Factors Affecting Emotional · Behavioral Problems in Early Adolescence: A Multilevel Model Study

PURPOSE: This study aims to investigate the individual and environmental factors related to emotional/behavioral problems to early adolescence in Korea by applying multilevel modeling. METHODS: From the database of the 2014 Korean Child and Youth Panel Survey (KCYPS), the researchers selected 1,977 adolescents who are in the second year of middle school. Multilevel model analysis was performed to estimate the impact of relevant factors at the individual and environmental levels. RESULTS: At the individual level, the significant factors associated with emotional/behavioral problems included BMI and study tendency in boys, and drinking, study tendency and economic levels in girls. At the environmental level, the significant factor associated with emotional/behavioral problems included relationship with the teacher. CONCLUSION: The emotional/behavioral problems of early adolescence are influenced not only by the individual factors but also by the environment factor. Therefore, the environment surrounding the adolescents should also be considered to prevent emotional/behavioral problems.

Efficacy of Alpha Blocker Treatment According to the Degree of Intravesical Prostatic Protrusion Detected by Transrectal Ultrasonography in Patients with Benign Prostatic Hyperplasia

PURPOSE: To analyze the effectiveness of tamsulosin 0.2 mg once daily for 3 months according to the degree of intravesical prostatic protrusion (IPP) in patients with benign prostatic hyperplasia (BPH). MATERIALS AND METHODS: A total of 134 BPH patients over 40 years of age treated with tamsulosin 0.2 mg between January 2007 and January 2009 were enrolled retrospectively. The patients were classified into three groups according to the degree of IPP: below 5 mm (group A), between 5 and 10 mm (group B), and over 10 mm (group C). Prostate volume, prostate-specific antigen (PSA), prostatic urethral length (PUL), and prostatic adenoma urethral length (PAUL) were evaluated before treatment. International Prostate Symptom Score and Quality of Life (IPSS/QoL), maximal urine flow rate (Qmax), and postvoid residual (PVR) volume were measured before treatment, and improvement in the three groups was compared after 3 months. RESULTS: The mean age of the patients was 65.01+/-7.38 years. Mean IPPs were 0.90+/-1.39 mm (group A, n=90), 6.92+/-1.10 mm (group B, n=24), and 16.60+/-4.06 mm (group C, n=20). Prostate volume, PUL, PAUL, PSA, Qmax, and PVR showed significant correlations with IPP (p0.05). Comparison of parameters before and after 3 months showed that medication improved total IPSS and subscores (p<0.001), QoL (p<0.001), Qmax (p<0.001), and PVR (p=0.030) in group A. In group B, it improved total IPSS (p=0.01), irritative subscore (p<0.001), and obstructive subscore (p=0.03). In group C, only total IPSS (p=0.01) and irritative score (p<0.001) were significantly improved. CONCLUSIONS: Tamsulosin may be more effective in improving symptom scores and Qmax in patients with mild IPP than in those with moderate or severe IPP.

Clinical Characteristics of Genitourinary Tuberculosis during a Recent 10-Year Period in One Center

PURPOSE: This study was conducted to analyze the clinical characteristics and treatments of patients with genitourinary tuberculosis (GUTB) over the past 10 years. MATERIALS AND METHODS: The study population comprised 101 patients who were diagnosed with GUTB and hospitalized from January 2000 to December 2009. Acid-fast bacilli (AFB) smear, urine tuberculosis culture, urine tuberculosis polymerase chain reaction (PCR), intravenous urography, cystoscopy, and histopathologic findings were used for patient selection. Yearly proportion, gender, patient distribution according to age, history of tuberculosis, and presence of other organ tuberculosis were analyzed. RESULTS: The patients hospitalized with GUTB counted for 0.9% of all patients admitted to the department of urology. The sex ratio was 1:1.53 (male:female), and the patients' mean age was 45.57+/-12.55 years (range, 19-81 years). Among the patients, there was one immunocompromised patient. A total of 22 patients (21.8%) had a medical history of tuberculosis, mostly pulmonary tuberculosis (90.9%). The sensitivity of AFB stain, tuberculosis culture, and PCR was 41.6%, 55.4%, 33.7%, respectively. A total of 54 patients required additional surgical treatment: 30 cases of nephrectomy, 8 cases of epididymectomy, 8 cases of ureteral stent, 5 cases of nephrostomy, 1 case of ureterectomy, 1 case of augmentation cystoplasty, and 1 case of transurethral resection of prostate. CONCLUSIONS: The frequency of GUTB tended to decrease progressively. However, GUTB is still a threat to public health. There was no previous history of tuberculosis in two-thirds of the cases of GUTB and more than half of them required further surgical treatment.

