No abstract available.
DNA* ; Heart* ; Humans*

Toremifene is an anti-estrogen which has been shown to be effective in the treatment of breast cancer, and is thought to be a less uterotrophic agent than tamoxifen. The risk assessment concerning endometrial cancer has been inconclusive because of its rare use up to the mid-1990s. We report a case of an adenosarcoma, which is a very rare type of uterine malignancy, after toremifene treatment for 5 years in a breast cancer patient. After 1 year of toremifene use, the patient had a benign Mullerian adenofibroma. After an additional 4 years of toremifene treatment, the endometrial polypoid lesion was transformed into a Mullerian adenosarcoma. Although toremifene is a promising anti-estrogenic agent in the treatment of breast cancer patients, clinicians should not neglect the possibility of a uterine malignancy.
Adenofibroma ; Adenosarcoma ; Breast ; Breast Neoplasms ; Endometrial Neoplasms ; Female ; Humans ; Risk Assessment ; Tamoxifen ; Toremifene

Animals ; Dental Implants ; Humans ; Male ; Methylmethacrylate ; Osseointegration ; Osteogenesis ; Plastics ; Porosity ; Rabbits ; Tibia

In this study, three treatment options to replace two posterior missing teeth were investigated using three dimensional finite element analysis: two wide(.5.0mm) implants(the experimental model I), two standard(.3.75mm) implants(the experimental model II), and three standard(.3.75mm) implants(the experimental model III). Two kinds of load case were applied ; 1) perpendicular on occlusal surface(axial load), parallel on occlusal surface(lateral load). 2) perpendicular on occlusal surface(3mm lateral to central point). The results obtained from this study were as follows; value of on-mises stress (equivalent stress) was smallest in the two wide implant among the three experimental models. It was reported that the diameter is the efficient factor than osseointegrated surface area.
Finite Element Analysis* ; Models, Theoretical ; Tooth

Here we investigated the central processing mechanisms of mechanical allodynia and found a direct excitatory link with low-threshold input to nociceptive neurons. Experiments were performed on male Sprague-Dawley rats weighing 230-280 g. Subcutaneous injection of interleukin 1 beta (IL-1β) (1 ng/10 µL) was used to produce mechanical allodynia and thermal hyperalgesia. Intracisternal administration of bicuculline, a gamma aminobutyric acid A (GABAA) receptor antagonist, produced mechanical allodynia in the orofacial area under normal conditions. However, intracisternal administration of bicuculline (50 ng) produced a paradoxical anti-allodynic effect under inflammatory pain conditions. Pretreatment with resiniferatoxin (RTX), which depletes capsaicin receptor protein in primary afferent fibers, did not alter the paradoxical anti-allodynic effects produced by the intracisternal injection of bicuculline. Intracisternal injection of bumetanide, an Na-K-Cl cotransporter (NKCC 1) inhibitor, reversed the IL-1β-induced mechanical allodynia. In the control group, application of GABA (100 µM) or muscimol (3 µM) led to membrane hyperpolarization in gramicidin perforated current clamp mode. However, in some neurons, application of GABA or muscimol led to membrane depolarization in the IL-1β-treated rats. These results suggest that some large myelinated Aβ fibers gain access to the nociceptive system and elicit pain sensation via GABA(A) receptors under inflammatory pain conditions.
Animals ; Bicuculline ; Bumetanide ; Capsaicin ; gamma-Aminobutyric Acid ; Gramicidin ; Humans ; Hyperalgesia* ; Injections, Subcutaneous ; Interleukin-1beta ; Male ; Membranes ; Muscimol ; Myelin Sheath ; Neurons ; Nociceptors ; Rats* ; Rats, Sprague-Dawley ; Receptors, GABA-A ; Sensation

