No Abstract Available.
Mass Screening*

Purpose: The serum prostate-specific antigen (PSA) level is increased after needle biopsy (Bx) of the prostate. This study tested the hypothesis that the prostate that harbors malignant lesions demonstrates less leakage of PSA after transrectal prostate Bx, and this phenomenon can be helpful in discriminating benign protrates from cancer ous prostrates. Materials and Methods: Eighty three patients were included in this prospective study because they had an increase PSA level (from 4 to 30ng/ml) and/or an abnormal digital rectal examination, and the serum PSA level was checked 60 minutes later after biopsy. We checked the pre-Bx total serum PSA, the post-Bx total serum PSA and the PSA ratio (post-Bx total serum PSA to pre-Bx total serum PSA), and we analyzed the sensitivity, specificity, positive predictive value, negative predictive value and the statistical differences. Results: Of the 31 men whose PSA ratio was less than 2.0, 27 (87%) men were proven to have prostate cancer. Of the 52 men whose PSA ratio was greater than 2.0, 49 (94%) were proven to have benign lesions. When setting 2.0 as the cutoff value, the difference was statistically significant (p<0.001); the sensitivity was 90.0%, the specificity 92.4%, the positive predictive value (PPV) 87.0% and the negative predictive value (NPV) 94.2%. Conclusions: Evaluating the 1-hour PSA ratio might be helpful for clinicians to diagnosis the high risk patients who might have cancer in their prostate glands. Repeat biopsy should be considered for patients who initially had negative biopsy results with a smaller PSA ratio.
Biopsy* ; Biopsy, Needle ; Diagnosis ; Digital Rectal Examination ; Humans ; Male ; Neoplasms ; Prospective Studies ; Prostate* ; Prostate-Specific Antigen* ; Prostatic Neoplasms ; Sensitivity and Specificity

Intracranial lipoma usually occurs at or near the midline, predominantly in the callosal cistern and very rarely in the sylvian fissure. We report a case of lipoma of the sylvian fissure without association with other congenital anomaly or vascular abnormality.
Brain ; Lipoma*

BACKGROUND: Overt hypothyroidism is a well-known cause of secondary hyperlipidemia and atherosclerosis. However, there have been some dissenting report of abnormalities and in serum lipid concentration in patients with subclinical hypothyroidism. We have attempted to analyze serum lipid concentrations to investigate whether they are increased in patients with subclinical hypothyroidism and to see if there is a correlation between serum LDL-C and TSH concentrations. METHODS: Serum lipid profiles(total cholesterol, triglycerides, LDL-C, HDL-C) of patients with subclinical hypothyroidism (M/F=7/119) compared with age, sex and body mass index matched control subjects(M/F=14/239) from Jan. 1 . 1996. to Dec. 30. 1997. RESULTS: There were no significant differences of serum total cholesterol, LDL cholesterol, TG, and HDL concentrations in 126 patients with subclinical hypothyroidism and 253 control subjects(178.47+/-35.76mg/dL vs. 173.05+/-35.93mg/dL ; 113.33+/-52.89mg/dL vs 117.64+/-68.70mg/dL ; 112.89+/-33.26mg.dL vs 109.65+/-29.02mg/dL ; 48.60+/-11.34mg/dL vs 46.51+/-11.73mg/dL). There was no correlation between LDL cholesterol and TSH concentrations in subclinical hypothyroidism(r=0.29, p<0.05). CONCLUSION: Serum lipid concentration (total cholesterol, LDL cholesterol, and TG, HDL) was not increased in patients with subclinical hypothyroidism. There was no correltion between serum LDL and TSH levels in patients with subclinical hypothyroidism.
Atherosclerosis ; Body Mass Index ; Cholesterol ; Cholesterol, LDL ; Dissent and Disputes ; Humans ; Hyperlipidemias ; Hypothyroidism* ; Lipoproteins* ; Triglycerides

