Castleman disease rarely presents as an isolated retroperitoneal mass. We report two cases of retroperitoneal Castleman disease. Sonography showed hypoechoic mass. in two CT demonstrated homogeneously enhancing mass in two cases and calcifications in one case.
Giant Lymph Node Hyperplasia*

No abstract available.
Esophagus*

No abstract available.
Arteriovenous Fistula* ; Renal Dialysis*

OBJECTIVES: This study was to determine how the perception and the satisfaction of outpatients who utilized clinics and hospitals are structurally related with their willingness to utilize the same institution in the future. METHODS: Three hundred and ten responses (via convenient sampling) were collected from 5 hospitals and 20 clinics located in Seoul listed in the "Korea National Hospital Directory 2005". Service quality was utilized as the satisfaction measurement tool. For analysis, we used a structural equation modeling method. RESULTS: The determining factors for general satisfaction with medical services are as follows: medical staff, reasonability of payment, comfort and accessibility. Such results may involve increased competition in the medical market and increased demands for quality medical services, which drive the patients to visit hospitals on their own on the basis of changed determining factors for satisfaction. CONCLUSIONS: The structural equation model showed that the satisfaction of outpatients with the quality of medical services is influenced by a few sub-dimensional satisfaction factors. Among these sub-dimensional satisfaction factors, the satisfaction with medical staff and payment were determined to exert a significant effect on overall satisfaction with the quality of medical services. The structural relationship in which overall satisfaction perceived by patients significantly influences their willingness to use the same institution in the future was also verified.
Adult ; Cross-Sectional Studies ; Female ; Humans ; Korea ; Male ; Middle Aged ; Models, Statistical ; *Outpatient Clinics, Hospital ; *Patient Satisfaction ; *Quality of Health Care ; Young Adult

PURPOSE: We investigated the effect on MK 801 on the development on brain damage, spontaneous recurrent seizures and mossy fiber sprouting in the pilocarpine induced status epilepticus animal model. Methods: Fifty two adult Sprague Dawley male rats(180-240gm) were studied under ketamine/xylazine(87mg/13mg/kg, IP) anesthesia and were implanted at the F3, P3, F4, P4 areas for recording EEG. With a single intraperitoneal(IP) administration of pilocarpine hydrochloride(360mg/kg), 70% developed status epilepticus(SE). When SE was not induced within 1 hour after injection of pilocarpine, the second dose of pilocarpine(175mg/kg, IP) was injected, with 86.6% of success. Results: All studied animals were divided into two large groups, one group was treated with NMDA receptor antagonist, the other was control group. The mean duration of SE was 62.00+/-6.80 minutes in the MK 801(1mg/kg, IP, 30 minutes after SE) treated group, and 61.10+/-7.37 minutes in the control group without any signigicant differences(P>0.05). Neuronal loss(necrosis dominantly) was observed at CA1 and CA3 areas in the control group, with more loss after 6 weeks than 24 or 72 hrs specimens. However, there was no neuronal loss in MK 801 treated group. The protective effect of MK 801 for neuronal injury suggested the glutamate receptor activation was involved in the neuronal injury induced by repeated seizure attack. Spontaneous recurrent seizures(SRS) were observed 70% of animals in the control group, but there were no SRS observed in the MK 801 treated group. The mean scores of mossy fiber sprouting were significantly higher in the control group(2.05+/-0.47) than MK 801 treated group(0.4+/-0.32)(P<0.05). Conclusion: These results suggested that SRS and mossy fiber sprouting were associated with NMDA receptor activation, and NMDA receptor activation had a key role in the epilepsy development.
Adult ; Anesthesia ; Animals* ; Brain* ; Dizocilpine Maleate* ; Electroencephalography ; Epilepsy ; Humans ; Male ; Models, Animal* ; N-Methylaspartate ; Neurons ; Pilocarpine* ; Receptors, Glutamate ; Seizures* ; Status Epilepticus*

PURPOSE: As our society ages, a disease like benign prostatic hyperplasia (BPH) are increasing and needs consequent management. Recently, through the expansion of the communication infrastructure and terminals, a network services can be provided. However, the concern about distant medical management is increasing. We introduce here the Personal BPH Control Program (PBCP) and its application to clinical patients. MATERIALS AND METHODS: We have asked BPH patients to input the variable elements on the digital survey through the Personal Digital Assistant (PDA) once a week. We used the International Prostate Symptom Score (IPSS) and the average flow rate as the variable elements. We have used an algorithm to determine the patients condition. With this, we have developed a program that helps patients to adjust their visits to the hospital. RESULTS: According to the input elements, we have determined that the patients' condition was good (visit the hospital every 3 months) when the IPSS decreased, compared with the baseline and when the average flow rate was up above 2ml/sec. The patients' condition was a warning (visit the hospital every 2 months) when the IPSS was increased to below 3 and the average flow rate was down below +/- 2ml/sec, and the patients' condition was urgent when the IPSS increased to above 4 and the average flow rate was down above 3ml/sec. CONCLUSIONS: We expect that the PBCP has great socioeconomic utility when applying it to patients. A portable personal apparatus for measuring the flow rate is now being developed. When sufficient examples of applying the symptom algorithm have accumulated, we are going to report afterward the prospects of using the PBCP in the future.
Computers, Handheld ; Humans ; Prostate ; Prostatic Hyperplasia ; Telecommunications

