Acute necrotizing pancreatitis often progresses into infection, sepsis, multiorgan failure and then, mortality and morbidity which are very high. From January 1988 to December 1996, 14 patients with surgically proved acute necrotizing pancreatitis at the Department of Surgery, Catholic University were analysed. 1) The patients consisted of 12 men and 2 women ranging in age from 27 to 74 years. 2) The ethiological factors included excessive alcohol abuse in 8 patients, biliary tract disease in 2 patients and unknown in 4 patients. 3) In clinical findings, the majority of the patients complained of sudden severe upper abdominal pain, nausea and vomiting, tachycardia, and abdominal distension. 4) Serum amylase level did not increase in 50% although the necrosis was severe, but aspartate transaminase increased in 13 cases. The lactic dehydrogenase and C-reactive protein increased in all tested cases. 5) In regards to diagnostic methods, computerized tomography was highly effective in getting early diagnosis and in finding the complications. 6) Early necrosectomy and drainage procedure was safe and effective. 7) Postoperative complications included pulmonary complications in 3 patients, pancreas fistula in 2, pancreas pseudocyst in 2, acute renal failure in 2, Diabetes mellitus in 2, gastrointestinal bleeding 1, and subphrenic abscess in 1 case. 8) Mortality rate was 36 %. In conclusion, computerized tomography may be used for early detection of acute necrotizing pancreatitis;. Aspartate transaminase, Lactate dehydrogenase and C-reactive protein may be good diagnostic and prognostic indicators upon admission. Necrosectomy and drainage should be chosen as the best surgical treatment in acute necrotizing pancreatitis patients.
Abdominal Pain ; Acute Kidney Injury ; Alcoholism ; Amylases ; Aspartate Aminotransferases ; Biliary Tract Diseases ; C-Reactive Protein ; Diabetes Mellitus ; Drainage ; Early Diagnosis ; Female ; Fistula ; Hemorrhage ; Humans ; L-Lactate Dehydrogenase ; Male ; Mortality ; Nausea ; Necrosis ; Oxidoreductases ; Pancreas ; Pancreatitis, Acute Necrotizing* ; Postoperative Complications ; Sepsis ; Subphrenic Abscess ; Tachycardia ; Vomiting

OBJECTIVE: Using [123I]IPT-SPECT, we compared between the dopamine transporter (DAT) density of the basal ganglia in first-episode, patients with schizophrenia and DAT density in normal control subjects. We investigated the change between DAT density before and after taking olanzapine during 4weeks in patients with schizophrenia. We studied correlations between the clinical symptoms of schizophrenia and DAT density. METHODS: Ten patients with schizophrenia and ten healthy control subjects were included in this study. Brief Psychiatric Rating Scale (BPRS) and Montgomery-Asberg Depression Rating Scale (MADRS) were obtained before and after 4-week treatment with olanzapine in schizophrenic group. Nuclear imaging using [123I]IPT-SPECT was obtained in normal control subjects and schizophrenic group before taking olanzapine. After 4-week treatment with olanzapine, Nuclear imaging was obtained in schizophrenic group. RESULTS: There is significant negative correlation between BPRS total score, withdrawal subscale score after treatment and DAT density before treatment. There is significant positive correlation between the age of onset and DAT density after treatment and there is significant negative correlation between the duration of illness and DAT density after treatment. CONCLUSION: The data of this study suggest that DAT density in basal ganglia in patients with schizophrenia would be a predicting factor in treatment response.
Age of Onset ; Basal Ganglia ; Brief Psychiatric Rating Scale ; Depression ; Dopamine Plasma Membrane Transport Proteins* ; Dopamine* ; Humans ; Psychopathology* ; Schizophrenia*

