TNM system has been generally used for the clinical classification and the estimation of the prognosis of malignant tumors but it has been criticized for its accuracy in the field of oral and maxillofacial malignant tumors. This is because the prognoses of tumors are affected by so many factors, which have been not fully understood yet. For oral squamous cell carcinoma, "Treatment-dependent prognosis Index(TPI)" was developed from the retrospective DOSAK(German-Austrian-Swiss Association for Head and Neck Tumors) study from 1952 to 1985 for the purpose of more accurate and more objective estimations of prognoses. Considering the additional factors, DOSAK developed TPI into "Computer-Aided Individual Prognosis (CIP)" from the prospective study in 1992. We yielded and compared the estimated survival rates and the real survival rates in 145 patients who can be traced their survival out of 241 oral squamous cell carcinoma patents in Seoul National University Hospital during a decade from 1986 to 1995 using Computer-Aided Individual Prognosis (CIP). The patients were divided into group of overall, groups of nonevidence of disease and evidence of disease, groups divided by stage, groups divided by T classifications and by N classifications. The results are as follows. 1. Overall five-year survival rates are 53.6% in real survival rate and 25.4% in estimated survival rate. Generally the real survival rates are higher than the estimated survival rates in the standard of 5 year survival rates. 2. The differences of survival rates are up to maximum 43.3% in stage 2 and minimum 17.1% in N2. 3. Among 15 groups, 11 groups have statistical meaningful correlations (p<0.01) except stage2, stage 3, N1 and N3 The prognoses of Korean oral squamous patients were able to be estimated indirectly by CIP. For the more accurate estimation of the prognoses of Korean oral squamous patients, it is necessary to develop our own CIP program through the systemic epidemic studies.
Carcinoma, Squamous Cell* ; Classification ; Head ; Humans ; Neck ; Prognosis* ; Seoul* ; Survival Rate

BACKGROUND: Infrequent restriction site PCR (IRS-PCR) is a recently described DNA fingerprinting technique based on selective amplification of restriction endonuclease-cleaved fragments. We applied of IRS-PCR to clinical isolates of Vibrio parahaemolyticus associated with diarrhea. METHODS: IRS-PCR assay was performed with adaptors for XbaI and HhaI restriction sites. A total of 35 strains of V. parahaemolyticus which were isolated from clinical specimens of patients with diarrhea were analyzed. The isolates were collected from different geographic areas of Seoul (n=12), Incheon (n=21) and Gwangju (n=2) during 1998-2000 in Korea. RESULTS: In IRS-PCR, amplifed DNA fragments between 50 and 400 bp were found to be the most reproducible in this study. When V. parahaemolyticus isolates were amplified with AH1 and PX-G as primers, 35 isolates could be grouped into five IRS-PCR patterns: A (n=16), B (n=4), C (n=6), D (n=5) and E (n=4). The patterns were subdivided into 15 subtypes: A1, A2, B1, B2, B3, B4, C1, C2, C3, D1, D2, D3, E1, E2 and E3. The IRS-PCR patterns of V. parahaemolyticus did not show any relationship with serotype or geographic origin, but the isolates from same outbreak produced a same pattern(A1). CONCLUSION: The results provide evidence of the discriminatory power of the IRS-PCR method as it applies to V. parahaemolyticus.
Diarrhea ; DNA ; DNA Fingerprinting ; Gwangju ; Humans ; Incheon ; Korea ; Polymerase Chain Reaction* ; Seoul ; Vibrio parahaemolyticus* ; Vibrio*

Applied TNM-system for determination and prognostic classification of the cancer patients of Oral and Maxillofacial region does, however, only partly justice, if at all, to the nature of the tumor disease. And the TNM-system implies among other defects a crude simplification of the complex pattern of the tumor disease. But in clinical practice, the prognosis must be determined on the bases of a specific combination of clinical factors under consideration of various therapeutical conditions. For more reliable and objective prognosis determination for the cancer patients of Oral and Maxillofacial region, `Retrospective DOSAK(German-Austrian-Swiss Association for Head and Neck Tumors) study' introduced Treatment-dependent Prognosis Index TPI in 1982. Treatment-dependent Prognosis Index TPI gives the clinician an opportunity to determine the prognosis before starting therapy at the time of the first admission of the patient, during the therapy and immediately after complete of the therapy. The fundamental purpose of the TPI can be summarized as follows. 1) In clinical-therapeutical cancer research the TPI provides a sound basis for the planning and verification of therapy studies. 2) In clinical practice the TPI allows a reliable and objective determination of the prognosis for the individual patient and thus provides the clinician valuable assistance in planning the treatment. The authors estimated the survival curves of the 179 cases of squamous cell carcinoma from 1985.1.1 to 1992.8.31 in the Department of Oral and Maxillofacial Surgery, Seoul National University Hospital according to Treatment-dependent Prognosis Index TPI of Retrospective DOSAK study and compared with the survival curves observed in long term study on prognosis of patients.
Carcinoma, Squamous Cell* ; Classification ; Head ; Humans ; Neck ; Prognosis* ; Retrospective Studies ; Seoul ; Social Justice ; Surgery, Oral

