No abstract available.
Animals ; Embryonic Structures* ; Freezing* ; Mice* ; Sucrose*

PURPOSE: To quantify the cardiac dose reduction during breathing adapted radiotherapy using Real-time Position Management (RPM) system in the treatment of left-sided breast cancer. MATERIALS AND METHODS: Twenty-two patients with left-sided breast cancer underwent CT scans during breathing maneuvers including free breathing (FB), deep inspiration breath-hold (DIBH), and end inspiration breath-hold (EIBH). The RPM system was used to monitor respiratory motion, and the in-house self respiration monitoring (SRM) system was used for visual feedback. For each scan, treatment plans were generated and dosimetric parameters from DIBH and EIBH plans were compared to those of FB plans. RESULTS: All patients completed CT scans with different breathing maneuvers. When compared with FB plans, DIBH plans demonstrated significant reductions in irradiated heart volume and the heart V25, with the relative reduction of 71% and 70%, respectively (p < 0.001). EIBH plans also resulted in significantly smaller irradiated heart volume and lower heart V25 than FB plans, with the relative reduction of 39% and 37%, respectively (p = 0.002). Despite of significant expansion of lung volume using inspiration breath-hold, there were no significant differences in left lung V25 among the three plans. CONCLUSION: In comparison with FB, both DIBH and EIBH plans demonstrated a significant reduction of radiation dose to the heart. In the training course, SRM system was useful and effective in terms of positional reproducibility and patient compliance.
Breast Neoplasms* ; Cardiac Volume ; Feedback, Sensory ; Heart ; Humans ; Lung ; Patient Compliance ; Radiotherapy* ; Respiration* ; Tomography, X-Ray Computed

No abstract available.
Colposcopy*

OBJECTIVES: The pathophysiology of restless legs syndrome (RLS) is not obvious, but many promising theories involve dopaminergic deficiency and genetic causes. The RLS is presumed to occur more frequently among schizophrenic patients who take antipsychotics, most of which blocks the dopamine receptors. This study aimed to investigate whether dopamine transporter gene (DAT1) 40 base pair (bp) variable number of tandem repeat (VNTR) polymorphism is associated with the antipsychotic-induced RLS in schizophrenia. METHODS: We determined the diagnosis of RLS among the 190 Korean schizophrenic patients by the diagnostic criteria of the International Restless Legs Syndrome Study Group (IRLSSG). Genotyping was performed for the 40bp VNTR in DAT1 gene using polymerase chain reaction. RESULTS: We separated the schizophrenic patients into 44 patients with RLS and 146 patients without RLS. The genotype and allele frequencies did not differ significantly between two groups. CONCLUSIONS: These results suggest that DAT1 gene 40bp VNTR is not associated with the antipsychotic-induced RLS in schizophrenia. To confirm these results, larger-scale association study is needed in the future.
Antipsychotic Agents ; Base Pairing ; Dopamine ; Dopamine Plasma Membrane Transport Proteins ; Gene Frequency ; Genotype ; Humans ; Receptors, Dopamine ; Restless Legs Syndrome ; Schizophrenia ; Tandem Repeat Sequences

No abstract available.
Female ; Pregnancy ; Pregnancy, Ectopic*

OBJECTIVE: Diurnal preference is an attribute reflecting whether people are alert and preferring to be active either early or late in the day. It also referred to as chronotype or morningness-eveningness trait. The PER3 genes have been known to influence diurnal preference. In this study, we have investigated the associations between the PER3 gene polymorphisms and diurnal preference in a healthy young population, controlling for the social and environmental confounding factors. METHODS: The participants in this experiment included 299 unrelated medical college students (M=191, F=108), with a mean age of 22.9 years. Diurnal preference was measured by a single administration of the 13-item Composite Scale for Morningness (CSM). Genotyping of the PER3 VNTR (rs57875989) was performed using polymerase chain reaction. A two-tailed alpha of 0.05 was chosen. RESULTS: The mean+/-SD score on the CSM scale for all subjects was 31.90+/-6.39. There was no significant difference in total CSM score between gender groups, although females showed a trend towards higher morningness score. Although PER3 5R/5R showed the tendency towards high CSM scores, there were no significant differences on CSM scores among genotypes and allele status of PER3 VNTR (rs57875989). CONCLUSIONS: We could not confirm that the PER3 VNTR is associated with diurnal preference in a Korean healthy young population. The future studies need to investigate the association between diurnal preference and other polymorphisms of PER3 gene in larger sample of Korean young healthy population.
Alleles ; Female ; Genotype ; Humans ; Polymerase Chain Reaction

