BACKGROUND/AIMS: Colorectal cancer is associated with different anatomical, biological, and clinical characteristics. We determined the impact of the primary tumor location in patients with metastatic colorectal cancer (mCRC). METHODS: Demographic data and clinical information were collected from 1,115 patients from the Republic of Korea, who presented with mCRC between January 2009 and December 2011, using web-based electronic case report forms. Associations between the primary tumor location and the patient's clinical characteristics were assessed, and factors inf luencing overall survival were analyzed using Cox proportional hazards regression models. RESULTS: Of the 1,115 patients recruited to the study, 244 (21.9%) had right colon cancer, 483 (43.3%) had left colon cancer, and 388 (34.8%) had rectal cancer. Liver and lung metastases occurred more frequently in patients with left colon and rectal cancer (p = 0.005 and p = 0.006, respectively), while peritoneal and ovarian metastases occurred more frequently in patients with right and left colon cancer (p < 0.001 and p = 0.031, respectively). The median overall survival of patients with tumors originating in the right colon was significantly shorter than that of patients whose tumors had originated in the left colon or rectum (13.7 months [95% confidence interval (CI), 12.0 to 15.5] vs. 18.0 months [95% CI, 16.3 to 19.7] or 19.9 months [95% CI, 18.5 to 21.3], respectively; p = 0.003). Tumor resection, the number of metastatic sites, and primary tumor location correlated with overall survival in the univariate and multivariate analyses. CONCLUSIONS: Primary tumor location influences the metastatic sites and prognosis of patients with mCRC.
Colon ; Colonic Neoplasms ; Colorectal Neoplasms* ; Humans ; Liver ; Lung ; Multivariate Analysis ; Neoplasm Metastasis ; Prognosis ; Rectal Neoplasms ; Rectum ; Republic of Korea

BACKGROUND: Sometimes general anesthesia is required for dental surgery in pregnant women. Facial bone fractures or neck abscess should be treated immediately. Dental surgery, however, creates a stressful situation that can cause inflammation. Inflammatory responses are a well-known major cause of preterm labor and preterm birth. Here we demonstrate the effects of remifentanil on the factors related to preterm labor and its mechanism of action on amniotic-derived epithelial cells (WISH cells). METHODS: WISH cells were exposed to lipopolysaccharide (LPS) for 24 h and co-treated with various concentrations of remifentanil. MTT assays were performed to measure cell viability. To explain the effects of remifentanil on the factors related to inflammation in WISH cells, activation of nuclear factor kappa B (NF-κB) and p38 and the expression of interleukin (IL)-1β, tumor necrosis factor (TNF)-α, cyclooxygenase (COX)2, and prostaglandin E (PGE)2 were quantified using western blotting and RT-PCR, respectively. RESULTS: Remifentanil did not affect WISH cell viability. In western blot analysis, co-treatment with remifentanil resulted in decreased phosphorylation of NF-κB, and expression of COX2 and PGE2 in LPS-induced inflammation, but the results were statistically significant only at low concentrations. Reduction of IL-1β and TNF-α expression was also observed with RT-PCR. CONCLUSION: Co-treatment with remifentanil does not affect the viability of WISH cells, but reduces the expression of the factors related to inflammation, which can induce uterine contraction and preterm labor. These findings provide evidence that remifentanil may inhibit uterine contraction and preterm labor in clinical settings.
Abscess ; Amnion ; Anesthesia, General ; Blotting, Western ; Cell Survival ; Dinoprostone ; Epithelial Cells ; Facial Bones ; Female ; Humans ; Inflammation ; Interleukins ; Neck ; NF-kappa B ; Obstetric Labor, Premature ; Phosphorylation ; Pregnancy ; Pregnant Women ; Premature Birth ; Prostaglandin-Endoperoxide Synthases ; Tumor Necrosis Factor-alpha ; Uterine Contraction

