No abstract available.
Colorectal Neoplasms*

Medical tourism has emerged as a an increasingly relevant issue worldwide and its spread is gaining greater momentum. In 2008, 750,000 Americans went overseas for medical procedures and the number is expected to reach 6,000,000 by the year 2010. The Health Industry Development Institute of Korea announced that the number of medical tourists to Asia has seen an annual increase of 30%, to 1,590,000 from 950,000, between 2003 and 2005. Among Asian countries, Thailand, India and Malaysia have already established themselves as particularly attractive destinations for medical services thanks to low medical fees and/or tourism related prices. The number of foreign patients visiting these countries for medical services has increased rapidly as they had been from the very early days of medical tourism. Following the revision of its laws and regulations in medical practice, Korea will join the competition against existing leaders of medical tourism to gain a larger share of global medical shoppers. Some strength that Korea offers as a medical service destination are its plentiful supply of high quality physicians and medical facilities, relatively low medical fees compared to quality of service, excellent medical accessibility, and the geographical closeness to medically less developed countries. A vibrant medical tourism industry will not only create new jobs and generate a new source of income for medical professionals but also enhance the national image of Korea abroad. Another benefit of developing Korea as a destination for medical services is the maintenance of a better balance between medical supply and demand. The recent and rapid increase in the number of hospital beds and medical professionals in Korea has triggered a concern for a possible oversupply in medical services. Medical tourism is precisely the type of business that could help prevent the development of these situations. The patient's trust in medical professionals and their medical skills is a critical factor in medical decision-making. Therefore, to further develop Korea's medical tourism, policy support by the government along with meticulous preparation by health service providers would be required to build up a firm foundation. At the same time, active marketing promotions to heighten the awareness of Korea as a medical destination would be necessary to maximize the economic benefit of the nation from medical tourism.
Asia ; Asian Continental Ancestry Group ; Commerce ; Developing Countries ; Fees, Medical ; Health Services ; Humans ; India ; Jurisprudence ; Korea ; Malaysia ; Marketing ; Medical Tourism ; Salicylates ; Social Control, Formal ; Thailand

Thymic epithelial cells constitute a major component of the thymic microenvironment. The thymus is involved in the regulation of the proliferation, maturation and differentiation of thymocytes. There is some controversy about the classification of thymic epithelial cell types. Traditionally, thymic epithelial cells have been divided into cortical and medullary epithelial cell types. In general, the thymic epithelium can be broadly subdivided into subcapsular, cortical and medullary epithelial cells, and Hassall's corpuscles by immunocytochemical methods. Although a few studies were performed on the ultrastructural characteristics of the different types of thymic epithelial cells, there is still some controversy about the classification of thymic epithelial cell subsets. Thus, the present study was performed to investigate the ultrastructural features of thymic epithelial cell subsets in adult male Sprague-Dawley rats, which are the most commonly used species of rat for biological researches, using transmission electron microscopy to shed more light on the heterogeneity of thymic epithelial cells. On the basis of ultrastructural features, we could identify and classify eight subsets of epithelial cells in normal rat thymus. In particular, this study provided a clear and easy way to identify the type 3 epithelial cells by their characteristic 'perinuclear arrangement pattern of relatively short bundles of tonofilaments'. This is an important finding since the type 3 epithelial cells has been considered to be the most difficult type to identify among various thymic epithelial cell types. The results of the present ultrastructural study of thymic epithelial cells provided more insight into the heterogeneity of thymic epithelial cells, and can contribute to the understanding of roles played by different types of thymic epithelial cells.
Adult ; Animals ; Classification ; Epithelial Cells* ; Epithelium ; Humans ; Male ; Microscopy, Electron, Transmission ; Population Characteristics ; Rats* ; Rats, Sprague-Dawley ; Thymocytes ; Thymus Gland*

