PURPOSE: Multimedia can be used to understand the basic anatomy and pathological features of the bladder, providing more intuitive knowledge than traditional education methods. Cystoscopy is one of the most fundamental and important diagnostic procedures for detecting pathology in the bladder. Thus, we developed a PC-based digitalized recording device and electronic document to create an electronic medical record to perform cystoscopy and used them for medical education. METHODS: To share them with an educatee, cystoscopic images from a camera unit were shown on the monitor of a personal computer, which was installed with an interface device with an S-VHS input. With these cystoscopic images, the operator could provide some information on important structures in the bladder, such as bilateral ureteral orifices, the verumontanum and the trigone to the educatee. Also, simple questionnaires were given to medical students to evaluate the effectiveness and value of this system. RESULTS: Cystoscopic images could be transferred to the monitor with considerable ease and quality through the personal computer. This system was effective and valuable in teaching the normal anatomy and pathology of the bladder. Also, based on the results of the questionnaire, we concluded that this system provides high-quality images that are sufficient to relay medical information and is superior to traditional methods with regard to educational effectiveness and increasing one's understanding of medical diseases. CONCLUSION: The PC-based recording system for cystoscopy substitutes for commercial recording devices for medical purposes, and provides sufficient medical information to medical students to allow them to understand the normal anatomy and pathological structure of the bladder.
Cystoscopy ; Education, Medical ; Electronic Health Records ; Electronics ; Electrons ; Humans ; Microcomputers ; Multimedia ; Organothiophosphorus Compounds ; Students, Medical ; Ureter ; Urinary Bladder ; Surveys and Questionnaires

The effects of (-)-epigallocatechin gallate (EGCG) on pacemaker activities of cultured interstitial cells of Cajal (ICC) from murine small intestine were investigated using whole-cell patch-clamp technique at 30degrees C and Ca2+ image analysis. ICC generated spontaneous pacemaker currents at a holding potential of -70 mV. The treatment of ICC with EGCG resulted in a dose-dependent decrease in the frequency and amplitude of pacemaker currents. SQ-22536, an adenylate cyclase inhibitor, and ODQ, a guanylate cyclase inhibitor, did not inhibit the effects of EGCG. EGCG-induced effects on pacemaker currents were not inhibited by glibenclamide, an ATP-sensitive K+ channel blocker and TEA, a Ca2+-activated K+ channel blocker. Also, we found that EGCG inhibited the spontaneous [Ca2+]i oscillations in cultured ICC. In conclusion, EGCG inhibited the pacemaker activity of ICC and reduced [Ca2+]i oscillations by cAMP-, cGMP-, ATP-sensitive K+channel-independent manner.
Adenine ; Adenylyl Cyclases ; Animals ; Gastrointestinal Motility ; Glyburide ; Guanylate Cyclase ; Interstitial Cells of Cajal ; Intestine, Small ; Mice ; Patch-Clamp Techniques ; Tea

BACKGROUND/AIMS: Cholestatic jaundice caused by a juxtapapillary diverticulum can be treated by excision of the diverticula or endoscopic sphincterotomy(EST). The aim of this study is to evaluate the effectiveness of EST for cholestatic jaundice in patient with juxtapapillary diverticulum with absence of common bile duct stones. METHODS: We recruited patients who underwent Endoscopic Retrograde Cholangio Pancreatography(ERCP) between September 2000 and May 2005. The presence of Juxtapapillary diverticula was seen in 92(29.3%)) out of 315 patients underwent ERCP. Cholestatic jaundice associated with juxtapapillary diverticula was considered when patients have jaundice, elevated serum bilirubin and alkaline phosphatase more than normal, and there are no other obstructive lesion on abdominal ultrasonography or computed tomography(CT) scan. The number of the patients were 13 who had cholestatic jaundice associated with juxtapapillary diverticula without common bile duct stones. All 13 patients underwent EST and had no complications. The patients were followed up to visit outpatient department or interviewed on the telephone. RESULTS: Of the 13 patients, 10 were male and 3 were female. The mean age was 70.4 years and mean duration of follow-up were 28.9 months. All 13 patients who had gallbladder presented RUQ discomfort and jaundice. Seven patients presented gallstone pancreatitis with jaundice. Nine patients had GB stone, 1 patients had GB sludge. In the follow-up period, from 1month to 46 months after EST, 1 patient died of unknown cause within 1 year. One patient had recurred gall stone pancreatitis with jaundice 12 months later. CONCLUSIONS: EST can be considered as a useful therapeutic modality especially in eldery patients with cholestatic jaundice and gallstone pancreatitis associated with juxtapapillary diverticulum.
Alkaline Phosphatase ; Bilirubin ; Cholangiopancreatography, Endoscopic Retrograde ; Common Bile Duct* ; Diverticulum* ; Female ; Follow-Up Studies ; Gallbladder ; Gallstones ; Humans ; Jaundice ; Jaundice, Obstructive* ; Male ; Outpatients ; Pancreatitis ; Sewage ; Telephone ; Ultrasonography

