BACKGROUND/AIMS: The prevalence of malignancies associated with human immunodeficiency virus (HIV) is rapidly increasing. The aim of the present study was to identify clinical features associated with malignancies in South Korean patients infected with HIV. METHODS: From January 1990 to June 2007, we reviewed an electronic database containing pathological reports obtained from HIV-infected patients and then retrospectively analyzed a total of 27 malignancy cases treated at four different institutions. RESULTS: Among 683 patients infected with HIV, malignant diseases were diagnosed in 27 cases (4.0%). Twenty-five of these patients were male, and the median age was 48 (range; 24-76). At the time of diagnosis, the median CD4+ lymphocyte count was 42/uL (range 3-339). Acquired immune deficiency syndrome (AIDS)-defining malignancies were diagnosed in 13 patients (48%) and non-AIDS-defining malignancies were diagnosed in 14 patients (52%). Two patients each were diagnosed with AIDS-defining and non-AIDS-defining malignancies during the pre-highly active anti-retroviral therapy (HARRT) period. In contrast, 11 patients (48%) and 12 patients (52%) were diagnosed with AIDS-defining and non-AIDS-defining malignancies during the HARRT period, respectively. Among AIDS-defining malignancies, non-Hodgkins lymphoma was the most frequently observed (9/13), followed by Kaposi's sarcoma (4/13). Among the 9 patients with non-Hodgkins lymphoma, diffuse large B-cell lymphoma was most common (5/9), followed by primary CNS lymphoma (3/9) and Burkitt's lymphoma (1/9). Gastrointestinal (GI) malignancies [i.e., gastric cancer (3/14), rectal cancer (3/14), and esophageal cancer (1/14)] and hepatocellular carcinoma (3/14) were the most commonly observed among the non-AIDS-defining malignancies. Other observed non-AIDS-defining malignancies were thyroid cancer (1/14), tonsillar cancer (1/14), angiosarcoma (1/14), and eccrine cancer (1/14). Finally, median CD4+ lymphocyte counts at the time of diagnosis were significantly different (18 vs. 114/uL, p=0.001) between AIDS-defining malignancies and non-AIDS-defining malignancies. CONCLUSIONS: Malignancies were diagnosed in 4.0% of patients infected with HIV. This study showed similar rates of incidence between AIDS-defining and non-AIDS-defining malignancies. Non-Hodgkins lymphoma was the most frequently observed malignancy, whereas GI malignancies and hepatocellular carcinoma were common among non-AIDS-defining malignancies.
Acquired Immunodeficiency Syndrome ; Burkitt Lymphoma ; Carcinoma, Hepatocellular ; Electronics ; Electrons ; Esophageal Neoplasms ; Hemangiosarcoma ; HIV ; Humans ; Incidence ; Lymphocyte Count ; Lymphoma ; Lymphoma, B-Cell ; Lymphoma, Non-Hodgkin ; Male ; Prevalence ; Rectal Neoplasms ; Retrospective Studies ; Sarcoma, Kaposi ; Stomach Neoplasms ; Thyroid Neoplasms ; Tonsillar Neoplasms

OBJECTIVE: Mean weight gains, standard deviations were calculated for each gestational months and the 10th, 25th, 50th, 75th, and 90th percentiles were determined. And the influence of prepregnancy body mass index and/or parity on monthly weight gain was investigated. METHODS: We analyzed the monthly weight gain data from 876 women who had healthy sigleton term pregnancy in Han-il Hospital(Jul 2001-Jun 2002). Data were categorized in three groups according to the prepregnancy body mass index. RESULTS: The monthly weight gain table has been determined and 'Sigmoid(S) shaped' monthly weight gain curve was presented. Primipara and multipara have less weight gain than nullipara in the 5th and the 7th-11th months. Monthly weight gains adjusted for parity and age were significantly different among prepregnancy body mass index groups from the 4th month. CONCLUSIONS: More careful prenatal care according to the monthly weight gain-gestational month tables is needed to prevent a lot of complications which may be associated with abnormal weight gain during pregnancy.
Body Mass Index ; Female ; Humans ; Parity ; Pregnancy* ; Prenatal Care ; Weight Gain*

