PURPOSE: Pancreatic cancer has a poor prognosis, due in part to the lack of an effective approach for its early detection. The identification of tumor antigens potentially provides a means for the early diagnosis. The purpose of this study was to use a proteomic approach for the identification of proteins that commonly induce a humoral response in patients with pancreatic cancer. MATERIALS AND METHODS: Proteins from the pancreatic adenocarcinoma cell line, BxPC3, were subjected to two-dimensional polyacrylamide gel electrophoresis, followed by Western blot analysis, where individual sera were tested for autoantibodies. Sera from 36 patients with pancreatic adenocarcinoma, and 68 from control groups (14 from lung adenocarcinoma, 19 from colon adenocarcinoma and 35 from healthy subjects) were analyzed. CLP36 expression was evaluated by immunohistochemical analysis and real-time PCR. The cellular localization of CLP36 as an autoantigen was investigated by Western blot analysis. RESULTS: The autoantibody was detected against a protein, identified by mass spectrometry as CLP36, in 14 of the 36 sera (38.9%) from patients with a pancreatic adenocarcinoma, and 3 of the 68 controls (4.4%). Immunohistochemical analysis of CLP36 in a tissue array demonstrated diffuse and consistent immunoreactivity in the pancreatic adenocarcinomas. The levels of CLP36 mRNA were highest in the pancreatic cancer cell lines of the different cells analyzed. The molecular weight of the protein displayed in the membrane-rich fraction was larger than that in the cytosolic fraction, which is likely attributable to a post-translational modification. CONCLUSION: CLP36 was identified as a tumor autoantigen inducing a humoral immune response in pancreatic adenocarcinomas. More detailed studies need to be undertaken to understand whether the humoral response by CLP36 is tumor-specific.
Adenocarcinoma ; Antibody Formation* ; Antigens, Neoplasm ; Autoantibodies ; Autoantigens ; Blotting, Western ; Cell Line ; Colon ; Cytosol ; Early Diagnosis ; Electrophoresis, Gel, Two-Dimensional ; Electrophoresis, Polyacrylamide Gel ; Humans ; Immunity, Humoral ; Lung ; Mass Spectrometry ; Molecular Weight ; Pancreatic Neoplasms* ; Prognosis ; Protein Processing, Post-Translational ; Proteomics ; Real-Time Polymerase Chain Reaction ; RNA, Messenger

No abstract available.
Humans ; Sexual Behavior* ; Uterine Cervical Neoplasms*

In cases of L4-5 spinal fusions, L5-S1 segment used to be included in the fusion traditionally for fear of progressive deterioration of the lumbosacral motion segment after fusion above. The purpose of this study was to evaluate the advisability of extension to L5-S1 segment in cases of L4-5 fusion for an isolated pathologic condition in L4-5 sement. A retrospective review of 72 patients with spinal fusion for an isolated pathologic condition in L4-5 segment was undertaken to compare the clinical results and adverse effects in two groups. One group consisted of 39 patients with floating L4-5 fusion(SF), and the other group consisted of 33 patients with L4-S1 fusion(LSF). The age, pathologic condition at L4-5, and the fusion method(lateral fusion) were matched in two groups. The mean follow-up period was 43.6 months(ranging 24-69 months). Comparisons were made for operative problems, post-operative complications, the amount of changes in angular motion at the adjacent segments to fusion at the last follow-up compared to the pre-operative motion, and the clinical results of treatment. The LSF group took 38 more minutes and lost 245 grams of more blood in averages to complete the additional surgical procedures compared with those in SF group. Several considerable post-operative complications were one deep infection in SF group and three metal failures of sacral fixation with subsequent two fusion failures in LSF group which were mostly concerned with the sacral fixations. The changes of angular motion at follow up compared to pre-operative motion in SF group were 1.5° gain in average (ranging 3° loss-6° gain) in L3-4 segment and 0.6° gain in average (ranging 5° loss-5° gain) in the L5-S1 segment. Those in L3-4 segment of LSF were 2.8° gain in average (ranging 2°-loss 9° gain). Therefore the higher stress and subsequent degeneration are more likely expected above the L4-S1 fusion rather than below the L4-5 fusion. The satisfactory clinical results were 89.7% in SF group and 87.9% in LSF group without significant difference between two groups. In conclusion there is no need to include the L5-S1 segment in the L4-5 fusion when the pathology is limited to L4-5 segment.
Follow-Up Studies ; Humans ; Pathology ; Retrospective Studies ; Spinal Fusion