OBJECTIVE: Using [123I]IPT-SPECT, we compared between the dopamine transporter (DAT) density of the basal ganglia in first-episode, patients with schizophrenia and DAT density in normal control subjects. We investigated the change between DAT density before and after taking olanzapine during 4weeks in patients with schizophrenia. We studied correlations between the clinical symptoms of schizophrenia and DAT density. METHODS: Ten patients with schizophrenia and ten healthy control subjects were included in this study. Brief Psychiatric Rating Scale (BPRS) and Montgomery-Asberg Depression Rating Scale (MADRS) were obtained before and after 4-week treatment with olanzapine in schizophrenic group. Nuclear imaging using [123I]IPT-SPECT was obtained in normal control subjects and schizophrenic group before taking olanzapine. After 4-week treatment with olanzapine, Nuclear imaging was obtained in schizophrenic group. RESULTS: There is significant negative correlation between BPRS total score, withdrawal subscale score after treatment and DAT density before treatment. There is significant positive correlation between the age of onset and DAT density after treatment and there is significant negative correlation between the duration of illness and DAT density after treatment. CONCLUSION: The data of this study suggest that DAT density in basal ganglia in patients with schizophrenia would be a predicting factor in treatment response.
Age of Onset ; Basal Ganglia ; Brief Psychiatric Rating Scale ; Depression ; Dopamine Plasma Membrane Transport Proteins* ; Dopamine* ; Humans ; Psychopathology* ; Schizophrenia*

Asthma is the most common chronic respiratory disease, affecting 1% to 18% of the population worldwide. It is characterized by various respiratory symptoms, such as wheezing, shortness of breath, chest tightness and cough, and variable airflow limitation. People with asthma often have periods of worsened symptoms and airway obstruction called exacerbations, which can be fatal. We would like to provide the updated clinical management protocols for patients with asthma.Current Concepts: The goal of asthma treatment is to control symptoms adequately and minimize exacerbations. Anti-inflammatory and bronchodilator therapies are the mainstay of asthma treatment and are recommended as a stepwise approach. The pharmacological treatment of asthma involves evaluating and reviewing the current control status based on the symptoms, future risk of exacerbation, comorbidities, side effects, and patient’s satisfaction. Asthma symptoms in some patients remain uncontrolled despite intensive treatment. The development of biomarkers, evaluation of the patient’s phenotype, and personalized treatment, including biologics, can provide new and effective treatment opportunities.Discussion and Conclusion: Successful asthma management can be achieved through accurate diagnosis of asthma, evaluation of the control stages, correct use of controllers and relievers, adjustment of asthma triggers, personalized approach, and training in self-management.

A renin- or angiotensin-II responsive aldosterone producing tumor is a rare cause of primary hyperaldosteronism. This tumor can be identified by tests that show that the aldosterone producing adrenal tumor is not fully autonomous. In other words partially it is responsible for the stimulation of aldosterone secretion that results aldosterone levels in an increase in serum in response to the upright posture and spironolactone treatment. Furthermore, the urinary 18-hydroxycortisol level is within the normal range. Because of different responses to surgical removal, the differential diagnosis of the causes of primary aldosteronism can't be overemphasized even for rare causes of primary aldosteronism such as unilateral nodular hyperplasia or a renin-responsible aldosterone producing tumor. We should consider renin or angiotensin-II responsive adrenal adenoma in the differential diagnosis of primary aldosteronism when biochemical data shows atypical results. Here we present the first case in Korea of a renin-responsive aldosterone producing adrenal adenoma which was fully accessible and was successfully treated by surgical removal. Also, sampling for aldosterone secretion just above the insertion site in the left renal vein before surgery showed a suspiciously abberant left adrenal vein drainage into the IVC, This was very helpful information during adrenal vein ligation in laparoscopic adrenalectomy.
Adenoma* ; Adrenalectomy ; Aldosterone ; Diagnosis, Differential ; Drainage ; Hyperaldosteronism ; Hyperplasia ; Korea ; Ligation ; Posture ; Reference Values ; Renal Veins ; Renin ; Spironolactone ; Veins*

