Pain from cancer is a major problem of managing the oral cancer patients in terminal stage. Overall, pain is reported by about 50% of patients at all stages of cancer and by over 70% with advanced neoplasms. Unrelieved pain can be incapaciting and preclude a satisfying quality of life. But, pain is often poorly assessed, and many clinicians lack sufficient knowledge to optimize cancer pain treatment. There are three basic approaches to the control of pain : modifying the source of pain, altering the central perception of pain, and blocking the transmission of pain to the central nervous system. The optimal use of these approaches and an individualized plan for pain control can maximize both quality and duration of life in dying patients. Opioid analgesics are are the mainstay of pharmacologic treatment. Practical opioid therapy include selection of both drug and route, dose titration, and management of side effects. We present our experienced pharmacologic treatment protocol for cancer pain management that collaborated by Dept. of Hospice, Catholic Medical Center. It will acts as a guideline for our colleague to facilitate the translation of current knowlegde into the clinical practice.
Analgesics, Opioid ; Central Nervous System ; Clinical Protocols ; Hospices ; Humans ; Mouth Neoplasms* ; Pain Management ; Quality of Life

It is interesting and in important to study histochemical changes of glucose-6-phosphatase (G-6-Pase) activity by electron microscopy in order to promote the knowledge needed for diagnosis and prognosis in such liver diseases as von Gierke's disease, hepatoma and various other hepatocellular alterations of different origins. Since we had not accomplished the electron microscopic demonstration of G-6-Pase, although light microscopic studies on changes of the enzyme activity were done in this laboratory, this investigation was planned to obtain a satisfactory technique for ultrastructural demonstration of the enzyme activity. Unfixed frozen sections (80 micro thick) of mouse liver were washed for 2~3 minutes in a 0.4M sucrose solution (pH6.8) containing 4 mM lead nitrate and then incubated for 15~20 minutes at 32~37 degrees C in several different media to which 0.4M sucrose solution was added: A) a modification of the original Chiquoine medium, B) the first modification of the Wachstein-Meisel medium C (the second modification; the 2% lead nitrate solution was reduced in amount to 1.5 m1 instead of 3.0 ml in the medium-B). After incubation, these sections were fixed in 1% osmic acid containing sucrose, followed by embedding in Epon, ultrathin-section, mounting and staining with uranyl acetate and/or lead nitrate. By incubating the sections in the medium (B or C), satisfactory preparations were obtainable for its electron microscopic demonstration. The granular deposits of reaction products were found characteristically on the membranous component of the rough-and smooth-surfaced endoplasmic reticulum and unclear envelope. Occasional deposits were observed within cisternae or vesicles, in the nucleus, and immediate1y adjacent to the cisternal membrane and glycogen areas.
Animal ; Glucose-6-Phosphatase/metabolism* ; Liver/enzymology* ; Liver/ultrastructure ; Male ; Mice ; Microscopy, Electron

Prednisolone, a cortisol analogue, was given intraperitoneally to rats with 5, 10 or 15 doses of 5 mg. per kg. of body weight per day. Sacrificing the animals 24 hours after the last injection, unfixed frozen sections from small pieces of liver tissue were incubated and stained by a modification from the method of Wachstein and Meisel(1965) for glucose-6-phosphatase (G-6-Pase) activity. Some of the tissue blocks were processed for staining with hematoxylin and eosin for histopathological observation. Glucose-6-phosphatase activity, being represented histochemically by brownish-black deposits, was progressively increased after administrations 5 or 10 times. With 15 doses of prednisolone the general histochemical picture of G-6-Pase activity appeared to be similar to that of the control group, except for a different distribution of hepatocytes possessing strong activity. In prednisolone treated rats, the swollen hepatocytes showed a marked, cytoplasmic vacuolization and nuclear pyknosis, particularly in the periportal and midzonal areas of hepatic lobules. Some discussion of the G-6-Pase corticosteroids are presented in terms of their metabolic effects.
Animal ; Glucose-6-Phosphatase/analysis* ; Liver/drug effects ; Liver/enzymology* ; Male ; Prednisolone/pharmacology* ; Rats

