In 38 of 70 patients who underwent lumbar spinal surgery, we performed a randomized, prospective double-blind study of the effect of caudal block with morphine sulfate on postoperative pain levels. Age, sex, clinical features, postoperative analgesic consumption, pain score, adverse effects and patient satisfaction on discharge were recorded. The consumption of parenteral analgesics on the 1st, 2nd and 3rd days was significantly lower in the morphine sulfate group(p<0.05), than in the control group. Caudal block with morphine sulfate also led to marked reductions in pain levels and thus increases patients satisfaction during the postoperative period(p<0.05). Transient respiratory depression occurred in three of 38 patients(7.9%), but further treatment was not needed. Seventeen patients(44.7%) developed urinary retention, but this recovered spontaneously. The present study demonstrates that caudal block with morphine sulfate leads to a highly significant reduction in pain during postoperative periods and a corresponding reduction in the need for additional postoperative analgesics, in addition, patients are more satisfied.
Analgesics ; Double-Blind Method ; Humans ; Morphine* ; Pain, Postoperative* ; Patient Satisfaction ; Postoperative Period ; Prospective Studies ; Respiratory Insufficiency ; Urinary Retention

From 1979 to 1987, 33 patients with polymorphic retrculosis (PMR) limited in the upper airway were treated with primary radiation therapy and the analysis of treatment results was undertaken. Systemic symptoms such as fever, night sweats, and weight loss were noted in 48%. The nasal cavity was most frequently involved (85%), although involvement of PNS (33%) and palate (30%) was not uncommon. The 5 and 10 year actuarial survival rates were 47% and 40%, respectively. The difference in NSD between patients with in-field failure and those without it was significant statistically. Also, field size was significantly smaller in patients with marginal failure than those without it. During the follow-up period, systemic failure was found in 5 patients (diffuse histiocytic lymphoma in 4, histiocytic medullary retriculosis in 1). In this study, we can suggested that total radiation dose of at least 4500 cGy with generous treatment volume should be delivered to achieve better local control and that the development of an effective systemic chemotherapeutic regimen is required to improve the survival after systemic relapse.
Fever ; Follow-Up Studies ; Granuloma, Lethal Midline ; Humans ; Lymphoma, Large B-Cell, Diffuse ; Nasal Cavity ; Palate ; Radiotherapy ; Recurrence ; Survival Rate ; Sweat ; Weight Loss

The pathogenetic mechanisms of minimal change disease and immunoglobulin A nephropathy remain uncertain, but recently various reports have reported the important role of the immunological aspect in the pathogenesis of glomerular injury. To assess the abnormalities of immunoregulatory system in these glomerular disease, the percentages of lymphocyte subpopulations in peripheral blood were studied in 24 cases of minimal change disease and 28 of immunoglobulin A nephropathy diagnosed by renal biopsy. The results were as follows: 1) CD4/CD8 ratio of the minimal change disease was significantly increased, compared with normal controls and immunoglobulin A nephropathy(P<0.05). 2) No significant difference in T helper cell and T suppressor cell was found between steroid response group and steroid non-response group in minimal change disease. 3) No significant difference in lymphocyte subpopulation was found between group with nephrotic range of proteinuria and group without nephrotic range of proteinuria in minimal change disease. 4) The discrepancies in lymphocyte subpopulations was not observed between group with infection and group without infection in immunoglobulin A nephropathy. 5) The pathologic grade (criteria of WHO) did not demonstrate a significant difference in lymphocyte subpopulation in immunoglobulin A nephropathy. In conclusion, these results suggest that the dysregulation of cell-mediated immunologic system is involved in the pathogenesis of minimal change disease and immunoglobulin A nephropathy, and some differences of immunoregulatory abnormalities between minimal change disease and immunoglobulin A nephropathy exist. But in this study the change in lymphocyte subpopulation does not anticipate the clinical course and prognosis of minimal change disease and immunoglobulin A nephropathy.
Biopsy ; Glomerulonephritis, IGA* ; Humans ; Immunoglobulin A* ; Lymphocyte Subsets* ; Lymphocytes* ; Nephrosis, Lipoid* ; Prognosis ; Proteinuria ; T-Lymphocytes, Helper-Inducer

