CD44 is a family of transmembrane glycoproteins involved in cell-cell and cell-matrix interactions. Expression of CD44 isofonns (splice variants) has been shown to be associated with poor prognosis in several human cancers. We evaluated the expression patterns of the CD44 isofortn (CD 44 splice variant v6) in infiltrating ductal carcinoma of the breast by immunohistochemical and RT-PCR method. Paraffin embedded blocks from seventy-five cases of mastectomized samples were analyzed immunohistochemically using monoclonoal antibody against CD44v6. CD44v6 was detected in fifty-seven cases (76%) of the tumor samples. Adjacent normal myoepithelial cells and ductal epithelial cells revealed focal positive reaction to CD44v6. Thirtytwo cases (80.0%) with lymph nodal metastasis revealed overexpression of CD44v6 monoclonal antibody, but twenty-five cases (71.4%) without nodal metastasis also showed positive reaction to CD44v6 monoclonal antibody, and there is no statistically significant value. Other prognostic factors of infiltrating ductal carcinoma, such as tumor size, histologic grade and hormonal receptors did not show any significant correlation with CD44v6 expression. The RT-PCR studies for 9 cases of infiltrating ductal carcinoma showed the same band patterns both in the normal and tumor tissues. From the above results, it is concluded that the expression of CD44v6 is not a valuable prognostic marker of infiltrating ductal carcinoma of breast.
Breast* ; Carcinoma, Ductal* ; Epithelial Cells ; Glycoproteins ; Humans ; Neoplasm Metastasis ; Paraffin ; Prognosis

BACKGROUND: Thoracoscopic sympathicotomy was, at first, thought to be a simple and safe method for treatment of hyperhydrosis. However, the main disadvantage of this procedure is irreversibility in additions so-called rebound sweating occurred in 30 40% of patients during the first 1 2 weeks after operation. Some patients regret the surgery, even to the extend of preferring the original sweaty hands. Recently clipping has been suggested one of the way to minimize such problem. Hypothesis of this study was that sympathetic nerve block effect by clipping may be weak compared to sympathicotomy. The aim of this study was to evaluate and compare the sympathicotomy by clipping effect on cardiovascular system. METHODS: Sixty-five patients with essential hyperhydrosis in ASA physical status class 1 undergoing thoracoscopic sympathetic block were randomly divided into two groups: The Clipping group (N = 21) and the sympathicotomy (N = 44) group. Anesthesia was induced with thiopental sodium (5 mg/kg) and pancuronium (0.05 mg/kg) and maintained with enflurane. The operation was done to the left side first and the to the right by an experienced surgeon. During the procedure, we measured blood pressure using a non invasive technique at the right forearm, heart rate and temperature after anesthetic induction as baseline values, immediately after the left side resection of the T2 sympathetic trunk or clipping, and after completely both sides resection. All the records were coded and analysed single blind by one author. RESULTS: After the T2 sympathicotomy, heart rate decreased from 87 +/- 14 to 76 +/- 17 (P < 0.05) and the mean blood pressure was reduced from 77 +/- 14 to 64 +/- 10 mmHg (P < 0.05). After T2 clipping, heart rate decrease from 88 +/- 18 to 73 +/- 14 (P < 0.05) and mean blood pressure was reduced from 74 +/- 12 to 67 +/- 13 mmHg (P < 0.05). CONCLUSION: The main result of this study was that there was no significant difference in sympathetic block effects on blood pressure and heart rate between clipping and sympathicotomy during the procedure.
Anesthesia ; Autonomic Nerve Block ; Blood Pressure* ; Cardiovascular System ; Enflurane ; Forearm ; Hand ; Heart Rate* ; Heart* ; Humans ; Pancuronium ; Sweat ; Sweating ; Thiopental

