BACKGROUND: The terminal destruction of the striatal dopaminergic axon can produce the retrograde degeneration of nigral dopaminergic neurons. An analyses of the postsynaptic dopamine D1 & D2 receptors and the DOPAC/DA level, revealed that this model mimics the early course of Parkinson's disease in humans. We evaluated the time course of the retrograde dopaminergic neuronal degeneration and the pattern of dopaminergic neuronal loss in the substantia nigra after various doses of 6-hydroxydopamine (6-OHDA) injections in the striatum of rats. METHODS: Different doses of 6- OHDA (0.0, 1.25, 2.5, 5, 10 ug/ul in 3.5 ul of saline) were unilaterally injected into the right striatum of rats using a stereotaxic frame. Structural and functional deficits were quantified and compared using apomorphine-induced rotations and tyrosine hydroxylase-immunoreactive (TH-IR) cell numbers in the substantia nigra pars compacta (SNpc) at 3, 6, 9 weeks after lesioning. RESULTS: Striatal 6-OHDA lesions produced dose-dependent decreases in TH-IR cell numbers in SNpc at 3 weeks (-3.8%, 17.9%, 41.2%, 58.5%, 69.9% cell loss compared with the contralesional side respectively), where the ventrolateral portion of the SNpc were more affected. As time progressed, nigral cell loss was significantly increased in all dosage groups and the lesion extended to the medial side of the SNpc and the ventral tegmental area. Apomorphine-induced rotations did not correlate well with nigral TH-IR cell loss. CONCLUSIONS: Intrastriatal injections of 6-OHDA, results in time-dependent and dose-dependent progressive degeneration of nigral dopaminergic neurons. We conclude that this rat model can be useful for the evaluation of further neuroprotective and neurotrophic therapies.
Animals ; Apoptosis ; Axons ; Cell Count ; Cell Death ; Dopamine* ; Dopaminergic Neurons ; Humans ; Models, Animal ; Oxidopamine* ; Parkinson Disease ; Rats* ; Retrograde Degeneration ; Substantia Nigra ; Tyrosine ; Ventral Tegmental Area

The adenoid cystic carcinoma in the orbit is rare, but is the most common in the malignancy of the orbit. The clinical signs are proptosis with displacement of the globe downward and inward, limitation of ocular movements and diplopia. The diplopia and ocular pain is due to the tumor metastasis to the extraocular mescle and nerve sheath. The authors have experienced a case of adenoid cystic carcinoma in the right orbit in a 72-year-old man.
Adenoids* ; Aged ; Carcinoma, Adenoid Cystic* ; Diplopia ; Exophthalmos ; Humans ; Neoplasm Metastasis ; Orbit*

BACKGROUND: Epithelial-mesenchymal transition (EMT) is critical for morphogenesis during embryonic development and is also implicated in the conversion of early-stage tumors into invasive malignancies. Recently, Twist has been identified to play an important role in EMTmediated metastatic progression of several types of human cancer. The present study examined the expression of Twist and evaluated its clinicopathologic significance in urothelial carcinoma of upper urinary tract. METHODS: Immunohistochemical staining for Twist expression was performed on 70 upper urinary tract urothelial carcinomas (UUT-UCs) using tissue microarray. RESULTS: Immunohistochemical staining for Twist was positive in 31/70 cases (44.3%) of UUT-UCs. Twist expression was associated with high-grade and advanced-stage (ISUP grade, p<0.01; stage, p=0.045). The patients with Twist positive-tumors revealed lower disease free survival rate than those with Twist negative-tumors (p<0.01). The overall survival for patients with Twist positive-tumors was slightly worse than the patients with Twist negative- tumors, but the difference was not statistically significant (p=0.12). CONCLUSION: Our results suggest that Twist is a novel marker for advanced UUT-UC.
Carcinoma, Transitional Cell ; Disease-Free Survival* ; Embryonic Development ; Epithelial-Mesenchymal Transition ; Female ; Humans ; Morphogenesis ; Pregnancy ; Twist Transcription Factor ; Urinary Tract*