This study was conducted to investigate relationships and gender differences in dietary supplement (DS) and oriental supplement (OS) prevalence as well as anti-doping awareness during training and the game period. Korea National Sport University athletes (343 male and 136 female) participated in this study and completed DS and OS practice and anti-doping awareness questionnaires. Forty-six percent of athletes used DS during the training period, and there was significantly higher DS use in females (53%) compared to males (43%) (P < 0.05). Twenty-eight percent of athletes used OS, and there was significantly higher OS use in females (35%) than males (26%) (P < 0.05) during the training period. The primary reason of DS use was to supply energy both in males (36%) and females (28%). The main reason for male athletes' OS use was to supply energy (41%). Meanwhile, the reasons for female athletes' OS use were to supply energy (23%), to maintain health (19%), and to improve recovery ability (20%), which showed a significant gender difference (P < 0.05). Athletes rated their perceived degree of satisfaction, perceived importance, and beliefs in efficacy of DS and OS use all over 50% during the training period, and no gender differences were detected. In a comparison between athletes educated about anti-doping (at least more than one time) and non-received athletes, DS and OS use during the training period was 2.30 (1.47-3.60) and 1.71 (1.03-2.82), respectively. DS and OS use immediately before the game period was 2.38 (1.50-3.80) and 3.99 (1.20-13.28), respectively. Elite athletes' anti-doping education was highly related to increased DS use during the training period and immediately before the game. Although elite athletes use various DS and OS during the training period and before the game period, doping education for elite athletes is related with DS and OS use during the training period and before the game.
Athletes ; Dietary Supplements ; Female ; Humans ; Korea ; Male ; Prevalence ; Surveys and Questionnaires ; Sports

STUDY DESIGN: A retrospective study. OBJECTIVES: This study analyzed the clinical and radiographic results of the posterior lumbar interbody fusion performed on patients 50-65 and >7-years-of-age suffering from degenerative lumbar disease. LITERATURE REVIEW SUMMARY: Several studies on posterior lumbar interbody fusion performed on patients aged about 65 years reported insignificant age-related differences in the spinal-fusion results. MATERIALS AND METHODS: The records of 121 patients with degenerative lumbar disease treated with posterior lumbar interbody fusion between 2004 and 2010 were assessed. The patients' clinical results, visual analogue scale (VAS) scores, Oswestry disability index (ODI) values, and complications before and after the surgery were compared. The radiographic results and changes in the fusion segmental angle before and after the surgery as well as in the height of the posterior intervertebral disc were also compared. RESULTS: In group A, comprising 44 patients >70-years-of-age, follow-up duration and number of comorbidities were 73.3 years and 17.8 months, respectively. In group B, comprising 77 patients 50-65-years-of-age, follow-up duration and number of comorbidities were 58.8 years and 31.8 months, respectively. In both groups, the average VAS scores and ODI values decreased. The incidence rate of vertebra-related postoperative complications was 13.6% in group A and 9.0% in group B. The incidence rate of general complications unrelated to the vertebra, was 18.1% in group A and 9.0% in group B. CONCLUSIONS: Posterior lumbar interbody fusion is considered effective even in patients over 70 years with a degenerative lumbar disease.
Aged ; Comorbidity ; Follow-Up Studies ; Humans ; Incidence ; Intervertebral Disc ; Postoperative Complications ; Retrospective Studies ; Spine ; Stress, Psychological

Dexamethasone (DEX), one of the corticosteroid hormones, is one of the most common therapeutic strategies in ophthalmological treatment. Despite its widespread use and clinical efficiency, little is known regarding the specific effects of DEX on cell growth, differentiation and cell death in human trabecular meshwork cells. The presence of the glucocorticoid receptor (GR, dexamethasone receptor) in TM-5 cell line, which was derived from the primary human trabecular meshwork cells, was verified by RT-PCR and western blot analysis. The effects of DEX on the cellular proliferation of TM5 cells were measured by a BrdU incorporation assay. Western blot analysis were used to examine the effects of DEX on the Ras/MEK/ERK signaling pathway. The total Ras, MEK1/2 and ERK1/2 protein levels as well as the levels of activated (phosphorylated) form were both significantly increased by the DEX treatment for 5 days. Both MEK1/2 and ERK1/2 were significantly activated by phosphorylation after 10 minutes. The dependence of this increased cell proliferation on GR activation by DEX and the sustained activation of ERK was examined using RU486 (a GR inhibitor) and U0126 (a MEK inhibitor). Both RU486 and U0126 prevented the induction of cell proliferation by the DEX treatment in the TM5 cells. In conclusion this study demonstrated that GR is expressed in TM5 cells. Secondly, DEX treatment for 5 days stimulates cell proliferation in TM5 cells, and that this increased proliferation effect is mediated by the Ras/MEK/ERK pathway.
Cell Division/*drug effects ; Cells, Cultured ; Dexamethasone/*pharmacology ; Human ; Mitogen-Activated Protein Kinase Kinases/metabolism ; Mitogen-Activated Protein Kinases/metabolism ; Protein-Serine-Threonine Kinases/metabolism ; Protein-Tyrosine Kinase/metabolism ; Proto-Oncogene Proteins c-raf/metabolism ; Receptors, Glucocorticoid/physiology ; Trabecular Meshwork/cytology/*drug effects