PURPOSE: Metastatic biliary tract cancer (mBTC) has a dismal prognosis. In this study, an independent dataset of patients with mBTC was used to implement and validate a routine clinico-laboratory parameter-based scoring model for risk group identification. MATERIALS AND METHODS: From September 2006 to February 2015, 482 patients with mBTC were assigned randomly (ratio, 7:3) into investigational (n=340) and validation datasets (n=142). The continuous variables were dichotomized using a normal range or the best cutoff values determined using the Contal and O'Quigley statistical methods. Following a Cox’s proportional hazard model, the scoring model was derived by summing the rounded chi-square scores for the factors identified by multivariate analysis. RESULTS: The performance status (Eastern Cooperative Oncology Group 3-4), hypoalbuminemia (< 3.4 mg/dL), carcinoembryonic antigen (≥ 9 ng/mL), neutrophil-to-lymphocyte ratio (≥ 3.0), and carbohydrate antigen 19-9 (≥ 120 U/mL) were identified as independent prognosticators (Harrell’s C index, 0.682; integrated area under the curve, 0.653). Survival was clearly correlated with the risk groups (low, intermediate, and high, 14.0, 7.3, and 2.3 months, respectively; p < 0.001). The prognosis was also discriminative in the validation data set (median survival, 16.7, 7.5, and 1.9 months, respectively; p < 0.001). Chemotherapy did not offer any survival benefits for high-risk patients. CONCLUSION: These proposed prognostic criteria for mBTC can facilitate accurate patient risk stratification and treatment-related decision-making.
Biliary Tract Neoplasms* ; Biliary Tract* ; Carcinoembryonic Antigen ; Dataset ; Drug Therapy ; Humans ; Hypoalbuminemia ; Multivariate Analysis ; Prognosis ; Proportional Hazards Models ; Reference Values ; Social Identification

Desmoid tumor is histologically benign, but this tumor is clinically considered to be malignant. Surgical resection is one of the most effective therapeutic options for patients with this tumor and resection is the best choice for cases of recurrence. We experienced two cases of recurrence of thoracic desmoid tumor, and the patients were repeatedly treated by surgical resection. The patients were discharged without any complications, and careful follow up has been performed periodically. Therefore, we report on these cases of recurrent desmoid tumor along with a review of the related literature.
Fibromatosis, Aggressive ; Follow-Up Studies ; Humans ; Recurrence ; Thoracic Neoplasms

PURPOSE: The diagnostic relevancies and characteristics and of clinical methods in the diagnosis of internal derangement (ID) were tested by comparing the results of them with those of magnetic resonance imaging (MRI). METHODS: 75 patients (150 temporomandibular joints; TMJs), who were suspected to have ID by clinical diagnoses, were included. Clinical diagnoses including mouth opening pathway and TMJ sound were conducted and MRI takings were done. Accuracies, sensitivities, specificities, positive predictive values, and negative predictive values of clinical diagnosis, mouth opening pathway, and TMJ sound were calculated by comparing with diagnoses with MRIs. RESULTS: Accuracy, sensitivity, specificity, positive predictive value, and negative predictive value of clinical diagnosis were 59.3%, 83%, 49%, 81%, and 51%. They were 59%, 82%, 25%, 73%, and 35% for mouth opening pathways. Although deviation was somewhat accurate for representing disc displacement with reduction (ADDWR), other discrepancies on opening pathways were not clinically relevant. Accuracy, sensitivity, specificity, positive predictive value, and negative predictive value of clicking sounds were 85%, 49%, 78%, 85%, and 37%. TMJs with crepitus were only three. But all TMJs with crepitus were diagnosed to have disc displacement without reduction (ADDWOR). CONCLUSION: When compared with diagnoses with MRIs, clinical diagnoses for ID were not so accurate. But they were suitable for screening tests for ID. Opening pathways and TMJ sounds were not so relevant in the diagnoses of IDs and so it was concluded that considerations for other factors must be included in the diagnoses of IDs.
Diagnosis* ; Humans ; Magnetic Resonance Imaging* ; Mass Screening ; Mouth ; Sensitivity and Specificity ; Temporomandibular Joint Disorders* ; Temporomandibular Joint*

Choroid plexus papilloma is a very rare disease in children. The manifestations of the disease differ according to the tumor size and the location. Increased CSF production by the tumor, hydrocephalus and symptoms of increased ICP are the main symptoms. The first line of treatment is surgical excision, but sometimes excision itself is very difficult due to the site and the size of the mass. Adjunctive radiation therapy or chemotherapy is not recommended. Since gross total resection without adjunctive therapy offers highest likelihood of success. Significant prognostic factors are sex, age, time of diagnosis, the duration between the appearance of symptoms and diagnosis, tumor volume, tumor site and the extent of surgery. We report a case of choroid plexus papilloma, in a child with anorexia and failure to thrive.
Anorexia* ; Child* ; Choroid Plexus* ; Choroid* ; Diagnosis ; Drug Therapy ; Failure to Thrive* ; Humans ; Hydrocephalus ; Papilloma, Choroid Plexus* ; Rare Diseases ; Tumor Burden

