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We report on two dimensional (2D)-nanostructured NaxCoO2 with enhanced thermoelectric properties prepared by the exfoliation/restacking method. We have shown that the exfoliation/restacking method is an effective route to constructing nanostructured cobalt oxide. Such a nanostructured sodium cobalt oxide results in an exceptionally low cross-plane conductivity, as low as 0.5 W m-1 K-1. Due to the decrease of in-plane thermal conductivity, Z T values of the restacked samples increase in comparison to that of the pristine, which shows the beneficial effect of the nanostructure on the thermoelectric property.

The objective of the study was to document practice pattern of gastroenterologists for the management of gastroesophageal reflux disease (GERD) under the minimal influence of the insurance reimbursement guideline. Data on management for 1,197 consecutive patients with typical GERD symptoms were prospectively collected during 16 weeks. In order to minimize the influence of reimbursement guideline on the use of proton pump inhibitors (PPIs), rabeprazole was used for the PPI treatment. A total of 861 patients (72%) underwent endoscopy before the start of treatment. PPIs were most commonly prescribed (87%). At the start of treatment, rabeprazole 20 mg daily was prescribed to 94% of the patients who received PPI treatment and 10 mg daily to the remaining 6%. At the third visits, rabeprazole 20 mg daily was prescribed to 70% of those who were followed and 10 mg daily for the remaining 30%. Continuous PPI treatment during the 16-week period was performed in 63% of the study patients. In conclusion, a full-dose PPI is preferred for the initial and maintenance treatment of GERD under the minimal influence of the insurance reimbursement guideline, which may reflect a high proportion of GERD patients requiring a long-term treatment of a full-dose PPI.

Background/Aims: Induction of human beta-defensin-2 (hBD2), an innate antimicrobial peptide in the intestinal mucosa, occurs after bacterial infections. The aim of this study is to evaluate the relationship between the expression of hBD2 and Helicobacter pylori (H. pylori) infection in the gastric epithelia. Materials and Methods: Gastric mucosa was sampled from the patients with chronic gastritis and peptic ulcers before and after H. pylori eradication and the expression of hBD2 was assessed with immunohistochemistry. The antimicrobial effect was assayed as the number of colony forming units of H. pylori incubated with the various concentrations of hBD2. Results: Thirty six patients were included in this study and 30 patients (83%) revealed expression of the hBD2 in their gastric epithelia. The hBD2 was not expressed in 22 patients after successful H. pylori eradication, but did expressed in 8 patients after H. pylori eradication failure. The expression of hBD2 was well correlated with the density of H. pylori, acute and chronic inflammation, and the degree of atrophy of gastric mucosa. Conclusions: The hBD2 is induced in the gastric epithelia in response to the H. pylori infection, and its expression is well correlated with the severity of gastric inflammation. (Korean J Helicobacter Upper Gastrointest Res 2011;11:112-116)

249 통신저자:이 승 준 서울시 광진구 화양동 건국대학교 의학전문대학원 정형외과학교실 Tel:02-2030-7360ᆞFax:02-2030-7369 E-mail:lsjmd@kku.ac.kr 접수: 2010. 5. 19 심사(수정): 1차 2010. 6. 18, 2차 2010. 9. 18, 3차 2011. 3. 6 게재확정: 2011. 3. 14 Address reprint requests to:Seoung Joon Lee, M.D. Department of Orthopaedic Surgery, Konkuk University School of Medicine, Hwayang-dong, Gwangjin-gu, Seoul 143-701, Korea Tel:82-2-2030-7360ᆞFax:82-2-2030-7369 E-mail:lsjmd@kku.ac.kr 지연 진단된 유구-중수골 관절의 골절 및 탈구의 수술적 치료

