No abstract available.
B-Lymphocytes* ; Cytokines* ; Humans*

Bilateral renal cell carcinoma is very rare. In the past, bilateral renal cell carcinoma indicated a poor prognosis. But recently, aggressive operative intervention with nephron salvaging procedure can improve the survival of bilateral renal cell carcinoma. The conservative treatment of bilatera1 renal cell carcinoma depends on the size, the location and the stage of the tumor. Of several conservative surgical procedures, either enucleation or extracorporeal partial nephrectomy with autotransplantation were performed followed by radical nephrectomy in our cases. The advantages of an extracorporeal approach in such case include an optimum exposure, a bloodless surgical field, an ability to perform a more precise operation with maximum conservation of renal parenchyma, and a greater protection of the kidney from prolonged ischemia. Although this technique involves increased operative time with greater potential morbidity, we performed this procedure without much difficulties with the surgical skills culminated from renal transplantation.
Autografts ; Carcinoma, Renal Cell* ; Ischemia ; Kidney ; Kidney Transplantation ; Nephrectomy ; Nephrons ; Operative Time ; Prognosis

PURPOSE: The residual intrahepatic stones with biliary strictures are difficult to remove percutaneously via T-tube tract after surgery in patients with recurrent pyogenic cholangitis. We evaluated the effectiveness of percutaneous balloon dilatation of benign biliary strictures. MATERIALS AND METHODS: The balloon dilatations with 6-12mm angioplasty balloon catheter and stone extractions were performed via a T-tube tract after surgical treatment in 15 patients with recurrent pyogenic cholangitis. The balloons were inflated for 3-4minutes under 5 atm. until disappearance of waist of the stricture site, from one to seven session. After balloon dilatation, residual stones were extracted with saline irrigation or stone basket. RESULTS: Among total 42 strictures, the balloon dilatation was succesful in 27 strictures(64.3%), partially successful in 12 strictures(28.6%), and failed in three strictures(7.1%). Single or central biliary strictures were dilated easily rather than multiple ductal strictures. Of 26 sites with residual intrahepatic stones, stone extraction was complete in 17 sites(65.4%), incomplete in seven sites(26.9%) due to impacted or large stone and acute ductal angulation, and failed in two sites(7.7%). CONCLUSION: Percutaneous balloon dilatation of benign biliary strictures is an effective procedure for extraction of residual intrahepatic stones associated with recurrent pyogenic cholangitis.
Angioplasty ; Catheters ; Cholangitis ; Constriction, Pathologic* ; Dilatation* ; Humans

We report a one-day-old Korean boy with 2-Methylbutyryl-CoA dehydrogenase(2-MBCDase) deficiency detected by urine organic acid and acylglycine analysis, plasma acylcarnitine analysis and confirmed by enzyme assay and Western blot. The patient was born at 35 weeks and three days with oligohydroamnios and premature rupture of membrane for 31 hours, as a second child of healthy non-consanguineous parents. There was no significant family history and spontaneous abortion. He was admitted at NICU under ventilator care due to prematurity, respiratory difficulty, and decreased generalized muscle tone. During the first week of hospitalization, he presented with disseminated intravascular coagulation and sepsis. A grade IV intraventricular hemorrhage on brain sonography was observed on the 7th day after birth with seizure. The clinical course of aggravation and recovery was repeated for one month. In laboratory tests, blood C5-acylcarnitines(isovaleryl/ methylbutyrylcarnitine) and urine 2-methylbutyrylglycine(2-MBG) were markedly elevated; butyrylglycine and isobutyrylglycine were also detected in small amounts in the urine. SBCAD(short branched-chain acyl-CoA dehydrogenase) enzyme activity was undetectable in cultured skin fibroblasts and Western blot showed no detectable immuno-reactive protein. Molecular analysis of the 2-MBCD gene revealed a polymorphism in the leader peptide region(38G>A; Arg13Lys) and homozygous for a non-coding polymorphism 639T>C. This is the first such case in Korea. This disorder is known to be relatively common in one other oriental ethnic group, the Hmong. The baby has been fed on a maple syrup urine disease(MSUD)-similar diet program, and is still alive and is 26-months-old now. However, he developed significant neurologic complications including communicating hydrocephalus, cerebral palsy, and blindness. Presumably the prematurity and its complications may also attribute to his severe neurologic problems. However, the clinical course was particularly severe, a finding in contrast with the observation from several asymptomatic Hmong cases. The clinical course of 2-MBCDase deficiency could be very variable and careful monitoring and follow up should be considered.
Abortion, Spontaneous ; Acer ; Blindness ; Blotting, Western ; Brain ; Cerebral Palsy ; Child ; Diet ; Disseminated Intravascular Coagulation ; Enzyme Assays ; Ethnic Groups ; Female ; Fibroblasts ; Follow-Up Studies ; Hematologic Tests ; Hemorrhage ; Hospitalization ; Humans ; Hydrocephalus ; Korea ; Male ; Membranes ; Oxidoreductases* ; Parents ; Parturition ; Plasma ; Pregnancy ; Protein Sorting Signals ; Rupture ; Seizures ; Sepsis ; Skin ; Ventilators, Mechanical

