No abstract available.
China* ; Depression* ; Republic of Korea*

Changes in the levels of biogenic amines in different brain regions and the cerebrospinal fluid in rats were measured after acute or chronic treatment with tricyclic antidepressants. After single or 3 weeks' treatment with imipramine or desipramine, blocks of tissues were obtained from seven regions of the brain (frontal cortex, corpus striatum, hippocampus, thalamus, hypothalamus, substantia nigra and cerebellum) immediately after collection of the cerebrospinal fluid (CSF) from the cisterna magna. The concentrations of biogenic amines and their metabolites (norepinephrine, epinephrine, dopamine, 5-hydroxytryptamine (5-HT), dihydroxyphenylacetic acid (DOPAC), homovanillic acid (HVA), 5-hydroxyindoleacetic acid (5-HIAA)) in brain tissues and the CSF were measured using the high performance liquid chromatography-electrochemical detection system (HPLC-ECD). Treatment with desipramine or imipramine caused major alterations in the concentrations of central norepinephrine or 5-HT and its metabolite, respectively. Brain regional responses were variable according to the kind of tricyclic antidepressants and the duration of treatment. It is noteworthy that chronic treatment with both desipramine and imipramine caused altered hippocampal concentrations of norepinephrine and/or 5-HT and its metabolites. Striatal DOPAC concentrations were also changed after acute or chronic treatment with both drugs. These results suggest that tricyclic antidepressants altered neurotransmission according to the brain region, and the hippocampal norepinephrine and 5-HT and/or the striatal dopamine may have a significant role for the expression of antidepressant action of tricyclic antidepressants.
Animal ; Antidepressive Agents, Tricyclic/*pharmacology ; Biogenic Monoamines/*metabolism ; Brain/*drug effects/metabolism ; Desipramine/pharmacology ; Imipramine/pharmacology ; Male ; Rats ; Rats, Sprague-Dawley

The authors carried out the funduscopic examination in 53 cases of leukemia (acute myeloblastic leukemia 17, acute lymphoblastic leukemia 2.0, acute monocytic leukemia 9, chronic myelogenous leukemia 5, acute progranulocytic leukemia 2) and 51 cases of various anemias (aplastic anemia 37, iron deficiency anemia, secondary anemia due to bleeding 4, miscellaneous 4) which were confirmed by hematological studies at Kyung-Pook National University Hospital from October 1969 to October 1975. The following results were obtained. 1) Of 53 cases of leukemia, 62% revealed retinopathy with retinal homorrhage. In 65% of 17 cases of acute myeloblastic leukemia, 55% of 2.0 cases of acute lymphoblastic leukemia, 77 % of 9 cases of acute monocytic leukemia, and 4.0% of 5 cases of chronic myelogenous leukemia, retinopathies were noted. 2) Of 51 cases of anemia, 45% revealed retinopathy with retinal hemorrhage. In 49% of 37 cases of aplastic anemia, and 33% of 6 cases of iron deficiency anemia, retinopathies were noted, but none of secondary anemia due to blood loss had retinal hemorrhage. 3) Acute leukemia had more retinal hemorrhage frequency than chronic leukemia. 4) The extent of the retinal hemorrhages seemed to parallel the severity of the anemia in aplastic anemia. 5) Generally the thrombocytopenia was noted in the aplastic anemia but the extent of the retinal hemorrhages not seemed to parallel the severity of the thrombocytopenia. 6) The extent of the retinal hemorrhages seemed to parallel the severity of the anemia in iron deficiency anemia. 7) Specific retinal pictures could not be noted in the various blood dyscrasias. 8) With the retinal pictures, no differentiation on type of the leukemia and the anemia could be noted.
Anemia* ; Anemia, Aplastic ; Anemia, Iron-Deficiency ; Granulocyte Precursor Cells ; Hemorrhage ; Leukemia* ; Leukemia, Monocytic, Acute ; Leukemia, Myelogenous, Chronic, BCR-ABL Positive ; Leukemia, Myeloid, Acute ; Leukemia, Promyelocytic, Acute ; Precursor Cell Lymphoblastic Leukemia-Lymphoma ; Retinal Hemorrhage ; Retinaldehyde ; Thrombocytopenia

Struma ovarii is a monodermal teratoma composed totally or in overwhelming proportion of thyroid tissue. It is uncommon and accounts for 1% to 3% of benign teratomas of ovary. Grossly, they are encapsulated neoplasms, several centimeters in diameter and have a red, shiny, and meaty surface. Microscopically, the tumor is composed of mature thyroid tissue consisting of various sizes, lined by a single layer of columnar or flattened epithelium. The clinical behavior is benign, and simple excision is adequate treatment. We had experienced two cases of struma ovarii arising in the left ovaries. So we report above cases with brief review of literatures.
Epithelium ; Female ; Ovary ; Struma Ovarii* ; Teratoma ; Thyroid Gland

