PURPOSE: TGF-beta is a key regulator of epithelial-mesenchymal transition. Among the TGF-beta responses, cell migration is closely associated with the expression of matrix metalloproteinases (MMPs). Therefore, we determined which MMPs are regulated by TGF-beta and examined the TGF-beta signaling involved in this event, focusing on Src family tyrosine kinases (SFKs) METHODS: First we examined the expression of MMPs in rat lens explant culture treated with TGF-beta and LECs attached to the anterior capsules of patients with nuclear (N), anterior polar (AP) cataracts using RT-PCR and immunofluorescence staining. It was examined whether the expression of MMPs is regulated by SFKs. RESULTS: The study using RT-PCR and immunofluorescence staining showed the expression of MMP-2 and -14 in explants and the expression of MMP-14 LECs of AP cataracts. The expression of MMP-2 and -14 was blocked by PP2 in explants. Furthermore, the activated form of SFKs was observed in LECs of AP cataracts by immunofluorescence staining. CONCLUSIONS: We suggest a novel role of SFKs signaling in the expression of MMP-14 induced by TGF-beta.
Animals ; Capsules ; Cataract ; Cell Movement ; Epithelial Cells* ; Epithelial-Mesenchymal Transition ; Fluorescent Antibody Technique ; Humans ; Matrix Metalloproteinases ; Rats ; src-Family Kinases ; Transforming Growth Factor beta*

No abstract available.
Emergencies* ; Emergency Service, Hospital* ; Emergency Treatment* ; Humans

BACKGROUND: Androgenetic alopecia is considered to be a genetically determined disorder influenced by age and androgen. The proportion of patients with androgenetic alopecia among the total number of patients with alopecia seems to be gradually increasing. OBJECTIVE: The purpose of this study was to find the family history, clinical and endocrine status of the patients with androgenetic alopecia. METHOD: 736 patients with androgenetic alopecia who had visited the Department of Dermatology, Yongsan and Pil-dong Hospital, College of Medicine, Chung-Ang University during the last 2 years(1999.1-2000.12) were examined. RESULTS: 1) Incidence of androgenetic alopecia among the total number of alopecia patients was 75.8%. 2) There were 571 male and 165 female patients being most prevalent in the 3rd decade in male patients and in the 4th decade in female patients. 3) In male androgenetic alopecia, Norwood-Hamilton's type II was the most common and following IIIv, II, IV, IIIa, and in female patients, Ludwig's type I was most common. 4) There was a family history of baldness in 59.5% of first degree relatives in male patients and 30.9% in female patients. 5) The most common associated disorder is seborrheic dermatitis. 6) Serum testosterone levels were increased in 78 males(13.7%) and 23 females(13.9%). CONCLUSION: Based on these results, the number of young patients who visit dermatologists tends to be increasing and genetic factor, ages and abnormal androgen metabolism in scalp are affecting the development of androgenetic alopecia.
Alopecia ; Dermatitis, Seborrheic ; Dermatology ; Female ; Humans ; Incidence ; Male ; Metabolism ; Scalp ; Testosterone

PURPOSE: Preoperative on-screen templating is a method of using acetate templates on digital images. The aim of the present study was to evaluate the accuracy, intra- and interobserver reliabilities of preoperative on-screen templating using digital radiographs for total hip arthroplasty (THA). MATERIALS AND METHODS: Two hundred patients with hip disease who were treated with primary cementless THA were retrospectively evaluated. The accuracy of on-screen templating was assessed by comparing the predicted prosthesis sizes with the actual sizes used operatively. The inter- and intraobserver reliabilities of the templating results were also evaluated. RESULTS: The prosthesis prediction accuracy within ±one size was 96.6% for the cup size and 97.8% for the stem size. The inter- and intraobserver reliabilities for the implant size were substantial (kappa>0.70). The intra- and interobserver reliabilities for the leg length discrepancy and femoral offset difference using the intraclass correlation coefficient ranged from 0.89 to 0.97. CONCLUSION: Preoperative on-screen templating using digital radiographs showed substantial accuracy and reliability for implant prediction. It is an effective method for predicting the size of implant, correcting the leg length discrepancy and restoring the femoral offset.
Arthroplasty, Replacement, Hip* ; Hip ; Humans ; Leg ; Methods ; Prostheses and Implants ; Radiographic Image Enhancement ; Retrospective Studies

