No abstract available.
Adenocarcinoma* ; Diverticulum* ; Female* ; Humans ; Metaplasia*

PURPOSE: Significant detrusor muscle hypertrophy is a well-recognized clinical finding observed benign prostate hyperplasia (BPH). This can be recognized as a bladder wall thickness (BWT) on transabdominal ultrasonography. The objective of this study was to assess the utility of a BWT measurement using ultrasound in patients with BPH. MATERIALS AND METHODS: A total of 197 men who underwent ultrasonic measurement of the BWT from August 1999 to August 2001 were enrolled in this study. Among them, 15 men comprised the normal control group, 145 men were in the symptomatic BPH group and 37 men were in the retention group. The BWT according to the clinical parameters (international prostate symptom score, peak flow rate, transverse diameter of prostate, age, duration of symptom, retention) was compared and analyzed. RESULTS: The mean BWT in the control group, BPH group and the retention group were 2.21+/-0.44mm, 3.39+/-0.87mm, 4.04+/-0.86mm, respectively. The BWT was well correlated with the international prostate symptom score (I-PSS), the peak flow rate (PFR), and age. The mean BWTs according to the I-PSS grouped into mild, moderate, and severe symptoms were 2.97 0.51mm, 3.12+/-0.68mm, 3.80+/-0.97mm, and the mean BWT according to PFR grouped into <10ml/sec, 10-15ml/sec, > 15ml/sec were 3.65+/-0.93mm, 3.23+/-0.76mm, 2.91+/-0.58mm, respectively. The mean BWT according to age grouped into 50-59 years, 60-69 years 70-79 years, =80 years were 3.03+/-0.70, 3.47+/-0.68, 3.96+/-0.91, 4.60+/-1.25, respectively. Using the receiver operative characteristic curve (ROC curve), the cut-off BWT that can be used to distinguish the obstructive group was 3.60mm. CONCLUSIONS: The BWT can be measured noninvasively. From this study, the BWT can be a useful parameter for evaluating BPH.
Humans ; Hyperplasia ; Hypertrophy ; Male ; Prostate ; Prostatic Hyperplasia* ; Ultrasonics ; Ultrasonography* ; Urinary Bladder*

OBJECTIVE: Although the prevalence of pulmonary tuberculosis has decreased progressively after the national control program for tuberculosis began, nowadays the number of MDRTB is increasing seriously. MDRTB tends to be poor responsive to current antituberculosis regimens. It is mainly due to poor compliance, high rate of side reaction of secondary drugs, and limitation in number of available drugs. The purpose of present study is to evaluate the clinical features of pulmonary tuberculosis patients admitted in one national tuberculosis hospital and to expose the problems pertaining to current remedies, to increase the treatment efficacy for pulmonary tuberculosis including MDRTB in the end. METHOD: Retrospective analysis of 336 pulmonary tuberculosis patients admitted in National Masan Tuberculosis Hospital was done. Contents of analysis were patients profile, the first diagnosed time and medical institutes, family history, residence, previous treatment history, chief complaints at the time of admission, lesion site on chest X-ray film, combined deseases, side reaction to antibuberculosis drugs, used drugs before admission and the results of drug sensitivity test. RESULTS: The ratio between male and female was 4:1. Age showed relatively even distribution from 3rd to 6 th decades. 64.6% of the patients was diagnosed at public health center. Weight loss was the most common complaint at admission. Bilateral lesions on chest X-ray films were 59.8%. 1 30patients had combined desease, of which DM was the most common(37.7%). 95patients had family history, of which parents were the most common(41.7%). According to the time of first diagnosis, 31 patients were diagnosed before 1980, and after then the number of patients was increased by degrees Residence overwhelmed in pusan and gyung-nam province. 258 patients got previous treatment history, of which 112 patients(43.4%) had more than 3 times and only 133 patients(51.6%) got regular medication. 97 patients used more than other 3 drugs in addition to INH, EMB, RFP and PZA before admission. 154 patients were informed with the results of drug sensitivity test. of which 77 patients had resistance to more than 5 drugs. Gastrointestinal problem was the most common in side reaction to drugs. CONCLUSION: In the case of weigt loss of unknown cause, tuberculosis should be suspected. In first treatment, sufficient and satisfactory explanation for tuberculosis is necessary and treatment period should not be stict to 6 month-short term therapy. In retreatment, new drugs should not be added to used drugs enen though drug sensitivity restlts show sensitivity to some of them. Proper time for surgical intervention should not be delayed.
Academies and Institutes ; Busan ; Compliance ; Diagnosis ; Drug Resistance ; Female ; Hospitals, Chronic Disease* ; Humans ; Male ; Parents ; Prevalence ; Public Health ; Retreatment ; Retrospective Studies ; Thorax ; Treatment Outcome ; Tuberculosis* ; Tuberculosis, Pulmonary* ; Weight Loss ; X-Ray Film

