OBJECTIVE: The aim of this study were to investigate degree of satisfaction in referring physicians' psychiatric consultation services and their attitudes and opinions toward psychiatry, and the correlation between two them. METHOD: A total of 159 survey questionnaire were distributed to physicians in a University Hospital. The questionnaires contained the level of satisfaction in referring physicians' psychiatric consultation services and their attitudes and opinions toward psychiatry. 135 surveys were returned, representing 85% return rate. Statistical method used were Cronbach's alpha coefficient for testing reliability, factor analysis for testing validity, and t-test or ANOVA with SAS. RESULTS: Internal consistency reliability was tested by Cronbach's alpha. Cronbach's alpha was 0.8594 for total 23 items. Twenty-three items and seven factors were emerged and these contributed 66.8% of the variance in the total score. Factor I in the psychiatric consultation questionnaire was positively correlated with overall merits of the field of psychiatry in the attitude questionnaire, factor II in the psychiatric consultation questionnaire was positively correlated with possible abuses and social criticisms in the attitude questionnaire, factor III in the psychiatric consultation questionnaire was positively correlated with efficacy in the attitude questionnaire, factor V in the psychiatric consultation questionnaire was positively correlated with possible abuses and social criticisms in the attitude questionnaire, factor VI in the psychiatric consultation questionnaire was positively correlated with overall merits of the field of psychiatry in the attitude questionnaire. CONCLUSIONS: Our results supported the hypothesis that referring physicians' satisfaction to the psychiatric consultation was positively correlated with psychiatrists' attitude, and that physicians with more positive attitudes and those had more knowledge on psychiatry showed greater satisfaction in psychiatric consultation service than those without.
Factor V ; Fibrinogen ; Prothrombin ; Surveys and Questionnaires ; Thromboplastin

A 66-year-old man with incidentally detected mass in the left kidney visited our hospital. Intravenous pyelogram, ultrasonogram, computerized tomography suggested a renal cell carcinoma in the left side of the horseshoe kidney. A left radical nephrectomy with division of the isthmus was performed. The pathological diagnosis revealed renal cell carcinoma consisting of clear cell type without invasion of the capsule or renal pelvis.
Aged ; Carcinoma, Renal Cell* ; Diagnosis ; Humans ; Kidney Pelvis ; Kidney* ; Nephrectomy ; Ultrasonography

PURPOSE: To identify the localization of indoleamine 2,3-dioxygenase (IDO) in human corneal cells and to evaluate its ability to act as a local immunosuppressive factor. METHODS: The expression profile of IDO was obtained with RT-PCR and Western blot of in a primary culture of human corneal cells (fibroblasts, epithelial cells and endothelial cells). In order to investigate the immunosuppressive function of IDO, immune cells were cultured in a human corneal cell-conditioned medium, and their prolifleration was identified by the MTT assay. Moreover, apoptotic effects of IDO in immune cells treated with IFN-gamma were also investigated with apoptosis ELISA. RESULTS: Among the three different types of human corneal cells analyzed, mRNA and protein expression of IDO was observed only in human corneal fibroblasts. Immune cells cultured in a human corneal fibroblast-conditioned medium showed inhibited proliferation. Moreover, IFN-gamma-induced expression of IDO significantly enhanced apoptotic ability in a dose-depandant manner. CONCLUSIONS: Our results suggest that human corneal fibroblasts are relatively immuno-resistant and that expression of IDO may be one of the factors involved in the immune tolerance observed in corneal grafts.
Apoptosis ; Blotting, Western ; Enzyme-Linked Immunosorbent Assay ; Epithelial Cells ; Fibroblasts ; Humans* ; Immune Tolerance ; Indoleamine-Pyrrole 2,3,-Dioxygenase ; RNA, Messenger ; Transplants

PURPOSE: To investigate the toxicity of a short-term application of timolol maleate, dorzolamide, and benzalkonium chloride (BAC) on human conjunctival epithelial cells in vitro. METHODS: Chang's conjunctival epithelial cell line was treated for 5 min, 15 min, 30 min, and 60 min with various concentrations of timolol, dorzloamide, or BAC, and then examined 4 hrs or 24 hrs later. Cell viabilities were assessed by MTT assay. The expressions of various cytokines by timolol maleate, dorzolamide, and BAC treatment in human conjunctival epithelial cells were evaluated using ELISPOT. RESULTS: BAC significantly decreased survival of conjunctival epithelial cells in a dose and time dependent manner compared with timolol and dorzolamide. Inflammatory cytokines, IL-6 and IL-8, were highly expressed in conjunctival epithelial cells treated with timolol, dorzolamide, and BAC. CONCLUSIONS: The present study suggests that increased expression of inflammatory markers, IL-6 and IL-8 might explain the ocular surface disorder in patients receiving antiglaucoma medication.
Benzalkonium Compounds ; Cell Survival ; Cytokines ; Enzyme-Linked Immunospot Assay ; Epithelial Cells* ; Humans* ; Interleukin-6 ; Interleukin-8 ; Timolol

