No abstract available.
Chromosome Aberrations*

Therapeutic plasma exchange is used in almost every condition in which there is a plasma factor thought possibly to the etiology or pathogenesis of a disease or one of its manifestations. In order to evaluate plasma exchange using fresh frozen plasma as replacement solution, eighty four therapeutic plasma exchanges were carried out in eighteen patients. In standardized procedures, 1.5 times the calculated plasma volume was replaced with a Hartman's solution and fresh frozen plasma. Anticoagulation was achieved using a whole venous blood to 2.5% trisodium citrate in the ratio of 10 to 1. Total calcium, phosphorus, glucose, urea nitrogen, creatinine, bilirubin, alkaline phosphatase, amylase, creatine kinase, IgG, C3, total white and red blood cell count, hemoglobin, and differential count were not significantly affected by the procedure. In contrast, serum cholesterol, total protein, albumin, aspartate aminotransferase, alanine aminotransferase, ionized calcium, IgM, C4 and platelet were significantly decreased by the plasma exchange. All these measurements had returned to the first pre-exchange level within 24 hours, while the C4 and platelet count took between 24 and 72 hours, and the IgM level, between 72 hours and 1 week. These data indicated that in an isovolemic plasma exchange there was a transient but rapidly reversible effect on all the components studied, with C4 and platelet count, returning more slowly to pre-exchange level than the others, and IgM levels responding the slowest. In summary, plasma exchanges using fresh frozen plasma as replacement solution were assumed to be not significantly affected the function of various organs.
Alanine Transaminase ; Alkaline Phosphatase ; Amylases ; Aspartate Aminotransferases ; Bilirubin ; Blood Platelets ; Calcium ; Cholesterol ; Citric Acid ; Creatine Kinase ; Creatinine ; Erythrocyte Count ; Glucose ; Humans ; Immunoglobulin G ; Immunoglobulin M ; Nitrogen ; Phosphorus ; Plasma Exchange* ; Plasma Volume ; Plasma* ; Platelet Count ; Urea

Although Malassezia furfur is normal skin flora causing superficial skin diseases, cases of fungemia have been reported recently in premature newborns or immunocompromised patients related to prolonged central venous catheterization for lipid supplementation. We report a case of M. furfur fungemia in a premature infant receiving intravenous lipid supplementation through central venous circulation. She was treated only with antifungal agents without removal of the catheter or discontinuation of lipid supplementation. Soon after, symptoms and signs of the patient seemed to be improved. However, central venous catheter was removed because of recurrent septicemia of Staphylococcus aureus and the culture of central venous catheter tip showed colonization of M. furfur.
Antifungal Agents ; Catheterization, Central Venous ; Catheters ; Central Venous Catheters* ; Colon ; Fungemia* ; Humans ; Immunocompromised Host ; Infant, Newborn ; Infant, Premature ; Malassezia* ; Sepsis ; Skin ; Skin Diseases ; Staphylococcus aureus

The diagnosis of acute undifferentiated leukemia is made when the leukemic cells cannot be classified using morphologic and cytochemical analyses, and do not express myeloid or lymphoid antigens. Trisomy 13 is a rare primary chromosomal abnormality in acute leukemia and associated with lineage inconsistency and poor prognosis. We report a rare case of acute undifferentiated leukemia showing negativity in periodic acid-Schiff (PAS) and myeloperoxidase (MPO) without any lineage-specific cell surface marker expression and having trisomy 13. The patient was a 72- year-old male who visited our hospital because of anemia and general weakness. On examination, leukocytosis with proliferated blasts (76%) in peripheral blood was noted. Bone marrow aspirate showed blast proliferation (74%) with morphologically hand-mirror type. The blast expressed CD34 (96%) and HLA-DR (76%) in immunophenotyping. Cytogenetic study of bone marrow cells showed 46,XY,+13,-21[15]/46,XY[5]. Induction chemotherapy was failed and differentiation to monocytic series was noted.
Anemia ; Bone Marrow ; Bone Marrow Cells ; Chromosome Aberrations ; Cytogenetics ; Diagnosis ; HLA-DR Antigens ; Humans ; Immunophenotyping ; Induction Chemotherapy ; Leukemia* ; Leukocytosis ; Male ; Peroxidase ; Prognosis ; Trisomy*

