OBJECTIVE: Ovarian failure is often common complication by the conditioning protocol used for bone marrow transplantation (BMT). To determine the frequency of recovery of ovarian function after allo-BMT and the major factor that predict recovery, we monitored ovarian function in 24 premenopausal women METHOD: Twenty-four women met the inclusion criteria, which were (1) moderate to severe aplastic anemia before BMT, (2) disease-free at least 18 month after transplantation, (3) age younger than 40 years and more than 3 years after menarche at transplantation and (4) regular menstrual periods before transplantation. Recovery of ovarian function was determined by regular menses without menopausal symptom and sign. we divided conditioning regimen to two groups, Group I : cytoxan alone(n=17), Group II : cytoxan plus total body irradiation (TBI)(n=7). RESULTS: All women became amenorrhea after BMT and the clinical characteristics were not significant between two groups. 17 patients who received only cytoxan all recovered ovarian function between 1 to 14 months(median : 7.28) after BMT. The median age at BMT of women with regained ovarian function was 26 years (range, 21 to 33) versus 30 (range, 21 to 37) for those who did not. The age at transplantation was not significant between two groups in our study and the most predictive independent factor in ovarian recovery is the presence of total body irradiation. None of women who received TBI regained ovarian function during 19-49 month follow up. CONCLUSION: Gonadal insufficiency due to pre-BMT conditioning is more severe in radiation based regimen than cytoxan alone. therefore, we recommend early hormone replacement therapy in radiation treated women to prevent the complication of premature menopause.
Amenorrhea ; Anemia, Aplastic* ; Bone Marrow Transplantation* ; Bone Marrow* ; Cyclophosphamide ; Female ; Follow-Up Studies ; Gonads ; Hormone Replacement Therapy ; Humans ; Menarche ; Menopause, Premature ; Whole-Body Irradiation

OBJECTIVES: This study aims to investigate trends of cardiovascular disease (CVD) risk factor profiles over 17 years in percutaneous coronary intervention (PCI) patients at the Mayo Clinic. METHODS: We performed a time-trend analysis within the Mayo Clinic PCI Registry from 1994 to 2010. Results were the incidence and prevalence of CVD risk factors as estimate by the Framingham risk score. RESULTS: Between 1994 and 2010, 25 519 patients underwent a PCI. During the time assessed, the mean age at PCI became older, but the gender distribution did not change. A significant trend towards higher body mass index and more prevalent hypercholesterolemia, hypertension, and diabetes was found over time. The prevalence of current smokers remained unchanged. The prevalence of ever-smokers decreased among males, but increased among females. However, overall CVD risk according to the Framingham risk score (FRS) and 10-year CVD risk significantly decreased. The use of most of medications elevated from 1994 to 2010, except for beta-blockers and angiotensin converting enzyme inhibitors decreased after 2007 and 2006 in both baseline and discharge, respectively. CONCLUSIONS: Most of the major risk factors improved and the FRS and 10-year CVD risk declined in this population of PCI patients. However, obesity, history of hypercholesterolemia, hypertension, diabetes, and medication use increased substantially. Improvements to blood pressure and lipid profile management because of medication use may have influenced the positive trends.
Adrenergic beta-Antagonists/therapeutic use ; Age Factors ; Aged ; Angiotensin-Converting Enzyme Inhibitors/therapeutic use ; Blood Pressure ; Body Mass Index ; Cardiovascular Diseases/complications/drug therapy/*epidemiology ; Diabetes Complications ; Diabetes Mellitus/diagnosis ; Female ; Humans ; Hypercholesterolemia/complications/diagnosis ; Hypertension/complications/diagnosis ; Male ; Middle Aged ; Percutaneous Coronary Intervention/*statistics & numerical data/trends ; Prevalence ; Registries/statistics & numerical data ; Risk Factors ; Smoking ; Time Factors