Objective: The ossification of the ligamentum flavum (OLF) is one of the major causes of thoracic myelopathy. Surgical decompression with or without instrumented fusion is the mainstay of treatment. However, few studies have reported on the added effect of instrumented fusion. The objective of this study was to compare clinical and radiological outcomes between surgical decompression without instrumented fusion (D-group) and that with instrumented fusion (F-group). Methods: A retrospective review was performed on 28 patients (D-group, n=17; F-group, n=11) with thoracic myelopathy due to OLF. The clinical parameters compared included scores of the Japanese Orthopedic Association (JOA), the Visual analogue scale of the back and leg (VAS-B and VAS-L), and the Korean version of the Oswestry disability index (K-ODI). Radiological parameters included the sagittal vertical axis (SVA), the pelvic tilt (PT), the sacral slope (SS), the thoracic kyphosis angle (TKA), the segmental kyphosis angle (SKA) at the operated level, and the lumbar lordosis angle (LLA; a negative value implying lordosis). These parameters were measured preoperatively, 1 year postoperatively, and 2 years postoperatively, and were compared with a linear mixed model. Results: After surgery, all clinical parameters were significantly improved in both groups, while VAS-L was more improved in the Fgroup than in the D-group (-3.4±2.5 vs. -1.3±2.2, p=0.008). Radiological outcomes were significantly different in terms of changes in TKA, SKA, and LLA. Changes in TKA, SKA, and LLA were 2.3°±4.7°, -0.1°±1.4°, and -1.3°±5.6° in the F-group, which were significantly lower than 6.8°±6.1°, 3.0°±2.8°, and 2.2°±5.3° in the D-group, respectively (p=0.013, p<0.0001, and p=0.037). Symptomatic recurrence of OLF occurred in one patient of the D-group at postoperative 24 months. Conclusion Clinical improvement was achieved after decompression surgery for OLF regardless of whether instrumented fusion was added. However, adding instrumented fusion resulted in better outcomes in terms of lessening the progression of local and regional kyphosis and improving leg pain. Decompression with instrumented fusion may be a better surgical option for thoracic OLF.

BACKGROUND: The present it is getting to be on aged society there is increasing that hospital has higher rate for place of death than home. Because we can expect that many patients who are faced with death come to hospital or hospice in the future, we have studied preferred place of death with an old women in seoul to have essential material of plan to understand asking for medical service of death, to divide medical manpowers and equipments and to supplement and to revise of medical educations. METHODS: Through the internet, 71 schools for the elderly. Of 277 an old woman who attending the schools out of 7 schools. We research into preferred place of death by self answering way through the June to July in 2000. RESULTS: The average age was 72.4 years. Of 277 respondents, 87 respondents(32.46%) reply their homes as a place of death and 166(61.94%) reply hospital, 15(5.6%) reply hospice, missing is 9. Statistical significance has connections with only level of education. The highest reason(47.5%) why respondents choose the hospital or hospice is only to reduce their children's burdens. Unlike respondents that education attending period is below 6 year, the relative risk of choosing the hospital or hospice between respondents who are 6 9year and above 9 year is each of 3.66, 5.58. CONCLUSION: This research shows that an elderly women in seoul prefer hospitals or hospice to homes as their place of death.
Aged* ; Surveys and Questionnaires ; Education ; Female ; Hospices ; Humans ; Internet ; Seoul*

