Purpose: Acute promyelocytic leukemia (APL) is a rare disease in children and there are some different characteristics between children and adult. We aimed to evaluate incidence, clinical characteristics and treatment outcomes of pediatric APL in Korea. Materials and Methods: Seventy-nine pediatric APL patients diagnosed from January 2009 to December 2016 in 16 tertiary medical centers in Korea were reviewed retrospectively. Results: Of 801 acute myeloid leukemia children, 79 (9.9%) were diagnosed with APL. The median age at diagnosis was 10.6 years (range, 1.3 to 18.0). Male and female ratio was 1:0.93. Thirty patients (38.0%) had white blood cell (WBC) count greater than 10×109/L at diagnosis. All patients received induction therapy consisting of all-trans retinoic acid and chemotherapy. Five patients (6.6%) died during induction chemotherapy and 66 patients (86.8%) achieved complete remission (CR) after induction chemotherapy. The causes of death were three intracranial hemorrhage, one cerebral infarction, and one sepsis. Five patients (7.1%) suffered a relapse during or after maintenance chemotherapy. The estimated 4-year event-free survival and overall survival (OS) rates were 82.1%±4.4%, 89.7%±5.1%, respectively. The 4-year OS was significantly higher in patients with initial WBC < 10×109/L than in those with initial WBC ≥ 10×109/L (p=0.020). Conclusion This study showed that the CR rates and survival outcomes in Korean pediatric APL patients were relatively good. The initial WBC count was the most important prognostic factor and most causes of death were related to serious bleeding in the early stage of treatment.

OBJECTIVES: The aim of this study is to report the results of extracorporeal fixation in patients with mandibular condylar fractures and compare them with the clinical results of conservative treatment. MATERIALS AND METHODS: The medical records of 92 patients (73 male [M] : 19 female [F], age 13-69 years, mean 33.1 years) treated for condylar fractures at the Department of Oral and Maxillofacial Surgery in Sun Dental Hospital (Daejeon, Korea) from 2007 to 2012 were reviewed. Patients were divided into three groups: group A (23 patients; M : F=18 : 5, age 21-69 years, mean 32.6 years), treated with extracorporeal fixation; group B (30 patients; M : F=24 : 6, age 16-57 years, mean 21.1 years), treated by conventional open reduction; and group C (39 patients; M : F=31 : 8, age 16-63 years, mean 34.4 years), treated with the conservative method ('closed' reduction). Clinical and radiographic findings were evaluated and analyzed statistically. RESULTS: Occurrence of postoperative condylar resorption correlated with certain locations and types of fracture. In this study, patients in group A (treated with extracorporeal fixation) did not demonstrate significant postoperative complications such as malocclusion, mandibular hypomobility, temporomandibular disorder, or complete resorption of condyle fragments. CONCLUSION: In superiorly located mandibular condyle fractures, exact reconstruction of condylar structure with the conventional open reduction technique can be difficult due to the limited surgical and visual fields. In such cases, extracorporeal fixation of the condyle using vertical ramus osteotomy may be a better choice of treatment because it results in anatomically accurate reconstruction and low risk of complications.
Female ; Follow-Up Studies* ; Humans ; Male ; Malocclusion ; Mandibular Condyle ; Mandibular Fractures ; Medical Records ; Osteotomy* ; Postoperative Complications ; Solar System ; Surgery, Oral ; Temporomandibular Joint Disorders ; Visual Fields

Extracranial carotid stenosis is a well-established, modifiable risk factor for stroke. Asymptomatic extracranial carotid stenosis is increasingly being detected due to the introduction of less-invasive and more-sensitive advanced diagnostic technologies. For severe asymptomatic stenosis, earlier pivotal clinical trials demonstrated the benefit of carotid endarterectomy over the best medical therapy. Since then, great advances have been made in interventional and medical therapies as well as surgical techniques. The first edition of the Korean Stroke Clinical Practice Guidelines for primary stroke prevention for the management of asymptomatic carotid stenosis reflected evidences published before June 2007. After the publication of the first edition, several major clinical trials and observational studies have been published, and major guidelines updated their recommendation. Accordingly, the writing group of Korean Stroke Clinical Practice Guidelines (CPG) decided to provide timely updated evidence-based recommendations. The Korean Stroke CPG writing committee has searched and reviewed literatures related to the management of asymptomatic carotid stenosis including published guidelines, meta-analyses, randomized clinical trials, and nonrandomized studies published between June 2007 and Feb 2011. We summarized the new evidences and revised our recommendations. Key changes in the updated guidelines are the benefit of intensive medical therapy and further evidence of carotid artery stenting as an alternative to carotid endarterectomy. The current updated guidelines underwent extensive peer review by experts from the Korean Stroke Society, Korean Society of Intravascular Neurosurgery, Korean Society of Interventional Neuroradiology, Korean Society of Cerebrovascular Surgery, and Korean Neurological Association. New evidences will be continuously reflected in future updated guidelines.
Carotid Arteries ; Carotid Stenosis ; Constriction, Pathologic ; Endarterectomy, Carotid ; Neurosurgery ; Peer Review ; Primary Prevention ; Publications ; Risk Factors ; Stents ; Stroke ; Writing

