No abstract available.
Biliary Tract Diseases/*surgery ; Catheterization/*methods ; Cholangiopancreatography, Endoscopic Retrograde/*methods ; Female ; Humans ; Male ; Sphincterotomy, Endoscopic/*methods

OBJECTIVE: Persistent infection of HPV increases the chance of carcinoma in situ of cervix through stages of cervical intraepithelial neoplasia (CIN) 1, 2, and 3, and finally progresses into cervical cancer. We aimed to explore the safety and efficacy of BLS-M07 which is orally administered agent expressing human papillomavirus (HPV) 16 E7 antigen on the surface of Lactobacillus casei in patients with CIN 3. METHODS: Patients with CIN 3 were recruited in our clinical trial. Reid Colposcopic Index (RCI) grading and serum HPV16 E7 specific antibody production were used to evaluate efficacy of BLS-M07. In phase 1, BLS-M07 was administered orally, 5 times a week, on weeks 1, 2, 4, and 8 with dosages of 500 mg, 1,000 mg, and 1,500 mg. In phase 2a, patients were treated with 1,000 mg. The primary endpoints were the safety and the pathologic regression on colposcopic biopsy. RESULTS: Nineteen patients were enrolled in the CIN 3 cohort. In phase 1, no patients experienced dose limiting toxicity. No grade 3 or 4 treatment-related adverse events or deaths were observed. At 16 weeks after treatment, RCI grading was improved and serum HPV16 E7 specific antibody production increased (p<0.05). Six of 8 (75%) patients with CIN 3 were cured in phase 2a. CONCLUSIONS: Oral immunization with BLS-M07 increases production of serum HPV16 E7 specific antibody which induces protective humoral immunity. The safety of this oral vaccine was proved and could be a competitive non-surgical therapeutic agent of CIN 3. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT02195089
Antibody Formation ; Biopsy ; Carcinoma in Situ ; Cervical Intraepithelial Neoplasia ; Cervix Uteri ; Cohort Studies ; Female ; Humans ; Immunity, Humoral ; Immunization ; Lactobacillus casei ; Papillomavirus E7 Proteins ; Papillomavirus Vaccines ; Uterine Cervical Neoplasms

BACKGROUND: The increase of smoking prevalence in adolescents Is serious problem because of physical and psychological influences furthermore, fixation of smoking habit. This study is aimed at providing applicable basic information to setting up the education programs and strategies to prevent smoking among high school students by analysing smoking behavior and its related factors. METHODS: 835 students from one senior high school in Taegu completed a self administerd questionnaire during school hours in May, 1996. 813 questionnaires with adequate responses were analyzed using SPSS/PC program. All students were asked class years, school satisfaction, school performance score, number of their three best friends who smoke, smoking status of their fathers, religion, allowance, alcoholic drinks, addicting drug use, Zung's self-rating depression scale(SDS) and Zung's self-rating anxiety scale(SAS), Smokers were asked amount of smoking, motives for smoking, when they started smoking, Fagerstrom score. RESULTS: Of the 813 students in the sample 135(16.6%) were current smokers. About the amount of smoking, 59.3% smoked less than 5 cigarettes/day. About the motives of smoking, 34.8% started smoking through the solicitation by friends or for making friends. About when they started smoking, 52.6% started smoking before entrance into senior high school. The related factor with smoking Included class years, school satisfaction, school performance score, numbers of three best friends who smoke, allowance, alcoholic drinking, addicting drug use, SDS. Predictor of smoking were number of three best friends who smoke, number of alcoholic drinking, and allowance. The related factors of nicotine dependency were amount of smoking, allowance, when they started smoking. Predictor of nicotine dependency were amount of smoking, number of three best friends who smoke. CONCLUSIONS: The related factors with smoking included class years, school satisfaction, school performance score, number of three best friends who smoke, allowance, alcoholic drinking, addicting drug use, and SDS. Predictors of smoking were number of three best friends who smoke, number of alcoholic drinking, and allowance.
Adolescent ; Alcoholics ; Anxiety ; Daegu* ; Depression ; Drinking ; Education ; Fathers ; Friends ; Humans ; Male* ; Nicotine ; Prevalence ; Smoke* ; Smoking* ; Surveys and Questionnaires

