Physical Activity of Patients with Chronic Schizophrenia and Related Clinical Factors

OBJECTIVE: This study aimed to investigate clinical factors contributing to the low physical activity (PA) of patients with chronic schizophrenia. METHODS: PA was measured in 50 outpatients with chronic schizophrenia using the International Physical Activity Questionnaire Short Form (IPAQ-SF). Psychopathology, psychosocial functioning, and extrapyramidal symptoms were assessed using the 18 item-Brief Psychiatric Rating Scale (BPRS-18), Global Assessment of Functioning (GAF), and Drug-Induced Extrapyramidal Symptom Scale (DIEPSS), respectively. We examined differences in these clinical variables between “inactive,”“minimally active,” and “health enhancing physical activity” groups. Linear regression analysis was used to examine the clinical factors explaining low PA levels in patients with schizophrenia. RESULTS: Subjects spent an average of 130.18±238.89 min/wk on moderate/vigorous-intensity PA and only 26% of them met the recommended PA guideline of 150 minutes of at least moderate PA per week. The inactive group showed significantly higher BPRS-18 and DIEPSS scores, and a lower GAF score than the other groups. Linear regression analysis showed that DIEPSS scores independently explained the amount of total PA (p=0.001) and time spent being sedentary (p=0.028). CONCLUSION: This study provides preliminary evidence that extrapyramidal symptoms could be a major impediment to the PA of patients with schizophrenia.

Effectiveness of bee venom acupuncture in alleviating post-stroke shoulder pain: a systematic review and meta-analysis / 中西医结合学报

<p><b>BACKGROUND</b>Shoulder pain is a common complication of stroke. Bee venom acupuncture (BVA) is increasingly used in the treatment of post-stroke shoulder pain.</p><p><b>OBJECTIVE</b>To summarize and evaluate evidence on the effectiveness of BVA in relieving shoulder pain after stroke.</p><p><b>SEARCH STRATEGY</b>Nine databases, namely MEDLINE, EMBASE, the Cochrane Library, the China National Knowledge Infrastructure (CNKI), the Japan Science and Technology Information Aggregator, Electronic (J-STAGE), and four Korean medical databases, namely, the National Assembly Library, the Research Information Service System, the National Discovery for Science Leaders, and OASIS, were searched from their inception through August 2014 without language restrictions.</p><p><b>INCLUSION CRITERIA</b>Randomized controlled trials (RCTs) were included if BVA was used at acupoints as the sole treatment, or as an adjunct to other treatments, for shoulder pain after stroke.</p><p><b>DATA EXTRACTION AND ANALYSIS</b>Two review authors independently selected trials for inclusion, assessed methodological quality and extracted data.</p><p><b>RESULTS</b>A total of 138 potentially relevant articles were identified, 4 of which were RCTs that met our inclusion criteria. The quality of studies included was generally low, and a preponderance of positive results was demonstrated. All four trials reported favorable effects of BVA on shoulder pain after stroke. Two RCTs assessing the effects of BVA on post-stroke shoulder pain, as opposed to saline injections, were included in the meta-analysis. Pain was significantly lower for BVA than for saline injections (standardized mean difference on 10-cm visual analog scale: 1.46 cm, 95% CI=0.30-2.62, P=0.02, n=86) CONCLUSION: This review provided evidence suggesting that BVA is effective in relieving shoulder pain after stroke. However, further studies are needed to confirm the role of BVA in alleviating post-stroke shoulder pain. Future studies should be conducted with large samples and rigorous study designs.</p>

Surgical Treatment of Graves' Disease: Comparison between Total Thyroidectomy and Subtotal Thyroidectomy

