No abstract available.

OBJECTIVES : Impaired autonomic function in patients with chronic renal failure has been well documented in a number of studies to assess the degree of cardiovascular autonomic dysfunction and to assess the relationship with plasma catecholamines. The purpose of the present study was to evaluate the prevalence of autonomic dysfunction and to determine the effect of autonomic dysfunction on the increment of plasma catecholamine, dialysis-induced hypotension and hypotension during chronic dialysis. METHODS: We measured the degree of autonomic damage and the concentration of plasma catecholamines in 20 patients on maintenance hemodialysis, 12 pre- dialysis patients with chronic renal failure and 20 normal controls using a standardized battery of five cardiovascular reflex tests. RESULTS: 1) In normal controls, 70% of cases had a normal or early parasympathetic abnormalities however in patients with chronic renal failure, 45.2% of patients had severe abnormalities. The prevalence of autonomic dysfunction was 62.5% and there was significant correlation between sympathetic and parasympathetic score in patients with chronic renal failure. 2) Although overall autonomic function was not different in two chronic renal failure groups, the magnitude of heart rate response to Valsalva maneuver was increased and the magnitude of fall of blood pressure in response to standing-up was reduced in dialyzed patients compared with nondialyzed patients. 3) Patients with autonomic dysfunction was older and had higher postdialysis concentration of plasma norepinephrine than those with normal autonomic function. 4) In dialyzed patients, predialysis concentration of plasma norepinephrine at rest varied widely and was significantly related to the duration of dialysis. Postdialysis concentration of norepinephrine was significantly correlated with the degree of parasympathetic damage. 5) There were no significant differences in autonomic damage or plasma catecholamines whether dialysis- induced hypotension and hypotension in chronic hemodialysis or not. CONCLUSION : Disturbances of autonomic nerve system are common in chronic renal failure with distinct abnormalities of parasympathetic function and additional sympathetic dysfunction. Elevated plasma norepinephrine seems to be related to the compensatory response of sympathetic nerve system to parasympathetic damage. Impairment of autonomic function does not appear specifically related to dialysis-induced hypotension or hypotension in chronic dialysis.
Autonomic Pathways ; Blood Pressure ; Catecholamines ; Dialysis ; Heart Rate ; Humans ; Hypotension ; Kidney Failure, Chronic* ; Norepinephrine ; Plasma ; Prevalence ; Reflex ; Renal Dialysis ; Valsalva Maneuver

Capsule endoscope is self-contained videoendoscopy device that transmit images of the gastrointestinal tract to an external receiver. Capsule endoscopy has become a very important tool for diagnosing of small bowel disorders. Upcoming capsule endoscopy techniques for the investigation of esophageal, stomach, and colon may render it promising technique for these organs as well. This document is intended to provide the principles by which credentialing organizations may create practical guidelines for granting privileges to perform capsule endoscopy. KSGE recommends that the use of capsule endoscopy be limited to practitioners already competent and privileged to perform standard upper and lower endoscopy and who have extensive experience viewing gastrointestinal mucosa. KSGE recommends additional specific training in capsule endoscopy as well as review of the 20 procedures to verify competence. KSGE also admitted formal fellowship training having a familiarity with the hardware and software systems and interpretation of the at least 10 cases under the supervision of professor in capsule endoscopy during GI fellowship.
Capsule Endoscopes ; Capsule Endoscopy ; Colon ; Credentialing ; Endoscopy ; Endoscopy, Gastrointestinal ; Fellowships and Scholarships ; Financing, Organized ; Gastrointestinal Tract ; Mental Competency ; Mucous Membrane ; Organization and Administration ; Recognition (Psychology) ; Stomach