PURPOSE: The purpose of this study was to evaluate the clinical and radiological outcomes after total hip arthroplasty using the S-ROM modular system for osteonecrosis of the femoral head, and to compare the results between the groups using metal-on-metal articulation and ceramic-on-ceramic articulation. MATERIALS AND METHODS: Sixty-six patients (78 hips) with osteonecrosis of the femoral head were evaluated after primary total hip arthroplasty between January 2001 and December 2004, using an S-ROM proximal modular femoral stem. The average follow-up was 77 months (range, 60 to 122 months) and all patients were followed for more than five years. RESULTS: The average Harris hip score improved from 53 points to 88.5 points at the final follow-up. At the latest radiologic evaluation, sixty-seven stems had bony ingrowth stability, and 10 stems had stable fibrous ingrowth. However, one stem had diffuse extensive osteolysis and loosening, which was revised at 9 years. Postoperative complications included 4 cases of heterotrophic ossificiation, 1 case of linear fracture after insertion of the femoral stem, 1 case of dislocation, 2 cases of infection, and 1 case of extensive osteolysis and loosening. There were 3 cases of revision and Kaplan-Meier survivorship analysis with revision estimated at a 95.7% chance of survival for the femoral component during 122 months. CONCLUSION: Our study showed that total hip arthroplasty using the S-ROM modular system with metal-on-metal articulation or ceramic-on-ceramic articulation had favorable clinical and radiological mid- to long-term results.
Arthroplasty ; Dislocations ; Follow-Up Studies ; Head ; Hip ; Humans ; Osteolysis ; Osteonecrosis ; Postoperative Complications ; Survival Rate

PURPOSE: Currently the most widely used method of measuring IgG concentration is the method employing ELISA. This method has an advantage to detect smaller quantities than other standard methods, but in certain cases, consistent results cannot be obtained, thus impairing reliable data analysis. In this study, we attempt to determine the advantages in data analysis offered by the new method developed by Binding Site Ltd. (England) that employs a nephelometry. METHODS: 20 healthy subjects were studied from each of the following age groups : neonates, 1-4 months old, 5-10 months old, 11-24 months old, and 2-5 years old children. Serum IgG and IgG subclass concentrations were measured by nephelometry (Gehring Nephelometer Analyzer II, Germany) using Human IgG subclass, Liquid reagents BNII kit (Binding Site Ltd., England). RESULTS: 1) The r values for the standard curves of IgG, IgG1, IgG2, IgG3, IgG4 concentrations were 0.991, 0.997, 0.980, 0.973, 0.997, respectively. 2) IgG, IgG3, and IgG4 concentrations were lowest at the age of 5-10 months and increased to normal adult levels at 2-5 years of age. 3) IgG1 and IgG2 were lowest at the age of 1-4 months and increased to normal adult levels at 2-5 years of age. CONCLUSION: The method employing nephelometry for measuring serum IgG & IgG subclasses concentration is not as sensitive as ELISA in detecting the lower concentrations. However, our studies indicate that it presents the advantage of better quality control in measuring values in the average range.
Adult ; Binding Sites ; Child* ; Enzyme-Linked Immunosorbent Assay ; Humans ; Immunoglobulin G* ; Indicators and Reagents ; Infant, Newborn ; Nephelometry and Turbidimetry ; Quality Control ; Reference Values* ; Statistics as Topic

Although bladder transitional cell carcinoma (TCC) is common, the underlying molecular events remain ill-defined. So we attempted to define the role of tumor suppressor genes in the pathogenesis of bladder tumor through a molecular genetic study. For 15 bladder TCC (6 gradeII, 1 gradeIII, and 8 grade IV), we performed the restriction fragment length polymorphism (RFLP) analysis for 6 loci of suspected or established tumor suppressor regions (3p21, 3p24-25, llp15, 13q14, and 17p13). Our data confirm that allelic losses are highly common in bladder tumors. We found that alleles from each of the four chromosomal arms tested were lost in most of the tumors. Reduction of allele occured at 3p21 (13%), 3p24~25 (50%), and 13q14 (38%). However, the greatest frequency of allelic loss was seen for 17p 13 (100% of informative cases) and llp15.5 (87% informative cases). Severe allelic losses of chromosome 17p and pADJ762 on lip were seen only in grade IV, not in grade II. Amplification of 3p21 was seen six out of eight. Amplification of 3p21 has not been previously observed on the other study. Addition to this, we observe the loss of H-ras allele on 11p in one case which was associated with duplication of the retained allele as was demonstrated in Wilms'tumors. The results of out study suggest that deletions of pADJ762 on chromosome 11p and 17p13 occur in high grade bladder tumor and may contribute to the progression of this disease. But, there was no apparent correlation between tumor grade and the loss of 3p or 13q14 alleles although they had some deletions. The role of these genetic alterations in the prognosis of bladder transitional cell carcinoma will require additional follow-up and further studies.
Alleles ; Arm* ; Carcinoma, Transitional Cell ; Chromosomes, Human, Pair 11* ; Genes, Tumor Suppressor ; Lip ; Loss of Heterozygosity ; Molecular Biology* ; Polymorphism, Restriction Fragment Length ; Prognosis ; Urinary Bladder Neoplasms* ; Urinary Bladder*

