To compare the differences between hemodialysis and essential hypertension patients and its affecting factors of left ventricular hypertrophy and left ventricular systolic dysfucntion in patients with hemodialysis, M-mode and two dimensional echocardiography were performed in 77 essential hypertension without azotemia and 78 chronic renal failure patients receiving maintenance hemodialysis. M-mode measurement including LV mass (192.56+/-63.6g vs 300.01+/-95.99g, P=0.000), r/th (radius/LV thickness, 4.41+/-0.97 vs 4.74+/-1.0, P=0.039), LV dimemsion and fractional shortening (4.68+/-0.6 vs 5.63+/-0.97, P=0.000, 30.0+/-19.7% vs 36.6+/-97%, P=0.000 respectively) showed more severe eccentric LV hypertrophy and LV dysfunction in patients with hemodialysis than those of essential hypertension. Using Pearson correlation in hemodialysis patients, Interdialytic weight gain was positively correlated with LVEDD (r=0.318, P=0.005). In addition to the determinant, serum PTH level was negatively (r=-0.344, P=0.002) and Kt/V (r= 0.0487, P=0.003) was positively correalated with systolic function. The hypertension and dialysis duration, patient's age, had no relationship with LV function and mass in this study. In Conclusion, LV hypertrophy and LV systolic dysfunction occur more frequently in hemodialysis patients than in essential hypertension patients. And the LV systolic dysfunction, which is acutally related with the patient's quality of life, was partially explained by serum parathyroid level and Kt/V. But additional laboratory and prospective clinical studies are needed to further elucidate the mechanisms involved in the development of LVH and LV impairment in hemodialysis patients.
Azotemia ; Dialysis ; Echocardiography* ; Humans ; Hypertension* ; Hypertrophy ; Hypertrophy, Left Ventricular ; Kidney Failure, Chronic ; Quality of Life ; Renal Dialysis* ; Ventricular Dysfunction, Left ; Weight Gain

Malakoplakia is a rare chronic granulomatous disease found in the genitourinary tract, mainly. It is considered to be related to immunosuppression and/or infectious processes. We would like to present an operative case of cecal malakoplakia in a patient with a history of surgical resection and chemotherapy for cervical cancer. A 74-year-old female patient visited our hospital for 1-year follow-up after operation and chemo-radiotherapy for cervical cancer. An infiltrative mass of 6 cm, between the cecal base and the right psoas muscle, was observed on computed tomography. An ileocectomy was performed for diagnosis. Histopathologic examination revealed cecal malakoplakia. After surgery, based on previous reports, antibiotics therapy was added. Then the patient was discharged and treated in the outpatient clinic. To our knowledge, a rare case has been described of cecal malakoplakia during observation after surgery and chemo-radiotherapy for cervical cancer. Malakoplakia is known to be related to immunosuppressive condition. Therefore, our case suggests that close observation should be made in patients on immunosuppressive condition, such as chemotherapy.

Malakoplakia is a rare chronic granulomatous disease found in the genitourinary tract, mainly. It is considered to be related to immunosuppression and/or infectious processes. We would like to present an operative case of cecal malakoplakia in a patient with a history of surgical resection and chemotherapy for cervical cancer. A 74-year-old female patient visited our hospital for 1-year follow-up after operation and chemo-radiotherapy for cervical cancer. An infiltrative mass of 6 cm, between the cecal base and the right psoas muscle, was observed on computed tomography. An ileocectomy was performed for diagnosis. Histopathologic examination revealed cecal malakoplakia. After surgery, based on previous reports, antibiotics therapy was added. Then the patient was discharged and treated in the outpatient clinic. To our knowledge, a rare case has been described of cecal malakoplakia during observation after surgery and chemo-radiotherapy for cervical cancer. Malakoplakia is known to be related to immunosuppressive condition. Therefore, our case suggests that close observation should be made in patients on immunosuppressive condition, such as chemotherapy.

