No abstract available.
Ependymoma*

No abstract available.
Tuberculosis, Meningeal*

Endoscopy is increasingly performed with the patient under conscious sedation in many countries. The majority of patients can be adequately and safely sedated during routine upper endoscopy and colonoscopy with a combination of a benzodiazepine and opioid. Midazolam is a water-soluble benzodiazepine that is characterized by a rapid onset of action and a shorter duration compared with that of the other drugs of the same class. The major side effect of midazolam is respiratory depression, which can be reversed by flumazenil, a benzodiazepine-specific antagonist. Propofol is a lipid-soluble agent that has the advantages of a more rapid onset of action and a shorter recovery time compared to that of midazolam. However, it should be used with caution since it can lead to hypotension and respiratory depression. Propofol can be safely and effectively administered by nonanesthesiology physicians and nurses provided that they have received adequate training. Two models have been proposed for the administration of propofol by endoscopists: nurse-administered propofol sedation (NAPS) and combination propofol (propofol plus other agents) sedation. In order to modify the pharmacological disadvantages of propofol, fospropofol sodium, a water-soluble prodrug of propofol, has recently been developed. In addition, new delivery systems have been devised: patient-controlled sedation and computer-assisted personalized sedation, in which the computer continuously monitors the patient's condition and adjusts the dose of propofol accordingly. Endoscopists must have a thorough understanding of the medications used for endoscopic sedation and they must acquire the skills necessary for the treatment of cardiopulmonary complications. Therefore, it is necessary to develop a practice guideline pertaining to endoscopic sedation and also training programs for physicians and nurses in Korea.
Benzodiazepines ; Colonoscopy ; Conscious Sedation ; Endoscopy ; Flumazenil ; Humans ; Hypotension ; Korea ; Midazolam ; Propofol ; Respiratory Insufficiency ; Sodium

Inadequate bowel preparation is observed in more than 25% of all colonoscopies. Identification of predictive factors for inadequate colon cleaning is helpful and more detailed preparation methods should be used for patients at high risk. Age, male sex, inpatient status, and comorbidities were identified as independent risk factors in several previous studies. In patients with insufficient colon preparation, colon irrigation with endoscopic pumps or next-day colonoscopy following further bowel cleaning should be performed. In order to improve the efficacy and safety of both bowel preparation and colonoscopy, the endoscopic team should identify the patient's medical conditions and choose the optimal bowel preparation agent and regimen.
Colon ; Colonoscopy* ; Comorbidity ; Humans ; Inpatients ; Male ; Risk Factors

The use of colonoscopy for the screening and surveillance of colorectal cancer has increased. However, the miss rate of advanced colorectal neoplasm is known to be 2% to 6%, which could be affected by the image intensity of colorectal lesions. Image-enhanced endoscopy (IEE) is capable of highlighting lesions, which can improve the colorectal adenoma detection rate and diagnostic accuracy. Equipment-based IEE methods, such as narrow band imaging (NBI), Fujinon intelligent color enhancement (FICE), and i-Scan, are used to observe the mucosal epithelium of the microstructure and capillaries of the lesion, and are helpful in the detection and differential diagnosis of colorectal tumors. Although NBI is similar to chromoendoscopy in terms of adenoma detection rates, NBI can be used to differentiate colorectal polyps and to predict the submucosal invasion of malignant tumors. It is also known that FICE and i-Scan are similar to NBI in their detection rates of colorectal lesions. Through more effective and advanced endoscopic equipment, diagnostic accuracy could be improved and new treatment paradigms developed.
Adenoma ; Capillaries ; Colonoscopy ; Colorectal Neoplasms ; Diagnosis, Differential ; Diagnostic Equipment ; Endoscopy* ; Epithelium ; Image Enhancement ; Mass Screening ; Narrow Band Imaging ; Polyps*

