Cirrhosis with portal hypertension is a common disease which has a significant impact on the quality of patients' life. Esophagogastric devascularization (EGDV) has been demonstrated to be an effective method to treat portal hypertension, however certain complications are associated with it. The purpose of this study was to evaluate the effectiveness and clinical outcome of the selective EGDV (sEGDV) for the treatment of portal hypertension. The study was conducted prospectively from Jan. 1 2011 to Dec. 31, 2012, and 180 patients were randomized to the sEGDV group (n=90) or the non-sEGDV (n-sEGDV) group (n=90). Patients' demographics, preoperative lab test results and operative details were comparable between the two groups. Postoperative and short-term complications were analyzed in two groups. There was statistically significant difference (P<0.01) in the PVF reduction between the two groups. Post-operative complications showed no statistically significant difference between the two groups in the incidence of bleeding, ascites, acute portal vein thrombosis, fever and hepatic encephalopathy. Mortality between two groups was comparable. The incidence of splenic fossa effusion after the surgery was lower in sEGDV group than in n-sEGDV group. There were no significant differences in the short-term follow-up data such as esophageal varices and portal hypertensive gastropathy (P>0.05). It is suggested that sEGDV is a safe, simple and effective surgical procedure. It has both the advantages of the shunt and devascularization because it preserves body's voluntary diversion. With the advantage of low incidence of postoperative complications, it is an ideal surgical approach for the treatment of portal hypertension.

OBJECTIVE: Due to longer life spans, patients newly diagnosed with unruptured intracranial aneurysms (UIAs) are increasing in number. This study aimed to evaluate how management of UIAs in patients age 65 years and older affects the clinical outcomes and post-procedural morbidity rates in these patients. METHODS: We retrospectively reviewed 109 patients harboring 136 aneurysms across 12 years, between 1997 and 2009, at our institute. We obtained the following data from all patients : age, sex, location and size of the aneurysm(s), presence of symptoms, risk factors for stroke, treatment modality, and postoperative 1-year morbidity and mortality. We classified these patients into three groups : Group A (surgical clipping), Group B (coil embolization), and Group C (observation only). RESULTS: Among the 109 patients, 56 (51.4%) underwent clipping treatment, 25 (23%) patients were treated with coiling, and 28 observation only. The overall morbidity and mortality rates were 2.46% and 0%, respectively. The morbidity rate was 1.78% for clipping and 4% for coiling. Factors such as hypertension, diabetes mellitus, hypercholesterolemia, smoking, and family history of stroke were correlated with unfavorable outcomes. Two in the observation group refused follow-up and died of intracranial ruptured aneurysms. The observation group had a 7% mortality rate. CONCLUSION: Our results show acceptable favorable outcome of treatment-related morbidity comparing with the natural history of unruptured cerebral aneurysm. Surgical clipping did not lead to inferior outcomes in our study, although coil embolization is generally more popular for treating elderly patients. In the treatment of patients more than 65 years old, age is not the limiting factor.
Aged ; Aneurysm ; Aneurysm, Ruptured ; Diabetes Mellitus ; Follow-Up Studies ; Humans ; Hypercholesterolemia ; Hypertension ; Intracranial Aneurysm ; Natural History ; Retrospective Studies ; Risk Factors ; Smoke ; Smoking ; Stroke ; Surgical Instruments

OBJECTIVES: The purpose of the study was to examine the relationships between temperament and character dimensions and family environments, and to investigate the influences of those factors on the antisocial personality traits in delinquent adolescents. METHODS: The subjects consisted of 160 male adolescents detained at the public prosecutor's office on the suspicion of crimes. To assess personality dimensions and family environmental factors, the Temperament and Character Inventory(TCI) and the Family Environment Scale(FES) were completed. Antisocial personality traits were assessed by the number of antisocial personality disorder symptoms of the Personality Disorder Questionnaire-Revised. RESULTS: Most of the TCI dimensions except Reward Dependence(RD) were highly correlated with the subscales of FES. Among temperament dimensions, Novelty Seeking(NS) and Persistence(P) were significantly affected by Organization, and Harm Avoidance(HA) was influenced by Expressiveness of FES. Self-Directednss(SD) was best predicted by Organization and Achievement-Orientation. While the Independence had significant effect on Cooperativeness, Expressiveness and Achievement-Orientation best predicted the level of Self-Transcendence(ST). On factor analysis, NS, HA, SD and ST were allocated to the same factors with subscales of FES. The level of antisocial personality trait was best predicted by NS, P and SD scores of TCI, and conflict subscale scores of FES. CONCLUSION: The findings of this study suggest that not only the character dimensions but also the temperament dimensions have close relationships with family environmental factors, and that the antisocial personality traits of delinquent adolescents may developed by the interaction between temperament/character dimensions and family environments.
Adolescent* ; Antisocial Personality Disorder* ; Crime ; Humans ; Personality Disorders ; Reward ; Temperament*

