In spite of recent introduction of such highly sophisticated diagnostic modalities as computerized tomography,cardioangiography and polytomography the simple PA chest remaines as an essential and important method of chestdiagnosis especially in terms of vascular diseases of the lung and heart. Until recently, however, theinterpretation of chest x ray has been largely dependent on much subjective observation of roentgen anatomy of thechest. Several years ago Simon proposed a quantitative approach to interpretation of the chest in an attempt tomake the judgement more objective. In the present study we have carried out a clinical study on normalities of thestandard PA chest of Korean adults. The materials consisted of 216 normal chest films. Age ranged from 20 to 60years and sex distribution 103 males and 113 females, We counted the number of vessels in both lung fields,measured the diameter of the basal artery and investigated the level of hilum points as well as hilar distance.There were 9 to 11 vessels in the upper zone and 9 to 12 in the lower zone. There were no significant sexdifference. The number of vessels was not affected by aging. The average diameter of the basal artery was11.7±2.4mm in the right lower zone and 10±1.8mm in the left lower zone in female. There was significant sexdifference (p 0.01). Aging seemed not to be affected the size of the basal artery. The majority of hilum point waslocated at the level of 5-6th rib at axillary portion and the left hilar point is 0.3-2.0cm higher in locationthan the right. The hilar distance was 4.1±0.4cm on the right 5.0±1.1cm on the left in male and 4.0±0.7cm onthe right and 4.7±0.5cm on the left in female. There was significant sex difference (p 0.01). There wassignificant difference in size of the basal arteries and hilar distance between the Koreans and Englishmen but thenumbers of vessels were not significantly different.
Adult ; Aging ; Arteries ; Clinical Study ; Female ; Heart ; Humans ; Lung ; Male ; Methods ; Ribs ; Sex Characteristics ; Sex Distribution ; Thorax ; Vascular Diseases

No abstract available.

Recently the reports of the autologous grafting of adrenal medullary tissue into the brain of parkinsonian patient have given the wide attention to the neurosurgeons as well as other clinicians, because the current therapeutic modalities are either imperfect or palliative. Although neural grafting of adrenal medullary tissue of fetal brain which can supply the dopamine seems to be a ideal form of treatment theoretically, many problems must be overcome for this approach to be a routine procedure. Authors made the rat parkinsonian model by destroying the substantia nigra and nigrostriatal fiber selectively with 6-OHDA. And abnormal behaviors and growth patterns were observed and studied using rotometry, T-maze and metabolic cage. With the results, some parameters which would be useful in further experiments could be established.
Animals ; Brain ; Dopamine ; Humans ; Oxidopamine ; Parkinson Disease ; Rats* ; Substantia Nigra ; Transplants

BACKGROUND: We reviewed the guidelines for the transfusion of red cells, platelets, and fresh frozen plasma (FFP) of the Korean Society of Blood Transfusion and modified the previous guidelines for transfusions at our hospital. We evaluated the appropriateness of the current hospital transfusions with these algorithms based on these guidelines. METHODS: The medical records of 266 transfusion episodes of patients receiving transfusions of red cells (144), platelets (61), and FFP (61), were reviewed retrospectively at Ewha Womans University Mokdong Hospital during 2002. RESULTS: Inappropriateness rates for transfusion episodes were 2.8% for red cells, 4.9% for platelets, and 44.3% for FFP. 144 red cell transfusions comprised 73 episodes (50.7%) in acute blood loss and 71 (49.3%) in chronic anemia. Among them, 2 episodes in each condition were assessed as inappropriate, respectively. 61 platelet transfusions comprised 32 episodes (52.5%) for a prophylaxis in marrow failure and 13 (21.3%) for active bleeding and 6 (9.8%) for acute disseminated intravascular coagulation (DIC) and 10 (16.4%) for others. Among them, 3 episodes for clinical bleeding were assessed as inappropriate. Out of 61 FFP transfusions, 34 episodes (56%) (16 liver disease with complications, 11 acute DIC, and 7 others) were assessed as appropriate and 27 episodes (44%) (8 liver diseases without complications, 10 surgical procedures and 9 others) were assessed as inappropriate. CONCLUSIONS: We modified our previous guidelines for transfusions according to the transfusion guidelines proposed by the Korean Society of Blood Transfusions. These guidelines could be easily applied to evaluate the appropriateness of transfusions performed at our hospital and to specify the cases of inappropriate transfusions.
Anemia ; Blood Transfusion ; Bone Marrow ; Dacarbazine ; Disseminated Intravascular Coagulation ; Female ; Hemorrhage ; Humans ; Liver Diseases ; Medical Records ; Plasma* ; Platelet Transfusion ; Retrospective Studies

