Tumor-draining lymph node (TDLN) lymphocytes contain immunologically sensitized to tumor but functionally deficient T cells. The 30 kDa protein antigen, a major secreted protein antigen of Mycobacterium tuberculosis, exhibits strong T cell stimulatory effect. In this study, it examined that the feasibility of using M tuberculosis 30 kDa antigen to stimulate tumor-draining lymph node cells for the generation of specific immune effector cells. Freshly isolated TDLN lymphocytes could directly respond to the 30 kDa antigen alone and their proliferative responses were markedly augmented by stimulation with rIL-2. TDLN cells were stimulated with the 30 kDa antigen for various time intervals and examined for the induction of IFN-r and IL-4 mRNA using RT-PCR. The expression of IFN-r mRNA was greatly augmented after 1 wk, whereas IL-4 mRNA is markedly decreased after 1 wk. Cytotoxic T cell activities induced by the 30 kDa antigen was also evaluated. TDLN cells stimulated with the 30 kDa antigen alone were able to generate remarkable cytotoxic response to K562 or Daudi cell lines after 6 days of culture. And their cytotoxic effects were highly augmented by stirnulation with rIL-2. These results suggest that the 30 kDa antigen of M. tuberculosis may selectively activate Thl cells of TDLN lymhocytes and induce the cytotoxic T cell activities. In conclusion, the 30 kDa antigen can be used as a biologic response modifier in tumor immunology.
Allergy and Immunology ; Cell Line ; Interleukin-4 ; Lymph Nodes* ; Lymphocytes* ; Mycobacterium tuberculosis* ; Mycobacterium* ; RNA, Messenger ; T-Lymphocytes ; Th1 Cells* ; Tuberculosis

PURPOSE: The long term results of a pubovaginal sling procedure were assessed in females with stress urinary incontinence (SUI), and the safety and efficacy, between the Cooper's ligament anchoring and the abdominal wall anchoring of the suture material, compared. MATERIALS AND METHODS: Fifteen, and 20, women underwent a pubovaginal sling procedure, with abdominal wall anchoring (group I), or with Cooper's ligament anchoring (group II), respectively. The surgical outcomes, the satisfaction of patients and the complications were assessed by a questionnaire. RESULTS: In groups I and II the mean follow-ups were 58.1 (range 43-71) and 42.5 (range 36-50) months, respectively. Thirteen (86.6%) and 1 (6.7%), and 17 (85.0%) and 2 (10.0%) of the patients in groups I, and II, were cured and improved, respectively. No statistical difference in the self-reported satisfaction scores was shown between the two groups. The duration of the hospital stay and residual urine less than 50ml were significantly lower in group II (p<0.01). No permanent urinary retention or de novo urge incontinence occurred, but the postoperative urgency remained at 50.0% in both groups. CONCLUSIONS: According to our long term follow-up, the pubovaginal sling procedure is a highly effective and safe surgery for SUI, without urge incontinence. The modified technique, of a pubovaginal sling procedure, with anchoring of the fascia at the Cooper's ligament, is an alternative treatment for SUI, with a low complication rate.
Abdominal Wall ; Fascia ; Female ; Follow-Up Studies ; Humans ; Length of Stay ; Ligaments ; Surveys and Questionnaires ; Sutures* ; Urinary Incontinence ; Urinary Incontinence, Urge ; Urinary Retention

PURPOSE: The purpose of this research was to develop and evaluate the effect of a mind map for relief of emotional labor and burnout among nurses in outpatient departments in cancer hospitals. METHODS: We developed a mind map to reduce emotional labor and burnout. A quasi-experimental study was used with a nonequivalent control group pretest-posttest design. Data were collected from December 2012 to April 2013. Participants were 35 nurses working in the outpatient department of a cancer hospital. The experimental group participated in the mind map program biweekly for 10 weeks. Data were analyzed using chi2-test, Mann-Whitney U test, paired t-test, and Wilcoxon sign rank test with the SPSS 21.0 program. RESULTS: The physical burnout and total burnout scores decreased significantly in the intervention group which took the mind map program. CONCLUSION: Findings indicate that the mind map is an effective intervention to reduce burnout in outpatient department nurses.
Cancer Care Facilities* ; Humans ; Outpatients*

A case of extrarenal Wilms' tumor, arising in the prostate, with liver metastasis in a 44-year-old male is reported. A literature review indicated that the incidences of Wilms' tumors arising in the extrarenal region are extremely rare, with only one reported case in the literature. The clinical features, and a review of the disease, are briefly discussed.
Adult* ; Humans ; Incidence ; Liver* ; Male ; Neoplasm Metastasis* ; Prostate ; Wilms Tumor*

