We attempted to identify parasite DNA in the biliary stones of humans via PCR and DNA sequencing. Genomic DNA was isolated from each of 15 common bile duct (CBD) stones and 5 gallbladder (GB) stones. The patients who had the CBD stones suffered from cholangitis, and the patients with GB stones showed acute cholecystitis, respectively. The 28S and 18S rDNA genes were amplified successfully from 3 and/or 1 common bile duct stone samples, and then cloned and sequenced. The 28S and 18S rDNA sequences were highly conserved among isolates. Identity of the obtained 28S D1 rDNA with that of Clonorchis sinensis was higher than 97.6%, and identity of the 18S rDNA with that of other Ascarididae was 97.9%. Almost no intra-specific variations were detected in the 28S and 18S rDNA with the exception of a few nucleotide variations, i.e., substitution and deletion. These findings suggest that C. sinensis and Ascaris lumbricoides may be related with the biliary stone formation and development.
Aged ; Aged, 80 and over ; Animals ; Ascaridida/genetics/isolation & purification ; Ascaris lumbricoides/genetics/isolation & purification ; Base Sequence ; Clonorchis sinensis/genetics/isolation & purification ; Common Bile Duct/*parasitology ; DNA, Helminth/*genetics ; DNA, Ribosomal/genetics ; Face/parasitology ; Female ; Gallbladder/parasitology ; Gallstones/*parasitology ; Helminths/genetics/*isolation & purification ; Humans ; Male ; Middle Aged ; Molecular Sequence Data ; Polymerase Chain Reaction/*methods ; RNA, Ribosomal, 18S/genetics ; RNA, Ribosomal, 28S/genetics ; Sequence Alignment

PURPOSE: We designed this study to identify and suggest the reasonable timing of adjuvant radiotherapy in the treatment of uterine carcinosarcoma according to the surgical intent and patterns of progression. MATERIALS AND METHODS: We retrospectively analyzed a total of 50 carcinosarcoma patients diagnosed between 1995 and 2010. Among these 50 patients, 32 underwent curative surgery and 13 underwent maximal tumor debulking surgery. The remaining five patients underwent biopsy only. Twenty-six patients received chemotherapy, and 15 patients received adjuvant radiotherapy. RESULTS: The median follow-up period was 17.3 months. Curative resection (p < 0.001) and stage (p < 0.001) were statistically significant factors affecting survival. During follow-up, 30 patients showed progression. Among these, eight patients (16.0%) had loco-regional progression only. The patients who had received adjuvant radiotherapy did not show loco-regional progression, and radiotherapy was a significant negative risk factor for loco-regional progression (p = 0.01). The time to loco-regional progression was much earlier for non-curative than curative resection (range, 0.7 to 7.6 months vs. 7.5 to 39.0 months). CONCLUSION: Adjuvant radiotherapy in the treatment of carcinosarcoma might be related to a low loco-regional progression rate. Radiotherapy should be considered in non-curatively resected patients as soon as possible.
Biopsy ; Carcinosarcoma ; Follow-Up Studies ; Humans ; Radiotherapy, Adjuvant ; Retrospective Studies ; Risk Factors

PURPOSE: We analyzed the appropriateness of the changes regarding the classification of gastric cancer in the fifth edition of the UICC TNMclassification of malignant tumors. MATERIALS AND METHODS: Gastrectomy was performed in 727 patients with gastric cancer between 1990 and 1994. The pN, pM and stage of each patient was reclassified according to the 5th edition. The previous and present pN, pM and stage of each patient were compared. RESULTS: Although ten cases of pNO were reclassified as pNX because the number of dissected regional lymph nodes was less than 15, there revealed a good correlation between old and new pN classification. Survival distribution according to the old pN classification identified significant differences among subgroups of patients. And this was true for the new pN classification. Nine pM1 patients who had involved hepatoduodenal lymph node were reclassified into pMO. Although 97 patients were down-staged and 30 patients were up-staged, comparison of stage according to two classifications revealed good correlation. Both survival distributions according to the new and old stage grouping identified significant differences among subgroups of patients. CONCLUSION: The classification of lymph node metastasis and stage grouping in gastric cancer should be more scientific and rational in future revisions.
Classification* ; Gastrectomy ; Humans ; Lymph Nodes ; Neoplasm Metastasis ; Stomach Neoplasms*

