PURPOSE: In gastric cancer, metastasis to the paraaortic lymph nodes had been regarded as an incurable factor, but many cases of long term survival have been reported with dissection of metastatic paraaortic nodes. And several reports suggested survival benefit with paraaortic lymph node dissection (D4) in advanced gastric cancer. In patients with advanced gastric cancer who underwent paraaortic lymph node dissection we tried to evaluate the factors predisposing metastasis in these nodes and survival data. MATERIALS AND METHODS: The authors analyzed retrospectively pathological features of 95 patients who underwent paraacntic lymph node dissection for advanced gastric cancer at Kangnam General Hospital Public Corporation Bom May 1991 to Feb. 1998. And we also analysed survival results of 72 cases among them. We excluded 18 cases of distant metastasis (3 liver metastasis, 15 peritoneal seeding), 2 operative mortalities, 1 other disease mortality, and 2 unlmown causes of death in survival analysis. RESULTS: The frequencies of paraaortic lymph node metastasis were 0.0% (0 of 32 cases) in T2, 19.2% (10 of 52 cases) in T3, 18.2% (2 of 11 cases) in T4. And those of paraaortic lymph node metastasis were 5.8% (3 of 52 cases) in antrum, 14.3% (3 fo 21 cases) in body, 20.0% (3 of 15 cases) in cardia, and 42.9% (3 of 7 cases) in whole area. The five-year survival rates (5 YSRs) in relation to the paraaortic lymph node (No16) status was 0.096 in No16+, and 57.8Po in Nol6 with D4 of advanced gastric cancer. The 5 YSRs were 78.1%, 40.8% and 0% in T2, T3 and T4, respectively and 93.8%, 64.2%, 24.2% and 0.0% in n0, nl, n2 and n.3, respectively and 88.9%, 80.5%, 57.9% and 0.0% (47.6%) and 0.0% in stage IB, II, IIIA, IIIB and IV, respectively. CONCLUSION: The depth of gastric wall invasion and the location of primary tumor were significant predisposing factors to para-aortic lymph node metastasis in multivariate analysis (p<0.05). Survival of No16 metastasis was very poor. And three factors of T stage, n stage, and Bonmann type were also prognostically significant in terms of five year survival in cases of D4 of advanced gastric cancer in multivariate analysis (p < 0.05).
Cardia ; Causality ; Cause of Death ; Drug Therapy* ; Granisetron* ; Hospitals, General ; Humans ; Liver ; Lymph Node Excision ; Lymph Nodes ; Mortality ; Multivariate Analysis ; Nausea* ; Neoplasm Metastasis ; Platinum* ; Prognosis ; Retrospective Studies ; Stomach Neoplasms ; Survival Rate ; Vomiting*

No abstract available.
Bile Duct Neoplasms* ; Bile Ducts* ; Bile*

In Korea, all domestic made test systems for detecting antibodies in HIV-1 contain the antigens from human immunodeficiency type 1 (HIV-1) subtype B. However, because HIV-1 subtype O is significantly different in amino acid sequences from all other subtypes of HIV-1, there has been a need for developing a test for detecting antibodies in subtype O. For this purpose, the entire nucleotide sequence corresponding to the extracellular domain of the transmembrane glycoprotein of HIV-1 subtype O was synthesized with consideration of Escherichia coli cordon usage. Various regions of the extracellular domain were cloned into E. coli expression vectors and tested for levels of protein production. The nucleotide sequence, named ECTM, that can encode a 129 amino acid-long peptide, was found to be expressed at a high level in E. coli. The protein of approximately 17 kDa specifically reacted with sera from individuals infected with HIV-1 subtype O. The ECTM protein was purified to near homogeneity by the CM-T gel chromatography, using concentrated, denatured inclusion bodies. In Western blot analysis, the purified viral antigen reacted with sera from individuals infected with subtype O more efficiently than subtype B. The enzyme linked immunoabsorbent assay (ELISA) system was developed using the subtype O viral protein and compared with the commercially available kit lacking the antigens from subtype O. The ELISA kit containing the subtype O antigen ECTM alone efficiently reacted with sera from individuals infected with subtype O. The subtype O antigen-containing kit produced a positive absorbence even when sera were diluted 512-fold, suggesting a high sensitivity. The commercially available kit also reacted with subtype O sera, but produced a negative result at a dilution of 8-fold. Our results suggest that the currently available kit may not be able to efficiently detect subtype O sera and that the viral protein developed in this study may be added to the current system to maximize the detection of sera from individuals infected with subtype O.
Amino Acid Sequence ; Antibodies ; Base Sequence ; Blotting, Western ; Chromatography, Gel ; Clone Cells ; Enzyme-Linked Immunosorbent Assay ; Escherichia coli ; Glycoproteins ; HIV* ; HIV-1* ; Humans* ; Inclusion Bodies ; Korea ; O Antigens