PURPOSE: Although a Do-Not-Resuscitate (DNR) order is widely in use, it is one of the challenging issues in end-of-life care. This study was conducted to investigate attitudes toward DNR according to education and clinical experience. METHODS: Data were collected using a structured questionnaire comprising 30 items in a tertiary hospital in Seoul, Korea. RESULTS: Participants were 238 nurses and 72 physicians. Most participants (99%) agreed to the necessity of DNR for reasons such as dignified death (52%), irreversible medical condition (23%) and patients' autonomy in decision making (19%). Among all, 33% participants had received education about DNR and 87% had DNR experience. According to participants' clinical DNR experience, their attitudes toward DNR significantly differed in terms of the necessity of DNR, timing of the DNR consent and post-DNR treatments including antibiotics. However, when participants were grouped by the level of DNR education, no significant difference was observed except in the timing of the DNR consent. CONCLUSION: This study suggests that the attitudes toward DNR were more affected by clinical experience of DNR rather than education. Therefore, DNR education programs should involve clinical settings.
Anti-Bacterial Agents ; Decision Making ; Education* ; Korea ; Professional Practice ; Resuscitation Orders ; Seoul ; Tertiary Care Centers

Hemosuccus pancreaticus is a rare cause of chronic and intermittent chronic gastrointestinal hemorrhage, and this condition cannot be easily detected by endoscopy. We report here on a 51-year-old woman with obstructive jaundice and a history of acute pancreatitis and chronic alcoholism. Abdominal computed tomography showed a dilated distal common bile duct. We performed endoscopic retrograde cholangiopancreatography to decompress the bile duct and we found a blood clot on the orifice of the ampulla of Vater. Hemobilia with massive bleeding was seen during the examination. Angiography for controlling the hemorrhage showed the pseudoaneurysm of the pancreaticoduodenal artery. Angiographic embolization was successful for controlling the arterial hemorrhage. The patient remained symptom-free and he was discharged without complications.
Alcoholism ; Ampulla of Vater ; Aneurysm, False ; Angiography ; Arteries ; Bile Ducts ; Cholangiopancreatography, Endoscopic Retrograde ; Common Bile Duct ; Endoscopy ; Female ; Gastrointestinal Hemorrhage ; Hemobilia ; Hemorrhage ; Humans ; Jaundice ; Jaundice, Obstructive ; Middle Aged ; Pancreatitis ; Pancreatitis, Chronic

We studied and analyzed 66 cases of choledochal cyst in a 9 year period from March, 1985 to December, l993 at Hangang, Kangnam and Chuncheon Sacred Heart Hospital. The results were as follows; 1) Age ranged from 1 year to 82 years and ll of 66 cases were below 10 years. The ratio of men to women was 1: 1.9. 2) The frequency of the triad of symptoms and signs were in order of abdominal pain 53 cases(80.3%), jaundice 12 cases(18.2%) and abdominal mass 9 cases(13.6%). The classical triad of pain, mass and jaundice was present in only 2 cases(3.0%). 3) Alkaline phosphatase was elevated in 42 cases(63.6%), hyperbilirubinemia in 29 cases(43.9%) and hyperamylasemia in 9 cases(13.6%). 4) Performed diagnostic procedures were ultrasonogram in 57 cases(86.4%), endo- scopic retrograde cholangiopancreatogram in 32 cases(48.5%), DISIDA scan in 18 cases(27.3%), computed tomogram in 14 cases(21.2%) and percutaneous transhepatic cholangiagram in 6 cases(9.1%). 5) Among 38 cases which ERCP or PTC were performed, according to the Todani's classification, Type I was seen in 28 cases(73.7%), Type IVA in 7 cases(18. 4%), Type II in 2 cases(5.3%) and Type V in I case(2.6%). 6) The associated diseases were cholangitis in 15 cases(22.7%), choledocholithiasis in 12 cases(18.2%) and cholangiocarcinoma in 2 cases(3.0%). 7) Operative procedures were performed in 22 of 66 cases, excision of cyst with Roux-en-Y c~holedochojejunostomy in 17 cases, choledochocystojejunostomy in 2 cases and external drainage in 3 cases.
Abdominal Pain ; Alkaline Phosphatase ; Cholangiocarcinoma ; Cholangiopancreatography, Endoscopic Retrograde ; Cholangitis ; Choledochal Cyst* ; Choledocholithiasis ; Classification ; Drainage ; Female ; Gangwon-do ; Heart ; Humans ; Hyperamylasemia ; Hyperbilirubinemia ; Jaundice ; Male ; Surgical Procedures, Operative ; Ultrasonography