BACKGROUND: Chronic Myelogenous Leukemia (CML) is the first proven disease in which gene abnormality, t(9;22)(q34;q11) can cause the disease to occur in humans. Recently, targeted therapy with STI571 (GleevecTM), signal transduction inhibitor for BCR-ABL kinase was developed and can induce cytogenetic remission in patients with CML. Hypermetaphase-FISH (HMF)/Interphase-FISH (I-FISH, Fluorescence in situ hybridization) aiming specific chromosomal abnormalities are unambiguous quantitative molecular genetic methods for individual Philadelphia (Ph1) chromosome positive cells. We evaluated the change of Ph1 chromosome in CML patients during STI571 therapy using HMF/I- FISH. METHODS: Twenty one patients with CML were treated with STI571 which was provided from Norvatis pharmaceutical company as Expanded Access Program for Compassionate Use from May 2001 at the doses of 200-600 mg/day orally. Median age of this cohort was 37 years old and median follow up duration was 113 days (48~165 days). HMF or I-FISH using bone marrow or peripheral blood were performed on the sample at baseline, day 14, day 28 and then monthly. RESULTS: Complete cytogenetic responses which were assessed by HMF/I-FISH counting several hundreds cells were found in 8 of 21 patients. Among them, 4 of 10 chronic phase, 2 of 2 accelerate phase and 2 of 8 blastic crisis patients achieved cytogenetic complete response. One patient with blastic crisis was relapsed after achieving cytogenetic complete response. Grade III-IV thrombocytopenia and neutropenia were noticed in 8 and in 7 patients respectively, but there were no major bleeding episodes nor neutropenic fever. CONCLUSION: BCR-ABL tyrosine kinase inhibitor, STI571 was tolerable for patients with CML. The majority of patients achieved hematologic remission and 8 out of 21 patients achieved complete cytogenetic response regardless of their disease stage. Cytogenetic response of Ph1 chromosome can be quantified accurately with HMF/I-FISH.
Adult ; Bone Marrow ; Chromosome Aberrations ; Cohort Studies ; Compassionate Use Trials ; Cytogenetics ; Fever ; Fluorescence ; Follow-Up Studies ; Fusion Proteins, bcr-abl ; Hemorrhage ; Humans ; Leukemia, Myelogenous, Chronic, BCR-ABL Positive* ; Molecular Biology ; Neutropenia ; Philadelphia Chromosome* ; Phosphotransferases ; Signal Transduction ; Thrombocytopenia ; Imatinib Mesylate

PURPOSE: To evaluate the efficacy and tolerability of tamsulosin 0.4 mg once daily in Korean patients with symptomatic benign prostatic hyperplasia (BPH) and investigate whether tamsulosin 0.4 mg can improve symptoms in patients with refractory lower urinary tract symptoms (LUTS) who were previously receiving tamsulosin 0.2 mg once daily. MATERIALS AND METHODS: A total of 116 patients from 3 urology centers participated. All study subjects entered a nonblind phase consisting of 8 weeks of tamsulosin 0.2 mg monotherapy followed by an additional 8 weeks of tamsulosin 0.2 mg (0.2 mg group) or 8 weeks of tamsulosin 0.4 mg (0.4 mg group). At week 8, we chose the 0.4 mg group on the basis of International Prostate Symptom Score (IPSS), quality of life (QoL), maximal urinary flow rate (Qmax), and adverse effects. At week 16, we compared the efficacy and tolerability of tamsulosin between the 0.2 and 0.4 mg groups. RESULTS: A total of 26 patients (22.4%) were escalated to tamsulosin 0.4 mg at week 8. There were significant differences in IPSS, QoL, and Qmax at week 8 in both groups. There were significant differences in improvement in IPSS, QoL, Qmax, and postvoid residual urine volume from baseline to week 16 in both groups. There were no significant differences in efficacy or tolerability between the groups at week 16. CONCLUSIONS: Our trial demonstrated that tamsulosin 0.4 mg has favorable efficacy and tolerability in Korean patients with symptomatic BPH refractory to tamsulosin 0.2 mg. No patients experienced any serious adverse effects when we escalated the dose of tamsulosin to 0.4 mg.
Humans ; Lower Urinary Tract Symptoms ; Prostate ; Prostatic Hyperplasia ; Quality of Life ; Sulfonamides ; Urology

