No abstract available.

PURPOSE: VCUG has been performed increasingly in neonates with prenatal hydronephrosis. Here, whether VCUG is essential in neonates with mild to moderate hydronephrosis has been investigated. MATERIALS AND METHODS: 65 neonates with less than Society for Fetal Urology grade II hydronephrosis were reviewed. 28 neonates underwent VCUG and 37 neonates were observed without VCUG. An investigation of renal complications was performed using DMSA renal scan, urine analysis and urine culture for up to 60 months postnatally. RESULTS: 4(14.3%) of the 28 neonates presented VUR and received prophylatic antibiotics. Of these 1 case with G V VUR underwent reimplantation due to poor compliance. All 24 neonates with negative VCUG were followed and none showed any signs of UTI. All 14 neonates evaluated by urine analysis and urine culture had normal results, and all 7 neonates evaluated by DMSA renal scan had normal findings. 34 of the 37 neonates observed without VCUG were followed. All 15 evaluated by urine analysis and urine culture and all 3 evaluated by DMSA presented normal results. None of the other 16 showed any signs of UTI. 3 neonates were followed up by telephone-call and showed no signs of UTI. CONCLUSIONS: On applying VCUG in neonatal hydronephrosis, VUR was detected in 14.3% of the cases, which was significantly higher than that reported among normal children(approximately 1%). However, those hydronephrosis patients without VCUG showed no signs of UTI. Although the study of VCUG is important, it's application to every patients with prenatal hydronephrosis is controversial. Therefore, it is our belief that VCUG may not be essential in neonatal patients with less than grade II hydronephrosis if proper care and periodic tests are given.
Anti-Bacterial Agents ; Compliance ; Humans ; Hydronephrosis* ; Infant, Newborn ; Prenatal Diagnosis ; Replantation ; Succimer ; Urology ; Vesico-Ureteral Reflux

Trichuris trichiura (T. trichiura) is soil-transmitted parasite and widely spreads all over the world. High infection rates occur especially in the poor hygiene area. T. trichiura is transmitted by the water and food contaminated with T. trichiura eggs. Most of mildly infected individuals could be asymptomatic, whereas heavily infected patients manifest with anemia, diarrhea, nausea, vomiting, abdominal pain, and weight loss. Serious manifestations such as intestinal obstruction and perforation were reported to be caused by Trichuriasis. Diagnostic methods are stool examination of T. trichiura eggs and eosinophil count in blood. Sometimes, colonoscopy can be useful diagnostic tool and treatment. We observed that the North Korean refugee with chronic abdominal pain and the patient with abdominal pain and loose stool have been diagnosed as T. trichiura infection confirmed by colonoscopy. After treatment, the patient's symptom has improved. Therefore we report two cases of trichuriasis with literature review.
Abdominal Pain ; Anemia ; Colonoscopy ; Diarrhea ; Eggs ; Eosinophils ; Humans ; Hygiene ; Intestinal Obstruction ; Nausea ; Ovum ; Parasites ; Refugees ; Trichuriasis ; Trichuris ; Vomiting ; Water ; Weight Loss

Although diabetes mellitus (DM) is treatable, it is still not curable. Its chronicity is associated with a high prevalence of psychiatric disorders, especially depression in type 2 DM and learned helplessness in type 1 DM. In turn, this depression and helplessness may affect a patient's adherence to medical appointments, compliance to treatment, and effective doctor-patient relationships, which are vital to promising outcomes. This study reviews the existing literature regarding the interactional relationships between depression, DM and the doctor/patient relationship, and also suggests certain aspects of the doctor/patient relationship which can contribute to more successful treatment outcomes.
Appointments and Schedules ; Compliance ; Depression ; Diabetes Mellitus ; Helplessness, Learned ; Object Attachment ; Physician-Patient Relations ; Prevalence

In order to investigate food purchase frequency of elementary school children and its related ecological factors, 4314th, 5th and 6th grade elementary school children and their mothers, living in Seoul and Daejon, small city and rural area of Chungnam Province, were participated in this study. The subjects and their parents were surveyed by a selfrecording questionnaire about food purchase frequency and some ecological factors. Average height and weight of the subjects by gender and grade were similar to or a little bit more than the 1998 Korean Growth Standard. According to relative body weight, 30.6% and 10.8% of the subjects belonged to under-weight and obesity categories, respectively. Of the subjects, 46.9% used PC telecommunication or internet, 53.8% of them used it for less than an hour per day, and 46.4% watched TV for 2 to 4 hours a day. About 42% of the subjects spent 500 Won or less daily to buy snacks. A half of the subjects took snacks once a day because of hunger. Mothers' nutrition knowledge score was averagely 8.16 out of 13 full score and the average attitude score was 43.22 out of 50 full score. Foods purchased more than once a week were milk and yoghurt, cookies, ice-cream, ramyun, and gum in order. Family income, parents' education level, mothers' nutrition knowledge and food attitude score, students' snacking frequency and TV watching time showed significant correlations with purchase frequencies of some individual food items. In conclusion, the elementary school children considered taste most important rather than nutrition in buying snacks and most frequently bought carbohydrate foods and concentrated sugars except milk. Ecological factors such as mothers' nutritional knowledge and food attitude, TV watching time and snacking frequency had influenced the children's food purchase frequency. Accordingly, it is necessary to educate both children and their mothers about good food purchase and the importance of snacking.
Body Weight ; Carbohydrates ; Child* ; Chungcheongnam-do ; Daejeon ; Education ; Gingiva ; Humans ; Hunger ; Internet ; Milk ; Mothers ; Obesity ; Parents ; Seoul ; Snacks* ; Telecommunications ; Yogurt

