PURPOSE: To determine the role of cytokines in the apoptosis of rat's liver following irradiation. MATERIALS AND METHODS: Sprague-Dawley rats were irradiated to entire body with a single dose of 8 Gy. The rats were divided into 5 groups according to the sacrifice day after irradiation. The liver and blood after 1, 3, 5, 7, and 14 days irradiation were sampled for evaluation of mechanism of apoptosis and role of cytokine in relation to radiation-induced tissue damage. The study was composed of microscopic evaluation of liver tissue, in situ detection method for apoptosis, immunohistochemical stain of IL-1, IL-4, IL-6 and TNF, bioassay and radioimmunoassay of IL-6 in liver tissue and blood. RESULTS: Radiation-induced liver damage was noted from first day of radiation, and most severe parenchymal damage associated with infiltration of chronic inflammatory cells was seen in the groups of 5 days after radiation. A number of apoptosis were observed 1 day after radiation on both light microscope and in situ method. Afterwards, the number of apoptosis was gradually diminished. On immunohistochemical study, IL-1 and TNF were expressed 1, 3 days after radiation, but not expressed after that. IL-4 was not expressed in the entire groups. IL-6 was expressed with strong positivity in 1, 3 days after radiation. Bioassay and RIA of IL-6 in liver tissue and blood showed the highest value in 1 day after radiation, and the value is diminished after then. CONCLUSION: Apoptosis seemed to be the important mechanism of radiation-induced liver damage, and is possibly induced by the release of cytokines, such as IL-1, IL-6, TNF in view the simultaneously increased appearance of apoptosis and cytokines.
Animals ; Apoptosis* ; Biological Assay ; Cytokines* ; Interleukin-1 ; Interleukin-4 ; Interleukin-6 ; Liver* ; Radioimmunoassay ; Rats ; Rats, Sprague-Dawley

Mature cystic teratoma represents 10~20% of all ovarian neoplasms in women during the second and third decades of life. Malignant transformation rarely takes place in this tumor, and is observed in approximately 1~2% of all cases. The most common malignancy developing in mature cystic teratoma is squamous cell carcinoma. The prognosis for patients with malignant transformation of mature cystic teratoma is poor and because of the rarity of malignant degeneration, the surgical and postoperative management is not established. A case of a stage IIIb squamous cell carcinoma which developed in a mature cystic teratoma in a 47-year-old female who was disease free after tumor debulking surgery and subsequent treatment of five cycles of bleomycin (30 mg iv injection Day 1), ifosfamide (1 g/m(2) iv injection Days 1-5), and cisplatin (50 mg/m(2) iv injection Day 1) is presented and issues regarding the diagnosis and management of this rare complication are discussed.
Bleomycin ; Carcinoma, Squamous Cell* ; Cisplatin ; Diagnosis ; Female ; Humans ; Ifosfamide ; Middle Aged ; Ovarian Neoplasms ; Prognosis ; Teratoma*

Mature cystic teratoma represents 10~20% of all ovarian neoplasms in women during the second and third decades of life. Malignant transformation rarely takes place in this tumor, and is observed in approximately 1~2% of all cases. The most common malignancy developing in mature cystic teratoma is squamous cell carcinoma. The prognosis for patients with malignant transformation of mature cystic teratoma is poor and because of the rarity of malignant degeneration, the surgical and postoperative management is not established. A case of a stage IIIb squamous cell carcinoma which developed in a mature cystic teratoma in a 47-year-old female who was disease free after tumor debulking surgery and subsequent treatment of five cycles of bleomycin (30 mg iv injection Day 1), ifosfamide (1 g/m(2) iv injection Days 1-5), and cisplatin (50 mg/m(2) iv injection Day 1) is presented and issues regarding the diagnosis and management of this rare complication are discussed.
Bleomycin ; Carcinoma, Squamous Cell* ; Cisplatin ; Diagnosis ; Female ; Humans ; Ifosfamide ; Middle Aged ; Ovarian Neoplasms ; Prognosis ; Teratoma*

