In case of submucosal tumor, adenoma and atypism, we can't frequently use the snare polypectomy for treatment of them. Adenoma and atypism are premalignant, so other therapeutic modalities are necessary for resection of them. We have perfortned endoscopic mueosectomy such as strip biopsy, and "O"ring ligation on various mucosal lesions of upper GI tract in 23 patients(11 men, l2 women) from June 1993 to December l994. Fourteen patients wbo had adenoma were followed up endoscopically for 6 months to 24 months(mean: 14 months). The results were as follows: 23 patients(27 lesions) were enrolled in this study. Mean age was 50.3(range 32-74 years). The method of mucosectomy was strip biopsy in 19 cases(21 lesions), and "O"ring ligation in 4 cases(6 lesions). The rate of complete resection was 88.9%. If adenomas were resected incompletely, we added a laser therapy. There was no recurrence except a case in which carcinoma was detected on the other site during follow-up. No serious compication occurred such as massive bleeding or perforation. Based on the above results, the endoscopic mucosectomy is considered to be a safe and effective modality in the treatment of the flat polyps of upper GI tract and could be used for prevention of gastric cancer.
Adenoma ; Biopsy ; Follow-Up Studies ; Hemorrhage ; Humans ; Laser Therapy ; Ligation ; Male ; Polyps ; Recurrence ; SNARE Proteins ; Stomach Neoplasms ; Upper Gastrointestinal Tract*

Purpose: The purpose of this study is three-fold: 1) to evaluate factors influencing hearing aid (HA) satisfaction; 2) to provide a profile of HA satisfaction in daily life; and 3) to examine the reasons why people gave up using HAs. Materials and Methods: Data for 1148 respondents were statistically analyzed and reported. Results: In the study, age (β=-0.03, p<0.01), level of education (β=1.21, p<0.01), HA purchase price (β=1.50, p<0.01), bilateral amplification (β=1.23, p<0.01), wearing time (β=0.28, p<0.01), and HA fitting and fine tuning on a regular basis (β=1.71, p<0.01) significantly influenced HA satisfaction. In addition, the authors observed that the most satisfactory factors were clarity of sound (53.5%), people’s trust in their HA (61.7%), and listening from a quiet environment (72.8%) in the domains of sound quality, HA features, and listening environments, respectively. Finally, with multiple choices being possible, 65% of the 40 respondents who no longer used HAs answered that their HAs ended up in a drawer since the background noise was annoying and distracting. Conclusion This study is significant in that it is a large-scale multi-center research to comprehensively examine the factors influencing HA satisfaction in South Korea. This data will provide helpful information that could lead to the successful rehabilitation of hearing loss with HAs.

PURPOSE: The purpose of this study is to evaluate the findings of magnetic resonance imaging(MRI) of posterior fossa hemangioblastoma and usefulness of contrast enhancement with Gd-DTPA. MATERIALS AND METHODS: Seven patients with posterior fossa hemangioblastoma were studied with both pre- and post-enhanced MRI. The MR images were reviewed regarding the location, size, signal intensities of cysts and mural nodules, and their contrast enhancement pattern. RESULTS: Five tumors were located in cerebellar hemisphere, one in vermis, and one in posterior part of medulla. One patient with von HippeI-Lindau disease had a medullary hemangioblastoma with multiple pancreatic cysts. In 6 cases, the major portion of the tumor was cysts and had small mulkal nodules. The solid portion was relatiely lange in one case, cemprising half of the tumor Cysts were oval shaped and their sizes were 3--6.7cm in diameter. In five cases(71%), septations were noted within the cysts. Cysts were isointense or slightly hyperintense on Tl-weighted image and hyperintense on T2-weighted image compared with cerebrospinal fluid. Mural nodules were oval or rounded appearance in five cases and flattened appearance in two, and their size was 0.5--2.5cm in diameter. Mural nodules were isointense to gray matter. They were detected in five cases on Tl-weighted images and one case on T2-weighted images. In two cases, vascular signal void area was noted in mural nodules. On contrast-enhanced Tl-weighted images, all mural nodules were intensely enhanced. CONCLUSION: MRI proved to be a good diagnostic method to detect and characterize posterior fossa hemangioblastoma. The most common finding is Cystic posterior fossa lesion with enhancing mural nodule. Contrast enhancement is essential for specific diagnosis.
Cerebrospinal Fluid ; Diagnosis ; Gadolinium DTPA ; Hemangioblastoma* ; Humans ; Magnetic Resonance Imaging* ; Pancreatic Cyst

