PURPOSE: Allelic loss on chromosome 18q is a hallmark of presence of a tummor represser gene. Recently, DPC4 (deleted in pancreatic carcinoma, locus 4), a candidate tumor suppressor gene, has been localized at 18q21. Inactivation of DPC4 gene was reported in pancreatic carcinomas, coloretal carcinomas, and prostatic carcinomas. The aim of the present study was to determine if it might be altered in stomach cancer. MATERIALS AND METHODS: We tested for DPC4 gene mutations and allelic status at 18q21 using a modified 'cold SSCP' method in 48 primary gastric carcinoma and correlated the findings with various clinicopathologic characteristics of the patients. RESULTS: The frequency of mutations in primary gastric cancer was 27.1% (13/48). Mutations of exon 1, 8, 10 were found in 2 (4.1%), 4 (8.2%) and 7 cases (14.6%), respectively. DNA sequencing of 13 cases with DPC4 mutations identified six cases (46.1%) with substitution, four cases with deletion (30.7%), and two cases (23.1%) with insertion. No significant difference was observed in the frequency of DPC4 mutations in terms of other various clinicopathologic characteristics. CONCLUSION: These findings suggest that DPC4 mutations may play a significant role in the establishment and progression of the primary gastric cancer.
Exons ; Genes, Tumor Suppressor ; Humans* ; Loss of Heterozygosity ; Polymorphism, Single-Stranded Conformational ; Sequence Analysis, DNA ; Stomach Neoplasms* ; Stomach*

OBJECTIVE: The purpose of this study was to evaluate the effects of malocclusion on the self-esteem of female university students. METHODS: The subjects were composed of 67 female university students who showed Class I molar relation, no missing or supernumerary teeth and has had no orthodontic treatment experience. Each subject was evaluated with Rosenberg's Self-esteem Scale to measure the level of self-esteem and also evaluated the degree of anterior crowding and lip protrusion through model analysis and cephalometric soft tissue profile analysis. RESULTS: The results showed that a protrusive profile and crowding of upper anterior teeth had significant reducing effects on the level of self-esteem. The protrusion and crowding groups showed no significant differences in self-esteem between groups. CONCLUSIONS: Malocclusion had significant negative effects on the self-esteem of female university students. Further research to investigate the negative psychological influence of malocclusion and the education of lay people about this influence is necessary.
Crowding ; Female ; Humans ; Lip ; Malocclusion ; Molar ; Tooth ; Tooth, Supernumerary

The purpose of this study was to compare en masse retraction of six anterior teeth with separate canine retraction in the amount of the anchorage loss and the retraction of the anterior teeth. The subjects consisted of 30 adult female patients with Angle Class I malocclusions who were treated by .022" straight wire appliance with 4 first premolar extraction. They were composed of two groups. Group 1 consisted of 15 subjects, whose six anterior teeth were retracted by en masse retraction. Group 2 consisted of 15 subjects, whose canines were retracted separately. Pre-treatment and post-treatment lateral cephalometric radiographs were analyzed. All data were processed statistically with independent samples t-test, and the conclusions were as follows. 1. There was no significant difference in the amount of the anchorage loss between two groups(p>0.05). 2. There was no significant difference in the amount of the retraction of the anterior teeth between two groups(p>0.05). 3. There was a significant difference in the amount of the inclinational change of the upper incisors between two groups. It was greater in Group 2. 4. There was a significant difference in the vertical positional change of the upper incisal edges between two groups. The upper incisal edges in Group 2 were more extruded than Group 1 by about 1 mm. 5. There was no significant difference in the vertical positional change of the root apex of the upper incisors between two groups(p>0.05). And there was no significant difference in the vertical positional change of the upper molar(p>0.05).
Adult ; Bicuspid ; Female ; Humans ; Incisor ; Malocclusion ; Malocclusion, Angle Class I ; Tooth*

Resuscitative endovascular balloon occlusion of the aorta (REBOA) is an effective resuscitative modality to temporize noncompressible truncal hemorrhage. Confirming the proper position of the balloon catheter in the target aortic zone is vital. Currently, there is a need for nonradiographical methods. This would overcome the drawbacks of conventional imaging modalities, such as fluoroscopy. Several studies have suggested ultrasound-guided visualization via subxiphoid, transperitoneal, or transesophageal views as an alternative to conventional imaging methods. However, such views are easily obscured in emergency settings. Herein, we report the case of a 70-year-old patient who was successfully resuscitated by REBOA under the guidance of transsplenic ultrasound. REBOA was safely performed using transsplenic visualization without fluoroscopy.

