PURPOSE: Croup is a common respiratory disease in children. The aim of this study was to analyze the epidemiology, etiology, and seasonal variations of respiratory virus infections in children with croup. METHODS: From October 2009 to September 2017, children admitted with croup to Gachon University Gil Medical Center under the age of 18 years were enrolled in this study. We retrospectively reviewed patients' medical records. RESULTS: A total of 1,053 of 27,330 patients (3.9%) infected with lower respiratory infections were diagnosed as having croup. In the age distribution, croup was most common (50.0%) in children aged 1 to <2 years. There were 2 peaks, the major in summer (July to August) and the minor in spring (March to May). Parainfluenza virus type 1 (15.8%) was most prevalent and coincided with the summer peaks of croup. Influenza virus type B and parainfluenza virus type 3 were the most frequent etiologic agents in a spring peak of croup. Although parainfluenza virus type 1 was predominant of all ages, human coronavirus was a significant cause of croup in children younger than 1 year, whereas influenza virus played an important role in children above the age of 3 years. CONCLUSION: Seasonality and epidemiology of croup varied with age and regions. Two peaks of seasonal fluctuation were in summer and spring, which were related to the seasonality of respiratory viruses in croup. These results may be helpful in planning clinical and research needs.
Age Distribution ; Child ; Coronavirus ; Croup* ; Epidemiology ; Humans ; Medical Records ; Orthomyxoviridae ; Parainfluenza Virus 1, Human ; Parainfluenza Virus 3, Human ; Respiratory System* ; Respiratory Tract Infections* ; Retrospective Studies ; Seasons*

PURPOSE: APC (adenomatous polyposis coli) gene is one of the tumor-suppressor genes that acts in the early stages of cancer. Among general colon cancer patients, normal APC gene expression is deficient in 80%. It seems that APC is the most important gene in the development of colon cancer. This study was performed to analyze the mutation spectra of APC gene in sporadic colon cancer tissue from Korean patients with colon cancer. METHODS: A total of 38 patients with sporadic colon cancer were enrolled. Colon cancer tissues were analyzed for the determination of APC gene mutation spectra by multiplex ligation-dependent probe amplification (MLPA) method using SALSA MLPA P403 APC kit (MRC-Holland, Amsterdam, NL). RESULTS: APC gene mutations showing deletion/duplication in one or more exons were detected in 23 (60.5%) patients. Duplication in 13 patients (56.5%), duplication and deletion in 7 patients (30.4%), and deletion in 3 patients (13.1%) was detected. The incidence of APC gene mutation found in this study was highest in exon 3. From this study, no significant differences were observed with respect to clinicopathologic findings and the presence or absence of APC mutations. CONCLUSION: The frequency of APC gene mutation was about 61% in Korean patients with colon cancer, it showed concordance with the previous reports on the frequency of APC gene mutation from Caucasian patients with sporadic colon cancer. However, in contrast to these reports, the frequency of duplication disclosed much higher than those of western countries.
Colon ; Colonic Neoplasms ; Exons ; Genes, APC ; Humans ; Incidence ; Multiplex Polymerase Chain Reaction

During recent years, cases of toxic shock syndrome have been reported with increasing frequency in plastic surgery patients. The majority of reports relate to aesthetic plastic surgical procedures such as rhinoplasty, augmentation mammoplasty, liposuction, and chemical peeling. We report a case of toxic shock syndrome with necrotizing fascitis after liposuction in a 23-year-old woman who had erythema and edema, blister formation and gangrene in the skin. The patient was admitted to the intensive care unit, and treatment was initiated with vigorous fluid resuscitation and intravenous antibiotic therapy. During the next days, the condition of the patient worsened, and pulmonary insufficiency required intubation and mechanical ventilation. Surgical treatment with multiple incision and irrigation was performed on the first, third and eighteenth day. The patient was discharged in good health on the 30th day after admission. Toxic shock syndrome with necrotizing fascitis is a rare disease; therefore, it is important to review its diagnostic and clinical features as only early diagnosis and prompt, radical surgery improves the survival rate.
Blister ; Early Diagnosis ; Edema ; Erythema ; Fasciitis, Necrotizing ; Female ; Gangrene ; Humans ; Intensive Care Units ; Intubation ; Lipectomy ; Mammaplasty ; Polymethacrylic Acids ; Respiration, Artificial ; Resuscitation ; Rhinoplasty ; Shock, Septic ; Skin ; Surgery, Plastic ; Young Adult

