PURPOSE: To assess the degree and clinical impact of location error of the dens on the X-axis during radiotherapy to brain and head and neck tumors. MATERIALS AND METHODS: Twenty-one patients with brain tumors or head and neck tumors who received three-dimensional conformal radiation therapy or intensity-modulated radiation therapy from January 2009 to June 2010 were included in this study. In comparison two-dimensional verification portal images with initial simulation images, location error of the nasal septum and the dens on the X-axis was measured. The effect of set-up errors of the dens was simulated in the planning system and analyzed with physical dose parameters. RESULTS: A total of 402 portal images were reviewed. The mean location error at the nasal septum was 0.16 mm and at the dens was 0.33 mm (absolute value). Location errors of more than 3 mm were recorded in 43 cases (10.7%) at the nasal septum, compared to 133 cases (33.1%) at the dens. There was no case with a location error more than 5 mm at the nasal septum, compared to 11 cases (2.7%) at the dens. In a dosimetric simulation, a location error more than 5 mm at the dens could induce a reduction in the clinical target volume 1 coverage (V95: 100%-->87.2%) and overdosing to a critical normal organ (Spinal cord V45: <0.1%-->12.6%). CONCLUSION: In both brain and head and neck radiotherapy, a relatively larger set-up error was detected at the dens than the nasal septum when using an electronic portal imaging device. Consideration of the location error of the dens is necessary at the time of the precise radiation beam delivery in two-dimensional verification systems.
Brain ; Brain Neoplasms ; Electronics ; Electrons ; Head ; Humans ; Nasal Septum ; Neck

PURPOSE: This aim of this study was to evaluate changes in gastric volume and organ position as a result of delayed gastric emptying after a subtotal gastrectomy performed as part of the treatment of stomach cancer. MATERIALS AND METHODS: The medical records of 32 patients who underwent concurrent chemoradiotherapy after a subtotal gastrectomy from March 2005 to December 2008 were reviewed. Of these, 5 patients that had more than 50 cc of residual gastric food detected at computed tomography (CT) simulation, were retrospectively enrolled in this study. Gastric volume and organ location was measured from CT images obtained before radiotherapy, twice weekly. In addition, authors evaluated the change of radiation dose distribution to planning the target volume and normal organ in a constant radiation therapy plan regardless of gastric volume variation. RESULTS: A variation in the gastric volume was observed during the radiotherapy period (64.2~340.8 cc; mean, 188.2 cc). According to the change in gastric volume, the location of the left kidney was shifted up to 0.7 - 2.2 cm (mean, 1.2 cm) in the z-axis. Under-dose to planning target volume (V43, 79.5+/-10.4%) and over-dose to left kidney (V20, 34.1+/-12.1%; Mean dose, 23.5+/-8.3 Gy) was expected, given that gastric volume change due to delayed gastric emptying wasn't taken into account. CONCLUSION: This study has shown that a great change in gastric volume and left kidney location may occur during the radiation therapy period following a subtotal gastrectomy, as a result of delayed gastric emptying. Detection of patients who experienced delayed gastric emptying and the application of gastric volume variation to radiation therapy planning will be very important.
Chemoradiotherapy ; Gastrectomy ; Gastric Emptying ; Humans ; Kidney ; Medical Records ; Retrospective Studies ; Stomach Neoplasms

Polycythemia is a condition in which the red blood cell count is increased due to an inherited or acquired mutation, a physiologic response to hypoxia, autonomous erythropoietin production, or deliberate erythropoietin administration. Higher testosterone levels appear to act as a stimulus for erythropoiesis and testosterone replacement therapies have rarely been reported as causes of polycythemia. We report here a case of a 51-year-old man with polycythemia that was caused by long-acting testosterone undecanoate (Nebido(R)).
Anoxia ; Erythrocyte Count ; Erythropoiesis ; Erythropoietin ; Humans ; Middle Aged ; Polycythemia ; Testosterone

BACKGROUND: It is not yet clear whether the abnormal cytokine production in relation to serum IgE levels in atopic dermatitis (AD) is associated with the amount of mRNA of cytokine gene. OBJECTIVE: Our purpose was to delineate the effect of reciprocal correlation in the level of mRNA between interleukin-4 (I") and interferon-gamma (IFN-γ) in severe AD. METHODS: We examined 15 cases including 5 AD patients with high serum IgE (>2,000 kU/liter), 5 AD patients with low serum IgE (<100 kU/liter), and 5 healthy controls. Using semi quantitative reverse transcription-polymerase chain reaction, IL-4 and IFN-γ gene expressions in peripheral mononuclear cells (PBMC) were examined. RESULTS: 1) IL-4 gene expression in spontaneous PBMC was higher in AD patient groups than in control group, significantly higher only in AD patient group with high serum IgE level (p < 0.05). 2) IFN-γ gene expression in spontaneous PBMC showed increased tendency in AD patient groups than in control group without statistical significance. 3) IL-4 and IFN-γ gene expressions in stimulated PBMC were not different among all three groups. CONCLUSION: In light of our results, high and low IgE subgroups in AD can exist and AD may not be R characterized by the shift in the reciprocal relationship between IL-4 and IFN-γ when T cells are stimulated under antigen presenting cell-independent conditions.
Dermatitis, Atopic ; Gene Expression ; Humans ; Immunoglobulin E* ; Interferon-gamma* ; Interleukin-4* ; RNA, Messenger ; T-Lymphocytes

