In 1, 345 patients suspected of having pancreatic or biliary tract disease, 23 patients were shown to have biliary ascariasis demonstrated by endseopic retrograded cholangiopancreatog raphy, at Kwang Ju Christian Hospital from Sep. 1976 to Aug. 1983. Authors report the clinical study and ERCP finding of 23 cases of biliary ascariasis. The result were as follows. 1) Out of 1,345 cases of ERCP, biliary ascariasis were 28 cases, The ascaris were found in CHD & IHD in 21 cases, and 2 casee were found in Ampulla of Vater. 2) There was no specifia age incidence and male to female ratio was 1: 1.9, 3) The disease was more prevalent in spring & summer, and more prevalent in rural area than urban area. 4) The chief eomplaints were RUQ and epigastric abdominal pain. The cases which were admitetted within 2weeks of onset were 16 cases. 5) Ascaris in biliary tract were removed by operation in 14 cases, and EST were performed in 5 cases. Two cases werere moved by DORMIA basket under the endoscopic direct visualization. 6) We report E.S.T. as a new therapeutic method of biliary ascariasis.
Abdominal Pain ; Ampulla of Vater ; Ascariasis* ; Ascaris ; Biliary Tract ; Biliary Tract Diseases ; Cholangiopancreatography, Endoscopic Retrograde ; Diagnosis* ; Female ; Gwangju ; Humans ; Incidence ; Male

Since the development of ultrasonography and computerized topography scanning, the diagnosis of uric acid stone the urinary system has not been difficult. But recently, we experienced a case of uric acid stone that was misdiagnosed as renal pelvis tumor.
Diagnosis ; Kidney Pelvis* ; Ultrasonography ; Uric Acid*

BACKGROUND: Medical decisions concerning the prolongation of life, the right to die and euthanasia are among the most extensively discussed issues within medicine and law today. The purpose of this study was to evaluate the attitudes of medical students and housestaff toward euthanasia. METHODS: From July 15 to September 15 of the 1998, the responses of 180 medical students and 132 housestaff to a self-administered questionnaire were analyzed to identify attitudes toward euthanasia. Over 312 respondents about attitudes toward euthanasia, the analysis of differences between proportions was made by the Chi-square test. RESULTS: About 69.9% of the respondents thought euthanasia should be legalized. The findings suggest that Buddhists (77.5%) and non-religious groups (88.1%) tend to support euthanasia more than Christians. Futhermore, medical students (74.4%) support euthanasia more than housestaffs(63.6%), male(75.1%) more often than female(57.9%). About 73.1% of the respondents said that active euthanasia is not justifiable, and 79.2% said that they do not like performing active euthanasia. In respect to passive euthanasia, 69.0% said that it is not ethically justifiable, but 63.0% would perform this as if it were legal. Housestaffs of internal medicine (76.9%) were more willing to do euthanasia than pediatrics (70.0%), surgery (63.6%), family practice (53.8%) and Ob/Gyn (33.3%). CONCLUSION: Respondents have positive attitudes toward legalization of euthanasia.. Most considered that passive euthanasia is not morally justifiable. But if it were legalized, they would be willing to do euthanasia, while they would still be disturbed by active euthanasia. The opinions of physician and medical students directly affect patient care and their attitudes must be considered if clear policies are to be developed concerning euthanasia.
Surveys and Questionnaires ; Euthanasia* ; Euthanasia, Active ; Euthanasia, Passive ; Family Practice ; Humans ; Internal Medicine ; Jurisprudence ; Life Support Care ; Patient Care ; Pediatrics ; Right to Die ; Students, Medical*

PURPOSE: Refractory small-cell lung cancer (SCLC) has a poor prognosis, and current salvage chemotherapy for refractory SCLC, such as CAV (cyclophosphamide, adriamycin, vincristine) or topotecan, has an unsatisfactory outcome, with a response rate and overall survival of less than 10% and 6 months, respectively. This phase II study evaluated the role of topotecan combined with etoposide in SCLC patients that have progressed, or relapsed, within 3 months following completion of the initial chemotherapy. MATERIALS AND METHODS: Twenty-seven patients were entered into this study. Eligible patients had an ECOG performance status of less than, or equal to, 2, at least one bidimensionally measurable lesion and adequate end organ function. IV topotecan, 1.0 mg/m2/d for 5 consecutive days, and etoposide, 100 mg/m2/d through days 1 to 3, were administered every 3 weeks until disease progression or undue toxicity. RESULTS: The major toxicity was myelosuppression. Grade 3/4 anemia, granulocytopenia, and thrombocy-topenia occurred in 14.2, 34.8, and 27.3% of cycles, respectively. There was no treatment-related death, and other non-hematologic toxicities were generally mild. Four patients achieved partial responses, with a response rate RR of 14.8%. The progression-free survival PFS ranged from 1 to 7 months, with a median of 2.0 months (95% confidence interval 1.22~2.78 months). Twenty-five patients died, with a median overall survival of 5.5 months (ranging from 1 to 21 months, 95% CI 4.32~6.68 months), and the 6-month survival rate was 32.1% (95% confidence interval 14.4~49.8%). CONCLUSION: The combination of topotecan and etoposide chemotherapy showed a modest response rate, but failed to prolong survival of refractory SCLC patients compared to topotecan monotherapy.
Agranulocytosis ; Anemia ; Carcinoma, Small Cell ; Disease Progression ; Disease-Free Survival ; Doxorubicin ; Drug Therapy ; Drug Therapy, Combination ; Etoposide* ; Humans ; Lung Neoplasms* ; Lung* ; Prognosis ; Survival Rate ; Topotecan*

