Purpose: T1 high grade (T1HG) bladder cancer (BC) is a type of non-muscle invasive BC (NMIBC) that is recognized as an aggressive subtype with a heightened propensity for progression. Current risk stratification methods for NMIBC rely on clinicopathological indicators; however, these approaches do not adequately capture the aggressive nature of T1HG BC. Thus, new, more accurate biomarkers for T1HG risk stratification are needed. Here, we enrolled three different patient cohorts and investigated expression of collagen type VI alpha 1 (COL6A1), a key component of the extracellular matrix, at different stages and grades of BC, with a specific focus on T1HG BC. Materials and Methods: Samples from 298 BC patients were subjected to RNA sequencing and real-time polymerase chain reaction. Results: We found that T1HG BC and muscle invasive BC (MIBC) exhibited comparable expression of COL6A1, which was significantly higher than that by other NMIBC subtypes. In particular, T1HG patients who later progressed to MIBC had considerably higher expression of COL6A1 than Ta, T1 low grade patients, and patients that did not progress, highlighting the aggressive nature and higher risk of progression associated with T1HG BC. Moreover, Cox and Kaplan–Meier survival analyses revealed a significant association between elevated expression of COL6A1 and poor progression-free survival of T1HG BC patients (multivariate Cox hazard ratio, 16.812; 95% confidence interval, 3.283–86.095; p=0.001 and p=0.0002 [log-rank test]). Conclusions These findings suggest that COL6A1 may be a promising biomarker for risk stratification of T1HG BC, offering valuable insight into disease prognosis and guidance of personalized treatment decisions.

OBJECTIVE: This research is a basic investigation of collecting experts' opinions for constructing the national cancer expert network. The objective of this research is to evaluate present situation and to use it for the planning of future korean cancer network in the cancer-related area. METHODS: We analyzed the need of the network and degree of information demand for constructing the network from Clinicians and Basic researchers(n=376) who answered themselves 'cancer expert'. The questionnaire consists of 9 questions and it was analyzed by using frequence, t-test and Chi-square. RESULTS: 53.7 percents of respondents answered they are already recognized cancer expert network and 93.5 percents of respondents answered that they need the network. Among the services that would be served by the network, the demand of cancer statistics, development and evaluation of cancer policy, and cancer clinical trials were listed in the high priorities. And recognized societies included in the high priorities were Korean Cancer Study Group, Korean Cancer Association, Korean Association for the Study of Lung Cancer. CONCLUSION: We are going to develop a database and network for the experts to generate, evaluate and verify cancer-related information based on evidence-based cancer information infrastructure. Hence, this research will be contributed to provide fundamental data for activating cancer-related research through joint studies with experts.
Surveys and Questionnaires ; Joints ; Lung Neoplasms

Obesity-Hypoventilation syndrome (OHS) is characterized by morbid obesity, hypoxia, and hypercapnea during wakefulness without parechymal lung disease or severe obstructive sleep apnea. A woman was admitted because of mental deterioration and diagnosed as OHS on the basis of obesity and hypoventilation, while awake, after ruling out other causes. By bilevel positive airway pressure (BiPAP) therapy, hypercapnea and hypoxia were resolved. We report that BiPAP can be an effective treatment for severe hypercapnea and hypoxia in OHS, which obviate the need for invasive endotracheal intubation.
Anoxia ; Female ; Humans ; Hypoventilation ; Intubation, Intratracheal ; Lung Diseases ; Obesity ; Obesity Hypoventilation Syndrome* ; Obesity, Morbid ; Sleep Apnea, Obstructive ; Wakefulness

We developed a cardiac cell model to explain the phenomenon of mechano-electric feedback (MEF), based on the experimental data with rat atrial myocytes. It incorporated the activity of ion channels, pumps, exchangers, and changes of intracellular ion concentration. Changes in membrane excitability and Ca2+ transients could then be calculated. In the model, the major ion channels responsible for the stretch-induced changes in electrical activity were the stretch-activated channels (SACs). The relationship between the extent of stretch and activation of SACs was formulated based on the experimental findings. Then, the effects of mechanical stretch on the electrical activity were reproduced. The shape of the action potential (AP) was significantly changed by stretch in the model simulation. The duration was decreased at initial fast phase of repolarization (AP duration at 20% repolarization level from 3.7 to 2.5 ms) and increased at late slow phase of repolarization (AP duration at 90% repolarization level from 62 to 178 ms). The resting potential was depolarized from -75 to -61 mV. This mathematical model of SACs may quantitatively predict changes in cardiomyocytes by mechanical stretch.
Action Potentials ; Animals ; Ion Channels ; Membrane Potentials ; Membranes ; Models, Theoretical ; Muscle Cells* ; Myocytes, Cardiac ; Rats*

