No abstract available.
Allografts* ; Dendritic Cells*

No abstract available.
Hyperaldosteronism*

No abstract available.
Seizures* ; Sparganosis*

A 49-year-old man with an uncorrected visual acuity (UCVA) of 20 / 1000, a best spectacle-corrected visual acuity (BSCVA) of 20 / 400, keratometric readings of K1 = 59.88 x 82degrees / K2 = 45.88 x 172degrees, and an inferior steepening that was consistent with keratoconus in his left eye was treated with clear-cornea phacoemulsification and an intraocular lens (IOL) implantation after insertion of keraring intrastromal corneal ring segments for severe keratoconus and cataract. An asymmetrical pair of kerarings was implanted with the assistance of a femtosecond laser in September 2008; the one segment was 250 microm and the other was 150 microm and both were placed at 70degrees. Three months after the kerarings were implanted, clear-cornea phacoemulsification and IOL implantation were performed on the left eye. After surgery, both the UCVA and the BSCVA of the left eye improved by eight lines. Postoperative central keratometry showed a decrease of 7.35 diopters in the left eye. Both the postoperative refraction (-0.75 -0.75 x 60degrees) and the keratometric reading (K1 = 50.05 x 93degrees / K2 = 48.83 x 3degrees) remained stable one month following the procedures. Thus, the sequential order of intrastromal corneal rings implantation and cataract surgery can be considered as a treatment option in patients with severe keratoconus and cataract.
Cataract/*complications/diagnosis ; Corneal Stroma/pathology/*surgery ; Corneal Topography ; Follow-Up Studies ; Humans ; Keratoconus/complications/diagnosis/*surgery ; Lens Implantation, Intraocular/*methods ; Male ; Middle Aged ; Phacoemulsification/*methods ; Severity of Illness Index

PURPOSE: The purpose of this study is to analyze the development and implementation of the Objective Structured Clinical Examination (OSCE) for the residency applicant examination at Daegu-Catholic Hospital. METHODS: Fifty-four Daegu-Catholic residency applicants were evaluated by written examination, internship scores, and OSCE. The correlation between written examination scores, internship scores, and OSCE scores was assessed. RESULTS: The correlation between OSCE and internship scores showed a tendency to be more significant than that between the written test and internship scores, but OSCE-internship correlation coefficients and written test and internship correlation coefficients was not statistically significant. The distribution of OSCE and internship scores on a graph corroborated this relationship between the two variables. CONCLUSION: The OSCE presents more objective criteria for residency application tests.
Clinical Competence ; Educational Measurement ; Internship and Residency

PURPOSE: We reviewed 604 cases of varicose veins managed in our hospital and the clinical feature and the results were analyzed between injection sclerotherapy and operative method. METHODS: Retrospective review of clinical records was done from January 1990 to June 1998. All of them were diagnosed as primary varicose veins of lower extremities. Sclerosing agents used were ethanolamine oleate, most commonly, hypertonic saline, sodium tetradecyl sulfate and sclerodex. Injections of the sclerosants were 1 to 5 times as the clinical courses. Then, elastic stocking was applied for 2 weeks. Operations were done under the spinal or general anesthesia and postoperatively remnant varicoses were managed by injection sclerotherapy. Student t-test was used in statistics. RESULTS: The distribution of age were 5th decade (36.8%), 6th decade (24.0%), 4th decade (22.2%) in order of frequency, and the mean age was 44.3 year and the male to female ratio was 1:4.0. The mean duration of illness was 12.6 year, and it was longer in female than male (13.2 vs. 8.7, p=0.02). The most common presumed predisposing factor was longstanding occupation (82% of all) and pregnancy was the 2nd in female (12.0%). Chief complaint was only cosmetic problem in 73% of patients and the others complained varicose induced symptoms and complications. Both lower extremities were involved in 41.9% and right leg was in 26.0%, left leg was in 32.1%. The locations of lesions were calf (41.4%), greater saphenous vein (34.6%), lesser saphenous vein (15.0%). Sclerotherapy was done in 48.0%, operation with sclerotherapy in 23.7%, operation only in 17.2%. The mean duration of illness in sclerotherapy group was significantly shorter than operation group (8.8 vs 14.7 year, p=0.0001). Operation methods were stab avulsion only (48.1%), greater saphenous vein stripping (37.3%) and perforator ligation (11.8%) and others. CONCLUSIONS: Injection sclerotherapy method is very effective and sufficient treatment modality in the management of lower extremity varicose vein with low recurrence and complication rate, especially in the early treated cases.
Anesthesia, General ; Causality ; Ethanolamine ; Female ; Humans ; Leg ; Ligation ; Lower Extremity ; Male ; Occupations ; Oleic Acid ; Pregnancy ; Recurrence ; Retrospective Studies ; Saphenous Vein ; Sclerosing Solutions ; Sclerotherapy ; Sodium Tetradecyl Sulfate ; Stockings, Compression ; Varicose Veins*