PURPOSE: Subtotal thyroidectomy has been the standard operation for Graves' disease in achieving a favorable outcome in recovery of euthyroid state. However, the postoperative outcomes following subtotal thyroidectomy differ by surgeon and postoperative thyroid dysfunctions develop as time passes. Here, we have studied the validity of total thyroidectomy for Graves' disease patients, with a comparison to subtotal thyroidectomy. METHODS: A total of 299 patients with Graves' disease underwent thyroid operation consecutively in Asan Medical Center, Seoul, Korea from December 1995 to December 2005. Among them, 241 cases had subtotal thyroidectomy and 43 had total thyroidectomy. The subtotal thyroidectomy cases were divided into 3 groups according to estimated remnant thyroid; or =6 g. Also, according to postoperative thyroid function, the patients were divided into euthyroid, hypothyroidism and hyperthyroidism groups. The postoperative changes of thyroid function, postoperative complications and hospital days were analyzed. RESULTS: In subtotal thyroidectomy, postoperative thyroid function showed euthyroid in 25 (10.4%), hypothyroidism 206 (85.5%) and hyperthyroidism 10 (4.1%). However, total thyroidectomy showed no persistent hyperthyroidism or recurrence. The postoperative thyroid function state changed in 24 patients out of 148 who had more than 2 years postoperative follow-up. Hyper-functional changes developed with higher rates (Hypo-6 vs. hyper-18). The postoperative complication rate was higher in subtotal thyroidectomy including bleeding, hoarseness and hypocalcemia. CONCLUSION: In our study, the patients showing normal thyroid function after subtotal thyroidectomy were very limited and thyroid dysfunction developed continuously with time lapse, especially towards hyperthyroid state. Therefore, we suggest that total thyroidectomy should be considered as a treatment option in Graves' disease.

The Surgical Management of Papillary Thyroid Microcarcinoma / 대한내분비외과학회지

PURPOSE: There has been a rapid rise in the incidence of thyroid cancer, particularly papillary thyroid microcarcinoma (PTMC). However, there is a lack of consensus of treatment guidelines or follow-up strategies. METHODS: A retrospective analysis of 606 patients who underwent operation due to thyroid cancer from March 2000 to December 2008 was conducted. Of these patients, 587 with pure papillary carcinomas were studied, of whom 392 (67%) presented with PTMC. RESULTS: Only 23% of patients were symptomatic, but 75% of patients were positive using the imaging techniques ultrasonography or positron emission tomography. When the microcarcinoma patient group (G1) was compared with the group of remaining patients (G2), less aggressive operations were chosen for G1. A lobectomy was performed in 63.8% of G1 versus in 14% of G2, and the central compartment neck dissection was omitted in 30% of G1 versus 16% of G2. During the follow-up period (mean 37.9±25.2 months), there were 11 recurrences. Two patients developed contralateral cancers 42 and 49 months after lobectomy. One patient had recurrences on central compartment lymph nodes 34 months post-operatively. Eight patients had lateral neck lymph nodes metastases 13~52 months postoperatively. Three of these eight patients had concomitant central neck lymph node metastases. CONCLUSION: Less aggressive treatments can be chosen for PTMC patients compared to non-PTMC patients. To clarify these results, longer follow up and larger and multi-institutional data are needed.

Minimally Invasive Parathyroidectomy without an Intraoperative i-PTH Test for Patients with Primary Hyperparathyroidism

PURPOSE: The aim of this retrospective study was to analyze the outcomes of minimally invasive parathyroidectomy without an intraoperative i-PTH test for the patients with primary hyperparathyroidism. METHODS: We analyzed a total of 179 patients with sporadic primary hyperparathyroidism and who underwent parathyroidectomy at ASAN Medical Center between February 1996 and September 2007. Minimally invasive parathyroidectomy without an intraoperative i-PTH test was performed in 75 patients under the guidance of a preoperative localization study that suggested the presence of single gland disease. Bilateral exploration was performed in 70 patients and unilateral exploration was performed in 34 patients. RESULTS: The success rate of minimally invasive parathyroidectomy without an intraoperative i-PTH test was 98.7%. Postoperative persistent hyperparathyroidism developed in only 1 patient among the 75 patients. The frequency of postoperatively confirmed single gland disease and multigland disease was 92.8% (166 patients) and 7.2% (13 patients), respectively. However, for most of the patients with multiglandular disease (11/13 cases, 84.5%), the possibility of multiglandular disease could be predicted by a preoperative localization study and these patients were excluded from the candidates for performing minimally invasive parathyroidectomy without an intraoperative i-PTH test. For cases that the preoperative localization study suggested single lesion, the frequency of multiglandular disease in those patients who underwent bilateral exploration was relatively low (2.7%, 1/38 cases). CONCLUSION: Selected patients with primary hyperparathyroidism can be successfully managed with minimally invasive parathyroidectomy and without an intraoperative i-PTH test when the preoperative localization study suggests the presence of single gland disease. However, careful evaluation of the preoperative localization study is mandatory to minimize the failure rate of minimally invasive parathyroidectomy without an intraoperative i-PTH test.