BACKGROUND: Recently, the number of thyroid surgery cases has been increasing; consequently, the number of patients who visit plastic surgery departments with a chief complaint of swallowing deformity has also increased. We performed a scar correction technique on post-thyroidectomy swallowing deformity via platysma flap with Z-plasty and obtained satisfactory aesthetic and functional outcomes. METHODS: The authors performed operations upon 18 patients who presented a definitive retraction on the swallowing mechanism as an objective sign of swallowing deformity, or throat or neck discomfort on swallowing mechanism such as sensation of throat traction as a subjective sign after thyoridectomy from January 2009 till June 2012. The scar tissue that adhered to the subcutaneous tissue layer was completely excised. A platysma flap as mobile interference was applied to remove the continuity of the scar adhesion, and additionally, Z-plasty for prevention of midline platysma banding was performed. RESULTS: The follow-up results of the 18 patients indicated that the definitive retraction on the swallowing mechanism was completely removed. Throat or neck discomfort on the swallowing mechanism such as sensation of throat traction also was alleviated in all 18 patients. When preoperative and postoperative Vancouver scar scales were compared to each other, the scale had decreased significantly after surgery (P<0.05). CONCLUSIONS: Our simple surgical method involved the formation of a platysma flap with Z-plasty as mobile interference for the correction of post-thyroidectomy swallowing deformity. This method resulted in aesthetically and functionally satisfying outcomes.
Cicatrix ; Congenital Abnormalities ; Deglutition ; Follow-Up Studies ; Humans ; Neck ; Neck Muscles ; Pharynx ; Sensation ; Subcutaneous Tissue ; Surgery, Plastic ; Thyroid Gland ; Thyroidectomy ; Traction ; Weights and Measures

BACKGROUND/AIMS: Gallbladder carcinoma has been associated with a dismal overall prognosis. Tumorigenesis of gallbladder carcinoma is complex and not completely understood. An association of gallbladder carcinoma with cholelithiasis or an anom alous arrangement of the panceraticobiliary duct suggests that long-term inflammation may modulate tumorigenesis and progression of carcinoma. COX-2 is a rate limiting enzyme of PG synthesis and related to chronic inflammation. Several report suggested the close relationship between and COX-2 and GB cancer. METHODS: We reviewed the clinical records of sixty-two patients with GB cancer who had undergone operation from January, 1990 to December, 1999 at Hanyang University Hospital. COX-2 expression of GB cancer were evaluated with im\munohistochemical staining and expression intensity was graded on a scale of 0-2 RESULTS: There were 62 patients, whose mean age was 52.5 years. The ages ranged from 28 years to 84 years. There were 27 male patients and 35 female patients. Generally, COX-2 expression was found in chronic inflammatory area and its level increased in dysplastic area and mucosal tumor. stromal tumor showed relatively weaker COX-2 expression level. COX-2 expression is related to depth of tumor invasion, lymph node metastasis, stage (TNM, Nevin) in a negative way. CONCLUSION: Early stage of GB cancer shows relatively increased level of COX-2. Its increased level means COX-2 can modulate early stage of GB cancer carcinogenesis. COX- 2 inhibitor, cancer chemopreventive agent in colon cancer, can be regarded as same one in GB cancer.
Carcinogenesis ; Cholelithiasis ; Colonic Neoplasms ; Female ; Gallbladder ; Humans ; Inflammation ; Lymph Nodes ; Male ; Neoplasm Metastasis ; Prognosis

Sarcomatoid carcinoma of the common bile duct (CBD) is an extremely rare malignant neoplasm, which is characterized by the presence of carcinomatous and sarcomatous components. We report a case of sarcomatoid carcinoma arising in the distal CBD. The patient was a 68- year-old woman who presented with abdominal pain. The computed tomography and endoscopic ultrasonography revealed a polypoid mass in the distal CBD. The resected specimen showed a polypoid mass with a narrow stalk in the distal CBD which was confined to the mucosa. The cut surface revealed a gray-whitish solid mass with focal hemorrhage and necrosis. Microscopically, the tumor was composed of carcinomatous and sarcomatous components without any heterologous elements. The sarcomatous area predominently consisted of pleomorphic spindle cells. The carcinomatous component was an adenocarcinoma. On immunohistochemistry, cytokeratin was coexpressed in the carcinomatous and sarcomatous components but vimentin was expressed exclusively in the sarcomatous component. The patient has been doing well for one year postoperatively.
Abdominal Pain ; Adenocarcinoma ; Common Bile Duct* ; Endosonography ; Female ; Hemorrhage ; Humans ; Immunohistochemistry ; Keratins ; Mucous Membrane ; Necrosis ; Vimentin

