BACKGROUND: Therapeutic indications for stellate ganglion block range from head and upper arm disease to general disease including psychosomatic disorders. The aim of this study was to evaluate the effects of superior cervical ganglionectomy on anxiety using the elevated plus maze test. METHODS: Male Sprague-Dawley rats (150-250 g) were used. Each rat was put into the elevated plus maze 5 minutes per day for 10 days. We checked the number of entries into each arm (open arm and closed arm) and the duration of time staying in each arm. Rats were then divided into two groups: a group that received bilateral superior cervical ganglionectomy, and a control group that received a sham operation. The elevated plus maze test was then repeated and we evaluated the effect of superior cervical ganglionectomy on anxiety. RESULTS: Although there was an increased tendency of ganglionectomized rats to enter each arm, there were no significant differences in number of entries or in duration of stay between experimental and control groups. CONCLUSIONS: Bilateral superior cervical ganglionectomy in rats does not reduce anxiety. However, further studies are needed, ones combined with neuroendocrine and clinical studies, to determine the effect of superior cervical ganglionectomy on behavioral responses.
Animals ; Anxiety ; Arm ; Ganglionectomy ; Head ; Humans ; Male ; Psychophysiologic Disorders ; Rats ; Rats, Sprague-Dawley ; Salicylamides ; Stellate Ganglion ; Sympathectomy

PURPOSE: Little is known regarding the factors associated with the willingness of family caregivers of terminal cancer patients to participate in a bereaved survey. This study aimed to ascertain the pre-loss factors that predict actual participation in a bereaved survey. METHODS: We conducted a prospective observational study using data from two multi-center surveys at the end-of-life and after loss. In order to identify the pre-loss factors associated with participating in the bereaved survey, we used a step-wise multivariate logistic regression analysis. RESULTS: Among 185 bereaved individuals, 30 responded to the survey (response rate: 16.2%). There were differences between the participation group and the non-participation group regarding religion, economic status, and perceived quality of care as assessed by the Quality Care Questionnaire-End of Life. A final multivariate model revealed that bereaved individuals who professed a religion (adjusted odds ratio [aOR]=5.01; P=0.008), had a high income (aOR=4.86, P=0.003), and satisfied with the care for familial relationship (aOR=4.49, P=0.003) were more likely to engage in the bereaved survey. CONCLUSION: Our finding suggests that improving the quality of end-of-life care may promote actual participation in a bereaved survey through easing post-loss distress. More attention should also be paid to those bereaved individuals who are hesitant to participate in a bereaved survey.
Bereavement ; Caregivers ; Hospice Care ; Humans ; Logistic Models ; Observational Study ; Odds Ratio ; Prospective Studies* ; Surveys and Questionnaires

Sjogren's syndrome is an autoimmune disease causing eye or dry mouth from the lymphocytic infiltration in the lacrimal gland and the salivary gland, and is classified as primary or secondary based on the absence or presence of complicating systemic rheumatic diseases. Extraglandular systemic lesions involving organs such as the lungs, liver, and kidney are seen, and renal involvement of these is reported to occur in 20% to 50% of patients with primary Sjogren's syndrome, and most commonly manifested with a tubulointerstitial nephritis. But a little over 20 cases with glomerulonephritis have been reported in the literature review, and only one case was reported in Korea. Glomerulonephritis is a late sequelae in the course of the disease, and is most attributed to deposition of immune complexes. Membranoproliferative glomerulonephritis are the most common glomerular lesions and only one case of minimal change nephrotic syndrome was reported in the literature review, and no previous case was reported in Korea. We report a minimal change nephrotic syndrome that is concurrently manifested with sicca complex in a case of Sjogren's syndrome.
Antigen-Antibody Complex ; Autoimmune Diseases ; Glomerulonephritis ; Glomerulonephritis, Membranoproliferative ; Humans ; Kidney ; Korea ; Lacrimal Apparatus ; Liver ; Lung ; Mouth ; Nephritis, Interstitial ; Nephrosis, Lipoid* ; Nephrotic Syndrome ; Rheumatic Diseases ; Salivary Glands ; Sjogren's Syndrome*