OBJECTIVE: To compare perioperative outcome of robot-assisted radical hysterectomy with abdominal radical hysterectomy for early-stage cervical cancer and endometrial cancer and to evaluate the feasibility of robotic-assisted radical hysterectomy. METHODS: We reviewed medical record of 37 patients who had radical hysterectomy at Hallym university for cervical cancer stage Ia1 to IIa and endometrial cancer stage Ia to Ib. Abdominal radical hysterectomy was carried out in 27 (Abdominal group) patients and robot-assisted radical hysterectomy carried out in 10 patients (Robotic group). We compared patient's characteristics between two groups. Perioperative characteristics compared included cancer stage, operative time, number of nodes, estimated blood loss, length of hospital stay and complications. RESULTS: There were no differences in age, parity, history of medical disease, body mass index between two groups (p>0.05). Robotic operative times were significantly longer than for abdominal (480.0+/-117.8 vs. 286.9+/-65.6 min, p<0.0001). Blood loss (660.0+/-245.9 vs. 1,137.0+/-608.4 mL. p<0.0001) and length of hospital stay (7.2 versus 17.1 days, p<0.0001) were significantly lower for the robotic group. Lymph node yield in the robotic group was equivalent to that for the abdominal group (30.1+/-8.7 vs. 35.4+/-16.9, p=0.356). No major operative complications occurred with both groups. CONCLUSION: Robot-assisted radical hysterectomy appears safe and feasible in early-stage cervical and endometrial cancer.
Body Mass Index ; Endometrial Neoplasms ; Female ; Humans ; Hysterectomy ; Length of Stay ; Lymph Nodes ; Medical Records ; Operative Time ; Parity ; Uterine Cervical Neoplasms

OBJECTIVES: he purpose of this study was to examine psychosocial factors related to burnout of social welfare officers working in Jeonnam Province.METHODS: A total of 395 social welfare officers (male 99, female 296) working in 22 areas of Jeollanam-do province, were subjects of this study. We examined socio-demographic factors, using a self-reporting questionnaire. Subjects were asked to complete the Maslach Burnout Inventory-General Survey (MBI-GS), Center for Epidemiological Studies Depression Scale (CES-D), Perceived Stress Scale (PSS), and the Generalized Self-Efficacy Scale (GSS), to assess psychosocial factors affecting to burnout of social welfare officers.RESULTS: Among 395 subjects, 221 (55.9%) reported recent experiences of burnout. There was no significant difference in age between two groups, divided by burnout. Sex (p < 0.001), rank (p=0.003), working period (p=0.034), depression (p < 0.001) revealed differences between the burnout group and control group. Scores of PSS (p < 0.001) were higher, while the scores of GSS (p < 0.001) were lower in the burnout group, than control group. Multivariate logistic regression analysis revealed that female (OR 2.840, 95%CI 1.466–5.504, p=0.002), depressive high-risk group (OR 6.824, 95%CI 2.893–16.096, p < 0.001) PSS (OR 1.247, 95%CI 1.153–1.349, p < 0.001) and GSS (OR 0.950, 95%CI 0.930–0.971, p < 0.001), were significantly associated with burnout.CONCLUSION: We found that some factors, were associated with experienced burnout in social welfare officers. Depressive symptoms were the strongest associative factor, for burnout in public servants in charge of social welfare. Sex, stress and self-efficacy also correlated with burnout, and especially self-efficacy was a protecting factor.
Depression ; Epidemiologic Studies ; Female ; Humans ; Jeollanam-do ; Logistic Models ; Psychology ; Social Welfare

PURPOSE: It has been reported that all-trans retinoic acid (ATRA) can inhibit glioma growing in vitro. However, clinical trials with ATRA alone in gliomas revealed modest results. ATRA has been shown to increase radiosensitivity in other tumor types, so combining radiation and ATRA would be one of alternatives to increase therapeutic efficacy in malignant gliomas. Thus, we intended to know the role of catalase, which is induced by ATRA, for radiosensitivity. If radiation-reduced reactive oxygen species (ROS) is removed by catalase, the effect of radiation will be reduced. MATERIALS AND METHODS: A rat glioma cell line (36B10) was used for this study. The change of catalase activity and radiosensitivity by ATRA, with or without 3-amino-1, 2, 4-triazole (ATZ), a chemical inhibitor of catalase were measured. Catalase activity was measured by the decomposition of H2O2 spectrophotometrically. Radiosensitivity was measured with clonogenic assay. Also ROS was measured using a 2, 7-dichlorofluorescein diacetate spectrophotometrically. RESULTS: When 36B10 cells were exposed to 10, 25 and 50microM of ATRA for 48 h, the expression of catalase activity were increased with increasing concentration and incubation time of ATRA. Catalase activity was decreased with increasing the concentration of AT (1, 10 mM) dose-dependently. ROS was increased with ATRA and it was augmented with the combination of ATRA and radiation. ATZ decreased ROS production and increased cell survival in combination of ATRA and radiation despite the reduction of catalase. CONCLUSION: The increase of ROS is one of the reasons for the increased radiosensitivity in combination with ATRA. The catalase that is induced by ATRA doesn`t decrease ROS production and radiosensitivity.
Animals ; Catalase* ; Cell Line ; Cell Survival ; Glioma* ; Radiation Tolerance* ; Rats* ; Reactive Oxygen Species ; Tretinoin*

