Background: To compare open partial nephrectomy (OPN) and robot-assisted partial nephrectomy (RAPN) in the management of renal tumors larger than 4 cm. Methods: Clinical records of 220 patients who underwent OPN or RAPN for a single renal tumor ≥ 4.0 cm with a normal contralateral kidney were reviewed. After determining the propensity score, surgical parameters, functional outcomes, and oncological outcomes were compared between OPN (n = 67) and RAPN (n = 67) groups of patients. Results: The RAPN group had longer operation time (149.0 min vs. 173.3 min, P = 0.030) and longer ischemic time (20.3 min vs. 29.4 min, P = 0.001), but shorter hospital stay (8.2 days vs 6.0 days, P = 0.001) than the OPN group. Estimated blood loss (P = 0.053), pain visual analog score at 1 day postoperatively (P = 0.194), and complications of grade III or higher (P = 0.403) were similar between OPN and RAPN groups. There was no radical conversion or positive surgical margin in either group. Mean change in 6-month estimated glomerular filtration rate was significantly better in the RAPN group (−8.2 vs. −3.1, P = 0.027). There was no statistical difference in recurrence-free survival (P = 0.970) or cancer-specific survival (P = 0.345) between the two groups. Conclusion RAPN is a safe and feasible surgical modality comparable to OPN for managing renal tumors larger than 4 cm in terms of surgical, functional, and oncological outcomes.

Background: To compare open partial nephrectomy (OPN) and robot-assisted partial nephrectomy (RAPN) in the management of renal tumors larger than 4 cm. Methods: Clinical records of 220 patients who underwent OPN or RAPN for a single renal tumor ≥ 4.0 cm with a normal contralateral kidney were reviewed. After determining the propensity score, surgical parameters, functional outcomes, and oncological outcomes were compared between OPN (n = 67) and RAPN (n = 67) groups of patients. Results: The RAPN group had longer operation time (149.0 min vs. 173.3 min, P = 0.030) and longer ischemic time (20.3 min vs. 29.4 min, P = 0.001), but shorter hospital stay (8.2 days vs 6.0 days, P = 0.001) than the OPN group. Estimated blood loss (P = 0.053), pain visual analog score at 1 day postoperatively (P = 0.194), and complications of grade III or higher (P = 0.403) were similar between OPN and RAPN groups. There was no radical conversion or positive surgical margin in either group. Mean change in 6-month estimated glomerular filtration rate was significantly better in the RAPN group (−8.2 vs. −3.1, P = 0.027). There was no statistical difference in recurrence-free survival (P = 0.970) or cancer-specific survival (P = 0.345) between the two groups. Conclusion RAPN is a safe and feasible surgical modality comparable to OPN for managing renal tumors larger than 4 cm in terms of surgical, functional, and oncological outcomes.

Background: To test the hypothesis that Galphas gene mutation may suppress the expression of TRH-R gene, we investigated whether hTRH-R gene expression is lower in human GH-secreting pituitary adenomas with Galphas mutation than in tumors without the mutation. Method: TRH-induced paradoxical response of GH was observed in 8 acromegalic patients. The mutation of gene was identified by direct sequencing of the genomic DNA prepared from GH-secreting pituitary adenomas. The expression of hTRHT mRNA was quantitated by RT-PCR. Results: The transcript of hTRH-R gene was detected in 6 of 8(75%) tumors. Three of these(50%) showed the paradoxical GH response to TRH and the other three patients did not show the response. The relative expression of hTRH-R mRNA in the tumors from patients with the paradoxical response of GH to TRH did not differ from that in the tumors from patients without the paradoxical response. Direct PCR sequencing of Galphas disclosed a mutant allele and a normal allele only at codon 201 in 4 of 8 tumors. The paradoxical response to TRH was observed in 2 of 4 patients without the mutation, and 2 of 4 patients with the mutation. The hTRH-R gene expression of pituitary adenomas did not differ between the tumors without the mutation and those with mutation. Conclusion: This study suggests that the expression of TRH-R gene is not likely to be a main determinant for the paradoxical response of GH to TRH, and that Galphas mutation does not seem to suppress the gene expression of TRH-R in GH secreting adenoma.
Acromegaly ; Adenoma* ; Alleles ; Codon ; DNA ; Gene Expression ; Growth Hormone-Secreting Pituitary Adenoma ; GTP-Binding Proteins ; Humans ; Pituitary Neoplasms ; Polymerase Chain Reaction ; Receptors, Thyrotropin-Releasing Hormone* ; RNA, Messenger

