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

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

BACKGROUND: It is evident that obesity and other associated chronic diseases are increasing. Since 1998, periodic health examination has been taken in the first grade of high school in accordance with the law nationally and will be expanded to other grades. We evaluated the health status of this population and thought the problems and pitfalls of this program. METHODS: We took 983 students of the first grade of high school in Seongnam city from April to June 2002. We used the questionnaire and test results as the first line methods of evaluation. Phone counselling was used as the follow-up method. Chi-square test was the main analytic method. RESULTS: Impaired visual acuity and absence of hepatitis B viral antibody were shown in over 40% of this population. Obesity, anemia, hyperlipidemia, hypertension were followed as the next most popular problems. Though 7.9% of 983 students were to be examined again, only 53.8% of them were re-examined. 52.7% of the student who took re-examination was proved normal. 47% of the test students thought that they were not healthy. Over half of students had the problems of exercise and eating behavior. CONCLUSION: We concluded that many students had the behavioral problems causing the chronic diseases. Medical prevention and education program is needed and medical faculties must participate in these programs. In periodic health examination various follow-up programs and screening-questionnaires on psychologic problems must be invented and applied for students.
Adolescent ; Anemia ; Chronic Disease ; Education ; Faculty, Medical ; Feeding Behavior ; Follow-Up Studies ; Gyeonggi-do* ; Hepatitis B ; Humans ; Hyperlipidemias ; Hypertension ; Jurisprudence ; Obesity ; Visual Acuity ; Surveys and Questionnaires

BACKGROUND: It is evident that obesity and other associated chronic diseases are increasing. Since 1998, periodic health examination has been taken in the first grade of high school in accordance with the law nationally and will be expanded to other grades. We evaluated the health status of this population and thought the problems and pitfalls of this program. METHODS: We took 983 students of the first grade of high school in Seongnam city from April to June 2002. We used the questionnaire and test results as the first line methods of evaluation. Phone counselling was used as the follow-up method. Chi-square test was the main analytic method. RESULTS: Impaired visual acuity and absence of hepatitis B viral antibody were shown in over 40% of this population. Obesity, anemia, hyperlipidemia, hypertension were followed as the next most popular problems. Though 7.9% of 983 students were to be examined again, only 53.8% of them were re-examined. 52.7% of the student who took re-examination was proved normal. 47% of the test students thought that they were not healthy. Over half of students had the problems of exercise and eating behavior. CONCLUSION: We concluded that many students had the behavioral problems causing the chronic diseases. Medical prevention and education program is needed and medical faculties must participate in these programs. In periodic health examination various follow-up programs and screening-questionnaires on psychologic problems must be invented and applied for students.
Adolescent ; Anemia ; Chronic Disease ; Education ; Faculty, Medical ; Feeding Behavior ; Follow-Up Studies ; Gyeonggi-do* ; Hepatitis B ; Humans ; Hyperlipidemias ; Hypertension ; Jurisprudence ; Obesity ; Visual Acuity ; Surveys and Questionnaires

It has been known that the improved drainage of a flap increases its survival and the increasing number of draining vein improves survival of flaps. But recently, researches have proved that the different orientation of venous outflow on the island flap is more important than the number of outflow tracts. The purpose of this study is to investgate the survival rates of flaps with various numbers or locations of draining veins. An 6 X 7cm flap was raised on the abdomen of 40 white rats (Sprague-Dowley, 350 - 400 gm). Rats were divided into 4 groups and each group consisted of 10 rats. In group 1 (A l$ flaps were based on the inferior epigastric artery and vein on the ipsilateral side. In group 2 (A-V), flaps were based on the inferior epigastric artery on the ipsilateral side and the inferior epigastric vein on the contralateral side. In group 3 (AV-V), flaps were based on the inferior epigastric artery and vein on the ipsilateral side and the inferior epigastric vein on the contralateral side. In group 4 (Av-V), flaps were based on the inferior epigastric artery and lateral thoracoepigastric vein on the ipsilateral side and the inferior epigastric vein on the contralateral side. A definite assessment was made on the seventh day after flap elevation. The necrotic areas of flaps were determined with Computer Image Analysis System and barum-sulfate microangiographys were performed The necrotic area was 38.14% in group 1, 18.73% in group 2, 33.53% in group 3, and 31.94% in group 4 respectively. The microangiographs showed striking digerences in the vascular pattern in the flaps, and numerous collaterals and dilated anastomotic vessels were observed in group 2. These data indicate that the location of draining vein is more important than the number, and proper location of the draining vein allows the recruitment of an adjacent angiosome and can improve the survival rates of island flap.
Abdomen ; Animals ; Drainage ; Epigastric Arteries ; Rats* ; Strikes, Employee ; Surgical Flaps* ; Survival Rate ; Veins

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