PURPOSE: To determine whether there is any difference in variceal distribution between patients with and without a history of esophageal variceal bleeding. MATERIALS AND METHODS: To compare the distribution of varices, abdominal CT scans of 24 patients with a history of esophageal variceal bleeding (hemorrhagic group) and 90 patients without a history of bleeding (non-hemorrhagic group) were retrospectively assessed. RESULTS: The most common varices in both the hemorrhagic (n = 21, 87.5 %) and nonhemorrhagic group (n = 53, 58.9 %) were coronary varices, with a statistically significant frequency (p < .01). Esophageal varices were also more common in the hemorrhagic than the nonhemorrhagic group (n=19, 79.2 % vs n = 36, 40.0 % : P < .005). Splenorenal shunts were more common in the nonhemorrhagic (n = 8, 8.9 %) than in the hemorrhagic group(n = 0, 0 %) (P < .05). Other types of varice such as paraumbilical (n = 10, 41.7 % vs n = 21, 23.3 %), perisplenic (n = 6, 25 % vs n = 15, 16.7 %) and retroperitoneal-paravertebral (n = 11, 45.8 % vs n = 24, 26. 7 %) were more common in the hemorrhagic group, but without a statistically significant frequency. CONCLUSION: The frequency of coronary and esophageal varices was significant in patients with a history of esophageal variceal bleeding. In patients without such a history, splenorenal shunts were seen.
Esophageal and Gastric Varices ; Hemorrhage ; Humans ; Hypertension, Portal* ; Retrospective Studies ; Splenorenal Shunt, Surgical ; Tomography, X-Ray Computed ; Varicose Veins

BACKGROUND/AIMS: The aim of this study was to investigate the epidemiological characteristics and changing patterns of gallstone disease over the last 20 years. METHODS: Four thousands and twenty gallstone patients who had received surgery at Seoul National University Hospital (1981~2000) were analyzed according to time of treatment; period I: 1981~1985 (831 cases), period II: 1986~1990 (888 cases), period III: 1991~1995 (1,040 cases) and period IV: 1996~ 2000 (1,261 cases). Data from 13 institutes in Korea reporting 13,101 gallstone cases were also reviewed with literature to elucidate the nation-wide trends. RESULTS: The number of gallstone cases has gradually increased. A female- predominance was not observed (F/M=1.17-1.37). The CBD stone patients were older than the GB and the IHD stone patients. Over the study period, the relative portion of the GB stone group increased. The portion of CBD stone group decreased, while that of the IHD stone group was unchanged. The rural pattern of gallstone disease (low GB stone, high CBD and IHD stone) has become similar to the urban pattern. Such patterns are well agreed with the other literature reported in Korea. CONCLUSIONS: The pattern of gallstone disease in Korea has become similar to that in Western countries except a high prevalence of hepatolithiasis.
Cholelithiasis/epidemiology/*surgery ; Female ; Humans ; Korea/epidemiology ; Male ; Middle Aged ; Prevalence

PURPOSE: Various mechanical causes which induce shoulder impingement syndrome have been identified with the help of MRI. The aim of this study is to evaluate the incidence of such causes. MATERIALS AND METHODS: A total of 54 patients with clinically confirmed shoulder impingement syndrome and a normal control group(n=20) without symptoms were included. We evaluated the incidence of hook shaped acromion, low lying acromion, downward slope of the acromion, subacromial spur, acromioclavicular joint hypertrophy, coracoacromial ligament hypertrophy, high cuff muscle bulk, and os acromiale. RESULTS: Among the 54 patients, the following conditions were present: acromioclavicular joint hypertrophy(n=36), coracoacromial ligament hypertrophy(n=20), subacromial spur(n=18), downward sloping of the acromion(n=16), hook shaped acromion(n=11), relatively high cuff muscle bulk(n=6), low lying acromion relative to the clavicle(n=3), and os acromiale(n=1). In the normal control group there were nine cases of acromioclavicular joint hypertrophy, nine of coracoacromial ligament hypertrophy, nine of downward sloping acromion, and three of low lying acromion, but hook shaped acromion, high cuff muscle bulk, and os acromiale were not found. Among 54 patients, the syndrome was due to five simultancous causes in one patient, four causes in two, three causes in 12, two causes in 22, and one cause in 17. CONCLUSION: Hook shaped acromion and subacromial spur are the statistically significant causes of shoulder impingement syndrome. In 69 % of patients, the condition was due to more than one cause.
Acromioclavicular Joint ; Acromion ; Deception ; Humans ; Hypertrophy ; Incidence ; Ligaments ; Magnetic Resonance Imaging* ; Shoulder Impingement Syndrome* ; Shoulder*

