PURPOSE: Inidence of recurrent common duct stones reported approximately 20% for a second operation, and with even higher rate following subsequent reoperation. However, the factors contributing to recurrent stones have not well defined. Some authors have reported on association of juxtapapillary diverticula with recurrent biliary stones. We have studied to assess the clinical significance of coexisting PAD on recurrent common bile duct stones and to establish the rational operative procedure in primary or recurrent common duct stones with coexisting PAD. METHODS: Medical records of 456 consecutive patients (Feb. 1993~Aug. 2002) who performed ERCP for biliary symptoms were reviewed. We comparative study retrospectively have done between patients with and without PAD on recurrence of common duct stones and outcome of treatment. RESULTS: Incidence of PAD was 15.1% on ERCP, and increased in the old aged patients. Incidence of biliary stone in PAD group was higher than that of non-PAD group (73.9% vs. 50.6%), and gall stone involving common duct was more prevalent in PAD group than non-PAD group. PAD group showed higher stone recurrence rate (23.5% vs. 6.1%) and earlier recurrence following conventional treatment, and needs more multiple treatments, compared with non-PAD group. Intradiverticular papillae (IDP) type showed higher stone recurrence, compared with juxtapapillary diverticula (JPD) type (36.8% vs. 15.6%). CONCLUSION: PAD would be one of important contributing factors for development and recurrence of common bile ductstones. So rational operative procedure for primary or recurrent common duct stones with coexisting PAD should include extirpation of PAD, particulary in IDP type.
Bile ; Cholangiopancreatography, Endoscopic Retrograde ; Common Bile Duct* ; Diverticulum* ; Gallstones ; Humans ; Incidence ; Medical Records ; Recurrence ; Reoperation ; Retrospective Studies ; Surgical Procedures, Operative

BACKGROUND: Recently-developed equipment based on bioelectrical impedance analysis (BIA) not only measures total body fat but also displays several estimated indicators that reflect intra-abdominal fat, such as waist circumference (WC) and waist-to-hip ratio (WHR). This study examined the usefulness of these indicators in the diagnosis of metabolic syndrome (MS). METHODS: A total of 632 people over 20 years of age (355 men and 277 women, mean age 48.61+/-11.08 years, mean BMI 23.62+/-3.00 kg/m2, 117 MS patients) were enrolled in the study. Measurements of WC and hip circumference were measured by one individual, and WHR was calculated. BIA was performed to estimate waist circumference (BIAWC) and waist-to-hip ratio (BIAWHR). Receiver operating characteristic (ROC) curve analysis was used to examine the usefulness of BIAWC and BIAWHR in diagnosing MS. RESULTS: The areas under the curve (AUCs) were 0.836 (95% CI 0.805-0.864) for WC, 0.814 (95% CI 0.782-0.844) for BIAWC, 0.815 (95% CI 0.782-0.844) for WHR, and 0.805 (95% CI 0.772-0.835) for BIAWHR. The difference between the AUCs of WC and BIAWC (0.022, 95% CI -0.004 to 0.048) and the difference between the AUCs of WHR and BIAWHR (0.010, 95% CI -0.015 to 0.034) were not significant. CONCLUSIONS: The indices for central obesity estimated by BIA had high agreement with the direct method, and they were not inferior to direct measured indices for predicting metabolic syndrome.
Adipose Tissue ; Area Under Curve ; Electric Impedance ; Female ; Hip ; Humans ; Intra-Abdominal Fat ; Male ; Obesity, Abdominal ; ROC Curve ; Waist Circumference ; Waist-Hip Ratio

BACKGROUND: The various manifestations of intrinsic cutaneous aging may reflect the age-related changes of dermal ground aubstances, the important components of the dermis. OBJECTIVE: This study was undertaken to observe whether there is any age-relsted change, quantitatively and qualitatively, in dermal glycosaminoglycan(GAG) METHODS: The Senescence-A.ccelerated-Mice(SAM) strain "Prone" to develop senescence(P/8), aged 4 days(P-Y a group, n=5) and 4 months old (P-0 group, n=5) were used, with SAM strain Resistance to senescence (R/1), aged 4 montha old (R-0 group, n=5). The whole skin of SAM was incubated in 0.1 sodium phosphate buffer(NaPB), 2M guanidine-HC1, and 4M guanidine-HCl, sequencially, for the extractiop of GAG. The amount of GAG was measured by using alcian blue and by methylene blue metachrometic assay. Uronic acid(UA) was estimate l employing carbazole reaction. Extracted skin protein profiles were analyed by SDS-PAGE. RESULTS: 1. The total contents of GAG per wet weight of skin, as measured uairq, alcian blue, was highter in R-0 group than R-Y and P-Y group, which is statistically significant. 2. The methylene blue metaehromatic assay yielded highter absorbance values in 2M guanidine-HCl extract than NaPB ext:racts. 3. The total contents of UA decreased with aging in R strains, buttriking increase was noted in the P strain. 4. On SDS-PAGE, the protein profiles of NaPB extracts showed similarity to serum protein. 125 kDa protein band was noted only in guanidine-HCl extracts. 37.40kDa protein bands were appeared in 2M, 4M guanicline-HCl extract of R-0 group. But. there was no significant difference in both strains. CONCLUSION: These findings suggest that macromolecules, such as GAG, is one of the target molecules of the cutaneous eging process, and these change muy be related to the age-related changes of dermal water content.
Aging* ; Alcian Blue ; Animals ; Dermis ; Electrophoresis, Polyacrylamide Gel ; Epidermolysis Bullosa Acquisita ; Humans ; Infant ; Methylene Blue ; Mice* ; Pemphigoid, Bullous ; Skin* ; Sodium