PURPOSE: The purpose of the present study was to evaluate the potential association of the G1691A mutation of factor V (factor V Leiden), which is a main causative factor of activated protein C resistance leading to intravascular coagulation, with osteonecrosis (ON) of the femoral head. MATERIALS AND METHODS: Genomic DNA was extracted from peripheral blood leukocytes of 116 consecutively identified patients with nontraumatic ON of the femoral head and 59 healthy controls. The region in exon 10, that encodes an APC cleavage site in factor V gene, was amplified by polymerase chain reaction (PCR) with use of the 2 primers (Korea Biotech Inc., Daejeon): 5'-GGA ACA ACA CCA TGA TCA GAG CA-3' (forward primer) and 5'-TAG CCA GGA GAC CTA ACA TGT TC-3'(reverse primer). Amplified product was subjected to MnlI restriction enzyme digestion and resulting fragments were separated by electrophoresis on 3% agarose gel. The homozygous and heterozygous patterns of DNA fragments of 1691G-A mutation in the factor V gene was investigated. RESULTS: The prevalence of factor V Leiden was 0% in the patients group and in the control group. CONCLUSIONS: The data suggested that thrombophilia by the G1691A mutation of factor V (factor V Leiden) was less likely to be associated with the development of ON of the femoral head in Koreans.
Activated Protein C Resistance ; Digestion ; DNA ; Electrophoresis ; Exons ; Factor V* ; Head* ; Humans ; Leukocytes ; Osteonecrosis* ; Polymerase Chain Reaction ; Prevalence ; Sepharose ; Thrombophilia

Germ-line mutations at DNA repair loci confer susceptibility to colon cancer in hereditary non-polypopsis colorectal cancer. Somatic loss of DNA mismatch repair gene has been reported in a large variety of other tumor types. Replication errors(RERs) judged by microsatellite instability(MSI) and its associated mutations have been recognized as an important mechanism in various tumor types. To investigate associations between MSI and oral squamous cell carcinoma, the frequency of MSI using 12 microsatellite markers were analyzed for the series of oral tumors. Of 17 tumors, 8 cases(47%) did not show instability at any of the 12 loci; 5(29%) showed instability at 2~3 loci; and 4(24%) showed instability above 4 loci. The 4 cases showing widespread MSI did not differ from those without evidence of instability in terms of age at diagnosis, degree of differentiation, metastasis to lymph node, tumor location or the presence of mutations in the p53 tumor suppressor gene. DCC and D17S 796 were the most frequently detected in MSI analysis. There were no correlation between smoking and MSI frequency, instead, smoking was suggested to increase the mutation rate of p53 and development of oral carcinomas.
Carcinoma, Squamous Cell* ; Colonic Neoplasms ; Colorectal Neoplasms ; Diagnosis ; DNA Mismatch Repair ; DNA Repair ; Genes, p53* ; Genes, Tumor Suppressor ; Germ-Line Mutation ; Lymph Nodes ; Microsatellite Instability* ; Microsatellite Repeats* ; Mutation Rate ; Neoplasm Metastasis ; Smoke ; Smoking