OBJECTIVE: Recent studies demonstrated that soluble tumor DNA is found in the plasma of cancer patients, and some microsatellite alteration have been identified in ovarian carcinoma. The aim of study was to detect microsatellite abnormalities in the plasma of patients with ovarian carcinoma and to evaluate their efficacy as molecular screening or diagnostic tool for ovarian cancer. METHODS: In fifteen ovarian carcinoma patients, DNA was extracted from the plasma samples and microsatellite analysis was done with 11 microsatellite markers. RESULTS: All fifteen cases showed at least one tumor specific alteration in microsatellite analysis. The frequency of genetic alteration varies from 14.2% to 85.7%. Highly frequent tumor specfic alteration markers are D18S69 (85.7%), D10S215 (69.2%), D16S504 (66.7%), D8SNEFL (62.5%) and D11S1340 (60.0%). CONCLUSION: These results suggest that the mutation of tumor DNA can be detected in plasma of patients with ovarian carcinoma. LOH is more frequent event and the frequency of genetic alteration is relatively higher than that of previous reports.
DNA ; Humans ; Loss of Heterozygosity* ; Mass Screening ; Microsatellite Instability ; Microsatellite Repeats* ; Ovarian Neoplasms* ; Plasma*

BACKGROUND: We have found abnormal expression of ICAM-1 in thyroid follicular cells from patients with Graves disease and Hashimoto disease. In this report, we present the hormonal regulation of ICAM-1 mRNA expression and the primary structure of 5-regulatory region which is important for transcriptional regulation of ICAM-1 gene. A I.S kb fragment of the 5-regulatory sequences are identified and linked to luciferase as a reporter. METHOD: Those reporter constructs were used to evaluate the expression in response to cytokines and hormones. Deletion analysis of 1.8 kb fragment of ICAM-1 promoter in FRTL-5 cells provide the evidence for the existence of several regulatory elements of enhancer and silencer in ICAM-1 gene transcription in thyroid cells. RESULTS: ICAM-1 mRNA is easily detected by Northern analysis using total RNA from FRTL-5 cells regardless of culture conditions. The transcripts of rat ICAM-1 showed single band of 2.6 kb in length. The FRT cells which was come from early FRTL cell culture did not show ICAM-1 mRNA with usual Northern analysis, We found differential regulation of ICAM-1 RNA level in different culture condition in FRTL-5 cells, The cells maintained at 3H (no hydrocortisone, no insulin, no TSH) condition showed the highest expression level compared to 4H, 5H, or 6H medium. Hydrocortisone markedly decreased the ICAM-1 RNA and insulin partially recovered the hydrocortisone induced repression. TSH which is important in growth and function of FRTL-5 cells could independently downregulate the ICAM-1 RNA levels. Forskolin (10 mM) could mimic the action of TSH on ICAM-1 mRNA. TNF-a and interferon-y increase ICAM-1 expression in FRTL-5 thyroid cells. TSH/forskolin inhibited maximal expression of ICAM-1 by TNF-a and interferon-r. Promoter activity of the ICAM-1 gene was positively regulated by cytokines, TNF-a and IFN-r and negatively regulated by thyroid stimulating hormone. The addition of TSH and FSK caused a 50% decrease in ICAM-1 promoter activity within 24 hour. The TSH and FSK action was mapped at 175 bp and 97 bp of the start of translation. The mutant construct pCAM-175 delGAS which has no GAS sequence showed no TSH mediated suppression of promoter activity. CONCLUSION: These findings suggested that hormones and cytokines differentially regulated the ICAM-1 gene expression and TSH downregulated ICAM-1 gene transcription by inhibiting the activation of IFN-r induced transcription factors which can bind the GAS of ICAM-1 promoter.
Animals ; Cell Culture Techniques ; Clone Cells* ; Cloning, Organism* ; Colforsin ; Cytokines ; Gene Expression ; Graves Disease ; Hashimoto Disease ; Humans ; Hydrocortisone ; Insulin ; Intercellular Adhesion Molecule-1* ; Luciferases ; Rats* ; Repression, Psychology ; RNA ; RNA, Messenger ; Thyroid Gland* ; Thyrotropin ; Transcription Factors

