Colorecal cancer undergo relatively long preneoplastic processes before being invasive. Fecal occult blood test (FOBT) has been a useful tool to detect the advanced colorectal cancers with cost-effectiveness. However, the patient’s compliance to FOBT was poor because of low sensitivity and annual sampling. The sigmoidoscopy and colonoscopy have the ten-year preventive effect for the advanced cancer. Recently the DNA stool test for detection of mutations has showed excellent sensitivity and specificity. It has several adventages such as collection of samples and automated analysis. Virtual colonoscopy, especially CT colonograpy, can be a viable option for the colorecal cancer screening. In November 2001, the Korean Society of Coloproctology (KSCP) and the Natinal Cancer Center (NCC) developed the guidelines on screening and surveillance for early detection of colorectal cancers in Korea. Average-risk men and women should start colonoscopic examination with a 10-year interval at the age of 50. Individuals with increased risk such as those with a family or personal history of colorectal cancer or colorectal adenomas, or family history of familial adenomatous polyposis, hereditary non-polyposis colorectal cancer should consult their surveillance to the specialty-physicians. The ideal screening tools may change by age.
Adenoma ; Adenomatous Polyposis Coli ; Colonography, Computed Tomographic ; Colonoscopy ; Colorectal Neoplasms* ; Compliance ; DNA ; Early Detection of Cancer ; Female ; Humans ; Korea ; Male ; Mass Screening* ; Occult Blood ; Sensitivity and Specificity ; Sigmoidoscopy

The authors determined the value of performing urine microscopy on biochemically negative urine sepcimens in a pediatric population. The 746 urine specimens of patients who were either visited or admitted to the Department of Pediatrics, National Police Hospital, from March 1991 to July 1992 were reviewed on the basis of comparative evaluation of biochemical and microscopic urine analysis. Eight reactions of Clinitek(r) 200 were used as biochemical indicators, namely, pH, nitrite, albumin, glucose, ketone, urobilinogen, bilirubin, and blood. Out of 746 urine specimens studied, 186 were true positive. Thirty-six specimens reacted biochemically in the absence of positive microscopic findings (false postive), 492 specimens were true negatives. Thirty-two specimens had negative biochemical indicators, in spite of positive microscopy. The sensitivity of the biochemical parameters for predicting significant microscopy of urinary sediment is 85% and the specificity is 99%. The positive predictive value is 69.7% and the negative predictive value is 99.3%. The sensitivity of blood for RBC is 94%. and the specificity is 99%. The predictive value of a positive result is 84.6% and that of a negative result is 99.7%. We therefore conclude that urine microscopy is less necessary in biochemically negative urine specimens from asymptomatic pediatric patients, with hopefully resultant time and cost effectiveness.
Bilirubin ; Cost-Benefit Analysis ; Glucose ; Humans ; Hydrogen-Ion Concentration ; Microscopy ; Pediatrics ; Police ; Sensitivity and Specificity ; Urinalysis* ; Urobilinogen

The efficacy of acetaminophen, sponging plus acetaminophen, and sponging alone as method of lowering body temperature was compared in 108 children aged 8 weeks to 5 years who presented with an axillary temperature of 38.5degrees C or greater during the period from January 1993 to April 1993. The following results were obtained. 1) The male to female ratio was 2.5:1 and clinical diagnosis in the order of frequency were upper respiratory infection, gastroenteritis, pneumonia, urinary tract infection, cellulitis, chickenpox and hand-foot-mouth disease. 2) At thirty minutes after treatment, there was no significant difference on the decrement of temperature among the three groups. 3) At sixty minutes, the temperature decrement was the greatest in the group of sponging plus acetaminophen and that was statistically significant (P<0.01). But there was no significant difference between the group of acetaminophen and that of sponging.
Acetaminophen ; Body Temperature ; Cellulitis ; Chickenpox ; Child* ; Diagnosis ; Female ; Fever* ; Gastroenteritis ; Humans ; Male ; Pneumonia ; Urinary Tract Infections

No abstract available.

Between January 1989 and July 1990, nonsurgical managements were tried in 9 patients with benign prostatic hyperplasia who were with a high surgical risk or didn`t want an operation. The prostatic balloon catheters were used in 3 patients and the urological spirals in 6 patients. They were followed with clinical evaluations, urine cultures and urine flow rates at 2 and 6 weeks. All procedures were done under the local anesthesia, except one spinal anesthesia. In the prostatic balloon catheter group, all three patients had recurrent voiding symptoms at 2, 3 and 9 months after prostatic balloon dilatation, respectively. In the urological spiral group, one procedure failed due to upward migration of the spiral into the bladder. In the remaining 5 patients, it has worked well up to 11 months after the procedure. Despite of some improvements in subjective voiding symptoms after procedure, there was no significant difference between before and after the procedure in maximum flow rate and total voided volume. Our results suggest that this modality, especially the urological spiral, can be a useful alternative to an operation in selected patients with an increased surgical risk.
Anesthesia, Local ; Anesthesia, Spinal ; Catheters* ; Dilatation ; Humans ; Prostatic Hyperplasia* ; Urinary Bladder

