Bacteriological index(BI) was calculated by slit-skin smears taken from the earlobe and the dorsal surfaces of the proximal phalanges of the index finger and of the great toe in 110 lepromatous leprosy patients who have been treated regularly by antileprosy chemotherapy. The bacteriaI indices from the three sites were compared, and the results were as follows. 1) Sixteen patients whose BI of the earlobe smear was 4. 0 in average shawed the highest degree of positivity of M. leprae in the smears taken from the finger and the great toe. 2) ln seventy-four patients whose BI of the earlobe smear was l. 0 or higher, eight (10.8%) showed higher BI in smears taken from both the finger and the great toe, fifteen (20. 3%) and twenty-seven(36. 5%) showed approximately the same BI in smears taken from the finger and the great toe, respectively, 3) In thirty-six patients whose BI of the earlobe smear was negative, twelve (33. 3%) showed higher BI in smears taken from both the finger and the great toe. 4) The mean value of BI of the three sites was 3.7 in the earlobe, 3. 2 in the finger and 3. 0 in the great toe. Comparing the BI of the three sites, the finger and the great toe were found to have comparable BI with the earlobe, although the BI of the earlobe was highest. The authors concluded that it was quite reasonable to include the finger and the great toe in slit-skin smears for M. leprae identification, particularly when the BI of the earlobe was negative. A follow-up investigation seems mandatory.
Drug Therapy ; Fingers* ; Follow-Up Studies ; Humans ; Leprosy, Lepromatous ; Mycobacterium leprae* ; Mycobacterium* ; Skin* ; Toes*

Objective To determine the diagnostic value of double-phase enhancement and virtual endoscopy with multi-slice spiral CT (MSCT) on clinical staging of preoperative bladder cancer.Methods Seventy-five patients with bladder cancer diagnosed by fibercystoscope or operation. All of them were examined by double-phase enhancement and virtual endoscopy with MSCT. The images were analyzed and clinical staging were obtained. The findings of MSCT (71 cases)were compared with the post-operative histopathological results. Results There were 94 lesions to be found. The staging of MSCT: T1 26 cases,T2, 27 cases, T2b 13 cases, T3 12 cases, T4 16 cases. Histopathological results: pT1 28 cases, pT2a 24 cases, pT2b 14 cases, pT3 12 cases, pT4 16 cases. The sensitivity of preoperative staging on bladder cancer was 89.4 % (84/94) by double-phase enhancement of MSCT;the sensitivity of virtual endoscopy was 96.6% (84/87)for polyploidy tumors and 90. 9 % (10/11) for sessile lesions. When double-phase enhancement and virtual images were evaluated together, the sensitivity rate increased to 94.5%. When the tumors were confined within the bladder wall (≤T2b), the diagnostic accuracy of double-phase enhancement and virtual images was 91.2% (51/56). When the tumors had invaded the tissues and organs beyond the bladder wall (≥T3), the accuracy was 100% (28/28). Conclusion Double-phase enhancement and virtual endoscopy of MSCT is of great value in clinical staging of bladder cancer.

PURPOSE: The aim of this study was to assess the effectiveness, survival rate and complication of radiation therapy in nasopharyngeal cancer. MATERIALS AND METHODS: From January 1980 to May 1989, Fifty Patients who had nasopharyngeal carcinoma treated with curative radiation therapy at Kosin Medical Center were retrospectively studied. Thirty seven patients(74%) were treated with radiation therapy alone(Group I) and 13 patients (26%) treated with combination fo chemotherapy and radiation(Group II). Age distribution was 16-75 years(median:45.8 years). In histologic type, squamous cell carcinoma was in 30 patients(60%), undifferentiated carcinoma in 17 patinets(34%), and lymphoepithelioma in 3 patients(6%). According to AJCC staging system, 4 patinets(8%) were in T1, 13 patients(2%) in T2, 20 patients(40%) in T3, 13 patients(26%) in T4 and 7 patients(14%) in N0, 6 patients(12%) in N1, 23 patients(46%) in N2, 14 patients (28%) in N3. Total radiaton dose ranges were 5250-9200 cGy(median : 7355 cGy) in Group I and 5360-8400 cGy(median :6758cGy) in Group II. Radiotherapy on 4-6MV linear accelerator and/or 6-12MeV electron in boost radiation was given with conventional thechnique to 26 patinets(52%), with hyperfractionation(115-120cGy/fr., 2times/day) to 16 patients(32%), with accelerated fractionation(160cGy/fr., 2 times/day) to 8 patients(16%). In Chemotherapy, 5 FU 1000mg daily for 5 consecutive days, pepleomycin 10mg on days 1 and 3, and cisplatin 100mg on day 1 were administered with 3 weeks interval, total 1 to 3 cycles(average 1.8cycles) prior to radiation therapy. Follow up duration was 6-140 months(mean:58 months). Statistics was calculated with Chi-square and Fisher's exact test. RESULTS: Complete local control rates in Group I and II were 75.7%, 69.2%. Overall 5 year survival rates in Group I and II were 56.8%, 30.8%. Five year survival rates by histologic type in Group I and II were 52.2, 14.3% in squamous cell carcinoma an d 54.5%, 50% in undifferentiated carcinoma. Survival rates in Group I were superior to those of Group II though there were not statistically significant. In both group, survival rates seem to be increased according to increasing total dose of radiation up to 7500cGy, but not increased beyond it. There were not statistically significant differences in survival rates by age, , stage, and radiation tehchniques in both group. Twenty four patients (48%) experienced treatment failures. Complications were found in 12 patients(24%). The most common one was osteomyelitis(4 patients, 33.3%) involving mandible (3 patients) and maxilla(1patient). CONCLUSION: Chemotherapy in combination with radiotherapy was found to be not effective to nasopharyngeal cancer and the survival rate was also inferior to that of radiation alone group though it was statistically not significant due to small population in chemotherapy combined group.
Age Distribution ; Carcinoma ; Carcinoma, Squamous Cell ; Cisplatin ; Drug Therapy ; Follow-Up Studies ; Humans ; Mandible ; Nasopharyngeal Neoplasms* ; Particle Accelerators ; Peplomycin ; Radiotherapy* ; Retrospective Studies ; Survival Rate ; Treatment Failure