Brugada syndrome, an autosomal dominantly inherited form of ventricular fibrillation, is characterized by ST-segment elevation in leads V1-3 and right bundle-branch block on surface electrocardiogram. It is caused by mutations in the cardiac sodium channel gene, SCN5A, and to the best of our knowledge, there has been no report of this mutation in Korea. Three members of a family were heterozygous for a G to T substitution at the nucleotide position 5851 in exon 28 of the SCN5A gene. This nucleotide alteration makes a missense mutation, leading to a valine to leucine substitution (V1951L), in the carboxy terminal region of the sodium channel a subunit. We report here a missense mutation in a Korean family with Brugada-type electrocardiogram.
Brugada Syndrome ; Bundle-Branch Block ; Electrocardiography ; Exons ; Humans ; Korea ; Leucine ; Mutation, Missense* ; Sodium Channels ; Valine ; Ventricular Fibrillation

BACKGROUND/AIMS: Gallstone pathogenesis is linked to mucin hypersecretion and bacterial infection. Several mucin genes have been identified in gallbladder epithelial cells (GBECs). We investigated MUC expression in cholesterol-associated gallbladder disease and evaluated the relationship between mucin and bacterial infection. METHODS: The present study involved 20 patients with cholesterol stones with cholecystitis, five with cholesterol stones with cholesterolosis, six with cholesterol polyps, two with gallbladder cancer, and six controls. Canine GBECs treated with lipopolysaccharide were also studied. MUC3, MUC5AC, MUC5B, and MUC6 antibodies were used for dot/slot immunoblotting and immunohistochemical studies of the gallbladder epithelial tissues, canine GBECs, and bile. Reverse-transcription polymerase chain reaction was performed to evaluate MUC3 and MUC5B expression. RESULTS: MUC3, MUC5AC, MUC5B, and MUC6 were expressed in the normal gallbladder epithelium, and of those, MUC3 and MUC5B exhibited the highest expression levels. Greatly increased levels of MUC3 and MUC5B expression were observed in the cholesterol stone group, and slightly increased levels were observed in the cholesterol polyp group; MUC3 and MUC5B mRNA was also upregulated in those groups. Canine GBECs treated with lipopolysaccharide also showed upregulation of MUC3 and MUC5B. CONCLUSIONS: The mucin genes with the highest expression levels in gallbladder tissue in cholesterol-associated diseases were MUC3 and MUC5B. Cholesterol stones and gallbladder infections were associated with increased MUC3 and MUC5B expression.
Antibodies ; Bacterial Infections ; Bile ; Cholecystitis ; Cholesterol ; Epithelial Cells ; Epithelium ; Gallbladder Diseases* ; Gallbladder Neoplasms ; Gallbladder* ; Gallstones ; Humans ; Immunoblotting ; Mucins ; Polymerase Chain Reaction ; Polyps ; RNA, Messenger ; Up-Regulation

Primary pericardial mesothelioma is extremely rare and the incidence is low among the mesotheliomas that originate from other parts of the body. The prognosis of the tumor is unfavorable due to its late presentation, difficulties in early diagnosis and complete resection, and the limited treatment options. Herein, we report a case of pericardial mesothelioma. The patient is a 55-year-old woman who presented with chronic cough and dyspnea. During the examination, pericardial effusion was found and pericardial window formation was followed. She visited our hospital because of persistent dyspnea, with right shoulder and chest pain. Four discrete masses were discovered in the chest CT. CT guided-fine needle aspiration biopsy was negative for malignancy. Right exploratory thoracotomy and partial resection of 3x3 cm mass abutting pericardium was performed and was histologically diagnosed as malignant mesothelioma, biphasic type. Pericardial mesothelioma is rare, but it should be remembered as an important differential diagnosis in patients with persistent pericardial effusion and symptoms of dyspnea and constrictive pericarditis.
Biopsy, Needle ; Chest Pain ; Cough ; Diagnosis, Differential ; Dyspnea ; Early Diagnosis ; Female ; Humans ; Incidence ; Mesothelioma* ; Middle Aged ; Needles ; Pericardial Effusion ; Pericarditis, Constrictive ; Pericardium ; Prognosis ; Shoulder ; Thoracotomy ; Tomography, X-Ray Computed