BACKGROUND: Modified lipoproteins may be involved in nephro- and glomerulosclerosis. Diabetic nephropathy-like lesions have also been induced in a rat model by glycated and glycoxidized albumin. In cultured rat or human mesangial cells, enhanced cell proliferation and production of mesangial matrix in response to lipoproteins and their modified forms have been demonstrated by [3H]-thymidine incorporation and cell counting assays. But these methods are relatively complex and most of them have used only one or two of the lipoprotein, albumin and their modified forms. METHODS: We investigated the effects of native and modifed lipoproteins, and albumin on cultured human mesangial cell proliferation using non-radioactive colorimetric method by MTS/PMS assay. Lipoproteins added were low density lipoprotein(LDL), high density lipoprotein(HDL), very low density lipoprotein(VLDL), oxidized LDL(oxidation with copper sulfate in vitro) and glycated LDL and we also used albumin, glycated albumin, and interleukin-1beta as a positive control. RESULTS: Interleukin-1beta promoted the proliferation of cultured human mesangial cells up to concentration 20 ng/mL. LDL induced the proliferation of mesangial cells in a concentration-dependent manner up to concentration 100 microgram/mL. HDL and VLDL had no significant proliferative effect. Oxidized LDL caused the proliferation of mesangial cells at low concentration up to concentration 25 microgram/mL. Addition of glycated LDL resulted in a concentration- dependent inhibition of mesangial cells. Albumin and glycated albumin inhibited the proliferation of mesangial cells at low concentration of 100 microgram/mL, but cell growth was increased at higher concentrations. CONCLUSION: We demonstrated the effects of the single and modified proteins on the proliferation of cultured human mesangial cell by relatively simple colorimetric method. Results were almostly identical to those of previous studies obtained by radioactive method or cell counting assay.
Animals ; Cell Count ; Cell Proliferation ; Copper Sulfate ; Humans* ; Interleukin-1beta ; Lipoproteins* ; Mesangial Cells* ; Models, Animal ; Rats

Low dose methotrexate (MTX) is widely used for treatment of rheumatoid arthritis (RA) due to prompt clinical response, relatively lack of serious side effects, tolerability and simplicity of medication. However, several serious adverse effects have been reported with the use of MTX. The prevalence of hematologic toxicity, including leukopenia, thrombocytopenia, megaloblastic anemia, and pancytopenia, is estimated to be 3% in MTX-treated RA patients. Pancytopenia, which occurs unpredictably, is one of the most serious adverse effects and the prevalence is estimated to be 1.4% and fatal pancytopenia reported to occur in 17% of these patients. Old age, impaired renal function, concurrent infection, hypoalbuminemia, increased mean corpuscular volume of red blood cell, concomitant medication such as trimethoprim-sulfamethoxazole and nonsteroidal antiinflammatory drug, are the risk factors of MTX induced pancytopenia. We experienced a case of fatal MTX induced early aplastic anemia in RA patients who medicated 3 times MTX (7.5mg/weekly, 22.5mg of cumulative dose) refractory to treatment with steroid pulse, recombinant human granulocyte macrophage colony stimulating factor (rhGM-CSF) and immunoglobulin.
Anemia, Aplastic* ; Anemia, Megaloblastic ; Arthritis, Rheumatoid* ; Erythrocyte Indices ; Erythrocytes ; Granulocyte-Macrophage Colony-Stimulating Factor ; Humans ; Hypoalbuminemia ; Immunoglobulins ; Leukopenia ; Methotrexate* ; Pancytopenia ; Prevalence ; Risk Factors ; Thrombocytopenia ; Trimethoprim, Sulfamethoxazole Drug Combination