OBJECTIVE: The etiology and pathogenesis of moyamoya disease remain unclear. Furthermore, the definitive diagnostic protein-biomarkers for moyamoya disease are still unknown. The present study analyzed serum proteomes from normal controls and moyamoya patients to identify novel serological biomarkers for diagnosing moyamoya disease. METHODS: We compared the two-dimensional electrophoresis patterns of sera from moyamoya disease patients and normal controls and identified the differentially-expressed spots by matrix-assisted laser desorption/ionization-time-of flight mass spectrometry and electrospray ionization quadruple time-of-flight mass spectrometry. RESULTS: We found and analyzed 22 differently-expressed proteomes. Two proteins were up-regulated. Twenty proteins were down-regulated. Complement C1 inhibitor protein and apolipoprotein C-III showed predominantly changed expressions (complement C1 inhibitor protein averaged a 7.23-fold expression in moyamoya patients as compared to controls, while apolipoprotein C-III averaged a 0.066-fold expression). CONCLUSION: Although our study had a small sample size, our proteomic data provide serologic clue proteins for understanding moyamoya disease.
Apolipoprotein C-III ; Biomarkers ; Complement C1 Inhibitor Protein ; Electrophoresis ; Humans ; Mass Spectrometry ; Moyamoya Disease ; Proteins ; Proteome ; Sample Size

BACKGROUND: Incident hemodialysis patients have the highest mortality in the first several months after starting dialysis. This study evaluated the in-hospital mortality rate after hemodialysis initiation, as well as related risk factors. METHODS: We examined in-hospital mortality and related factors in 2,692 patients starting incident hemodialysis. The study population included patients with acute kidney injury, acute exacerbation of chronic kidney disease, and chronic kidney disease. To determine the parameters associated with in-hospital mortality, patients who died in hospital (nonsurvivors) were compared with those who survived (survivors). Risk factors for in-hospital mortality were determined using logistic regression analysis. RESULTS: Among all patients, 451 (16.8%) died during hospitalization. The highest risk factor for in-hospital mortality was cardiopulmonary resuscitation, followed by pneumonia, arrhythmia, hematologic malignancy, and acute kidney injury after bleeding. Albumin was not a risk factor for in-hospital mortality, whereas C-reactive protein was a risk factor. The use of vancomycin, inotropes, and a ventilator was associated with mortality, whereas elective hemodialysis with chronic kidney disease and statin use were associated with survival. The use of continuous renal replacement therapy was not associated with in-hospital mortality. CONCLUSION: Incident hemodialysis patients had high in-hospital mortality. Cardiopulmonary resuscitation, infections such as pneumonia, and the use of inotropes and a ventilator was strong risk factors for in-hospital mortality. However, elective hemodialysis for chronic kidney disease was associated with survival.
Acute Kidney Injury ; Arrhythmias, Cardiac ; C-Reactive Protein ; Cardiopulmonary Resuscitation ; Dialysis ; Hematologic Neoplasms ; Hemorrhage ; Hospital Mortality* ; Hospitalization ; Humans ; Hydroxymethylglutaryl-CoA Reductase Inhibitors ; Logistic Models ; Mortality ; Pneumonia ; Renal Dialysis* ; Renal Insufficiency, Chronic ; Renal Replacement Therapy ; Risk Factors* ; Vancomycin ; Ventilators, Mechanical

