PURPOSE: There are numerous prostate cancer-related genes that involve in carcinogenesis and tumor progression. Among the genes, DNA mismatch repair genes recognize and repair misincorporated nucleotides during DNA replication. In this analysis, we evaluated the association of hMSH2 which is one of the mismatch repair genes, with risk of aggressive prostate cancer and prostate cancer recurrence. MATERIALS AND METHODS: Immunohistochemistry was performed in 46 patients who diagnosed prostate cancer and underwent radical prostatectomy between January 2006 and December 2012 at Kyung Hee University Hospital at Gangdong. We evaluated an association between the degree of hMSH2 immunohistochemical staining and various clinical variables including prostate-specific antigen (PSA), Gleason score, pathological stage, and biochemical recurrence. The intensity of immunostaining for hMSH2 was divided into 2 groups: low expression group (immunostaining score < 2) and high expression group (immunostaining score ≥2). RESULTS: Although seminal vesicle invasion was marginally associated with the degree of hMSH2 immunohistochemical staining, PSA, Gleason score, lymph node metastasis, presence of lymphatic, perineural, vascular invasion, and extracapsular extension were not associated with the degree of hMSH2 immunohistochemical staining. Furthermore, the association of biochemical recurrence free survival with hMSH2 expression was not statistically significant. CONCLUSIONS: The hMSH2 expression was marginally associated with risk of aggressive prostate cancer such as seminal vesicle invasion. Further evaluation with a larger number of cases is needed to verify these results.
Base Pair Mismatch ; Carcinogenesis ; DNA Mismatch Repair ; DNA Repair ; DNA Replication ; Gene Expression ; Humans ; Immunohistochemistry ; Lymph Nodes ; Neoplasm Grading ; Neoplasm Metastasis ; Nucleotides ; Prostate ; Prostate-Specific Antigen ; Prostatectomy ; Prostatic Neoplasms ; Recurrence ; Seminal Vesicles

PURPOSE: We compared renal function outcomes in patients undergoing open or laparoscopic radical nephrectomy. MATERIALS AND METHODS: Seventy-one patients undergoing open or laparoscopic radical nephrectomy for kidney disease with a normal contralateral kidney were identified between January 2004 and December 2007. Renal function was calculated by using the Cockcroft-Gault formula. Serial renal functions were checked from the day before surgery to 1 year after surgery. Exclusion criteria were preexisting renal insufficiency, urinary stone disease, and pancreatic and liver disorders. RESULTS: Forty-one and 30 patients were treated with open radical nephrectomy or laparoscopic radical nephrectomy, respectively. The operative time and urine output of patients who underwent open and laparoscopic radical nephrectomy were 211.7+/-5.8 and 330.8+/-15.6 and 196.4+/-19.6 and 130.7+/-12.1, respectively (p=0.001, p=0.013). The glomerular filtration rates of patients who underwent open or laparoscopic radical nephrectomy were insignificant from baseline to postoperative day 360 (p>0.05). CONCLUSIONS: No significant differences in renal function were detected in the groups of patients who underwent open or laparoscopic radical nephrectomy from baseline to long-term follow-up.
Follow-Up Studies ; Glomerular Filtration Rate ; Humans ; Kidney ; Kidney Diseases ; Laparoscopy ; Liver ; Nephrectomy ; Operative Time ; Renal Insufficiency ; Urinary Calculi