PURPOSE: The five-year survival rate is over 95% for radically resected early gastric cancer. The development of diagnostic techniques enables early detection of gastric cancer, so the life expectancy of patients with early gastric cancer is prolonged. Therefore, a limited number of surgeries are performed these days for the purpose of increasing the quality of life. The purpose of this study is to assess the postoperative quality of life after a pylorus-preserving gastrectomy (PPG) compared with that after a subtotal gastrectomy with gastroduodenal anastomosis (B-I). MATERIALS AND METHODS: One hundred seven (107) patients who underwent gastric surgery for early gastric cancer from January 1999 to December 2003 at the Department of Surgery of Chonnam National University Hospital were selected. We compared patients who underwent a PPG with those who underwent a B-I. The clinical results were compared by using the chi-square test and the Student's T-test. The data were considered to be significant when the P value was less than 0.05. RESULTS: Twenty-nine patients (29) underwent a PPG, and the other seventy-eight (78) patients underwent a B-I. There was no significant difference between the two groups on sex, age, and postoperative abdominal symptoms. The patients who underwent a PPG showed shorter operation times and less reflux gastritis and esophagitis on endoscopic evaluation than the patients who underwent a B-I. CONCLUSION: The pylorus-preserving gastrectomy (PPG) is a more physiologic operation than the subtotal gastrectomy with gastroduodenal anastomosis (B-I) and improves the postoperative quality of life.
Esophagitis ; Gastrectomy* ; Gastritis ; Humans ; Jeollanam-do ; Life Expectancy ; Quality of Life ; Stomach Neoplasms* ; Survival Rate

Telomere Length Changes in Colorectal Cancers and Polyps Telomere shortening and telomerase activation occur frequently in cases of colorectal carcinoma. In this study, we correlated the clinicopathological parameters with the telomere length in colorectal carcinomas, colonic polyps, and normal colonic tissues. We also investigated whether the telomere length changes reflect the biologic behavior of tumors and different modes of tumor development. Telomere length was determined by terminal restriction fragment Southern blot analysis in 20 invasive colorectal carcinomas and normal mucosa from the same patients. We also examined 20 colonic polyps and associated normal mucosa. Telomere shortening was detected in 16/20 (80%), and telomere elongation in 2/20 (10%) cases of colorectal carcinoma, and no changes in 2 subjects. In the colonic polyp patients, shortening was detected in 4/20 (20%), elongation in 6/20 (30%), and no change in 10/20 (50%). The frequency of telomere shortening was significantly different between colorectal carcinoma and polyp groups. Decreased telomere length was noted in 92.9% (13/14) of Dukes' C and 50% (3/6) of Dukes' B. The difference between these two sub-groups was statistically significant. This study suggests that the telomere length in colorectal carcinomas is decreased upon the development of malignancy. A significant difference in telomere length between polyps and invasive colorectal carcinomas may reflect a different biologic behavior of colorectal carcinomas.
Adult ; Aged ; Blotting, Southern ; Carcinoma/*pathology ; Colonic Polyps/*pathology ; Colorectal Neoplasms/*pathology ; Female ; Humans ; Lymphatic Metastasis ; Male ; Middle Aged ; Telomere/genetics/*pathology

