OBJECTIVE: Our previous study demonstrated that the placental GnRH and GnRH mRNA did not parallel the time course of hCG secretion, though it is thought to be one of the potential paracrine regulators of hCG secretion from the trophoblasts. The present study was designed to examine the potential variation in GnRH-receptor mRNA expression in the placenta, which may account for the GnRH-mediated action of hCG secretion during pregnancy. METHODS: Human placentas in firt, second, and third trimester of normal pregnancy were obtained. These placentas were fixed with 4% paraformaldehyde and embedded in OCT compound, and sectioned by cryostat. For in situ hybridization, S labeled RNA probes were used and followed by autoradiography. RESULTS: The GnRH-receptor mRNA signals were present in both cytotrophoblast and syncytiotrophoblast cell layers. Signal intensities varied with gestational ages and were abundant at 6-7 weeks, peaked at 9-12weeks, declined at 14 and 24 weeks, and were barely detectable at term. The present study demonstrates that GnRH-receptor mRNA exhibits changes paralleling the time course of hCG secretion during pregnancy CONCLUSION: These data provide mechanistic understanding that the paracrine/autocrine regulation of hCG secretion by placental GnRH is mediated through an increase followed by a decline in GnRH-receptor mRNA expression from the first trimester to term placenta.
Autoradiography ; Female ; Gestational Age ; Gonadotropin-Releasing Hormone ; Humans ; In Situ Hybridization ; Placenta* ; Pregnancy Trimester, First ; Pregnancy Trimester, Third ; Pregnancy* ; RNA Probes ; RNA, Messenger* ; Trophoblasts

PURPOSE: In this study, the authors attempted to evaluate the stage migration phenomenon according to D1 lymphadectomy and D2 lymphadectomy in the same patients. METHODS: A retrospective study was performed in 300 consecutive patients with gastric cancer who had undergone curative resection with nodal yields of D2 or more from 1994 to 1997. The lymph node status was evaluated in two different extents. Group B included patients with whole harvested regional lymph nodes (D2<) while group A include patients with perigastric lymph nodes (D1). Each group was staged by the number of involved lymph nodes according to the UICC-TNM stage (5th), and by the ratio of involved to resected lymph nodes. Stage migration and the difference of 5YSR were observed between the two groups. RESULTS: In staging by the number of involved lymph nodes, 25 cases (8.3%) of group B were staged up. According to the status by the ratio of involved lymph nodes, 14 cases (4.6%) of group B were staged up and 28 (9.3%) were staged down. CONCLUSION: In the staging of gastric cancer, adequate lymph node dissection was essential for accurate lymph node staging. In the cases of limited lymph node dissection, some extent of stage migration was considered assessing in the prognosis.
Humans ; Lymph Node Excision* ; Lymph Nodes* ; Prognosis ; Retrospective Studies ; Stomach Neoplasms*

A 19-year-old woman developed painful abdominal distension, headache and mental deterioration. Several days later, she complained of paraparesis, urinary incontinence and diuresis. Intestinal pseudo-obstruction was detected by a laparoscopic examination. Brain MRI showed encephalitis with a high signal intensity of the corpus callosum on diffusion-weighted images. In serum and CSF, the varicella-zoster virus (VZV) IgM antibody was positive. After treatment with steroids and acyclovir, her symptoms improved. We report a patient with intestinal pseudo-obstruction, encephalitis and meningoradiculitis caused by VZV without skin lesions.
Acyclovir ; Brain ; Corpus Callosum ; Diuresis ; Encephalitis* ; Female ; Headache ; Herpesvirus 3, Human* ; Humans ; Immunoglobulin M ; Intestinal Pseudo-Obstruction* ; Magnetic Resonance Imaging ; Paraparesis ; Skin ; Steroids ; Urinary Incontinence ; Young Adult

A 63-year-old man was admitted with newly developed left hemiparesis. He had experienced left hemiparesis that had resulted from an earlier right thalamic hemorrhage. Diffusion-weighted images showed only high signal intensity lesion in the left internal capsule. Ipsilateral motor evoked potentials were obtained at the affected hand muscles when the unaffected motor cortex was stimulated. This suggests that cortical reorganization in the unaffected hemisphere after the first stroke may be involved in the occurrence of such symptom.
Evoked Potentials, Motor ; Hand ; Hemorrhage ; Humans ; Internal Capsule* ; Middle Aged ; Motor Cortex ; Muscles ; Paresis* ; Stroke*

