No abstract available.
Biomarkers, Tumor/analysis ; Biopsy ; Carcinosarcoma/chemistry/*secondary/surgery ; Chemoradiotherapy, Adjuvant ; Fatal Outcome ; Humans ; Immunohistochemistry ; Lung Neoplasms/chemistry/*pathology/surgery ; Male ; Middle Aged ; Mouth Floor/chemistry/*pathology/surgery ; Mouth Neoplasms/chemistry/*secondary/surgery ; Pneumonectomy ; Time Factors ; Tomography, X-Ray Computed ; Treatment Outcome

PURPOSE: To investigate the care patterns for radiation therapy and to determine inter-hospital differences for patients with laryngeal carcinoma in Korea. MATERIALS AND METHODS: A total of 237 cases of laryngeal carcinoma (glottis, 144; supraglottis, 93) assembled from 23 hospitals, who underwent irradiation in the year of 1998 and 1999, were retrospectively analyzed to investigate inter-hospital differences with respect to radiotherapy treatment. We grouped the 23 hospitals based on the number of new patients annually irradiated in 1998; and designated them as group A (> or =900 patients), group B (> or =400 patients and <900 patients), and group C (<400 patients). RESULTS: The median age of the 237 patients was 62 years (range, 25 to 88 years), of which 216 were male and 21 were female. The clinical stages were distributed as follows: for glottis cancer, I; 61.8%, II; 21.5%, III; 4.2%, IVa; 11.1%, IVb; 1.4%, and in supraglottic cancer, I; 4.3%, II; 19.4%, III; 28.0%, IVa; 43.0%, IVb; 5.4%, respectively. Some differences were observed among the 3 groups with respect to the dose calculation method, radiation energy, field arrangement, and use of an immobilization device. No significant difference among 3 hospital groups was observed with respect to treatment modality, irradiation volume, and median total dose delivered to the primary site. CONCLUSION: This study revealed that radiotherapy process and patterns of care are relatively uniform in laryngeal cancer patients in Korean hospitals, and we hope this nationwide data can be used as a basis for the standardization of radiotherapy for the treatment of laryngeal cancer.
Female ; Glottis ; Humans ; Immobilization ; Korea ; Laryngeal Neoplasms ; Male ; Retrospective Studies

The aim of this case study was to report the clinical outcome of immediate provisionalization using one-piece narrow diameter (3.0mm) implants in missing maxillary lateral or mandibular incisors. The present study included 36 patients who were treated with 62 one-piece narrow diameter implants. After implant placement, immediate provisional restorations were delivered. All implants showed favorable osseointegration and after progressive loading from 3 months to 9 months (average of 5 months), final restorations were completed without failure in all cases. A survival rate of 100 % (62 of 62) was observed up to 23 months of observation (average of 12.6 months).
Humans ; Incisor ; Osseointegration ; Survival Rate

Xanthohumol (XH), the principal prenylflavonoid of the hop plant (Humulus lupulus L.), dose-dependently inhibited isobutylmethylxanthine (IBMX)-induced melanogenesis in B16 melanoma cells, with little cytotoxicity at the effective concentrations. Decreased melanin content was accompanied by reduced tyrosinase enzyme activity, protein and mRNA expression. The levels of tyrosinase-related protein 1 and 2 mRNAs were decreased by XH. XH also inhibited alpha-melanocyte stimulating hormone- or forskolin-induced increases in melanogenesis, suggesting an action on the cAMP-dependent melanogenic pathway. XH downregulated the protein and mRNA expression of microphthalmia-associated transcription factor (MITF), a master transcriptional regulator of key melanogenic enzymes. These results suggest that XH might act as a hypo-pigmenting agent through the downregulation of MITF in the cAMP-dependent melanogenic pathway.
1-Methyl-3-isobutylxanthine/pharmacology ; Animals ; Cell Line ; Cell Survival/drug effects ; Dose-Response Relationship, Drug ; Down-Regulation ; Drug Antagonism ; Forskolin/pharmacology ; *Humulus ; Intramolecular Oxidoreductases/antagonists & inhibitors/biosynthesis ; Melanins/antagonists & inhibitors/*biosynthesis ; Melanocytes/*drug effects/*metabolism ; Melanoma, Experimental ; Membrane Glycoproteins/antagonists & inhibitors/biosynthesis ; Mice ; Microphthalmia-Associated Transcription Factor/antagonists & inhibitors ; Monophenol Monooxygenase/antagonists & inhibitors/biosynthesis/genetics ; Oxidoreductases/antagonists & inhibitors/biosynthesis ; Propiophenones/*pharmacology ; Signal Transduction/drug effects ; alpha-MSH/metabolism

