The aim of the present study was to investigate the CGRP-IR pattern in the ureter in stone-implanted rats and ureteral formalin irritated rats. Artificial ureteral stone rats were made according to Giamberardino's guide lines. For urethral formalin irritated rats, a small amount of diluted formalin was instilled into the ureter. The behavioral characteristics were observed and recorded with CCTV and analyzed, statistically. The rats showing characteristic visceral episode were sacrificed three days after stone implantation operation and after overnight chemical irritation followed by immunostaining of the ureter with anti-CGRP on the ureter In the artificial ureteral stone rats, CGRP IR fiber pattern showed variable changes on the upper portion of the stone implanted ureter. i.e., complete depletion, reticular pattern, and reticular pattern with more increased CGRP immunoreactivity were observed. In contrast, more-distinct CGRP IR fibers formed a reticular pattern but were not increased in density in the formalin irritated ureter. The results show the variable changing pattern of CGRP immunoreactivity in the ureter after artificial urethral calculosis, and the constant CGRP immunoreactivity in the ureter after chemical ureteral irritation.
Animals ; Formaldehyde ; Lithiasis ; Rats* ; Ureter*

BACKGROUND: Infection of hepatitis B virus(HBV) is one of the most important cause of the liver diseases in Korea, although HBV infection tends to be decreased. Diagnostic kits more accurately detecting HBV infection have been required'in order to diagnose and prevent the HBV infection. Recently LG Chemical Ltd. developed new diagnostic kits for HBsAg, anti-HBs and anti-HBc, using HBV from Korean patients. We evaluated these new kits by comparing them with microplate enzyme immunoassay (EIA) from BehringTU(Germany) and microparticle EIA (MEIA) from AbbottTM(USA). METHOD: Sera from 1,500 healthy blood donors and 500 patients were obtained to test HBsAg, anti- HBs and anti-HBc using diagnostic kits from AbbottTM, BehringTM and LG Chemical Ltd. We analyzed the results of 3 manufacturers and confirmed the discordant results of HBsAg by Southern hybridization after HBV PCR and those of anti-HBs by neutralization assay with HBsAg from LGTM. We also evaluated the reproducibility and detection limit. RESULTS: Of 1,500 healthy blood donors, HBsAg was positive in 34 (2.3%), representing completely the same results from 3 manufacturers. However, of 500 patients, 7 (1.4%) had discordant results; HBsAg was positive in all 7 sera tested with BehringTM and positive in only one tested with AbbottTM and LGTM, respectively. HBV DNA was not detected in all 7 discordant results of HBsAg, so false positive results totaled 7 (1.4%) with BehringTM and 1 (0.2%) with AbbottTM and LGTM, respectively. Of 2,000 sera, the results of anti-HBs and anti-HBc from 3 manufacturers were same in 1,876 (93.8%) and in 1,949 (97.5%), respectively. Results of HBsAg, anti-HBs and anti-HBc from 3 manufacturers were constant on repeating tests. When testing the detection limit, BehringTM kits for HBsAg and anti-HBs retained significantly higher sensitivity than AbbottTM and LGTM. On the other hand, BehringTM kit for anti-HBc showed significantly lower sensitivity than AbbottTM and LGTM. CONCLUSION: The diagnostic kits for HBV developed by LG Chemical Ltd. showed comparable results with those by AbbottTM or BehringTM and will be useful as screening blood donors or detecting patients with HBV infection.
Blood Donors ; DNA ; Hand ; Hepatitis B Surface Antigens ; Hepatitis B* ; Hepatitis* ; Humans ; Immunoenzyme Techniques ; Korea ; Limit of Detection ; Liver Diseases ; Mass Screening ; Polymerase Chain Reaction

