BACKGROUND: In general, it is well known that dizzy patients show a remarkable ability to compensate for the loss of peripheral vestubular function. When the patient had decreased response to caloric stimulation and showed no symptoms of vestibular dysfunction, we thought that was a compensated state of unilateral peripheral vestibular loss. OBJECTIVES: The purpose of this study is to provide the basic data for analysis of findings of further rotatory chair test through analyzing the results of rotation test of unilateral peripheral vestibular loss patients. MATERIALS AND METHODS: We analysed the findings of rotatory chair test and clinical manifestations of 24 cases of unilateral vestublar loss which didn't show any symptoms of vestibular dysfunction and they were confirmed by bithermal caloric test and Kobrak's ice water test. RESULTS: We could find that phase lead, low gain and asymmetry could persist despite of chronic compensated state and these findings were relatively common in patients with nonspecific vestibular symptoms. CONCLUSION: Abnornal phase lead and decreased gain were observed in the compensated unilateral vestibular loss patients who showed nonspecific symptoms including oscillopsia, vague unsteadiness. We thought that their compensation was not completely perfect and SHA test was a good tool which detect the minor degree of vestibular dysfunction. We have to consider the past history and nonspecific symptoms of patients through precise history taking. Frequency of SHA test is slower than that of normal human movement and this status is not a real physiologic condition, so it would be advisable to consider the results of other vestibular function tests for precise evaluation the degree of compensation, and the serial check is also recommended.
Caloric Tests ; Compensation and Redress ; Humans ; Ice ; Vestibular Function Tests ; Water

Generally, if the size of a lip cancer defect exceeds 30% of the lower lip, a local flap or free flap is recommended. However, defects up to 50% of the lower lip in size have been reconstructed successfully by primary closure without a local flap or free flap. In one case, an 80-year-old male farmer who had smoked for more than 50 years presented with squamous cell carcinoma of the lower lip and underwent mass resection and supraomohyoid neck dissection. The defect accounted for almost 2/3 of the lower lip and was repaired by primary closure with V-shaped resection. Biopsy results confirmed pT2N0cM0 stage II disease with clear margins. In another case, a 68-year-old male also presented with squamous cell carcinoma of the lower lip and underwent mass resection. The defect accounted for about half the size of the lower lip but was repaired by primary closure with V-shaped resection.Both patients experienced no discomfort while eating or speaking and were satisfied with the cosmetic and functional outcomes with no evidence of recurrence. Thus, direct closure can be considered even in large lower lip cancers.

PURPOSE: We investigated the incidence and clinical course of hypoalbuminemia and identified relevance of prognosis including mortality in extremely low birth weight infants (ELBWIs). Also, we assessed the efficacy of intravenous albumin infusion. METHODS: A retrospective study including 83 preterm infants <1,000 g of birth weight who were admitted to Ajou university hospital's neonatal intensive care unit from January 2008 to December 2012 was performed. Patients were divided into the normoalbuminemia (> or =2.5 g/dL serum albumin, n=42) group and the hypoalbuminemia (<2.5 g/dL serum albumin, n=41) group, and also the hypoalbuminemia group were subdivided into the intravenous albumin infusion group (n=36) and the control group (n=5). RESULTS: Of those 83 ELBWIs, 41 infants (49.4%) were classified as the hypoalbuminemia group. Associated conditions with hypoalbuminemia were patent ductus arteriosus (PDA, 19.5%), intraventricular hemorrhage (IVH, > or =grade III, 4.9%), necrotizing enterocolitis (NEC, > or =stage IIa, 46.3%), pneumonia (4.9%), sepsis (24.4%). In univariate analysis, there were no statistically significant differences in major morbidities such as PDA, IVH, NEC, bronchopulmonary dysplasia and mortality between the normoalbuminemia and the hypoalbuminemia groups except gestational age (26+6+/-2+1 vs. 26+0+/-1+5, P=0.045) and birth weight (868+/-117 vs. 783+/-121, P=0.002). In multivariate logistic regression, birth weight is the only meaningful factor associated with hypoalbuminemia (OR.995, 95% CI .990-.999, P=0.019). The mortality (47.2% vs. 0%, P=0.065) and morbidities did not differ between the intravenous albumin infusion and the control group. CONCLUSION: In ELBWIs, there were no significant differences in major morbidities and mortality between the hypoalbuminemia and the normoalbuminemia groups. The lower birth weight is the only factor associated with hypoalbuminemia. In addition, major morbidities and mortality rate were not affected by the albumin infusion.
Birth Weight ; Bronchopulmonary Dysplasia ; Ductus Arteriosus, Patent ; Enterocolitis, Necrotizing ; Gestational Age ; Hemorrhage ; Humans ; Hypoalbuminemia* ; Incidence ; Infant* ; Infant, Low Birth Weight* ; Infant, Newborn ; Infant, Premature ; Intensive Care, Neonatal ; Logistic Models ; Mortality ; Pneumonia ; Prognosis ; Retrospective Studies ; Sepsis ; Serum Albumin