Endoscopic retrograde cholangiopancreatography (ERCP) is an essential technique for the diagnosis and treatment of pancreatobiliary diseases. However, ERCP-related complications such as pancreatitis, cholangitis, hemorrhage, and perforation may be problematic. For a successful and safe ERCP, preprocedural evaluations of the patients and intervention-related risk factors are needed. Furthermore, in light of the recent population aging and increase in chronic cardiopulmonary diseases in Korea, precautions including endoscopic sedation and prevention of cardiopulmonary complications should be considered. In this literature review, we describe these risk factors and the use of endoscopic sedation. In addition, we reviewed the commonly available guidewires, including their materials and options, used as a basic accessory for ERCP procedures.
Aging ; Cholangiopancreatography, Endoscopic Retrograde* ; Cholangitis ; Diagnosis ; Hemorrhage ; Humans ; Korea ; Pancreatitis ; Risk Factors

Iatrogenic duodenal perforation associated with endoscopic retrograde cholangiopancreatography (ERCP) is a very uncommon complication that is often lethal. Perforations during ERCP are caused by endoscopic sphincterotomy, placement of biliary or duodenal stents, guidewire-related causes, and endoscopy itself. In particular, perforation of the medial or lateral duodenal wall usually requires prompt diagnosis and surgical management. Perforation can follow various clinical courses, and management depends on the cause of the perforation. Cases resulting from sphincterotomy or guidewire-induced perforation can be managed by conservative treatment and biliary diversion. The current standard treatment for perforation of the duodenal free wall is early surgical repair. However, several reports of primary endoscopic closure techniques using endoclip, endoloop, or newly developed endoscopic devices have recently been described, even for use in direct perforation of the duodenal wall.
Cholangiopancreatography, Endoscopic Retrograde ; Duodenum ; Endoscopy ; Sphincterotomy, Endoscopic ; Stents

BACKGROUND: Diastolic function can be assessed by Doppler-derived left ventricular(LV) filling patterns. E/A ratio<1 and prolongation of isovolumic relaxation time(IVRT) are diagnostic of impaired relaxation of left ventricle during diastole. In early stage of acute myocardial infarction, myocardial stiffness can normalize the E/A ratio and mask the Doppler indexes of abnormal relaxation in patients with acute myocardial infarction. METHODS: LV filling patterns were studied with Doppler echocardiography in 10 healthy subjects and 27 patients with recent acute myocardial infarction. Cardiac catherterization was performed in the 11+/-2 days after onset of acute myocardial infarction and left ventricular end-diastolic pressure(LVEDP) and myocardial stiffiness index(MSI) were studied. RESULTS: In patients with acute myocardial infarction, IVRT was significantly prolonged ; E/A ratio and deceleration time were decreased but not significantly different from those of normal subjects. In the patient's group of E/A>1,IVRT and atrial filling fraction(AFF) were significantly shortened, and LVEDP was significantly increased, compared to those of the patient's group of E/A<1. But ejection fraction was similar in both groups. In the patients with acute myocardial infarction, E/A ratio and LVEDP showed good correlation(r=0.64, p<0.05). MSI was increased in the patient's group of E/A>1 and also was well correlated with LVEDP(r=0.8, p<0.05). CONCLUSIONS: Thus we conclude that normal of increased E/A ratio in recent acute myocardial infarction may reflect increased LVEDP due to increased myocardial stiffness.
Deceleration ; Diastole ; Echocardiography* ; Echocardiography, Doppler ; Heart Ventricles ; Humans ; Masks ; Myocardial Infarction* ; Relaxation

Various endoscopic techniques have been developed to overcome the difficulties in biliary or pancreatic access during endoscopic retrograde cholangiopancreatography, according to the preference of the endoscopist or the aim of the procedures. In terms of endoscopic methods, guidewire-assisted cannulation is a commonly used and well-known initial cannulation technique, or an alternative in cases of difficult cannulation. In addition, precut sphincterotomy encompasses a range of available rescue techniques, including conventional precut, precut fistulotomy, transpancreatic septotomy, and precut after insertion of pancreatic stent or pancreatic duct guidewire-guided septal precut. We present a literature review of guidewire-assisted cannulation as a primary endoscopic method and the precut technique for the facilitation of selective biliary access.
Catheterization ; Cholangiopancreatography, Endoscopic Retrograde ; Methods ; Pancreatic Ducts ; Stents