PURPOSE: Transurethral resection of prostate(TURP) is the gold standard for the treatment of benign prostate hyperplasia(BPH) at the present. But many attempts have been made to develop minimally invasive method. We studied the efficacy of transurethral needle ablation(TUNA) of prostate for treatment of BPH. MATERIALS AND METHODS: We performed TUNA in 20 BPH patients including 13 patients with acute urinary retention. Preoperatively all patients were evaluated using urinary flow rates, International Prostate Symptom Score(1-PSS), Quality of life and cystoscopic examination. The urinary flow rates, 1-PSS and Quality of life were checked at 1, 3 and 6 months after TUNA in all patients. RESULTS: The average value of peak flow rate of the patients with urinary retention were 10ml/sec, 12ml/sec and 13ml/sec at 1, 3 and 6 months follow-up. The average value of Qmax of the patients without urinary retention were 9ml/sec preoperatively and increased to 13ml/sec, 13ml/sec and 14ml/sec at 1, 3 and 6 months postoperatively. 1-PSS of patients with urinary retention improved from average 26 at preoperation to 14, 13, 10 at 1, 3 and 6 months postoperatively. Quality of life of patients with urinary retention improved from average 5 at preoperation to 2, 2, 2 at 1, 3 and 6 months postoperatively. The average value of patients without urinary retention improved from average 26, 5 at preoperation to 14, 11, 11 and 2, 2, 2 at 1, 3 and 6 months follow-up. No patients complained of erectile dysfunction and retrograde ejaculation postoperatively. CONCLUSIONS: The result of our preliminary study suggest that TUNA can be considered to be a simple, safe and efficacious procedure for the treatment of BPH including urinary retention.
Ejaculation ; Erectile Dysfunction ; Follow-Up Studies ; Humans ; Male ; Needles* ; Prostate ; Quality of Life ; Tuna ; Urinary Retention

We investigated the effects of isoflurane-induced hypotension on global cerebral blood flow (CBF), cerebral metabolic rate for oxygen (CMRO,), and the balance between cerebral oxygen supply and demand in 8 mongrel dogs. After endotracheal intubation, anesthesia was maintained with nitrous oxide (50%)-oxygen (50%)-fentanyl (2u/kg/hour). Ventilation was controlled to normocapnia. Mean arterial pressure (MAP) was lowered to 60 mmHg with inhalation of isoflurane. CBF was measured directly using sagittal sinus outflow method before (prehypotension), during (hypotension), and after (posthypotension) isoflurane-induced hypotension. Concomitantly, arterio-sagittal sinus venous oxygen content differen- ce was measured to calculate CMRO2. During hypotension, CBF and CMRO, were measured at 20 minutes after MAP was lowered to 60 mmHg and maintained stably. The time to induce hypotension was 8.6+/-6.1 (mean+/-SD) min. Mean inspired isoflurane concentra tion to induce desired hypotension was 3.1+/-0.9 vol%. The time to recover from hypotension was 28.6+/-7.7 min. MAP and heart rate were reduced significantly during hypotension (p<0.05, respectively) and returned to prehypotensive values during posthypotension. CBF was not changed between three peroiods. CMRO2 was reduced significantly during hypotension (6.5+/-1.2 vs 4.3+/-0.8ml/100/g/min, mean+/-SD, p<0.05) and returned to prehypotensive values during posthypotension. The percentage of CMRO2 reduction from prehypotension to hypotension (% CMRO2 reduction) was 32.5+/-12.9%. CBF/CMRO2 ratio was increased significantly during hypotension (12.8+/-3.3 vs 18.2+/-6.1, mean+/-SD, p<0.05) and lowered to prehypotensive values during posthypotension. Isoflurane-induced hypotension maintained CBF and reduced CMRO2 and therefore favorably influenced the balance between the global cerebral oxygen supply and demand. In conclusion, isoflurane induced-hypotension may be a safe and effective technique in view of the balance of the global cerebral oxygen supply and demand.
Anesthesia ; Animals ; Arterial Pressure ; Dogs* ; Heart Rate ; Hypotension* ; Inhalation ; Intubation, Intratracheal ; Isoflurane* ; Nitrous Oxide ; Oxygen* ; Ventilation