BACKGROUND: One of the important mechanisms responsible for a tumor escaping the immune response is an absence of the tumor associated antigen (TAA) on the cancer cell surface. To overcome this, combination gene therapy using a herpes simplex thymidine kinase (HSTK) gene, prototype of drug sensitizing gene, was conducted to enhance TAA release by cell destruction, as well as the cytokine genes for immune cell attraction. METHODS: We investigated whether or not transduction with the adenovirus-HSTK (Ad-HSTK) enhanced the sensitivity of Lewis lung carcinoma (LLC) to ganciclovir (GCV) and induced a bystander effect. A Tumor vaccine trial was performed using LLC with ad-HSTK ±ad-GM-CSF±ad-IL-2 to determine if they exhibit some antitumor effect on established lung cancer xenografts. RESULTS: LLC with ad-HSTK revealed a much higher sensitivity to ganciclovir (GCV). LLC transduced with ad-HSTK and/or ad-IL-2, ad-GM-CSF showed a lower in vivo tumorigenicity. In the treatment experiment, vaccination with LLC transduced with ad-HSTK, ad-IL-2, or ad-GM-CSF alone modestly suppressed the growth of an established tumor. Combined transduction with HSTK and GM-CSF induced stronger growth suppression of a established lung cancer, while HSTK and IL-2 combination transduction did not have any antitumor effect on individual transduction. Vaccination with LLC-HSTK-GM-CSF increased the infiltration of dendritic cells in the spleen. CONCLUSION: It was concluded that a tumor vaccine transduced with HSTK and GM-CSF induces strong antitumor immunity by activating the dendritic cells.
Adenoviridae ; Animals ; Bystander Effect ; Carcinoma, Lewis Lung ; Cytokines* ; Dendritic Cells ; Ganciclovir ; Genetic Therapy* ; Granulocyte-Macrophage Colony-Stimulating Factor ; Herpes Simplex* ; Heterografts ; Interleukin-2 ; Lung Neoplasms* ; Lung* ; Phosphotransferases* ; Simplexvirus* ; Spleen ; Thymidine Kinase ; United Nations ; Vaccination

A clinical and laboratory study was conducted on 58 children who had been admitted to out pediatric department from February to September 1979, under the clinical diagnosis of septicemia. Following results were obtained: 1. Boys were affected more frequently than girls(1.3:1), and highest incidence was noticed in newborn period, comprising 50% of the total cases. 2. The common clinical manifestations, in order of frequency, were fever, lethargy, jandice, poor sucking and abdominal distension, and hyperbilirubionemia was the most common assocaited disease, followed by anemia and leukemia. 3. Clinical course revealed death in 6 patients(10.3%), discharge against advice in 7cases(21.1%) and complete recovery in the remaining 45 cases(77.6%). 4. Peripheral blood count showed leukocytosie in 40%, leukopenia in 12.1% and thrombocytopenia was seen in 45% of cases. 5. Gram staining of buffy coat smear showed bacteria in 34.5% and especially high ratio was noticed in newborn infants(48.3%). 6. Positive blood culture was seen in 39.7% with highest ratio of 45% in newborn infants. In positive blood culture group, toxic granules were noted in 32.8%, shift to left in 25.9%, hrombocytopenia in 18.9% and positive buffy coat smear in 15.5%. In summary, thrombocytopenia, toxic granules, shift to left were quite helpful in early diagnosis of sepsis. In addition to diagnostic value, examination of buffy coat smear could aid physician to select appropriate antibiotic regimen especially in sepsis of newborn period.
Anemia ; Bacteria ; Child* ; Diagnosis ; Early Diagnosis ; Fever ; Humans ; Incidence ; Infant, Newborn ; Lethargy ; Leukemia ; Leukopenia ; Sepsis* ; Thrombocytopenia