No abstract available.
Salmonella*

BACKGROUND: Some of elective surgical procedures may be postponed or cancelled due to inadequate preoperative assessment and preparation. To minimize this problem, our preadmission anesthesia consultation clinic had been designed and managed at the outpatient department. The case referral pattern and efficacy of the clinic were evaluated for 1 year. METHODS: The study was done collected prospectively on 881 patients referred to the clinic from January to December 1997, 1 year. The age, sex, departmental distribution of consultation, ASA physical status of patients, the clinical department and reasons of consultation, and satisfaction of the patients or their parents were analized prospectively. The preoperative hospital stay periods before and after the opening of the clinic were compared. RESULTS: The sex ratio(M/F) were 6/4. Thirty-seven percent of the patients were under 10 years old and 11.8% were twenties. ENT(48.4%), ophthalmology(15.6%), general surgery(12.6%) were mainly referral departments. Reasons for consultation were related to chest X-ray abnormality(28.9% of the cases) and EKG abnormality(17.9%). The majority of consultation had pediatric(30%) and cardiologic problem(26%). URI(54.2%) and liver disease(12.6%) were major disease entities to postpone their surgery. In 2.7% of the patients, their admission or operation were postponed by the anesthesiologists in the clinic. Ninety-one percent of the patients were satisfied to visit the clinic. CONCLUSION: We conclude that reduction in preoperative hospital stay and shortening in delay of surgery are provided, and most patients are satisfied to the preadmission anesthesia consultation clinic.
Anesthesia* ; Child ; Electrocardiography ; Humans ; Length of Stay ; Liver ; Outpatients ; Parents ; Prospective Studies ; Referral and Consultation ; Surgical Procedures, Elective ; Thorax

STUDY DESIGN: A retrospective study was designed to evaluate the radiographic diagnostic method to detect any abnormal findings and differentiate stable burst fractures with compression fractures at thoracolumbar spine. OBJECTIVES: To evaluate diagnostic sensitivity of radiographic analysis and confirm the effectiveness of the radiographic diagnostic methods to differentiate stable burst fractures with pure compression fractures. SUMMARY OF BACKGROUND DATA: A data showed that the diagnostic sensitivity using radiographic analysis was 83%. The greater sensitivity was obtained at high posterior superior vertebral angle and PSVA/PIVA > 1.3. MATERIALS AND METHODS: Thirty-one patients with thoracolumbar spine fractures were evaluate to differentiate stable burst fractures with pure compression fractures. All patients were taken X-ray and CT. The PSVA(Posterior superior vertebral angle), PIVA(Posterior inferior vertebral angle), PSVA/PIVA were checked using lateral plain radiographs during follow-up period, and the final data was analysed using radiological & statistical methods. RESULTS: Middle column failure of stable burst fractures was greatly observed at high PSVA(especially >100degree) and high PSVA/PIVA ratio(> 1.3). CONCLUSION: The radiographic analysis using PSVA(Posterior superior vertebral angle), PIVA(Posterior inferior vertebral angle), PSVA/PIVA might be the one of useful methods to differentiate stable burst fractures with pure compression fractures at thoracolumbar spine during follow-up period.
Diagnosis ; Follow-Up Studies ; Fractures, Compression* ; Humans ; Retrospective Studies ; Spine*

No abstract available.
Kidney Transplantation* ; Urinary Diversion*

OBJECT AND METHOD: Minor physical anomalies(MPAs) are frequently seen in patients with schizophrenia. MPAs are considered to arise from the anomalous development of ectoderm-originated tissues in the developing fetus. Since the central nervous system originates from ectoderm, MPAs can be regarded as externally observable and objective indicators of the aberrant development which might have taken place in the central nervous system. To investigate whether MPAs are more frequent in schizophrenic patients, the frequencies of MPAs were compared between schizophrenic patients and normal controls. Total 245 schizophrenic patients diagnosed with DSM-IV(male : 158, female : 87), and 418 normal control subjects(male : 216, female : 202) were included in this study. The MPAs were measured using the modified Waldrop scale with fifteen items in six bodily regions; head, eye, ear, mouth, hand, and foot. RESULT: The total scores of Waldrop scale were 4.40+/-1.93(mean+/-standard deviation) in patients and 3.43+/- 1.68 in controls for females, and for males, 4.58+/-1.75 in patients and 4.28+/-1.59 in controls. For females, the excess of MPAs in schizophrenic patients was statistically significant(t-test : p<0.001). For males, schizophrenic patients also showed more MPAs than normal controls, but this tendency did not reach statistical significance (t-test : p=0.094). When the modified Waldrop total scores excluding head circumference were compared, the total scores in schizophrenic patients were significantly higher for both male and female subjects(t-test : male p<0.001, female p=0.001). The individual anomaly items included in Waldrop scale were also investigated. The items of epicanthus, hypertelorism, malformed ears, syndactylia were significantly more frequent in schizophrenic patients. In contrast, the items of adherent ear lobes, asymmetric ears, furrowed tongue, curved fifth finger, single palmar crease and big gap between toes did not show any differences in frequency between schizophrenic patients and normal controls. Since a lot of statistical analyses showed different results between male and female subjects, it seems to be necessary to consider gender as an important controlling variable for the analysis, however only the item of head circumference showed statistically significant gender-related difference according to log-linear analysis. CONCLUSION: With a relatively large sample size, the frequencies of MPAs enlisted in Waldrop scale were compared between schizophrenic patients and normal controls in this study. MPAs were more frequently seen in schizophrenic patients and, especially, several specific items in the Waldrop scale showed prominent excess in schizophrenic patients. Although definite conclusions cannot be drawn due to the inherent limitation of the study using Waldrop scale, these results seem to support the possibility that aberrant neurodevelopmental process might be involved in the pathogenesis of schizophrenia in some of the patients.
Central Nervous System ; Ear ; Ectoderm ; Female ; Fetus ; Fingers ; Foot ; Hand ; Head ; Humans ; Hypertelorism ; Male ; Mouth ; Sample Size ; Schizophrenia* ; Syndactyly ; Toes ; Tongue, Fissured