No abstract available.
Humans ; Inpatients*

The purpose of this study was to evaluate the effect of high glucose on prostaglandin E2 production in human gingival fibroblasts and periodontal ligament cells in vitro. In control group, the cells(5x10(4) cells/ml) were cultured with Dulbecco's Modified Eagle's Medium contained with 10% fetal bovine serum, 45mg/dl glucose. In experimental groups, glucose was added to the above culture condition at the final glucose concentrations of 100mg/dl(Test group 1), 200mg/dl (Test group 2) and 400mg/dl(Test group 3). Then each group was tested for the cell proliferation rate, protein levels, and prostaglandin E2 production at 1/2, 1, 2, 5 days. The results were as follows ; 1. As glucose concentration increased, cell proliferation rate decreased significantly at 1, 2, 5 days in human gingival fibroblasts and periodontal ligament cells(P<0.01). 2. In human gingival fibroblasts, test group 2 and 3 showed significantly decreased protein levels as compared to control group at 5 days(P<0.01). 3. In human periodontal ligament cells, as glucose concentration increased, protein levels decreased significantly at 2 days and 5 days(P<0.01). 4. Prostaglandin E2 production in human gingival fibroblasts and human periodontal ligament cells significantly increased as glucose concentration increased(P<0.01). The results at 5 days showed obvious difference as compared to those at 2 days. From the above results, high glucose appeared to affect cellular activities including cell proliferation rate, protein levels and enhance prostaglandin E2 production. It was assumed that prostaglandin E2 production by high glucose enhances inflammatory reaction and has a toxic effect on human gingival fibroblasts and human periodontal ligament cells. This study suggests that periodontal disease in diabetic patient is related to prostaglandin E2 production.
Cell Proliferation ; Dinoprostone* ; Fibroblasts* ; Glucose* ; Humans* ; Periodontal Diseases ; Periodontal Ligament*

No abstract available.

Ventriculoperitoneal shunt (VP shunt) for hydrocephalus is thought to inhibit the closure of processus vaginalis by increasing intraabdominal pressure, thus it promotes the inguinal hernia. We reviewed the incidence and characteristics of the inguinal hernia in VP shunted patients, and tried to estimate the patency rate of processus vaginalis in early childhood. A reprospective review of patients undergone insertion of VP shunt between January 1980 and May 1998 at Seoul National University Children Hospital was done. 262 patients were included in this study. Among them, 28 patients developed inguinal hernia (10.7%). Six patients developed inguinal hernia before the insertion of VP shunt. According to the age of VP shunt, the inguinal hernia developed in 16.2% (12/74) of patients who had undergone VP shunt before 6 months old, 12.4% (11/89) between 6 months and 2 years old and 5.1% (5/99) after 2 years old. Among 22 patients excluding 6 patients who developed hernia before VP shunt, the incidence of inguinal hernia after VP shunt was 8.6% (22/256) with male predominance (M:F=18:4). 8 patients developed inguinal hernia bilaterally (36.4%). It is suggested that at least 14% of processus vaginalis is patent until 2 years old.
Child ; Child, Preschool ; Hernia ; Hernia, Inguinal* ; Humans ; Hydrocephalus ; Incidence ; Infant ; Male ; Seoul ; Ventriculoperitoneal Shunt*

