Cutaneous angiosarcomas are uncommon malignancies which account about 1% of sarcomas. They are found most commonly in the head and neck regions, frequently on the scalp. Although preferred treatment has been combined surgery and postoperative radiation therapy, the extensiveness and multiplicity of the lesions set limits to such an approach and the patient is often referred for radiotherapy without surgery. As the entire scalp usually needs to be treated, radiation therapy is a challenging problem to radiation oncology staffs. We report a case of angiosarcoma of the scalp, which was treated successfully by radiation therapy with a simple and repeatable method using mixed photon and electron beam technique. Using a bolus to increase the surface dose of the scalp and to minimize dose to the normal tissues of the brain desirable but difficult technically to be well conformed o the three dimensional curved surface such as vertex of the head. A helmet made of thermoplastics filled with paraffin was elaborated and used for the treatment, resulting of the relatively uniform surface doses along the several points measured on the scalp, the difference among the points not exceeding 7% of the prescribed dose by TLD readings.
Brain ; Head ; Head Protective Devices ; Hemangiosarcoma* ; Humans ; Neck ; Paraffin ; Radiation Oncology ; Radiotherapy* ; Reading ; Sarcoma ; Scalp*

The purpose of this study was to examine the effects of dietary caffeine supplementation on bone mineral density and bone mineral content in ovariectomized rats. Twenty eight female Sprague-Dawley rats (body weight 210 +/- 5 g) were divided into two groups, ovariectomy (OVX) and Sham groups, which were each randomly divided into two subgroups that were fed control and control supplemented with caffeine diets (caffeine 0.03% diets). All rats were fed on experimental diet and deionized water ad libitum for 6 weeks. Bone mineral density (BMD) and bone mineral content (BMC) were measured using PIXImus (GE Lunar Co, Wisconsin) in spine and femur. Serum alkaline phosphatase activity (ALP) and osteocalcin and urinary DPD crosslinks value were measured as markers of bone formation and resorption. The results of this study indicate that body weight gain and food intake were higher in OVX groups than in Sham groups regardless of diets. There were no differences weight gain between the control and caffeine groups in both OVX and Sham groups. Within the OVX groups, serum Ca concentration was lower in rats fed caffeine than in rats fed the control diet. Serum ALP, osteocalcin, urinary Ca, and phosphate were not different in each group. Spine BMD, spine BMD/weight, and spine BMC/weight, femur BMD/weight and femur BMC/weight of ovariectomy groups were significantly lower than Sham groups. Within the OVX group, there were no differences in spine BMD and BMC and femur BMD and BMC. These results indicate that no significant differences in spine and femur BMD were found due to 0.03% caffeine intakes in diet in OVX rats for 6 weeks. No negative effect of caffeine in 0.03% diet on bone mineral density were found in the present study. Further investigation of the relation between caffeine and bone mineral density are warranted.
Alkaline Phosphatase ; Animals ; Body Weight ; Bone Density ; Caffeine ; Diet ; Eating ; Female ; Femur ; Humans ; Osteocalcin ; Osteogenesis ; Ovariectomy ; Rats ; Rats, Sprague-Dawley ; Salicylamides ; Spine ; Water ; Weight Gain

OBJECTIVES: Patients with schizophrenia often present the idea of reference in social situations ; however, the number of research studies examining the nature of the idea of reference and the visual searching pattern in social situations is limited. The aim of this study was to investigate behavioral and visual searching characteristics of patients with schizophrenia in social situations in which the idea of reference can be provoked. METHODS: Eighteen subjects with schizophrenia (eight males) and 18 healthy volunteers (seven males) performed the idea-of-reference-provoking task, which was composed of movie clips with scenes of two women sitting on a bench 1 m away. The participants' reactions were rated using questionnaires for self-reference, malevolent intentions, and anxiety. Visual scan path was monitored during performance of the task. RESULTS: There were significant group differences in the reactions on self-reference, malevolent intentions, and anxiety. The visual searching pattern in patients with schizophrenia was to avoid looking at the women's body area in every movie clip. However, there was no significant difference in the face area in both groups. CONCLUSION: A distinct visual strategy in schizophrenia may affect the self-referential bias and paranoid response. The absence of difference in attention to a core information region (face) may suggest the possibility of inferential errors as well as the cause of self-referential bias and paranoid responses.
Anxiety ; Bias (Epidemiology) ; Female ; Healthy Volunteers ; Humans ; Intention ; Surveys and Questionnaires ; Schizophrenia*