A case of telangiectatic osteosarcoma of the proximal tibia of left leg in 19-year-old man was reported. Radiologically the tumor was aneccentric blow-out osteolytic lesion simulating aneurysmal bone cyst. Pathologically the tumor presented multiple blood filled cystic spaces and anaplastic spindle cells of osteoclastic type and focal osteoid deposition. The patient died 8 months after he underwent high above knee amputation followed by adjuvant chemotherapy. Distinct clinicopathologic finding of telangiectatic osteosarcoma was described with special emphasis on differential diagnosis.
Amputation ; Aneurysm ; Bone Cysts ; Chemotherapy, Adjuvant ; Diagnosis, Differential ; Humans ; Knee ; Leg ; Osteoclasts ; Osteosarcoma ; Tibia ; Young Adult

A 69-year-old Korean man was admitted to emergency room with complaints of abdominal pain, vomiting, and diarrhea. Laboratory tests revealed eosinophilia, anemia, hypoproteinemia, and hyponatremia. The gastric mucosa showed whitish mottled and slightly elevated lesions on the body angle of antrum. Microscopically, chronic gastritis with incomplete intestinal metaplasia was observed. Many adult worms, larvae, and eggs in cross sections were located in the crypts. Furthermore, the filariform larvae of Strongyloides stercoralis with a notched tail were detected through the culture.
Aged ; Albendazole/therapeutic use ; Animals ; Anthelmintics/therapeutic use ; Feces/parasitology ; Female ; Humans ; Intestines/parasitology ; Korea ; Male ; Strongyloides stercoralis/*isolation & purification ; Strongyloidiasis/*diagnosis/drug therapy/parasitology

BACKGROUND: The use of caudal morphine for postoperative analgesia has been increased in popularity since 1981. The purpose of this study was to compare the effect of analgesia and incidence of side effects of a mepivacaine-morphine mixture with mepivacaine alone. METHODS: Forty patients were randomly divided into two groups. In group 1, caudal block was performed with 1% mepivacaine 1 ml/kg alone. In group 2, caudal block was performed with 1% mepivacaine 1ml/kg-morphine 0.03 mg/kg mixture. Postoperative five-point pain scores and side effects were measured. RESULTS: There were no significant differences in sedation dose, incidence of side effects and supplemental analgesics. Pain scores were significantly lower at postoperative 2 and 3 hours in mepivacaine-morphine mixture group. CONCLUSIONS: Caudal epidural mepivacaine-morphine (0.03 mg/kg) mixture is effective in children for control of postoperative pain without significant side effects.
Analgesia* ; Analgesics ; Child* ; Humans ; Incidence ; Mepivacaine ; Morphine* ; Pain, Postoperative

BACKGROUND AND OBJECTIVES: Pemphigus is an autoimmune bullous disease of the skin and mucous membranes. There are two major types of pemphigus, namely pemphigus vulgaris(PV) and pemphigus foliaceus(PF) which can be classified by the specificity of the autoantibodies against the epidermal desmosomal antigens in this disease. Like many other autoimmune diseases, pemphigus is also considered to be strongly associated with certain HLA alleles; some alleles can be detected with higher frequencies as compared with those found in ethnically matched populations. At this time, we tried to find out if there were certain HLA class II allele(s) associated significantly with Korean patients of pemphigus. PATIENTS AND METHODS: Thirty patients with pemphigus (fifteen of PV and fifteen of PF), and one hundred healthy Korean controls were enrolled in this study. For the genotyping of HLA class II alleles in DRB1 loci, genomic DNAs prepared from buccal epithelia were amplified by polymerase chain reactions with nucleotide sequence-specific primers. Each allele of thirteen different generic types belonging to the DRB1 loci were used to identify the existence of each allele in both patient and control groups on gel electrophoreses. RESULTS: In PV, there was a significantly increased frequency of HLA-DRB1*01 alleles than from the findings observed in the controls(pc=0.0013, RR:5). In patients with PF, there was a significant degree of association with HLA-DRB1*01(pc=0.00013, RR:5.5) when compared with that in normal controls. However, no allele of negative association with a significantly low frequency in the patient group was detected in both types of the disease. CONCLUSION: It can be suggested that DRB1*01 alleles may be susceptibility genes in Korean patients with PV, and DRB1*01 alleles could contribute to the autoimmune reactivity in patients with PF. This data shows different patterns in the frequency of each DRB1 allele in patient groups compared with those found in patients of other ethnic backgrounds.
Alleles* ; Autoantibodies ; Autoimmune Diseases ; DNA ; Electrophoresis ; HLA-DRB1 Chains* ; Humans ; Mucous Membrane ; Pemphigus* ; Polymerase Chain Reaction ; Sensitivity and Specificity ; Skin

