Interstitial cystitis is an inflammatory disease of unknown etiology. To facilitate the study of the pathophysiology of interstitial cystitis, an animal model that correlates with the etiology of interstitial cystitis and expresses histologic features consistent with those observed in interstitial cystitis patients was developed. Changes in permeability and histology were investigated in experimental cystitis induced by intravesical antigen challenge following sensitization. Rats were sensitized by intraperitoneal injection of ovalbumin (10mg/ml/kg) given on days 1, 3 and 5. The experiments were performed 4 weeks after the last injection. Controls were run simultaneously with the sensitized animals. Each group ( unsensitized and sensitized) was divided into two subgroups; Rats treated with intravesical ovalbumin (10mg/ml, 1ml) or those receiving 1ml saline intravesically. After antigen (or saline) challenge for one hour, 1ml of 14C-urea was placed into the bladder for two hours. We examined the peripheral blood concentration of 14C-urea at periods up to 120 minutes. There was a progressive increase in the blood level of 14C-urea with time only in the sensitized ovalbumin group. There was no 14C-urea present in the blood of the sensitized saline or in any unsensitized groups. We also measured mast cell density in the submucosa and detrusor muscle layer with Leiz light microscope (x 200). There was no statistical difference in submucosal mast cell densities among all groups. There was a significant increase in detrusor mast cell density only in the sensitized-ovalbumin when compared to the other groups. And degranulated mast cells in the detrusor and submucosa were found only in sensitized-ovalbumin group. With the method employed in this study, we could successfully induce cystitis in rats, without any chemical or mechanical damage to the bladder, by immunologic methods that depends on an allergic response of bladder mucosa. This experimental cystitis expresses histologic features similar to interstitial cystitis of human that increases the bladder mucosal permeability and increases the mast cell numbers in the detrusor muscle.
Animals ; Cystitis* ; Cystitis, Interstitial ; Humans ; Injections, Intraperitoneal ; Mast Cells ; Models, Animal ; Mucous Membrane ; Ovalbumin ; Permeability* ; Rats* ; Urinary Bladder*

OBJECTIVE: The purpose of this study was to determine the efficacy of bone cement-augmented short segment fixation using percutaneous screws for thoracolumbar burst fractures in a background of severe osteoporosis. METHODS: Sixteen patients with a single-level thoracolumbar burst fracture (T11-L2) accompanying severe osteoporosis treated from January 2008 to November 2009 were prospectively analyzed. Surgical procedures included postural reduction for 3 days and bone cement augmented percutaneous screw fixation at the fracture level and at adjacent levels without bone fusion. Due to the possibility of implant failure, patients underwent implant removal 12 months after screw fixation. Imaging and clinical findings, including involved vertebral levels, local kyphosis, canal encroachment, and complications were analyzed. RESULTS: Prior to surgery, mean pain score (visual analogue scale) was 8.2 and this decreased to a mean of 2.2 at 12 months after screw fixation. None of the patients complained of pain worsening during the 6 months following implant removal. The percentage of canal compromise at the fractured level improved from a mean of 41.0% to 18.4% at 12 months after surgery. Mean kyphotic angle was improved significantly from 19.8degrees before surgery to 7.8 at 12 months after screw fixation. Canal compromise and kyphotic angle improvements were maintained at 6 months after implant removal. No significant neurological deterioration or complications occurred after screw removal in any patient. CONCLUSION: Bone cement augmented short segment fixation using a percutaneous system can be an alternative to the traditional open technique for the management of selected thoracolumbar burst fractures accompanied by severe osteoporosis.
Humans ; Kyphosis ; Osteoporosis ; Prospective Studies

