OBJECTIVE: To delineate the role of antidiuretic hormone (ADH) in relation to nocturnal polyuria, and to identify the factors influencing on the diurnal antidiuretic hormone level. METHOD: The ADH was measured by radioimmuoassay at daytime (2:00 PM) and at nighttime (2:00 AM) with nocturnal polyuria group (11) and without nocturnal polyuria group (8). Urine volume, serum osmolarity, urine osmolarity, and blood pressure were also measured at the same time. RESULTS: 1) The ADH at 2:00 AM did not increase in nocturnal polyuria group, although it increased in no-symptom group. 2) There was a statistically significant correlation between wheelchair ambulation time and daytime ADH level. 3) The difference of ADH level between daytime and nighttime showed decrease in orthostatic hypotension group. CONCLUSION: There was relationship between nocturnal polyuria and diurnal variation of ADH level. The ADH concentration seems to be influenced by the postural factors and sympathetic factors.
Blood Pressure ; Hypotension, Orthostatic ; Osmolar Concentration ; Polyuria* ; Spinal Cord Injuries* ; Spinal Cord* ; Walking ; Wheelchairs

Daphne jejudoensis, an endemic plant found in Gotjawal area in Jeju Island, was reported as a new species in 2013 due to its distinct characteristics and distribution, which differentiate it from its related species, D. kiusiana. This study focuses on the comparative phytochemical analysis and antioxidant activities of D. jejudoensis leaves based on the collection period in order to identify the optimal harvest time. Daphnin and daphnetin were identified as the major components with the highest content observed in samples collected during spring, and the highest antioxidant activities were recorded during the same time period. This study represents the first investigation into the quantitative analysis of daphnin and daphnetin in the leaves of D. jejudoensis based on the collection period.

PURPOSE: Early degeneration of articular cartilage is accompanied by a loss of glycosaminoglycan (GAG) and the consequent change of the integrity. The purpose of this study was to biochemically quantify the loss of GAG, and to evaluate the Gd(DTPA)2--enhanced, and T1, T2, rho relaxation map for detection of the early degeneration of cartilage. MATERIALS AND METHODS: A cartilage-bone block in size of 8mmx10 mm was acquired from the patella in each of three pigs. Quantitative analysis of GAG of cartilage was performed at spectrophotometry by use of dimethylmethylene blue. Each of cartilage blocks was cultured in one of three different media: two different culture media (0.2 mg/ml trypsin solution, 1mM Gd (DTPA)2- mixed trypsin solution) and the control media (phosphate buffered saline (PBS)). The cartilage blocks were cultured for 5 hrs, during which MR images of the blocks were obtained at one hour interval (0 hr, 1 hr, 2 hr, 3 hr, 4 hr, 5 hr). And then, additional culture was done for 24 hrs and 48 hrs. Both T1-weighted image (TR/TE, 450/22 ms), and mixed-echo sequence (TR/TE, 760/21-168ms; 8 echoes) were obtained at all times using field of view 50 mm, slice thickness 2 mm, and matrix 256x512. The MRI data were analyzed with pixel-by-pixel comparisons. The cultured cartilage-bone blocks were microscopically observed using hematoxylin & eosin, toluidine blue, alcian blue, and trichrome stains. RESULTS: At quantitation analysis, GAG concentration in the culture solutions was proportional to the culture durations. The T1-signal of the cartilage-bone block cultured in the Gd(DTPA)2- mixed solution was significantly higher (42% in average, p<0.05) than that of the cartilage-bone block cultured in the trypsin solution alone. The T1, T2, rho relaxation times of cultured tissue were not significantly correlated with culture duration (p>0.05). However the focal increase in T1 relaxation time at superficial and transitional layers of cartilage was seen in Gd(DTPA)2- mixed culture. Toluidine blue and alcian blue stains revealed multiple defects in whole thickness of the cartilage cultured in trypsin media. CONCLUSION: The quantitative analysis showed gradual loss of GAG proportional to the culture duration. Microimagings of cartilage with Gd(DTPA)2--enhancement, relaxation maps were available by pixel size of 97.9x195 micrometer. Loss of GAG over time better demonstrated with Gd(DTPA)2--enhanced images than with T1, T2, rho relaxation maps. Therefore Gd(DTPA)2--enhanced T1-weighted image is superior for detection of early degeneration of cartilage.
Alcian Blue ; Cartilage ; Cartilage, Articular* ; Coloring Agents ; Culture Media ; Eosine Yellowish-(YS) ; Hematoxylin ; Magnetic Resonance Imaging* ; Patella ; Relaxation ; Spectrophotometry ; Swine ; Tolonium Chloride ; Trypsin

