented. METHODS: Data including the examination results and questionnaire survey was collected by cooperative officials in Korea National Enterprise for Clinical Trials. Applicants who were selected eligible for examination by the steering committee were asked to complete questionnaires provided with the test papers on the day of the certification examination. RESULTS: In the first certification examination, a total of 221 eligible participants completed the examination. 99.5 % of the participants responded the questionnaire survey. In the second examination, a total of 223 applicants participated. The examination consisted of 50 multiple-choice questions with cut-off score of 70 per cent score.176 & 194 CTPs passed the first & second examinations respectively. CONCLUSION: This paper that described the results of the two certification tests and questionnaire surveys might be helpful in establishment and activation of the certification program in the future. Quality improvement of CTPs and international competitiveness of clinical trial in Korea can be anticipated by the certification program.
Certification ; Cytidine Triphosphate ; Humans ; Korea ; Quality Improvement ; Surveys and Questionnaires ; Silanes