PURPOSE: The purpose of this study was to describe the anglographic finding and clinical result of transarterial embolotherapy(TAE) in patients with injuries of renal artery branches by blunt trauma. MATERIALS AND METHODS: The study was based on retrospective analysis of seven cases, in which TAE was attempted for the control of traumatic renal arterial bleeding. All procedures were performed via the transfemoral approach. TAE was performed with stainless steel coil in two cases, Gelfoam in one case, and Gelfoam and stainless steel coil in four cases. RESULTS: Angiographic findings of vascular injuries were pseudoaneurysm in four cases, extravasation in two cases and arteriocalyceal fistula in one case. All procedures were performed successfully without complication. CONCLUSION: Pseudoaneurysm is a common anglographic finding in patients with injury of renal artery branches and TAE is considered a safe and effective method for treating such cases.
Aneurysm, False ; Embolization, Therapeutic* ; Fistula ; Gelatin Sponge, Absorbable ; Hemorrhage ; Humans ; Renal Artery* ; Retrospective Studies ; Stainless Steel ; Vascular System Injuries

PURPOSE: Preoperative radiation treatment with concomittant intravenous infusion of 5-fluorouracil has been known to be effective in shrinking and downstaging the tumor. Treatment with Doxifluridine (synthetic 5-deoxynucleoside derivative) medication prolongs drug exposure to tumor tissue, so it can be considered synergistic to concurrent radiotherapy. Intravenous 5-FU and oral Doxifluridine were compared with respect to tumor response, toxicity, and quality of life of patients. METHODS: Twenty eight patients with rectal cancer, staged as over T3N1 or T4 by transrectal ultrasonography between July 1997 and December 1998 were included. Intravenous 5-FU (450 mg/m2/day) and leucovorin (20 mg/m2) was given for five consecutive days during first and fifth weeks of irradiation therapy (50.4 Gy) (N=14). Oral Doxifluridine (700 mg/m2/day) and leucovorin (20 mg/m2) was given daily during radiation treatment (N=14). Quality of life was scored according to twenty two activity items (good: >77, fair: >58, poor: <57). Surgical resection was performed four weeks after completion of concurrent chemoradiation treatment. Tumor response was classified as CR (Complete Response), PR (Partial Response: 50% diminution of tumor volume or downstaging), or NR (No Response). RESULTS: Tumor response was CR: 3/14 (21.4%), PR: 7/14 (50%) and NR: 4/14 (28.6%) in IV arm versus CR: 2/14 (14.2%), PR: 6/14 (42.9%) and NR: 6/14 (42.9%) in oral arm (p=0.16, 0.23, 0.24, respectively). Quality of life was poor (36.4% vs 33.3%), fair and good (63.6% vs 66.7%, respectively) between IV arm and oral arm. Systemic recurrence during follow up periods was 1/14 (7.1%) in IV arm and 2/14 (14.3%) in oral arm, respectively (p=0.307). One local recurrence was observed in oral arm. Hematologic toxicity was 3/14 (21.4%) in IV arm versus 4/14 (28.5%) in oral arm, respectively. Gastrointestinal toxicity was 2/14 (14.3%) versus 5/14 (35.7%) and stomatitis was observed in IV arm (1/14, 7.1%) CONCLUSION: Oral doxifluridine based chemotherapy shows a comparable tumor response and oncologic results, but there was no benefits as far as quality of life and toxicity were concerned.
Arm ; Drug Therapy ; Fluorouracil* ; Follow-Up Studies ; Humans ; Infusions, Intravenous ; Leucovorin ; Prospective Studies* ; Quality of Life ; Radiotherapy ; Rectal Neoplasms* ; Recurrence ; Stomatitis ; Tumor Burden ; Ultrasonography