Percuaneous mitral valvuloplasty(PMV) is an alternative to surgical mitral commissurotomy for patients with mitral stenosis. To assess the immediate and follow-up results of PMV and to identify factors in fluencing the outcome and coplications of PMV, we analyzed the clinical, echocardiographic and hemodynamic data of 108 patients who underwent PMV. 1) Good hemodynamic results were obtained in 86 patients(79.6%). The factors predicting immediate outcome of PMV were mitral valve mobility, total echoscore, and EBDA/BSA. 2) Predictors of the increase in mitral valve area by PMV were age, sex, rhythm, and NYHA functional class before PMV. The independant predictors were rhythm(p=0.008) and functional class(p=0.002). 3) The degree of mitral regurgitation increased in 26 patients(24%), did not changed in 79 patients(73%) and decreased in 3 patients(3%). The increase of MR could not predicted from any features of the clinical, echocardiographic or hemodynamic daa. The severity of MR decreased by one grade in 15% of patients and did not change in 66% of patients during follow-up. 4) Left-to-right shunt was detected in 19 patients(18%). The predictors were valve mobility, pulmonary artery pressure and pulmonary vascular resistance. 5) Follow-up catheterization(mean 14 months) identified restenosis in six of 16 patients. The predictors of restenosis were sex, total echosecore, and left atrial volume. 6) The hemodynamic data at follow-up were good compared with prePMV data(p<0.01), but follow-up miral valve area decreased than that of postPMV(p<0.05). Immediate decrease in pulmonary vascular resistance followed by progressive improvement during follow-up. 7) Immediate complications of PMV were peripheral arterial embolism in one patient(1%), pericardial effusion in two(2%), transient arrhythmia in four(4%), left-to-right shunt in nineteen(18%) and increase in the grade of MR in twenty-six(24%). This study suggests, that PMV produces excellent immediate and follow-up results and is a safe and effective procedure in the nonsurgical treatment of mitral stenosis.
Arrhythmias, Cardiac ; Echocardiography ; Embolism ; Follow-Up Studies* ; Hemodynamics ; Humans ; Mitral Valve ; Mitral Valve Insufficiency ; Mitral Valve Stenosis* ; Pericardial Effusion ; Pulmonary Artery ; Vascular Resistance

Percuaneous mitral valvuloplasty(PMV) is an alternative to surgical mitral commissurotomy for patients with mitral stenosis. To assess the immediate and follow-up results of PMV and to identify factors in fluencing the outcome and coplications of PMV, we analyzed the clinical, echocardiographic and hemodynamic data of 108 patients who underwent PMV. 1) Good hemodynamic results were obtained in 86 patients(79.6%). The factors predicting immediate outcome of PMV were mitral valve mobility, total echoscore, and EBDA/BSA. 2) Predictors of the increase in mitral valve area by PMV were age, sex, rhythm, and NYHA functional class before PMV. The independant predictors were rhythm(p=0.008) and functional class(p=0.002). 3) The degree of mitral regurgitation increased in 26 patients(24%), did not changed in 79 patients(73%) and decreased in 3 patients(3%). The increase of MR could not predicted from any features of the clinical, echocardiographic or hemodynamic daa. The severity of MR decreased by one grade in 15% of patients and did not change in 66% of patients during follow-up. 4) Left-to-right shunt was detected in 19 patients(18%). The predictors were valve mobility, pulmonary artery pressure and pulmonary vascular resistance. 5) Follow-up catheterization(mean 14 months) identified restenosis in six of 16 patients. The predictors of restenosis were sex, total echosecore, and left atrial volume. 6) The hemodynamic data at follow-up were good compared with prePMV data(p<0.01), but follow-up miral valve area decreased than that of postPMV(p<0.05). Immediate decrease in pulmonary vascular resistance followed by progressive improvement during follow-up. 7) Immediate complications of PMV were peripheral arterial embolism in one patient(1%), pericardial effusion in two(2%), transient arrhythmia in four(4%), left-to-right shunt in nineteen(18%) and increase in the grade of MR in twenty-six(24%). This study suggests, that PMV produces excellent immediate and follow-up results and is a safe and effective procedure in the nonsurgical treatment of mitral stenosis.
Arrhythmias, Cardiac ; Echocardiography ; Embolism ; Follow-Up Studies* ; Hemodynamics ; Humans ; Mitral Valve ; Mitral Valve Insufficiency ; Mitral Valve Stenosis* ; Pericardial Effusion ; Pulmonary Artery ; Vascular Resistance

