BACKGROUND: The changes of serum TNF-alpha, sTNFR, sIL-2R and sICAM-1 levels have been recently reported in some cancer patients but the clinical significance of these cytokines is not clearly established. To define the changes and clinical significance of these cytokines in patients with hepatocellular carcinoma (HCC), serum levels of TNF- alpha, sTNFR, sIL-2R and sICAM-1 were measured. METHODS: The serum levels of TNF-alpha, sTNFR, sIL-2R and sICAM-1 were measured before and after transarterial chemoembolization (TACE) by enzyme immunoassay in 20 patients with HCC and 10 adult healthy subjects as controls. These patients were divided into two groups, no response (NR, 14 cases) and partial response (PR, 6 cases) on the basis of changes of tumor size, new growth foci on the ultrasonographic or CT findings, and serum levels of alpha-fetoprotein. RESULTS: Serum levels of TNF-alpha, sTNFR, sIft-2R and sICAM-1 were significantly higher in all patients with HCC than in those of adult healthy controls (p<0.01). Serum levels of TNF-alpha after TACE tended in to be higher in comparison with those before TACE in the NR group (p<0.1), but those were not significantly different between before and after TACE in the PR group. Serum levels of sTNFR, sIL-2R and sICAM-1 were not significantly different between after and before TACE in both groups. CONCLUSIONS: These results suggest that serum levels of TNF-alpha, sTNFR, sIL-2R and sICAM:-1 in patients with HCC before therapy are significantly increased, compared with those of the control group, and the measurement of serum TNF-alpha levels may become useful in the diagnosis and monitoring of hepatocellular carcinoma in the future.
Adult ; alpha-Fetoproteins ; Carcinoma, Hepatocellular* ; Cytokines ; Diagnosis ; Humans ; Immunoenzyme Techniques ; Tumor Necrosis Factor-alpha*

BACKGROUND: The changes of serum TNF-alpha, sTNFR, sIL-2R and sICAM-1 levels have been recently reported in some cancer patients but the clinical significance of these cytokines is not clearly established. To define the changes and clinical significance of these cytokines in patients with hepatocellular carcinoma (HCC), serum levels of TNF- alpha, sTNFR, sIL-2R and sICAM-1 were measured. METHODS: The serum levels of TNF-alpha, sTNFR, sIL-2R and sICAM-1 were measured before and after transarterial chemoembolization (TACE) by enzyme immunoassay in 20 patients with HCC and 10 adult healthy subjects as controls. These patients were divided into two groups, no response (NR, 14 cases) and partial response (PR, 6 cases) on the basis of changes of tumor size, new growth foci on the ultrasonographic or CT findings, and serum levels of alpha-fetoprotein. RESULTS: Serum levels of TNF-alpha, sTNFR, sIft-2R and sICAM-1 were significantly higher in all patients with HCC than in those of adult healthy controls (p<0.01). Serum levels of TNF-alpha after TACE tended in to be higher in comparison with those before TACE in the NR group (p<0.1), but those were not significantly different between before and after TACE in the PR group. Serum levels of sTNFR, sIL-2R and sICAM-1 were not significantly different between after and before TACE in both groups. CONCLUSIONS: These results suggest that serum levels of TNF-alpha, sTNFR, sIL-2R and sICAM:-1 in patients with HCC before therapy are significantly increased, compared with those of the control group, and the measurement of serum TNF-alpha levels may become useful in the diagnosis and monitoring of hepatocellular carcinoma in the future.
Adult ; alpha-Fetoproteins ; Carcinoma, Hepatocellular* ; Cytokines ; Diagnosis ; Humans ; Immunoenzyme Techniques ; Tumor Necrosis Factor-alpha*

