PURPOSE: Unilateral ureteral obstruction results in tubulointerstitial fibrosis of the affected kidney which is driven by increased levels of angiotensin II. In this study, we examed the fibrotic changes in un inephrectomized rats with incomplete urteral obstruction and explored the effect of an angiotensin converting enzyme(ACE)inhibitor, enalapril on the tubulointerstitial fibrosis of obstructive uropathy. MATERIALS AND METHODS: 130 Rats were sacrificed at 1, 2, 4 weeks after nephrectomy or obstruction. Collagen type I, II, and III were localized by immunohistochemical staining. And the distribution of each collagen type was analyzed using differences of their staining densities. RESULTS: There is no difference in total collagen amount and immunohistochemical staining between control and uninephrectomized group. After 2weeks in incomplete ureteral obstruction in uninephretomized rat, the total amount of collagen in affected kidney was significantly increased compared to control (p<0.05), and immunohistochemical staining for all type of collagen was gradually increased by increased duration of incomplete ureteral obstruction. Enalapril did not affect the total collagen amount and immunohistochemical staining in the kidney of uninephrectomized rat. Enalapril significantly decreased the collagen amount in affected kidneys of collagen was not significantly changed compaired to control group. CONCLUSIONS: the incomplete ureteral obstruction in uninephrectomized rat induces progressive increase of amount of collagen according to the duration of obstruction, especially 2 weeks, and enalapril administration after incomplete unilateral obstruction of tubulointerstitial fibrosis of obstructive uropathy.
Angiotensin II ; Angiotensins ; Animals ; Collagen Type I ; Collagen* ; Enalapril* ; Fibrosis ; Kidney ; Nephrectomy ; Rats* ; United Nations ; Ureter* ; Ureteral Obstruction*

BACKGROUND: It has long been suggested that neutrophils and their products are implicated as the central mediators of the acute lung injuries. Contrary to the dominant role of neutrophils in ARDS, many cases of ARDS has occurred in the setting of severe neutropenia without pufrnonary neutrophil infiltration. Therefore it is certain that effector cell(s) other than neutrophil play an important role in the pathogenesis of ARDS. This experiment was performed to define the mechanism of ARDS in the setting of neutiopenia, 1) by comparing the severity of endotoxin-induced lung injury, 2) by measurement of hydrogen peroxide production and cytokine concentration in the bronchoalveolar lavage cells and fluids obtained from different rats with and without cyclophosphamide-pretreatment. METHOD: The male Sprague-Dawleys were divided into the normal control (NC)-, endotoxin (ETX)-, and cyclophosphamide (CPA)-group in which neutropenia was induced by injecting cyclophosphamide intraperitoneally. Acute lung injury was evoked by injecting lipopolysaccharide (LPS) into a tail vein. The bronchoalveolar lavage (BAL) was performed at 3 and 6 hour after administration of LPS to measure the change of cell counts and concentrations of protein and cytokines, tumor necrosis factor-alpha (TNF-alpha) and interleukin-6 (IL-6). Hydrogen peroxide (HPO) production from BAL cel]s was measured at 6 hour after LPS administration by phenol red microassay with and without zymosan stimulation. RESULTS: The results were as follows. A change of leukocyte counts in the peripheral blood after treatment with CPA More than 95% of total leukocytes and neutrophils were reduced after CPA administration, resulting in severe neutropenia. A change of BAL cells In the ETX-group, the number of total cells (p<0.01) and of macrophage and neutrophll (p<0.05) were increased at 3 and 6 hour after LPS administration compared to those of NC- group. In the CPA-group, the number of total leukocyte and macrophage were not changed after LPS administration, but neutrophil counts were significantly reduced and jt took part in less than 0.1% of total BAL cells (p<0.01 vs NC-group). BAL cells in this group were almost all macrophages (99.7%). A change of protein concentration in the BALF In the ETX-group, protein concentration was increased at 3 hour and was more increased at 6 hour after LPS administration (p<0.05 and <0.01 vs NC-group, respectively). In the CPA-group, it was also significantly elevated at 3 hour after LPS administration (p<0.05 vs NC-group) , but the value was statistically not different from that of ETh-group. The value measured at 6 hour after LPS administration in the CPA-group became lower than that of ETX-group (p<0.05), but showed still a higher value compared to that of NC-group (p<0.05). A change of cytokine concentration in the BALF TNF-alpha and IL-6 were elevated in the ETX- and CPA-group compared to those of NC-group at both time intervals. There was no statistical difference in the values of both cytokines between the ETX- and CPA-groups. Measurement of hydrogen peroxide production from BAL cells There was no intergroup difference of HPO production from resting cells. HPO production after incubation with opsonized zymosan was significantly elevated in all groups. The percent increment of HPO production was highest in the ETX-group (89.0%, p<0.0008 vs NC-group ), and was 42.85 in the CPA-group (p = 0.003 vs NC-group ). Conclusion Acute lung injury in the setting of neutropenia might be caused by functional activation of resident alveola r macrophages.
Acute Lung Injury* ; Animals ; Bronchoalveolar Lavage ; Cell Count ; Cyclophosphamide ; Cytokines ; Humans ; Hydrogen Peroxide ; Interleukin-6 ; Leukocyte Count ; Leukocytes ; Lung Injury ; Macrophages* ; Male ; Neutropenia ; Neutrophil Infiltration ; Neutrophils ; Phenolsulfonphthalein ; Rats* ; Tumor Necrosis Factor-alpha ; Veins ; Zymosan

