PURPOSE: Matrix metalloproteinase-2 (MMP-2) and MMP-7 have been implicated in tumor growth and metastasis. This study aimed to investigate the expressions of MMP-2 and -7 in colorectal cancer and to evaluate their values as prognostic markers. METHODS: Immunohistochemical staining for MMP-2 and -7 was done in 144 resected colorectal cancer specimens. Clinicopathological data and survival results were compared with regard to the expression results. RESULTS: The expression rates of MMP-2 in tumor cells in the tumor center and the tumor border were 16.7% and 38.9%, respectively. That of MMP-2 in stromal cells was 27.8%. MMP-7 immunoreactivities of tumor cells in the tumor center and the tumor border were 6.9% and 23.6%. The expressions of MMP-2 and MMP-7 were correlated. MMP-2 expression in stromal cells was more increased in the distal part of the colorectum: 8.8% in right colon cancer, 29.5% in left colon cancer and 36.4% in rectal cancer. MMP-2 expression of tumor cells in the tumor border was correlated with T-stage. MMP-7 expression of tumor cells in the tumor border was increased in case of infiltrative cancer compared with fungating tumor. The expression patterns of MMP-2 and -7 were not correlated with other clinicopathological factors, including tumor markers, node metastasis, distant metastasis, lymphatic invasion, tumor differentiation, and recurrence. No significant associations between the overall and disease-free survival rates and the MMP-2 and -7 expression patterns were noted. CONCLUSION: The high expression rates of MMP-2 and -7 in tumor borders suggest that MMP-2 and -7 have some role in tumor invasion, but in this study, MMP-2 and -7 did not appear to be significant predictors of prognosis in colorectal cancer.
Colonic Neoplasms ; Colorectal Neoplasms ; Disease-Free Survival ; Immunohistochemistry ; Lymphatic Metastasis ; Matrix Metalloproteinase 2 ; Matrix Metalloproteinases ; Neoplasm Metastasis ; Prognosis ; Rectal Neoplasms ; Recurrence ; Stromal Cells ; Biomarkers, Tumor

Purpose: This study evaluated changes in growth and nutritional status using the first basic and the second repeated surveys on children from North Korean refugee families who settled in South Korea. Methods: A total of 337 children were included in the survey. Using a structured questionnaire, the data collected included sex, date of birth, country of birth, date of entry to South Korea, and birth parents’nationality. The prevalence of stunting, underweight, wasting, and obesity were evaluated using the 2017 Korean National Growth Chart for Children and Adolescents. Results: The prevalence of stunting decreased from 7.9% in the first survey to 6.9% in the second survey; that of underweight decreased from 6.0% to 4.7%; and that of wasting decreased from 6.3% to 3.5%; however, these changes were not statistically significant. The prevalence of obesity significantly increased from 8.0% to 13.2% in the first and second surveys, respectively (p=0.037). There was no significant difference in the prevalence of malnutrition according to the length of stay in South Korea or the children’s country of birth. However, the prevalence of obesity was significantly higher in children with longer lengths of stay and in those born in South Korea. Conclusion Although children from North Korean refugee families have settled in South Korea for a long time, the rate of malnutrition is still high, and the prevalence of obesity continuously increases.

We report a case of pure spinal epidural cavernous hemangioma and discuss the relationships among its clinical manifestation, diagnosis and treatment. A 35-year-old woman was admitted to our department with a six-month history of severe headache, nausea and back pain. Magnetic resonance imaging (MRI) of the thoracic spine showed a spindle-shaped epidural lesion extending into the neural foramen, with compression of the spinal cord at the T8-12 levels and multifocal mass lesions on the paravertebral muscles. The patient underwent microsurgery, the lesion was completely removed, and the patient recovered fully. The lesion in the spinal canal was dark-reddish and was located in the posterolateral epidural space. Histopathologic examination revealed a cavernous hemangioma. Pure spinal epidural cavernous hemangiomas have characteristic MRI findings; however, their differential diagnoses requires careful initial examination and a corresponding clinical correlation.
Adult ; Back Pain ; Caves ; Diagnosis, Differential ; Epidural Space ; Female ; Headache ; Hemangioma, Cavernous ; Humans ; Magnetic Resonance Imaging ; Microsurgery ; Muscles ; Nausea ; Spinal Canal ; Spinal Cord ; Spinal Cord Compression ; Spine