The thymus is the central lymphoid organ for development of bone marrow-derived precursor cells into mature T-cells. The thymic stroma provides the specialized microenvironment for the proliferation, differentiation, and maturation of the immature T-cells, thymocytes. The CD27 is a tumor necrosis factor (TNF) receptor family member whose expression is limited to cells of the lymphoid lineage. CD70, the ligand of CD27, is a TNF related trans-membrane protein induced upon activation on T and B cells, dendritic cells and macrophages. CD70/CD27 interaction plays a key role in T dependent B cell responses and is responsible for plasma cell differentiation. This study was performed to investigate the expression of CD70 during regeneration following acute involution induced by cyclophosphamide (CY) in the rat thymus using RT-PCR analysis and single and double immunohistochemistry. The results from RT-PCR analysis showed that CD70 is expressed in mouse thymic medullary interdigitating (IDC)-like cells (MDC), DC2.4 and Raw264.7 but not expressed in the mouse thymic epithelial cells (subcapsular/cortex epithelial cells, cortical epithelial cells and medullary epithelial cells). Interestingly, upregulation of CD70 expression was observed in the thymic stromal cells and thymocytes isolated from rat thymus during thymus regeneration. Furthermore, immunohistochemistry demonstrated that CD70 was mainly expressed in the ED1 positive macrophages predominantly in the thymic cortex both in the normal thymus and during thymus regeneration. In line with the data obtained by biochemical analysis, CD70 immunoreactive macrophages is increased both in number and in size during thymus regeneration. Thus, the results of the present study suggest that CD70 expressed on the thymic macrophages could play a role in the development of new T cells to replace T cells damaged by cyclophosphamide treatment during thymus regeneration.
Animals ; B-Lymphocytes ; Cyclophosphamide ; Dendritic Cells ; Epithelial Cells ; Humans ; Immunohistochemistry ; Macrophages ; Mice ; Plasma Cells ; Rats* ; Regeneration* ; Stromal Cells ; T-Lymphocytes ; Thymocytes ; Thymus Gland* ; Tumor Necrosis Factor-alpha ; Up-Regulation

The syndrome of inappropriate ADH secretion is a disorder characterized by hyponatremia which results from water retention attributable to ADH release. The hallmark of SIADH is hyponatremia due to water retention, in the presence of urinary osmolality above plasma osmolality. The SIADH was initially described by Schwartz et al (1957). This syndrome, first recognized in patients with bronchogenic carcinoma, has now been observed in a variety of other illnesses. Recently, we encountered a 59 year-old female with small cell lung cancer, also she had SIADH. Thus, we present a case and review the literature on the subject.
Carcinoma, Bronchogenic ; Female ; Humans ; Hyponatremia ; Inappropriate ADH Syndrome* ; Osmolar Concentration ; Plasma ; Small Cell Lung Carcinoma* ; Water

PURPOSE: Many techniques have evolved to treat benign prostatic hyperplasia (BPH). These techniques attempt to achieve the clinical benefits of transurethral resection of the prostate, while trying to decrease the morbidity associated with this procedure. Visual laser ablation of the prostate (VLAP) has also been used as an effective treatment modality of BPH. The objective of this paper was to evaluate the long term effect of VLAP for patients with symptomatic BPH. MATERIALS AND METHODS: 85 patients with BPH underwent an initial operation, where a VLAP was performed with a neodymium:YAG laser. 65 patients, 6 months after the operation, and 25, 6 years after the operation, were available for follow-up studies. Voiding outcomes, including peak urinary flow rates, residual urine volumes and American Urological Association (AUA) symptom scores, were measured over time. RESULTS: 6 months after the operation significant improvement was seen in the prostatic size, maximal flow rate and post-void residual volume. However, no significant statistical improvement in these parameters was noticed in the subsequent 6 year follow-up (p>0.05). Comparisons of the mean AUA scores, before the operation, and 6 months (p<0.05) and 6 years (p>0.05) after, showed significant differences for the different times. With regard to the quality of life due to the urinary symptoms, 87.7% of patients 6 months, and 72.7% 6 years after the operation felt more than mildly satisfied. CONCLUSIONS: There have been numerous reports on the efficacy of VLAP, which show its many advantages, such as low morbidity, high simplicity and good short-term effect. However, according to this study, the long-term therapeutic effect of VLAP was poor, but its exact role for the treatment of BPH remains to be determined.
Follow-Up Studies* ; Humans ; Laser Therapy* ; Prostate* ; Prostatic Hyperplasia ; Quality of Life ; Residual Volume ; Transurethral Resection of Prostate

