Iodinated contrast-induced acute renal failure is estimated to occur in 0.15 to 2% of all patients undergoing contrast imaging studies. Incidence is higher in patients with renal insufficiency, diabetes mellitus, dehydration, multiple myeloma, congestive heart failure, advanced age. We here report successful vascular interventional procedure by using gadopentetate dimeglumine(Gd-DTPA) as a contrast agent in a patient with chronic renal insufficiency and right superficial femoral artery stenosis. The patient had a history of iodinated contrast-induced acute renal failure. Gd-DTPA(0.17mmoVkg) diluted 1: 1 with 0.9% norrnal saline was used as contrast agent for the interventional procedure. Percutaneous transluminal angioplasty was successfully performed and there was no evidence of contrast material- induced acute renal failure after the procedure. Gd- DTPA is an alternative contrast agent for patients with chronic renal insufficiency.
Acute Kidney Injury ; Angioplasty* ; Constriction, Pathologic ; Dehydration ; Diabetes Mellitus ; Femoral Artery ; Gadolinium DTPA* ; Heart Failure ; Humans ; Incidence ; Multiple Myeloma ; Pentetic Acid ; Renal Insufficiency ; Renal Insufficiency, Chronic*

PURPOSE: Brain metastasis is estimated to occur in 20~40% of solid tumor patients and the most common primary tumor is lung cancer. Even though the prognosis of brain metastasis is grave and the 1-year survival rate is only 15%, symptom palliations are made with whole brain radiation therapy. We retrospectively evaluated the clinical features and prognostic factors of lung cancer with brain metastasis. MATERIALS AND METHODS: From January 1987 to October 1999, 50 lung cancer patients with brain metastasis underwent whole brain radiation therapy. We reviewed the improvement in neurologic symptoms and survival according to the following parameters; performance status, histological type, presence of brain metastasis at the initial diagnosis of lung cancer, presence of extracranial metastasis, multiplicity of brain lesion, presence of primary lung symptom and treatment modalities. RESULTS: The most frequent symptom with brain metastasis was a headache (50%). Palliation of the headache and other symptoms was achieved in 81% of the patients. Median overall survival after brain metastasis was 21 weeks and the 1 year survival rate was 15%. Patients without extracranial metastasis had a longer median survival than those with, 38 weeks versus 15 weeks, respectively (p=0.01). CONCLUSION: In lung cancer with brain metastasis, neurologic symptoms can be palliated with whole brain radiation therapy, and in this study among such patients, absence of extracranial metastasis can be a good prognostic factor.
Brain* ; Diagnosis ; Headache ; Humans ; Lung Neoplasms* ; Lung* ; Neoplasm Metastasis* ; Neurologic Manifestations ; Prognosis* ; Retrospective Studies ; Survival Rate

PURPOSE: Infantile constipation is one of the most common problems in pediatric gastrointestinal outpatient clinic. We planed to show the clinical feature of infantile constipation and explore the possible relationship between diets and symptoms of constipation. METHODS: We analyzed the medical records and telephone questionnaire about infants under 2 years of age with constipation, who visited outpatient clinic of Department of Pediatrics, Ilsan Paik Hospital during the time from March 2002 to February 2005. Data including the symptoms and signs of constipation, diet history, and past-medical history were analyzed. RESULTS: Total 96 infants, 40 male and 56 female, were enrolled in this study. The mean age was 9 months. Twenty-three infants were exclusively breast milk fed (BMF), 20 infants were cow's milk fed (CMF) and 53 infants had a history of mixed feeding with cow's milk and breast milk (MMF). Patients showed painful defecation (95.8%), abdominal distension (53.1%), palpable rectal stool (35.1%), hard stool (30.2%), blood-tinged stool (29.2%) and anal fissure (16.7%). Patients with exclusive cow milk feeding had prominent clinical features, such as anal fissure (p=0.03), hematochezia (p=0.04) and palpable rectal stool (p=0.025). Patients who had a history of larger intake of liquid food had a tendency to get anal skin tag (p<0.05). CONCLUSION: Exclusive breast milk feeding seemed important to avoid constipation with clinical significance. To educate caregivers in appropriate way of the weaning food may help the infants with constipation.
Ambulatory Care Facilities ; Breast Feeding ; Caregivers ; Constipation* ; Defecation ; Diet ; Female ; Fissure in Ano ; Gastrointestinal Hemorrhage ; Humans ; Infant ; Male ; Medical Records ; Milk ; Milk, Human ; Pediatrics ; Surveys and Questionnaires ; Skin ; Telephone ; Weaning

