Between May 1990, and June 1994, 79 patients with malignant tumors were treated radiosurgically using a Leksell gamma unit at Asan Medical Center. Of these patients, 57 were metastatic brain tumor, 12 were glioblastoma multiforme (GM), 4 were primitive neuroectodermal tumor, 3 were malignant germ cell tumor, 2 were recurrent lymphoma, and 1 was adenoid cystic carcinoma of the orbit. Among 57 patients with metastatic tumors, 28 patients harboring 60 tumors were followed clinically and radiographically. The median marginal dose for these tumors was 30 Gy and the median survival rate was 15 months. Twenty-one tumors disappeared and 32 tumors decreased in size during 2 to 6 months after radiosurgery on computed tomographic or magnetic resonance imaging scans. All 12 patients with GM were treated with conventional radiation (6,240 approximately 6,500 cGy) after surgical resection or biopsy prior to radiosurgery (13 approximately 15 Gy to margin). The results were varied. Radiosurgical treatment of two recurrent lymphomas and three recurrent mixed germ cell tumors after radiation and chemotherapy provided rapid clinical improvement with disappearance of the tumor. However, new lesions appeared in two lymphomas and one mixed germ cell tumor within 3 to 4 months. One patient with adenoid cystic carcinoma of the orbit, who was treated radiosurgically prior to resection, is alive without recurrence 31 months after the treatment. Gamma knife radiosurgery appears to be the best alternative method to surgical excision plus radiation therapy for single and multiple cerebral metastases. It also provides rapid palliation of symptoms due to recurrent malignant tumors. And it may have an adjuvant role in the treatment of some tumors delaying local recurrence, if given prior to resection. However, the preliminary results for the malignant gliomas were inconclusive.
Adult ; Aged ; Brain Neoplasms/secondary/*surgery ; Female ; Follow-Up Studies ; Human ; Male ; Middle Age ; *Radiosurgery

Acute appendicitis is the most frequent cause of acute abdomen. However, bacteremia in patient with acute appendicitis is rare. A 34-year-old male patient presenting with fever and abdominal discomfort for two days showed leukocytosis, elevated C-reactive protein and erythrocyte sedimentation rate. Gram-negative rods were cultured in blood and empirical ceftriaxone was injected intravenously. On abdominal CT, wall enhanced and distended retrocecal appendix was recognized. Appendectomy was performed, which revealed suppurative inflammation without perforation. We report a case of acute appendicitis without perforation associated with Escherichia coli sepsis and atypical clinical manifestations in a healthy male.
Abdomen, Acute ; Adult ; Appendectomy ; Appendicitis ; Appendix ; Bacteremia ; Blood Sedimentation ; C-Reactive Protein ; Ceftriaxone ; Escherichia ; Escherichia coli ; Fever ; Humans ; Inflammation ; Leukocytosis ; Male ; Sepsis

OBJECTIVE: This study was performed to assess whether uterine intraendometrial or intramyometrial arterial blood flow impedance in Doppler sonography is related to the outcomes of IVF-ET cycles. METHODS: A total of 24 patients undergoing IVF-ET was recruited for the study. All patients received controlled ovarian hyperstimulation(COH) with GnRH agonist and gonadotropins. Doppler sonographic examinations were performed by using Combison 530(Medison) with 5.5 MHz transvaginal probe. Pulsatility index(PI) was evaluated for uterine, radial, and spiral arteries on the days of hCG administration, oocyte retrieval, and embryo transfer(ET). Serum E2 level was assayed on the hCG day. RESULTS: The overall pregnancy rate after IVF-ET was 29.2%(7/24). There was no significant difference in PI of uterine artery between pregnant and nonpregnant groups, No pregnancy occurred in 4(16.7%) patients without intraendometrial or subendometrial blood flow. Compared with nonpregnant group, PI of radial artery on the hCG day and PI of spiral artery on the hCG and oocyte retrieval days were significantly lower in pregnant group. There were no significant correlations between Serum E level on the hCG day and Pl of any three arteries. CONCLUSION: This study suggests that the Doppler sonographic parameter, PI, of intraendometrial and intramyometrial arteries are more useful than that of uterine artery not only in predicting the success of IVF-ET, but also in assessing the endometrial receptivity.
Arteries* ; Electric Impedance ; Embryo Transfer* ; Embryonic Structures* ; Fertilization in Vitro* ; Gonadotropin-Releasing Hormone ; Gonadotropins ; Humans ; Oocyte Retrieval ; Pregnancy Rate ; Pregnancy* ; Radial Artery ; Serum ; Ultrasonography ; Ultrasonography, Doppler* ; Uterine Artery

