Suppression of apoptosis is one of the hallmarks of carcinogenesis. Tumor cells endure apoptotic pressure by overexpressing several antiapoptotic proteins, and FLICE inhibitory protein (FLIP) is one of the important antiapoptotic proteins that have been shown to be overexpressed in various primary tumor cells. FLIP has two death-effector domains in tandem, mimicking the prodomain of procaspase-8. It is recruited to Fadd in death-inducing signaling complex, thereby preventing the activation of procaspase-8. To date, three isoforms of human cytosolic FLIP (c-FLIP) and six viral homologs (v-FLIP) have been identified. Recently, the crystal structure of v-FLIP MC159 was determined for the first time as an atomic-detail FLIP structure, which revealed that two death effector domains are packed tightly against each other mainly through conserved hydrophobic interactions. The overexpression of c-FLIP in tumor cells has been shown to be the determinant of the tumor's resistance to death ligands such as FasL and TRAIL. It has also been shown that the down-regulation of c-FLIP results in sensitizing resistant tumor cells. Therefore, the agents directly targeting c-FLIP at mRNA and protein levels are expected to be developed in near future and tested for the potential as a new class of anti-cancer drugs.
Apoptosis ; CASP8 and FADD-Like Apoptosis Regulating Protein/antagonists & inhibitors/chemistry/*metabolism ; Caspases/antagonists & inhibitors/metabolism ; Humans ; Neoplasms/*metabolism/pathology/*therapy ; Signal Transduction

No abstract available.
Cheek* ; Ultrasonography*

PURPOSE: Multiple Endocrine Neoplasia Type 2A (MEN 2A) is an autosomal dominant disease characterized by development of the medullary thyroid cancer, adrenal pheochromocytoma and parathyroid hyperplasia. Gennline mutations of RET gene, which cause a susceptibility to MEN 2A syndrome, have been reported in MEN 2A families. The identification of germline mutation in family members with hereditary tumor syndrome makes the presymptomatic diagnosis possible. However, there are only a few reports on the germline mutation of RET gene in Korean patients with MEN 2A. This study was performed to investigate the germline mutation of RET gene in a Korean MEN 2A family. MATERIALS AND METHODS: Blood samples were taken from family members of a MEN 2A family. Mutational status was investigated using single strand conformation polymorphism (SSCP) method, and following direct sequencing. Basal level of calcitonin was measured, and calcium provocation test was done when the result of basal level of calcitonin was equivocal. RESULTS: A missense type germline mutation of RET gene was identified at codon 634 (TGC->TGG) in eight patients from the family. All patients with the germline mutation of RET gene showed elevation of calcitonin level either in basal test or in calcitonin provocation test. CONCLUSION: We identified a germline mutation of RET gene in a family with MEN 2A, and it would make the accurate presymptomatic diagnosis possible.
Calcitonin ; Calcium ; Codon ; Diagnosis ; Germ-Line Mutation ; Humans ; Hyperplasia ; Multiple Endocrine Neoplasia Type 2a* ; Multiple Endocrine Neoplasia* ; Pheochromocytoma ; Thyroid Neoplasms

Torsade de pointes (TdP) is a form of polymorphic ventricular tachycardia that is associated with prolongation of the QT interval. Although it occurs in many clinical settings, torsade de pointes is most commonly caused by drugs. The second generation antihistamines, including terfenadine and astemizole, have little sedation or other adverse effects on the CNS. They have been used widely to treat various allergic diseases, but it has been reported that overdoses or combinations with antifungal agents or macrolide antibiotics may lead to TdP. We report a case of TdP that occured during com-bination therapy of terfenadine and ketoconazole.
Anti-Bacterial Agents ; Antifungal Agents ; Astemizole ; Histamine H1 Antagonists, Non-Sedating ; Ketoconazole* ; Tachycardia, Ventricular ; Terfenadine* ; Torsades de Pointes*

