Influence of Postconceptional Age on the Renal Biomarkers in Very-Low-Birth-Weight Infants

Purpose@#We investigated whether consecutive levels of new emerging renal biomarkers, including serum cystatin C (CysC) and urinary neutrophil gelatinase-associated lipocalin (NGAL)/creatinine (Cr) ratio, were affected by postconceptional age in very-low-birth-weight (VLBW) infants. @*Methods@#Repeatedly measured samples for each infant were divided into four groups according to postnatal age: at birth (stage I), 3 to 7 days postnatally (stage II), 8 to 28 days postnatally (stage III), and >28 days postnatally (stage IV). The association between renal biomarkers and postconceptional age was assessed using Pearson’s correlation coefficient, and the mean values of renal biomarkers in the four stages were compared using repeated-measures analysis of variance. @*Results@#For samples measured at birth, serum CysC (r=–0.358, P=0.032) and urinary NGAL/Cr ratio (r=–0.522, P=0.001) were negatively correlated with gestational age, whereas serum Cr (r=0.148, P=0.390) was not. In addition, for all samples measured, serum CysC (r=–0.209, P=0.012), urinary NGAL/Cr ratio (r=–0.536, P28 days postnatally seems to be more affected by postconceptional age than serum CysC in VLBW infants.

Influence of Postconceptional Age on the Renal Biomarkers in Very-Low-Birth-Weight Infants

Purpose@#We investigated whether consecutive levels of new emerging renal biomarkers, including serum cystatin C (CysC) and urinary neutrophil gelatinase-associated lipocalin (NGAL)/creatinine (Cr) ratio, were affected by postconceptional age in very-low-birth-weight (VLBW) infants. @*Methods@#Repeatedly measured samples for each infant were divided into four groups according to postnatal age: at birth (stage I), 3 to 7 days postnatally (stage II), 8 to 28 days postnatally (stage III), and >28 days postnatally (stage IV). The association between renal biomarkers and postconceptional age was assessed using Pearson’s correlation coefficient, and the mean values of renal biomarkers in the four stages were compared using repeated-measures analysis of variance. @*Results@#For samples measured at birth, serum CysC (r=–0.358, P=0.032) and urinary NGAL/Cr ratio (r=–0.522, P=0.001) were negatively correlated with gestational age, whereas serum Cr (r=0.148, P=0.390) was not. In addition, for all samples measured, serum CysC (r=–0.209, P=0.012), urinary NGAL/Cr ratio (r=–0.536, P28 days postnatally seems to be more affected by postconceptional age than serum CysC in VLBW infants.

Huge Benign Prostatic Hyperplasia / 계명의대학술지

Benign prostatic hyperplasia (BPH) is one of the most common diseases in older men and it may be accompanied with significant problems in the quality of life. Histological changes of BPH is starting at the age of 35, and there is induced in 60% of 60-year-old men, 80% of 80-year-old men, in 50% of the patient group may lead to lower urinary tract symptoms (LUTS). A 74-year-old man with huge BPH visited outpatient clinic with severe LUTS of an year duration. He was diagnosed with BPH 11 years ago and underwent transurethral resection of prostate twice. However, the prostate grew up to remarkable size again, which lead to the bladder outlet obstruction (BOO) and renal failure. There is no report for huge BPH (above 300 g) in Korea, we report a case with huge prostate size that is measured 330 g and treated with suprapubic open prostatectomy.

Anticancer Effects of Astaxanthin and alpha-tocopherol in Esophageal Cancer Cell Lines

BACKGROUND/AIMS: Astaxanthin (AX) has been attributed with potential for protecting the organism against different types of cancer due to its anti-oxidant activity. Also several in vivo and in vitro studies suggest certain naturally occurring vitamin E (i.e. alpha-tocopherol) as promising anticancer agents. We assessed the effect of AX and alpha-tocopherol (AT) respectively and their combination on human esophageal cancer cell lines to investigate the mechanism of anticancer effect and their therapeutic potential. MATERIALS AND METHODS: Two human esophageal cancer cell lines (TE-1, TE-4) were exposed to AX (6 to 10 microg/mL) and AT (20 to 100 microM) for 24 hours. Quantification of proliferation was performed by MTT assay. Cell cycle machinery proteins such as p-AKT, p-p38, cyclin D1, p27 and caspase-3 were investigated by Western blot. RESULTS: Significant inhibition of cell proliferation of AX and AT was observed in TE-4 cell line by a dose-dependent manner. Furthermore, AX and AT as single agents increased the protein expression of p27 and cleaved caspase-3 in TE-4 cell line. The combination of the two agents decreased the expression of cyclin D1, however they did not demonstrate pro-apoptotic effect. CONCLUSIONS: AX and AT as single agents are effective at inhibition of cell proliferation and induce apoptosis by the modulation of cell cycle machinery proteins in esophageal cancer cell lines. However, our data could not suggest that their combination has any cooperative apoptotic effect.