Neurite outgrowth and its maintenance are essential aspects of neuronal cells for their connectivity and communication with other neurons. Recent studies showed that over-expression of either leucine-rich repeat kinase 2 (LRRK2), whose mutations are associated with familial Parkinson's disease (PD), or Rab5b, an early endosomal marker protein, induces reduction in neurite length. Based on our recent findings that LRRK2 co-localizes and interacts with Rab5, we tested the hypothesis that LRRK2 and Rab5 may functionally interplay while controlling neurite outgrowth. Firstly, we confirmed previous reports that over-expression of either the LRRK2 PD-specific G2019S mutant or the Rab5 constitutively active Q79L mutant, but not of dominant negative N133I mutant, significantly reduces neurite outgrowth. Secondly, when over-expression of either LRRK2 wild type (WT) or G2019S was accompanied with over-expression of one of the Rab5 variants (WT, Q79L and N133I), or with down-regulation of Rab5, the reduction extent of its neurite length was similar to that of cells over-expressing LRRK2 alone, regardless of Rab5's status. Finally, we observed similar patterns of neurite length regulation in embryonic rat hippocampal neuron cultures. Taken together, our results suggest that LRRK2 and Rab5 functionally coordinate their regulation of neurite outgrowth and that LRRK2 is a more critical factor than Rab5.
Animals ; Down-Regulation ; Neurites ; Neurons ; Parkinson Disease ; PC12 Cells ; Phosphotransferases ; Rats

We describe two cases of primary thyroid lymphoma, involving 64-and 74-year-old women who presented with arapidly growing palpable mass in the anterior neck. In both patients, plain radiographs of this region re-vealedtracheal displacement and soft tissue mass, and CT scans demonstrated the presence of a large soft tis-sue masswith homogeneously low attenuation, predominantly located in the unilateral lobe of the thyroid g-land. Within themasses there was no calcification, necrosis, or hemorrhage, though in one patient the trachea was involvedposteriorly by the mass Both masses appeared as cold nodules on RI scan, and in both patients, the final diagnosiswas diffuse large cell type non-Hodgkin's lymphoma with a background of Hashimoto's thyroiditis.
Aged ; Female ; Hemorrhage ; Humans ; Lymphoma* ; Lymphoma, Non-Hodgkin ; Neck ; Necrosis ; Thyroid Gland ; Thyroiditis ; Tomography, X-Ray Computed ; Trachea

Immunoglobulin A (IgA) nephropathy in patients with the clinical findings of rapidly progressive glomerulonephritis usually demonstrate crescentic glomerulonephritis (CrGN). It is characterized by mesangial immune complex deposits containing IgA and is rarely associated with ANCA. The following case report illustrates a CrGN with mesangial & capillary wall IgA deposits by immunofluorescence (IF) and mesangial & endocapillary electron dense deposits by electron microscopy (EM) in patient with positive ANCA serology. A 54-year-old male visited due to the discomfort of right flank. Blood pressure was 150/90 mmHg. BUN and serum Creatinine was 40 mg/dL, 4.4 mg/dL respectively. Urinalysis revealed protein 2+, >30 RBC's/ HPF (dysmorphic), 24hr urine protein 1,612 mg/day and creatinine clearance 19 mL/min/1.73m2. Serological P-ANCA was positive by indirect immunofluorescence & ELISA. The histologic findings showed global scleorsis and fibrocelluar crescent without hypercellularity on LM, mesangial IgA deposition on IF, mesangial and subendothelial electrone dense material depositions on EM. After treatment (Methylprednisolon 500 mg/day for 3 days and then prednisolone 60 mg/day), Serum creatinin level, proteinuria and ANCA titer were decreased.
Antibodies ; Antibodies, Antineutrophil Cytoplasmic* ; Antigen-Antibody Complex ; Blood Pressure ; Capillaries ; Creatinine ; Enzyme-Linked Immunosorbent Assay ; Fluorescent Antibody Technique ; Fluorescent Antibody Technique, Indirect ; Glomerulonephritis ; Glomerulonephritis, IGA* ; Humans ; Immunoglobulin A* ; Male ; Microscopy, Electron ; Middle Aged ; Prednisolone ; Proteinuria ; Urinalysis