OBJECTIVE: To investigate the relationship between vitamin D receptor (VDR) gene polymorphisms and bone mineral density (BMD) in postmenopausal Korean women, and to evaluate if VDR gene polymorphisms are associated with serum levels of 1,25 (OH)2 vitamin D3 and bone turnover markers METHODS: The BsmI, TaqI, ApaI, and FokI polymorphisms were analyzed by restriction fragment length polymorphism in 443 postmenopausal Korean women. Serum CrossLaps (CTX), bone alkaline phosphatase (BAP), osteocalcin and 1,25 (OH)2 vitamin D3 levels were measured by enzyme linked immunosorbent assay and immmunoassay and BMD at the lumbar spine and proximal femur by dual energy X-ray absorptiometry. RESULTS: BMD at the femoral neck and Ward' triangle in women with the Bb, and Tt genotype (uppercase letters signifying the absence and lowercase letters the presence of the restriction site) was lower than that in women with the bb, and tt genotype respectively. Haplotype analysis showed that BbTt genotype had lower BMD at all skeletal sites than bbtt genotype. No significant association between adjusted BMD at any skeletal site and the FokI or ApaI genotypes was observed. There were no significant associations between the adjusted levels of the bone markers and 1,25 (OH)2 vitamin D3 and single or combined genotypes. CONCLUSION: The VDR gene BsmI, and TaqI polymorphisms are genetic factors which may affect BMD at the lumbar spine and proximal femur in postmenopausal Korean women, but does not affect serum levels of 1,25 (OH)2 vitamin D3 and bone turnover markers.
Absorptiometry, Photon ; Alkaline Phosphatase ; Bone Density* ; Cholecalciferol ; Enzyme-Linked Immunosorbent Assay ; Female ; Femur ; Femur Neck ; Genotype ; Haplotypes ; Humans ; Osteocalcin ; Polymorphism, Restriction Fragment Length ; Receptors, Calcitriol* ; Spine ; Vitamin D* ; Vitamins*

OBJECTIVE: The purpose of this study was to evaluate intrauterine fetal death and to elucidate the etiology of intrauterine fetal death. METHODS: This is a clinical study of 153 cases of fetal death in utero (FDIU) among 11,866 deliveries at Holy Family Hospital during Mar. 1995 to Feb. 2002. RESULTS: 1. The average incidence of FDIU was 1.29%. 2. The age distribution of mother with FDIU was between 16 to 45 year old and was highest in the 25 to 29 year old age group (45%). 3. The parity of mothers with FDIU was the highest in nulliparous group (58.5%) and there was a decreased tendency with high parity. 4. There were 80 cases (52.1%) with previous history of abortion and 8 cases (5.2%) with previous history of FDIU. 5. The highest incidence rate of FDIU was shown at 20~24 weeks of gestation (36.6%) and in the fetus weighted less than 1,000 gm (56%), and the sex ratio of male versus female fetus was 1.29:1. 6. The mode of delivery FDIU was labor induction (54.3%), laparotomy (15.2%), spontaneous labor (30.4%). The indication for laparotomy were placental abruption, previous cesarean section state, twin and maternal death. As the gestational age and fetal weight decreased, the mean time interval from start of labor induction to fetal expulsion and the variety of labor induction became increase. 7. The etiology factors of FDIU was unexplained causes (44%), congenital anomaly (17%), cord complication (14%) in order. CONCLUSION: The proper antenatal care should be taken of fetuses on the basis of risk factors of antepartum and intrapartum so that unnecessary intrauterine fetal death might be able to be prevented.
Abruptio Placentae ; Adult ; Age Distribution ; Cesarean Section ; Female ; Fetal Death* ; Fetal Weight ; Fetus ; Gestational Age ; Humans ; Incidence ; Laparotomy ; Male ; Maternal Death ; Middle Aged ; Mothers ; Parity ; Pregnancy ; Risk Factors ; Sex Ratio ; Twins

The lateral rhinotomy signifies only an incision and not on operation and a lateral rhinotomy incision with osteotomy of the nasal bones provides access to the entire nasal cavity and maxillary, ethmoid, and sphenoid sinuses as well as the frontal sinus if the floor is removed, permitting removal of benign lesions at these sites and en bloc resection of the ethmoid labyrinth and the party wall between the nasal cavity and antrum with infiltrating tumors. The authors treated a tumor patient and a midfacial bone fracture patient via lateral rhinotomy approach and had a good result. So we report the cases with literature review.
Ear, Inner ; Fractures, Bone ; Frontal Sinus ; Humans ; Nasal Bone ; Nasal Cavity ; Osteotomy ; Sphenoid Sinus

