PURPOSE: To evaluate the predictive value of the early response of 18F-flurodeoxyglucose positron emission tomography (FDG PET) during concurrent chemoradiotherapy (CCRT) for locally advanced non-small cell lung cancer (NSCLC). MATERIALS AND METHODS: FDG PET was performed before and during CCRT for 13 NSCLC patients. Maximum standardized uptake value (SUVmax), mean standardized uptake value (SUVmean), metabolic tumor volume (MTV), and total lesion glycolysis (TLG) were measured and the changes were calculated. These early metabolic changes were compared with the standard tumor response by computed tomograms (CT) one month after CCRT. RESULTS: One month after the completion of CCRT, 9 patients had partial response (PR) of tumor and 4 patients had stable disease. The percent changes of SUVmax (%DeltaSUVmax) were larger in responder group than in non-responder group (55.7% +/- 15.6% vs. 23.1% +/- 19.0%, p = 0.01). The percent changes of SUVmean (%DeltaSUVmean) were also larger in responder group than in non-responder group (54.4% +/- 15.9% vs. 22.3% +/- 23.0%, p = 0.01). The percent changes of MTV (%DeltaMTV) or TLG (%DeltaTLG) had no correlation with the tumor response after treatment. All the 7 patients (100%) with %DeltaSUVmax > or = 50% had PR, but only 2 out of 6 patients (33%) with %DeltaSUVmax < 50% had PR after CCRT (p = 0.009). Likewise, all the 6 patients (100%) with %DeltaSUVmean > or = 50% had PR, but only 3 out of 7 patients (43%) with %DeltaSUVmean < 50% had PR after CCRT (p = 0.026). CONCLUSION: The degree of metabolic changes measured by PET-CT during CCRT was predictive for NSCLC tumor response after CCRT.
Carcinoma, Non-Small-Cell Lung* ; Chemoradiotherapy* ; Glycolysis ; Humans ; Lung Neoplasms ; Positron-Emission Tomography ; Tumor Burden

OBJECTIVES: The vocal changes after a thyroidectomy are temporary and nonsevere, therefore, obtaining accurate analytical results on the pathological vocal characteristics following such a procedure is difficult. For a more objective acoustic analysis, this study used the cepstral analysis method to examine changes in the patients' voices during the perioperative period regarding sustained vowel phonation. METHODS: The sustained phonation of the five vowels (i.e., /a/, /e/, /i/, /o/, and /u/) by 35 patients with thyroidectomy were recorded by using a Multi-Speech program. Of the 35 patients, 10 were men and 25 were women, with an average age of 51.5 years. Voice data were collected a total of 3 times (preoperatively, 5-7 days after the operation, and 6 weeks after the operation) and were edited according to each fragment (on-set, mid, and off-set) for cepstral analysis. RESULTS: The cepstral analysis on the patients' voices revealed no significant differences between the examination periods of all vowel phonations. However, analysis of the on-set fragment of the vowel /i/ revealed pathological characteristics in which the cepstral measurements of the voice were significantly lower after the operation than before the operation, with the cepstral measurements of the voice increasing further 6 weeks following surgery. CONCLUSION: The results of the acoustic analysis on the on-set fragment of the vowel /i/ will be important data for characterizing the vocal changes during the perioperative period. This study contributes to future research on the mechanisms underlying changes in the voice of patients with a history of thyroid or neck surgery.
Acoustics ; Female ; Humans ; Male ; Methods ; Neck ; Perioperative Period ; Phonation ; Thyroid Gland ; Thyroidectomy* ; Voice*

