The authors and their affiliation are incorrectly listed in the article. Also, the Acknowledgments section of the above article incorrectly omitted.

A poor prognosis of oral squamous cell carcinoma (SCC) is partly due to the invasiveness and metastasis of the tumor. A key element in tumor invasion and metastasis in the degradation of extracellular matrix is matrix metalloproteinases (MMPs). This study was performed to determine the expression of MMP-2 and MMP-9 of oral SCCs with regard to the histologic invasiveness and differentiation in 5 normal oral mucosa and 36 oral SCCs. The histologic invasiveness of oral SCCs were classified into 4 grades. The differentiation of oral SCCs was divided into 3 grades. The streptavidin-biotin immunohistochemical staining, using MMP-2 and MMP-9 monoclonal antibodies, was performed to determine the expression of MMP-2 and MMP-9. The expression of MMP-2 was positive in 6 of 17 oral SCCs with weak invasiveness and was positive in 7 of 19 oral SCCs with strong invasiveness. The MMP-2 expression did not increase significantly with respect to the invasiveness of oral SCCs (P>0.05). The expression of MMP-9 was strongly positive in 6 out of 17 SCCs with weak invasiveness and was strongly positive in 14 of 19 SCCs with strong invasiveness. The MMP-9 expression increased significantly with respect to the invasiveness of oral SCCs; the stronger the expression, the stronger the invasiveness (P<0.05). The expression of MMP-9 was in 57.9% of well differentiated SCCs, 57.1% of moderately differentiated ones, and 33.3% of poorly differentiated SCCs. The expression of MMP-2 and MMP-9 did not increase significantly with respect to the histologic differentiation. We conclude that with respect to the invasiveness, the MMP-9 expression increases significantly in oral SCCs but the MMP-2 expression does not; and that with respect to the histologic differentiation, their expressions do not increase significantly. These results suggeste that MMP-9 can be used as a tool to evaluate the invasiveness of oral SCCs.
Antibodies, Monoclonal ; Carcinoma, Squamous Cell* ; Extracellular Matrix ; Matrix Metalloproteinase 2* ; Matrix Metalloproteinases ; Mouth Mucosa ; Neoplasm Metastasis ; Prognosis

Clear cell sarcoma of kidney(CCSK) is a rare pediatric neoplasm characterized by a predominating component of clear cells, a predilection for metastases to bone, and a poor prognosis. The incidence of CCSK peaks during the 2nd year of life and adult cases are very rare. We report a case of CCSK encountered in the right kidney of a 39-year-old man. Grossly, it was a lobulated mass showing infiltrative margin, measured 7x5.5x5cm and had a homogeneous gray-tan color with a soft, fish-flesh consistency. Microscopically, about half of the tumor revealed the classic pattern of CCSK, having tumor cell cords or nests separated by the characteristic alveolar capillary networks. The tumor cells had clear pale cytoplasm, bland looking round nuclei and inconspicuous nucleoli. The other half showed the epithelioid-trabecular pattern forming pseudorosette or cord-like structures. Immunohistochemically, there was only a focal positive reaction to vimentin. Ultrastructurally, the tumor cells showed the primitive nephrogenic mesenchymal differentiation such as electron lucent cytoplasm, a small amount of organelles, scanty heterochromatin, inconspicuous nucleoli, and a lack of flocculant basal lamina material around the cytoplasmic membrane. We consider that this is a case of CCSK occuring in the oldest patient ever reported, confirmed by both immunohistochemistry and electron microscopy.
Adult ; Male ; Female ; Humans ; Incidence ; Neoplasm Metastasis

OBJECTIVES: The practice of telemedicine requires social interventions and systems for efficient implementation. Further, it requires sufficient discussions among related parties because the purpose of telemedicine is diagnosis and treatment, and the participation of medical specialists is essential. Based on the characteristics of the healthcare structure of Korea, which has a low proportion of public healthcare and most patients are taken care of by a few large tertiary care hospitals, the fundamental issues need to be discussed. METHODS: A comparison was conducted with overseas cases to discuss the prerequisites for the effective implementation of telemedicine in South Korea under the current situation. We also examined the structural characteristics of the Korean medical community. RESULTS: The current paper recommends that an in-depth analysis and studies are conducted on the following aspects: a search for telemedicine services focused on public healthcare, a search of services for illnesses that impose high levels of burden on households, and the development and implementation of a telemedicine system for follow-up management at primary and secondary care hospitals after the patient undergoes surgery or treatment at tertiary care hospitals. CONCLUSIONS: As the technology develops, the focus should also be on factors such as safety, usefulness, availability, and how the functions will be realized in order to enable user communication. A clear system should be established to regulate and manage the lack of sufficient discussions. In addition, seeking projects and systems that reflect the characteristics of each country will facilitate the efficient implementation of telemedicine.
Delivery of Health Care ; Diagnosis ; Family Characteristics ; Follow-Up Studies ; Health Policy ; Humans ; Korea* ; Secondary Care ; Specialization ; Telemedicine* ; Tertiary Healthcare

