PURPOSE: Inidence of recurrent common duct stones reported approximately 20% for a second operation, and with even higher rate following subsequent reoperation. However, the factors contributing to recurrent stones have not well defined. Some authors have reported on association of juxtapapillary diverticula with recurrent biliary stones. We have studied to assess the clinical significance of coexisting PAD on recurrent common bile duct stones and to establish the rational operative procedure in primary or recurrent common duct stones with coexisting PAD. METHODS: Medical records of 456 consecutive patients (Feb. 1993~Aug. 2002) who performed ERCP for biliary symptoms were reviewed. We comparative study retrospectively have done between patients with and without PAD on recurrence of common duct stones and outcome of treatment. RESULTS: Incidence of PAD was 15.1% on ERCP, and increased in the old aged patients. Incidence of biliary stone in PAD group was higher than that of non-PAD group (73.9% vs. 50.6%), and gall stone involving common duct was more prevalent in PAD group than non-PAD group. PAD group showed higher stone recurrence rate (23.5% vs. 6.1%) and earlier recurrence following conventional treatment, and needs more multiple treatments, compared with non-PAD group. Intradiverticular papillae (IDP) type showed higher stone recurrence, compared with juxtapapillary diverticula (JPD) type (36.8% vs. 15.6%). CONCLUSION: PAD would be one of important contributing factors for development and recurrence of common bile ductstones. So rational operative procedure for primary or recurrent common duct stones with coexisting PAD should include extirpation of PAD, particulary in IDP type.
Bile ; Cholangiopancreatography, Endoscopic Retrograde ; Common Bile Duct* ; Diverticulum* ; Gallstones ; Humans ; Incidence ; Medical Records ; Recurrence ; Reoperation ; Retrospective Studies ; Surgical Procedures, Operative

Respiratory syncytial virus (RSV) and Influenza virus are the most common pathogen for causing severe upper respiratory infection in all age groups. A multiplex reverse transcription polymerase chain reaction (RT-PCR) has been developed to detect and subtype influenza A (H3N2 and H1N1), B virus and RSV simultaneously in one tube reaction. Amplification with primers derived from conserved sequences within the nucleocapsid for RSV and hemagglutinin subunit for Influenza A (H3N2 and H1N1) and B viruses yielded a 384 bp, a 300 bp, a 236 bp and a 151 bp, respectively. Assay specificity was confirmed by pulse field gel electrophoresis and autosequencing method. Assay sensitivity was 3 PFU/ml of RSV, 22 PFU/ml, 45 PFU/ml of Influenza type A (H3N2 and H1N1) and 6.6 PFU/ml of Influenza B virus by plaque assay. A rapid and sensitive detection method of a one-tube with multiplex RT-PCR capable of identifying more than one viral template as well as synchronizing reverse transcription and PCR had the potential to produce considerable savings of time and cost effectiveness in the diagnostic laboratory.
Conserved Sequence ; Cost-Benefit Analysis ; Electrophoresis ; Hemagglutinins ; Herpesvirus 1, Cercopithecine ; Humans* ; Income ; Influenza B virus ; Influenza, Human* ; Nucleocapsid ; Orthomyxoviridae* ; Polymerase Chain Reaction* ; Respiratory Syncytial Virus, Human* ; Respiratory Syncytial Viruses ; Reverse Transcription* ; Sensitivity and Specificity

A prospective study was carried out to evaluate the validity of TROPT troponin T rapid assay in early diagnosis of acute myocardial infarction(AMI) in patients with ischemic chest pain, in comparison with conventional diagnostic tools such as serum troponin T(c-TnT) level, creatine Kinase(CK), CK-MB level and initial EKG finding. The study was performed at the emergency department(ED) of Yong Dong Severance hospital from March 1st 1996 to February 28th 1997. One hundred eighty one patients visiting ED with chief complaint of atraumatic chest pain within 24 hours of visit were eligible for the study. Those who lacked enough data collection and those who had chest paint of noncardiac origin and EKG of PSVT were excluded from the study. The overall study population was a total of 131 patients. Initial EKG, TROPT rapid assay, CK, CK-MB and c-TnT level were obtained simultaneously. Diagnosis of AMI was made according to the international diagnostic criteria for AMI. Of the 131 patients 61 patients(46.6%) were diagnosed as AMI. Within 4 hours of their symptom onset, initial EKG showed the highest sensitivity(63.2%) whereas the sensitivities of TROPT rapid assay, c-TnT, CK and CK-MB were poor(0-0.7%). From 4-8 hours, the sensitivities of c-TnT, CK and CK-MB were higher than that of TROPT rapid assay(80% vs. 30%). The sensitivites of TROPT rapid assay, c-TnT, CK and CK-MB rose over time and reached 100% after 8 hours symptom onset. The specificities of the TROPT rapid assay, c-TnT, CK & CK-MB and EKG were all 100% within 8 hours after symptom onset. Discrepancy between TROPT rapid assay and c-TnT was noted in nine patients(6.9%). In this study TROPT rapid assay was valuable in the diagnosis of AMI after 8 hours of symptom onset.
Chest Pain* ; Creatine ; Data Collection ; Diagnosis ; Early Diagnosis ; Electrocardiography ; Emergencies ; Humans ; Paint ; Prospective Studies ; Thorax* ; Troponin ; Troponin T