OBJECTIVE: To evaluate the clinical efficacy of transabdominal ultrasound-guided embryo transfer for in vitro fertilization and embryo transfer (IVF-ET) according to age of women. METHODS: A total of 211 cycles of IVF?ET were included in this study. The pregnancy outcomes were compared between transabdominal ultrasound?guided embryo transfer (USG-guided group, n=108) and clinical touch technique (Clinical touch group, n=103) groups. Then, comparative analysis was performed in women aged <35 years, 35~37 years and in those > or =38 years. RESULTS: Clinical characteristics of study subjects did not differ between the two groups. There was no difference between the two groups in terms of duration of controlled ovarian hyperstimulation, dose of gonadotropins used, numbers of oocytes retrieved and embryos transferred. Clinical pregnancy rate was significantly higher in USG-guided group than Clinical touch group (27.8% vs. 16.5%, p<0.05). This difference was also found in women 35~37 years (27.6% vs. 8.6%, p<0.05), but not in those <35 years. USG-guided group showed a significantly higher implantation rate in women 35~37 years (10.5% vs. 3.4%, p<0.05), but not in those <35 years. In women at 38 years or older, USG-guided group showed higher clinical pregnancy and implantation rates than Clinical touch group (15.0% vs. 7.6%; 4.8% vs. 2.5%, respectively), however the differences were not statistically significant. CONCLUSION: Transabdominal ultrasound-guided embryo transfer may improve the pregnancy outcomes in IVF-ET cycles, especially in women at age 35 years or older.
Embryo Transfer* ; Embryonic Structures* ; Female ; Fertilization in Vitro* ; Gonadotropins ; Humans ; Oocytes ; Pregnancy ; Pregnancy Outcome ; Pregnancy Rate ; Ultrasonography

Exercise training (ET) and selenium (SEL) were evaluated either individually or in combination (COMBI) for their effects on expression of glucose (AMPK, PGC-1alpha, GLUT-4) and lactate metabolic proteins (LDH, MCT-1, MCT-4, COX-IV) in heart and skeletal muscles in a rodent model (Goto-Kakisaki, GK) of diabetes. Forty GK rats either remained sedentary (SED), performed ET, received SEL, (5 micromol/kg body wt(-1)/day(-1)) or underwent both ET and SEL treatment for 6 wk. ET alone, SEL alone, or COMBI resulted in a significant lowering of lactate, glucose, and insulin levels as well as a reduction in HOMA-IR and AUC for glucose relative to SED. Additionally, ET alone, SEL alone, or COMBI increased glycogen content and citrate synthase (CS) activities in liver and muscles. However, their effects on glycogen content and CS activity were tissue-specific. In particular, ET alone, SEL alone, or COMBI induced upregulation of glucose (AMPK, PGC-1alpha, GLUT-4) and lactate (LDH, MCT-1, MCT-4, COX-IV) metabolic proteins relative to SED. However, their effects on glucose and lactate metabolic proteins also appeared to be tissue-specific. It seemed that glucose and lactate metabolic protein expression was not further enhanced with COMBI compared to that of ET alone or SEL alone. These data suggest that ET alone or SEL alone or COMBI represent a practical strategy for ameliorating aberrant expression of glucose and lactate metabolic proteins in diabetic GK rats.
Animals ; Area Under Curve ; Citrate (si)-Synthase ; Glucose ; Glycogen ; Heart ; Insulin ; Lactic Acid ; Liver ; Muscle, Skeletal ; Muscles ; Proteins ; Rats ; Rodentia ; Selenium ; Up-Regulation