OBJECTIVE: A general orientation along the cervical spine could be estimated by external landmarks, and it was useful, quick and less exposable to radiation, but, sometimes it gave reference confusion of target cervical level. The authors reviewed the corresponding between the neck external landmarks and cervical levels. METHODS: Totally 1,031 cervical lateral radiographs of different patients were reviewed in single university hospital. Its compositions were 534 of males and 497 females; 86 of second decades (10-19 years-old), 169 of third decades, 159 of fourth decades, 209 of fifth decades, 275 of sixth decades, and 133 of more than seventh decades (>60 years-old). Reference external landmarks (mandible, hyoid bone, thyroid cartilage, and cricothyroid membrane) with compounding factors were reviewed. RESULTS: The reference levels of cervical landmarks were C2.13 with mandible angle, C3.54 with hyoid bone, C5.12 with thyroid cartilage, and C6.01 with cricothyroid membrane. The reference levels of cervical landmarks were differently observed by sex, age, and somatometric measurement (height) accordingly mandible angle from C1 to C3, hyoid bone from disc level of C2 and C3 to C5, thyroid cartilage from disc level of C3 and C4 to C7, and cricothyroid membrane from C4 to disc level of C7 and T1. CONCLUSION: Surface landmarks only provide general reference points, but not correspond to exact levels of the cervical spine. Intraoperative fluoroscopy ensures a more precise placement to the targeted cervical level.
Female ; Fluoroscopy ; Humans ; Hyoid Bone ; Male ; Mandible ; Membranes ; Neck ; Spine* ; Thyroid Cartilage

OBJECTIVE: Homeostasis of the extracellular matrix (ECM) is maintained by the action of a specific system of proteolytic enzymes known as matrix metalloproteinases (MMP) and tissue inhibitors of metalloproteinases (TIMP). The MMP/TIMP system regulates the composition and turnover of ECM to control the site and extent of connective tissue remodeling. In pathologic conditions, MMP play a key role in degradation of basement membrane and extracellular matrix, and is responsible for cancer invasion, progression and metastasis. The aim of this study is to evaluate the correlation between expressions of MMP/TIMP and clinicopathologic factors in endometrial cancer. METHODS: Expressions of MMP-2, MMP-9, TIMP-1, and TIMP-2 were assessed by immunohistochemistry in a total of 55 endometrial cancers and were analyzed by the correlation between expressions of MMP/TIMP and clinicopathologic factors in endometrial cancer. RESULTS: Expression rates of MMP-2,-9, TIMP-1, and TIMP-2 were 71.7%, 54.9%, 41.2%, and 76.5% respectively. Expression of MMP-2 was correlated with the group of positive lymph node metastasis in endometrial cancer (p=0.04). Specially, coexpression of MMP-2 and TIMP-2 was significantly more frequent in the group of positive lymph node metastasis (p<0.01) and the group of positive peritoneal CONCLUSION: The expressions of MMP and TIMP were not a significant difference in survival analysis, but this study was recognized that the coexpression MMP-2 and TIMP-2 is correlated with lymph node metastasis and positive peritoneal cytology.
Basement Membrane ; Connective Tissue ; Endometrial Neoplasms ; Extracellular Matrix ; Female ; Homeostasis ; Immunohistochemistry ; Lymph Nodes ; Matrix Metalloproteinases ; Metalloproteases ; Neoplasm Metastasis ; Peptide Hydrolases ; Tissue Inhibitor of Metalloproteinase-1 ; Tissue Inhibitor of Metalloproteinase-2

In this article (J Korean Med Sci 2015; 30: 644-50), one author's name is misspelled. Correct Sung-Hun Im into Seong Hoon Lim.