BACKGROUND: Aspirin resistance (AR) in platelet function assays showed substantial variation depending on the methods used to evaluate it. METHODS: In this study, we prospectively compared the results of Multiplate impedance platelet aggregometry (IPA) with those of light transmission aggregometry (LTA) and VerifyNow(R) system in determination of the prevalence of aspirin resistance (AR) and investigated the correlation between its presence and poor outcome (modified Rankin scale >2) in 105 patients with aspirin after acute ischemic stroke (AIS). RESULTS: After 5 days of using aspirin, 15 patients (14.3%) were classified as aspirin-resistance with the use of IPA, 24 patients (22.9%) by the LTA, and 14 patients (13.3%) by VerifyNow. Good agreement between the results of IPA and VerifyNow, was found (R=0.674, P<0.01). The concordance rate of AR detection was high between VerifyNow and IPA (k=0.72, P<0.01), albeit quite low between LTA and IPA. Regarding on its influence on clinical outcome after AIS, there wasn't any significant relationship between occurrence of poor outcome and the presence of AR in three platelet function assays. CONCLUSION: This study reveals that the incidence of AR in AIS might be highly test-specific. IPA seems to be similar to VerifyNow as a platelet function test.
Aspirin ; Blood Platelets ; Electric Impedance ; Humans ; Incidence ; Light ; Platelet Function Tests ; Prevalence ; Prospective Studies ; Stroke

PURPOSE: Although neoadjuvant therapy has been accepted as a treatment option in locally-advanced gastric cancer, its prognostic value has been difficult to evaluate. MATERIALS AND METHODS: Seventy-four gastric cancer patients who underwent gastrectomy after neoadjuvant treatment were divided into two groups according to the pathologic response: favorable (ypT0) and others (ypT1-4). The clinicopathologic characteristics, predictive factors for pathologic response, and oncologic outcome were evaluated. RESULTS: Eleven patients (14.8%) demonstrated ypT0 and the remaining 63 patients (85.2%) were ypT1-4. Chemoradiotherapy (CCRTx) rather than chemotherapy (CTx) was the only predictive factor for a favorable pathologic response. Chemotherapeutic factors and tumor marker levels did not predict pathologic response. The 1-, 2-, and 3-year disease-free survivals were 83.4%, 70%, and 52.2%. The 1-, 3-, 5-year overall survivals were 88.5%, 67.5%, and 51.2%, respectively. Although a complete pathologic response (ypT0N0M0) was achieved in 7 patients, 28.6% of them demonstrated recurrence of the tumor within 6 months after curative surgery. CONCLUSION: CCRTx rather than CTx appears to be more effective for achieving good pathologic response. Although favorable pathologic response has been achieved after neoadjuvant treatment, the survival benefit remains controversial.
Aged ; Chemoradiotherapy/*methods ; Disease-Free Survival ; Female ; Gastrectomy ; Humans ; Male ; Middle Aged ; Neoadjuvant Therapy ; Neoplasm Recurrence, Local/pathology ; Stomach Neoplasms/*drug therapy/mortality/pathology/*radiotherapy/surgery ; Treatment Outcome ; Tumor Markers, Biological

PURPOSE: In order to elicit efficient and effective operation of the Korean Emergency Medical Service System, we observed patients brought in by way of the Emergency Center by 119 ambulances and analyzed the appropriateness of the transport and the level of emergency care provided. METHODS: For the month of August 2002, patients who visited a university hospital emergency unit in Seoul were separated and evaluated according to the study protocols. The appropriateness of the 119 transport was based on a patient questionnaire and an evaluation of medical records and was categorized as follows; 1) need for emergency care or urgency/emergency transport by 119 ambulance, 2) need for emergency care or urgency/emergency transport by non 119 ambulance, 3) no need for emergency care or subemergency/nonemergency transport by 119 ambulance, 4) no needs for emergency care or subemergency/ nonemergency transport by non 119 ambulance. Of these, category 1 is viewed as the appropriate level of transport to the hospital emergency unit by 119 rescuers whereas category 3 is considered inappropriate transportation by 119 rescuers. The analysis of the appropriateness of the level of emergency care was based on sorting patients into 5 service categories; 1) emergency care required - appropriate operation, 2) emergency care required - no operation, 3)emergency care required - inappropriate operation, 4) no emergency care required - operation, 5) no emergency care required - no operation. Within these, categories 1 and 5 are considered appropriate and categories 2, 3 and 4 as inappropriate. RESULTS: Over the course of the study, 1,376 out of 1,451 patients transported to the hospital emergency unit qualified to be included under study protocols. Among them, the proportion of patients who needed emergency care or urgency/emergency transport was 22.8% (314 patients), and the proportion of those who received appropriate transport by the 119 emergency team was 62.6% (196 patients). Among the 282 patients who were transported by 119 emergency teams, in 195 patients (69.1%), emergency care was indicated while only 81 of the 195 patients (41.5%) received operations with an emergency or critical level of care. Of these 81, 47 patients (58.0%) received the appropriate operation. Therefore, the overall appropriateness of emergency care was 45.0% (127 patients), including emergency care required - appropriate operation (47 patients) and no emergency care required - no operation (80 patients). CONCLUSION: From this study, the appropriateness of transport by 119 rescuers is 62.6% but if subemergency cases are included, the appropriateness of transport increases to 95.2%. However, the appropriateness of care is only 45.0%, implying a need for continuing training for 119 emergency medical technicians and further organization of the medical control system.
Ambulances ; Emergencies ; Emergency Medical Services ; Emergency Medical Technicians ; Emergency Service, Hospital ; Humans ; Medical Records ; Surveys and Questionnaires ; Seoul ; Transportation

