BACKGROUND: Biodegradable microspheres are a useful method of drug delivery because they are both injectable and biodegradable. Previous work in our group has characterized implantable preparations of local anesthetics in pellets for prolonged regional anesthesia. In this paper we evaluated injectable suspensions of lidocaine-polymer microspheres for extended period of percutaneous sciatic nerve blockade in rats. METHODS: Microspheres were prepared using poly (lactide-co-glycolide) loaded with 50 wt% lidocaine by a solvent evaporation method. In vitro release rate of lidocaine from microspheres was determined by high performance liquid chromatography (HPLC). Percutaneous blockade of the rat sciatic nerve was performed, and sensory blockade of the nerve was assessed using an analgesiometer. RESULTS: Lidocaine was released in a controlled manner in vitro. In general 60% of the drug released in the first day, 80% in two days. Sciatic nerve blockade duration ranged from 8 to 12 hours. Incorporation of dexamethasone 0.05 wt% into the microspheres resulted in significant prolongation of block. CONCLUSION: Prolonged percutaneous blockade of peripheral nerve is achieved using biodegradable polymeric lidocaine microspheres.
Anesthesia, Conduction* ; Anesthetics, Local ; Animals ; Chromatography, Liquid ; Dexamethasone ; Lidocaine* ; Microspheres* ; Peripheral Nerves ; Polymers* ; Rats ; Sciatic Nerve ; Suspensions

Colonic stenting has been suggested as an acceptable therapeutic option for the palliation of malignant colorectal obstruction or to achieve bowel decompression and preparation. It is effective as a bridge to surgery that is useful as an option to avoid emergency colostomy. However, it is associated with complications such as intestinal perforation, stent migration, bleeding, and failure of bowel decompression. Of all the complications, intestinal perforation and failure of bowel decompression are most serious and require surgical treatment. Here we report a case of abdominal compartment syndrome after stent insertion for obstructive colon cancer. The main causative factors for abdominal compartment syndrome were bowel distension associated with endoscopic gas inflation and failure to achieve bowel decompression.
Colon ; Colonic Neoplasms ; Colostomy ; Decompression ; Emergencies ; Hemorrhage ; Inflation, Economic ; Intestinal Perforation ; Intra-Abdominal Hypertension ; Stents

PURPOSE: The aim of this study was to obtain single cell-derived clones from human umbilical cord blood (hUCB) derived mesenchymal stem cell (MSC) population, to compare the gene expression patterns and differentiation characteristics among the hUCB derived MSC population and its monoclonal cell populations, and to determine if the MSC population is homogenous. MATERIALS AND METHODS: The single cells were isolated from a hUCB derived MSC population and cultured on each well of a culture plate. The gene expression pattern of each monoclonal cell population expanded from the single cells was detected by RT-PCR for osteogenic, chondrogenic, and adipogenic specific genes. The monoclonal cell populations were differentiated into osteogenic, chondrogenic, and adipogenic lineages and were confirmed by specific staining. RESULTS: Fifteen monoclonal cell populations were obtained from the total seeding of 864 single cells. The cell morphology and gene expression patterns among the hUCB derived MSCs and its monoclonal cell population were different. Tri-lineage differentiation potency was different among the monoclonal cell populations. CONCLUSION: The difference in the cell morphology, gene expression patterns, and differentiation characteristics among the monoclonal cell populations suggest heterogeneity of the MSC population isolated using the currently available method.
Clone Cells ; Fetal Blood* ; Gene Expression ; Humans* ; Mesenchymal Stromal Cells* ; Population Characteristics ; Umbilical Cord*