Kallmann syndrome (KS) is characterized by the association of hypogonadotropic hypogonadism and anosmia. Although the vast majority of KS cases are sporadic, some X-linked recessive (KAL1), autosomal dominant (FGFR1), and autosomal recessive (most commonly GNRHR) modes of inheritance have been described. Two boys were referred to our department because of cryptorchidism and the absence of puberty. Upon laboratory evaluation they were diagnosed with hypogonadotropic hypogonadism. Agenesis of the olfactory bulbs was detected in radiologic tests, and total deletion of the KAL1 gene was detected through multiplex ligation-dependent probe amplification (MLPA). Although cryptorchidism was diagnosed in the siblings, only the older brother suffered from sensorineural hearing loss and right renal agenesis, a feature that had been reported in X-linked KS. We describe herein the clinical heterogeneity of two affected brothers who carry a complete deletion in KAL1; this is the first case of familial Kallmann syndrome due to the complete deletion of the KAL1 gene reported in Korea.
Congenital Abnormalities ; Cryptorchidism ; Hearing Loss, Sensorineural ; Humans ; Hypogonadism ; Kallmann Syndrome ; Kidney ; Kidney Diseases ; Korea ; Male ; Multiplex Polymerase Chain Reaction ; Olfaction Disorders ; Olfactory Bulb ; Population Characteristics ; Puberty ; Siblings ; Wills

Kallmann syndrome (KS) is characterized by the association of hypogonadotropic hypogonadism and anosmia. Although the vast majority of KS cases are sporadic, some X-linked recessive (KAL1), autosomal dominant (FGFR1), and autosomal recessive (most commonly GNRHR) modes of inheritance have been described. Two boys were referred to our department because of cryptorchidism and the absence of puberty. Upon laboratory evaluation they were diagnosed with hypogonadotropic hypogonadism. Agenesis of the olfactory bulbs was detected in radiologic tests, and total deletion of the KAL1 gene was detected through multiplex ligation-dependent probe amplification (MLPA). Although cryptorchidism was diagnosed in the siblings, only the older brother suffered from sensorineural hearing loss and right renal agenesis, a feature that had been reported in X-linked KS. We describe herein the clinical heterogeneity of two affected brothers who carry a complete deletion in KAL1; this is the first case of familial Kallmann syndrome due to the complete deletion of the KAL1 gene reported in Korea.
Congenital Abnormalities ; Cryptorchidism ; Hearing Loss, Sensorineural ; Humans ; Hypogonadism ; Kallmann Syndrome ; Kidney ; Kidney Diseases ; Korea ; Male ; Multiplex Polymerase Chain Reaction ; Olfaction Disorders ; Olfactory Bulb ; Population Characteristics ; Puberty ; Siblings ; Wills