Soft-tissue sarcomas account for 1% of all solid tumors. Of these, less than 15% will occur in the retroperitoneum. Late diagnosis and large tumor size make retroperitoneal sarcomas difficult to resect. Resection with wide margins in all directions is rarely possible owing to proximity to vital structures. Radiation therapy is limited in dosage and, as with chemotherapy, has only been successful in a limited number of cases. These problems result in a poor prognosis. A series of patients with retroperitoneal sarcoma was reviewed with a focus on issues of surgical management and prognostic factors. A retrospective analysis of 12 patients with retroperitoneal sarcomas who had undergone operations at the Department of Surgery, Inje University Paik Hospital, Seoul, from 1980 through 1996 was performed. The mean age of the 10 adult patients was 51 years; the male-to-female ratio was 2:1. Eighty-three percent of the patients presented with an abdominal mass. The mean diameter of the tumors was 18.3 cm. Leimyosarcomas(33%) and liposarcomas(25%) comprised the majority of the histologic types. The tumor grades were I, II, and III in 3 cases each. Resection of the tumor was possible in 75%(9/12) of the cases, although 17% of the resections were incomplete. Resection of adjacent organs was required in 66% of the cases. The resectability rose from 60% in 80s to 86% in 90s, with no statistical significance, possibly due to the small number of cases in this series. There was no postoperative morbidity or mortality. Actuarial 1-, 3-, and 5-year survival rates after resection were 75%, 60%, and 30%, respectively. Four of the 7(57%) patients who underwent complete resections had recurrence 3 to 33 months after surgery; this was notable for grade II or III tumors only. Two patients with grade I tumors are alive 65 and 102 months respectively after complete resection and show no evidence of the disease. One patient who underwent an incomplete resection of the tumor died 50 months after the operation. Only the tumor grade was a significant prognostic factor(p=0.0207). In conclusion, a wide en-bloc resection of a retroperitoneal sarcoma with a clear margin in all directions is a prerequisite for long-term survival. Aggressive follow-up for the first 3 years after a complete resection of a high-grade tumor is justified.
Adult ; Delayed Diagnosis ; Drug Therapy ; Follow-Up Studies ; Humans ; Mortality ; Prognosis ; Recurrence ; Retrospective Studies ; Sarcoma* ; Seoul ; Survival Rate

PURPOSE: This study addressed the feasibility and effect of surgical treatment of metachronous periampullary carcinoma after resection of the primary extrahepatic bile duct cancer. The performance of this secondary curative surgery is not well-documented. METHODS: We reviewed, retrospectively, the medical records of 10 patients who underwent pancreaticoduodenectomy (PD) for secondary periampullary cancer following extrahepatic bileduct cancer resection from 1995 to 2011. RESULTS: The mean age of the 10 patients at the second operation was 61 years (range, 45-70 years). The primary cancers were 7 hilar cholangiocarcinomas, 2 middle common bile duct cancers, and one cystic duct cancer. The secondary cancers were 8 distal common bile duct cancers and 2 carcinomas of the ampulla of Vater. The second operations were 6 Whipple procedures and 4 pylorus-preserving pancreaticoduodenectomies. The mean interval between primary treatment and metachronous periampullary cancer was 20.6 months (range, 3.4-36.6 months). The distal resection margin after primary resection was positive for high grade dysplasia in one patient. Metachronous tumor was confirmed by periampullary pathology in all cases. Four of the 10 patients had delayed gastric emptying (n = 2) or pancreatic fistula (n = 2) after reoperation. There were no perioperative deaths. Median survival after PD was 44.6 months (range, 8.5-120.5 months). CONCLUSION: Based on the postoperative survival rate, PD may provide an acceptable protocol for resection in patients with metachronous periampullary cancer after resection of the extrahepatic bile duct cancer.
Ampulla of Vater ; Bile Ducts, Extrahepatic* ; Cholangiocarcinoma ; Common Bile Duct ; Cystic Duct ; Gastric Emptying ; Humans ; Medical Records ; Neoplasms, Second Primary ; Pancreatic Fistula ; Pancreaticoduodenectomy* ; Pathology ; Reoperation ; Retrospective Studies ; Survival Rate

BACKGROUND: Although a history of febrile convulsion (FC) is common in epilepsy patients, the preferential associa-tion of febrile convulsion with temporal lobe epilepsy (TLE) is not clear. METHODS:We obtained the FC data from "Paik and Bongsang hospital" epilepsy clinic. We classified epilepsy syndromes into generalized epilepsy (GE), temporal lobe epilepsy (TLE), extratemporal epilepsy (ETLE), unclassified partial and undetermined epilepsy by standardized criteria. The incidence of antecedent FC was evaluated in relation to the epilepsy classifications. We calculated kappa values for inter and intra observer reliability for the classifications of epilepsy syndromes. RESULTS: The agreement of epilepsy classifications were reliable (intra-observer kappa value=0.78, inter-observer kappa value=0.77). Thirteen percent of the studied patients (72/537) had a history of FC and 38% of FC (27/72) were complex types of FC. TLE was more likely to be preceded by FC 25% (42/166) than ETLE 6% (12/189), p<0.05 or GE 13% (12/93), p<0.05 and 85% of complex FC (23/27) preceded TLE. GE however, was more likely to have non-complex FC 100% (12/12) than partial epilepsy 55% (32/58), p<0.05. CONCLUSIONS We therefore conclude and agree that FC should be preferentially associated with TLE.
Classification ; Epilepsies, Partial ; Epilepsy ; Epilepsy, Generalized ; Epilepsy, Temporal Lobe* ; Humans ; Incidence ; Seizures, Febrile* ; Temporal Lobe*