Hyponatremia, well known as a serious medical condition, is the most frequent electrolyte disorder in clinical medicine. The aim of this study is to bring to readers affecting factors in hyponatremia treatment and to suggest effective treatment guideline. We studied general characteristics, associated serum potassium change, relationship of sodium concentration in urine, and affecting factors on serum sodium correction in 76 hyponatremic patients who had admitted Hanyang University Kuri Hospital. These 73 hyponatremic patients were divided into 10 groups according to cause and treatment by retrospective analysis(1 group : G-I origin, 2 group : CRF, 3 group : CHF, 4 group: LC, 5 group : adrenal origin, 6 group : diuretics use, 7 group : CHF with di- uretics use, 8 group : LC with diuretics use, 9 group : polydypsia, 10 group : SIADH). Serum sodium were 124.2+/-6.9mEq/L in initial diagnosis, 125.6 +/-7.7mEq/L after 48 hour, and 129.8+/-6.3mEq/L in final evaluation. Among these hyponatremic patients, thirty patients' (41.1%) sodium correction rate were below 0.5mEq/L/hr during initial 48 hour and fifteen patients(20.5%) were corrected above 135mEq/l in serum sodium Initial serum potassium was average 4,07mEq/L, and 15 patients in 73 hyponatremic patients were hypokalemic feature. Eight patients of 15 hypokalemic patients were corrected to normal potassium level and in addition, four patients of 8 corrected patients were corrected to normal sodium level above 135mEq/L. The disease frequency were highest in GI origin (31.5%), followed by SIADH(20.5%) and LC(12.3%). In our study, hyponatremia correction was not related to patient sex, age, and initial serum sodium concentration. In conclusion, Hyponatremia prognosis was not related to initial serum sodium concentration and corection rate, but related to treatment of underlying disease. And hypokalemia acompanied by hyponetremia was corrected after correction of hyponatremia.
Clinical Medicine ; Diagnosis ; Diuretics ; Humans ; Hypokalemia ; Hyponatremia* ; Potassium ; Prognosis ; Retrospective Studies ; Sodium

Pterygium is a proliferative disease. Recent research has reported that stem cells are involved in the pathogenesis of various proliferative diseases, including solid tumors and diabetic proliferate vitreoretinopathy. In previous literature, we hypothesized that adult stem cells originated from bone marrow were involved in the pathogenesis of pterygium. We proved this by immunohistochemical staining with various stem cell markers. The staining showed adult stem cells in the pterygium. c-kit positive cells were observed primarily in the stroma, and some cells were also found in the basal epithelium. AC133 and CD34 positive cells were primarily found in the basal epithelium and were ovoid shaped, similar to the c-kit cells. However, some cells were found in vascular endothelium. STRO-1 positive cells were found mainly in the stroma and were spindle shaped. In recurrent pterygium, cells were more scattered and the expression pattern was denser. Therefore, we suggest a new theory of pterygium pathogenesis. Inflammation caused by environmental factors triggers the abnormal production of some growth factors and cytokines in order to recover from cellular damage. If these healing signals are excessive, limbal basal cells will be changed to abnormally-altered pterygial cells. The excessive wound healing process and remnant altered cells result in recurrence using the same mechanism.
Stem Cells/*physiology ; Pterygium/*etiology ; Proto-Oncogene Proteins c-kit/analysis ; Peptides/analysis ; Middle Aged ; Humans ; Glycoproteins/analysis ; Bone Marrow Cells/*physiology ; Antigens, CD34/analysis ; Antigens, CD/analysis

Small cell osteosarcoma is rare, representing 1-4% of all osteosarcomas. We experienced a case of small cell osteosarcoma in an 8-year-old girl on her calcaneus. Histologically, the tumor consists of small round cells that resemble those of Ewing's sarcoma, and variable foci of lacy osteoid formation between tumor cells. The rare location, histologic characteristics and differential diagnostic points are discussed.
Bone Neoplasms/diagnosis/*pathology ; Calcaneus/*pathology ; Case Report ; Child ; Female ; Human ; Microscopy, Electron ; Osteosarcoma/diagnosis/*pathology ; Tomography, X-Ray Computed