OBJECTIVE: The purpose of this study was to retrospectively evaluate and compare the incidence of diffusion-weighted image (DWI) lesions between the Guglielmi detachable coil (GDC) and the Target coil for treating unruptured intracranial aneurysm. METHODS: From 2010 to 2011, consecutive 222 patients with an intracranial aneurysm underwent coil embolization. Inclusion criterias were : 1) unruptured intracranial aneurysm, 2) one or more GDC or Target coils used with or without other coils, 3) DWI examination within 24 hours after coiling, and 4) coiling performed without a balloon or stent. RESULTS: Ninety patients (92 cases) met the inclusion criteria. DWI lesions were detected in 55 (61.1%) of 90 patients. In the GDC group (n=44), DWI lesions were detected in 31 (70.5%). The average number of DWI lesions was 5.0+/-8.7 (mean+/-SD; range, 1-40) in aneurysm-related territory. In the Target coil group (n=48), DWI lesions were detected in 24 (50.0%). The number of DWI lesion was 2.1+/-5.4 (range, 1-32) in aneurysm-related territory. There was no significant correlation between a number of coils and DWI lesions. No significant differences were also observed in the number of DWI lesions in each group. CONCLUSION: The GDC and Target coils, which have an electrolytic detachable system, showed no differences in the incidence of DWI lesion.
Humans ; Incidence ; Intracranial Aneurysm ; Magnetic Resonance Imaging ; Retrospective Studies ; Thromboembolism

BACKGROUND AND OBJECTIVES: The antihypertensive efficacy and tolerability of losartan (LST) in fixed combination with hydrochlorothiazide (HCTZ) has not been compared to those of amlodipine monotherapy in Asians. This is an important comparison to draw, because Asians have been suggested to respond more favorably to calcium channel blockers and less favorably to angiotensin-converting enzyme inhibitors in comparison to Westerners. We sought to compare these two regimens in Korean patients with mild to moderate hypertension. SUBJECTS AND METHODS: 174 patients were randomized to receive LST 50 mg once daily, which could be titrated to LST/HCTZ 50/12.5 mg at 4 weeks, followed by 100/25 mg at 8 weeks; or to receive amlodipine besylate 2.5 mg once daily, which could be titrated to 5 mg at 4 weeks, followed by 10 mg at 8 weeks to achieve diastolic blood pressure <90 mmHg. RESULTS: At 12 weeks, the differences between the LST/HCTZ and amlodipine groups with regard to diastolic and systolic blood pressure were 1.2 mmHg (95% confidence interval: -1.1 to 3.4) and -0.5 mmHg (95% confidence interval: -4.3 to 3.4), respectively. The rates of achieving systolic blood pressure <140 mmHg were 66.7% in the LST/HCTZ group and 75.9% in the amlodipine group (p=0.20). The rates of drug-related adverse events were 15.6% in the LST/HCTZ group and 11.9% in the amlodipine group (p=0.49). CONCLUSION: The two regimens, with a relatively higher dose of LST/HCTZ compared to that required in Westerners, produced equivalent blood pressure reduction and were comparably well tolerated in Korean patients with mild to moderate hypertension.
Amlodipine ; Angiotensin-Converting Enzyme Inhibitors ; Asian Continental Ancestry Group ; Blood Pressure ; Calcium Channel Blockers ; Drug Combinations ; Humans ; Hydrochlorothiazide ; Hypertension ; Losartan

A 38-year-old man was admitted to the hospital because of abrupt left flank pain. He had no fever and physical examination revealed tenderness of the left costovertebral angle. Laboratory data revealed white blood cell 16,060/microL, C-reactive protein 0.93 mg/dL. Urinalysis showed more than 1/2 red cells per high-power field with severe proteinuria (4+). Enhanced computed tomography (CT) showed the thickened abdominal aorta wall with partial thrombus. The thickened aorta wall compressed the left renal vein and it caused left renal vein thrombosis. Abdominal CT findings suggested aortitis of the abdominal aorta with complication of left renal vein. We could exclude other types of aortitis including autoimmune aortitis, Takayasu's arteritis, giant cell arteritis, and infectious causes based on a serologic test and the history of the patient. Therefore, the patient was diagnosed with idiopathic aortitis and treated with glucocorticoid. After treatment, his symptoms disappeared and a follow-up CT showed decreased mural thickening of the abdominal aorta. Isolated idiopathic aortitis presented with renal vein thrombosis is extremely rare and has not been reported in Korea yet. We present a rare case report on idiopathic aortitis of the abdominal aorta with complication of left renal vein thrombosis.
Adult ; Aorta ; Aorta, Abdominal ; Aortitis* ; C-Reactive Protein ; Fever ; Flank Pain ; Follow-Up Studies ; Giant Cell Arteritis ; Humans ; Inflammation ; Korea ; Leukocytes ; Physical Examination ; Proteinuria ; Renal Veins* ; Serologic Tests ; Takayasu Arteritis ; Thrombosis* ; Tomography, X-Ray Computed ; Urinalysis

BACKGROUND: Complementary and alternative medicine (CAM) use is popular and current trend suggests a demand for CAM education during residency training. Our objective was to assess perception, the need and experience of CAM education for family practice residents by training faculty. METHODS: A questionnaire was administered to family physicians (n=262) who were registered in the Korean Academy of Family Medicine as residency training faculty between February and May 2006. RESULTS: One hundred and seven (40.8%) of 262 faculty completed the questionnaires. Eighty three (77.6%) respondents recognized the need of CAM education during residency training and fifty two (46.8%) respondents have already educated some kind of CAM. Thirty nine (36.4%) respondents replied that partial CAM educational contents were given out at conferences. Seventy eight (72.9%) respondents recognized the need for educating residents on the general outlines of CAM along with education on verified CAM. Sixty six (61.7%) respondents replied that the Korean Academy of Family Medicine should host such education. CONCLUSION: Most family practice training faculty recognized the need for providing CAM education for family practice residents during residency training, but about an half of family practice training faculty did not have experiences of CAM education.
Complementary Therapies ; Congresses as Topic ; Surveys and Questionnaires ; Education, Medical ; Family Practice ; Humans ; Internship and Residency ; Physicians, Family ; Republic of Korea

