STUDY DESIGN: Retrospective chart review. PURPOSE: To assess whether spontaneous reduction of spondylolisthesis, as seen on magnetic resonance imaging (MRI), is related to the degree of segmental instability and low back pain. OVERVIEW OF LITERATURE: The flexion-extension radiographs obtained in the sagittal plane are frequently used when segmental instability of spondylolisthesis is evaluated. METHODS: We retrospectively reviewed 137 patients and measured the differences of the percentage of sagittal translation and sagittal angulation to determine the segmental instability between the flexion and extension radiographs, and the spontaneous reduction on MRI. We then compared the degrees of segmental instability and the degrees of spontaneous reduction. To assess the effect of low back pain on segmental motion in regards to the flexion-extension radiographs, we compared the preoperative visual analogue scales (VAS) score for low back pain between the more and the less spontaneous reduction groups. RESULTS: The mean degree of spontaneous reduction was 5.2%. A statistically significant correlation was found between the sagittal translation on the flexion-extension radiographs and the degree of spontaneous reduction (r = 0.557, p < 0.001) and between the sagittal angulation on the flexion-extension radiographs and the degree of spontaneous reduction (r = 0.215, p = 0.012). The preoperative VAS scores for low back pain of the more spontaneous reduction group and the less spontaneous reduction group were 4.6 and 3.6 points, respectively, and this difference was statistically significant (p = 0.002). CONCLUSIONS: Spontaneous reduction of spondylolisthesis on MRI was found to be closely related to segmental instability, and the degree of spontaneous reduction seen on MRI could be useful for the evaluation of segmental instability in patients with spondylolisthesis, especially with severe low back pain.
Humans ; Low Back Pain ; Magnetic Resonance Imaging ; Magnetic Resonance Spectroscopy ; Magnetics ; Magnets ; Retrospective Studies ; Spondylolisthesis ; Weights and Measures

Sihler's staining allows visualization of the nerve distribution within soft tissues without extensive dissection and does not require slide preparation, unlike traditional approaches. This technique can be applied to the mucosa, muscle, and organs that contain myelinated nerve fibers. In particular, Sihler's technique may be considered the best tool for observing nerve distribution within skeletal muscles. The intramuscular distribution pattern of nerves is difficult to observe through manual manipulation due to the gradual tapering of nerves toward the terminal end of muscles, so it should be accompanied by histological studies to establish the finer branches therein. This method provides useful information not only for anatomists but also for physiologists and clinicians. Advanced knowledge of the nerve distribution patterns will be useful for developing guidelines for clinicians who perform operations such as muscle resection, tendon transplantation, and botulinum toxin injection. Furthermore, it is a useful technique to develop neurosurgical techniques and perform electrophysiological experiments. In this review, Sihler's staining technique is described in detail, covering its history, staining protocol, advantages, disadvantages, and possible applications. The application of this technique for determining the arterial distribution pattern is also described additionally in this study.
Anatomists ; Arteries ; Botulinum Toxins ; Humans ; Mucous Membrane ; Muscle, Skeletal ; Muscles ; Nerve Fibers, Myelinated ; Tendons ; Transplants

PURPOSE: The aim of this study was to assess the expression of VEGF-C (vascular endothelial growth factor-C) and LYVE-1 (lymphatic vessel endothelial HA receptor-1) mRNA in human breast cancer, and to compare the expression of VEGF-C protein and VEGF-C, LYVE-1 mRNA with the clinico-pathological outcomes. METHODS: RT-PCR was carried on the VEGF-C, LYVE-1 mRNA drawn from three samples of adjacent normal breast tissues, the MCF-7 breast cancer cell line and 39 breast cancer tissues. Immunohistochemical staining was done to detect the expression of VEGF-C protein in 39 cancer tissues and in 5 benign tissues with using well preserved, paraffin embedded tissues. The clinico-pathological findings were retrospectively reviewed for menopausal status, lymphatic invasion, hormonal status, the expression of p53 and c-erbB2. RESULTS: RT-PCR analysis revealed the expression of VEGF-C mRNA in 22 of 39 (56.4%) and LYVE-1 mRNA in 19 of 39 breast cancer tissues (48.7%). The expression of VEGF-C mRNA was positive in all cases except for one in LYVE-1 mRNA positive case, this revealed good correlation between the two molecules. Immunohistochemical analysis revealed that VEGF-C protein was expressed only in the breast cancer cells, with specific VEGF-C staining evident in 10 of 39 (25.6%). There was no significant correlation between VEGF-C, LYVE-1 mRNA expressions and the other pathologic variables. However, VEGF-C protein expression was negative in the group with a postmenopausal status, positive estrogen receptor and negative c-erbB2 significantly. CONCLUSIONS: VEGF-C mRNA seems to be related to the lymphangiogenetic marker-LYVE-1 mRNA and the amplification of the VEGF-C may be correlated with some clinico-pathological factors in the breast cancer.
Breast Neoplasms* ; Breast* ; Cell Line ; Estrogens ; Humans ; Paraffin ; Retrospective Studies ; RNA, Messenger ; Vascular Endothelial Growth Factor C*

