PURPOSE: Insulin-like growth factor I (IGF-I) is a ubiquitous peptide, which influences cell proliferation and differentiation in many tissues through the actions of endocrine, autocrine and paracrine. Recent studies have suggested that individuals with increased IGF-I levels have an increased risk of prostate cancer (Pca). We determined the serum IGF-I levels in patients with Pca to evaluate the clinical use of IGF-I. MATERIALS AND METHODS: The control group was composed of 60 age-matched healthy subjects, and the BPH group comprised of 40 patients with benign prostatic hyperplasia (BPH). Serum samples were collected from the control and Pca groups, both before and during the hormonal therapy, and in the hormone-refractory state (n=103). The median PSA levels in the healthy subjects and the patients with BPH and Pca were 1.7, 2.9 and 71.9ng/ml, respectively. The median prostate volume in the healthy subjects and the patients with BPH and Pca were 17, 39 and 42gm, respectively. The IGF-I levels between the groups were compared, according to the age, prostate volume, prostate-specific antigen (PSA) and treatment. RESULTS: The median serum IGF-I levels in the healthy subjects and the patients with BPH and Pca were 61.4, 55.5 and 53.5ng/ml, respectively, with no statistical significance. The median IGF-I level during treatment for Pca (51.5ng/ml) was not significantly altered compared to that in the pretreated Pca. The median IGF-I level was lower in the hormone-refractory Pca (50.7ng/ml) than in the pretreated Pca, but this decrease was not statistically significant. There was no association between the serum IGF-I levels and PSA in the patients with BPH and Pca. No correlation was detected between the serum IGF-I levels and the prostate volume. There was no significant difference between the serum IGF-I levels and age. CONCLUSIONS: Our results suggest IGF-I is not a useful marker in the diagnosis and management of Pca.
Cell Proliferation ; Diagnosis ; Humans ; Insulin-Like Growth Factor I* ; Passive Cutaneous Anaphylaxis ; Prostate* ; Prostate-Specific Antigen ; Prostatic Hyperplasia ; Prostatic Neoplasms*

Video-assisted thoracoscopic surgery (VATS) has advantages compared with open thoracotomy. One lung ventilation, is indispensible to VATS, commonly is accomplished with a double-lumen endotracheal tube. For infants and small children, there is no double-lumen endotracheal tube suitable, various modified techniques are used to achieve one lung ventilation. Recently introduced a small sized wire-guided endobronchial blocker gives us another choice of one lung ventilation for VATS in small children. Using a wire-guided endobronchial blocker and multiport adapter for young children under flexible bronchoscope, we provided one lung ventilation (OLV) during VATS successfully without complications.
Bronchoscopes ; Child ; Humans ; Infant ; One-Lung Ventilation ; Thoracic Surgery, Video-Assisted ; Thoracotomy

OBJECTIVE: Bupropion is an antidepressant with proven efficacy for smoking cessation, however the response rate is some limited. With this background, the authors investigated the difference of early bupropion response in smoking cessation according to individual genetic polymorphism and temperamental characteristics. METHOD: Subjects were 113 Korean male volunteers who were nicotine dependent and wanted to quit smoking. Authors compared 6 candidate genes (DRD2, DRD4, dopamine transporter, norepinephrine transporter, serotonin transporter, COMT), and Temperament Character Inventory (TCI) between response group and non-response group after 3 weeks bupropion treatment. RESULT: Among 6 candidate genes, DRD2 homozygotes (A2/A2+A1/A1), COMT H/H genotype and H allele carriers showed high rate of smoking cessation by bupropion. NET-8 GG genotype and G allele carriers showed low rate of smoking cessation by bupropion. Persistence score in TCI was significant between two groups. CONCLUSION: DRD2, COMT, NET-8 genetic polymorphisms and some temperamental characteristics could predict success of smoking cessation by early treatment response of bupropion.
Alleles ; Bupropion* ; Dopamine Plasma Membrane Transport Proteins ; Genotype ; Homozygote ; Humans ; Male ; Nicotine ; Norepinephrine Plasma Membrane Transport Proteins ; Polymorphism, Genetic* ; Serotonin Plasma Membrane Transport Proteins ; Smoke* ; Smoking Cessation* ; Smoking* ; Temperament* ; Volunteers

We report a case of biopsy-proven secondary hemosiderosis of the lung in a 58-year-old patient with mitralvalvular heart disease. Both chest radiography and high-resolution CT demonstrated patchy areas of ground-glassopacity; the former indicated that it was in both lungs, while the latter showed inter- and intralobular septalthickening. These findings were reversible when pulmonary venous hypertension was corrected.
Heart Diseases ; Heart Valve Diseases* ; Hemosiderosis* ; Humans ; Hypertension ; Lung ; Middle Aged ; Radiography ; Thorax