PURPOSE: The present study assessed the diagnostic significance of digital infrared thermal imaging (DITI) in determining the inflammatory state of patients with nonspecific orbital inflammation. METHODS: The present study included 11 patients diagnosed with nonspecific orbital inflammation between December 2009 and March 2011 and who were followed-up for more than 6 months. All patients were all diagnosed based on computed tomography (CT), magnetic resonance image (MRI) and tissue biopsy. The grade of eyelid swelling was classified as 5 and severe compared with the temperature of location. The temperature of the upper eyelid, caruncle, medial conjunctiva, lateral conjunctiva, lower eyelid, cornea and lateral orbit were measured with DITI. RESULTS: When comparing the normal eye with the diseased eye in patients with nonspecific orbital inflammation, the temperature of the upper eyelid and cornea were statistically significant (p = 0.003, p = 0.038, respectively, Mann-Whitney test). The correlation between the grade of eyelid swelling and the temperature of location was most highly related in the temperature of the upper eyelid (Spearman's correlation coefficient, r = 0.55, p = 0.008) and cornea (Spearman's correlation coefficient, r = 0.45, p = 0.037). CONCLUSIONS: DITI may aid in evaluating the inflammatory state of nonspecific orbital inflammation. In particular, the temperature of the upper eyelid and cornea can be very useful indicator. Future studies, including larger study population are necessary in order to confirm DITI as a diagnostic tool which can assess the results of medical treatment by comparing temperature before and after treatment.
Biopsy ; Conjunctiva ; Cornea ; Eye ; Eyelids ; Humans ; Inflammation ; Magnetic Resonance Spectroscopy ; Orbit

BACKGROUND AND OBJECTIVE: It is generally accepted that one third of children with food allergy lose their clinical activity if the responsible food allergen can be identified and completely eliminated from their diet. But buckwheat allergy rarely lose clinical activity. So, we have produced hypoallergenic buckwheat(HBW) according to Ikezawa's method, and characterized the allergenicity by immunoblot method using monoclonal antibodies to raw buckwheat. MATERIAL AND METHODS: HBW was prepared from raw buckwheat by salting with 0.5 M NaCl. 18 monoclonal antibodies to raw buckwheat were made according to standard polyehtylene glycol method. We performed SDS-PAGE of HBW and transferrd to nitrocellulose membranes, which were immunoblotted by selected 3 monoclonal antibodies to raw buckwheat. RESULTS: The protein concentration of HBW was 47.3 microgram/microliter. As the result of SDS-PAGE of HBW the protein bands of 50, 36, 13 kD of raw buckwheat disappeared. 3 monoclonal antibodies were selected due to their higher specificities in ELISA. Immunoblot study showed that 2 among 3 monoclonal antibodies bind to HBW. CONCLUSION: The SDS-PAGE of HBW showed less protein bands in comparison to raw buckwheat. But the allergic component of HBW still remained. So further studies are required to eliminate the residual allergenicity of hypoallergenic food.
Antibodies, Monoclonal* ; Child ; Collodion ; Diet ; Electrophoresis, Polyacrylamide Gel ; Enzyme-Linked Immunosorbent Assay ; Fagopyrum* ; Food Hypersensitivity ; Humans ; Hypersensitivity ; Membranes

PURPOSE: We postulated that the success rate for subclavian venous catheterization could be enhanced by improving body positioning. The purpose of this study was to determine the optimal positioning. The ideal position should result in the largest antero-posterior diameter of the subclavian vein and the shortest depth from the skin to the subclavian vein. METHODS: We used 7.5MHz linear probe. Eighteen adult volunteers underwent ultrasound imaging of the right subclavian vein while supine in the following eight positions: NP/PO/AT, NP/PO/AN, NP/PX/AT, NP/PX/AN, LP/PO/AT, LP/PO/AN, LP/PX/AT, LP/PX//AN (neutral head position, NP; head turned to left, LP; on pillow, PO; off pillow, PX; arm traction, AT; neutral arm position, AN). We checked the antero-posterior diameter of the subclavian vein and the depth from skin to the subclavian vein in each position. Statistical significance was determined using Wilcoxon's signed rank test. RESULTS: The antero-posterior diameter of the subclavian vein in NP/PX/AN position is largest and in LP/PO/AN position is smallest (p=0.01). The difference of the depths from skin to the subclavian vein in each positions is not significant statistically. CONCLUSION: There was no statistically significant effect of head position on the antero-posterior diameter of the subclavian vein or on the depth from the skin to subclavian vein. Arm traction did not result in an increase in the anteroposterior diameter. Positioning on the pillow likewise conferred no advantage in the antero-posterior diameter. The most optimal position for subclavian venous catheterization was the neutral head position without pillow between the scapulas and without the arm retracted position.
Adult ; Arm ; Catheterization* ; Catheterization, Central Venous ; Catheters* ; Head ; Humans ; Scapula ; Skin ; Subclavian Vein ; Traction ; Ultrasonography ; Volunteers