PURPOSE: The purpose of this study was to determine the comparative effectiveness of androgen deprivation therapy (ADT) combined with docetaxel (DTX)-based chemotherapy in Korean and Japanese castration-resistant prostate cancer (CRPC) patient cohorts.MATERIALS AND METHODS: Metastatic CRPC patients who underwent more than three DTX-based chemotherapy cycles in Korea and Japan between 2002 and 2017 were retrospectively analyzed and divided into the DTX-only (DTX, n=30) and combination (DTX+ADT, n=46) groups. Progression-free survival (PFS) was calculated as the time from the start of chemotherapy to the occurrence of either disease progression (prostate-specific antigen [PSA] progression or radiographic progression) or death. The primary end point was PFS and the secondary end point was overall survival (OS).RESULTS: In the DTX and DTX+ADT groups, the median PFS was 6.0 and 11.0 months (log-rank p=0.053). The multivariate Cox regression analysis revealed that the significant predicting factors of PFS were ADT administration (hazard ratio [HR], 0.478; 95% confidence interval [CI], 0.284–0.804; p=0.005) and number of DTX-based chemotherapy cycles (HR, 0.934; 95% CI, 0.899–0.970; p<0.001). In the DTX and DTX+ADT groups, the median OS was 16.0 and 19.5 months (log-rank p=0.825). Through multiple Cox regression analysis, we found that the significant predicting factors of OS were the PSA nadir level (HR, 1.001; 95% CI, 1.000–1.002; p<0.001) and number of DTX-based chemotherapy cycles (HR, 0.932; 95% CI, 0.876–0.991; p=0.024).CONCLUSIONS: Concurrent DTX-based chemotherapy and ADT may be beneficial compared with DTX-based chemotherapy alone in chemotherapy-naïve metastatic CRPC patients in terms of the PFS, but not the OS.

Chronic neutrophilic leukemia is a rare myeloproliferative disorder. We have experienced a typical case of chronic neutrophilic leukemia in a 76-year-old man who complained abdominal distension due to hepatosplenomegaly. White blood cell count of peripheral blood was 50,500/nL with 90% segmented neutrophils. The underlying disease for a leukemoid reaction had not been detected. Leukocyte alkaline phosphatase score and the serum levels of vitamin B12 and uric acid were elevated. Chromosome study showed a normal karyotype without Philadelphia chromosome or bcr/abl rearrangement. Phorbol myristate acetate-activated respiratory burst activity of neutrophils measured with chemiluminescence showed increased activity.
Aged ; Alkaline Phosphatase ; Humans ; Karyotype ; Leukemia, Neutrophilic, Chronic* ; Leukemoid Reaction ; Leukocyte Count ; Leukocytes ; Luminescence ; Myeloproliferative Disorders ; Myristic Acid ; Neutrophils* ; Philadelphia Chromosome ; Respiratory Burst* ; Uric Acid ; Vitamin B 12

BACKGROUND: In the primary care setting, compliance with lipid lowering therapy was relatively low. In order to compare the efficacy of a short messaging service (SMS) text messaging and postal reminder as means of improving attendance rates during the first 24 weeks of lipid-lowering therapy, a randomized controlled trial of 918 patients from 19 family practice clinics was conducted between February 2003 and June 2006. METHODS: Patients were randomly assigned into 3 groups: SMS (327), postal (294),and control (297) group. To ascertain attendance rates, patients were followed up at 24 weeks after their treatment. Reminders were sent at 16 weeks from the coordinating center. RESULTS: Overall attendance rate was 74.1%. This differed between groups, with 76.1% attendance for the SMS group, 73.5% for the postal group, and 72.4% for the control group. According to a multivariate analysis, the SMS group had a significantly higher attendance rate (Odds ratios [OR] 1.48; 95% confidence interval [CI], 1.01 to 2.16) than the control group, but the postal group (OR, 1.15; 95% CI, 0.79 to 1.69) did not. Moreover, the cost per attendance for the SMS reminder (155 Korean Won [KRW]) was much lower than that for the postal reminder (722 KRW). CONCLUSION: SMS reminder may be more cost saving method to improve the attendance rate compared with the postal reminder.
Compliance ; Cost Savings ; Family Practice ; Humans ; Multivariate Analysis ; Primary Health Care ; Text Messaging

Purpose: To evaluate the incidence of de novo overactive bladder (OAB) and the factors related to its occurrence following radical prostatectomy (RP) in patients with clinically localized prostate cancer (PCa). Materials and Methods: We prospectively examined 50 patients without OAB who underwent RP for clinically localized PCa in our institution from August 2019 to February 2020. We performed assessments using the International Prostate Symptom Score (IPSS), the Overactive Bladder Symptom Score (OABSS), and uroflowmetry before surgery and 3 months after RP. OAB was defined as a score of 1 or more on the urgency components of the OABSS. Three months after RP, the patients were divided into 2 groups based on the presence of de novo OAB symptoms. We evaluated the patients’ demographics and outcomes after RP according to their de novo OAB grouping. The predictive factors of de novo OAB after RP were analyzed using a multivariate logistic regression model. Results: Of the 50 patients, 22 (44%) had de novo OAB 3 months after RP. The patients in the de novo OAB group were older, had higher preoperative IPSS storage subscores, and had larger volumes of postvoid residual urine on preoperative uroflowmetry than those in the non-de novo OAB group. Multivariate analysis showed that age and preoperative IPSS storage subscores were predictive factors of de novo OAB after RP. Conclusions de novo OAB was observed in 44% of the patients 3 months after RP. Age and preoperative IPSS storage subscores were predictive factors of de novo OAB following RP.