No abstract available.
Family Practice* ; Fatigue* ; Humans ; Pilot Projects* ; Prospective Studies*

The funding acknowledgment in this article was omitted as published.

PURPOSE: To evaluate the effect of common three photon energies (6-MV, 10-MV, and 15-MV) on intensity-modulated radiation therapy (IMRT) plans to treat prostate cancer patients. MATERIALS AND METHODS: Twenty patients with prostate cancer treated locally to 81.0 Gy were retrospectively studied. 6-MV, 10-MV, and 15-MV IMRT plans for each patient were generated using suitable planning objectives, dose constraints, and 8-field setting. The plans were analyzed in terms of dose-volume histogram for the target coverage, dose conformity, organs at risk (OAR) sparing, and normal tissue integral dose. RESULTS: Regardless of the energies chosen at the plans, the target coverage, conformity, and homogeneity of the plans were similar. However, there was a significant dose increase in rectal wall and femoral heads for 6-MV compared to those for 10-MV and 15-MV. The V20 Gy of rectal wall with 6-MV, 10-MV, and 15-MV were 95.6%, 88.4%, and 89.4% while the mean dose to femoral heads were 31.7, 25.9, and 26.3 Gy, respectively. Integral doses to the normal tissues in higher energy (10-MV and 15-MV) plans were reduced by about 7%. Overall, integral doses in mid and low dose regions in 6-MV plans were increased by up to 13%. CONCLUSION: In this study, 10-MV prostate IMRT plans showed better OAR sparing and less integral doses than the 6-MV. The biological and clinical significance of this finding remains to be determined afterward, considering neutron dose contribution.
Head ; Humans ; Neutrons ; Organs at Risk ; Prostate ; Prostatic Neoplasms ; Retrospective Studies

Renal papillary necrosis is rare. It usually occurs in association with diabetes mellitus, pyelonephritis, urinary tract obstruction, analgesic abuse and sickle cell hemoglobinopathies. The basic pathophysiologic process in renal papillary necrosis appears to be ischemic necrosis. We experienced a case of renal papillary necrosis associated with diabetes mellitus. This 59 years old female was diabetic for 10 years and had persistent pyuria, not controlled with antibiotics. The excretory urography showed nonvisualized left kidney and retrograde pyelography showed multiple irregular filling defect in pelvis and ureter. The nephrectomized kidney showed typical findings of papillary necrosis, grossly and microscopically.
Anti-Bacterial Agents ; Diabetes Mellitus* ; Female ; Hemoglobinopathies ; Humans ; Kidney ; Middle Aged ; Necrosis* ; Pelvis ; Pyelonephritis ; Pyuria ; Ureter ; Urinary Tract ; Urography

Renal infarction with ethanol was induced exprimentally in rabbits and selective renal angiography wasperformed to evaluate the effectiveness of ethanol as embolic material. The results were as follows; 1. Completeobstruction of renal artery was produced in all cases within 1 week after injection of absolute ethanol(0.5ml/kg). 2. Incomplete obstruction of renal artery was produced in majority after injection of absolute ethanol(0.2ml/kg) and changed to complete obstruction above half cases with time. 3. Incomplete obstruction of renalartery was produced in minority after injection of 60% ethanol (0.2ml/kg) and complete obstruction of renal arterywas not produced. It was considered that ethanol is an effective agent for complete renal infarction and 0.2 to0,5ml/kg of absolute ethanol is effective dose for complete renal infarction.
Angiography ; Ethanol ; Infarction ; Rabbits ; Renal Artery

