Background/Aims: Papillary adenocarcinoma is classified to differentiated-type gastric cancer and is indicated for endoscopic submucosal dissection. However, due to its rare nature, there are limited studies on it. The purpose of this study was to determine the outcome of endoscopic submucosal dissection in patients with papillary-type early gastric cancer and to find the risk factors of lymph node metastasis. Methods: Patients diagnosed with papillary-type early gastric cancer at eight medical centers, who underwent endoscopic submucosal dissection or surgical treatment, were retrospectively reviewed. The clinical results and long-term outcomes of post-endoscopic submucosal dissection were evaluated, and the risk factors of lymph node metastasis in the surgery group were analyzed. Results: One-hundred and seventy-six patients with papillary-type early gastric cancer were enrolled: 44.9% (n=79) in the surgery group and 55.1% (n=97) in the endoscopic submucosal dissection group. As a result of endoscopic submucosal dissection, the en bloc resection and curative resection rates were 91.8% and 86.6%, respectively. The procedure-related complication rate was 4.1%, and local recurrence occurred in 3.1% of patients. Submucosal invasion (odds ratio, 3.735; 95% confidence interval, 1.026 to 12.177; p=0.047) and lymphovascular invasion (odds ratio, 7.636; 95% confidence interval, 1.730 to 22.857; p=0.004) were the risk factors of lymph node metastasis in papillary-type early gastric cancer patients. Conclusions The clinical results of endoscopic submucosal dissection in papillary-type early gastric cancer were relatively favorable, and endoscopic submucosal dissection is considered safe if appropriate indications are confirmed by considering the risk of lymph node metastasis.

Adequate organ growth is an important aspect of growth evaluation in children. Renal size is an important indicator of adequate renal growth; computed tomography (CT) can closely estimate actual kidney size. However, insufficient data are available on normal renal size as measured by CT. This study aimed to evaluate the relationships of anthropometric indices with renal length and volume measured by CT in Korean pediatric patients. Renal length and volume were measured using CT images in 272 pediatric patients (age < 18 years) without renal disease. Data for anthropometric indices—including height, weight, and body surface area (BSA)—were obtained using medical records. Using the equation for an ellipsoid, renal volume was calculated in cubic centimeters. Height showed greatest correlation with renal length on stepwise multiple linear regression analysis; BSA showed the strongest significant correlation with renal volume. The mean renal size for each age group and height group was determined; it showed a tendency to increase with age and height. This is the first Korean study to report the relationship between body indices and renal size measured by CT. These results can serve as normative standards for assessing adequate renal growth.
Body Surface Area ; Child* ; Humans ; Kidney ; Linear Models ; Medical Records ; Regression Analysis

Although acupuncture is known as a safe procedure that is widely used in many countries, complications including infection, hemorrhage, hematoma, pneumothorax, nerve damage, and cardiac tamponade have been reported. A needle penetrating the stomach after acupuncture, however, is very rare. Here, we report the case of 47-year-old woman who experienced abdominal pain 2 days after receiving acupuncture. Upper gastrointestinal endoscopy identified an approximately 2.5-cm long needle in the posterior wall of the antrum. The needle was removed endoscopically using rat tooth forceps with no complications.
Abdominal Pain ; Acupuncture* ; Animals ; Cardiac Tamponade ; Endoscopy, Gastrointestinal ; Female ; Foreign Bodies ; Hematoma ; Hemorrhage ; Humans ; Middle Aged ; Needles* ; Pneumothorax ; Rats ; Stomach* ; Surgical Instruments ; Tooth

OBJECTIVECheongseoikki-tang (CIT, Korean), also called Qingshu Yiqi decoction () and Seisho-ekki-to (Japanese), is well known as an effective traditional combination of herbs for treating cardiovascular diseases. This study was to research its effects on bone marrow-derived mast cell (BMMC)-mediated allergy and inflammation mechanisms.

