IgA nephropathy is the most common form of glomerulonephritis characterized by deposit of IgA on mesangium. We experienced an elderly patient who was admitted for generalized edema, and diagnosed IgA nephropathy and early gastric cancer concomittantly. It has been reported that the incidence of nephrotic syndrome combined with malignancy increases with aging. Moreover, close relationship between IgA nephropathy and malignancy has been reported especially in the elderly patient. So, active investigations for possible malignancy are required in case of elderly patient with IgA nephropathy. In this case, we found improved proteinuria and hematuria of the patient after tumor resection during following up. This case suggest causal association between early gastric cancer and IgA nephropathy clinically.
Aged* ; Aging ; Delirium ; Depression ; Edema ; Glomerulonephritis ; Glomerulonephritis, IGA* ; Hematuria ; Humans ; Immunoglobulin A* ; Incidence ; Nephrotic Syndrome ; Proteinuria ; Stomach Neoplasms*

PURPOSE: Though web-based tests have many advantages, they do not become the main test form in medical education because of their many technical or operational limitations. We have developed a new web-based test system to overcome these limitations and, ultimately, to replace conventional paper and pencil tests. METHODS: We developed a web-based test system using a windows 2000 server, mySQL, visual basic 6.0 and ASP script as developing tools. We applied this system to formal examinations. The system was modified and optimized based on users' demands and problems identified during testing. RESULTS: Since web-based testing was first administered in 2003 to the third-year students during their clinical practice examinations, it has been used in 51 examinations at the College of Medicine in Chungbuk National University. In 2004, it was used in more than a half of the regular examinations at our medical college. At the beginning, lecturers were reluctant to adopt a new test system because of unfamiliarity and fear of additional workload. Shortly, however, they found that they were able to handle the multimedia contents more easily and obtain much information from results analysis without additional work. Examinees also favored web-based tests in presenting multimedia data but had some difficulties in focusing on the test. Overall, examinees' preference for web.based tests was comparable to conventional tests. According to user demand, we improved this test system by verifying question formats and making test analysis. CONCLUSION: Web-based tests can replace paper and pencil tests in medical education. Improvement of this testing system is expected with serious and continuous concerns from examiners.
Chungcheongbuk-do ; Education, Medical* ; Humans ; Multimedia ; Viperidae

Leiomyoma is the most common benign tumor of the esophagus, but it still occurs rarely as compared with the incidence of carcinoma in this area. Most of leiomyomas may manifest itself with unusual and inconsistent symptoms, and found incidentally during endoscopic or radiographic examination. Those who menifested symptoms are included as dysphagia and vague pain mostly. We experienced recently two cases with esophageal leiomyoma who underwent successful surgical resection and endoscopic enucleation, respectively.
Deglutition Disorders ; Esophagus* ; Incidence ; Leiomyoma*

Oral calcium supplementation has been recommended for prevention of osteoporosis in postmenopausal women. However experimental studies have suggested that oral calcium supplementation may increase the biliary calcium concentration and the incidence of gallstone formation in some animals. We designed an experiment to establish the effect of oral calcium supplementation in Guinea pigs. Nineteen Guinea pigs were divided into 2 groups. Group I (n=10) was fed with normal water, and group II (n=9) was fed with calcium-containing water(oscal 1000 mg/250 ml normal water). After 6 weeks, all animal were sacrifised, and the presence of gallstones was examined by inspection. Gallbladder bile and blood also were sampled. Gallstones were not found in group I, but in group II, gallstones were observed in five animals (56%). The level of calcium, bile acid, phospholipid, cholesterol, and bilirubin in the gallbladder bile was the same for both group I and group II. The levels of calcium and cholesterol in the serum was also the same for these two groups, but the level of bilirubin was remarkably lower group II than in group I. Oral calcium supplementation increased gallstone formation in guinea pigs, but there was no difference in the level of calcium in the bile composition. This present study could not confirm that oral calcium supplementation increased biliary calcium and then the incidence of gallstone formation in Guinea pigs. We think that the increase of biliary calcium after oral calcium supplementation is not the sole fator in gallstone formation and that other factors may be involved.
Animals ; Bile ; Bilirubin ; Calcium* ; Cholesterol ; Female ; Gallbladder ; Gallstones* ; Guinea Pigs* ; Guinea* ; Humans ; Incidence ; Osteoporosis ; Water

