No abstract available.
Muscle, Smooth* ; Relaxation*

Cervical pregnancy is a rare form of ectopic gestation in which the blastocyst implants in the cervical mucosa below the histologic cervical os. Because of the serious vaginal bleeding, hysterectomy was usually done in the management of cervical pregnancy. Howerver, conservative treatment is desirable for women who want to be pregnancy in the future. Methotrexate has been utilized recently for conservative management of cervical pregnancy. We report a case of cervical pregnancy which was treated succesfully with intramuscular methotrexate injection.
Blastocyst ; Female ; Humans ; Hysterectomy ; Methotrexate* ; Mucous Membrane ; Pregnancy* ; Uterine Hemorrhage

No abstract available.
Cytosine Deaminase* ; Cytosine* ; Genetic Therapy* ; Osteocalcin* ; Prostate* ; Prostatic Neoplasms*

PURPOSE: The aim of this study was to evaluate the efficacy of a combination therapy with PDE5 inhibitor and testosterone replacement therapy in erectile dysfunction patients with testosterone deficiency syndrome (TDS) after failure of PDE5 inhibitor mono-therapy. MATERIALS AND METHODS: From March 2004 to July 2008, we evaluated 38 men (aged 38 to 69 years) who showed no response to PDE5 inhibitor therapy at the maximal recommended dose and they had testosterone levels less than 350ng/dL. Testosterone replacement therapy (TRT) was subsequently started with injectable testosterone undecanoate (NEBIDO(R)) or transdermal testosterone (Testogel(R)) in those patients. They received TRT during an 18-week period. After 14 weeks of TRT alone, PDE5 inhibitor was added to the TRT for an additional 4 weeks. After treatment, we evaluated the patients' sexual function, which was primarily based on the International Index of Erectile Function (IIEF), and the serum testosterone levels. RESULTS: All patients showed elevated serum testosterone levels after TRT (range: 212 to 662ng/dl, mean level: 362.19 ng/dl). At week 18, almost all of the men reported improved potency with combination therapy. After treatment, the mean total IIEF score and each sub-domain score were increased significantly compared to the baseline score. CONCLUSIONS: Testosterone replacement therapy combined with PDE5 inhibitor may be beneficial in improving the erectile function in testosterone deficiency syndrome patients with erectile dysfunction and who are unresponsive to PDE5 inhibitor alone.
Erectile Dysfunction ; Humans ; Hypogonadism ; Male ; Testosterone

PURPOSE: The purpose of this study was to examine the academic achievement of the first year medical students at Gachon University of Medicine and Science based on their characteristics (i.e. age, gender, and academic degree types (bachelors/masters), field of major (biology/ non-biology), and admission variables (i.e. MEET, GPA, attitude, interview, and English test). METHODS: The admission scores and demographic information were obtained from 39 students who had entered the university in 2005. T-test was used to examine the differences in academic achievement according to the students' characteristics. Correlations between admission variables and academic achievements were examined while multiple regression analysis was used to decipher the influence of students' characteristics and admission variables on the academic achievements. RESULTS: This study showed that the academic achievements differed significantly depending on degree level, age, and field of study, but not gender. It was also found that both the Nature Science Reasoning (NSR) of MEET subscale score and GPA score correlated significantly with academic achievement in the first year students. Attitude, interview, and English test scores did not correlate significantly. The result of the multiple regression analysis revealed that NSR 1 and 2, field of major, and age accounted for a substantial amount of the variance in academic achievement. CONCLUSION: Students with higher scores in NSR 1 and 2 who majored in biology-related fieldsand who are younger tend to do better academically in their first year of medical school. The results of this study may be helpful to graduate medical schools in designing effective admissions strategies for recruiting students, as well as, in planning the curriculum to improve the academic achievements of medical students.
Curriculum ; Humans ; Schools, Medical* ; Students, Medical