BACKGROUND/AIMS: The atrophic gastritis with intestinal metaplasia of gastric mucosa has been considered to be the major factor of carcinogenesis in the stomach. However, the key molecules are still poorly understood. To elucidate the molecular genetic basis, we report the results of our initial microarray data to analyze the genome pattern in patients with atrophic gastritis and intestinal metaplasia of the stomach. METHODS: We used oligonucleotide microarray technique to evaluate the gene expression profiles in atrophic gastritis with intestinal metaplasia, in comparison with those of normal mucosa. For the identification of differentially expressed genes, Significance Analysis of Microarrays (SAM) package method was used. The results were analyzed using global normalization, intensity dependent normalization, and box plot normalization. RESULTS: Eight genes including FABP, REG, OR6C1, MEP1, SLC6A1, SI, Mucin 1, and RAB23 in mucosa of atrophic gastritis and intestinal metaplasia were up-regulated by more than 10 times as compared with normal gastric mucosa. Only one gene, LOC44119 was down-regulated by more than 10 times of the expression as compared with normal gastric mucosa. In respect to the expression of known genes related to gastric carcinogenesis, 8 genes including FN1, SRMS, TP53, TP53IMP2, TP53I3, FGFR4, TGFB1, and TGFA showed up- and down-regulations more than 2 folds in expression pattern. CONCLUSIONS: We could identify a total genome pattern in patient with atrophic gastritis and intestinal metaplasia using oligonucleotide microarray. We believe that the current results will serve as a fundamental bioinformative basis for clinical applications in diagnosis and treatment of gastric cancer and precancerous lesion in the future.
Down-Regulation ; Gastritis, Atrophic/*genetics/metabolism ; Gene Expression Profiling ; Humans ; Intestines/*metabolism/*pathology ; Metaplasia/genetics/metabolism ; Microarray Analysis ; Tumor Markers, Biological/genetics/metabolism ; Up-Regulation

BACKGROUND: Stomach cancer is the most common cancer in Korea. Lifelong health management program recommends that males over 40 years and women over 50 years should undergo stomach cancer screening by endoscopy or upper gastrointestinal series every two years. The importance of re-screening of stomach cancer in a high risk group is emphasized. METHODS: A telephone questionnaire was done one year after to 123 patients over 40 years old considered as a high risk group with either chronic atropic gastritis, intestinal metaplasia, gastric ulcer, gastric adenoma among 804 subjects who had undergone anendoscopic examination from February 2002 to June 2003 at a university hospital health promotion center. RESULTS: The number of patients who responded were 109. The average recognition rate of high risk group was 53.2%. The rate of recognition of high risk group was lower in good subjective health estimation group and in less educated group, in old age group, and in chronic atrophic gastritis and intestinal metaplasia group. The rate of not receiving re-screening after 1 year was 48 (44.0%). Re-screening rate in patients with intestinal metaplasia (35.3%) and chronic atropic gastritis (39.1%) compared to gastric ulcer (77.8%) and gastric polyp (90.0%), in those not recognizing themselves as high risk group, in low education group, in old age, was lower. CONCLUSION: In patients with chronic atropic gastritis and intestinal metaplasia, in those not recognizing themselves as high risk group, in old age and in good subjective health state. We need to educate the importance for regular screening of stomach cancer more intensively.
Adenoma ; Education ; Endoscopy ; Female ; Gastritis ; Gastritis, Atrophic ; Health Promotion ; Humans ; Korea ; Male ; Mass Screening* ; Metaplasia ; Polyps ; Stomach Neoplasms* ; Stomach Ulcer ; Telephone ; Surveys and Questionnaires

