Korean Society of Thyroid-Head and Neck Surgery appointed a Task Force to provide guidance on the implementation of a surgical treatment of oral cancer. MEDLINE databases were searched for articles on subjects related to “surgical management of oral cancer” published in English. Results were restricted to systematic reviews, randomized control trials/controlled clinical trials, and observational studies. The quality of evidence was rated with use RoBANS (Risk of Bias Assessment Tool for Nonrandomized Studies) and AMSTAR (A Measurement Tool to Assess the Methodological Quality of Systematic Reviews). Evidence-based recommendations for practice were ranked according to the American College of Physicians grading system. Additional directives are provided as expert opinions and Delphi questionnaire when insufficient evidence existed. The Committee developed 68 evidence-based recommendations in 34 categories intended to assist clinicians and patients and counselors, and health policy-makers. Proper surgical treatment selection for oral cancer, which is directed by patient- and subsite-specific factors, remains the greatest predictor of successful treatment outcomes. These guidelines are intended for use in conjunction with the individual patient's treatment goals.
Advisory Committees ; Bias (Epidemiology) ; Carcinoma, Squamous Cell ; Counseling ; Expert Testimony ; Humans ; Mouth Neoplasms ; Neck ; Republic of Korea

BACKGROUND AND OBJECTIVES: Although increasing evidence has indicated that radial access is a beneficial technique, few studies have focused on Korean subjects. The aim of this study was to evaluate current practice of coronary angiography (CAG) and percutaneous coronary intervention (PCI) using radial access in South Korea. SUBJECTS AND METHODS: A total of 6338 subjects were analyzed from Korean Transradial Intervention prospective registry that was conducted at 20 centers in Korea. After evaluating the initial access, subjects intended for radial access were assessed for their baseline, procedure-related, and complication data. Subjects were categorized into three groups: group of overall subjects (n=5554); group of subjects who underwent PCI (n=1780); and group of subjects who underwent primary percutaneous coronary intervention (PPCI) (n=167). RESULTS: The rate of radial artery as an initial access and the rate of access site crossover was 87.6% and 4.4%, respectively, in overall subjects. Those rates were 82.4% and 8.1%, respectively, in subjects who underwent PCI, and 60.1% and 4.8%, respectively, in subjects who underwent PPCI. For subjects who underwent CAG, a 6-F introducer sheath and a 5-F angiographic catheter was the most commonly used. During PCI, a 6-F introducer sheath (90.6%) and a 6-F guiding catheter were standardly used. CONCLUSION: The large prospective registry allowed us to present the current practice of CAG and PCI using radial access. These data provides evidence to achieve consensus on radial access in CAG and PCI in the Korean population.
Catheters ; Consensus ; Coronary Angiography* ; Korea ; Percutaneous Coronary Intervention ; Prospective Studies* ; Radial Artery ; Registries

PURPOSE: This randomized clinical trial was conducted to assess the safety and effectiveness of the ErhBMP-2 in alveolar bone regeneration as well as preservation of the beta-TCP bone graft material that contains ErhBMP-2. MATERIALS AND METHODS: This study involved 72 patients at the 3 study centers. The patients, who were divided into 2 groups: the experiment group who had ErhBMP-2 coated TCP/HA and the control group who had TCP/HA graft material alone transplanted immediately after tooth extraction. CT was taken before and 3 months after the transplantation and healing status was compared between the two groups. The efficacy endpoints that were used to measure the degree of bone induction included alveolar bone height and 3 measurements of bone width. The paired t test was used to determine the significance of the changes (P<.05). RESULTS: Changes in alveolar bone height were -1.087 +/- 1.413 mm in the control group and -.059 +/- 0.960 mm in the experimental group (P<.01). At 25% extraction socket length [ESL], the changes were 0.006 +/- 1.149 mm in the control group and 1.279 +/- 1.387 mm in the experimental group. At 50% ESL, the changes were 0.542 +/- 1.157 mm and 1.239 +/- 1.249 mm, respectively (P<.01 for 25% ESL, and P<.05 for 50% ESL). During the experiment, no adverse reactions to the graft material were observed. CONCLUSION: ErhBMP-2 coated beta-TCP/HA were found to be more effective in preserving alveolar bone than conventional beta-TCP/HA alloplastic bone graft materials.
Bone Regeneration ; Calcium Phosphates ; Escherichia ; Humans ; Tooth Extraction ; Transplants