PURPOSE: To avoid prolonged recovery time and scar tenderness in open carpal tunnel release and possible nerve or tendon injuries by bulky instruments in endoscopic techniques, we tried to percutaneously release the transverse carpal ligament using simple, thin instruments. MATERIALS AND METHODS: We performed carpal tunnel release percutaneously through a single small incision on the wrist with curved mosquito and meniscectomy hook knife under general or regional anesthesia in 41 wrists of 27 patients during the last 5 years and followed up for at least one year. Before and after release, endoscopic examinations were done to rule out space occupying lesions or other anormalies and to confirm complete release. RESULTS: According to the Cseuz's criteria, 38 cases (93%) showed excellent or good results, which was compatible to open or endoscopic technique with special instruments and there was no major neurovascular injury except one superficial palmar arch laceration associated with the second palmar incision in complicated case. CONCLUSIONS: From earlier experience, we learned that this simple technique may be used successfully with low cost without any fear of complication.
Anesthesia, Conduction ; Cicatrix ; Culicidae ; Humans ; Lacerations ; Ligaments ; Tendon Injuries ; Wrist

We reviewed 46 hips of the 36 patients treated with free vascularized fibular graft for avascular necrosis of femoral head with a mean follow-up of 39.9 months (ranging from 2 years to 6 years 4 months). There were thirty-four men and two women. The mean age of patients at the time of operation was 36.6 years (ranging from seventeen to fifty-seven years). The procedure was performed on both hips in ten patients. Of the 46 hips, twenty-nine were idiopathic, ten alcoholic, six steroid induced, and one traumatic. According to Ficats stage, there were eighteen in Stage 2A, fifteen in Stage 2B and thirteen in Stage 3. According to Ohzonos classification, there were four in Type 1B, forty in Type 1C and one in Type 3B. Clinical assessments according to the cause and severity of the disease were evaluated using Harris hip scoring system. Thirty-two hips(69.6%) were excellent, 9 hips(19.6%) were good, 2 hips(4.3%) were fair, and 3 hips(6.5%) were poor. Therefore clinically satisfactory results, including excellent and good, were obtained in 41 hips(89.2%). Radiographic assessments according to healing of avascular necrosis lesion and collapsing the femoral head postoperatively were performed. Thirty hips(65.2%) were excellent, 9 hips(19.6%) were good, 4 hips(8.7%) were fair, and 3 hips(6.5%) were poor. Therefore radiographic satisfactory results were obtained in 39 hips(84.8%). Clinical and radiographic assessments according to Ohzonos classification were also evaluated. Clinically satisfactory result were obtained in 6 hips(100%) of Type 1A and 3B in 33 hips(82.5%) of Type 1C. The etiological factors didn t affect the results. There were two cases of peroneal nerve palsy in which one was irreversible and one case of clawing of great toe as complications. In conclusion, free vascularized fibular graft appears to be a very effective method for Ficats stage 2A, 2B, and early stage 3 of symptomatic avascular necrosis of femoral head, in Ohzonos Type 1C which have a high incidence of collapse.
Alcoholics ; Animals ; Classification ; Female ; Follow-Up Studies ; Head* ; Hip ; Hoof and Claw ; Humans ; Incidence ; Male ; Necrosis* ; Paralysis ; Peroneal Nerve ; Toes ; Transplants*