PURPOSE: This study was performed to estimate the incidence of nosocomial sepsis and to identify the most relevant risk factors for nosocomial sepsis in high-risk very low birth weight (VLBW) infants. METHODS: A retrospective review of 341 VLBW infants, admitted to the Neonatal Intensive Care Unit of the Eulji University Hospital (Daejeon & Seoul) between January 2002 and June 2009, who survived more than 72 hours was performed. The incidence, causative organisms, risk factors and prognosis of nosocomial sepsis in VLBW infants were analyzed. RESULTS: The incidence of nosocomial sepsis was 16.1% and the onset date of nosocomial sepsis was 21.5+/-15.9 days (mean+/-SD) after delivery. Staphylococcus aureus (21.3%) was the most common organism in the patients with nosocomial sepsis in VLBW infants. The multiple logistic regression analysis showed that, gestational age [odds ratio (OR), 0.87; 95% CI, 0.83-0.91], umbilical artery catheter use for more than 5 days (OR, 2.2; 95% CI, 1.15-4.46), umbilical venous catheter use for more than 5 days (OR, 2.1; 95% CI, 1.11-4.16), peripheral arterial line use (OR, 2.1; 95% CI, 1.14-4.04) and intravenous intralipids (OR, 4.3; 95% CI, 1.13-14.32) were identified as risk factors. CONCLUSION: The limited usage of intravascular catheter related procedures and the short providence of intravenous nutrition may decrease the incidence of nosocomial sepsis in VLBW infants.
Catheters ; Cross Infection ; Gestational Age ; Humans ; Incidence ; Infant ; Infant, Newborn ; Infant, Very Low Birth Weight ; Intensive Care, Neonatal ; Logistic Models ; Prognosis ; Retrospective Studies ; Risk Factors ; Sepsis ; Staphylococcus aureus ; Umbilical Arteries ; Vascular Access Devices

We reviewed retrospectively the medical records of 229 cases of tuberculosis, who had been diagnosed clinically and admitted to the departmet of pediatrics, Seoul National Univeristy Children's Hospital, during the period of 6 years from October, 1985, to October, 1991. Patients with tuberculosis occupied 1.2% of the hospitalized patients. Forty-three percent of the patients were under 3 years of age. Principal involvement sites were; the lungs-26.7%, the pleura-18.8%, the central nervous system-30.6%, the abdomen-7.4%, the genito-urinary tract-1.3%, the bones and joints-3.0%, the lymph nodes-3.0%. In 147 patients with extrapulmonary tuberculosis, pulmonary lesions suggestive of tuberculosis were found in 33.3%, 9.2% of the patients had miliary dissemination. In pulmonary tuberculosis and extrapulmonary tuberculosis with lung involvement, the gastric aspirates were positive for acid-fast bacilli (AFB) by Ziehl-Neelson stain in 6.1%, and grew M. tuberculosis in 43.5%. The sputa were positive for AFB in 12.9%, culture in 18,5%. In extrapulmonary tuberculosis, the specimens from involved sites were positive for staining in 5.7%, culture in 19.3%. Twenty-one isolates of M. tuberculosis were submitted to susceptibility to 11 antituberculous drugs. Resistance to one or more drugs were found in 38.1% of the isolates. INH resistance was found in 33.3%, RFP resistance in 28.6%. We conclude that bacteriologic documentation of tuberculosis is possible in significant proportion of the pediatric patients, drug resistance of M. tuberculosis isolated from the children is high in Korea, and continued monitoring of drug resistance is required.
Child ; Drug Resistance ; Humans ; Korea ; Lung ; Medical Records ; Pediatrics ; Retrospective Studies ; Seoul ; Tuberculosis* ; Tuberculosis, Pulmonary

Rhizomelic chondrodysplasia punctata(RCDP) is a rare autosomal recessive disorder clinically characterized by symmetrical shortening of the proximal limbs, contractures of joints, a typical dysmorphic face, cataracts, and itchyosis. Patients with RCDP can be subdivided into three subgroups based on biochemical analysis and complementation studies. RCDP type I results from mutations in the PEX7 gene encoding the peroxisomal targeting signal type II(PST2) receptors and presents with both a defect in plasmalogen biosynthesis and phytanic acid oxidation. RCDP type II is deficient in the activity of dihydroxyacetonephosphate acyltransferase(DHAP-AT). RCDP type III is deficient in alkyl-dihydroxyacetonephosphate synthase(alkyl-DHAP). We report a case of RCDP type I which was confirmed with biochemical study, fibroblast culture, and gene study.
Cataract ; Chondrodysplasia Punctata, Rhizomelic* ; Complement System Proteins ; Contracture ; Extremities ; Fibroblasts ; Humans ; Joints ; Phytanic Acid