Authors have recently experienced a rare case of avulsion of the left eye ball due to ocular injury in 7 years old Korean girl. The eye ball was completely exposed out of the lid margin. In this case authors supposed that the dynamic inertia was played a major role in the mechanism of avulsion of this eye ball. A breief review of other literatures has also been described.
Child ; Female ; Humans

The strategies of incorporating monoclonal antibodies (MoABs) have now proved efficacy in the first-line treatment of advanced non-small cell lung cancer (NSCLC). These include targeting the vascular endothelial growth factor (VEGF) or epidermal growth factor receptor (EGFR). Bevacizumab is a MoAB targeting the vascular endothelial growth factor (VEGF), an important mediator of new blood vessel formation. Cetuximab is a MoAB directed at EGFR. Binding cetuximab to EGFR blocks signal transduction and promotes receptor internalization and degradation. In this review, we present current data of bevacizumab and cetuximab for the first line treatment of advanced NSCLC. We also refer to their potential for Asian patients with advanced NSCLC in the first-line setting.
Antibodies, Monoclonal/*therapeutic use ; Antineoplastic Agents/*therapeutic use ; Asian Continental Ancestry Group ; Carcinoma, Non-Small-Cell Lung/*drug therapy ; Humans

Osteoporosis, the typical metabolic bone disease of the elderly, is characterized by a reduction in bone mineral density (BMD) and increased fracture risk. Genetic and environmental factors are known to play a key role in bone metabolism, and diet is also considered to be one of the important factors. The purpose of the present study was to investigate the relationship among the factors affecting BMD, including stature, body weight, age, time period since onset of menopause, and biochemical markers of bone turnover in postmenopausal women. Seventy-eight postmenopausal women who visited health promotion center for health examinations volunteered to participate in this study and they were divided into two groups according to the time period since onset of menopause : women with a time period since onset of menopause of less than 5 years (Group 1) and women with a time period since onset of menopause of 5 years or more (Group 2). The demographic characteristics and dietary intake were surveyed using a questionnaire. BMDs of the lumbar spine and femoral neck of subjects were measured by dual energy X-ray absorptiometry. Serum levels of 25-hydroxy-vitamin D and parathyroid hormone (PTH), known to be indicators of bone related hormone status, were anlyzed. Serum samples were measured for calcium, phosphorus, alkaline phosphatase, and osteocalcin as bone formation indicators, and urine was analysed for deoxypyridinoline, creatinine, calcium, and sodium as bone resorption indicators. The results are as follow : The mean BMDs of the lumbar spin and femoral neck were 1.02+/-0.02 g/cm2 and 0.81 +/-0.02 g/cm2, respectively, and the BMD level of Group 2 was significantly lower than tat of Group 1 (p<0.01, p<0.05, respectively). The mean daily intake of energy was 1838 +/- 55 kcal. When nutrient intake was compared with the recommended dietary allowances (RDA) of the subjects, only calcium, vitamin A and riboflavin intake showed means lower than the RDA. The nutrient intake did not show any significant differences between Group 1 and 2 Serum and urine levels of biochemical markers of bone turnover did not show any significant differences between Group 1 and 2, and all were within the normal range. However, the PTH and deoxypyridinoline levels showed a tendency to be higher, and the osteocalcin level to be lower in Group 2 than in Group 1. Although age and years after menopause (YAM) showed negative correlations with lumbar spine bone mineral density (LBMD) (r= -0.38, p<0.001, and r= -0.26, p<0.05, respectively), no correlation was found with femoral neck bone mineral density (NBMD). While height, body weight and body mass index (BMI) showed a positive correlation with LBMD (r= 0.32, p<0.001, r= 0.38, p<0.001, r= 0.22, p= 0.05, respectively), only body weight and BMI showed a positive correlation with NBMD (r= 0.30, p<0.01, and r= 0.27, p<0.05, respectivley). There was no significant corealtion between BMDs and the nutrient intake of subjects, except in the case of carbohydrates (r= 0.22, p<0.05). Also, serum and urine levels of bone turnover markers showed no significant correlation with nutrient intake. On the other hand, serum osteocalcin had a positive correlation with vitamin C intake (r= 0.22, p= 0.05), and urine deoxypyridinolin showed a negative correlation with niacin intake (r= -0.22, p= 0.05). Urinary na was negatively correlated with protein intake(r= -0.23, p= 0.05). The results suggested that it is difficult to prevent the decrease in bone mass among postmenopausal women eating the usual Korean diet. However, the BMDs of the lumbar spine and femoral neck were positively related to body weight ad BMI in postmenopausal women. Therefore, this study confirmed that one of the most effective ways to minimize bone loss in postmenopausal women would be to maintain an adequate body weight with balanced nutrient intake and activity in the pre-and postmenopausal periods.
Absorptiometry, Photon ; Aged ; Alkaline Phosphatase ; Ascorbic Acid ; Biomarkers ; Body Height ; Body Mass Index ; Body Weight ; Bone Density ; Bone Diseases, Metabolic ; Bone Resorption ; Calcium ; Carbohydrates ; Creatinine ; Diet ; Female ; Femur Neck ; Hand ; Health Promotion ; Humans ; Menopause ; Metabolism ; Niacin ; Osteocalcin ; Osteogenesis ; Osteoporosis ; Parathyroid Hormone ; Phosphorus ; Postmenopause ; Recommended Dietary Allowances ; Reference Values ; Riboflavin ; Sodium ; Spine ; Vitamin A ; Surveys and Questionnaires