The existence of a functional link between the nervous and immune systems has been well established. The present study was to characterize the expression of p75NTR during thymus regeneration from acute involution induced by cyclophosphamide in the rat. Immunohistochemical and double immunofluorescence analyses demonstrated that expression of the p75NTR was decreased in the thymic medullary epithelial cells and interdigitating dendritic cells during thymus regeneration. The presence of p75NTR protein in extracts from the control and regenerating rat thymus was confirmed by western blot. Furthermore, RT-PCR analysis supported these results by demonstrating that thymic extracts contain p75NTR mRNA at lower levels during thymus regeneration. Thus, our results suggest that the p75NTR located on the thymic medullary epithelial cells and interdigitating dendritic cells could play a role in the development of new T cells to replace the thymocytes damaged during thymus regeneration
Aluminum Hydroxide ; Animals ; Blotting, Western ; Carbonates ; Cyclophosphamide ; Dendritic Cells ; Epithelial Cells ; Fluorescent Antibody Technique ; Immune System ; Rats ; Regeneration ; RNA, Messenger ; T-Lymphocytes ; Thymocytes ; Thymus Gland

BACKGROUND/AIMS: To compare efficacy and tolerability of rabeprazole (RAB) 10 mg versus omeprazole (OME) 20 mg in patients with duodenal ulcer. METHODS: This randomized, comparative, multicenter study was conducted at 10 centers in Korea, from February to September in 1999. Patients with active duodenal ulcer as proven by endoscopy were randomized to RAB (n=123) or OME (n=123) groups. One hundred-twenty-three patients received RAB 10 mg once daily, and 123 patients received OME 20 mg once daily for 2 or 4 weeks. Primary efficacy parameter was complete healing by endoscopy and secondary parameter was the improvement in the severity of clinical symptoms after the therapy. RESULTS: After 2 weeks, complete healing was achieved in 81.7% (85/104) of patients given RAB 10mg and in 81.1% (77/95) of patients given OME 20 mg (p=0.902). After 4 weeks, complete healing was documented in 97.1% (101/104) of patients given RAB 10 mg and in 93.7% (89/95) of patients given OME 20 mg (p=0.315). The percentages of patients resolved daytime pain and night-time pain at Day 4 were 87.5% and 90.1% in RAB group and 79.0% and 80.5% in OME group (p=0.138 and p=0.087 for day-time k night-time pain, respectively). No clinically meaningful changes or other between-group differences were observed in laboratory parameters and adverse events which were evaluated to be related with medication. CONCLUSIONS: In this study, rabeprazole 10 mg produced healing rates and symptom relief equivalent to omeprazole 20 mg at weeks 2 and 4 in patients with active duodenal ulcer and provided a tendency of faster symptom relief than omeprazole 20 mg, although it didn't reach statistical significance. Both the treatments were well tolerated.
Duodenal Ulcer* ; Endoscopy ; Humans ; Korea ; Omeprazole* ; Rabeprazole*

Liquid biopsy for detection of mutation from circulating tumor DNA is a new technology which is attractive in that it is non-invasive. Epidermal growth factor receptor (EGFR) tyrosine kinase inhibitors (TKI) is an effective first line drug for advanced non-small cell lung cancer patients who harbor activating EGFR mutation. During the course of treatment, resistance against TKI arises which can be contributed to EGFR T790M mutation in about 50–60% of patients. Third generation TKI may overcome the resistance. In patients who cannot undergo tissue biopsy due to variable reasons, liquid biopsy is an excellent alternative for the detection of EGFR T790M mutation. However, this relatively novel method requires standardization and vigorous quality insurance. Thus, a standard set of guideline recommendations for liquid biopsy for EGFR mutation testing suitable for the Korean medical community is necessary. In this article, we propose a set of provisional guideline recommendations that was discussed and approved by the Cardiopulmonary Pathology Study Group of the Korean Society of Pathologists.
Biopsy ; Carcinoma, Non-Small-Cell Lung ; DNA ; Genes, erbB-1 ; Humans ; Insurance ; Lung Neoplasms ; Lung ; Methods ; Pathology ; Protein-Tyrosine Kinases ; Receptor, Epidermal Growth Factor

