PURPOSE: To evaluate US and CT characteristics of small renal cell carcinomas with diameter less than 3cm. MATERIALS AND METHODS: We retrospectively analysed US and CT findings of the small renal cell carcinomas which were surgically confirmed. We analysed echogenicity, peritumoral hypoechoic rim, intratumoral cysts on US. We analysed CT with viewpoints of tumor margin, growth pattern, renal contour change, attenuation on pre- and postcontrast scan, homogeneity, and perirenal changes. RESULTS: The US characteristics of the small renal cell carcinomas were hyperechogenicity(89%), peritumoral hypoechoic rim(66%) and intratumoral cysts(44%). They had relatively well-defined margin(90%), smooth and round contour(90%), endophytic growth pattern(65%), and outward bulging of renal contour(75%) on CT. They had iso- or high attenuation(87%) on precontrast CT, and were relatively homogeneous low-attenuated on postcontrast CT. CONCLUSION: The constellation of US and CT findings may be helpful in the diagnosis and understanding of the internal architecture of the small renal cell carcinomas.
Carcinoma, Renal Cell* ; Diagnosis ; Retrospective Studies

No abstract available.
Endoscopy ; Gastrointestinal Hemorrhage*

BACKGROUND: There were a lot of problems in the health care system of Korea, which was divided into Western and Korean Traditional Medicine since 1951. In 1976 WHO published program of The promotion and development of traditional medicine. In 1977, Korean Medical Association(KMA) asked unification of health care system to government. But there was no progress because there were the lacks of mutual respect and understanding be-tween doctors of Western and Korean Traditional Medicine. As one health care group competed with the other, so KMA proposed the unification of health system again in 1997. The objectives of this research are to analyze attitude and opinions of western medical doctors on Korean Traditional Medicine and to analyze the opinions on the unification of medical care system in Korea. METHODS: A list of western medical doctor in Seoul and Incheon was obtained from Korean Medical Association. We sampled 937 doctors by stratified random sampling method. We sent them a postal questionnaire with a prepaid return envelope two times during March and April 1997. Of the 937 questionnaire, 266 replies were received. We analyzed the preference score related referral, Korean Traditional Medicine education and unification of medical care system We analyzed the data by Chisquare test, t-test, ANCOVA. RESULTS: This study shows that the western doctors have negative attitude on Korean Traditional Medicine(M=1K8, SD=5.2). They thought Korean Traditional Medicine was not reliable because it was not scientific(79.4%). Doctor, who didn't take oriental medical education, preferred unification of health care system, but it was not statistically significant. Those who experienced oriental medical education used oriental medical treatment more frequently(F=1.17, p=0.04). The more positive attitude they have about Korean Traditional Medicine, the more frequently they refereed the patient to oriental medical doctor(t =3.57, p =0.0004). CONCLUSIONS: Western medical doctors have a negative attitude on Korean Traditional Medicine. Doctors, who did not have oriental medical education, preferred unification of health care system, but it was not statistically significant. In summary, the lack of mutual respect and understanding between doctors of the Western and Korean Traditional Medicine prevent unification of medical care system.
Delivery of Health Care ; Education ; Education, Medical ; Humans ; Incheon ; Korea ; Medicine, Korean Traditional* ; Medicine, Traditional ; Referral and Consultation ; Seoul ; Surveys and Questionnaires

No Abstract Available.

Hemorrhagic cystitis is potentially life-threatening sequellae of chemotherapy using oxazaphosphorine alkylating agents (cyclophosphamide and ifosfamide). Mesna contains a sulfhydryl group that is believed to bind acrolein within the urinary collecting system and reduce the hemorrhagic cystitis without affecting the chemotherapeutic potential. To date, about thirty cases of hypersensitivity or allergic reactions of the delayed and urticarial type associated with mesna have been reported. We reported two patients with systemic lupus erythematosus who developed facial rash and flushing associated with mesna which imitate malar rash.
Acrolein ; Alkylating Agents ; Cyclophosphamide ; Cystitis ; Drug Therapy ; Exanthema* ; Flushing ; Humans ; Hypersensitivity* ; Lupus Erythematosus, Systemic ; Mesna*