BACKGROUND/AIMS: To investigate the epidemiologic changing patterns of gallstone diseases in Korea during past 25 years. METHODS: A total of 5,671 gallstone patients who underwent surgery in our center during 1981-2005 were analyzed. The patients were divided into 5 periods: period I (1981-1985, n=831), period II (1986-1990, n=888), period III (1991-1995, n=1,040), period IV (1996-2000, n=1,261) and period V (2001-2005, n=1,651). Korean literatures published from 1961 to 2005 were reviewed to elucidate the nationwide trends of gallstone diseases. RESULTS: Number of gallstone disease cases were gradually increasing. Female predominance was not noted (male/female ratio, 1.07-1.37). Patients with common bile duct (CBD) stone were older than those with gallbladder (GB) stone or intrahepatic duct (IHD) stone. During past 25 years, relative proportion of GB stone cases increased from 53.0% to 89.7%, while that of CBD stone cases decreased from 68.0% to 15.1%. Relative proportion of IHD stone patients remained stationary. In rural areas, tendency of increasing GB stone and decreasing CBD stone disappeared since period III. However, in urban areas, these tendencies remained till period V. Relative frequency of IHD stone group remained unchanged in two areas. The body mass indexes of the GB stone group, CBD stone group, and IHD stone group were higher than that of the average population. CONCLUSIONS: In gallstone disease, increasing tendency of GB stone and decreasing tendency of CBD stone in rural area have disappeared. However, relative frequency of IHD stone is still high in Korea.
Body Mass Index ; Demography ; Female ; Gallstones/diagnosis/*epidemiology/surgery ; Humans ; Korea/epidemiology ; Male ; Middle Aged ; Prevalence ; Retrospective Studies

OBJECTIVE: To determine whether local estrogen production takes place in adenomyosis and in normal endometrium. METHODS: The study included 23 cases of adenomyosis and 17 cases of normal uterine endometrium obtained through hysterectomy or curettage at Kangnam Cha Hospital. The frozen tissue specimens were examined by immunohistochemistry using P450 arom. RESULTS: P450 arom was immunolocalized exclusively in the cytoplasm of glandular cells of adenomyotic tissue. However, no apparent staining was observed in stromal cells. Aromatase was expressed in the ectopic glands (82.6%), but also in the eutopic endometrium of patients with adenomyosis (23.5%). In the case of normal endometrium, P450arom was not detected. CONCLUSION: These results suggest that the aromatase activity is correlated to the pathophysiology of adenomyosis.
Adenomyosis* ; Aromatase* ; Curettage ; Cytochrome P-450 Enzyme System* ; Cytochromes* ; Cytoplasm ; Endometrium ; Estrogens ; Female ; Humans ; Hysterectomy ; Immunohistochemistry ; Stromal Cells

Osteoclasts, together with osteoblasts, control the amount of bone tissue and regulate bone remodeling. Osteoclast differentiation is an important factor related to the pathogenesis of bone-loss related diseases. Reactive oxygen species (ROS) acts as a signal mediator in osteoclast differentiation. Simvastatin, which inhibits 3-hydroxy-3-methylglutaryl coenzyme A, is a hypolipidemic drug which is known to affect bone metabolism and suppresses osteoclastogenesis induced by receptor activator of nuclear factor-kappaB ligand (RANKL). In this study, we analyzed whether simvastatin can inhibit RANKL-induced osteoclastogenesis through suppression of the subsequently formed ROS and investigated whether simvastatin can inhibit H2O2-induced signaling pathways in osteoclast differentiation. We found that simvastatin decreased expression of tartrate-resistant acid phosphatase (TRAP), a genetic marker of osteoclast differentiation, and inhibited intracellular ROS generation in RAW 264.7 cell lines. ROS generation activated NF-kappaB, protein kinases B (AKT), mitogen-activated protein kinases signaling pathways such as c-JUN N-terminal kinases, p38 MAP kinases as well as extracellular signal-regulated kinase. Simvastatin was found to suppress these H2O2-induced signaling pathways in osteoclastogenesis. Together, these results indicate that simvastatin acts as an osteoclastogenesis inhibitor through suppression of ROS-mediated signaling pathways. This indicates that simvastatin has potential usefulness for osteoporosis and pathological bone resorption.
Acid Phosphatase/genetics/metabolism ; Animals ; Anticholesteremic Agents/*pharmacology ; Blotting, Western ; *Cell Differentiation ; Cells, Cultured ; Hydrogen Peroxide/pharmacology ; Isoenzymes/genetics/metabolism ; Macrophages/cytology/drug effects/metabolism ; Mice ; Mitogen-Activated Protein Kinases/genetics/metabolism ; NF-kappa B/genetics/metabolism ; Osteoclasts/*cytology/*drug effects/metabolism ; RANK Ligand/metabolism ; RNA, Messenger/genetics ; Reactive Oxygen Species/*metabolism ; Real-Time Polymerase Chain Reaction ; Simvastatin/*pharmacology

