A prospective randomised trial was performed to assess the diagnostic accuracy according to the time interval and the efficacy of endoscopic injection of hypertonic saline-epinephrine(HS- E)solution, consisting of 3.5% sodium chloride with 0.0045% epinephrine, for actively bleeding peptic ulcers, exposed vessel or blood clot on ulcer bed, or Mallory-Weiss tear. Over 24 month, emergency endoscopy in 180 patients admitted for upper gastrointestinal hemorrhage identified 51 patients with nonvariceal hemorrhage. The causes of bleeding were; gastric ulcer in 32; duodenal ulcer in 13; gastric cancer in 4; Mallory-Weiss tear in 2. With this method, the hemostatic effect was permanent in 40 cases(84.3%), temporary in 9 cases(11.8%), and failed in 2 cases(3.9%). By applying this method, the rate of emergency operation for patients with bleeding from the upper gastrointestinal tract was significantly reduced from 20.0% (8/40)to 3.9%(2/51)(p<0.05). Emergency endoscopy in acute UGI bleeding increases the accuracy of detection of actual bleeding sites(p<0.05), but if the endoscopic procedure was performed within 48 hours, the hemostatic rate was not affected(p<0.05). We concluded that hypertonic saline-epinephrine injection method could provide a simple maneuver with reasonable cost, high safety, and satisfactory hemostatic efficacy in the treatment of nonvariceal upper gastrointestinal bleeding.
Duodenal Ulcer ; Emergencies ; Endoscopy ; Epinephrine* ; Gastrointestinal Hemorrhage ; Hemorrhage* ; Hemostasis ; Humans ; Mallory-Weiss Syndrome ; Peptic Ulcer ; Prospective Studies ; Sodium Chloride ; Stomach Neoplasms ; Stomach Ulcer ; Ulcer ; Upper Gastrointestinal Tract*

Currently, endoscopic injection sclerotherapy(EIS) is the most widely used method for treating and eradicating acutely bleeding esophageal varices in repeated sessions, but may be associated with some undesirable local and systemic complications. (continue...)
Esophageal and Gastric Varices* ; Esophagus ; Hemorrhage ; Hemostasis ; Ligation* ; Sclerotherapy* ; Varicose Veins

No abstract available.
Lymphoma*

The aim of the present study was to evaluate the efficacy and toxicity of stereotactic body radiation therapy (SBRT) for low- to intermediate-risk prostate adenocarcinoma. Thirty-nine patients were retrospectively reviewed. The SBRT was delivered using the CyberKnife with the fiducial tracking method combined with In-tempo imaging. The gross target volume, which included the prostate only, was delineated on the fused CT/MRI scans. The prescription dose was delivered every other day as 5 fractions of 7.5 Gy. Venous blood was obtained before and after SBRT to assess the prostate-specific antigen (PSA) level. Toxicity was evaluated using the CTCAE, v4.03. The median follow-up time was 30.0 months. The median initial PSA level was 7.7 ng/mL. PSA levels decreased in all patients treated with SBRT, and after 5 months, the median PSA was less than 2 ng/mL. The rate of overall 3-yr actuarial biochemical failure free survival was 93.9%. Acute side effects were generally comparable with those of previous studies. The PSA change and toxicity after SBRT for low- to intermediate-risk prostate adenocarcinoma indicates favorable biochemical responses and tolerable levels of toxicity. Additionally short course treatment may produce cost benefit and convenience to patients.
Adenocarcinoma/*diagnosis/*surgery ; Aged ; Aged, 80 and over ; Humans ; Male ; Middle Aged ; Prostatic Neoplasms/*diagnosis/*surgery ; Radiosurgery/*methods ; Radiotherapy Dosage ; Radiotherapy Planning, Computer-Assisted ; Radiotherapy, Image-Guided/*methods ; Risk Assessment ; Treatment Outcome