Effective and systematic sanitation management programs are necessary to prevent foodborne disease outbreaks in school foodservice operations. The purpose of this study was to identify the elements to improve in order to ensure the safety of school food service by evaluating sanitation management practices implemented under HACCP-based programs. The survey was designed to assess the level of hygiene practices of school food service by using an inspection checklist of food hygiene and safety. Fifty-four school foodservice establishments considered as poor sanitation practice groups from two year inspections by Seoul Metropolitan Office of Education were surveyed from September to December in 2005. Inspection checklists consisted of seven categories with 50 checkpoints; facilities and equipment management, personal hygiene, ingredient control, process control, environmental sanitation management, HACCP system and safety management. Surveyed schools scored 68.0+/-12.42 points out of 100 on average. The average score (% of compliance) of each field was 10.7/20 (53.3%) for facilities and equipment management, 7.4/11 (67.2%) for personal hygiene, 7.4/11 (74.1%) for ingredient control, 22.4/32 (69.8%) for process control, 8.9/12 (73.8%) for environmental sanitation management, 4.2/7 (59.7%) for HACCP systems management, and 7.2/8 (89.7%) for safety management, respectively. The field to be improved first was the sanitation control of facilities and equipment. The elements to improve this category were unprofessional consultation for kitchen layout, improper compartment of the kitchen area, lacks of pest control, inadequate water supply, poor ventilation system, and insufficient hand-washing facilities. To elevate the overall performance level of sanitation management, prerequisite programs prior to HACCP plan implementation should be stressed on the school officials, specifically principals, for the integration of the system.
Checklist ; Disease Outbreaks ; Education ; Food Safety* ; Food Services* ; Foodborne Diseases ; Hazard Analysis and Critical Control Points ; Humans ; Hygiene ; Pest Control ; Safety Management ; Sanitation ; Seoul* ; Ventilation ; Water Supply

Sequence information from the ribosomal RNA molecule can be used as a molecular clock. Therefore, 16S rRNA sequences have become a widely used tool in bacterial systematics, bacterial typing and studies of the composition of micro-organisms in environmental samples. Consequently, the databases are continuously updated with new 16S rRNA sequence information from different species. This in turn facilitates the identification of new isolates, which is important for the diagnosis of various infectious diseases in research. To development differential identification technique in the Yersinia species, the 16S rDNA for total 17 serotypes of Y. pseudotuberculosis type strains and one of Y. enterocolitica wild strain were amplified by polymerase chain reaction and cloned into pGEM-T vector, partially sequenced and analyzed. The 16S rDNA nucleotide sequence homologies among Yersinia strains were ranged 100% to 93.6%. Phylogenetic tree generated from 16S rDNA sequencing data showed different phyletic line that could be readily separated from each serotypes and other enteric bacterium.
Bacterial Typing Techniques ; Base Sequence ; Classification ; Clone Cells ; Communicable Diseases ; Diagnosis ; DNA, Ribosomal* ; Evolution, Molecular* ; Polymerase Chain Reaction ; RNA, Ribosomal ; Yersinia*

PURPOSE: At birth, as the fetus adjusts to the "new world", the fetal pulmonary circulation undergoes a striking transition, characterized by an immediate rise in pulmonary blood flow and a sustained decrease in pulmonary vascular resistance(PVR). In the factors which reduce PVR after birth, are ventilation of the lung by gas, increase of oxygen tension in pulmonary vascular system, and some vasoactive mediators. Nitric oxide(NO) is regarded as one of the vasoactive mediators. Therefore we attempted to determine endogenous NO formation in newborns by measuring urinary nitrite(NO2) and citrulline which are indexes of endogenous NO formation. METHODS: We measured the urinary excretion of NO2 and citrulline in 20 term and 15 preterm neonates at the age of 1, 3, 7 days. RESULTS: The urinary excretion of NO2 and citrulline in the neonate group was higher as compared with the older children group(P<0.05). And it increased from the 1st to the 3rd day in the neonatal period(P<0.05). Furthermore the urinary excretion of them and the gestational age were inversely related(P<0.05). CONCLUSION: These changes of the urinary excretion of NO2 and citrulline in the neonate group suggest the presence of an active physiological role of NO in the pulmonary vascular biology during neonatal transition.
Biology ; Child ; Citrulline* ; Fetus ; Gestational Age ; Humans ; Infant, Newborn* ; Lung ; Nitric Oxide* ; Oxygen ; Parturition ; Pulmonary Circulation ; Strikes, Employee ; Ventilation