Pulmonary Embolism can develop in variable conditions, and presents with nonspecific symptoms and signs. If diagnosis is delayed, it can be resulted in catastrophic results. Therefore, early diagnosis and adequate treatment is crucial in Pulmonary Embolism. Lung Perfusion Scan is useful screening test. Negative result can exclude pulmonary embolism, But, perfusion defects don't always mean pulmonary embolism. To find the better methods of interpretation of king perfusion scan and To evaluate the clinical course and outcomes of the patients, in whom pulmonary embolism was suspected by lung perfusion scan, we reviewed the clinical records of 49 cases suspected by lung perfusion scan at Seoul National University Hospital during the period of January, 1995 to July, 1996. The results are as follows. First impression of cases in which PE was present at time of admission were pulmonary embolism (63%), heart diseases (26%), and pneumonia (11%) in orders. Underlying diseases of cases in which PE developed during admission were malignancy (36.5%), 10-I (22.7%), sepsis (13.7%), and SLE (9.1%) in orders. The predisposing factors were operation (20%), cancer (16%), immobility (16%), connective tissue disease (16%), heart dis. (10%), old age (10%), and preg/pelvic dis. (8%) The results of lung perfusion scan were HPPE 40cases(26.8%), IPPE 21 cases(14.1%), LPPE 88 cases(59.l %) and cases(%) of treatment in these cases were HPPE 34 cases(85%), IPPE 9 cases(42,9%), IPPE 0 case(0.0%). Treatments were heparin and warfarin (69.5%), heparin alone (8.2%), warfarin alone (2.0%), embolectomy(4.1%), thrombolytics (20%), IVC filter (2.0%), and no treatment (12.2%) In 34 cases (694%), follow up could be done, and 5 cases were recurred (10.2%). The causes of recurrence was incomplete anticoagulant therapy (3 cases) 2rnd recurrence of predisposing factor (2 cases). Expired case due to pulmonary embolism was one who was expired just before trial of thrombolytie therapy. CONCLUSION: Efforts should be made to shorten the interval from onset of Sx to Dx, ie, high index of suspision.
Causality ; Connective Tissue Diseases ; Diagnosis ; Early Diagnosis ; Follow-Up Studies ; Heart ; Heart Diseases ; Heparin ; Humans ; Lung* ; Mass Screening ; Perfusion* ; Pneumonia ; Pulmonary Embolism* ; Recurrence ; Seoul ; Sepsis ; Warfarin

A laparoscopicradical nephrectomy or nephrouretectomy with bladder cuff excision are acceptable treatments for renal or upper urinary tract malignancies, respectively. However, laparoscopic surgery in dialysis patients is associated with high morbidity due to the long operation time and intraabdominal insufflation of carbon dioxide. Herein, two cases of a renal cell carcinoma and an urothelial carcinoma in dialysis patients are reported.
Carbon Dioxide ; Carcinoma, Renal Cell ; Dialysis* ; Humans ; Insufflation ; Kidney Failure, Chronic ; Laparoscopy ; Nephrectomy* ; Urinary Bladder ; Urinary Tract

BACKGROUND: Endotoxin, the component of outermembrane of gram negative organism, plays an important role in the initiation and amplification of inflammatory reaction by its effects on inflammatory cells. Until recently, there have been continuing efforts to delinate the mechanisms of the signal trasduction pathway of endotoxin stimuli on inflammatory cells. By uncovering the mechanisms of signal transduction pathway of endotoxin stimuli, we can expect to have tools to control the excessive inflammatory responses which sometimes may be fatal to the involved host. It was generally accepted that endotoxin exerts its inflammatory effects through inflammatory cytokines that are produced by endotoxin-stimulated inflammatory cells and there were some reports on the importance of protein kinase C and protein tyrosine kinase activation in the production of inflammatory cytokines by endotoxin. So we evaluated the effect of pretreatment of protein kinase C inhibitors (H7, Staurosporin) and protein tyrosine kinase inhibitors(Herbimycin, Genistein) on the endotoxin-stimulated cytokines(IL-8 & TNF-alpha) mRNA expression. METHOD: Peripheral blood monocytes were isolated from healthy volunteers by Ficoll-Hypaque density gradient method and purified by adhesion to 60mm Petri dishes. Endotoxin(LPS 100ng/ml) was added to each dishes except one control dish, and each endotoxin-stimulated dishes was preincubated with H7, Staurosporin(protein kinase C inhibitor), Herbimycin or Genistein(protein tyrosine kinase inhibitor) respectively except one dish. Four hours later the endotoxin stimulation, total RNA was extracted and Northern blot analysis for IL-8 mRNA and TNF-alpha mRNA was done. RESULT: Endotoxin stimulation increased the expression of IL-8 mRNA and TNF-alpha mRNA expression in human peripheral blood monocyte as expected and the stimulatory effect of endotoxin on TNF-alpha mRNA expression was inhibited by protein kinase C inhibitors(H7, Staurosporin) and protein tyrosine kinase inhibitors (Herbimycin, Genistein). The inhibitory effect of each drugs was increased with increasing concentration. The stimulatory effect of endotoxin on IL-8 mRNA was also inhibited by H7 and protein tyrosine kinase inhibitors (Herbimycin, Genistein) dose-dependently but not by Staurosporin. CONCLUSION: Protein kinase C and protein tyrosine kinase are involved in the endotoxin induced signal transduction pathway in human peripheral blood monocyte.
Blotting, Northern ; Cytokines ; Healthy Volunteers ; Humans ; Interleukin-8 ; Monocytes* ; Phosphotransferases ; Protein Kinase C* ; Protein Kinases* ; Protein-Tyrosine Kinases* ; RNA ; RNA, Messenger ; Signal Transduction* ; Tumor Necrosis Factor-alpha