BACKGROUND :Although clinicopathologic differences have been described between Epstein-Barr virus (EBV)-positive and negative gastric adenocarcinomas, the pathogenetic basis for these differences remains unclear. In this study, efforts were made to confirm that expression of EBV-latent membrane protein (LMP1) and immunohistochemical characteristics of EBVpositive gastric adenocarcinomas. METHODS: We investigated genomic deletion, and RNA & protein expression of the EBV-LMP1, as well as immunohistochemical protein expression of transforming growth factor (TGF)-beta1, TGF-bata RII, p21, p16, E2F1, thymidylate synthase, and NF-kappaB in relation to EBV positive gastric adenocarcinoma. RESULTS: A total of 38 Epstein-Barr Virus Encoded RNA-positive and 80 negative gastric carcinomas were examined. A 30 bp DNA deletion in the EBV-LMP1 gene, initiating at codon 342, was detected in 94.4% of EBVpositive cases. By RT-PCR and western blotting, EBV-LMP1 mRNA and protein expressions were absent in all cases, re-gardless of DNA deletion. No significant differences in TGF-bata1, TGF-betaRII, p21, NF-kappaB, E2F1, or thymidylate synthase expression were identified. However, the decreased expression of p16 was found in 84.2% of EBV-positive carcinomas, relative to only 57.5% of EBV-negative tumors (p=0.024). CONCLUSION: EBV-LMP1 DNA deletion, mRNA and protein losses are highly prevalent in EBV-positive gastric adenocarcinoma among Korean patients, along with decreased p16 expression.
Adenocarcinoma* ; Blotting, Western ; Codon ; DNA ; Herpesvirus 4, Human* ; Humans ; Membrane Proteins* ; Membranes* ; NF-kappa B* ; RNA ; RNA, Messenger ; Stomach Neoplasms ; Thymidylate Synthase* ; Transforming Growth Factors*

Purpose: This study examined the clinical and radiological outcomes of TFNA (Trochanteric Fixation Nail-Advanced) and PFNA-II (Proximal Femoral Nail Antirotation-II) used in the treatment of unstable intertrochanteric femur fractures. The association between lateral screw sliding and lateral trochanteric pain was analyzed. Materials and Methods: The study included 116 patients diagnosed with unstable intertrochanteric femur fractures who underwent intramedullary nailing surgery at the author’s hospital. The patients were divided into two groups: 72 who received PFNA-II and 44 who received TFNA. Ten patients with positive greater trochanter tenderness and 106 patients with negative tenderness were assessed for the factors associated with lateral trochanteric pain. The radiological outcomes included an evaluation of fracture union, screw position, tipapex distance, proximal femoral nail protrusion, and lateral sliding length of the helical blade. The clinical outcomes were assessed using the Harris Hip Score, visual analogue scale (VAS) score, greater trochanter tenderness, and pre- and postoperative ambulation ability. Results: Thirty-three patients (45.8%) of the PFNA-II group and 18 (40.9%) of the TFNA group had lateral sliding of the helical blade, with no significant difference between the two groups (p=0.604). The VAS score was significantly higher in the TFNA group (3.77±1.71) than the PFNA-II group (3.10±1.57, p=0.032). Furthermore, the prevalence of a positive greater trochanter tenderness was significantly higher in the TFNA group (seven patients) than in the PFNA-II group (3 patients, p=0.04). Eight patients had lateral sliding in the positive greater trochanter tenderness group, whereas 43 had lateral sliding in the negative greater trochanter tenderness group (p=0.030). The lateral sliding length was 8.87±5.22 and 2.68±4.47 in the positive and negative groups, respectively (p<0.001). Conclusion The PFNA-II and TFNA groups showed favorable clinical and radiological outcomes, suggesting that both devices are suitable for treating unstable intertrochanteric femur fractures. A comparison of the two devices showed that TFNA induces more lateral trochanteric pain than PFNA-II, and the presence and extent of lateral sliding were associated with lateral trochanteric pain.