PURPOSE: Inflammatory bowel disease (IBD) in Korea has been increasing in recent years, but accurate statistics about operations for IBD are lacking. The purpose of this study was to investigate the trends and current status of IBD surgeries in Korea. METHODS: Using a national database from the Korea Health Insurance Review and Assessment Service, we analyzed data from patients who underwent surgery for Crohn disease and ulcerative colitis from January 2009 to October 2016. RESULTS: The mean number of patients who underwent surgery for Crohn disease was 791.8 per year. Colorectal surgery, small bowel surgery, and anal surgery were performed fairly often (31.2%, 29.4%, 39.4%, respectively), and laparoscopic surgery continued to increase, recently exceeding 30%. About 50% of Crohn patients used biologics before and after surgery, and those patients also underwent a relatively high rate of anal surgeries (44.2%). The mean number of patients who underwent surgery for ulcerative colitis was 247.6 per year. Colorectal surgery accounted for more than half of all operations, and laparoscopic surgery has been increasing rapidly, having been performed in about 60% of patients in recent years. The incidence of colorectal cancer in patients with ulcerative colitis was very high and increased rapidly during the study period, reaching about 80%. CONCLUSION: The number of patients undergoing laparoscopic surgery for IBD in Korea has increased significantly. Biologics are actively used by patients with Crohn disease, with a high proportion of anal surgeries required. Many of the surgical indications for ulcerative colitis have shifted into colorectal cancer.
Biological Products ; Colitis, Ulcerative ; Colorectal Neoplasms ; Colorectal Surgery ; Crohn Disease ; Humans ; Incidence ; Inflammatory Bowel Diseases* ; Insurance, Health ; Korea* ; Laparoscopy

Alopecia areata is a chronic organ-specific autoimmune disease and it could be associated with other autoimmune diseases. We, herein, report a case of alopecia areata in a patient with a thymoma without myasthenia gravis. Multiple hairless patches rapidly developed 6 weeks before the first visit on the patient who had been newly diagnosed with thymoma 2 weeks before the hairless patches occurred, and thymectomy was done 2 weeks before visiting dermatologic department. She had no symptoms associated with myasthenia gravis, and there were no abnormal findings on neurologic exams and acetylcholine receptor autoantibody was not detected in serum. Scalp biopsy showed numerous lymphocytic inflammations around hair follicles and in immunohistochemical staining, the aggregation of CD4+ and CD8+ T cells was observed around hair follicles and FoxP3+ T lymphocytes were rarely observed around hair follicles. The patient refused any treatment and her hairless patches were completely recovered 3 months after thymectomy, without being recurred 3 years after thymectomy. On the basis of both clinical manifestations and histologic findings, we concluded that alopecia areata in the patient had developed in association with thymoma and was recovered rapidly after thymectomy.

PURPOSE: To compare the rebound tonometer with the TonoPen for measuring the intraocular pressure (IOP) in rats METHODS: Chronic IOP elevation models were induced unilaterally in nine Sprague-Dawley rats by applying an argon laser to the trabecular meshwork. IOP was measured before laser treatment and at one, two, and three days following laser treatment. Two independent operators collected five readings of the rebound tonometer and the TonoPen. Correlation analysis and comparison with the Bland & Altman method were performed. The intraclass correlation coefficient of each measurement and the difference between two independent operators were calculated. RESULTS: The IOP values measured with the rebound tonometer were well correlated with those of the TonoPen (r=0.676, p<0.001); however, the mean difference expressed as the percent difference of the averages of two tonometers, was 27.5%. The IOP values measured with a rebound tonometer exhibited a significantly higher intraclass correlation coefficient (0.966; 95% CI, 0.945-0.980 vs 0.412; 95% CI, 0.264-0.581) and a lower difference between the two operators (3.10+/-2.17 mmHg vs 6.17+/-5.17 mmHg) than those of the TonoPen. CONCLUSIONS: Although the IOP values measured with the rebound tonometer were lower than those of the TonoPen, they were in good agreement and were less variable than those of the TonoPen.
Animals ; Argon ; Intraocular Pressure* ; Rats* ; Rats, Sprague-Dawley ; Reading ; Trabecular Meshwork