Loss of Heterozygosity of Chromosome 17p13 and p53 Expression in Invasive Ductal Carcinomas / 한국유방암학회지

PURPOSE: The p53 gene is located on chromosome 17p13 and may play important roles in cell cycle regulation, apoptosis and the regulation of the expression of other genes as well as tumor suppression. In addition, the p53 gene is believed to play an important role in the progression of various human malignant tumors through mutation and overexpression. There have been few studies on loss of heterozygosity (LOH) study on 17p13 in invasive ductal carcinoma. This study evaluated a 17p13 LOH and protein expression in invasive ductal carcinomas and correlated these results with the clinicopathological factors. METHODS: LOH analysis was carried out using a polymerase chain reaction with four polymorphic microsatellite markers (D17S796, TP53, D17S5, D17S513) in 50 surgically resected tumors and their non-tumorous counterparts. The p53 protein expression level was examined using immunohistochemistry. RESULTS: A LOH and protein expression was detected in 66% and 54% of the tumors, respectively. The LOH rates ranged from 26.3% (D17S513) to 33.3% (TP53). There was no detected LOH or protein expression in the non-tumor parts. The LOH results correlate well with the tumor size and stage. The protein expression results correlate well with the tumor histological grade. There was no correlation between the LOH and protein loss. CONCLUSION: 17p13 LOH and p53 gene abnormalities may be associated with tumorigenesis and tumor invasion. In addition, the combined use of both methods may help in early detection as well as for determining the prognosis of an invasive ductal carcinoma. 17p13 LOH and p53 protein expression may contribute to tumor progression through reciprocal complementation in some portions of the invasive ductal carcinoma.

Two Cases of Superior Mesenteric Artery Aneurysms

Aneurysms of the superior mesenteric artery (SMA) are very rare disease entities. The etiology of a visceral aneurysm includes a bacterial aneurysm due to an infected thrombus from endocarditis (60%). The other causes are atherosclerosis, arterial endometrial necrosis, trauma, polyarteritis nodosum etc. Some aneurysms are diagnosed coincidently but most are discovered by the development of hypovolemic shock due to aneurysmal rupture. Approximately 30% of the patients are at risk of rupture and require surgical management. We report two cases of SMA aneurysms, a 44-year-old male patient who complained of abdominal and back pain and a 42-year-old female who developed a SMA aneurysm postoperatively after undergoing surgery for hemoperitoneum due to a traffic accident. The first patient was treated surgically and the latter was treated conservatively.

Two Cases of Superior Mesenteric Artery Aneurysms

Aneurysms of the superior mesenteric artery (SMA) are very rare disease entities. The etiology of a visceral aneurysm includes a bacterial aneurysm due to an infected thrombus from endocarditis (60%). The other causes are atherosclerosis, arterial endometrial necrosis, trauma, polyarteritis nodosum etc. Some aneurysms are diagnosed coincidently but most are discovered by the development of hypovolemic shock due to aneurysmal rupture. Approximately 30% of the patients are at risk of rupture and require surgical management. We report two cases of SMA aneurysms, a 44-year-old male patient who complained of abdominal and back pain and a 42-year-old female who developed a SMA aneurysm postoperatively after undergoing surgery for hemoperitoneum due to a traffic accident. The first patient was treated surgically and the latter was treated conservatively.

Xenografting of the Human Vitrified Ovarian Tissues into the Immune Deficient Animal / 대한불임학회지

OBJECTIVE: The present study was conducted to evaluate the viability of germ cells form the adult and fetal ovarian tissues after vitrification followed by xenografting. METHOD: The human adult ovarian tissues were obtained from 33 years old patients, and the fetal ovarian tissues were obtained from 22 weeks and 25 weeks in gestation. ovarian tissues were cryopreserved by vitrification with 5.5 M ethylene glycol (EG 5.5) and 1.0 M sucrose as cryoprotectants. Adult and fetal ovarian tissues were pre-equilivrated with EG 5.5 at room temperature for 10 and 5 minutes, respectively and plunged into liquid nitrogen immediately. Frozen-thawed tissues were xenografted into NOD-SCID mice to evaluated the viability and capacity for further growth of the primordial follicles. Grafts were recovered from the recipients 4 weeks after transplantation and histological analysis was accomplished. RESULT AND CONCLUSION: Grafts recovered 4 weeks after transplantation contained less number of oocytes and primordial follicles compared to that of the fresh tissues. Survived follicles were mainly primordial and intermediary with larger diameter and more granulosa cells. It is confirmed that 1) the ovarian tissues were healthy and the germ cells were survived after vitrification, and 2) the survived fetal primordial follicles after vitrification resumed the growth in the xenofrafts.

