CD44, also known as the Hermes antigen, H-CAM, pgp-1 antigen, and extracellular matrix receptor ECM-III, is a widely distributed integral membrane protein that exists in a variety of forms with different molecular sizes ranging from 85kd to 160kd. A number of evidence implicates CD44 as a cell adhesion molecule with a possible role in tumor progression. To evaluate the possible roles of CD44 in the metastatic process of gastric carcinoma to the regional lymph nodes, we applicated immunohistochemical stains with the CD44H and CD44v6 primary antibodies onto the 2 groups of gastric adenocarcinomas. Each group was comprised of 22 primary tumors extending to the subserosa, and one group showed nodal metastasis, while the other group did not. Seventeen primary tumors (77%) out of the 22 cases with the nodal metastasis demonstrated positivity to the CD44v6, while only 9 primary tumors (41%) out of the 22 cases without nodal metastasis did. However CD44H immunoreactivity was demonstrated in tumor cells of all cases (100%) of both groups as well as in the normal cell components. These results suggest that CD44H form is not related to the metastasis to the regional lymph nodes of gastric carcinoma. However, the expression of CD44v6 seems to play a certain role in the metastatic process of the gastric carcinoma.
Adenocarcinoma* ; Antibodies ; Cell Adhesion ; Cellular Structures ; Coloring Agents ; Extracellular Matrix ; Lymph Nodes ; Membrane Proteins ; Neoplasm Metastasis

Osteochondroma, also known as osteocartilaginous exostosis, or just exostosis, is the most common benign bone tumor. Most of osteochondromas are solitary lesions and affect long bones; however, about 12% of osteochondromas are multiple lesions with the autosomal dominant inheritance. Only 1~4% of solitary osteochondromas originate in the spine. Symptoms vary depending on its location. We experienced a case of osteochondroma of the atlas presenting as an oropharyngeal mass. We report the case with a review of literatures.
Exostoses ; Osteochondroma* ; Spine ; Wills

Hyperkalemic periodic paralysis and paramyotona congenita share common clinical manifestations, such as autosomal dominant diseases with missense mutations at a gene encoding alpha-subunit of skeletal muscle voltage sensitive sodium channel (SCN4A). Exercise and cold provocation tests are physiological phenomena of clinical characteristics of these diseases. The authors experienced a case with hyperkalemic periodic paralysis and performed these tests comparing them with a patient with hypokalemic periodic paralysis and a normal person. Significant decremental changes of CMAPs were found by both tests in the case with hyperkalemic periodic paralysis, compared with those in a case of hypokalemic periodic paralysis or normal control. In conclusion, we suggest that exercise and cold provocation tests may be useful for the differential diagnosis between hyperkalemic periodic paralysis and hypokalemic periodic paralysis.
Diagnosis, Differential ; Electrodiagnosis ; Genes, vif ; Humans ; Hypokalemic Periodic Paralysis ; Muscle, Skeletal ; Mutation, Missense ; Paralysis ; Paralysis, Hyperkalemic Periodic* ; Physiological Phenomena ; Sodium Channels

BACKGROUND: Currently, the incidence of hepatitis A is on the increase in Korea. Although there is emphasis on contact precautions, the nosocomial outbreak of hepatitis A virus (HAV) in healthcare personnel has increased within endemic areas because these workers inevitably come in close contact with patients and work under suboptimal hygiene conditions. In this study, we evaluated the necessity of immunization against HAV for healthcare personnel. METHODS: We investigated the seropositivity of serum immunoglobulin G (IgG) anti-HAV antibody (Ab) in 672 healthcare personnel on the basis of their age-group, sex, and occupation in Soon Chun Hyang University Hospital and Soon Chun Hyang University Bucheon Hospital. RESULTS: The subjects were divided into 6 groups on the basis of their ages to identify differences among the various age groups in the number of cases with HAV Ab seropositivity. Significant intergroup differences were noted in this respect: 21-25 years, 2/152 (1.3%); 26-30 years, 33/245 (13.5%); 31-35 years, 70/148 (47.3%); 36-40 years, 52/79 (65.8%); >40 years, 44/48 (91.7%). CONCLUSION: The number of seropositive cases was low among young healthy personnel: low seropositivity is an emerging risk for vulnerable population. With the increase in the incidence of hepatitis A, healthcare personnel have become a risk population for hepatitis A, as are community residents. Therefore, for healthcare personnel working in hospitals, immunization against HAV should be recommended for personnel younger than 30 years, and serological testing for older personnel.
Delivery of Health Care ; Hepatitis ; Hepatitis A ; Hepatitis A Antibodies ; Hepatitis A Vaccines ; Hepatitis A virus ; Humans ; Hygiene ; Immunization ; Immunoglobulin G ; Incidence ; Korea ; Occupations ; Serologic Tests ; Vulnerable Populations