Background/Aims: This study verifies whether endoscopic findings differ according to the symptoms of patients with functional dyspepsia. Materials and Methods: This study surveyed upper gastrointestinal symptoms in 325 patients with functional dyspepsia and conducted esophagogastroduodenoscopy. The endoscopic findings were classified according to the Sydney classification, as edema, erythema, friability, exudates, flat erosion, raised erosion, rugal hyperplasia, atrophy, visibility of vascular pattern, intramural bleeding spot, nodularity, respectively in antrum, body and fundus. Results: 1) The average age of 325 patients was 47.8 years. There were 134 males and 191 females among the 325 patients. 2) Among 325 patients, 134 (41.2%) had epigastric pain syndrome, 169 (52.0%) had postprandial distress syndrome, and 22 (6.7%) had unspecific dyspepsia. 3) Compared to postprandial distress syndrome patients, those with epigastric pain syndrome had more erythema (85.1% vs. 60.2%, P＜0.01)and raised erosion (26.0% vs. 18.9%, P=0.01) in antrum, and more erythema (59.0% vs. 36.7%, P=0.02) in body. 4) Compared to epigastric pain syndrome patients, those with postprandial distress syndrome had more atrophy (23.7% vs. 10.4%, P=0.04) in fundus. Conclusions: Erythma and raised erosion were more frequently observed in antrum of epigastric pain syndrome patients, and atrophy was frequently observed in fundus of postprandial distress syndrome patients, through endoscopy. (Korean J Helicobacter Upper Gastrointest Res 2011;11:124-128)

A case of hemophagocytic syndrome associated with ulcerative colitis is very rare. A 32-year-old man visited the hospital complaining of fever and severe abdominal pain for 7 days. He was diagnosed to have ulcerative colitis 2 years ago and had been treated with sulfasalazine. Three months ago, he had abdominal pain, weight loss, and hematochezia, so prednisolone and mercaptopurine were added to the treatment. On admission, the physical examination showed splenomegaly. Peripheral blood counts revealed pancytopenia, and bone marrow aspirate smears showed many histiocytes with active hemophagocytosis. There was no evidence of viral and bacterial infections and other neoplasms, which were commonly associated with hemophagocytic syndrome. He was successfully treated with high dose steroid. We report this case along with a review of the related literatures.

e22175 Background: The present study analyzed the impact of p53 expression and TP53 codon 72 polymorphism on the prognosis in patients with operated invasive breast cancer. Methods: Two hundred thirty-four patients with ductal breast cancer who underwent surgery with curative intent were enrolled in the present study. The tumor expressions of p53, ER, PR, and HER2 were graded immunohistochemically and TP53 codon 72 polymorphism was determined by a PCR-RFLP assay using genomic DNA extracted from paraffin-embedded tissue. Results: The median age was 49 (range, 24–82) years, and 134 (57.3%) patients were premenopause at the time of diagnosis. Pathologic stages after surgery were as follows: stage I (n=77, 32.9%), stage II (n=110, 47.0%), and stage III (n=47, 20.1%). Tumor overexpression of p53 protein was observed in 59 (25.2%) patients and was associated with an unfavorable relapse-free survival (RFS) in an univariate analysis adjusted to age, stage, and menstrual status. In a multivariate analysis, p53 overexpression was an independent prognostic factor for RFS (HR=2.36; 95% CI=1.09–5.13; p=0.030). However, no associations were observed between the genotype of TP53 codon 72 polymorphism and survival or clinicopathologic characteristics. Conclusions: Overexpression of p53 protein can be considered as a prognostic factor for RFS in the breast cancer patients after surgery. No significant financial relationships to disclose.

Purpose: The aim of this study was to analyze the influence on voiding symptoms when performing sling operation on patients with stress urinary incontinence with detrusor underactivity. Materials and Methods: We analyzed medical records of 100 patients who received the sling operation. Based on their preoperative urodynamic study, we defined "stress urinary incontinence with detrusor underactivity (SUI with DU)" group as these findings; peak flow less than 11 ml/s or void with abdominal pressure instead of detrusor contraction or residual urine volume more than 100 ml. And the others were defined as the "stress urinary incontinence only (SUI)"group. We compared two groups and analyzed the changes of pre- and postoperative uroflowmetry. Results: The number of patients with the "SUI with DU" group was 30 and that with the "SUI" group was 70. In the "SUI with DU" group, there were no changes in peak flow rate and residual urine volume between postoperative uroflowmetry and preoperative urodynamic study (15.1 ± 7.9 vs. 14.7 ± 7.1 ml/s, 123.1 ± 79.2 vs. 127.3 ± 91.9 ml) (p>0.05). Twenty four patients underwent urinary drainage with nelatone catheter either on postoperative first or second day. However, 22 patients did not need to continue self catheterization. Conclusion: Sling operation could be performed on patients who are diagnosed as stress urinary incontinence with detrusor underactivity without aggravating their voiding symptoms. (J Korean Continence