An Anteriorly Positioned Midline Prostatic Cyst Resulting in Lower Urinary Tract Symptoms / 대한배뇨장애요실금학회지

Most prostatic cysts are not symptomatic and are found incidentally. There have been some reports of prostatic cysts presenting as an infravesical obstruction. Our case is the second published report of an anteriorly positioned midline prostatic cyst of the bladder neck. The prostatic cyst in a 41-year-old man presenting with lower urinary tract symptoms was located in the anterior and midline area of the prostate and was protruding into the bladder neck at the precise twelve o'clock position. The cyst obstructed the bladder neck by acting like a checking valve. Transurethral resection of the cyst was performed, and the obstructive symptoms successfully improved.

Serial Magnetic Resonance Imagings of Multiple Brain Abscesses in a Patient with Pneumococcal Meningoencephalitis

We report a 43-yr-old man manifesting bacterial meningoencephalitis and multiple abscesses by Streptococcus pneumoniae. Serial magnetic resonance (MR) imagings and MR spectroscopy showed the evolution of multiple brain abscesses over 4 weeks: the enhanced rings became thicker and the dimension of whole lesions larger despite shrinkage of the ring-enhanced regions. These findings may be evidence of active inflammation working to sequestrate the lesion and protect the surrounding normal brain parenchyma from additional damage, even in the final stage of the brain abscess.

Histopathological Changes of Olfactory Epithelium in the Rats Exposed to Cigarette Smoke / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Although exposure to cigarette smoke has been reported to be associated with olfactory dysfunction, the pathophysiology is poorly understood. The purpose of this study is to evaluate the histopathological change of olfactory epithelium according to exposure duration of cigarette smoke and to investigate the effects of cigarette smoke on the olfactory epithelium. SUBJECTS AND METHOD: Thirty-six healthy Sprague-Dawley rats were divided into 2 groups. Experimental groups (n=28) were exposed to cigarette smoke during 2.5 hours (total 5 cigarettes) per one day for 5 days, 11 days and 3, 4, 5, 6, 9 weeks. Control group (n=8) was placed at the same room without smoke exposure and sacrificed at 4 and 9 weeks. Histopathological changes of olfactory epithelium through light microscope and immunohistochemistric findings of olfactory marker protein (OMP) through confocal microscope were observed. The numbers of cells in olfactory epithelium were counted at each period. RESULTS: From 5 days of cigarette smoke exposure, defection of epithelial cells, random arrangement of olfactory receptor cells and decreased thickness of olfactory epithelium were noticed. Numbers of olfactory receptor cells were significantly decreased at 11 days and 3 weeks after smoke exposure, and this finding of decreased number of olfactory receptor cells were continued until 9 weeks of exposure. Numbers of OMP-positive olfactory receptor cells were continuously decreased according to exposure duration. CONCLUSION: The olfactory epithelial cells could be directly affected by cigarette smoke. The numbers of olfactory epithelial cells including olfactory receptor cells were continuously decreased until 9 weeks after cigarette smoke exposure.

Predicting the Long-Term Outcome after Subacute Stroke within the Middle Cerebral Artery Territory