BACKGROUND: Self-monitoring of blood glucose plays an important role in management of diabetes mellitus. Blood glucose measurement is based on using plasma glucose separated from whole blood, but many people with diabetes and health care providers use a portable glucose meter for convenience. The aim of this study was to evaluate the accuracy and agreement of G300 portable glucose monitoring system against standard venous glucose testing methods, based on ISO 15197:2013 standards. METHODS: This study was the evaluation of G300 system accuracy following ISO 15197:2013 standards. We estimated precision, system accuracy, hematocrit interference, interfering substances, and user performance. RESULTS: In repeatability precision evaluation of those glucometers, standard deviation was 2.9–3.7 mg/dL at glucose levels under 100 mg/dL and coefficient of variation was 1.7–3.2% at glucose levels over 100 mg/dL, respectively. In accuracy evaluation, 99.5% of difference values between results of G300 portable glucose monitoring system and clinical laboratory were within 95%. Consensus Error grid analysis showed that all values (100%) are within zone A. Hematocrit range between 20% and 60% did not cause interference. These results were acceptable for the ISO15197:2013 criteria in all glucose concentrations. CONCLUSIONS: This study showed that G300 can provide reliable blood glucose results for patients and health care providers to manage diabetes mellitus, satisfying the ISO 15197:2013 criteria.
Blood Glucose Self-Monitoring ; Blood Glucose* ; Capillaries* ; Consensus ; Diabetes Mellitus ; Electrochemical Techniques ; Fasting* ; Glucose ; Health Personnel ; Hematocrit ; Humans

Objective: : Chronic subdural hematoma (CSDH) is a common disease in neurosurgical departments, but optimal perioperative management guidelines have not yet been established. We aimed to assess the current clinical management and outcomes for CSDH patients and identify prognostic factors for CSDH recurrence. Methods: : We enrolled a total of 293 consecutive patients with CSDH who underwent burr hole craniostomy at seven institutions in 2018. Clinical and surgery-related characteristics and surgical outcomes were analyzed. The cohort included 208 men and 85 women. Results: : The median patient age was 75 years. Antithrombotic agents were prescribed to 105 patients. History of head trauma was identified in 59% of patients. Two hundred twenty-seven of 293 patients (77.5%) had unilateral hematoma and 46.1% had a homogenous hematoma type. About 70% of patients underwent surgery under general anesthesia, and 74.7% underwent a single burr hole craniostomy surgery. Recurrence requiring surgery was observed in 17 of 293 patients (5.8%), with a median of 32 days to recurrence. The postoperative complication rate was 4.1%. In multivariate analysis, factors associated with CSDH recurrence were separated hematoma type (odds ratio, 3.906; p=0.017) and patient who underwent surgery under general anesthesia had less recurrence (odds ratio, 0.277; p=0.017). Conclusion : This is the first retrospective multicenter generalized cohort pilot study in the Republic of Korea as a first step towards the development of Korean clinical practice guidelines for CSDH. The type of hematoma and anesthesia was associated with CSDH recurrence. Although the detailed surgical method differs depending on the institution, the surgical treatment of CSDH was effective. Further studies may establish appropriate management guidelines to minimize CSDH recurrence.

PURPOSE: To evaluate prospectively the results of interventional radiologic placement of tunneled centralve-nous catheters, and subsequent complications. MATERIALS AND METHODS: Between April 1997 and April 1998, a totalof 557 tunneled central venous catheters were percutaneously placed in 517 consecutive patients in aninterventional radiology suite. The indications were chemotherapy in 533 cases, total parenteral nutrition in 23and transfusion in one. Complications were e-valuated prospectively by means of a chart review, chest radiography,central vein angiography and blood/catheter culture. RESULTS: The technical success rate for tunneled centralvenous catheter placement was 100% (557/557 cases). The duration of catheter placement ranged from 4 to 356 (mean,112 +/-4.6) days; Hickman catheters were re-moved in 252 cases during follow-up. Early complications included 3cases of pneumothorax(0.5%), 4 cases of local bleeding/hematoma(0.7%), 2 cases of primary malposition(0.4%), and 1case of catheter leakage(0.2%). Late complications included 42 cases of catheter-related infection(7.5%), 40 casesof venous thrombosis (7.2%), 18 cases of migration (3.2%), 5 cases of catheter / pericatheter of occlusion(0.8%),and 1 case of pseudoa-neurysm(0.2%) . The infection rate and thrombosis rate per 1000 days were 1.57 and 1.50,respectively. CONCLUSIONS: The technical success rate of interventional radiologic placement of tunneled centralvenous catheters was high. In comparison to conventional surgical placement , it is a more reliable method andleads to fewer complications.
Angiography ; Catheters ; Central Venous Catheters* ; Drug Therapy ; Follow-Up Studies ; Humans ; Parenteral Nutrition, Total ; Prospective Studies ; Thorax ; Thrombosis ; Veins ; Venous Thrombosis