Work-related musculoskeletal disorders (WMSDs) can be compensated through the Industrial Accident Compensation Insurance Act. We looked at the characteristics of WMSDs in worker's compensation records and the epidemiological investigation reports from the Occupational Safety and Health Research Institute (OSHRI). Based on the records of compensation, the number of cases for WMSDs decreased from 4,532 in 2003 to 1,954 in 2007. However the proportion of WMSDs among the total approved occupational diseases increased from 49.6% in 2003 to 76.5% in 2007, and the total cost of WMSDs increased from 105.3 billion won in 2004 to 163.3 billion won in 2007. The approval rate of WMSDs by the OSHRI accounted for 65.6%. Ergonomic and clinical characteristics were associated with the approval rate; however, the degenerative changes had a minimal affect. This result was in discordance between OSHRI and the Korea Workers' Compensation & Welfare Service. We presumed that there were perceptional gaps in work-relatedness interpretation that resulted from the inequality of information in ergonomic analyses. We propose to introduce ergonomic analysis to unapproved WMSDs cases and discuss those results among experts that will be helpful to form a consensus among diverse groups.
Accidents, Occupational ; Adult ; Cumulative Trauma Disorders ; Female ; Human Engineering ; Humans ; Low Back Pain ; Male ; Middle Aged ; *Musculoskeletal Diseases ; *Occupational Diseases ; Republic of Korea ; Risk Factors ; *Workers' Compensation/economics/trends

PURPOSE: Bone morphogenetic protein-2(BMP-2) has been shown to possess significant osteoinducitve potential. There have been attempts to overcome a limitation of mass production, and economical efficiency of BMP. The aim of this study was to produce recombinant human BMP-2(rhBMP-2) from E. coli in a large scale and evaluate its biological activity. MATERIALS AND METHODS: The E.coli strain BL21(DE3) was used as a host for rhBMP-2 production. Dimerized rhBMP-2 was purified by affinity chromatography using Heparin column. To determine the physicochemical properties of the rhBMP-2 expressed in E. coli, we examined the HPLC profile and performed Western blot analysis. The effect of the purified rhBMP-2 dimer on osteoblast differentiation was examined by alkaline phosphatase (ALP) activity and representing morphological change using C2C12 cell. RESULTS: E. coli was genetically engineered to produce rhBMP-2 in a non-active aggregated form. We have established a method which involves refolding and purifying a folded rhBMP-2 dimer from non-active aggregates. The purified rhBMP-2 homodimer was characterized by SDS-PAGE as molecular weight of about 28kDa and eluted at 34% acetonitrile, 13.27 min(retention time) in the HPLC profile and detected at Western blot. The purified rhBMP-2 dimer stimulated ALP activity and induced the transformation from myogenic differentiation to osteogenic differentiation. CONCLUSION: rhBMP-2 was produced in E. coli using genetic engineering. The purified rhBMP-2 dimer stimulated ALP activity and induced the osteogenic differentiation of C2C12 cells.
Acetonitriles ; Alkaline Phosphatase ; Blotting, Western ; Bone Morphogenetic Protein 2 ; Chromatography, Affinity ; Chromatography, High Pressure Liquid ; Durapatite ; Electrophoresis, Polyacrylamide Gel ; Genetic Engineering ; Heparin ; Humans ; Molecular Weight ; Osteoblasts ; Recombinant Proteins ; Sprains and Strains ; Transforming Growth Factor beta

OBJECTIVE: To analyze the incidence of chromosomal abnormalities according to age and indications in midtrimester amniocentesis performed for prenatal genetic diagnosis. METHODS: We retrospectively analyzed the results of 3,537 cases of midtrimester prenatal genetic amniocentesis which were performed from 1994 to June 2006 in the cytogenetic laboratory at Pusan National University Hospital. RESULTS: Of the 3,537 midtrimester amniocentesis cases, the most common maternal age group was 25~29 years old (32.8%), followed by 30-34 years old (32.1%) and 35~39 years old (24.3%). The indications for amniocentesis were abnormal triple test (42.6%), advanced maternal age (31.8%), family history of chromosomal abnormality (7.0%), in the respective order. The overall incidence of chromosomal abnormalities was 5.0%, of which numerical abnormalities and structural abnormalities were 2.4% and 2.6%, respectively. Chromosomal abnormalities were most frequently found in the maternal age over 45 (16.7%), followed by 40~44 years old (6.3%) and 25~29 years old (5.6%). According to the indications of amniocentesis, chromosomal abnormalities were found in patients with habitual abortion (21.2%), previous history of chromosomal abnormality (14.3%), abnormal finding on ultrasonography (11.5%) and advanced maternal age (5.7%), in the respective order. CONCLUSION: In this study, in addition to although abnormal triple test and advanced maternal age as important indications of midtrimester amniocentesis for prenatal diagnosis, other indications such as habitual abortion, previous history of chromosomal abnormality and abnormal finding on ultrasonography should be considered important as indications of midtrimester amniocentesis.
Abortion, Habitual ; Amniocentesis* ; Busan ; Chromosome Aberrations ; Cytogenetics* ; Diagnosis ; Female ; Humans ; Incidence ; Maternal Age ; Pregnancy ; Pregnancy Trimester, Second* ; Prenatal Diagnosis ; Retrospective Studies ; Ultrasonography

