BACKGROUND/AIMS: The heavy metals like cadmium (Cd) are neither destroyed nor produced in human body and may infiltrated into air, water, soil, food, human body and redistributed by biological and geographical circulation. With advent of recent industrialization detrimental heavy metal poisoning in human body is increased by industrial pollution. We aimed to establish the relative abilities of chelators to mobilized liver cadmium contents in chronic cadmium intoxication rats. METHODS: Sprague-Dawley albino male rats weighing 200 to 250 mg were used. All animals were loaded with 3 intraperitoneal injections of cadmium chloride (1.5 mg/kg) given at % hourly interval. Intraperitoneal injection of chelators commenced 1 week after the last loading injection and continued every 72 hour for a total of 10 injections. Chelators were given at a level of 1 mmole/kg (except 0.01 mmol/kg of BAL). The chelators used in present experiment are 1,2-diaminocyclohexane tetra acetate (CDTA), disodium calcium ethylene diamine tetra acetate (EDTA), sodium 2.3-dimer capto propane sulfonate (DMPS), sodium di ethyl dithio carbamate (DDTC), dimercapto succinate (DMSA), 2,3-dimer capto propanol (BAL), diethylene triamine penta acetate (DTPA), triethylene tetr amine hexa acetate (TTHA), D-penicillamine(DPA), Nacetyl penicillamine (NAPA). RESULTS: 1) The residual liver cadmium content was reduced in rats administered DPA, EDTA, NAPA, CDTA, DDTC and DMSA (32%, 23%, 19%, 17%, 16% and 15% respectively) compared with control group. 2) The residual kidney cadmium content was reduced in rats administered DPA, DDTC, CDTA and EDTA (33%, 21%, 18% and 17% respectively) 3) The summation of residual cadmium content in liver and kidney was reduced in rats administered DPA, EDTA, DDTC and CDTA (33%, 20%, 18% and 17% respectively) compared with control group. CONCULUSIONS: We suggested that DPA, EDTA, CDTA and DDTC might have protective role against the toxic effects of cadmium.
1-Propanol ; Animals ; Cadmium Chloride ; Cadmium* ; Calcium ; Characidae ; Chelating Agents* ; Edetic Acid ; Human Body ; Humans ; Injections, Intraperitoneal ; Kidney ; Liver* ; Male ; Metals, Heavy ; Penicillamine ; Poisoning ; Propane ; Rats* ; Rats, Sprague-Dawley ; Sodium ; Soil ; Succimer ; Succinic Acid

OBJECTIVE: To investigate the diagnostic yield and accuracy of CT enterography (CTE) for early (< 12 postoperative months) surveillance of anastomotic recurrence after bowel resection for Crohn's disease (CD). MATERIALS AND METHODS: We analyzed 88 adults (60 males and 28 females; mean age, 31.4 ± 9.6 years) who underwent bowel surgery for CD that created ileocolic anastomosis without enteric stoma, and underwent CTE for surveillance of CD recurrence/aggravation within 12 post-operative months. The CD activity index (CDAI) at the time of CTE was < 150 (i.e., clinically silent) in 51 patients, and ≥ 150 in 37 patients. Diagnostic yields of CTE regarding CD recurrence in the ileocolic anastomosis and extraluminal penetrating complications were determined. CTE-related step-up therapy was recorded. These outcomes were compared between the two CDAI groups after accounting for major risk factors for CD recurrence. In a subgroup of 31 patients who underwent both CTE and ileocolonoscopy within 1 month, CTE accuracy for anastomotic recurrence was assessed using the Rutgeerts scoring as the reference standard. RESULTS: CTE diagnostic yield was 35.2% (31/88) for the anastomotic recurrence and 9.1% (8/88) for penetrating complications. 20.5% (18/88) of the patients underwent step-up therapy after CTE detection of anastomotic recurrence. These outcomes were not significantly different between CDAI < 150 and CDAI ≥ 150, except that CTE yield for extraluminal penetrating complications was significantly higher in CDAI ≥ 150 (16.2% [6/37] vs. 3.9% [2/51]; multivariable-adjusted p = 0.029). CTE showed 92.3% (12/13) sensitivity and 83.3% (15/18) specificity for anastomotic recurrence. CONCLUSION: CTE may be a viable option for the early postsurgical surveillance of recurred disease in CD patients.
Adult ; Crohn Disease* ; Female ; Follow-Up Studies ; Humans ; Intestines ; Male ; Observational Study* ; Recurrence* ; Risk Factors ; Sensitivity and Specificity