PURPOSE: Measurement of transmission dose is useful for in vivo dosimetry. In this study, the algorithm for estimating the transmission dose for open radiation fields was modified for application to partially blocked radiation fields. MATERIALS AND METHODS: The beam data was measured with a flat solid phantom with various blocked fields. A new correction algorithm for partially blocked radiation field was developed from the measured data. This algorithm was tested in some settings simulating clinical treatment with an irregular field shape. RESULTS: The correction algorithm for the beam block could accurately reflect the effect of the beam block, with an error within +/-1.0%, with both square fields and irregularly shaped fields. CONCLUSION: This algorithm can accurately estimate the transmission dose in most radiation treatment settings, including irregularly shaped field.

PURPOSE: Measurement of transmission dose is useful for in vivo dosimetry. In this study, previous algorithm for estimation of transmission dose was modified for use in cases with tissue deficit. MATERIALS AND METHODS: The beam data was measured with flat solid phantom in various conditions of tissue deficit. New algorithm for correction of transmission dose for tissue deficit was developed by physical reasoning. The algorithm was tested in experimental settings with irregular contours mimicking breast cancer patients using multiple sheets of solid phantoms. RESULTS: The correction algorithm for tissue deficit could accurately reflect the effect of tissue deficit with errors within +-1.0% in most situations and within +-3.0% in experimental settings with irregular contours mimicking breast cancer treatment set-up. CONCLUSION: Developed algorithm could accurately reflect the effect of tissue deficit and irregularly shaped body contour on transmission dosimetry.
Breast Neoplasms ; Humans

Endogenous endophthalmitis is a sight-threatening ophthalmic emergency that requires vitrectomy unless prompt treatment is undertaken. It is usually caused by hematogenous spread from a distant endogenous focus of infection. We treated a patient with endogenous endophthalmitis who also had prostate and perianal abscesses caused by Klebsiella pneumoniae. Clinicians should entertain the possibility of endogenous endophthalmitis if a patient with a urologic disease such as a prostate abscess or acute prostatitis resulting in bacteremia complains of ophthalmologic symptoms.

BACKGROUND: Consensus guidelines clearly define how epinephrine is administered during cardiopulmonary resuscitation (CPR). In South Korea, it is not known whether epinephrine is administered in accordance with the current advanced cardiovascular life support (ACLS) guidelines during actual practice. We sought to investigate adherence to ACLS guidelines during actual CPR in terms of the dose of epinephrine and the interval between doses. METHODS: A retrospective review of medical records was performed on 394 adult cardiac arrest patients who received CPR at an emergency room. Data including the duration of CPR, the dose of epinephrine, and the interval between doses was collected from CPR records. RESULTS: Standard-dose epinephrine (1 mg) was used in 166 of 394 patients (42.1%). In 58.8% of patients, the average between-dose interval was within the 3-5 min recommended in the guidelines, whereas it was shorter than 3 min in 31.4% of patients. As a whole, epinephrine was administered in accordance with the current ACLS guidelines in only 96 of 394 patients (24.4%). Logistic regression analysis revealed the duration of CPR to be an independent factor affecting the use of standard-dose epinephrine and the adequate between-dose interval. CONCLUSIONS: Epinephrine was not administered according to the ACLS guideline in most patients. A national multi-center study is required to determine whether the poor adherence to the ACLS guideline is a widespread problem. In addition, efforts to improve adherence to the ACLS guideline are required.
Adult ; Cardiopulmonary Resuscitation ; Compliance ; Consensus ; Emergencies ; Epinephrine ; Heart Arrest ; Humans ; Logistic Models ; Medical Records ; Republic of Korea ; Retrospective Studies