OBJECTIVES: There is a need for effective processes in healthcare clinics, especially in tertiary hospitals, that consist of a set of complex steps for outpatient care, in order to provide high quality care and reduce the time cost. This study aimed to discover the potential of a process mining technique to determine an outpatient care process that can be utilized for further improvements. METHODS: The outpatient event log was defined, and the log data for a month was extracted from the hospital information system of a tertiary university hospital. That data was used in process mining to discover an outpatient care process model, and then the machine-driven model was compared with a domain expert-driven process model in terms of the accuracy of the matching rate. RESULTS: From a total of 698,158 event logs, the most frequent pattern was found to be "Consultation registration > Consultation > Consultation scheduling > Payment > Outside-hospital prescription printing" (11.05% from a total cases). The matching rate between the expert-driven process model and the machine-driven model was found to be approximately 89.01%, and most of the processes occurred with relative accuracy in accordance with the expert-driven process model. CONCLUSIONS: Knowledge regarding the process that occurs most frequently in the pattern is expected to be useful for hospital resource assignments. Through this research, we confirmed that process mining techniques can be applied in the healthcare area, and through detailed and customized analysis in the future, it can be expected to be used to improve actual outpatient care processes.
Ambulatory Care ; Delivery of Health Care ; Hospital Information Systems ; Humans ; Mining ; Outpatients ; Prescriptions ; Tertiary Care Centers

PURPOSE: To find the applicability of adjuvant radiotherapy for extrahepatic bile duct cancer (EBDC), we analyzed the pattern of failure and evaluate prognostic factors of locoregional failure after curative resection without adjuvant treatment. MATERIALS AND METHODS: In 97 patients with resected EBDC, the location of tumor was classified as proximal (n = 26) and distal (n = 71), using the junction of the cystic duct and common hepatic duct as the dividing point. Locoregional failure sites were categorized as follows: the hepatoduodenal ligament and tumor bed, the celiac artery and superior mesenteric artery, and other sites. RESULTS: The median follow-up time was 29 months for surviving patients. Three-year locoregional progression-free survival, progression-free survival, and overall survival rates were 50%, 42%, and 52%, respectively. Regarding initial failures, 79% and 81% were locoregional failures in proximal and distal EBDC patients, respectively. The most common site was the hepatoduodenal ligament and tumor bed. In the multivariate analysis, perineural invasion was associated with poor locoregional progression-free survival (p = 0.023) and progression-free survival (p = 0.012); and elevated postoperative CA19-9 (> or =37 U/mL) did with poor locoregional progression-free survival (p = 0.002), progression-free survival (p < 0.001) and overall survival (p < 0.001). CONCLUSION: Both proximal and distal EBDC showed remarkable proportion of locoregional failure. Perineural invasion and elevated postoperative CA19-9 were risk factors of locoregional failure. In these patients with high risk of locoregional failure, adjuvant radiotherapy could be considered to improve locoregional control.
Bile Duct Neoplasms ; Bile Ducts, Extrahepatic* ; Celiac Artery ; Cystic Duct ; Disease-Free Survival ; Follow-Up Studies ; Hepatic Duct, Common ; Humans ; Ligaments ; Mesenteric Artery, Superior ; Multivariate Analysis ; Prognosis ; Radiotherapy, Adjuvant* ; Recurrence ; Risk Factors ; Survival Analysis ; Survival Rate

BACKGROUND: The information on nasal transport and the metabolism of peptides have been obtained from pharmacokinetic investigations in experimental animals. However, there are no transport and metabolic studies of human nasal epithelial cells. In this study, the permeability characteristics and the metabolic properties of in vitro human nasal cell monolayers were investigated. Material and METHODS: Normal human inferior nasal conchal tissue samples were obtained from patients undergoing endoscopic nasal cavitary surgery. The specimens were cultured in a transwell using an air-liquid interface (ALI) culture, and the transepithelial electrical resistance (TEER) value of the blank filter and confluent cell monolayers were measured. To determine the % leakage of mannitol, 4µmol 14C-labelled mannitol was added and the % leakage was measured every 10 minute for 1 hour. RESULT: Human nasal epithelial cells in the primary culture grew to a confluent monolayer within 7 days and expressed microvilli. The tight junction between the cells was confirmed by transmission electron microscopy. The TEER value of the blank filter, fifth day and seventh day reached 108.5 ohm.cm2, 141 ohm.cm2 and 177.5 ohm.cm2, respectively. Transcellular % leakage of the 14C-mannitol at 10, 20, 30, 40, 50 and 60 minutes was 35.67±5.43, 34.42±5.60, 32.75±5.71, 31.76±4.22, 30.96±3.49 and 29.60±3.68 %, respectively. CONCLUSION: The human nasal epithelial monolayer using ALI using techniques is suitable for a transcellular permeability study. The data suggests that human nasal epithelial cells in as ALI culture technique shows some promise for a nasal transport and metabolism study.
Animals ; Culture Techniques* ; Electric Impedance ; Epithelial Cells* ; Humans* ; Mannitol ; Metabolism ; Microscopy, Electron, Transmission ; Microvilli ; Peptides ; Permeability ; Tight Junctions