BACKGROUND: Depletion of nutritional reserves and significant weight loss can lead to an increased risk of morbidity, reduced chemotherapy response, and shorter survival in patients with cancer. Numerous methodologies are used for the assessment of nutritional status. However, it remains unclear which of these tools is the most appropriate in the setting of cancer chemotherapy. The PINI (prognostic inflammatory nutritional index) is a simple scoring system that has been used to evaluate nutritional status and prognosis in critically ill patients. The aim of this study was designed to investigate the relationship between nutritional status after the palliative chemotherapy and prognosis in advanced metastatic cancer. METHODS: This study included 130 patients with ECOG PS (Eastern Cooperative Oncology Group performance status) 1~3 in advanced metastatic cancer following the palliative chemotherapy. ECOG PS, body mass index, alpha 1-acid glycoprotein, C-reactive protein, albumin, prealbumin, transferrin, protein, lactate dehydrogenase, PINI ratio, and survival time were evaluated. RESULTS: In 130 patients, the median age was 57 years. The ECOG PS was 1 68 patients, 2 43, 3 19. The mean value of PINI was PS 1 16.0+/-47.8, PS 2 55.6+/-106.9, PS 3 106.3+/-141.6. The mean survival was PS 1 144.0+/-71.8, PS 2 68.9+/-41.2, PS 3 32.0+/-6.9 days. In the PS 3 group, the mean values of alpha 1-acid glycoprotein, C-reactive protein, and lactate dehydrogenase were significantly higher than in the PS 1 group. In the PS 3 group, the mean values of albumin, prealbumin, and transferrin were significantly lower than in the PS 1 group. The survival time was correlated with the ECOG PS (r=-0.602, p<0.001,), PINI (r=-0.318, p<0.001,), alpha 1-acid glycoprotein (r=-0.265, p=0.002), C-reactive protein (r=-0.345, p<0.001), albumin (r=0.324, p<0.001), prealbumin (r=0.260, p=0.003) and transferrin (r=0.277, p=0.001). CONCLUSIONS: The PINI may be a useful scoring system for the assessment of nutritional status and prognosis in advanced metastatic cancer following palliative chemotherapy, but the ECOG PS is most strong correlation with the survival time.
Body Mass Index ; C-Reactive Protein ; Critical Illness ; Drug Therapy ; Humans ; L-Lactate Dehydrogenase ; Nutrition Assessment ; Nutritional Status* ; Orosomucoid ; Prealbumin ; Prognosis* ; Transferrin ; Weight Loss

Cytomegalovirus (CMV) infection is more frequent in immunocompromised patients those with acquired immunodeficiency syndrome (AIDS), malignant disease, steroid therapy. However, CMV can infect a healthy person who has normal immunity. Most cases of CMV infections are due to reactivation of latent virus. We report a case of cytomegalovirus colitis in a 73 years old woman who has congestive heart failure with normal immunity. Sigmidoscopy reveals cobble stone like mucosa and deep ulceration. CMV infection produces a cytomegalic cell containing a intranuclear inclusion, which is surrounded by clear halo in Hematoxylin-Eosin stain. Immunohistochemical stain for CMV reveals focal positive in cytoplasm and in nuclei of large cells. We diagnosed CMV colitis with histopathologic finding and immunohistochemistry through sigmoidoscopic mucosal biopsy.
Acquired Immunodeficiency Syndrome ; Aged ; Biopsy ; Colitis* ; Cytomegalovirus* ; Cytoplasm ; Female ; Heart Failure ; Humans ; Immunocompromised Host ; Immunohistochemistry ; Intranuclear Inclusion Bodies ; Mucous Membrane ; Ulcer