No abstract available.

BACKGROUND: This study was undertaken to test the validity of M-mode and a new cross sectional cehocardiographic quantification of pericardial effusion. METHODS: This study was performed in 12 patients with large pericardial effusion of whom hed M-mode and 2-D echocardiography just before therpeutic drainage of the effusion. The volume of Pericardial fluid removed by pericardiocentesis was compared with te echo-free space estimated by M-mode echocardiography and the volume estimated by new 2-D echocardiographic method. The pericardial sac volume and the cardiac volume were calculated by applying the formula for the volume of a prolate ellipse. RESULTS: 1) There was a good correlation between 2-D echocardiographic estimate and the actual volume removed by pericardiocentesis(r=0.72, p<0.05). 2) The correlation between the echo-free space estimated by M-mode echocardiography at the level of mitral valve and the actual volume was also good(r=0.81,p<0.001). CONCLUSION: The M-mode and 2-D echocardiographic method is successful in helping to estimate large pericardial effusion.
Cardiac Volume ; Drainage ; Echocardiography* ; Humans ; Mitral Valve ; Pericardial Effusion* ; Pericardiocentesis ; Phosmet

PURPOSE: The aim of this study was to investigate the impact of a distal subtotal gastrectomy on the quality of life (QoL). MATERIALS AND METHODS: The QoL data of 126 patients were obtained on their 5th annual follow-up visit after a curative distal subtotal gastrectomy for gastric cancer (Group A). The QoL data of 130 age- and gender-adjusted healthy population were obtained from the individuals who visited the health screening center for a medical check-up (Group B). There were 42 women and 84 men in the study group and their mean age was 56.0+/-11.1 years. QoL was assessed using the Korean versions of the European Organization for Research and Treatment of Cancer (EORTC) QoL Questionnaire Core 30 (QLQ-C30) and QLQ-STO22. RESULTS: The EORTC QLQ-C30 global health status and QoL scores of Group A and Group B were 63.9+/-22.7 and 61.3+/-22.1, respectively (p=0.361). Group A revealed a better score for emotional functioning (84.1+/-16.1 and 75.2+/-21.4, respectively; p<0.001), cognitive functioning (82.0+/-16.4 and 75.0+/-21.4, respectively; p=0.004) and fatigue (27.7+/-20.8 and 33.8+/-23.2, respectively; p=0.028). However, Group A revealed a worse score for nausea and vomiting (14.8+/-20.0 and 10.2+/-16.0, respectively; p=0.042), financial difficulties (14.8+/-22.9 and 7.1+/-16.1, respectively; p=0.002), reflux (16.7+/-17.7 and 10.1+/-17.0, respectively; p=0.003), eating restrictions (13.6+/-15.2 and 6.6+/-10.2, respectively; p<0.001) and body image (23.3+/-25.4 and 16.2+/-24.6, respectively; p=0.023). CONCLUSION: The QoL of long-term survivors after a distal subtotal gastrectomy is still influenced by the surgery itself even though they are considered to be free of disease.
Body Image ; Eating ; Fatigue ; Female ; Follow-Up Studies ; Gastrectomy ; Humans ; Male ; Mass Screening ; Nausea ; Quality of Life ; Stomach Neoplasms ; Survivors ; Vomiting ; Surveys and Questionnaires