Each diastereomer of 10-thiophenyl- and 10-benzenesulfonyl-dihydroartemisinin was synthesized from artemisinin in three steps, and screened against chloroquine-resistance and chloroquine-sensitive Plasmodium falciparum. Three of the four tested compounds were found to be effective. Especially, 10 beta-benzenesulfonyl-dihydroartemisinin showed stronger antimalarial activity than artemisinin.
Animals ; Antimalarials/chemistry/*pharmacology ; Artemisinins/chemistry/*pharmacology ; Chloroquine/pharmacology ; Drug Resistance ; Plasmodium falciparum/*drug effects ; Research Support, Non-U.S. Gov't

The prevalence of periodontal disease was steadily increased. The best prevention methods for periodontal disease are teeth brushing and scaling. The purpose of this study was to investigate the status of scaling experience and related factors among some workers. Total 455 workers in 5 manufacturing companies in Gwangju were selected using convenience sampling method. General characteristics, work-related characteristics, oral health-related characteristics and scaling experience were collected by self-reported questionnaires. Chi-square tests, t-tests and multiple logistic regression analysis were performed to investigate the factors influencing the scaling experience using SPSS software. Statistical significance was defined as a p-value<0.05. The proportion of scaling experience during the past year was 47.0%. In simple analysis, age, current working position, number of oral disease, interest in oral health, use of secondary oral products, oral health screening use, oral health education experience and awareness of scaling inclusion in the National Health Insurance (NHI) coverage were associated with scaling experience. Finally, the odds ratios (ORs) for scaling experience were significantly higher in younger subjects (adjusted OR [aOR], 3.09; 95% confidence internal [CI], 1.60∼5.96), assistant manager (aOR, 2.68; 95% CI, 1.55∼4.63), subjects with high interest in oral health (aOR, 2.15; 95% CI, 1.02∼4.52), subjects with oral health screening use (aOR, 2.76; 95% CI, 1.50∼5.11) and awareness of scaling inclusion in the NHI coverage (aOR; 2.91, 95% CI, 1.80∼4.72) in multiple logistic regression analysis. Scaling experience was relatively low (47.0%). The related factors with scaling experience were age, working position, use of screening and awareness of scaling inclusion in the NHI coverage. Considering these factors will increase the utilization rate of scaling.
Dental Scaling ; Education ; Employment ; Gwangju ; Logistic Models ; Mass Screening ; Methods ; National Health Programs ; Occupations ; Odds Ratio ; Oral Health ; Periodontal Diseases ; Prevalence ; Tooth

PURPOSE: We aimed to assess retrospectively the benefit of the use of ultrasonography (US) in comparison with the use of only CT imaging for the detection of the transition zone and adhesions to determine a diagnosis of adhesive small-bowel obstruction (SBO). MATERIALS AND METHODS: Thirty-five patients underwent an additional US examination after CT imaging to determine a diagnosis of SBO. All of the patients were surgically confirmed as having adhesive SBO. The CT images were interpreted for the location of the transition zone, the location and shape of adhesions and for other SBO findings. All of the additional US scans were performed with reference to the CT findings. The standard of reference for the diagnosis was the surgical findings. The diagnostic accuracy and mean confidence score of the transition zone location and the detection rate of adhesions were evaluated for both CT imaging alone and for CT imaging with additional US. RESULTS: The diagnostic accuracy to locate the transition zone was significantly increased with the use of additional US with CT imaging (94.6%, 33/35) as compared to 65.7% (23/35) with the use of only CT imaging (p = 0.01). The mean confidence score was significantly increased (by 0.95) with the use of an additional US examination (p < 0.01). The detection rate for adhesions was 20% (7/35) with the use of only CT imaging and the detection rate was 68.6% (24/35) with the use of an additional US examination. CONCLUSION: The use of a US examination in addition to CT imaging can increase the accuracy and confidence to locate the transition zone and can increase the rate to detect adhesions in patients with adhesive SBO. An additional US examination may be especially helpful when the CT findings are equivocal.
Adhesives ; Humans ; Retrospective Studies

The occurrence of an adenocarcinoma arising from a rectal diverticulum that causes mechanical ileus is very rare. Recently, we diagnosed a case of a mucinous adenocarcinoma in a rectal diverticulum after an emergent abdominal perineal resection and permanent colostomy by laparotomy. Here, we present a case report and a review of the literature.
Adenocarcinoma ; Adenocarcinoma, Mucinous ; Colostomy ; Diverticulum ; Ileus ; Laparotomy ; Mucins