OBJECTIVES: The purpose of present study is to investigate the influence of a spinal gamma-aminobutyric acid B (GABAB) receptor on a central regulation of blood pressure(BP) and heart rate(HR), and to define its mechanism in the spinal cord. METHODS: In urethane-anesthetized, d-tubocurarine- paralyzed and artificially ventilated male Sprague-Dawley rats, intrathecal administration of drugs were carried out using injecton cannula(33-gauge stainless steel) through the guide cannula(PE 10) which was inserted intrathecally at lower thoracic level through the puncture of a atlantooccipital membrane. RESULTS: Intrathecal injection of an GABAB receptor agonist baclofen(30, 60, 100 nmol) decreased both blood pressure and heart rate dose-dependently. Pretreatment with 8-bromo-cAMP(50 nmol), a cAMP analog or glipizide(50 nmol), a ATP-sensitive K+ channel blocker attenuated the depressor and bradycardic effects of baclofen (100 nmol) but not with 8-bromo-cGMP(50 nmol) a cGMP analog. CONCLUSIONS: The GABAB receptor in the spinal cord plays an inhibitory role in central cardiovascular regulation and that this depressor and bradycardic actions are mediated by the decrease of cAMP via the inhibition of adenylate cyclase and the opening of K+ channel.
Adenylyl Cyclases ; Animals ; Baclofen ; Blood Pressure ; gamma-Aminobutyric Acid ; Heart ; Heart Rate ; Humans ; Injections, Spinal ; Male ; Membranes ; Punctures ; Rats* ; Rats, Sprague-Dawley ; Spinal Cord*

BACKGROUND AND AIMS: Prophylactic antibiotics are used in an attempt to avoid the septic complications of endoscopic retrograde cholangiopancreatography (ERCP). But, there is individual tendency to choose prophylactic antibiotics due to a lack of definite guidelines for prophylactic antibiotics. Therefore, the effectiveness of ciprofloxacin to prevent post ERCP infectious complications was evaluated. METHODS: One hundred patients underwent 75 diagnostic ERCPs and 25, therapeutic ERCPs. They were classified randomly into a group of 51 prophylaxis (ciprofloxacin 200 mg i.v. 30 min before the procedure) and 49 controls. Pre- and post-ERCP blood cultures were prospectively performed and surveyed for infectious complications. RESULTS: Sepsis was detected in 4 patients in each group (p>0.05). Two cases were related to diagnostic ERCP and the remaining six cases, therapeutic ERCP (p<0.01). Bacteremia was found in 6 cases, but only two cases (Escherichia coli, Citrobacter freundii) were clinically significant. CONCLUSIONS: The frequency of sepsis following ERCP was not significantly reduced by antibiotic prophylaxis (7.8% vs. 8.2%).
Anti-Bacterial Agents ; Antibiotic Prophylaxis* ; Bacteremia ; Cholangiopancreatography, Endoscopic Retrograde* ; Ciprofloxacin ; Citrobacter ; Humans ; Prospective Studies ; Sepsis

BACKGROUND/AIMS: Some patients complaining chest pain have normal coronary angiograms. In these cases of noncardiac chest pain, esophageal disease might be a reasonable explanation. However, causal relationship between esophageal motility or reflux disease and chest pain may be difficult to be proven. Therefore, we performed this study to evaluate the esophageal abnormality as a potential cause of noncardiac chest pain. METHODS: We underwent esophagogastroduodenoscopy, esophageal mancenetry and 24 hour esophageal pH monitoring in 58 patients with chest pain and normal coronary arteriogram or negative thallium study. RESULTS: Of 58 patients, 17 patients (29.3%) had abnormal esophageal manometry test. There were 6 cases of nonspecific esophageal motility disorder, 5 cases of hypertensive lower esophageal sphincter, 5 cases of diffuse esophageal spasm and 1 case of nutcracker esophagus. In 56 patients with 24 hour pH monitoring, 13 patients had positive DeMeester score and 29 patients experienced chest pain during the test period. 11 patients (18.9%) had both positive DeMeester score and chest pain. Mean symptom index of these patients was 70.0% (range 40-100%). CONCLUSIONS: Esophageal motility disorders and gastroesophegeal reflux diseases were frequantly found in patients with noncardiac chest pain. Much efforts should be made to find esophageal cause in patients with noncardiac chest pain.
Chest Pain* ; Endoscopy, Digestive System ; Esophageal Diseases ; Esophageal Motility Disorders ; Esophageal pH Monitoring ; Esophageal Spasm, Diffuse ; Esophageal Sphincter, Lower ; Gastroesophageal Reflux ; Humans ; Hydrogen-Ion Concentration ; Manometry ; Thallium ; Thorax*

