PURPOSE: We describe the daily bladder volume change observed by mega-voltage computed tomography (MVCT) during pelvic radiotherapy with potential predictors of increased bladder volume variations. MATERIALS AND METHODS: For 41 patients who received pelvic area irradiation, the volumes of bladder and pelvic body contour were measured twice a day with pre- and post-irradiation MVCT from the 1st to the 10th fraction. The median prescription dose was 20 Gy (range, 18 to 30 Gy) up to a 10th fraction. The upper and lower margin of MVCT scanning was consistent during the daily treatments. The median age was 69 years (range, 33 to 86 years) and 10 patients (24.4%) were treated postoperatively. RESULTS: Overall bladder volume on planning computed tomography was 139.7 ± 92.8 mL. Generally, post-irradiation bladder volume (POSTBV) was larger than pre-irradiation bladder volume (PREBV) (p < 0.001). The mean PREBV and POSTBV was reduced after 10 fraction treatments by 21.3% (p = 0.028) and 25.4% (p = 0.007), respectively. The MVCT-scanned body contour volumes had a tendency to decrease as the treatment sessions progressed (p = 0.043 at the 8th fraction and p = 0.044 at the 10th fraction). There was a statistically significant correlation between bladder filling time and PREBV (p = 0.001). CONCLUSION: Daily MVCT-based bladder volume assessment was feasible both intra- and inter-fractionally.
Humans ; Pelvic Neoplasms ; Prescriptions ; Radiotherapy ; Radiotherapy, Intensity-Modulated ; Urinary Bladder

OBJECTIVES: Cohort studies of associations between air pollution and health have used exposure prediction approaches to estimate individual-level concentrations. A common prediction method used in Korean cohort studies is ordinary kriging. In this study, performance of ordinary kriging models for long-term particulate matter less than or equal to 10 mum in diameter (PM10) concentrations in seven major Korean cities was investigated with a focus on spatial prediction ability. METHODS: We obtained hourly PM10 data for 2010 at 226 urban-ambient monitoring sites in South Korea and computed annual average PM10 concentrations at each site. Given the annual averages, we developed ordinary kriging prediction models for each of the seven major cities and for the entire country by using an exponential covariance reference model and a maximum likelihood estimation method. For model evaluation, cross-validation was performed and mean square error and R-squared (R2) statistics were computed. RESULTS: Mean annual average PM10 concentrations in the seven major cities ranged between 45.5 and 66.0 mug/m3 (standard deviation=2.40 and 9.51 mug/m3, respectively). Cross-validated R2 values in Seoul and Busan were 0.31 and 0.23, respectively, whereas the other five cities had R2 values of zero. The national model produced a higher crossvalidated R2 (0.36) than those for the city-specific models. CONCLUSIONS: In general, the ordinary kriging models performed poorly for the seven major cities and the entire country of South Korea, but the model performance was better in the national model. To improve model performance, future studies should examine different prediction approaches that incorporate PM10 source characteristics.
Air Pollution ; Busan ; Cohort Studies ; Korea ; Particulate Matter* ; Seoul ; Spatial Analysis*

Intussusception in adult is a rare disease and laparotomy is usually considered because of the probability of malignancy. Especially with obstruction symptom or sign, it might be needed emergency operation. This case was a simultaneous development of small bowel intussusception and acute hepatitis A. The patient had abdominal pain and vomiting. Intitial laboratory examination with elevated aminotransferase revealed that the diagnosis was acute hepatitis. As managing acute hepatitis, the abdominal pain was not improved and the patient had tenderness on periumbilical area on physical examination. A jejunal intussusception with a lead point was proved on the abdominal computed tomography scan. Fortunately, symptom of intussusception was relieved while nulli per os (NPO) and intravenous hydration. After recovery of acute hepatitis, laparotomy was done. The lead point was 2.5x3.0 cm sized hamartoma. This was the case that the symptom of intussusception was confused with that of acute hepatitis.
Abdominal Pain ; Adult ; Emergencies ; Hamartoma ; Hepatitis ; Hepatitis A ; Humans ; Intussusception ; Laparotomy ; Physical Examination ; Rare Diseases ; Vomiting