Cerebrovascular disease and coronary heart disease are the first and the fourth common causes of death among adults in Korea. Reported risk factors of one of these diseases may prevent other diseases. Therefore, we tried to compare and discriminate the risk factors of these diseases. We recruited four case groups and four control groups among the inpatients who were admitted to Wonju Christian Hospital from March, 1994 to November, 1995. Four control groups were matched with each of four case groups by age and sex. The number of patients in each of four case and control groups were 106 and 168 for acute myocardial infarction(AMI), 84 and 133 for subarachnoid hemorrhage(SAH), 102 and 148 for intracerebral hemorrhage(ICH), and 91 and 182 for ischemic stroke(IS) respectively. Factors whose levels were significantly higher in AMI and IS than in responding control group(RCG) were education, economic status, and triglyceride. Factors whose levels were significantly lower in hemorrhagic stroke than in RCG were age of menarch, and prothrombin time. The factor whose level was higher in AMI than in RCG was uric acid. The factor whose level was higher in AMI, ICH, and SAH than in RCG was blood sugar. Factors whose levels were significantly higher in all the case groups than in RCG were earlobe crease, Quetelet index, white blood cell count, hemoglobin, hematocrit, and total cholesterol. The list of risk factors were somewhat different among the four diseases, though none of the risk factors to the one disease except prothrombin time acted as a preventive factor to the other diseases. The percent of grouped cases correctly classified was higher in the discrimination of ischemic diseases(AMI and IS) from hemorrhagic diseases(SAH and ICH) than in the discrimination of cerebrovascular disease from AMI. The factors concerned in the discrimination of ischemic diseases from hemorrhagic diseases were prothrombin time, earlobe crease, gender, age uric aci, education, albumin, hemoglobin, the history of taking steroid, total cholesterol, and hematocrit according to the selection order through forward selection.
Adult ; Blood Glucose ; Body Mass Index ; Case-Control Studies* ; Cause of Death ; Cholesterol ; Coronary Disease* ; Discrimination (Psychology) ; Education ; Gangwon-do ; Hematocrit ; Humans ; Inpatients ; Korea ; Leukocyte Count ; Prothrombin Time ; Risk Factors* ; Stroke ; Triglycerides ; Uric Acid

Lymphocytes can produce various kinds of cytokines which are responsible for the development of the infectious and allergic inflammation. We focused on the role of the lymphocyte in the pathogenesis of the nasal polyp. This study was designed to evaluate the functional differences of the lymphocytes between allergic and non-allergic polyp. Lymphocytes were obtained from peripheral blood and tissues of polyp in 12 patients with non-allergic polyp, 7 patients with allergic polyp and 5 normal subjects as control. Cytokines were measured with ELISA from each group of lymphocytes after stimulation with Concanavalin A (Con A). We compared the production of interleukin (IL)-2, IL-4, tumor necrosis factor (TNF)-alpha and interferon (IFN)-gamma between the non-allergic and allergic groups. The levels of IL-4 and IL-6 from polyp tissue lymphocytes were higher in allergic group, while those of IL-2 and IFN-gamma were higher in non-allergic group. The levels of IL-4, IL-6 and TNF-alpha from peripheral blood lymphocytes were higher in allergic group, and IFN-gamma was higher in non-allergic group. These results suggest that cytokine productivity of the polyp tissue lymphocytes appear to be parallel to that of the peripheral blood lymphocytes in each group and shows distinct pattern of ytokine production between two groups.
Concanavalin A ; Cytokines ; Efficiency ; Enzyme-Linked Immunosorbent Assay ; Humans ; Hypersensitivity ; Inflammation ; Interferons ; Interleukin-2 ; Interleukin-4 ; Interleukin-6 ; Interleukins ; Lymphocytes* ; Nasal Polyps* ; Polyps ; Tumor Necrosis Factor-alpha

