PURPOSE: Allelic loss on chromosome 18q is a hallmark of presence of a tummor represser gene. Recently, DPC4 (deleted in pancreatic carcinoma, locus 4), a candidate tumor suppressor gene, has been localized at 18q21. Inactivation of DPC4 gene was reported in pancreatic carcinomas, coloretal carcinomas, and prostatic carcinomas. The aim of the present study was to determine if it might be altered in stomach cancer. MATERIALS AND METHODS: We tested for DPC4 gene mutations and allelic status at 18q21 using a modified 'cold SSCP' method in 48 primary gastric carcinoma and correlated the findings with various clinicopathologic characteristics of the patients. RESULTS: The frequency of mutations in primary gastric cancer was 27.1% (13/48). Mutations of exon 1, 8, 10 were found in 2 (4.1%), 4 (8.2%) and 7 cases (14.6%), respectively. DNA sequencing of 13 cases with DPC4 mutations identified six cases (46.1%) with substitution, four cases with deletion (30.7%), and two cases (23.1%) with insertion. No significant difference was observed in the frequency of DPC4 mutations in terms of other various clinicopathologic characteristics. CONCLUSION: These findings suggest that DPC4 mutations may play a significant role in the establishment and progression of the primary gastric cancer.
Exons ; Genes, Tumor Suppressor ; Humans* ; Loss of Heterozygosity ; Polymorphism, Single-Stranded Conformational ; Sequence Analysis, DNA ; Stomach Neoplasms* ; Stomach*

PURPOSE: Laparoscopic totally extraperitoneal (TEP) hernia repair is known to be relatively difficult in cases with a history of lower abdominal surgery. We assess the feasibility of laparoscopic TEP hernia repair in those patients. METHODS: Thirty five patients with a previous history of radical prostatectomy or lower abdominal surgery who underwent laparoscopic TEP hernia repair for inguinal hernia were reviewed retrospectively. All operations were performed by a single experienced surgeon. RESULTS: Thirty three out of the 35 patients (94%) were men. Laparoscopic TEP hernia repair was performed successfully in 30 out of 35 cases. Twenty five cases (71%) were right inguinal hernia, 6 cases (17%) were left hernias, and 4 cases (11%) had an inguinal hernia on both sides. Five cases were converted to transabdominal preperitoneal (TAPP) (n=3) or open methods (n=2). Mean operation time was 111 minutes. The patient group with previous radical prostatectomy was the largest (n=22, 63%) and required a longer operation time (124 minutes). Blood loss was less than 50 cc in all cases. Average hospital stay was 1.2 days after surgery. Voiding difficulties requiring catheterization were observed in 13 cases (37%). CONCLUSION: Laparoscopic TEP hernia repair for a patient with previous history of radical prostatectomy or lower abdominal surgery except for appendectomy can be safely performed by an experienced surgeon, but is not recommended as a standard choice because of a longer operation time and higher conversion rate.
Appendectomy* ; Catheterization ; Catheters ; Hernia* ; Hernia, Inguinal ; Herniorrhaphy* ; Humans ; Laparoscopy ; Length of Stay ; Male ; Prostatectomy* ; Retrospective Studies

A retrospective analysis of 122 consecutive of rhegmatogenous retinal detatchment cases which obtained successful surgical results was performed. All the cases were followed for longer than 1 year postoperatively. 15 eyes (12.3%) developed macular pucker. There was no significant difference in sex distribution and mean age was 43.7 years. The mean lapse time between surgery and the development of macular pucker was 7.2 months. Significant factors for developing macular pucker were multiple operation, preoperative macular detachment, and duration of retinal detachment (longer than 1 month). Other factors such as subretirial fluid drainage and myopia were not significant. 9 of 15 eyes with macular pucker were treated with vitrectomy and visual acuity improved in 66.7% of surgically treated eyes. These results suggest that success with single surgical procedure, operation before macular detachment, and early treatment of retinal detachment are important for preventing postsurgical macular pucker.
Drainage ; Myopia ; Retinal Detachment* ; Retinaldehyde* ; Retrospective Studies ; Sex Distribution ; Visual Acuity ; Vitrectomy

