PURPOSE: The purpose of this study is to investigate the correlations of various kinetic parameters derived from the time intensity curve in a xenograft mouse model injected with a prostate cancer model (PC-3 and LNCaP) using an ultrasound contrast agent with histopathologic parameters. MATERIALS AND METHODS: Twenty nude mice were injected with human prostate cancer cells (15 PC-3 and five LNCaP) on their hind limbs. A bolus of 500 microL (1 x 10(8) microbubbles) of second-generation US contrast agent (SonoVue) was injected into the retroorbital vein. The region of interest was drawn over the entire tumor. The time intensity curve was acquired and then fitted to a gamma variate function. The maximal intensity (A), time to peak (Tp), maximal wash-in rate (washin), washout rate (washout), area under the curve up to 50 sec (AUC50), area under the ascending slope (AUC(in)), and area under the descending slope (AUC(out)) were derived from the parameters of the gamma variate fit. Immunohistochemical staining for VEGF and CD31 was performed. Tumor volume, the area percentage of VEGF stained in a field, and the count of CD31 (microvessel density, MVD) positive vessels showed correlation with the parameters from the time intensity curve. RESULTS: No significant differences were observed between the kinetic and histopathological parameters from each group. MVD showed positive correlation with A (r=0.625, p=0.003), washin (r=0.462, p=0.040), AUC50 (r=0.604, p=0.005), and AUC(out) (r=0.587, p=0.007). Positive correlations were also observed between tumor volume and AUC50 (r=0.481, p=0.032), washin (r=0.662, p=0.001), and AUC(out) (r=0.547, p=0.012). Washout showed negative correlations with MVD (r=-0.454, p=0.044) and tumor volume (r=-0.464, p=0.039). The area percentage of VEGF did not show any correlation with calculated data from the curve. CONCLUSION: MVD showed correlations with several of the kinetic parameters. CE-US has the potential for prediction of tumor vascularity in a prostate cancer animal model.
Animals ; Extremities ; Humans ; Mice ; Mice, Nude ; Models, Animal ; Prostate ; Prostatic Neoplasms ; Transplantation, Heterologous ; Tumor Burden ; Vascular Endothelial Growth Factor A ; Veins

PURPOSE: While performing clean intermittent catheterization(CIC), atraumatic and non-infecting techniques are important in preventing long-term complications secondary to CIC. The aim of this study is to characterize several essential technical aspects of CIC in patients with neurologically stable spinal cord injury or diseases(SCI/D). MATERIALS AND METHODS: Between July 2002 and March 2003, a prospective questionnaire survey was undertaken in 106 neurologically stable SCI/D patients who were performing CIC as primary bladder emptying methods. Structured questionnaire was administered with the interview. Questionnaire items included key technical CIC steps and related questions. RESULTS: Mean age of the patients(74 males and 32 females) were 35.9(+/-1.3, SE) years and the duration of CIC was 17.3(+/-2.3) months. Levels of SCI/D were: cervical in 45 patients(42.4%), followed by thoracic in 43(40.6%), lumbar in 16(15.1%), and sacral in 2(1.9%). Omitting hand washing before CIC was found in 16 patients(15.1%), meatal cleansing before CIC in 13(12.3%), using lubricants in 12(11.3%), and performing CIC as a timed basis in 36(34.0%). The most preferred posture to perform CIC were: sitting(63.0%), followed by lying(19.1%) and standing(14.6%) in men, while sitting(45.6%), followed by the squatting(33.3%) and lying(15.8%) in women. Majority of the patients performed CIC five times a day with spending about ten minutes for each CIC. Omitting key elements were not significantly associated with the sex, age, level of SCI/D, duration of CIC, level of education, socioeconomic status. However, omitting meatal cleaning before CIC were significantly associated with the patients with shorter duration of performing CIC, lower educational level, and lower socioeconomic status(p<0.05). 57.6% of the patients were satisfied with the current CIC methods. CONCLUSION: Our results showed that some patients do omit key elements of the CIC steps. These elements should be emphasized during the initial CIC education and also must be screened during long-term followup in the SCI/D patients performing CIC.
Catheterization ; Education ; Female ; Follow-Up Studies ; Hand Disinfection ; Humans ; Intermittent Urethral Catheterization* ; Lubricants ; Male ; Posture ; Prospective Studies ; Surveys and Questionnaires ; Social Class ; Spinal Cord Diseases* ; Spinal Cord Injuries* ; Spinal Cord* ; Urinary Bladder ; Urinary Bladder, Neurogenic