BACKGROUND: Numerous reports suggest the role of oxygen in melanogenesis. However, little has been reported on the effect of a hypoxic environment on cellular melanogenesis. OBJECTIVE: The effect of low oxygen tension on cellular melanogenesis was investigated in B16 murine melanoma cells. METHODS: Using cells cultured under an ambient (21% O2) or hypoxic (5% O2) condition, melanin content and tyrosinase activity were measured spectrophotometrically. The expression of tyrosinase, tyrosinase-related protein (TRP)- 1, and TRP-2 were analyzed by RT-PCR and Western blot. RESULTS: Culture of cells under hypoxic conditions caused significant inhibition of isobutylmethylxanthine (IBMX)- induced increase of melanin content. No cytotoxicity was observed during the hypoxic culture periods. Decreased melanin content occurred through the decrease of tyrosinase protein and activity (p<0.01). The mRNA levels of tyrosinase and TRP-2 were also decreased by hypoxia, while that of TRP-1 was unchanged. Similar inhibitions of melanin content and tyrosinase activity were observed in the cells stimulated with dibutyryl-cAMP. CONCLUSION: IBMX-induced melanogenesis in B16 cells was significantly inhibited under hypoxic culture conditions, suggesting the important role of oxygen tension in cellular melanogenesis.
Anoxia* ; Blotting, Western ; Melanins ; Melanoma ; Melanoma, Experimental* ; Monophenol Monooxygenase ; Oxygen ; RNA, Messenger

Therapeutic endoscopy in patients with pancreas divisum has continued to evolve with the availability of minor papilla endoscopic sphincterotomy, stenting, or sphinteroplasty. A combination of a sphincterotomy followed by balloon/basket deployment and emergency mechanical lithotripsy had facilitated the removal of impacted or large stones in the pancreatic and biliary ducts. The impaction of the basket with captured stones or rupture of the basket traction-wire during mechanical lithotripsy are rare complications. We report the successful retrieval of a center-severed and impacted lithotomy basket in the duct of Santorini in a 47-year-old patient with pancreas divisum. Endobiliary biopsy forceps were introduced into minor papilla, the basket was drawn and the stone was removed successfully after 2 months. To the best of our knowledge, this is a first report of the removal of a center-severed and impacted lithotomy basket in the pancreatic duct.
Biopsy ; Emergencies ; Endoscopy ; Humans ; Lithotripsy ; Middle Aged ; Pancreas* ; Pancreatic Ducts* ; Rupture ; Sphincterotomy, Endoscopic ; Stents ; Surgical Instruments

OBJECTIVE: Patients with lung cancer have a relative high risk of developing secondary primary lung cancers. This study examined the additional value of autofluorescence bronchoscopy (AFB) for diagnosing synchronous lung cancers and premalignant lesions. METHODS: Patients diagnosed with lung cancer from January 2005 to December 2005 were enrolled in this study. The patients underwent a lung cancer evaluation, which included white light bronchoscopy (WLB), followed by AFB. In addition to the primary lesions, any abnormal or suspicious lesions detected during WLB and AFB were biopsied. RESULTS: Seventy-six patients had non-small cell lung cancer (NSCLC) and 23 had small cell lung cancer (SCLC). In addition to the primary lesions, 84 endobronchial biopsies were performed in 46 patients. Five definite synchronous cancerous lesions were detected in three patients with initial unresectable NSCLC and in one with SCLC. The secondary malignant lesions found in two patients were considered metastatic because of the presence of mediastinal nodes or systemic involvement. One patient with an unresectable NSCLC, two with a resectable NSCLC, and one with SCLC had severe dysplasia. The detection rate for cancerous lesions by the clinician was 6.0% (6/99) including AFB compared with 3.0% (3/99) with WLB alone. The prevalence of definite synchronized cancer was 4.0% (4/99) after using AFB compared with 2.0% (2/99) before, and the staging-up effect was 1.0% (1/99) after AFB. Since the majority of patients were diagnosed with advanced disease, the subjects with newly detected cancerous lesions did not have their treatment plans altered, except for one patient with a stage-up IV NSCLC who did not undergo radiotherapy. CONCLUSIONS: Additional AFB is effective in detecting early secondary cancerous lesions and is a more precise tool in the staging workup of patients with primary lung cancer than with WLB alone.
Biopsy ; Bronchoscopy* ; Carcinoma, Non-Small-Cell Lung ; Humans ; Lung Neoplasms* ; Lung* ; Prevalence ; Radiotherapy ; Small Cell Lung Carcinoma

BACKGROUND: Autofluorescence bronchoscopy (AFB), when used as an adjunct to conventional white light bronchoscopy (WLB) improves the bronchoscopist's ability to localized small intraepithelial lesions. Current study was undertaken to evaluate prevalence of preinvasive intraepithelial lesions (dysplasia II-III and CIS) and efficacy of additional AFB system to WLB in comparison with WLB alone. METHODS: In patients with suspicion of lung cancer or follow-up ones with known lung cancer, WLB (Pentax; BP 3500, Japan) and AFB (Richard Wolf, Germany) were done and all subjects with endoscopic abnormalities underwent biopsies from January 2005 to December 2005. RESULTS: 169 patients (134 suspected to have lung cancer radiologically, 18 with known lung cancer, and 17 with initial abnormal WLB visual findings) were enrolled. Overall preinvasive intraepithelial lesions were detected in 6.5% (11 persons). Biopsy based sensitivity of WLB+AFB and WLB alone for detecting preinvasive intraepithelial lesions was 77.8% compared with 22.2% (relative ratio 3.5, 95% CI 0.93-13.24). Corresponding specificity was 56.9% compared with 89.2% (relative ratio 0.64, 95% CI 0.54-0.75). The positive predicitve value was 6% and 3%, and the negative predictive value was 94% and 87%, respectively, for WLB+AFB and WLB alone. CONCLUSIONS: WLB+AFB was superior to WLB alone in detecting preinvasive intraepithelial lesions, but general use of AFB as a screening tool seems to be limited in suspected or known lung cancer group because of low prevalence. It is necessary of further study for precise indication for AFB among the lung cancer risk groups.
Biopsy ; Bronchoscopy* ; Follow-Up Studies ; Humans ; Lung Neoplasms ; Mass Screening ; Prevalence ; Sensitivity and Specificity ; Wolves