PURPOSE: Intravenous 5-Fluorouracil (5-FU) and oral doxifluridine were compared with respect to therapeutic efficacy, drug toxicity, and quality of life to clarify the efficiency of oral doxifluridine. METHODS: One hundred sixty-six (166) patients who underwent a curative resection for TNM stage II and III rectal cancer between Oct. 1997 and Feb. 1999 were randomized to receive intravenous 5-FU (450 mg/m2/day) or oral doxifluridine (700 mg/m2/day) in combination with leucovorin (20 mg/m2/day). 5-FU was infused intravenously 5 consecutive days per month for a total of 12 cycles (IV arm, N=74) in one group, and doxifluridine was given orally daily for 3 weeks with a rest of 1 week for a total of 12 cycles (Oral arm, N=92). Drug toxicity and quality of life were observed. Quality of life was scored according to twenty-two daily activity items (good,>71, fair,53< or =and<70, poor,< or =52). RESULTS: There was no significant difference in the mean age, sex, TNM stage distribution, or type of operation between the two groups (>0.05). Mean number of chemotherapy cycles was 6.5+/-3.7 (IV arm) vs 7.2+/-4.3 (Oral arm). The recurrence rate was 9/74 (12.1%) in IV arm and 6/92 (6.5%) in oral arm (P=0.937). Local recurrence was 2/74 (stage III; 2.7%) in IV arm and 1/92 (stage II; 1.1%) in oral arm. Systemic recurrence was 7/74 (Stage III; 9.4%) in IV arm and 5/92 (Stage III; 5.4%) in oral arm. Toxicity pro-files are as follows: Leukopenia (30/74, 17/92) and alopecia (21/74, 13/92) were more common in IV arm than in oral arm, and the difference was statistically significant. Diarrhea was more common in oral arm. The quality of life score was better at 1 month (19.5%, 49%) and at 2 months (47%, 72%) in the oral arm group (<0.05). CONCLUSION: Oral Doxifluridine with leucovorin as a postoperative adjuvant therapy shows a therapeutic efficacy comparable to the intravenous 5-FU regimen and has a high quality of life. The oral regimen also can be safely given with an appropriate toxicity and tolerability.
Alopecia ; Arm ; Diarrhea ; Drug Therapy ; Drug-Related Side Effects and Adverse Reactions ; Fluorouracil* ; Humans ; Leucovorin ; Leukopenia ; Prospective Studies* ; Quality of Life ; Rectal Neoplasms* ; Recurrence

OBJECTIVE: Capsaicin, a noxious stimulant and main component of the hot flavor of red peppers, has an analgesic effect when administered to humans. We investigated the expression of proopioimelanocortin (POMC) mRNA in the arcuate nucleus of Sprague-Dawley (SD) rats after administering capsaicin, hypothesizing that administering capsaicin activates the central opioid system. METHODS: SD rats were divided randomly into two groups; one group received a saline injection and the other received a capsaicin injection. The POMC mRNA level in the arcuate nucleus of the hypothalamus was measured by the reverse transcription-polymerase chain reaction at 0, 20, 40, 60, and 120 minutes after capsaicin administration. RESULTS: Capsaicin administration resulted in a significantly increased POMC mRNA level, compared to that in saline-treated rats at the 20-minute time point (t=-4.445, p=0.001). However, no significant group differences were observed at other times (t=-1.886, p=0.089; t= -0.973, p=0.353; t=-2.193, p=0.053 for 40, 60, and 120 minutes, respectively). CONCLUSION: The analgesic effect of capsaicin might be associated with increased activity of the cerebral opioid system. This finding suggests that capsaicin acted for nociception and analgesia and could affect alcohol-intake behavior, which might further imply that a food culture could affect drinking behavior.
Analgesia ; Animals ; Arcuate Nucleus ; beta-Endorphin ; Capsaicin ; Capsicum ; Drinking Behavior ; Humans ; Hypothalamus ; Nociception ; Pro-Opiomelanocortin ; Rats ; Rats, Sprague-Dawley ; RNA, Messenger