BACKGROUND: Sexual dysfunction such as erectile dysfunction (ED) may be a hidden agenda, but, it should be dealt with by family physicians in primary care. We investigated the prevalence of ED and utilization of sexual consultation practice among community family physicians. METHODS: We analyzed the subjects who were males aged over 30 and married who visited 10 community family clinics around Seoul, Korea and completed questionnaires related to erectile function and utilization of sexual consultation service from May 9 to 28 2009. ED was designated if the 5-item version of international index of erectile dysfunction (IIEF-5) scores were less than 17. RESULTS: The average age of the responders was 45.6 years. The prevalence of ED was 43.3% and increased according to age, chronic disease, low educational history and low family income. Almost all of the mild ED patients answered that they needed sexual consultation. But, half of them had no plan to have a sexual consultation. Odds ratios (ORs) with 95% confidence intervals (CIs) for having a sexual consultation or not according to variables were calculated with logistic regression. More severe ED (OR = 0.875; 95% CI, 0.827 to 0.926), existence of chronic disease (OR = 1.828; 95% CI, 1.026 to 3.260), inferior education (OR = 0.395; 95% CI, 0.196 to 0.796), and lower income (OR = 0.326; 95% CI, 0.124 to 0.857) were the factors which influenced to have a sexual consultation with a family physician. CONCLUSION: The prevalence of ED in family clinic was over 40%, but the utilization of sexual consultations was under 50%. We need to develop intervention strategies for more sexual counseling practice according to educational history, family incomes and status of ED in community family medicine clinics.
Aged ; Chronic Disease ; Counseling ; Erectile Dysfunction ; Humans ; Korea ; Logistic Models ; Male ; Odds Ratio ; Physicians, Family ; Prevalence ; Primary Health Care ; Referral and Consultation ; Sex Counseling

PURPOSE: To compare the usefulness of single-slice acquisition imaging and conventional maximum intensity projection imaging, as employed in magnetic resonance cholangiopancreatography (MRCP) using the Half-Fourier Acquisition Single Shot Turbo Spin-Echo(HASTE) sequence. MATERIALS AND METHODS: Five healthy volunteers underwent MRCP using the HASTE sequence on a 1.5T MR unit. Two data acquisition techniques were used : 1) single slice acquisition, with 20 mm slice thickness (imaging time, 2 sec), 2) multi-slice acquisition, with 5 mm slice thickness (imaging time, 19 sec), followed by maximum intensity projection reconstruction. Two radiologists independently evaluated the MRCP images obtained using these two techniques; based on the depiction by each of ten anatomic structures, their quality was graded as excellent (3 points), good (2 points), fair(1 point) or poor(0). Mean scores were totalled, and to compare the quality of the two techniques, these scores were compared. Data was statistically analyzed using the paired student t-test. RESULTS: There was no difference in bile duct image quality between the two techniques. The pancreatic duct was more conspicuous on single-slice (mean score, 1.94) than on maximum intensity projection imaging (mean score, 0.7). The sum of the mean scores of single-slice imaging was 18.75, and that of maximum intensity projection imaging was 14.7 (p=0.42); the general difference between the two techniques was thus statistically insignificant. CONCLUSION: Compared with maximum intensity projection imaging, single-slice imaging had a distinct advantage : acquisition time was short (within 2 sec), thus motion artifacts could be avoided, and there was no need for post-processing. There is a close and direct connection between the avoidance of motion artifact and short acquisition time, but lack of need for post-processing is independent. On single-slice images, the pancreatic duct was more conspicuous than on maximum intensity projection images. The former can therefore be used with patients who experience respiratory difficulty or are suspected to be suffering from disease of the pancreotic duct.
Artifacts ; Bile Ducts ; Cholangiopancreatography, Magnetic Resonance ; Healthy Volunteers ; Humans ; Pancreatic Ducts