Helocobacter pylori(Hp) is thought to play an important role in the pathogenesis of active gastritis and other upper gastrointestinal mucosal lesions. Although upper gastrointestinal mucosal lesion have been one of the most common complication in patients with chronic renal failure. A few reports are available regarding the prevalence of H. pylori and its influence on the upper gastrointestinal tract. The objective of our study was to evaluate the prevalence of Hp in end-stage renal failure who were undergoing dialysis. The study population consisted of seventeen patients with upper gastrointestinal tract symptoms. Thirty-six patients without any known kidney disease were used control. Gastric mucosa and gastric juice were obtained endoscopically. Rapid urease test(CLO test) were used for the determination of Hp. Hp was observed in 35.3% of the dialysis group and 77.8% of the control. Gastroduodenal lesion in Hp positive dialysis patients included erosive gastritis, atrophic gastritis and superficial gastritis. In the dialysis group, ammonia concentration in gastric juice were higher in patients with Hp than in those without Hp (461.5+/-211.1 vs. 244.4+/-168.1microgram/mL, p< 0.05). Patients with end-stage renal failure who were undergoing dialysis were shown to have a low prevalence of Hp colonization. In the end-stage renal failure, Hp is associated with peptic ulcer and chronic active gastritis but its influence on the upper gastro- intestinal tract is milder than in those of normal renal function. Several factor including Hp may play a role in the pathogenesis of gastointestinal mucosal lesion.
Ammonia ; Colon ; Dialysis ; Gastric Juice ; Gastric Mucosa ; Gastritis ; Gastritis, Atrophic ; Helicobacter pylori ; Humans ; Kidney Diseases ; Kidney Failure, Chronic* ; Peptic Ulcer ; Prevalence ; Upper Gastrointestinal Tract ; Urease

No abstract available.
Iliac Artery* ; Nephrosis, Lipoid* ; Thrombosis*

The authors evaluated the results of various operative methods for the treatment of axillary osmidrosis in 256 axillae of 132 patients. The methods studied herein are elliptical excision with(without Z-plasty, excision by modified W-plasty, undercutting of apocrine glands with preserving deep dermal vascular plexus (DDP) designed by the authors, undercutting of apocrine glands with ignoring deep dermal vascular plexus. With the undercutting methods, the skin incision was made by three different ways ', single vertical line, double vertical lines or single horizontal line in respect to the long axis of axillary vault. The results were as follows: 1. In the undercutting methods the stitch removals were done earlier than those of the excision methods by 3 to 8 days. The earliest stitch removal was in the undercutting methods with preservation of DDP done by single vertical incision (UPS). 2. Operative complications (wound disruption, flap necrosis or hematoma) occured in 12.9%. The wound disruption was main complication in the excision methods, the hematoma and flap necrosis in the undercutting methods. In the undercutting methods flap necrosis was seen only when DDP was ignored. 3. 123 axillae were followed up for more than 6 months after the operations. Among these the widely extended scars were seen in 94% of simple elliptical excisions(31 cases) and in 100% of excision with Z-plasty(16 cases) or modified W-plasty(3 cases). In the undercutting methods the scars were linear or invisible and best in UPS. 4. Success rate for the eradication of the malodor showed somewhat better results with undercutting methods compared with excisionmethods, but there was no statistical differences between the different groups. 5. In 6 axillae with the undercutting methods, histological examinations were done after more than three months. Apocrine glands were not seen in all the specimens. But some of them showed eccrine glands.
Apocrine Glands ; Axilla ; Axis, Cervical Vertebra ; Cicatrix ; Eccrine Glands ; Hematoma ; Humans ; Necrosis ; Skin ; Wounds and Injuries

Sixteen cases of congenital hemangiomata were treated with intralesional corticosteroid injectinn and followed up for 3 to 48 months. They consisted of 9 cases of strawberry hemangiomata with soft consistency, 4 cases of strawbery hemangiomata with firm consistency and 3 cases of cavernous hemangiomata. The results were as follows : 1) All the soft strawberry hemangiomata showed excellent response with marked shrinkage by single treatment. 2) The firm strawberry hemangiomata showed poor response with visible shrinkage after five times treatment, in average. 3) Among three cases of cavernous hemangiomata, one case with large palpable blood vessels in the lesion showed poor response, and two cases without palpable blood vessels in the lesion showed good response. 4) Temporary atrophy and pallor of the skin color were noticed in about half of the cases. Considering the concern of the patients parents, course of the hemangiomata., and the simplicity and effects of the treatment, this therapeutic method is regarded useful in the management of congenital hemangiomata, especially in soft st r awberry hemangiomata.
Atrophy ; Blood Vessels ; Fragaria ; Humans ; Pallor ; Parents ; Skin