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.

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: 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*

OBJECTIVE: This study was conducted to elucidate the associations of HLA with systemic sclerosis (SSc) in Koreans. METHODS: HLA associations with SSc according to SSc-specific autoantibody status and clinical subsets (diffuse and limited) were investigated. HLA-A, B, and C antigens were typed by the serological method using microlymphocytotoxicity test, and HLA-DR by DNA typing method using PCR-reverse hybridization and PCR-SSCP in 56 Korean patients with SSc and 226 healthy controls. For SSc patients, anti-Scl-70 and anicentromere antibodies were tested by double immunodiffusion and indirect immunofluorescence, respectively. RESULTS: The results of HLA class I antigen typing showed that the frequencies of HLA-A24, B52 and B62 were increased, whereas those of A33, B44 and B58 were decreased in SSc patients compared to healthy controls. The frequency of HLA-DR2 was significantly increased, whereas that of HLA-DR13 was decreased in patients with SSc compared to controls. Among HLA-DR2 alleles, both HLA-DRB1*1501 and *1502 were increased in SSc patients compared to controls. According to clinical status, HLA-DRB1*1501 was increased in limited SSc patients and that of DRB1*1502 was increased both in diffuse and limited SSc patients compared to controls. According to autoantibody status, HLA- DRB1 1502 was significantly increased in anti-Scl-70-positive SSc patients and that of DRB1 1501 was increased in anti-Scl-70-negative SSc patients compared to controls. The association of HLA-DR2 alleles with SSc according to clinical subsets and anti-Scl-70 antibody status revealed that the frequency of HLA- DRB1 *1501 was significantly increased in anti-Scl-70-negative limited SSc patients compared to controls. CONCLUSIONS: These results suggest that different HLA-DR2 alleles are associated with different types of SSc in Koreans. HLA-DRB1 1502 shows strong association with anti-Scl-70-positive SSc, and DRB1 1501 with anti-Scl-70-negative limited SSc. It is concluded that the pathogenesis of SSc in Koreans is in part, based on the same genetic background.
Alleles ; Antibodies ; Asian Continental Ancestry Group ; DNA Fingerprinting ; Fluorescent Antibody Technique, Indirect ; HLA-A Antigens ; HLA-A24 Antigen ; HLA-DR Antigens ; HLA-DR2 Antigen ; HLA-DRB1 Chains ; Humans ; Immunodiffusion ; Scleroderma, Systemic*

No abstract available.
Duodenal Ulcer* ; Humans ; Recurrence*

PURPOSE: Abdominal actinomycosis is a rare chronic suppurative infectious disease, caused by a gram-positive bands Actinomyces israelii organism. The pathogens produces a characteristic granulomatous inflammatory fibrosis and mass lesion. Actinomycosis is usually divided into three clinical types; cervicofascial, thoracic and abdominopelvic. This study was designed to investigate the clinical or radiologic variability and the meanings of the diagnostic differentiality of abdominopelvic actinomycosis when patients present with an unusual abdominal mass or abscess. METHODS: The medical records of 19 patients treated at the Departments of Surgery and Obstetrics and Gynecology, Dong-A University Hospital were reviewed. The clinical characteristics, diagnostic evaluation and surgical treatment results were retrospectively analyzed. RESULTS: Of the 19 patients, 7 cases involved the colon and 11 the uterus and ovary with one case also involving the retroperoneum and ureter. Most cases (84.2%) had predisposing factors of disease progression, including intrauterine device (IUD), abortion, previous surgery, appendicitis and diverticulitis. The common presentations of the patients were abdominal pain (57.8%) and a palpable mass (15.7%). Preoperatively, no case was diagnosed as actinomycosis, but misconceived as a pelvic abscess, ovarian or colon cancers, a mesenteric origin mass, a lymphoma, periappendiceal abscess, acute appendicitis, uterine myoma, dysfunctional uterine bleeding or endometriosis. Explorations were performed in all patients. Eighteen cases were cured following surgery with subsequent antibiotics. However, one case recurred due to incompletion of antibiotics following surgical drainage. CONCLUSION: Abdominopelvic actinomycosis should be included as a differential diagnosis when an unusual abdominal mass presents on abdominal CT or ultrasound. Appropriate antibiotics, as well as surgery, are important in the treatment of abdominopelvic actinomycosis.
Abdominal Pain ; Abortion, Induced ; Abscess ; Actinomyces ; Actinomycosis* ; Anti-Bacterial Agents ; Appendicitis ; Causality ; Colon ; Colonic Neoplasms ; Communicable Diseases ; Diagnosis, Differential ; Disease Progression ; Diverticulitis ; Drainage ; Endometriosis ; Female ; Fibrosis ; Gynecology ; Humans ; Intrauterine Devices ; Leiomyoma ; Lymphoma ; Medical Records ; Metrorrhagia ; Obstetrics ; Ovary ; Retrospective Studies ; Tomography, X-Ray Computed ; Ultrasonography ; Ureter ; Uterus