PURPOSE: Organotypic slice cultures are suitable for morphological and electrophysiological studies, and a valuable method to evaluate physiological and pathological responses to external stimuli. This study was designed to establish a method and to assess its values of organotypic slice cultures of rats' hippocampus for neuroscience research. METHODS: 8-day-old neonatal Sprague-Dawley rat's brain was dissected quickly and the brain was removed. Both of the hippocampi were dissected out in Petri dishes and placed on a chopper or tissue cutter with Gey's balanced salt solution(GBSS). Slices of 450 micrometer were cut and separated by adding of a drop of GBBS. Extra GBBS was aspirated. Transfer tissue slices of Millicell membrane were inserted in six-well plates containing 1 mL of warmed Gahwiler's media. Six-well plates were placed in an incubator at 36 degrees C with 5% CO2, and the media were changed regularly every 2 to 3 days. Some tissues were placed in 4% paraformaldehyde for staining and others were placed in Phosphate buffered saline(PBS) for 30 min for Western blotting. Then, we stained the free-floating, cryocutting or paraffin embedded slices with H&E or the days of 6, 9, 14 and 24 in vitro(DIV), and evaluated any changes of tissues and neurons by an image analysis system RESULTS: Hippocampal cultures had well-defined cell body layers of dentate gyrus, CA1, 2, 3 and 4 as early as the day of 6 in vitro(DIV). After 14 DIV, the cultures became gradually thinner from 450 micrometer to 150 micrometer. After 21 DIV, there were migrations of cells away from the margins of the slices and degenerative changes of some neuronal cells occurred. But pyramidal cells always were organized in well-defined cellular layer even after several weeks in the culture. Therefore, the best results were obtained by culturing slices of 6 to 14 DIV. Slice cutures was maintained after 4 weeks in vitro, but the oppotunity of contamination and infection increased as the periods of cultures trolonged. In staining, after any tissue was cultured in 2 weeks in vitro, no differentiation of the morphology and distribution in dentate gyrus, CA1, 2 and 3 were seen. In organo-typic slice culture of rats' hippocampus, we witnessed growth of glial and neuronal cell, and found pyramidal and granular cells. NeuN proteins were identified by Western blotting, and the density of NeuN protein bands was at the maximum value on the day of 9 in vitro. CONCLUSION: Since the organotypic slice cultures of rats' hippocampus were similar to the hippocampus in vivo in terms of anatomical and cellular morphology, it will become a valuable method for neuroscience research.
Animals ; Blotting, Western ; Brain ; Dentate Gyrus ; Hippocampus* ; Incubators ; Membranes ; Neurons ; Neurosciences* ; Paraffin ; Pyramidal Cells ; Rats* ; Rats, Sprague-Dawley

PURPOSE: Organotypic slice cultures are suitable for morphological and electrophysiological studies, and a valuable method to evaluate physiological and pathological responses to external stimuli. This study was designed to establish a method and to assess its values of organotypic slice cultures of rats' hippocampus for neuroscience research. METHODS: 8-day-old neonatal Sprague-Dawley rat's brain was dissected quickly and the brain was removed. Both of the hippocampi were dissected out in Petri dishes and placed on a chopper or tissue cutter with Gey's balanced salt solution(GBSS). Slices of 450 micrometer were cut and separated by adding of a drop of GBBS. Extra GBBS was aspirated. Transfer tissue slices of Millicell membrane were inserted in six-well plates containing 1 mL of warmed Gahwiler's media. Six-well plates were placed in an incubator at 36 degrees C with 5% CO2, and the media were changed regularly every 2 to 3 days. Some tissues were placed in 4% paraformaldehyde for staining and others were placed in Phosphate buffered saline(PBS) for 30 min for Western blotting. Then, we stained the free-floating, cryocutting or paraffin embedded slices with H&E or the days of 6, 9, 14 and 24 in vitro(DIV), and evaluated any changes of tissues and neurons by an image analysis system RESULTS: Hippocampal cultures had well-defined cell body layers of dentate gyrus, CA1, 2, 3 and 4 as early as the day of 6 in vitro(DIV). After 14 DIV, the cultures became gradually thinner from 450 micrometer to 150 micrometer. After 21 DIV, there were migrations of cells away from the margins of the slices and degenerative changes of some neuronal cells occurred. But pyramidal cells always were organized in well-defined cellular layer even after several weeks in the culture. Therefore, the best results were obtained by culturing slices of 6 to 14 DIV. Slice cutures was maintained after 4 weeks in vitro, but the oppotunity of contamination and infection increased as the periods of cultures trolonged. In staining, after any tissue was cultured in 2 weeks in vitro, no differentiation of the morphology and distribution in dentate gyrus, CA1, 2 and 3 were seen. In organo-typic slice culture of rats' hippocampus, we witnessed growth of glial and neuronal cell, and found pyramidal and granular cells. NeuN proteins were identified by Western blotting, and the density of NeuN protein bands was at the maximum value on the day of 9 in vitro. CONCLUSION: Since the organotypic slice cultures of rats' hippocampus were similar to the hippocampus in vivo in terms of anatomical and cellular morphology, it will become a valuable method for neuroscience research.
Animals ; Blotting, Western ; Brain ; Dentate Gyrus ; Hippocampus* ; Incubators ; Membranes ; Neurons ; Neurosciences* ; Paraffin ; Pyramidal Cells ; Rats* ; Rats, Sprague-Dawley