PURPOSE: We reviewed 19 patients with interstitial cystitis from March 1992 to August 1996. All patients were treated with simple hydrodistention of bladder, and we followed the results of their effect. MATERIALS AND METHODS: Most of the patients were middle aged women(mean age: 50.4 years). On cystoscopy, glomerulations were noted in all patients. Major symptoms were frequency(100%), dysuria(74%), urgency(74%) and suprapubic discomforts(47%). Simple hydrodistention was used in all patients. Mean bladder capacity was 150m1(50-280) in 1 month after procedure compared with 114m1(50-190) before procedure. Hematuria was noted during postoperative period in all patients. RESULTS: As the result of the postoperative urodynamic study, 5 out of 19 patients(26.3%) had no more symptoms, 9 patients(47.4%) was improved, but 5 patients(26.3%) showed no improvement. Sixteen of 19 patient were followed up 1.5-14(mean: 71) months, previous symptoms were recurred in 12 patients 3-4 months after the treatment. CONCLUSIONS: Even though the results show short-term effects, simple bladder hydrodistention would be one of the effective treatment modalities of interstitial cystitis.
Cystitis, Interstitial* ; Cystoscopy ; Hematuria ; Humans ; Middle Aged ; Postoperative Period ; Urinary Bladder* ; Urodynamics

Real-time ultrasongraphy is a simple, accurate, noninvasive and potentially valuable means of studying gallbladder size and emptying. The authors calculated ultrasonographically the ejection fraction of 80 cases of normally functioning gallbladder on oral cholecystography, from June 1983 to April 1984, at the department of radiology, Hangang Sacred Heart Hospital. The results were obtained as follows; 1. Ultrasongraphic Ejection Fraction at 30 minutes after the fatty meal was 73.1+-16.85. 2. There was no significant difference in age and sex, statistically.
Cholecystography ; Gallbladder ; Heart ; Meals

The value of ultrasonography and percutaneous transhepatic cholangiography in determining the site and etiology of biliary obstruction with surgical jaundice was studied in 30 patients. All diagnoses were subsequently made by surgery and pathology. The results were as follows; 1. In ultrasonography, the site of obstruction was delineated in 46%, while the etiology of the lesion was established in 40%, In comparison, percutaneous transhepatic cholangiography delineated the site in 100% and the etilogy in 93%. 2. Although the percutaneous transhepatic cholangiography is invasive to the human body, it is considered to be the single procedure of choicein the managment of the patient with biliary obstructive jaundice because of its diagnostic accuracy, technical simplicity and relative safety.
Cholangiography ; Diagnosis ; Human Body ; Humans ; Jaundice ; Jaundice, Obstructive ; Pathology ; Ultrasonography

From July 1988 to September 1992, we experienced 15 cases of thrombolysoangioplasty (TLA) at Chonnam University Hospital. Among 15 cases, 5 had claudication (Clinical stage II according to Modified Fontaine Classification), pain at rest (III), and gangrene(IV). Duration of symptoms was 1-7 months except patients of clinical stage IV unable to guess occlusion age. The occlusion length was 5-10cm in 8 cases, 10-20cm in 4 cases, and above 30cm in 2 cases. In all cases, thromolytic therapy was performed with intraarterial urokinase infusion. The total amount of urokinase ranged from 300,000 IU to 2,000,000 IU and infusion time ranged from 2 to 50 hours except three cases infused bolus dose only. Complete successful TLA was defined as technical (less than 50% of residual stenosis) and clinical success. Partial success was defined as technical success but clinical failure. Follow-up angiography could be performed in 8 cases. Overall initial success rate was 86.6% (13/15). Among them. Complete success was in 11 cases and partial success was in 2 cases. Recurrence of disease was not noted on all cases(n=8). Severe complications, such as hemorrhage, did not occurred. TLA was considered to be effective and safe way to recanalized chronic long artery occlusion in lower extremity.
Angiography ; Arteries ; Follow-Up Studies ; Hemorrhage ; Humans ; Jeollanam-do ; Lower Extremity ; Recurrence ; Urokinase-Type Plasminogen Activator