BACKGROUND: Since metallo-beta-lactamase (MBL)-producing isolates can hydrolyze carbapenem and also easily transfer the resistance genes to other bacteria, a rapid and accurate detection of MBL has become very important. We evaluated the utility of Mueller Hinton agar (MHA) biplate containing dipicolinic acid (DPA) as a screening method to detect IMP-1 and VIM-2 type MBL-producing isolates. METHODS: Based on our preliminary tests using various concentrations of DPA, 200 and 300 microg/mL concentration of DPA were chosen for further study. Bacterial lawns were grown on MHA biplate, one half of which contained DPA while the other did not. The inhibition zone around the imipenem (IPM) disk on both sides of this plate was compared. The stability of DPA in the stored DPA-MHA biplate was also evaluated during three months using two MBL- and one non-MBL-producing isolates. RESULTS: When the criterion of a > or =7 mm increase of inhibition zone around the IPM disk on the MHA containing DPA compared to MHA without DPA was used, the sensitivities and specificities were 94.7% and 97.6% for 200 microg/mL DPA-MHA biplate, and 98.2% and 97.6% for 300 microg/mL DPA-MHA biplate, respectively. The activity of the DPA in this biplate was stable for three months. CONCLUSIONS: Assays using DPA 300-MHA biplate were highly sensitive and specific for the detection of IMP-1 and VIM-2 type MBL-producing bacteria. In addition, it is easy to perform; so, it may be useful to apply this method for detection of IMP-1 and VIM-2 type MBL in clinical laboratories.
Agar ; Anti-Bacterial Agents/*pharmacology ; Bacteriological Techniques ; Chelating Agents/chemistry/*pharmacology ; Drug Resistance, Bacterial ; Gram-Negative Bacteria/drug effects/enzymology/*isolation & purification ; Imipenem/*pharmacology ; Picolinic Acids/chemistry/*pharmacology ; Reagent Kits, Diagnostic ; Sensitivity and Specificity ; beta-Lactamases/*analysis/biosynthesis

BACKGROUND: Recently, the number of internet users is rapidly increasing and internet medical counseling for medical information is also becoming frequent. The aim of this study was to assess the responses and accuracy of internet medical counseling, and compare the responses according to years and operating groups. METHODS: The subject websites were 79 websites in August, 2000, and 88 in May, 2002, which operated board-type medical counseling. We questioned a simulated case of an acute dermatologic disease. Then we analysed the response rate, the time taken to reply and the accuracy of reponses. RESULTS: The number of websites that answered the question was 38 (48.1%) in 2000, and 73 (83.0%) in 2002. The response rate was significantly higher in 2002 than 2000. Time to reply was significantly shorter in 2002 than 2000. The response rate in hospital or clinic groups was higher than in other groups. The rate to make a correct diagnosis was significantly higher in 2002 than 2000. The rate to mention prognosis and necessity of intensive treatment was significantly higher in 2002 than 2000. CONCLUSION: The response rate was higher 2002 than 2000. Time to reply and the accuracy of answer improved in 2002. The response rate was higher in hospital or clinic group than in other groups.
Counseling* ; Diagnosis ; Humans ; Internet* ; Prognosis