PURPOSE: We retrospectively investigated to find out the equation of calculating the probability of minimal change nephrotic syndrome (MCNS) using clinical parameters. We prospectively investigated to determine the usefulness of the mathematical model. METHODS: We retrospectively examined 56 patients with nephrotic syndrome (NS) (30 MCNS and 26 non-MCNS) diagnosed by kidney biopsy. A mathematical model for calculating the probability of MCNS was obtained through multiple logistic analysis in SAS statistics package. In addition, we prospectively studied 28 patients with NS. Clinical MCNS and non-MCNS were classified according to the probability of 85% in the mathematical model. Kidney biopsy was performed, and serum albumin and urinalysis were measured after 2 weeks of steroid treatment. RESULTS: In the retrospective study, the mathematical model was P=ea/(1+ea), a=17.2507 - 5.5777xON - 4.2256xALB-0.000579x24PROT - 1.2569xUBL+2.1703xUAL. The mode of onset (ON), 24 hours urine protein (24PROT), serum albumin concentration (ALB), the grade of hematuria (UBL) and proteinuria (UAL) were included as clinical parameters. At the probability of 85%, the sensitivity and specificity for predicting MCNS was 73.3% and 100% respectively. In the prospective study, the result of kidney biopsy was consistent with clinical MCNS and non-MCNS according to a mathematical model. All clinical MCNS showed negative proteinuria on urinalysis and a significant increase in serum albumin after 2 weeks treatment (1.85+/-0.30 g/dL to 2.88+/-0.26 g/dL, p<0.05). CONCLUSION: We conclude that the mathematical model for predicting the probability of MCNS may be useful in diagnosis of the MCNS.
Biopsy ; Diagnosis ; Hematuria ; Humans ; Kidney ; Models, Theoretical* ; Nephrosis, Lipoid* ; Nephrotic Syndrome ; Prospective Studies ; Proteinuria ; Retrospective Studies ; Sensitivity and Specificity ; Serum Albumin ; Urinalysis

BACKGROUND/AIMS: Viral breakthrough has been considered a major limitation of lamivudine in the treatment of hepatitis B virus related chronic liver disease. Its clinical meaning has not been thoroughly assessed. METHODS: 64 patients who showed viral breakthrough during lamivudine treatment were retrospectively reviewed. We evaluated the rate of HBeAg seroconversion and hepatic decompensation after viral breakthrough. RESULTS: After viral breakthrough, serum alanine transaminase (ALT) elevation more than 1.2X upper limit of normal (ULN) was noticed in 40 patients (62.5%). Acute flare (serum ALT elevation >X5 ULN, or serum bilirubin >3 mg/dL) occured in 15 patients (23.4%). During the period of follow up (15.0 +/- 9.7 months; range, 0-31 months) since viral breakthrough, decreased serum HBV-DNA level to below the detection limit and serum ALT normalization was seen in 15 patients (23.4%). HBeAg seroconversion was noticed in 7 (13.7%) of a total of 51 HBeAg positive patients at base line; in 4 (15.4%) of 26 patients with non-hepatic failure (chronic hepatitis or Child-Pugh class A liver cirrhosis) at base line; and in 2 (40.0%) of 5 patients with non-hepatic failure at base line and acute flare after viral breakthrough. During this period, terminal hepatic decompensation (Child-Pugh class C) or death was noticed in 9 (90.0%) of 10 patients who had hepatic decompensation (Child-Pugh class B or C) at baseline and acute flare after viral breakthrough. CONCLUSIONS: Acute flare after viral breakthrough seemed to continue during HBeAg seroconversion and rarely developed into terminal hepatic decompensation or death in patients with non-hepatic decompensation at baseline. Its incidence is not only high but lethal to most patients with hepatic decompensation at baseline.
Acute Disease ; Adult ; Aged ; Antiviral Agents/*therapeutic use ; DNA, Viral/blood ; English Abstract ; Female ; Hepatitis B e Antigens/blood ; Hepatitis B virus/genetics/isolation & purification ; Hepatitis B, Chronic/complications/drug therapy/*virology ; Humans ; Lamivudine/*therapeutic use ; Male ; Middle Aged ; Reverse Transcriptase Inhibitors/*therapeutic use