No abstract available.
Psychotherapy*

Met protein is a transmembrane 190 kD heterodimer with tyrosine kinase activity, encoded by c-Met oncogene. It serves as a high affinity receptor for hepatocyte growth factor (HGF)/scatter factor (SF), a cytokine which stimulates cell proliferation, motility, and invasion. In this study, we immunohistochemically evaluated the expression of Met/hepatocyte growth factor receptor in colorectal cancers. Met protein was expressed in 31 of 72 patients (43.1%). The staining pattern was cytoplasmic in nature, present throughout the tumor, and showed variable intensity from case to case. The relationship between the expression rate and intensity, and age and sex of patients, tumor size (p=0.645), tumor site (p=0.902) and tumor differentiation (p=0.844) was not statistically significant. The expression rate and intensity were significantly correlated with lymphovascular invasion (p=0.001), lymph node metastasis (p=0.010), depth of invasion (0.019), and stage (p=0.023). Cytoplasmic accumulation of Met protein was not associated with enhanced PCNA index of tumor cells (p=0.052). These results suggest that Met protein may play an important role in the invasion and metastasis of colorectal cancer cells.
Cell Proliferation ; Colorectal Neoplasms* ; Cytoplasm ; Hepatocyte Growth Factor ; Humans ; Lymph Nodes ; Neoplasm Metastasis ; Oncogenes ; Proliferating Cell Nuclear Antigen ; Protein-Tyrosine Kinases

OBJECTIVE: The amount of hemorrhage observed on a brain computed tomography scan, or a patient's Fisher grade (FG), is a powerful risk factor for development of shunt dependent hydrocephlaus (SDHC). However, the influence of treatment modality (clipping versus coiling) on the rate of SDHC development has not been thoroughly investigated. Therefore, we compared the risk of SDHC in both treatment groups according to the amount of subarachnoid hemorrhage (SAH). METHODS: We retrospectively reviewed 839 patients with aneurysmal SAH for a 5-year-period. Incidence of chronic SDHC was analyzed using each treatment modality according to the FG system. In addition, other well known risk factors for SDHC were also evaluated. RESULTS: According to our data, Hunt-Hess grade, FG, acute hydrocephalus, and intraventricular hemorrhage were significant risk factors for development of chronic SDHC. Coiling group showed lower incidence of SDHC in FG 2 patients, and clipping groups revealed a significantly lower rate in FG 4 patients. CONCLUSION: Based on our data, treatment modality might have an influence on the incidence of SDHC. In FG 4 patients, the clipping group showed lower incidence of SDHC, and the coiling group showed lower incidence in FG 2 patients. We suggest that these findings could be a considerable factor when deciding on a treatment modality for aneurysmal SAH patients, particularly when the ruptured aneurysm can be occluded by either clipping or coiling.
Aneurysm ; Aneurysm, Ruptured ; Brain ; Hemorrhage ; Humans ; Hydrocephalus ; Incidence ; Intracranial Aneurysm ; Retrospective Studies ; Risk Factors ; Subarachnoid Hemorrhage ; Surgical Instruments

Sexual violence crime causes severe trauma to victim's family as well as the victim, and its aftereffect which is hard to be healed can last for the entire lifetime. And thus plenty of social cost is incurred due to the crime. It has long been reported that paraphilia is associated with sexual offenders and sexual violence. In this study, the previous foreign data on the psychiatric medication used for sexual offender or paraphilia were summarized for the first time in Korea, and the possibility of medication in Korea was examined. As for the drugs used for sexual offender or paraphilia, SSRI was most frequently reported and besides that, tricyclic antidepressant, antipsychotics, antiepileptic drugs, mirtazapine, and naltrexone were reported.
Anticonvulsants ; Antipsychotic Agents ; Crime ; Criminals ; Humans ; Korea ; Mianserin ; Naltrexone ; Paraphilic Disorders ; Sex Offenses