BACKGROUND AND PURPOSE: The National Institutes of Health Stroke Scale (NIHSS) score is known to be effective in predicting the likelihood of recovery after stroke. However, the baseline NIHSS score predicts long-term outcomes rather crudely because early changes in stroke scores may influence the stroke outcomes. Therefore, a precise prognostic algorithm or a cutoff point for predicting long-term outcomes based on data from serial NIHSS scores is needed. METHODS: We serially assessed 437 patients with acute symptomatic ischemic stroke within the middle cerebral artery territory who presented with nonlacunar stroke and were followed-up for at least 6 months after symptom onset. The NIHSS score was serially checked at 0, 1, 3, 7, and 14 days after admission. In all patients, the Barthel index (BI) and the modified Rankin Scale (mRS) score were checked, with a poor outcome defined as any of the following endpoints: death, modified mRS score of >3, or BI of <60. RESULTS: A marked neurological improvement or worsening (i.e., a change in the NIHSS score of at least 4) was seen in 13.5% or 5.5% of the patients, respectively, during the first 7 days after admission. About 25% of the 437 patients had poor long-term outcomes. Analysis of receiver operating characteristic curves showed that the NIHSS score at day 7 after admission was better for predicting poor long-term outcomes than was the baseline score (P=0.003). In addition, we analyzed the cutoff point of the 7th-day NIHSS score for predicting a poor outcome at 6 months after symptom onset. An NIHSS score of at least 6 at day 7 after admission predicted poor long-term outcomes with a sensitivity of 84% [95% confidence interval (CI), 76-90%], a specificity of 92% (95% CI, 88-94%), and positive and negative predictive values of 77% and 95%, respectively. A logistic regression analysis revealed that age, diffusion-weighted imaging lesion volume, stroke history, and 7th-day NIHSS score were independently associated with poor outcome. However, no score used in addition to the 7th-day NIHSS score improved the prediction of a poor outcome. CONCLUSIONS: An NIHSS score of at least 6 on day 7 after admission accurately forecasts a poor long-term outcome after stroke. Our data may be helpful in predicting the long-term prognosis as well as in making decisions regarding novel therapeutic applications in subacute-stroke trials.

Melanogenesis: Experimental Models

Melanogenesis, or synthesis of melanin has been a focus of intense investigation by pigment cell biologists during the past few decades. Melanogenesis provides pigment in skin, thus serving as a unique, if not only, physiological defense against sun-induced injuries, including photocarcinogenesis. Moreover, skin color plays a major role in visual esthetics of an individual. Therefore, unwanted hyper- or hypo-pigmentation, especially on facial skin, could cause significant psychological stress. Epidermal melanocytes, derived from neural crest cells, are mainly responsible for melanin in skin. In human skin, nearly all normal pigmentation is due to melanin and with the exception of hemoglobin, it is one of the only endogenously synthesized pigments in man. Melanin has numerous functions in mammals, including increasing the optical efficiency of the eye, producing color patterns in various organs, including hair or skin, serving as camouflage, heat exchange, sexual recognition and protection from sunlight. The incidences of malignant melanoma have been increasing dramatically in western countries, at least by a factor of 15 over the past 60 years, and this has caused an intense interest in understanding melanogenesis. More than 40,000 new cases of malignant melanoma have been diagnosed in 1997, and it is one of the most common cancers in young adults. The research in the area of melanogenesis has exploded during the last ten years because model systems to study molecular mechanisms regulating melanogenesis have become available. This review examines currently available in vitro and in vivo model systems to study melanogenesis.

The Effects of Propofol on Kupffer Cells in the Rat Liver / 대한마취과학회지

BACKGROUND: Propofol has an antioxidant capacity and can be used for ischemia-reperfusion injury of the liver. However, the effects of propofol on the Kupffer cells have not been established. METHODS: Kupffer cells were isolated and cultured from male Sprague-Dawley rats. The effects of propofol on the Kupffer cells were evaluated by a phagocytosis assay, TNF-alpha gene expression, TNF-alpha production, and superoxide anion release after administering propofol in different concentrations on the cultured Kupffer cells. RESULTS: The latex bead phagocytosis by the Kupffer cells was suppressed when the Kupffer cells were exposed to propofol irrespective of concentrations. Higher propofol concentrations decreased the loss of Kupffer cells after latex bead phagocytosis. Propofol induced TNF-alpha mRNA expression in the Kupffer cells, but the mRNA expression level after 50microgram/ml of propofol decreased. The pattern of TNF-alpha mRNA expression induced by propofol was different to that induced by LPS: TNF-alpha mRNA was expressed continuously in the propofol-treated cells until 16 hours after exposure to propofol, whereas the level of TNF-alpha mRNA expression induced by LPS was evident after 2 hours and was not found thereafter. TNF-alpha production after propofol treatment was not higher than that of the control. Formazan precipitation did not show any qualitative differences between cells untreated or treated with propofol concentrations of 0.5, 5.0, and 50microgram/ml. CONCLUSIONS: These results showed that propofol might inhibit Kupffer cells. This suggests that propofol can be used for patients with ischemia-reperfusion injury of the liver.

