OBJECTIVE: To evaluate the additive effects of hyaluronidase combined with steroids in patients with peri-articular shoulder disorder. METHOD: Thirty patients with peri-articular shoulder disorder were given subacromial bursa injections once a week for three consecutive weeks. Fifteen patients (Group A) underwent subacromial bursa injections with hyaluronidase 1,500 IU, triamcinolone 40 mg and 0.5% lidocaine (total 6 ml). Another fifteen patients (Group B) underwent the same injections with triamcinolone 40 mg and 0.5% lidocaine (total 6 ml). We examined the active range of motion (AROM) in the shoulder, used a visual analogue scale (VAS) for measurement, and administered a shoulder disability questionnaire (SDQ) at the commencement of the study and then every week until one week after the third injection. RESULTS: There were no significant difference between group A and B before the injections took place (p>0.05). Statistically significant improvement was seen in the VAS, SDQ, and AROM of flexion, abduction, internal rotation at one week after the first and second injections compared with the parameters measured at previous visits in both groups (p<0.05), except the SDQ between one week after the first and second injections in group B (p>0.05). Improvement in all parameters measured at one week after the third injection compared with the measurement values at one week after the second injection were not statistically significant in both groups (p>0.05). However, group A (the hyaluronidase group) showed significantly greater improvements than group B in terms of their SDQ and AROM of internal rotation scores one week after the three injections had taken place (p<0.05). CONCLUSION: Peri-articular shoulder disorder patients who underwent subacromial bursa injections using hyaluronidase and steroids showed greater functional improvements than those who were given only steroid injections.
Humans ; Hyaluronoglucosaminidase ; Hypogonadism ; Lidocaine ; Mitochondrial Diseases ; Ophthalmoplegia ; Range of Motion, Articular ; Shoulder ; Steroids ; Triamcinolone ; Surveys and Questionnaires

OBJECTIVE: To investigate the additive effect of sono-guided subacromial bursa injection of hyaluronate with steroid in patients with peri-articular shoulder disorders. METHOD: This prospective randomized controlled trial involved 26 patients who had shoulder pain. Group A, consisting of 13 patients, was treated with a sono-guided subacromial bursa injection containing a mixture of 0.5% lidocaine (5 ml) and triamcinolone 40 mg (1 ml), followed by injection with sodium hyaluronate (2 ml) once a week for 3 weeks. The other 13 patients (Group B) were treated with a sono-guided subacromial bursa injection containing a mixture of 0.5% lidocaine (5 ml) and triamcinolone 40 mg (1 ml) once a week for 3 weeks. The effects were assessed using a visual analogue scale (VAS) of shoulder pain, active range of motion (AROM), shoulder function assessment scale (SFA), shoulder disability questionnaire (SDQ) at study entry and every week from first injection until 4 weeks after the 1st injection (= 2 weeks after 3rd injection). RESULTS: (1) Demographic features and all parameters measured before injection did not show a significant difference between the 2 groups. (2) Statistically significant improvements were shown in VAS, SFA, SDQ during the 1st, 2nd, and 4th week after the first injection in both groups (p<0.05). (3) SFA showed significant improvement at 1 week after injection only in group A (p<0.05). (4) AROM of internal rotation showed significant improvement at week 4 after the 1st injection only in group A (p<0.05). CONCLUSION: Subacromial bursa injection of hyaluronate with steroid in patients with peri-articular shoulder disorders has additive effects on functional improvement of the affected shoulder, including the AROM of internal rotation.
Humans ; Hyaluronic Acid ; Lidocaine ; Prospective Studies ; Range of Motion, Articular ; Shoulder ; Shoulder Pain ; Triamcinolone ; Surveys and Questionnaires

