OBJECTIVE: The goal of this study was to determine the efficacy of prolotherapy in relieving the pain of patients with tendon or ligament laxity. METHOD: The subjects were 67 patients (40 male, 27 female) who were suffering from chronic musculoskeletal pain, excluding those with metabolic diseases that could influence the nature of the pain. The effect of the treatment was evaluated by checking the VAS score after a monthly injection of 15% dextrose solution injected around the patient's ligaments and teno-osseous junction that were suspicious of laxity. This same procedure was followed after a second injection. To make an accurate evaluation before and after the treatment, the use of NSAID, physical therapy or exercise therapy was prohibited. RESULTS: The mean pain duration of the subjects was 5.48+/-7.04 years, and the mean age of the subjects was 49.58+/-16.52 years. The result from VAS showed a statistically remarkable reduction after the injection (p<0.01). The VAS decreased from 7.00+/-0.17 to 4.31+/-0.21 after the first injection and this score further decreased to 2.55+/-0.19 after the second injection. There was no statistically significant relationship between the duration of pain and the effect of the treatment (p>0.05). CONCLUSION: This research demonstrated that prolotherapy is an effective method in treating patients with chronic musculoskeletal pain caused by tendon or ligament relaxation.
Chronic Pain* ; Exercise Therapy ; Glucose ; Humans ; Ligaments ; Male ; Metabolic Diseases ; Musculoskeletal Pain ; Musculoskeletal System* ; Relaxation ; Tendons

BACKGROUND: Tumor angiogenesis is required for tumor growth and metastasis. In this study, we investigated the correlation between the intensity of angiogenesis and stage, nodal status, histologic type, metastasis and survival rate of non-small cell lung cancer. METHOD: Formalin fixed, paraffin embedded surgical specimens of 45 patients who had surgically resected primary non-small cell lung cancers without pre or post perative adjuvant chemotherapy or radiotherapy were examined. The microvessel count(MVC) was demonstrated by immunohistochemical staining for CD31(platelet ednothlial cell adhesion molecule, PECAM). RESULTS: Microvessel counts(MVCs)in stage IIIA and IIIB were higher than in stage I and II(p<0.05). The MVC in patients with lymph node metastasis was higher than that in patients without lymph node metastasis, although the difference was not statistically significant(p>0.05). However, in adenocarcinoma, the MVC in patients with lymph node metastasis was significantly higher than that seen in patients without lymph node metastasis(p<0.05). The MVC in adenocaricinoma was higher than that in squamous cell carcinoma(p<0.05). The difference between the MVCs of adenocarcinoma and squamous cell carcinoma was not statistically significant in stage Iand II or NO stage(p>0.05). However, in stage IIIA and IIIB or N1~3 stage, the MVC in adenocarcinoma was higher than that in squamous cell carcinoma(p<0.05). MVC was more increased when metastasis developed within 12 months. In the same histologic type and stage, the duration of survival time in patients with high MVC was shorter than in patients with low MVC, however the difference was not statistically significant(p>0.05). The survival rate in patients with high MVCs was lower than that in patients with low MVCs(P<0.05). CONCLUSION: In non-small cell lung cancer, MVC correlated relatively well with pathologic stage, nodal status (limited in patients with adenocarcinoma), histologic type, postoperative metastasis and survival rate. However, in the same histologic type and stage, MVC was not significantly related to the duration of survival. Therefore the assessment of the intensity of angiogenesis in non-small cell lung cancer may be helpful in predicting prognosis and in selecting patients for systemic adjuvant therapy of potential metastasis according to the results.
Adenocarcinoma ; Carcinoma, Non-Small-Cell Lung* ; Carcinoma, Squamous Cell ; Cell Adhesion ; Chemotherapy, Adjuvant ; Formaldehyde ; Humans ; Lung Neoplasms ; Lymph Nodes ; Microvessels ; Neoplasm Metastasis ; Paraffin ; Prognosis* ; Radiotherapy ; Survival Rate

