OBJECTIVE: To evaluate the efficacy of growth hormone in reversing glucocorticoid-induced musculoskeletal changes including osteoporosis and myopathy in rats. METHOD: Experimental rats were divided into five groups and each group was composed of 10 rats. The group 1 was administered with saline, group 2 with growth hormone, group 3 with glucocorticoid, group 4 with combined dosages of growth hormone and glucocorticoid, and group 5 with glucocorticoid for 4 weeks and then growth hormone for another 4 weeks. All injections were carried out every other day for 8 weeks. The half of animals were sacrificed after 4 weeks and another half after 8 weeks in each group. The triceps surae muscle was biopsied and examined histologically for the evaluation of mean area of muscle fiber. The femur was removed and dissected for the measurement of its weight, length, and diameter. The bone mineral density of the femur was measured by a dual energy X-ray absorptiometer. RESULTS: Administration of growth hormone partially reversed the complications of steroid such as decrease in body weight, decrease in weight, length, diameter, and bone mineral density of femur, and decrease in mean area of muscle fiber. CONCLUSION: This study indicated that growth hormone could be applied for the management of steroid-induced osteoporosis and myopathy.
Animals ; Body Weight ; Bone Density ; Femur ; Growth Hormone* ; Muscular Diseases ; Osteoporosis ; Rats*

Paget's disease of the bone is a chronic, progressive disease of unknown etiology, characterized by abnormal bony resorption and deposition. It is a common skeletal disease in Europe and North America, while it is very rare in Asia. Paget's disease of the temporal bone has been reported to cause hearing loss, tinnitus, and mild vestibular symptom. We report a 28-year-old man with Paget's disease, which was a first reported case of bilateral sensorineural hearing loss for the first time in Korea.
Adult ; Asia ; Europe ; Hearing Loss ; Hearing Loss, Sensorineural ; Humans ; Korea ; North America ; Temporal Bone* ; Tinnitus

OBJECTIVE: This study was designed to evaluate the effect of growth hormone on bone mineral density of corticosteoid-induced osteoporosis in male rat. METHOD: Twenty Sprague-Dwaley male rats was studied, divided into four group, each group has 5 rats. The group 1 was treated with saline. The group 2 was treated with corticosteroid (Methylprednisolone 10 mg/kg). The group 3 was treated with corticosteroid and growth hormone (recombinant human growth hormone 0.5 IU/kg). The group 4 was treated with growth hormone after corticosteroid treatment. The treatment duration was 6 weeks for each group. After six weeks of hormone administration, the animals were sacrificed, the bilateral femur were removed and tested for bone mineral density using dual energy X-ray absorptiometry and examined histomorphometrically. RESULTS: Administration of growth hormone after corticosteroid therapy, the growth hormone could reverse the decrease in body weight and bone mineral density induced by corticosteroid therapy (p<0.05). CONCLUSION: When growth hormone is administrated after corticosteroid therapy, the growth hormone can protect the osteoporosis in male rats induced by a high dose of corticosteroid.
Absorptiometry, Photon ; Animals ; Body Weight ; Bone Density* ; Femur ; Growth Hormone* ; Human Growth Hormone ; Humans ; Male ; Osteoporosis* ; Rats*

Missing observations are common in medical research and health survey research. Several statistical methods to handle the missing data problem have been proposed. The EM algorithm (Expectation-Maximization algorithm) is one of the ways of efficiently handling the missing data problem based on sufficient statistics. In this paper, we developed statistical models and methods for survey data with multivariate missing observations. Especially, we adopted the Em algorithm to handle the multivariate missing observations. We assume that the multivariate observations follow a multivariate normal distribution, where the mean vector and the covariance matrix are primarily of interest. We applied the proposed statistical method to analyze data from a health survey. The data set we used came from a physician survey on Resource-Based Relative Value Scale(RBRVS). In addition to the EM algorithm, we applied the complete case analysis, which used only completely observed cases, and the available case analysis, which utilizes all available information. The residual and normal probability plots were evaluated to access the assumption of normality. We found that the residual sum of squares from the EM algorithm was smaller than those of the complete-case and the available-case analyses.
Biostatistics ; Dataset ; Health Surveys* ; Models, Statistical ; Relative Value Scales

