No abstract available.
Hernia, Inguinal* ; Humans

Clinical and bacteriologicaql studies on 133 cases of urinary tract infection who were admitted to the Dept. of Pediatrics, NMC during the period of Jan. 1974 to Jan. 1979 were subjected in this study. The resultes were as follows : 1. Among the total 133 cases, 100 cases(75.2%) were male and 33 cases(24.8%) were female with sex ratio of 3:1. 2. The highest incidence(42.1%) was in children below the age of one year. The rate then decreased with age. 3. Seasonal incidence was relatively high in summer months, but seasonal difference was not significant. 4. Edema, signs of URI, vomiting, hematuria, failure to thrive and feeding problem were common clinical features. 5. Urinalysis disclosed proteinuria in 43 cases(32.3%), hematuria in 36 cases(27.1%) and pyuria in 26 cases(19.6%). 6. Hematological findings showed low hemoglobin in 40 cases(30.0%), leucocytosis in 31 cases(23.3%) and elevated ESR in 42 cases(31.6%). 7. IVP was performed in 13 cases, and 3 cases of them showed abnormal findings. 8. Nephrotic syndrome, acute glomerulonephritis, hyperbilirubinemia and sepsis were the common concurrent illnesses. 9. E. coli predominated as the infecting organisms(36.8%). It was most sensitive to ;gentamycin(83.7%) and cefamezine(77.8%)
Child* ; Edema ; Failure to Thrive ; Female ; Glomerulonephritis ; Hematuria ; Humans ; Hyperbilirubinemia ; Incidence ; Male ; Nephrotic Syndrome ; Pediatrics ; Proteinuria ; Pyuria ; Seasons ; Sepsis ; Sex Ratio ; Urinalysis ; Urinary Tract Infections* ; Urinary Tract* ; Vomiting

Clinical and bacteriologicaql studies on 133 cases of urinary tract infection who were admitted to the Dept. of Pediatrics, NMC during the period of Jan. 1974 to Jan. 1979 were subjected in this study. The resultes were as follows : 1. Among the total 133 cases, 100 cases(75.2%) were male and 33 cases(24.8%) were female with sex ratio of 3:1. 2. The highest incidence(42.1%) was in children below the age of one year. The rate then decreased with age. 3. Seasonal incidence was relatively high in summer months, but seasonal difference was not significant. 4. Edema, signs of URI, vomiting, hematuria, failure to thrive and feeding problem were common clinical features. 5. Urinalysis disclosed proteinuria in 43 cases(32.3%), hematuria in 36 cases(27.1%) and pyuria in 26 cases(19.6%). 6. Hematological findings showed low hemoglobin in 40 cases(30.0%), leucocytosis in 31 cases(23.3%) and elevated ESR in 42 cases(31.6%). 7. IVP was performed in 13 cases, and 3 cases of them showed abnormal findings. 8. Nephrotic syndrome, acute glomerulonephritis, hyperbilirubinemia and sepsis were the common concurrent illnesses. 9. E. coli predominated as the infecting organisms(36.8%). It was most sensitive to ;gentamycin(83.7%) and cefamezine(77.8%)
Child* ; Edema ; Failure to Thrive ; Female ; Glomerulonephritis ; Hematuria ; Humans ; Hyperbilirubinemia ; Incidence ; Male ; Nephrotic Syndrome ; Pediatrics ; Proteinuria ; Pyuria ; Seasons ; Sepsis ; Sex Ratio ; Urinalysis ; Urinary Tract Infections* ; Urinary Tract* ; Vomiting

PURPOSE: To investigate the effects of estrogen on the expression of the alpha1 receptor and nitric oxide synthase (NOS) in rat urethra and bladder after oophorectomy. MATERIALS AND METHODS: Forty-five mature female Sprague-Dawley rats (aged 10-11 weeks, 235-250 g) were randomly assigned to one of three groups: control group, oophorectomy group (Opx), or oophorectomy and estradiol replacement group (Opx+ Est). The degree of expression of alpha1 receptor (alpha1A and D) and NOS (neuronal NOS [nNOS] and endothelial NOS [eNOS]) in bladder and urethral tissues was investigated by using immunohistochemical staining and Western blotting. RESULTS: In the bladder, the expression rates of alpha1 receptor (alpha1A and alpha1D) increased in the Opx group but decreased in the Opx+Est group. These changes were not statistically significant. The alpha1A and alpha1D receptor of the urethra decreased in the Opx group but increased in the Opx+Est group. These changes were not statistically significant. In the bladder and urethra, the expression rates of nNOS and eNOS significantly increased in the Opx group but decreased in the Opx+Est group (p<0.05). CONCLUSIONS: These data suggest that estrogen depletion increases NOS and alpha1 receptor expression in the rat bladder. However, these changes could be restored by estrogen replacement therapy.
Animals ; Collagen/metabolism ; Estradiol/analogs & derivatives/blood/pharmacology ; Estrogen Replacement Therapy/*methods ; Female ; Muscle, Smooth/pathology ; Nitric Oxide Synthase/*metabolism ; Ovariectomy ; Rats, Sprague-Dawley ; Receptors, Adrenergic, alpha-1/*metabolism ; Urethra/drug effects/*metabolism/pathology ; Urinary Bladder/drug effects/*metabolism/pathology