Finite Element Analysis

PURPOSE: Respiratory motion is a considerable inhibiting factor for precise treatment with stereotactic radiosurgery using the CyberKnife (CK). In this study, we developed a moving phantom to simulate three-dimensional breathing movement and investigated the distortion of dose profiles between the use of a moving phantom and a static phantom. MATERIALS AND METHODS: The phantom consisted of four pieces of polyethylene; two sheets of Gafchromic film were inserted for dosimetry. Treatment was planned to deliver 30 Gy to virtual tumors of 20, 30, 40, and 50 mm diameters using 104 beams and a single center mode. A specially designed robot produced three-dimensional motion in the right-left, anterior-posterior, and craniocaudal directions of 5, 10 and 20 mm, respectively. Using the optical density of the films as a function of dose, the dose profiles of both static and moving phantoms were measured. RESULTS: The prescribed isodose to cover the virtual tumors on the static phantom were 80% for 20 mm, 84% for 30 mm, 83% for 40 mm and 80% for 50 mm tumors. However, to compensate for the respiratory motion, the minimum isodose levels to cover the moving target were 70% for the 30~50 mm diameter tumors and 60% for a 20 mm tumor. For the 20 mm tumor, the gaps between the isodose curves for the static and moving phantoms were 3.2, 3.3, 3.5 and 1.1 mm for the cranial, caudal, right, and left direction, respectively. In the case of the 30 mm tumor, the gaps were 3.9, 4.2, 2.8, 0 mm, respectively. In the case of the 40 mm tumor, the gaps were 4.0, 4.8, 1.1, and 0 mm, respectively. In the case of the 50 mm diameter tumor, the gaps were 3.9, 3.9, 0 and 0 mm, respectively. CONCLUSION: For a tumor of a 20 mm diameter, the 80% isodose curve can be planned to cover the tumor; a 60% isodose curve will have to be chosen due to the tumor motion. The gap between these 80% and 60% curves is 5 mm. In tumors with diameters of 30, 40 and 50 mm, the whole tumor will be covered if an isodose curve of about 70% is selected, equivalent of placing a respiratory margin of below 5 mm. It was confirmed that during CK treatment for a moving tumor, the range of distortion produced by motion was less than the range of motion itself.
Polyethylene ; Radiosurgery* ; Range of Motion, Articular ; Respiration

BACKGROUND: Use of single donor apheresis platelets and concerning for the quality of apheresis platelets has been rapidly increased. Apheresis platelets depleted white blood cell (WBC) are used to prevent or to reduce febrile non-hemolytic transfusion reactions, alloimmunization and cytomegalovirus infection. We compared COBE Spectra LRSTM (leukoreduction system) and COBE Spectra with PALL PXLTM8 in terms of the yield predictors, processing times, and WBC contamination. METHOD: Seventy-two single donors who visited Apheresis Unit (APU) in St. Mary's hospital were prospectively randomized into COBE Spectra LRSTM and COBE Spectra followed by PALL PXLTM8 between September 1997 and October 1998. We used Coulter counting for platelet and Nageotte hemocytometer for WBC count. Data were analyzed by independent t-test. RESULTS: The mean platelet yield per unit was 3.6 +/- 1.0X1011 with COBE spectra LRSTM compared to 2.9 +/- 1.1X1011 with COBE Spectra (p=0.002), and the mean WBC content per unit with COBE spectra LRSTM was 4.1X104 (0.4-23.5) compared to 3.7X104 (0.43-17.9) with PALL PXLTM8 (p=0.0728). CONCLUSIONS: This study shows that COBE Spectra LRSTM has higher platelet yields than that of COBE Spectra, and similar WBC contamination compared to PALL PXLTM8. Therefore, this data suggests that COBE Spectra LRSTM is conveient than COBE Spectra with PALL PXLTM8 in clinical practice.
Blood Component Removal ; Blood Group Incompatibility ; Blood Platelets* ; Cytomegalovirus Infections ; Humans ; Leukocytes* ; Prospective Studies ; Tissue Donors*