BACKGROUND AND OBJECTIVES : The etiology of polyp is still largely unknown. Vascular remodelling, with local angiogenesis and plasma leakage, could play a role in the growth process of nasal polyps. The aim of this study was to detect and localize angiogenesis factor expressions in nasal polyp tissue and compare these findings with those of inferior turbinate tissues. MATERIALS AND METHODS: The author examined specimens from patients undergone elective turbinectomy (n=10) or nasal polypectomy (n=23). The mRNA expressions of angiogenesis factors were detected by semi-quantitative reverse transcription-polymerase chain reaction (RT-PCR) followed by Southern blot analysis. The protein expression of angiogenesis factors in nasal polyp tissues were evaluated by immunohistochemistry. RESULTS: Semi-quantitative RT-PCR/Southern analysis of RNA demonstrated that the level of mRNA expression of basic fibroblast growth factors (bFGF) and vascular endothelial growth factors (VEGF) were decreased in nasal polyp tissues compared with inferior turbinate specimens. The platelet-derived endothelial cell growth factor (PD-ECGF) mRNA expression was significantly increased in nasal polyps compared with inferior turbinates. The immunohistochemical studies revealed that a immunoreactivity to these angiogenesis facors were localized to epithelium, inflammatory cell, and vascular endothelium in all samples reviewed. The high levels of expression for VEGF protein and PD-ECGF protein in the nasal polyp tissues were demonstrated. CONCLUSION: We suggest that PD-ECGF and VEGF contribute to the growth of nasal polyps. Hypoxia may play an important role in the growth of the nasal polyps considering that VEGF and PD-ECGF, secretions of which are stimulated by hypoxia, were highly expressed in the nasal polyp tissues.
Angiogenesis Inducing Agents ; Anoxia ; Blotting, Southern ; Endothelial Cells* ; Endothelium, Vascular ; Epithelium ; Fibroblast Growth Factor 2 ; Fibroblasts* ; Humans ; Immunohistochemistry ; Nasal Polyps* ; Plasma ; Polyps ; RNA ; RNA, Messenger ; Thymidine Phosphorylase ; Turbinates ; Vascular Endothelial Growth Factor A ; Vascular Endothelial Growth Factors

BACKGROUND AND OBJECTIVES: Normal angiogenesis occurs as a part of the body's repair processes like the healing of wounds and fractures. By contrast, uncontrolled angiogenesis can often be pathological. Vascular remodelling could therefore play an important role in the growth process of solid tumors. The aim of this study was to detect the expression of platelet-derived endothelial cell growth factor (PD-ECGF), basic fibroblast growth factor (bFGF), and vascular endothelial growth factor (VEGF), and investigate the correlation between these factors. Also, we studied the relationships between the expressions of these factors and the clinical stage, nodal involvement, and histologic grade in the squamous cell carcinoma of larynx. MATERIALS AND METHOD: The authors examined the expression of three angiogenic factors in specimens of laryngeal squamous cell carcinoma (n=17). The mRNA expressions of angiogenic factors were detected by the semi-quantitative reverse transcription-polymerase chain reaction (RT-PCR). Statistics were analysed using the Fisher's exact test, the Wilcoxon signed rank test, and the Spearman correlation coefficiency. RESULTS: PD-ECGF and bFGF were significantly higher in the stages III and IV cancers than in the stages I and II cancers, and thus shows that bFGF was related to severity of the nodal involvement. The expression of more than one factor was significantly related with stages III and IV cancer. PD-ECGF and VEGF were related with each other. CONCLUSION: The authors suggest that angiogenic factors, especially, PD-ECGF and bFGF, may be used as prognostic factors for the squamous cell carcinoma of larynx.
Angiogenesis Inducing Agents ; Carcinoma, Squamous Cell* ; Endothelial Cells* ; Fibroblast Growth Factor 2 ; Fibroblasts* ; Larynx* ; RNA, Messenger ; Thymidine Phosphorylase ; Vascular Endothelial Growth Factor A ; Wounds and Injuries

BACKGROUND AND OBJECTIVES: This study aimed to investigate differences in olfactory thresholds and odor discrimination between the two sides of the nose in relation to the right hand and the right eye. MATERIALS AND METHOD: Eighty subjects (40 women, 40 men) participated in this study. All were in excellent health without any nasal or health problems. The olfactory function tests designed by Connecticut Chemosensory Clinical Reserch Center (CCCRC) were performed. RESULTS: We found a slight tendency for lower thresholds and better discrimination on the right nostril; this phenomenon was not influenced by the subjects' handedness. However, the left-handers performed better at the right side compared with the left nostril than right-handers and the differences between the two sides of the nose were larger in the left-handers. There were no relationships between the ocular and nasal dominance. CONCLUSION: The data indicate that olfactory functions exhibit a certain degree of lateralization to the right side.
Connecticut ; Discrimination (Psychology) ; Female ; Functional Laterality ; Hand ; Humans* ; Nose ; Odors ; Smell