PURPOSE: This study aimed at investigating sexual behavior patterns of elderly residents of urban areas in South Korea and their correlation with lower urinary tract symptoms. MATERIALS AND METHODS: From May, 2009 to October, 2009, 154 males and 299 females over 60 years old who visited senior welfare centers of Seoul were administered a questionnaire on sex life patterns and voiding symptoms. RESULTS: Among the 154 males, 59 (38.3%) had sexual intercourse at least one time per month. The remaining 95 males (61.7%) did not have sexual intercourse, because of impotence for 52 males (52.6%), no sexual desire for 28 males (29.4%), and sex partner's problems for 15 males (15.7%). The higher International Prostate Symptom Score was, the lower International Index of Erectile Dysfunction-5 was (p=0.035). Among 299 females, 37 (12.4%) had sexual intercourse at least one time per month. The remaining 262 females (87.6%) did not have sexual intercourse, because of no spouse for 163 females (63.2%), no sexual desire for 48 females (18.6%), the spouse's impotence for 34 females (13.2%), and the spouse's bad health for 10 females (3.9%). It was found that self-diagnosis of overactive bladder affects sex life negatively. CONCLUSIONS: The sexual behaviors of the elderly included varying activity. Sexual intercourse were significantly associated with lower urinary tract symptoms. Our results suggest that the counseling with the elderly about sexual health is as important as it is with non-elderly individuals.
Aged ; Coitus ; Counseling ; Erectile Dysfunction ; Female ; Humans ; Lower Urinary Tract Symptoms ; Male ; Prostate ; Surveys and Questionnaires ; Reproductive Health ; Republic of Korea ; Sexual Behavior ; Spouses ; Urinary Bladder, Overactive ; Urinary Tract

Behcet's disease is a multisystemic, chronic relapsing inflammatory disease characterized by vasculitides, mucocutaneous lesions, thrombophlebitis, arthritis. Among them, the ocular involvement is usual (50~70%) and the most serious morbidity is blindness (20~25% of those of affected). Immunosuppressive treatment is currently the main therapy in chronic relapsing uveitis, but many patients experience recurrent sight-threatening uveitis. T lymphocytes play an important role in the pathogenesis of uveitis by releasing cytokines such as tumor necrosis factor (TNF) alpha. There are some reports that the anti-TNFalpha treatment is effective in refractory Behcet's uveitis, but it has not been reported in Korea. We report a case of refractory uveitis in Behcet's disease which is improved after anti-TNFalpha therapy.
Arthritis ; Blindness ; Cytokines ; Humans ; Korea ; T-Lymphocytes ; Thrombophlebitis ; Tumor Necrosis Factor-alpha ; Uveitis* ; Vasculitis ; Infliximab

OBJECTIVE: Recently the existence of a CD4+CD25+ regulatory (Treg) population has been described in rodents and humans. It is unclear how the immune response cells interact to tumor cells effectively, but the malignant tumor cell growth was suppressed by the main effect of T lymphocytes and natural killer cells in experimental studies using various biologic response modifier. This study was performed to investigate the proportion of CD4+CD25high Tregs and expression of Foxp3 in Peripheral blood (PBL)s in patients with cervical, ovarian or uterine cancers. METHODS: Blood samples were collected from 10 healthy women and a total of 40 patients with gynecologic cancer at department of Obstetrics and Gynecology, Asan Medical Center, Seoul, Korea, from March 2005 to September 2005, were enrolled in study group. Information regarding patient history and tumor stage was recorded. They were diagnosed at same center at first, and never been treated any therapy. The population of CD4+CD25+high Tregs as a percentage of total CD4+cells was evaluated by flow cytometric analysis. We measured the proportion of Treg cell that co-express CD4 and CD25 in the peripheral blood lymphocytes form patients with either cervical, ovarian uterine cancer or carcinoma in situ of cervix. Expression of Foxp3 in the CD4+subsets defined by electrophoresis. RESULTS: The following tumor entities were included cervical cancer (n=10. 7 in stage I, 1 in stage II, 1 in stage III, 1 in stage IV); ovarian cancer (n=10. 4 in stage I, 0 in stage II, 5 in stage III, 1 in stage IV), ; uterine cancer (n=10. 9 in stage I, 0 in stage II, 0 in stage III, 1 in stage IV). In cervical cancer patient, ovarian cancer patients, uterine cancer patients and healthy women, the proportion of CD4+CD25high Tregs was 4.53% (SD 2.30), 6.89% (SD 7.81), 4.37% (SD 2.43) and 0.87% (SD 0.57) of the total CD4+cells respectively. The proportion of CD4+CD25+high T cells was significantly higher in cervical cancer patients (p=0.016), ovarian cancer patients (p=0.001) and uterine cancer patients (p=0.038) when compared with healthy women. But there was no significant difference in proportion of CD4+CD25+ Tregs comparing with healthy women. Expression of Foxp3 was significantly thicker in tumor-associated lymphocytes than control T cells by electrophoresis. CONCLUSION: In conclusion, our data suggested that the increase in frequency of regulatory T cells might play a role in modulation of the immune response against cervical, ovarian, uterine cancer could be important in design of immunotherapeutic approaches.
Carcinoma in Situ ; Cervix Uteri ; Chungcheongnam-do ; Electrophoresis ; Female ; Gynecology ; Humans ; Killer Cells, Natural ; Korea ; Lymphocytes* ; Obstetrics ; Ovarian Neoplasms ; Rodentia ; Seoul ; T-Lymphocytes ; T-Lymphocytes, Regulatory ; Uterine Cervical Neoplasms ; Uterine Neoplasms