BACKGROUND: Most of the school meal service workers in Korea are middle-aged individuals. They have high workload, which increases their incidence of musculoskeletal disorders. This study aimed to evaluate the prevalence and risk factors of subjective musculoskeletal symptoms, presumptive diagnosis, medical care use, and sick leave among female school meal workers. METHODS: We analyzed the results of musculoskeletal disease screening of 1581 female school meal workers. The screening consisted of self-administered questionnaire, history taking by occupational physicians, and physical examination. The prevalence of subjective musculoskeletal symptoms, presumptive diagnosis after initial examination by occupational physicians, use of medical care for more than 7 days, and sick leave due to musculoskeletal diseases during the past year were evaluated in this study. The relative risk of four outcome indicators of musculoskeletal disorders was compared with respect to potential factors, such as age, subjective physical loading, present illness, injury experience, and type of school, using log-binomial regression. RESULTS: The prevalence of subjective musculoskeletal symptom was 79.6%; presumptive diagnosis, 47.6%; hospital visits over 7 days, 36.4%; and sick leave, 7.3%. The relative risk of musculoskeletal symptoms by age (≥50 years vs < 50 years) was 1.04 (95% confidence interval (CI): 1.00–1.09); presumptive diagnosis of musculoskeletal disease, 1.17 (95% CI: 1.06–1.30); hospital visits over 7 days, 1.26 (95% CI: 0.85–1.85); and sick leave, 1.17 (95% CI: 1.02–1.34). The relative risk of musculoskeletal symptoms due to subjective physical loading (very hard vs low) was 1.45 (95% CI: 1.33–1.58); presumptive diagnosis, 2.92 (95% CI: 2.25); hospital visits over 7 days, 1.91 (95% CI: 1.02–3.59); and sick leave, 2.11 (95% CI: 1.63–2.74). CONCLUSIONS: Subjective physical loading was a more important factor in musculoskeletal disorders than the age of female school meal workers.
Diagnosis ; Female ; Humans ; Incidence ; Korea ; Mass Screening ; Meals ; Musculoskeletal Diseases ; Physical Examination ; Prevalence ; Risk Factors ; Sick Leave

Diverticulitis is the most common clinical complication of diverticular disease, affecting 10-25% of the patients with diverticula. The prevalences of diverticulitis and colon cancer tend to increase with age and are higher in industrialized countries. Consequently, diverticulitis and colon cancer have been reported to have similar epidemiological characteristics. However, the relationship between these diseases remains controversial, as is the performance of routine colonoscopy after an episode of diverticulitis to exclude colon cancer. Recently, we experienced three cases of colon cancer after treating acute diverticulitis, based on which we suggest the importance of follow-up colonoscopy after acute diverticulitis.
Colon ; Colonic Neoplasms ; Colonoscopy ; Developed Countries ; Diverticulitis ; Diverticulum ; Follow-Up Studies ; Humans ; Prevalence

PURPOSE: This study was performed to evaluate factors that can predict the presence of a malignancy for localized intrahepatic bile duct dilatation without a visible mass or stone as depicted on CT images. MATERIALS AND METHODS: A total of 29 patients (male: 16, female: 13) who had localized intrahepatic bile duct dilatation without a visible mass, stone or injury as depicted on CT images were included in the study. A history of extrahepatic malignancy and biliary stone disease, tumor marker levels, CT findings of the intrahepatic bile duct and associated findings were reviewed. The findings were analyzed between two groups (patients with a malignancy and patients with benign disease) on follow-up. RESULTS: In 29 patients, 11 patients had malignant lesions (four metastases and seven cholangiocarcinomas). The history of an extrahepatic malignancy and the shape of an intrahepatic duct obstruction or stenosis as seen on CT were significantly correlated with the results between the benign and malignant group of patients. The follow-up results of the malignant group of patients indicated that for six patients who had developed a new mass, one patient each showed aggravation of ductal dilatation and thickening of the ductal wall. CONCLUSION: When a patient with localized intrahepatic bile duct dilatation without a definite cause has a history of an extrahepatic malignancy or shows abrupt tapering or irregular narrowing on CT images, short-term follow-up should be performed. The patient should be investigated carefully for mass formation or a change of the dilated bile duct due to a possibility of malignant ductal dilatation.
Bile Ducts ; Bile Ducts, Intrahepatic ; Constriction, Pathologic ; Dilatation ; Dilatation, Pathologic ; Follow-Up Studies ; Humans ; Neoplasm Metastasis