BACKGROUND: Tumor markers have been used in diagnosis, predicting the extent of disease, monitering recurrence after therapy and prediction of prognosis. But the utility of markers in lung cancer has been limited by low sensitivity and specificity. TPA-M is recently developed marker using combined monoclonal antibody of Cytokeratin 8, 18, and 19. This study was conducted to evaluate the efficacy of new tumor marker, TPA-M by comparing the estabilished markers 8CC, CEA, Cyfra2 I - I in hmg cancer. METHODS: An immunoradiometric assay of serum CEA, SCC, Cyfra2l-I, and TPA-M was performed in 49 pathologically confirmed lung cancer patients who visited Keimyung University Hospital from April 1996 to August 1996, and 29 benign lung diseases. Commercially available kits, Ab bead CM (Eiken) to CEA, SCC RIA BEAD (DAINABOT) to SCC, CA21-1 (TEE) to Cyfra21-1, arid TPA-M (DAIICHI) to TPA-M were used for this study. RESULTS: The mean serum values of lung cancer group and control group were 10.05 +/- 38.39 micro/L, l.59+/-0.94 micro/L in CEA, 3.04+/-5.79 micro/L, 1.58+/-2.85 micro/L in SCC, 8.27+/-11.96 micro/L, 1.77+/-2.72 micro/L in Cyfra21-1, and 132.02+/-209.35 U/L, 45.86+/-75.86 U/t in TPA-M respectively. Serum values of Cyfra21-1 and TPA-M in lung cancer group were higher than control group (p<0.05). Using cutoff value recommended by the manufactures, that is 2.5 micro/L, in CEA, 3.0 micro/L in Cyfra21-1, 70.0 U/L in TPA-M, arid 2.0 micro/L in SCC, sensitivity and specificity of lung cancer were 33.3%, 786% in CEA, 50.0%, 89.7% in Cyfra2l-l, 52.3%, 89.7% in TPA-M, 23.8%, 89.3% in SCC. Sensitivity and specificity of nonsmall cell lung cancer were 36.1%, 78.1% in CIA, 50.1%, 89.7% in Cyfra2l-1, 53.1%, 89.7% in TPA-M, 33.8%, 89.3% in SCC. Sensitivity and specificity of small cell king cancer were 25.0%, 78.5% in CEA, 50.0%, 89.6% in Cyfra2l-1, 50.0%, 89.6% in TPA-M, 0%, 89.2% in SCC. Cutoff value according to ROC(Receiver operating characteristics) curve was l.25 micro/L in CEA, 1.5 micro/L in Cyfra2l-1, 35 U/L in TPA-M, 0.6 micro/L in SCC. With this cutoff value, sensitivity, specificity, accuracy and kappa index of Cyfra21-1 and TPA-M were Letter than CEA and SCC. SCC only was related with statistic significance to TNM stages, dividing to operable stages(TNM stage I to IIIA) and inoperable stages (IIIB and IV) (p<0.05). But no tumor markers showed any correlation with significance with tumor size(p>0.05). CONCLUSION: Serum TPA-M and Cyfra21-1 shows higher sensitivity and specificity than CEA and SCC in overall lung cancer and nonsmall cell lung cancer those were confirmed pathologically. SCC has higher specificity in nonsmall cell lung cancer. And the level of serum SCC are significantly related with TNM staging.
Carcinoma, Non-Small-Cell Lung ; Diagnosis ; Humans ; Immunoradiometric Assay ; Keratin-8 ; Lung Diseases ; Lung Neoplasms* ; Lung* ; Neoplasm Staging ; Prognosis ; Recurrence ; Biomarkers, Tumor

