BACKGROUND: This study describes a novel analytical method for simultaneously determining sarpogrelate and its metabolite (M-1) in human plasma, using liquid chromatography coupled with tandem mass spectrometry, with electrospray ionization in the positive ion mode. METHODS: Sarpogrelate, M-1, and labeled internal standard (d3-sarpogrelate) were extracted from 50 microL of human plasma by simple protein precipitation. Chromatographic separation was performed by using a linear gradient elution of a mobile phase involving water-formic acid (99.9:0.1, v/v) and acetonitrile-formic acid (99.9:0.1, v/v) over 4 min of run time on a column, with a core-shell-type stationary phase (Kinetex C18, 50 mm x 2.1 mm i.d., 2.6-microm particle size, Phenomenex, USA). Detection of the column effluent was performed by using a triple-quadruple mass spectrometer in the multiple-reaction monitoring mode. RESULTS: The developed method was validated in human plasma, with lower limits of quantification of 10 ng/mL for sarpogrelate and 2 ng/mL for M-1. The calibration curves of sarpogrelate and M-1 were linear over the concentration ranges of 10-2,000 and 2-400 ng/mL, respectively (R2>0.99). The carry-over effect, precision, accuracy, and stability of the method met the criteria for acceptance. CONCLUSIONS: A simple, fast, robust, and reliable analytical method was successfully developed and applied to the high-throughput determination of sarpogrelate and its metabolite in real plasma samples in a pharmacokinetic study of healthy subjects.
Calibration ; Chromatography, Liquid ; Humans ; Mass Spectrometry* ; Particle Size ; Plasma* ; Tandem Mass Spectrometry

BACKGROUND: Because of improvement of economic state and eating habit changes in Korea, 60-70% of gallbladder stones are cholesterol stones. As ultrasonography was used increasingly, detection of asymptomatic gallstone were increased. There has been few studies about asymptomatic gallstone in Korea. So, this study was designed to obtain associated factor of prevalence of asymptomatic gallstone. METHODS: We screened adults over 20 years who were visited the health Promotion Center in a university hospital from May 1995 to May 1999. Subjects were defined as case group(584 subjects) who were diagnosed gallstone by abdominal ultrasonogaphy by radiologist. Control group(1153 subjects) were selected by random sampling from visitors of the Health Promotion Center. Every subjects were assessed with respect to gender, age, height, weight, fasting blood glucose, serum total cholesterol, high density lipoprotein-cholesterol, triglyceride. Social-Economic state, smoking were assessed by self-administered questionnaires. Associated factor of prevalence of asymptomatic gallstone were analyzed by Chi-square test and multiple logistic regression. RESULTS: Age, BMI(Body Mass Index), fasting blood glucose were associated with gallstone by Chi-square test(P<0.05). Multiple logistic regression showed that prevalence of asymptomatic gallstones was increased by age(>40 years old) and were associated with BMI(>25 kg/m2), fasting blood glucose. CONCLUSION: Associated factors of prevalence of asymptomatic gallstone were increased by age(>40 years old) and were associated with BMI(>25 kg/m2), fasting blood glucose, and were not different from those in West countries. further studies will be needed about associated factors according to the composition of gallstone and developing from asymptomatic gallstone to asymptomatic gallstone.
Adult ; Blood Glucose ; Cholesterol ; Eating ; Fasting ; Gallbladder ; Gallstones* ; Health Promotion ; Humans ; Korea ; Logistic Models ; Prevalence* ; Smoke ; Smoking ; Triglycerides ; Ultrasonography ; Surveys and Questionnaires

BACKGROUNDS: The education by the family physician. is important for more practical primary care medicine education. In this study, we try to know the presnent state of education and the future and the number of education resource and how to multiply this resource. METHODS: we have got the list of family physicians who have their clinic in Seoul by the help of the Korean Academy of Family Medicine. And we performed telephone questionary. We also asked the demographic factors RESULTS: 134 persons were asked questionary by the telephone. 17persons were joining in education. Trainee by the 3rd grade hospitals was the major, the next was by 2nd grade hospital, and doctors who did not have the training. 14 persons have begun education by asking of the training hospital, 3 persons wanted it, but none thought it beneficial to them. 44 persons wanted to join education in the future, and there was no difference between the 3rd and the 2nd grade hospital trainee. CONCLUSION: There was no difference between the 3rd and 2nd grade hospital trainee but 2nd grade hospital trainee was less joining than the 3rd. This shows that the 2nd grade hospital trainee can be the good pool of the future education if there are adequate supply. So many adequate supply is necessary.
Demography ; Education* ; Humans ; Physicians, Family* ; Primary Health Care ; Seoul* ; Telephone