This study was aimed to investigate the effect of baicalin on proliferation and apoptosis of HL-60 cells and its mechanism. Cell proliferation was assayed by using Cell Counting Kit-8. The morphological changes of HL-60 cells were examined by light microscopy and nucleolus morphological changes were observed by fluorescent microscopy after Hoechst 33342 staining. The early cell apoptosis was detected by using flow cytometry with Annexin V-FITC/PI double staining. The expression of caspase-3, caspase-9, Bcl-2 and Bax mRNA was detected by RT-PCR and Western blot assay was carried out to examine Bax, Bcl-2, caspase-8 and cleaved caspase-3 expression. The results showed that Baicalin inhibited the proliferation of HL-60 cells in a time- and concentration-dependent manner. HL-60 cells exhibited typical morphological features (for example, cell shrinkage, membrane blebbing and formation of apoptotic bodies). Cell apoptosis in early stage could be detected, the expression of caspase-3, caspase-9 and Bax mRNA was obviously up-regulated, while the Bcl-2 expression down-regulated, and accordingly Bcl-2/Bax ratio decreased. Such results were consistent with the expression of these proteins. In addition, the expression of cleaved caspase-8 protein was induced significantly after treated with baicalin. It is concluded that baicalin can significantly inhibit the proliferation of HL-60 cells and induce the apoptosis of HL-60 cells, which may occur through decreasing Bcl-2/Bax ratio by intrinsic pathway and through extrinsic pathway. It suggests that baicalin may be a promising drug for the therapy of acute myeloid leukemia.
Apoptosis ; drug effects ; Caspase 3 ; metabolism ; Caspase 8 ; metabolism ; Caspase 9 ; metabolism ; Cell Proliferation ; drug effects ; Flavonoids ; pharmacology ; HL-60 Cells ; Humans ; Proto-Oncogene Proteins c-bcl-2 ; metabolism ; bcl-2-Associated X Protein ; metabolism

PURPOSE: This retrospective study was conducted to estimate the effects of climate factors and air pollution on asthma exacerbations using a case-crossover analysis. METHODS: Patients who visited the emergency department (ED) of 2 university hospitals in Chuncheon for asthma exacerbations from January 1, 2006, to December 31, 2011, were enrolled. Daily average data for meteorological factors (temperature, daily temperature range, relative humidity, wind speed, atmospheric pressure, presence of rain, solar irradiation, and presence of fog) and the daily average levels of gaseous air pollutants (SO2, NO2, O3, CO, and PM10) were obtained. A case-crossover analysis was performed using variables about the weather and air pollution at 1-week intervals between cases and controls before and after ED visits. RESULTS: There were 660 ED visits by 583 patients with asthma exacerbations. Low relative humidity (lag 1 and 2) and high wind speed (lag 1, 2, and 3) were associated with ED visits for asthma. Fog (lag 2) showed protective effects against asthma exacerbations in Chuncheon (risk increase: -29.4% [95% CI=-46.3% to -7.2%], P=0.013). These relationships were stronger in patients ≤19 years old than in those >60 years old. High levels of ambient CO (lag 1, 2, and 3) and NO2 (lag 2 and 3) were associated with decreased ED visits for asthma. However, there were no significant relationships among levels of ambient CO or NO2 and asthma exacerbations after adjusting for wind speed and relative humidity. CONCLUSIONS: High wind speed and low humidity were associated with an increased risk of asthma ED visits. Fog was associated with a decreased risk of asthma ED visits after controlling for seasonal variations in weather and air pollution.
Air Pollutants ; Air Pollution* ; Asthma* ; Atmospheric Pressure ; Climate ; Emergencies* ; Emergency Service, Hospital* ; Gangwon-do* ; Hospitals, University ; Humans ; Humidity ; Korea* ; Meteorological Concepts ; Rain ; Retrospective Studies ; Seasons ; Weather* ; Wind