OBJECTIVE: To compare the long-term effect and safety of an epidural steroid injection in spinal stenosis patients, with or without local anesthetics. METHODS: Twenty-nine patients diagnosed with spinal stenosis were included and randomly divided into two groups. Translaminar epidural and selective nerve root spinal injection procedures were performed using steroids mixed with local anesthetics or normal saline. The effects of spinal injection procedures were measured with visual analogue scale (VAS) and functional rate index (FRI). These measurements were performed before injection, at 1 month after injection and at 3 months after injection. The occurrence of side effects was investigated each time. RESULTS: The VAS and FRI scores were significantly reduced in both the local anesthetics group and normal saline group at 1 and 3 months after the injection. However, there was no significant difference in VAS and FRI score reduction between the two groups each time. Side effects are not noted in both groups. CONCLUSION: The spinal injection procedures using steroids mixed either with local anesthetics or normal saline have an effect in reducing pain and improving functional activities. However, there was no significant difference between the two groups in relation to side effects and the long-term effects of pain and function.
Anesthetics ; Anesthetics, Local* ; Humans ; Injections, Epidural ; Injections, Spinal ; Spinal Stenosis* ; Steroids

OBJECTIVES: The serum total cholesterol is supposed to be increased as dietary pattern is westernized recently in our country. We studied the longitudinal change of serum total cholesterol levels in normal adult Korean male workers and analyzed the influence of lifestyle on change of serum total cholesterol levels. METHODS: The 7677 healthy adult male workers were studied during recent 5years(1992 and 1997). Those who suffered from hypertension, diabetes mellitus, ischemic heart disease, nephritis were excluded. Those who ingested antilipidemic drugs were also excluded. Serum total cholesterol were measured by the same enzymatic method and their levels were analyzed during fasting state. Data on lifestyle were obtained using self administered questionnaires. RESULTS: 1) The serum total cholesterol levels increased by 9.45+/-23.99mg/dl(1.89mg/dl per year) between 1992 and 1997 surveys. 2) The increment of serum total cholesterol levels was most prominent in the twenties (3.45mg/dl per year) and less prominent in 5th, 6th decades. 3) A change of 1kg/m2 in body mass index contributed a change of 3.449mg/dl in serum total cholesterol. 4) The change of body mass index(BMI) was most significantly correlated with that of serum total cholesterol levels among the influencing variables.( =3.449 p=0.0001 r2=0.035) 5) The changed value of serum total cholesterol levels was significantly correlated with smoking and exercise, however, was not significantly correlated with the amount of alcohol ingestion. CONCLUSION: The serum total cholesterol levels increased by 9.45mg/dl(1.89mg/dl per year) during recent 5 years. The increment of serum total cholesterol levels was more prominent in younger age group. The changed value of BMI was most strongly correlated with that of serum total cholesterol levels of all influencing variables.
Adult* ; Body Mass Index ; Cholesterol* ; Diabetes Mellitus ; Eating ; Fasting ; Follow-Up Studies* ; Gyeongsangbuk-do* ; Humans ; Hypertension ; Life Style ; Longitudinal Studies ; Male* ; Myocardial Ischemia ; Nephritis ; Smoke ; Smoking ; Surveys and Questionnaires