No abstract available.
Education*

OBJECTIVE: To examine the clinical factors and brain lesion locations related to the patterns of dysphagia in stroke patients in a rehabilitation hospital. METHODS: The medical records of 116 stroke patients who underwent a videofluoroscopic swallowing study (VFSS) between January 2010 and January 2015 in a rehabilitation hospital were reviewed retrospectively. The swallowing-related parameters were assessed using a VFSS. The brain lesion locations were classified as the cortex, basal ganglia, thalamus, midbrain, pons, medulla, cerebellum, and others (subarachnoid or intraventricular hemorrhage). The ambulation ability was assessed using functional ambulation categories (FACs). The independence in the activities of daily living and the degree of cognitive impairment were assessed using the Korean versions of the modified Barthel index (K-MBI) and Mini-Mental State Examination (K-MMSE), respectively. After adjusting for the potential confounding factors in multivariate analysis, the odds ratios and confidence intervals of the stroke brain lesions were calculated and the clinical factors for predicting the VFSS findings were determined. RESULTS: Among the 116 patients, 35 (27%) had an impaired oral stage and 58 (50%) had aspiration. The impaired oral stage was associated significantly with the onset time, basal ganglia stroke, dietary and fluid intake methods at the time of the VFSS, symptoms of dysphagia, FACs, K-MBI, and K-MMSE. Aspiration was correlated with a pontine stroke, methods of dietary and fluid intakes at the time of the VFSS, symptoms of dysphagia, FACs, and K-MBI. Multivariate analysis showed that the pontine stroke and methods of dietary and fluid intake at the time of VFSS predicted aspiration after adjusting for the potential confounding factors. In subgroup analysis of the diet type, the liquid and semisolid aspirations were correlated with the dietary and fluid intake methods and pontine stroke, respectively. CONCLUSION: Patients with a pons lesion stroke, who are on a modified diet (fluid thickening and tube feeding), have higher risks of aspiration. This provides evidence for precise clinical reasoning in this specific patient group.
Activities of Daily Living ; Aspirations (Psychology) ; Basal Ganglia ; Brain ; Cerebellum ; Cognition Disorders ; Deglutition Disorders ; Deglutition* ; Diet ; Humans ; Medical Records ; Mesencephalon ; Multivariate Analysis ; Odds Ratio ; Oral Stage ; Pons ; Rehabilitation ; Retrospective Studies ; Stroke* ; Thalamus ; Walking

Fluorouracil is well known as a standard chemotherapeutic drug in breast cancer and other cancers that is converted to flurodeoxyuridine monophosphate (FdUMP) and leads to the inhibition of thymidylate synthase (TS) in tumor tissue. The role of this enzyme is the catalysis of the methylation from deoxyuridine monophosphate (dUMP) to deozythymidine monophosphate (dUMP), which is a very important process for DNA synthesis in tumor tissues. Increased level of TS protein correlates inversely with sensitivity and response to 5 FU in human cancer cell lines. Authurs evaluated the TS expression level using the immunohistochmical staining and analysed their relationship with other prognostic factors and clinical outcome of breast cancer patients. The results were as follows; 1) TS level was not related histopathologic stage, involvement of axillary lymph nodes, estrogen receptor, progesterone receptor, recurrent type, primary tmor and recurrent tumors, disease free survival rate. 2) TS level was associated with e-erbB2 overexpression. 3) c-erbB2 overexpression was related with recurrence rate. 4) TS level appeared to be related with recurrence rate. So w conclude the TS level can be used as an independant prognostic predictor on breast cancer patients.
Breast Neoplasms* ; Breast* ; Catalysis ; Cell Line ; Deoxyuridine ; Disease-Free Survival ; DNA ; Estrogens ; Fluorouracil ; Humans ; Lymph Nodes ; Methylation ; Receptors, Progesterone ; Recurrence ; Thymidylate Synthase*

Primitive neuroectodermal tumor (PNET) is frequent in children and adolescents, but rare in adults. Most of the extraosseous Ewing's sarcoma or PNET occur in the soft tissues of the extremities, the paravertebral region, and the pelvic cavity. PNET in the gastrointestinal tract is uncommon. We report herein a case of PNET arising from the jejunum in a 38-year-old woman. She presented with anorexia, nausea, vomiting, and weight loss. Abdominal computed tomography revealed a mass in the small bowel with obstruction. She had a small bowel segmental resection, from which PNET was diagnosed. Multi-agent chemotherapy comprised of vincristine, adriamycin, cyclophophamide, ifosfamide, and etoposide (VAC/IE) was administered for 1 year. The treatment was well-tolerated. She remains alive and continues to be disease free 30 months postoperatively.
Adolescent ; Adult ; Anorexia ; Child ; Doxorubicin ; Etoposide ; Extremities ; Female ; Gastrointestinal Tract ; Humans ; Ifosfamide ; Jejunum ; Nausea ; Neuroectodermal Tumors ; Neuroectodermal Tumors, Primitive ; Sarcoma, Ewing ; Vincristine ; Vomiting ; Weight Loss