Purpose: This study aimed to identify independent predictors of favorable outcomes associated with emergent carotid artery stenting (CAS) in patients with acute anterior circulation stroke. Materials and Methods: This study included 93 patients with acute stroke who underwent emergent CAS to treat stenoocclusive lesions in the cervical internal carotid artery (ICA) within 6 hours of the onset of the associated symptoms. Data were compared between patients with and without favorable outcomes. The independent predictors of a favorable outcome were determined via logistic regression analysis (modified Rankin Scale 0–2 at 90 days). Results: Intracranial tandem occlusion was noted in 81.7% of patients (76/93) among which (76/93), 55 of whom underwent intracranial recanalization therapy. Intracranial reperfusion was successful in 74.2% (69/93) and favorable outcomes were noted in 51.6% of patients (48/93). The mortality rate was 6.5% (6/93). In logistic regression analysis, diffusion-weighted imaging-Alberta Stroke Program Early CT Score [odds ratio (OR), 1.487; 95% confidence interval (CI), 1.018–2.173, p = 0.04], successful reperfusion (OR, 5.199; 95% CI, 1.566–17.265, p = 0.007), and parenchymal hemorrhage (OR, 0.042; 95% CI, 0.003–0.522, p = 0.014) were independently associated with a favorable outcome. Conclusion Baseline infarct size, reperfusion status, and parenchymal hemorrhage were independent predictors of favorable outcomes after emergent CAS to treat stenoocclusive lesions in the cervical ICA in patients with acute anterior circulation stroke.

PURPOSE: Complex clinical information in cerebral angiointervention unit requires effective management of statistical analysis for the classification of diagnosis and intervention including follow-up data from the interventional treatment. We present an application of Microsoft Access program for the management of patient data in cerebral angiointervention unit which suggests practical methods in recording and analyzing the patient data. MATERIALS AND METHODS: Since January 2002, patient information from cerebral angiointervention was managed by a database with over 4000 patients. We designed a program which incorporates six items; Table, Query, Form, Report, Page and Macro. Patient data, follow-up data and information regarding diagnosis and intervention were established in the Form section, related by serial number, and connected to each other to an independent Table. Problems in running the program were corrected by establishing Entity Relationship (ER) diagrams of Tables to define relationships between Tables. Convenient Queries, Forms and Reports were created to display expected information were applied from selected Tables. RESULTS: The relationship program which incorporated six items conveniently provided the number of cases per year, incidence of disease, lesion site, and case analysis based on interventional treatment. We were able to follow the patients after the interventional procedures by creating queries and reports. Lists of disease and patients files were identified easily each time by the Macro function. In addition, product names, size and characteristics of materials used were indexed and easily available. CONCLUSION: Microsoft Access program is effective in the management of patient data in cerebral angiointervention unit. Accumulation of large amounts of complex data handled by multiple users may require client/sever solutions such as a Microsoft SQL Server.
Classification ; Diagnosis ; Follow-Up Studies ; Humans ; Incidence ; Running ; Statistics as Topic