Branchio-oto-renal (BOR) syndrome is a clinically heterogeneous autosomal dominant form of syndromic hearing loss characterized by variable hearing impairment, malformations of the pinnae, the presence of branchial arch remnants, and various renal abnormalities. BOR syndrome is caused by mutations in EYA1 and SIX1, which are critical to organogenesis and are expressed together in developing otic, branchial, and renal tissue. Branchio-otic (BO) syndrome comprises branchial fistulas and preauricular pits, but lacks renal anomalies. We present a case of BO syndrome in 30year-old man with a review of the literature.
Branchial Region ; Branchio-Oto-Renal Syndrome ; Branchioma ; Fistula ; Hearing Loss ; Organogenesis

Myxoid degeneration (MD) in the cartilage results from the accumulation of hyaluronic acid in the stroma. However, it is rarely found in the auricular cartilage, with only one published report to date. This article describes two histologically confirmed cases of MD of the auricle that was excised with favorable aesthetic results. Two men presented with auricular masses, with no history of trauma or tumors in the auricle. Laterally protruding masses were located around the helix and antihelix, which were similar in appearance to the normal auricular cartilage. We made an aesthetic skin incision under local anesthesia, and carved the mass from the normal cartilage for pathological and cosmetic reasons. Both excised masses showed MD of the auricular cartilage. We report these two cases with a review of the literature.
Anesthesia, Local ; Cartilage ; Ear ; Ear Cartilage* ; Humans ; Hyaluronic Acid ; Male ; Skin

PURPOSE: The principle of prehospital transport is that the patient should be transported to the nearest hospital that is suitable for the severity of the illness. Therefore, out-of-jurisdiction transport is improper. The purpose of this study was to understand the present situation and evaluate the appropriateness of out-of-jurisdiction prehospital transport by the 119 rescue group. METHODS: Between January and December 2009 we enrolled patients who were transported to the Gwangju Regional Emergency Medical Center by the 119 rescue group, which belongs to Jeolla province. The appropriateness of out-of-jurisdiction transport was based on the transport chart and medical record of the 119 rescue group and categorized into three groups. RESULTS: The total number of patients transported was 440: 78 (17.7%) were appropriate; 329 (74.8%) were inappropriate; 33 (7.5%) patients were very inappropriate. Of the 440, 156 (35.5%) were emergency cases, 147 (33.4%) were sub-emergency cases, and 137 (31.1%) were non-emergency cases. Comparing these data with the triage by the 119 rescue group, the kappa value was 0.368 (p<0.001). The patients or their guardians selected the hospital to which the patient was be transported in 382 (86.8%) cases. The actual transport distance was 40.0 km (range: 26.0 to 50.0) and was significantly longer than the nearest distance to a local emergency center which was 10.0 km (4.0 to 18.0) (p<0.001). CONCLUSION: Inappropriate out-of-jurisdiction transporting of patients is done frequently. Therefore, guidelines for prehospital transportation according to the triage is necessary. Additionally, the medical director and emergency medicine information center could play a role in selecting a hospital. A fee or a fine of transporters who do not observe the guidelines might limit the proportion of inappropriate transport cases.
Ambulances ; Emergencies ; Emergency Medical Services ; Emergency Medicine ; Fees and Charges ; Humans ; Information Centers ; Medical Records ; Physician Executives ; Transportation ; Transportation of Patients ; Triage

PURPOSE: This study was performed to investigate the present condition of drug abuse and its association with depression, self-rated health and health behaviors by job status in Korean adults. METHODS: Data were derived from the study on four addiction problem and suicide in 2014. Multiple logistic regression was used to analyze patterns of drug abuse according to depression, self-rated health and health behaviors. RESULTS: The prevalence of drug abuse during the past year was 17.1% of the 4,018 subjects. About 3.3 times risk for drug abuse was found among individuals who had high depression scores. The risk of drug abuse was higher among those who were smoking (OR:1.46, 95% CI:1.17~1.83), drinking more frequently (OR:1.30, 95% CI:1.07~1.58), sleeping insufficiently (OR:1.31, 95% CI:1.03~1.67), eating irregularly (OR:1.45, 95% CI:1.19~1.76). Drug abuse problem was detected more seriously among employed than unemployed adults. CONCLUSION: Health-related behaviors, such as smoking, drinking, sleeping, eating should be considered simultaneously when designing strategies to deal with drug abuse problem, and it is important to understand the interaction between drug abuse and mental health. Furthermore, workplace based intervention can be effective in solving drug abuse problem.
Adult ; Depression* ; Drinking ; Eating ; Health Behavior* ; Humans ; Logistic Models ; Mental Health ; Prevalence ; Smoke ; Smoking ; Substance-Related Disorders* ; Suicide