BACKGROUND: DHEA-S is the most abundant steroid hormone in circulation, and primarily secreted from the adrenal cortex, but its physiological role is little known. One of the characteristic features of DHEA-S is progressive decrement of plasma DHEA-S level with advancing age, in contrast, plasma levels of other adrenal hormones are not chaging or littie decreasing. To grasp the trends of plasma DHEA-S level and DHEA-S/cortisol ratio by age in healthy Korean, we measured the plasma DHEA-S levels and DHEA-S/cortisol ratios in healthy Korean. METHODS: Healthy Korean (men: 99, women: 102, age range: 15-97 year old)were studied. Subjects were not taking drugs (such as glucocorticoid or androgenic medication) or cigarettes known to modify the plasma level of DHEA-S and cortisol, and had no evidence of hepatic, renal disease or hyperlipidemia as determined by serum lipid, bilirubin, SGOT, SGPT, BUN, creatinine. Data were analyzed by 10-year age group for men and women: i.e, 10-19, 20-29, 30-39, 40-49, 50-59, 60-69, 70-79, 80-89 and 90 year or more. Plasma DHEA-S levels were measured by using a commercially available RIA kit with 125I labeled-DHEA-SO4 (Coat-A Count DHEA-SO4), and for the measurement of plasma cortisol levels, commercial Gamma Coat TM[125I] Cortisol Radioimmunassay Kit was used. RESULTS:. 1) In both men and women, plasma DHEA-S level showed high interindividual variation within the same age group. 2) There were individual sex differences in plasma levels of DHEA-S, in all age groups, plasma DHEA-S levels were significantly higher values for men than for women. 3) Maximum plasma DHEA-S levels (men; 237+-3.35 ug/dL, women; 108+-17.5 ug/dL) were at third decade in both men and women. 4) Both men and women showed the continuous decline in plasma DHEA-S level with age. These age-related decline was more prominent in men than in women (men; y=-3.152 * +292.6, r2= 0.8459, P<0.05, women; y= -1.417 * +143.3, r2 = 0.7278, P< 0.05). 5) As an index of aging, there was no stastical difference between DHEA-S and DHEA-S/cortisol ratio. CONCLUSION: In healthy Korean, there were high interindividual variation of plasrna DHEA-S levels. In both men and women plasma DHEA-S level was peak at third decade, and from when it declined progressively with age. These results suggest that although the reliability of single plasma DHEA-S measurement are limited, the decline of DHEA-S with advancing age might be a specific marker of endocrinologic hormonal milieu (aging index). Also, concerning to individual adrenal secreting capacity, we measured DHEA-S/cortisol ratio. But we did not found that plasma DHEA-S/cortisol ratio is superior to the plasma DHEA-S level as an aging index.
Adrenal Cortex ; Aging ; Alanine Transaminase ; Aspartate Aminotransferases ; Bilirubin ; Creatinine ; Female ; Hand Strength ; Humans ; Hydrocortisone* ; Hyperlipidemias ; Male ; Plasma* ; Sex Characteristics ; Tobacco Products

PURPOSE: A physical therapy, with extracorporeal magnetic innervation (ExMi) treatment, has recently substituted direct electrical stimulation for the treatment of many diseases. The efficacy of ExMi treatment was evaluated as a new therapeutic modality in chronic pelvic pain syndrome. MATERIALS AND METHODS: In 30 patients, diagnosed as NIH type III prostatitis, the efficacy of an ExMi was evaluated. Each treatment session was composed of 10 min at 40Hz, 2 min rest and 10 min at 50Hz, with an on-off ratio of 5sec:5sec. Both before and after the completion of 8 sessions of ExMi treatment, self-administered (NIH-CPSI) questionnaire were recorded to assess the changes of patient's symptoms. Three months after treatment, any recurrence was evaluated in patients with symptom improvements of 30% or more by telephone interviews. RESULTS: The mean age of the patients and number of treatment sessions were 39.3 years and 10.5, respectively. Following the ExMi treatments, 20 of the 30 patients (66.7%) experienced a 30% or more improvement of their symptoms. The total NIH-CPSI score was significantly improved, from 23.7 to 15.2 (p<0.01). Each domain of the NIH-CPSI was improved as follows: pain, from 11.37 to 6.77; urination, from 5.03 to 3.27 and the effect on the QOL (quality of life), from 7.27 to 5.17. In responding patients, the improvement remained in 72% of the patients for 3 months after completion of the treatment. CONCLUSIONS: These results suggest that ExMi is an effective and useful tool in the management of chronic pelvic pain syndrome. In chronic pelvic pain syndrome patients, ExMi treatment has advantages over other treatment options due to its easy, comfortable, non-invasive nature.
Electric Stimulation ; Humans ; Interviews as Topic ; Pelvic Pain* ; Prostatitis ; Surveys and Questionnaires ; Recurrence ; Urination