OBJECTIVES: The purpose of this study was to develop a program applying participatory action-oriented training (PAOT) methods for the management of cardiovascular disease risk factors and to assess its effectiveness in the workplace. METHODS: The cardiovascular disease risk factors of 817 workers in the workplace were assessed, and periodic health examination was conducted. Sixty-four workers (7.8%) were selected as a moderate-risk group and high risk group, and performed the participatory approach program for cardiovascular disease preventive management. RESULTS: The sixty-four workers who participated in the participatory approach program made a total of 246 action plans, 3.8 action plans per person and 115 action plans were achieved after three months, so that 46.7% of action plans have been achieved. In the intervention group that participated in the program, the rate of smoking decreased from 36.2% to 8.6% and systolic and diastolic blood pressure significantly decreased from 140.0+/-9.4 mmHg to 134.2+/-12.3 mmHg and from 92.6+/-7.1 mmHg to 80.0+/-9.8 mmHg respectfully. In addition, risk factor score also decreased by 0.3, whereas the control group who did not participate in the program also showed a significant reduction in the mean systolic and diastolic blood pressure. Regular exercise increased from 8.5% to 16.0%. CONCLUSIONS: To improve the effectiveness of the participatory approach program for the management of cardiovascular disease risk factors, the need to continues implementing programs and analysis of the long-term effects are required.
Blood Pressure ; Cardiovascular Diseases ; Humans ; Risk Factors ; Smoke ; Smoking

BACKGROUND: This study was conducted to identify the sleep status of daytime workers who do not work in shifts. This study analyzed factors affecting sleep duration and sleep quality. METHODS: This study was conducted on 1171 daytime workers at a manufacturing workshop. We used a self-administered questionnaire to investigate demographic variables, work type, working period, musculoskeletal symptoms and the Pittsburgh Sleep Quality Index to assess sleep. Regular health checkup was conducted for the worker’s clinical examination. RESULTS: The mean sleep duration was 6.36 h and the mean score on the Pittsburgh Sleep Quality Index was 4.46. Work type and obesity were related to sleep duration. Age, obesity and musculoskeletal pain were significantly related to sleep quality. The prevalence ratio of researcher group for short sleep duration was 1.27 (95% confidence interval: 1.02–1.58). The prevalence ratio of those aged 50 years and over was 0.47 (0.25–0.91) and of those in their 40s was 0.56 (0.35–0.91) for poor sleep quality compared to those in their 20s. The prevalence ratio of the obesity group for poor sleep quality was 1.53 (1.10–2.12). The prevalence ratio of musculoskeletal pain group for poor sleep quality was 1.92 (1.29–2.84). CONCLUSIONS: Age, obesity and musculoskeletal pain were factors affecting the poor quality on sleep of daytime workers. In addition, work type related to short sleep duration.
Education ; Musculoskeletal Pain ; Obesity ; Prevalence

Aluminum hydroxide (alum) is the most widely used adjuvant in human vaccines. Nevertheless, it is virtually unknown whether alum acts on B cells. In the present study, we explored the direct effect of alum on Ig expression by murine B cells in vitro. LPS-activated mouse spleen B cells were cultured with alum, and the level of isotype-specific Ig secretion, IgG1 secreting cell numbers, and Ig germ-line transcripts (GLT) were measured using ELISA, ELISPOT, and RT-PCR, respectively. Alum consistently enhanced total IgG1 production, numbers of IgG1 secreting cells, and GLTgamma1 expression. These results demonstrate that alum can directly cause IgG1 isotype switching leading to IgG1 production.
Alum Compounds ; Aluminum Hydroxide ; Animals ; B-Lymphocytes ; Cell Count ; Enzyme-Linked Immunosorbent Assay ; Enzyme-Linked Immunospot Assay ; Humans ; Hydroxides ; Immunoglobulin Class Switching ; Immunoglobulin G ; Mice ; Spleen ; Vaccines

