Background/Objectives: Shoulder function is an important aspect of health related quality of life (QOL). Neck dissection impairment index (NDII) is a simple shoulder-specific questionnaire. This study aimed to evaluate the association between QOL and NDII in patients who underwent neck dissection to validate the Korean version of NDII.Materials & Methods: This study enrolled 74 patients with head and neck cancer who underwent neck dissection from December 2013 to April 2014. Patients completed questionnaires on QOL including the European Organization of Research and Treatment of Cancer 30-item Core QOL questionnaire (EORTC QLQ-C30) and NDII which was translated into Korean. Validity was evaluated by calculating the Pearson correlation coefficient between NDII and EORTC QLQ-C30. Results: We compared preoperative, postoperative within a week, 1st and 3rd months NDII scores. The total NDII scores were 14.7, 47.4, 33.7 and 34.3 each. Clinical variables including gender, site of primary tumor, performing revision neck dissection, radiotherapy and flap reconstruction were not significantly associated with NDII. However NDII mean score of patients who underwent unilateral neck dissection over 3 levels is most increased after operation. During all periods NDII scores were significantly associated with functioning score. Although other scores are lower correlation than function scores, global health status scores and symptom scores are also correlation with NDII. Conclusion NDII was valid instrument and can be used not only in the clinical practice to assess shoulder dysfunction but also in the simple instrument to evaluate global QOL in Korea patients with having neck dissection.

BACKGROUND/AIMS: To examine whether visceral adiposity serves as a risk factor for colorectal cancer (CRC) and colorectal adenomas. METHODS: Two hundred healthy subjects, 200 patients with colorectal adenoma, and 151 patients with CRC (46 with early-stage and 105 with advanced-stage cancers) were enrolled at a tertiary referral hospital. All subjects underwent colonoscopy, and had laboratory data, and computed tomography (CT) scan available for abdominal fat measurement. An abdominal CT scan taken 1 to 4 years (mean interval, 20.6 months) before the diagnosis of CRC was also available in the 42 CRC patients. RESULTS: The mean areas of visceral adipose tissue (VAT) areas in the control, adenoma, early- and advanced-stage CRC groups were 94.6, 116.8, 110.4, and 99.7 cm², respectively (P<0.001). The risk of adenoma positively correlated with VAT area and the visceral-to-total fat ratio (P for trend <0.01), but the risk of CRC did not (P>0.05). The risk of both adenoma and CRC positively correlated with fasting plasma glucose levels (P for trend <0.05). In patients with early-stage cancer (n=17), VAT area decreased when the CT scan at diagnosis was compared with that taken before the diagnosis of CRC, but superficial adipose tissue area did not, so visceral-to-total fat ratio significantly decreased (46.6% vs. 50.7%, respectively, P=0.018) CONCLUSIONS: VAT area is related to the risk of colorectal adenoma. However, VAT decreases from the early stages of CRC. Impaired fasting glucose has a role in colorectal carcinogenesis.
Abdominal Fat ; Adenoma ; Adipose Tissue ; Adiposity ; Blood Glucose ; Carcinogenesis ; Colonoscopy ; Colorectal Neoplasms ; Diagnosis ; Fasting ; Glucose ; Healthy Volunteers ; Humans ; Insulin Resistance ; Insulin ; Intra-Abdominal Fat ; Obesity ; Risk Factors ; Tertiary Care Centers ; Tomography, X-Ray Computed

BACKGROUND: The appropriate procedures and equipment for the pretransfusion test are fundamental to a safe blood transfusion. The present study aimed to assess the current status of procedures and equipment for pretransfusion tests at small- and medium-sized medical institutions, as well as to use this basic raw data to better manage blood transfusions at these institutions. METHODS: Offline and online questionnaire surveys were performed at institutions that used between 24 and 1,000 units of blood products in 2014. A total of 338 institutions participated, and the survey results were subsequently analyzed. RESULTS: Among 307 institutions where on-site ABO blood typing was performed, 15.0%, 2.1%, and 43.5% did not conduct ABO serum typing, RhD typing, and irregular antibody screening tests, respectively, and 12.8% only conducted the saline phase for crossmatching. Moreover, among 338 institutions, only 66.7% of blood banks had centrifuges, 84.5% had 37℃ incubators, 41.1% had slide view boxes; in addition, 66.1% and 18.6% had refrigerators and deep freezers, respectively, for blood storage. CONCLUSION: Certain small- and medium-sized institutions did not have the essential equipment required to operate as blood banks. Moreover, they also needed to improve their testing procedures. To address these issues, the initiation of systematic training programs and the employment of institutional strategies are necessary to enhance testing procedures and equipment, respectively.
Blood Banks ; Blood Grouping and Crossmatching ; Blood Transfusion ; Education ; Employment ; Incubators ; Korea* ; Mass Screening

