OBJECTIVE: To evaluated whether clusterin over-expression is significantly correlated with paclitaxel resistance in ovarian cancer cell lines. METHODS: Clusterin was validated by performing expression profiling analysis and subsequently, the correlation between clusterin mRNA expression levels and the IC50 of paclitaxel was tested. Transfection of clusterin was performed on SKOV3, which expressed paclitaxel-sensitivity and low level of clusterin, and transfection of clusterin siRNA on PEOH, which expressed paclitaxel-resistance and high level of clusterin, to evaluate their effect on chemo-sensitivity, apoptosis, and cell cycle by XTT assay, cell death ELISA, and flow cytometry, respectively. RESULTS: Clusterin mRNA and protein expression levels were significantly correlated with paclitaxel resistance (P<0.001). Transfection of cluterin on SKOV3 significantly decreased apoptosis and increased paclitaxel resistance. And transfection of clusterin siRNA on PEOH significantly increased paclitaxel-sensitivity (P<0.05), and shifted cells from S to G2/M phase of the cell cycle after paclitaxel treatment. CONCLUSION: These findings suggested that clusterin overexpression confers paclitaxel-resistance by the modulation of the apoptotic pathway and cell cycle progression in ovarian cancer cells.
Apoptosis ; Cell Cycle ; Cell Death ; Cell Line ; Clusterin* ; Enzyme-Linked Immunosorbent Assay ; Flow Cytometry ; Inhibitory Concentration 50 ; Ovarian Neoplasms* ; Paclitaxel* ; RNA, Messenger ; RNA, Small Interfering ; Transfection

A 39-year-old man, his 35-year-old wife, and their 13-year-old daughter were found dead in their home. The man and his daughter were found lying in her bedroom, with his head wrapped in a plastic bag connected to four helium gas cylinders by green polypropylene tubes. Fragments of the burnt ignition briquette were found in the bucket located at her feet. His wife was found in a decomposed state lying on her right side in her bedroom. Autopsy findings for the man were unremarkable except for cherry pink lividity; the blood carboxyhemoglobin concentration was 73%. Autopsy findings were unremarkable for the woman as well, except for a few petechial hemorrhages and conjunctival congestion. The daughter showed no definite abnormalities; however, her blood and lung contained helium gas. The deceased man's suicide note, evidence gathered at the scene, and postmortem examination revealed that this was a case of dyadic death.
Adolescent ; Adult ; Asphyxia ; Autopsy* ; Carboxyhemoglobin ; Deception ; Estrogens, Conjugated (USP) ; Female ; Foot ; Head ; Helium* ; Hemorrhage ; Humans ; Lung ; Nuclear Family ; Plastics ; Polypropylenes ; Prunus ; Spouses ; Suicide

Dysphagia is a disorder of the swallowing mechanism and presents a major problem in the rehabilitation of stroke patients. In-the present study, computerized laryngeal analyzer (CLA) was used for noninvasive assessment of the pharyngeal phase of the swallowing mechanism. Laryngeal elevation was measured with pressor sensor placed on the skin over the thyroid cartilage. In the study. CLA was applied at each posture of neck flexion, neutral, and extension in stroke group and control group. Significant differences were found in each of the these parameters measured in control group and stroke group. The quantitative measurements may aid the physician in choosing the appropriate therapy during the course of recovery. The onset latency of swallowing was delayed in stroke group than control group at all posture of neck(p<0.05). The pharyngeal transit time (PTT) was longer at extension than flexion and neutral posture of neck in stroke group(p<0.05). The PTT was longer in stroke group than control group at all posture of neck, but not significant(p>0.05). The amplitude of swallowing was decreased in stroke group at extension and neutral posture of neck compared to those of control group (p<0.05), but there was no significant difference between stroke group and control group in neck flexion (p>0.05).
Deglutition Disorders ; Deglutition* ; Humans ; Neck* ; Posture* ; Rehabilitation ; Skin ; Stroke* ; Thyroid Cartilage

Recently, worldwide dietary reference intakes have been considered an important guideline for public health. Some governments and the World Health Organization (WHO) provide guidelines concerning dietary intake. Although an ingredient may have a history of use as a culinary material, changes in the environment over time suggest that the acceptable maximum intake each of food/culinary material should be regularly evaluated. Arctium lappa L. has been used as a culinary material for many centuries in Korea and Japan and some recent studies have reported related therapeutic effects. However, there are no reports on the safety of repeated oral administration. In this study, we evaluated the safety of a 8-weeks repeated oral intake of A. lappa. We concluded that treatment with <250 mg/kg A. lappa, which was within the safety range, resulted in body weight decrease and blood glucose suppression.
Administration, Oral* ; Arctium* ; Blood Glucose ; Body Weight ; Japan ; Korea ; Public Health ; Recommended Dietary Allowances ; Therapeutic Uses ; World Health Organization