PURPOSE: The hemostasis and closure of the collecting system are still problems to be overcome during a partial nephrectomy. Herein, our initial experience of a parenchymal compression technique, without clamping of the renal pedicle during an open partial nephrectomy, is reported. MATERIALS AND METHODS: Between May 2000 and August 2005, 10 patients underwent an open partial nephrectomy, without pedicle clamping, for a renal mass. The open partial nephrectomy was performed under regional ischemia, which was achieved by parenchymal compression using a long curved vascular clamp. Several parameters were retrospectively assessed, including the tumor size, location, pathology, estimated blood loss, preoperative and postoperative serum creatinine, complications, and tumor recurrence. RESULTS: The mean mass size was 23.8mm, ranging between 12 and 55mm, and the tumors were located in the upper, mid and lower poles in 2, 3 and 4 cases, respectively. Pathological examinations revealed renal cell carcinomas in 6, an angiomyolipoma in 1, and complicated renal cysts in 3 patients. In all the patients with renal cell carcinoma, the frozen and permanent sections analyses confirmed negative margins. There were no differences between the preoperative and postoperative creatinine levels, with no significant complications observed, including urinary leak and bleeding, during the recovery period. No patient developed a local recurrence or distant metastasis during the mean follow-up period of 17.2 months. CONCLUSIONS: This technique is simple, and can be easily practiced by any urological surgeon, without concerns relating to the ischemic time and complications. It is suggested that the regional parenchymal compression is an efficient technique for hemostasis and repair of the collecting system during an open partial nephrectomy.
Angiomyolipoma ; Carcinoma, Renal Cell ; Constriction* ; Creatinine ; Follow-Up Studies ; Hemorrhage ; Hemostasis ; Humans ; Ischemia ; Kidney Neoplasms ; Neoplasm Metastasis ; Nephrectomy* ; Pathology ; Recurrence ; Retrospective Studies

Wilms' tumor is a rare malignant renal tumor in adults and it usually presents as a parenchymal mass that resembles renal cell carcinoma. The authors observed one case of adults Wilms' tumor developing in the renal pelvis and the initial diagnosis was renal pelvis tumor. The patient underwent radical nephroureterectomy with bladder cuff excision and adjuvant chemotherapy with the combination of vincristine and actinomycin. The patient has remained healthy and was without evidence of tumor recurrence on a follow-up CT scan at 18 months postoperatively.
Adult ; Carcinoma, Renal Cell ; Chemotherapy, Adjuvant ; Dactinomycin ; Diagnosis ; Follow-Up Studies ; Humans ; Kidney Pelvis* ; Recurrence ; Tomography, X-Ray Computed ; Urinary Bladder ; Vincristine ; Wilms Tumor*

BACKGROUND/AIMS: Gastrointestinal stromal tumors (GIST) in the small intestine are rare and can cause bleeding. The study investigated the clinical characteristics of GIST in the small intestine and to determine the factors related to gastrointestinal bleeding. METHODS: We retrospectively evaluated the clinical outcomes of 22 patients with small bowel GIST who were pathologically diagnosed at Gangneung Asan Hospital between March 1997 and August 2012. RESULTS: The median age was 63.5 (38-82) years. Nine patients (40.9%) had gastrointestinal bleeding, five patients (22.7%) had abdominal pain, two patients (9%) had palpable mass. The site of tumor was the duodenum in nine cases (40.9%), jejunum in 7 cases (31.8%), and ileum in six cases (27.3%). Most patients underwent small bowel resection or wedge resection but three patients underwent pancreaticoduodenectomy. Tumor size ranged from 1.6 to 19 cm (median 6.5 cm). The median mitotic rate was 2 (0-50)/50 high power fields (HPF). The median mitotic rate was 2 (0-50)/50 HPF. Five patients (25%) showed recurrence. Gender, aspirin or warfarin use, size and mitotic index of tumor, hospital stay, recurrence and survival were not significantly different between bleeding and non-bleeding group. Bleeding group showed older age, proximal location in small intestine and mucosal ulceration significantly. CONCLUSIONS: Small bowel GISTs with bleeding were marked by older age, mucosal ulceration and location of proximal small bowel (duodenum and jejunum) rather than distal small bowel (ileum).
Abdominal Pain ; Aspirin ; Duodenum ; Gastrointestinal Hemorrhage ; Gastrointestinal Stromal Tumors ; Hemorrhage ; Humans ; Ileum ; Intestine, Small ; Jejunum ; Length of Stay ; Mitotic Index ; Pancreaticoduodenectomy ; Recurrence ; Retrospective Studies ; Ulcer ; Warfarin