PURPOSE: To evaluate the effects of transient prone position on vault and anterior chamber angle parameters in ICL implanted patients. METHODS: 40 eyes of 20 ICL implanted patients with at least 1 month of follow-up were included in the present study. The central ICL vault and anterior chamber parameters including angle opening distance at 500 (AOD500) were measured with the Visante anterior segment optical coherence tomography (OCT) (Carl Zeiss, Dublin, CA) in both the sitting and prone positions by tilting the OCT 90 degrees in the vertical axis and having the patient fixate downwards towards the floor. RESULTS: The mean central vault was 0.55 +/- 0.21 mm (SD) and 0.59 +/- 0.21 mm (SD) in the sitting and prone positions, respectively (p < 0.0001). The nasal and temporal AOD500 were 0.26 +/- 0.11 mm and 0.28 +/- 0.08 mm, respectively in the sitting position, which decreased to 0.24 +/- 0.10 mm and 0.26 +/- 0.08 mm in the prone position, however, both were not statistically significant (p = 0.08, p = 0.09). AOD500 was inversely correlated with vault (r = -0.47; p = 0.0024). There were no significant correlations between increase of vault and anterior chamber depth or white to white nor ICL vault. CONCLUSIONS: Transient prone positioning of ICL implanted patients can induce a significant increase in ICL vault.
Anterior Chamber ; Axis, Cervical Vertebra ; Eye ; Follow-Up Studies ; Humans ; Phakic Intraocular Lenses ; Prone Position ; Tomography, Optical Coherence

No abstract available.

This study was conducted to assess the risk of breast cancer by menstrual, reproductive, and lactational factors in Korean women. A total of 210 women living in Seoul aged 30 to 60 with a first diagnosis of breast cancer from 2 teaching hospitals in Seoul, and 249 control subjects, randomly selected from the female pensioners of Korean Medical Insurance Company living in Seoul were interviewed. There was a increasing risk with the decrease of age at menarche, and the adjusted odds ratio(OR) of early menarche(age 14 years or less compared with over 17 years) was 1.61(95% Confidence Interval [CI]: 0.95-2.74). The longer the interval between menarche and regular menstruation, the less risk of breast cancer(OR=0.31, 95% CI: 0.16-0.60). The effect of these menarche factors were more prominent among premenopausal women. The adjusted OR for the second category(25-29 years old) of the age at first pregnancy and the age at the first full term pregnancy, compared to the reference category( 24 years old), were 0.52(95% CI: 0.30-0.92) and 0.58(95% CI: 0.32-1.06), respectively. The late age at the last full term pregnancy had significant protective effect (OR=0.29, 95% CI: 0.10-0.88), and the age itself was important rather than the interval between the first and last full term pregnancy. Factors related to breast feeding(BF) had protective effect consistently. Among parous women, in referent to no BF, women with 1 year of BF had adjusted OR of 0.34(95% CI: 0.17-0.68), while those with 1-3 years of BF had 0.35(95% CI: 0.18-0.67), 3-5 years had 0.29(95% CI: 0.12-0.74), and more than 5 years had 0.06(95% CI: 0.02-0.17). Age at menarche with regular cycle have stronger effect on especially pre-menopausal breast cancer among Korean women. Recent increase in breast cancer incidence in Korea would be explained by delayed age at first pregnancy or delivery, earlier age at menarche and last delivery, and decrease in brest feeding.
Breast Feeding ; Breast Neoplasms* ; Breast* ; Case-Control Studies* ; Diagnosis ; Female ; Hospitals, Teaching ; Humans ; Incidence ; Insurance ; Korea* ; Menarche ; Menstruation ; Pensions ; Pregnancy ; Seoul