BACKGROUND: The various manifestations of intrinsic cutaneous aging may reflect the age-related changes of dermal ground aubstances, the important components of the dermis. OBJECTIVE: This study was undertaken to observe whether there is any age-relsted change, quantitatively and qualitatively, in dermal glycosaminoglycan(GAG) METHODS: The Senescence-A.ccelerated-Mice(SAM) strain "Prone" to develop senescence(P/8), aged 4 days(P-Y a group, n=5) and 4 months old (P-0 group, n=5) were used, with SAM strain Resistance to senescence (R/1), aged 4 montha old (R-0 group, n=5). The whole skin of SAM was incubated in 0.1 sodium phosphate buffer(NaPB), 2M guanidine-HC1, and 4M guanidine-HCl, sequencially, for the extractiop of GAG. The amount of GAG was measured by using alcian blue and by methylene blue metachrometic assay. Uronic acid(UA) was estimate l employing carbazole reaction. Extracted skin protein profiles were analyed by SDS-PAGE. RESULTS: 1. The total contents of GAG per wet weight of skin, as measured uairq, alcian blue, was highter in R-0 group than R-Y and P-Y group, which is statistically significant. 2. The methylene blue metaehromatic assay yielded highter absorbance values in 2M guanidine-HCl extract than NaPB ext:racts. 3. The total contents of UA decreased with aging in R strains, buttriking increase was noted in the P strain. 4. On SDS-PAGE, the protein profiles of NaPB extracts showed similarity to serum protein. 125 kDa protein band was noted only in guanidine-HCl extracts. 37.40kDa protein bands were appeared in 2M, 4M guanicline-HCl extract of R-0 group. But. there was no significant difference in both strains. CONCLUSION: These findings suggest that macromolecules, such as GAG, is one of the target molecules of the cutaneous eging process, and these change muy be related to the age-related changes of dermal water content.
Aging* ; Alcian Blue ; Animals ; Dermis ; Electrophoresis, Polyacrylamide Gel ; Epidermolysis Bullosa Acquisita ; Humans ; Infant ; Methylene Blue ; Mice* ; Pemphigoid, Bullous ; Skin* ; Sodium

A prospective study was carried out to evaluate the validity of TROPT troponin T rapid assay in early diagnosis of acute myocardial infarction(AMI) in patients with ischemic chest pain, in comparison with conventional diagnostic tools such as serum troponin T(c-TnT) level, creatine Kinase(CK), CK-MB level and initial EKG finding. The study was performed at the emergency department(ED) of Yong Dong Severance hospital from March 1st 1996 to February 28th 1997. One hundred eighty one patients visiting ED with chief complaint of atraumatic chest pain within 24 hours of visit were eligible for the study. Those who lacked enough data collection and those who had chest paint of noncardiac origin and EKG of PSVT were excluded from the study. The overall study population was a total of 131 patients. Initial EKG, TROPT rapid assay, CK, CK-MB and c-TnT level were obtained simultaneously. Diagnosis of AMI was made according to the international diagnostic criteria for AMI. Of the 131 patients 61 patients(46.6%) were diagnosed as AMI. Within 4 hours of their symptom onset, initial EKG showed the highest sensitivity(63.2%) whereas the sensitivities of TROPT rapid assay, c-TnT, CK and CK-MB were poor(0-0.7%). From 4-8 hours, the sensitivities of c-TnT, CK and CK-MB were higher than that of TROPT rapid assay(80% vs. 30%). The sensitivites of TROPT rapid assay, c-TnT, CK and CK-MB rose over time and reached 100% after 8 hours symptom onset. The specificities of the TROPT rapid assay, c-TnT, CK & CK-MB and EKG were all 100% within 8 hours after symptom onset. Discrepancy between TROPT rapid assay and c-TnT was noted in nine patients(6.9%). In this study TROPT rapid assay was valuable in the diagnosis of AMI after 8 hours of symptom onset.
Chest Pain* ; Creatine ; Data Collection ; Diagnosis ; Early Diagnosis ; Electrocardiography ; Emergencies ; Humans ; Paint ; Prospective Studies ; Thorax* ; Troponin ; Troponin T

