BACKGROUND: Soluble IL-2R, soluble CD8 and TNF-alpha are elevated in sera of some patients with hematological malignancies, and a marked elevation of these cytokines could be used to assess disease activity and prognosis in this malignancy group. METHODS: The serum levels of sIL-2R, sCD8 and TNF-alpha were assessed in 28 patients with myelodysplastic syndrome (MDS) and 32 patients with acute myeloid leukemia (AML), and 39 cases of healthy control subjects to define clinical usefulness as prognostic markers by sandwich enzyme immunoassay. RESULTS: In MDS patients, serum sIL-2R levels were significantly higher as compared with controls, and a more pronounced increase of serum sIL-2R levels was found in patients with RAEB RAEB-t and CMML as compared with RA and RARS. Serum sCD8 levels were higher as compared with controls, but not related with FAB classification. In patients with leukemic conversion. sCD8 levels tended to be higher as compared with patients with non-conversion. The sIL-2R levels of AML patients were significantly higher than controls, and a significant correlation was detected between the levels of sIL-2R and WBC counts. Higher sIL-2R levels( >2000 U/ml) tended to affect both complete remission rate and survival. Serum sCD8 levels were higher than controls, but not related to FAB classification. No differences of serum TNF-alpha levels were detected as compared with healthy controls. CONCLUSIONS: From these results, this study indicates that serum sIL-2R and sCD8 are significantly increased in some patients with MDS and AML, and increased levels of serum sIL-2R and sCD8 may be useful for predicting prognosis of these patients.
Anemia, Refractory, with Excess of Blasts ; Classification ; Cytokines ; Hematologic Neoplasms ; Humans ; Immunoenzyme Techniques ; Leukemia, Myeloid, Acute* ; Myelodysplastic Syndromes* ; Prognosis ; Tumor Necrosis Factor-alpha*

PURPOSE: The purpose of this study was to evaluate the surgical results of balloon catheter dacryocystoplasty (DCP) for congenital nasolacrimal duct (NLD) obstruction in children and partial NLD obstruction in adults. METHODS: The authors performed balloon catheter DCP as a secondary treatment of eight children (nine lacrimal systems) over 12 months of age who had been failed by probing, and as a primary treatment of five adults (five lacrimal systems) whose lacrimal system was partially obstructed. In children, Lacricath was inflated at the level of the valve of Hasner and 5 mm proximal to that level, three times with eight atm (bars) for 90 seconds at each level. In adults, the procedure was the same for children, but if there is any doubt of common canalicular stenosis, inflation at that level was included. RESULTS: Seven of eight children (eight of nine lacrimal systems) and three of five adults (three of five lacrimal systems) showed objective and subjective improvement at the mean follow-up period of 5.3 months and 5.0 months, respectively. CONCLUSIONS: Balloon catheter DCP was thought to be an alternative to silicone tube intubation in children with NLD obstruction who had been failed by probing and also a useful primary treatment in adults with partial NLD obstruction in the office setting.
Adult* ; Catheters* ; Child* ; Constriction, Pathologic ; Follow-Up Studies ; Humans ; Inflation, Economic ; Intubation ; Nasolacrimal Duct ; Silicones

This study was designed to determine the effectiveness of transrectal ultrasonography compared with chain cystourethrography in stress urinary incontinence. The advantages of transrectal ultrasonography are that it is a simple. comfortable, noninvasive and quick out patient procedure. The diagnostic criteria of stress urinary incontinence are more than 146.6` in posterior urethrovesical angle, more than 1.02cm in bladder neck descent and more than 0.14cm in bladder neck opening. In conclusion, transrectal ultrasonography is a highly sensitive and specific method for the diagnosis of stress urinary incontinence.
Diagnosis ; Diagnostic Tests, Routine* ; Female* ; Humans ; Neck ; Ultrasonography* ; Urinary Bladder ; Urinary Incontinence*