Joong Geun Lee, Sang Hyub Lee, Seung Hyun Jeon, Jin Il Kim, Koo Han Yoo From the Department of Urology, School of Medicine, Kyung Hee University, Seoul, Korea Silver-Russel syndrome (SRS) is a disorder present at birth that involves poor growth, low birth weight, differences in the size of the two sides of the body, and genital anomalies. The diagnosis is based on distinct prenatal growth restriction and the presence of typical dysmorphic features, including short stature and limb asymmetry. We report a case of bilateral cryptorchidism with no other genital anomalies in SRS. This report provides an overview of the genital anomalies of SRS and describes, for the first time, a laparoscopic orchiopexy in SRS. (Korean J Urol 2009;50:615-618) 󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏

Eleven years has passed since the guideline of the Korean College of Helicobacter and Upper Gastrointestinal Research group for H. pylori infection was produced in 1998. During this period the research for H. pylori has much progressed that H. pylori is now regarded as the major cause of gastric cancer. The seroprevalence of H. pylori in Korea was found to be decreased especially below the age of 40s and in the area of Seoul-Gyeonggi province, and annual reinfection rate of H. pylori has decreased up to 2.94%. In the aspect of diagnostic tests of H. pylori the biopsy is recommended in the body instead of antrum in the subjects with atrophic gastritis and/or intestinal metaplasia for the modified Giemsa staining or Warthin Starry silver staining. The urea breath test is the test of choice to confirm eradication when follow-up endoscopy is not necessary. Definite indication for H. pylori eradication is early gastric cancer in addition to the previous indications of peptic ulcer including scar and Marginal zone B cell lymphoma (MALT type). Treatment is also recommended for the relatives of gastric cancer patient, unexplained iron deficiency anemia, and chronic idiopathic thrombocytopenic purpura. One or two week treatment of proton pump inhibitor (PPI) based triple therapy consisting of one PPI and two antibiotics, clarithromycin and amoxicillin, is recommended as the first line treatment regimen. In the case of treatment failure, one or two weeks of quadruple therapy (PPI+metronidazole+tetracycline+bismuth) is recommended. Herein, Korean College of Helicobacter and Upper Gastrointestinal Research proposes a diagnostic and treatment guideline based on currently available evidence.

AIM: To analyze the clinical characteristics of patients diagnosed with Fitz-Hugh-Curtis syndrome. METHODS: The clinical courses of patients that visited St. Mary’s Hospital with abdominal pain from January 2005 to December 2006 and were diagnosed with Fitz-Hugh-Curtis syndrome were examined. RESULTS: Fitz-Hugh-Curtis syndrome was identified in 22 female patients of childbearing age; their mean age was 31.0 ± 8.1 years. Fourteen of these cases presented with pain in the upper right abdomen alone or together with pain in the lower abdomen, and six patients presented with pain only in the lower abdomen. The first impression at the time of visit was acute cholecystitis or cholangitis in 10 patients and acute appendicitis or pelvic inflammatory disease in eight patients. Twenty-one patients were diagnosed by abdominal computer tomography (CT), and the results of abdominal sonography were normal for 10 of these patients. Chlamydia trichomatis was isolated from 18 patients. Two patients underwent laparoscopic adhesiotomy and 20 patients were completely cured by antibiotic treatment. CONCLUSION: For women of childbearing age with acute pain in the upper right abdomen alone or together with pain in the lower abdomen, Fitz-Hugh-Curtis syndrome should be considered during differential diagnosis. Moreover, in cases suspected to be Fitz-Hugh-Curtis syndrome, abdominal CT, rather than abdominal sonography, assists in the diagnosis.