Diverticular disease of the colon is frequently involved in Western countries, which in korea, it is regarding as rare disease. In Western the diverticulosis is mainly affected on left side and increasing in according to age and false type is more frequent than ture type. While in oriental countries, the diverticulosis of the colon is mainly affected on right side and it is more frequent in younger patients. Cecal diverticulitis is known to a very rare disease and very difficult to be differenciated from acute scopy has purnished another useful tool in the differential diagnosis of diverticular disease. We experienced a case of cecal diverticultitis which had been diagnosed by colonofiberscopy and reviewed literatures briefly.
Colon ; Diagnosis, Differential ; Diverticulitis* ; Diverticulum ; Humans ; Korea ; Rare Diseases

Recently, percutaneous epidural neuroplasty has become widely used to treat radicular pain caused by spinal stenosis or a herniated intervertebral disc. A 19-year-old female patient suffering from left radicular pain caused by an L4-L5 intervertebral disc herniation underwent percutaneous epidural neuroplasty of the left L5 nerve root using a Racz catheter. After the procedure, the patient complained of acute motor weakness in the right lower leg, on the opposite site to where the neuroplasty was conducted. Emergency surgery was performed, and swelling of the right L5 nerve root was discovered. The patient recovered her motor and sensory functions immediately after the surgery. Theoretically, the injection of a large volume of fluid in a patient with severe spinal stenosis during epidural neuroplasty can increase the pressure on the opposite side of the epidural space, which may cause injury of the opposite nerve by barotrauma from a closed compartment. Practitioners should be aware of this potential complication.
Barotrauma ; Catheters ; Constriction, Pathologic ; Emergencies ; Epidural Space ; Female ; Hemiplegia ; Humans ; Intervertebral Disc ; Leg ; Lower Extremity* ; Sensation ; Spinal Stenosis ; Young Adult

Renal biopsy is an essential diagnostic tool for detecting acute and chronic kidney rejection as well as recurrent and de novo nephropathies in renal allograft recipients. However, a well-known complication of percutaneous renal biopsy is arteriovenous fistula (AVF). Most post-biopsy AVFs are asymptomatic and regress spontaneously but some AVFs result in hypertension, hematuria, and renal insufficiency. Whether post-biopsy AVF superimposed on transplant renal artery stenosis (TRAS) also regresses spontaneously is unknown. We present a case of acute renal insufficiency in a 51-year-old female renal allograft recipient with post-biopsy AVF and TRAS. Percutaneous angioplasty with stent implantation was performed for the TRAS and transcatheter arterial coil embolization therapy applied for AVF. The patient's renal function returned to baseline levels and is currently being followed up for 6 months.
Acute Kidney Injury ; Angioplasty ; Arteriovenous Fistula ; Biopsy ; Female ; Hematuria ; Humans ; Hypertension ; Kidney ; Rejection (Psychology) ; Renal Artery ; Renal Artery Obstruction ; Renal Insufficiency ; Stents ; Transplantation, Homologous ; Transplants