The prevalence of colon cancer is increasing in Korea and the principal strategy of its management is early detection and surgical resection. For the early detection of colon cancer, endoscopic evaluation is important and the ability to find out early stage small lesion is needed for the endoscopist. To find out encloscopic features of early colon cancer, we reviewed 17 cases of early colon cancer who have admitted to Seoul National University Hospital from January 1982 to December 1993. 1)59% of the lesions were located in rectum and the size ranged from 0.7cm to 9cm, all of the 17 cases showed polypoid mass contour and the surface of them had erosion, hyperemia, ulceration and easy touch bleeding tendency. 2) Colon cancer was diagnosed by endoscopic gross findings in 41% and endoscopic biopsy could confirm colon cancer in 70%. However, barium enema could diagnose only 41% of early colon cancer. 3) Five cases were operated under the diagnosis of colonic adenoma which were large(>3 cm) villous type or contained severe dysplasia 4) Submucosal tumor infiltration was found in 10 cases and 65% had associated adenoma 5) Lymph node involvement was none and there was no recurrence in 47 month follow up period after various surgical treatments.
Adenoma ; Barium ; Biopsy ; Colon* ; Colonic Neoplasms* ; Diagnosis ; Endoscopy ; Enema ; Follow-Up Studies ; Hemorrhage ; Hyperemia ; Korea ; Lymph Nodes ; Prevalence ; Rectum ; Recurrence ; Seoul ; Ulcer

Signet ring cell carcinoma is a rare form of gallbladder cancer and has a worse prognosis. Since few cases have been reported, information regarding the behavior and prognosis of the gallbladder carcinoma is limited. About twenty four cases of gallbladder signet ring cell carcinoma have been reported so far. We present a rare case of primary signet ring cell carcinoma of the gallbladder. A 58-year-old male presented with epigastric pain. Abdominal computed tomography showed diffuse gallbladder wall thickening with enhancement, gallstones, and choledocholithiasis. After endoscopic treatment of choledocholithiasis, laparoscopic cholecystectomy was performed. Pathologic examination of the resected gallbladder revealed adenocarcinoma of signet ring cell type in the epithelium. Immunohistochemical stain for cytokeratin 7 was positive for tumor cells. The final pathologic diagnosis was primary signet ring cell carcinoma of the gallbladder. Lymph node metastasis was detected and he received chemotherapy and radiotherapy. After one year of follow-up, bone metastasis in the lumbar spine and malignant ascites were found. The patient is being provided with palliative care.
Adenocarcinoma ; Ascites ; Carcinoma, Signet Ring Cell* ; Cholangitis ; Cholecystectomy, Laparoscopic ; Cholecystitis* ; Cholecystitis, Acute ; Choledocholithiasis ; Diagnosis ; Drug Therapy ; Epithelium ; Follow-Up Studies ; Gallbladder Neoplasms ; Gallbladder* ; Gallstones ; Humans ; Keratin-7 ; Lymph Nodes ; Male ; Middle Aged ; Neoplasm Metastasis ; Palliative Care ; Prognosis ; Radiotherapy ; Spine

PURPOSE: This study was to observe whether the apoptotic function of tumor-infiltrating lymphocytes (TIL) is induced in human gastric epithelial dysplasia and gastric adenocarcinoma according to the role of FasL expression. MATENRIALS AND METHODS: A total of 56 gastric epithelial dysplasia and gastric adenocarcinoma patients were enrolled in this study: 9 cases of gastric epithelial dysplasia, 18 cases of early gastric carcinomas (EGC) and 29 cases of advanced gastric carcinomas (AGC). Immunohistochemical staining was performed for FasL and CD45, and the terminal deoxynucleotidyl transferase mediated dUTP nick end labelling (TUNEL) method was used to detect cell death in tumor-infiltrating lymphocytes. RESULTS: 1) Positive reactions of FasL to neoplastic cells were 88.9% (8/9) in gastric epithelial dysplasia, 83.3% (15/18) in EGC, and 75.9% (22/29) in AGC. 2) Expression of TIL was decreased in the FasL positive region and was increased in the FasL negative region, and significant expression of TIL was observed in the AGC group (P=0.001). 3) Expression of apoptotic TIL was very similar to the FasL expression, and 100% expression was observed in gastric epithelial dysplasia group. 4) Expression of apoptotic TIL was increased in the FasL positive region and decreased in the FasL negative region, and significant apoptotic expression was observed in the gastric epithelial dysplasia and EGC groups (P=0.0420, P=0.0263, respectively). CONCLUSION: These results suggest that FasL is a prevalent mediator of immune privilege in epithelial dysplasia and cancer of the stomach.
Adenocarcinoma* ; Apoptosis* ; Cell Death ; DNA Nucleotidylexotransferase ; Humans ; Lymphocytes, Tumor-Infiltrating ; Stomach Neoplasms