This study was designed to determine the effectiveness of transrectal ultrasonography compared with chain cystourethrography in stress urinary incontinence. The advantages of transrectal ultrasonography are that it is a simple. comfortable, noninvasive and quick out patient procedure. The diagnostic criteria of stress urinary incontinence are more than 146.6` in posterior urethrovesical angle, more than 1.02cm in bladder neck descent and more than 0.14cm in bladder neck opening. In conclusion, transrectal ultrasonography is a highly sensitive and specific method for the diagnosis of stress urinary incontinence.
Diagnosis ; Diagnostic Tests, Routine* ; Female* ; Humans ; Neck ; Ultrasonography* ; Urinary Bladder ; Urinary Incontinence*

No abstract available.
Typhlitis*

OBJECTIVES: This study was conducted to review the diffusion process and factors affecting the adoption of the Health Center Information System (HIS). METHODS: Data were collected from POSDATA (private company), MOHW, other Ministries and local governments. To specify the date of adoption, supplementary information was collected from 40 health centers. The following three kinds of factors were analyzed. Internal factors included type, size, and innovativeness of health centers. Community factors were composed of population size, economic status, and level of education. Organizational environmental factors consisted of information score of the municipalities, financial support of the from central government, and the neighborhoodness of innovator health centers. RESULTS: All health centers in the metropolitan cities of Seoul, Gwangju and Jeju adopted the HIS. The laggards were those in the metropolitan cities of Busan (18.8%), Incheon (20.0%) and Daejun (20.0%), and cities with population more than 300, 000 (54.8%) and counties with health center hospitals (47.1%). Financially supported rural health centers adopted the HIS more rapidly than those not supported. The factors identified as being statistically significant (p< 0.05), from a univariate analysis by Kaplan-Meier method, were: (1) internal factors of the type, size and innovativeness of health centers; (2) community factors of population size and economic status; (3) organizational environmental factors of the central government financial support and the neighborhoodness of innovator health centers. A multivariate analysis, using a Cox proportional hazard method, proved the innovativeness of health centers, central government financial support and the neighborhoodness of innovator health centers, were statistically significant (p< 0.05). CONCLUSIONS: The innovativeness of health centers, financial support from central government and the neighborhoodness of innovator health centers, rather than community factors related to regional socioeconomic status, affected the adoption of the HIS in health centers. Further in-depth studies, modifying the MOHW's strategy to propagate the HIS to the laggard health centers, are recommended.
Busan ; Diffusion of Innovation ; Diffusion* ; Education ; Financial Support ; Gwangju ; Incheon ; Information Systems* ; Methods ; Multivariate Analysis ; Population Density ; Residence Characteristics ; Rural Health Services ; Seoul ; Social Class

Background/Aims: To assess the effects and safety of DA-9701 (Motilitone) in patients with constipation-type irritable bowel syndrome (IBS-C) whichfrequently accompany functional dyspepsia (FD). Methods: FD and IBS-C were diagnosed based on the Rome III criteria. Randomized subjects were administered 30 mg of DA-9701 or placebo 3times a day for 4 weeks. The study endpoints were evaluated the percentage of responders in the overall symptom evaluation of IBS-C and FD. Results: Thirty IBS-C patients and 30 placebos were prospectively enrolled. The proportion of responders with improvement in overall symptoms of IBS-C was 53.33% in the DA-9701 group and 40.00% in the placebo group (P = 0.301). Compared to the placebo group, the decrease of abdominal pain score in the DA-9701 group was significantly higher at week 3 in the DA-9701 group (0.96 ± 0.77 vs 0.55 ± 0.79, P = 0.042) but no significance at week 4. There was no significant difference in total IBS quality of life score at week 4 between the 2 groups (P = 0.897). Among patients with IBS-C accompanied by FD, the proportion of responders in the DA-9701 group was 50.00% (15/30), which was higher than 31.03% (9/29) of the placebo group (P = 0.138). Conclusions DA-9701 showed trend of treatment efficacy in patients with IBS-C and FD overlap including overall improvement, and safety,compared to placebo but without significance probably due to small numbers. It is suggested the need for a large-scale clinical trial toconfirm this preliminary effect of DA-9701.

