Polymorphism in the DNA Repair Gene XRCC1 Associated with Squamous Cell Carcinoma and Basal Cell Carcinoma of the Skin in Koreans

PURPOSE: DNA in most cell is regularly damaged by endogenous and exogenous mutagens. Unrepaired damage resulted in apoptosis or may lead to unregulated cell growth and cancer. Inheritance of genetic variants at one or more loci results in an reduced DNA repair capacity. These polymorphisms are highly prevalent in the population, and therefore the attributable risks for cancer could be high. Several studies have documented that polymorphisms of XRCC1, XPD and XRCC3 are associated with skin cancer, especially, XRCC1 among of them has been reported frequently. So, this study involves the relationship between mutation of XRCC1 of squamous cell and basal cell cancer of the skin and risk of cancer development in Korean population. METHODS: In case control study, study population (n=100, each cancer) is patients who were pathologically diagnosed as skin cancer(squamous cell carcinoma and basal cell carcinoma) in Yonsei Wonju Christian Hospital and Bundang CHA General Hospital between 1998 and 2004. The samples of DNA from whom no history of premalignant skin lesion and other malignant diseases were reported belonged to the control group(n=210). Blood and tissue samples were analyzed for presence of XRCC1 Arg399Glu, Arg280His, Arg194Trp using PCR/ RFLP method. RESULTS: For Korean, there was a significant correlation between XRCC1 Arg399Gln gene mutation and risk of basal cell carcinoma development(Arg 399Gln(GA), p=0.012, OR=2.016, 95% CI; 1.230-3.305) /Arg399Gln (AA), p=0.011, OR=1.864, 95% CI; 1.149-3.026)). And, there was also significant correlation between XRCC1 Arg194Trp and risk of skin squamous cell carcinoma development (Arg194Trp (CT+TT), p=0.041, OR=0.537, 95% CI; 0.301-0.960)). In contrast, there was no significant correlation between XRCC1 Arg280His and risk of either basal cell carcinoma or squamous cell carcinoma development. CONCLUSION: Our result present that XRCC1 Arg399 Gln in basal cell carcinoma and XRCC1 Arg194Trp in squamous cell carcinoma have possibility of cancer risk and biomarker in Korean population. But XRCC1 Arg280 His known having cancer risk on other studies is not associated with cancer risk to squamous cell carcinoma and basal cell carcinoma in Korean population.

Scrotal Reconstruction by the Gracilis Muscle Flap Following Fournier's Gangrene

Fournier's gangrene is life-threatening disease characterized by abrupt onset of a rapidly progressive necrotizing soft tissue infection involving the perineum and scrotum. In Fournier's original descriptions, the disease arose in healthy subjects without an obvious cause. Despite controversy still surrounds its etiology, current studies identify definite urologic and colorectal causes with its combined disease in a majority of cases. We experienced cases of large scrotal and perineal defect caused by Fournier's gangrene. Aggressive and extensive debridement with a parenteral broad spectrum antimicrobial agents was executed at the important points to the treatment. The patient also received adjuvant hyperbaric oxygen therapy. The clinical efficacy of hyperbaric oxygen was discussed. After control of infection and unavoidable loss of soft tissue, the major concern following Fournier's gangrene lies on the protection of the testicles and adequate volumetric scrotal appearance. The defect was successfully reconstructed with unilateral or bilateral gracilis muscle flap transposition and split- thickness skin graft. We present this article utilizing bilateral gracilis muscle flaps as an acceptable alternative in the approach to scrotal reconstruction in Fournier's gangrene.

External Fixation for Inappropriate Closed Reduction of Nasal Bone Fracture

Nasal bone fracture is the most common fracture among facial fractures. The nasal bone fracture has a very complex and infinitive variety but often is undermanaged only by closed reduction. The prognosis and outcome after operation had been reported by many surgeons and it's result is dependant upon many factors such as etiology, experience of surgeons, type of anesthesia and maintenance of fixation after surgery. In our study, we have grouped our fractures as favorable and unfavorable fractures. Favorable fractures are simple fractures that are easily reduced by closed reduction, whereas unfavorable fractures were fractures that remain unstable after reduction. In our opinion, the method of reduction and fixation after reduction plays an important role in unfavdrable fracture. We applied a new method of external fixation for unfavorable fractures After closed reduction to gain optimal reduction and maintenance.