BACKGROUND/AIMS: First-line therapies against Helicobacter pylori, including proton pump inhibitors (PPIs) plus two antibiotics, may fail in up to 20% of patients. 'Rescue' therapy is usually needed for patients who failed the first-line treatment. This study evaluated the eradication rate of bismuth-containing quadruple rescue therapy over a 1- or 2-week period. METHODS: We prospectively investigated 169 patients with a persistent H. pylori infection after the first-line triple therapy, which was administered from October 2008 to March 2010. The patients were randomized to receive a 1- or 2-week quadruple rescue therapy (pantoprazole 40 mg b.i.d., tripotassium dicitrate bismuthate 300 mg q.i.d., metronidazole 500 mg t.i.d., and tetracycline 500 mg q.i.d.). After the 'rescue' therapy, the eradication rate, compliance, and adverse events were evaluated. RESULTS: The 1-week group achieved 83.5% (71/85) and 87.7% (71/81) eradication rates in the intention to treat (ITT) and per-protocol (PP) analyses, respectively. The 2-week group obtained 87.7% (72/84) and 88.9% (72/81) eradication rate in the ITT and PP analyses, respectively. There was no significant difference in the eradication rate, patient compliance or rate of adverse events between the two groups. CONCLUSIONS: One-week bismuth-containing quadruple therapy can be as effective as a 2-week therapy after the failure of the first-line eradication therapy.
Anti-Bacterial Agents ; Bismuth ; Compliance ; Helicobacter ; Helicobacter pylori ; Humans ; Intention ; Metronidazole ; Organometallic Compounds ; Patient Compliance ; Prospective Studies ; Proton Pump Inhibitors ; Tetracycline

BACKGROUND: Stomach cancer is the most common cancer in Korea, and it can be easily diagnosed by performing endoscopy. Helicobacter pylori (H. pylori) is associated with stomach cancer, and there has been much recent interest in the epidemiology of stomach cancer. Therefore, we estimated the incidence of stomach cancer in Chuncheon-si during 2000-2002. METHODS: From July 1st, 2000 through June 30th, 2002, we investigated the subjects who were confined to be newly diagnosed cases living in Chuncheon-si. The data was collected from the medical records from all the medical facilities located in Chuncheon-si. RESULTS: The total number of cases of newly diagnosed stomach cancer during this period (2000-2002) was 186 (117 males and 69 females). The annual crude incidence rate of stomach cancer was estimated to be 37.0 per 100,000 persons overall, and 47.0 and 27.2 in the males and females, respectively. The annual age standardized incidence rate for the Korean population was 33.7 per 100,000 persons overall, and 42.2 and 25.1 for the males and females, respectively. The major symptoms of stomach cancer patients were epigastric pain (61.8%) and weight loss (31.2%). The proportion of early gastric cancer was 34.9% (60 among 172 persons) of the cases of stomach cancer. 64 patients (74%) were H. pylori positive. CONCLUSIONS: We report here on the estimated incidence rate of the stomach cancer and the characteristics of the stomach cancer patients in Chuncheon-si during 2000-2002. This study has generated basic epidemiologic data to identify the effect of H. pylori eradication on the future incidence rate of stomach cancer.
Endoscopy ; Epidemiology ; Female ; Gangwon-do* ; Helicobacter pylori ; Humans ; Incidence* ; Korea ; Male ; Medical Records ; Stomach Neoplasms* ; Stomach* ; Weight Loss

BACKGROUND/AIMS: Quadruple therapy can be considered as a first-line therapy in areas where the resistance rate to clarithromycin is high. Comparison study of triple therapy and quadruple therapy for Helicobacter pylori (H. pylori) eradication is still lacking in Korea despite the increasing prevalence of antibiotic resistance. This study was conducted to compare the efficacy of triple and quadruple therapy as a first-line treatment in H. pylori infected patients with peptic ulcer. METHODS: Consecutive 149 cases of peptic ulcer disease associated with H. pylori infection were randomized either to proton pump inhibitor (PPI, bid), amoxicillin (1,000 mg, bid), and clarithromycin (500 mg, bid) (PAC group) or to PPI (bid), bismuth subcitrate (300 mg, qid), metronidazole (500 mg, tid), and tetracycline (500 mg, qid) (PBMT group) eradication treatments for 7 days. Outcome of eradication therapy was assessed by 13C-urea breath test performed 4-6 weeks after eradication. RESULTS: Eradication rates in PAC and PBMT group were 78.7% (59/75) and 71.6% (53/74) by intention to treat analysis, respectively (p=0.424). By per protocol analysis, eradication rates of PAC and PBMT group were 85.5% (59/69) and 85.5% (53/62), respectively (p=1.012). Adverse reactions occurred in 5 (6.6%) and 7 (9.5%) patients in PAC and PBMT group, respectively (p=0.346). CONCLUSIONS: One week-quadruple therapy as a first-line treatment for H. pylori infection does not offer any advantage over PPI-based triple therapy in Korean patients.
Adolescent ; Adult ; Aged ; Antacids/administration & dosage ; Anti-Infective Agents/administration & dosage ; Drug Therapy, Combination ; English Abstract ; Female ; Helicobacter Infections/complications/*drug therapy/microbiology ; *Helicobacter pylori ; Humans ; Male ; Middle Aged ; Peptic Ulcer/microbiology ; Proton Pumps/antagonists & inhibitors