OBJECTIVES: Given the roles of bcl-2, bax and p53 in apoptosis, we investigated the effect of their expression on the response to cisplatin in order to understand the molecular events of cisplatin-resistance in lung cancers. METHODS: Three parental human lung cancer cell lines (PC9, PC14 and H69) and their in vitro selected cisplatin-resistant sublines were examined. Cells treated with cisplatin were processed for acridine orange and ethidium bromide staining and DNA gel electrophoresis for the morphologic detection of apoptosis. The endogenous levels of bcl-2, bax and p53 protein expression in lung cancer cells were assessed by Western blot analysis and DNA of polymerase chain reaction-amplified exon 5 to 8 of p53 gene was directly sequenced. RESULTS: H69, which had bcl-2 expression, p53 mutation and decreased expression of p53 and bax, was relatively resistant to cisplatin and delayed and reduced apoptosis. Although apoptosis was markedly reduced in cisplatin-resistant sublines compared to their parental cells, there were no significant differences in the expression of p53, bcl-2 and bax. CONCLUSIONS: Cisplatin-resistance was associated with the reduced cellular susceptibility to apoptosis. Cancer cells with the natural expression of bcl-2 and p53 mutation may be more resistant to cisplatin and less susceptible to apoptosis.
Antineoplastic Agents/pharmacology* ; Apoptosis/genetics ; Apoptosis/drug effects* ; Cisplatin/pharmacology* ; Drug Resistance ; Gene Expression ; Genes, bcl-2 ; Genes, p53 ; Human ; Lung Neoplasms/pathology ; Lung Neoplasms/genetics ; Lung Neoplasms/drug therapy ; Proto-Oncogene Proteins/genetics ; Tumor Cells, Cultured

Over the past years, university administrators have known how hard it is to transform into the modern university. Rigid in-bred research system, narrow interest, unworkable graduate programs are complicatedly woven into a network of academic fraction. Cronyism and protectionism flood various laboratories and research institutes affiliated with the university. Until recently, the department structure of medical school has steadfastly guarded its territory and refused to allow non-medical undergraduate students to apply for the graduate schools of medical science. The graduate schools in medical science are considered just extra appendages because most of graduate students should be engaged in hard work position such as junior faculty or residentship training course of university hospital. In the present environment of graduate program, medical schools are consequently not able to bring in full-time young researchers, but only recently has its door been open for others. It should be time to reorganize the medical school graduate course into large multidisciplinary research group by expanding graduate programs.
Academies and Institutes ; Administrative Personnel ; Humans ; Schools, Medical*

The objective of this study was to characterize the alterations of 9p21 and TP53 in Korean transitional bladder cancer and to assess the relationship between the histopathologic parameter and the alteration of these genes. Allele loss in 29 surgically resected transitional cell carcinoma was examined by using the multiplex PCR with 7 and 1 microsatellite markers for 9p21 and TP53, respectively. Twenty-one (72%) demonstrated allele loss at 9p21 and/or TP53. Deletion at the 9p21 region was detected in 17(61%) of 28 informative cases at one or more loci, and LOH at TP53 was found in 12(55%) of 22 informative cases. Of 7 microsatellite markers for 9p21, allele loss occurred the most frequently at locus D9S162(69%) and D9S104(69%). Additionally, hemizygous deletion was slightly more common than homozygous deletion. Deletion at 9p21 and TP53 was not related with increased grade. These results suggest that the alteration of 9p21 may be an early event in the development of Korean bladder cancer, while p53 gene may be involved in early event of some bladder cancers as well as in their late events.
Adult ; Aged ; Bladder Neoplasms/*genetics ; Carcinoma, Transitional Cell/*genetics ; *Chromosome Deletion ; *Chromosomes, Human, Pair 9 ; Female ; *Genes, p53 ; Human ; Male ; Middle Age

Recently the adenomaatous polyposis coli(APC) gene, a tumor suppressor gene, was identified and the cDNA was cloned from chromosome 5q21. Allelic deletion or point mutation of tumor suppressor genes(TSGs) has been considered as an important mechanism in development of human tumor. Point mutations affecting APC gene are seen in the hereditary syndrome, adenomatous polyposis and spordic colon cancer. However, the mutation of APC gene and other TSGs have not been described in gastric cancer. In order to identify the mutation of exon 11 of APC gene for gastric cancer, we amplified DNA extracted from paraffin-embedded tissues by polymerase chain reaction(PCR) and digested the PCR products with restriction enzyme Rsa I. We examined the DNA extracted from paraffin-embedded 44 gastric cancer tissues with lymph nodes. Eighteen(41%) among 44 were informative for the study exon 11 of the APC gene, and we found loss of heterozygosity(LOH) for APC in 6/18(33.3%). These data suggest that the point mutation or the base change of APC gene commonly occurs in gastric cancer. We conclude that the mutation of APC gene is strongly connected with development of human gastric cancer.
Humans ; Genes, Tumor Suppressor ; Stomach Neoplasms

No abstract available.
Endothelial Cells*

No abstract available.
Humans* ; Kidney*