Although active inflammation may be deleterious and indicate immunologic activation in chronically rejected grafts, the underlying mechanism of tissue destruction has been little studied. Twenty-four cases of chronic rejection (CR) with or without acute rejection (AR) were stained with antibodies against CD3, CD8, CD68, granzyme B and TIA-1, and the number of positive cells were counted. Eleven cases of AR served as controls. The number of CD3 and CD8 positive cells increased in the acute on CR group compared to the CR group. About a half of CD3 positive T cells were CD8 positive in both groups, however, the proportion of TIA-1 or granzyme B positive cells was higher in the acute on CR group. The numbers of CD3, CD68, granzyme B and TIA-1 positive cells were higher in the AR group than the acute on CR group, however, no significant difference was found between the two groups. Serum creatinine level and proteinuria at the time of biopsy and the percentages of late onset AR and graft failure rate were higher in the acute on CR group than the CR group. Summarizing, these results suggest that infiltration of activated T cells containing cytotoxic granules plays a role in graft destruction in acute on CR.
Adult ; Antigens, CD3/analysis ; Antigens, CD8/analysis ; Female ; Follow-Up Studies ; *Graft Rejection ; Human ; Immunohistochemistry ; *Kidney Transplantation ; Male ; Membrane Proteins/*analysis ; RNA-Binding Proteins/*analysis ; Serine Endopeptidases/*metabolism ; Transplantation, Homologous

Transplant glomerulopathy (TG) is a special form of glomerular injury in renal allografts. It affects varying proportions of glomeruli, which may have an influence on the amount of proteinuria or graft survival. We reviewed 32 cases of TG to evaluate histologic changes and graft outcome. The severity of TG as well as acute and chronic changes of the glomerular, tubulointerstitial and vascular compartment were scored according to Banff classification. There were 17 cases of cg1, 3 cases of cg2 and 12 cases of cg3. There was no significant difference in age, duration of transplant at time of biopsy and duration of follow-up between groups. Serum creatinine level and the degree of proteinuria were higher in cg3 and statistically significant. However, there was no difference in the degree of glomerulosclerosis, interstitial inflammation, fibrosis, tubular atrophy or vascular wall thickening between groups. Graft failure was present in 13 cases, mostly due to chronic rejection including sepsis and CMV infection in one case each. Five-year graft survival was 84.1% and was not significantly different from cases without TG. In conclusion, the severity of TG indicates profuse proteinuria, but does not affect graft outcome, which indicates tubulointerstitial and vascular pathology as being a more important prognosticator.
Allografts ; Atrophy ; Biopsy ; Classification ; Creatinine ; Fibrosis ; Follow-Up Studies ; Graft Survival* ; Inflammation ; Pathology ; Proteinuria* ; Sepsis ; Transplants*

PURPOSE: The smoking rates among teenagers in Korea grow gradually since 1980s despite of the numerous programs for youth smoking prevention and cessation have been developed and implemented. The purpose of this study was to explore and describe the processes of habituating to smoking among teenagers using the grounded theory methodology. METHOD: Qualitative data was collected via six focus group interviews. A total of 38 people, twelve teachers and 24 middle school students participated in this study. All focus group interviews were tape-recorded, transcribed, and analyzed according to the grounded theory methodology. RESULTS: The overriding theme of the elicited grounded theory was "stepping into a quagmire by a merest chance". The student participants began smoking by a simple chance. The contingent factors to starting smoking were "discord within the family", "family member's smoking", "schoolwork stresses", or "a rebellious spirit". The conditions of smoking included accessibility, going around in group, and the lack of discipline. "Stigmatizing", "involved in mob violence", and "making a poor academic record" coexisted as the covariance of the smoking habituation. CONCLUSION: The findings of this study illustrated the comprehensive and insightful picture of the phenomena under investigation. Nursing implications and further directions for research were discussed.
Adolescent* ; Focus Groups ; Humans ; Korea ; Nursing ; Smoke* ; Smoking* ; Tobacco Products

Kidney transplantation using living donors has been performed in our hospital since the very start in 1979. In recent years, we have expanded living donor pool, including unrelated one, because the number of cadaveric donors is insufficient. A very important issue in living kidney donor transplantation is whether the donation is safe or not for the donor. The aim of this study was to examine the long-term impact of uninephrectomy on the renal function, blood pressure, and proteinuria in living kidney donors. We could followed 59 donors who had donated a kidney more than 10 years ago. Among these 59 donors, 19 donors visited hospital and were undertaken physical examination and laboratory evaluation. We checked blood pressure, BUN/creatinine, 24 hours urine protein, and creatinine clearance to these donors. The rest 40 donors were traced by telephone survey for medical history and survival. The mean duration of follow-up were 12.8 +/-2.6 and 13.2+/- 2.5 years, respectively in both group of the donors. The mean age at last follow-up were 44.3+/- 11.2 and 46.7+/- 11.1 years old, respectively. Actually 2 patients proved to have well controlled hypertension with anti-hypertensive medications. Mean values of systolic and diastolic blood pressure were 129+/- 19 and 82+/- 11 mmHg in 19 donors, which showed no difference from general population compared with nationwide survey of blood pressure. There were no difference of BUN/creatinine, 24 hours urine protein, and creatinine clearance between pre-nephrectomy and follow-up values. There was one patient death in the telephone surveyed group, who died of stomach cancer. No body had specific medical illness and took hypertensive medication in the telephone surveyed group. We could not demonstrate any deterioration of renal function and development of uninephrectomy induced hypertension in living kidney donor more than 10 years after kidney donation.
Blood Pressure ; Cadaver ; Creatinine ; Follow-Up Studies* ; Humans ; Hypertension ; Kidney Transplantation ; Kidney* ; Living Donors ; Physical Examination ; Proteinuria ; Stomach Neoplasms ; Telephone ; Tissue Donors*