PURPOSE: The aim of present study was to compare the mean serum levels of Insulin-like growth factor-I (IGF-I) and Insulin-like growth factor binding protein-3 (IGFBP-3) according to the Korean standard growth chart especially in children with idiopathic short stature. METHODS: Serum levels of IGF-I and IGFBP-3 were determined in 454 children (252 boys and 202 girls; ages 7-15 yr), grouped into two, according to their height below 10 percentile (idiopathic short stature) and 25-50 percentile based on growth chart- 1998 reported by Korean Society of Pediatrics. Serum levels of IGF-I were measured by RIA method and serum levels of IGFBP-3 were measured by IRMA method. RESULTS: Mean serum levels of IGF-I and IGFBP-3 were lower in below 10 percentile group compared with those of 25-50 percentile group in both sexes. In some age groups, the differences between two groups revealed statistical significance. The difference of serum levels according to growth channel showed more prominence in IGF-I compared than IGFBP-3. Significant statistical correlations were demonstrated in all study groups between serum IGF-I and IGFBP-3 levels according to the age, respectively. CONCLUSION: Our results strongly suggest that mean serum levels of IGF-I and IGFBP-3 in children with idiopathic short stature were lower than those of control group.
Child ; Growth Charts ; Humans ; Insulin-Like Growth Factor Binding Protein 3 ; Insulin-Like Growth Factor I ; Pediatrics

BACKGROUND: Patients with major burns require replacement of intravascular volume. Hydroxyethyl starch (HES) solutions are widely used to replace intravascular volume. Dilution with crystalloids or colloids and corresponding platelet dysfunction are known causes of perioperative bleeding tendencies. The aim of the current study was to evaluate the effect of crystalloid and colloid solutions on platelet function in patients with major burns. METHODS: Forty patients scheduled for burn surgery were divided into 4 groups. The infusion was started with a Hartman solution infusion (group 1) from 7 A.M. until surgery. HES (6%, Voluven(R)) was infused in the following concentrations: 7 ml/kg (group 2), 10 ml/kg (group 3), and 15 ml/kg (group 4). The bleeding time (BT), prothrombin time (PT), prothrombin time international ratio (PT INR), activated partial thromboplastin time (aPTT), hemoglobin (Hb), platelet function analyzer-100 closing time (PFA CT), and platelet count (Plt) were measured. RESULTS: Hartmann solution and HES had no significant effect on the BT, PT, PT INR, a PTT, Hb, and Plt. The post-operative PFA CT was significantly higher in group 4 than in group 3. In group 4, the PFA CT was significantly higher post-operatively compared to pre-operatively. CONCLUSIONS: The use of high dose HES may increase the risk of bleeding tendencies in burn patients.
Bleeding Time ; Blood Coagulation ; Blood Platelets ; Burns ; Colloids ; Hemoglobins ; Hemorrhage ; Hetastarch ; Humans ; International Normalized Ratio ; Isotonic Solutions ; Partial Thromboplastin Time ; Platelet Count ; Prothrombin Time

Primary thyroid lymphoma is defined as a lymphoma involving either the thyroid gland alone or both the thyroid gland and neck lymph nodes, without contiguous spread or distant metastases from other areas of involvement at the time of diagnosis. Despite its rarity, prompt recognition of primary thyroid lymphoma is essential due to its distinct management, which differs significantly from the treatment approaches for other neoplasms of the thyroid gland. Herein, we report a 64 years old female patient who complained of hoarseness, and was diagnosed as thyroid lymphoma with unilateral vocal fold paralysis. After chemotherapy, vocal fold paralysis was relieved and the patient’s hoarseness improved.

Interleukin (IL)-8 and vascular endothelial growth factor (VEGF) are important factors that induce the migration and proliferation of endothelial cells, increase the vascular permeability, and the modulate chemotaxis of monocytes. These molecules have been found in human atherosclerotic plaques. However, it is not clear whether the circulating levels of IL-8 and VEGF correlate with the extents of carotid stenosis. In this study, we investigated the relationship between circulating levels of IL-8 as well as VEGF and the extents of carotid stenosis. Sera from 41 patients with carotid stenosis were assessed for concentrations of IL-8 and VEGF by enzyme-linked immunosorbent assay. The degree of stenosis of extracranial carotid artery was calibrated by carotid B- mode ultrasonography. The serum concentration of IL-8 (r=-0.04733, p>0.05) was not correlated with the degree of stenosis. However, the serum concentration of VEGF (r=0.4974, p<0.01) was significantly correlated with the degree of carotid stenosis. These findings suggest that increased serum level of VEGF might be a marker for higher degree of stenosis of extracranial carotid artery.
Adult ; Aged ; Carotid Artery Diseases/blood ; Carotid Stenosis/*blood ; Disease Progression ; Endothelial Growth Factors/*blood ; Female ; Human ; Interleukin-8/*blood ; Lymphokines/*blood ; Male ; Middle Age