BACKGROUND: Although transfusion is a paramount life-saving therapy, there are multiple potential significant risks. Therefore, all adverse transfusion reaction (ATR) episodes require close monitoring. Using the computerized reporting system, we assessed the frequency and pattern of non-infectious ATRs. METHODS: We analyzed two-year transfusion data from electronic medical records retrospectively. From March 2013 to February 2015, 364,569 units of blood were transfused. Of them, 334,582 (91.8%) records were identified from electronic nursing records. For the confirmation of ATRs by blood bank physicians, patients' electronic medical records were further evaluated. RESULTS: According to the nursing records, the frequency of all possible transfusion-related events was 3.1%. After the blood bank physicians' review, the frequency was found to be 1.2%. The overall frequency of febrile non-hemolytic transfusion reactions (FNHTRs) to red blood cells (RBCs), platelet (PLT) components, and fresh frozen plasmas (FFPs) were 0.9%, 0.3%, and 0.2%, respectively, and allergic reactions represented 0.3% (RBCs), 0.9% (PLTs), and 0.9% (FFPs), respectively. The pre-storage leukocyte reduction significantly decreased the frequency of FNHTRs during the transfusion of RBCs (P<0.01) or PLTs (Pfalling dots0.01). CONCLUSIONS: The frequency of FNHTRs, allergic reactions, and "no reactions" were 22.0%, 17.0%, and 60.7%, respectively. Leukocyte-reduction was associated with a lower rate of FNHTRs, but not with that of allergic reactions. The development of an effective electronic reporting system of ATRs is important in quantifying transfusion-related adverse events. This type of reporting system can also accurately identify the underlying problems and risk factors to further the quality of transfusion care for patients.
Blood Transfusion/*adverse effects/statistics & numerical data ; Humans ; Republic of Korea/epidemiology ; Retrospective Studies ; Tertiary Care Centers ; Transfusion Reaction/*epidemiology/etiology

PURPOSE: To analyze the gene expression profiles of uterine cervical cancer, and its variation after radiation therapy, with or without concurrent chemotherapy, using a cDNA microarray. MATERIALS AND METHODS: Sixteen patients, 8 with squamous cell carcinomas of the uterine cervix, who were treated with radiation alone, and the other 8 treated with concurrent chemo-radiation, were included in the study. Before the starting of the treatment, tumor biopsies were carried out, and the second time biopsies were performed after a radiation dose of 16.2~27 Gy. Three normal cervix tissues were used as a control group. The microarray experiments were performed with 5 groups of the total RNAs extracted individually and then admixed as control, pre-radiation therapy alone, during-radiation therapy alone, pre-chemoradiation therapy, and during-chemoradiation therapy. The 33P-labeled cDNAs were synthesized from the total RNAs of each group, by reverse transcription, and then they were hybridized to the cDNA microarray membrane. The gene expression of each microarrays was captured by the intensity of each spot produced by the radioactive isotopes. The pixels per spot were counted with an Arrayguage(R), and were exported to Microsoft Excel(R). The data were normalized by the Z transformation, and the comparisons were performed on the Z-ratio values calculated. RESULTS: The expressions of 15 genes, including integrin linked kinase (ILK), CDC28 protein kinase 2, Spry 2, and ERK 3, were increased with the Z-ratio values of over 2.0 for the cervix cancer tissues compared to those for the normal controls. Those genes were involved in cell growth and proliferation, cell cycle control, or signal transduction. The expressions of the other 6 genes, including G protein coupled receptor kinase 6, were decreased with the Z-ratio values of below -2.0. After the radiation therapy, most of the genes, with a previously increase expressions, represented the decreased expression profiles, and the genes, with the Z-ratio values of over 2.0, were cyclic nucleotide gated channel and 3 Expressed sequence tags (EST). In the concurrent chemo-radiation group, the genes involved in cell growth and proliferation, cell cycle control, and signal transduction were shown to have increased expressions compared to the radiation therapy alone group. The expressions of genes involved in angiogenesis (angiopoietin-2), immune reactions (formyl peptide receptor-like 1), and DNA repair (cAMP phosphodiesterase) were increased, however, the expression of gene involved in apoptosis (death associated protein kinase) was decreased. CONCLUSION: The different kinds of genes involved in the development and progression of cervical cancer were identified with the cDNA microarray, and the proposed theory is that the proliferation signal starts with ILK, and is amplified with Spry 2 and MAPK signaling, and the cellular mitoses are increased with the increased expression of Cdc 2 and cell division kinases. After the radiation therapy, the expression profiles demonstrated the evidence of the decreased cancer cell proliferation. There was no significant difference in the morphological findings of cell death between the radiation therapy alone and the chemo-radiation groups in the second time biopsy specimen, however, the gene expression profiles were markedly different, and the mechanism at the molecular level needs further study.
Apoptosis ; Biopsy ; Carcinoma, Squamous Cell ; Cell Death ; Cell Division ; Cell Proliferation ; Centers for Disease Control and Prevention (U.S.) ; Cervix Uteri ; Cyclic Nucleotide-Gated Cation Channels ; DNA Repair ; DNA, Complementary ; Drug Therapy ; Expressed Sequence Tags ; Female ; Gene Expression* ; GTP-Binding Proteins ; Humans ; Membranes ; Mitosis ; Oligonucleotide Array Sequence Analysis ; Phosphotransferases ; Protein Kinases ; Radioisotopes ; Reverse Transcription ; RNA ; Signal Transduction ; Transcriptome* ; Uterine Cervical Neoplasms*