In 1, 345 patients suspected of having pancreatic or biliary tract disease, 23 patients were shown to have biliary ascariasis demonstrated by endseopic retrograded cholangiopancreatog raphy, at Kwang Ju Christian Hospital from Sep. 1976 to Aug. 1983. Authors report the clinical study and ERCP finding of 23 cases of biliary ascariasis. The result were as follows. 1) Out of 1,345 cases of ERCP, biliary ascariasis were 28 cases, The ascaris were found in CHD & IHD in 21 cases, and 2 casee were found in Ampulla of Vater. 2) There was no specifia age incidence and male to female ratio was 1: 1.9, 3) The disease was more prevalent in spring & summer, and more prevalent in rural area than urban area. 4) The chief eomplaints were RUQ and epigastric abdominal pain. The cases which were admitetted within 2weeks of onset were 16 cases. 5) Ascaris in biliary tract were removed by operation in 14 cases, and EST were performed in 5 cases. Two cases werere moved by DORMIA basket under the endoscopic direct visualization. 6) We report E.S.T. as a new therapeutic method of biliary ascariasis.
Abdominal Pain ; Ampulla of Vater ; Ascariasis* ; Ascaris ; Biliary Tract ; Biliary Tract Diseases ; Cholangiopancreatography, Endoscopic Retrograde ; Diagnosis* ; Female ; Gwangju ; Humans ; Incidence ; Male

OBJECTIVE: The survival rate of very low birth weight infants (VLBWI) has increased markedly in Korea. The purpose of this study was to investigate the outcome of VLBWI in Busan area. METHODS: We retrospectively reviewed 273 VLBWI less than 1,500 g who were admitted to the neonatal intensive care units of three university hospitals in Busan between January, 2007, to December, 2008. The survival rate, distribution of infants by birth weight and gestational age, and complications were compared with previous reports in Busan. RESULTS: We enrolled 273 VLBWI, including 31.1% extremely low birth weight infants, and the overall survival rate of VLBWI was 77.3%. Mean gestational age was 29.2+/-2.9 weeks and birth weight was 1,115+/-249 g. Infants weighing <750 g, 750-999 g, 1,000-1,249 g and 1,250-1,499 g showed survival rates of 30.4%, 62.9%, 83.0%, and 92.0%, respectively. Infants at < or =24 weeks, 25-26 weeks, 27-28 weeks and > or =29 weeks had survival rates of 25.0%, 57.5%, 75.0%, and 91.0%, respectively. Survival rates by birth weight (<750 g, 750-999 g) and gestational age (< or =24 weeks, 25-26 weeks) had increased significantly compared to 2003-2005. Common morbidities of VLBWI included respiratory distress syndrome (54.9%), patent ductus arteriosus (33.3%), bronchopulmonary dysplasia (31.5%), sepsis (20.1%), necrotizing enterocolitis (7.3%), retinopathy of prematurity (> or =stage III) (6.2%) and intraventricular hemorrhage (> or =Gr III) (5.1%). CONCLUSIONS: The survival rate of VLBWI born in Busan was 77.3% over the past 2 years. Survival rates of extreme prematurity weighing less than 1,000g and gestational age of < or =26 weeks were significantly increased.
Birth Weight ; Bronchopulmonary Dysplasia ; Ductus Arteriosus, Patent ; Enterocolitis, Necrotizing ; Gestational Age ; Hemorrhage ; Hospitals, University ; Humans ; Infant ; Infant, Low Birth Weight ; Infant, Newborn ; Infant, Very Low Birth Weight ; Intensive Care Units, Neonatal ; Korea ; Retinopathy of Prematurity ; Retrospective Studies ; Sepsis ; Survival Rate

