Analysis of the Cancer Genome Atlas Data to Determine the Prognostic Value of GABPB1L and TERT in Glioblastoma / 계명의대학술지

Glioblastoma multiforme (GBM) is the most lethal type of brain tumor and its prognosis was extremely poor. Here, we studied the clinical and prognostic value of telomerase reverse transcriptase (TERT) and GA Binding Protein Transcription Factor Subunit Beta 1 longer (GABPB1L) mRNA expression in GBM by using open big data. In total 152 GBM patients, gene expressions were downloaded from the Cancer Genome Atlas (TCGA) data and its values were statistically analyzed. TCGA data showed that GABPB1L mRNA expression levels did not correlate with those of TERT mRNA (r = -0.027, p = 0.744). GABPB1L and TERT expressions in GBM were associated with subtype by gene expression. GABPB1L (562.7 ± 76.8 days vs. 479.1 ± 5.8 days, p = 0.401) and TERT (468.1 ± 43.6 days vs. 565.3 ± 75.8 days, p = 0.403) expression was not associated with GBM prognosis. However, disease-free survival was tended to be different in GBM patients according to TERT and GABPB1L expressions though it did not get statistical significance (2122.6 ± 160.2 days vs. 1381.1 ± 244.0 days, p = 0.072). These genes may contribute to the GBM pathogenesis and its further study should be performed in GBM patients and cell lines.

Absence of Clinical Value of TZAP Mutation and Expression in Non-small Cell Lung Cancers / 계명의대학술지

The zinc finger protein ZBTB48 is a telomere-associated factor and renamed it as telomeric zinc finger-associated protein (TZAP). It binds preferentially to long telomeres competing with TRF1 and TRF2. However, its mutation in cancers has not been studied. In the present study, we analyzed TZAP mutation in 134 non-small cell lung cancers (NSCLCs). And its big data analysis was performed using COSMIC and TCGA data analysis. TZAP mutation was not found in 134 NSCLCs. And big data also showed that TZAP mutation was extremely low (0.59%, 15/2548). TCGA survival analysis showed no prognostic value of TZAP expression in lung adenocarcinoma (p = 0.185) and squamous cell carcinoma (p = 0.817). When stratified patients sorting as 25:25 (quarter), it has a significance (p = 0.003). This result suggested that genetic change of TZAP did not appear to be a possible molecular marker in lung cancer.

Anatomy in Michelangelo Art / 계명의대학술지

Michelangelo was a Renaissance artist showing many works. As the secrets of Michelangelo's art have been revealed recently, various studies have been carried out, revealing the secret code of human anatomy in his work. This was an important clue that Michelangelo dissected a huge number of human beings and was a anatomist with considerable expertise. Brazilian doctors Jalousie Bahaetto and Marcelo G Gli Oliveira, from the Vatican Sistina ceiling murals to the sculpture Pieta, examined the works of the Renaissance genius artist Michelangelo in detail and found anatomical elements in many works. Although some interpretations are controversial, it would be a good experience for medical doctor to appreciate masterpieces of Michelangelo in comparison to their human anatomy.

Variations in Branching Patterns of the Anterior Circumflex Humeral Artery / 계명의대학술지

Anatomic variations in the branching pattern of the axillary artery are common and have been studied by many authors. The origin of the anterior circumflex humeral artery is also various and its association with other variations has been focused recently. This study identified the origin of the anterior circumflex humeral artery, the communication between the musculocutaneous and median nerves, and the third head of the biceps brachii muscle, and then their associations were examined. Axillae of 75 cadavers were dissected and these variations were collected. The anterior circumflex humeral artery arose directly from the third parts of the axillary artery in 82.0% of upper limbs. It also arose as common stem for both humeral arteries in 7.3% of the third part of the axillary artery and in 5.3% of the subscapular artery, respectively. The anterior circumflex humeral artery was absent in 2.7% and two anterior circumflex humeral artery was found in 1.3% of limbs. The communication between the musculocutaneous and median nerves and the third head of the biceps brachii muscle were found in 32.0% and 16.0% of upper limbs, respectively. These variations were not statistically associated with each other. These results may provide deep knowledge about the anatomy of the anterior circumflex humeral artery and contribute to explain its clinical implications.

The Prevalence and Genetic Pattern of Clinodactyly in Korean Populations / 체질인류학회지

Clinodactyly, as rare congenital malformation, refers to a curvature of a digit in a radial or ulnar direction in the coronal plane. The abnormality is inherited as an autosomal dominant trait. And its frequency was low, however, it was higher by accompanying other congenital anomaly. In present study, the frequency and genetic characteristics of clinodactyly were investigated. In 100 family (382 peoples), clinodactyly was found in 4.7% (n=18). All clinodactyly were bilateral and it was more frequent in female (6.8%) than male (2.6%), without statistical difference (p=0.056). Its inheritance was autosomal dominant trait in 80% (4/5) families, however, one family did not have any inheritance pattern. We described the frequency and clinical implication of clinodactyly, and this description will be lead to an improved understanding of its spectrum and inheritance.

Muscular axillary arch accompanying variation of the musculocutaneous nerve: axillary arch / 대한해부학회지

Continuous attention has been developed on the anatomical variations of the axilla in anatomist and surgeon due to their clinical importance. The axillary region is an anatomical space between the lateral part of the chest wall and the medial aspect of the upper limb. During the routine dissection of embalmed cadavers, we found variant muscular slip originating from the lateral border of tendinous part of the latissimus dorsi and continuing 9 cm more crossing the axilla. And then, it inserted into the superior margin of the insertion of the pectoralis major. We considered this muscular variation as axillary arch muscle. Correct identification of the relevant anatomy and subsequent simple surgical division is curative, paying special attention to anatomical variations in this region and its clinical importance due to its close relationship to the neurovascular elements of the axilla.