Purpose: To analyze the association of systemic and ophthalmic disease in patients with pseudoexfoliation syndrome. Methods: We retrospectively reviewed the records of 207 patients with pseudoexfoliation syndrome and 201 age-matched controls without pseudoexfoliation syndrome seen from January 2016 to January 2021. Age, sex, systemic diseases such as diabetes mellitus, hypertension, cardiovascular and cerebrovascular disease, and ocular disease including retinal vascular occlusion, age-related macular degeneration (AMD), glaucoma, cataract surgery rate, complications related to cataract surgery, and ocular characteristics were compared. Factors associated with pseudoexfoliation syndrome were analyzed using logistic regression. Results: The frequencies of diabetes mellitus, hypertension, AMD, glaucoma, a history of cataract surgery, and complications related to cataract surgery were significantly higher in patients with pseudoexfoliation syndrome (all Ps ≤ 0.049). The pseudoexfoliation syndrome group had a significantly thinner global retinal nerve fiber layer, worse mean deviation and pattern standard deviation, and smaller dilated pupil size than the controls (all Ps < 0.001). In univariate and multivariate logistic regressions, the presence of diabetes mellitus (odds ratio [OR] = 1.613, p = 0.041), AMD (OR = 3.071, p = 0.001), and glaucoma (OR = 17.800, p < 0.001) were associated with pseudoexfoliation syndrome. Conclusions Diabetes mellitus, hypertension, AMD, and glaucoma were more frequent in pseudoexfoliation syndrome patients. Since pseudoexfoliation syndrome is closely related to AMD and glaucoma, this requires clinical consideration.

Endoscopic polypectomy was firstly introduced by Tsuneoka in 1969, and till now this method has been widely used for the treatment of benign and malignant polyps with the advent of technical improvement. This method is a very important modality as secondary prevention of malignancy because polyps in gastraintestinal tract are now being considered as precancerous lesion. Polypectomy with snare and electrocautery is mainly used for pedunclated polyps (eg. Yamada Class III, IV), but sessile polyps pose technical difficulty and occasionally cause serious gastrointestinal hemorrhage when resection margin adjacent polyp base. We performed polypectomy with "O"-ring used in endocopic variceal ligation (EVL) to make sessile polyp as semipedunclated form, and also to control bleeding, and then successfully remove it with conventional snare polypectomy. We report these 5 cases with the review of the literature.
Electrocoagulation ; Gastrointestinal Hemorrhage ; Hemorrhage ; Ligation* ; Polyps ; Secondary Prevention ; SNARE Proteins

No abstract available.
Adenocarcinoma*

Many risk factors for atherosclerosis have been proposed to identify high risk individuals. We conducted a retrospective study to determine the risk factors for development of carotid stenosis (CS) in Koreans. Database of 2,805 subjects who underwent a check up of carotid artery for health examination were analyzed. Stenosis (%) of common carotid artery or proximal internal carotid artery was examined with ultrasonography. Subjects were divided into 2 groups (Group I; CS <10%, Group II; CS > or =30%). We compared demographic, laboratory and clinical data between 2 groups to determine the risk factors of CS. One hundred ninety seven subjects (7.0%) were categorized as Group II. At age- and sex-adjusted multivariate analysis, diabetes mellitus, hypertension, cerebrovascular disease, ischemic heart disease, hyperlipidemia, aspirin medication, current smoking, fasting glucose, total cholesterol, low density lipoprotein-cholesterol (LDL-C) and leukocyte count were significant risk factors of CS. At stepwise logistic regression analysis, age, hypertension, hyperlipidemia, LDL-C and leukocyte count were independent risk factors. At subgroup analysis by smoking, age and leukocyte count were independent risk factors in smoker and age and hypertension in nonsmoker.
Adult ; Age Factors ; Aged ; Carotid Stenosis/blood/*epidemiology/etiology ; Cholesterol/blood ; Comparative Study ; Female ; Humans ; Korea/epidemiology ; Lipoproteins, LDL Cholesterol/blood ; Logistic Models ; Male ; Middle Aged ; Multivariate Analysis ; Prevalence ; Retrospective Studies ; Risk Factors ; Smoking/adverse effects

Background: In Korea, the health gap widens due to the number of medical resources and access to medical services between metropolitan and rural. The purpose of this study is to identify the impact of residential migration on medical utilization and accessibility. Methods: This study extracted 528,516 claimed cases in the National Health Insurance Service-Cohort Sample Database from 2006 to 2015. Subjects were classified into two groups by the magnitude of the region, the metropolitan and the rural. The inversed probability weights were calculated for each group. And coefficients of the two-part model were estimated by generalized estimation equation. Results: Those who moved region from metropolitan to rural tend to increase the length of stay and inpatients with ambulatory care sensitive conditions (ACSC) disease. Contrariwise, those who moved areas from rural to metropolitan tend to decrease the total medical cost, the adjusted patient days, the number of outpatients and the number of outpatients and inpatients with ACSC disease. Conclusion This study identified that between the residents who continued to reside in the region and the migrants, there were significant differences in the medical accessibility, quality of primary care, and unmet medical need.