Laboratory Vestibular Function Testing

Basically laboratory vestibular function testing use the vestibular ocular reflex and vestibular spinal reflex like as bedside examination or outpatients' evaluation. Such vestibular laboratory testing can aid diagnosis and can be used to document an abnormality suspected at bedside evaluation. The ability to perform serial vestibular evaluations allows an assessment over time of patients who are undergoing treatment for dizziness or treatment with potentially ototoxic medication. Generally speaking, it includes spontaneous nystagmus, some kinds of evoked nystagmus, ocular eye movement testing, Caloric's testing, rotational chair testing, vestibular evoked myogenic potential, subjective visual vertical, posturography and so on. Those testing have been developed with biomedical engineering based on the proven scientific facts together.

Treatment Results and Complications of Anti-incontinence Tape Procedures in Female Stress Urinary Incontinence

PURPOSE: We compared the treatment results and complications between retropubic route of IVS (intravaginal sling) & SPARC (suprapubic arc) and transobturator route of TOT (transobturator tape) & TVT-O (tension-free vaginal tape-obturator). MATERIALS AND METHODS: Targeting group was limited to 104 patients who were diagnosed with female stress urinary incontinence from January 2004 to July 2005. The preoperative evaluation included careful history taking, physical examination, stress and pad test. The postoperative evaluation included a questionnaire, stress test and complications. RESULTS: The numbers of the patients with IVS, SPARC, TOT and TVT-O were 16, 18, 53, 17, respectively. The success rates (cured+improved) were 93.8 (75+18.8)%, 94.4 (83.3+11.1)%, 98.2 (92.5+5.7)%, 100 (88.2+11.8)%, respectively (p>0.05). There was no serious complication. Although urinary tract infection, supurapubic pain, inguinal pain were reported, all the complications got better with conservative therapy. Transobturator route groups took a bit shorter than retropubic route groups as the operation of IVS, SPARC, TOT, TVT-O took 31.8 minutes, 30 minutes, 20 minutes and 21.2 minutes, respectively (p<0.05). CONCLUSIONS: There were no differences in complications and the results of treatment among IVS, SPARC, TOT and TVT-O. Consequently, if all the operation methods are regarded as the proper ones, transobturator route would be preferred to retropubic route, due to shorter operation time and unnecessary for cystoscopy.

A Case of Endometriosis at the Site of Abdominal Scar following Cesarean Section and A Case of Parenchymal Pulmonary Endometriosis / 대한산부인과학회잡지

Abdominal wall endometriosis secondary to cesarean section is very rare condition, being reported in less than 0.5% of patients undergoing cesarean section. Moreover, parenchymal pulmonary endometriosis is a rare gynecologic problem, characterized by cyclic hemoptysis. We experienced 38 years old female patient who had had cyclically appearing painful abdominal wall mass after cesarean section pathologically proven endometriosis and 33 year-old female patient with recurrent catamenial hemoptysis localized with CT scanning, and then treated with GnRH agonist. So, we present two cases with a brief review of literatures.

Feasibility of FDG-PET Scan before Second Look Operation in Patients with Ovarian Cancer / 대한산부인과학회잡지