In order to investigate the implication of viral replication in acute, subacute, and chronic infections of coxsackievirus B3 (CVB3), we examined the histopathological changes and plus- and minus-strand viral RNA dynamics in heart, pancreas, brain, and liver of CVB3-infected A/J mice. Mice were inoculated intraperitoneally with CVB3 and sacrificed on 1, 2, 3, 4, 7, 10, 14, 21, 30, 60, and 90 days post infection (p.i.). Plus- and minus-strand viral RNAs in the organs were quantitated and the organs were additionally evaluated histopathologically for inflammation. No inflammatory infiltrates were observed in the liver, brain, and heart. In contrast, massive lymphocyte infiltration and fat replacement were shown in the pancreas with loss of acinar cells. Both plus- and minus-strand viral RNA levels were detected by 21 days p.i. in heart, 90 days p.i. in pancreas, 4 days p.i. in liver, and 10 days p.i. in brain. The plus-strand RNA was found at least fifty fold higher than the minus-strand RNA by 4 days p.i. in heart and pancreas and by 3 days p.i. in liver. The plus- to minus-strand RNA ratio in brain was found less than 1:20. Our data indicate that viral replication was actively occurred in heart, pancreas, and liver during acute CVB3 infection, whereas viral replication was limited in brain. Furthermore, chronic persistent viral RNA was observed in pancreas. In conclusion, CVB3 at low dose of virus induces severe pancreatitis but marginal or no inflammatory changes in the heart, liver, and brain.
Acinar Cells ; Animals ; Brain ; Heart ; Inflammation ; Liver ; Lymphocytes ; Mice ; Pancreas ; Pancreatitis ; RNA ; RNA, Viral ; Viruses

PURPOSE: A preoperative biliary drainage procedure (endoscopic nasogastric biliary drainage, ENBD; endoscopic retrograde biliary drainage, ERBD; or percutaneous transhepatic biliary drainage, PTBD) is infrequently performed in periampullary cancer patients with obstructive jaundice. Among these different biliary drainage procedures, a safer and more informative procedure should be performed in the indicated cases. However, no comparative study has been done between the two biliary drainage methods (endoscopic vs. percutaneous). The aim of this study is to compare the clinical outcome of these two biliary drainage methods in periampullary cancer and to suggest guidelines for selecting the appropriate preoperative biliary drainage procedure. METHODS: Between January 1996 and June 2002, 25 patients underwent pancreaticoduodenectomy (Whipples' operation or pylorus preserving pancreaticoduodenectomy) after ENBD/ERBD (Group A) due to periampullary cancer. Twenty- five patients who ubderwent PTBD preoperatively were matched with Group A, according to age group, sex, diagnosis, and type of operation during the same period (Group B). RESULTS: There were no differences in operative time, intraoperative/postoperative transfusion, total/postoperative length of hospital stay, incidence of postoperative complication, TNM staging, or perineural/endovascular/endolymphatic invasion. However, the thickness of CBD wall (Group A: Group B=1.78+/-0.55 mm : 1.14+/-0.37 mm, P<0.001) and degree of inflammation of the CBD wall (Group A> Group B, P<0.001) were significantly different between the two groups. CONCLUSION: Although a significant difference of clinical outcome between the two preoperative biliary drainage methods could not be identified in this study, the inflammation of operative field resulting from ENBD/ERBD is expected to cause surgical difficulties and ultimately affect postoperative complications.
Diagnosis ; Drainage* ; Humans ; Incidence ; Inflammation ; Jaundice, Obstructive ; Length of Stay ; Neoplasm Staging ; Operative Time ; Pancreaticoduodenectomy ; Postoperative Complications ; Pylorus