Oral calcium supplementation has been recommended for prevention of osteoporosis in postmenopausal women. However experimental studies have suggested that oral calcium supplementation may increase the biliary calcium concentration and the incidence of gallstone formation in some animals. We designed an experiment to establish the effect of oral calcium supplementation in Guinea pigs. Nineteen Guinea pigs were divided into 2 groups. Group I (n=10) was fed with normal water, and group II (n=9) was fed with calcium-containing water(oscal 1000 mg/250 ml normal water). After 6 weeks, all animal were sacrifised, and the presence of gallstones was examined by inspection. Gallbladder bile and blood also were sampled. Gallstones were not found in group I, but in group II, gallstones were observed in five animals (56%). The level of calcium, bile acid, phospholipid, cholesterol, and bilirubin in the gallbladder bile was the same for both group I and group II. The levels of calcium and cholesterol in the serum was also the same for these two groups, but the level of bilirubin was remarkably lower group II than in group I. Oral calcium supplementation increased gallstone formation in guinea pigs, but there was no difference in the level of calcium in the bile composition. This present study could not confirm that oral calcium supplementation increased biliary calcium and then the incidence of gallstone formation in Guinea pigs. We think that the increase of biliary calcium after oral calcium supplementation is not the sole fator in gallstone formation and that other factors may be involved.
Animals ; Bile ; Bilirubin ; Calcium* ; Cholesterol ; Female ; Gallbladder ; Gallstones* ; Guinea Pigs* ; Guinea* ; Humans ; Incidence ; Osteoporosis ; Water

PURPOSE: This study was aimed to evaluate whether the size of the changed area included in the registration area affects the validity of superimposition in three-dimensional (3D) images. MATERIALS AND METHODS: Ten mannequin heads which were sectioned to simulate maxillary and mandibular setback surgery were used. A total of 30 images, including 10 initial images, 10 images after moving both middle and lower faces, and 10 images after moving only lower face, were obtained. The 9 landmarks which consisted of the bilateral and midline landmarks of the upper, middle, and lower faces respectively were used. Each 3D image obtained after simulation was superimposed 3 times according to the different 3 registration areas. The one-way ANOVA and post-hoc analysis were performed.RESULT: In the case of moving middle and lower faces, there was no significant difference in all markers when superimposition was performed based on no changed area and forehead area. However, in the case of superimposition by the whole face, all measurements showed a significant difference (P<0.05) except for Pn (P>0.05). In the case of moving only lower face, all measurements did not show a significant difference regardless of the registration area. CONCLUSION The validity of 3D superimposition in 3D images could be affected by the size of changed areas included in the registration area. In the postoperative evaluation of mandibular surgery, the registration area does not affect the accuracy of the 3D superposition. However, after the maxilla-mandibular surgery, the registration area should be set except for the changed soft tissue.

Orbital complications of sinus disease continue to appear in clinical practice. Acute visual loss may occur in association with sinusitis either as a complication of orbital cellulitis or, less frequently, as a part of the orbital apex syndrome. The classification which defines the degree of orbital extension is valuable, therapeutically and prognostically. The orbital apex syndrome is associated with an affection of the vessels and nerves passing through the superior orbital fissure and the optic foramen and characterized by visual loss and ophthalmoplegia. But it has minimal or no signs of orbital inflammation such as proptosis, chemosis, or lid edema. We experienced a case of temporary monocular visual loss and ophthalmoplegia caused by mucocele in the sphenoid sinus. Thus, we report, with a review of literature, a case of orbital apex syndrome caused by mucocele in the sphenoid sinus in a 53 year-old male patient.
Classification ; Edema ; Exophthalmos ; Humans ; Inflammation ; Male ; Middle Aged ; Mucocele* ; Ophthalmoplegia ; Orbit* ; Orbital Cellulitis ; Orbital Diseases ; Sinusitis ; Sphenoid Sinus* ; Vision Disorders