In this 21st century which is considered as the era of biotechnology, the regenerative medicine emerging as an important medical science has been expected to provide hope to patients of incurable diseases, such as myriad of degenerative disease or terminal organ failure which can not be solved until recently. Because It is also thought to be a epochal alternative therapy in every medical part including cardiovascular disease, neurological disorder, hereditary disease, liver disease, endocrine disorder, bone or cartilage disease, and skin disease, many stem cell researches are conducted and many results are reported. Stem cells are at the center of this regenerative medicine. Although there is public debate because it is inevitably associated with ethical problems like destruction of embryo or risk of reproductive cloning, stem cell research generated much interest because the expected therapeutic effect and the derived economic value would be enormous. This review will describe the characteristics of stem cell and summarize the published research results recently.
Adult Stem Cells ; Biotechnology ; Cardiovascular Diseases ; Cartilage Diseases ; Clone Cells ; Cloning, Organism ; Embryonic Stem Cells ; Embryonic Structures ; Genetic Diseases, Inborn ; Hope ; Humans ; Liver Diseases ; Nervous System Diseases ; Regenerative Medicine ; Skin Diseases ; Stem Cell Research ; Stem Cells*

OBJECTIVE: The aim of this study was to investigate the relationship between chromosome abnormalities and male or female reproductive dysfunction and to be convinced of the role of pericentric inversion of chromosome 9 (inv (9)) on human phenotypes. METHODS: Between Jan. 1995 and Dec. 2003, results of 1713 chromosomal analyses which were referred to our cytogenetic laboratory were analyzed. Study groups consisted of 658 cases of men and 18 cases of women with unexplained infertility, 65 cases of men and 109 cases of women with history of recurrent spontaneous abortion, 78 cases of women with primary amenorrhea, 61 cases of women with secondary amenorrhea and, 382 cases of men and 342 cases of women with no reproductive dysfunction (control group). The incidence of inv (9) among each group was compared with control group. RESULTS: Chromosomal abnormalities were found in 110 cases (16.7%), 2 cases (11.1%), 3 cases (4.6%), 15 cases (13.8%), 29 cases (37.2%) and 10 cases (16.4%) in each group. The incidence of chromosomal abnormalities in male infertility was higher than previous reports, and 10 cases of inv (9) were detected in male infertility group. In cases of women with infertility and secondary amenorrhea, we couldn't find the relevance between reproductive dysfunction and chromosomal abnormality. In cases of women with recurrent spontaneous abortion, 6 cases (5.5%) had autosomal translocation and 7 cases (6.42%) had inv (9). In cases with primary amenorrhea, most chromosomal abnormalities found were related to sex chromosome such as Turner's syndrome, similar to other investigations. Thirty three cases of inv (9) was detected among the whole 1713 chromosomal analyses (1.93%). In cases of male infertility, 10 cases (1.52%) had inv (9), not significantly different with male control group. But 7 cases (6.42%) of inv (9) in women with recurrent spontaneous abortion were significantly higher than female control group (p<0.05). CONCLUSION: Because considerable proportion of patients with reproductive dysfunction had various cytogenetic abnormalities, the chromosomal analysis should be considered as a diagnostic tool in the evaluation of reproductive dysfunction such as infertility, recurrent spontaneous abortion, and amenorrhea. We also found that Inv (9) had a significantly increased incidence in female recurrent spontaneous abortion.
Abortion, Spontaneous ; Amenorrhea ; Chromosome Aberrations* ; Chromosomes, Human, Pair 9 ; Cytogenetics* ; Female ; Humans ; Incidence ; Infertility ; Infertility, Male ; Male ; Phenotype ; Pregnancy ; Sex Chromosomes ; Turner Syndrome

Imperforate hymen is a common congenital malformation, but usually remains asymptomatic and not detected until menarche. Neonatal hydrometrocolpos caused by imperforate hymen is reported to be very rare. We report a case of hydrometrocolpos in newborn presenting with pelvic mass and bulging membrane in vaginal introitus causing both hydronephrosis which is treated surgically with good result.
Female ; Humans ; Hydronephrosis* ; Hymen* ; Infant, Newborn* ; Membranes ; Menarche

Gastric cancer is rarely associated with pregnancy and its incidence is reported to be 0.1%. The dilemma in the treatment of this rare occasion is that it is usually diagnosed at an advanced stage. The most common reason for delayed diagnosis is that early symptoms of gastric cancer, such as nausea, vomiting and epigastric discomfort, are nonspecific and usually misinterpreted as those related to pregnancy. Clinicians' reluctance to request diagnostic studies is another reason for delayed diagnosis. So these make the prognosis much worse. We must consider the rare possibility of gastric cancer in case of persistent nausea and vomiting. We report a case of advanced gastric cancer diagnosed by gastroscopic examination performed in the second trimester because of persistent nausea and vomiting.
Delayed Diagnosis ; Endoscopy* ; Female ; Humans ; Incidence ; Nausea* ; Pregnancy ; Pregnancy Trimester, Second* ; Prognosis ; Stomach Neoplasms* ; Vomiting*