PURPOSE: Among various modalities of treatment in hepatic metastasis of colorectal cancer, hepatic resection has been proven to be the most effective treatment. This analysis was intended to determine important prognostic parameters and to understand clinically significant factors during hepatic resection and follow-up period in patients with hepatic metastasis from colorectal cancer. MATERIALS AND METHODS: Among 1,022 colorectal cancer patients treated at Asan Medical Center from July 1989 to December 1995, 99 patients were found to have liver metastasis at the time of first diagnosis or during follow-up period. These 99 patients were the subject of analysis in this retrospective clinical study. Surgical resection with curative intent was done in 35 patients and chemotherapy in 46 patients. Eighteen patients were with no treatment or misssed during follow-up. Survival rate was analysed according to clinicopathological parameters: sex, age, location of primary tumor, preoperative serum CEA level, TNM staging of primary tumor, number of hepatic metastasis, distribution, synchronous or metachronous lesions, diesase free interval, mode of treatment, type of resection, tumor free resection margin. RESULTS: Overall survival of the patients with hepatic metastasis was significantly related with numbers of metastasis (<4 vs. >4), distribution (unilobar vs. bilobar), synchronous or metachronous lesions, disease free interval ( < 12 vs. > 12 months), mode of treatment (hepatic resection vs. chemotherapy vs, no treatment, p<0.01. A multivariate analysis showed a significant association of survival with mode of treatment (p<0.01). Survival of patients with hepatic resection was significantly related with resection margin (positive vs. < 1 cm vs. > 1 cm), TNM staging of primary tumor (II vs. III), number of hepatic metastasis (p<0.01), disease free interval (p<0.05). A multivariate analysis showed a significant correlation with survival for tumor free resection margin (p<0.01). CONCLUSION: An aggressive approach of hepatic resection in the colorectal liver metastasis will improve survival, if the lesion pennits. In patients with hepatic resection, tumor free resection margin was the most important prognostic parameter by the uniand multivariate analysis. Therefore, every effort should be made to ensure that the clear margin be kept at least more than 1 cm during hepatic resection.
Chungcheongnam-do ; Colorectal Neoplasms* ; Diagnosis ; Drug Therapy ; Follow-Up Studies ; Humans ; Liver ; Multivariate Analysis ; Neoplasm Metastasis* ; Neoplasm Staging ; Retrospective Studies* ; Survival Rate

OBJECTIVE: The aim of this study is to extend the indications of hysteroscopic myomectomy. METHODS: Total 304 women who had undergone hysteroscopic myomectomy between February 2001 and March 2005, were selected. Clinical characteristics, laboratory data and postoperative results were analyzed. RESULTS: Mean size of myoma is 3.5 cm, mean op. time is 47 minutes, mean deficit of distension media is 193 cc, types of distension media is URIONE(R) and normal saline, average duration of hospitalization is 4.9 days, average changes of Hb. is 1.5 g/dL, complications of op. were happended in 14 cases, that is uterine perforation (n=8), hyponatremia (n=2), pulmonary edema (n=2), delayed bleeding (n=2). CONCLUSION: The indications of hysteroscopic myomectomy can be extended. In case that patient want to preserve the uterus, deep myometrial embedded or pure intramural myoma might be resected hysteroscopically by single- or multi-step procedure. Hysteroscopic myomectomy performed at observational period may be alternative to hysterectomy in selected cases. In case of recurrence, repeat procedure may reduce the chance of hysterectomy. Intraoperative ultrasonographic guidance is an important procedure in hysteroscopic myomectomy. It lower the complications and morbidity rate.
Female ; Hemorrhage ; Hospitalization ; Humans ; Hyponatremia ; Hysterectomy ; Myoma ; Pulmonary Edema ; Recurrence ; Uterine Perforation ; Uterus