OBJECTIVE: This study examined the differences in psychiatric comorbidities and behavioral aspects in accordance with the severity of Internet addiction in male adolescents. METHODS: One hundred and twenty-five adolescents from four middle and high schools in Seoul were enrolled in this study. The subjects were divided into non-addict, abuse, and dependence groups according to a diagnostic interview by psychiatrists. The psychiatric comorbidities and behavioral aspects of subjects were evaluated through psychiatric clinical interviews based on the Diagnostic and Statistical Manual of Mental Disorders (4th edition), the Children's Depression Inventory, the State-Trait Anxiety Inventory, the Internet Addiction Test, and a self-reported questionnaire about behavioral aspects. RESULTS: The psychiatric comorbidity distributions were significantly different in the abuse and dependence groups, particularly in terms of attention-deficit hyperactivity disorder and mood disorder items. The Children's Depression Inventory, the State-Trait Anxiety Inventory, and the Internet Addiction Test scores were also significantly different among the three groups. There were significant differences in 10 of the 20 items of the Internet Addiction Test between the non-addict, abuse, and dependence groups. There were significant differences in seven items between the non-addict and abuse groups, but no differences between subjects in the abuse and dependence groups. Significant differences were observed in three items between the abuse and dependence groups, but there were no significant differences between the non-addict and abuse groups. In terms of behavioral aspects, scores for abusive, sexual, and decreased social interest behaviors were highest in the dependence group, and lowest in the non-addict group. However, the behavioral aspects of decreased interpersonal relationships did not show this difference between groups. CONCLUSION: This study suggests that there are differences in psychiatric comorbidities and behavioral aspects between adolescent males with characteristics of Internet abuse and Internet dependence.
Adolescent* ; Anxiety ; Comorbidity* ; Depression ; Diagnostic and Statistical Manual of Mental Disorders ; Humans ; Internet* ; Male ; Mood Disorders ; Psychiatry ; Surveys and Questionnaires ; Seoul

OBJECTIVE: Direct surgical clipping of paraclinoid aneurysms is challenging due to nearby anatomic structures. However, as endovascular techniques advance, endovascular coil embolizations for paraclinoid aneurysms are more frequently performed. We reviewed our experience with endovascular coil embolization of paraclinoid aneurysms to evaluate its safety and efficacy. METHODS: From 2005 to 2011, 78 patients underwent endovascular procedures with detachable coils for 86 paraclinoid aneurysms at our institute. A retrospective review of the medical records was performed. RESULTS: Seventy-eight patients with 86 paraclinoid aneurysms were evaluated. Thirteen patients (16.7%) were men and 65 (83.3%) were women. Patient age ranged from 23 to 78 years (mean age, 48 years). Five patients (6.4%) presented with subarachnoid hemorrhage (SAH) with decreased consciousness and visual field defects. In the 86 treated aneurysms, the immediate post procedural angiogram demonstrated complete occlusion in 73 aneurysms (84.9%), near-complete occlusion in eight aneurysms (9.3%) and partial occlusion in five aneurysms (5.8%). We obtained angiographic follow-up in 46 cases. Minor recanalization occurred in two cases and major recanalization occurred in one case. One thromboembolic complication and one blurred vision occurred among the 78 patients. CONCLUSION: Despite difficulties with surgical approaches for paraclinoid aneurysms, these lesions can be successfully managed by endovascular treatment. Favorable outcomes with a low morbidity suggest endovascular techniques as alternatives to microsurgical therapy for treating paraclinoid aneurysms.
Aneurysm ; Consciousness ; Endovascular Procedures ; Female ; Follow-Up Studies ; Humans ; Male ; Medical Records ; Retrospective Studies ; Subarachnoid Hemorrhage ; Surgical Instruments ; Vision, Ocular ; Visual Fields

OBJECTIVETo explore the value of (18)F-FDG PET/CT in the diagnosis and treatment evaluation in patients with pretreatment or recurrent extranodular natural killer/T-cell lymphoma nasal type (ENTCL).

METHODS(18)F-FDG PET/CT images and clinical records of 35 cases (67 scans) of pathologically confirmed ENTCL treated in our hospital within the last 9 years were analyzed. The imaging characteristics of the upper aerodigestive tract (UAT) and the non-aerodigestive tract (NUAT) lesions were analyzed. Lesion distribution, clinical stages, SUVmax and patient survival data were compared between pretreatment and recurrent cases.