Since the publication of the first edition of Korean clinical practice guidelines of secondary stroke prevention, encouraging data from recent large clinical trials and meta-analysis have led us to consider many therapeutic options in the treatment of symptomatic extracranial carotid stenosis. Accordingly, the writing group of Clinical Research Center for Stroke decided to provide recent views on the therapeutic revascularization of extracranial carotid stenosis, and timely evidence-based recommendations. In this updated version, new evidences about carotid angioplasty/stenting, treatment timing, and perioperative preparation are given, and qualifying conditions for operator are elucidated. This refinement was based on current consensus between Korean Society of Intravascular Neurosurgery, Korean Society of Interventional Neuroradiology, and Korean Society of Cerebrovascular Surgery and approved by Korean Stroke Society, Korean Neurological Association, and Korean Society of Geriatric Neurology. These recommendations are subject to future correction based on new evidences from ongoing and future studies.
Carotid Arteries ; Carotid Stenosis ; Consensus ; Endarterectomy, Carotid ; Neurology ; Neurosurgery ; Publications ; Secondary Prevention ; Stroke ; Writing

The fibromatoses are a broad group of fibrous proliferations. They have a biologic behavior and histopathologic pattern that is intermediate between those of benign fibrous lesions and fibrosarcoma. Because they are not common diseases, it is important to differentiate the fibromatoses from other similar diseases. In this report, we present a case of fibromatosis, and possible other diseases to be differentiated, with a review of literatures.
Fibroma* ; Fibrosarcoma ; Mandible*

OBJECTIVE: This study was performed to evaluate the efficacy, safety and complications of tension-free vaginal tape (TVT) combined with total hysterectomy under general anesthesia. METHODS: Retrospective comparison of 76 women treated by TVT procedure with total hysterectomy from January 2003 to December 2003. All patients had undergone preoperative evaluation including history taking, physical examination, pelvic examination, 1-hour pad test and urodynamic test, and then were operated under general anesthesia. There were 65 patients combined with LAVH (laparoscopic assisted vaginal hysterectomy), 6 patients combined with VTH (vaginal total hysterectomy) and 5 patients combined with TAH (total abdominal hysterectomy). RESULTS: The mean follow up and hospital day were respectively 13 months (range 6-18 months) and 7.6 days (range 6-15 days). Objective and subjective success rate were respectively 97.4% (cured 92.1%, improved 5.3%) and 97.4% (cured 88.1%, improved 9.3%). Preoperative and postoperative 1-hour pad test were respectively 36.4 gm and 4.1 gm (p<0.001). Complications were bladder perforation (6.6%), voiding dysfunction (7.9%) and overactive bladder syndrome (7.9%). CONCLUSION: Conclusively, the cure rate was 88.1% in the TVT combined with hysterectomy when performed under general anesthesia.
Anesthesia, General ; Female ; Follow-Up Studies ; Gynecological Examination ; Humans ; Hysterectomy* ; Physical Examination ; Retrospective Studies ; Suburethral Slings* ; Urinary Bladder ; Urinary Bladder, Overactive ; Urodynamics

PURPOSE: To assess the current status of endourology and laparoscopy in Korea. MATERIALS AND METHODS: Using the database directory of the Korean Urological Association, 83 urology training hospitals were identified. A detailed questionnaire was designed and sent by post and e-mail. The questionnaire included questions regarding the number of various endourological and laparoscopic procedures between 1998 and 2002. The questionnaires of those responding were analyzed. RESULTS: Responses were received from 45 hospitals (response rate 54.2%). 133 antegrade and 626 retrograde endourological procedures for urinary strictures were performed during the period of the study in 12 and 35 hospitals, respectively. 42 hospitals (93.3%) were performing shock wave lithotripsy for urinary stone disease. 29 hospitals (64.4%) reported having performed more than one laparoscopic procedure during the five years. The annual total numbers of laparoscopic procedures increased from 217 in 1998 to 725 in 2002. Simple laparoscopic nephrectomy was the most widely accepted procedure, and was being performed in 18 hospitals. Laparoscopic adrenalectomy, radical nephrectomy, diagnostic laparoscopy, laparoscopic renal cyst marsupialization, nephroureterectomy and donor nephrectomy were performed in more than 10 hospitals. However, the actual number of laparoscopic procedures was limited in most hospitals. More than 40 laparoscopic procedures per year were performed by only four hospitals. CONCLUSIONS: This survey revealed an increasing number of endourological and laparoscopic procedures. However, laparoscopy seems to be mainly a larger hospital-based technology in Korea. These results can be utilized as fundamental data for establishing future developmental requirements of endourology and laparoscopy in Korea.
Adrenalectomy ; Constriction, Pathologic ; Electronic Mail ; Endoscopy ; Humans ; Korea ; Laparoscopy* ; Lithotripsy ; Nephrectomy ; Surveys and Questionnaires ; Shock ; Surgical Procedures, Minimally Invasive ; Tissue Donors ; Urinary Calculi ; Urology*