No abstract available.
Female* ; Humans ; Transplants*

PURPOSE: To date, the benefits of central neck node dissection (CND) in patients with differentiated thyroid carcinoma (DTC) have not been clearly demonstrated and must be considered against the potential risks of the procedure. However, recent papers suggest that lymph node metastasis exerts a significant influence on survival and is associated with a higher risk of recurrence. The purpose of our study was to assess the recurrent laryngeal nerve and parathyroid risks of CND following total thyroidectomy in patients with DTC and to compare the results with those obtained in patients who underwent total thyroidectomy only. METHODS: We retrospectively analysed 143 consecutive patients with DTC (116 with papillary, 24 with follicular, and 3 with Hurthle cell carcinoma) operated on by a single experienced endocrine surgeon from January 1989 to January 1999. There were 61 total thyroidectomies with CND (Group 1) and 82 total thyroidectomies only (Group 2). Group 1 patients displayed evidence of macroscopic lymph node invasion during surgery. The definitions of the two main complications in the thyroid surgery were as follows: transient and permanent recurrent laryngeal nerve palsy (persisting hoarseness over six months after thyroidecomy), transient and permanent hypoparathyroidism (non-recovery of normal parathyroid function and calcemia below 8.0 mg/dl over six momths after thyroidectomy). RESULTS: There was no difference observed in the demographic data between the two groups. Three cases (4.9%) of transient hypocalcemia were detected in Group 1 and two cases (2.4%) in Group 2. Five cases (8.2%) of transient nerve palsy were presented in Group 1 and one case (1.2%) in Group 2. However, there was no significant statistical difference between the two groups (p=0.051). None of the patients demonstrated permanent nerve palsy. CONCLUSION: Following total thyroidectomy for DTC, CND does not increase the morbidity of parathyroid gland and recurrent laryngeal nerve. Therefore, in order to decrease the incidence of regional recurrence and avoid the risk of reoperation in the central neck area, we recommend cervical neck node dissection from the central neck compartment concomitant with total thyroidectomy when overt lymph nodes are palpated.
Hoarseness ; Humans ; Hypocalcemia ; Hypoparathyroidism ; Incidence ; Lymph Node Excision* ; Lymph Nodes* ; Neck* ; Neoplasm Metastasis ; Paralysis ; Parathyroid Glands ; Recurrence ; Recurrent Laryngeal Nerve ; Reoperation ; Retrospective Studies ; Thyroid Gland* ; Thyroid Neoplasms* ; Thyroidectomy ; Vocal Cord Paralysis

BACKGROUND: Although elevated serum cholesterol level has been considered as a significant health problem because it is associated with coronary artery disease, the relation with various health problem (esp. depression) from low serum cholesterol is not well known in Korean people. The authors tried to observe the degree of depression in low serum cholesterol group for its better management. METHODS: The study population was selected among adults who visited the National University Hospital Health Screening Center between May and July 1998. They had no history of cancer and liver disease and no significant medical illnesses which may affect blood cholesterol level. Using the Korean standard BDI, we evaluated the degree of depression scale. RESULTS: The number of subjects with low serum cholesterol was 77 (males 42, females 35) and that of the control group was 82 (males 47, females 34). The low serum cholesterol group had a statistically significantly higher BDI score(12.2+/-8.2) than the control group (7.6+/-6.3) (P<0.05). In males the mean BDI score of 11.9+/-7.4 in the low serum cholesterol group was significantly higher than the mean score of 5.0+/-3.8 in the control group (P<0.05). In females, there was no significant difference in depression scale between both groups. CONCLUSION: Since the male low serum cholesterol group had a high depression scale, the multi-disciplinary approaches which include psychological supports may be required to manage and treat them. And persistent significant association between low serum total cholesterol level and psychological problems suggests that further long-term study on the association of low cholesterol with depression is necessary.
Adult ; Cholesterol* ; Coronary Artery Disease ; Depression* ; Female ; Humans ; Liver Diseases ; Male ; Mass Screening