BACKGROUND: Streptococcus pneumoniae is one of the most common pathogens of communityacquired pneumonia (CAP) which needs rapid diagnosis and appropriate therapeutic approaches. We evaluated a new rapid urinary antigen test kit, NOW S. pneumoniae antigen test (Binax Inc., Maine, USA), for the detection of the S. pneumoniae antigen in the urine of patients who were suspected of CAP. METHODS: A total of 115 urine samples were tested during April to July, 2004. Patients were divided into 2 groups: the first was the patients who were suspected of CAP and the second was the patients with other disorders. Urinary antigen test was performed done by immunochromatographic methods and results were read within 15 minutes. All the urine samples were random and unconcentrated. The patients were reviewed clinically, together with the results of sputum and blood cultures, urinalysis and other laboratory tests. RESULTS: Overall mean age was 62-years old and male proportion was 59%: Group 1 had mean age of 63-years old and male 54% whereas group 2 had 60-years old and 76%. S. pneumoniae antigen was detected in the urine from 14 (12.2%) of 115 patients. Of the 14 patients with positive urinary antigen tests, 12 were from 90 patients with CAP with fever, leukocytosis and appropriate radiological findings, giving the sensitivity of 13.3%; the remaining 2 patients were from 25 patients with other disorders. Only 2 of the 12 patients showed S. pneumoniae in sputum or blood cultures, respectively. Urinary antigen was not detected in 23 of the 25 patients with other disorders, giving the specificity of 92%. CONCLUSIONS: Since this simple and rapid urinary antigen test showed low sensitivity in this study, the clinical symptoms and signs and radiological findings of patients should be reviewed together with the results of the urine test for early and accurate diagnosis and treatment, consistent clinical symptoms and signs with radiological studies are inevitable. Thus further studies would be necessary. The urinary antigen test showed high specificity and therefore should be a useful adjunct to cultures to be in aid of the diagnosis of CAP.
Diagnosis* ; Fever ; Humans ; Leukocytosis ; Maine ; Male ; Middle Aged ; Pneumonia ; Pneumonia, Pneumococcal* ; Sensitivity and Specificity ; Sputum ; Streptococcus pneumoniae ; Urinalysis

PURPOSE: Since a significant number of patients with locally invasive bladder tumor(T3a/T3b) subsequently develop distant metastases, there have been lots of controversies in deciding treatment modalities. In the past decade, progress has been made in the development of effective chemotherapy for the treatment of advanced transitional cell carcinoma of the urothelium. Thus, we reviewed the effectiveness of the M-VAC(methotrexate, vinblastine, adriamycin, and cisplatin) chemotherapy for locally invasive transitional cell carcinoma (TCC) of the bladder. MATERIALS AND METHODS: We reviewed 36 patients who were diagnosed as T3a/T3b TCC and treated with aggressive transurethral resection of the bladder tumor(TURBt) and M-VAC chemotherapy Remission was defined in case of complete disappearance of the tumor or downstaging, and progression was defined in case of persistent disease or upstaging. RESULTS: Mean age of the patients was 60.4 years old(33 males; 3 females), and mean follow up was 12.2 +/- 8.9 months. Response rate considering loss of follow up according to the Kaplan-Meyer's method, was 79, 49, 44, 37% at 6, 12, 18, 24th month, respectively. Disease progressions were found in 19 patients during follow up, and the mean duration to progression was 9.2 +/- 5.0(1-19)months. 79% of the patients with disease progression showed progression within 12 months. Lymph node metastases or distant metastases were confirmed in 68% of progressed patients. CONCLUSIONS: M-VAC chemotherapy after aggressive TURBt is limited, but erective treatment modality, and it is also useful in deciding the prognosis of cancer with its responsiveness.
Carcinoma, Transitional Cell* ; Disease Progression ; Doxorubicin* ; Drug Therapy* ; Follow-Up Studies ; Humans ; Lymph Nodes ; Male ; Neoplasm Metastasis ; Prognosis ; Urinary Bladder Neoplasms ; Urinary Bladder* ; Urothelium ; Vinblastine*

BACKGROUND: Accumulating evidence shows that interleukin(IL)-1 plays a critical role in inflammation and connective tissue destruction observed in both osteoarthritis and rheumatoid arthritis. IL-1 induces gene expression related to cytokines, chemokines and matrix metalloproteinases by activation of many different transcription factors. MATERIALS AND METHODS: The chondrosarcoma cell line, SW1353, is known to be a valuable in vitro system for investigating catabolic gene regulation by IL-1beta in chondrocytic cells. To explore and analyze the changes in gene expression by IL-1 responsible for arthritis, SW1353 was treated with IL-1 for 1, 6 and 24 h and then total RNAs were purified for each time. The changes in gene expression were analyzed with 17k human cDNA microarrays and validated by semi-quantitative RT-PCR. RESULTS: Greater than a two-fold change was observed in 1,200 genes including metallothioneins, matrix metalloproteinases, extracellular matrix proteins, antioxidant proteins, cytoskeleton proteins, cell cycle regulatory proteins, proteins for cell growth and apoptosis, signaling proteins and transcription factors. These changes appeared to be correlate with the pathophysiological changes observed in early osteoarthritis. CONCLUSION: cDNA microarray analysis revealed a marked variability in gene expression, and provided insight into the overall molecular changes. The result of this study provide initial information for further studies to identify therapeutic targets in osteoarthritis pathogenesis.
Apoptosis ; Arthritis ; Arthritis, Rheumatoid ; Cell Cycle Proteins ; Cell Line ; Chemokines ; Chondrosarcoma* ; Connective Tissue ; Cytokines ; Cytoskeleton ; DNA, Complementary* ; Extracellular Matrix Proteins ; Gene Expression ; Humans* ; Inflammation ; Interleukin-1 ; Interleukin-1beta ; Interleukins* ; Matrix Metalloproteinases ; Metallothionein ; Microarray Analysis ; Oligonucleotide Array Sequence Analysis* ; Osteoarthritis ; RNA ; Transcription Factors