PURPOSE: The aim of this study was to assess the long-term clinical outcomes of the tension-free vaginal tape (TVT) procedure for stress urinary incontinence (SUI) in elderly women and to identify the factors influencing failure in these cases. MATERIALS AND METHODS: Women with SUI who underwent a TVT procedure were studied. "Cure" was defined as no urine leakage at all in any circumstances and "improvement" was defined as some urine leakage but a score of over 4 points out of 5 in a satisfaction inquiry. Patients were divided into two groups (middle-aged, <65 years and elderly, > or =65 years) for comparison of clinical outcomes. In the elderly group, patients were subdivided into two groups (cure and no cure groups) and were compared to identify the factors influencing failure. RESULTS: A total of 136 women (middle-aged group, 106; elderly group, 30) were enrolled in the study. The mean ages of the patients in the 2 groups were 53.5+/-5.9 and 72.0+/-5.0 years and the mean follow-up times were 50.5+/-9.4 and 48.8+/-9.1 months, respectively. The cure and improvement rates in the middle-aged and elderly groups were 80.2% vs. 66.7% and 4.7% vs. 3.3%, respectively (p>0.05). The satisfaction scores in the middle-aged and elderly groups were 3.8+/-1.1 vs. 3.3+/-1.5 points (p>0.05). In the elderly group, the body mass index of the cure and no cure groups were 24.6+/-3.3 kg/m2 and 26.6+/-1.0 kg/m2, and body mass index was the only factor that differed significantly between the two subgroups (p=0.028). CONCLUSIONS: Our long-term results suggest that TVT is an effective treatment even in elderly women. However, elderly women who are obese should be counseled carefully about the success rate.
Aged ; Body Mass Index ; Female ; Follow-Up Studies ; Humans ; Suburethral Slings ; Urinary Incontinence

BACKGROUND: The long-term survival in patients with non-Hodgkin's lymphoma (NHL) after conventional chemotherapy is about 35% and the rest of the patients tend to have relapse. So, in relapsed or refractory NHL, the outcome of patients undergoing high-dose chemotherapy and autologous peripheral stem cell transplantation (APBSCT) was evaluated, and the main prognostic factors were determined. METHODS: 17 patients with relapsed or resistant NHL (5 complete response group, 7 partial response group, 4 primary refractory group, 1 resistant relapse) underwent BEAM (carmustine, etoposide, cytarabine, melphalan) chemotherapy and APBSCT between July 1997 and February 1999. RESULTS: The median follow-up duration was 17 months (range: 4-47). The response rate was 58.3% (complete response 33.3%, partial response 25.0%) in 12 patients in whom complete response group was not included. The 2-year, 3-year overall response rate were 41.2%, 27.5%, respectively. And 2-year progression free survival was 35.3%. The disease status before high-dose chemotherapy was the only significant prognostic factor in determining overall survival (univariate p=.024, multivariate p=.059) and progression free survival (univariate p=.013, multivariate p=.026). Patients with complete response to salvage regimen had better overall survival (p=.021) and progression free survival (p=.008) than patients with refractory response. WBC (> or = 1,000/uL) was recovered at the median 11 days (range; 8-24), and platelet (> or = 50,000/uL) was recovered at the median 18 days (range; 9-44). There was no treatment-related death and no grade 3 and 4 toxicity. Neutropenic infection was in 4 patients (1 Herpes zoster, 1 typhlitis, 1 perianal infection, 1 otitis externa). CONCLUSION: The pre-transplant disease status was the main prognostic factor. Patients with complete response to salvage regimen had the significant benefit in survival from high-dose chemotherapy and APBSCT, but patients with refractory or resistant relapsed NHL did not have any significant benefit.
Blood Platelets ; Cytarabine ; Disease-Free Survival ; Drug Therapy ; Etoposide ; Follow-Up Studies ; Herpes Zoster ; Humans ; Lymphoma* ; Lymphoma, Non-Hodgkin ; Otitis ; Peripheral Blood Stem Cell Transplantation* ; Recurrence ; Typhlitis

Solitary fibrous tumor(SFT) was previously named localized fibrous mesothelioma, and this is a rare mesenchymal neoplasm that usually shows benign behavior. It is the most commonly recognized tumor of the pleura. These tumors have been recently reported to be found in unexpected locations. To the best of our knowledge, there have been only 2 reports of SFT arising from the urinary bladder in Koreans. We review this third case of SFT that was misdiagnosed as bladder cancer. This tumor was removed from a 40-year-old man who had a history of lower urinary tract symptoms.
Adult ; Humans ; Lower Urinary Tract Symptoms ; Mesoderm ; Pleura ; Solitary Fibrous Tumor, Pleural ; Solitary Fibrous Tumors* ; Urinary Bladder Neoplasms* ; Urinary Bladder*