BACKGROUND: Hepatocellular carcinoma (HCC) is the most common primary malignant tumor of the human liver. However, the molecular changes and mechanisms that regulate the development and progression of HCC remain unclear. Beta-catenin is known as a multi-functional protein that acts as a regulator of the cadherin-mediated cell-cell adhesion system and also in the Wingless/Wnt signal transduction pathway. The aim of this study was to investigate the expression of beta-catenin and its possible role in HCC. METHODS: We investigated the expression of beta-catenin, Ki-67, TP53, alpha-smooth muscle actin and CD34 by performing immunohistochemical staining for 61 specimens of HCC and their adjacent non-tumorous tissue. We also examined the relationship between the nuclear expression of beta-catenin and the clinicopathologic parameters. RESULTS: The altered expression of beta-catenin was not detected in the nontumorous liver tissue. The nuclear expression of beta-catenin was observed in approximately 16% (10/61) of the HCC specimens. Double immunohistochemical staining for beta-catenin and E-cadherin showed a close relationship between nuclear translocation of beta-catenin and the loss of the membranous E-cadherin expression. Significant correlation was found between the nuclear translocation of beta-catenin and the tumor size, tumor necrosis and the presence of microvessel invasion and intrahepatic metastasis (p<0.05). CONCLUSIONS: This data indicates that nuclear translocation of beta-catenin could play a role in the growth and progression of HCC.
Humans ; Carcinoma, Hepatocellular ; Neoplasm Metastasis

OBJECTIVES: The lung cancer mortality in Korea has increased remarkably during the last 20 years, and has been the first leading cause of cancer-related deaths since 2000. The aim of the current study was to examine the time trends of occupational lung cancer and carcinogens exposure during the period 2006-2009 in South Korea, by assessing the proportion of occupational burden. METHODS: We defined occupational lung cancer for surveillance, and developed a reporting protocol and reporting website for the surveillance of occupational lung cancer. The study patients were chosen from 9 participating university hospitals in the following 7 areas: Seoul, Incheon, Wonju, Daejeon, Daegu, Busan, and Gwangju. RESULTS: The combined proportion of definite and probable occupational lung cancer among all lung cancers investigated in this study was 10.0%, 8.6%, 10.7%, and 15.8% in the years 2006 to 2009, respectively, with an average of 11.7% over the four-year study period. The main carcinogens were asbestos, crystalline silica, radon, polyaromatic hydrocarbons (PAHs), diesel exhaust particles, chromium, and nickel. CONCLUSION: We estimated that about 11.7% of the incident lung cancer was preventable. This reveals the potential to considerably reduce lung cancer by intervention in occupational fields.
Asbestos ; Carcinogens ; Chromium ; Crystallins ; Hospitals, University ; Humans ; Hydrocarbons ; Korea ; Lung ; Lung Neoplasms ; Radon ; Republic of Korea ; Silicon Dioxide ; Vehicle Emissions

BACKGROUND: Molecular tools for tissue profiling generally require collection of fresh frozen tissues (FFT) as sources of high-quality DNA and RNA. Nowadays, researchers carry out large-scale, multi-center studies and they request inter-institutional minimal intrinsic bias, some fundamental similarities, and the same standardized and validated procedures. METHODS: This study reports standardized quality control procedure for fresh frozen tissue of the National Biobank of Korea. RESULTS: The main procedures for quality control for FFT are as follows: records related to sample collection such as labeling of samples, transport temperature, lag time from excision of tissue to freezing, and sample size were reviewed for all fresh frozen samples. The stability of RNA and DNA in fresh frozen tissue was evaluated for 3% of collected samples and purity was assessed (ratio of the absorbance at 260 and 280 nm) as was integrity (agarose gel electrophoresis). Stained hematoxylin and eosin sections were reviewed by a pathologist to confirm the diagnosis and to assess how representative the frozen sample was. CONCLUSIONS: We introduced that the quality-control criteria for fresh frozen tissue of the NBK. We expect that this study contributes to standardization of collection, storage, and quality control of fresh frozen tissue.
Bias (Epidemiology) ; DNA ; Eosine Yellowish-(YS) ; Freezing ; Hematoxylin ; Korea ; Quality Control ; RNA ; Sample Size