PURPOSE: Total parenteral nutrition (TPN) has been widely used in malnourished, critically ill or surgical patients since the 1970's. However, short-term application of TPN after elective gastrointestinal surgery has rarely been studied. The purpose of this study was to evaluate the safety and efficacy of postoperative TPN in patients after gastrectomy. METHODS: Forty seven patients who underwent elective gastrectomy from October 2005 to December 2005 were enrolled in this trial. Twenty two patients (TPN group) received multivitamin-containing TPN (Fulcaliq(R), Terumo, Japan) and 25 patients (control group) received the usual 10% dextrose solution for five days after surgery. Vital signs, body weight and nutritional support-related complications were evaluated on a daily basis. In addition, CBC, LFT, electrolyte, and trace elements were measured four times (preoperatively, POD1, POD 3 and POD 6). RESULTS: Nutritional support-related complications did not develop in the groups studied. Body weight and serum albumin levels were not different in comparisons between the two groups. However, in the TPN group, the total protein level on POD 6 had a tendency to be higher than in the control group. On POD 6, AST and ALT levels were significantly higher in the TPN group, but the total bilirubin and cholesterol levels were significantly higher in the control group. CONCLUSION: Multivitamin-containing TPN appears to be safe and effective for patients, in the short term, after gastric surgery.
Bilirubin ; Body Weight ; Cholesterol ; Critical Illness ; Gastrectomy* ; Glucose ; Humans ; Parenteral Nutrition, Total* ; Serum Albumin ; Trace Elements ; Vital Signs

PURPOSE: Recurrent gastric cancer has a very poor prognosis due to its diagnostic difficulties, variant recurrence patterns and no effective treatment modalities. In this study, we retrospectively analyzed treatment results of the recurrent gastric cancer. MATERIALS AND METHODS: We reviewed 1,286 patients who had taken radical surgery for primary gastric cancers and were diagnosed to have recurrences of their primary diseases. According to the medical records, we retrospectively analyzed the gross features, histologic types and TNM stages of primary gastric cancers. The symptoms, diagnostic modalities, durations, recurrence patterns, treatments and prognoses of recurrent diseases were also reviewed. RESULTS: The median survival time of total recurrent gastric cancer patients was 6.8 months. Ldegrees Co-regional and distant recurrences had better results than peritoneal and mixed recurrences (p<0.01). Curative resection of recurrent cancer was done in only 1.6% (18 cases in ldegrees Co-regional recurrence and 4 cases in distant recurrence), but in these cases, significant survival gain (5 year survival rate: 30.5%) was found compared to other treatment modalities (p<0.01). In multivariate analysis, the type of first operation, TNM stage, duration till recurrence, recurrence pattern, and treatment modality of recurrence were meaningful for the survival time after recurrence. CONCLUSION: In selective cases, recurrent gastric cancer had an effective treatment modality and was expected to have prolonged survival. Therefore, a careful diagnosis and an active treatment of the patients who have the recurrent gastric cancers should be done, especially for the ldegrees Co-regional recurrence.
Diagnosis ; Humans ; Medical Records ; Multivariate Analysis ; Prognosis ; Recurrence ; Retrospective Studies* ; Stomach Neoplasms* ; Survival Rate

PURPOSE: The purpose of this retrospective study is to evaluate the prognostic significance of lymph node dissection in gastric cancer surgery. MATERIALS AND METHODS: We analysed the survival curves of 1661 cases of gastric cancer patients who received gastric resection from 1987 to 1991, in whom the number of dissected lymph nodes is more than 9 (to minimize stage migration). We used modified TNM system with numeric classification. RESULT: The average number of resected lymph nodes of the study group was 31.5 and there was no significant difference in the average number of resected lymph nodes during the study period. In stage I, IIa, IIb and IV, there was no significant difference in survival curves according to the number of resected lymph nodes (25, 35 or 45). However, in stage IIIa, the 5-year survival rate (5YSR) was better in the patients (n=171) of more than 25 lymph nodes than in the patiens (n=104) of less than 26 resected lymph nodes (64.1% vs. 59.9%, p=0.031). In stage IIIb, 5YSR was better in the patients (n=206) of more than 35 lymph nodes than in the patients (n=307) of less than 36 lymph nodes (33.2% vs. 18.3%, p=0.029). In multivariate analysis, number of dissected lymph node was an independent prognostic factor. CONCLUSION: Survival benefit of extended lymph node dissection in the gastric cancer surgery is limited in the stage IIIa and IIIb and the recommended number of dissection is more than 35. This study also suggests a positive correlation between tumor stage and required quantity of lymph node dissection for better survival (>25 for stage IIIa and >35 for stage IIIb).
Classification ; Humans ; Lymph Node Excision* ; Lymph Nodes* ; Multivariate Analysis ; Prognosis ; Retrospective Studies ; Stomach Neoplasms* ; Survival Rate