OBJECTIVE: Perfusion computed tomography (PCT) has the ability to measure quantitative value and produce maps of mean transit time (MTT), cerebral blood flow (CBF), and cerebral blood volume (CBV). We assessed cerebral hemodynamics by using these parameters and acetazolamide (ACZ) challenge for pre- and post-procedural evaluation in patients with unilateral cerebrovascular stenotic disease. METHODS: Thirty patients underwent pre-procedural PCT with ACZ challenge, and 24 patients (80%) was conducted follow up PCT after angioplasty with same protocol. The mean MTT, CBF, and CBV were measured and compared in both middle cerebral arterial (MCA) territories before and after ACZ challenge. Hemispheric ratio and percent change after ACZ challenge were calculated before and after angioplasty. RESULTS: The mean stenosis rate was 76.6%. Significant increases in MTT (32.6%, p=0.000) and significant decreases in CBF (-14.2%, p=0.000) were found in stenotic side MCA territories. After ACZ challenge, there were significant changes in MTT (37.4%, p=0.000), CBF (-13.1%, p=0.000), and CBV (-10.5%, p=0.001) in pre-procedural perfusion study. However, no significant increases were found in MTT, or decreases in CBF and CBV in post-procedural study. There were no significant changes after ACZ challenge also. In addition, the degrees of these changes (before and after ACZ challenge) were highly correlated with the stenotic degrees in pre-procedural perfusion study. CONCLUSION: PCT with ACZ challenge appears to be a useful tool to assess the cerebral perfusion status especially in patients with unilateral symptomatic stenotic disease.
Acetazolamide* ; Angioplasty ; Blood ; Blood Volume ; Constriction, Pathologic ; Follow-Up Studies ; Hemodynamics ; Humans ; Perfusion*

No abstract available.
Humans ; Mastocytosis

BACKGROUND: Biomarkers for cancer have several potential clinical uses, including the following: early cancer detection, monitoring for recurrence prognostication, and risk stratification. However, no biomarker has been shown to have adequate sensitivity and specificity. Many investigators have tried to validate biomarkers for the early detection and recurrence of lung cancer. To evaluate plasma G-CSF as such a biomarker, protein levels were measured and were found to correlate with the clinicopathological features of primary lung tumors. METHODS: Between December 2006 and May 2008, 100 patients with histologically-validated primary lung cancer were enrolled into this study. To serve as controls, 127 healthy volunteers were enrolled into this study. Plasma G-CSF levels were measured in lung cancer patients using the sandwich ELISA system (R & D inc.) prior to treatment. RESULTS: The mean plasma G-CSF levels were 12.2+/-0.3 pg/mL and 46.0+/-3.8 pg/mL (mean+/-SE) in the normal and in the cancer groups, respectively. In addition, plasma G-CSF levels were higher in patients with early lung cancer than in healthy volunteers (p<.001). Plasma G-CSF levels were higher in patients who were under 65 years old or smokers. Within the cancer group, plasma G-CSF levels were higher in patients with non small cell lung cancer than in patients with small cell lung cancer (p<.05). Overall, plasma G-CSF levels were shown to increase dependent upon the type of lung cancer diagnsosed. In the order from highest to lowest, the levels of plasma G-CSF tended to decrease in the following order: large cell carcinoma, squamous cell carcinoma, adenocarcinoma, and bronchioloalveolar carcinoma. Plasma G-CSF levels tended to be higher in patients with advanced TNM stage than in localized TNM stage (I, II Adenocarcinoma ; Adenocarcinoma, Bronchiolo-Alveolar ; Adrenal Glands ; Biomarkers ; Carcinoma, Large Cell ; Carcinoma, Squamous Cell ; Enzyme-Linked Immunosorbent Assay ; Granulocyte Colony-Stimulating Factor ; Humans ; Lung ; Lung Neoplasms ; Neoplasm Metastasis ; Plasma ; Recurrence ; Research Personnel ; Small Cell Lung Carcinoma