To assess the occurrence of gastric acid reflux into the esophagus in endoscopically confirmed prolapse gastropathy syndrome (PGS).Using ambulatory esophageal pH measurement (BRAVO(TM) wireless esophageal pH monitoring system), twenty-six patients with PGS were compared with twenty-one patients with erosive esophagitis (EE) as controls. We assessed several reflux parameters, including the percentage of total time at pH4, and the DeMeester score.There were no statistical differences between the PGS group and the EE group as to mean age, sex ratio and pH recording time. The EE group showed more severe reflux than the PGS group, as evaluated in terms of the longest duration of reflux, the number of reflux episodes, the number of reflux episodes lasting5 min, the total time with pH4 during acid reflux episodes, and the DeMeester score, but none of these parameters showed statistically significant difference. Although 53.8% (14/26) of the PGS group and 76.2% (16/21) of the EE group demonstrated pathologic acid reflux (DeMeester score14.72), there was no statistically significant difference between the two groups in the incidence of pathologic acid reflux (P = 0.11).There was no statistically significant difference in pathologic acid reflux between the PGS and EE group. These data suggest that endoscopically diagnosed PGS might be a predictor of pathologic acid reflux.

Purpose: We wanted to evaluate the levels of effect and safety of high-intensity focused ultrasound ablation (HIFU) for treating patients with advanced pancreatic cancer. Materials and Methods: Nineteen sessions of HIFU, with the patients under general anesthesia, were performed in 18 patients with advanced pancreatic cancer. The change of the gray-scale of the target lesion was analyzed during HIFU, and MRI was performed before and after HIFU. We assessed the extent of coagulative necrosis, the change of pain and the complications after HIFU. The change of tumor size and the survival of patients were also evaluated. Results: The average size of tumor was 4 cm in diameter. Eighty nine percent of the target tumors showed increased echogenicity. On MRI, necrosis of the entire target tumor occurred in 79% of the patients. After treatment, effective pain relief was noted in 89% of the patients. There were no major complications. No size increase of the treated tumor was noted during 24 weeks of follow-up for 10 patients. Six patients among 12 patients who were available for follow-up are still alive and they are receiving chemotherapy. Six patients expired due to other disease or progression of metastasis. Conclusion: HIFU is a safe method without any major complications, and it is effective for inducing tumor necrosis and achieving pain control for patients with advanced pancreatic cancer.

4019 Background: Recent studies demonstrated that the expression of vascular endothelial growth factor (VEGF) family had a prognostic significance in patients with gastric cancer. The present study analyzed VEGF polymorphism and its impact on prognosis in patients with gastric cancer. Methods: Five hundred three consecutive patients with surgically resected gastric adenocarcinoma at a single institution between January 2000 and December 2001 were enrolled into the study. Genomic DNA was extracted from paraffin-embedded tumor tissue and four VEGF (-460T > C, +405C > G, 936C> T, and -1154G > A) genotypes were determined using a PCR-RFLP assay. Results: The median age of patients was 60.0 years (range, 25–83 years), and 337 (67.0%) patients were male. Pathologic stages after resection were as follows: stage 0 (n=6, 1.2%), stage I (n=277, 55.1%), stage II (n=105, 20.9%), stage III (n=74, 14.7%), and stage IV (n=41, 8.2%). The estimated 5-year disease-free survival (DFS) rates according to stage were significantly different (p < 0.0001). Three VEGF polymorphisms (+405C > G, 936C, and -1154G > A > T) were not associated with survival of patients, while -460T > C polymorphism had a prognostic significance. In patients with early stage gastric cancer (stage 0 or 1, n=283), the estimated 5-year DFS and carcinoma-specific survival (CSS) for patients with homozygous genotype (CC or TT) of -460T > C were superior to those for heterozygous genotype (CT) (98.1% versus 90.3%, p=0.0047; 98.1% versus 92.5%, p=0.0284). In Cox multivariate regression, stage and VEGF -460T > C genotype were an independent prognostic factors for both DFS (p=0.007; p=0.010) and CSS (p=0.013; p=0.038). Conclusions: VEGF -460T > C polymorphism was found to be an independent prognostic marker for patients with curatively resected early stage gastric adenocarcinoma. Accordingly, VEGF -460T > C polymorphism can help to identify patients with unfavorable clinical outcome and thereby may be useful to refine therapeutic decisions in early stage gastric cancer. No significant financial relationships to disclose.