Study for the Improvement of Early Implantation and Long Term Graft Survival in Pancreatic Islet Cell Transplantation by Induction of Angiogenesis with Gene Transfection of Vascuar Endothelial Growth Factor / 대한이식학회지

PURPOSE: Transplantation of pancreas islet has been worldwidely studied as a one of therapeutic modalities to achieve the insulin independence. We studied whether the expression of vascular endothelial growth factor (VEGF) on pancreas islets with liposomal VEGF gene transfer could improve the efficacy of early implantation and long term graft survival in pancreatic islet cell transplantation. METHODS: Syngenic pancreas islets were transplanted beneath the renal capsule. Islets were transfected with plasmid VEGF c-DNA using cationic liposome DMRIE-C. Glucose metabolism and histologic findings were compared between the groups transplanted with VEGF DNA containing islets (n=5) and the control group with (n=5) or without (n=4) local recombinant VEGF adminstration during islet transplant. RESULTS: Glucose was controlled at 5.5 days after transplantation in control group without r-VEGF adminstration, at 4 days in group with recombinant VEGF adminstration, and at 6.6 days in group with VEGF DNA transfected islets. Euglycemia was maintained over 150 days in control group. However, graft failure was developed in 22 days after transplantation in group with VEGF DNA transfected islet. Histologically there were severe infiltrations of neutrophil and lymphocyte in VEGF DNA transfected grafts from 5 days after transplantation. CONCLUSION: Although VEGF could be a favorable angiogenic factor in pancreas islet transplantation, VEGF expression following VEGF DNA transfection into islets could not increase the graft survival due to inflammatory process. More investigations are needed to clarify the mechanism on destructive process of islets after gene transfection into islets, and another approaches to get the effect of gene transfection should be followed.

The Implication of Monocyte/Macrophage into the Graft Following Heart Transplantation in Rat

BACKGROUND: In organ transplantation, the cellular immune reaction, namely T-cell immunity, plays a major role in rejecting the graft. While T & B cell activities in organ transplantation have been studied extensively, monocytes/macrophages have not because of their a minor role in innate immunity. Monocytes act as immunologically active cells in several aspects in organ transplantation, such as antigen-presenting cells, cells releasing many substance, such as IL-1, IL-2, TNF-alpha, and many growth factors, and cells phagocytosing foreign antigens and tissues in the effector phase of immune reaction. METHODS: We attempted to study the role of monocytes/ macrophages in graft rejection following allogenic organ transplantation in rodents. RESULTS: While graft survivals following a cardiac allograft were more then 100 days in all the singenic Wistar to Wistar transplants, the graft survival for Lewis to Wistar allografts were 7 to 12 days with a mean of 9.2 days. In the histology of the transplanted hearts, cellular infiltration developed from posttransplantation day 1, and all the histologic findings, such as myocardial ischemia, interstitial bleeding, and endocardial changes, were more progressive around the days of graft rejection. Macrophage infiltration analyzed by immunohistochemstry using the spectific antibody ED1, was noticed from postoperative day 1, and the macrophages were distributed all through the layer of the heart. In the study on the intragraft monokine gene by using RT-PCR, mRNA of IL-1 expressed on day 1 and reappearedon day 7. mRNA of TNF-alphaexpressed on day 3 and MCP-1 on day 1. All the monokine gene expressions progressed up to the days of rejection. CONCLUSION: From these results showing the concurrent pattern of cell infiltration and intragraft cytokine gene expression of monocytes/macrophages with the lymphocyte, we suggest that intervention of monocytes in organ transplantation may prolong graft survival with or without the anti T cell strategy.

