Traditional soft tissue Bankart repair has high failure rates in the setting of a critical glenoid bone defect in recurrent shoulder dislocation.Hence, coracoid transfer, particularly the Latarjet procedure, can be performed to reduce the recurrence. A commercialized guide can be used during the Latarjet procedure. On the other hand, it is difficult to handle the guide parallel to the glenoid articular surface because of the predetermined fixed direction of the guide, and the guide pin is so thin that it can be broken in the wrong direction of insertion. Screw holes can also be drilled using the free hand technique without a guide, but it is inaccurate in maintaining a parallel direction or constant spacing between the screw holes. This study devised an instrument by cutting a 3.5 mm locking compression plate used in fracture surgeries, and the Latarjet procedure was performed relatively easily.

Abdominal oblique muscle injuries are relatively common in professional baseball players and can result in substantial loss of playing time. It is usually caused by a sudden movement of the torso in sports involving repetitive activity requiring trunk rotation and it tend to occur on the contralateral side of the dominant arm. We report a unique case of sequentially occurred bilateral abdominal internal oblique muscle rupture in a right-handed professional baseball batter over two seasons. Each internal oblique rupture had a different mechanism of the injury, the non-dominant side occurred during bat swing and the dominant side during bent leg sliding. After rest and rehabilitation, each injury was recovered to play in about 1 month.

PURPOSE: There are few reports from Asian countries about the long-term results of aromatase inhibitor adjuvant treatment for breast cancer. This observational study aimed to evaluate the long-term effects of letrozole in postmenopausal Korean women with operable breast cancer. METHODS: Self-reported quality of life (QoL) scores were serially assessed for 3 years during adjuvant letrozole treatment using the Korean version of the Functional Assessment of Cancer Therapy-Breast questionnaires (version 3). Changes in bone mineral density (BMD) and serum cholesterol levels were also examined. RESULTS: All 897 patients received the documented informed consent form and completed a baseline questionnaire before treatment. Adjuvant chemotherapy was administered to 684 (76.3%) subjects, and 410 (45.7%) and 396 (44.1%) patients had stage I and II breast cancer, respectively. Each patient completed questionnaires at 3, 6, 12, 18, 24, 30, and 36 months after enrollment. Of 897 patients, 749 (83.5%) completed the study. The dropout rate was 16.5%. The serial trial outcome index, the sum of the physical and functional well-being subscales, increased gradually and significantly from baseline during letrozole treatment (p<0.001). The mean serum cholesterol level increased significantly from 199 to 205 after 36 months (p=0.042). The mean BMD significantly decreased from −0.39 at baseline to −0.87 after 36 months (p<0.001). CONCLUSION: QoL gradually improved during letrozole treatment. BMD and serum cholesterol level changes were similar to those in Western countries, indicating that adjuvant letrozole treatment is well tolerated in Korean women, with minimal ethnic variation.
Aromatase ; Asian Continental Ancestry Group ; Bone Density ; Breast Neoplasms* ; Breast* ; Chemotherapy, Adjuvant ; Cholesterol ; Consent Forms ; Female ; Humans ; Observational Study ; Quality of Life*

PURPOSE: Pathologic stage is the most accurate prognostic factor of renal cell carcinoma. We evaluated whether perirenal fat infiltration is a significant factor in tumors 7 cm or less in size. MATERIALS AND METHODS: We retrospectively reviewed the record of 164 cases of tumors 7 cm or less in size. We divided the patients into two groups according to the presence of perirenal fat infiltration (group A, pT1; group B, pT3a). We evaluated relationships, recurrence-free survival and disease-specific survival according to clinicopathologic parameters. Statistical differences were calculated by log-rank test. RESULTS: A total 131 patients were included in group A, with a mean age of 55.8 years, average tumor size was 4.2 cm, and a mean follow-up period of 43 months. Group B included 33 patients, with a mean age of 55.9 years, an average tumor size of 4.1 cm, and a mean follow-up period of 38 months. There was no significant difference in disease-specific survival; however, recurrence-free survival showed significantly different between two groups (group A: 95.5%, group B: 84.4%). CONCLUSION: In this study, perirenal fat infiltration proved to be an independent prognostic factor for predicting disease-free survival in patients with tumors of 7 cm or less in size. Therefore, as this study showed, the presence of perirenal fat infiltration requires stricter follow-up planning, even in small renal cell carcinoma.
Adipose Tissue ; Carcinoma, Renal Cell* ; Disease-Free Survival ; Follow-Up Studies ; Humans ; Neoplasm Invasiveness ; Prognosis ; Retrospective Studies