Eight patients, with brain abscess or localized cerebritis proved histologically, were seen at The National Medical Center from 1971 to 1972, and 3 died, which is 37.5% mortality. Evidence of infection was often minimal in patients with brain abscess. The presence of increased erythrocyte sedimentation rate, highly suggestive of a cerebral abscess when an intracranial space-occupying lesion is suspected. The cerebral angiography and EEG were the best diagnostic tests. Early accurate diagnosis and early intracranial relieving with surgical procedure were most important factor in management of brain abscess. Primary excision of the abscess was considered to be the most satisfactory therapy.
Abscess ; Blood Sedimentation ; Brain Abscess* ; Brain* ; Cerebral Angiography ; Diagnosis ; Diagnostic Tests, Routine ; Electroencephalography ; Humans ; Mortality

PURPOSE: Diagnosis of acute abdomen in infants and children is difficult. The aim of this study is to evaluate the usefulness of sonography in the children suffering from acute abdominal pain. METHODS: From January 2001 through July 2002, abdominal sonography was carried out in 265 children who had abdominal pain, vomiting, or irritability. The suspected diagnosis were acute appendicitis, intussusception, congenital pyloric obstruction, inguinal hernia, and illeocolitis. Medical records were reviewed retrospectively for age, sex, sonographic diagnosis, and the impact of the sonography in the treatment was evaluated by comparing the sonographic diagnosis with the final diagnosis (guidance for treatment). RESULTS: Among 265 patiens, the sex ratio (male:female) was 1.7:1. According to the findings of sonographic studies, mesenteric lymphadenitis (40.8%) was the most common diagnosis and was followed by acute appendicitis (21.9%), normal abdomen (19.2%), intussusception (14.3%), ileus (3.4%), and epididymitis (0.4%). In 259 of the 265 patients, sonography helped guideline for treatment (97.7%). CONCLUSION: Sonography is very useful in the diagnosis and establishing the treatment guideline of pediatric patients with acute abdomen.
Abdomen ; Abdomen, Acute* ; Abdominal Pain ; Appendicitis ; Child ; Diagnosis ; Emergencies* ; Epididymitis ; Hernia, Inguinal ; Humans ; Ileus ; Infant ; Intussusception ; Male ; Medical Records ; Mesenteric Lymphadenitis ; Retrospective Studies ; Sex Ratio ; Ultrasonography ; Vomiting

Pneumatosis cystoides intestinalis is a rare condition which is characterized by multiple gas-filled cysts of varying sizes in the wall of the gastrointestinal tract. In 85% of the cases, it is associated with gastrointestinal, pulmonary, and connective tissue diseases or with other conditions. In about 15% of the cases, the etiology remains obscure. In most cases, the prognosis is poor, so early diagnosis and treatment are required. We report two cases of primary pneumatosis cystoides intestinalis with portal venous gas which were associated with alcoholism and diabetes mellites and which were complicated by pneumoperitoneum and panperitonitis.
Alcoholism ; Connective Tissue Diseases ; Early Diagnosis ; Gastrointestinal Tract ; Pneumatosis Cystoides Intestinalis* ; Pneumoperitoneum ; Portal Vein ; Prognosis

PURPOSE: This study was designed to evaluate the clinical charateristics, surgical treatment and outcome of carcinoid tumors of the rectum. METHODS: A retrospective review of the charts of all patients treated for rectal carcinoid tumors at Kangbuk Samsung Medical Center between Jan 1989 and April 1998. Thirteen patients with rectal carcinoids tumors were treated. Follow-up data, histopathological information and surgical procedures were obtained from case notes. RESULTS: There were 10 men and 3 women. The ages ranged from 28 to 60 years (mean 41.1 years for all, 43.8 years for men and 32 years for women). Eight patients (61.5%) had no symptoms. Of the five patients, four complained of rectal bleeding (30.8%), and one complained of defecational difficulty (7.7%). Size of rectal carcinoid tumor was less than 1 cm in 7 patients (53.8%), between 1 cm and 2 cm in 2 patients (15.4%), in four patients (30.8%) larger than 2 cm. Three patients were treated in Abdominoperineal resection. Two patients underwent stapled low anterior resection. The remaining 8 patients underwent conservative resection (3 colonoscopic polypectomy and electrocauterization, 2 colonoscopic snaring biopsy, 2 transanal resection and one Mason's operation). The depth of invasion was contained within sutmucosa in 3 patients. Liver metastasis was found in 2 patients. Average follow-up time was 35.6 months. Two patients died of mutiple mestastasis (liver, bone, peritoneum) 9 and 30months later. CONCLUSION: We concluded that tumors smaller than 1 cm could be managed by local treatment whereas larger than 2 cm should be managed by radical treatment.
Biopsy ; Carcinoid Tumor* ; Female ; Follow-Up Studies ; Hemorrhage ; Humans ; Liver ; Male ; Neoplasm Metastasis ; Rectum ; Retrospective Studies ; SNARE Proteins