In a retrospective study, the prognostic value of monitoring the decay of alpha-fetoprotein (AFP) was assessed. Serum AFP was determined serially in 18 children with malignant germ cell tumors or malignant hepatic tumors: Fifteen children had malignant germ cell tumors (endodermal sinus tumor;7, embryonal carcinoma;3, malignant teratoma;5). Two children had hepatoblastoma and a third had hepatocellular carcinoma. The actual half-life (AHL) of AFP was computed according to the formula after the surgical resection of the tumor. In group 1, which had a complete resection and no recurrence during follow-up (n=13), the AHL of AFP was 4.0+/-0.9 days. In group 2, which had a incomplete resection or recurrence during follow-up (n=5), the AHL of AFP was 24.8+/-20 days. The AHL of group 2 was significantly longer than that of group 1 (p = 0.0026). The increased AHL of AFP indicated the residual active tumor after surgical resection. The AHL of AFP may be more sensitive than the serial monitoring of AFP in detecting the preclinical recurrence after surgical resection of AFP secreting tumors. Treatment strategies can be based on AFP clearance and prospective clinical trials are warranted.
alpha-Fetoproteins* ; Carcinoma, Hepatocellular ; Child ; Follow-Up Studies ; Half-Life* ; Hepatoblastoma ; Humans ; Neoplasms, Germ Cell and Embryonal ; Recurrence ; Retrospective Studies

PURPOSE: Myocutaneous flap was widely used for trochanteric pressure sore but it had many drawbacks such as donor site morbidity, dog-ear deformity and functional muscle sacrifice. We have performed fasciocutaneous flap based on perforating vessels and succeeded in overcoming its drawbacks. METHODS: We experienced 11 cases of perforator-based fasciocutaneous flap for the coverage of trochanteric pressure sore in 9 patients, 2 cases of which were bilateral. The ambulatory status of patient group is as follows: 6 of them used a wheelchair, 2 of them are free walking, 1 of them use a wheelchair or crutches. Flap was supplied by cutaneous perforating vessel of descending branch of the lateral circumflex femoral artery and the third perforating artery of the deep femoral artery. The size of wounds were from 4x6.5cm to 10x13cm. RESULTS: We did not find any flap loss or congestion except 2 partial wound dehiscences and 1 wound infection. Donor site morbidity was not found. We observed no recurrence of the pressure sore during the 2.5 year follow-up period. CONCLUSION: We considered that perforator-based fasciocutaneous flap could overcome the traditional drawbacks of the conventional myocutaneous flap and its modified flap for trochanteric pressure sore. And this flap has many advantages for covering trochanteric pressure sore without any donor site deformity and morbidity, which would greatly improve the aesthetic result.
Arteries ; Congenital Abnormalities ; Crutches ; Estrogens, Conjugated (USP) ; Femoral Artery ; Femur* ; Follow-Up Studies ; Humans ; Myocutaneous Flap ; Pressure Ulcer* ; Recurrence ; Tissue Donors ; Walking ; Wheelchairs ; Wound Infection ; Wounds and Injuries

The primary malignant tumor of the peritoneum also known as primary peritoneal carcinoma or primary peritoneal papillary serous carcinoma is rare and involves the peritoneum, especially the pelvic peritoneum of female patients. It is difficult to differentiate histologically between papillary mesothelioma, primary ovarian tumor and primary peritoneal carcinoma. We report two cases of the primary peritoneal carcinoma with clinical presentation and histologic characteristics.
Diagnosis, Differential ; Female ; Humans ; Mesothelioma ; Peritoneum*