BACKGROUND AND OBJECTIVES: According to the MADIT II criteria, a low left ventricular ejection fraction (LVEF) is one of the most important predicting factors for sudden cardiac death (SCD) in post myocardial infarction (PMI) patients, and it is a reasonable indication for ICD implantation. The aim of this study is to reveal the incidence and the prognostic value of the non-invasive parameters and whether the MADIT II criteria for ICD implantation can be applied to Korean PMI patients. SUBJECTS AND METHODS: During the period from January 2001 to June 2005, 640 PMI survivors were included in this study. The incidence of an abnormal SAECG, premature ventricular complex (PVC) counts > or = 10/hr, non-sustained ventricular tachycardia (NSVT) on ambulatory ECG and a low (< or = 30%) LVEF were studied and used as risk stratification markers for later adverse arrhythmic events. RESULTS: The incidence of PVCs > or = 10/hr and NSVT on the ambulatory ECG was 14.3% and 7.5%, respectively. 29 patients (4.9%) had a LVEF of less than 30%. Arrhythmic events occurred in 9 of the 29 patients (31%). SCD or adverse arrhythmic events occurred in 42 of the 640 patients. The percentage of patients who were using beta-blocker was lower than that in the MADIT II study group (55% vs 70%, respectively). In the adverse arrhythmic event (+) group, the percentage of beta-blocker use was significantly lower than that in the arrhythmic event (-) group (32.5% vs 58%, respectively). CONCLUSION: The MADIT II criteria and PVCs > or = 10/hr or NSVT on the ambulatory ECG can be suggested as the indications for implanting an ICD in Korean PMI patients. The use of beta-blocker is important for preventing adverse arrhythmic events.
Death, Sudden, Cardiac* ; Electrocardiography ; Humans ; Incidence ; Myocardial Infarction* ; Risk Assessment ; Stroke Volume* ; Survivors ; Tachycardia, Ventricular ; Ventricular Premature Complexes

A 52-year-old woman, who was suffering from aplastic anemia, presented with the clinical features of severe heart failure. The transthoracic echocardiogram showed a heterogeneous, huge mass on the base of the posterior mitral valve. We guessed that the mass would be a benign neoplasm and probably myxoma, and we decided upon surgical resection. After tumor resection, an unexpected result of the histopathology was a high grade osteosarcoma. The other studies that were done after we had the diagnosis could not reveal any evidence of metastatic malignancy.
Anemia, Aplastic ; Diagnosis ; Female ; Heart Failure ; Heart Neoplasms ; Humans ; Middle Aged ; Mitral Valve ; Myxoma ; Osteosarcoma*

Aortic intramural hematoma is a clinical condition that still has not been completely defined. And the treatment of intramural hematoma remains controversial. We present a patient with intramural hematoma combined with hemopericadium who was treated by an emergent surgical treatment.
Aorta* ; Cardiac Tamponade ; Hematoma* ; Humans

BACKGROUND: Although significant progress has been made in the surgical treatment of esophageal carcinoma as well as in the detection of early stage esophageal carcinoma by diagnostic techniques, the prognosis of the esophageal carcinoma patients remain poor. The p53 gene product is known to regulate cell growth and proliferation. And the nm23 gene was identified originally as an anti-metastatic influence whose expression was correlated inversely with tumor metastatic potential in murine melanoma cell lines. This experiment was intended to know the relationship among the p53 and nm23 gene expression versus clinicopahologic characteristics of the esophageal cancer. MATERIAL AND METHOD: Total 40 cases were collected from patients who had undergone esophagectomy at St. Mary's Hospital, Catholic university of Korea. Immunohistochemical stain for p53 mutant-type protein and nm23 proein was graded as <10% positive tumor cells: negative; 10~30% positive tumor cells: + ; 30 ~50% positive tumor cells: ++ , and >50% positive tumor cells: +++ . The tumor invasion was grades as none: - ; mild: + ; moderate: ++ ; severe: +++ . RESULT: Overexpression of p53 protein and nm23 was not associated with the survival and cliniocopathologic characteristics of the esophageal cancer. Moreover, the combination analysis of p53 and nm23 revealed that there was no relationship between the gene expression and the clinicopatholic characteristics of the esophageal cancer.
Cell Line ; Esophageal Neoplasms* ; Esophagectomy ; Gene Expression* ; Genes, p53* ; Humans ; Korea ; Melanoma ; Oncogene Proteins ; Prognosis