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: 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*

The aim of this study was to examine the hypoglycemic effect of chlorella in 6 week-old type 2 diabetic Goto-Kakizaki (GK, n=30) rats and 6 week-old normal Wistar (n=30) rats. Animals were randomly assigned to 3 groups respectively, and were fed three different experimental diets containing 0%, 3% or 5% (w/w) chlorella for 8 weeks. In diabetic GK rats, the insulinogenic-indices were not significantly different among the groups. The concentrations of fasting plasma glucagon and hepatic triglyceride, and the insulin/glucagon ratios of the GK-3% chlorella and GK-5% chlorella groups were significantly lower than those of the GK-control group. The HOMA-index and the concentrations of fasting blood glucose and plasma insulin of the GK-3% chlorella and GK-5% chlorella groups were slightly lower than those of the GK-control group. In normal Wistar rats, the insulinogenic-indices were not significantly different among the normal groups, but that of the Wistar-5% chlorella group was slightly higher than the other groups. The concentrations of fasting blood glucose and plasma insulin, and the HOMA-index of the Wistar-5% chlorella group were a little higher, and the fasting plasma glucagon concentration and the insulin/glucagon ratio of the Wistar-5% chlorella group were significantly higher than those of the Wistar-control and Wistar-3% chlorella groups. In conclusion, this study shows that the glucose-stimulated insulin secretion was not affected by the intake of chlorella, which could be beneficial, however, in improving insulin sensitivity in type 2 diabetic GK and normal Wistar rats.
Animals ; Blood Glucose ; Chlorella ; Chlorella vulgaris ; Diet ; Fasting ; Glucagon ; Hypoglycemic Agents ; Insulin ; Insulin Resistance ; Plasma ; Rats ; Rats, Wistar

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

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

This is a case of a 30-year-old man who was referred to our hospital for evaluation of a rapidly growing tumor in the left thyroid gland. It was palpated 2 weeks ago. But it was growing fast. A 4x3 cm mass was palpated in the left thyroid gland. Our impression was anaplastic thyroid carcinoma. Computed tomography finding indicated a thyroid malignant tumor and cytology result suggested spindle cell neoplasm. A lower anterior neck mass was resected and final histopathological result turns out to be a rhabdomyosarcoma (RMS). Although cervical RMS is very rare in adults, it has to be included for the differential diagnosis for the rapidly growing mass at thyroid gland.
Adult ; Diagnosis, Differential ; Humans ; Neck ; Rhabdomyosarcoma* ; Thyroid Gland* ; Thyroid Neoplasms*

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

OBJECTIVE: To investigate a poly (A) microsatellite in vitamin D receptor (VDR) gene and to evaluate its relationship with bone mineral density (BMD) in postmenopausal Korean women. METHODS: The poly (A) polymorphism was analyzed in 417 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: When alleles of poly (A) microsatellite were classified into two groups, long (L: A18-22) and short (S: A12-17), based upon the length of the repeat, the prevalence of SS was 1.4%, LS 10.1%, and LL 88.5%. There was a significant correlation between BMD and poly (A) polymorphism. BMD at the femoral neck and trochanter in LS genotype was significantly lower than that in LL genotype. LL genotype was more prevalent in women with normal BMD compared with women with low bone mass while LS genotype was more prevalent in the latter group. There were no significant associations between the adjusted levels of the bone markers, 1,25 (OH)2 vitamin D3 and poly (A) genotypes. CONCLUSION: The VDR gene poly (A) polymorphism is one of genetic factors which may affect BMD in Korean women.
Absorptiometry, Photon ; Alkaline Phosphatase ; Alleles ; Bone Density* ; Cholecalciferol ; Enzyme-Linked Immunosorbent Assay ; Female ; Femur ; Femur Neck ; Genotype ; Humans ; Microsatellite Repeats* ; Osteocalcin ; Prevalence ; Receptors, Calcitriol* ; Spine ; Vitamin D* ; Vitamins*

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