In Vitro Analysis of Co-cultured Pancreatic Islet with Lymphocyte / 대한이식학회지

BACKGROUND: Transplantation of Pancreatic islet represents one of the most exciting treatment modalities for Type I diabetes mellitus. To achieve better graft survival, it is important to protect the graft from alloantigen-specific immune response. It was emphasized that islets, as with other forms of cellular transplants, have the potential advantage of being immunologically altered before transplantation, resulting in tolerance to the host without using long-term, nonspecific immunosuppression. The mixed islet-lymphocyte culture is an excellent tool to evaluate the immunogenicity of a pancreatic islets. Therefore, we co-cultured pancreatic islet and lymphocyte to investigate cytokine gene expression from the lymphocyte, and to investigate pancreatic islet viability and functional changes after co-culture. MATERIALS AND METHODS: Lewis rat islets were purified from pancreas by collagenase type XI and dextran gradient method. Afterwards, Lewis rat islets were co-cultured as a stimulator and Wistar rat lymphocyte as a reponder. As a control group lymphocyte alone and islet alone were cultured in a same condition. For estimating islets viability, we counted islet viability as an IEQ (Islet equivalent). For evaluation of islets function, insulin release assay was perfomed by RIA under the glucose challenge. used by RIA. We studied cytokines gene expression of cultured cells by reverse transcriptase polymerase chain reaction (RT-PCR). RESULT AND CONCLUSION: 1) Islet yield was 1229.8 420.1 per rat, and counted as 2615.4 548.2 IEQ per rat. 2) Islet viability was decreased gradually with the lapse of time, more rapid in allogenic co-culture group than islet alone or isogenic co-culture group. 3) Release of insulin increased until day 3, and then decreased gradually. Insulin release was positively correlated with glucose gradient. The amount of released insulin was greater in co-cultured group than islet alone group. 4) Interleukine-2 and interferron-gamma gene expression increased in allo co-culture group, however transforming growth factor-beta gene expression was not affected by co-culture.

In Vitro Analysis of Co-cultured Pancreatic Islet with Lymphocyte / 대한이식학회지

BACKGROUND: Transplantation of Pancreatic islet represents one of the most exciting treatment modalities for Type I diabetes mellitus. To achieve better graft survival, it is important to protect the graft from alloantigen-specific immune response. It was emphasized that islets, as with other forms of cellular transplants, have the potential advantage of being immunologically altered before transplantation, resulting in tolerance to the host without using long-term, nonspecific immunosuppression. The mixed islet-lymphocyte culture is an excellent tool to evaluate the immunogenicity of a pancreatic islets. Therefore, we co-cultured pancreatic islet and lymphocyte to investigate cytokine gene expression from the lymphocyte, and to investigate pancreatic islet viability and functional changes after co-culture. MATERIALS AND METHODS: Lewis rat islets were purified from pancreas by collagenase type XI and dextran gradient method. Afterwards, Lewis rat islets were co-cultured as a stimulator and Wistar rat lymphocyte as a reponder. As a control group lymphocyte alone and islet alone were cultured in a same condition. For estimating islets viability, we counted islet viability as an IEQ (Islet equivalent). For evaluation of islets function, insulin release assay was perfomed by RIA under the glucose challenge. used by RIA. We studied cytokines gene expression of cultured cells by reverse transcriptase polymerase chain reaction (RT-PCR). RESULT AND CONCLUSION: 1) Islet yield was 1229.8 420.1 per rat, and counted as 2615.4 548.2 IEQ per rat. 2) Islet viability was decreased gradually with the lapse of time, more rapid in allogenic co-culture group than islet alone or isogenic co-culture group. 3) Release of insulin increased until day 3, and then decreased gradually. Insulin release was positively correlated with glucose gradient. The amount of released insulin was greater in co-cultured group than islet alone group. 4) Interleukine-2 and interferron-gamma gene expression increased in allo co-culture group, however transforming growth factor-beta gene expression was not affected by co-culture.