OBJECTIVES: Religion may be beneficial to the treatment of schizophrenia, but religion frequently have bad influence on drug compliance because religion give false concept of the treatment of psychosis. We investigated the influence of religion on the treatment of schizophrenia by assessing the preference for the treatment of psychosis according to religion. METHODS: 102 patients of schizophrenia who were diagnosed by DSM-IV and above 41 scores of GAF score were selected. We assessed religious orientation with the Intrinsic and Extrinsic Religious Orientation Scale and assessed the preference for the treatment method of psychosis(supernatural treatment, primitive medicinal treatment, psychological treatment, religious treatment, biological treatment). The relationship among the variables of demographic data, religious orientation, the treatment method of psychosis were analyzed. RESULTS: 1) Schizophrenic patient showed first preference for biological treatment and psychological treatment and they showed second preference for religious treatment and primitive medicinal treatment. 2) Protestant showed preference for religious treatment. 3) Patient group who have intrinsic religious orientation showed more preference for psychological treatment than patient group who have antireligious orientation. CONCLUSIONS: Generally the relation between religious orientation and the treatment method of psychosis was not significant. But it couldn't be said that religion and the treatment method of psychosis was not related because religious orientation was not related with religious ideology but was related with personality. Schizophrenic patient showed more preference for religious treatment and primitive medicinal treatment and specifically, protestant showed preference for religious treatment. Therefore, we suggest that it is necessary to give persistent education about schizophrenia to patients and their family.
Compliance ; Diagnostic and Statistical Manual of Mental Disorders ; Education ; Humans ; Protestantism ; Psychotic Disorders* ; Schizophrenia

Although rare, agranulocytosis is the most serious, potentially fatal side effect of antithyroid drug. We experienced a 13-year-old girl who developed methimazole-induced agranulocytosis at 1 month after the initiation of treatment. Her granulocyte count recovered after discontinuation of methimazole and treatment with broad spectrum-antibiotics, G-CSF, and methylprednisolone. After recovery from agranulocytosis she was treated with radioiodine ablation therapy. Early detection and proper management of antithyroid drug-induced agranulocytosis is very important.
Adolescent ; Agranulocytosis* ; Female ; Granulocyte Colony-Stimulating Factor* ; Granulocytes* ; Humans ; Methimazole ; Methylprednisolone*