Gastric mucosal calcinosis (GMC) is a very rare condition that is characterized by the nodular deposition of calcium salts in the gastric mucosa. It has been associated with renal failure, gastric cancer, ingestion of aluminum- containing antacids and the use of sucralfate in organ transplant patients. The etiology of this condition is uncertain, but several theories have been proposed; the condition is due secondarily to hyperparathyroidism in renal failure and to the alkalinization of the gastric mucosa. We report here on two patients who had long-term use of bismuth and/or aluminum-containing antacids to treat their gastro-esophageal reflux symptoms. The esophagogastroduodenoscopy revealed acute gastritis patterns, and GMC was confirmed histologically with biopsy. When one patient stopped ingesting bismuth-containing antacid solution, the follow-up esophagogastroduodenoscopy and the biopsy revealed a completely improved state. We report here on these interesting cases and we include a brief review of the literature.
Antacids ; Biopsy ; Bismuth ; Calcinosis* ; Calcium ; Eating ; Endoscopy, Digestive System ; Follow-Up Studies ; Gastric Mucosa ; Gastritis ; Gastroesophageal Reflux ; Humans ; Hyperparathyroidism ; Renal Insufficiency ; Salts ; Stomach Neoplasms ; Sucralfate ; Transplants

OBJECTIVE: The purpose of this study was to evaluate retrospective data concerning patients with adnexal masses that were managed surgically during pregnancy and their effect on fetal outcome. METHODS: Data were reviewed concerning pregnant women who required surgery at our hospital from January 1991 to December 2000 for an adnexal mass. RESULTS: In the recent 10 years at our hospital a total of 47 pregnant women aged 27.9+/-3.6 years were diagnosed with adnexal masses that required surgery. The masses were removed at 12.3+/-3.7 weeks of gestation and maximum diameter was 8.4+/-2.3 cm. The pathologic features of the 47 lesions were as follows : 17 mature cystic teratomas, 14 epithelial origins (12 serous cystadenoma, 2 mucinous cystadenoma), 9 functional cysts, 4 endometriotic cysts, 2 paraovarian cysts, 1 malignant neoplasm. Of the 41 patients for whom the outcome of pregnancy was available, 2 (4.2%) gave preterm birth before 37 weeks, while 4 (8.5%) experienced spontaneous abortion. There were not any perinatal death for the 43 infants. CONCLUSION: Although our studies are smaller for confirmation, so larger studies are required, but our results suggest that an adnexal mass may be associated with an adverse fetal outcome. Surgical intervention at<22 weeks of gestation might not have been related to the adverse fetal outcomes.
Abortion, Spontaneous ; Cystadenoma, Serous ; Female ; Humans ; Infant ; Mucins ; Pregnancy* ; Pregnant Women ; Premature Birth ; Retrospective Studies ; Teratoma

A 69-year-old male admitted to the psychological department due to delusion. One week later, he developed pneumonia and deep drowsy mental status. Despite improvement of pneumonia, his mental status got worse and he was referred to neurological department. The complete blood count tests showed repeated hypereosinophilia. The serologic tests revealed toxocariasis. He was treated with steroid and albendazole and his mental state rapidly improved. Toxocariasis is a common cause of reactive hypereosinophilia, which may be an underestimated etiology of reversible encephalopathy.
Aged ; Albendazole ; Blood Cell Count ; Delusions ; Humans ; Male ; Pneumonia ; Serologic Tests ; Toxocariasis*

Carcinoid tumors of the rectum are relatively uncommon and comprise only about one percent of all rectal neoplasms. Typically, rectal carcinoids present as small, solitary submucosal nodules and have benign course. But, multicentricity is rare. The frequency of an associated second malignancy is about 13%. The explanation of the high frequency of other neoplasms associated with carcinoid tumors is still unclear. We have experienced two cases of multiple carcinoid tumors of the rectum, one was coexisted with adenocarcinoma of the sigmoid colon. They presented with mass on the right inguinal area and hematochezia. Carcnoids was found incidentally. Because the tumors measured 15 mm or less in diameter, did not infiltrate beyond the submucosal layer and had no histological atypia, carcinoids was treated by endoscopic polypectomy and mucosal resection. Thereafter, one underwent surgery for adenocarcinoma of the sigmoid colon. Herein we present our experience with reviewed literatures.
Adenocarcinoma ; Carcinoid Tumor* ; Colon, Sigmoid ; Gastrointestinal Hemorrhage ; Neoplasms, Second Primary ; Rectal Neoplasms ; Rectum*