PURPOSE: Although obstructive jaundice is a rare presentation, it is an omnious prognostic sign in patients with gastrectomy for gastric carcinoma. The major cause of bile duct obstruction has been identified as lymphadenopathy in the hepatoduodenal ligament that has metastasized from predominantly advanced gastric carcinomas. METHODS: Extrahepatic biliary obstruction caused by metastatic gastric carcinoma was retrospectively studied in order to determine demographics, pathological characteristics, time interval from previous gastrectomy, site of recurrence, and the prognosis of the disease. RESULTS: In this study, 983 patients with gastric adenocarcinoma underwent gastrectomy, and obstructive jaundice was revealed in 22 patients (2.2%). The mean age of the patients was 56 years, and the male to female sex ratio was 1.7 : 1. Antrally located, poorly differentiated, and advanced stage (above III) gastric carcinoma were commonly associated with obstructive jaundice. The most common site of the obstruction was the porta hepatis (54%). A percutaneous transhepatic biliary drainage (PTBD) procedure was accomplished in 19 patients and the jaundice was decreased, however the survival was not improved. The mean duration from jaundice to death was 2.8 months. CONCLUSION: These results show that the cause of bile duct obstruction in advanced gastric carcinoma was predominantly metastatic lymphadenopathy in the hepatoduodenal ligament. In order to improve the quality of life in obstructive jaundiced patients, further evaluation and continued follow-up and examination may be necessary.
Adenocarcinoma ; Cholestasis ; Demography ; Drainage ; Female ; Gastrectomy* ; Humans ; Jaundice ; Jaundice, Obstructive* ; Ligaments ; Lymphatic Diseases ; Male ; Prognosis ; Quality of Life ; Recurrence ; Retrospective Studies ; Sex Ratio

Telomerase, an enzyme associated with cellular immortality, is expressed by most malignant cells and is inactive in most normal somatic cells, with the exception of proliferative stem cells, germ cells and activated lymphocytes. Measuring telomerase activity clinically may provide useful diagnostic and prognostic information of cancer. The purpose of this study was to investigate the change in telomerase activity following chemoradiation in rectal cancer, which almost always produces positive enzymatic activity. A total of 24 tumor tissue samples were used in this study, consisting of 12 paired specimens before and 4 week after chemoradiation. Telomerase activity was determined by PCR-based telomeric repeat amplification protocol (TRAP) assay. The telomerase activity was positive in 10 out of 12 patients (83%) in pre-irradiated and post-irradiated states. The levels of telomerase activity was decreased in 8 out of 10 patients after chemoradiation (80%) and two cases showed no change in enzymatic activity. One case showed no activity in either sample. The other case showed no enzymatic activity in the pre-irradiated sample, but showed weak activity in the post-irradiated sample. These data indicate that telomerase activity in rectal cancer is reduced after neoadjuvant chemoradiation therapy, possibly suggesting a mechanism of downstaging following chemoradiation therapy in cancer.
Adult ; Aged ; Antimetabolites, Antineoplastic/administration & dosage ; Antineoplastic Agents/administration & dosage ; Cisplatin/administration & dosage ; Combined Modality Therapy ; Enzyme Activation/radiation effects ; Enzyme Activation/drug effects ; Female ; Fluorouracil/administration & dosage ; Gene Amplification ; Human ; Male ; Middle Age ; Rectal Neoplasms/radiotherapy* ; Rectal Neoplasms/enzymology* ; Rectal Neoplasms/drug therapy ; Telomerase/metabolism*

BACKGROUND: The nm23 gene was originally identified by screening of cDNA libraries from murine melanoma cell lines of varying metastatic potential. Gene expression of nm23 has been investigated in a number of tumors. Its down-regulation has been shown to be associated with metastasis or disease progression in some of the tumors. METHODS: We evaluated the nm23 mRNA levels in 23 surgically resected primary gastric cancers, in the matched adjacent mucosa, and in lymph nodes or distant metastatic foci by using Northern blot analyses and immunohistochemical staining. RESULTS: The expression of nm23 mRNA was lower in the matched normal adjacent mucosa than in the primary tumor. The expressions of the nm23 gene were higher in normal lymph nodes and in lymph nodes with metastasis than in primary tumors. This result was due to the high expression in normal lymph nodes. The expression of nm23 in distant metastatic foci was lower than it was in primary tumor tissues (p<0.05). The expression of the nm23 protein in a primary tumor with distant metastasis was higher than it was in a primary tumor with lymphnode metastasis only (p<0.05). CONCLUSIONS: It is suggested that down-regulation of the nm23 gene might have a role in distant metastasis in gastric cancer, possibly leading to a poor prognosis.
Blotting, Northern ; Cell Line ; Disease Progression ; Down-Regulation ; Gene Expression ; Gene Library ; Lymph Nodes ; Mass Screening ; Melanoma ; Mucous Membrane ; Neoplasm Metastasis ; Prognosis ; RNA, Messenger ; Stomach Neoplasms*