Accurate estimation of the exposure-response relationship between ambient urban particulate matters (PM) and public health is important for regulatory perspective of ambient urban particulate matters (PM). Ambient PM contains various transition metals and organic compounds. PM10 (aerodynamic diameter less than 10 microgram) is known to induce diverse diseases such as chronic cough, bronchitis, chest illness, etc. However, recent evaluation of PM2.5 (aerodynamic diameter less than 2.5 microgram) against health outcomes has suggested that the fine particles may be more closely associated with adverse respiratory health effects than particles of larger size. This study was performed to evaluate PM2.5-induced oxidative stress in rat lung epithelial cell in order to provide basic data for the risk assessment of PM2.5. PM2.5 showed higher cytotoxicity than PM10. Also, PM 2.5 induced more malondialdehyde (MDA) formation than PM10. In Hoechst 33258 dye staining and DNA fragmentation assay, apopotic changes were clearly detected in PM2.5 treated cells in compared to PM10. Expression of catalase mRNA was increased by PM2.5 rather than PM10. PM2.5 induced higher Mth1 mRNA than PM10. In pBR322 DNA treated with PM2.5, production of single strand breakage of DNA was higher than that of PM10. In Western blot analysis, PM2.5 induced more Nrf-2 protein, associated with diverse transcriptional and anti-oxidative stress enzymes, compared to PM10. Our data suggest that PM2.5 rather than PM10 may be responsible for PM-induced toxicity. Additional efforts are needed to establish the environmental standard of PM2.5.
Air Pollutants/chemistry/*toxicity ; Animals ; Apoptosis/physiology ; Benzimidazoles/metabolism ; Blotting, Western ; Cell Line ; Cell Survival/physiology ; DNA Fragmentation/physiology ; DNA Repair Enzymes/genetics/metabolism ; DNA-Binding Proteins/metabolism ; Epithelial Cells/drug effects/enzymology/pathology ; Formazans/metabolism ; GA-Binding Protein Transcription Factor ; Lipid Peroxides/metabolism ; Lung Diseases/*chemically induced/enzymology/pathology ; Oxidative Stress/*physiology ; RNA, Messenger/chemistry/genetics ; Rats ; Reverse Transcriptase Polymerase Chain Reaction ; Tetrazolium Salts/metabolism ; Transcription Factors/metabolism

PURPOSE: To evaluate the effectiveness and safety of primary intravitreal ranibizumab injection as a treatment for retinopathy of prematurity. METHODS: Retrospective analysis of the medical records of patients diagnosed with retinopathy of prematurity and treated with intravitreal ranibizumab injection from January 1, 2013 to January 1, 2016 was performed. We complied with the standards for ‘prethresold, type 1’ established by the Early Treatment of Retinopathy of Prematurity study for intravitreal ranibizumab injection. The follow-up period after injection was at least 9 months. Patients who received additional treatment such as laser photocoagulation or intravitreal injection without reactivation of retinopathy of prematurity were excluded. RESULTS: A total of 21 patients (39 eyes) were included in this study. Nine (16 eyes) were male and 12 (23 eyes) were female. The average duration between treatment decision and intravitreal ranibizumab injection was 2.1 ± 1.5 days. Complete regression of the plus sign occurred 18.2 ± 9.1days after injection. One eye with reactivation was treated with panretinal laser photocoagulation while four other eyes with reactivation were treated with intravitreal bevacizumab injection. There were 87.1% (34/39) eyes that underwent primary intravitreal ranibizumab injection with stable results without any reactivation. There were no systemic complications related to intravitreal ranibizumab injection. CONCLUSIONS: Primary intravitreal ranibizumab injection as a treatment for retinopathy of prematurity showed good efficacy and safety. However, thorough evaluation is needed after primary intravitreal ranibizumab injection due to the potential for reactivation. Long-term monitoring is needed after intravitreal ranibizumab injection.
Bevacizumab ; Female ; Follow-Up Studies ; Humans ; Intravitreal Injections ; Light Coagulation ; Male ; Medical Records ; Ranibizumab* ; Retinopathy of Prematurity* ; Retrospective Studies

One of the fundamental causes of periodontal disease is accumulation of bacterial plaque and calculus and most effective method of removing these plaque and calculus are scaling and root planning using hand curet and ultrasonic scaler. Many studies concerning residual degenerated mineral content after periodontal therapies have been carried out, but some problems about these studies were also known. This research studies mineral concents and distribution of residual root surfaces after perfoming hand curet and ultrasonic scaler on root surfaces of single rooted teeth which were extracted for periodontal reasons. EPMA were used to avoid errors from chemical quantative analysis and in addition SEM observation was also performed. The results were as follows. 1. No differences were found between curet group andultrasonic scaler group in Ca, P, Mg and Na level. 2. Concentration level was decreased in the sequence of Ca, P, Mg and Na. 3. Ca and P level were decreased as going to apical portion at curet group and ultrasonic scaler group. 4. More cementum was removed at cervical portion compared to other portion at curet group and ultrasonic scaler group. 5. Ca, P, Mg level was higher in dentin compared to cememtum. There was no difference in mineral level for Ca, P, Mg and Na between root surfaces treated with hand curet and ultrasonic scaler.
Calculi ; Dental Cementum ; Dentin ; Hand ; Periodontal Diseases ; Tooth ; Ultrasonics*