PURPOSE: The aim of this study was to assess the expression of VEGF-C (vascular endothelial growth factor-C) and LYVE-1 (lymphatic vessel endothelial HA receptor-1) mRNA in human breast cancer, and to compare the expression of VEGF-C protein and VEGF-C, LYVE-1 mRNA with the clinico-pathological outcomes. METHODS: RT-PCR was carried on the VEGF-C, LYVE-1 mRNA drawn from three samples of adjacent normal breast tissues, the MCF-7 breast cancer cell line and 39 breast cancer tissues. Immunohistochemical staining was done to detect the expression of VEGF-C protein in 39 cancer tissues and in 5 benign tissues with using well preserved, paraffin embedded tissues. The clinico-pathological findings were retrospectively reviewed for menopausal status, lymphatic invasion, hormonal status, the expression of p53 and c-erbB2. RESULTS: RT-PCR analysis revealed the expression of VEGF-C mRNA in 22 of 39 (56.4%) and LYVE-1 mRNA in 19 of 39 breast cancer tissues (48.7%). The expression of VEGF-C mRNA was positive in all cases except for one in LYVE-1 mRNA positive case, this revealed good correlation between the two molecules. Immunohistochemical analysis revealed that VEGF-C protein was expressed only in the breast cancer cells, with specific VEGF-C staining evident in 10 of 39 (25.6%). There was no significant correlation between VEGF-C, LYVE-1 mRNA expressions and the other pathologic variables. However, VEGF-C protein expression was negative in the group with a postmenopausal status, positive estrogen receptor and negative c-erbB2 significantly. CONCLUSIONS: VEGF-C mRNA seems to be related to the lymphangiogenetic marker-LYVE-1 mRNA and the amplification of the VEGF-C may be correlated with some clinico-pathological factors in the breast cancer.
Breast Neoplasms* ; Breast* ; Cell Line ; Estrogens ; Humans ; Paraffin ; Retrospective Studies ; RNA, Messenger ; Vascular Endothelial Growth Factor C*

Menetrier's disease is a rare, characterized by the presence of large rugal folds involving part or all of the stomach. Patients with hypertrophic gastropathy often have distressing abdominal symptoms, weight loss, and edema due to gastric protem loss. A 64 year old male patient was admitted with the chief complaint of epigastric discomfort. Endoscopic, radiologic and histologic examination, revealed characteristic findings of Menetrier's disease. A case of Menetrier's disease is reported with a brief review of literature.
Edema ; Gastritis, Hypertrophic* ; Humans ; Male ; Middle Aged ; Stomach ; Weight Loss

BACKGROUND AND AIMS: Abdominal distension from the insufflation of air can create more troublesome discomfort after colonoscopy (CFS) than after upper endoscopy. Many patients report difficulty in expelling insufflated air after CFS. One previous study demonstrated that insertion of rectal tube at the conclusion of CFS significantly improves patient satisfaction with the procedure. The aim of this study was to compare the effectiveness of rectal tube placement for abdominal decompression after CFS in an effort to limit patient discomfort by carefully applying air suction during CFS. METHODS: We conducted a prospective trial in 103 consecutive patients undergoing elective CFS. Patients were randomized to receive rectal tube placement at the end of the procedure or simple air suction during the procedure. Patients were evaluated by clinical symptoms and signs 10 minutes after completion of CFS. RESULTS: All 103 patients had a complete examination of the colon to the cecum. No specific complications occurred during and a day after examination. The two groups were well matched with respect to age, sex, height, weight, chief complaints. There were no significant differences between the two groups for bowel preparation, duration of examination, abdominal pain during procedure, abdominal disten-sion 10 minutes after CFS, and abdominal pain 10 minutes after CFS (p >0.05). CONCLUSIONS: Meticulous air suction during CFS reduces abdominal discomfort and distension after CFS and is as effectively as the placement of a rectal tube at the con-clusion of CFS.
Abdominal Pain ; Cecum ; Colon ; Colonoscopy* ; Endoscopy ; Humans ; Insufflation ; Lower Body Negative Pressure ; Patient Satisfaction ; Prospective Studies ; Suction