BACKGROUND AND OBJECTIVES: Left ventricular hypertrophy (LVH) is associated with an increased risk of cardiovascular morbidity and mortality. Electrocardiography (ECG) is a widely available, simple and cost-effective screening method for the diagnosis of left ventricular hypertrophy. Since all the ECG criteria for LVH used for Koreans are based on ECG data from Caucasians, i.e., people whose body size is generally bigger than Koreans, its test accuracy may be low. The purpose of this study was to investigate by ECG the best cut-off value for LVH in terms of the left ventricular mass, as determined by echocardiogram. SUBJECTS AND METHODS: We investigated ECG and echocardiograms of 200 consecutive patients who visited the Korean University Anam Hospital. The sensitivity, specificity and diagnostic accuracy of the left ventricular mass for LVH, by the Sokolow-Lyon voltage criteria and Romhilt-Estes point score, were calculated and compared according to the cut-off values of 35, 40 and 45 mm and 3, 4 and 5 points, respectively. RESULTS: The sensitivities of the Sokolow-Lyon voltage criteria at 40 mm were slightly decreased (42.5, 37.5 and 8.8%; > or =35, > or =40, > or =45 mm), but the specificities and diagnostic accuracies were increased (specificities of 84.2, 95.0 and 99.2%, and diagnostic accuracies of 67.5, 72.0 and 63%; > or =35, > or =40, > or =45 mm). The sensitivities of a Romhilt-Estes point score of 4 points were slightly decreased (43.8, 37.5 and 13.8%; > or =3, > or =4, > or =5 points), but the specificities and diagnostic accuracies were increased (specificities 85.8, 94.2 and 98/3%, and diagnostic accuracies 69.0, 71.5 and 64.5%; > or =3, > or =4, > or =5 points). CONCLUSION: The Sokolow-Lyon voltage criteria at 40 mm or more and a Romhilt-Estes point score 4 points or more are appropriate ECG criteria for LVH in Koreans.
Body Size ; Diagnosis* ; Echocardiography* ; Electrocardiography* ; Humans ; Hypertrophy, Left Ventricular* ; Mass Screening ; Mortality ; Sensitivity and Specificity

PURPOSE: We examined the expressions of claudin-4 and E-cadherin, which are known as cell adhesion-associated proteins, in stomach cancer. The relationship of their expression with the clinicopathologic factors was examined to investigate the roles of these proteins in the invasion or metastasis of stomach adenocarcinoma. METHODS: The expressions of claudin-4 and E-cadherin were examined in 73 cases of adenocarcinoma of the stomach by performing immunohistochemical staining. RESULTS: The expressions of claudin-4 and E-cadherin in the stomach adenocarcinoma were both correlated with the histologic grade, the T-stage and nodal metastasis, respectively (P<0.05). The expression of claudin-4 was significantly associated with the expression of E-cadherin. CONCLUSION: Our data suggests that claudin-4 and E-cadherin are involved in the processes of histologic differentiation, invasion and metastasis of stomach adenocarcinoma.
Adenocarcinoma ; Cadherins* ; Claudin-4* ; Neoplasm Metastasis ; Stomach Neoplasms* ; Stomach*

OBJECTIVE: The high-dose vitamin C is useful in the cancer. Consequently its use should have become how many help even from gynecological cancer patient who is in chemotherapy. METHODS: The study was performed prospective on 57 patients who is diagnosed initially the gynecological cancer during chemotherapy at Gospel Hospital of Kosin University between January 2005 and October 2006. The study was divided to its use 29 (cervix cancer: 17, ovarian cancer 12) and no high-dose vitamin C use 28 (cervix cancer: 11, ovarian cancer 17). The cervix cancer was treated by FP chemotherapy for all stage and the ovarian cancer was treated by CC chemotherapy for stage 1, CT or PT chemotherapy for advanced stage for 6 times respectively regarding a treatment in tumor marker change aspect and the side effect researched GOG classifications. RESULTS: It evaluated the nausea and vomiting significantly in ovarian cancer (p<0.05). It evaluated for liver enzyme, Hb, WBC, platelet serum creatinine, sensory, motor nervous system and tumor marker with the high-dose vitamin C group does not have the difference from the control group statistically. CONCLUSION: The high-dose vitamin C is a possibility of reducing nausea and vomiting in the ovarian cancer chemotherapy without other side effect. The regarding a tumor marker change it was not significantly but when it analyzed a recurrence a survival rate with more patient and follow up in long period, its use of should have become how many help in gynecological cancer treatment.
Ascorbic Acid* ; Blood Platelets ; Classification ; Creatinine ; Drug Therapy* ; Follow-Up Studies ; Humans ; Liver ; Nausea ; Nervous System ; Ovarian Neoplasms ; Prospective Studies ; Recurrence ; Survival Rate ; Uterine Cervical Neoplasms ; Vitamins* ; Vomiting