From among the 1485 patients with gastric cancer who had gastric resections at the Department of General Surgery, Chonnam National University Hospital, from January 1986 to December 1995, a clinical study was made of 104 patients (7%) who had signet ring cell carcinomas. Patients with this form of cancer tended to be younger and female; the tumors were smaller and involved the stomach body and antrum rather than the cardia, but none of these findings was significantly different from the findings for other types of gastric cancer. Mucosal and submucosal tumor were more prominent in gastric canner, and lymph-node metastases were statistically less likely to be present in signet ring cell carcinoma (p<0.05). The tumor stage of signet ring cell carcinomas tended statistically to be early (I) rather than advanced (III, IV) in comparison with those of other types of gastric cancer. The ploidy pattern of signet ring cell carcinomas was tended to be diploidy (80.7%) rather than aneuploidy (19.3%), and this finding was statistically significant compared with those of other types. Surgery was more curative in cases of signet ring cell carcinoma (92.3%) than in cases of other types of gastric cancer (73.4%), and the 5-year survival rates were 43.7% for patients with signet ring cell cancer and 32.8% for those with other types of gastric cancer (p<0.05). In patients with signet ring cell gastric cancer, the lesion is less extensive; thus, these patients probably can expect a longer survival time and good prognosis.
Aneuploidy ; Carcinoma, Signet Ring Cell* ; Cardia ; Diploidy ; Female ; Humans ; Jeollanam-do ; Neoplasm Metastasis ; Ploidies ; Prognosis ; Stomach Neoplasms ; Stomach* ; Survival Rate

Liver metastasis is reported about 5 to 7 percent of the time with primary gastric cancer. Advances in diagnostic tools, such as abdominal ultrasonography and abdominal CT, have made detection of liver metastases from primary gastric cancer easy. Many studies have reported on the benefit of hepatic resection for metastatic tumors from colorectal cancer. However, few reports exist on the treatment of metastatic liver tumors from primary gastric malignancy. We experienced 70 cases of gastric cancer with liver metastases among 1391 cases of gastric cancer during a 11-year period from 1986 to 1996, and we examined the relationship between the types of treatment and the mean survival time for those no cases. To that end, those patients were divided into 4 groups. Group A was comprised of 13 patients who underwent a gastrectomy with hepatic resection. Group B was comprised of 41 patients who underwent a gastrectomy with systemic chemotherapy. Group C was comprised of 3 patients who underwent a gastrectomy with chemoimmunotherapy via hepatic artery catheter. Group D was comprised of 13 patients who underwent a gastrojejunostomy only. The thirty-month survival rate of Group A was 23% and that of Group B was 13%. This difference between Groups A and B was statistically significant (p<0.05). In Group C, one patient died within 7 months, one patient died after 13 months of survival, and one patient was still living 3 months postoperatively. In Group D, no patient survived past 12 months. These results suggest that combined resection of the stomach and a part of the liver in gastric cancer patients with liver metastasis leads to longer survival time compared with other treatment methods, such as systemic chemotherapy and chemoimmunotherapy via hepatic artery cannulation.
Catheterization ; Catheters ; Colorectal Neoplasms ; Drug Therapy ; Gastrectomy ; Gastric Bypass ; Hepatic Artery ; Humans ; Liver* ; Neoplasm Metastasis* ; Stomach ; Stomach Neoplasms* ; Survival Rate ; Tomography, X-Ray Computed ; Ultrasonography