The digastric muscle is located in the suprahyoid region which consists of anterior belly, intermediate tendon and posterior belly. This muscle is an important landmark when performing an operation of submental and upper neck region. Previous researches have reported about variations of the anterior and posterior belly of digastric muscle. However, there are few studies about the general morphology of the digastric muscle and the relationship with surrounding muscles. The purpose of this study was to analyze the morphology of the anterior belly of digastric muscle and confirm the topographic relationship between the digastric muscle and the stylohyoid muscle of Korean. Thirty-four cadavers (21 males, 13 females; mean age 65 years; range 24~89 years) were used in this study. The skin, subcutaneous tissues, superficial fascia and platysma were removed and a detailed dissection was performed, with extreme care being taken not to damage underlying the muscles of submental and upper neck region. After the dissections, all specimens were sketched and photographed. In 8 specimens, we observed the accessory bellies of the anterior belly of digastric muscle. We classified the accessory bellies into the crossover type (five specimens, 14.7%) that cross the mandibular raphe and unilateral type (three specimens, 8.82%). The findings resulting from observation of the anatomical relationship between the posterior belly of digastric and stylohyoid muscles, the posterior belly of digastric muscle perforated the stylohyoid muscle in 32 cases (65%) out of 49 sides. This case was subdivided into the belly of the stylohyoid muscle lean to the lateral (twenty-one specimens, 42.9%) or medial side (eleven specimens, 22.4%) of the posterior belly of digastric muscle. In 17 specimens (35%), the stylohyoid muscle existed on the medial side of the posterior belly of digastric muscle.
Anatomic Variation ; Cadaver ; Humans ; Male ; Muscles ; Neck ; Skin ; Subcutaneous Tissue ; Tendons

Purpose: This study aimed to investigate the effectiveness of postoperative chemotherapy in pT1bN0 and pT2N0 gastric cancer patients with high risk factors. Materials and Methods: Clinicopathological data of gastric cancer patients, who had undergone gastrectomy in high volume centers in Korea and China and were finally diagnosed with pT1bN0 and pT2N0 between 2006 and 2010, were analyzed retrospectively. Survival analyses stratified by risk factors and multivariable analyses were performed. Results: A total of 1509 patients were enrolled, with 41 (2.7%) patients receiving adjuvant chemotherapy after gastrectomy and 1468 (97.3%) patients undergoing surgery alone. The adjuvant chemotherapy group showed higher percentages of tumor with maximal diameter >3 cm (51.2% vs. 25.8%), poor differentiation (68.3% vs. 49.8%), and less harvested lymph nodes (17.1% vs. 5.2%) compared to the surgery alone group. The overall survival rates were 95.1% in the adjuvant chemotherapy group and 93.3% in the surgery alone group, without significant difference. In multivariable analysis, age was found to be an independent prognostic factor. However, there were no difference in the overall survival between patients with risk factors and those without risk factors, even in terms of age. Meanwhile, patients with more than two risk factors who received chemotherapy showed better survival trend, especially for pT2N0 patients, compared to the surgery alone group, although no significant differences were observed. Conclusion In pT1bN0 and pT2N0 patients, age was found to be an independent prognostic factor. However, adjuvant chemotherapy seemed to be unnecessary, while postoperative chemotherapy might offer survival benefits to pT2N0 patients with more than two risk factors.

This study was performed to investigate the effect of a concentrate of fermented wild ginseng root culture (HLJG0701) on memory improvement in the scopolamine (SPL)-induced memory-deficient mouse model. Eight-week-old male ICR mice were used to evaluate the protective effect of HLJG0701 against the SPL-induced memory loss animal model. The Morris water maze test, which measures hippocampus-dependent learning ability, and the Y-maze test, a short-term memory assessment test, were performed and related markers were analyzed. HLJG0701-treated groups displayed significantly reduced acetylcholinesterase activity and increased acetylcholine level compared with the SPL-administered group (SPL-G) (P < 0.05). In the Y-maze test, the spontaneous alternation in al HLJG0711-treated groups was significantly increased compared with that in SPL-G (P < 0.05). In the Morris water maze test, the escape latency and time spent in the target quadrant in all HLJG0701-treated groups were significantly decreased and increased, respectively, compared with those in SPL-G (P < 0.05). In addition, the brain-derived neurotrophic factor level in groups treated with HLJG0701 300 and 600 mg/kg body weight was significantly increased compared with that in SPL-G (P < 0.05). These results suggest that the HLJG0701 may protect against memory loss by inhibiting acetylcholinesterase activity and preventing acetylcholine deficiency.
Acetylcholine ; Acetylcholinesterase ; Animals ; Body Weight ; Brain-Derived Neurotrophic Factor ; Ginsenosides ; Humans ; Learning ; Male ; Memory Disorders* ; Memory* ; Memory, Short-Term ; Mice* ; Mice, Inbred ICR ; Models, Animal ; Panax* ; Scopolamine Hydrobromide ; United Nations ; Water

In the Materials and Methods section, material supply source is incorrectly cited and has been changed upon request of authors.