BACKGROUND: In the background of increasing silver, the measurement of risk factors of cardiovascular system and abilities of controlling that of the aged are becoming the interest. 'Old age' is one of the risk factors of postoperative cardiovascular complication. We summarized diseases, discovered when randomly examined by transthoracic echocardiography (TTE) and frequencies of the diseases in old aged, older than 60 years. So we could discuss the clinical impact of preoperative TTE at resting state over 60 year old for postoperative cardiovascular system of noncardiac surgery. METHODS: For the period 15months, from September 1, 1999 to January 10, 2001, we examined patients who are older than 60 years, to be scheduled to undergo operation of noncardiac surgery, by using SONOS 1000, made by Hewlett-Packkard, USA. 933 patients (595 men and 337 women) were examined. RESULTS: We examined 993 patients, 595 men (63.8%) and 337 women (36.2%), who were aged from 60 years to 93 years (average 68.5+/-7.1 years old). 87.2% of patients had left ventricular relaxation abnormatilties, average ejection fraction at resting state was 62.0+/-6.8%, which is in normal range and left ventricular end diastolic diameter was 49.2+/-5.4 mm. Becoming older, average left ventricular ejection fraction is decreasing, average of desceleration time and IVRT, parameters of LV relaxation abnormality, are increasing but they are not stastically meaningful.There were four cases of dilated cardiomyopathy (0.4%) in which two cases were incidentally discovered by TTE and they had no specific past histories. 38 persons (4.1%) had pulmonary hypertension (RVSP, higher than 35 mmHg) and they had no specific complication at the operations and postoperative state. In 3 of the patients who had pulmonary hypertension, one was incidentally discovered, had Atrial septal defect and all of three had normal LV function. In our study there were 333 patients (35.7%) of Mitral regurgitation and 343 patients (36.8%) of aortic insufficiency which are pathologic change of aging, and patients severe than grade III were 3 patients (0.3%). One was treated by postoperative congestive heart failure at intensive care unit and other 2 patients could not be followed because of transfer and against discharge. 3 patients was diagnosed by Mitral valve prolapse of patients of Mitral regurgitation (0.3%). In case of Aortic valve stenosis, most popular vavular heart disease in old aged patients, have no symptom unless that is severe, often incidentally discover at TTE in our study at pre-operative state. There were 10 patients of aortic valve stenosis (1.1% frequency), 9 cases were mild ones and remaining one case was severe and received aortic valve replacement at Chest surgery department. CONCLUSION: The prevalence of cardiovascular disease that incidentally discovered at TTE in resting state is similar with the result of the reference in for the old aged population and the group of patients who had no symptom at resting state, could have risks of cardiovascular disease. We cannot predict all of the postoperative cardiovascular complication and risks with TTE at resting state in old age patients, but it was useful for screening of valvular diseases, congenital cardiac disease, pulmonary hypertension. It is also good for carrying out before stress TTE with exercise or dopamine. It has an important role for making decision of performing other stress tests in patients who have cardiovascular risk factors and grouping that need to have intervention therapy like the coronary angiography or not. Besides monitoring the cardiovascular system at operation and postoperation periods, medication during the preoperation period and surgical treatments when cardiovascular abnormalities found at TTE, cardiologic medical treatments are needed to lower the postoperative complication rates and improve the prognosis.
Aging ; Aortic Valve ; Aortic Valve Stenosis ; Cardiomyopathy, Dilated ; Cardiovascular Abnormalities ; Cardiovascular Diseases ; Cardiovascular System ; Coronary Angiography ; Dopamine ; Echocardiography* ; Exercise Test ; Female ; Heart Diseases ; Heart Failure ; Heart Septal Defects, Atrial ; Humans ; Hypertension, Pulmonary ; Intensive Care Units ; Male ; Mass Screening ; Middle Aged* ; Mitral Valve Insufficiency ; Mitral Valve Prolapse ; Postoperative Complications ; Prevalence ; Prognosis ; Reference Values ; Relaxation ; Risk Factors ; Silver ; Stroke Volume ; Thorax

