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

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*

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*

Necrotizing sarcoid granulomatosis (NSG), now referred to as “sarcoidosis with NSG pattern,” is an uncommon variant of sarcoidosis. NSG is characterized by a trio of features: sarcoid granulomas, vasculitis, and extensive areas of necrosis. Symptoms can include cough, fever, chest pain, and dyspnea, typically presenting as either solitary or multiple lung nodules or masses. In this report, we describe a case of NSG accompanied by a persistent low-grade fever. Unlike the dominant presentation of NSG with single or multiple nodules, our case demonstrated diffuse micronodules with combined perilymphatic and random distribution on CT.Histological examination revealed widespread necrotizing granulomas surrounded by anthracotic pigmentation, alongside necrosis and vasculitis, diverging from the classic presentation of sarcoidosis. The diagnosis of NSG was established through a multidisciplinary discussion. The patient was administered oral prednisolone that led to noticeable clinical and radiological improvement within three months.

Necrotizing sarcoid granulomatosis (NSG), now referred to as “sarcoidosis with NSG pattern,” is an uncommon variant of sarcoidosis. NSG is characterized by a trio of features: sarcoid granulomas, vasculitis, and extensive areas of necrosis. Symptoms can include cough, fever, chest pain, and dyspnea, typically presenting as either solitary or multiple lung nodules or masses. In this report, we describe a case of NSG accompanied by a persistent low-grade fever. Unlike the dominant presentation of NSG with single or multiple nodules, our case demonstrated diffuse micronodules with combined perilymphatic and random distribution on CT.Histological examination revealed widespread necrotizing granulomas surrounded by anthracotic pigmentation, alongside necrosis and vasculitis, diverging from the classic presentation of sarcoidosis. The diagnosis of NSG was established through a multidisciplinary discussion. The patient was administered oral prednisolone that led to noticeable clinical and radiological improvement within three months.

Necrotizing sarcoid granulomatosis (NSG), now referred to as “sarcoidosis with NSG pattern,” is an uncommon variant of sarcoidosis. NSG is characterized by a trio of features: sarcoid granulomas, vasculitis, and extensive areas of necrosis. Symptoms can include cough, fever, chest pain, and dyspnea, typically presenting as either solitary or multiple lung nodules or masses. In this report, we describe a case of NSG accompanied by a persistent low-grade fever. Unlike the dominant presentation of NSG with single or multiple nodules, our case demonstrated diffuse micronodules with combined perilymphatic and random distribution on CT.Histological examination revealed widespread necrotizing granulomas surrounded by anthracotic pigmentation, alongside necrosis and vasculitis, diverging from the classic presentation of sarcoidosis. The diagnosis of NSG was established through a multidisciplinary discussion. The patient was administered oral prednisolone that led to noticeable clinical and radiological improvement within three months.

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

A rare case of poorly differentiated thyroid carcinoma (PDTC) with gross intraluminal invasion to the internal jugular vein whose clinical manifestation was multiple lung metastases is described. A 66-year-old man was referred to the outpatient clinic of the Department of Internal Medicine, hemato-oncology subdivision for multiple lung nodules found by his regular health check-up. These lung nodules showed variable sizes with irregular shapes, and typical distributions throughout the parenchyma, which were consistent with metastatic nodules. Ultrasonography revealed a 4.5 cm sized hypoechoic mass with irregular shape in his left thyroid lobe and a huge thrombus in the left internal jugular vein. PDTCs associated with gross intraluminal invasion to the great cervical vein and multiple lung nodules as their first clinical manifestation are extremely rare. We would emphasize the importance of preoperative detailed evaluation of the disseminated disease by ultrasonography in suspected patients.
Aged ; Ambulatory Care Facilities ; Humans ; Internal Medicine ; Jugular Veins* ; Lung* ; Neoplasm Metastasis* ; Thrombosis ; Thyroid Gland ; Thyroid Neoplasms* ; Ultrasonography ; Veins

BACKGROUND: V. parahaemolyticus O3:K6 strains responsible for the increase in the number of cases of diarrhea in Southeast Asia since 1995. We performed serotyping of V. parahaemolyticus isolated from different geographic areas in Korea since 1998. METHODS: A total of 45 V. parahaemolyticus strains were isolated from clinical specimens of pa-tients with diarrhea in different geographic areas of Seoul (Hanyang University Hospital, 16 cases), Incheon (Gachon Medical Center, 27 cases) and Gwangju (Chonnam University Hospital, 2 cases) from 1998 to 2000 in Korea. Serovar O3:K6 of V. parahaemolyticus was determined by slide and tube agglutination tests with specific antisera (Seiken, Japan). RESULTS: The twenty-eight (62%) of 45 samples were positive to specific antisera of V. parahae-molyticus O3:K6. The O3:K6 strains were detected 11/16 (69%) in Seoul, 15/27 (56%) in Incheon, and 2/2 (100%) in Gwangju. V. parahaemolyticus O3:K6 was detected 11/16 (69%) in 1998, 12/18 (67%) in 1999, and 5/11 (45%) in 2000, respectively. CONCLUSIONS: We report the epidemic emergence of V. parahaemolyticus O3:K6 in Korea, since 1998.
Agglutination Tests ; Asia, Southeastern ; Diarrhea ; Gwangju ; Immune Sera ; Incheon ; Korea* ; Seoul ; Serotyping ; Vibrio parahaemolyticus* ; Vibrio*