Verification of internal organ motion during treatment and its feedback is essential to accurate dose delivery to the moving target. We developed an offline based internal organ motion verification system (IMVS) using cine EPID images and evaluated its accuracy and availability through phantom study. For verification of organ motion using live cine EPID images, a pattern matching algorithm using an internal surrogate, which is very distinguishable and represents organ motion in the treatment field, like diaphragm, was employed in the self-developed analysis software. For the system performance test, we developed a linear motion phantom, which consists of a human body shaped phantom with a fake tumor in the lung, linear motion cart, and control software. The phantom was operated with a motion of 2 cm at 4 sec per cycle and cine EPID images were obtained at a rate of 3.3 and 6.6 frames per sec (2 MU/frame) with 1,024x768 pixel counts in a linear accelerator (10 MVX). Organ motion of the target was tracked using self-developed analysis software. Results were compared with planned data of the motion phantom and data from the video image based tracking system (RPM, Varian, USA) using an external surrogate in order to evaluate its accuracy. For quantitative analysis, we analyzed correlation between two data sets in terms of average cycle (peak to peak), amplitude, and pattern (RMS, root mean square) of motion. Averages for the cycle of motion from IMVS and RPM system were 3.98+/-0.11 (IMVS 3.3 fps), 4.005+/-0.001 (IMVS 6.6 fps), and 3.95+/-0.02 (RPM), respectively, and showed good agreement on real value (4 sec/cycle). Average of the amplitude of motion tracked by our system showed 1.85+/-0.02 cm (3.3 fps) and 1.94+/-0.02 cm (6.6 fps) as showed a slightly different value, 0.15 (7.5% error) and 0.06 (3% error) cm, respectively, compared with the actual value (2 cm), due to time resolution for image acquisition. In analysis of pattern of motion, the value of the RMS from the cine EPID image in 3.3 fps (0.1044) grew slightly compared with data from 6.6 fps (0.0480). The organ motion verification system using sequential cine EPID images with an internal surrogate showed good representation of its motion within 3% error in a preliminary phantom study. The system can be implemented for clinical purposes, which include organ motion verification during treatment, compared with 4D treatment planning data, and its feedback for accurate dose delivery to the moving target.
Diaphragm ; Human Body ; Lung ; Particle Accelerators ; Track and Field

BACKGROUND: Cisplatin (cis-diaminedichloroplatinum, CDDP) is a widely used chemotherapeutic agent for the treatment of many cancers. However, initial resistance to CDDP is a serious problem in treating these cancers. Vitis coignetiae Pulliat (Meoru in Korea) have shown anti-nuclear factor kappa B and anti-epidermal growth factor receptor activities in cancer cells. METHODS: In this study, in order to seeking an approach to increase the anti-cancer effects of CDDP with natural products. Here, we investigated anthocyanins isolated from Vitis coignetiae Pulliat (anthocyanidins isolated from meoru, AIMs) can enhance anti-cancer effects of cisplatin (CDDP) in stomach cancer cells. The cell viability of SNU-1 and SNU-16 cells after treated with AIMs and CDDP were analyzed by MTT assay. The expressions of Akt and X-linked inhibitor of apoptosis protein (XIAP) proteins were examined by western blot in AIMs- and CDDP-treated cells. RESULTS: We found that AIMs enhanced anticancer effects of CDDP, which activity was additive but not synergistic. AIMs suppressed Akt activity of the cancer cells activated by CDDP. AIMs also suppressed in XIAP an anti-apoptotic protein. CONCLUSIONS: This study suggests that the anthocyanins isolated from fruits of Vitis coignetiae Pulliat enhanced anti-cancer effects of CDDP by inhibiting Akt activity activated by CDDP.
Anthocyanins* ; Biological Products ; Blotting, Western ; Cell Survival ; Cisplatin* ; Fruit* ; Humans* ; Stomach Neoplasms* ; Vitis* ; X-Linked Inhibitor of Apoptosis Protein

AIM To improve the quality standard for Guanxin Shengmai Pills.METHODS TLC was adopted in the qualitative identification of Ginseng Radix et Rhizoma and Notoginseng Radix et Rhizoma,the analysis was performed on a silica G thin layer plate,along with the low layer solution of chloroform-methanol-water(13 : 7 : 2)stood at below 10℃ as a mobile phase,and 10％sulfuric acid ethanol solution as a derivatization reagent.HPLC was applied to determining the contents of ginsenoside Rg1,ginsenoside Re,ginsenoside Rb1 and ginsenoside Rd,the analysis was performed on a 20℃ thermostatic Thermo Accucore-C18 column(4.6 mm×150 mm,2.6 μm),with the mobile phase comprising of acetonitrile-water flowing at 0.8 mL/min in a gradient elution manner,and the detection wavelength was set at 203 nm.RESULTS The clear TLC bands present without negative interference.Four constituents showed good linear relationships within their own ranges(R2≥0.999 9),whose average recoveries were 91.21％-106.86％with the RSDs of 0.68％-1.43％.CONCLUSION This specific and reproducible method can provide a reference for the quality control of Guanxin Shengmai Pills.