The hematologic manifestations of human immunodeficiency virus (HIV) infection and acquired immune deficiency syndrome (AIDS) are common and may cause symptoms that are life threatening and impair the quality of life in these patients1). The most important of these manifestations is cytopenia. Among cytopenias, thrombocytopenia is caused by immune-mediated destruction of platelets, in addition to inadequate platelet production2). Thrombocytopenia has been reported in 5~15% of HIV-seropositive patients3). Profound thrombocytopenia (< 20,000/mm3) is rare (occurs in only 1.5% of cases) and presents only during advanced AIDS. With the exception of thrombocytopenia associated with advanced AIDS, severe thrombocytopenia in AIDS patients is extremely rare3). There are only a few reports of AIDS patients who first presented with severe thrombocytopenia. Here we report the case study of an AIDS patient who first presented with severe thrombocytopenia, mild abdominal distension, and edema in both lower legs. A brief review of the relevant literature is also presented.
Acquired Immunodeficiency Syndrome ; Blood Platelets ; Edema ; HIV ; Humans ; Leg ; Quality of Life ; Thrombocytopenia

The hematologic manifestations of human immunodeficiency virus (HIV) infection and acquired immune deficiency syndrome (AIDS) are common and may cause symptoms that are life threatening and impair the quality of life in these patients1). The most important of these manifestations is cytopenia. Among cytopenias, thrombocytopenia is caused by immune-mediated destruction of platelets, in addition to inadequate platelet production2). Thrombocytopenia has been reported in 5~15% of HIV-seropositive patients3). Profound thrombocytopenia (< 20,000/mm3) is rare (occurs in only 1.5% of cases) and presents only during advanced AIDS. With the exception of thrombocytopenia associated with advanced AIDS, severe thrombocytopenia in AIDS patients is extremely rare3). There are only a few reports of AIDS patients who first presented with severe thrombocytopenia. Here we report the case study of an AIDS patient who first presented with severe thrombocytopenia, mild abdominal distension, and edema in both lower legs. A brief review of the relevant literature is also presented.
Acquired Immunodeficiency Syndrome ; Blood Platelets ; Edema ; HIV ; Humans ; Leg ; Quality of Life ; Thrombocytopenia

Bazedoxifene, used as bazedoxifene acetate, is a selective estrogen receptor modulator that selectively affects the uterus, breast tissue, bone metabolism, and lipid metabolism by antagonizing or enhancing estrogens in the estrogen receptor in the tissue. This study was conducted as an open, randomized, two-period, two-treatment, crossover design to compare the pharmacokinetic (PK) characteristics and tolerability of two bazedoxifene tablets when administered to 50 healthy Korean male volunteers. Enrolled subjects were randomly allocated to 2 sequences of a single oral administration of a test drug and a reference drug, or vice versa with a 14-day washout period between the two doses. Serial blood samples were collected over 96 h for PK analysis. Plasma concentration of bazedoxifene was assayed using liquid chromatography-tandem spectrometry mass. Forty-five participants completed the study with no clinically relevant safety issues. The peak concentrations (Cmax, mean ± strandard deviation) of reference drug and test drug were 3.191 ± 1.080 and 3.231 ± 1.346 ng/mL, respectively, and the areas under the plasma concentration‐time curve from 0 to the last measurable concentration (AUClast) were 44.697 ± 21.168 ng∙h/mL and 45.902 ± 23.130 ng∙h/mL, respectively. The geometric mean ratios of test drug to reference drug and their 90% confidence intervals for Cmax and AUClast were 0.9913 (0.8828–1.1132) and 1.0106 (0.9345–1.0929), respectively. The incidence of adverse events between the two formulations was similar. The present study showed that PK and tolerability of two bazedoxifene tablet formulations were comparable when administered to healthy Korean male volunteers.