BACKGROUND: Renal function in patients, who undergo medical examination, is usually evaluated by the serum creatinine level. However this numerical value does not always represent the entire renal function because the values increases only when the renal function has decreased more than 50%. The purpose of this study was to find the prevalence of renal diseases through the GFR (Glomerular filtration rate) using MDRD (Modification of Diet in Renal Disease) equation and to analyze the risk factors related to renal diseases. METHODS: We reviewed all the clinical records of 440 patients who had visited for medical examination between January 1, 2004 and December 31, 2004. We have calculated the GFR for each group using the MDRD equation and then figured out the correlation between the GFR and its risk factors. RESULTS: Patients haing GFR of less than 60 mL/min/1.73 m2 were 19 (7.2%), 60~90 mL/min/1.73 m2 were 123 (46.4%) and more than 90 mL/min/1.73 m2 were 123 (46.2%). The correlation between the GFR and age, obesity, hypertension and diabetes melitus were observed as negative results in univariate analysis of variance (P<0.05). Age and diabetes melitus were independent factors affecting the GFR (OR=3.1, 2.2 respectively, P<0.05) in multiple logistic regression analysis. CONCLUSION: It is a well known fact that the declined renal function is related to the aging process and diabetes melitus. Therefore, the mortality rate caused by renal failure and its complications should be decreased through the control of diabetes melitus, aging process and other risk factors.
Aging ; Creatinine ; Diet ; Filtration ; Humans ; Hypertension ; Logistic Models ; Mortality ; Obesity ; Prevalence* ; Renal Insufficiency ; Risk Factors*

Passive smoking is a major cause of respiratory morbidity, and is associated with increased bronchial responsiveness in children. To evaluate the effect of smoking by a parent on asthma symptoms, atopy, and airway hyperresponsiveness (AHR), we conducted a cross-sectional survey of 503 schoolchildren that involved questionnaires, spirometry, allergy testing, and a bronchial challenge test. If the PC20 methacholine was less than 16 mg/mL, the subject was considered to have AHR. The prevalence of a parent who smoked was 68.7%. The prevalence of AHR was 45.0%. The sensitization rate to common inhalant allergens was 32.6%. Nasal symptoms such as rhinorrhea, sneezing, nasal itching, and nasal obstruction were present in 42.7%. Asthma symptoms such as cough and wheezing were present in 55.4%. The asthma symptoms were significantly more prevalent in children who had a parent who smoked than in those whose parents did not. The nasal symptoms, atopy, and AHR did not differ according to whether a parent smoked. In a multiple logistic regression model, the asthma symptoms and atopy were independently associated with AHR, when adjusted for confounding variables. Passive smoking contributed to asthma symptoms in schoolchildren and was not an independent risk factor of airway hyperresponsiveness in an epidemiological survey.
Adult ; Asthma/*epidemiology/physiopathology ; Bronchial Hyperreactivity/*epidemiology/physiopathology ; Child ; Data Collection ; Female ; Human ; Hypersensitivity/*epidemiology/physiopathology ; Male ; Parents ; Prevalence ; Risk Factors ; Support, Non-U.S. Gov't ; Tobacco Smoke Pollution/*adverse effects/*statistics & numerical data