Large nonfunctioning adrenocortical carcinoma: a case report / 대한비뇨기과학회지

Nonfunctioning carcinoma of the adrenal cortex is an extremely rare disease. We have presented a case of nonfunctioning adrenocortical carcinoma. The patient was a 35 year-old female who had complained of discomfort and gradually growing mass in the left upper quadran1. No significant laboratory findings or evidence of hormonal disturbance wee clinically noted. Ultrasonography and abdominal CT revealed about 15 x 13cm sized mass in the left suprarenal area. Left adrenal gland. kidney and spleen were removed. The tumor was multilobulated but well encapsulated. measuring 16 x 15 x 13cm in size and weighing 420 grams. Cut surface of the tumor showed massive hemorrhage and necrosis, Microscopically, the tumor showed marked cellular pleomorphism, nuclear hyperchromatism and increased mitoses with some atypical mitoses. Capsular and vascular invasion of tumor cells was observed.

A Successful Occlusion of Traumatic Carotico-Cavernous Fistula with Debrun's Detachable Balloon Catheter

A case of traumatic carotico-cavernous fistula was managed by intravascular occlusion using detachable balloon catheter. The great advantage of this technique is that the cerebral blood flow can usually be preserved after the occlusion of the fistula. The fistula was obliterated by this procedure. The radiological feature, symptomatology and management were discussed with brief review of the literature.

A Case of Primary Transitional Cell Carcinoma in Bladder Diverticulum / 대한비뇨기과학회지

We report a case of primary transitional cell carcinoma developed in bladder vdiverticulum with brief review of literatures. Patient was a 71 year-old man who had painless gross hematuria for 10 days. Excretory urogram showe a large diverticulum in the bladder. At cystoscopy a 0.5 x 0.5cm sized papillary mass was seen on diverticular mucosa. Urine cytology revealed class V transitional cell carcinoma. At pelvic CT, metastatic evidence was not seen. We carried out partial cystectomy involving diverticulum under the diagnosis of primary transitional cell carcinoma developed in vesical diverticulum. The histopathologic diagnosis was grade III, stage A transitional cell carcinoma combining with carcinoma in situ.

Patch Test in the Suspected Cosmetic Contact Dermatitis / 대한피부과학회지

Of the 166 cases of suspected cosmetic contact dermatitis, 92 showed positive reactions to one or more of the allergens of the commercial test kits or patients, own coametics by patch test. Tincture of benzoin, ammoniated mercury, cinnamic alcohol and benzyl salicylate were the most commonly identified agents. By product category, skin care produts dominated as the cause of the cosmetic conact dermatitis. However, it was suspected that the most common sensitizer may be present in the eye-make up preparations. The positive rate of foreign cosmetics was more than 2 fold higher than the domestic ones.

Morphological observations on Clonorchis sinensis obtained from rats treated with praziquantel

The present study was undertaken to observe the morphological changes of Clonorchis sinensis obtained from experimentally infected rats treated with praziquantel (Biltricide) which is a new anthelmintic agent with high activity against a broad spectrum of cestode and trematode species. For this study, the rats were infected experimentally with about 50 metacercariae of C. sinensis and were given praziquantel a single dose of 600 mg per kg of body weight at 5 weeks after infection. The Clonorchis worms were isolated from the bile ducts of the rats which were autopsied on the 4th day after treatment. After isolation the parasites were observed their shape and motility in the medium of 37 C physiological saline solution, and then the fine structure of the tegument of C. sinensis was studied by means of light, scanning and transmission electron microscope. The findings of the observation were compared with those of untreated parasites. The results are as follows: All the isolated worms moved actively in the medium of physiological saline solution (37 C). A majority of the parasites obtained from the treated rats showed a large balloon shaped structure on the surface between oral and ventral suckers. But such structure has never seen in the parasites obtained from control rats. By the scanning electron microscopic observation, the regular pattern of the tegumental ridges was significantly changed on the outer surfaces of parasites obtained from the treated rats as compared with those of the control rats. By the transmission electron microscopic observation, the numerous mitochondriae in the syncytial tegumental layer of the treated parasites appeared to be degenerated and formed small vacuoles, and the tegumental ridges were also degenerated and showed somewhat flattened. In the parasites obtained from the treated rats, a different size of vacuoles interspersed in the distal part of the syncytial tegument and also in subepithelial region of the urinary bladder. These vacuoles are fused each other and lead to the disruption of the apical region of syncytial tegument along the basement layer. Finally the basement layer was dislocated. So that the tegumental layer appeared as a large balloon.