OBJECTIVE: To investigate the effect of botulinum toxin type A (BTXA) on drooling and the morphologic change of the salivary gland in patients with cerebral palsy. METHOD: Eight cerebral palsy patients suffering from severe drooling participated in this study. BTXA was injected into both submandibular and parotid glands under intravenous sedation and with ultrasound guidance (1 unit/gland/kg: maximum 100 units) in an outpatient or inpatient procedure. The severity of drooling was measured before injection and 3 weeks after injection using the Teacher Drooling Scale, the Drooling Score-severity, frequency and the Visual Analog Scale. To investigate the morphologic change of the salivary glands, the size of salivary glands were measured before injection and 3 weeks after injection using computed tomography of the neck. The measurement values were analyzed by Wilcoxon signed rank test. RESULTS: Statistically significant improvements were shown in all three parameters for assessing the severity of drooling after BTXA injections (p<0.05). Size of the salivary glands were significantly decreased at 3 weeks after BTXA injection (p<0.05). CONCLUSION: Salivary gland injection with BTXA could be a useful treatment method to reduce drooling in patients with cerebral palsy and decreased size of salivary glands may partially explain the mechanism.
Botulinum Toxins ; Botulinum Toxins, Type A ; Cerebral Palsy ; Humans ; Inpatients ; Neck ; Outpatients ; Parotid Gland ; Salivary Glands ; Sialorrhea ; Stress, Psychological

In order to prepare the fundamental data for the health promotion by assessing the exposure level of styrene, the author determined the concentration of mandelic acid and phenylglyoxylic acid in urine of 42 workers who were exposed to styrene by high performance liquid chromatography and surveyed 16 symptoms, by questionnaire and also tested neurobehavioral test(digit symbol, benton visual retention) in 2 FRP plants of Kyung Nam area from July to September, 1995. Control was sampled by age sex matching method. The concentration of styrene in air was determined by gas chromatography. The results were as follows; 1. Geometric mean concentration of styrene in air was 17.4ppm, geometric mean concentration of mandelic acid(MA) in urine were 404.3mg/g creatinine for exposure group, 46.4mg/g creatinine for control group, geometric mean concentration of phenylglyoxylic acid(PGA) in urine were 57.5mg/g creatinine for exposure group, 9.5mg/g creatinine for control group. Mean concentration of MA and PGA showed statistically significant difference between exposure group and control group(p<0.01). 2. Number of symptom were 2.9 for exposure group, 3.3 for control group, number of digit symbol were 24.1 for exposure group, 32.5 for control group, number of Benton visual retention test were 6.1 for exposure group, 6.0 for control group, respectively. As result of adjusting the education year, number of Benton visual retention test showed statistically significant difference between exposure group and control group(p<0.05). 3. Excellent correlation were observed between environmental styrene exposure and urinary MA(r=0.80), PGA(r=0.73), and MA+PGA(r=0.81).
Chromatography, Gas ; Chromatography, Liquid ; Creatinine ; Education ; Health Promotion ; Surveys and Questionnaires ; Styrene*

Alveolar Bone Loss ; Follow-Up Studies ; Glutamates ; Guanine ; Humans ; Incisor ; Molar ; Organothiophosphorus Compounds ; Prognosis ; Retrospective Studies ; Tooth ; Pemetrexed

PURPOSE: Laparoscopic gastric wedge resection is a standard treatment for removing gastric submucosal tumors (SMTs). So far, however, there have been few reports of single-incision laparoscopic intragastric wedge resection. Our aim was to describe this procedure and our experience with it. METHODS: From January 2010 to December 2013, a total of 21 consecutive patients with gastric SMTs underwent single-incision intragastric resection at our institution. Their clinicopathologic data were analyzed retrospectively. RESULTS: The patients consisted of nine men and 12 women with a mean age of 51.9 +/- 12.9 years (22-69 years). Their mean body mass index was 22.6 +/- 2.0 kg/m2. Mean tumor size was 2.4 +/- 0.7 cm, with the following anatomic distribution: esophagogastric junction in three patients, fundus in twelve, upper body in three, and lower body in two. Mean operating time was 68.6 +/- 12.0 minutes. There were no conversions to open surgery and no major intraoperative complications. Time to resumption of water intake was 1.4 +/- 0.5 days. Mean hospital stay was 4.9 +/- 1.7 days. There were no recurrences or deaths during the mean 19-month follow-up. CONCLUSION: Single-incision intragastric wedge resection is a feasible and safe procedure. It is especially efficient for treating small endophytic gastric SMTs located on the upper and mid portion of the stomach.
Body Mass Index ; Drinking ; Esophagogastric Junction ; Female ; Follow-Up Studies ; Gastrectomy ; Gastric Mucosa ; Gastrointestinal Stromal Tumors ; Humans ; Intraoperative Complications ; Laparoscopy ; Length of Stay ; Male ; Recurrence ; Retrospective Studies ; Stomach ; Stomach Neoplasms