BACKGROUND: Vascular endothelial growth factor (VEGF)-C and VEGF-D are novel growth factors that regulate lymphatic vessel growth. This study was designed to examine whether the expression of three VEGF family members, VEGF-A, VEGF-C and VEGF-D are associated with the clinicopathologic parameters, especially with lymph node metastasis, in advanced gastric carcinomas. METHODS: Immunohistochemical staining was performed for VEGF-A, VEGF-C, and VEGF-D in the surgically resected specimens from 102 patients with advanced gastric carcinoma. The mRNA expressions of the three VEGF family members were assessed in 16 cases of tumor tissues and their corresponding non-neoplastic tissues. RESULTS: Of the 102 gastric carcinomas, 74 (73%), 82 (80%), and 34 (33%) cases showed cytoplasmic immunoreactivity for VEGF-A, VEGF-C and VEGF-D, respectively. Both VEGF-A and VEGF-C expressions were associated with lymphatic invasion and lymph node metastasis (p<0.05), but the VEGF-D expression was not associated with them (p>0.05). In the tumor tissue, VEGF-C mRNA expression was greater, while VEGF-D mRNA expression was lower than in the nonneoplatic tissue adjacent to the tumor. CONCLUSIONS: VEGF-A and VEGF-C may play important roles for the lymphatic spread of gastric carcinoma. We suggest that neutralizing both VEGF-A and VEGF-C may be reguired to block lymph node metastasis.
Adenocarcinoma* ; Cytoplasm ; Humans ; Intercellular Signaling Peptides and Proteins ; Lymph Nodes ; Lymphatic Vessels ; Neoplasm Metastasis ; RNA, Messenger ; Vascular Endothelial Growth Factor A* ; Vascular Endothelial Growth Factor C ; Vascular Endothelial Growth Factor D ; Vascular Endothelial Growth Factors*

PURPOSE: In the analysis of risk factors affecting the renal graft survival and graft function, time-dependent effect of each risk factor should be differentiated from net effect of risk factor. We attempted to analyze the impact of immunologic and/or non-immunologic risk factors on the graft function and survival after renal transplantation among the recipients having same immunologic risks at the time of transplantation. METHODS: Three hundred ninety recipients who underwent haplotype matched living related donor kidney transplantation and have been regularly followed-up were retrospectively evaluated in a single center. All recipients were treated with cyclosporine-based double or triple regimens. The graft function was evaluated by serum creatinine (Scr) level and 24 hours urinary excretion of protein every year until 5 years after transplantation. The donor kidney weight/ recipient body weight ratio (KW/BW), donor age/ recipient age ratio (DA/RA), donor-recipient sex (D-R sex) relationship, and episodes of acute rejection (AR) within 1 year were regarded as the potential risk factors affecting the graft survival and function in this study. Kaplan-Meier method and Cox proportional-hazard model were used for survival analysis. ANOVA to evaluate time-point difference of graft function, and repeated measures ANOVA to evaluate the yearly difference of graft function were used. RESULTS: Only the episode of AR was a significant risk factor affecting the graft survival. However, each non-immunologic risk factors (KW/BW, DA/RA, D-R sex) and AR episode persistently showed statistically significant impact on Scr level until 5 years after transplantation. Recipients having lowest KW/BW (1st Q KW/BW) and highest DA/RA (4th Q DA/RA) had experienced accelerated increment of Scr level from 4th year after transplantation. From 3rd year after transplantation, there is a significant correlation between the numbers of non-immunologic risk factor the recipients having had and yearly increment of Scr level. However, episode of AR didn't influence the annual slope of Scr level even 4th year after transplantation. CONCLUSIONS: Non-immunologic risk factors had an detrimental effect on renal graft function, especially from 3rd year after transplantation. To have a better long-term graft function, non-immunologic risk factors should be considered from the time of live donor evaluation for transplantation. From the early period of transplantation, the recipients should be aware of the negative impact of overweight in terms of graft function and other metabolic derangement.
Body Weight ; Creatinine ; Graft Survival* ; Haplotypes* ; Humans ; Kidney ; Kidney Transplantation ; Living Donors* ; Overweight ; Retrospective Studies ; Risk Factors ; Tissue Donors ; Transplantation* ; Transplants*