OBJECTIVES: We investigated the clustering of selected lifestyle factors (cigarette smoking, heavy alcohol consumption, lack of physical exercise) and identified the population characteristics associated with increasing lifestyle risks. METHODS: Data on lifestyle risk factors, sociodemographic characteristics, and history of chronic diseases were obtained from 7,694 individuals > or =20 years of age who participated in the 2005 Korea National Health and Nutrition Examination Survey (KNHANES). Clustering of lifestyle risks involved the observed prevalence of multiple risks and those expected from marginal exposure prevalence of the three selected risk factors. Prevalence odds ratio was adopted as a measurement of clustering. Multiple correspondence analysis, Kendall tau correlation, Man-Whitney analysis, and ordinal logistic regression analysis were conducted to identify variables increasing lifestyle risks. RESULTS: In both men and women, increased lifestyle risks were associated with clustering of: (1) cigarette smoking and excessive alcohol consumption, and (2) smoking, excessive alcohol consumption, and lack of physical exercise. Patterns of clustering for physical exercise were different from those for cigarette smoking and alcohol consumption. The increased unhealthy clustering was found among men 20-64 years of age with mild or moderate stress, and among women 35-49 years of age who were never-married, with mild stress, and increased body mass index (>30 kg/m2). CONCLUSIONS: Addressing a lack of physical exercise considering individual characteristics including gender, age, employment activity, and stress levels should be a focus of health promotion efforts.

As the number of survivors of motor vehicle accidents and extreme sporting accidents increases, more people must live with brachial plexus injuries. Brachial plexus injuries also occur in multiple trauma patients and can be debilitating. Although the injured limb will never return to normal, an improved understanding of the pathophysiology of nerve injury and repair, as well as advances in microsurgical techniques, have provided the upper extremity reconstructive surgeons with opportunities to improve function in patients with these life-altering injuries. The purpose of this review is to present in detail some of the current concepts in the treatment of adult brachial plexus injuries and to give the reader an understanding of the nuances of the timing of treatment, the available treatment options, and the outcomes of treatment.
Adult* ; Brachial Plexus* ; Extremities ; Humans ; Motor Vehicles ; Multiple Trauma ; Sports ; Surgeons ; Survivors ; Upper Extremity

With the sharply increasing practice of cesarean section(C/S), formerly known as a landmark of developing medical technology, appropriateness of the procedure has been widely inquired into. Appropriateness of a specific procedure could be an indicator for quality, at the individual or organizational level. Cesarean section rate is regarded as a sensitive indicator reflecting clinical quality at the hospital level. We are interested in the validity and significance of C/S rate as a quality indicator in Korean hospitals, in addition to the current status of the practice. This study was carried out retrospectively based on the clinical records of cesarean sections in 32 hospitals nationwide from March to May 1996. Standardized survey format was distributed, and reviews were performed by volunteer surveyors from each hospital after two sessions of pre-survey education. The results were as follows : 1. There were 13,241 deliveries with 4,599 cases of cesarean sections, giving an incidence of 38.5%. This result shows the incidence of cesarean section was 1.6 times higher than U.S. and about four times higher than European countries. 2. The monthly incidence of cesarean section was not variable, but it shows great differences among the hospitals. 3. The incidences of cesarean sections were variable among different age groups with marked higher rate in older one. 4. Most of deliveries were with gestational period from 37 to 44 weeks(91%), in which C/S rate was 39%. For pregnancies with less than or equal to 32 weeks, the rate was 21% and for more than or equal to 45 weeks the rate was 25%. 5. The most frequent indication of cesarean birth was previous cesarean section(37.7%), followed by cephalopelvic disproportion and dystocia(24.4%). 6. There were no statistical differences in cesarean section rates by hospital variables such as ownership, teaching status, proportion of specialists, number of physicians per bed, number of nurses per bed, regional location, and number of beds. Exceptionally, hospitals with independent obstetrics department, separated from gynecology, showed significant lower rate than hospitals with conventional obstetrics-gynecology department. We could confirm higher C/S rate than any other countries. However, C/S rate, not significantly different among hospitals with variable quality level in structural aspect, was not acceptable as a sensitive indicator for clinical quality at the hospital level. Different rates between comparable organizational settings, sometimes indirectly related to the clinical quality, suggested that more studies focused on other aspects of quality than structure should be needed.
Cephalopelvic Disproportion ; Cesarean Section* ; Education ; Female ; Gynecology ; Humans ; Incidence ; Obstetrics and Gynecology Department, Hospital ; Ownership ; Parturition ; Pregnancy ; Quality Indicators, Health Care* ; Retrospective Studies ; Specialization ; Volunteers

No abstract available.
Prescriptions*