BACKGROUND: Osteoporosis is becoming major health problem in old age and menopausal women, and osteoarthritis is most common joint disease in both ages. The inverse relationship between osteoporosis and osteoarthritis was first noticed 20years ago. However the subject had not been studied in korea. Thus, our objectives is to examine the influence of osteoarthritis on bone density measurements. METHODS: The study group consisted of 120 women, aged over 40 years, who visited for health examination in Health Center of Poondang Jesaeng general hospital from October 1998 to April 1999. Bone mineral density(BMD) of the lumar spine was measured, using dual energy X ray absorptiometry(Lunar, Expert XL), and lateal lumbar spine radiograph was taken. Severity of osteoarthritis were scored on osteophytes, disk space narrowing and vertebral body sclerosis. RESULTS: Postmenopausal women had signifcantly lower BMD than premenopausal women(p<0.001). Age(r= 0.545, p<0.001), body mass index(r=0.264, p<0.01) and education(r=0.284, p<0.01) were significantly correlated with BMD, but smoking, exercise, radiogrphic OA variables not correlated. However, stepwise multiple regression analysis using osteoporosis related variables and OA variables is indicated that menopausal status, body mass index, age, osteophytes were significantly associated factor with BMD, and lumbar osteophytes explained 2.7% of variation in lumbar spine BMD. CONCLUSION: We conclude that, among women, lumbar BMD is highier in those with osteophytosis of the lumbar spine. The effect is largely directed by osteophytes being included in the BMD measurement.
Body Mass Index ; Bone Density* ; Female ; Hospitals, General ; Humans ; Joint Diseases ; Korea ; Osteoarthritis* ; Osteophyte ; Osteoporosis ; Sclerosis ; Smoke ; Smoking ; Spine*

A weanling Thoroughbred foal was admitted to Equine Hospital, Korea Racing Association with signs of colic. On admission the foal was sweating profusely, appeared anxious and exhibiting signs suggestive of abdominal pain. Clinical examination revealed: tachycardia (90 beats/min), tachypnea (50 breaths/min) and congested and slightly cyanotic mucous membranes. No intestinal sounds were auscultated in all 4 abdominal quadrants. Rectal palpation identified concurrent cecum and large colon impactions. Treatment consisted of intravenous administration of a balanced electrolyte solution, nasogastric siphonage and administration of analgesics. Nasogastric reflux contained ascarids. This treatment failed to alleviate the signs of colic. The foal died 3 hours later following discharge because the owner didn't want laparatomy because of economic constraints. Prior to admission this foal had not received any prophylactic anthelmintic treatment. In necropsy, there were masses of ascarids accumulation in the stomach, small intestine and large intestine. The outcome of this report is to describe the first diagnosed case of gastrointestinal impaction by P. equorum in a Thoroughbred foal in South Korea and indicates the importance of regular anthelmintic treatment.
Animals ; Ascaridida Infections/diagnosis/parasitology/*veterinary ; Ascaridoidea/*isolation&purification ; Fatal Outcome ; Fecal Impaction/diagnosis/parasitology/*veterinary ; Horse Diseases/diagnosis/*parasitology ; Horses ; Intestinal Diseases, Parasitic/diagnosis/parasitology/*veterinary ; Korea

No abstract available.

PURPOSE: This study was done to identify the state of internet addiction and to investigate the relationships among internet addiction, depression and suicidal ideation in adolescents. METHOD: Participants were 1,670 high school students in an urban city. The Internet Addiction Scale was used to measure internet addiction, the DISC-MDD-SQ was used to measure depression, and the Suicidal Ideation Questionnaire-JR was used to measure suicidal ideation. RESULT: 38.1% of participants were perceived to be in the early stages of internet addiction and 1.5% reported heavy addiction. Overall the internet addiction scale score was 37.57(+/-12.52). The differences of internet addiction in sample characteristics were found to be significant in rank in class. The differences in DISC-MDD-SQ and IAS scores among the states of internet addiction were statistically significant. The level of internet addiction correlated positively to the level of depression and suicidal ideation. CONCLUSION: Based upon these findings, there were significant positive correlations among Internet addiction, depression, and suicidal ideation in adolescents. As schools are often the first line for the identification of potential life-threatening behaviors, nurses, especially school-based health professionals, need to be cognizant of measures and procedures for the assessment of Internet addiction, depression, and suicidal ideation.
Adolescent ; *Adolescent Psychology ; Behavior, Addictive/diagnosis/*psychology ; Depression/diagnosis/*psychology ; Female ; Humans ; *Internet ; Male ; Suicide/*psychology