Surgical Outcomes of Adrenocortical Carcinoma; 20 Years of Experience in a Single Institution / 대한내분비외과학회지

PURPOSE: Adrenocortical carcinoma (ACC) is a rare malignant tumor. Early detection is difficult and prognosis is poor. We report on 20 years of ACC surgical experience at our institution. METHODS: This study included 32 ACC patients who underwent surgical resection at the Department of Surgery of the Yonsei University Health System in South Korea between January 1990 and February 2012. We reviewed these 32 patients and retrospectively analyzed long-term clinical outcomes and prognosis after radical surgery for ACC. RESULTS: The median age of the 32 patients at diagnosis was 42.25 years (range 3~81 years). There were 16 (50%) female and 16 (50%) male patients. Mean tumor size was 12.36 cm (range 1.8~20 cm). Twenty-five patients (78.12%) had nonfunctioning tumors while the other seven patients (21.87%) had functioning tumors. Seventeen patients (53.12%) were classified as stage II, two (6.25%) as stage III, and 13 (40.62%) as stage IV. Fourteen patients underwent radical surgical resection, while 14 patients received adjuvant chemotherapy, two received adjuvant radiotherapy, and two received adjuvant chemoradiation. Four patients were lost to follow-up. Among the remaining 28 patients, 15 patients survived. The 5- and 10-year overall survival was 60.6% and 37.8%, respectively (median survival=85+/-24.3 months). Seventeen patients (53%) experienced disease recurrence. Five- and 10-year recurrence-free survival was 41.5% and 29.7%, respectively (median survival=18+/-5.5 months). CONCLUSION: Early stage at diagnosis and surgical resection were the most important prognostic factors associated with prolonged survival. The role of additional therapy remains controversial and new agents should continually be evaluated for efficacy.

Appendicitis during Pregnancy: The Clinical Experience of a Secondary Hospital

PURPOSE: Appendicitis is the most common condition leading to an intra-abdominal operation for a non-obstetric problem in pregnancy. The aim of this study was to examine our experience and to analyze the clinical characteristics and the pregnancy outcomes for appendicitis during pregnancy that was reported in Korea. METHODS: We reported 25 cases of appendicitis during pregnancy that were treated at Good Moonhwa Hospital from January 2004 to March 2010. We also analyzed appendicitis during pregnancy reported in Korea between 1970 and 2008 by a review of journals. RESULTS: The incidence of acute appendicitis during pregnancy was one per 568 deliveries. The mean age was 27.92 years old, the gestational stage at the onset of symptoms was the first trimester in 10 patients (40%), the second trimester in 14 patients (56%), and the third trimester in 1 patient (4%). Among the 25 cases, 21 were treated with an open appendectomy and 4 with laparoscopic appendectomies. The postoperative complications were 2 wound infections and 1 spontaneous abortion. CONCLUSION: Our experience demonstrated that appendectomies on pregnant patients can be successfully performed at secondary hospitals.

Development of a Web-based Donor Eligibility Expert System / 대한수혈학회지

BACKGROUND: The determination of blood donor eligibility has become critical and challenging to blood operators as so many conditions and restrictions should be considered to correctly decide the donor eligibility. Since the launching of the BIMS (Blood Information Management System) in May 2003, the demand of developing a more intelligent system to assist the determination of donor eligibility has been growing. The Korean Red Cross Blood Service intended to develop an expert system for donor eligibility determination with high efficiency and ease of use. METHODS: The content of the system was determined through the activity of a team consisting of medical doctors, nurses, safety managers, and the system developers. Algorithms were developed according to the donor history taking process. The efficiency of the system was tested by the comparison of the time needed for inquiries and the number of inappropriate blood collections before and after the implementation of the new system. RESULTS: The new system's user interface integrated many complicated work processes with a user-friendly flexibility. The types of decision included the restricted donations. The donor interviewers were highly satisfied with the system because almost all cases were correctly determined in a relatively short time. Using this system, the number of inappropriate blood collections was significantly lowered. CONCLUSION: We developed an expert system that can aide the donor eligibility determination process and prevent the violation of the related regulations. This system will contribute to enhancement of the blood safety as well as donor protection for our blood services.

Development of a Web-based Donor Eligibility Expert System / 대한수혈학회지

BACKGROUND: The determination of blood donor eligibility has become critical and challenging to blood operators as so many conditions and restrictions should be considered to correctly decide the donor eligibility. Since the launching of the BIMS (Blood Information Management System) in May 2003, the demand of developing a more intelligent system to assist the determination of donor eligibility has been growing. The Korean Red Cross Blood Service intended to develop an expert system for donor eligibility determination with high efficiency and ease of use. METHODS: The content of the system was determined through the activity of a team consisting of medical doctors, nurses, safety managers, and the system developers. Algorithms were developed according to the donor history taking process. The efficiency of the system was tested by the comparison of the time needed for inquiries and the number of inappropriate blood collections before and after the implementation of the new system. RESULTS: The new system's user interface integrated many complicated work processes with a user-friendly flexibility. The types of decision included the restricted donations. The donor interviewers were highly satisfied with the system because almost all cases were correctly determined in a relatively short time. Using this system, the number of inappropriate blood collections was significantly lowered. CONCLUSION: We developed an expert system that can aide the donor eligibility determination process and prevent the violation of the related regulations. This system will contribute to enhancement of the blood safety as well as donor protection for our blood services.