PURPOSE: This study examined the effect of a varus positioned femoral stem after cementless proximal fitting total hip arthroplasty. MATERIALS AND METHODS: A total of 144 hips in 136 patients who underwent cementless total hip arthroplasty, were followed-up. Twenty-one varus positioned hips were compared with 123 neutral positioned hips. The clinical results were analyzed according to the level of thigh pain and the Harris Hip score. The radiological outcome was assessed according to osteolysis, loosening and stem failure. RESULTS: In the varus positioned hips, thigh pain was present in 1 hip, and the average Harris Hip Score was 96 points. None of the implants showed radiological evidence of loosening or impending failure. Localized osteolysis was identified in 1 hip, non-progressive radiolucencies in 2 hips, and cortical hypertrophy in 1 hip. In the neutral positioned hips, thigh pain was present in 6 hips, and the average Harris Hip Score was 97 points. Localized osteolysis was identified in 8 hips, non-progressive radiolucencies in 7 hips, cortical hypertrophy in 9 hips. CONCLUSION: Patients with varus alignment of the stem did not present poorer clinical outcomes than those with neutral alignment of the stem.
Arthroplasty, Replacement, Hip* ; Hip ; Humans ; Hypertrophy ; Osteolysis ; Thigh

PURPOSE: The objective of this study was to obtain improved susceptibility weighted images (SWI) of the cervical spinal cord using respiratory-induced artifact compensation. MATERIALS AND METHODS: The artifact from B0 fluctuations by respiration could be compensated using a double navigator echo approach. The two navigators were inserted in an SWI sequence before and after the image readouts. The B0 fluctuation was measured by each navigator echoes, and the inverse of the fluctuation was applied to eliminate the artifact from fluctuation. The degree of compensation was quantified using a quality index (QI) term for compensated imaging using each navigator. Also, the effect of compensation was analyzed according to the position of the spinal cord using QI values. RESULTS: Compensation using navigator echo gave the improved visualization of SWI in cervical spinal cord compared to non-compensated images. Before compensation, images were influenced by artificial noise from motion in both the superior (QI = 0.031) and inferior (QI = 0.043) regions. In most parts of the superior regions, the second navigator resulted in better quality (QI = 0.024, P < 0.01) compared to the first navigator, but in the inferior regions the first navigator showed better quality (QI = 0.033, P < 0.01) after correction. CONCLUSION: Motion compensation using a double navigator method can increase the improvement of the SWI in the cervical spinal cord. The proposed method makes SWI a useful tool for the diagnosis of spinal cord injury by reducing respiratory-induced artifact.
Artifacts ; Cervical Cord ; Compensation and Redress ; Diagnosis ; Methods ; Noise ; Qi ; Respiration ; Spinal Cord ; Spinal Cord Injuries

BACKGROUND: As the result of renal transplantation improving, also increasing the number of graft failure which will be a candidate for second renal transplantation. The purpose of this study is to evaluate the factors that influence the survival of retransplanted kidney. METHODS: Among 775 renal transplantations that have been performed in Dongsan Medical Center until August 2007, 225 cases were failed their graft function and 59 of them were retransplanted during their follow up period. Graft survival of retransplanted kidney was compared with primary renal transplantation and factors that affecting the survival of kidney retransplantation were evaluated. RESULTS: Main causes of graft failure of first kidney transplantation were chronic rejection, followed by recurrence of original disease of recipient and acute vascular rejection. Mean survival time was 72.6 months (15 days~161 months). One and 5 years graft survivals were 94.6%, 90.7%, and patient survivals were 100.0%, 97.8%, respectively. Among the factors which showed significance in univariate analysis, short interval between failure of first transplantation and retransplantation, and graft failure due to chronic rejection were statistically significant unfavorable factors for survival of retransplanted kidney. CONCLUSIONS: Kidney retransplantation showed similar graft and patient survival compare to the first one. However, retransplantation should be performed after enough time after graft failure and should be cautious in a patient who lost their graft due to chronic rejection.
Follow-Up Studies ; Graft Survival ; Humans ; Kidney ; Kidney Transplantation ; Recurrence ; Rejection (Psychology) ; Survival Rate ; Transplants