The purpose of this study was to investigate the comparative effects of subgingival irrigation using some oral mouth rinses on early healing process of periodontal inflammation. The study population consisted of 13 patients with periodontal inflammation and distributed into 4 groups. Oral hygiene instruction, delicate scaling and root planing were done and then irrigated per 3 days during 2 weeks in situ with 1 of 4 solutions ; normal saline, C31G, Benzotonium chloride and tetracycline. Examination regarding probing pocket depth, plaque index, sulcular bleeding index, gingival index, gingival recession and leukocytes differential count was performed. Evaluation was made at the baseline and 2 weeks after non-surgical periodontal therapy. The results were as follows: 1. Clinical indices including probing pocket depth, plaque index, sulcular bleeding index, gingival index and gingival recession were significantly improved from baseline to 2 weeks. But there was no significant differences among 4 groups. 2. PMNs percent on leukocytes differential count was significantly decreased from baseline to 2 weeks on all groups. Those of tetracycline and C31G were significantly decreased than those of normal saline group. These results suggest that clinical indices were not different, but the decrease of inflammation were significantly different among some mouth rinses.
Gingival Recession ; Hemorrhage ; Humans ; Inflammation* ; Leukocytes ; Mouth* ; Oral Hygiene ; Periodontal Index ; Root Planing ; Tetracycline

Tuberculosis can affect the sacroiliac joint. The involvement has been reported in up to 10 percent of patients with osteoarticular tuberculosis. The onset is usually insidious, and early diagnosis requires a high index of clinical suspicion. Lack of awareness of this presently uncommon form of infection often leads to diagnostic delay and increased morbidity. Early diagnosis and proper treatment with anti-tuberculous medication could obtain a satisfactory functional outcome. We report a case of tuberculous sacroiliitis in a 21 year-old male patient including his clinical presentation, radiographic features and outcome of medical treatment.
Early Diagnosis ; Humans ; Male ; Sacroiliac Joint ; Sacroiliitis* ; Tuberculosis ; Tuberculosis, Osteoarticular ; Young Adult

Recent genomewide association studies of large samples have identified genes that are associated with blood pressure. The Global Blood Pressure Genetics (Global BPgen) and Cohorts for Heart and Aging Research in Genome Epidemiology (CHARGE) consortiums identified 14 loci that govern blood pressure on a genomewide significance level, one of which is CASZ1 confirmed in both Europeans and Asians. CASZ1 is a zinc finger transcription factor that controls apoptosis and cell fate and suppresses neuroblastoma tumor growth by reprogramming gene expression, like a tumor suppressor. To validate the function of CASZ1 in blood pressure, we decreased Casz1 mRNA levels in mice by siRNA. Casz1 siRNA reduced mRNA levels by 59% in a mouse cell line. A polyethylenimine-mixed siRNA complex was injected into mouse tail veins, reducing Casz1 mRNA expression to 45% in the kidney. However, blood pressure in the treated mice was unaffected, despite a 55% reduction in Casz1 mRNA levels in the kidney on multiple siRNA injections daily. Even though Casz1 siRNA-treated mice did not experience any significant change in blood pressure, our study demonstrates the value of in vivo siRNA injection in analyzing the function of candidate genes identified by genomewide association studies.
Aging ; Animals ; Apoptosis ; Asian Continental Ancestry Group ; Blood Pressure ; Cell Line ; Cohort Studies ; Gene Expression ; Genome ; Heart ; Humans ; Kidney ; Mice ; Neuroblastoma ; RNA, Messenger ; RNA, Small Interfering ; Transcription Factors ; Veins ; Zinc Fingers

Gefitinib is regarded as a relatively safe agent for the treatment of an advanced non-small cell lung cancer (NSCLC). Pulmonary toxicity such as interstitial lung disease associated with gefitinib is uncommon with an estimated all time incidence around 1% worldwide. Moreover, a case of gefitinib associated with pulmonary cystic changes has not been reported yet. In this report we present a case of progressive multiple air cystic changes in both lungs in a patient with NSCLC and intrapulmonary metastases who underwent a gefitinib therapy.
Antineoplastic Agents/*adverse effects ; Brain Neoplasms/secondary ; Carcinoma, Non-Small-Cell Lung/*drug therapy/secondary ; Cysts/*chemically induced ; Female ; Humans ; Lung/pathology ; Lung Diseases/*chemically induced ; Lung Diseases, Interstitial ; Lung Neoplasms/*drug therapy ; Middle Aged ; Quinazolines/*adverse effects