BACKGROUND/AIMS: Propofol is an effective sedative drug in endoscopic procedures, but it has potentially serious adverse effects, so close monitoring of the vital signs should be performed during endoscopy. This study was undertaken to determine the adequate induction dose of propofol for safe and effective sedation during esophagogastrodudenoscopy (EGD) in persons 60 years or older. METHODS: Three hundred patients who visited our hospital for EGD were randomly assigned to three groups (A,B and C). An initial induction dose of 0.5 mg/kg, 0.75 mg/kg and 1.0 mg/kg of propofol was allocated to groups A, B and C, respectively. RESULTS: The 0.5 mg/kg, 0.75 mg/kg and, 1 mg/kg dose of propofol were all safe as an initial dose of propofol for achieving sedation during EGD in persons 60 years or older. There was no difference in the total amount of propofol among the three groups. Group C had a significantly shorter induction time and a lower dose was required for an additional injection of propofol without increasing adverse events, as compared to the two other groups. CONCLUSIONS: We suggest that 1 mg/kg of propofol is an effective induction dose for sedation during EGD in persons 60 years or older.
Aged ; Conscious Sedation ; Endoscopy ; Endoscopy, Digestive System ; Humans ; Propofol ; Vital Signs

BACKGROUND: It is not known with certainty whether patients with persistently positive sputum smear results who have also had negative sputum culture results require prolongation of treatment for tuberculosis in order to avoid an increased risk of eventual relapse. The purpose of the present study was to retrospectively describe the treatment characteristics and evaluate the appropriate duration of treatment in these patients. METHODS: Sixty of 69 patients with sputum smear positive and culture negative tests at 5 months after first line anti-tuberculous chemotherapy from 2002 to 2003 were retrospectively analyzed. Exclusion criteria included incomplete treatment or resistance to rifampicin or two additional antibiotics, as determined by a drug susceptibility test (DST). RESULTS: Smear conversion of the study subjects was observed after 8.3+/-2.3 months treatment, and the patients were culture negative after 2.0+/-0.8 months. The relapse rates of the study subjects were 3.8, 10.0, and 25.8% after 1, 2, and 5 years of anti-tuberculosis chemotherapy, respectively. The relapse rates were not significantly affected by a series of risk factors such as age, sex, presence of diabetes, a sputum culture examination after 2 months treatment, previous treatment history, chest radiograph, and duration of the treatment (p>0.05). CONCLUSION: Regimen change is not required for patients with persistent smear positive but culture negative tests in the fifth month for first line antituberculous treatment. However, a further study will be needed to clarify the high relapse rate in this specific group of patients.
Anti-Bacterial Agents ; Drug Therapy* ; Humans ; Radiography, Thoracic ; Recurrence ; Retrospective Studies ; Rifampin ; Risk Factors ; Sputum* ; Tuberculosis ; Tuberculosis, Pulmonary

PURPOSE: In 2000, the American Heart Association and International Liaison Committee on Resuscitation published guidelines for CPR (Cardiopulmonary Resuscitation), and these guidelines were revised in 2005. Many physicians perform CPR differently than suggested by these guidelines. We investigated guideline conformation rates for CPR by non-emergency physicians. METHODS: From January 1st, 2005, to December 31st, 2005, and from January 1st, 2007, to September 30th, 2007, 103 in-hospital CPR cases were enrolled. We separated the 103 cases into two groups: 2005 patients and 2007 patients. Fifty-two cases in the 2005 group and 51 cases in the 2007 group were enrolled. The defibrillation method, defibrillation energy, epinephrine use, and atropine use were analyzed. RESULTS: Nineteen cases (82.6%) in the 2005 group and three cases (21.4%) in the 2007 group were performed using the appropriate defibrillation method (p=0.0002). Seventeen cases (73.9%) in the 2005 group and four cases (28.6%) in the 2007 group received the appropriate defibrillation energy (p=0.0069). Seven cases (14.0%) in the 2005 group and 16 cases (32.0%) in the 2007 group used the appropriate epinephrine dose (p=0.0325). Fourteen cases (28.0%) in the 2005 patient group and 14 cases (29.2%) in the 2007 patient group used the appropriate atropine dose (p=0.8983). CONCLUSION: Although CPR guidelines were renewed in 2005, many physicians do not follow these guidelines. We suggest that adequate information, education, feedback, and further study are needed for guideline conformation.
American Heart Association ; Atropine ; Cardiopulmonary Resuscitation ; Electric Countershock ; Epinephrine ; Humans ; Resuscitation