No abstract available.
Epinephrine* ; Heart Arrest*

In Uremic condition, Secondary Hyperparathyroidism ensues due to phosphate retention, low level of calcitriol, decreased calcium absorption from intestine, skeletal resistance to the Parathyroid Hormone (PTH), hypocalcemia and eventually parathyroid hyperplasia. Theoretically, Reversal of hyperparathyroidism can be expected after successful kidney transplantation. However, Some patients show continuous increase of parathyroid function due to autonomous excretion of PTH, in which case, we could assume a tertiary hyperparathyroidism. There were sporadic reports for the treatment of tertiary hyperparathyroidism after successful kidney transplantation. And in some aspects, there remains a controvesrsy about the timing of parathyroidectomy. The occurrence of a single parathyroid adenoma after kidney transplantation is ever unusual finding. In our hospital, we have experienced a case of parathyroid adenoma who had taken successful kidney transplantation. The patient was 62 year old man who had a long duration of hemodialysis for 10 years. His hypercalcemic findings were managed medically for 1 year. As the patient's hypercalcemic symptom aggrevated, he was admitted and parathyroid adenoma was diagnosed by a CT scan and parathyroid scan. After excsion of the parathyroid adenoma, his general condition and kidney function improved. In our conclusion, there may be a debate for the timing of subtotal parathyroidectomy in the patient with tertiary hyperparathyroidism after kidney transplantation. But when the patient shows a hypercalcemic profile, the parathyroid scan, CT scan, Neck Ultrasonography must be considered to detect single parathyroid adenoma which is so simple to remove surgically.
Absorption ; Calcitriol ; Calcium ; Humans ; Hyperparathyroidism ; Hyperparathyroidism, Secondary ; Hyperplasia ; Hypocalcemia ; Intestines ; Kidney Transplantation* ; Kidney* ; Middle Aged ; Neck ; Parathyroid Hormone ; Parathyroid Neoplasms* ; Parathyroidectomy ; Renal Dialysis ; Tomography, X-Ray Computed ; Ultrasonography

PURPOSE: The objectives of this study were to define the prognostic factors of papillary microcarcinoma of the thyroid (PMCT), to analyse their histopathologic and epidemiologic characteristics and to investigate the optimal therapeutic management. METHODS: Our series included 254 consecutive patents who were affected by PMCT and who were operated on by the same surgeon between 1985 and 2002 among a total of 3,100 patients who underwent thyroid surgery. All the surgical specimens were examined in the same Department of Pathology. The prognostic factors were evaluated by uniand multivariate statistical analyses. RESULTS: The histopathologic characteristics such as vascular extension, infiltration into the adjacent parenchyma, a larger primary tumor (size ≥5 mm) or tumor in the thyroid capsule were all indicative of a poor prognosis. For the patents with poor prognostic factors and who were treated by partial thyroidectomy alone, the prevalence of recurrent disease was higher than that for the patients who were with treated by total thyroidectomy and 131 iodine administration. CONCLUSION: According to the prognostic factors, different therapeutic modalities could be proposed to treat patients with pillary thyroid microcarcinoma. It is reasonable to perform total thyroidectomy and 131 iodine therapy for patients with PMCT and who have high risk factors.
Humans ; Iodine ; Pathology ; Prevalence ; Prognosis ; Risk Factors ; Thyroid Gland* ; Thyroidectomy

BACKGROUND: Although the pro-convulsant or anticonvulsant properties of propofol remain a matter of controversy, it is evident that propofol can produce involuntary movement. Such movement is a relatively common side effect, especially in children, and may be dose-related or injection rate-related. The goal of this study was to evaluate the effect of injection rate upon involuntary movement during propofol induction in children. METHODS: Children (age 3-14 yr) undergoing elective Eye and ENT surgery were randomly allocated to one of 4 groups based on the propofol injection rate (A, manual/15 s; B, 360 ml/hr; C, 200 ml/hr, D, 100 ml/hr) using a manual injection method and syringe pumps. No premedication was used. The induction dosage of propofol was 3 mg/kg in all groups. Fentanyl 1mcg/kg and 1% lidocaine 1-2ml were given I.V. before propofol. Involuntary movement was graded 0-2 on severity. The infused dose of propofol at movement was measured. Movement due to pain or mask fitting was not regarded as an involuntary movement. All results were analyzed using the Chi-Square Test and ANOVA. RESULTS: 595 children were studied. Age, gender, and weight were similar in the 4 groups. Involuntary movements were apparent in 179 (30.1%) of the 595 subjects. Movements were significantly less in group A (12.4%) and B (16.4%) compared to group C (46.6%) and D (45.3%). The grades of movement were not different among the 4 groups. The durations of movement in group A and B were significantly short compared to group C and D. The infused dose of propofol (mg/kg) at movement was higher in group C (2.65+/-0.62) than in A (1.99+/-0.62) and B (2.43+/-0.78). There were no significant hemodynamic and SPO2 changes during and after the propofol injection. CONCLUSIONS: We concluded that slow injection may increase the incidence of involuntary movement during propofol induction in children. Since the bolus injection rates are usually slow in most syringe pumps, manual injection for 10 15 s may be a better choice for smoother induction, as it requires fewer interventions to prevent venous catheter displacement in children.
Catheters ; Child* ; Dyskinesias* ; Fentanyl ; Hemodynamics ; Humans ; Incidence ; Lidocaine ; Masks ; Premedication ; Propofol* ; Syringes