PURPOSE: RKIP (Raf kinase inhibitor protein) is a novel candidate tumor suppressor, known to inhibit the MAPK signaling by interfering with the MEK phosphorylation by Raf-1. The aim of this study was to investigate the expression of RKIP and analyze the pattern of inactivation and mutation of the RKIP gene in human gastric cancer. METHODS: To explore if RKIP inactivation is implicated in gastric tumorigenesis, an expression analysis on the transcription and protein expression levels and a mutational analysis of RKIP were performed in 15 human gastric cancer cell lines and 92 primary carcinoma tissues. RESULTS: Abnormal reduction of the level of RKIP expression was frequently detected in the cancer cell lines and primary tumor tissues, at both the transcript and protein levels. Moreover, the expression level of RKIP in the tumor cells was inversely correlated with the level of Erk phosphorylation, indicating that RKIP plays a key role in the regulation of the Raf-MEK-Erk signaling pathway in human gastric cells. While the expression of the RKIP transcript was not re-activated in low expressor cells by treatment with the demethylating agent 5'Aza-dC, the genomic RKIP was detected at low levels in many cancer cell lines, suggesting that an abnormal reduction of level of RKIP expression in tumors might be caused by allelic deletion of the gene rather than transcriptional silencing due to aberrant DNA hypermethylation. A loss of heterozygosity study, using an intragenic polymorphic marker, revealed that approximately 21% of the gastric cancers harbored allelic loss of the RKIP gene. CONCLUSION: Collectively, this study has demonstrated that RKIP is a tumor suppressor, whose expression is frequently downregulated by allelic deletion in human gastric cancers. This study also suggests that an altered expression of RKIP might contribute to the development of gastric cancer via abnormal elevation of the Raf-Erk signaling pathway.
Carcinogenesis ; Cell Line ; DNA ; Humans* ; Loss of Heterozygosity ; Phosphorylation ; Phosphotransferases* ; Stomach Neoplasms*

BACKGROUND: One of the most important prognostic factors in colorectal cancer is lymph node metastasis, which predicts a reduced survival time. Although lymph node metastases were not detected by a conventional hematoxylin-eosin stain technique, 20 to 30 percent of patients fail long-term survival on account of a local or systemic recurrence. Recurrent disease in these patients is believed to develop from occult tumor in lymph nodes. PURPOSE: The authors have conducted an immunohistochemical study with two different antibodies against cytokeratin to identify occult micrometastases in lymph nodes which were diagnosed as tumor negative by conventional histopathology. METHODS: Paraffin blocks of sixty-five patients with colorectal cancer (T2/3, N0, M0) after a curative resection between January 1991 and December 1993 at Kyung-Hee University Hospital were stained with avidin-biotin-peroxidase complex technique using two monoclonal antibodies (anti-cytokeratin AE1/AE3 and anti-cytokeratin No. 20, DAKO, Hamburg, Germany). To assess the clinical correlation between micrometastasis in lymph node and patients survial, 5-year disease-free survival rates were calculated by Kaplan-Meier method and the significance of the differences was estimated by the log-rank test. P values <0.05 were taken to be significant. RESULTS: Of the sixty-five patients with 1133 lymph nodes, tumor cells detected by anti-cytokeratin AE1/AE3 and anti-cytokeratin No. 20, were 2.4 percent (27/1133) and 3.4 percent (38/1133), respectively. Micrometastases were detected in twenty-six patients (40.0 percent). The histologic stage of four cytokeratin positive cases was upstaged from T2, N0, M0 to T2, N1/2, M0, and twenty-two of T3, N0, M0 to T3, N1/2, M0. Cytokeratin-positive cases showed statistically significant recurrence rate (42.3 percent) compared to that of cytokeratin -negative cases (17.9 percent)(x2 test, p=0.032). With the median follow-up of 62 months, 5-year disease-free survival rates of the micrometastses negative and positive cases were 81.7 percent and 61.3 percent, respectively (p=0.0438). CONCLUSIONS: In conclusion, immunohistochemical technique to identify the occult micrometastases in lymph nodes overlooked in conventional histopathology is a useful staging method to anticipate a recurrence and a prognosis more precisely.
Antibodies ; Antibodies, Monoclonal ; Colorectal Neoplasms* ; Disease-Free Survival ; Follow-Up Studies ; Humans ; Keratins ; Lymph Nodes ; Neoplasm Metastasis ; Neoplasm Micrometastasis* ; Paraffin ; Prognosis ; Recurrence