Development of Animal Model for Orthotopic Non-Small Cell Lung Cancer in Nude Rat / 대한흉부외과학회지

A major obstacles to evaluation of newly-developed treatment strategy for human lung cancer has been the lack of appropriate experimental animal models. We describe a new experimental model of orthotopically-developed non-small cell lung cancer in nude rat, involving inoculation of tumor cell suspension by thoracotomy. Over 40 direct implantation to the periphery of the lung has been performed to date, each requiring less than 1 hour for completion. This model has been used to perform a series of experiments to investigate whether the rat lung and surrounding structures trapped tumor cells with 2 different non-small cell lung cancer cell lines(NCI-H460 and NCI-H1299). Every animal showed development of tumor masses, which were loculated at the periphery of the lung paren- chyma and identified also by radiography. After 3 weeks of the inoculation, tumor develop ment at the mediastinal strutures were identified. The life expectancies of the victims were different between the cell lines, but were approximately 5 weeks when NCI-H460 cell line was used. This new orthotopic lung cancer model may be facilitate future studies of the new therapeutics of localized non-small cell lung cancer .

Limited Cytotoxic Effect of Adenoviral-mediated p53 Gene Transfer in Variable Non-small Cell Lung Cancer (NSCLC) Cell Lines / 대한암학회지

PURPOSE: Cancer gene therapeutic strategy using p53 tumor suppresser gene have been suggested to be effective in many solid tumors including non-small cell lung cancer (NSCLC). To test generalized applicability, we tested a number of non-small cell lung cancer cell lines for their sensitivity to adenoviral-mediated wild-type p53 gene transfer. MATERIALS AND METHOD: Replication-incompetent recombinant adenovirus encoding wild- type p53 (Avp53) under the control of the human cytomegalovirus (CMV) promoter was constructed and the cytotoxic effectiveness was evaluated in various NSCLC cell lines. Because 20 moi (multiplicity of infection; number of active virus particle/cell number) of Avp53 showed highly-effective cytotoxicity in p53-deleted cell lines (NCI-H1299, and NCI-H358), same amount was used for other cell lines. RESULTS: Variable degree of cytotoxicity were observed in cell line with p53 mutation, but almost no effect were observed in those with will-type p53. Neither the infectivity of adenovirus, which was observed by x-gal stain after adenoviral mediated lac Z gene, nor the expression of p53 protein in infected cell, which was observed by western blot, was not the useful marker to expect the cytotoxic effect of Avp53. However, in responsive cell lines with Avp53, prominent expression of p21 protein, which was observed by western blot, was noticed. CONCLUSION: In conclusion, adenoviral-mediated wild-type p53 transfer may not be applicable to every patient with non-small cell lung cancer, especially when the tumor has wild-type p53 gene. Better method to predict the effectiveness before application and strategy to widen the applicable extent is needed.

Telomerase Activity in Non-small Cell Lung Cancer / 대한흉부외과학회지

Although many reseraches have been persued to detect the molecular tumor marker to define the cancer, ideal tumor marker which speak for the characteristics of malignancy and has high sensitivity and specificity is not known. One of the characteristics of the malignant cells is indefinite proliferative potential, in other word, immortality. The expression of telomerase and stabilization of telomeres are concomitant with the attainment of immortality in tumor cells; thus the measurement of telomerase activity in clinically obtained tumor samples may provide important information which would be useful as a diagnostic marker to detect immortal cancer cells. Telomerase activity was analyzed in 12 non-small cell lung cancer cell lines and 41 primary non-small cell lung cancers with the use of a PCR-based assay. All the cell lines and the majority of tumors displayed telomerase activity, but telomerase was not detectable in most of the corresponding pathologically-normal tissues. Telomere length was not correlated with telomerase activity. The present study indicate that measurement of telomerase activity may be useful as a molecular tumor marker in non-small cell lung cancer.