PURPOSE: Although thyroid diseases have a high prevalence, controversy over their diagnosis and treatment continues owing to the difficulties in the differentiation between malignant and benign states in the thyroid nodule and in the decision of medical treatment, surgical intervention, and surgical method and extent. METHODS: We researched the clinical features, prevalence of malignant thyroid cancer and difference of prognosis between two groups of patients: group 1 was treated primarily with TSH suppression management or observation and then surgery, while group 2 underwent immediate surgery. In addition, we studied the proper management and diagnostic method for patients with thyroid nodule. RESULTS: The research comparison between group 1 (301 cases) and group 2 (920 cases) produced the following results. There was a relatively high prevalence of malignancy in group 1 managed improper TSH suppression as compared with group 2, postoperatively (38.9: 18.7%). AMES classification showed a high ratio of the high risk group in group 1 (papillary cancer, 47.6: 28.4%; follicular cancer, 41.7: 18.4%) and a prolonged treatment period in group 1 (64.6: 20.8 days). In addition, group 1 required a more aggressive operation method (bilateral thyroidectomy, 49.2: 37.2%). CONCLUSION: These data confirm that the accurate and early diagnosis of patients with thyroid nodule is essential to decide the management method and the patient prognosis, and emphasize the importance of the decision for proper treatment course. We therefore concluded that to decide the management course for patients with thyroid nodule, the selection of high risk group patients through routine examination and fine needle aspiration is very important. Furthermore, for patients with a very hard nodule, consideration should be given to enlarged nodule, past history of irradiation, status of attachment on the local tissue, and cervical lymph node enlargement. Finally, after the selection of the patient group, proper surgical management should be considered primarily.
Biopsy, Fine-Needle ; Classification ; Diagnosis ; Early Diagnosis ; Humans ; Lymph Nodes ; Prevalence ; Prognosis ; Thyroid Diseases ; Thyroid Neoplasms ; Thyroid Nodule* ; Thyroidectomy

PURPOSE: This study evaluated the association of the BRAF(V600E) mutation with known prognostic factors and ultrasonographic characteristics in cases of papillary thyroid carcinoma. METHODS: Subjects included 169 patients who received thyroidectomy at Wonju Christian Hospital under the diagnosis of papillary thyroid cancer from February 2010 to October 2011. RESULTS: Of the total patients who received thyroidectomy, there were 128 cases (75,7%) of BRAF(V600E) mutation. Neither age nor sex were associated with the BRAF(V600E) mutation. Tumor size, shape, margin, extrathyroidal extension, central node metastasis and lateral node metastasis were found not to be associated with the BRAF(V600E) mutation. Tumor calcification, echogenicity and vascularity were also not associated with the mutation. CONCLUSION: As debate remains about the association between the BRAF(V600E) mutation and clincopathologic factors and ultrasonographic characteristics in cases of papillary thyroid carcinoma, further study is needed.
Diagnosis ; Gangwon-do ; Humans ; Neoplasm Metastasis ; Thyroid Gland* ; Thyroid Neoplasms* ; Thyroidectomy

5-fluorouracil (5-FU) is a chemotherapeutic agent commonly used for treatment of solid tumors, including colorectal cancer. However, chemoresistance against 5-fluorouracil (5-FU) often limits its success for chemotherapy and, therefore, finding out appropriate adjuvant(s) that might overcome chemoresistance against 5-FU bears a significant importance. In the present study, we have found that α-mangostin can sensitize 5-FU-resistant SNUC5/5-FUR colon cancer cells to apoptosis. Exposure of α-mangostin induced significant DNA damages and increased the intracellular 8-hydroxyguanosine (8-OH-G) and 4-hydroxynonenal (4-HNE) levels in SNUC5 and SNUC5/5-FUR cells. Western blot analysis illustrated that α-mangostin-induced apoptosis was mediated by the activation of the extrinsic and intrinsic pathways in SNUC5/5-FUR cells. In particular, we observed that Fas receptor (FasR) level was lower in SNUC5/5-FUR cells, compared with SNUC5 cells and that silencing FasR attenuated α-mangostin-mediated apoptosis in SNUC5/5-FUR cells. Together, our study illustrates that α-mangostin might be an efficient apoptosis sensitizer that can overcome chemoresistance against 5-FU by activating apoptosis pathway.
Antigens, CD95 ; Apoptosis* ; Blotting, Western ; Colon* ; Colonic Neoplasms* ; Colorectal Neoplasms ; DNA Damage ; Drug Therapy ; Fluorouracil