The actions and side effcts of the benzodiazepine antagonist flumazenil were evaluated in a clinical study in which midazolam was used as an anesthetir induction agent. Anesthesia was maintained with nitrous oxide-oxygen-fentanyl. Sixty-five adult surgical patients received either 0.3 mg (3 ml) of flumazenil (33 cases) or 3 ml of saline (32 cases) at the conclusion of surgery. Blood pressure, pulse rate, and respiratory rate were checked before premedication, just before, 5 minutes, 30 minutes, and 120 minutes after the administration flumazenil or saline. Also level of consciouseness, orientation in time and space, and cooperativeness along with end tidal carbon dioxide and hemoglobin oxygen saturation were evaluated. Various larboratory parameters were checked before premedication and 24 hours after operation. The results were as follows: 1) The flumazenil group revealed improved level of consciousness, orientation in time and space, and cooperativeness which began just after the administration, and was maintained 30 minutes thereafter. 2) There was no difference in the changes of laboratory parameters between the two groups. 3) The changes of blood pressure, pulse rate, respiratory rate, and SaO2 showed no difference between those two groups. 4) The end tidal concentrations of carbon dioxide after drug administration were significantly lower in the flumazenil group than those of the saline group. 5) Tolerance to flumazenil (0.3 mg) was good without any side effect.
Adult ; Anesthesia* ; Benzodiazepines ; Blood Pressure ; Carbon Dioxide ; Consciousness ; Flumazenil* ; Heart Rate ; Humans ; Midazolam* ; Oxygen ; Premedication ; Respiratory Rate

PCR is a rapid and sensitive method for detection of viruses from clinical samples and good primers are essential for successful PCR. However, high mutation rate of viral genomes often results in failure in detecting viruses, and there have been attempts to develop primers from multiple viral sequences. Thus, we developed a program called Universal Primers Score Ranking (UPSR) which generates primers from multiple sequences and ranks the quality of primers automatically. The feasibility of the UPSR program was tested using hepatitis B viruses (HBV) isolated from Korean patients. UPSR generated primer candidates with quality score ranks according to two T(m) values. We found that T(m2) values calculated based on the thermodynamics of nearest neighboring bases were better correlated with actual detection rate of HBV from patients' sera. The primer with number 1 rank by T(m2) values detected more samples than any other primers designed by UPSR, commercial primer, or other reference primers suggested by previous literatures. Thus, UPSR proved to be easy and useful to design primers from multiples sequences in detecting viruses.
Collodion ; Genome, Viral ; Hepatitis B virus ; Humans ; Mutation Rate ; Polymerase Chain Reaction ; Thermodynamics

PURPOSE: We investigated the feasibility and clinical applicability of sentinel lymph node biopsy (SLNB) in patients with neoadjuvant chemotherapy, tumor size > 2 cm, and privious excisional biopsy. METHODS: 175 patients with 176 breast cancer underwent aLNB between October 2001 and October 2002. Among them twenty-five patients with locally advanced breast cancer underwent SLNB after neoadjuvant chemotherapy. Eighty-nine (50.6%) had primary tumor > 2 cm. The recent biopsy method used before SLNB was excision in thirty-one (17.6%) procedures. The identification rate, false-negative rate, negative prediction value and accuracy of SLNB were determined. RESULTS: SLNB was successful in 164 of 176 cases (detection rate, 93.2%). The identification rate of patients who had neoadjuvant chemotherapy was 68% and lower than that of who had not (97.3%), significantly (P=0.00). However, mapping success was not influenced by large tumor size (> 2 cm) or previous excisional biopsy. The false-negative rate and accuracy were 16.5% and 91.5, respectively. The false negative rate was 21.3% (3/14) in those patients received neoadjuvant chemotherapy compared with a 15.5% in those patents not received neoadjuvant chemotherapy (P> 0.05). In addition, Tumor size > 2 cm and previous excision did not adversely impact the false negative rate and accuracy. CONCLUSION: Neoadjuvant chemotherapy was associated with a lower identification rate for SLNB. But if detected, SLNB after neoadjuvant chemotherapy might reliably predict axillary status. SLNB is feasible and accurate in patients with large tumor (> 2 cm) and previous excision.
Biopsy ; Breast Neoplasms ; Drug Therapy* ; Humans ; Sentinel Lymph Node Biopsy*