PURPOSE: To establish the immortalized human corneal endothelial cell line (IHCEn) by transducing human papilloma virus (HPV) 16 E6/E7 oncogenes, and to identify their characteristics when cultivated on a lyophilized human amniotic membrane (LAM). METHODS: Primary human corneal endothelial cells (PHCEn) were infected using a retroviral vector with HPV 16 E6/E7, and transformed cells were clonally selected by G418. Growth properties and characteristics of IHCEn were compared with PHCEn by cell counting and RT-PCR of VDAC3, SLC4A4, CLCN3, FGF-1, Col IV, and Na+/K+ ATPase. IHCEn were cultured on LAM. Messenger RNA expressions of VDAC3, CLCN3, and Na+/K+ ATPase, and protein expressions of Na+/K+ ATPase and Col IV in IHCEn cultivated on LAM were investigated by RT-PCR, immunofluorescence, and immunohistochemical staining, respectively. RESULTS: Successful immortalization was confirmed by stable expression of HPV 16 E6/E7 mRNA by RT-PCR, and IHCEn exhibited typical corneal endothelial morphology. Doubling time of IHCEn was 30.15+/-10.96 hrs. Both IHCEn and PHCEn expressed VDAC3, CLCN3, SLC4A4, FGF-1, Col IV, and Na+/K+ ATPase. IHCEn cultivated on LAM showed stronger expression of VDAC3, CLCN4, and Na+/K+ ATPase mRNA than on plastic culture dish. Immunohistochemical staining and immunofluorescence revealed the positive expression of Na+/K+ ATPase and Col IV. CONCLUSIONS: IHCEn were successfully established, and LAM is a good substrate for the culture of human corneal endothelial cells.
Transfection ; Reverse Transcriptase Polymerase Chain Reaction ; Repressor Proteins/genetics/*pharmacology ; RNA, Messenger/genetics ; Protein-Tyrosine Kinases ; Oncogene Proteins, Viral/genetics/*pharmacology ; Immunohistochemistry ; Humans ; Gene Expression Regulation, Viral ; Freeze Drying ; Endothelium, Corneal/*cytology/drug effects/metabolism ; Cell Line, Transformed ; Cell Count ; Amnion

This study was aimed to assess the free calcium status with or without its direct measurement in patients on hemodialysis(HD: n=27) and malnourished ones from extrarenal diseases(MN: n=14). It was performed by the comparison of measured free calcium (Ca++m) levels by gas analyzer and calculated free calcium(Ca++c) levels based on those of total calcium (TCa), albumin, and pH with the modified algorithm invented by Moore(J Clin Invest. 49:318, 1970). Of 27 HD pts, 14(5296) had low[Ca++m] below 1.05mmol/L despite only 2(796) with low [TCa] below 2.05mmoV L, whereas 14 MN pts had similar numbers between low[Ca++m] and low[TCa]. Compared to MN pts, HD pts showed significantly lower mean levels(SE) of pH(7.37 0.01 vs. 7A4 0.01, p<0.01), higher[TCa](2.33 0.04 vs. 1.83 0.08mmol/L, p<0.01), and higher albumin (4.33 0.06 vs. 2.59 0.17mg/dL, p<0.01).However, [Ca++m] between 2 groups did not reveal any significant difference. Furtherrnore, in total 41 pts of 2 groups, no similarity was observed between the values of [Ca++ml and [Ca++c] but with their significant difference(p<0.05). Only[TCa] was significantly corre- lated with albumin level(r=0.73, p<0.01). Furthermore, multiple regression analysis between [Ca++m] and other factors including pH and albumin didn't show any correlation. In conclusion, this data suggests that relatively high prevalence of low values of physiologically important free ionized calcium in chronically ill pts, especially on maintenance HD, could be missed when predicted on total calcium level, and pH without its direct measurement.
Calcium* ; Chronic Disease* ; Humans ; Hydrogen-Ion Concentration* ; Prevalence

OBJECTIVE: Computed tomography (CT), rather than conventional 2-dimensional radiography, was used to scan and measure pelvic parameters. The results were compared with measurements using X-ray. METHODS: Pelvic parameters were measured using both CT and X-ray in 254 patients who underwent both abdomino-pelvic CT and X-ray at the pelvic site. We assessed the similarity of the pelvic parameters between the 2 exams, as well as the correlations of pelvic parameters with sex and age. RESULTS: The mean values of the subjects’ pelvic parameters measured on X-ray were: sacral slope (SS), 31.6°; pelvic tilt (PT), 18.6°; and pelvic incidence (PI), 50.2°. The mean values measured on CT were: SS, 35.1°; PT, 11.9°; and PI, 47.0°. PT was found to be 4.07° higher on X-ray and 2.98° higher on CT in women, with these differences being statistically significant (p < 0.001, p < 0.001). PI was 4.10° higher on X-ray and 2.78° higher on CT in women, with these differences also being statistically significant (p < 0.001, p=0.009). We also observed a correlation between age and PI. For men, this correlation coefficient was 0.199 measured using X-ray and 0.184 measured using CT. For women, this correlation coefficient was 0.423 measured using X-ray and 0.372 measured using CT. CONCLUSION: When measured using CT compared to X-ray, SS increased by 3.5°, PT decreased by 6.7°, and PI decreased by 3.2°. There were also statistically significant differences in PT and PI between male and female subjects, while PI was found to increase with age.
Age Factors ; Female ; Humans ; Incidence* ; Male ; Posture* ; Radiography ; Sex Factors