We evaluated the effects of guanosine 5′-monophosphate (GMP)-chelated calcium and iron (CaFe-GMP) on health and egg quality in layers experimentally infected with Salmonella Gallinarum. In this study, a CaFe-GMP feed additive was added to a commercial layer feed and fed to layers over a four-week period. All were inoculated with Salmonella Gallinarum. Body weight, mortality, clinical symptoms, and poultry production including feed intake, egg production, egg loss, and feed conversion rate were observed, and Salmonella Gallinarum was re-isolated from the liver, spleen, and cecum of the layers. All tested internal organs for the CaFe-GMP additive group exhibited significantly lower re-isolation numbers of Salmonella Gallinarum and less severe pathological changes than those in the control group, indicating that the CaFe-GMP feed supplement induced bacterial clearance and increased resistance to Salmonella Gallinarum. Additionally, due to the inhibitory action of CaFe-GMP on the growth of Salmonella Gallinarum, the CaFe-GMP additive group exhibited better egg production, including a higher laying rate and fewer broken eggs. The results suggest that a 0.16% CaFe-GMP additive may help prevent salmonellosis in the poultry industry.
Body Weight ; Calcium* ; Cecum ; Eggs ; Guanosine* ; Iron* ; Liver ; Mortality ; Ovum* ; Poultry ; Poultry Products ; Salmonella Infections ; Salmonella* ; Spleen

PURPOSE: To evaluate retrospectively the survival outcome, patterns of failure, and complications in patients treated with postoperative chemoradiotherapy (CRT) in advanced gastric cancer. MATERIALS AND METHODS: Between January 2000 and December 2006, 80 patients with advanced gastric cancer who received postoperative concurrent CRT were included. Pathological staging was IB-II in 9%, IIIA in 38%, IIIB in 33%, and IV in 21%. Radiotherapy consisted of 45 Gy of radiation. Concurrent chemotherapy consisted of a continuous intravenous infusion of 5-fluorouracil and leucovorin on the first 4 days and last 3 days of radiotherapy. RESULTS: The median follow-up period was 48 months (range, 3 to 83 months). The 5-year overall survival, disease-free survival, and locoregional recurrence-free survivals were 62%, 59%, and 80%, respectively. In the multivariate analysis, significant factors for disease-free survival were T stage (hazard ratio [HR], 0.278; p = 0.038), lymph node dissection extent (HR, 0.201; p = 0.002), and maintenance oral chemotherapy (HR, 2.964; p = 0.004). Locoregional recurrence and distant metastasis occurred in 5 (6%) and 18 (23%) patients, respectively. Mixed failure occurred in 10 (16%) patients. Grade 3 leukopenia and thrombocytopenia were observed in 4 (5%) and one (1%) patient, respectively. Grade 3 nausea and vomiting developed in 8 (10%) patients. Intestinal obstruction developed in one (1%). CONCLUSION: The survival outcome of the postoperative CRT in advanced gastric cancer was similar to those reported previously. Our postoperative CRT regimen seems to be a safe and effective method, reducing locoregional failure without severe treatment toxicity in advanced gastric cancer patients.
Chemoradiotherapy ; Combined Modality Therapy ; Disease-Free Survival ; Fluorouracil ; Follow-Up Studies ; Humans ; Infusions, Intravenous ; Intestinal Obstruction ; Leucovorin ; Leukopenia ; Lymph Node Excision ; Multivariate Analysis ; Nausea ; Neoplasm Metastasis ; Radiotherapy, Adjuvant ; Recurrence ; Retrospective Studies ; Stomach Neoplasms ; Thrombocytopenia ; Vomiting