Objective: We have reported that intimal hyperplasia, which is the pathologic change of the radial artery, is associated with early failure of arteriovenous fistula (AVF) in hemodialysis (HD) patients (Am J Kidney Dis, 41:422–428, 2003). Intima-media thickness (IMT), which represents the whole thickness of arterial wall, can be easily measured by ultrasonography, unlike intima thickness. This study was performed to investigate the impact of IMT of radial artery on early failure of AVF in HD patients. Methods: Ninety HD patients undergoing radiocephalic AVF operation were included in this study. The AVF was constructed in an end vein–to–side artery fashion at the wrist by one vascular surgeon. During the operation, 10-mm long partial arterial walls were removed with elliptical form for microscopic analysis. Specimens were stained with trichrome and examined by a pathologist blinded to the clinical data. AVF patency was prospectively followed up for 1 year after the operation. Results: Mean age of the patients was 56 ± 13 years and the number of females was 44 (48.9%). Mean IMT was 430 ± 132 μm (133–760 μm). Of the total 90 patients, 31 patients (34.4%) had AVF failure within 1 year after the operation. Mean IMT was higher in the failed group (n = 31) than in patent group (n = 59)(486 ± 130 μm vs. 330 ± 178 μm, p = 0.004). Using a threshold of 500 μm of IMT, AVF patency rate was compared between these two groups using Kaplan-Meier method with log rank test. The AVF patency rate within 1 year after the operation was higher in patients with IMT ≥ 500 μm (n = 26) than in patients with IMT

Increased radial artery wall thickness (RAWT) is considered to be associated with early failure of radiocephalic arteriovenous fistula (AVF) as well as coronary artery atherosclerosis in hemodialysis patients. Therefore, exact measurement of RAWT by noninvasive method before the operation is very important. Objective: This study was designed to evaluate accuracy of Doppler ultrasonography in measuring RAWT in hemodialysis patients. Methods: This study enrolled 21 hemodialysis patients undergoing radiocephalic AVF operation for the first time. We measured RAWT (intima-media thickness) using high-resolution Doppler ultrasonography at the wrist before the AVF operation. We obtained specimens of the radial artery during the AVF operation and then measured RAWT by histologic examination. Results: Mean age of the patients was 60 ± 13 years and the number of females was 7 (33.3%). Mean values of RAWT measured by Doppler ultrasonography and histologic examination were 485 ± 93 μm (300–700 μm) and 426 ± 106 μm (300–700 μm), respectively. The value of RAWT of Doppler sonographic measurement well correlated with that of histologic measurement (r = 0.800, p

An unusual adenosquamous carcinoma originating in the prostate of a 73-year-old man is described. The histological finding showed a well differentiated squamous cell carcinoma admixed in an adenocarcinomatous area. A transitional area of 2 carcinomatous elements was also noted. Seven months prior to the development of this lesion, a diagnosis of adenocarcinoma had been established by transurethral resection of the prostate and the patient had been treated with bilateral orchiectomy. This is the first case of adenosquamous carcinoma of the prostate reported in Korea. The pathogenesis and previous reports of this lesion will be discussed.

A channel estimation technique in the uplink of a noncoherent DS/CDMA system with M-ary orthogonal signalling over multipath fading channels is considered. This method is used for the multiuser interference cancellation with coherent detection. The performance of the proposed multiuser detector is compared with that of a conventional detector and a significant improvement of performance is shown.