BACKGROUND: Diagnosis of tuberculous pleurisy is sometimes difficult using conventional diagnostic methods. We have investigated the utility of pleural fluid cell IFN-gamma production assay in the diagnosis of tuberculous pleurisy. METHODS: We prospectively performed pleural fluid cell IFN-gamma production assay in 39 patients with tuberculous pleural effusions (TPE) and in 26 patients with nontuberculous pleural effusions (NTPE) (13 malignant pleural effusions and 13 parapneumonic effusions). Pleural fluid cells were cultured in DMEM media and stimulated with purified protein derivatives (PPD), and phytohemagglutinin (PHA) for 24 hr. The amount of IFN-gamma released in the culture supernatant was quantitated by IFN-gamma ELISA assay. We have also measured adenosine deaminase (ADA) activities and IFN-gamma concentrations in the pleural fluid. RESULTS: 1) The pleural fluid levels of ADA activity and IFN-gamma concentrations were significantly higher in TPE than NTPE (p<0.01). 2) IFN-gamma production in TPE cells stimulated by PPD (755,266+/-886,636 pg/ml) was significantly higher than NTPE cells (3,509+/-6,980 pg/ml) (p<0.01). By considering the fact that IFN-gamma concentrations over 10,000 pg/ml is a criteria for the diagnosis of TBE, sensitivity and specificity of the test were 97.4 and 92.3%, respectively. 3) The ratios of IFN-gamma production by the stimulation with PPD and PHA (PPD/PHA) were significantly higher in TPE cells (59+/-85) than NTPE cells (5+/-18)(p<0.01). Considering the criteria for the diagnosis of TBE as PPD/PHA ratio over 5, sensitivity and specificity of the test were 76.9 and 92.3%, respectively. CONCLUSION: Pleural fluid cell IFN-gamma production assay may be useful for the diagnosis of tuberculous pleurisy.
Adenosine Deaminase ; Diagnosis* ; Enzyme-Linked Immunosorbent Assay ; Humans ; Pleural Effusion ; Pleural Effusion, Malignant ; Pleurisy ; Prospective Studies ; Tuberculosis ; Tuberculosis, Pleural*

PURPOSE: As preoperative diagnostic tools have advanced, the rate of multiple early gastric cancer diagnoses have increased. The author investigated the clinicopathological features of multiple early gastric cancers to elucidate the clinical feasibility of minimally invasive gastrectomy such as laparoscopy or robot assisted gastrectomy for their surgical treatment. METHODS: One thousand one hundred and eighty-five open gastrectomies and 607 laparoscopies or robot-assisted gastrectomies for gastric cancers from January 2003 through August 2009 were retrospectively reviewed. Among them, 844 were diagnosed as early gastric cancers, of which 47 cases had multiple early gastric cancers. Twenty-seven cases underwent open gastrectomy and 20 cases underwent laparoscopy or robot assisted gastrectomy. The author analyzed clinicopathological features in these multiple early gastric cancers. RESULTS: The incidences of multiple early gastric cancers among the early gastric cancers were 5.6%. There were no statistical differences in the clinicopathological parameters except the type of gastrectomy and anastomosis. The distances of both proximal and distal margin show no statistical difference in both groups. The hospital stay was shorter in laparoscopy or robot assisted gastrectomy group (P=0.022). The postoperative complications developed 7 cases in open group and 1 case in laparoscopy or robot assisted gastrectomy group (P=0.046). During the mean follow-up period of 43.8+/-26.4 and 36.2+/-19.8 months, no recurrence was found in both groups. CONCLUSION: Laparoscopy or robot assisted gastrectomy are as acceptable as open methods to obtain a safe surgical margin, and to perform the desirable type of gastrectomy and radical lymph node dissection.
Follow-Up Studies ; Gastrectomy ; Incidence ; Laparoscopy ; Length of Stay ; Lymph Node Excision ; Postoperative Complications ; Recurrence ; Retrospective Studies ; Stomach Neoplasms