Background: In Korea, the health gap widens due to the number of medical resources and access to medical services between metropolitan and rural. The purpose of this study is to identify the impact of residential migration on medical utilization and accessibility. Methods: This study extracted 528,516 claimed cases in the National Health Insurance Service-Cohort Sample Database from 2006 to 2015. Subjects were classified into two groups by the magnitude of the region, the metropolitan and the rural. The inversed probability weights were calculated for each group. And coefficients of the two-part model were estimated by generalized estimation equation. Results: Those who moved region from metropolitan to rural tend to increase the length of stay and inpatients with ambulatory care sensitive conditions (ACSC) disease. Contrariwise, those who moved areas from rural to metropolitan tend to decrease the total medical cost, the adjusted patient days, the number of outpatients and the number of outpatients and inpatients with ACSC disease. Conclusion This study identified that between the residents who continued to reside in the region and the migrants, there were significant differences in the medical accessibility, quality of primary care, and unmet medical need.

OBJETIVES: Gastric leiomyosarcomas are uncommon, represent 1 to 3% of primary malignant neoplasms of the stomach and variable in clinical outcomes. This paper is a retrospective study of the clinical behaviour, histopa thologic features and prognostic factors. METHODS: Between January 1990 and August 1996, the records of nine patients with primary gastric leio myosarcoma treated at Chung-Nam National University Hospital were reviewed for clinical presentations and histopathologic features. The statiscal analysis with SAS system was employed for evaluation of prognostic factors. RESULTS: 1) The median age of the patients was 53.4 years with even age distribution from 31 to 76 years. The male and female ratio was 1.25 to 1. 2) The common symptoms were abdominal pain(67%), bleeding(22%) and indigestion(11%). 3) The locations of the tumor was body(56%) and fundus(44%). The growth pattern of the tumor was mostly submucosal(67%). 4) The average size of tumors was 11cm (6-18cm). 5) The central ulcer on the tumor showed 100%. The endoscopically and preoperative diagnosed leiomyosar coma with endoscopic biopsy was 33% . 6) The low grade tumors were 7 cases and high grade was 1 in eight resected primary gastric leiomyosarcomas. 7) The overall resectability was 89%. The resected cases had no lymph node metastasis. Chemotherapy and radiotherapy was done 5 cases and 1 case, respectively in patients with high mitotic number, large size and distant metastases. 8) The follow-up period was 4 to 49 months and 3 patients were died. Two of 3 died patients were initially diagnosed stage IVA and 1 patient was stage II with very large size (18cm). The average survival time of 3 died patients was 37 months. 9) The two patients from surgically resected eight cases were recurred at liver and peritoneum and died 11 months and 31 months after recurrence, respectively. CONCLUSION: The advanced stage and recurred case has short survival time but the more many cases and longer follow-up periods should be need to identify for prognostic factors and the effective postoperative adju vant therapy should be studied for high risk patients.
Age Distribution ; Biopsy ; Coma ; Drug Therapy ; Female ; Follow-Up Studies ; Humans ; Leiomyosarcoma* ; Liver ; Lymph Nodes ; Male ; Myosarcoma ; Neoplasm Metastasis ; Peritoneum ; Radiotherapy ; Recurrence ; Retrospective Studies ; Stomach ; Ulcer

Fifteen percent of patients with Cushing's syndrome could be accompanied with nonpituitary tumors that secrets ACTH-the ectopic ACTH syndrome. Among them, bronchial carcinoid is one of the rare causes of the ectopic ACTH syndrome. We experienced a 60-year-old woman who showed conditions of weight gain, generalized edema, hypokalemia, diabetes mellitus, and right middle lung mass. Histologically, the tumor was diagnosed with bronchial carcinoid and was confirmed as an ectopic ACTH syndrome through immunohistochemical staining of ACTH. After resection of the lung mass, blood sugar, electrolytes, generalized weakness, and blood pressure improved.
ACTH Syndrome, Ectopic* ; Adrenocorticotropic Hormone ; Blood Glucose ; Blood Pressure ; Carcinoid Tumor* ; Cushing Syndrome ; Diabetes Mellitus ; Edema ; Electrolytes ; Female ; Humans ; Hypokalemia ; Lung ; Middle Aged ; Weight Gain