No abstract available.
Helicobacter pylori* ; Helicobacter* ; Urease*

Microsurgical clipping is a standard treatment modality of cerebral aneurysms. Despite the far advances in surgical technique and craft, aneurysm surgery is still challenge to neurosurgeons. It carries considerable risk of mortality and morbidity to the patient unless the surgeon keeps the basic principles and tactics for accurate placement of aneurysm clip. To attain the goal of complete isolation of aneurysm from the cerebral circulation with concurrent saving parent artery and critical perforators, safe exposure of aneurysm, proper clip selection and accurate placement of the clip should be necessary. From exposure of target aneurysm to the final clip application, the authors will describe notable considerations for the successful clipping of aneurysm based on their own experience and review of literature.
Aneurysm ; Arteries ; Humans ; Intracranial Aneurysm* ; Mortality ; Parents

Voice changes developing after endotracheal intubation during right hemicolectomy with endotracheal intubation have been found to be due to a right recurrent laryngeal nerve palsy in 43-years-old male patient. It was likely that the inflated cuffed tube rode up to the level of the cricoid cartilage during the course of surgery as traction was placed on the endotracheal tube because the condenser humidifier and breathing circuit weighed heavy. Cuff overexpansion, in addition to muscle relaxation and decreased tracheal elasticity were considered as contributing factors of vocal cord palsy. We believe that tube traction and cuff overexpansion were the mechanism of vocal cord palsy in our patient. So we recommend the routine use of tube stand so that weigh of the breathing circuit does not transmit traction to the endotracheal tube. Concurrently, filling the cuff with a sample of the inspired mixture of gases, saline and 4% lidocaine in special cases or regular deflation of the cuff must be considered.
Cricoid Cartilage ; Elasticity ; Gases ; Humans ; Intubation, Intratracheal* ; Lidocaine ; Male ; Muscle Relaxation ; Respiration ; Traction ; Vocal Cord Paralysis* ; Vocal Cords* ; Voice

Authors concluded an experimental study in order to find out what the effects of parathyroid hormone on cells derived from human Trabecular bone in vitro are on terms of proliferation of cells, adenylate cyclase activity and production of small substances such as osteocalcin and collagen type I. The results were as follows; 1. 3H-thymidine incorporation into cultured osteoblast was initially low (day 1–2), increased by exponential curve from day 3 till day 11. The uptakes of 3H-thymidine by osteoblasts, when bovine parathyroid hormone was added, increased dose-dependently. Greater increments were seen at concentrations of bovine PTH higher than 5.0 X10-8 mole. 2. Intracellular c-AMP accumulation was stimulated by bovine PTH in a dose-dependent manner and greater production was seen at concentrations of bovine PHT higher than 5.0 X10-8 mole. Maximal stimulation was observed at 1 X10-7 mole of bovine PTH. The concentrations of c-AMP were observed significantly higher in the presence of bovine PTH in a dose-dependent manner when compared to those of bovine PTH-absent culture condition. 3. Treatment with bovine parathyroid hormone of cultured osteoblasts resulted in increase of alkaline phophatase activity and synthesis of osteocalcin in the cultured media in a dose-dependent manner. Greater productions were observed at concentrations of bovine PTH higher than 5.0 X10-8 mole. 4. Synthesis of type I collagen by cultured osteoblasts in bovine PTH-added media was inversely proportional to their concentration, whereas control group showed minimal increments of no significance. These in vitro findings may suggest that PTH has a stimulatory effect on proliferation of osteoblast, c-AMP production and alkaline phosphatase activity in a direct manner.
Adenylyl Cyclases ; Alkaline Phosphatase ; Cell Proliferation ; Collagen Type I ; Humans ; In Vitro Techniques ; Osteoblasts ; Osteocalcin ; Parathyroid Hormone

PURPOSE: In order to obtain basic data for treatment plan in radiosurgery, we measured small fields of 6 MV X-rays and compared the measured data with our Monte Carlo simulations for the small fields. MATERIALS AND METHODS: The small fields of 1.0, 2.0 and 3.0 cm in diameter were used in this study. Percentage depth dose (PDD) and beam profiles of those fields were measured and calculated. A small semiconductor detector, water phantoms, and a remote control system were used for the measurement. Monte Carlo simulations were performed using the EGS4 code with the input data prepared for the energy distribution of 6 MV X-rays, beam divergence, circular fields and the geometry of the water phantoms. RESULTS: In the case of PDD values, the calculated values were lower than the measured values for all fields and depths, with the differences being 0.3 to 5.7% at the depths of 2.0 to 20.0 cm and 0.0 to 8.9% at the surface regions. As a result of the analysis of beam profiles for all field sizes at a depth of 10cm in water phantom, the measured 90% dose widths were in good agreement with the calculated values, however, the calculated penumbra radii were 0.1 cm shorter than measured values. CONCLUSION: The measured PDDs and beam profiles agreement with the Monte Carlo calculations approximately. However, it is different when it comes to calculations in the area of phantom surface and penumbra because the Monte Carlo calculations were performed under the simplified geometries. Therefore, we have to study how to include the actual geometries and more precise data for the field area in Monte Carlo calculations. The Monte Carlo calculations will be used as a useful tool for the very complicated conditions in measurement and verification.
Radiosurgery ; Semiconductors ; Water