OBJECTIVE: This study is to investigate whether Positron Emission Tomography (PET) is useful for determining pathologic complete response in patients with ovarian carcinoma who had a clinical complete response after primary treatment. METHODS: FDG-PET scans were performed in 10 patients with advanced ovarian cancer (4 patients with stage IIC, 6 patients with IIIC), who showed complete response with cytoreductive surgery and 6 cycles of post-operative adjuvant Cisplatin-based combination chemotherapy. FDG-PET scan was obtained with GE Advance Scanner, beginning at 50 minutes after injection of 370-555 MBq (10-15 mCi) of 18F FDG. Uptakes exceeding 3.5 SUV (Standardized Uptake Value) or larger than surrounding tissue were determined as a positive findings. Second-look laparotomy was undertaken within median 4 days after FDG-PET scanning. RESULTS: The mean age of the patients was 45 years and serous cystadenocarcinoma was most common histologic type. None showed active lesion in pelvis or abdomen with FDG-PET scan (SUV: >3.5 kg/ml), however, 5 patients (50%) showed residual tumors on multiple biopsy during second look operation. One patient showed positive lesion in lung on FDG-PET scan, which was confirmed to have metastatic lesion. CONCLUSION: FDG-PET scan is not useful for detection of small ovarian cancer lesions in pelvis and abdomen and cannot substitute for second-look operation to determine pathologic complete response.

Stenting of an Anomalous Coronary Artery in Acute Myocardial Infarction

Single coronary artery is rare and the application of coronary angioplasty to these arteies presents unique technical challenge. As technical advances in the guiding catheter and balloon system occur, more challenging lesions including anomalous coronary artery are able to be treated. Correct guiding catheter selection is important to ensure adequate access to the anomalous vessel and provide support to cross the lesion. This report describes successful angioplasty with stent in right coronary artery of single ostium coronary anomaly in a patient presenting with an acute myocardial infaction.

Meningitis due to Listeria Monocytogenes Following Orthotopic Heart Transplantation

We report a first case of meningitis due to listeria monocytogenes after cardiac transplantation in Korea. This patient is a 40-year-old man with Dilated cardiomyopathy, he presented with intermittent dyspnea and abdominal distension for about 1 year. After cardiac transplantation, he was treated with azathioprine, cyclosporine and prednisolone for graft rejection. He was presented with intermittent fever, headache and lethargy for about 10days after cardiac transplantation. Listeria monocytogenes was isolated from blood culture and CSF culture. He was treated with intravenous penicillin G for 10days successfully and changed with ampicillin for 10days, took oral ampicillin for 10days without any complication after discharge.

A Case of Spontaneous Coronary Artery Dissection during Exercise Treated with Stenting

Spontaneous coronary artery dissection (SCAD) is a rare disease that occurs most commonly in young people, especially in peripartum or postpartum women. It is usually catastrophic and fatal. The etiology of dissection is still under discussion. Possible factors are inflammation, changes of flow dynamics, and preexisting intima lesions. The treatment of choice for spontaneous coronary artery dissection is still not settled. The authors report a twenty-nine year-old woman with coronary lesions diagnosed as spontaneous coronary artery dissection which developed during exercise and was treated with intracoronary stenting.

A Case of Transcatheter Alcohol Ablation of the Septum in a Patient of Hypertrophic Obstructive Cardiomyopathy

Hypertrophic obstructive cardiomyopathy (HOCM) is characterized by inappropriate myocardial hypertrophy that occurred in the absence of an obvious cause for the hypertrophy and dynamic left ventricular outflow tract obstruction, caused by asymmetrical septal hypertrophy and systolic anterior motion of the anterior mitral leaflet. The pathophysiological abnormality in HOCM is diastolic dysfunction, abnormal stiffness of the left ventricle with resultant impaired ventricular filling and impaired vasodilator reserve (perhaps related to the thickened and narrowed small intramural coronary arteries found in HOCM). During the early course of this progressive disease, treatment consists of negative inotropic drugs. Surgery has been the only therapeutic option in patients with hypertrophic cardiomyopathy who are resistant to drug treatment and sequential pacemaker therapy. We describe a novel catheter-based technique that may replace surgical myocardial reduction. The technique is interventional infarction of a portion of the interventricular septum by the infusion of alcohol into a selectively catheterized septal artery.

A Case of Partial Left Ventriculectomy in a Patient with End-stage Dilated Cardiomyopathy

The end-stage dilated cardiomyopathy is usually treated with cardiac transplantation although some limited success have also been obtained in selected patients using dynamic cardiomyoplasty or medical assist devices. Recently, a new surgical alternatives, called partial left ventriculectomy (PLV) was introduced by Randas J. V Batista in 1995. A 40-year-old man who had end-stage dilated cardiomyopathy refractory to optimal doses of medicines underwent partial left ventriculectomy (Batista's operation), which reduces ventricular volume to improve left ventricular function. The left ventricular ejection fraction increased from 20 % to 58 % at 4 month after operation.