METHODSIn this study, the biological effect of Cheongseoikki-tang ethanol extract (CITE) was evaluated, focusing on its effects on the production of allergic mediators by phorbol 12-myristate 13-acetate (PMA) plus calcium ionophore A23187 (A23187)-stimulated BMMCs. These allergic mediators included interleukin-6 (IL-6), prostaglandin D2 (PGD2), leukotriene C4 (LTC4), and β-hexosaminidase (β-hex).

RESULTSOur data revealed that CITE inhibited the production of IL-6, PGD2, LTC4, and β-hex induced by PMA plus A23187 (P<0.05).

CONCLUSIONThese findings indicate that CITE has the potential for use in the treatment of allergy.

Animals ; Anti-Inflammatory Agents ; pharmacology ; therapeutic use ; Bone Marrow Cells ; pathology ; Calcimycin ; pharmacology ; Cell Degranulation ; drug effects ; Cell Survival ; drug effects ; Drugs, Chinese Herbal ; pharmacology ; therapeutic use ; Hypersensitivity ; drug therapy ; pathology ; Interleukin-6 ; secretion ; Leukotriene C4 ; pharmacology ; Male ; Mast Cells ; drug effects ; pathology ; physiology ; Mice ; Mice, Inbred BALB C ; Prostaglandin D2 ; biosynthesis ; Tetradecanoylphorbol Acetate ; pharmacology ; beta-N-Acetylhexosaminidases ; metabolism

BACKGROUND: Diabetes education and lifestyle modification are critical components in controlling blood glucose levels of people with type 2 diabetes. Until now, available data on the effectiveness of education with respect to the duration of diabetes are limited. We investigated whether adherence to lifestyle behavior modification prompted by diabetes education was influenced by the duration of diabetes. METHODS: Two hundred and twenty-five people with type 2 diabetes were recruited for an intensive, collaborative, group-based diabetes education program with annual reinforcement. We divided the patients into two groups based on the duration of their diabetes prior to the education program (< or =1 year [< or =1Y] vs. > or =3 years [> or =3Y]). Dietary habits, physical activity, and the frequency of blood glucose self-monitoring were evaluated with a questionnaire prior to education and at the follow-up endpoint. RESULTS: The mean follow-up period was 32.2 months. The mean hemoglobin A1c (A1C) value was significantly lower in the < or =1Y group. Self-care behaviors, measured by scores for dietary habits (P=0.004) and physical activity (P<0.001), were higher at the endpoint in the < or =1Y group than in the > or =3Y group. Logistic regression analysis revealed that a longer diabetes duration before education was significantly associated with mean A1C levels greater than or equal to 7.0% (53 mmol/mol). CONCLUSION: Diabetes duration influenced the effectiveness of diabetes education on lifestyle behavior modification and glycemic control. More-intense, regular, and sustained reinforcement with encouragement may be required for individuals with longstanding type 2 diabetes.
Behavior Therapy ; Blood Glucose ; Blood Glucose Self-Monitoring ; Diabetes Mellitus, Type 2 ; Follow-Up Studies ; Food Habits ; Hemoglobins ; Humans ; Life Style ; Logistic Models ; Motor Activity ; Reinforcement (Psychology) ; Self Care ; Surveys and Questionnaires