Diphenylhydantoin (DPH) is one of the most widely used anticonvulsants for treatment and prevention of seizures. However it is frequently associated with drug-induced leukopenia. Hypersensitivity reactions to phenytoin are well recognized and can be severe. Phenytoin is associated with serious hematologic side effects such as agranulocytosis, thrombocytopenia, red cell aplasia and hemolytic anemia, either through humoral or cell-mediated immunemechanism. We describe a 57-year-old male patient who developed a severe granulocytopenia while taking phenytoin for 66 days in the total amount of 21.6 gram. Bone marrow examination showed isolated depletion of myeloid elements. After 10 days of phenytoin withdrawal and G-CSF treatment, the patient recovered from granulocytic suppression. Using in vitro culture, marrow suppression associated with phenytoin therapy was felt to be non-immune mediated marrow suppression.
Agranulocytosis ; Anemia, Hemolytic ; Anticonvulsants ; Bone Marrow Examination ; Bone Marrow* ; Granulocyte Colony-Stimulating Factor ; Humans ; Hypersensitivity ; Leukopenia ; Male ; Middle Aged ; Phenytoin* ; Seizures ; Thrombocytopenia

PURPOSE: The HER2 gene encodes a 185-kd transmembrane glycoprotein receptor (p185(HER2)) that has partial homology with the epidermal growth factor receptor (EGFR) and shares intrinsic tyrosine kinase activity. The HER2 gene has been found to be amplified in various human cancers and to be associated with poor prognosis. The authors investigated the correlation between clinicopathologic factors and the overexpression of the p185(HER2) in Korean gastric adenocarcinoma patients, and determined whether the antiproliferative effects of anti- p185(HER2) antibody can also be observed on gastric cancer cell lines that overexpress this growth factor receptor. MATERIALS AND METHODS: We evaluated the relationship between p185(HER2) overexpression and clinicopathological features in 94 (M: F=52: 42) gastric adenocarcinoma patients (median age 59 years). Protein expression was analysed by immunohistochemical staining in paraffin embedded tissues with monoclonal antibody for p185(HER2). To explore the role of humanized anti-p185(HER2) monoclonal antibody trastuzumab (Herceptin ) in vitro, the growth curve of Korean gastric cancer cells that overexpress the p185(HER2) protein was studied and a cell cycle analysis was performed. RESULTS: p185(HER2) overexpression correlates positively with lymph node metastasis (p=0.002), distant metastasis (p=0.01), AJCC classification (p=0.01), higher relapse rate p=0.001), and a tendential association with the pT stage (p=0.054). p185(HER2) overexpression was found to be more frequent in advanced gastric cancer than early gastric cancer (54.1% vs 24.2%, p=0.008). Patients with overexpression of p185(HER2) were found to have significantly lower relapse-free (p=0.003) and overall survival (p= 0.0004) than patients without overexpression. Among several Korean gastric cancer cell lines, SNU-1, SNU-5, and SNU-620 overexpress p185(HER2). Trastuzumab inhibited the proliferation of p185(HER2) overexpressed Korean gastric cancer cell line by 21% with down-regulation of p185(HER2) protein expression. DNA fluorescence flow cytometry of propidium iodide-stained nuclei showed a reduction in the fraction of the S phase following treatment with trastuzumab. CONCLUSIONS: Taken together, our observations suggest the potential prognostic significance of p185(HER2) overexpression in Korean gastric adenocarcinoma patients and point to the need for further research on this mechanism. This suggests the possible use of p185(HER2) as a therapeutic target in gastric cancer.
Adenocarcinoma ; Cell Cycle ; Cell Line* ; Classification ; DNA ; Down-Regulation ; Flow Cytometry ; Fluorescence ; Genes, erbB-2 ; Glycoproteins ; Humans ; Lymph Nodes ; Neoplasm Metastasis ; Paraffin ; Prognosis ; Propidium ; Protein-Tyrosine Kinases ; Receptor, Epidermal Growth Factor ; Recurrence ; S Phase ; Stomach Neoplasms ; Trastuzumab