The tibial pilon fracture has been described as difficult fracture to manage. We have reviewed 23 cases of tibial pilon fractures from Mar. 1987 to Feb. 1993 at our hospital. 1. The fractures were classified into five types according to the system of Ovadia and Beals and the methods of treatment were divided into two groups; 9 cases were treated with Ilizarov device(Group I). 6 cases out of Group I were type 3, 4 and 5. Other methods were performed in 14 cases(Group II). 8 cases out of Group II were type 3, 4, and 5. 2. In type 3, 4 and 5 fractures, there were 86 per cent good and fair radiographic results in Group I and 63 per cent good and fair results in Group II. 3. Satisfactory results were obtained by the treatment of Ilizarov method especially in type 3, 4 and 5 fractures. The advantages of Ilizarov device were its primary reduction with ligamentotaxis, easy open reduction due to proximal and distal stabilization, minimal soft tissue injury and minimal internal fixation.
Ilizarov Technique ; Soft Tissue Injuries

OBJECTIVE: This study was to evaluate the association of the G1691A mutation of factor V gene with preeclamptic patients in Korea. METHODS: Factor V genotype were determined in 113 preeclamptic patients and 100 normotensive pregnant women. A 267 base-pair DNA fragment of the factor V gene that includes nucleotide 1691 was amplified by PCR. PCR product was digested with MnlI restriction enzyme and the fragments were analysed by electrophoresis using 2% agarose gel. RESULTS: The difference of genetic and allelic frequencies between two groups could not be mentioned because all women were G1691G homozygotes. There was no individuals with mutant allele among preeclamptic patients and control women. CONCLUSION: There was no evidence of association between preeclampsia and factor V gene polymor- phism in Korean population.
Alleles ; DNA ; Electrophoresis ; Factor V* ; Female ; Genotype ; Homozygote ; Humans ; Korea* ; Polymerase Chain Reaction ; Pre-Eclampsia ; Pregnant Women ; Sepharose

No Abstract available.
Academic Medical Centers* ; Infection Control*

PURPOSE: The purpose of this study is to prove the effects of topical anesthetics (EMLA) to control pain in preterm infants during invasive procedure (percutaneous central venous catheterization, PCVC). METHODS: A total of 18 preterm infants of birth weight <2,000 g and gestational age <36 weeks born at EulJi University Hospital, at Daejeon in 2010 were randomly included in this study. EMLA was applied in nine preterm infants 40 minutes before starting PCVC and placebo was applied in another nine preterm infants. Based on PIPP (preterm infant pain profile), we evaluated their heart rate, oxygen saturation before, 15 seconds during and 30 seconds after procedure. Behavioral responses were also recorded for 2 minutes after procedure. RESULTS: Experimental group showed significantly less behavioral response during procedure (P=0.005) and 2 min after procedure (P=0.001). Also, experimental group showed less increase in heart rate (P=0.033) and reduction of behavioral state (P=0.017). CONCLUSION: Despite limitation of small size in this study, experimental group showed lower pain score compared with placebo control group during catheterization. In neonatal care unit (NICU), we recommend the use of topical anesthetics such as EMLA to control pain during invasive procedures.
Anesthetics ; Birth Weight ; Catheterization ; Catheterization, Central Venous ; Catheters ; Central Venous Catheters ; Gestational Age ; Heart Rate ; Humans ; Infant ; Infant, Newborn ; Infant, Premature ; Lidocaine ; Oxygen ; Prilocaine

INTRODUCTION: Apoptosis is a naturally occurring cell suicide pathway. The absence of a survival factor, such as a particular hormone or growth factor, will induce a cell to initiate its own cell death. This process induced in osteoblast is thought to play a role in the pathophysiology of postmenopausal osteoporosis. Estrogen plays an important role and exerts direct effects on bone cells, but the role in the maintenance of cell survival and apoptosis is poorly understood. Based on the importance of survival factors and cytokines in bone remodeling, some studies suggest that estrogen acts on bone cell by modulation of cytokine production that increases bone resorption. However other studies have not investigated the effect of estrogen on the apoptosis of osteoblast cells. OBJECTIVE: To understand how estrogens regulate the apoptosis of osteoblast cells, the physiologically active etrogen metabolite 17 beta-estradiol was tested to determine its effects on the well characterized murine osteoblastic cell-line MC3T3-E1. METHODS: Experiments were designed to identify the effects of estrogen on TNF-alpha induced apoptosis and cytokine gene expression, and collagen synthesis. RESULTS: 1.Within 48 hours of exposure, recombinant murine at 10(-11)M - 10(-10)M TNF-alpha increased the rates of DNA synthesis and 10(-11)~M - 10(-9)M TNF-alpha reduces cell proliferation. 2.Estrogen treatment coordinately increased DNA contents, cell proliferation and collagen synthetic activity. 3.10(-10)M TNF-alpha increased the IL-1beta, IL-6 gene expression. 4.Estrogen attenuated the TNF-alpha- dependent increase in these gene expression. 5.Murine osteoblastic MC3T3-E1 cells underwent apoptosis following removal of serum, or addition of TNF-alpha, as indicated by terminal deoxynucleotidyl transferase-mediated dUTP nick end labeling and DNA fragmentation studies. 6.Estrogen inhibited the apoptosis of osteoblast cells induced by 10(-10)M TNF-alpha but not to the levels observed in those control. CONCLUSION: This in vitro evidence suggests that estrogen might exert at least part of antiapoptotic inflence on the bone cells.
Apoptosis* ; Bone Remodeling ; Bone Resorption ; Cell Death ; Cell Proliferation ; Cell Survival ; Collagen ; Cytokines ; DNA ; DNA Fragmentation ; Estradiol ; Estrogens* ; Female ; Gene Expression* ; Humans ; Interleukin-6 ; Necrosis* ; Osteoblasts* ; Osteoporosis, Postmenopausal ; Suicide ; Tumor Necrosis Factor-alpha