A retrospective analysis of 122 consecutive of rhegmatogenous retinal detatchment cases which obtained successful surgical results was performed. All the cases were followed for longer than 1 year postoperatively. 15 eyes (12.3%) developed macular pucker. There was no significant difference in sex distribution and mean age was 43.7 years. The mean lapse time between surgery and the development of macular pucker was 7.2 months. Significant factors for developing macular pucker were multiple operation, preoperative macular detachment, and duration of retinal detachment (longer than 1 month). Other factors such as subretirial fluid drainage and myopia were not significant. 9 of 15 eyes with macular pucker were treated with vitrectomy and visual acuity improved in 66.7% of surgically treated eyes. These results suggest that success with single surgical procedure, operation before macular detachment, and early treatment of retinal detachment are important for preventing postsurgical macular pucker.
Drainage ; Myopia ; Retinal Detachment* ; Retinaldehyde* ; Retrospective Studies ; Sex Distribution ; Visual Acuity ; Vitrectomy

PURPOSE: Laparoscopic totally extraperitoneal (TEP) hernia repair is known to be relatively difficult in cases with a history of lower abdominal surgery. We assess the feasibility of laparoscopic TEP hernia repair in those patients. METHODS: Thirty five patients with a previous history of radical prostatectomy or lower abdominal surgery who underwent laparoscopic TEP hernia repair for inguinal hernia were reviewed retrospectively. All operations were performed by a single experienced surgeon. RESULTS: Thirty three out of the 35 patients (94%) were men. Laparoscopic TEP hernia repair was performed successfully in 30 out of 35 cases. Twenty five cases (71%) were right inguinal hernia, 6 cases (17%) were left hernias, and 4 cases (11%) had an inguinal hernia on both sides. Five cases were converted to transabdominal preperitoneal (TAPP) (n=3) or open methods (n=2). Mean operation time was 111 minutes. The patient group with previous radical prostatectomy was the largest (n=22, 63%) and required a longer operation time (124 minutes). Blood loss was less than 50 cc in all cases. Average hospital stay was 1.2 days after surgery. Voiding difficulties requiring catheterization were observed in 13 cases (37%). CONCLUSION: Laparoscopic TEP hernia repair for a patient with previous history of radical prostatectomy or lower abdominal surgery except for appendectomy can be safely performed by an experienced surgeon, but is not recommended as a standard choice because of a longer operation time and higher conversion rate.
Appendectomy* ; Catheterization ; Catheters ; Hernia* ; Hernia, Inguinal ; Herniorrhaphy* ; Humans ; Laparoscopy ; Length of Stay ; Male ; Prostatectomy* ; Retrospective Studies

BACKGROUND: In recent years, the incidence of obesity increased in Koreans. The main cause suggested is the diet style of Korean changed to that of Western. It has been proved that obesity is a risk factor or an aggravating factor of hypertension and diabetes mellitus, cardiovascular disease, etc. Primary physician has been interested in the correlation of blood pressure with relative body weight and aging. The purpose of this study was to focus on the influence of age and relative body weight on blood pressure. METHODS: Subjects were collected from 2,068 adults who had received Adult Health Examination. That subjects were divided according to age, relative body weight and then the relation of blood pressure with age according to relative body weight and relation with relative body weight according to age were investigated. RESULTS: Systolic blood pressure increased significantly according to age in all male and female three weight groups and then increased significantly according to relative body weight in all male and female three age groups except male seventh decade group. Diastolic blood pressure increased significantly according to age in all male and female three weight groups except male obesity group and then increased significantly according to the relative body weight in all male and female three age groups except male and female seventh decade groups. Systolic blood pressure has higher correlation with age than relative body weight and diastolic blood pressure has higher correlation with relative body weight in male. In female, systolic and diastolic blood pressure have higher correlations with age. CONCLUSIONS: It can be suggested that blood pressure increase significantly according to aging process and relative body weight. These two factors have a little different effects to systolic and diastolic blood pressure according to sex. Relative body weight has more effect to diastolic blood pressure than systolic blood pressure in male.
Adult ; Aging ; Blood Pressure* ; Body Weight ; Cardiovascular Diseases ; Diabetes Mellitus ; Diet ; Female ; Humans ; Hypertension ; Incidence ; Male ; Obesity* ; Risk Factors