BACKGROUND AND PURPOSE: Although thrombolytic strategies with streptokinase(STK) and tissue-type plasminogen activator(t-PA) in the treatment of acute myocardial infarction(AMI) have been studied in large-scale clinical trials in the western countries, such large-scale studies with urokinase(UK) are scanty. Even though UK is most commonly used thrombolytic agent for the treatment of AMI in Korea, there is no consensus on the dosage and the way of administration of UK in patients with AMI. Accordingly, a prospective clinical study was performed to evaluate the effects of thrombolytic strategies of intravenous double bolus method and standard double-infusion method with different dosage of UK in the treatment of AMI. SUBJECTS AND METHODS: Ninety there patients with AMI(male 75, female 18, age 57.5+/-10.8 years) were studied. The patients were divided into 3 groups according to dosage of UK and method of administration. Group I : 19 patients who received 1.5 million U of UK IV bolus, followed by 1.5 million U IV infusion for an hour(High Dose Group). Group II : 34 patients received 20,000U/kg body weight of UK IV bolus, followed by 20,000U/kg IV infusion for an hour(Double Dose Group). Group III : 40 patients received 1.5 million U of UK IV bolus and followed by 20,000U/kg IV bolus in 30 minutes with total dose of no more than 3 million U(Double Bolus Group). Coronary angiography(CAG) and left ventriculography(LVG) were performed 90 minutes after the administration of UK and post-AMI 7-10 days to investigate the patency of infarct-related artery(IRA) and LV function. Patency of IRA was graded according to the extent of flow of IRA. TIMI grade 0-1 was regarded as occluded, and grade 2-3 flow as patent. LV ejection fraction(EF) by echocardiography was measured on day 1, day 7-10 and 1 month after AMI. Indirect clinical parameters of thrombolysis were evaluated and were compared with CAG findings. RESULTS: 1) The 90 minutes IRA patency in Group III(Double bolus ; 79.0%) was higher than that in Group 1, but showed no statistically significant difference(High dose ; 61.5%, p=0.790). The 90 minutes IRA patency in Group III showed borderline significance with Group II(Double dose ; 57.1%, p=0.057). TIMI flow III in Group III(60.6%) was significantly higher than that in Group II(53.6%, p=0.0468) but showed no statistically significant difference with Group I(61.5%, p=0.158). 2) The EF by LVG were 49.1% in Group I, 41.7% in Group II and 49.2% in Group III. The difference in EF between Group I and Group III vs Group II was significant(p=0.008 in Group I, p=0.014 in Group III vs Group II). 3) Fatal bleeding complications(1 intracranial hemorrhage and 1 gastric ulcer bleeding) developed in Group II (Double dose). 4) Pain to door time, pain to needle time and door to needle time tended to be shorter in open(TIMI flow II-III) IRA group than in closed IRA group. 5) Initial EF were similar between open IRA group and closed IRA group(46.1% and 42.1% ; p=NS). The EF of open IRA group measured by LVG on initail coronary angiography(41.8% in closed IRA vs 48.0%, in open IRA, p=0.03) and by 2D-Echo on 7-10 day(41.7% in closed IRA vs 51.0% in open IRA, p=0.004) were better than those of closed IRA group. 6) Indirect clinical indices of reperfusion such as mean CPK peak, time to CPK peak significantly lower in open IRA group than in closed IRA group. 7) Fatal bleeding complications(1 intacranial hemorrhage and 1 gastric ulcer bleeding) developed in closed IRA group. CONCLUSION: The findings we observed in this trial showed that earlier initiation and more rapid infusion of UK were associated with more increased 90min patency of infarct-related artery and more improved LV function without any obviously increased bleeding complications or other serious life-threatening complications than conventional UK therapy. Specifically, double bolus IV injection of UK(1.5 million U bolus followed by 20,000 U/Kg bolus in 30min)was more effective method of thrombolysis than conventional method for achieving optimal reperfusion in AMI patients. Also, IRA patency at 90 minutes after the initiation of thrombolysis was important in preserving global LV function in early recovery phase of AMI. Further trials may be needed to determine more effective thrombolysis with UK in AMI.
Arteries ; Body Weight ; Consensus ; Echocardiography ; Female ; Hemorrhage ; Humans ; Intracranial Hemorrhages ; Korea ; Myocardial Infarction* ; Needles ; Plasminogen ; Prospective Studies ; Reperfusion ; Stomach Ulcer ; Urokinase-Type Plasminogen Activator*