BACKGROUND: The study of pneumonia among young men living in a group is rare. prospective study was conducted to determine the etiology, and compare the effects of macrolide and second-generation cephalosporin on the treatment of pneumonia among combat policemen. PATIENTS AND METHODS: From January 2003 to April 2004, Fifty-two patients with pneumonia were treated with either azithromycin(n=25) or cefuroxime(n=27). In order to determine the cause of the pneumonia, culture studies and serologic tests for antibodies to Mycoplasma pneumoniae and Chlamydia pneumoniae were carried out. During the two weeks of medication, the Chest X-rays, blood tests and culture studies(if necessary) were followed weekly. A serologic study was followed at the end of the second week. RESULTS: The main pathogens for pneumonia among combat policemen were Mycoplasma pneumoniae(50.0%), Chlamydia pneumoniae(10.8%), and Streptococcus pneumoniae(3.8%). The treatment was successful in most cases(51/52 cases, 98.1%). The effects of azithromycin and cefuroxime were similar (96.0% vs 100%, p>5). In one patient who had taken azithromycin, the clinical and radiological findings did not improved until intravenous second generation ce?phalosporin had been infused. CONCLUSION: Atypical pathogens were the main causes of the pneumonia in the combat policemen, and the effects of macrolide and second generation cephalosporin for pneumonia were similar. However, further studies will be needed to determine if single therapy with macrolide is possible.
Antibodies ; Azithromycin ; Cefuroxime ; Cephalosporins ; Chlamydia ; Chlamydophila pneumoniae ; Hematologic Tests ; Humans ; Macrolides ; Male ; Mycoplasma ; Mycoplasma pneumoniae ; Pneumonia* ; Pneumonia, Mycoplasma ; Prospective Studies* ; Serologic Tests ; Streptococcus ; Thorax

BACKGROUND: This nationwide survey was undertaken to characterize the general pathological features of colorectal cancer in Korea, and especially to elucidate the geographical characteristics by means of their anatomical distribution. METHODS: We analysed 1,676 colorectal cancers (from 1,602 patients) surgically resected in 1998 at 15 institutions from nine geographical sites in Korea. RESULTS: The topographic incidence of colorectal cancer in seven out of the total nine geographical sites, was the highest in the rectum (32-54%); and those from Wonju and Cheongju were in the sigmoid colon (28% for both). The right colon cancer incidence was 42% in Wonju and 36% in Cheongju, while it was 17-22% in the other areas. The cecal cancer incidences in Wonju and in Taegu were 7% and 8%, respectively, but 0-4% in the other areas. As for histology, moderately differentiated adenocarcinoma was the most frequent (46-84%), except for in Wonju and Chonju, where the most predominant type was well differentiated (63% and 52%, respectively). CONCLUSION: The incidence of right colon cancer was higher in Wonju and Cheongju, than in the other geographical sites. The cecal predilection was prominent in Taegu and Wonju. The Elucidation of geographical differences in degree of differentiation for tubular adenocarcinoma seems to require further cumulative study with strict guidelines.
Adenocarcinoma ; Cecal Neoplasms ; Chungcheongbuk-do ; Colon, Sigmoid ; Colonic Neoplasms ; Colorectal Neoplasms* ; Daegu ; Gangwon-do ; Humans ; Incidence ; Jeollabuk-do ; Korea ; Pathology ; Rectum

BACKGROUND/AIMS: During endoscopic retrograde cholangiopancreatography (ERCP), all efforts should be made to be aware of radiation hazards and to reduce radiation exposure. The aim of this study was to investigate the status of radiation protective equipment and the awareness of radiation exposure in health care providers performing ERCP in Korean hospitals. METHODS: A survey with a total of 42 questions was sent to each respondent via mail or e-mail between October 2010 and March 2011. The survey targeted nurses and radiation technicians who participated in ERCP in secondary or tertiary referral centers. RESULTS: A total of 78 providers from 38 hospitals responded to the surveys (response rate, 52%). The preparation and actual utilization rates of protective equipment were 55.3% and 61.9% for lead shields, 100% and 98.7% for lead aprons, 47.4% and 37.8% for lead glasses, 97.4% and 94.7% for thyroid shields, and 57.7% and 68.9% for radiation dosimeters, respectively. The common reason for not wearing protective equipment was that the equipment was bothersome, according to 45.7% of the respondents. CONCLUSIONS: More protective equipment, such as lead shields and lead glasses, should be provided to health care providers involved in ERCP. In particular, the actual utilization rate for lead glasses was very low.
Cholangiopancreatography, Endoscopic Retrograde ; Data Collection ; Delivery of Health Care ; Electronic Mail ; Eyeglasses ; Glass ; Health Personnel ; Humans ; Korea ; Postal Service ; Referral and Consultation ; Thyroid Gland