Skip Navigation
Skip to contents

KMJ : Kosin Medical Journal

OPEN ACCESS
SEARCH
Search

Previous issues

Page Path
HOME > Browse articles > Previous issues
9 Previous issues
Filter
Filter
Article category
Keywords
Authors
Volume 27(1); June 2012
Prev issue Next issue
Review articles
Circulating Tumor Cells and Extracellular Nucleic Acids in Breast Cancer
Dong Won Ryu, Chung Han Lee
Kosin Med J. 2012;27(1):1-9.   Published online June 11, 2012
DOI: https://doi.org/10.7180/kmj.2012.27.1.1
  • 258 View
  • 6 Download
  • 1 Citations
Abstract PDFPubReader   ePub   CrossRef-TDMCrossref - TDM

Circulating tumor cells (CTCs) are defined as tumor cells circulating in the peripheral blood of patients, shed from either the primary tumor or from its metastases. The detection of circulating tumor cells (CTCs) in the peripheral blood of breast cancer patients may account for the different steps in the biologic progression of the disease. The detection of microscopic disease in patients with breast cancer is imperative to prognosis and can predict the efficacy of targeted treatments. In general, there are two main methods for their detection. These are based on cytometric and nucleic acid manipulation. Both methods generally require an enrichment step to increase sensitivity of the assay. This step is based on either detection of specific surface markers using immuno-selection and/or on morphological features, such as cell size or density. We review the methods of detecting CTCs, their prognostic implications, and opportunities to exploit the properties of CTCs to develop personalized therapy.

Recent Trends in Chronic Pelvic Pain Diagnosis
Ari Kim, Heung Yeol Kim
Kosin Med J. 2012;27(1):11-16.   Published online June 11, 2012
DOI: https://doi.org/10.7180/kmj.2012.27.1.11
  • 238 View
  • 0 Download
Abstract PDFPubReader   ePub   CrossRef-TDMCrossref - TDM

Chronic pelvic pain is a common and significant disorder of women. It is estimated to have a prevalence of 3.8% in women. The etiology of chronic pelvic pain in women is poorly understood. Although a specific diagnosis is not found in the majority of cases, some common diagnoses include endometriosis, adhesions, irritable bowel syndrome, and interstitial cystitis. The initial history and physical examination can narrow the diagnostic possibilities, guide any subsequent evaluation, and rule out malignancy or significant systemic disease. If the initial evaluation does not reveal a specific diagnosis, a limited laboratory and ultrasound evaluation can clarify the diagnosis, as well as rule out serious disease and reassure the patient.

Laboratory and imaging studies should be selectively utilized, as should laparoscopy. Conscious laparoscopic pain mapping has been proposed as a way to improve information derived from laparoscopic evaluations.

Original articles
The Study in Vitamin D Concentration in the Blood for Infants with High Level of Alkaline Phosphatase
Ji Sung Kim, Jae Yong Choi, Kyun Woo Lee, Ick Jin Song, Cheol Am Kim, Byeong Hee Son, Jung Hyun Lee
Kosin Med J. 2012;27(1):17-24.   Published online June 11, 2012
DOI: https://doi.org/10.7180/kmj.2012.27.1.17
  • 284 View
  • 0 Download
  • 3 Citations
Abstract PDFPubReader   ePub   CrossRef-TDMCrossref - TDM
Objectives

Nowadays most infants on exclusively breast feeding have vitamin D deficiency due to the increase of breast feeding. However, domestic research lacks appropriate materials. Therefore, we researched practical clinical aspects of vitamin D deficiency related to breast milk feeding for infants who have a high amount of alkaline phosphatase (> 500 IU/L).

Methods

The subjects of the study were 31 infants with high alkaline phosphatase level. We tested with 25-hydroxycholecalciferol (25-OHD3), parathyroid hormone, calcium, ionized calcium, phosphorus in their blood and with a wrist x-ray. Then, we divided them into two groups of breast feeding and formula feeding and compared the results.

Results

Eighteen infants (58%) out of 31 infants that have high alkaline phosphatase were vitamin D insufficiency or deficiency, and 16 (100%) breast feeding infants of them showed vitamin D deficiency or insufficiency. However, only 2 (13%) of 15 formula feeding infants were at insufficiency. There was a correlation between alkaline phosphatase and 25-OHD3 concentration in multiple regression analysis, but no correlation in other variables was found in group of breast milk feeding infants. There was neither correlation between vitamin D concentration and alkaline phosphatase nor other correlated variables in the group of formula milk feeding infants.

Conclusions

In this study, there was a high probability of vitamin D deficiency in the breast feeding infants with a high alkaline phosphatase level. Therefore, it is considered to be worth utilizing alkaline phosphatase as a screening test for vitamin D deficiency or rickets for breast feeding infants.