BACKGROUND: The relationship of lifestyle and socioeconomic factors with weight change over 4 years in Korean middle-aged group was assessed. METHODS: A total of 1,167 men, aged 40~59 years, were selected from the Health Promotion Center of Ulsan University Hospital during the period of Jan. 2000 through Mar. 2000. Including anthropometric measures, designed questionnaires were administered concern lifestyle behavior topics with cigarette smoking, exercise, alcohol consumption, dairy product consumption and socioeconomic factors of monthly income and education. The subjects were divided into three groups by body mass index (BMI: kg/m(2)); normal (<23 kg/m(2)), overweight, and obesity (> or =25 kg/m(2)). After 4 years of follow-up, the men were classified into weight change categories; 1) stable weight group (from normal to normal, from overweight to overweight) and 2) weight gain group (from normal to overweight/obesity, from overweight to obesity). RESULTS: The weight gain group were 18.4% (n=215) and the stable overweight group were 81.6% (n=952). Adjusted for age, the frequency of dairy product consumption, the frequency of alcohol drinking, the regularity of exercise, education and monthly income, the smokers (> or =10/day) had significantly high incidence rates of increase in weight (odds ratio=1.77, 95% CI 1.07~2.90). The increased dairy consumers (> or =4/week) had significantly low incidence rates of increase in weight (odds ratio=0.43, 95% CI 0.20~0.93). Otherwise, there were no significant relationships in weight change. CONCLUSION: Smoking and decreased dairy product consumption were related to the increase in weight.
Aged ; Alcohol Drinking ; Body Mass Index ; Dairy Products ; Follow-Up Studies ; Health Promotion ; Humans ; Incidence ; Life Style ; Male ; Obesity ; Overweight ; Smoke ; Smoking ; Socioeconomic Factors ; Weight Gain ; Surveys and Questionnaires

Endoscopic palliative biliary drainage is considered as a gold standard treatment in advanced or inoperable hilar cholangiocarcinoma. Also, metal stents are preferred over plastic stents in patients with >3 months life expectancy. However, the endoscopic intervention of advanced hilar obstruction is often more challenging and complex than that of distal malignant biliary obstructions. In this literature review, we describe the issues commonly encountered during endoscopic unilateral (single) versus bilateral (multiple) biliary stenting for malignant hilar obstruction. Also, we provide technical guidance to improve the technical success rates and patient outcomes, focusing on bilateral metallic stenting techniques such as stent-in-stent or side-by-side deployment.
Cholangiocarcinoma ; Drainage ; Humans ; Life Expectancy ; Plastics ; Stents*

E6 and E7 proteins produced by oncogenic HPV bind to the protein products of cellular tumor suppressor genes p53 and Rb, respectively. This mechanism has been suggested to contribute to the oncogenesis of HPV-infected carcinoma. The cells which are blocked the function of p53 and pub protein continue to divide by bypassing Ml stage known as antiproliferative mechanism but telomeres, the genetic elements at the ends of chromosomes, continue to shorten until the telomeres are so short that further replication is prevented(M2 stage). But telomeres can be maintained if telomerase is derepressed, giving rise to a immortal cell. The present study has been investigated the presence of HPV, telomere length and telomerase activation in cervical carcinomas. HPV DNA were detected by polymerase chain reaction in 17 of 19 precancerous lesions and cervical carcinoma specimens; HPV16 was detected in 12 cases, HPV18 in one case, HPV33 in two cases, and HPV58 in two cases. Overall, the prevalence of HPV was 89.5%. To study the difference of telomere length in cervical carcinomas and each normal counterpart, DNAs were digested with Hinf III and Rsa I to liberate the terminal restriction fragments(TRF). TRFs were resolved on agarose gels and detected by hybridization to the telomeric probe. This result indicated that there were no significant difference of TRF length in samples tested except two cases. TRF length of one carcinoma specimen was found to be significantly increased as compared with normal counterpart, but the other was found to be significantly decreased. Telomerase activity was detected in 4 of dysplasia specimens(5 cases), all of carcinoma in situ(CIS), and 6 of 8 invasive carcinoma. Overall, telomerase activity was detected in 84%. The degree of telomerase activity was high in 2 of dysplasia, 3 of CIS, and 3 of invasive carcinoma. And then there was no apparent association between HPV types and levels of telomerase activity. However, telomerase activity was depressed in invasive carcinoma as compared to dysplasia and CIS. These results suggest that HPV may be a possible causative agent in cervical carcinoma. In addition, telomerase activation may be necessary for the immortalization of cells and the progression of malignancy in cervical carcinoma.
Carcinogenesis ; Cervix Uteri* ; DNA ; Female ; Gels ; Genes, Tumor Suppressor ; Humans* ; Papilloma* ; Polymerase Chain Reaction ; Prevalence ; Sepharose ; Telomerase* ; Telomere*