OBJECT & METHOD: Thirty-four patients (mean age: 58.1+/-8.3 years, M:F=1:13) with angina in the absence of previous myocardial infarction, who underwent percutaneous coronary intervention (stenting and/or balloon PTCA, n=5) or coronary arterial bypass grafting (CABG, n=) were evaluated to assess the relationships between the degree of improvement in myocardial dipyridamole Tl-201 SPECT and the degree of decrease in QTc dispersion after coronary revascularization. QTc dispersions were measured manually using digitizer by a single observer from ECGs printed at 25mm/sec, 1 day before, immediately, 1 day, and 1 month after the revascularization procedure. Myocardial Tl-201 SPECTs were performed before and 1 month after the revascularization and ischemic indices were measured in all cases. RESULTS: Mean QTc dispersion was 51.4+/-17.0msec before revascularization, 42.6+/-15.1msec immediately after, 45.6+/-19.3msec 1 day after and 37.4+/-11.6msec 1 month after revascularization. The decrease of QTc dispersion immediate (p=.001) and 1 month (p<0.001) after revascularization, were statistically significant. Mean Tl-201 SPECT ischemic index measured before the revascularization (7.8+/-5.9) was significantly higher (p<0.001) than the one measured 1 month after the revascularization (1.5+/-2.8). But, in deltaischemic index (ischemic index before revascularization-ischemic index 1 month afer revascularization), there was no significant difference between the patients with decrease in QTc dispersion after revascularization(6.2+/-6.3, n=7) and the patients without decrease in QTc dispersion (6.6+/-5.2, n=). There was no statistically significant correlation between deltaQTc (QTc dispersion before revascularization-QTc dispersion 1 month afer revascularization) and delta ischemic index in total subjects. CONCLUSION: QTc dispersions decrease after successful coronary revascularizations in patients with angina, but considering the relationships between the changes of QTc dispersions and ischemic indices in myocardial dipyridamole Tl-201 SPECT, the degree of decrease in QTc dispersion after coronary revascularization does not have the relationships with the quantitative degree of improvement in myocardial ischemia.
Dipyridamole ; Electrocardiography ; Humans ; Myocardial Infarction ; Myocardial Ischemia* ; Percutaneous Coronary Intervention ; Tomography, Emission-Computed, Single-Photon ; Transplants

OBJECT & METHOD: Thirty-four patients (mean age: 58.1+/-8.3 years, M:F=1:13) with angina in the absence of previous myocardial infarction, who underwent percutaneous coronary intervention (stenting and/or balloon PTCA, n=5) or coronary arterial bypass grafting (CABG, n=) were evaluated to assess the relationships between the degree of improvement in myocardial dipyridamole Tl-201 SPECT and the degree of decrease in QTc dispersion after coronary revascularization. QTc dispersions were measured manually using digitizer by a single observer from ECGs printed at 25mm/sec, 1 day before, immediately, 1 day, and 1 month after the revascularization procedure. Myocardial Tl-201 SPECTs were performed before and 1 month after the revascularization and ischemic indices were measured in all cases. RESULTS: Mean QTc dispersion was 51.4+/-17.0msec before revascularization, 42.6+/-15.1msec immediately after, 45.6+/-19.3msec 1 day after and 37.4+/-11.6msec 1 month after revascularization. The decrease of QTc dispersion immediate (p=.001) and 1 month (p<0.001) after revascularization, were statistically significant. Mean Tl-201 SPECT ischemic index measured before the revascularization (7.8+/-5.9) was significantly higher (p<0.001) than the one measured 1 month after the revascularization (1.5+/-2.8). But, in deltaischemic index (ischemic index before revascularization-ischemic index 1 month afer revascularization), there was no significant difference between the patients with decrease in QTc dispersion after revascularization(6.2+/-6.3, n=7) and the patients without decrease in QTc dispersion (6.6+/-5.2, n=). There was no statistically significant correlation between deltaQTc (QTc dispersion before revascularization-QTc dispersion 1 month afer revascularization) and delta ischemic index in total subjects. CONCLUSION: QTc dispersions decrease after successful coronary revascularizations in patients with angina, but considering the relationships between the changes of QTc dispersions and ischemic indices in myocardial dipyridamole Tl-201 SPECT, the degree of decrease in QTc dispersion after coronary revascularization does not have the relationships with the quantitative degree of improvement in myocardial ischemia.
Dipyridamole ; Electrocardiography ; Humans ; Myocardial Infarction ; Myocardial Ischemia* ; Percutaneous Coronary Intervention ; Tomography, Emission-Computed, Single-Photon ; Transplants