OBJECTIVES: We compared the characteristics of the pain threshold and pain experience between demented group and non-demented group. METHODS: This study was part of Gangwon projects for early detection of dementia in 2010. We recruited 8302 local resident ages over 65 years old. Of theses, 1259 people who scored low MMSE were selected and 365 of them completed CERAD-K(Consortium to Establish a Registry for Alzheimer's disease). Finally, 90 in non-demented group and 57 in demented group(mild to moderate Alzheimer's disease) were analyzed. Pain threshold was experimentally measured by pressure algometer and we investigated the pain experience, by Brief pain inventory (BPI), a self-report test. RESULTS: In the demographic characteristics, there are more female, higher ages, lower education in the demented group. There was no significant difference between the two groups in the pain threshold. On the BPI results, 'shoulder pain', 'the number of pain' and 'interference of working' were significantly more prevalent in non-demented group. However, there are no significant differences between the groups in the 'pain severity', 'prevalence of pain' and 'pain treatment'. CONCLUSIONS: Demented group report less pain experience but, still perceived pain. It support previous studies that patient with dementia have increased pain tolerance but preserved pain threshold. Thus, active pain assessment and treatment for patients with dementia is needed.
Aged* ; Dementia* ; Education ; Female ; Gangwon-do ; Humans ; Pain Measurement ; Pain Threshold*

We report a case of calcific bursitis of the shoulder in four-year-old boy who had severe pain and limitation of motion of the left shoulder joint for three days. Radiographs revealed the oval radiopaque lesion in the subacormial space, and the MR signal intensity of the mass was moderate on T2WI. Histological examination of the mass showed acute necrotizing inflammation with calcification.
Bursitis ; Humans ; Inflammation ; Male ; Shoulder ; Shoulder Joint

BACKGROUND: The Nuss procedure is a recently developed technique for minimally invasive repair of pectus excavatum using a metal bar. Although its technical simplicity and cosmetic advantages are remarkable, applications have been limited to children with standard pectus excavatum. We report a single center experience of the technique that has been evolving in order to correct asymmetric pectus configurations and adult patients. MATERIAL AND METHOD: Between August 1999 and June 2002, 322 consecutive patients underwent repair by the Nuss technique and its modifications. Among them, 71 (22%) were adults. For the precise correction, morphology of the pectus was classified as symmetric and asymmetric types. Asymmetric type was subdivided into eccentric and unbalanced types. In repair, differently shaped bars were applied to individual types of pectus to achieve symmetric correction. RESULT: Symmetric type was 57.5% (185/322) and asymmetric type was 42.5% (137/322). Eccentric, unbalanced, and combined types were 71, 47 and 19, respectively. Major modifications were bar shaping and fixation. In asymmetric group, different shapes of asymmetric bars were applied (n=125, 38.8%). For adult patients, double bar or compound bar technique was used (n=51, 15.8%). To prevent bar rotation, multipoint wire fixations to ribs were used. Major postoperative complications were pneumothorax (n=24, 7.5%) and bar displacement (n=11, 3.4%). 42 patient had bar removal 2 years after the initial procedure. CONCLUSION: The Nuss procedure is safe and effective.Modifications of the techniques in accordance with precise morphological classification enabled the correction of all variety of pectus excavatum including asymmetric types and adult patients.
Adult ; Child ; Classification ; Funnel Chest* ; Humans ; Pneumothorax ; Postoperative Complications ; Ribs