PURPOSE: This report introduces a new method for tensioning the remnant PCL with a reconstruction of the anterolateral (AL) bundle of the PCL using a modified tibial inlay technique with an assessment of the outcome of this method in chronic PCL injury. MATERIALS AND METHODS: From January 1998 to August 2003, eighty six patients was underwent tensioning of a laxed remnant PCL with a reconstruction of the anterolateral bundle of the PCL. Of these, fifty two patients who were followed up for more than 2 years were evaluated. Tensioning was performed using a distal transfer of the tibial attachment with the posteromedial approach in the supine position. The AL bundle of the PCL was reconstructed with 4 bundles of a hamstring autograft or tibialis anterior tendon allograft. The stability was assessed objectively using stress radiographs with the Telos(R) device and the maximal manual test with the KT-1000 arthrometer. The clinical results were assessed by the IKDC (International Knee Documentation Committee) and OAK (Orthopadische Arbeitsgruppe Knie) scores. The posterior drawer test, varus stress test, posterolateral drawer test and dial test in 30 degrees and 90 degrees flexion were performed for a physical examination. RESULTS: The average side to side difference of the posterior tibial translation in stress radiographs with the Telos(R) device decreased from 10.4+/-2.0 mm to 2.2+/-1.0 mm. The average side to side difference in the maximal manual test with the KT-1000 arthrometer also decreased from 8.2+/-1.5 mm to 1.9+/-1.0 mm. The final IKDC score was A in eleven (21.2%), B in thirty-five (67.3%) and C in six (11.5%) patients. The average OAK score improved from 64.3+/-8.9 to 90.8+/-7.2. CONCLUSION: Tensioning of the laxed remnant PCL with a reconstruction of the AL bundle in chronic PCL injuries showed good clinical results and excellent posterior stability.
Allografts ; Autografts ; Exercise Test ; Humans ; Inlays ; Knee ; Physical Examination ; Posterior Cruciate Ligament* ; Supine Position ; Tendons

PURPOSE: The purpose of this study was to identify the risk factors for intrauterine fetal death (IUFD). METHODS: We carried out a case control retrospective study, at the Chonnam National University Hospital, Korea. We included all pregnant women diagnosed as singleton IUFD in pregnancies of 28 weeks of gestation or more, admitted to the hospital from Jan 2003 to Dec 2007. There were 53 cases of singleton IUFD and 3,298 cases of singleton live birth during that period. The incidence, age distribution, and prevalent gestational weeks were analysed. The risk factors were analyzed by using odds ratio, student's t test, and Chisquare test. Logistic regression analysis was applied to determine independent risk factors. RESULTS: The overall incidence of IUFD was 1.6%. The age distribution of mother with IUFD was highest in the age group of 20 year old or less (5.3%). IUFD was the most prevalent at 28-32 weeks of gestation (41.5%). Significant risk factors were maternal body weight just before delivery, weight gain during pregnancy, and abruptio placentae. The independent risk factors were weight gain during pregnancy (beta=0.002, P=0.000) and abruptio placentae (beta=-0.067, P=0.000). CONCLUSION: Lower maternal body weight just before delivery, lower weight gain during pregnancy, and abruptio placentae are factors significantly associated with IUFD. Further investigations are needed to understand the complex etiology of stillbirth.
Abruptio Placentae ; Age Distribution ; Body Weight ; Case-Control Studies ; Female ; Fetal Death ; Humans ; Incidence ; Korea ; Live Birth ; Logistic Models ; Mothers ; Odds Ratio ; Pregnancy ; Pregnant Women ; Retrospective Studies ; Risk Factors ; Stillbirth ; Weight Gain

Hypermethylation of CpG island is a common mechanism for the inactivation of tumor-related genes. In the present study, we analyzed 13 genitourinary cancer cell lines for aberrant DNA methylation of 5 tumor-related genes using methylation- specific polymerase chain reaction (MSP). GSTP1 was methylated in 5 (38.5%), E-cadherin in 1 (8%), VHL in 1 (8%), and MGMT and hMLH1 in none (0%). Six out of thirteen genitourinary cancer cell lines had methylation of at least one of five genes; 5 had one gene methylated, and, 1 had two genes methylated. Methylation of these 5 genes was not detected in any of the bladder cancer cell lines. GSTP1 was methylated in all of the 3 prostate cancer cell lines. We conclude that aberrant hypermethylation may be an important mechanism for the inactivation of cancer-related genes in kidney and prostate cancer cell lines.
Bladder Neoplasms/genetics ; Cadherins/genetics ; *DNA Methylation ; DNA Primers ; Genetic Screening/methods ; Glutathione Transferase/genetics ; Human ; Isoenzymes/genetics ; Kidney Neoplasms/genetics ; Ligases/genetics ; Male ; Neoplasm Proteins/genetics ; O(6)-Methylguanine-DNA Methyltransferase/genetics ; Polymerase Chain Reaction ; Prostatic Neoplasms/genetics ; Tumor Cells, Cultured ; Urogenital Neoplasms/*genetics