BACKGROUND/AIMS: Local drug delivery to the bile duct may be effective to prevent proliferative cholangitis (PC) through capability of high dose administeration with minimal systemic side effects. Paclitaxel is an anticancer drug whose side effect on the stabilization of microtubule leads to cell death. The aims of this study were to establish the proliferative cholangitis model in rat, mimicking biliary stricture in human, and to test whether paclitaxel-coated nylon thread prevents biliary stricture in a PC model of rat. METHODS: PC was induced by introducing a fine nylon thread into the bile duct in a rat from 1 week to 4 week. To evaluate the effects of paclitaxel as a locally-delivered anti-proliferative drug, dog gallbladder epithelial cells were exposed to sequential concentrations of paclitaxel (0.1microM, 1microM, 10microM, and 100microM) for 20 min. in vitro, and inhibition of proliferation was measured by (3)H-thymidine uptake assay. Paclitaxel- coated 5-0 nylon threads (1.8+/-0.5 ug/3 cm thread, measured by HPLC) were made by immersion of ethanolic paclitaxel (50 mg/ml) and evaporation of the solvent. Nylon threads were inserted into the bile duct of male Sprague-Dawley rats weighing 200~50 g. Paclitaxel (n=15) and control (n=15) groups were divided with or without paclitaxel-coating procedure. The paclitaxel effects were assessed by histomorphological examination one week after thread implantation. RESULTS: The decrease of (3)H-thymidine uptake was observed at 100microM of paclitaxel exposured for 20 minutes in the presence of epidermal growth factor (50 nM/ml) than control. PC model characterized by epithelial-glandular proliferation and fibrous thickening of the bile duct wall through 1~ week. This model was established at 1 week. The effect of paclitaxel-coated nylon thread into the bile duct were evaluated after 1 week. In paclitaxel treated the luminal area, luminal length and the ratio of lumen to bile duct cross sectional area increased by 276% (p=0.044), 87% (p=0.012) and by 330% (p=0.000), respectively, versus control. The total wall area, epithelial-glandular area, and stromal area were similar between paclitaxel treated group and control (p>0.05). The bile duct wall thickness of paclitaxel group decreased by 33% (p=0.011, 273 (90)microM vs 410 (95)microM, paclitaxel vs control). CONCLUSION: Paclitaxel-coated nylon thread into bile duct was effective for the suppression of luminal stenosis, and may offer a therapeutic option for biliary stricture and biliary stricture associated disease.
Animals ; Bile Ducts ; Cell Death ; Cholangitis* ; Constriction, Pathologic ; Dogs ; Epidermal Growth Factor ; Epithelial Cells ; Ethanol ; Gallbladder ; Humans ; Immersion ; Male ; Microtubules ; Nylons* ; Paclitaxel ; Phenobarbital ; Rats* ; Rats, Sprague-Dawley

OBJECTIVES: Due to the heterogeneous receptor distribution and changes of receptor status over time, the biochemical measurement of estrogen receptor status of biopsy specimens is not sufficient to diagnose breast cancer. As a result, I-123 labeled estradiols have been applied for the diagnosis. The purpose of this study was to develop a suitable radioligand for imaging estrogen receptor-positive human breast tumors. METHODS: Among the various estradiol derivatives, 17alpha-[123I]iodovinyl estradiol ([123I]IVE) has been prepared from 17alpha-ethynyl estradiol. Labeling of E-17alpha-[123I]iodovinyl estradiol (E-[123I]IVE) was carried out using peracetic acid with [123I]NaI and Z-[123I]IVE labelling was archived using chloamine- T/HCl solution with [123I]NaI. Labeling yield was determined by silica thin-layer chromatography (TLC) and radiochemical purity was measured by high performance liquid chromatography (HPLC). The biodistribution of E-[123I]IVE was measured in immature female rats at 60 min, 120 min and 300 min after injection. RESULTS: The labeling yield of two isomers was 92% and 94% (E-[123I]IVE and Z-[123I]IVE, respectively). The radiochemical purity was more than 98% after purification. The highest uptake was observed at 120 min in uterus (3.11% ID/g for E-[123I]IVE). CONCLUSION: These results suggest the possibility of using E-[123I]IVE as an imaging agent for the evaluation of the presence of estrogen receptor in patients with breast cancer.
Animals ; Biopsy ; Breast Neoplasms ; Chromatography, Liquid ; Chromatography, Thin Layer ; Diagnosis ; Estradiol* ; Estrogens ; Female ; Humans ; Peracetic Acid ; Rats ; Silicon Dioxide ; Uterus

We have previously demonstrated that transferrin binding protein (TfBP) is a reliable marker for mature oligoden-drocytes (OLGs) in the avian central nervous system (CNS). Unlike mammalian CNS in which OLGs are generated largely postnatally, avian OLGs are differentiated during embryonic development of CNS. In this study, several aspects of TfBP(+/-) OLG development were immunohistochemically examined in the embryonic chick cerebellum : (1) change in shapes of immature cells with respect to time and to location within the cerebellum, (2) possible sites of origin, and (3) pathways of precursor cell migration. Our results indicate that TfBP expression gradually increases and extends from the deep portion of the white matter to gray matter with proportion to progress of cerebellar development. A few TfBP? cells were first observed in the deep portion of the cerebellum at E9. At E13, TfBP(+/-) cells were distributed evenly within the white matter. At E17, many TfBP(+/-) OLGs were located at granular layer and at the near place of Purkinje cell layer. At E20, a large number of TfBP cells appeared at the granular layer with a few in the molecular layer. Our data demonstrated distinct patterns of morphology and location of TfBP(+/-) OLGs in the cerebellum during development and suggest a role of TfBP in OLG development.
Animals ; Carrier Proteins ; Cell Movement ; Central Nervous System ; Cerebellum* ; Chick Embryo ; Embryonic Development ; Female ; Oligodendroglia ; Pregnancy ; Transferrin