RESULTSs All the ENTCL lesions were hypermetabolic. The UAT lesions involved mainly the nasal cavity and pharynx, while the NUAT lesions may involve the lymph nodes and all the organs. UAT lesions were more common in pretreatment cases while NUAT lesions tended to increase in recurrent cases. The SUVmax of pretreatment and recurrent lesions were 10.4∓4.4 and 9.6∓5.2, and showed no significant difference among patients with different lesion distribution patterns, clinical stages, or treatment history. The tumor remission rate evaluated by PET/CT were higher in cases with an initial diagnosis than in those with recurrence [(89.5% (17/19) vs 33.3% (5/15), P<0.005)]. Cox regression analysis revealed no significant differences in the survival rates among patients with different treatment history, clinical stages, lesion distribution patterns, or SUVmax levels (P>0.05).

CONCLUSION(18)F-FDG PET/CT can sensitively detect the pretreatment or recurrent lesions in ENTCL patients and helps in accurate tumor staging and curative effect evaluation.

OBJECTIVETo study the efficacy of metformin intervention on insulin resistance during catch-up growth in mice with fetal growth restriction (FGR).

METHODSMouse models of FGR were established by low protein diet feeding of the pregnant mice. Both the newborn female mice with FGR and normal control (NC) mice were randomized for feeding with a standard diet (SF) or a high-fat diet (HF) after weaning and treatment with gavage of either metformin or normal saline. The mice were examined for vaginal opening time and the estrous cycle at the age of 8 weeks. At the age of 12 weeks, 6 mice in anestrus from each group were fasted for 12 h for measurement of body weight, height, poundera index (PI), fasting blood glucose (FBG), fasting insulin (Fins), follicle stimulating hormone (FSH) and anti-Mullerian hormone (AMH), and the HOMA-IR was calculated. The reproductive capacity of female mice was assessed by mixing them with male mice at the ratio of 2:1. The 3 × 2 factorial analysis was conducted to determine the interactions between FGR, high-fat feeding and metformin.

RESULTSFactorial analysis showed that FGR and high-fat feeding had significant effects on the PI index, Fins, HOMA-IR, vaginal opening time, and AMH (P<0.05). Metformin significantly affected the factors related to high-fat feeding including weight, PI, FPG, Fins, HOMA-IR and estrous cycle (P<0.05) and the factors related to FGR with the exception of height and FSH (P<0.05). FGR significantly affected the factors tested except for body weight (P<0.05); high-fat feeding affected all the factors but the FSH (P<0.05); metformin affected all the factors but the height and FSH (P<0.05). In the female mice treated with saline, the pregnancy rates differed significantly between FGR mice with high-fat feeding and control mice with standard feeding, and between FGR mice with standard feeding and high-fat feeding (P<0.05).

CONCLUSIONFGR mice can present with delayed puberty with rare ovulation and adulthood insulin resistance, and high-fat feeding after birth can promote the catch-up growth of FGR mice. Metformin intervention is effective for improving insulin resistance and reproductive-endocrine disorders in FGR mice during catch-up growth.

OBJECTIVETo detect the frequencies of anti-GPIIb/IIIa antibody secreting B cells and platelet-specific antibody in patients with idiopathic thrombocytopenic purpura (ITP) and non-immune thrombocytopenia, and to evaluate their roles in the diagnosis of ITP and their clinical significance.

METHODSThe frequencies of circulating B cells secreting anti-GPIIb/IIIa antibody and platelet-specific antibody in 58 ITP patients, 33 non-ITP patients and 31 healthy controls were tested by Enzyme-linked Immunospot Assay (ELISPOT) and modified monoclonal antibody immobilization of platelet antigens assay (MAIPA) respectively.

RESULTSThe frequencies of circulating B cells secreting anti-GPIIb/IIIa antibody in ITP patients \[(6.6 ± 4.2)/10(5) PBMNC\] were significantly increased (P < 0.05) than that of the controls \[(1.3 ± 0.5)/10(5) PBMNC\] and non-immune thrombocytopenic purpura patients \[(2.2 ± 2.0)/10(5) PBMNC\]. However there was no apparent difference between the latter two groups (P > 0.05). ELISPOT had a sensitivity of 70.69%, a specificity of 90.91% for the diagnosis of ITP, the sensitivity being higher than that of modified MAIPA's (43.10%) (χ(2) = 7.03, P < 0.05). The ROC curve showed the discriminative validity of cytometric bead array was 0.886.

CONCLUSIONThe frequencies of circulating B cells secreting anti-GPIIb/IIIa antibody may reflect the pathogenesis of ITP. ELISPOT assay have high sensitivity and specificity than modified MAIPA for the diagnosis of ITP and the guidance for clinical therapy.