BACKGROUND: Recurrent aphthous stomatitis (RAS) is usually the earliest sign of Behcet's disease. Hyperhomocysteinemia can damage endothelial cells and progress to obstructive vascular disease. It has been reported that hyperhomocysteinemia is a marker of activation in Behcet's disease. Enzyme 5,10-methylenetetrahydrofolate reductase may be one of the main factors that regulates plasma homocysteine levels. Homozygosity for the C677T (MTHFR C677T) mutation is associated with reduced activity of this enzyme and considered the most common genetic cause of elevated serum homocyteine levels. However its relationship to vascular injury in Behcet's disease remains controversial, and its relationship to RAS is unknown. Apolipoprotein E (Apo E) has both immunoregulatory and anti-infective features. Search for Apo E polymorphism and lipid composition in RAS patients might be a clue to pathogenesis of RAS. OBJECTIVE: To analyze the relationship of MTHFR gene C677T polymorphism, several epidemiologic factors such as age and sex, smoking, lipid composition and Apo E polymorphism to vasculitis in RAS, we assessed the MTHFR gene C677T polymorphism, Apo E polymorphism and lipid composition in RAS and normal population. METHODS: We analyzed data from the General Health survey conducted on 1,243 participants (M:F=281:962) over a 20 year-old in Incheon city. Medical interview and laboratory test for methylenetetrahydrofolate reductase (MTHFR) C677T gene polymorphism, apolipoprotein E polymorphism were completed. Statistical significance was analyzed by chi-square test and multistep logistic regression analysis. RESULTS: Among normal population over the age of twenty, a total of 34.2% (426/1,243) had RAS. Female predominance (4.5:1, p=0.003) was noted. The incidence of RAS in age group 20 to 39 year old is higher than the over 40 age group. The incidence is higher in smoking group compared to the nonsmoking group in multistepwise logistic regression analysis. Frequency of the MTHFR C677T genotypes was highest at CT compared to CC and TT homozygous genotype in normal and RAS patients group. There was no significant statistical differences in MTHFR genotypes in RAS patients compared to the control group. Similarly, Apo E genotype analysis revealed no significant statistical differences either. Apo E genotype and total cholesterol, HDL-cholesterol, triglyceride level didn't show any associations. CONCLUSION: This study revealed insignificant association between the MTHFR C677T mutation and RAS. Apo E genotype didn't show a significant statistical difference in RAS patients compared to normal controls.
Apolipoproteins ; Apolipoproteins E ; Cholesterol ; Endothelial Cells ; Epidemiologic Factors ; Female ; Genotype ; Health Surveys ; Homocysteine ; Humans ; Hyperhomocysteinemia ; Incidence ; Logistic Models ; Methylenetetrahydrofolate Reductase (NADPH2) ; Oxidoreductases ; Plasma ; Smoke ; Smoking ; Stomatitis, Aphthous ; Tetrahydrofolates ; Vascular Diseases ; Vascular System Injuries ; Vasculitis

A desmoplastic small round cell tumor (DSRCT) is a rare and aggressive neoplasm with an extremely poor prognosis. It primarily affects children and young males. The most common sites are the abdomen areas, particularly the pelvic region. Usually, it is a large tumor mass accompanied by extensive peritoneal seeding. Microscopically, the typical appearance is a well-defined nests or clusters of small round tumor cells with an undifferentiated type, surrounded by a prominent desmoplastic stroma. Immunohistochemically, the tumor cells show a primitive uncertain histogenesis that can simultaneously express the epithelial, mesenchymal, and neural phenotype. There is no definitive treatment modality. Although a surgical resection, chemotherapy and radiotherapy are to the main treatments, the prognosis is poor. We experienced a case of a desmoplastic small round cell tumor at the retroperitoneal space. A 42-year-old woman was admitted for a palpable mass in the left upper abdomen for 1 months. Compoterized tomography revealed a retroperitoneal tumor. A complete excision of the tumor was performed. The histological examination confirmed the diagnosis of a desmoplastic small round cell tumor. The tumor recurred 3 months later. She received the first chemotherapy regimin with high-dose cyclophosphamied, adriamycin and vincristine. Computed tomography showed that the recurred tumor disappeared after 6 cycles of chemotherapy, but it relapsed 6 months later. She died of sepsis during the second chemotherapy regimen. The survival time was 21 months.
Abdomen ; Adult ; Child ; Desmoplastic Small Round Cell Tumor* ; Diagnosis ; Doxorubicin ; Drug Therapy ; Female ; Humans ; Male ; Pelvis ; Phenotype ; Prognosis ; Radiotherapy ; Retroperitoneal Space ; Sepsis ; Vincristine

PURPOSE: This study was conducted to suggest direction and strategy of safety education proper to elementary school children. METHOD: The subject of this survey consisted of 313 3rd-5th grade from 4 elementary schools in Kyungi-Do and Kwangwon-Do. Data were collected from March to May, 2002 using a questionnaire about "safety education needs", "knowledge about injury prevention", "attitude about injury prevention. RESULT: 1. The degree of safety education needs showed averaged 77.50 on the basis of 100 points. 2. The degree of knowledge and attitude about injury prevention showed averaged 72.81 and 81.74 seperately on the basis of 100 points. 3. With the respect to the demographic characteristics, there were stastically significant differences in safety education need according to children's grade(F=8.692, p=.003), sex(t=-2.059, p=.040), family type(t=-2.229, p=.027) and in knowledge & attitude about injury prevention, there statiscally significant difference according to experience of injury prevention education(t=3.058, p=.003; t=5.308, p=.000) each. 4. The level of safety education needs is correlated at signficant level with knowledge and attitude about injury prevention of childrens(r=.166, p=.048; r=.265, p=.001) and between knowledge and attitude about injury prevention, there was significant correlation (r=.427, p=.000). CONCLUSION: From this results, nurses can plan safety education program appropriate to children's needs, level of knowledge and attitude about injury prevention.
Child* ; Education* ; Gangwon-do ; Humans ; Child Health ; Surveys and Questionnaires