No abstract available.
Myocardial Infarction*

OBJECTIVE: The aim of this study was to assess artifacts induced by metallic restorations in three-dimensional (3D) dental surface models derived by cone-beam computed tomography (CBCT). METHODS: Fifteen specimens, each with four extracted human premolars and molars embedded in a plaster block, were scanned by CBCT before and after the cavitated second premolars were restored with dental amalgam. Five consecutive surface models of each specimen were created according to increasing restoration size: no restoration (control) and small occlusal, large occlusal, disto-occlusal, and mesio-occluso-distal restorations. After registering each restored model with the control model, maximum linear discrepancy, area, and intensity of the artifacts were measured and compared. RESULTS: Artifacts developed mostly on the buccal and lingual surfaces. They occurred not only on the second premolar but also on the first premolar and first molar. The parametric values increased significantly with increasing restoration size. CONCLUSIONS: Metallic restorations induce considerable artifacts in 3D dental surface models. Artifact reduction should be taken into consideration for a proper diagnosis and treatment planning when using 3D surface model derived by CBCT in dentofacial deformity patients.
Artifacts* ; Bicuspid ; Cone-Beam Computed Tomography* ; Dental Amalgam ; Dentofacial Deformities ; Diagnosis ; Humans ; Molar

No abstract available.
Atrial Fibrillation* ; Heart* ; Thoracic Surgery*

The purpose of present study is comparing the effect of Teflon Membrane and Nylon Membrane on bone regeneration in rabbit tibia. The 6 defects of 8x8x5mm size were drilled with dental handpiece in rabbit tibia, which on left side as an order of Control group(no coverage), Group 1(Nylon 5 micrometer size), Group 3(Nylon 10 micrometer size), and on right side Control group, Group 2(5 micrometer Teflon), Group 4(10 micrometer Teflon). Animals were killed at 7, 10, 14, 42 days to make specimens and observed the difference of healing potentials with light microscopy. The results were as follows ; 1. New bone formation has taken place at 14 days in Guided Bone Regeneration (GBR) group comparing to the Control group of massive inflammatory status. 2. Larger pore membrane allows more favorable healing potentials. Bone formation started earlier in larger membrane pore groups than smaller groups, until 14 days. 3. Bone forming potentials of Teflon membrane group was higher than Nylon membrane groups, Control group has the lowest bone forming potentials. 4. New bone formation was almost ended in 42 days, and there was no difference of bone formation between Nylon and Teflon membrane group of different size. There was no difference of bone formation at final stage(42 days) between Nylon membrane and Teflon membrane of same pore size. So nylon membrane may be clinically usable in guided bone regeneration case with further studies.
Animals ; Bone Regeneration ; Control Groups ; Membranes* ; Microscopy ; Nylons* ; Osteogenesis ; Polytetrafluoroethylene* ; Tibia*

BACKGROUND: It is well known that hypertension attenuate endothelium-dependent vasodilator response. And this finding is closely related to the development of atherosclerosis. Recently it is reported that the expression of NADPH-dependent oxidase is increased in angiotensin-induced hypertension model and superoxide (O2) produced from that might contribute to the development of vascular diseases. The possible mechanism is the degradation of endothelium-derived NO by O2. We hypothesized that SOD prevents endothelial dysfunction via prevention of the degradation of endothelium-derived NO. METHODS AND MATERIALS: We made renovascular hypertension model by constricting abdominal aorta just above the left renal artery of Sprague-Dawley female rats. The descending thoracic aorta was stuied in the organ chambers using acetylcholine as an endothelium-dependent vasodilator with or without pretreatment of SOD. RESULTS: Blood pressures of all 14 rats were significantly increased (174/123 mmHg, mean 146 mmHg). The residual tensions of the vessels precontracted by phenylephrine were similar in both groups (15.04+/-19.53 % in SOD group vs 11.84+/-18.57% in non-SOD group, p=.66). CONCLUSIONS: The endothelial dysfunctions in the rat aorta with renovascular hypertension were not improved by SOD. There is no acute effect of SOD on endothelial function in high renin/angiotensin state.
Acetylcholine ; Animals ; Aorta* ; Aorta, Abdominal ; Aorta, Thoracic ; Atherosclerosis ; Endothelium ; Female ; Humans ; Hypertension ; Hypertension, Renovascular* ; Oxidoreductases ; Phenylephrine ; Rats* ; Rats, Sprague-Dawley ; Renal Artery ; Superoxides ; Vascular Diseases