Actinomycosis is an oppoturnistic infection of actinomyces, which are relatively avirulent endogenous oral commensals. After trauma or infection, they breach the normally protective mucosal barriers to invade adjacent soft tissue structures. Lesions routinely contain other bacteria, the normal resident flora at the site of primary infection, which act synergistically with actinomyces species to provoke this unique infection, which range from an acute suppurative process to a chronic fibrotic process. According to epidemic studies about pelvic actinomycosis, it should be significantly related to IUD(intrauterine device). It is accounted that IUD cause chronic intrauterine infection, tissue injury and act as nucleus for parasitic infestation. Here we present a case of pelvic actinomycosis related to IUD with brief review of the concerned literature.
Actinomyces ; Actinomycosis* ; Bacteria

BACKGROUND: The prevalence and prognostic value of overt disseminated intravascular coagulation (DIC) in patients with septic shock presenting to emergency departments (EDs) is poorly understood, particularly following the release of a new definition of septic shock. The purpose of this study was to investigate the prevalence and prognostic value of DIC in septic shock. METHODS: We performed retrospective review of 391 consecutive patients with septic shock admitting to the ED of tertiary care, university-affiliated hospital during a 16-month. Septic shock was defined as fluid-unresponsive hypotension requiring vasopressor to maintain a mean arterial pressure of 65 mmHg or greater, and serum lactate level ≥ 2 mmol/L. Overt DIC was defined as an International Society on Thrombosis and Hemostasis (ISTH) score ≥ 5 points. The primary endpoint was 28-day mortality. RESULTS: Of 391 patients with septic shock, 290 were included in the present study. The mean age was 65.6 years, the 28-day mortality rate was 26.9%, and the prevalence of overt DIC was 17.6% (n = 51) according to the ISTH score. The median DIC score was higher in non-survivors than in survivors (5.0 vs. 2.0, p = 0.001). Significant higher risk of mortality was observed in overt DIC patients compared to those without (28.2% vs. 13.7%, p = 0.005). Multivariable logistic regression analysis identified DIC to be independently associated with 28-day mortality (odds ratio, 2.689 [95% confidence interval, 1.390-5.201]). CONCLUSIONS: Using the ISTH criteria of DIC, overt DIC in septic shock was found to be common among patients admitting to the ED and to be associated with higher mortality when it is accompanied with septic shock. Efforts are required to identify presence of overt DIC during the initial treatment of septic shock in patients presenting the the ED.
Arterial Pressure ; Consensus* ; Dacarbazine ; Disseminated Intravascular Coagulation* ; Emergencies* ; Emergency Service, Hospital* ; Hemostasis ; Humans ; Hypotension ; Lactic Acid ; Logistic Models ; Mortality ; Prevalence* ; Retrospective Studies ; Shock, Septic* ; Survivors ; Tertiary Healthcare ; Thrombosis

PURPOSE: The prognosis for Borrmann type 4 gastric cancer is dismal although therapies for gastric cancer have been developed. We investigated the outcomes for Borrmann type 4 gastric cancers compared to those for other types of cancer. MATENRIALS AND METHODS: Between 1993 and 2000, 777 patients with advanced gastric cancer underwent surgical resection at the Department of Surgery, Korea University Hospital. The clinicopathologic features of 138 patients with Borrmann type 4 carcinomas of the stomach were retrospectively reviewed from the database of gastric cancer. The results were compared with those of 639 patients with other types of gastric carcinomas. RESULTS: Patients with Borrmann type 4 carcinomas tended to be younger and to have larger tumors. The location, the depth of invasion, lymph node metastasis, and distant metastasis were significantly different between the two groups. Patients with Borrmann type 4 carcinomas had a more advanced stage than patients with other types of carcinomas. The analysis of the treatment factors revealed that total gastrectomies were more frequent in the group with Borrmann type 4 carcinomas and that the curative resection rate of patients with Borrmann type 4 gastric carcinomas was lower than that of patients with other types of gastric carcinomas (P<0.001). The 5-year survival rate for Borrmann type 4 gastric cancer was 19.4% and that for other types was 52.9% (P=0.001). In curative cases, the 5-year survival rates were 32.8% for patients with Borrmann type 4 gastric carcinomas and 63.4% for other types of carcinomas (P=0.001). CONCLUSION: Borrmann type IV gastric cancer has more advanced features and a poorer prognosis than other types of gastric cancer. Improving the prognosis for patients with Borrmann type 4 gastric cancer requires early detection and a curative resection.
Gastrectomy ; Humans ; Korea ; Lymph Nodes ; Neoplasm Metastasis ; Prognosis ; Retrospective Studies ; Stomach ; Stomach Neoplasms* ; Survival Rate