OBJECTIVES: Recently posterior dynamic stabilizations (PDS) are increased in degenerative lumbar disease. But, some previous studies had doubts its long term prognosis. Long term clinical and radiological results of PDS using interspinous device (Interspinous U, DIAM) were analyzed. METHODS: We have used the 'interspinous U' and 'DIAM' for patients with lumbar spinal stenosis. We included single level lumbar spinal stenosis patients who completed minimum 60 months follow-up evaluation. All patients checked plain lateral and flexion-extension views at immediately after the surgery and each follow-up. The clinical outcome was measured by Odom's criteria. Complications including post operative infection, bony erosion, device fracture, device malformations, and instabilities were surveyed. RESULTS: We included 18 for 'Interspinous U' and 7 patients 'DIAM' groups. Mean follow-up durations for 'Interspinous U' and 'DIAM' were 74.6 and 62.6 months, respectively. Satisfactory groups were 50.0% and 42.9 % for 'Interspinous U' and 'DIAM' groups. In 'Interspinous U' group disc height ratio increased transiently in immediate postoperative period (from 0.18 to 0.21) and then, decreased significantly in last follow-up (0.18). In 'DIAM' group, disc height ratio increased transiently in immediate postoperative period (from 0.18 to 0.19), and then decreased significantly in the last follow-up (0.16). Three (16.7%) and two (28.6%) patients undergo on a re-operation due to severe back pain in 'Interspinous U' and 'DIAM' groups. CONCLUSION: Long term follow up 'Interspinous U' and 'DIAM' group showed low patient satisfaction and poor radiological outcomes. To ascertain the benefit of PDS compare with posterior screw fixation, prospective analysis with larger population and multi-center study will be needed.
Back Pain ; Follow-Up Studies ; Humans ; Patient Satisfaction ; Postoperative Period ; Prognosis ; Spinal Stenosis

OBJECTIVE: Traumatic atlanto-occipital dislocation (AOD) results from high energy trauma and is an uncommon and usually fatal injury due to an injury to the cervicomedullary junction. Recently, improved prehospital management, early diagnosis and effective treatment led to increasing reports of survival. This study of patients with AOD initial imaging modalities recognizes the clinical features and diagnostic considerations for a quick diagnosis. METHODS: In this article, five survived adult patients with traumatic AOD are presented and retrospectively reviewed. Diagnosis was made by lateral cervical spine x-ray, cervical computed tomography (CT), or magnetic resonance imaging(MRI). Treatment consisted of early immobilization, respiratory support, and subsequent occipitocervical fusion. RESULTS: Four patients were male and the other one was female. Three were diagnosed early and the others were delayed in confirmations. One was type I AOD and four were type II AOD. All patients were applied occipitocervical fusion. Two cases were worse; neurological states and the other three that showed no change. Lateral X-ray film of all patients in the prevertebral soft tissue swelling at the C2 level was noted. The mean thickness of prevertebral soft tissue C2 level was 17.88 mm(15.18 to 20.17mm). Two were in the normal range of dens-basion index(DBI), three showed abnormalities, and Power's ratio was abnormal in 3 patients. CONCLUSION: As for damages caused by a strong external force in patients with severe prevertebral soft tissue swelling at C2 level abnormaly, the doctor determines whether more should be carefully AOD and considers 3D CT or MRI to confirm AOD in these patients.
Adult ; Atlanto-Occipital Joint ; Dislocations ; Early Diagnosis ; Female ; Humans ; Immobilization ; Magnetic Resonance Spectroscopy ; Male ; Reference Values ; Retrospective Studies ; Spine ; X-Ray Film

OBJECTIVES: Recently posterior dynamic stabilizations (PDS) are increased in degenerative lumbar disease. But, some previous studies had doubts its long term prognosis. Long term clinical and radiological results of PDS using interspinous device (Interspinous U, DIAM) were analyzed. METHODS: We have used the 'interspinous U' and 'DIAM' for patients with lumbar spinal stenosis. We included single level lumbar spinal stenosis patients who completed minimum 60 months follow-up evaluation. All patients checked plain lateral and flexion-extension views at immediately after the surgery and each follow-up. The clinical outcome was measured by Odom's criteria. Complications including post operative infection, bony erosion, device fracture, device malformations, and instabilities were surveyed. RESULTS: We included 18 for 'Interspinous U' and 7 patients 'DIAM' groups. Mean follow-up durations for 'Interspinous U' and 'DIAM' were 74.6 and 62.6 months, respectively. Satisfactory groups were 50.0% and 42.9 % for 'Interspinous U' and 'DIAM' groups. In 'Interspinous U' group disc height ratio increased transiently in immediate postoperative period (from 0.18 to 0.21) and then, decreased significantly in last follow-up (0.18). In 'DIAM' group, disc height ratio increased transiently in immediate postoperative period (from 0.18 to 0.19), and then decreased significantly in the last follow-up (0.16). Three (16.7%) and two (28.6%) patients undergo on a re-operation due to severe back pain in 'Interspinous U' and 'DIAM' groups. CONCLUSION: Long term follow up 'Interspinous U' and 'DIAM' group showed low patient satisfaction and poor radiological outcomes. To ascertain the benefit of PDS compare with posterior screw fixation, prospective analysis with larger population and multi-center study will be needed.
Back Pain ; Follow-Up Studies ; Humans ; Patient Satisfaction ; Postoperative Period ; Prognosis ; Spinal Stenosis