PURPOSE: To understand the MR findings of extraabdominal desmold tumors by correlation with histopathologic findings. MATERIALS AND METHODS: MR images of histologically proved 12 patients with extraabdominal desmold tumor were retrospectively reviewed. Three types of MR features were defined; type I had signal changes on T1 and T2 weighted images and relatively homogeneous nature, type II had homogeneously low signal intensities on T1 and T2 weighted images and type III was a mixed form of type I and type II. Signal intensity, enhancement pattern and margin of the lesions were analyzed on MR images. Pathologic features were analyzed by three aspects, which were cellularity, amount of collagen and vascularity, and were correlated with MR images. RESULTS: The signal intensities of type I desmolds were intermediate on T1 weighted image and higher on T2 weighted image with localized margin and gadolinium enhancement. Pathologically this type showed predominant cellularity and vascularity. The signal intensities of type II desmold were homogenous low signal intensities on both T1 and T2 weighted images without enhancement. Pathologically this type showed predominant collagen components and hypovascularity. Type III desmolds were mixed form of type I and type II on MR images as well as on pathologic features. Type I and type II desmold tumors had localized margins, however type III had both localized and infiltrative margins. CONCLUSION: The MR findings of extraabdominal desmold tumors would reflect the pathologic background of the tumor.
Collagen ; Gadolinium ; Humans ; Retrospective Studies

BACKGROUND: Irbersatan, an orally active antihypertensive agent, effectively reduce blood pressure by directly blocking angiotensin II receptors without any significant adverse effects. The purpose of this study is to evaluate the efficacy and safety of irbesartan in patients with mild to moderate hypertension. METHODS: This study enrolled 83 patients who had diastolic pressure above 95 mmHg and below 110 mmHg on two measurements. Sixty eight patients were administered 150mg of irbesartan, an angiotensin II receptor blocker, daily for four weeks as an initial dosage. If the sitting diastolic pressure was equal to or greater than 90 mmHg after a 4 week treatment period, the dosage was doubled until the end of 8 weeks. Baseline pressures, antihypertensive effect, side effects, laboratory findings were compared before and after treatment. RESULTS: Fourty two patients out of 53 patients having completed this study showed decreased blood pressure equal to or more than 5 mmHg of the sitting diastolic pressure (response rate=79%). Twenty one patients out of 53 patients showed normalized blood pressure below 90 mmHg of the sitting diastolic pressure (normalization rate=40%). The extent of decrease in diastolic and systolic blood pressure after eight week treatment was an average 11.7+/-10.1 mmHg and 16.3+/-18.9 mmHg, respectively (p<0.05). Nineteen ontoward side effects was observed in 17 patients out of 68 patients with medication (frequency of ontoward effects=25%). Only one case with headache was considered to be related to the medication. Abnormal laboratory findings were observed in eight patients, and only one case with elevation of bilirubin and ALT levels was considered to be related to the medication. CONCLUSION: In conclusion, irbesartan is a safe and effective antihypertensive drug in patients with mild to moderate hypertension with tolerable side effects.
Bilirubin ; Blood Pressure ; Headache ; Humans ; Hypertension* ; Receptors, Angiotensin

PURPOSE: To evaluate the diagnostic value of radiologic studies in the Cushing's disease MATERIALS AND METHODS: We analyzed retrospectively the CT(n=19, dynamic CT was not perfomed), MR (n=23, dynamic MR in 2 cases), and the results of inferior petrosal sinus sampling(IPSS)(n=13) in 25 patients(19 women, 6men, age range 16-58, mean 32.2) with pathologically-confirmed ACTH secreting pituitary adenoma. We analyzed the radiologic findings and determined how accurately each method could detect and lateralize the lesion within the pituitary gland. The results were compared with the surgical findings and with each other. RESULTS: Seven patients(28%) out of 25 had macroadenomas and the lesions were detected and correctly diagnosed by CT and MR in all. Eighteen patients(72%) had microadenoma. In patients with microadenoma the sensitivity was 38.5%(5/13) in CT, 64.7%(11/17) in MR, 90.9%(10/11) in IPSS. In two patients with dynamic MR, in whom the conventional Gd-enhanced MR showed false negative results, the lesions were detected as low signal intensity mass and correctly lateralized. Considering the results of both MR and IPSS, the sensitivity increased up to 94.1%(17/18). CONCLUSION: Considering the invasiveness of IPSS, Gd-enhanced MR, preferably dynamic, seems to be an imaging modality of choice in Cushing's disease. Combined use of IPSS in selected patients further increases the accuracy of diagnosis and lateralization.
ACTH-Secreting Pituitary Adenoma ; Diagnosis ; Female ; Humans ; Pituitary Gland ; Retrospective Studies