A 54-year-old female developed symmetrical, grouped, perioral papules affecting the perioral area for four years. Histologic examination revealed spongiosis and edema in the follicular infundibulum. Mild mononuclear cell exocytosis and perivascular lymphohistiocytic infiltration were seen. In addition, granulomatous areas were present. She had used topical corticosteroid intermittently and no associated systemic abnormalities. We made diagnosis that this condition was granulomatous perioral dermatitis, which began to resolve in about three weeks after oral doxycycline and topical metronidazole treatment.
Dermatitis, Perioral* ; Diagnosis ; Doxycycline ; Edema ; Exocytosis ; Female ; Humans ; Metronidazole ; Middle Aged

PURPOSE: The objective of this study was to assess the efficacy and clinical outcome of vaginal wall sling in the management of women with stress urinary incontinence. MATERIALS AND METHODS: A total of 37 patients with stress urinary incontinence underwent vaginal wall sling procedure by a single surgeon from January 1998 to December 2001. All patients were evaluated preoperatively with detailed history, physical examination, urinalysis, abdominal ultrasonography, Q-tip test and stress provocation test. The 4 sutures comprising vaginal wall sling (two at the level of mid-urethral complex and two at the level of bladder neck) provide a rectangle of support and compression from the bladder neck to the mid-urethra. The efficacy and clinical outcomes of this procedure were evaluated. RESULTS: With a mean follow-up of 19.2 months(5 to 46 months), 30 patients(81%) failed. Mean operation time was 63.3 minutes. Mean duration of indwelling catheter was 5.2 days and mean duration of hospitalization was 7.2 days. One patient(2.7%) suffered from prolonged voiding difficulty for 30 days. One patient(2.7%) had postoperative bleeding necessitating blood transfusion. De novo urge incontinence developed in 3 patients(8.1%). Other transient minor complications were urinary tract infection(13 cases), suprapubic discomfort(5 cases), and urgency(4 cases). CONCLUSIONS: We consider that vaginal wall sling is a simple and effective procedure for the treatment of stress urinary incontinence, though longer follow-up is necessary to assess the long term effect.
Blood Transfusion ; Catheters, Indwelling ; Female ; Follow-Up Studies ; Hemorrhage ; Hospitalization ; Humans ; Neck ; Physical Examination ; Sutures ; Ultrasonography ; Urinalysis ; Urinary Bladder ; Urinary Incontinence* ; Urinary Incontinence, Urge ; Urinary Tract

Bronchial asthma is a disease characterized by the condition of airway hyper-responsiveness, which serves to produce narrowing of the airway secondary to airway inflammation and/or various spasm-inducing stimulus. Nonspecific bronchoprovocation testing is an important method implemented for the purpose of diagnosing asthma; this test measures the actual degree of airway hyper-responsiveness and utilizes direct and indirect bronchoprovocation testing. Direct bronchoprovocation testing using methacholine or histamine may have superior sensitivity as these substances directly stimulate the airway smooth muscle cells. On the other hand, this method also engenders the specific disadvantage of relatively low specificity. Indirect bronchoprovocation testing using mannitol, exercise, hypertonic saline, adenosine and hyperventilation serves to produce reactions in the airway smooth muscle cells by liberating mediators with stimulation of airway inflammatory cells. Therefore, this method has the advantage of high specificity and also demonstrates relatively low sensitivity. Direct and indirect testing both call for very precise descriptions of very specific measurement conditions. In addition, it has become evident that challenge testing utilizing each of the various bronchoconstrictor stimuli requires distinct and specific protocols. It is therefore important that the clinician understand the mechanism by which the most commonly used bronchoprovocation testing works. It is important that the clinician understand the mechanism of action in the testing, whether direct stimuli (methacholine) or indirect stimuli (mannitol, exercise) is implemented, when the testing is performed and the results interpreted.
Adenosine ; Asthma ; Bronchial Provocation Tests ; Hand ; Histamine ; Hyperventilation ; Inflammation ; Mannitol ; Methacholine Chloride ; Methods ; Myocytes, Smooth Muscle ; Respiratory Hypersensitivity ; Sensitivity and Specificity