Poststernotomy mediastinitis is a rare but potentially life-threatening complication of cardiac surgery. Up to present, poststernotomy wound infection has been treated by closure of wound directly or by use of myocutaneous flaps after irrigation and debridement of wound. We describe a new treatment of poststernotomy wound infection by using the vacuum- assisted closure technique. This technique was successfully applied in 3 patients with poststernotomy wound infection and mediastinitis, and a healed sternotomy wound could be achieved using this new technique.
Debridement ; Humans ; Mediastinitis* ; Myocutaneous Flap ; Negative-Pressure Wound Therapy* ; Sternotomy ; Thoracic Surgery ; Wound Infection* ; Wounds and Injuries*

PURPOSE: To evaluate the changes and remission of disease activity with changes in inflamed synivial volumes of rheumatoid joints after therapy. MATERIALS AND METHODS: Seven rheumatoid arthritis patients who had been treated with antiinflammatory drugs were followed up. Using NIH imaging and a segmentation technique, pre- and post-enhanced images were measured in subtracted images. Intra- and interobserver variation were evaluated by two radiologists(A and B), using two independent measurements. For comparison, the cases were assigned to one of two groups : remission and non-remission. Changes in ESR and total joint counts(TJC) after therapy were compared with inflamed synovial volumes. RESULTS: Intraobserver variations were 3.2% and 2.7% in A and B, respectively, interobserver variation between A and B was 7.1%. Changes in inflamed synovial volumes correlated well with those in ESR (r=0.88, p<0.009) and TJC (r=0.78, p<0.037) after therapy. Changes between the remission and non-remission group were insignificant, however. CONCLUSION: Changes in inflamed synovial volumes reflect those in the activity of rheumatoid arthritis between pre- and post- treatment. This technique may be used as a tool for predicting therapeutic response in rheumatoid arthritis cases. Changes in inflamed synovial volumes are of limited value, however, in predicting the remission of rheumatoid arthritis after therapy.
Arthritis, Rheumatoid ; Humans ; Joints ; Observer Variation ; Synovial Membrane* ; Synovitis* ; Wrist Joint* ; Wrist*

PURPOSE: To evaluate the changes and remission of disease activity with changes in inflamed synivial volumes of rheumatoid joints after therapy. MATERIALS AND METHODS: Seven rheumatoid arthritis patients who had been treated with antiinflammatory drugs were followed up. Using NIH imaging and a segmentation technique, pre- and post-enhanced images were measured in subtracted images. Intra- and interobserver variation were evaluated by two radiologists(A and B), using two independent measurements. For comparison, the cases were assigned to one of two groups : remission and non-remission. Changes in ESR and total joint counts(TJC) after therapy were compared with inflamed synovial volumes. RESULTS: Intraobserver variations were 3.2% and 2.7% in A and B, respectively, interobserver variation between A and B was 7.1%. Changes in inflamed synovial volumes correlated well with those in ESR (r=0.88, p<0.009) and TJC (r=0.78, p<0.037) after therapy. Changes between the remission and non-remission group were insignificant, however. CONCLUSION: Changes in inflamed synovial volumes reflect those in the activity of rheumatoid arthritis between pre- and post- treatment. This technique may be used as a tool for predicting therapeutic response in rheumatoid arthritis cases. Changes in inflamed synovial volumes are of limited value, however, in predicting the remission of rheumatoid arthritis after therapy.
Arthritis, Rheumatoid ; Humans ; Joints ; Observer Variation ; Synovial Membrane* ; Synovitis* ; Wrist Joint* ; Wrist*

PURPOSE: The mortality rate for elective repair of abdominal aortic aneurysm (AAA) has gradually decreased to approximately 5%. However the mortality rate for ruptured AAA (RAAA) has not changed significantly and continues to be 45% to 50%, and the mortality rate exceeds 90% if deaths occurring before patients reach the hospital are included in the statistics. The aim of this study was to determine what factors are associated with operative death in patients with RAAA. METHOD: For January 1997 and December 2003, 35 patients underwent surgery for RAAA. The factors of the preoperative status included age, gender, history of loss of consciousness, mental change, hemodynamics, the serum creatinine level and the patients' comorbidities were analyzed. As for the aneurysmal factors, the site, etiology, maximal diameter and rupture status of the aneurysms were evaluated. Finally operative factors including the operation time and status, surgeon, type of grafting, renal dysfunction during operation and the amount of blood transfusion were also analyzed. As the statistical method, Fischer's exact test and multi-step logistic regression method were used. RESULT: The 30-day mortality rate was 17.1% (6/35). By univariate analysis, mental change, increased preoperative serum creatinine level (>2 mg/dl), intraoperative renal dysfunction, prolonged intraoperative hypotension over 30 minutes, the amount of transfusion, diameter of aneurysms and surgeon's experience were statistically significant. On multivariate analysis, the amount of transfusion and intraoperative renal dysfunction were defined as the significant risk factors. CONCLUSION: To reduce the operative mortality of RAAA, preventing massive bleeding and the subsequent acute renal failure by early operative control of bleeding, fluid resuscitation and maintenance of blood pressure are important.
Acute Kidney Injury ; Aneurysm ; Aortic Aneurysm, Abdominal* ; Blood Pressure ; Blood Transfusion ; Comorbidity ; Creatinine ; Hemodynamics ; Hemorrhage ; Humans ; Hypotension ; Logistic Models ; Mortality* ; Multivariate Analysis ; Resuscitation ; Risk Factors* ; Rupture ; Transplants ; Unconsciousness