OBJECTIVE: Korea Institute of Drug Safety and Risk Management works for signal detection and safety information generation by analyzing spontaneous adverse event reports database. As the number of reports and detected signals of aripiprazole by each data mining indices were more than other drugs, aripiprazole was selected as a subject of study. METHODS: 1989-2012 spontaneous reporting database was analyzed and the model drug ingredient was aripiprazole. We estimated proportional reporting ratio, reporting odds ratio, and information component for data mining. Then we assessed the causality through review of local and foreign drug labels and literatures. RESULTS: In reconstructed 1989-2012 spontaneous reporting database, there were 2,062 reports on aripiprazole and 2,565 aripiprazole-adverse events pairs. As a result of data mining analysis and signal prioritization, 78 adverse events were detected, 20 adverse events of them were not included in drug label. After literature review, back pain, epistaxis, xerophthalmia and ejaculation disorder were generated as novel safety information on aripiprazole. CONCLUSION: Those 4 novel safety informations of Aripiprazole, back pain, epistaxis, xerophthalmia and ejaculation disorder had become listed on the local label in April 2013.
Back Pain ; Data Mining ; Ejaculation ; Epistaxis ; Korea ; Male ; Odds Ratio ; Risk Management ; Xerophthalmia ; Aripiprazole

OBJECTIVE: To know the accuracy of caudal epidural steroid injection procedure without fluoroscopy guidance, and determine ascending level of injected solution according to injection volume. METHOD: The subjects were 35 patients with low back pain. Needle insertion was performed without fluoroscopy, then we confirm the position of needle with fluoroscopy. The level of injected solution was measured with fluoroscopy and x-ray after injecting every 5 ml of solution, which is mixture of triamcinolone, 2% lidocaine, contrast medium, and normal saline. The effect of treatment was measured by Visual Analogue Scale (VAS). RESULTS: Successful needle placement occurred in 27 cases without fluoroscopy. After injecting 20 ml of solution, the ascending level of solution were S1 in 8 cases, L5 in 12 cases, L4 in 8 cases, L3 in 1 case, L2 in 4 cases, L1 in 2 cases. In the comparison of the VAS before and after treatment, it was 6.3+/-1.2 and 2.9+/-1.3 respectively, which demonstrated statistically significant decrease (p+/-0.05). CONCLUSION: Caudal epidural injection could be performed more accurately under the fluoroscopic guidance. After injecting 20 ml of solution, the ascending level of the solution were restricted at lower lumbosacral area in most of cases.
Fluoroscopy ; Humans ; Injections, Epidural* ; Lidocaine ; Low Back Pain ; Needles* ; Triamcinolone

OBJECTIVE: To compare the ultrasonographic findings of chronic lateral epicondylitis of elbow with partial tear of common extensor tendon before and after prolotherapy. METHOD: The subjects were 12 cases of chronic lateral epicondylitis with partial tear of common extensor tendon, which were confirmed by ultrasonography. We examined the common extensor tendon with ultrasonography at initial visit. After injecting 15% dextrose solution monthly for five times, follow up ultrasonography was performed one month after last injection. RESULTS: Before prolotherapy, every case had anechoic focus without normal fibrillar pattern, which represented partial tear of tendon. Seven cases showed focal or diffuse hypoechoic foci with loss of normal fibrillar pattern of tendon, which represented tendinosis. After prolotherapy, initial anechoic foci were changed to smaller size with diffuse fibrillar pattern inside in 6 cases, to the same the sized hypoechoic foci with diffuse fibrillar pattern inside in 2 cases. And a few fibrillar pattern were seen within the initial anechoic focus in 1 case and most of anechoic foci were filled with fibrillar pattern except small anechoic foci in 3 cases. CONCLUSION: Prolotherapy can help the recovery process of chronic lateral epicondylitis. And ultrasonography can be a useful method to evaluate the therapentic effect of lateral epicondylitis.
Elbow ; Follow-Up Studies ; Glucose ; Tears* ; Tendinopathy ; Tendons ; Ultrasonography