This study was conducted to investigate dietary and other factors affecting bone mineral density (BMD) in Korean premenopausal women. Seventy-eight premenopausal women who visited the Health Promotion Center for health examinations volunteered to participate in this study. They were divided into two groups according to their bone status as shown by their T-scores: a non-osteoporotic group and a osteoporotic group. The results are as follows: The mean BMDs of the lumbar spine and femoral neck were 1.21 +/- 0.02 g/cm2 and 0.97 +/- 0.04 g/cm2, respectively. The BMD levels of the osteoporotic group were significantly lower than those of the non-osteoporotic group (p < 0.001, respectively). The heights of the women in the osteoporotic group were significantly lower than those of the non-osteoporotic group (p < 0.01) however, their body weights did not show any significant differences although they tended to be lower. The mean daily intake of energy was 1720 +/- 52 kcal. When the nutrient intake was compared with the Korean recommended dietary allowances (RDA), calcium, Fe, vitamin A and riboflavin intakes were lower than the RDA. Their was no significant difference in the nutrient intake of the non-osteoporotic group and osteoporotic group except for the intakes of protein, fat and niacin. Their was no significant difference between the non-osteoporotic group and the osteoporotic group and all were within the normal range. However, the serum alkaline phosphatase level of the osteoporotic group was significantly higher than that of the non-osteoporotic group (p < 0.001). Height measurements showed positive correlations with lumbar spine bone mineral density (LBMD, r = 0.332, p < 0.01) however there was no correlation with femoral neck bone mineral density (NBMD). Age, age at menarche, body weight, body mass index (BMI) and obesity showed no correlation with BMD. The BMD of the lumbar spine was significantly and positively related to the intake of niacin and vitamin C (r = 0.236, p < 0.05; r = 0.274, p < 0.05). Serum levels of calcium and phosphorus showed negative correlations with LBMD (r = -0.698, p = 0.0001; r = -0.503, p = 0.0001, respectively). The results suggested that the BMD of the lumbar spine was positively related to the intake of niacin and vitamin C in premenopausal women. Therefore, this study confirmed that one of the most effective ways to minimize bone loss would be have a higher intake of niacin and vitamin C rich foods and engaging habitually in physical activity may have a beneficial effect on BMD in the premenopausal period.
Alkaline Phosphatase ; Ascorbic Acid ; Body Mass Index ; Body Weight ; Bone Density ; Calcium ; Female ; Femur Neck ; Health Promotion ; Humans ; Menarche ; Motor Activity ; Niacin ; Obesity ; Phosphorus ; Premenopause ; Recommended Dietary Allowances ; Reference Values ; Riboflavin ; Spine ; Vitamin A

No abstract available.
Antibodies, Monoclonal* ; Base Sequence* ; DNA*

The variable clinical responses seen with rnost cancer immunotherapy suggests that there is a large interindividual variation in immunoiogic response to tumors. One of the key functional parameter.s of an immune response is the loca1 production of cytokines. These multifunctional cytokines have been implicated in growth stimulation and cytotoxicity of ovarian tumor celle. To determine the presence and quantities of cytokines in ovarian cancer tissue, the cons-titutive expression of cytokine mRNA in biopsies from epithelial ovarian carcinomas was determined by using a PCR-assisted mRNA amplification asssy(RT-PCR). Using a set of cytokine-specific primers for 14 different cytokines, distinctive patterns of cytokine gene expression between normal and malignant ovarian tissues could be found. Several cytokines were detected even in the norma1 ovarian tissue including IL-1A, IL-8, TGF-A, TGF-B, GM-CSF, and IL,-2R. In case of the ovarian cancer, the signals were more intense than normal and we could detect the expression of some other cytokines, such as IL-1B, IL- 4, IL-6, IL-l0, TNF, and INF-T, which could not be detected in normal tissue. The presence of eytokines in ovarian cancer tissue could be impartant in the growth and development of cancer, more specifically, in relation to host immune responsiveness.
Biopsy ; Cytokines ; Gene Expression* ; Granulocyte-Macrophage Colony-Stimulating Factor ; Growth and Development ; Immunotherapy ; Interleukin-6 ; Interleukin-8 ; Ovarian Neoplasms* ; RNA, Messenger