BACKGROUND: The use of light technology in dermatology has grown rapidly over the last decade, with many developments in its use for the treatment of a wide variety of skin conditions from non-melanoma skin cancers to facial resurfacing for photo-damaged skin. Light-emitting diodes (LEDs) have attracted much attention in medical fields. OBJECTIVE: (1) To assess the optimal distance of 630 nm LEDs (OmniLux(R), (Phototherapeutics Ltd, the UK)) and 830 nm LEDs (Healite(R) (Lutronic, Korea)) for maximum power as determined by a power meter and (2) to apply theory to practical use. METHODS: Two separate hinged planar light emitting diode arrays were studied: 1) the Omnilux Revive(TM) (Phototherapeutics Ltd, the UK), which delivers non-coherent red light at a wavelength of 633+/-3 nm and 2) the Lutronic Healite (Korea), which delivers non-coherent light at a wavelength of 830+/-5 nm. An X93 power meter (Gigahertz-Optik, Germany) was placed against a black background in order to reduce the amount of reflected light. We measured the LED powers over a range of 3~25 cm in 1 cm increments. RESULTS: On the irradiation side of the LED, power increases according to the mass effect of the radiation angle. However, at a certain distance, the power decline effect predominated over the amassment effect. In this respect, the LED light was estimated to be emitted in a reverse V shape. The proper irradiation distance for use in medical fields can thus be determined. CONCLUSION: The proper irradiation distance of LED will be useful and the proper use of LED under the subjects' shape will be done in many medical fields.
Dermatology ; Enzyme Multiplied Immunoassay Technique ; Light ; Skin ; Skin Neoplasms

BACKGROUND: Mild iron deficiency anemia is known to be asymptomatic in most of the cases. In view of this, we studied response of the mild anemics to the maximal exercise loading test to learn whether or not they respond similarly to the normals. METHODS: The maximal exercise loading tests by Bruce's protocol were carried out in 22 female asymptomatic anemics with hemoglobin level of between 10.0gm/dL and less than 12.0gm/dL, and the results were compared with those of 44 non-anemic matched controls with mean hemoglobin level of 13.1gm/dL. The ages in both groups were in their 30's to 40's, and even the anemics were otherwise normal clinically and on various laboratory tests. RESULTS: There were no significant difference between two groups in VO2 max, HR max, VCO2 max and VE max and their derivatives including VT/VC and VE/MVV. CONCLUSIONS: Our results indicate that in patients with mild iron deficiency anemia, the cardiorespiratory response to maximal exercise loading is not different from the normals, and suggest that oxygen transport to tissues is not affected even at maximal exercise. probably by adaptive compensatory mechanism.
Anemia* ; Anemia, Iron-Deficiency ; Female ; Humans ; Oxygen

PURPOSE: Liver metastasis is the most common type of failure in the treatment of colorectal cancer. The identification of differential expressions of genes in colorectal cancer and liver metastasis is important to differentiate the genetic mechanism of carcinogenesis and liver metastasis from that of a normal mucosa. The aim of this study is to find candidate genes playing roles in liver metastasis of colorectal cancer by using cDNA microarray. METHODS: We screened a group of genes differentially expressed in a normal mucosa and in cancer and liver metastasis by using a 4.7 K cDNA microarray chip in 8 patients with far advanced colorectal cancer from Jan 2003 to May 2004 at Kyungpook National University Hospital. RESULTS: A comparison of mRNA expressions of genes in normal mucosa vs. cancer, normal mucosa vs. liver metastasis, and cancer vs. liver metastasis, 76 and 27 known and unknown genes were significantly over-expressed in cancer and liver metastasis, respectively. Also 62 and 26 genes were down- regulated in cancer and liver metastasis. Among those genes, TIMP-1, SRY-box9, Rattus norvegicus fibronectin 1, mitotic check point regulator, etc. were constantly up- regulated in cancer or metastasis, and hsgk, etc. were down-regulated in cancer or liver metastasis. CONSLUSIONS: The cDNA microarray chip technique could be a useful for robust screening of candidate genes involved in carcinogenesis or metastasis of colorectal cancer.
Animals ; Carcinogenesis ; Colorectal Neoplasms* ; DNA, Complementary* ; Fibronectins ; Gene Expression ; Gyeongsangbuk-do ; Humans ; Liver* ; Mass Screening ; Mucous Membrane ; Neoplasm Metastasis* ; Oligonucleotide Array Sequence Analysis* ; Pilot Projects* ; Rats ; RNA, Messenger ; Tissue Inhibitor of Metalloproteinase-1