Raynaud's syndrome causes discolorization, ischemic claudication(pain) and necrosis of the digits through insufficiency in the circulation which is induced by intermittent spasms of the digital arteries. From January, 2002 to December, 2004, 10 patients were surgically treated for Raynaud's syndrome. 9 patients were female and 1 patient was male. 2 patients showed unilateral involvement, 8 patients were operated on both hands. 6 patients had necrotic changes on the finger tips due to the disease. Ages ranged from 21 to 60 with an average of 39.1. Ischemic pain, discolorization, and cold intolerance of the digits were the common symptoms. All patients were evaluated with color doppler before the surgery. Two different procedures were applied according to the severity of the disease: Patients with decreased circulation received, what we call a limited digital sympathectomy, i.e. stripping of the adventitia of the ulnar, radial and common digital arteries. An extended procedure, radical digital sympathectomy, was performed on patients with a complete block of circulation. Stripping of the adventitia in these patients also involved the proper digital arteries. Symptoms like discolorization, ischemic pain, and cold intolerance improved immediately after the surgery. The patients did not suffer from pain even with exposure to cold weather. We conclude that digital sympathectomy could improve the symptoms in Raynaud's patients who do not respond to conservative treatment such as calcium channel blocker and other vasodilators.
Adventitia ; Arteries ; Calcium Channels ; Female ; Fingers ; Hand ; Humans ; Male ; Necrosis ; Spasm ; Sympathectomy* ; Vasodilator Agents ; Weather

PURPOSE: Hepatic resection is generally considered as the most satisfactory treatment for patients having intrahepatic stones. Yet for cases of right-sided intrahepatic stones, role of hepatic resection is still ambiguous because of the higher operative risks that are entailed when performing surgery at that location. This report presents the results of hepatic resection for the treatment of right-sided intrahepatic stones. METHODS: Seventy-one patients with right-sided intrahepatic stones were operated on during a period of 14 years. The operative procedures executed in the patients were 40 hepatic resections and 31 biliary lithotomies. We analyzed the operative findings and the results of treatment were then compared between the two treatment groups. RESULTS: The intrahepatic bile duct changes associated with stones were cholangitis (n=16), biliary stricture (n=31), biliary dilatation (n=13), and liver atrophy (n=11). Biliary dilatation and liver atrophy were more frequently observed in patients with hepatic resection (p< 0.05). Operative complications occurred in 6.5% of patients after biliary lithotomy and in 25.0% of patients after hepatic resection. There was no operative mortality in both groups. Retained stones were found in 51.6% of patients after biliary lithotomy. There were no retained stones in patients undergoing hepatic resection. After biliary lithotomy, the rate of retained stones was higher for patients having associated bile duct strictures and dilatations (cholangitis; 18.2%, stricture; 64.7%, dilatation; 100%, p< 0.05). Recurrent stones were found to have developed in 10 patients (14.2%), yet the rates for the recurrent stones were not different in both groups. CONCLUSION: Hepatic resection is an effective and safe treatment for right-sided intrahepatic stones. For intrahepatic stones associated with definite bile duct strictures, hepatic resection is the most suitable procedure for the complete removal of stones.
Atrophy ; Bile Ducts ; Bile Ducts, Intrahepatic ; Cholangitis ; Cholelithiasis ; Constriction, Pathologic ; Dilatation ; Hepatectomy ; Humans ; Liver ; Mortality ; Surgical Procedures, Operative

BACKGROUND: Short-term measurement of heart rate variability is known to be a non-invasive technique to examine autonomic nerve system. Heart rate variability exhibits circadian rhythm according to work/sleep cycle and biological clock. In primary practice, short-term measurement of heart rate variability is usually used during the day. Therefore the aims of this study were to investigate the possibility of differences in heart rate variability between morning and afternoon and also to examine the relationship among associated factors. METHODS: Sixty-eight healthy volunteers underwent short- term measurement of heart rate variability on two occasions: in the morning (08:30~11:00) and in the afternoon (13:30~16:00). A structured questionnaire was used to access general characteristics, emotion, fatigue and sleeping hours. RESULTS: The mean heart rate was significantly increased and SDNN, RMSSD, TP, HF and VLF were significantly decreased in the afternoon compared to the morning. LF and LF/HF were not changed. The anxiety group, the depression group and the fatigue group showed significantly greater reduction in TP and RMDDS than the control group. CONCLUSION: In the afternoon, parasympathetic activity and total power were decreased significantly compared to the morning. Short-term heart rate variability should be measured in the same time zone and need to consider food intake effect. Those who complained of anxiety, depression or fatigue were related to much decrease in TP and RMSSD in the afternoon.
Anxiety ; Autonomic Pathways ; Biological Clocks ; Circadian Rhythm ; Depression ; Eating ; Fatigue ; Heart ; Heart Rate ; Surveys and Questionnaires