Central diabetes insipidus is a rare disorder that can result as a consequence of diverse etiologies, including malformations, autoimmune, infiltrative(e.g. neoplastic or histiocytosis) or traumatic processes, as well as mutations in the gene encoding arginine vasopressin. Idiopathic central diabetes insipidus is a diagnosis of exclusion, one that has been made less frequently through the decades. Idiopathic central diabetes insipidus in children and adolescent requires a frequent follow-up regimen using serial brain MRI and CSF examinations especially if an isolated pituitary stalk thickening or loss of a hyperintense signal in the posterior lobe is observed. Also, so-called "idiopathic" central diabetes insipidus warrants close follow-up to determine the etiology, especially if anterior pituitary hormone deficiencies are detected. We report a case of idiopathic central diabetes insipidus with growh hormone deficiency and loss of a hyperintense signal in the posterior lobe. He is a 13 years old. We are scheduled to follow-up with serial contrast enhanced brain MRI and CSF evaluation for the early detection of an evolving occult hypothalamic-stalk lesion.
Adolescent ; Arginine Vasopressin ; Brain ; Child ; Diabetes Insipidus, Neurogenic* ; Diagnosis ; Follow-Up Studies ; Growth Hormone* ; Humans ; Magnetic Resonance Imaging ; Pituitary Gland

PURPOSE: One of the most difficult problems in the care of children with nephrotic syndrome remains the occurrence of relapses, despite initial response to steroids. Constantinescu reported that rapidity of initial response to steroid therapy could predict fewer relapses in the first year. So we evaluated the changes in serum lipid abnormalities in children with corticosensitive nephrotic syndrome before steroid treatment and the correlation between serum lipid levels and renal function, days to remission. METHODS: We analyzed the medical records of children who were managed by us between October 1994 and August 2000. In 33 patients with corticosensitive nephrotic syndrome, we evaluated the correlation between serum lipid levels and renal function [Creatinine clearance(Ccr)] and proteinuria before steroid treatment, and days to remission defined as the third day when the patient`s urine becomes protein free. RESULTS: There were 21 males and 12 females. Median age at presentation was 6.4 years (range: 1.8-17.3 years). Median days to remission were 15.4 days (range 4-42 days) on Prednisolone 60mg/m2 daily. The increased levels of triglyceride, total cholesterol, LDL cholesterol, apolipoprotein B, total cholesterol/HDL cholesterol, Lipoprotein(a) were observed. But the level of HDL cholesterol was not increased. Serum albumin was decreased and proteinuria was increased before steroid treatment. But Ccr was not decreased. There were negative correlation between serum albumin and total cholesterol (r = -0.5157, P<0.005), LDL cholesterol (r = -0.5543, P<0.005), total cholesterol/HDL cholesterol (r = -0.4506, P<0.01), lipoprotein(a) (r = -0.4570, P<0.025), apolipoprotein B (r = -0.5297, P<0.025), apolipoprotein B/apolipoprotein A1 (r = -0.5851, P<0.01), apolipoprotein B/HDL cholesterol (r = -0.4961, P<0.05) before steroid treatment. There was no correlation between proteinuria and serum lipid profiles. Also Ccr and serum lipid profiles were not correlated. There was positive correlation between days to remission and HDL cholesterol (r = +0.4511, P<0.05), apolipoprotein B (r = +0.5190, P<0.05), apolipoprotein B/HDL cholesterol (r = +0.7169, P<0.005). CONCLUSIONS: This results reveal that HDL cholesterol, apolipoprotein B and apolipoprotein B/HDL cholesterol can be used as a predictive factor in corticosensitive nephrotic syndrome. We could not determine the significant level of these lipids for insufficient patients number, but these level may predict future relapses of corticosensitive nephrotic syndrome patients and thus may allow to better management and treatment protocols. More data and long term follow up studies should be needed.
Apolipoproteins ; Child ; Cholesterol ; Cholesterol, HDL ; Cholesterol, LDL ; Female ; Follow-Up Studies ; Humans ; Hyperlipidemias* ; Lipoprotein(a) ; Male ; Medical Records ; Nephrotic Syndrome* ; Prednisolone ; Proteinuria ; Recurrence* ; Serum Albumin ; Steroids ; Triglycerides