Evaluation of the sacrum in anorectal malformations (ARMs) is important because of the frequent association with ARMs and functional outcome after correction of ARMs. Sacral defects are not easily detected because of immaturity of sacrum in children and overlooking of pediatric surgeons. The authors utilized the sacral ratio in normal children and patients with ARMs. In normal children, the mean true sacral ratio and mean sacrococcygeal ratio were 0.60+/-0.08 and 0.72+/-0.13 respectively. Sacral ratio was not correlated with age and did not changed with age in same patient. However, true sacral ratio and sacrococcygeal ratio were significantly lower in patients with high type ARMs than those of normal children (p<0.001). There was no difference between patients with low type ARMs and normal children. These results suggest that abnormal sacrums are more frequently encountered in patients with high type ARMs than in normal children, and that true sacral ratio and sacrococcygeal ratio can be used in the evaluation of the abnormal sacrum.
Arm ; Child* ; Humans ; Sacrum

Motor loss caused by herpes zoster is less well known but occurs in a significant number of cases, probably far more frequent than is recognized because the weakness is readily obscured by pain. The incidence of herpetic motor involvement was reported to be between 0.5% and 31%. A 65-year-old male patient with herpes zoster on the right lower limb had complained with progressive weakness of the limb, during treatment. We examined the limb using electromyographic(EMG) and motor nerve conduction velocity(MNCV) studies. Thereafter we concluded he had motor paralysis caused by herpes zoster. The weakness progressed to the complete motor loss of the right limb. Presenty, he still suffers from the paralysis of the right limb.
Aged ; Extremities ; Herpes Zoster* ; Humans ; Incidence ; Lower Extremity ; Male ; Neural Conduction ; Paralysis*

Purpose: Surgical management of obstructive left colon cancer (OLCC) is still a matter of debate. The classic Hartmann procedure (HP) has a disadvantage that requires a second major operation. Subtotal colectomy/total abdominal colectomy (STC/TC) with ileosigmoid or ileorectal anastomosis is proposed as an alternative procedure to avoid stoma and anastomotic leakage. However, doubts about morbidity and functional outcome and lack of long-term outcomes have made surgeons hesitate to perform this procedure. Therefore, this trial was designed to provide data for morbidity, functional outcomes, and long-term outcomes of STC/TC. Methods: This study retrospectively analyzed consecutive cases of OLCC that were treated by STC/TC between January 2000 and November 2020 at a single tertiary referral center. Perioperative outcomes and long-term outcomes of STC/TC were analyzed. Results: Twenty-five descending colon cancer (45.5%) and 30 sigmoid colon cancer cases (54.5%) were enrolled in this study. Postoperative complications occurred in 12 patients. The majority complication was postoperative ileus (10 of 12). Anastomotic leakage and perioperative mortality were not observed. At 6 to 12 weeks after the surgery, the median frequency of defecation was twice per day (interquartile range, 1–3 times per day). Eight patients (14.5%) required medication during this period, but only 3 of 8 patients required medication after 1 year. The 3-year disease-free survival was 72.7% and 3-year overall survival was 86.7%. Conclusion The risk of anastomotic leakage is low after STC/TC. Functional and long-term outcomes are also acceptable. Therefore, STC/TC for OLCC is a safe, 1-stage procedure that does not require diverting stoma.