BACKGROUND/AIMS: Cytomegalovirus (CMV) reactivations are frequently observed in patients with active ulcerative colitis (UC), and ganciclovir therapy is effective in patients with steroid-refractory UC. This study aimed to determine the long-term outcomes of CMV reactivation and the long-term therapeutic efficacy of ganciclovir treatment. METHODS: This retrospective multicenter study included a cohort of 72 patients with moderate-to-severe UC who were evaluated for CMV reactivation at the time of their initial UC flare. Colectomy, disease relapse, and the recurrence rate of CMV reactivation were investigated. RESULTS: The mean duration of follow-up for the 72 patients was 43.16+/-19.78 months (range, 1 to 67 months). The cumulative colectomy (log-rank, p=0.025) and disease flare-up rates (log-rank, p=0.048) were significantly higher in the CMV-positive group. Of the 11 patients who were successfully treated with ganciclovir in the initial treatment, three patients (27.3%) experienced CMV reactivation, and six patients (54.5%) experienced poor outcomes, such as the need for colectomy or a steroid-dependent state. CONCLUSIONS: The patients who had CMV-reactivated UC showed poor outcomes at the long-term follow-up, and the long-term efficacy of ganciclovir therapy was marginal. Careful assessment is necessary for patients who exhibit evidence of CMV reactivation.
Antiviral Agents/*therapeutic use ; Case-Control Studies ; Cohort Studies ; Colectomy/utilization ; Colitis, Ulcerative/complications/*drug therapy ; *Cytomegalovirus ; Cytomegalovirus Infections/complications/*drug therapy ; Ganciclovir/*therapeutic use ; Humans ; Longitudinal Studies ; Remission Induction ; Retrospective Studies ; Severity of Illness Index ; Treatment Outcome ; *Virus Activation

BACKGROUND/AIMS: The aim of this study was to analyze the actual application patterns of how Korean diagnostic guidelines for inflammatory bowel disease (IBD) were applied in clinical practice. METHODS: Questionnaires regarding guidelines for ulcerative colitis (UC), Crohn's disease (CD), intestinal Behcet's disease (BD) and intestinal tuberculosis (TB), were distributed during the 2011 Korean Association for the Study of Intestinal Disease annual conference, and e-mail survey was additionally conducted. Forty eight questionnaires were collected. RESULTS: Most of responders (79.2%) were working at secondary (> or =500 beds) or tertiary referral centers. For the necessity of guidelines, 93.8% of responders gave positive answers in UC; 95.8% in CD; 81.3% in BD; 91.7% in TB. Of the clinicians, 95.8%, 91.7%, 64.6%, 77.1% had read UC, CD, BD and TB guideline, and 87.0%, 93.2%, 90.3%, and 92.0% replied that diagnostic guidelines for UC, CD, BD and TB were helpful in practice, respectively. Practice patterns were changed in 39.1%, 33.2%, 41.9%, and 54.1% of responders by UC, CD, BD and TB guidelines, respectively. For the needs of update, 58.7% of responders answered 'yes' in UC, 54.5% in CD, 51.6% in BD and 48.7% in TB. There were differences between recommendations and practice patterns, including colonoscopy surveillance in UC, radiological examinations for small bowel in CD and for intestinal obstruction in UC, or biopsy method in UC, CD and TB, and diagnostic criteria in BD. CONCLUSIONS: Although most of responders perceived the Korean diagnostic guidelines for IBD, there were differences between recommendations of guidelines and actual practice patterns. Therefore, the publicity and revision of diagnostic guidelines are important to reconcile theory and practice.
Asian Continental Ancestry Group ; Behcet Syndrome/diagnosis ; Colitis, Ulcerative/diagnosis ; Colonoscopy ; Crohn Disease/diagnosis ; Humans ; Inflammatory Bowel Diseases/*diagnosis ; *Practice Guidelines as Topic ; Questionnaires ; Republic of Korea ; Tuberculosis, Gastrointestinal/diagnosis