A clinical and laboratory study was conducted on 75 children with dysentery-like stool, who had been admitted or visited to our pediatric department, during 8 months period from January to August 1980. The following results were obtained: One to five years of age group was affected most frequently(47%), Shigella flexneri was identified by stool culture in 23 cases(30%) and Entameba histolytica in 13 cases(17%). In bacillary dysentery group, fever was the most common symptom occuring in 83%, followed by abdominal pain in 35%. vomiting in 26% and convulsion in 22%. In amoebic dysentery group, fever was noted in 31% and convulsion in 8%, showing some contrast to the frequency of fever & CNS manifestation. About the character of diarrheal stool, 83% of bacillary dysentery group showed bloody, mucoid stool and 62% of amoebic dysentery group mucoid ones. Frequency of diarrhea was 11 times per day or more in 73% of bacillary dysentery patients, and 10 times per day or lese in 92% of amoebic dysentery patients. The result of sensitivity test of isolated Shigella to various antibiotics were as follow : 100% sensitive to kanamycin, gentamicin, amikacin, cephaloridine & rifampin, 87% to nalidixic acid, an4 4.3% to sulfonamide, chloramphcnicol, streptomycin, tetracyclin, ampicillin & bactrim. And 22 out of 23 isolated Shigella strains revealed multiple- drug-resistance pattern on 6 or more antibiotics.
Abdominal Pain ; Amebiasis ; Amikacin ; Ampicillin ; Anti-Bacterial Agents ; Cephaloridine ; Child* ; Daegu* ; Diarrhea ; Dysentery, Amebic ; Dysentery, Bacillary ; Fever ; Gentamicins ; Humans ; Kanamycin ; Nalidixic Acid ; Rifampin ; Seizures ; Shigella ; Shigella flexneri ; Streptomycin ; Trimethoprim, Sulfamethoxazole Drug Combination ; Vomiting

BACKGROUND: Two tumor suppressor genes, p53 and p16, which have different roles in controlling the cell cycle and inducing apoptosis, are frequently inactivated during carcinogenesis including lung cancer. Single tumor suppressor gene therapies using tither with p53 or p16 have been studied extensively. However, there is a paucity of reports regarding a combined gene therapy using these two genes. METHODS: The combined effect of p53 and p16 gene transfer by the adenoviral vector on the growth of lung cancer cell lines and its interactive mechanism was investigated. RESULTS: An isobologram showed that the co-transduction of p53 and p16 exhibited a synergistic growth inhibitory effect on NCI H358 and an additive effect on NCI H23. Cell cycle analysis demonstrated the induction of a synergistic G1/S arrest by a combined p53 and p16 transfer. This synergistic interaction was again confirmed in a soft agar clonogenic assay. CONCLUSION: These observations suggest the potential of a p53 and p16 combination gene therapy as another potent strategy in cancer gene therapy.
Adenoviridae ; Agar ; Apoptosis ; Carcinogenesis ; Cell Cycle ; Cell Line* ; Genes, Neoplasm ; Genes, p16 ; Genes, Tumor Suppressor ; Genetic Therapy ; Lung Neoplasms* ; Lung*

BACKGROUND/AIMS: Ulcerative colitis undergoes periods of exacerbation and remission. Fecal calprotectin levels increase with gut inflammation and correlate with endoscopic disease activity in ulcerative colitis. Intestinal blood loss and fecal immunochemical test levels also correlate with endoscopic disease activity. This study statistically evaluated the usefulness of fecal calprotectin, fecal immunochemical test, and C-reactive protein (CRP) as markers of disease activity. METHODS: A total 106 ulcerative colitis patients who underwent endoscopy and fecal calprotectin, fecal immunochemical test, and CRP testing, from March 2015 to August 2016, were retrospectively reviewed. Disease activity was assessed using a partial Mayo score and Mayo endoscopic score. The ability of fecal and serologic tests to reflect endoscopic disease severity was statistically evaluated. RESULTS: Among 106 patients, 68 underwent endoscopy and stool study within 2 weeks. In patients with mild to severe activity, fecal immunochemical test and fecal calprotectin were superior to CRP at Mayo endoscopic score detection rate. The area under the curves of fecal immunochemical test and fecal calprotectin for the detection of Mayo endoscopic score ≥1 were 0.956 and 0.942, respectively, and were superior to that of CRP (0.756). At Mayo endoscopic score, the effects of combination of fecal immunochemical test and CRP or fecal calprotectin and CRP were found to be higher than those of the independent fecal immunochemical test or fecal calprotectin. CONCLUSIONS: Fecal immunochemical test and fecal calprotectin can effectively detect active ulcerative colitis better than remission. As these markers reflect the status of mucosal inflammation, they may reduce the requirement for invasive endoscopic examination.
C-Reactive Protein ; Colitis, Ulcerative* ; Endoscopy ; Humans ; Inflammation ; Leukocyte L1 Antigen Complex* ; Retrospective Studies ; Serologic Tests ; Ulcer*