the first EVL was associated with rebleeding (p=0.01); whereas, age, Child class, grade and extent of varices, presence of gastric varices and/or portal hypertensive gastropathy, total number of bands and sessions for successful EVL were not (p >0.05). Persistence of esophageal ulcer at 2 weeks after the first EVL was associated with rebleeding also in multivariate analysis (relative risk 5.87, p=0.01). 3) In univariate analysis, grade (p=0.01) and extent (p=0.01) of varices were related to recurrence; whereas, age, Child class, presence of gastric varices and/or portal hypertensive gastropathy, total number of bands and sessions for successful EVL were not (p >0.05). In multivariate analysis, grade of varices was the only risk factor associated with recurrence (relative risk 3.76, p=0.01). CONCLUSIONS: 1) Persistence of esophageal ulcer at second week after the first EVL was associated with rebleeding. 2) Frequent follow-up endoscopic examinations are necessary in patients who present with high grade of varices since risk of recurrence is high even after successful EVL.
Child ; Esophageal and Gastric Varices ; Follow-Up Studies ; Humans ; Ligation* ; Multivariate Analysis ; Recurrence* ; Risk Factors* ; Ulcer ; Varicose Veins

Pseudomyxoma peritonei is a benign mucin producing tumor of the peritoneum which is usually diagnosed using a laparotomy. It is uncommon to find a case of pseudomyxoma peritonei which has been diagnosed using a peritoneoscopy in Korea; there are only two cases reported in the literature. We recently experienced a case of pseudomyxoma peritonei in a 61 year old woman who manifested a typical case using a peritoneoscopy. Thick, jelly-like materials were adherent to polypoid nodular masses of the parietal peritoneum, which originated from the mucinous cystadenocarcinoma of an ovary. In this report we discuss the case with relevant review of the literature.
Cystadenocarcinoma, Mucinous ; Female ; Humans ; Korea ; Laparoscopes ; Laparoscopy ; Laparotomy ; Middle Aged ; Mucins ; Ovary ; Peritoneum ; Pseudomyxoma Peritonei*

BACKGROUND/AIMS: The precise rebleeding rate and risk factors of rebleeding after heat probe thermocoagulation in peptic ulcer patients with bleeding are not clear and still need to be evaluated. If we could identify the pre-dictors for rebleeding, the mortality rate might be loweted with early retreatment or surgery in these high risk group. METHODS: The 94 patients in whom heat probe was applied were enrolled and the 18 patients with bleeding tendencies. Initial hemostasis was defined as hemostasis persisting for 24 hours post-treatment and permanent hemostasis as absence of bleeding for 7 days after therapy. Rebleedig was defined as oozing or spurting hemorrhage in the ulcer base and/or unstable vital signs and continuting tarry or bloody stool or hematemesis after therapy. RESULTS: In 35 patients with active bleeding sign, initial hemostasis was obtained in 30 (85.7%) patients. After having achieved initial hemostasis, 9 (30.0%) patients rebled. In 41 ulcer patients with non-bleeding visible vessel, 40 cases (97.6%) achieved successful pre-vention of rebleeding. No evident complication was observed. With univariate analysis, bleeding ulcer patients with spurting and oozing hemorrhage had a higher re-bleeding rate than those with non-bleeding visible vessel. CONCLUSIONS: The heat probe thermocoagulaton is relative safe and effective procedure to protect bleeding in pectic ulcer patients with non-bleeding visible vessel, but insufficient to hemostasis in bleeding peptic ulcer patients with spurting or oozing in ulcer base. Spurting and oozing hemorrhage are the only risk factors of rebleeding after initial hemostasis with heat probe thermocoagulation in peptic ulcer patients with bleeding.
Electrocoagulation* ; Hematemesis ; Hemorrhage* ; Hemostasis ; Hot Temperature* ; Humans ; Mortality ; Peptic Ulcer ; Retreatment ; Risk Factors* ; Ulcer* ; Vital Signs