PURPOSE: To identify risk factors for premature birth among premature obstetric labor women. METHODS: Participants were 129 hospitalized women who were diagnosed with potential premature obstetric labor with 20 weeks to 37 weeks of gestation. Data were analyzed using descriptive statistics, χ2 test, t-test, and binary logistic regression. RESULTS: Of 129 women, 78(60.5%) gave premature birth and 51 (39.5%) gave full-term birth. Risk factors for premature birth were education level (≤bachelor's degree), abnormal bowel condition (constipation or diarrhea), time firstly diagnosed with a premature obstetric labor (below 28 weeks of pregnancy), and multiple pregnancy. There were also increased risks of premature birth for participants with high level of anxiety and high level of prenatal stress. In social support, there was an increased risk of premature birth for participants with low level of social support. CONCLUSION: Prenatal nursing programs should consider not only psychosocial factors such as anxiety, prenatal stress, and social support, but also some general and obstetric factors such as education level, abnormal bowel condition, time firstly diagnosed with a premature obstetric labor, and multiple pregnancy to increase maternal and child health.
Anxiety ; Child Health ; Cohort Studies* ; Education ; Female ; Humans ; Logistic Models ; Nursing ; Obstetric Labor, Premature* ; Parturition ; Pregnancy ; Pregnancy, Multiple ; Premature Birth* ; Prospective Studies* ; Psychology ; Risk Factors*

Pelizaeus-Merzbacher disease(PMD) is very rare x-liked recessive leukodystrophy, rather dysmyelinating d due to defect of biosynthesis of proteolipid protein, a component of myelin. Its usual clinical features are stridor, pendular nystagmus, extrapyramidal sign, pyramydal sign, developmental delay and cognition deterioration. Until now PMD has not been published in our country. A 4-year 3 month-old boy developed abnormal eye movement at 3 months of age. His psychomotor development was delayed. On our examination, definite horizontal pendular nystagmus was noted. He showed severe dysarthria, quadriparesis with generalized hyperreflexia, bilateral extensor plantar signs. All laboratory findings including cerebrospinal fluid study were normal. Brain magnetic resonance image (MRI) -revealed diffuse and symmetrical white matter changes in cerebrum and cerebellum. His 23-year-old younger maternal uncle also showed similar clinical history and brain MRI findings. Although the diagnosis of PMD depended on histopathologic investigation, recently MRI can make an important contribution to the diagnosis of PMD with characteristic clinical features. So we could diagnose him and his uncle as PMD.
Brain ; Cerebellum ; Cerebrospinal Fluid ; Cerebrum ; Cognition ; Diagnosis ; Dysarthria ; Eye Movements ; Humans ; Infant ; Magnetic Resonance Imaging* ; Male ; Myelin Sheath ; Nystagmus, Pathologic ; Pelizaeus-Merzbacher Disease* ; Quadriplegia ; Reflex, Abnormal ; Respiratory Sounds ; Young Adult

We describe a case of mucinous adenocarcinoma which originated from the prostatic urethra, extended to right ischiorectal fossa and the seminal vesicles, and metastasized to bone. This case was identical to adenocarcinoma arising from the urinary bladder and differed from mucinous adenocarcinoma of the prostate. This tumor was negative immunohistochemically for prostate-specific antigen and prostate-specific acid phosphatase and positive for carcinoembryo -nic antigen. In terms of therapy, the distinction between mucinous adenocarcinoma of urinary bladder-type arising from the prostatic urethra and mucinous adenocarcinoma of the prostate is significant.
Acid Phosphatase ; Adenocarcinoma ; Adenocarcinoma, Mucinous* ; Mucins* ; Prostate ; Prostate-Specific Antigen ; Seminal Vesicles ; Urethra* ; Urinary Bladder*