Further understanding of male human papillomavirus (HPV) infection is necessary to prevent infection in men, as well as transmission to women. In our current study, we investigated patterns of HPV infection and genotype distributions in male genital warts using the Anyplex II HPV28 Detection kit. We reviewed the medical records of 80 male patients who presented to 5 neighborhood clinics in Ulsan, Korea, for the treatment of genital warts between April 2014 and January 2015. All patients underwent HPV genotyping. The prevalence and characteristics of HPV infection were analyzed, and the patterns of HPV infection according to age were assessed. Among the study patients, 13 (16.3%) were negative for HPV infection, 46 (57.3%) were infected with low-risk HPV, and 21 (26.3%) were infected with high-risk HPV. Patients with multiple HPV infection were more likely to have high-risk HPV infection (P = 0.001). The prevalence of HPV infection was much higher in samples obtained by tissue excision due to a definite lesion (P = 0.001). There were no differences in high-risk HPV infection (P = 0.459), multiple HPV infection (P = 0.185), and recurrence at diagnosis (P = 0.178) according to age. HPV-6 and HPV-11 were the most common type overall (39.7% and 13.8%, respectively). HPV-16 and HPV-18 were the most common high-risk infections (both 3.4%). HPV infection is not only commonly encountered in male genital warts, but is also accompanied by high-risk HPV and multiple infections.
Adult ; Condylomata Acuminata/epidemiology/*pathology/virology ; DNA, Viral/genetics/metabolism ; Genotype ; Human papillomavirus 11/*genetics/isolation & purification ; Human papillomavirus 16/genetics/isolation & purification ; Human papillomavirus 18/genetics/isolation & purification ; Human papillomavirus 6/*genetics/isolation & purification ; Humans ; Male ; Middle Aged ; Prevalence ; Real-Time Polymerase Chain Reaction ; Republic of Korea/epidemiology ; Retrospective Studies ; Risk Factors

PURPOSE: To assess the CT findings of intrahepatic cholangiocarcinoma associated with hepatolithiasis. MATERIALS AND METHODS: The CT features of 26 patients with cholangiocarcinoma and hepatolithiasis were reviewed and compared with those of 23 patients with intrahepatic stones alone, acting as control subjects. CT findings were analyzed for tumor appearance and adjacency to hepatolithiasis. We studied clinical findings, noting the presence or absence of wall thickening or soft tissue attenuation within the bile duct, the luminal diameter of dilated bile duct, and the presence of periductal enhancement, and compared these with the findings for control groups. RESULTS: CT images of the tumor revealed a hepatic low-attenuating mass with peripheral rim enhancement(n=14, 54 %), or periductal thickening, or low-attenuating lesions in segmental dilatation of intrahepataic bile ducts(n=12, 46%). Most hepatic tumors were seen in areas adjacent to hepatolithiasis, or in a bile duct. Compared with control groups, patients with cholangiocarcinoma were old (p<0.001), and showed frequent weight loss and elevated CA 19 -9(p<0.001). With regard to the location of hepatolithiasis, luminal diameter, and periductal enhancement, no significant differences were seen between the two groups (p>0.05). CONCLUSION: When an intrahepatic low-attenuating mass, or peridutal thickening and low-attenuating lesions in segmental dilated intrahepatic duct are found associated in adjacent intrahepatic stones, intrahepatic cholangiocarcinoma should be considered.
Bile ; Bile Ducts ; Cholangiocarcinoma* ; Dilatation ; Humans ; Phenobarbital ; Weight Loss