Metabolic acidosis (MA) is associated with increased proteolysis, increased osteoclast activity and blunted cardiac muscle response, but the effect of MA on various clinic al parameters in CAPD patients is not well known. To evaluate the effects of MA on serum albumin level and other nutritional parameters in CAPD patients, we studied 106 CAPD patients retrospectively who have had monthly biochemical measurement and urea kinetic studies every 6 months for more than 2 years. The patients were divided into three groups according to their mean total CO2 (tCO2) level of the 2-year follow-up (Group l; mean tCO2 < 22mM/L, Group ll; 22mM/L < or = mean tCO2 < 26mM/L, and Group lll; mean tCO2 > or = 26mM/L), and the clinical, biochemical, and urea kinetic data were compared among the three groups. 1)The mean age of the subjects was 46.9+/-12.2 years with a sex ratio of 1.2:1, the mean CAPD duration 28.3+/-21.8 months, mean body weight (Bwt) 59.0+/-8.9kg, %Bwt/IBW 104.1+/-11.5%, %LBM/Bwt 75.5+/-11.1% and well-nourished patients by subjective global assessment (SGA) were 65%. 2)The mean BUN, creatinine, total protein and albumin of all patients were 55.6+/-13.6mg/dL, 12.3+/-3.5mg/dL, 6.6+/-0.7g/dL and 4.0+/-0.4g/dL, respectively. In urea kinetic study, the mean NPCR, weekly Kt/ Vurea, SCCr and RRF were 0.96+/-0.16g/kg/day, 2.02+/-0.37, 63.7+/-18.4L/week/1.73m2, and 0.99+/-1.32ml/ min, respectively. 3)The mean age was significantly higher in group l (51.0+/-10.8) than those of group ll (47.0+/-12.4) and lll (42.6+/-11.4) (P<0.05). %Bwt/IBW of group l (114.4+/-15.8%) was also significantly higher than those of group ll (104.6+/-12.6%) and lll (103.5+/-13.7 %) (P<0.05), but there were no significant differences in sex ratio, CAPD duration, %LBM/Bwt, and SGA among the three groups. 4)The mean tCO2 in group l, group ll, and group lll were 20.6+/-1.2mM/L, 23.9+/-1.1mM/L, and 27.3+/-0.8mM/L, respectively. Compared to group lll, group l had significantly higher BUN (61.1+/-14.3 vs. 46.1+/-7.2mg/dL, P<0.05) and serum albumin (4.04+/-0.31 vs. 3.75+/-0.39g/dL, P<0.05), in spite of comparable dialysis dose and albumin loss into dialysate. 5)NPCR (1.02+/-0.21g/kg/day vs. 0.88+/-0.14g/kg/ day, P<0.05) and ultrafiltration volume (1.4+/-0.4 vs. 1.0+/-0.3, P<0.05) were significantly higher in group l than those of group lll. But there were no significant differences in Kt/Vurea, SCCr, RRF, and 24-hour dialysate loss of protein/albumin among the three groups. 6)No differences were observed among the three groups in the changes of body weight, %Bwt/IBW, %LBM/Bwt, BUN, albumin, NPCR, and RRF from the baseline values after the 2-year follow-up. 7)There were significant inverse correlations between the mean tCO2 level and NPCR (r=-0.33, P<0.001), %Bwt/IBW (r=-0.32, P<0.001), RRF (r=-0.29, P<0.005), and serum albumin level (r=-0.24, P<0.05). But, creatinine, %LBM/Bwt, and Kt/Vurea did not show any correlation with the mean tCO2 level. 8)Using stepwise multiple regression analysis, NPCR (beta=-0.3491, P<0.001), %Bwt/IBW (beta=-0.046, P<0.001), and ultrafiltration volume (beta=-0.0012, P< 0.005) were independent factors affecting the mean tCO2 level. In conclusion, low total CO2 level in long-term CAPD patients may reflect increased protein intake and mild to moderate degree of metabolic acidosis may not affect the nutritional status of well-dialyzed CAPD patients.
Acidosis* ; Body Weight ; Creatinine ; Dialysis ; Follow-Up Studies ; Humans ; Myocardium ; Nutritional Status ; Osteoclasts ; Peritoneal Dialysis, Continuous Ambulatory* ; Proteolysis ; Retrospective Studies ; Serum Albumin* ; Sex Ratio ; Ultrafiltration ; Urea