No abstract available.
Animals ; Dizocilpine Maleate* ; Rats* ; Spinal Cord*

Recent studies have demonstrated that tumor necrosis factor-alpa(TNF-alpa) decreased production of type I and III procollagens and increased production of collagenase in cultured human dermal fibroblasts. The purpose of this study was to examine the effect of TNF-alpa on the level of expression of type I procollagen, collagenase mRNA in hypertrophic scar and keloid fibroblasts in culture. The cultured fibroblasts from normal skin, hypertrophic scar and keloid were exposed to 0, 1, 10, and 100 ng/ml of TNF-alpa for 24 hours. Then, type I procollagen mRNA and collagenase mRNA were measured by quantitative RT-PCR and quantified by computerized densitometry(TINA). In normal skin fibroblasts, TNF-alpa significantly decreased the level of type I procollagen mRNA and increased collagenase mRNA. The maximal inhibition for type I procollagen mRNA was noted at 100 ng/ml of TNF-alpa and maximal enhancement for collagenase mRNA was noted at 100ng/ml of TNF-alpa. In hypertrophic scar fibroblasts, TNF-alpa significantly decreased the level of type I procollagen mRNA and increased collagenase mRNA. The maximal inhibition for type I procollagen mRNA was noted at 100 ng/ml of TNF-alpa which was the same as normal skin fibroblasts but there were no significant differences among TNF-alpa treated groups for collagenase mRNA. In keloid fibroblasts, TNF-alpa also significantly decreased the level of type I procollagen mRNA and increased collagenase mRNA. The maximal inhibition for type I procollagen mRNA was noted at 100 ng/ml of TNF-alpa which was the same as normal skin and hypertrophic scar fibroblasts but there were no significant differences among TNF-alpa treated groups for collagenase mRNA. These results strongly suggested that TNF-alpa might have a role in preventing progression of fibroproliferative disease, such as hypertrophic scar or keloid, and that the most effective concentration of TNF-alpa was found in 100 ng/ml.
Cicatrix, Hypertrophic* ; Collagen Type I* ; Collagenases* ; Fibroblasts* ; Gene Expression* ; Humans ; Keloid* ; Necrosis* ; Procollagen ; RNA, Messenger ; Skin

PURPOSE: To report the surgical results of volar percutaneous cannulated compression screw fixation in subacute scaphoid fracture. MATERIALS AND METHODS: Between January 2004 and January 2007, eight consecutive patients with subacute scaphoid waist fracture, who sought medical attention between 4 weeks to 6 months after injury, were included in this study. All patients were male of an average age 29.2 years (range, 19 to 44). Mean duration of injury was 10.3+/-4.1 weeks. An acutrak cannulated screw (Acumed, Hillsboro, OR) was introduced volarly under image intensifier guidance in all patients. We performed radiological evaluation preoperatively and postoperatively. And we performed 12 months postoperatively using grip strength, range of motion (ROM) of the wrist, Mayo Modified Wrist Score (MMWS) and Disabilities of the Arm, Shoulder and the Hand (DASH) score for functional evaluation. RESULTS: Preoperative radiography showed minimal sclerosis line in three patients and a bone resorption around fracture sites in two patients. However, no patient had dorsal intercalated segment instability or more than 35 degrees of lateral intrascaphoid angle. Fractures united successfully at 11.6+/-2.1 weeks postoperatively without any requirement for a further procedure. At 12 months follow-up evaluations, ROM of the injured wrist was 93% of the uninjured wrist and grip strength of the injured wrist was 95% of the injured wrist. The mean MMWS was 93+/-6.6 and the mean DASH score was 4.8+/-1.2. CONCLUSION: We believe that volar percutaneous cannulated screw fixation is a reliable method in case of subacute scaphoid waist fracture without scaphoid deformity or carpal instability.
Arm ; Bone Resorption ; Congenital Abnormalities ; Follow-Up Studies ; Hand ; Hand Strength ; Humans ; Male ; Range of Motion, Articular ; Sclerosis ; Shoulder ; Wrist