PURPOSE: To evaluate the efficacy of percutaneous cholecystostomy (PC) as a therapeutic maneuver for patientswith spontaneous gallbladder (GB) perforation. MATERIAL AND METHODS: Ten patients with acute cholecystitis andsuspected GB perforation underwent emergency PC; perforation was documented by means of ultrasound, computedtomography, and/or fluoroscopy. All patients but two had a variety of high risk factors for open cholecystectomy:diabetes mellitus (n=2), cardiac disease (n=2), acute renal failure (n=1), liver cirrhosis (n=1), overwhelmingsepsis (n=1), and age over 80 (n=1). All percutaneous cholecystostomies were performed with ultrasound guidanceand preferably via the transhepatic route. A favorable response to PC was defined as an improvement in clinicalsymptoms and signs or reduction in fever, and return of the WBC to normal within 72 hr of the procedure. RESULTS:All procedures were technically successful, and no major procedure-related complications occurred. Eight patients(80%) responded favorably to PC. One, who did not respond, underwent emergency cholecystectomy next day due toworsening peritonitis, and the other who failed to respond within 72 hr showed delayed response after drainage ofa coexistent liver abscess at seven days after the procedure. A patient who responded to PC experienced catheterdislodgement four days after the procedure but reinsertion was not required. Five of eight patients who respondedpositively underwent elective cholecystectomy after the improvement of clinical symptoms, and the three remainingpatients improved without further surgery. CONCLUSION: For the treatment of patients in whom GB perforation issuspected, PC is a safe and effective alternative to surgical cholecystectomy.
Acute Kidney Injury ; Cholecystectomy ; Cholecystitis ; Cholecystitis, Acute ; Cholecystostomy* ; Drainage ; Emergencies ; Fever ; Fluoroscopy ; Gallbladder* ; Heart Diseases ; Humans ; Liver Abscess ; Liver Cirrhosis ; Peritonitis ; Risk Factors ; Ultrasonography

PURPOSE: Thyroid transcription factor-1 (TTF-1) has been known to regulate the transcriptional activity of thyroid-specific genes. Ki-67 has been known as a marker for indicating tumor growth. This study was designed to campare the expressions of TTF-1 and Ki-67 on non- neoplastic and neoplastic thyroid tissues. METHODS: The surgically resected specimens of various histological types of thyroid tumor, from the files of the Dept. of surgery, Chung-Ang University Pil-Dong Hospital, between January 1998 and June 2002 were reviewed, and 55 cases selected for immunohistochemical studies. The materials consisted of tissues from 10 nodular hyperplasias, 28 papillary carcinomas, 15 follicular adenomas and 12 follicular carcinomas. All specimens were routinely processed, and paraffin blocks were available in all cases. Immunohistochemical stains for TTF-1 and Ki-67 were also performed. RESULTS: In all the cases, including the nodular hyperplasias, papillary carcinomas, follicular adenomas and follicular carcinomas, expressions of the TTF-1 were observed. The properties of the TTF-1 expression, including staining intensity, extent and index were not related to the tumor type. The expression of TTF-1 was inversely correlated with the tumor proliferation fraction, as assessed by the Ki-67 staining index. CONCLUSION: TTF-1 was expressed in almost all the benign lesions and well differentiated carcinomas, and correlated with the tumor proliferation fraction.
Adenoma ; Carcinoma, Papillary ; Coloring Agents ; Hyperplasia ; Paraffin ; Thyroid Gland* ; Thyroid Neoplasms*

Twin pregnancies are increasing these days due to recent development of the technology in treating infertility and twin pregnancies tend to cause more congenital anomaly than singleton pregnancies do. Although anencephaly is not uncommon, occurring in about one in every 1,000 births, anencephaly developed in a twin pregnancy is very rare. We experienced a twin pregnancy which consisted of an anencephalic fetus and a normal one. This pregnancy was conceived by IVF and ET. This pregnancy was continued without having special problems and was delivered at 36 weeks of gestation by cesarean section due to SROM (spontaneous rupture of membrane). The anencephalic fetus weighed 1,430 gm and was already dead in the uterus. The other weighed 2,660 gm and showed no external anomaly. Its Apgar score was 8 in 1 minute and 9 in 5 minute. The pregnancy resulted in a cesarean section delivery of one dead anencephalic fetus and one normal healthy fetus. We report with a brief review of literature a case of a twin pregnancy, conceived by IVF and ET, in which anencephaly was associated with a normal fetus.
Anencephaly* ; Apgar Score ; Cesarean Section ; Embryo Transfer* ; Embryonic Structures* ; Female ; Fertilization in Vitro* ; Fetus ; Humans ; Infertility ; Parturition ; Pregnancy ; Pregnancy, Twin* ; Rupture ; Twins* ; Uterus