BACKGROUND: In recent years, numerous human tumor specific antigens such as melanoma antigen gene(MAGE) that is recognized by autologous cytotoxic T lymphocytes have been identified. MAGE is expressed in many human malignancies in various organs, such as lung, breast, stomach, esophagus and leukemia. Therefore MAGE has been studied widely for tumor diagnosis and immunotherapy. But, so far there were no clinical studies evaluating the role of MAGE in pleural effusion. We investigated the expression of MAGE in the patients with exudative pleural effusion for it's diagnostic utility and the RESULTS: were compared with those of cytologic examinations. METHODS: Diagnostic thoracentesis was performed in 44 consecutive patients with exudative pleural effusion during 6 months. We examined the expression of MAGE and cytology with the obtained pleural effusion. Expression of MAGE was interpreted by means of a commercial kit using RT-PCR method. Enrolled patients were divided into two groups such as malignant and benign and we analyzed its' sensitivity and specificity. RESULTS: There were no significant differences between two groups in age, sex, white blood cell counts in pleural fluid, pleural fluid/serum protein ratio and pleural fluid/serum LDH ratio. The sensitivity and specificity of MAGE were 72.2% and 96.2% respectively and the positive predictive value and negative predictive value of MAGE were also 92.9% and 83.3% respectively. The sensitivity and negative predictive value of cytologic examinations were 66.7% and 81.3% respectively. There were no significant differences between sensitivities of MAGE and cytologic examinations but false positive result of MAGE was found in 1 case of tuberculous pleurisy. CONCLUSION: MAGE is a sensitive and specific marker for the differential diagnosis between benign and malignant effusion in patients with exudative pleural effusion. And MAGE would provide the equal sensitivity compared with that of cytologic examination in patients with malignant pleural effusion if 5mL of the pleural fluid is examined.
Breast ; Diagnosis ; Diagnosis, Differential ; Esophagus ; Humans ; Immunotherapy ; Leukemia ; Leukocyte Count ; Lung ; Melanoma ; Pleural Effusion* ; Pleural Effusion, Malignant ; Sensitivity and Specificity ; Stomach ; T-Lymphocytes, Cytotoxic ; Tuberculosis, Pleural

OBJECTIVES: This study was conducted to investigate the relationship between long working hours and suicidal ideation. METHODS: Data based on the fourth Korea National Health and Nutrition Health and Nutrition Examination Survey_(2007~2009) pertaining to a total of 4,539 full-time workers were analyzed. Working hours were divided into four groups (<40 hours/week, 40~51 hours/week, 52~60 hours/week, >60 hours/week). The relationship between working hours and suicidal ideation was then analyzed after adjusting for general and occupational characteristics using a multivariate logistic regression model. RESULTS: Working 40-51 hours/week showed the lowest suicidal ideation(9.5%), whereas working 52~59 hours/week, over 60 hours/week and less than 40 hours/week showed suicidal ideations of 14.8%, 15.7% and 17.2% respectively. Even after adjusting for general and occupational characteristics, employees working 40~51 hours/week had the lowest suicidal ideation. Working 52~59 hour/week, over 60 hours/week and less than 40 hours/week showed an odds ratios of 1.413(p-value: 0.058), 1.380(p-value: 0.020) and 1.164(p-value: 0.358) respectively. CONCLUSIONS: The results suggest that working long hours, especially over 60 hours per week, is related to suicidal ideation.
Korea ; Logistic Models ; Odds Ratio ; Suicidal Ideation ; Suicide

A 64-year-old woman was diagnosed with non-small cell lung cancer. Her disease was stage 4 (T2N2M1) with squamous cell carcinoma. She had been treated with docetaxel and carboplatin. After a completion of 11 cycle of chemotherapy, edema appeared on both feet and had spread rapidly up to the pretibial area without response to diuretics. Sclerotic changes and pigmentation followed but both knees and other parts of the body were spared. There was no evidence of vascular occlusions. On serologic tests, antinuclear, anti-centromere, and anti-topoisomerase I antibodies were all negative. A skin biopsy revealed diffuse infiltration of lymphocytes and discretely thickened collagen bundles in the superficial dermis. After discontinuing docetaxel chemotherapy, she was treated with prednisolone and D-penicillamine and sclerotic changes on the lower legs were improved.
Antibodies ; Biopsy ; Carboplatin ; Carcinoma, Non-Small-Cell Lung ; Carcinoma, Squamous Cell ; Collagen ; Dermis ; Diuretics ; Edema ; Female ; Foot ; Glycogen Storage Disease Type VI ; Humans ; Knee ; Leg ; Lung Neoplasms ; Lymphocytes ; Penicillamine ; Pigmentation ; Prednisolone ; Sclerosis ; Serologic Tests ; Skin ; Taxoids