OBJECTIVE: This study was conducted to compare radiologic changes and clinical outcomes in adjacent level of percutaneous pedicle screws with those of conventional (open) pedicle screws. METHODS: From January 2007 to December 2009, 51 patients underwent L3-5 decompression and spinal fusion. Percutaneous pedicle screws were used in 22 patients, and open pedicle screws were used in the remaining patients. For estimation of instability, we performed measurements of change in the lordotic and adjacent segment angles. A retrospective evaluation of the patients' data and several assessment scales was conducted for determination of clinical outcomes. RESULTS: The radiological examinations revealed no significant differences, except the L2-3 sagittal angle change. The upper adjacent level angle change in the open group was larger than that in the percutaneous group. In the percutaneous group, the sagittal angle changed from 9.7+/-3.0degrees to 11.25+/-3.6degrees during the follow-up periods, and in the open group, the sagittal angle changed from 10.8+/-4.1degrees to 13.6+/-4.5degrees. Radiological instability was observed in 5 patients (17%) in the open group and in 2 patients (9%) in the percutaneous group. Both groups showed similar clinical outcomes. CONCLUSION: We suggest that open screws have a greater tendency to cause degenerative change in the upper segment than percutaneous screws. This may be because percutaneous screw fixation causes minimal injury to supporting structures and preserves adjacent facet joints.
Decompression ; Follow-Up Studies ; Humans ; Postoperative Complications ; Retrospective Studies ; Spinal Fusion ; Weights and Measures ; Zygapophyseal Joint

OBJECTIVE: Traumatic atlanto-occipital dislocation (AOD) results from high energy trauma and is an uncommon and usually fatal injury due to an injury to the cervicomedullary junction. Recently, improved prehospital management, early diagnosis and effective treatment led to increasing reports of survival. This study of patients with AOD initial imaging modalities recognizes the clinical features and diagnostic considerations for a quick diagnosis. METHODS: In this article, five survived adult patients with traumatic AOD are presented and retrospectively reviewed. Diagnosis was made by lateral cervical spine x-ray, cervical computed tomography (CT), or magnetic resonance imaging(MRI). Treatment consisted of early immobilization, respiratory support, and subsequent occipitocervical fusion. RESULTS: Four patients were male and the other one was female. Three were diagnosed early and the others were delayed in confirmations. One was type I AOD and four were type II AOD. All patients were applied occipitocervical fusion. Two cases were worse; neurological states and the other three that showed no change. Lateral X-ray film of all patients in the prevertebral soft tissue swelling at the C2 level was noted. The mean thickness of prevertebral soft tissue C2 level was 17.88 mm(15.18 to 20.17mm). Two were in the normal range of dens-basion index(DBI), three showed abnormalities, and Power's ratio was abnormal in 3 patients. CONCLUSION: As for damages caused by a strong external force in patients with severe prevertebral soft tissue swelling at C2 level abnormaly, the doctor determines whether more should be carefully AOD and considers 3D CT or MRI to confirm AOD in these patients.
Adult ; Atlanto-Occipital Joint ; Dislocations ; Early Diagnosis ; Female ; Humans ; Immobilization ; Magnetic Resonance Spectroscopy ; Male ; Reference Values ; Retrospective Studies ; Spine ; X-Ray Film