OBJECTIVES: Shift work is a stressful situation. It is important to know the factors associated with the ability to adapt to a shift work schedule. The aim of the present study was to investigate the association between sleep, as well as personality variables, and the resilience of shift work nurses. METHOD: Self-report questionnaires were administered to 95 nurses who worked in one national university hospital. Connor-Davidson resilience scale, hospital anxiety and depression scale, morningness-eveningness scale, Pittsburgh sleep quality index, other sleep-related questionnaires, and Korean defense style questionnaires were used. RESULTS: Age, shift work duration, off-day oversleep, depression, anxiety, adaptive defense style, and self-suppressive defense style were significantly associated with resilience (p < 0.05). Multiple regression analysis showed that age (beta = 0.34, p < 0.05), depression (beta = -0.25, p < 0.05), adaptive defense style (beta = 0.45, p < 0.001), and self-suppressive defense style (beta = -0.19, p < 0.05) significantly predicted the resilience of shift work nurses. Concerning individual defense mechanisms, resignation (beta = -0.20, p < 0.05), sublimation (beta = 0.19, p < 0.05), omnipotence (beta = 0.19, p < 0.05), and humor (beta = 0.20, p < 0.05) significantly predicted the resiliency. CONCLUSION: The findings indicate that a specific defense style and other mechanisms were associated with the resilience of shift work nurses. A future prospective study with more participants could further clarify the relationship between sleep-related variables, as well as personality factors, and resilience of shift work nurses.
Anxiety ; Appointments and Schedules ; Defense Mechanisms ; Depression ; Surveys and Questionnaires ; Sublimation

STUDY DESIGN: Establishment of a multipotent neural stem cell line from the adult mouse cerebrum. OBJECTIVES: To establish a daughter cell line, B2A1, from B2 cells through the limiting dilution method, and to determine if the cells have the characteristics of neural stem cell (NSCs) using immunocytochemistry and RT-PCR methods. SUMMARY AND LITERATURE REVIEW: In the development of NSCs, differentiated organ or tissue-derived multipotent stem cells have attracted considerable interest because of the lack of ethical issues. Previously, a glial precursor cell line (B2 cells) was generated from the primary cultures of oligodendrocytes/ astrocytes in an adult BALB/c mouse brain. These cells exhibited the cell-type specific markers for immature neuroectodermal cells, astrocytes, and oligodendrocytes in serum-contained media. MATERIALS AND METHODS: The primary cultures of oligodendrocytes/astrocytes were established from the whole brains of 12 to 16-week-old BALB/c mice from either gender. After 6 months with 25 serial passages, the culture consisted of a morphologically homogeneous cell population, which was designated as B2 cells. A subclone, B2A1, was isolated from B2 cells through two consecutive limiting dilutions. RESULTS: More than 90% of B2A1 cells showed immunopositivity for nestin, a specific marker for NSC. The cells also showed immunopositivity for the neuronal, astrocytic and oligodendroglial markers. These cells expressed the genotypic mRNA messages for both neural progenitor cells and differentiated neuronoglial cells. These positive immunocytochemical reactions and mRNA messages for neuronoglial cells varied according to the extrinsic growth factors used. However, the treatment of extrinsic growth factors did not produce any significant differences in the nestin-immunopositive cells. CONCLUSIONS: B2A1 cells have the immunocytochemical and cytogenetic properties of NSCs, and the capacity to differentiate into neuronoglial cells.
Adult* ; Animals ; Astrocytes ; Brain ; Cell Line ; Cerebrum* ; Cytogenetics ; Ethics ; Humans ; Immunohistochemistry ; Intercellular Signaling Peptides and Proteins ; Mice* ; Multipotent Stem Cells ; Nestin ; Neural Plate ; Neural Stem Cells* ; Neurons ; Nuclear Family ; Oligodendroglia ; RNA, Messenger ; Serial Passage ; Stem Cells