BACKGROUND/AIMS: Heart rate variability (HRV) is a method for evaluation of autonomic nervous system activity by expressing the balance of sympathetic and parasympathetic tones. Some studies of HRV in patients with end-stage renal disease (ESRD) have been performed in Korea. However, few have examined kidney transplantation (KT) patients. Therefore, we investigated autonomic nervous system activity by means of HRV in patients with KT due to ESRD. METHODS: We compared the pattern of cardiac sympathetic and parasympathetic activity by time- and frequency-domain analysis of HRV with 24-h Holter monitoring of 23 KT and 56 dialysis patients. Patients underwent KT between January, 2008 and June, 2011. RESULTS: The mean ages of KT and dialysis patients were 54.2 +/- 12.3 and 53.7 +/- 12.6 years, respectively. The KT group showed increased time- and frequency-domain HRV (including HRV index), very low frequency (VLF), means and standard deviations of all normal R-R intervals for all 5-min segments of the entire recording (SDNNi), low frequency (LF), LF in normalized units (LF norm), and LF to high-frequency power ratio, compared with the dialysis group. CONCLUSIONS: Autonomic tone in patients with KT is higher than that in patients with ESRD on dialysis.
Autonomic Nervous System ; Dialysis ; Electrocardiography ; Electrocardiography, Ambulatory ; Heart ; Heart Rate ; Humans ; Kidney ; Kidney Failure, Chronic ; Kidney Transplantation ; Korea

OBJECTIVE: The incidence of leptomeningeal dissemination from malignant glioma is rare, so the clinical features of this are not well documented yet. We attempted to determine the clinical features of leptomeningeal dissemination from malignant gliomas. METHODS: We retrospectively analyzed 11 cases of leptomeningeal dissemination of malignant glioma, who were treated at our institution between 2006 and 2009. We investigated the clinical features of these patients by considering the following factors : tumor locations, the events of ventricular opening during surgery and the cerebrospinal fluid (CSF) profiles, including the cytology. RESULTS: The group was composed of 9 males and 2 females. The histological diagnosis of their initial intracranial tumors were 4 primary glioblastoma, 3 anaplastic astrocytoma, 1 anaplastic oligoastrocytoma, 2 ganglioglioma and 1 pleomorphic xanthoastrocyotma with anaplastic features. The mean age of the patients at the time of the initial presentation was 42.8+/-10.3 years. The mean time between surgery and the diagnosis of spinal dissemination was 12.3+/-7.9 (3-28) months. The mean overall survival after dissemination was 2.7+/-1.3 months. All our patients revealed a history of surgical opening of the ventricles. Elevated protein in the CSF was reported for eight patients who had their CSF profiles checked. CONCLUSION: We propose that in the malignant gliomas, the surgical opening of ventricles can cause the spinal leptomeningeal dissemination and the elevated protein content of CSF may be a candidate marker of leptomeningeal dissemination.
Astrocytoma ; Female ; Ganglioglioma ; Glioblastoma ; Glioma ; Humans ; Incidence ; Male ; Retrospective Studies

BACKGROUND/AIMS: Heart rate variability (HRV) is regulated by the balance between the sympathetic and parasympathetic tones. HRV can be used to assess the effects of drugs and other interventions on cardiac autonomic tone, including exercise, respiration, metabolic change, and psychological or physical stress. As few studies have examined HRV in end-stage renal disease (ESRD) patients in Korea, we investigated autonomic nervous system activity reflected in HRV in patients on peritoneal dialysis for ESRD. METHODS: We compared the pattern of cardiac sympathetic and parasympathetic activity through time-and frequency-domain analysis of HRV in 20 ESRD patients and 65 hypertensive control subjects using 24-hour Holter monitoring. The patients had been undergoing peritoneal dialysis at the Bongseng Hospital between January 2006 and December 2008. RESULTS: The mean age of the patients and controls was 53.8+/-13.1 and 55.1+/-13.7 years, respectively. In the patient group, all of the time- and frequency-domain HRV measures were reduced compared with the control group, including the HRV index, normalized unit of low-frequency (LF norm), and ratio of low-frequency power to high-frequency power (LF/HF), whereas the normalized unit of high frequency (HF norm) was increased. CONCLUSIONS: Autonomic tone in ESRD patients on peritoneal dialysis is decreased compared with patients with hypertension. The parasympathetic tone in ESRD patients on peritoneal dialysis dominates over the sympathetic tone.
Autonomic Nervous System ; Electrocardiography, Ambulatory ; Heart ; Heart Rate ; Humans ; Hypertension ; Kidney Failure, Chronic ; Korea ; Peritoneal Dialysis ; Respiration