PURPOSE: The aim of the present study aimed to evaluate the effect of testosterone on cardiovascular disease by using the Framingham Risk Score (FRS) in patients with sexual dysfunction. MATERIALS AND METHODS: A total of 308 men with sexual dysfunction were enrolled in this study. Clinical assessments included the 15-item International Index of Erectile Function (IIEF), blood pressure measurement, and clinical laboratory indexes. The FRS, which predicts the incidence rate of cardiovascular diseases in the next 10 years, was calculated on the basis of age, gender, total cholesterol, smoking status, high density lipoprotein cholesterol, and systolic blood pressure. RESULTS: The mean age of the 308 enrolled patients was 49.42+/-10.73 years, and the patients' mean body mass index (kg/m2) was 25.07+/-3.14. The mean total IIEF score was 28.44+/-18.06. The median total testosterone concentration was 3.2 ng/mL (interquartile range [IQR]: 2.3~3.2 ng/mL). The median calculated free and bioavailable testosterone concentrations were 0.052 ng/mL (IQR 0.039~0.070 ng/mL) and 1.30 ng/mL (IQR: 1.00~1.76 ng/mL), respectively. The mean FRS was 10.47+/-6.45. The FRS tended to show a negative correlation with the total and calculated free testosterone levels, but this was not significant (p=0.064 and p=0.074, respectively). In the multiple linear regression analysis, a significant negative correlation was observed between the total testosterone level and the FRS (p=0.048). CONCLUSIONS: The results suggest that the testosterone level is related to the FRS and that a high testosterone level may decrease the risk of cardiovascular disease.
Blood Pressure ; Body Mass Index ; Cardiovascular Diseases* ; Cholesterol ; Cholesterol, HDL ; Humans ; Incidence ; Linear Models ; Male ; Smoke ; Smoking ; Testosterone*

PURPOSE: To evaluate the relationship between optic disc and retinal nerve fiber layer (RNFL) measurements obtained with the optical coherence tomography (OCT) and the Heidelberg retina topography (HRT) in normal, normal tension glaucoma (NTG), and high tension glaucoma (HTG). METHODS: Normal, NTG and HTG subjects who met inclusion and exclusion criteria were evaluated retrospectively. One hundred seventy eyes of 170 patients (30 normal, 40 NTG, and 100 HTG) were enrolled. Complete ophthalmologic examination, HRT, OCT, and automated perimetry were evaluated. RESULTS: Disc area, cup area and cup/disc area ratio measured with HRT were significantly different between NTG and HTG (all p<0.05). Mean RNFL thickness measured by OCT with ascanning diameter of 3.4 mm was larger in NTG than HTG (84.97+/-24.20 micrometer vs. 73.53+/-27.17 micrometer, p=0.037). Four quadrant RNFL thickness measurements were not significantly different between NTG and HTG (all p>0.05). Mean deviation and corrected pattern standard deviation measured by automated perimetry was significantly correlated with mean and inferior RNFL thickness in both NTG and HTG (Pearson's r, p<0.05). Mean RNFL thickness/disc area ratio was significantly larger in HTG than NTG (35.21+/-18.92 vs. 31.30+/-10.91, p=0.004). CONCLUSIONS: These findings suggest that optic disc and RNFL damage pattern in NTG may be different from those of HTG.
Adult ; Aged ; Axons/*pathology ; *Diagnostic Techniques, Ophthalmological ; Female ; Glaucoma, Open-Angle/*diagnosis ; Humans ; Male ; Middle Aged ; Ocular Hypertension/diagnosis ; Optic Disk/*pathology ; Optic Nerve Diseases/*diagnosis ; Perimetry ; Retinal Ganglion Cells/*pathology ; Retrospective Studies ; *Tomography, Optical Coherence ; Visual Fields