PURPOSE: To evaluate the efficacy of preoperative intravitreal bevacizumab (Avastin(R); Genetech, San Francisco, CA, USA) injections of pars plana vitrectomy (PPV) for proliferative diabetic retinopathy (PDR). METHODS: Thirty patients (30 eyes) who underwent PPV for treatment of PDR and received a preoperative intravitreal bevacizumab injection of 1.25 mg were retrospectively analyzed. The study group (group 1, 30 patients, 30 eyes) was compared with a control group (group 2, 29 patients, 30 eyes and matched with the study group for preoperative parameters) who underwent PPV without preoperative intravitreal bevacizumab injection. RESULTS: In both groups, visual acuity improved but there was no statistical significance. Intraoperative vitreous hemorrhage occurred in 14 eyes (46.7%) from group 1 and 11 eyes (36.7%) from group 2. There was no statistical significance of intraoperative bleeding occurrence (p=0.3). Postoperative vitreous hemorrhage occurred in 4 eyes from group 1 and 14 eyes from group 2. The group 1 had a lower incidence of postoperative hemorrhage than group 2 (p=0.005). CONCLUSIONS: Preoperative intravitreal bevacizumab injection appears effective in decreasing early postoperative vitreous hemorrhage and maybe technically helpful in PPV for PDR.
Antibodies, Monoclonal, Humanized ; Diabetic Retinopathy ; Eye ; Hemorrhage ; Humans ; Incidence ; Postoperative Hemorrhage ; Retrospective Studies ; San Francisco ; Visual Acuity ; Vitrectomy ; Vitreous Hemorrhage ; Bevacizumab

PURPOSE: To evaluate the efficacy of preoperative intravitreal bevacizumab (Avastin(R); Genetech, San Francisco, CA, USA) injections of pars plana vitrectomy (PPV) for proliferative diabetic retinopathy (PDR). METHODS: Thirty patients (30 eyes) who underwent PPV for treatment of PDR and received a preoperative intravitreal bevacizumab injection of 1.25 mg were retrospectively analyzed. The study group (group 1, 30 patients, 30 eyes) was compared with a control group (group 2, 29 patients, 30 eyes and matched with the study group for preoperative parameters) who underwent PPV without preoperative intravitreal bevacizumab injection. RESULTS: In both groups, visual acuity improved but there was no statistical significance. Intraoperative vitreous hemorrhage occurred in 14 eyes (46.7%) from group 1 and 11 eyes (36.7%) from group 2. There was no statistical significance of intraoperative bleeding occurrence (p=0.3). Postoperative vitreous hemorrhage occurred in 4 eyes from group 1 and 14 eyes from group 2. The group 1 had a lower incidence of postoperative hemorrhage than group 2 (p=0.005). CONCLUSIONS: Preoperative intravitreal bevacizumab injection appears effective in decreasing early postoperative vitreous hemorrhage and maybe technically helpful in PPV for PDR.
Antibodies, Monoclonal, Humanized ; Diabetic Retinopathy ; Eye ; Hemorrhage ; Humans ; Incidence ; Postoperative Hemorrhage ; Retrospective Studies ; San Francisco ; Visual Acuity ; Vitrectomy ; Vitreous Hemorrhage ; Bevacizumab

PURPOSE: The purpose of this study was to evaluate the success rate of dental implant on post-traumatic region to rehabilitate missing teeth. PATIENTS AND METHODS: 5 patients who had been treated due to maxillofacial trauma during 2000 to 2004 at samsung medical center were selected for this study. 22 dental implants were installed to them for restoring missing teeth. The success rate of these dental implants was evaluated with criteria by T. Albrektsson .We divided installed 22 implants into 2 categories. One category consisted rough surface implants group and smooth surface implants group. And the other category consisted more healing group and less healing group. The healing time was calculated from point of trauma. RESULTS: The success rate of dental implants is 68.2% that is lower than other studies because of poor vascularity of bone bed and mechanical stress according to trauma. Rough surface implants group and More healing group showed superior success rate to others. (P < 0.05) CONCLUSION: We found that to increase success rate, it may need rough surface implants and longer healing period.
Dental Implants* ; Humans ; Prognosis* ; Stress, Mechanical ; Tooth