Protein-calorie malnutrition is common in CAPD patients and is associated with increase in morbidity and mortality in CAPD patients. There are many causes of malnutrition in CAPD patients, and it is well known that a large amount of protein losses through peritoneal membrane is one of them. To investigate the effect of the peritoneal membrane transport characteristics on the nutritional status in long-term CAPD patients, we conducted a cross- sectional study on clinically stable 115 patients (63 males and 52 females) who have been on CAPD for more than 2 years, and assessed nutritional status by subjective global assessment (SGA), biochemical, anthropometric and urea kinetic parameters. Patients were divided into 4 groups according to the results of standard peritoneal equilibration test (PET). The results were as follows: 1) The patients were divided into 4 groups according to the PET results: high transporter (n=16, 14%), high average transporter (n=38, 33%), low average transporter (n=50, 43%), and low transporter (n=11, 10%). 2) The mean age of the patients was 50.1+/-11.6 years (range, 19-75) with sex ratio (M:F) 1.2:1 and mean duration of dialysis was 57.5+/-27.8 months (range, 24-135). The mean body weight (Bwt) was 59.2+/-8.9kg, percent ideal body weight (%IBW) was 104.7+/-15.6%, %lean body mass (LBM)/Bwt was 82.1+/-11.1%, and malnourished patients by subjective global assessment (SGA) were 32.2% (38/115). 3) The mean BUN, creatinine, total protein, and albumin level of the patients were 54.5+/-13.1mg/dL, 12.3+/-3.0mg/dL, 6.7+/-0.8g/dL, and 3.8+/-0.6g/dL, respectively. 4) There were no significant differences in age, sex ratio, CAPD duration, peritonitis rate, %LBM/ Bwt, and SGA among the 4 groups. 5) Total protein (g/dL) and albumin (g/dL) levels in high transporters were 6.4+/-0.5, 3.5+/-0.4, respectively, and they were significantly lower than those of low transporters (7.2+/-0.6, 4.2+/-0.5) (P<0.05). 6) 24 hour dialysate protein (g/day) and albumin (g/day) losses were significantly higher in high transporters (8.10+/-1.85, 4.19+/-1.23) compared to those of low transporters (5.07+/-1.85, 2.78+/-0.99) (P<0.05). 7) The level of IGF-1 (ng/mL) was significantly lower in high transporters (150.5+/-86.2) compared to that of low transporters (310.3+/-162.1) (P<0.05). 8) The level of BUN (mg/dL), Cr (mg/dL) were also lower in high transporters (45.4+/-13.1, 10.1+/-2.0) than those of low transporters (61.6+/-18, 14.7+/-2.7), but there were no significant differences in Hct, total cholesterol, prealbumin, and transferrin among the 4 groups. 9) There were no statistically significant differences in Kt/Vurea, RRF, NPCR, dietary calorie and protein intakes among the 4 groups. 10) Anthrometric parameters such as TSF, BSF, MAC and LBM measured by three different methods (LBMCr, LBMimp, LBManthro) didn't show any significant differences among the 4 groups. In conclusion, increased peritoneal permeability may not adversely affect SGA and anthropometric status of long-term CAPD patients, although it is associated with lower serum albumin, creatinine, and IGF-1 level. Clinical significance of these findings remains to be elucidated.
Body Weight ; Cholesterol ; Creatinine ; Dialysis ; Humans ; Ideal Body Weight ; Insulin-Like Growth Factor I ; Male ; Malnutrition ; Membranes ; Mortality ; Nutritional Status* ; Peritoneal Dialysis, Continuous Ambulatory* ; Peritonitis ; Permeability ; Prealbumin ; Protein-Energy Malnutrition ; Serum Albumin ; Sex Ratio ; Transferrin ; Urea

Hypercalcemia is a common complication in CAPD patients treated with calcium-containing phosphate binders and using the standard dialysate (SCD) calcium concentration of 3.5mEq/L. We performed a retrospective study in 25 CAPD patients to determine whether a low calcium dialysate (LCD) containing 2.5mEq/L calcium would reduce the incidence of hypercalemia with adequate control of serum inorganic phosphate levels and diminish the need to use aluminum-containing phosphate binders. All patients had previously used SCD before converting to LCD. The incidence of hypercalcemia (more than 2 episodes of corrected serum calcium > or = 10.5mg/dL) tended to be lower after converting to LCDl 0.27 (0-2.76) vs. 0 (0-1.97) episodes/patient-yearl. Intact PTH level increased from 38.8 (0.1-1599.3)pg/mL to 70.6 (9.5-1540.0)pg/mL after conversion, but there was no statistical sifnificance. Serum calcium, inorganic phosphate, alkaline phosphatase and bicarbonate levels did not change after converting to LCD. We were able to reduce aluminum hydroxide dosagel 1.09 (0-10.88) vs. 0 (0-3.26)g/day/patientl and increase calcium carbonate dosage (1.95 0.92 vs. 2.98 2.14g/day/ patient) after conversion significantly (P<0.05). The frequency of peritonitis was similar in LCD and SCD period. In conclusion, low calcium dialysate is useful in diminishing aluminum-containing phosphate binder dosage and increasing calcium carbonate dosage to maintain a similar phosphate value. Its effects on renal osteodystrophy remain to be assessed.
Alkaline Phosphatase ; Aluminum Hydroxide ; Calcium Carbonate ; Calcium* ; Humans ; Hypercalcemia ; Incidence ; Kidney Failure, Chronic ; Peritoneal Dialysis, Continuous Ambulatory* ; Peritonitis ; Renal Osteodystrophy ; Retrospective Studies

No abstract available.
Gastrostomy*

No abstract available.
Granuloma, Lethal Midline*

Xanthelasma palpebrarum is the most common cutaneous xanthoma found on the medial side of the eyelid. The typical lesion is usually a flat and yellowish plaque on the skin. However, we report on a unique case of intramuscular xanthoma found during blepharoplasty for the correction of ptosis. A 53-year-old male patient visited our department with a complaint of a ptotic eyelid. He was concerned about the cosmetic appearance and the uncomfortable feeling while opening his eyes, and wanted these problems to be solved. A yellowish plaque of about 0.3 × 0.3 cm in size was found in the orbicularis oculi muscle during the surgery. The lesion was excised and xanthelasma was confirmed with biopsy. We have found this specific case of xanthelasma palpebrarum in the only muscle. Therefore, a careful approach to clinical and histologic examination and imaging is required for patients with these lesions.
Biopsy ; Blepharoplasty* ; Eyelids ; Humans ; Male ; Middle Aged ; Muscles ; Skin ; Xanthomatosis