CD99 plays an critical role in the diapedesis of monocytes, T cell differentiation, and the transport of MHC molecules. Engagement of CD99 by agonistic monoclonal antibodies has been reported to trigger multifactorial events including T cell activation as well as cell-cell adhesion during hematopoietic cell differentiation. In this study, to identify the functional domains participating in the cellular events, we mapped the epitopes of CD99, which are recognized by two agonistic CD99 monoclonal antibodies, DN16 and YG32. Using recombinant fusion proteins of GST with whole or parts of CD99, we found that both antibodies interact with CD99 molecules independently of sugar moieties. DN16 mAb detected a linear epitope located in the amino terminal region of CD99 while YG32 mAb bound another linear epitope in the center of the extracellular domain. To confirm that the identified epitopes of CD99 are actually recognized by the two mAbs, we showed the presence of physical interaction between the mAbs and the fusion proteins or synthetic peptides containing the corresponding epitopes using surface plasmon resonance analyses. The dissociation constants of DN16 and YG32 mAbs for the antigen were calculated as 1.27 X 10(-7) and 7.08 X 10(-9) M, respectively. These studies will help understand the functional domains and the subsequent signaling mechanism of CD99.
Amino Acid Sequence ; Antibodies, Monoclonal/*immunology ; Antigens, CD/*chemistry/*immunology ; Blotting, Western ; Cell Adhesion Molecules/*chemistry/*immunology ; *Epitope Mapping ; Epitopes/*chemistry/*immunology ; Glutathione Transferase ; Human ; Molecular Sequence Data ; Peptide Fragments/chemistry/immunology ; Recombinant Fusion Proteins/chemistry/immunology

Deranged expression of cell cycle modulators has been reported to contribute to the development and progression of hepatocellular carcinoma (HCC). However, their expression patterns remain poorly understood in hepatitis B virus (HBV)-related HCC, which constitutes about 65-70% of HCC in Korea. The aims of this study were to evaluate the expressions of G1-S modulators in HBV-related HCCs and dysplastic nodules (DNs), and to correlate with the histopathologic features of HCCs. Immunohistochemical expressions of cyclin D1, cyclin E, p53, p27, p21, p16, Rb, and PCNA proteins were investigated in 80 HCCs and 22 DNs. Cyclin D1 overexpression showed positive relationships with advanced tumor stage, poor differentiation, larger tumor size, microvascular invasion, intrahepatic meta-stasis, no tumor capsule formation, infiltrative growth, aberrant p53 expression, and high PCNA labeling index (LI) of HCC (p<0.05). Aberrant p53 expression showed positive relationship with poor differentiation of HCC (p<0.01). Expression of cyclin D1 or p53 was not observed in DNs. The p27 LI and p16 LI were lower in HCCs with intrahepatic metastasis (p<0.05). Cyclin D1 overexpression and aberrant p53 expression could be associated with the progression of HBV-related HCC, and might have a less crucial role in the DN-HCC sequence. In addition, elevated expression of p27 and p16 proteins might have inhibitory action to the intrahepatic metastasis of HBV-related HCC.
Adult ; Aged ; Carcinoma, Hepatocellular/chemistry/etiology/*pathology ; Cyclin D1/*analysis ; Female ; G1 Phase ; Hepatitis B/*complications ; Human ; Immunohistochemistry ; Liver Neoplasms/chemistry/etiology/*pathology ; Male ; Microfilament Proteins/analysis ; Middle Age ; Precancerous Conditions/*virology ; Proliferating Cell Nuclear Antigen/analysis ; Protein p16/analysis ; Protein p53/*analysis ; Retinoblastoma Protein/analysis ; S Phase

The association between cancer and deep vein thrombosis or pulmonary embolism has been recognized by most clinicians. Adenocarcinoma of the pancreas, female reproductive organs, breast, colon, lung, and prostate have been found to be associated with the highest risk of deep vein thrombosis. However, the isolated deep vein thrombosis is a rare phenomenon in renal cell carcinoma. Only two cases of deep vein thrombosis in renal cell carcinoma were reported in the literature. The tumor thrombi of renal cell carcinoma is found in renal vein and inferior vena cava, with the incidence of 20-49% and 5-10%, respectively. We report two cases of renal cell carcinoma which are associated with the deep vein thrombosis due to the obstruction of inferior vena cava by the tumor thrombi.
Adenocarcinoma ; Breast ; Carcinoma, Renal Cell* ; Colon ; Female ; Humans ; Incidence ; Lung ; Pancreas ; Prostate ; Pulmonary Embolism ; Renal Veins ; Vena Cava, Inferior ; Venous Thrombosis*