Transesophageal echocardiography(TEE) is a new acoustic window to the cardiac structures and great vessels via retrocardiac esophagus. Because of the close relation between the esophagus and the heart, higher transducer frequencies can be applied, therefore leading to improved resolution and more accurate images than transthoracic echocardiography. We describe our experience with the first 353 awake patients. The procedure was well tolerated by the patients and associated with no major complications, within examination 10 to 20 minutes. Clinical diseases which appear to be suited for TEE includes 1) evaluation of native valve diseases, particulary mitral valve, pathologic valvular abnormalities and color Doppler regurgitant flows ; 2) assesment of prosthetic heart valves to better define malfunction and important pathologic associations ; 3) congenital heart disease, particularly atrial septal defect ; 4) endocarditis and detection of vegetations and complications ; 5) detection of thrombus and tumors, size, location, morphology, stalk ; and 6) aortic pathology including atherosclerosis, aneurysm and dissection. We conclude that transesophageal echocardiography is a new imaging technique that is rapidly evolving into a major tool for general cardiac imaging in a variety pathologic conditions and is a safe and useful tool in patients. Future advances in probe technology will continue to expand its applications.
Acoustics ; Aneurysm ; Atherosclerosis ; Echocardiography ; Echocardiography, Transesophageal* ; Endocarditis ; Equidae ; Esophagus ; Heart ; Heart Defects, Congenital ; Heart Septal Defects, Atrial ; Heart Valves ; Humans ; Mitral Valve ; Pathology ; Thrombosis ; Transducers

PURPOSE: The purpose of this study was to review the daily practice of inferior vena cava filters (IVCFs) in a tertiary referral center in Korea and to reveal the retrieval rate and the methods for improving it. MATERIALS AND METHODS: Through the electronic medical record system, a retrospective review was performed on 115 consecutive patients who underwent placement of retrievable IVCFs between February 2000 and January 2011 in Seoul National University Hospital. RESULTS: IVCF placement was done in 115 cases (113 patients). There were 68 men (59.1%), and the mean age was 58.5+/-15.5 years (range, 10-96 years). The affiliated departments were Vascular Surgery (57 cases, 49.6%), and Internal Medicine (20 cases, 17.4%). Advanced malignancy was the most commonly associated disease (n=30, 26%). The indications for IVCF placement were categorized; absolute indications in 36 cases (31.3%), relative indications in 78 cases (67.8%), and prophylactic use in 1 case (0.9%). The most common indications were thrombolysis/thrombectomy for iliocaval deep vein thrombosis (DVT) (n=55, 47.8). Of the 115 filters, 68 were retrieved (retrieval rate, 59%). The most common cause of non-retrieval was chronic high risk of venous thromboembolism in 24 patients (51%), followed by residual proximal DVT (n=7, 15%), and negligence by unknown reasons (n=6, 13%). CONCLUSION: To improve the retrieval rate, the number of follow-up losses to vascular specialists must be decreased, which can be achieved by establishment of a dedicated IVC filter clinic, implementation of a filter registry, and regular education for medical teams and patients along with their families.
Education ; Electronic Health Records ; Follow-Up Studies ; Humans ; Internal Medicine ; Korea ; Male ; Malpractice ; Pulmonary Embolism ; Retrospective Studies ; Seoul ; Specialization ; Tertiary Care Centers* ; Vena Cava Filters* ; Venous Thromboembolism ; Venous Thrombosis

As the development of CT scan enabled rapid and precise diagnoses of epidural hematoma, recent efforts have been sought to reduce its mortality rate. This study is a retrospective clinical analysis of one hundred eighty-one consecutive cases of epidural hematoma treated at the Department of Neurosurgery in Dong-guk University Hospital between Jan. 1991 and Dec. 1994. The rate of unsatisfactory outcome is 10.5%, While the mortality rate is 4.9%. Delayed epidural hematoma was founded tobe 12%. The authors have attempted to identify the factors influencing the prognosis of epidural hematoma. Based on the results of the above study we concluded that age, initial Glasgow coma scale, pupillary reflex and its size, IICP findings on brain CT, hematoma amount, associated intracranial lesions, rate of development of symptoms and timing of operation after injury are all relevant prognostic factors.
Brain ; Diagnosis ; Glasgow Coma Scale ; Hematoma* ; Mortality ; Neurosurgery ; Prognosis ; Reflex, Pupillary ; Retrospective Studies ; Tomography, X-Ray Computed