PURPOSE: To investigate the role of gadolinium enhanced MR imaging in the evaluation of gestational trophoblastic tumors (invasive mole and choriocarcinoma). MATERIALS AND METHODS: Pre-enhanced T1-and T2-weighted images and gadolinium enhanced T1-weighted images of 34 gestational trophoblastic tumors (15 choriocarcinomas, 19 invasive moles) were evaluated retrospectively. Enhanced patterns of gestational trophoblastic tumors were analyzed. Morphologic differences and structural characterstics were analyzed by the evaluation of tumor margin, patterns of hemorrhagic necroses, development of intratumoral vascularity, and molar villi. Graded scores of MR findings between pre- and gadolinium enhanced images were given in the following criteria ; 1) visualization of tumor margin 2) distinction between tumor necrosis and zone of trophoblastic proliferation, and 3) molar villi. Statistical differences between graded scores of pre-and post-enhanced images were analyzed. RESULTS: Choriocarcinoma was a well-defined mass with peripheral rim enhancement and central hemorrhagic necrosis. Invasive mole was a ill-defined mass with partial necrosis, tiny cystic areas and increased intratumoral vascularity with dense reticular enhancement. Interface between tumor necrosis and zone of trophoblastic proliferation was better visualized on the gadolinium enhanced images than on the pre-enhanced images. Tumor margin and intratumoral molar villi were clearly discrimated on the gadolinium enhanced images only in invasive mole. There was no statistical difference in the visualization of tumor margin of choriocarcinoma between the pre-and post-enhanced images. CONCLUSION: Gadolinium enhanced MR image was helpful in the visualization of tumor characterstics in gestational trophoblastic tumors, and in the differential diagnosis between invasive mole and choriocarcinoma.
Choriocarcinoma ; Diagnosis, Differential ; Female ; Gadolinium* ; Hydatidiform Mole, Invasive ; Magnetic Resonance Imaging* ; Molar ; Necrosis ; Pregnancy ; Retrospective Studies ; Trophoblastic Neoplasms* ; Trophoblasts*

PURPOSE: To investigate whether bone mineral density(BMD) occurs in association with fatty replacement oflower paraspinal muscles and whether it relates with the area ratio(Ps/V) of psoas muscle(Ps) divided by adjacentvertebral body(V). MATERIALS AND METHODS: For the evaluation of osteoporosis, 100 females underwent quantitativeCT. At L1,L2 and L3 levels, the fatty replacement of lower paraspinal muscles was numerically graded and therelationship between this and BMD of the vertebral body was evaluated. The correlation between BMD and Ps/V at L2and L3 levels was also evaluated, as was the relationship between the thickness of subcutaneous fat tissue at L1,L2 and L3 levels. RESULTS: BMD showed significant inverse correlations with the grade of the fatty replacement oflower paraspinal muscles at L1(p<.01), L2 level and L3 level(p<.001). In particular, significant differenceswere established between grade 0 and 2 (p<.05) at L1 level, and between grade 0 and 2, and 1 and 2 (p<.05) at L2and L3 levels. There was markedly low correlation (gamma=.33) between BMD and Ps/V at L3 level(p<.001) and lowercorrelation (gamma=.22) at L2 level(p<.05). At L2 and L3 levels, there was no correlation between the thickness ofsubcutanous fat tissue and BMD or Ps/V. CONCLUSION: The present study demonstrates that there was significantinverse correlation between BMD and fatty replacement of lower paraspinal muscles, and low correlation between BMDand Ps/V.
Bone Density* ; Female ; Humans ; Osteoporosis ; Paraspinal Muscles* ; Spine* ; Subcutaneous Fat

PURPOSE: Gemcitabine and 5-fluorouracil (5-FU) are two compounds with reproducible activity against advanced pancreatic carcinomas. To evaluate the activity and feasibility of this combination chemotherapy, a multi-institutional phase II study was performed. MATERIALS AND METHODS: Twenty patients (male: female 15: 5, median age: 60.5 years), with histologically verified locally advanced or metastatic pancreatic carcinomas, were enrolled between April 2000 and March 2002. Gemcitabine was administered by intravenous injection at the doses of 1, 000 mg/m2 on days 1, 8 and 15, and 5-FU 800 mg/m2/day, was given by continuous intravenous infusion on days 1~5. The treatment was repeated every 4 weeks. The clinical benefit response (CBR) was a composite of the pain, Karnofsky performance status and body weight change measurement. RESULTS: Nineteen of the twenty patients were assessable for response. The median follow-up duration was 4.6 months (0.4~15.2 months). Five patients achieved a partial response and eight a stable disease. The overall response rate was 25.0%. The CBR was assessable in 12 patients. The overall CBR was 41.7% (5/12). The median survival of all the patients was 8.0 months. Grade 3~4 toxicities included neutropenia (9.3%) and thrombocytopenia (5.3%). CONCLUSION: This study suggested that gemcitabine, combined with infusional 5-FU, was well tolerated, and produced modest antitumor activity and symptomatic relief in advanced pancreatic cancer patients.
Body Weight Changes ; Drug Therapy, Combination ; Female ; Fluorouracil* ; Follow-Up Studies ; Humans ; Infusions, Intravenous ; Injections, Intravenous ; Karnofsky Performance Status ; Neutropenia ; Pancreatic Neoplasms* ; Thrombocytopenia