PURPOSE: The purpose was trying to clarify utility of allogenous bone graft on open type high tibial osteotomy, among the method of treatment of osteoarthritis with genu varum deformity. MATERIALS AND METHODS: Working with eight patients who have osteoarthritis with genu varum deformity, performed the open type high tibial osteotomy. and after transplanting allogenous bone graft, fixed using L-shaped plate. Before and after the operation, measured the degree of correction of genu varum through radiography of anterior and posterior of weigh load, understudied degree of union by testing bone histology during removal of implant, and evaluated functional factor as well as improvement of patients using Lysholm's knee score and HSS knee score. RESULTS: According to radiography of anterior and posterior of weigh load, the average of varus angle was 5.3 +/- 3.2 degrees before operation, the average of correction angle was 16.1 +/- 4.1 degrees after operation and the average of valgus angle was 10.7 +/- 4.3 degrees. By radiography of anterior and posterior of weigh load and lateral taken during the continual observation, complete bone union was seen. It got result that bone histology of transplanted part was composed of osteologic tissue and ratio of live bone and dead bone was 3.3:1, which live bone was 76.7 +/- 8% by image analyzer (Pro Plus(R) system) during the implant removal. The average of correction loss angle was 1.5 +/- 1.0 degrees After 15.3 months, average period of observation, average of Lysholm's score and HSS knee score were increased from 66.2 +/- 8.3 to 75.7 +/- 9.1 and from 55.2 +/- 9.0 to 79.0 +/- 7.5 respectively. CONCLUSION: The method that using a transplantation of allogenous bone graft on open type high tibial osteotomy, can be a fine surgical technique because it gains a perfect union, has an inconsiderable loss of correction angle and precision of correction angle, and can be contributed to the improvement of functional knee joint.
Congenital Abnormalities ; Genu Varum ; Humans ; Knee ; Knee Joint ; Osteoarthritis ; Osteotomy* ; Radiography ; Transplants*

BACKGROUND: The disposable patient-controlled analgesia (PCA) devices are convenient for portability and management. An ideal PCA can be developed as an electronic device with various functions of safety and control. Recently, Accumate 1000(R) was developed as an electronic pump in Korea, and has passed the relevant laboratory criteria of safety and efficacy. We conducted a clinical study on the safety and efficacy when the device is applied to patients. METHODS: Fentanyl 1,500microgram, ketorolac 180 mg, and ondansetron 8 mg were used for PCA. Continuous infusion rate, bolus dose, and lockout time were set at 1 ml/h, 1 ml, and 15 min, respectively. Fifty patients were monitored for 48 h. The safety of Accumate 1000(R) was evaluated by backflow and siphonage, auto-clamp function, and lockout time intraoperatively. The efficacy was evaluated by the accuracy of bolus and total infused dose, and the satisfaction rates of patients and users. RESULTS: Backflow and siphonage did not occur, and the auto-clamp function was excellent. There was no bolus infusion during lockout time, and the bolus dose was infused accurately after lockout time. For the accuracy of the total infused dose, the mean and median value of performance error between the infused and target doses were -0.55%, and -0.29%, respectively. Noise, button sense, and convenience of cable were rated as satisfactory by 90%, 78%, and 84%, of patients respectively. CONCLUSIONS: The safety and efficacy of Accumate 1000(R) were established by clinical trial. We can provide patients with the more precise and optimal analgesia. The history of drug infusion can be used as research data.
Analgesia ; Analgesia, Patient-Controlled* ; Fentanyl ; Humans ; Ketorolac ; Korea ; Noise ; Ondansetron ; Passive Cutaneous Anaphylaxis

Cancer of the vulva accounts for approximately 0.5% of all gynecologic malignancies. At diagnosis, one-third of these cases is detected in an advanced stage (FIGO stages III, IV), and local extension of primary vulvar cancer may involve adjacent midline structures such as the clitoris, urethra, vagina, and anus. Initial surgical therapy of such locally advanced primary cancers may compromise the functional integrity of midline structures, necessitating ultraradical surgery including pelvic exenteration. In view of the relatively elderly age of the patients and the morbidity of this ultraradical dissection, concomitant chemoradiation therapy - that the efficacy had been proven in head and neck cancer, anal cancer has approached for patients with locally advanced vulvar cancer. We experienced a case of stage III vulvar cancer patient, who underwent concomitant chemoradiation therapy with 5-fluorouracil(FU) and cisplatin and who showed complete response. So, we report this case with brief review of the literatures.
Aged ; Anal Canal ; Anus Neoplasms ; Cisplatin ; Clitoris ; Diagnosis ; Female ; Head and Neck Neoplasms ; Humans ; Pelvic Exenteration ; Urethra ; Vagina ; Vulvar Neoplasms*