PURPOSE: Serum aspartate aminotransferase (AST) is an enzyme widly used in the diagnosis of acute liver disease. It is also highly sensitive in cases of myocardial infarction and muscular injury. This study is designed to ascertain the utility of AST for diagnosis in emergency room. METHODS: From July 2001 to September 2002, 98 patients with AST greater than ten times (400 U/L) the normal range were identified by the biochemistry laboratory in the Emergency Medical Center of Chonnam National University Hospital. The patients 'clinical records were studied to determine the diagnosis, the clinical course, the physical finding on arrival, the past history, other serological and imaging studies, etc. RESULTS: The most common cause of elevated AST level was hepatic in origin (74 cases, 75.5%). Other causes were soft tissue injury (13 cases, 13.3%) and myocardial infarction (11 cases, 11.2%). In group with hepatic causes for raised AST, 21 (28.3%) patients had pancreaticobiliary desease, 20 (27.0%) patients were in conditions producing hepatic ischemia, 18 (24.3%) patients had hepatocellular desease, 6 (8.1%) patients had traumatic liver injury, and 4 (5.4%) patients had malignancy. The hepatic ischemia was caused by sepsis (6 cases, 30.0%), heart failure (6 cases, 30.0%), hypoxia (5 cases, 25.0%), and prolonged hypotension (3 cases, 15.0%). CONCLUSION: The main cause of a notably increased serum AST level is known to be hepatocellular disease, but this study for emergency patients revealed that other causes, such as hepatic ischemia, traumatic liver injury, and muscular disease, were also remarkable. When the level of serum AST is abnormally high, the clinician must consider not only hepatocellular disease but also prolonged hypotension, circulatory collapse, hypoxia, traumatic liver injury, etc.
Anoxia ; Aspartate Aminotransferases ; Biochemistry ; Diagnosis ; Emergencies* ; Emergency Service, Hospital ; Heart Failure ; Humans ; Hypotension ; Ischemia ; Jeollanam-do ; Liver ; Liver Diseases ; Muscular Diseases ; Myocardial Infarction ; Reference Values ; Sepsis ; Shock ; Soft Tissue Injuries

The occurrence of carcinoma in a congenital uterine anomaly is uncommon. Indeed, malignancy of the uterine fundus with congenital uterine anomaly is quite rare, with fewer than 50 cases reported in the world liturature. Many patients go through life without the knowledge of their presence, and they are discovered at autopsy. Early diagnosis and proper management is necessary to decrease the high mortality. We present a case of endometrial carcinoma in a single horn of a bicornuate uterus.
Animals ; Autopsy ; Early Diagnosis ; Endometrial Neoplasms* ; Female ; Horns* ; Humans ; Mortality ; Uterus*

BACKGROUND AND OBJECTIVES: Spontaneous progression of severe congestive heart failure is structurally characterized by cellular degeneration and multiple foci of myocardial cell death. The cardiac troponin I (cTnI), one of the subunits of the troponin regulatory complex, binds to actin and inhibits interaction between actin and myosin. cTnI is uniquely expressed in the adult human myocardium, and an increase in its circulating levels is highly indicative of myocardial injury. In this study, we addressed the usefulness of cTnI as a sensitive and specific molecular marker for severity in patients with congestive heart failure. MethodscTnI, creatinin kinase-MB (CK-MB), and myoglobin were assessed in 59 patients with severe congestive heart failure diagnosed by the echo-cardiography and gated equilibrium blood pool heart scan. Also we assesed cTnI, creatinin kinase-MB (CK-MB), and myoglobin in 25 persons without cardiac disease in echocardiography. RESULTS: 1) The cTnI con-centration was 89.6+/-69.3 pg/mL in patients with congestive heart failure and its level was greater than that of the control group (22.4+/-17.1, p=0.001). 2) The cTnI level differed significantly according to left ventricular ejection fraction (EF), 117.3+/-73.8 pg/mL in patients with EF\<40% (28 patients), 66.3+/-44.5 pg/mL in patients with EF> or =40% (31 patients), 22.4+/-17.1 pg/mL in the control group (25 persons) (p=0.001). CONCLUSION: cTnI was useful as a specific and sensitive serum molecular marker in patients of congestive heart failure. And its level reflected the severity of congestive heart failure.
Actins ; Adult ; Cell Death ; Echocardiography ; Equidae ; Estrogens, Conjugated (USP)* ; Heart ; Heart Diseases ; Heart Failure* ; Humans ; Myocardium ; Myoglobin ; Myosins ; Stroke Volume ; Troponin I* ; Troponin*