Degree of Agreement between Phadia EliA ENA and Euroimmun line Immunoassay; Comparison of Two Methods to Evaluate the Ability to Detect ENA Antibodies
Hyun Yong Hwang
Kosin Med J. 2012;27(1):25-30.   Published online June 11, 2012
DOI: https://doi.org/10.7180/kmj.2012.27.1.25
  • 200 View
  • 0 Download
Abstract PDFPubReader   ePub   CrossRef-TDMCrossref - TDM
Objectives

The purpose of this study is to compare newly developed assay for identification of ENA antibody, Phadia EliA ENA with Euroimmun line immunoassay by analyzing the degree of agreement and the individual antibodies between two methods.

Methods

A total of 82 patient samples were used. Indirect immunofluorescence assay using Hep-2 cell was performed to screen the antinuclear antibody (ANA). Euroimmun line immunoassay (LIA) and Phadia EliA ENA assay were tested to identify the antibodies against extractable nuclear antigens (ENAs). Kappa statistics was used to evaluate the degree of agreement.

Results

Mean age of patients was 41.0 (8-79), and the M:F ratio was 21:61. ANA was positive in 74 samples, and negative were 8 samples. Kappa analysis of the 82 tested samples showed a moderate strength of agreement (κ = 0.521, P = 0.000). There were differences in the order of identified individual antibodies between two methods (Ro > La = RNP > Centromere > Sm > Scl-70 in Phadia EliA ENA, Ro > RNP > Sm>La > Scl-70 > Centromere=Jo-1 in Euroimmun LIA). Ro antibody was most frequently identified in Phadia EliA ENA negative-Euroimmun LIA positive specimens (Ro > RNP = Jo-1 > La = Sm = Centromere > Scl-70).

Conclusions

A moderate strength of agreement was observed between the Phadia EliA ENA and the Euroimmun LIA. There seemed to be a significant difference in the ratio of individual antibodies, especially in the anti-Ro and Sm antibodies.

Clinical Outcome of Positive Margin of Postgastrectomy with Adenocarcinoma of Stomach
Song-I Yang, Sang-Ho Lee
Kosin Med J. 2012;27(1):31-36.   Published online June 11, 2012
DOI: https://doi.org/10.7180/kmj.2012.27.1.31
  • 190 View
  • 0 Download
Abstract PDFPubReader   ePub   CrossRef-TDMCrossref - TDM
Objectives

Many investigators have recommended adequate resection margin and lymphadenectomy for radical curative resection. The aim of this study is to evaluate clinical characteristics of positive resection margin (proximal or distal) of postgastrectomy in advanced gastric cancer.

Methods

We studied 17 patients with gastric cancer who were diagnosed positive resection margin by intraoperative frozen biopsy or permanent biopsy report from January 2005 to December 2007, retrospectively. Surgical margin monitored by endoscopy.

Results

Distal gastrectomy was performed in 13 patients and total gastrectomy in 4. Gastrectomy with combined resection including splenectomy was performed in 3, distal pancreatectomy in 2, transverse colon segmental resection in 1, and cholecystectomy in 2. Positive Proximal margin was found in 12, positive distal margin in 3, and both in 2. Palliative chemotherapy was performed in 8 patients. Postoperative follow up endoscopy was established in only 8 patients. Malignant results from endoscopic biopsy in gastroenteric or esophagoenteric anastomotic line were proven in 2 patients during follow up. 9 patients were not performed follow-up endoscopy. Among total 17 patients, 2 patients are alive. Fifteen patients died of aggravation of disease in 13 and postoperative complication in 2.

Conclusions

Although positive surgical margin in far advanced gastric cancer were found, it can consider that does not further resection to obtain microscopic clear anastomotic margin.

Treatment of Unstable Intertrochanteric Fracture with Bipolar Hemiarthroplasty of Hip in Elderly Population-Short-term Results-
Gun Woo Lee, Jae-Man Kwak, So Hak Chung
Kosin Med J. 2012;27(1):37-43.   Published online June 11, 2012
DOI: https://doi.org/10.7180/kmj.2012.27.1.37
  • 188 View
  • 1 Download
Abstract PDFPubReader   ePub   CrossRef-TDMCrossref - TDM
Objectives

The aim of this study is to evaluate the short-term results and complications of treating the intertrochanteric fracture with bipolar hemiarthroplasty (BHA) in elderly population.

Methods

We retrospectively reviewed 31 unstable intertrochanteric fracture patients who were treated with BHA between January 2007 and August 2009 in older populations more than 65 years old. The 6 males and 25 females had a mean age of 79.8 years (range: 66-88) and a mean follow-up of 36.3 months (range: 24-55). We analyzed the radiological outcomes, functional recovery grade, using Jensen's social function score and Harris hip score (HHS), and complications.