PURPOSE: Polyps and polypoid lesions of the gallbladder are now increasingly detected. However the nature of disease is hard to define before operation and the indications for surgical intervention remain controversial. We attempted to differentiate between benign polyps and neoplastic lesions by comparing their clinical data and pathological findings. METHODS: The study comprised 128 consecutive patients who underwent resection for polypoid lesions of the gallbladder. The lesions were classified into five groups histologically, and the clinico-pathological characteristics were compared among the groups. RESULTS: We found cholesterol polyps in 42 patients, inflammatory polyps in 13, adenomyomatoses in 14, adenomas in 15, and carcinomas in 44. The mean age of the patients with carcinoma, all of whom were over 40 years, was significantly higher than that of the other groups (P<0.05). Carcinoma patients showed a female preponderance. The incidences of gallstones and presenting symptoms were not different between the benign and malignant diseases. The mean diameters of cholesterol polyps and inflammatory polyps were less than 5 mm, those of adenomyomatoses and adenomas were around 1 cm, and that of carcinoma was over 2 cm (P<0.05). Most of the benign polyps were pedunculated, but sessile lesions were more frequent in the malignant polyps (P<0.05). Neoplastic polyps tended to be single. CONCLUSION: It is suggested that polypoid lesions of the gallbladder should be removed surgically when the lesion exceeds 1 cm in diameter, is single in number, or is sessile. The possibility for malignancy should be considered if the patient is female, and over 40 years of age.
Adenoma ; Cholesterol ; Female ; Gallbladder* ; Gallstones ; Humans ; Incidence ; Polyps

Tuberculosis (TB) is associated with an increased risk of chronic lung impairment. The aim of this study was to compare the clinical characteristics and lung functions according to definition of past TB. We used the population-based, Korea National Health and Nutrition Examination Survey (KNHANES) (2008–2012) to analyze 13,522 subjects age 40 years or older who underwent spirometry and chest X-ray (CXR). Subjects with TB lesions on CXR (with or without a history of TB) were older, more likely to be male, ever smokers, and of low socioeconomic status than subjects with only a history of TB or without evidence of TB. Airflow obstruction (AFO) was associated with only a history of TB (odds ratio [OR] 1.53, 95% confidence interval [CI] 0.95–2.46), only TB lesion on CXR (OR 2.37, 95% CI 1.80–3.12), and both a history and TB lesions on CXR (OR 4.47, 95% CI 3.07–6.51) after adjustment for gender, age, body mass index, education, income, and smoking amount (P for trend < 0.001). Spirometric restriction was associated with only a history of TB (OR 1.29, 95% CI 0.80–2.08), only TB lesions on CXR (OR 2.03, 95% CI 1.49–2.76), and both a history and TB lesions on CXR (OR 2.65, 95% CI 1.74–4.05) after adjustment for the above variables (P for trend < 0.001). How to define past TB in population study affects the magnitude of association between past TB and respiratory dysfunction. Without considering TB lesions on CXR, the association between TB and respiratory dysfunction could be underestimated.
Body Mass Index ; Education ; Humans ; Korea* ; Lung ; Lung Diseases ; Male ; Mass Chest X-Ray ; Nutrition Surveys* ; Smoke ; Smoking ; Social Class ; Spirometry ; Thorax ; Tuberculosis* ; Tuberculosis, Pulmonary*