The object of this study is to measure the transit time and passage rate of capsule endoscopy (CE) in the gastrointestinal tract in medium sized beagle dogs (7~13 kg). Animals were divided into four groups: only capsule (group 1, n=10), capsule+water (group 2, n=10), mettoclopramide+capsule (group 3, n=10), metoclopramide +capsule+water (group 4, n=10). The capsule transit times through the stomach and small bowel were evaluated by radiography findings. Gastric transit time (GTT), small intestinal transit time (SITT) and complete passage rate were measured in four groups. GTT's for each group were as follows; 45+/-20 min (group 1), 117+/-35 min (group 2), 150+/-40 min (group 3), and 154+/-65 min (group 4), while SITT's were 75+/-20 min (group 1), 195+/-55 min (group 2), 70+/-15 min (group 3), and 76+/-15 min (group 4). The complete passage rates were 20% (group 1), 40% (group 2), 20% (group 3), 50% (group 4). In all groups, if CE could pass through the pylorus, it passed all small intestinal tracts within 8 hours (battery life). Administration of water helped CE to pass pylori, except in case of metoclopramide administration. These results indicate that CE could be an useful tool for examining gastrointestinal diseases in the veterinary medicine.
Animals ; Capsule Endoscopy ; Dogs ; Gastrointestinal Diseases ; Gastrointestinal Tract ; Gastrointestinal Transit ; Metoclopramide ; Pylorus ; Stomach ; Veterinary Medicine ; Water

BACKGROUND AND OBJECTIVES: Asian sand dust (ASD) is a meteorological phenomenon that occurs in spring time in Korea. ASD is composed of various organic and inorganic materials, which induce airway inflammation. MUC4 is an important membrane-bound mucin gene in the human airway, and its expression is increased in pathologic proliferative lesions such as nasal polyps. However, the effect of ASD on MUC4 in human airway epithelial cells is unclear. Therefore, this study aimed to investigate the effect and signaling pathway of ASD on MUC4 expressions in human airway epithelial cells. METERIALS AND METHOD: The effect and signaling pathway of ASD on MUC4 expressions were investigated in NCI-H292 cells and in the primary cultures of human nasal epithelial cells using reverse transcription-polymerase chain reaction, real-time polymerase chain reaction, enzyme immunoassay, and immunoblot analysis with several specific inhibitors and small interfering ribonucleic acid (siRNA). RESULTS: ASD induced MUC4 expression and the activated the phosphorylation of extracellular signal-regulated kinase 1/2 (ERK1/2) and p38 mitogen-activated protein kinase (MAPK). An ERK1/2 MAPK inhibitor and a p38 MAPK inhibitor inhibited the ASD-induced MUC4 expression. In addition, the knockdowns of ERK1, ERK2 and p38 MAPK by the respective siRNA blocked the ASD-induced MUC4 mRNA expression. ASD induced toll-like receptor 4 (TLR4) mRNA expression. The knockdown of TLR4 by TLR4 siRNA blocked the phosphorylation of ERK1/2 and p38 MAPK, and the ASD-induced MUC4 mRNA expression. CONCLUSION: These results show that ASD induces MUC4 expressions via TLR4-dependent ERK1/2 and p38 MAPK signaling pathway in human airway epithelial cells.
Asian Continental Ancestry Group* ; Dust* ; Epithelial Cells* ; Humans ; Humans* ; Immunoenzyme Techniques ; Inflammation ; Korea ; Methods ; Mucins ; Nasal Polyps ; p38 Mitogen-Activated Protein Kinases ; Phosphorylation ; Phosphotransferases ; Protein Kinases ; Real-Time Polymerase Chain Reaction ; RNA ; RNA, Messenger ; RNA, Small Interfering ; Toll-Like Receptor 4