BACKGROUND: Recent research has shown that reactive oxygen species (ROS) play a significant role in the development and persistence of neuropathic pain through central sensitization via N-methyl-D-aspartate (NMDA) receptor activation. In the present study, we examined whether the intraperitoneal administration of vitamins C and E alone or together could alleviate mechanical allodynia in a chronic post-ischemia pain (CPIP) rat model. METHODS: Vitamins C and E were administered intraperitoneally to 48 male Sprague Dawley rats once per day for 3 days before hindpaw ischemia-reperfusion (I/R) injury was induced. On the third day, the CPIP rat model was produced by inducing ischemia in the left hindpaw by applying an O-ring for 3 h, followed by reperfusion. Three days after reperfusion, hindpaw mechanical allodynia was assessed by measuring the withdrawal response to von Frey filament stimulation. The rats were sacrificed immediately after behavioral testing to determine the phosphorylated NMDA receptor subunit 1 (pNR1) and extracellular-signal-regulated kinases (pERK) levels in the spinal cord. RESULTS: When the antioxidant vitamins C and E were administered intraperitoneally to CPIP rats, I/R injury-induced mechanical allodynia was attenuated, and pNR1 and pERK levels were decreased in the rat spinal cord. Additionally, the co-administration of both vitamins had an increased antiallodynic effect. CONCLUSIONS: The reduced phosphorylated NR1 and ERK levels indicate that vitamins C and E inhibit the modulation of spinal cord neuropathic pain processing. Co-administration of vitamins C and E had a greater antiallodynic effect.
Animals ; Antioxidants ; Ascorbic Acid* ; Central Nervous System Sensitization ; Complex Regional Pain Syndromes ; Humans ; Hyperalgesia ; Inositol Phosphates ; Ischemia ; Male ; Mitogen-Activated Protein Kinases ; Models, Animal* ; N-Methylaspartate ; Neuralgia ; Phosphotransferases ; Prostaglandins E ; Rats* ; Rats, Sprague-Dawley ; Reactive Oxygen Species ; Receptors, N-Methyl-D-Aspartate ; Reperfusion ; Reperfusion Injury ; Spinal Cord ; Vitamin E* ; Vitamins*

Jejunogastric intussusception is a rare, but potentially lethal complication after gastrectomy or gastrojejunostomy. In the acute condition, early diagnosis and prompt surgical treatment are mandatory to reduce the incidence of mortality. We present here a case of jejunogastric intussusception that was diagnosed by gastroscopy in a patient with a history of subtotal gastrectomy, and she had experienced increasing epigastric pain and vomiting for 1 day.
Early Diagnosis ; Gastrectomy ; Gastric Bypass ; Gastroscopy ; Humans ; Incidence ; Intussusception ; Vomiting

BACKGROUND:Influenza is a respiratory infectious disease with high morbidity and relatively high mortality which occurs every winter. Therefore, influenza vaccination is recommended annually for high risk groups. However, the vaccination rate is not very high. It is well known that influenza vaccination prevents influenza, and some reports show partial preventive effects for the common cold. Therefore, the authors implemented this study to find out the preventive effects of influenza vaccination for influenza and the common cold. METHODS: The study period was six months from October 1997 to March 1998, and the subjects were chosen from those who visited seven Family Practice Clinics and two Family Practice Outpatient Departments of University Hospital. The vaccination group composed of those who received influenza vaccination during the period and the control group was those who did not receive the vaccination with age difference +/-3 years and of same gender. The study was done by a survey questionnaire. The data were analyzed using SPSS version 8.0 and chisquare test, t-test, and logistic regression was implemented RESULTS: The number of vaccination group was 223, the number of control group was 214, and the total subjects were 437 persons. Influenza occurred in 4 persons(1.8%) for the vaccination group, and 12 persons(5.6%) for the control group which showed significant difference(p=0.032). The common cold occurred in 69.1% of vaccination group and in 71.0% of control group with no difference. However, the duration of the common cold was 6.0 days for the vaccination group which was slightly shorter than 7.5 days for the control group(p=0.088), and the frequency of the common cold was 1.49 times for the vaccination group and 1.84 times for the control group(p=0.033). Logistic regression analysis showed that the relative risk of influenza for the vaccination group was 0.261(p=0.032), which meant 73.9% protective effect for influenza, but not for the common cold. CONCLUSIONS: Influenza vaccination can protect people from influenza, but did not protect them from common cold. However, it can lessen the frequency and duration of the common cold.
Common Cold ; Communicable Diseases ; Family Practice ; Humans ; Influenza, Human* ; Logistic Models ; Mortality ; Outpatients ; Vaccination* ; Surveys and Questionnaires