Typhlitis is a necrotizing enterocolitis of the cecum, ascending colon and terminal ileum. Typhlits has been reported in the severely neutropenic patients and likely results from a combination of neutropenia and defects in the bowel mucosa related to cytotoxic chemotherapy. This disease is most common in patients with leukemia who have undergone intensive myeloablative chemotherapy. Presumptive diagnostic criteria for typhlitis include fever, abdominal pain and tenderness, and radiologic evidence of right-sided colonic inflammation in patients with neutropenia. Recently, this disease is also reported in patients with solid tumor due to increasing challenges of high dose chemotherapy. We report a case of typhlitis developed in the circumstance of neutropenia induced by chemotherapy in a patient with malignant testicular tumor.
Abdominal Pain ; Cecum ; Colon ; Colon, Ascending ; Drug Therapy* ; Enterocolitis, Necrotizing ; Fever ; Humans ; Ileum ; Inflammation ; Leukemia ; Mucous Membrane ; Neutropenia ; Typhlitis*

OBJECTIVE: This study was conducted in order to investigate professional job perception, job stress and job satisfaction in doctors. METHOD: The authors conducted a survey using a self-administered questionnaire, conducted between August and September, 2001. The study subjects were 457 doctors practicing at local clinics in Daegu City. RESULTS: For the professionalism scale, the score for 'sense of calling to field' and 'feeling of autonomy' were relatively high. Age, working hours per day, and perception of socioeconomic status significantly influenced the professionalism scale scores (p< 0.01). For the job stress scale, the scores for 'clinical responsibility/ decision' factor were the highest of all the surveyed factors. Working hours per day significantly influenced the job stress scores (p< 0.01). To investigate the overall relationship between the variables, the authors conducted a linear structural equation model analysis. The equation was statistically appropriate and a good fit. The job stress, and the professionalism factors, respectively influenced job satisfaction negatively and positively (T> 2.0). The working hours per day and status perception also influenced their job satisfaction (T> 2.0). CONCLUSION: To promote the job satisfaction of doctors, the development of coping tools and other intervention methods are needed to increase doctor's professional job perception and reduce their job stress. Further studies are required to understand the characteristics of job satisfaction and for its promotion with doctors.
Daegu* ; Job Satisfaction* ; Methods ; Professionalism ; Social Class

OBJECTIVES: This study was conducted to investigate the levels of psychosocial stress, job stress and their related factors among medical doctors practicing at local clinics. METHODS: A survey using a self administered questionnaire was administered to 1,456 doctors practicing at private clinics via post for 2 months (2006. 1 - 2006. 3). Psychosocial stress, job stress,demographic factors, job related factors and health related behaviors were investigated. Among the eligible study population, the respondents were 428 doctors (29.4%). RESULTS: The average scores of psychosocial stress and job stress were 2.19 and 3.13, respectively. The levels of psychosocial stress and job stress were statistically lower in older respondents, those who worked shorter or who were more satisfied with their job, and those with higher socioeconomic status. The level of psychosocial stress was related with smoking status, drinking status and exercise. The level of job stress was related with smoking status and exercise. In multiple linear regression analysis using psychosocial stress as a dependent variable, age, working hours per day, job satisfaction and perception on socioeconomic status were significant independent variables. In analysis using job stress as a dependent variable, age, working hours per day and job satisfaction were significant independent variables. CONCLUSIONS: Stress affects the doctor-patient relationship, productivity and overall health level of people. Therefore, it is important to manage and relieve the stress of doctors. It is suggested that more advanced studies on stress level and related factors and ways to improve the stress and health related behaviors of medical doctors should be conducted.
*Stress, Psychological ; Questionnaires ; Psychology ; Physicians/*psychology ; Occupational Exposure ; Middle Aged ; Male ; Korea ; Humans ; Female ; *Ambulatory Care Facilities ; Adult