In this paper, a case of corneal squamous cell carcinoma is reported. Invasive squamous cell carcinoma of the cornea is a rare disorder and has not been previously described in the Korean literature. In this case, the invasive squamous cell carcinoma of the cornea was treated by complete excision and cryotherapy. No evidence of metastasis or recurrence has been found since the procedure. Complete excision and adjunctive cryotherapy has become the treatment of choice because of the higher recurrence rate following a simple excision.
Aged ; Carcinoma, Squamous Cell/*pathology/surgery/therapy ; Case Report ; Corneal Diseases/*pathology/surgery/therapy ; Cryotherapy ; Eye Neoplasms/*pathology/surgery/therapy ; Human ; Male ; Neoplasm Invasiveness

BACKGROUND: The author surveyed and analyzed the changes of perception and satisfaction about family medicine. So that the outcome may bring us a reference to advance family medicine more. METHODS: 247 in and out patients in one general hospital in Seoul were surveyed by the questionnaire from July 26, 2000 to June 20. The date was analyzed statistically by SAS program. RESULTS: As for the knowledge of family medicine, 61.5% of the patients answered that they knew what it is, and the most of them, 54%, via medical institution. The office workers, married , and highly educated people tend to know more about family medicine (P<0.05). As for attitude, 68% of the group answered that family medicine is necessary, because "family medicine doctors give proper advice and consult through out all fields of medicine"(58.8%). As for the preference so prirate doctor, 56.7% of the group answered that they would register for family medicine clinic, and students and office workers are fond of family medicine(P<0.05). As for the satisfaction, 34.4% were ever been to family medicine clinic, and 35.5% out of them were dissatisfied, mainly due to the lack of knowledge of physicians about their diseases(70.1%). CONCLUSION: The perception of family medicine are still scanty compared to the old studies.
Hospitals, General* ; Humans ; Outpatients ; Seoul ; Surveys and Questionnaires

PURPOSE: Most malignant peritoneal or pleural effusions caused by advanced malignancy are unresponsive to systemic chemotherapy except for chemotherapy sensitive tumors, and they are equally ineffective to regional therapy or radiotherapy. Thus, for the purpose of palliating the symptoms related to malignant effusion and to reduce fluid reaccumulations, we evaluated the therapeutic feasibility and efficacy of intracavitary ' Ho-CHICO (chito- san complex) instillation for intractable malignant effusions. MATERIALS AND METHODS: Thirty one patients with cytologically or pathologically proven malignant effusions underwent intracavitary 166Ho-CHICO therapy from May 1996 to March 1998 at Ajou University Hospital. The subjective and objective responses were evaluated 4 weeks after the treatment, including the changes of symptoms, weight, abdominal girth, doses of diuretics, frequencies and amounts of repeat aspirations for fluid reaccumulations, and imaging studies of chest radiograph and ultrasounds. RESULTS: The response rates treated with Ho-CHICO were 50% in patients with peritoneal effusion and 46% in patients with pleural effusion (overall 49%). The response rates between 166Ho-CHICO doses of 50-80 mCi and 90-100 mCi were similar (50% vs 47%). Response rate of 70% was noted in patients with even distribution of radioisotope on the post-therapy scan, but, the response rate was lower in cases with focal (44%) and uneven (29%) distribution pattern. There was no difference in response by the effusion sites. All patients tolerated intracavitary 166Ho-CHICO instillation well, although the majority of patients experienced Grade I/II side effects such as pain, fever, weakness and dyspnea. But, no serious complications of Grade lII or IV degree were observed with 166Ho-CHICO therapy. CONCLUSION: Intracavitary 166Ho-CHICO instillation was clinically efficacious in controlling malignant effusions without a significant toxicity seen with conventional sclerotic therapy. The therapeutic modality appeared to offer similar benefits obtained with the conventional intracavitary therapy.
Ascitic Fluid ; Aspirations (Psychology) ; Chitosan* ; Diuretics ; Drug Therapy ; Dyspnea ; Fever ; Holmium* ; Humans ; Pleural Effusion* ; Radiography, Thoracic ; Radiotherapy ; Ultrasonography