PURPOSE: To evaluate the effectiveness and safety of fentanyl-TTS in the management of radiotherapy induced acute pain and cancer pain treated with radiotherapy. MATERIALS AND METHODS: Our study was open labelled prospective phase IV multi-center study. the study population included patients with more 4 numeric rating scale(NRS) score pain although managed with other analgesics or more than 6 NRS score pain without analgesics. Patients divided into two groups; patients with radiotherapy induced pain (Group A) and patients with cancer pain treated with radiotherapy (Group B). All patients received 25 ug/hr of fentanyl transdermal patch. Primary end point was pain relief; second end points were change in patient quality of life, a degree of satisfaction for patients and clinician, side effects. RESULTS: Between March 2005 and June 2005, 312 patients from 26 participating institutes were registered, but 249 patients completed this study. Total number of patients in each group was 185 in Group A, 64 in Group B. Mean age was 60 years and male to female ratio was 76:24. Severe pain NRS score at 2 weeks after the application of fentanyl was decreased from 7.03 to 4.01, p=0.003. There was a significant improvement in insomnia, social functioning, and quality of life. A degree of satisfaction for patients and clinician was very high. The most common reasons of patients' satisfactions was good pain control. Ninety six patients reported side effect. Nausea was the most common side effect. There was no serious side effect. CONCLUSION: Fentanyl-TTS was effective in both relieving pain with good tolerability and improving the quality of life for patients with radiotherapy induced acute pain and cancer pain treated with radiotherapy. The satisfaction of the patients and doctors was good. There was no major side effect.
Academies and Institutes ; Acute Pain ; Analgesics ; Female ; Fentanyl* ; Humans ; Male ; Nausea ; Prospective Studies ; Quality of Life ; Radiotherapy* ; Sleep Initiation and Maintenance Disorders ; Transdermal Patch*

OBJECTIVE: The aim of this study was to investigate the gene expression profiles using GeneFishing(TM) DEG kit in Korean women with cervical squamous cell carcinoma. METHODS: Cervical cancer biopsies were obtained from patients at the Department of Obstetrics and Gynecology, St. Mary's hodpital. In this study, we used a common reference that was mixed with an equal amount of RNA extracted from non-cervical cancer patients. The profiles of expression genes between cervical normal and squamous cell carcinoma tissue were identified using GeneFishing(TM) DEG Kit and screened by BLAST search. RESULTS: Almost 100 differential expressed genes were identified in universal control and cervical squamous cell carcinoma, 53 of differential expressed genes, up-regulated expression of 32 and 21 down-regulated expression was sequenced. Up-regulated genes were calcylin, calgranulin A, TRK oncogene, HLC5, fibrillarin, collagene type I alpha1 etc. and down-regulated genes were galectin 1, PRP8 pre-mRNA precessing factor 8 homology, clusterin etc. CONCLUSION: We identified gene expression profile in cervical squamous cell carcinoma using GeneFishing(TM) Kit in Korean women. The functional genomics of these genes should be further studied.
Biopsy ; Calgranulin A ; Carcinoma, Squamous Cell* ; Clusterin ; Collagen ; Female ; Galectin 1 ; Gene Expression* ; Genomics ; Gynecology ; Humans ; Obstetrics ; Oncogenes ; Polymerase Chain Reaction* ; RNA ; RNA Precursors ; Transcriptome ; Uterine Cervical Neoplasms

The first step in the commissioning procedure of a treatment planning system is always verification of the basic beam data. In this work, we have measured PDD curves and beam profiles between 1x1 cm2 and 40x40 cm2. In an attempt, Pinnacle 7.4f detect discrepancies between predicted dose distribution and delivered dose distribution. The discrepancies between measurement data and caculation data was found. The delivered dose was underestimated in field but overestimated out of field. The Dmax depth of 1x1 cm2 was reduced about 2 mm. For the larger field size (> or = 4x4 cm2), the beam profile and PDD curve showed good agreement between measurement data and calculation data.