PURPOSE: Citron seed oil (CSO) has been reported to have high antioxidant activity. However, the composition and other biologically activities of CSO have not been reported. In this study, we confirmed the fatty acid composition of CSO, which may be beneficial to vascular disease and obesity. METHODS: We investigated the oil composition of CSO using gas chromatography coupled with mass spectrometry (GC-MS) analysis, and cytotoxicity was confirmed by Cell Counting Kit-8 (CCK-8) assay. Nitric oxide (NO) production in human umbilical vein endothelial cells (HUVECs) was measured using Griess reagent, and lipid accumulation and leptin secretion in 3T3-L1 cells were measured by Oil-Red O staining and commercial ELISA kit, respectively. RESULTS: GC-MS analysis indicated that CSO contains several components, including linoleic acid, oleic acid, palmitic acid, stearic acid, linolenic acid, palmitoleic acid, and arachidic acid. In physiological activity analysis, CSO did not induce cytotoxic effects in HUVECs and 3T3-L1 cells. Further, CSO significantly induced nitric oxide and leptin secretion as well as inhibited lipid accumulation. CONCLUSION: CSO increased NO release, inhibited lipid accumulation, and induced leptin secretion, suggesting it may be useful for the management of vessels and weight gain. Although further studies are required to investigate the safety and mechanism of action of CSO, our results show that the composition and physiological activity of CSO are sufficient for its use as functional edible oil.
3T3-L1 Cells ; alpha-Linolenic Acid ; Cell Count ; Chromatography, Gas ; Enzyme-Linked Immunosorbent Assay ; Human Umbilical Vein Endothelial Cells ; Leptin* ; Linoleic Acid ; Mass Spectrometry ; Nitric Oxide* ; Obesity

This study was conducted in order to compare the biological activities of leaf and root water extracts of Smilax china L. (SC) by measuring the total polyphenol and flavonoid contents, anti-oxidant activity, inhibitory effect on alpha-glucosidase, and anti-inflammatory gene expression. The total polyphenol and flavonoid contents of SC leaf (SCLE) and root (SCRE) water extracts were 127.93 mg GAE/g and 39.50 mg GAE/g and 41.99 mg QE/g and 1.25 mg QE/g, respectively. The anti-oxidative activities of SCLE and SCRE were measured using the 1,1-diphenyl-2-picrylhydrazyl (DPPH) and 2,2'-azino-bis(3-ethylbenzothiazoline-6-sulfonic acid) diammonium salt (ABTS) radical scavenging activity assay and reducing power assay. Both SCLE and SCRE scavenged radicals in a concentration-dependent manner, and SCLE showed stronger radical scavenging activity and reducing power than SCRE; however, both SCLE and SCRE exhibited lower activities than ascorbic acid. Compared to the anti-diabetic drug acarbose, which was used as a positive control, SCLE and SCRE exhibited low alpha-glucosidase inhibition activities; nevertheless, the activity of SCLE was 3.7 fold higher than that of SCRE. Finally, SCLE caused significantly decreased expression of the LPS-induced cytokines, iNOS, and COX-2 mRNA in RAW264.7 cells, indicating anti-inflammatory activity. These results indicate that SCLE might be a potential candidate as an anti-oxidant, anti-diabetic, and anti-inflammatory agent.
Acarbose ; alpha-Glucosidases ; Ascorbic Acid ; Biphenyl Compounds ; China ; Cytokines ; Gene Expression ; Picrates ; RNA, Messenger ; Smilax ; Water

OBJECTIVES: This study aims to find differences that reflect the magnitude of health disparities in wage workers in Korea according to income index(personal income, household income, equivalized income) by gender. METHODS: Data was obtained from the 11th wave of Korean Labor and Income Panel Survey in 2008. This study analyzed 4,205 subjects(2,570 males and 1,635 females) aged 19-65 years. To compare the health effects of each income index by gender, unconditional multiple logistic regression, health-related behaviors, and working conditions were used. The unconditional multiple logistic regression was adjusted by socio-demographic characteristics. All statistics were estimated using SAS survey procedures. RESULTS: According to unconditional multiple logistic regression, significant differences in ORs between men and women were observed in this study for those wage workers who self-rated their health status to be poor. This was consistent between each income index. Men had an OR of 1.76 (95% CI, 1.28~2.43) by personal income, 1.70 (95%CI, 1.25~2.32) by household income and 1.69 (95% CI, 1.23~2.31) by equivalized income. Women had an 2.09 (95% CI, 1.47~2.97) by household income and OR of 1.95 (95% CI, 1.36~2.79) by equivalized income, but personal income did not have a significant effect on OR for women. CONCLUSIONS: The study of occupational and environmental medicine should consider that each income index has different effects on the self-rated health status according to gender. Household income index and equivalized income index would represent a health status for women.
Aged ; Electrolytes ; Environmental Medicine ; Family Characteristics ; Female ; Humans ; Korea ; Logistic Models ; Male ; Phenothiazines ; Salaries and Fringe Benefits ; Socioeconomic Factors