BACKGROUND: Norovirus is one of the most prevalent pathogens causing acute gastroenteritis in children. We compared the clinical features of noroviral gastroenteritis to those of rotaviral gastroenteritis and analyzed the noroviruses' genotype frequencies. MATERIALS AND METHODS: Stool samples were obtained form 433 children hospitalized with acute gastroenteritis from May 2008 through February 2009 at Soonchunhyang University Cheonan Hospital and examined for the presence of norovirus or rotavirus. We then analyzed the clinical features of noroviral gastroenteritis in comparison with rotaviral gastroenteritis and observed the capsid protein gene sequences from the isolated norovirus for genotyping. RESULTS: Norovirus was isolated from 69 patients (16.4%) and rotavirus from 49 patients (11.6%). The noroviral gastroenteritis patients experienced vomiting (77.4%), diarrhea (73.2%), and respiratory symptoms (53.6%); the rotaviral gastroenteritis patients experienced diarrhea (71.4%), dehydration (69.3%), and vomiting (65.3%). Dehydration in patients with noroviral gastroenteritis (43.4%) was rare compared with rotavirus (69.3%) (P=0.008). The isolated norovirus belonged primarily to the GII.4 genogroup (85.5%). Our phylogenetic analysis of the GII.4 isolates revealed 3 clusters, including novel cluster C. CONCLUSIONS: Vomiting was the most common symptom in noroviral gastroenteritis patients. Dehydration in noroviral gastroenteritis patients was less common compared with rotavirus gastroenteritis patients. The majority of the norovirus strains isolated from children with acute gastroenteritis belonged to the GII.4 genogroup.
Capsid Proteins ; Child ; Child, Hospitalized ; Dehydration ; Diarrhea ; Gastroenteritis ; Genotype ; Humans ; Norovirus ; Rotavirus ; Vomiting

PURPOSE: We evaluated the changes of the erectile function and histology of the corpus cavernosum in a rat model of metabolic syndrome. MATERIALS AND METHODS: We used male spontaneous hypertensive rats (SHRs) as an experimental group (n=6) and Wistar-Kyoto rats as a control group (n=6). The SHRs were fed with a high fat diet, but the Wistar-Kyoto rats were fed with a normal fat diet for 12 weeks. All the groups were then checked for body weight and various biochemiclal parameters. To investigate penile erection, the intracavernosal pressure (ICP), mean arterial pressure (MAP) and cGMP level of the corpus cavernosum were recorded for all the groups. Serial sections of the penis were used to perform Masson's trichrome staining and immunohistochemistry for determining the TGF-beta 1 expression. RESULTS: We confirmed that metabolic syndrome was induced in the experimental group by the significant difference of the various biochemical parameters. (ED note: For the results of erectile function? This wasn't clear.)As a result of erectile function, the ICP/MAP ratios were checked as 51.0+/-7.5% and 31.0+/-5.5%, respectively, for the control and experimental groups. So the ICP/MAP ratio of the latter was markedly decreased compared with the former and the cGMP level of the corpus cavernosum was the same for both groups. On Masson's trichrome staining, the number of smooth muscle cell was decreased and the collagen fibers with an irregular, distorted arrangement were increased in the experimental group. The immunoreactivity for TGF-beta 1 tended to increase in the experimental group. These histological findings revealed that fibrosis of the corpus cavernosum occurred in the experimental group. CONCLUSIONS: Our results demonstrate that metabolic syndrome is harmful to erectile function and it leads to histological changes of the corpus cavernosum according to a rat model of metabolic syndrome.
Animals ; Arterial Pressure ; Body Weight ; Collagen ; Diet ; Diet, High-Fat ; Erectile Dysfunction ; Fibrosis ; Humans ; Immunohistochemistry ; Male ; Myocytes, Smooth Muscle ; Penile Erection ; Penis ; Rats ; Transforming Growth Factor beta