PURPOSE: The purpose of this study was to investigate the effect of smoking habit change on the risk of cancer. MATERIALS AND METHODS: From the Korean National Health Insurance Service database, we determined the change in smoking habit between the first (2002 and 2003) and second (2004 and 2005) health examination periods. A total of 143,071 men were categorized into baseline heavy (≥ 20 cigarettes per day), moderate (10-19 cigarettes per day), light (< 10 cigarettes per day) smokers, quitters, and never smokers, after which the change in smoking status was determined during the second health examination. The participants were then followed up from 2006 to 2013 for all cancer, smoking related cancer, and lung cancer. RESULTS: Compared to heavy continual smokers, heavy smokers who quit had reduced risk of smoking related cancer (hazard ratio [HR], 0.74; 95% confidence interval [CI], 0.56 to 0.97) and tended to have reduced risk of all cancer (HR, 0.87; 95% CI, 0.75 to 1.00). Moderate smokers who reduced the amount of smoking to light levels had decreased risk of all cancer (HR, 0.82; 95% CI, 0.72 to 0.94), smoking related cancer (HR, 0.74; 95% CI, 0.59 to 0.93), and lung cancer (HR, 0.55; 95% CI, 0.38 to 0.79) compared to heavy continual smokers. CONCLUSION: Smoking reduction decreases the risk of all cancer, smoking related cancer, and lung cancer. While smoking cessation should be the treatment of choice for smokers, smoking reduction may serve as an alternative strategy for those who cannot quit.
Humans ; Lung Neoplasms ; Male ; National Health Programs ; Smoke* ; Smoking Cessation* ; Smoking* ; Tobacco Products

OBJECTIVES: This study aims to investigate health disparities between lesbian, gay, and bisexual (LGB) adults and the general population in Korea, where there is low public acceptance of sexual minorities and a lack of research on the health of sexual minorities. METHODS: The research team conducted a nationwide survey of 2,335 Korean LGB adults in 2016. Using the dataset, we estimated the age-standardized prevalence ratios (SPRs) for poor self-rated health, musculoskeletal pain, depressive symptoms, suicidal behaviors, smoking, and hazardous drinking. We then compared the SPRs of the LGB adults and the general population which participated in three different nationally representative surveys in Korea. SPRs were estimated for each of the four groups (i.e., gay men, bisexual men, lesbians, and bisexual women). RESULTS: Korean LGB adults exhibited a statistically significantly higher prevalence of depressive symptoms, suicidal ideation and attempts, and musculoskeletal pain than the general population. Lesbian and bisexual women had a higher risk of poor self-rated health and smoking than the general women population, whereas gay and bisexual men showed no differences with the general men population. Higher prevalence of hazardous drinking was observed among lesbians, gay men, and bisexual women compared to the general population, but was not observed in bisexual men. CONCLUSIONS: The findings suggest that LGB adults have poorer health conditions compared to the general population in Korea. These results suggest that interventions are needed to address the health disparities of Korean LGB adults.
Adult* ; Bisexuality* ; Dataset ; Depression ; Drinking ; Female ; Health Status Disparities ; Homosexuality* ; Homosexuality, Female* ; Humans ; Korea* ; Male ; Minority Health ; Musculoskeletal Pain ; Prevalence ; Republic of Korea ; Smoke ; Smoking ; Suicidal Ideation

OBJECTIVES: This study aims to investigate health disparities between lesbian, gay, and bisexual (LGB) adults and the general population in Korea, where there is low public acceptance of sexual minorities and a lack of research on the health of sexual minorities.METHODS: The research team conducted a nationwide survey of 2,335 Korean LGB adults in 2016. Using the dataset, we estimated the age-standardized prevalence ratios (SPRs) for poor self-rated health, musculoskeletal pain, depressive symptoms, suicidal behaviors, smoking, and hazardous drinking. We then compared the SPRs of the LGB adults and the general population which participated in three different nationally representative surveys in Korea. SPRs were estimated for each of the four groups (i.e., gay men, bisexual men, lesbians, and bisexual women).RESULTS: Korean LGB adults exhibited a statistically significantly higher prevalence of depressive symptoms, suicidal ideation and attempts, and musculoskeletal pain than the general population. Lesbian and bisexual women had a higher risk of poor self-rated health and smoking than the general women population, whereas gay and bisexual men showed no differences with the general men population. Higher prevalence of hazardous drinking was observed among lesbians, gay men, and bisexual women compared to the general population, but was not observed in bisexual men.CONCLUSIONS: The findings suggest that LGB adults have poorer health conditions compared to the general population in Korea. These results suggest that interventions are needed to address the health disparities of Korean LGB adults.
Adult ; Bisexuality ; Dataset ; Depression ; Drinking ; Female ; Health Status Disparities ; Homosexuality ; Homosexuality, Female ; Humans ; Korea ; Male ; Minority Health ; Musculoskeletal Pain ; Prevalence ; Republic of Korea ; Smoke ; Smoking ; Suicidal Ideation