BACKGROUND/AIMS: Hepatolithiasis is a common disease in East Asia and presents as a histological feature of proliferative glands containing mucin. 5-10% of hepatolithiasis is known to be associated with cholangiocarcinoma. Recent studies reported that epidermal growth factor receptor (EGFR) could be activated through heparin binding- EGF cleavage by metalloproteinases. Matrix metalloproteinases (MMPs) which digest the extracellular matrix are required for cancer cell invasion and the expression of MMP-9 is known to be increased in cholangiocarcinoma. However, there has been few studies on the expressions and roles of EGFR and MMP in hepatolithiasis. This study was performed to clarify and compare the expressions of EGFR, erbB2 and MMP-9 in hepatolithiasis and cholangiocarcinoma. METHODS: Surgically resected liver tissues with hepatolithiasis (n=14), cholangiocarcinoma (n=20) and trauma (n=2 as controls) were included. The expressions of EGFR, erbB2 and MMP-9 in tissue samples were examined by immunohistochemistry using respective monoclonal antibodies. RESULTS: In traumatic livers, the expressions of EGFR, erbB2 and MMP-9 were all negative. The expression of EGFR was increased in hepatolithiasis group (79%, 11/14) compared with cholangiocarcinoma group (25%, 5/20) (p<0.05). The expression of erbB2 was detected only in cholangiocarcinoma (25%, 5/20). MMP-9 was increased in both hepatolithiasis (79%, 11/14) and cholangiocarcinoma (95%, 19/20) (p>0.05). CONCLUSIONS: EGFR expression appears to be the dominant component in periductular hyperplasia of hepatolithiasis and MMP-9 is upregulated not only in cholangiocarcinoma but also in hepatolithiasis. This study suggests that EGFR and MMP-9 are associated with cholangiocarcinoma and hepatolithiasis.
Adult ; Bile Duct Neoplasms/*metabolism ; *Bile Ducts, Intrahepatic ; Cholangiocarcinoma/*metabolism ; English Abstract ; Female ; Gelatinase B/*analysis ; Humans ; Lithiasis/*metabolism ; Liver Diseases/*metabolism ; Male ; Middle Aged ; Receptor, Epidermal Growth Factor/*analysis ; Receptor, erbB-2/analysis ; Up-Regulation

Colorectal carcinomas are extremely rare in childhood and adolescence; however, the colon is the most common site of a gastrointestinal carcinoma. Mucin secreting adenocarcinomas with signet ring formation is the most common type of colon cancer identified in children. An 11-year-old boy had abdominal pain and weight loss for three months, back pain and left thigh pain for two months, and hematochezia for four days. Colonoscopy showed an annular mass in the sigmoid colon and the histopathology revealed a signet ring cell carcinoma. A metastatic signet ring cell carcinoma was suspected from the findings of the bone scan, and confirmed later by a left scalp mass incisional biopsy and a bone marrow biopsy. We report a case of a metastatic signet ring cell carcinoma of the colon in a child.
Abdominal Pain ; Adenocarcinoma ; Adolescent ; Back Pain ; Biopsy ; Bone Marrow ; Carcinoma, Signet Ring Cell* ; Child* ; Colon* ; Colon, Sigmoid ; Colonic Neoplasms ; Colonoscopy ; Colorectal Neoplasms ; Gastrointestinal Hemorrhage ; Humans ; Male ; Mucins ; Scalp ; Thigh ; Weight Loss

BACKGROUND/AIMS: Sacroiliitis (SI) is one of the most frequent extraintestinal manifestations in inflammatory bowel disease (IBD) patients, but the exact prevalence has not been evaluated in Asia. There are few data on the association between SI and other clinical features of IBD. The prevalence of SI was evaluated using computed tomography (CT) and the phenotypic parameters associated with SI in Korean IBD patients were determined. METHODS: Eighty-two patients with ulcerative colitis (UC) and 81 patients with Crohn's disease (CD) were evaluated clinically. The presence of SI was evaluated using bone window setting of abdomino-pelvic CT images by two radiologists. RESULTS: The prevalence rates of SI were 12.2% and 21.0% in the UC and CD groups, respectively. There was no relationship between the localization or extent of intestinal inflammation and the presence of SI in the UC group. Multivariate analyses confirmed that perianal and upper-gastrointestinal (from the mouth through to the jejunum) diseases were associated with the occurrence of SI in the CD group (p=0.026 and p=0.047, respectively). CONCLUSIONS: SI was as common among Korean IBD patients as among Western patients. Perianal or upper-gastrointestinal involvement is associated with SI in CD patients.
Asia ; Colitis, Ulcerative ; Crohn Disease ; Humans ; Inflammation ; Inflammatory Bowel Diseases ; Mouth ; Multivariate Analysis ; Prevalence ; Sacroiliitis

Carcinoid tumors arise from enterochromaffin cells of neural crest origin. Rectal carcinoid tumors make up 1 to 2% of all rectal tumors. Approximately 50% of rectal carcinoid tumors are found incidentally on routine endoscopy, and they are asymtomatic. Rectal carcinoid is easily diagnosed by the characteristic submucosal tumor with yellowish color. There have been, however, some rare cases where the rectal carcinoid tumor was not easily diagnosed because of its atypical feature. We report a case of atypical rectal carcinoid tumor misdiagnosed as rectal cancer on endoscopic finding: this atypical gross morphology on endoscopy may be due to atypical histopathologic findings.
Carcinoid Tumor* ; Colonoscopy ; Endoscopy ; Enterochromaffin Cells ; Neural Crest ; Rectal Neoplasms ; Rectum