BACKGROUND: Endometriosis is defined as the presence of endometrial tissue outside the uterus, causing diverse diseases, including infertility, pelvic pain, dysmenorrhea, and constipation. While there is a growing body of evidence that genetic and immunologic factors play important roles in the pathogenesis of the disease, HLA-A, B antigens have been reported to be associated with the risk of endometriosis in the Japanese population. This study was performed to determine whether the susceptibility to advanced endometriosis is also associated with HLA-A, B antigens in the Korean population, which is the closest ethnic group to Japanese. METHODS: We recruited 50 Korean patients with advanced endometriosis confirmed by surgical and histolological examinations. Distribution of HLA-A and B antigens was compared with that of 200 unrelated ethnically matched individuals. HLA-A and B genotyping was carried out using a PCRsequence specific oligonucleotide hybridization method. RESULTS: An increased frequency of B39 was observed in endometriosis patients compared with control subjects, but the difference was not statistically significant after correcting for multiple comparisons (4.0% patients vs 0.8% controls, OR=5.5, 95% CI=1.21-25.04, P=0.03, P(c)=not significant). No significant differences were found between the patients with endometriosis and the general control group with regards to the distribution of other HLA-A and B antigens. CONCLUSIONS: The findings of the present study suggest that the susceptibility to advanced endometriosis, unlike in the Japanese population, is not associated with HLA-A, B antigens in the Korean population.
Alleles ; Endometriosis/*genetics ; Female ; Gene Frequency ; *Genes, MHC Class I ; *Genetic Predisposition to Disease ; HLA-A Antigens/*genetics ; HLA-B Antigens/*genetics ; Humans ; Korea

No abstract available.
Abdominal Wall ; Herpes Zoster

OBJECTIVES: To identify the psychosocial well-being status in a rural community, and examine the association between the psychosocial well-being status and adverse lipid profile. METHOD: In 2001, we surveyed 575 subjects in Yangpyoung, Kyounggido, including medical examination, fasting-blood sample and questionnaires for the psychosocial well-being status, socioeconomic position and behavioral risk factors. The logistic regression analysis was used to examine explanatory factors of the psychosocial well-being status, and association between the psychosocial well-being status and adverse lipid profiles. RESULT: The association between the psychosocial well-being status and adverse lipid profiles was not strong. The total cholesterol and triglyceridelevels were associated with psychosocial well-being. The adjusted odds ratio for moderate psychosocial well-being relating to total cholesterol was 1.90 (95%CI, 0.82-4.04), but that for triglyceride was 0.65 (95%CI, 0.36-1.21). The HDL-Cholesterol and LDL-Cholesterol level were not associated with the psychosocial well-being status. CONCLUSION: The total cholesterol and psychosocial well-being status were weakly associated, but the between the psychosocial well-being status and adverse lipid profiles were not consistent.
Cardiovascular Diseases ; Cholesterol ; Logistic Models ; Methods ; Odds Ratio ; Risk Factors ; Rural Population ; Social Class ; Triglycerides