Meckel's diverticulum is one of the common causes of gastrointestinal bleeding in the pediatric patient requiring laparotomy. Two children with Meckel's diverticulum have been successfully treated by laparoscopic excision. Both patients recovered without incident and were discharged at 3 and 5 days after surgery. The authors believe that laparoscopic diverticulectomy is a safe, effective, and minimal invasive treatment of Meckel's diverticulum in children.
Child* ; Hemorrhage ; Humans ; Laparotomy ; Meckel Diverticulum

To investigate the pathogenesis of accelerated graft atherosclerosis after rdiac transplantation, a genetically well-defined and reproducible animal del is required. We performed heterotopic intraabdominal heart transplantation tween the two inbred strains of mice. Forty hearts from B10.A mice were ansplanted into B10.BR mice. Recipients were sacrificed at 1, 3, 5, 7, 14, 28, d 42 days after implantation. The specimens from both donor and recipient were amined with fluorescent immunohistochemistry and the serial histopathologic anges were evaluated. In the donor hearts, ICAM-1 and VCAM-1 expressions were nimal at day 1 and they gradually increased, reaching their peaks on day 5 or and remained unchanged by day 42. However, there were very little expressions the recipients' hearts. Mean percent areas of intima in the donor coronaries vealed progressive increase by day 42. However, those in the recipients cupied consistently less than 5% of the lumen. In conclusion, we demonstrated at a heterotopic murine heart transplantation model was a useful tool to oduce transplantation coronary artery disease and that adhesion molecules on e cardiac allografts were activated very early and remained elevated at all me-points, nonetheless the arterial lesion was detected after day 28 and its ogression was accelerated thereafter.
Animal ; Coronary Vessels/pathology ; Heart Transplantation*/pathology ; Intercellular Adhesion Molecule-1/biosynthesis* ; Mice ; Myocardium/pathology ; Myocardium/metabolism* ; Time Factors ; Transplantation, Heterotopic*/pathology ; Vascular Cell Adhesion Molecule-1/biosynthesis*

BACKGROUND: The rectum is a relatively uncommon site for lymphoma compared with other gastrointestinal sites; no consensus regarding management of primary rectal lymphoma (PRL) has been formed due to its limited frequency. We aimed to investigate clinical characteristics and treatment outcomes in patients with PRL in a single center patient cohort. METHODS: We retrospectively analyzed the results of 16 consecutive patients with PRL, identified and treated at the Asan Medical Center, Seoul, Korea between January 1993 and December 2014. RESULTS: These 16 patients with PRL constituted 0.8% of all non-Hodgkin's lymphoma patients (N=1,984). B-cell lymphomas (N=14) made up the majority of the series, and half of these were extranodal marginal zone lymphomas (ENMZL, N=7). Ten patients received systemic chemotherapy with (N=3) or without rituximab (N=7), and 4 of these received additional local therapy. The others received radiotherapy (N=3) or endoscopic mucosal resection (N=3). Twelve patients (75%) achieved complete response (CR) after first-line treatment. Event-free survival (EFS) and overall survival (OS) in stages IE and IIE were significantly longer compared with stages IVE (P=0.001 and P=0.001, respectively). All patients with ENMZL (N=7) achieved CR during or after initial treatment. CONCLUSION: PRL is very rare and seems to present mostly as B-cell type. Stage is the most important prognostic factor, with significantly better survival associated with localized diseases. ENMZL may be one of the most common types of PRL with favorable treatment outcomes.
B-Lymphocytes ; Chungcheongnam-do ; Cohort Studies ; Consensus ; Disease-Free Survival ; Drug Therapy ; Humans ; Korea ; Lymphoma* ; Lymphoma, B-Cell ; Lymphoma, Non-Hodgkin ; Prognosis ; Radiotherapy ; Rectum ; Retrospective Studies ; Rituximab ; Seoul