PURPOSE: The purpose of the study was to evaluate the relationship between the location of bone signalabnormality and associated injury, as seen on MR, in patients with acute knee joint injury. MATERIALS AND METHODS: Thirty-six patients with acute knee injury and bone signal abnormalities on MR were included in this study. Thefemur and tibia were each divided into six compartments, namely the anteromedial, medial, posteromedial,anterolateral, lateral, and posterolateral ; these were obtained in each knee joint. We evaluated the location ofbone signal abnormality and the corresponding arthroscopic or operative findings of injury to ligaments andmenisci. Cases with signal abnormalities involving more than three compartments were excluded. RESULT: Bonesignal abnormalities were demonstrated in 51 compartments. Most(84%, 43/51) were noted in the lateral half of theknee joint, the most common location being the tibio- posterolateral compartment(13/51). The femoro-lateral(11/51) and tibio- anterolateral compartment(8/51) were the next most common locations. All cases(13/13)with bone signal abnormality in the tibio- posterolateral compartment had tears at the anterior cruciate ligament,while 9 of 11 cases(81%) with abnormality in the femoro- lateral compartment had tears at the anterior cruciateligament. Six of eight cases(75%) with signal abnormality in the tibio- anterolateral compartment had tears at theposterior cruciate ligament ; 31 of 43 cases (72%) with abnormality in the lateral half of the knee joint hadtears at the medial collateral ligament. Six of eight cases(75%) with signal abnormality in the medial half of theknee joint had tears at the medial meniscus, but no lateral meniscal tear was found. Among patients with signalabnormality in the lateral half of the knee joint, the tear was lateral meniscal in nine of 43 cases(21%) andmedial meniscal in six of 43(14%). CONCLUSION: The location of bone signal abnormality, as seen on knee MR, inpatients with acute knee joint injury could be an important finding suggesting associated injury.
Collateral Ligaments ; Humans ; Inpatients ; Joints ; Knee Injuries ; Knee Joint* ; Knee* ; Ligaments ; Magnetic Resonance Imaging* ; Menisci, Tibial ; Tibia

It has been reported that heat shock (43degrees C) induces an episode of cell death in developing central nervous system as part of pathogenesis leading to abnormal growth and development. Cell death induced by heat shock is likely to occur by a process termed apoptosis. On the other hand, protective role of mild heat shock on heat shock-induced apoptosis has also been suggested. In this study, the effect of 43degrees C heat shock on the induction of apoptosis was investigated in detail firstly by determining internucleosomal DNA fragmentation (DNA laddering) and secondly by determining apoptotic bodies using TUNEL (TdT-mediated dUTP-biotin nick end labeling). In addition, the effect of mild heat shock (42degrees C) on the apoptotic process was examined. In order to modulate the environmental temperatures of the developing embryos, we used whole embryo culture technique. DNA fragmentation and apoptotic body was induced a little by 42degrees C exposure but embryos exposed to 43degrees C showed strong DNA fragmentations. In comparison, the amount of DNA fragmentation was significantly reduced in embryos with 42degrees C pretreatment than 43degrees C group. In the control embryos (37degrees C exposure), basal levels of DNA fragmentation and apoptotic bodies were observed. From this study, it was evident that thermotolerance could protect the early postimplantation embryos from hyperthermia.
Animals ; Apoptosis* ; Cell Death ; Central Nervous System ; DNA ; DNA Fragmentation ; Embryo Culture Techniques ; Embryonic Structures* ; Fever ; Growth and Development ; Hand ; Hot Temperature ; In Situ Nick-End Labeling ; Rats* ; Shock

PURPOSE: This study was to investigate the nationwide operational status of the professional medical support staffs (PMSS) who practice the expanded roles in the hospital setting. METHODS: The data were obtained through survey from 36 hospitals with over 500 beds from 25th May to 12th July 2016. Data from 1,666 PMSS were analyzed. RESULTS: Since the job titles varied, we classified them into 5 groups according to their roles; advanced practice nurse, clinical nurse expert, PA (physician assistant), coordinator, and others. There were differences in the operation status of PMSSs depending on the region, nurse staffing grade and number of hospital beds. Qualification criteria varied from hospital to hospital, and almost half of the hospitals didn't have any qualification standards for them. There were differences in age, educational level, clinical careers, rewards, and job satisfaction in 5 groups. Especially PA group had low salary, poorer working conditions, more difficulties in performing their work, and lower job satisfaction than other groups. Most PMSS (99.5%) were using a delegated prescription authority, however only 68.3% had job description and 19.9% had documented delegated role. CONCLUSION: Adequate training curriculum, documented delegated roles, and the protocols for legal protection and efficient medical services are needed.
Curriculum ; Humans ; Job Description ; Job Satisfaction ; Nurse Clinicians ; Organization and Administration ; Physician Assistants ; Prescriptions ; Reward ; Salaries and Fringe Benefits

PURPOSE: This study aimed to investigate the current statistics of professional medical support staffs(PMSSs) working in general hospitals with less than 500 beds. METHODS: This study was conducted on 35 general hospitals with less than 500 beds from September 11th to October 27th, 2017. RESULTS: Four hundred fifty one PMSSs were currently providing medical support. The number of clinical nurse experts was the highest among the roles, followed by Physician Assistants(PA) and Advanced Practice Nurses. The mean job satisfaction score was 3.07 out of 5. In the case of PA group, most of the delegated prescriptions were performed, however the delegated roles were not much documented in written format. The paucity of documentation requires a development of a committee for PMSSs, including a development of selection criteria and a scope of practice in each institution. CONCLUSION: The results of this study suggested the composition of a committee for PMSSs in the medical institutions and renaming the specified titles of PMSSs.
Hospitals, General ; Humans ; Job Satisfaction ; Nurse Clinicians ; Nurse Practitioners ; Nursing ; Patient Selection ; Physician Assistants ; Prescriptions