PURPOSE: We determined the clinical significance of telomerase activity and telomere length in breast cancer patients and also developed the measuring system of telomerase activity change with RNAse A pre-treatment. MATERIALS AND METHODS: We measured the telomerase activity in 71 breast cancer tissues and paired normal tissues with TRAP (Telomeric Repeat Amplification Protocol) assay. Telomerase activity was calculated by computer-assisted densitometry compared to telomerase activity of the 293 control cell line. To develop the measuring system of telomerase activity modulation, we measured the telomerase activity after the treatment with RNAse A, 150microgram/ml, which inhibited 70% of telomerase activity compared to control in the 293 control cell line. In 59 paired tissues with telomerase activity, terminal restriction fragment (TRFs) length were measured using Southern blotting. RESULTS: Sixty-three out of 71 cancer tissues showed telomerase activity (88.7%), while no telomerase activity was detected in their paired normal tissues. Telomerase activity was correlated to the node metastasis (p=0.02) and stage (p=0.005), but not to the tumor size or the hormonal receptor status. TRFs were neither specific to tumor tissues nor related to any of the clinical parameters. However, changes of TRFs of the tumor tissues from their paired normal tissues were correlated to the telomerase activities. Also the patients with different TRFs between cancer and normal tissues were in more advanced stage. After pre-treatment with the 150microgram/ml of RNAse A, telomerase activity in the tumor tissues showed variable inhibition. Relative inhibition, the ratio of inhibited telomerase activity in each tumor tissue compared to the inhibition of 293 control cell line, was proportional to the telomerase activity. CONCLUSION: In breast cancer, telomerase activity was specific to the tumor tissues and correlated to tumor progression. A combination of telomerase activity and TRFs changes can be used as a guidline in detecting a better candidate for telomerase inhibition. Semi-quantitative assay with RI system can be used in evaluating the changes of telomerase activity after treatment with a new telomerase inhibitor with TRAP assay.
Biological Therapy* ; Blotting, Southern ; Breast Neoplasms* ; Breast* ; Cell Line ; Densitometry ; Humans ; Neoplasm Metastasis ; Ribonuclease, Pancreatic ; Telomerase* ; Telomere

The purpose of this study is to determine if distance stereoacuity could be used as an objective means of assessing control in intermittent exotropia. We evaluated distance stereoacuity in 37 patients with intermittent exotropia showing orthophoria postopratively using the Mentor B-VAT II Videoacuity tester. All patients had fusion at near but 14 of 31 patients(38%) had fusion at distance preoperatively. The mean preoperative distance stereoacuities were 216 seconds with binocular vision circle(BVC) and 351 seconds with binocular vision random dot E(BVRDE) ( p=0.0002). The postoperative improvement was statistically significant with BVC(p=0.001), not statistically significant with BVRDE(p=0.7). On our results it seems to be easier to know BVC than BVRDE in children. It suggests that the BVC is a useful test for assessing control in intermittent exotropia.
Child* ; Exotropia* ; Humans ; Mentors ; Vision, Binocular

Physeal distraction is used for limb lengthening or correction of deformities in skeletally immature patients. But the effect of distraction on the physis is uncertain. The young rabbits were arranged into five groups according to the slow distraction rates: Group I (no distraction), Group II (distraction rate of 0.25mm per day), Group III (distraction rate of 0.5mm per day), Group IV (distraction rate of 0.75 mm per day), Group V (distraction rate of 1mm per day). The tibial length, size of proliferating zone, microscopic findings of physis immunostained with bromodeoxyuridine, and physeal response to physeal distraction on each group were studied. The results were as follows. 1. There was an increase in bone length on the distracted side (1.8 to 4.2mm). 2. There was an irregular increase in the thickness of the distracted physis. 3. There was an abnormal accumulation of hypertrophic chondrocytes in hypertrophic zone in distracted physis. 4. There was no evidence of anomalous cell proliferation, in the resting, proliferating and hypertrophic zones. These results conclude that the physeal distraction does not stimulate cell proliferation in the physis, even when it is seen to be thickened after the chondrodiatasis.
Bromodeoxyuridine ; Cell Proliferation ; Chondrocytes ; Congenital Abnormalities ; Extremities ; Humans ; Rabbits*