Most submucosal tumors of the stomach are of mesenchymal origin. According to the advances of immunohistochemical staining and electron microscopy, spindle cell tumors which were considered as leiomyoma or leiomyosarcoma appeared to be heterogeneous group; from smooth muscle cell, neural, bidirectionally differentiated cells of smooth muscle cell and neural cell, or immature mesenchymal cell. Therefore, the gastrointestinal mesenchymal tumors are referred to as gastrointestinal stromal tumors. The biologic behavior of gastrointestinal stromal tumors is difficult to predict, except benign leiomyoma and schwannoma. Recently, we experienced a case of 5 cm-diameter submucosal tumor with a central ulcer on body of the stomach, endoscopically. The tumor was a well cir- cumscribed submucosal mass located in the midbody along greater curvature. Micros- copically, the tumor was composed of fasciculating bundles of spindle cells with benign nuclear atypia and peripheral lymphoid cell cuffing. The tumor cells revealed a diffuse strong immunoreactivity to S-100 protein and vimentin, but were negative to desmin and smooth muscle actin. Ultrastructurally, many tumor cells showed a number of thin elon-gated and interdigitating dendritic-like cell processes, distinct uniform basal laminae, frequent cellular attachments and microfilaments. The findings supported the schwannian nature of the tumor.
Actin Cytoskeleton ; Actins ; Basement Membrane ; Desmin ; Gastrointestinal Stromal Tumors ; Leiomyoma ; Leiomyosarcoma ; Lymphocytes ; Microscopy, Electron ; Muscle, Smooth ; Myocytes, Smooth Muscle ; Neurilemmoma* ; S100 Proteins ; Stomach ; Ulcer ; Vimentin

PURPOSE: The purpose of this study is to find out clinical and radiological outcomes in 70 patients of both calcaneal fracture. MATERIALS AND METHODS: From March 1993 to March 2011, 70 patients underwent non-operative management or operative management at our hospital. Conservative management was performed in 15 cases of undisplaced fracture (Group A). Operative management was performed in 125 cases including 32 cases of undisplaced fracture (Group B), 60 cases of joint depression type fracture (Group C), 33 cases of tongue type fracture (Group D). Results were evaluated by VAS score, AOFAS score, circle draw test, Bohler angle (BA), Gissane angle, width & height of calcaneus. RESULTS: VAS scores were 2.0 in group A, 2.0 in group B, 2.2 in group C, 2.7 in group D. AOFAS scores were 90.4 in group A, 91.9 in group B, 72.2 in group C, 79.2 in group D. Circle draw tests were 8.4 cm in group A, 10.1 cm in group B, 7.6 cm in group C, 7.9 cm in group D. Bohler angles (BA) and Gissane angles were 19.1degrees, 96.7degrees in group A, 21.8degrees, 119.1degrees in group B, 26.3degrees, 121.2degrees in group C, 19.7degrees, 119.7degrees in group D. Calcaneal widths and heights were 39.5 mm, 31.6 mm in group A, 32.7 mm, 37.0 mm in group B, 34.4 mm, 39.2 mm in group C, 35.2 mm, 38.7 mm in group D. CONCLUSION: The main cause of bilateral calcaneal fracture is an injury from a fall, and the cases were more frequently occurred in men than women. Also the fracture in the right side tend to occur more severely compared to the left side. The surgical treatment shows better results than conservative treatment in bilateral calcaneal fracture.
Calcaneus ; Depression ; Female ; Humans ; Joints ; Male ; Tongue