Inducible nitric oxide synthase (iNOS) and cyclooxygenase 2 (COX-2) have been known to be involved in various pathophysiological processes such as inflammation. This study was performed to determine the regulatory function of superoxide dismutase (SOD) on the LPS-induced expression of iNOS, and COX-2 in RAW 264.7 cells. When a cell-permeable SOD, Tat-SOD, was added to the culture medium of RAW 264.7 cells, it rapidly entered the cells in a dose-dependent manner. Treatment of RAW 264.7 cells with Tat-SOD led to decrease in LPS-induced ROS generation. Pretreatment with Tat-SOD significantly inhibited LPS-induced expression of iNOS and NO production but had no effect on the expression of COX-2 and PGE2 production in RAW 264.7 cells. Tat-SOD inhibited LPS-induced NF-kappaB DNA binding activity, IkappaBalpha degradation and activation of MAP kinases. These data suggest that SOD differentially regulate expression of iNOS and COX-2 in LPS-stimulated RAW 264.7 cells.
Animals ; Cell Line ; Cyclooxygenase 2/*genetics/metabolism ; Cytokines/immunology ; *Gene Expression Regulation ; Lipopolysaccharides/immunology/metabolism ; Mice ; Mitogen-Activated Protein Kinase Kinases/metabolism ; NF-kappa B/metabolism ; Nitric Oxide/metabolism ; Nitric Oxide Synthase Type II/*genetics/metabolism ; Reactive Oxygen Species/metabolism ; Superoxide Dismutase/*metabolism

HIV-1 Tat is considered to be one of key players to facilitate monocyte entry into the CNS, which is characteristic feature of AIDS-related encephalitis and dementia. This study was performed to determine the regulatory function of superoxide dismutase (SOD) on the HIV-1 Tat-induced signaling pathways leading to NF-kappaB activation, expression of adhesion molecules, and monocyte adhesion in CRT-MG human astroglioma cells by using cell-permeable SOD. When cell-permeable SOD was added to the culture medium of CRT-MG cells, it rapidly entered the cells in dose- and time-dependent manners. Treatment of astrocytes with cell-permeable SOD led to decrease in Tat-induced ROS generation as well as NF-kappaB activation. Cell-permeable SOD inhibited the activation of MAP kinases including ERK, JNK and p38 by HIV-1 Tat. Treatment of CRT-MG cells with cell-permeable SOD significantly inhibited protein and mRNA levels of ICAM-1 and VCAM-1 up-regulated by HIV-1 Tat, as measured by Western blot analysis and RT-PCR. Furthermore, enhanced adhesiveness of monocyte to astrocyte by HIV-1 Tat was significantly abrogated by pretreatment with cell-permeable SOD fusion proteins. These data indicate that SOD has a regulatory function for HIV-1 Tat-induced NF-kappaB activation in astrocytes and suggest that cell-permeable SOD can be used as a feasible therapeutic agent for regulation of ROS-related neurological diseases.
Astrocytes/*enzymology ; Cell Adhesion/*physiology ; Cell Membrane Permeability ; Gene Products, tat/*pharmacology ; HIV Infections/metabolism ; HIV-1/*chemistry ; Humans ; Monocytes/cytology/*drug effects ; Signal Transduction ; Superoxide Dismutase/genetics/*physiology

Pregnancy related stroke is rare and poorly understood. A 28-year-old pregnant woman at 20 weeks of gestation presented with sudden headache and left homonymous hemianopsia. MRI revealed acute right posterior cerebral artery territory infarction. Laboratory data revealed combined protein C and S deficiencies. Coagulation profiles returned to normal 6 months after the delivery. Although stroke can occur either with protein C or S deficiency, acute cerebral infarction associated with combined protein C and S deficiencies during gestation is very rare.
Adult ; Cerebral Infarction ; Female ; Headache ; Hemianopsia ; Humans ; Infarction ; Magnetic Resonance Imaging ; Posterior Cerebral Artery ; Pregnancy* ; Pregnant Women ; Protein C* ; Protein S ; Stroke*