Results

The average operation time and blood loss was 148.9 min (range, 110-215 min) and 455.2 mL (range, 200-1200 mL). Mean preoperative and postoperative hemoglobin (Hb) was 10.9 g/dL (range, 8.6-13.4 g/dL) and 10.5 g/dL (range, 5.1-14.1 g/dL) respectively. Average 1.3 pints of blood transfusion was performed. Ambulation with (or without) crutch was possible at mean 6.8 days postoperatively. The stability and alignment indices were adequate in all cases at final follow-up. On clinical results, the average HHS score, was changed from 79.7 points (range, 44-100) preoperatively to 73.0 points (range, 46-92) postoperatively, and the preoperative and postoperative Jensen's score was 1.8 (range, 1-3) and 2.1 (range, 1-4) respectively.

Conclusions

The BHA is an acceptable alternative for unstable intertrochanteric fractures in older population.

Case reports
A Case of Henoch Schönlein Purpura with Gastrointestinal Bleeding Due to Jejunal Ulcer by Capsule Endoscopy
Yong Kang Lee, Tak Keun Oh, Ara Choi, Ji Hoon Lee, Mi Na Kim, Sung Pil Hong
Kosin Med J. 2012;27(1):45-49.   Published online June 11, 2012
DOI: https://doi.org/10.7180/kmj.2012.27.1.45
  • 288 View
  • 0 Download
Abstract PDFPubReader   ePub   CrossRef-TDMCrossref - TDM

Henoch-Schönlein purpura (HSP) is the most common form of systemic vasculitis in children. Palpable purpura, arthralgia, arthritis, abdominal pain and renal involvement are the major clinical manifestations. Gastrointestinal involvement is related with abdominal pain and bleeding.

We described a 71 year-old female experienced acute exacerbation of HSP presented with gastrointestinal bleeding. She was hospitalized for hematemesis and diagnosed duodenitis by esophagogastroduonenoscopy (EGD). Duodenitis was improved at EGD checked in 7 days. She still complained of melena and abdominal pain. There were no abnormal findings at sigmoidoscopy. Jejunal ulcer and purpura were diagnosed by capsule endoscopy. Symptoms were relieved after administration of systemic steroid. But she needed renal replacement therapy for 3 months.

Small bowel ulcer diagnosed by capsule endoscopy in patients with HSP was rarely described in Korean literature. This case suggests that capsule endoscopy have a role in diagnosis of small bowel ulcer and its severity in HSP with gastrointestinal symptom.

A Case of F-18 FDG PET-CT Detection of Sporadic Medullary Thyroid Carcinoma and Cervical Lymph Node Metastasis of Ovarican Cancer
Joo Wan Seo, Chang Jun Park, Yun Kyung Jeon, Sang Soo Kim, Bo Hyun Kim, In Ju Kim
Kosin Med J. 2012;27(1):51-56.   Published online June 11, 2012
DOI: https://doi.org/10.7180/kmj.2012.27.1.51
  • 249 View
  • 0 Download
Abstract PDFPubReader   ePub   CrossRef-TDMCrossref - TDM

Medullary thyroid carcinoma (MTC) is derived from the parafollicular or C-cells. As surgical resection is the only curative therapy for MTC, the early diagnosis is important for the patient's survival. F18-Fluorodeoxyglucose positron emission tomography-computed tomography (F-18 FDG PET CT) is a noninvasive imaging method which can be used to diagnose malignant thyroid tumors including recurrent or residual MTC. However, due to the limitations of this technique, it is difficult to differentiate benign from malignant thyroid tumors. We herein present a 47-year-old woman with ovarian cancer history who was found to have thyroid incidentaloma with metastatic cervical lymph node through F-18 FDG PET CT. Thyroid incidentaloma of the patient was examined by fine needle aspiration and the result of this diagnostic procedure showed suspicious MTC. The patient was subsequently diagnosed as having sporadic medullary thyroid carcinoma and metastatic cervical lymph node due to ovarian cancer.

A Comminuted Spiral Fracture with Butterfly Fragment of Distal Humerus by Arm Wrestling -A Case Report-
Gun Woo Lee, Jung-Hwan Son, Tae-Hun Kim
Kosin Med J. 2012;27(1):57-60.   Published online June 11, 2012
DOI: https://doi.org/10.7180/kmj.2012.27.1.57
  • 246 View
  • 3 Download
  • 1 Citations
Abstract PDFPubReader   ePub   CrossRef-TDMCrossref - TDM

The fracture of the humerus during arm wrestling are uncommon, but may occur in the shaft or medial condyle. In the shaft of humerus, the fractures are usually spiral and between the middle and distal third, with or without neurological involvement. A case of a comminuted spiral fracture with butterfly fragment of the distal third of the humerus is reported which had occurred during arm wrestling and was treated by open reduction and internal fixation. The possible mechanism of injury and the question of treatment are discussed.


KMJ : Kosin Medical Journal