OBJECTIVES: The Korean College of Neuropsychopharmacology and the Korean Academy of Schizophrenia developed the Korean medication algorithm project for schizophrenia (KMAP) to aid clinical decisions. The purpose of this study was to investigate problems and revision of Korean Medication Algorithm for Schizophrenia after feasibility test. METHODS: A total of 108 schizophrenia patients were enrolled at 19 centers and treated according to the algorithm. Prescribing investigators were able to change the recommended treatment strategies of the algorithm if necessary. All subjects were assessed over a 4-month period. Appropriateness of choice, dosage, duration and switch of antipsychotics and definition of treatment response were examined. RESULTS: Compliance of 1(st) choice antipsychotics in KMAP was favorable. Atypical antipsychotics which is a 1(st) stage drug selected first was above 84%, especially in case of no previous medical history was nearly all. In case that shift of stage was needed, there is a trend that combination treatment stage (6(th) stage) and clozapine treatment stage (5(th) stage) were preferred to rather than 3(rd) stage and 4(th) stage (typical antipsychotics and atypical antipsychotics treatment stage). The rates of switching antipsychotics at the time points other than CDP (critical decision points) was low and the reason was almost the side effects. So the compliance of CDPs in KMAP was good in case of insufficiency of treatment response. Also the reasons why many investigators continued using current antipsychotics without switching despite insufficiency of treatment response were definition of treatment response, discrepancy between brief symptom rating scale for negative symptom and decision of clinicians. In addition, compliance of co-existence symptoms and side effect of medication in KMAP was favorable. CONCLUSION: It is some difference from clinical practice such as stage of antipsychotics, definition of treatment response and usefulness of brief symptom rating scale for negative symptom. But the majority apart from points of preceding paragraph is feasible in clinical practice. These results are essential to revise the next version of KMAP.
Antipsychotic Agents ; Clozapine ; Compliance ; Cytidine Diphosphate ; Humans ; Research Personnel ; Schizophrenia

BACKGROUND/AIMS: Transradial intervention (TRI) is becoming the preferred method over transfemoral intervention (TFI) because TRI is associated with lower incidence of major bleeding and vascular complications. However, there has been limited published data regarding the clinical outcomes of TRI versus TFI in Korean patients with ST-elevation myocardial infarction (STEMI). METHODS: A total of 689 consecutive STEMI patients who underwent primary percutaneous coronary intervention (PCI) with drug-eluting stents (DESs) from January to December of 2009 at nine university hospitals were enrolled in this study. Mid-term angiographic and 12-month cumulative clinical outcomes of the TRI group (n = 220, 31.9%) were compared to those of the TFI group (n = 469, 28.1%). RESULTS: After propensity score matching, in-hospital complications and the 12-month major clinical outcomes during follow-up in the two groups were similar to each other. However, the incidence rates of repeat revascularization (6.4% vs. 0.5%, p = 0.003), target vessel revascularization (6.4% vs. 0.5%, p = 0.003), and major adverse cardiac events (MACE; 11.6% vs. 4.6%, p = 0.018) in the TFI group were higher than those in the TRI group during the 12-month of follow-up. CONCLUSIONS: In our study, TRI in STEMI patients undergoing primary PCI with DESs was associated with lower incidence of access site hematoma, 12-month repeat revascularization, and MACE compared to TFI. Therefore, TRI might play an important role in reducing bleeding complications while improving major clinical outcomes in STEMI patients undergoing primary PCI with DESs.
Drug-Eluting Stents ; Follow-Up Studies ; Hematoma ; Hemorrhage ; Hospitals, University ; Humans ; Incidence ; Methods ; Myocardial Infarction* ; Percutaneous Coronary Intervention ; Propensity Score