BACKGROUND: It is not known with certainty whether patients with persistently positive sputum smear results who have also had negative sputum culture results require prolongation of treatment for tuberculosis in order to avoid an increased risk of eventual relapse. The purpose of the present study was to retrospectively describe the treatment characteristics and evaluate the appropriate duration of treatment in these patients. METHODS: Sixty of 69 patients with sputum smear positive and culture negative tests at 5 months after first line anti-tuberculous chemotherapy from 2002 to 2003 were retrospectively analyzed. Exclusion criteria included incomplete treatment or resistance to rifampicin or two additional antibiotics, as determined by a drug susceptibility test (DST). RESULTS: Smear conversion of the study subjects was observed after 8.3+/-2.3 months treatment, and the patients were culture negative after 2.0+/-0.8 months. The relapse rates of the study subjects were 3.8, 10.0, and 25.8% after 1, 2, and 5 years of anti-tuberculosis chemotherapy, respectively. The relapse rates were not significantly affected by a series of risk factors such as age, sex, presence of diabetes, a sputum culture examination after 2 months treatment, previous treatment history, chest radiograph, and duration of the treatment (p>0.05). CONCLUSION: Regimen change is not required for patients with persistent smear positive but culture negative tests in the fifth month for first line antituberculous treatment. However, a further study will be needed to clarify the high relapse rate in this specific group of patients.
Anti-Bacterial Agents ; Drug Therapy* ; Humans ; Radiography, Thoracic ; Recurrence ; Retrospective Studies ; Rifampin ; Risk Factors ; Sputum* ; Tuberculosis ; Tuberculosis, Pulmonary

PURPOSE: This study was aimed to explore and report the short term results of primary cementless hip arthroplasty in treatment of unstable intertrochanteric femur fracture in elderlys. MATERIALS AND METHODS: Between March 2009 and Feburary 2012, 35 arthroplasty cases performed by single surgeon and followed up for more than one year were evaluated. They were 21 females and 14 males with mean age of 78 years (range, 71-92 years). Preoperative evaluation was performed by American Society of Anesthesia score. Retrospective evaluation was performed by operative time, transfusion amount, time to operation days, hospital stay and time to full weight bearing. Clinically, ambulatory ability was checked by Parker and Palmer (P&P) score and function of hip was appraised by Harris hip score (HSS). Radiologically, bone healing of fractured trochanteric fragment and presence of subsidence, stress shielding or osteolysis were checked. RESULTS: Fracture type was 11 cases of A2.2, 18 cases of A2.3 and 6 cases of A3.3. Femoral stems used were 8 cases of rectangular tapered wedge type and 27 cases of fluted modular distal fixation type. P&P score improved from mean preinjury score of 7.1 to mean postoperative last follow-up score of 6.5. Median HHS at last follow-up was 75. Mean time to full weight bearing was 47 days (24-79 days). Postoperative complications were one case of linear periprosthetic femoral fracture and one case of postoperative dislocation. CONCLUSION: Cementless hip replacement arthroplasty could be a good option for unstable intertrochanteric femoral fracture in elderlys.
Anesthesia ; Arthroplasty* ; Arthroplasty, Replacement, Hip ; Dislocations ; Female ; Femoral Fractures ; Femur* ; Follow-Up Studies ; Hip* ; Humans ; Length of Stay ; Male ; Operative Time ; Osteolysis ; Postoperative Complications ; Retrospective Studies ; Weight-Bearing

PURPOSE: To evaluate the efficacy of vitrectomy for persistent diabetic macular edema after laser photocoagulation or intravitreal triamcinolone injections and to determine the demographic and ocular factors that influence functional and anatomical outcomes. METHODS: We retrospectively evaluated 55 eyes (51 patients) that had persistent diffuse macular edema after laser photocoagulation or intravitreal triamcinolone injections. We compared preoperative and postoperative best corrected visual acuity and macular thickness by Optical Coherence Tomography and investigated factors including patient's age, presence of vitreomacular traction, grade of diabetic retinopathy, and intraoperative internal limiting membrane removal that may influence the surgical results. RESULTS: The mean preoperative BCVA (log MAR) was 0.91+/-0.40 (0.8-1.2). The BCVA improved to 0.72+/-0.39 (0.3-1.2). The mean preoperative macular thickness was 440+/-130 (202-805) micrometer and the mean macular thickness decreased to 306+/-97 (136-580) micrometer postoperatively. The eyes showed statistically significant improvement in BCVA and central macular thickness (p<0.001). Preoperative better BCVA was associated with an improved postoperative visual acuity. (p=0.04). No other covariates were found to be statistically significant factors for prognosis of postoperative BCVA. CONCLUSIONS: In eyes with persistent diabetic macular edema after laser or IVTA injections, vitrectomy was effective for decreasing macular thickness and improvement of vision. The visual improvement after vitrectomy was associated with the preoperative better BCVA.
Adult ; Aged ; Diabetic Retinopathy/*surgery/therapy ; Female ; Humans ; Injections ; Laser Coagulation ; Macular Edema/*surgery/therapy ; Male ; Middle Aged ; Retreatment ; Retrospective Studies ; Treatment Outcome ; Triamcinolone/administration & dosage/therapeutic use ; *Vitrectomy ; Vitreous Body