Soluble forms of ICAM-1 (sICAM-1) and VCAM-1 (sVCAM-1) have been reported from the supernatant of cytokine-activated endothelial cells, cancer cells and from sera of cancer patients. We measured sICAM-1 and sVCAM-1 from the serum of 20 healthy volunteers and 142 gastric cancer patients by ELISA assay. Ninety-five patients were operable and 47 patients were in-operable at the time of this study. Particularly in the 28 operable patients, we sampled both portal and peripheral blood simultaneously and measured the levels of the soluble forms of cell adhesion molecules (sCAMs). The sCAMs level and sero-positivity rate increased with cancer progression in order of the healthy controls, operable patients, and inoperable patients. In in-operable cancer, the sICAM-1 level increased more with liver metastasis. sICAM-1 and sVCAM-1 did not correlate with each other in either portal or peripheral blood. A total of 58.3% of patients with liver metastasis and 22.9% of patients without liver metastasis showed synchronous expression of both sCAMs (p = 0.03). Synchronous sero-positivity of sCAMs and alpha FP was higher with liver metastasis (p = 0.01). The median overall survival duration which co-expressed both sCAMs was 9 months. This showed a significant difference compared with the sICAMs non-expressing group, where the median survival was not reached until 24 months follow-up (p = 0.002). The synchronous expression of sCAMs was an independent risk factor in gastric cancer patients. We raise the possibility that synchronous sICAM-1 and sVCAM-1 elevation may be a useful monitor to determine tumor burden in gastric cancer.
Adult ; Aged ; Female ; Human ; Intercellular Adhesion Molecule-1/blood* ; Liver Neoplasms/secondary ; Male ; Middle Age ; Stomach Neoplasms/mortality ; Stomach Neoplasms/blood* ; Survival Rate ; Vascular Cell Adhesion Molecule-1/blood*

PURPOSE: For tumor growth, invasion and metastasis, a cascade of linked sequential biological events is essential; overproduction of growth factors, activation of proteolytic enzymes, induction of tumor angiogenesis, and enhanced tumor cell motility and attachment. We tried to test whether the biological therapy against the biological targets can modulate the specific biological characteristics, and furthermore increased anti-tumor effects can be induced when the biological therapy and cytotoxic chemotherapy were combined. MATERIALS AND METHODS: YCC-1, 2, 3, 7, and AGS human gastric cancer cell lines were used in these studies. Pentosan polysulfate (PPS) as a heparin-binding growth factor (HBGF) inhibitor, Tranexamic acid as a plasmin inhibitor, Adriamycin as a chemotherapeutic agent, were selected. The methods were Northern blot analysis for the detection of Midkine (MK) expression, soft agar assay for autocrine tumorigenicity. The expression of uPA, PAI-1 was determined by ELISA, while the MMPs activities were evaluated by zymography. The effects of each drug on tumorigenicity and tumor cell proliferation were evaluated by soft agar assay and cell proliferation assay, respectively. RESULTS: YCC-3, 7, AGS cell lines expressed MK mRNA, whereas YCC-1, 2 did not. YCC-2 cell line showed increased expression of uPA and MMP activities. Only MK expressing YCC-3 and 7 cell lines showed the tumorigenicity. PPS suppressed the colony forming activities as much as Adriamycin did (PPS; 8~24%, Adriamycin; 12~40%), but it showed only cytostatic effects in cell proliferation assay (PPS; 60~103%, Adriamycin; 22~97%). When PPS was combined with Adriamycin on the Adriamycin resistant, MK expressing YCC-7 cell line, the growth inhibition rate increased up to 84%, while that of PPS or Adriamycin single treatment was 40%, 22%, respectively (p=0.001). CONCLUSION: The modulation of specific biological targets can induce the anti-tumor effects. This suggests the possible clinical application of biological therapy in gastric cancer.
Agar ; Antifibrinolytic Agents ; Biological Therapy ; Blotting, Northern ; Cell Line* ; Cell Movement ; Cell Proliferation ; Doxorubicin ; Drug Therapy ; Enzyme-Linked Immunosorbent Assay ; Humans* ; Intercellular Signaling Peptides and Proteins ; Matrix Metalloproteinases ; Neoplasm Metastasis ; Pentosan Sulfuric Polyester ; Peptide Hydrolases ; Plasminogen Activator Inhibitor 1 ; Population Characteristics ; RNA, Messenger ; Robenidine ; Stomach Neoplasms* ; Tranexamic Acid