PURPOSE: To compare the accuracy of digital subtraction images acquired by two different methods different in positioning four reference points for geometrical standardization. MATERIALS AND METHODS: A total of 36 digital radiographic images of 6 volunteers were taken at the areas of the incisor, premolar, and molar of both the maxilla and mandible using the Digora system. Each image was moved 4 mm vertically and horizontally. Four oral and maxillofacial radiologists performed digital subtraction radiography between the paired images before and after movement using Emago (Oral Diagnostic Systems, Amsterdam, The Netherlands) and Sunny (Biomedisys Co., Seoul, Korea). The standard deviation of the internal gray value in Region of Interest (ROI) was statistically analyzed between the two programs using the paired t-test. RESULTS: The standard deviation of pixel gray values from the digital subtraction images using the Sunny program were lower than that of the Emago program (p<0.05). All observers showed significant differences between each other when the Sunny program was used (p<0.05), but one observer showed a significantly higher score than other observers when they used Emago (p<0.05). The standard deviations of premolar area from both Sunny and Emago programs were significantly higher than those of anterior and molar regions (p<0.05). CONCLUSION: The subtracted images using the Sunny program were more accurate and sensitive than those taken using the Emago program.
Bicuspid ; Incisor ; Mandible ; Maxilla ; Molar ; Radiography* ; Radiography, Dental, Digital ; Seoul ; Subtraction Technique ; Volunteers

Adrenal insufficiency during the treatment of pulmonary tuberculosis is a troublesome condition and can at times be lifethreatening if untreated. Rifampin is one of the most widely prescribed anti-tuberculosis agents. Furthermore, rifampin has been known to be capable of affecting the metabolism of various medications, including glucocorticoids. In this paper, a case of recurrent adrenal insufficiency induced by rifampin during the treatment of pulmonary tuberculosis is reported. The patient was a 63-year-old man who was diagnosed with Addison's disease 17 years earlier and had been undergoing glucocorticoid replacement therapy. Five months before, the patient manifested pulmonary tuberculosis and was immediately given anti-tuberculosis medication that included rifampin. After one week of medication, general weakness and hyponatremia occurred. Despite the increased dose of the glucocorticoid medication, the adrenal insufficiency recurred many times. Since the substitution of levofloxacin for rifampin, the episodes of adrenal insufficiency have not recurred so far.
Addison Disease ; Adrenal Insufficiency ; Glucocorticoids ; Humans ; Hyponatremia ; Middle Aged ; Ofloxacin ; Rifampin ; Tuberculosis, Pulmonary

Anesthesia, General ; Animals ; Azaperone ; Durapatite ; Humans ; Osteoblasts ; Osteogenesis ; Polyethylenes ; Polypropylenes ; Seeds ; Swine

The liver fluke, Clonorchis sinensis is an important human parasite and is endemic in Eastern Asia including Korea, China, and Japan. Patients acquire the infestation by eating raw or undercooked freshwater fish. Radiologic examinations usually reveal dilated peripheral intrahepatic bile ducts and normal extrahepatic bile duct. The diagnosis of clonorchiasis may sometimes be difficult and a presentation as an obstructive mass at the common hepatic duct is a rare event. Here we report a case of clonorchiasis of 54-year-old woman presented with epigastric pain. Endoscopic retrograde cholangiography revealed a mass at the common hepatic duct with dilatation of the intrahepatic ducts mimicking cholangiocarcinoma. Using an endoscopic basket, muddy, sludge-like materials were extracted through the papillary orifice. We report this case with a review of literatures.
Bile Ducts, Extrahepatic ; Bile Ducts, Intrahepatic ; China ; Cholangiocarcinoma ; Cholangiography ; Cholestasis ; Clonorchiasis* ; Clonorchis sinensis ; Diagnosis ; Dilatation ; Eating ; Far East ; Fasciola hepatica ; Female ; Fresh Water ; Hepatic Duct, Common* ; Humans ; Japan ; Korea ; Middle Aged ; Parasites