PURPOSE: To identify possible predictors of pathologic complete response (pCR) of rectal cancer after preoperative concurrent chemoradiotherapy (CCRT). MATERIALS AND METHODS: We conducted a retrospective review of 53 patients with rectal cancer who underwent preoperative CCRT followed by radical surgery at a single center between January 2007 and December 2012. The median radiotherapy dose to the pelvis was 54.0 Gy (range, 45.0 to 63.0 Gy). Five-fluorouracil-based chemotherapy was administered via continuous infusion with leucovorin. RESULTS: The pCR rate was 20.8%. The downstaging rate was 66%. In univariate analyses, poor and undifferentiated tumors (p = 0.020) and an interval of ≥7 weeks from finishing CCRT to surgery (p = 0.040) were significantly associated with pCR, while female gender (p = 0.070), initial carcinoembryonic antigen concentration of <5.0 ng/dL (p = 0.100), and clinical stage T2 (p = 0.100) were marginally significant factors. In multivariate analysis, an interval of ≥7 weeks from finishing CCRT to surgery (odds ratio, 0.139; 95% confidence interval, 0.022 to 0.877; p = 0.036) was significantly associated with pCR, while stage T2 (odds ratio, 5.363; 95% confidence interval, 0.963 to 29.877; p = 0.055) was a marginally significant risk factor. CONCLUSION: We suggest that the interval from finishing CCRT to surgery is a predictor of pCR after preoperative CCRT in patients with rectal cancer. Stage T2 cancer may also be an important predictive factor. We hope to perform a robust study by collecting data during treatment to obtain more advanced results.
Carcinoembryonic Antigen ; Chemoradiotherapy* ; Drug Therapy ; Female ; Hope ; Humans ; Leucovorin ; Multivariate Analysis ; Pelvis ; Polymerase Chain Reaction ; Radiotherapy ; Rectal Neoplasms* ; Rectum ; Retrospective Studies ; Risk Factors

PURPOSE: To evaluate CT findings which may help differentiate benign from malignant parotid tumors. MATERIALS AND METHODS: The CT findings of seventy-one cases with surgically-proven parotid tumors were retrospectively analysed for size, location, margin, internal density, adjacent tissue plane and lymphadenopathy. RESULTS: The margin of the mass was smooth and sharp in most benign tumors (89.5%), and irregular or indistinct in twelve which were malignant (75%, p<0.01). With regard to internal density, 70.2% of benign tumors were homogeneous (similar to muscle) and 81.3% of malignant tumors were heterogeneous (p<0.01). When analysing low density patterns within the mass, focal low densities in benign tumors (11/17) and diffuse or scattered multifocal low densities in those which were maligant (8/13) were frequently seen. Three malignant tumors invaded adjacent muscles, the parapharyngeal space, and bones, each in one case, and twelve malignant and one benign tumor infiltrated the adjacent fascia or subcutaneous fat layer. In five patients with a malignant tumor, obliteration by the mass of the fat plane between the mastoid tip and styloid process was noted, suggesting facial nerve invasion, while in three cases of malignancy, lymphadenopathy greater than 1cm was seen. CONCLUSION: In differentiating malignant and benign parotid tumors, the presence of irregular or indistinct margin of the mass, and invasion of adjacent structures, are important. Lymph node enlargement greater than 1cm and diffuse internal low densities, which may suggest necrosis or cystic change were also helpful in differential diagnosis.
Diagnosis, Differential* ; Facial Nerve ; Fascia ; Humans ; Lymph Nodes ; Lymphatic Diseases ; Mastoid ; Muscles ; Necrosis ; Retrospective Studies ; Subcutaneous Fat