BACKGROUND/AIMS: The aim of this study was to investigate changes in the clinical and demographical characteristics of gallstone disease in Korea, based on 30 years of surgically treated patients at a single institute. METHODS: In total, 7,949 gallstone patients who underwent surgery between 1981 and 2010 were analyzed. Patients were divided into six time periods: period I (1981 to 1985, n=831), period II (1986 to 1990, n=888), period III (1991 to 1995, n=1,040), period IV (1996 to 2000, n=1,261), period V (2001 to 2005, n=1,651) and period VI (2006 to 2010, n=2,278). RESULTS: The total number and mean age of the patients gradually increased, and the male/female ratio decreased. The proportion of gallbladder (GB)-stone cases increased, whereas the proportions of common bile duct (CBD)- and intrahepatic duct (IHD)-stone cases decreased. Differences in patient geographical origins also decreased. Based on the relationship between changes in the prevalence of gallstone disease and socioeconomic status, the prevalence of CBD stones showed a strong correlation with Engel's coefficient (p<0.001). CONCLUSIONS: Our study indicates that although the total number of cases and the mean age of gallstone patients have continuously increased, there are trends of increasing GB-stone cases and decreasing CBD- and IHD-stone cases.
Adult ; Age Distribution ; Body Mass Index ; Choledocholithiasis/*epidemiology/surgery ; Female ; Gallstones/*epidemiology/surgery ; Humans ; Male ; Middle Aged ; Prevalence ; Republic of Korea/epidemiology ; Rural Population/trends ; Sex Ratio ; Socioeconomic Factors ; Urban Population/trends

Although formaldehyde (FA) is known to be a major allergen responsible for allergic contact dermatitis, there are conflicting reports regarding correlation between FA exposure and interleukin (IL-4) expression. To investigate whether allergic responses including IL-4 expression were induced by repeated dermal exposure to low dose FA, alterations in the luciferase signal and allergic phenotypes were measured in IL-4/Luc/CNS-1 transgenic (Tg) mice containing luciferase cDNA under control of the IL-4 promoter after exposure to 4% FA for 2 weeks. High levels of luciferase were detected in the abdominal region of the whole body and submandibular lymph node (SLN) of FA treated mice. Additionally, the ear thickness and IgE concentration were significantly upregulated in the FA treated group when compared with the acetone olive oil (AOO) treated group. FA treated mice showed enhanced auricular lymph node (ALN) weight, epidermis and dermis thickness, and infiltration of inflammatory cells. Furthermore, the expression of IL-6 among T helper 2 cytokines was higher in the FA treated group than the AOO treated group, while vascular endothelial growth factor (VEGF) levels remained constant. Overall, the results presented herein provide additional evidence that various allergic responses may be successfully induced in IL-4/Luc/CNS-1 Tg mice after exposure to low dose FA for 2 weeks. The luciferase signal under the IL-4 promoter may reflect general indicators of the allergic response induced by exposure to low dose FA.
Acetone ; Animals ; Cytokines ; Dermatitis, Allergic Contact ; Dermis ; DNA, Complementary ; Ear ; Epidermis ; Formaldehyde* ; Immunoglobulin E ; Interleukin-4 ; Interleukin-6 ; Interleukins ; Luciferases ; Lymph Nodes ; Mice ; Mice, Transgenic* ; Olea ; Phenotype ; Vascular Endothelial Growth Factor A ; Olive Oil