Background: Little is known regarding the functional outcome and quality of life of neuro-ICU survivors. In Korea, the neuro-ICU concept was introduced relatively late and data about long term outcome and predictors concerning functional outcome is scarce. The main objective of this study was to analyze functional outcome and mortality, and to determine prognostic predictors for the outcome in patients admitted to Korean neuro-ICUs. Methods: Consecutive adult (≥ 15-years-of-age) patients admitted to a neuro-ICU due to various causes including ischemic or hemorrhagic stroke, and other neurological or neurosurgical problems such as traumatic brain injury, seizure, or drug intoxication during an 18-month period from July 2008 through December 2009 were included. Demographic and clinical variables were compared between groups stratifi ed based on 6-month modifi ed Rankin scale score. Results: Of 555 patients, there were signifi cant differences in age (P=0.013), sex (P=0.02), hospital stay (P<0.01), neuro-ICU stay (P<0.01), admission diagnosis (P=0.001), intubation (P<0.01), mechanical ventilation (P<0.01), tracheostomy (P<0.01), comorbid conditions such as atrial fi brillation (P<0.01), cardiac complication (P<0.01) and pulmonary complication (P<0.01), a high Therapeutic Intervention Scoring System (TISS-28) score (P<0.01), and a high Acute Physiology and chronic health evaluation (APACHE) II score (P<0.01) between favorable and unfavorable outcome groups. The overall mortality rate was 15.0% (n=83). In multivariable logistic regression analysis, age, sex, high TISS-28, high APACHE II score, intubation, and cardiac complication were independent predictors of unfavorable outcome. Conclusion: The identifi ed predictors for functional outcomes in Korean neuro-ICU patients will be an important aid in diagnosing and treating neuro-ICU patients.

From December 1989 to February 1993, 108 patients with Non-Small Cell Lung Cancers(NSCLC) were studied retrospectively to evaluate radiotherapeutic significance of serum levels of NSE. We considered elevated serum neuron specific pathologic evaluation revealed 86 squamous cell carcinomas, 11 adenocarcinomas, 3 large cell carcinomas, 3 mucoepidermoid carcinomas, and 5 unknown pathology. Eight patients had stageI, 40 stage III A, and 60 stageIII B. S-NSE level greater than 15 ng/ml was considered as elevated, and below this considered as normal. All patients received radiotherapy as primary treatment modality. The responders to radiotherapy had significantly higher mean S-NSE level than on-responders (28.5 ng/ml vs 20 ng/ml, p=0.01). Overall 2-year survival rate (YSR) was 23.6%. According to radiotherapy response, 2 YSR for patients with CR, PR, and NR were 39.2%, 28.6%, and 6.2% respectively (p=0.001). 2 YSR for patients with elevated and normal S-NSE were 14.6% and 31.7%(p=0.02). The patients with NR showed no difference in survival according to S-NSE level. When we considered all patients, S-NSE level showed no significant impact on response. But for squamous cell cardinomas alone, patients with elevated S-NSE had more patients with higher nodal stage. Based on our and other data, NSCLSC with neuroendocrine features have different response to treatment and clinical behavior compared to other NSCLSC. Thus, this subgroup may need different treatment modality, and S-NSE level may have prognostic significance.
Adenocarcinoma ; Carcinoma, Large Cell ; Carcinoma, Mucoepidermoid ; Carcinoma, Squamous Cell ; Humans ; Lung Neoplasms* ; Lung* ; Neurons ; Pathology ; Phosphopyruvate Hydratase ; Radiotherapy ; Retrospective Studies ; Survival Rate

Ross syndreome is a rare peripheral nervous system disorder defined by Adie' tonic pupil, hyporeflexia, and segmental anhidrosis. The pathogenesis is believed to result from damage to the ganglion cells or postganglionic fibers, including sympathetic, parasympathetic and dorsal root ganglion cells. A 46 year-old woman complained of right ptosis and decreased sweating of right face. The pupil showed anisocoria, which was evaluated under the variable conditions and recorded with the pupillography using Infrared Scanning Laser Photography(HRA , Heidelberg engineering, Germany). The neurologic examinations including starch-iodine test demonstrated areflexia of lower limbs and hypohidrosis of right face. The above examinations provided evidences that the sympathetic and parasympathetic ganglion cells or the post ganglionic fibers were involved and the diagnosis of Ross syndrome with Horner syndrome was made.
Anisocoria ; Diagnosis ; Female ; Ganglia, Parasympathetic ; Ganglia, Spinal ; Ganglion Cysts ; Horner Syndrome* ; Humans ; Hypohidrosis ; Lower Extremity ; Middle Aged ; Neurologic Examination ; Peripheral Nervous System ; Pupil ; Reflex, Abnormal ; Sweat ; Sweating ; Tonic Pupil