Cytomegalovirus colitis, invasive cytomegalovirus infection of colon, is an important opportunistic infection in immunosuppressed individuals. The clinical symptoms are abdominal pain, diarrhea, colionic hemorrhage and perforation. The endoscopic appearance show three characteristic features, 1) Focal or diffuse inflammatory changes: erythema, edema and erosion 2) Submucosal hemorrhagic spots 3) Clean-based, well demarcated ulcers(0.5-2 cm) We report a case of cytomegalovirus colitis in 41-year-old male with massive hematochezia, which confirmed by histopathologic findings in autopsy.
Abdominal Pain ; Adult ; Autopsy ; Colitis* ; Colon ; Cytomegalovirus Infections ; Cytomegalovirus* ; Diarrhea ; Edema ; Erythema ; Gastrointestinal Hemorrhage ; Hemorrhage ; Humans ; Male ; Opportunistic Infections

Hypoglossal nerve palsy (HNP) is an uncommon neurological abnormality that can provoke characteristic clinical signs, including unilateral atrophy of the tongue musculature. We present the case of a healthy 11-year-old Korean male who was admitted to the outpatient department of our institution with acute onset dysarthria, tongue fasciculations, and right-sided tongue weakness upon awakening. His evaluation included a virology work-up, neck magnetic resonance imaging (MRI), brain MRI, and otorhinolaryngological physical examination; all tests were normal and showed no evidence of inflammation. Fifteen days after the onset of symptoms, the patient recovered completely. Herein, we report a case of idiopathic isolated HNP in a Korean male.
Atrophy ; Brain ; Child ; Dysarthria ; Fasciculation ; Humans ; Hypoglossal Nerve ; Hypoglossal Nerve Diseases ; Inflammation ; Magnetic Resonance Imaging ; Male ; Neck ; Outpatients ; Paralysis ; Tongue

PURPOSE: This study aimed to evaluate whether a shorter time from the arrival at a hospital to delivery is related to the occurrence of cerebral palsy in premature infants of less than 34 weeks of gestational age. METHODS: We studied 142 newborns of less than 34 weeks of gestational age. The time from the arrival at the hospital to delivery was measured. The correlation between the time required for delivery and the occurrence of cerebral palsy was elucidated by diagnosing cerebral palsy in neonates using the Korean Infant Development Screening Test and neurological examination. RESULTS: Preliminary result suggested that a shorter time from hospital arrival to delivery was related to a lower development score for gross motor activity and to a higher frequency of cerebral palsy occurrence. Moreover, it was responsible for a tendency of obtaining lower Apgar scores at 1 and 5 minutes. The shorter delivery time was associated with a higher probability of respiratory distress syndrome (RDS) occurrence when the length of delivery time was less than 6 hours and there was a higher probability of a shorter gestation period. However, the multifactor analysis revealed that there was little impact of delivery time on the occurrence of cerebral palsy. Conclusions: The length of hospital arrival time to delivery did not significantly influence the occurrence of cerebral palsy in premature infants of less than 34 weeks of gestational age.
Cerebral Palsy ; Child ; Child Development ; Gestational Age ; Humans ; Infant, Newborn ; Infant, Premature ; Mass Screening ; Motor Activity ; Neurologic Examination ; Pregnancy