Choledochal cysts are congenital lesions involving cystic dilatation of the bile ducts. The choledochocele, the rarest type of choledochal cyst, is a cystic dilatation of the distal common bile duct that protrudes into the duodenum. There have been few reports concerning malignancy in the biliary tree associated with choledochoceles. We recently experienced a case of a choledochocele with gallbladder cancer.
Bile Ducts ; Biliary Tract ; Choledochal Cyst ; Common Bile Duct ; Dilatation ; Duodenum ; Gallbladder ; Gallbladder Neoplasms

Hiatal hernia is a very rare disease in the pediatric population. However information from our esophageal atresia postoperative follow-up program has hypotheses; "Hiatal hernia may more frequently occur in postoperative esophageal atresia patients (EA group) than in the general pediatric population (GP group)" and "The tension on the esophagus after esophageal anastomosis may be an important etiologic factor of hiatal hernia in EA group". To prove the first hypotheses, we compared the incidence of hiatal hernia in the GP group with the incidence in the EA group. The Incidence in the GP group was obtained from national statistic data from Statistics Korea and Health Insurance Review and Assessment Service of Korea. The incidence in the EA group was obtained from the medical record and the imaging studies of our esophageal atresia postoperative follow-up program. To prove the second hypothesis, the presumptive risk factors for the development of hiatal hernia in EA group, such as the type of esophageal atresia, degree of esophageal gap, the stage operation and the redo-operation with resection and re-anastomosis of esophagus were analyzed statistically. The total number of patients in the EA group was ninety-nine and there were 5 hiatus hernias. The incidence of EA group (5 %) is significantly higher than incidence of GP group (0.024 %). (p=0.0001) The statistical analysis of the presumptive risk factors for hiatal hernia development in EA group failed to show any evidence of correlation between postoperative esophageal tension and the hiatal hernia. This study shows that the postoperative patients with esophageal atresia have high occurrence of hiatal hernia and should be followed up carefully to detect hiatal hernia.
Esophageal Atresia ; Esophagus ; Follow-Up Studies ; Hernia ; Hernia, Hiatal ; Humans ; Incidence ; Insurance, Health ; Korea ; Medical Records ; Rare Diseases ; Risk Factors

The pathophysiology of Hirschsprung's disease (HD) is not fully understood, but recent studies have disclosed that neural cell adhesion molecule (NCAM) and glial cell line-derived neurotrophic factor (GDNF) play important roles in the formation of aganglionic bowel of Hirschsprung's disease. To evaluate the roles of NCAM and GDNF in HD, immunohistochemical analysis was performed using formalin-fixed and paraffin-embedded tissue sections. On the basis of the results, we tried to evaluate them as diagnostic markers. The specimens were obtained from 7 patients with HD who underwent modified Duhamel operation. The diagnosis was based on the clinical findings and the absence of ganglion cells in the nerve plexuses by routine microscopy. NCAM immunoreactivity was found in the nerve plexuses and scattered nerve fibers in the smooth muscle layers of ganglionic segments. In aganglionic segments, the number of NCAM positive nerve fibers in the smooth muscle layers was significantly reduced compared with ganglionic segments. In two cases the nerve plexuses in aganglionic segments, NCAM was negligible. The smooth muscle cells showed diffuse immunoreactivity for GDNF and the staining intensity was not different in the aganglionic and ganglionic segments. However, higher expression of GDNF in the nerve plexus of the ganglionic segments was noted comparing to aganglionic segments. These data suggest that both NCAM and GDNF may play important roles in pathogenesis of Hirschsprung's disease and immunohistochemical staining for NCAM can be used as an ancillary diagnostic tool for HD.
Diagnosis ; Ganglion Cysts ; Glial Cell Line-Derived Neurotrophic Factor* ; Hirschsprung Disease* ; Humans ; Microscopy ; Muscle, Smooth ; Myocytes, Smooth Muscle ; Nerve Fibers ; Neural Cell Adhesion Molecules* ; Neuroglia*