OBJECTIVE: This study was conducted in order to investigate the professionalism, job stress and job satisfaction in western and oriental doctors in Korea. METHODS: The authors conducted a survey using a selfadministered questionnaire, conducted between August and September, 2001. The study subjects were 457 western doctors and 161 oriental doctors practicing at local clinics in Daegu City. RESULTS: For the professionalism scale, the score for 'belief in service to the public' of western doctors was significantly higher than that of oriental doctors (p< 0.05) whereas the scores for 'sense of calling to the field' and 'feeling of autonomy' were higher in oriental doctors (p< 0.01). For the job stress scale, the scores for 'work factor', and 'clinical responsibility/decision factor' of western doctors were significantly higher than those of oriental doctors (p< 0.01). Of the western doctors, 59.7% expressed satisfaction with their job as a doctor, 69.5% responded that the role of a doctor was appropriate to their aptitude, and 61.8% answered that they wouldn't consider other kinds of job even if offered. In case of oriental doctors, these responses were83.1%, 82.5%, and 82.3%, espectively. CONCLUSION: The job stress scores of western doctors were higher than those of oriental doctors, but the job satisfaction was lower. The reasons for the above results are not clear. Further studies are required to understand the characteristics of job stress and job satisfaction in doctors.
Aptitude ; Daegu ; Job Satisfaction* ; Korea ; Professionalism

BACKGROUND: The signal pathways and their precise roles for acute respiratory distress syndrome caused by endotoxin (ETX) has not been established. Since there has been several in vitro experiments suggesting that activation of protein kinase C (PKC) pathway may be responsible for endotoxin-induced inflammatory reaction, we performed in vivo experiments in the rats with the hypothesis that PKC-inhibition can effectively prevent endotoxin-induced acute lung injury. METHODS: We studied the role of PKC in ETX-induced ALl using PKC inhibitor (staurosporine, 5Th) in the rat. Specific pathogen free male Sprague-Dawley weighted from 165 to 270g were used for the study. Animals were divided into the normal control (NC)-, vehicle control (VC)-, ETX-, PMA (phorbolmyristateacetate)-, STP+PMA-, and STP+ETX-group. PMA (50mg/kg) or ETX (7mg/kg) was instilled through polyethylen catheter after aseptic tracheostomy with and without STP (0.2mg/kg) pretreatment. STP was injected via tail vein 30mm before intratracheal injection (IT) of PMA or ETX. Bronchoalveolar lavage (BAL) was done 3- or 6-hrs after IT of PMA or FTX respectively, to measure protein concentration, total and differential cell counts. RESULTS The results were as follows. The protein concentrations in BALF in the PMA- and ETX-group were very higher than that of VC-group (p<0.001). When animals were pretreated with STP, the %reduction of the protein concentration in BALF was 64.8 8.5 and 30.4 2.5% in the STP+PMA- and STP+ETX-group, respectively (p=0.028). There was no difference in the total cell counts between the PMA-and VC-group (p = 0.26). However the ETX-group showed markedly increased total cell counts as compared to the VC- (p=0.003) and PMA group (p=0.0027), respectively. The total cell counts in BALF were not changed after pretreatment with STP compared to the PMA- (p=0.22) and ETX-group (p=0.46). The percentage of PMN, but not alveolar macrophage, was significantly elevated in the PMA-, and ETX-group. Especially in the ETX-group, the percentage of PMN was 17 times higher than that of PMA (p<0.001). The differential cell counts was not different between the PMA and STP+PMA. On the contrary the STP+ETX-group showed decreased percentage of PMN (p = 0.016). There was no significant relationship between the protein concentration and the total or differential cell counts in each group. CONCLUSION: Pretreatment with PKC-inhibitor (staurosporine) partially but significantly inhibited ETX-in-duced ALI.
Acute Lung Injury* ; Animals ; Bronchoalveolar Lavage ; Catheters ; Cell Count ; Humans ; Macrophages, Alveolar ; Male ; Protein Kinase C* ; Protein Kinases* ; Rats ; Rats, Sprague-Dawley ; Respiratory Distress Syndrome, Adult ; Signal Transduction ; Specific Pathogen-Free Organisms ; Staurosporine ; Tracheostomy ; Veins