Anticoagulant(heparin, warfarin) or thrombolytic agent(urokinase, tissue plasminogen activator) can be one of the causes of spontaneous ICH. Even though ICH related with anticoagulants and thrombolytic agents represent low incidence and slow progression, the final outcome usually very poor. Recently the use of anticoagulants and thrombolytic agents have been increased for recanalization of cerebral and myocardial infarction. Therefore, the importance of possible ICHs related to these agents need to be reemphesized. The authors analysed 18 patients of ICH related with anticoagulants and thrombolytic agents to evaluate the underlying mechanism, their characters, the factors which influence the formation of ICH and the prognosis. Eighteen cases of ICH related with anticoagulants and thrombolytic agents were analysed through the medical record, operation record and brain CT. In this study, patients in sixth decade showed the highest incidence. The most common primary disease was middle cerebral infarction(67%). Urokinase was most commonly infused for recanalization of cerebral and myocardial infarction. The mean duration between drug administration and hemorrhagic attack was 59 hours(with range from 1 hour to 96 hours). After onset of the hemorrhage, fourteen of eighteen cases revealed prolonged prothrombin time more than 1 1/2 to 2 times of control and nine of fourteen cases revealed prolonged thrombin time more than 1 1/2 to 2 times of cotrol. The mean volume of ICH was 31cc and locations of hemorrhage were lobar(45%), ganglionic(22%), thalamic(22%) and cerebellar(11%) in decreasing orders. Brain CT scans revealed that 12 cases were single hematoma and 6 cases were multiple hematoma. Twelve cases were treated conservatively and six cases were operated with stereotactic surgery(3 cases) and open craniotomy (3 cases). One case with stereotactic surgery and the other case with craniotomy were reoperated because of rebleeding and retained hematoma, respectively. The neurological condition before administration of anticoagulants and thromb-olytic agents was relatively good, but suddenly deteriorated after hemorrhage attack. Almost all cases(94%) prese-nted poor porgnosis as wholly dependent, vegetative and dead at discharge except one case of small cerebellar ICH. In this study, previously existed infarction and anticoagulants itself contributed to the occurrence of intracerebral hemorrhage. The prolonged prothrombin time may be useful predictable value in the formation of ICH. Although we could not find definitive factors to influence the prognosis, the mortality rate of multiple hematoma was much higher than single hematoma. The final outcome of these patients were very poor. Therefore, the choice of agents, dosage and duration of administration should be considered more judicious.
Anticoagulants* ; Brain ; Cerebral Hemorrhage* ; Craniotomy ; Fibrinolytic Agents* ; Hematoma ; Hemorrhage ; Humans ; Incidence ; Infarction ; Medical Records ; Mortality ; Myocardial Infarction ; Plasminogen ; Prognosis ; Prothrombin Time ; Thrombin Time ; Tomography, X-Ray Computed ; Urokinase-Type Plasminogen Activator

BACKGROUND: A prospective study about the association between serum ferritin concentration and diabetes mellitus showed that higher risk of diabetes was found in men in higher concentration of serum ferritin. The aims of this study is to examine the association between serum ferritin concentration and the risk of diabetes mellitus in healthy Korean in hospital-based samples. METHODS: In a volunterred healthy population(n=14,782), who underwent health examination in Samsung Medical Center, from January to December 1997, serum ferritin and glucose were determined. RESULTS: After adjusting for age, BMI, serum triglyceride concentration, and multiple logistic regression analysis showed that those in the highest quartile had increased risk of diabetes mellitus (OR: men 2.26(95% CI 2.41-2.95, p=0.0001), women 3.03(95% CI 2.51-3.67, p=0.0001), compared with those in the lowest quartile. CONCLUSION: In studied population, elevated serum ferrtin concentration was associated with an increaed risk of diabetes.
Diabetes Mellitus ; Female ; Ferritins ; Glucose ; Humans ; Logistic Models ; Male ; Prospective Studies ; Risk Factors ; Triglycerides