Purpose: A survey was conducted to investigate the role, priority, and awareness of physical therapists in the community care system for the elderly. Methods: Nine hundred ninety-three physical therapists were invited to an online survey from 1st to 30th June 2020. Results: While the awareness of physical therapists for the community care system for the elderly was found to be low, the role priority and performance ability were found to be high. Fall training scored the highest for the job duties of physical therapists, and functional training scored the highest for the performance ability of physical therapists. For the role priority by the education status regarding the community care system, the participants who received the education program showed higher scores in the performance ability than those who did not. For the role priority and performance ability according to the education levels, higher education levels resulted in higher scores in both outcomes. Regarding the clinical experience, low scores were found in the participants with less than five years of experience. Conclusion Physical therapy establishes itself as an essential area of expertise in the community care system for the elderly. Therefore, these results can be utilized in developing a model for Korean community care for the elderly.

Purpose: A survey was conducted to investigate the role, priority, and awareness of physical therapists in the community care system for the elderly. Methods: Nine hundred ninety-three physical therapists were invited to an online survey from 1st to 30th June 2020. Results: While the awareness of physical therapists for the community care system for the elderly was found to be low, the role priority and performance ability were found to be high. Fall training scored the highest for the job duties of physical therapists, and functional training scored the highest for the performance ability of physical therapists. For the role priority by the education status regarding the community care system, the participants who received the education program showed higher scores in the performance ability than those who did not. For the role priority and performance ability according to the education levels, higher education levels resulted in higher scores in both outcomes. Regarding the clinical experience, low scores were found in the participants with less than five years of experience. Conclusion Physical therapy establishes itself as an essential area of expertise in the community care system for the elderly. Therefore, these results can be utilized in developing a model for Korean community care for the elderly.

A 43-year-old female patient with a congenital right coronary artery to right atrial fistula presented as congestive heart failure and aortic valve infective endocarditis. The diagnosis was made on the basis of echocardiography, especially TEE and confirmed by tight heart catheterization & aortography. She underwent aortic valve replacement due to severe aortic valve regurgitation with vegetations, fistulectomy and coronary aneurysmorrhaphy. The postoperative course was uneventful. She was treated with antibiotics because of infective endocarditis for 6 weeks. At present she remains well and visits out patient clinic regularly for oral anticoagulation without problem.
Adult ; Anti-Bacterial Agents ; Aortic Valve* ; Aortography ; Arteriovenous Fistula* ; Cardiac Catheterization ; Cardiac Catheters ; Coronary Vessels ; Diagnosis ; Echocardiography ; Endocarditis* ; Estrogens, Conjugated (USP)* ; Female ; Fistula ; Heart Failure* ; Humans

BACKGROUND AND OBJECTIVES: Persistent and recurrent otorrhea following open cavity tympano-mastoidectomy can be a serious problem for the patient and the otologic surgeon. Frequent post-operative otorrhea hallmarks surgical failure. Medical treatment may often yield resolution, but a significant number of patients would still require re-operation. So we applied CO2 laser cauterization to draining cavity. The objective of the present study was to introduce the CO2 laser cauterization on draining cavity, and to describe the clinical course of the laser treatment. MATERIALS AND METHOD: Twenty-one cases of post-operative persistent or recurrent otorrhea were diagnosed at our hospital from January 1999 to December 2000. Fifteen cases were selected in this study. The selection criteria included chronic ear patient, open cavity tympano-mastoidectomy, absent residual or recurrent cholesteatoma. The minimum duration of follow up was 6 months. All cases were locally anesthetized with 10% xylocaine. The CO2 laser was Shaplan 100 which was connected to a microscope. The interval of CO2 laser cauterization was one week. RESULTS: All of 15 cases were cured completely. There was no recurrence during the follow up period. The locations of granulation tissues were tegmen (10 cases), mastoid tip (6 cases), retro-facial or facial ridge (4 cases), and sino-dural angle (4 cases). The mechanical causes of retention of debris in open cavity procedures included insufficient meatoplasty (3 cases) and high facial ridge (2 cases). The times of CO2 laser coagulation ranged from 2 to 5. CONCLUSION: Based on our research on the effect of CO2 laser among patients with draining cavity, we concluded that : 1) CO2 laser cauterization was an efficient method for the management of draining cavity, 2) CO2 laser cauterization has benefits which reduced the frequency of OPD visits and 3) CO2 laser cauterization provided a delicate, selective removal of granulation tissues.
Cautery ; Cholesteatoma ; Ear ; Follow-Up Studies ; Granulation Tissue ; Humans ; Lasers, Gas ; Lidocaine ; Mastoid ; Patient Selection ; Recurrence