BACKGROUND: Atherosclerotic cardiovascular disease and metabolic syndrome are both rapidly increasing in Koreans due to the new westernized eating habits and the aging of the population. The pulse wave velocity (PWV) reflects arterial stiffness and it may be used as an indicator of atherosclerosis. This study was conducted to investigate the association of the PWV with metabolic syndrome. METHODS: Among 1438 persons who visited the Internal Medicine Clinic or Health Center of a general hospital in Seoul, Korea, 384 adults (age range: 30-69 years old) were selected as study subjects. Those patients with cardiovascular disease or other systemic disease were excluded, but the patients with hypertension and diabetes mellitus were included. Ninety four (25.4%) subjects were classified as patients with metabolic syndrome when jointly applying the WHO Asia-Pacific criteria and NCEP ATPIII criteria. RESULTS: The PWV was higher in the older aged group and in the men compared to the other group. The greater the number of diagnostic criteria of the metabolic syndrome subjects had, the higher was their PWV. After adjustment for age, gender, blood pressure, BMI and fasting blood glucose, a PWV change of 1.0 m/sec increased the risk of metabolic syndrome by 1.31 times (95% CI: 0.81-2.09). The risk of metabolic syndrome was 7.62 times higher among the subjects with a PWV greater than 7.5 m/sec (95% CI: 1.07-54.42), as compared with that of subjects with a PWV less than 7.5 m/sec. CONCLUSIONS: The PWV may independently increase the risk of metabolic syndrome as a non-linear pattern. A prospective study needs to be conducted to confirm the meaning of PWV as a risk factor for metabolic syndrome, and especially to determine the cut off point.
Adult ; Aging ; Atherosclerosis ; Blood Glucose ; Blood Pressure ; Cardiovascular Diseases ; Diabetes Mellitus ; Eating ; Fasting ; Hospitals, General ; Humans ; Hypertension ; Internal Medicine ; Korea ; Male ; Prospective Studies ; Pulse Wave Analysis* ; Risk Factors ; Seoul ; Vascular Stiffness

PURPOSE: In western countries, the reported incidence of deep vein thrombosis (DVT) after total hip arthroplasty (THA) ranges from 12 to 23% when an accepted form of prophylaxis is used but when it is not, it ranges from 48 to 70%. However, the incidence of postoperative DVT in Asia has always been considerably lower (20~30%) and compare to western countries and no clear indication for prophylaxis has been suggested. The aim of this study was to document the incidence of DVT among Koreans, and to find the correlation between DVT and its risk factors after total hip arthroplasty. METHOD: 196 patients, who underwent THA from 2002 to 2004, were evaluated to figure out the incidence of DVT and its correlation with well known risk factors, such as age, body mass index (BMI), gender, preoperative coagulation assays (platelet, PT and aPTT) and operation time. All patients wore elastic compression stockings, and early ambulation was encouraged. Venography or Doppler sonography was obtained routinely between 7th and 10th postoperative days. RESULT: The incidence of DVT and pulmonary embolism following THA was 12.6% (25 cases) and 0.5% (1 case), respectively. The mean age of the patients evaluated was 49. 12 cases showed thrombi in the muscle branch below the knee, 9 cases in the posterior tibial vein and 4 cases in the veins above the knee. Age and aPTT were statistically significant with a higher incidence of DVT (P<0.05). However, no correlation between DVT and other factors, such as PT, platelet count, transfusion rate, operation time and BMI, was identified. CONCLUSION: The incidence of DVT in our study was 12.6%. Age and the preoperative aPTT level were significantly associated with the development of DVT after THA.
Arthroplasty ; Arthroplasty, Replacement, Hip* ; Asia ; Body Mass Index ; Early Ambulation ; Humans ; Incidence* ; Knee ; Phlebography ; Platelet Count ; Pulmonary Embolism ; Risk Factors* ; Stockings, Compression ; Veins ; Venous Thrombosis*