In clinical therapy, the current goal of dental implants is to enhance quantity and quality of osseointegration. Surface roughness and oxide structure are considered to influence the behavior of adherent cells. The purpose of this study is to evaluate the effect of different surface treatment on cellular response. The attachment and proliferation of osteoblast-like cell on sandblasted, sandblasted and etched, thermal oxidated surfaces have been compared. Sandblasting was done with Al2O3 particles(grain size of 50micrometer), etching was processed with NH4OH : H2O2 : H2O(1:1:5) at 90degrees C for 1 minute. Thermal oxidation was followed sandblasting and etching at 400degrees C, 600degrees C, 800degrees C for 2 hours. Measurement of surface roughness after the different treatment did not show any differences of Ra value between terated surfaces. Cell attachment and proliferation were increased during experiment period, but no difference was observed. SEM evaluation revealed a similar pattern of osteoblastlike cells, well attached with dendritic extension and producing numerous matrix vesicles on cell surface. The results of this study showed that oxide layer alteration by thermal oxidation did not affect the attachment and proliferation of osteoblast-like cells. This suggests the possibility that the cellular responses are further influenced by surface roughness than titaniun oxide structure. This study was supported by a grant(HMP-98-G-2-035-B) of the HAN(highly advanced National) Projected, Ministry of Health & Welfare, R.O.K
Dental Implants ; Osseointegration ; Osteoblasts

Spindle cell carcinoma of the esophagus containing both carcinomatous and sarcomatous elements is rare, accounting for approximately 1- 2% of all esophageal neoplasms. Terms used to describe this lesion include carcinosarcoma, pseudosarcoma, polypoid carcinoma, pseudosarcomatous squamous cell carcinoma and spindle cell variant of squamous cell carcinoma. Spindle cell carcinomas were originally classified as carcinosarcomas or pseu- dosarcomas, depending on the morphology and bilologic behavior of the particular lesian. However, pseudosarcoma and carcinosarcoma appear to be the same pathologic entity with varying degrees of anaplastic spindle cell metaplasia of the carcinomatous portion of the tumor. Thus, these lesions have been clsssified together as spindle cell carcinomas. A 59 year-old man who experienced weight loss for 4 months was hospitalized as a result of suffering from dysphagia for 2 months. A diffuse bulky protruding mass with superficial ulceration and easy friability on 25 to 35 cm from the incisors, which invaded the right intermediate bronchus and involved the right paratracheal and subcarnial lymph nodes, were obsetved in esophagogram, endoscopy and chest CT. Pathologic finding, including immunoreactivity to cytokeratin and vimentin, was consistent with spindle cell carcinoma. We report a case of spindle cell carcinoma of the esophagus.
Bronchi ; Carcinoma, Squamous Cell ; Carcinosarcoma ; Deglutition Disorders ; Endoscopy ; Esophageal Neoplasms ; Esophagus* ; Humans ; Incisor ; Keratins ; Lymph Nodes ; Metaplasia ; Middle Aged ; Tomography, X-Ray Computed ; Ulcer ; Vimentin ; Weight Loss

In generalized amyloidosis, involvement of heart is not rare, but development fo severe conduction distubance in cardiac amyloidosis is a rare presentation in a clinical situation. We report the first case in Korea of cardiac amyloidosis with complete atrioventricular block, which was confirmed by endomyocardial biopsy. A 59-year-old woman was admitted due to drowsy mentality. We observed a severe atrioventricular conduction disturbance on the electrocardiogram and a marked hypertrophied ventricular wall and a granular sparkling appearance within the wall, a characteristic feature in cardiac infiltration of amyloidosis, on the echocardiography. Endomyocardial biopsy was performed and revealed extensive deposition of amorphous eosinophilic materials within the cardiac muscle cells. Polarizing illumination after Congo-red staining showed typical green birefrigence. We performed a insertion of permanent pacemaker(VVI type) for the treatment of complete atrioventricular block.
Amyloidosis* ; Atrioventricular Block* ; Biopsy ; Echocardiography ; Electrocardiography ; Eosinophils ; Female ; Heart ; Humans ; Korea ; Lighting ; Middle Aged ; Myocytes, Cardiac