PURPOSE: To investigate the clinical usefulness of a follow-up examination using serum squamous cell carcinoma antigen (SCC) for the early detection of recurrence in patients treated for cervical squamous cell carcinoma. MATERIALS AND METHODS: 20 patients who were treated for recurrent cervical squamous cell carcinoma between 1997 and 1998, who had experienced a complete remission after radiotherapy and who underwent an SCC test around the time when recurrence was detected, were included in this study. The levels of SCC were measured from the serum of the patients by immunoassay and values less than 2 ng/mL were regarded as normal. The sensitivity of the SCC test for use in the detection of recurrence, the association between the SCC values and the recurrence patterns and the tumor size and stage, and the temporal relation between the SCC increment and recurrence detection were evaluated. RESULTS: The SCC values were above normal in 17 out of 20 patients, so the sensitivity of the SCC test for the detection of recurrence was 85%, and the mean and median of the SCC values were 15.2 and 9.5 ng/mL, respectively. No differences were observed in the SCC values according to the recurrence sites. For 11 patients, the SCC values were measured over a period of 6 months before recurrence was detected, and the mean and median values were 13.6 and 3.6 ng/mL, respectively. The SCC values of 7 patients were higher than the normal range, and the SCC values of the other 4 patients were normal but 3 among them were above 1.5 ng/mL. At the time of diagnosis, the SCC valuess were measured for 16 of the 20 recurrent patients, and the SCC values of the patients with a bulky tumor (> or =4 cm) or who were in stage IIb or III were higher than those of the patients with a non-bulky tumor or who were in stage Ib or IIa. CONCLUSION: The SCC test is thought to be useful for the early detection of recurrence during the follow up period in patients treated for cervical squamous cell carcinoma. When an effective salvage treatment is developed in the future, the benefit of this follow-up SCC test will be increased.
Carcinoma, Squamous Cell* ; Cervix Uteri* ; Diagnosis ; Female ; Follow-Up Studies* ; Humans ; Immunoassay ; Radiotherapy ; Recurrence ; Reference Values ; Uterine Cervical Neoplasms

PURPOSE: We investigated the temporal alterations of apoptosis and mitotic death followingirradiation in the rat's small intestinal crypts. MATERIALS AND METHODS: Male Sprague-Dawley rats were irradiated 2 Gy by 6 MV linear accelerator and sacrified at 2, 4, 8, 24, 48 hours after irradiation. The mean numbers of the apoptotic cells and mitotic cells per their small intestinal crypts were measured in the unirradiated control and irradiated groups. To compare with H & E staining, ISEL (In Situ End Labelling) were performed in the group having the highest apoptotic count. RESULTS: The mean number of the apoptosis per crypt in the control group was 0.14 and those at 2, 4, 8, 24, 48 hours after irradiation were 1.43, 3.19, 1.15, 0.26, 0.17, respectively. So the apoptosis development was increased upto 4 hours and then normalized around 24 hours following irradiation. The mean number of the mitotic cells per crypt in the control group was 1.29 and those at 2, 4, 8, 24, 48 hours after irradiation were 0.56, 0.47, 0.23, 0.65, 1.19, respectively. The mitotic cell counts following irradiation was decreased to 8 hours and recovered to the normal level about 48 hours. So the increment of apoptotic cell count was occurred earlier and more remarkable than the decrement of mitotic cell count after irradiation. According to the staining time, false positivity was found in the ISEL staining. CONCLUSIONS: The cell death in the small intestinal crypt developed by acute radiation damage was usually decreased to the normal level within 24~48 hours after irradiation and the apoptosis was thought to be more important process than the mitotic death.
Animals ; Apoptosis* ; Cell Count ; Cell Death ; Humans ; Intestine, Small ; Male ; Mitosis ; Particle Accelerators ; Rats* ; Rats, Sprague-Dawley

PURPOSE: To investigate the pathways of radiation induced apoptosis and the effect of cysteamine (beta-mercaptoethylamine), as a radioprotector, on it. MATERIALS AND METHODS: HL-60 cells were assigned to control, irradiated, and cysteamine (1 mM, 10mM) pretreated groups, Irradiation was given in a single fraction of 10 Gy (6 MV x-ray) and cysteamine was administered 1 hour before irradiation. The activities of caspase-8 were measured in control and irradiated group to evaluate its relation to the radiation induced apoptosis. To evaluate the role of cysteamine in radiation induced apoptosis, the number of viable cells, the expression and activity of caspase-3, and the expression of poly (ADP-ribose) polymerase (PARP) were measured and compared after irradiation the HL-60 cells with cysteamine pretreatment or not. RESULTS: The intracellular caspase-8 activity, known to be related to the death receptor induced apoptosis, was not affected by irradiation (p>0.05). The number of viable cells began to decrease from 6 hours after irradiation (p>0.05), but the number of viable cells in 1 mM cysteamine pretreated group was not decreased afger irradiation and was similar to those in the control group. In caspase-3 analyses, known as apoptosis executioner, its expression was not different but its activity was increased by irradiation (p>0.05). However, this increase of activity was suppressed by the pretreatment of 1mM crysteamine. The cleavage of PARP, thought to be resulted from caspase-3 activation, occurred after irradiation, which was attenuated by the pretreatment of 1mM cysteamine. CONCLUSION: these results show that radiation induced apoptotic process is somewhat different from death receptor induced one and the pretreatment of 1 mM cysteamine has a tendency to decrease the radiation-induced apoptosis in HL-60 cells.
Apoptosis* ; Caspase 3 ; Caspase 8 ; Cysteamine* ; HL-60 Cells ; Humans