PURPOSE: To analyze postoperative complications for gastric cancer patients undergoing laparoscopic gastrectomy in single institution over long period of time. METHODS: The data of 1332 consecutive patients undergoing laparoscopic gastrectomy for gastric cancer at a single institution from January 2007 to December 2015 were reviewed. The patients were classified into the early or late surgery group; the initial 100 cases were classified as the initial group. We compared between the two groups and analyzed risk factors for postoperative complications. RESULTS: A total of 265 postoperative complications occurred in 223 patients (16.7%). Major complications occurred in 38 patients (2.9%) including 1 death (0.1%). Operative time and hospital stay were significantly shorter in the late group. Blood loss was greater in the initial group. Sex, comorbidity, tumor location, D2 LND, operative method, non B-I anastomosis, co-resection, long operative time, and blood loss were significant risk factors for overall postoperative complication. In the multivariate analysis, male sex, comorbidity, D2 lymph node dissection, total or proximal gastrectomy, non B-I anastomosis, co-resection, operative time and blood loss were associated with postoperative overall complications. CONCLUSION: Sex, co-morbidity, D2 LND, operative method, co-resection, operative time and blood loss revealed as the risk factor of overall postoperative complication. And there was no significant differences of risk factor related to postoperative complication between initial and maturation surgical period. This suggests that beginners also can safely perform laparoscopic gastrectomy through the appropriate patient selection.
Comorbidity ; Gastrectomy* ; Humans ; Laparoscopy ; Length of Stay ; Lymph Node Excision ; Male ; Methods ; Multivariate Analysis ; Operative Time ; Patient Selection ; Postoperative Complications* ; Risk Factors ; Stomach Neoplasms*

BACKGROUND AND OBJECTIVES: Roflumilast, a selective inhibitor of phosphodiesterase type 4, has an anti-inflammatory property. It has been used in the treatment of chronic inflammatory airway diseases such as chronic obstructive pulmonary disease and asthma. However, the effect of roflumilast on mucus secretion in inflammatory airway epithelial cells has not been reported. Therefore, this study was aimed at investigating the effects of roflumilast on the inflammatory mediator-induced MUC5AC and MUC5B expression in human airway epithelial cells. MATERIALS AND METHOD: In human mucin-producing NCI-H292 airway epithelial cells and primary cultures of nasal epithelial cells, the effects of roflumilast on lipopolysaccharide (LPS)- and phorbl-12-myrsitate-13-acetate (PMA)-induced MUC5AC and MUC5B expression were analyzed by reverse transcription polymerase chain reaction and enzyme-linked immunosorbent assay. RESULTS: Roflumilast attenuated LPS-induced MUC5AC and MUC5B mRNA and glycoprotein expression in NCI-H292 cells. And roflumilast attenuated PMA-induced MUC5AC and MUC5B mRNA and glycoprotein expression in NCI-H292 cells. In addition, roflumilast attenuated LPS and PMA-induced MUC5AC and MUC5B mRNA expression in the primary cultures of nasal epithelial cells. CONCLUSION: These results suggest that roflumilast attenuates MUC5AC and MUC5B expressions in airway epithelial cells. Roflumilast may be a potentially ideal therapeutic agent for the control of mucus-hypersecretion in treating chronic inflammatory airway diseases.
Asthma ; Enzyme-Linked Immunosorbent Assay ; Epithelial Cells* ; Glycoproteins ; Humans ; Mucus ; Polymerase Chain Reaction ; Pulmonary Disease, Chronic Obstructive ; Reverse Transcription ; RNA, Messenger