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

OBJECTIVE: Gastric carcinoma is one of the most common cause of death in Korea with limited effectiveness of chemotherapy. Thymidylate synthase(TS) is a critical therapeutic target for the fluoropyrimidine cytotoxic drugs, that are the mainstay of the treatment for the advanced gastrointestinal malignancies. We assessed the relationship between the levels of TS expression and survival and effect of 5-fluorouracil based chemotherapy in gastric adenocarcinoma. METHODS: Thirty six patients with gastric adenocarcinoma who underwent curative resection of stomach at Ewha Womans University Hospital were evaluated. TS protein expression in tumor tissues was assessed by standard immunohistochemical staining techniques with TS 106 monoclonal antibody. RESULTS: TS expression was high(3+) in 19 patients (52.8%) and low(< or =2+) in 17 patients(47.2%). Between these two groups, there was no significant difference in the histopathologic type or stage. Seventy-two point five percent of patients with low TS expression were disease free at 5 years compared with 58.2% of patients with high TS expression(p=0.31) and 73.7% of patients with low TS expression were alive at 5 years compared with 61.4% of patients with high TS expression(p=0.34). In patients with high TS expression, disease-free survival (DFS) and overall survival(OS) of patients who received adjuvant chemotherapy were longer than those of patients with surgery alone without significance(p=0.28, p=0.16). CONCLUSIONS: We could not confirm the association between the level of TS expression in tumor tissues and DFS and OS of patients with gastric adenocarcinoma who underwent curative resection. Further study with more cases as well as prospective study will be necessary for establishment of relationship between TS expression of tumor and prognosis of gastric adenocarcinoma
Adenocarcinoma* ; Cause of Death ; Chemotherapy, Adjuvant ; Disease-Free Survival ; Drug Therapy ; Female ; Fluorouracil ; Humans ; Korea ; Prognosis* ; Stomach ; Thymidylate Synthase*

PURPOSE: Brain metastasis is estimated to occur in 20~40% of solid tumor patients and the most common primary tumor is lung cancer. Even though the prognosis of brain metastasis is grave and the 1-year survival rate is only 15%, symptom palliations are made with whole brain radiation therapy. We retrospectively evaluated the clinical features and prognostic factors of lung cancer with brain metastasis. MATERIALS AND METHODS: From January 1987 to October 1999, 50 lung cancer patients with brain metastasis underwent whole brain radiation therapy. We reviewed the improvement in neurologic symptoms and survival according to the following parameters; performance status, histological type, presence of brain metastasis at the initial diagnosis of lung cancer, presence of extracranial metastasis, multiplicity of brain lesion, presence of primary lung symptom and treatment modalities. RESULTS: The most frequent symptom with brain metastasis was a headache (50%). Palliation of the headache and other symptoms was achieved in 81% of the patients. Median overall survival after brain metastasis was 21 weeks and the 1 year survival rate was 15%. Patients without extracranial metastasis had a longer median survival than those with, 38 weeks versus 15 weeks, respectively (p=0.01). CONCLUSION: In lung cancer with brain metastasis, neurologic symptoms can be palliated with whole brain radiation therapy, and in this study among such patients, absence of extracranial metastasis can be a good prognostic factor.
Brain* ; Diagnosis ; Headache ; Humans ; Lung Neoplasms* ; Lung* ; Neoplasm Metastasis* ; Neurologic Manifestations ; Prognosis* ; Retrospective Studies ; Survival Rate

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

The percutaneous placement of a totally implantable vascular access port via the subclavian vein is commonly used in patients with a need for multiple intravenous infusions such as administration of chemotherapy. Unfortunately, the use of central venous ports have been associated with adverse events that are hazardous to patients. Here we report the case of a 5-year-old child who died of catastrophic hemothorax after several attempts at insertion of an implantable subclavian venous access device and removal of an infected port. Massive hemothorax occurred on the side contralateral to unsuccessful attempts at insertion of a new port and ipsilateral to the removal of an infected port. We could not confirm the cause of death and hemothorax without autopsy, but we discuss several possible causes of massive hemothorax.
Autopsy ; Cause of Death ; Child ; Hemothorax ; Humans ; Infusions, Intravenous ; Preschool Child ; Subclavian Vein ; Vascular Access Devices