PURPOSE: In papillary thyroid carcinoma, lymph node metastasis at presentation does not seem to affect survival adversely, but does increase the risk of loco-regional tumor recurrence. The benefits of prophylactic central neck node dissection (PCND) have not been clearly demonstrated so far and should be weighed against the potential risks of the procedure. The aims of this study are as follows; to determine the frequency and the pattern of the lymph node metastasis and the risk factors influencing the metastasis to level VI lymph nodes, and to determine the necessity of the contralateral central lymph node dissection. METHODS: A retrospective analysis had been carefully performed over 68 patients with papillary carcinomas undergoing total thyroidectomy with PCND during the period from July 1, 2000 to August 31, 2002. In addition to the analyses of the incidence and the pattern of central lymph node metastasis, we statistically analyzed the correlation between lymph node metastases and the risk factors such as tumor size, age, lymphatic tumor emboli, vascular tumor emboli, perithyroidal soft tissue invasion, and multifocality, etc. RESULTS: The mean age was 46 years (22~76) and the tumor size ranged from 0.2 to 9 cm (mean 2.2 cm). The micropapillary carcinoma was detected by pathological findings in 10 patients (14.7%). The lymphatic tumor emboli and vascular tumor emboli occurred in 8 patients (11.8%) and 2 patients (2.9%) respectively. Thirty eight patients (55.9%) showed perithyroidal tissue invasion. The mean number of harvested lymph nodes in level VI was 13.7 (6~32). Among 68 patients, lymph node metastasis occurred in 49 patients (72.1%) and the mean number of metastatic lymph node was 5.4. Among the patients with metastasis, the rate of metastasis among the harvest nodes amounted to 39.0%. Metastasis to Delphian nodes was detected in 2 patients (2.9%). In addition, 15 patients (22.1%) showed metastatic contralateral central nodes. Patients less than 40 years old tend to have more metastatic lymph nodes (P=0.012). Futhermore, the patients with tumor larger than 2 cm increased incidence of lymph node metastasis (P=0.036). CONCLUSION: After the prophylactic central neck nodes dissection in case of papillary carcinoma patients, metastatic lymph nodes were found in 72.1%. In conclusion, we would like to recommend prophylactic central neck node dissection to papillary carcinoma patients in order not only to prevent local recurrence but to avoid the difficulties of reoperation, especially for those with high risk for nodal involvement (less than 40 years old or more than 2 cm of tumor size). Because of the relatively high incidence of contralateral central lymph nodes metastasis, we suggest the importance of dissection of contralateral central lymph nodes along with unilateral central.
Carcinoma, Papillary* ; Humans ; Incidence ; Lymph Node Excision ; Lymph Nodes* ; Neck* ; Neoplasm Metastasis* ; Recurrence ; Reoperation ; Retrospective Studies ; Risk Factors ; Thyroid Gland* ; Thyroid Neoplasms ; Thyroidectomy

OBJECTIVES: We investigated the effects of sleep apnea syndrome (SAS) on cognitive functions in patients with REM sleep behavior disorder (RBD). We also studied correlations between sleep variables related with SAS and parameters of cognitive function tests. METHODS: Twenty two RBD patients with SAS and 20 RBD patients without SAS participated in the study. The diagnoses of RBD and SAS were confirmed on polysomnography. All the participants performed neuropsychological tests by the Korean version of the Consortium to Establish a Registry for Alzheimer's disease (CERAD-K) Assessment Packet. RESULTS: There were no differences between two groups in age and sex, education, body mass index, and results of the Beck depression inventory (BDI) and the Epworth sleepiness scale (ESS). No difference was found in any of parameters of the CERAD-K between two groups. The cognitive functions were not correlated with BDI, ESS, or variables related with SAS. CONCLUSION: SAS had no influence on cognitive functions of RBD patients. The result could be explained by negligible effects of SAS on cognitive functions among aged population and no difference in daytime sleepiness between the RBD patients with and without SAS.
Aged ; Alzheimer Disease ; Body Mass Index ; Depression ; Humans ; Neuropsychological Tests ; Phenothiazines ; Polysomnography ; REM Sleep Behavior Disorder ; Sleep Apnea Syndromes ; Sleep, REM

Purpose: Three years of adjuvant imatinib is the standard treatment for resected gastrointestinal stromal tumors (GISTs) with rupture, but the recurrence rate is prominently high. We aimed to investigate the efficacy and safety of 5-year adjuvant imatinib compared with 3-year treatment in patients with a ruptured GIST following surgical resection. Materials and Methods: A total of 51 patients were included in the analysis. The assessment of GIST rupture was based on Nishida’s classification. Twenty patients who were diagnosed before November 2013 were treated with 5 years of imatinib, and 31 patients who were diagnosed after November 2013 were treated with 3 years of imatinib. We retrospectively compared the clinical outcomes of the two groups. Results: Baseline characteristics and the incidence of the adverse events were generally comparable between the two groups. During a median follow-up duration of 43.8 months and 104.2 months in the 3- and 5-year group, 8 and 9 patients had a disease recurrence, respectively. The 5-year group showed better recurrence-free survival (RFS) than the 3-year group. In multivariate analysis, low mitotic index was a significant independent favorable prognostic factor for RFS, while 5-year imatinib treatment was marginally associated with a favorable RFS. Conclusion Five years of adjuvant imatinib treatment in patients with ruptured GIST was associated with favorable survival outcomes with manageable toxicity profiles. Our findings warrant validation and confirmation in future studies.