OBJECTIVES: This study was conducted to propose the need of re-establishing the criteria of the body weight classification in the elderly. We compared the Asia-Pacific Region Criteria (APR-C) with Entropy Model Criteria (ENT-C) using Morbidity rate of chronic diseases which correlates significantly with Body Mass Index (BMI). METHODS: Subjects were 886 elderly female participating in the 2007-2009 Korea National Health and Nutrition Examination Survey (KNHANES). We compared APR-C with those of ENT-C using Receiver Operating Characteristics (ROC) curve and logistic regression analysis. RESULTS: In the case of the morbidity of hypertension, the results were as follows: Where it was in the T-off point of APR-C, sensitivity was 67.5%, specificity was 43.1%, and Youden's index was 10.6. While in the cut-off point of ENT-C, it was 56.7%, 56.6%, and 13.3 respectively. In the case of the morbidity of diabetes, the results were as follows: In the cut-off point of APR-C, Youden's index was 14.2. While in the cut-off point of ENT-C, it was 17.2 respectively. The Area Under the ROC Curve (AUC) of the subjects who had more than 2 diseases among hypertension, diabetes, and dyslipidemia was 0.615 (95% CI: 0.578-0.652). Compared to the normal group, the odds ratio of the hypertension group which will belong to the overweight or obesity was 1.79 (95% CI: 1.30-2.47) in the APR-C, and 2.04 (95% CI: 1.49-2.80) in the ENT-C (p > 0.001). CONCLUSIONS: We conclude that the optimal cut-off point of BMI to distinguish between normal weight and overweight was 24 kg/m2 (ENT-C) rather than 23 kg/m2 (APR-C).
Aged* ; Body Mass Index* ; Body Weight ; Chronic Disease* ; Classification ; Dyslipidemias ; Entropy* ; Female ; Humans ; Hypertension ; Korea ; Logistic Models ; Nutrition Surveys ; Obesity ; Odds Ratio ; Overweight ; ROC Curve ; Sensitivity and Specificity

The paper by Lee YJ et al. [1] was printed with spelling errors.

The aim of this study was to investigate if dietary Chlorella vulgaris (chlorella) intake would be effective on cadmium (Cd) detoxification in rats fed dietary Cd. Fourteen-week old male Sprague-Dawley (SD) rats weighing 415.0 +/- 1.6 g were randomly divided into two groups and fed slightly modified American Institute of Nutrition-93 Growing (AIN-93G) diet without (n=10) or with (n=40) dietary Cd (200 ppm) for 8 weeks. To confirm alteration by dietary Cd intake, twenty rats fed AIN-93G diet without (n=10) and with (n=10) dietary Cd were sacrificed and compared. Other thirty rats were randomly blocked into three groups and fed slightly modified AIN-93G diets replacing 0 (n=10), 5 (n=10) or 10% (n=10) chlorella of total kg diet for 4 weeks. Daily food intake, body weight change, body weight gain/calorie intake, organ weight (liver, spleen, and kidney), perirenal fat pad and epididymal fat pad weights were measured. To examine Cd detoxification, urinary Cd excretion and metallothonein (MT) concentrations in kidney and intestine were measured. Food intake, calorie intake, body weight change, body weight gain/calorie intake, organ weight and fat pad weights were decreased by dietary Cd intake. Urinary Cd excretion and MT concentrations in kidney and small intestine were increased by dietary Cd. After given Cd containing diet, food intake, calorie intake, body weight change, body weight gain/calorie intake, organ weights and fat pad weights were not influenced by dietary chlorella intake. Renal MT synthesis tended to be higher in a dose-dependent manner, but not significantly. And chlorella intake did not significantly facilitate renal and intestinal MT synthesis and urinary Cd excretion. These findings suggest that, after stopping cadmium supply, chlorella supplementation, regardless of its percentage, might not improve cadmium detoxification from the body in growing rats.
Adipose Tissue ; Animals ; Body Weight ; Body Weight Changes ; Cadmium ; Chlorella ; Chlorella vulgaris ; Diet ; Eating ; Humans ; Intestine, Small ; Intestines ; Kidney ; Male ; Metallothionein ; Organ Size ; Rats ; Rats, Sprague-Dawley ; Spleen ; Weights and Measures

This study was designed to determine whether acute fructose or sucrose administration at different levels (0.05 g/kg, 0.1 g/kg or 0.4 g/kg body weight) might affect oral glucose tolerance test (OGTT) in normal and type 2 diabetic rats. In OGTT, there were no significant differences in glucose responses between acute fructose- and sucrose-administered groups. However, in normal rats, the AUCs of the blood glucose response for the fructose-administered groups tended to be lower than those of the control and sucrose-administered groups. The AUCs of the lower levels fructoseor sucrose-administered groups tended to be smaller than those of higher levels fructose- or sucrose-administered groups. In type 2 diabetic rats, only the AUC of the lowest level of fructose-administered (0.05 g/kg body weight) group was slightly smaller than that of the control group. The AUCs of fructose-administered groups tended to be smaller than those of the sucrose-administered groups, and the AUCs of lower levels fructose-administered groups tended to be smaller than those fed higher levels of fructose. We concluded from this experiment that fructose has tendency to be more effective in blood glucose regulation than sucrose, and moreover, that smaller amount of fructose is preferred to larger amount. Specifically, our experiments indicated that the fructose level of 0.05 g/kg body weight as dietary supplement was the most effective amount for blood glucose regulation from the pool of 0.05 g/kg, 0.1 g/kg and 0.4 g/kg body weights. Therefore, our results suggest the use of fructose as the substitute sweetener for sucrose, which may be beneficial for blood glucose regulation.
Animals ; Area Under Curve ; Blood Glucose ; Body Weight ; Dietary Supplements ; Fructose ; Glucose ; Glucose Tolerance Test ; Rats ; Sucrose ; Sweetening Agents