PURPOSE: The aim of this study was to assess the diagnostic accuracy of chest comput-ed radiography for thedetection of bronchiectasis diagnosed by high-resolution CT. MATERIALS AND METHODS: Our study included 100consecutive patients with bronchiec-tasis and 20 normal subjects, all seen on high-resolution CT. Two independentobservers analyzed chest computed radiographs and recorded the presence and type of bronchiectasis, and the invo lved lobe. RESULTS: On high-resolution CT, bronchiectasis was seen in one lobe in 29 patients, two lobes in 29,three lobes in 16, four lobes in 14, five lobes in 10, and six lobes in t wo. The bronchiectasis was tubular in 55patients, mixed tubular and cystic in 29, and cystic in 16. For observer 1, the sensitivity, specificity, andaccuracy of chest com-puted radiography was 95%, 85%, and 93%, respective l y, while for observer 2, thecorresponding figures were 93%, 85%, and 92%. Sensitivity and specificity for observ-er 1 were 33% and 96% for theright upper lobe (46% and 95% for observer 2), 68% and 86% for the right middle lobe (76% and 86%), 70% and 78%for the right lower lobe (48% and 83%), 50% and 100% for the left upper lobe (50% and 97%), 63% and 90% for thelingular segment (49% and 93%), and 87% and 75% for the left lower lobe (75% and 90%), respective l y. Tubularbronchiectasis involving a single lobe was the most common source of false negative readings based on the findingsof chest com-puted radiography. CONCLUSION: Because chest computed radiography is not inferior to high-resolutionCT for the detection of bronchiectasis, the routine use of chest computed radiography in screening forbronchiectasis is feasible. Howeve r, due to its low sensitivity in detect-ing bronchiectasis in a specific lobe,preoperative high-resolution CT examination may be needed.
Bronchiectasis* ; Humans ; Mass Screening ; Radiography* ; Reading ; Sensitivity and Specificity ; Thorax*

PURPOSE: Medical direction is an integral part of proper prehospital care, which is performed by EMS providers. In Gyunggi province, a number of measures have been implemented to improve the direct medical direction system. We aimed to report on the process and results of the newly implemented medical direction system. METHODS: This is a descriptive analysis of the newly implemented medical direction system for community EMS providers from June 2014 to October 2014. Direct medical direction was requested by emergency medical technicians (EMTs) during the study period, as follows: when a destination hospital was selected, EMTs requested medical direction from the physicians at the destination hospital. During the study period specially-trained advanced EMTs were permitted to perform intravenous (IV) access for fluid or glucose infusion without direct medical direction. EMTs were asked to complete records when they requested direct medical direction and performed IV access without medical direction. These records were collected and used in the analysis. RESULTS: Of 5949 direct medical direction requests, 5527 were analyzed; 2958 (53.5%) cases were requested to the destination hospitals, 2569 (46.5%) were requested to the centralized dispatch center. 'Patient evaluation' was the most common reason for EMTs to request medical direction to the destination hospitals (1680, 54.4%) and centralized dispatch center (980, 38.1%). EMTs' degree of satisfaction did not differ significantly between destination hospitals and the centralized dispatch center (4.12+/-0.82 and 4.09+/-0.84, p=0.053). IV access rate for hypotensive patients increased 6.1% during the study period compared to the same period of 2013 (17.6% and 11.5%, p<0.01). CONCLUSION: We found that it is feasible to request direct medical direction to the destination hospitals and perform IV access for fluid or glucose infusion without direct medical direction for specially-trained advanced EMTs. Continuing efforts to establish an optimized medical direction system would be required for proper pre-hospital care.
Emergency Medical Service Communication Systems ; Emergency Medical Services ; Emergency Medical Technicians ; Glucose ; Humans ; Korea

BACKGROUND: Total knee arthroplasty (TKR) is associated with a significant loss of blood. Fluid substitution with crystalloid or colloid solutions to correct perioperative hypovolemia is essential. Colloid solutions, and especially hydroxyethyl starches (HES), are used to treat hypovolemia, but they may affect blood coagulation. The purpose of this study was to test the efficacy and the safety of colloid solutions in patients undergoing TKR. METHODS: The patients undergoing TKR were divided into a group that underwent fluid management with Voluven(R) (n = 22) and a group that was managed with Hextend(R) (n = 24). The blood loss, the autotransfused blood volume, the hemoglobin level, the allogenic blood requirement, the urine output and the complications were assessed. RESULTS: There were no significant differences in the amount of blood loss, the autotransfused blood volume, the allogenic requirement, the urine output and the complications between the two groups. CONCLUSIONS: Voluven(R) and Hextend(R) are equally efficacious plasma volume substitutes when performing TKR with an autotransfusion of drained blood.
Arthroplasty ; Blood Coagulation ; Blood Transfusion, Autologous ; Blood Volume ; Colloids ; Hemoglobins ; Hetastarch ; Humans ; Hypovolemia ; Isotonic Solutions ; Knee ; Plasma Volume ; Postoperative Hemorrhage