PURPOSE: Many techniques have evolved to treat benign prostatic hyperplasia (BPH). These techniques attempt to achieve the clinical benefits of transurethral resection of the prostate, while trying to decrease the morbidity associated with this procedure. Visual laser ablation of the prostate (VLAP) has also been used as an effective treatment modality of BPH. The objective of this paper was to evaluate the long term effect of VLAP for patients with symptomatic BPH. MATERIALS AND METHODS: 85 patients with BPH underwent an initial operation, where a VLAP was performed with a neodymium:YAG laser. 65 patients, 6 months after the operation, and 25, 6 years after the operation, were available for follow-up studies. Voiding outcomes, including peak urinary flow rates, residual urine volumes and American Urological Association (AUA) symptom scores, were measured over time. RESULTS: 6 months after the operation significant improvement was seen in the prostatic size, maximal flow rate and post-void residual volume. However, no significant statistical improvement in these parameters was noticed in the subsequent 6 year follow-up (p>0.05). Comparisons of the mean AUA scores, before the operation, and 6 months (p<0.05) and 6 years (p>0.05) after, showed significant differences for the different times. With regard to the quality of life due to the urinary symptoms, 87.7% of patients 6 months, and 72.7% 6 years after the operation felt more than mildly satisfied. CONCLUSIONS: There have been numerous reports on the efficacy of VLAP, which show its many advantages, such as low morbidity, high simplicity and good short-term effect. However, according to this study, the long-term therapeutic effect of VLAP was poor, but its exact role for the treatment of BPH remains to be determined.
Follow-Up Studies* ; Humans ; Laser Therapy* ; Prostate* ; Prostatic Hyperplasia ; Quality of Life ; Residual Volume ; Transurethral Resection of Prostate

No abstract available.
Aspirin* ; Coronary Aneurysm ; Mucocutaneous Lymph Node Syndrome*

PURPOSE: We evaluates if the administration of tamsulosin increases the efficacy of extracorporeal shock wave lithotripsy (ESWL) in the patients with upper ureteral stones and if this decreased the use of analgesic drugs after the procedure. MATERIALS AND METHODS: A total of 45 patients with stones 6-12mm in size that were located in the upper ureter were enrolled in the study. The patients were randomly divided into two groups. Group 1 (n=23) received 3 times a day oral treatment of 20mg caroverine (a spasmolytic drug). Group 2 (n=22) received one time a day oral therapy of 0.2mg tamsulosin. All the patients received oral treatment for 14 days. Both groups of patients were allowed to use 30mg ketorolac trimethamine intramuscular injections on demand. The endpoint of the study was the stone expulsion rate, the use of analgesics and the drug adverse effects during treatment. RESULTS: The average stone size was 7.9+/-2.79mm for group 1 and 8.2+/-3.14mm for group 2. No statistical difference between the two groups was found for the stone size, age and gender distribution. The expulsion rate was significantly higher in group 2 (90.9%) compared with group 1 (65.2%) (p=0.038). The average number of pain control injections was 0.78 for group 1 and 0.23 for group 2, and there was a statistically significant difference between the two groups (p=0.042). CONCLUSIONS: The use of tamsulosin proved to be effective and safe, as demonstrated by the increased stone expulsion rate and the lesser need for pain control than that when using just a spasmolytic drug for ESWL of upper ureter stones.
Analgesics ; Humans ; Injections, Intramuscular ; Ketorolac ; Lithotripsy* ; Shock* ; Ureter* ; Urinary Calculi

PURPOSE: Many investigators suggested that changes in hormonal environment in the postmenopausal women functionally or histologically effect the clitoris and vagina. We investigated the mechanism of female se xual dysfunction occurring in the decreased hormonal status, and aimed to establish and experimental base for the hormone replacement in postmenopausal women to correct sexual dysfunction. MATERIALS AND METHODS: Twenty mature female New Zealand white rabbits were randomly divided into three groups; control group, oophorectomy group, estrogen replacement group after oophorectomy. Nitric oxide synthase (NOS) activity and the degree of expression of neuronal NOS (nNOS) and endothelial NOS (eNOS), collagen content in clitoral tissues were analysed. RESULTS: nNOS and eNOS were significantly increased in the oohporectomized group while decreased in the estrogen replacement group (p<0.01). NOS activity showed the similar pattern of change (p<0.05). Oophorectomy induced a significant increase in collagen content, while the ratio of smooth muscle content was increased significantly after the estrogen replacement (p<0.01). CONCLUSIONS: Estrogen deficiency induces collagen synthesis and decreases the content of smooth muscle in clitoris, resulting in a structural relaxation difficulty. We believe that NOS becomes more active to improve the relaxation difficulty and that hormone replacement helps to restore the normal state of smooth muscle relaxation. Considering these findings, we suggest that estrogen down-regulates NOS and its activity.
Clitoris* ; Collagen ; Estrogen Replacement Therapy ; Estrogens* ; Female ; Humans ; Muscle, Smooth ; Neurons ; Nitric Oxide Synthase ; Ovariectomy ; Rabbits ; Relaxation ; Research Personnel ; Vagina