X-linked agammaglobulinemia is attributed to the genetic defect for Bruton's tyrosine kinase at Xq22 region and the developmental arrest of pre-B lymphocytes. The characteristics of the disease are as follows; 1) male sex, 2) onset in infancy or early childhood, 3) severe panhypogammaglobulinemia, 4) normal cell mediated immunity, 5) recurrent, hardly controlled infection. The most common sites of infection are the respiratory tract and the gastrointestinal tract. The disease must be suspected when the recurrent, hardly controlled infection or the unusual, multiple sites of infection are present. Regular intravenous immune globulin approved the preventive effect against severe infection and fatal complication. But the final outcome remains grave in spite of intensive care. We report an adult case, 20 years old male patient, of X-linked agammaglobulinemia. He has been suffered from recurrent pneumonia and other sites of infection including meningitis and cellulitis. Pseudomonas aeruginosa was cultured from blood. X-linked agammaglobulinemia was diagnosed based on clinical history, severe panhypogammagloblinemia, lack of the gamma-fraction on the serum protein electrophoresis and absence of B-lymphocytes in peripheral blood. The clinical course waxed and waned until intravenous infusion of immune globulin, which dramatically improved pneumonia.
Adult ; Agammaglobulinemia* ; B-Lymphocytes ; Cellulitis ; Electrophoresis ; Gastrointestinal Tract ; Humans ; Immunity, Cellular ; Immunoglobulins, Intravenous ; Infusions, Intravenous ; Critical Care ; Male ; Meningitis ; Pneumonia ; Precursor Cells, B-Lymphoid ; Protein-Tyrosine Kinases ; Pseudomonas aeruginosa ; Respiratory System ; Young Adult

OBJECTIVES: This study examined the effect of 2% chlorhexidine on the microTBS of a direct composite restoration using one-step self-etch adhesives on human dentin. MATERIALS AND METHODS: Twenty-four extracted permanent molars were used. The teeth were assigned randomly to six groups (n = 10), according to the adhesive system and application of chlorhexidine. With or without the application of chlorhexidine, each adhesive system was applied to the dentin surface. After the bonding procedure, light-cure composite resin buildups were produced. The restored teeth were stored in distilled water at room temperature for 24 hours, and then cut and glued to the jig of the microtensile testing machine. A tensile load was applied until the specimen failed. The failure mode was examined using an operating microscope. The data was analyzed statistically using one-way ANOVA, Student's t-test (p < 0.05) and Scheffe's test. RESULTS: Regardless of the application of chlorhexidine, the Clearfil S3 Bond showed the highest microTBS, followed by G-Bond and Xeno V. Adhesive failure was the main failure mode of the dentin bonding agents tested with some samples showing cohesive failure. CONCLUSIONS: The application of 2% chlorhexidine did not affect the microTBS of the resin composite to the dentin using a one-step self-etch adhesive.
Adhesives ; Chlorhexidine ; Dental Cements ; Dentin ; Dentin-Bonding Agents ; Humans ; Methacrylates ; Molar ; Resin Cements ; Tooth ; Water

This study was designed to determine the protective effect of Rumex Aquaticus Herba extracts containing quercetin-3-beta-D-glucuronopyranoside (ECQ) on experimental reflux esophagitis. Reflux esophagitis was induced by surgical procedure. The rats were divided into seven groups, namely normal group, control group, ECQ (1, 3, 10, 30 mg/kg) group and omeprazole (30 mg/kg) group. ECQ and omeprazole groups received intraduodenal administration. The Rats were starved for 24 hours before the experiments, but were freely allowed to drink water. ECQ group attenuated the gross esophagitis significantly compared to that treated with omeprazole in a dose-dependent manner. ECQ decreased the volume of gastric juice and increased the gastric pH, which are similar to those of omeprazole group. In addition, ECQ inhibited the acid output effectively in reflux esophagitis. Significantly increased amounts of malondialdehyde (MDA), myeloperoxidase (MPO) activity and the mucosal depletion of reduced glutathione (GSH) were observed in the reflux esophagitis. ECQ administration attenuated the decrement of the GSH levels and affected the MDA levels and MPO activity. These results suggest that the ECQ has a protective effect which may be attributed to its multiple effects including anti-secretory, anti-oxidative and anti-inflammatory actions on reflux esophagitis in rats.
Animals ; Control Groups ; Esophagitis ; Esophagitis, Peptic ; Gastric Juice ; Glutathione ; Hydrogen-Ion Concentration ; Malondialdehyde ; Omeprazole ; Peroxidase ; Rats ; Rumex ; Water

It is well-known that electrical field stimulation (EFS)-induced contraction is mediated by a cholinergic mechanism and other neurotransmitters. NO, ATP, calcitonin gene-related peptide (CGRP), and substance P are released by EFS. To investigate the purinergic mechanism involved in the EFS-induced contraction, purinegic receptors antagonists were used. Suramine, a non-selective P2 receptor antagonist, reduced the contraction induced by EFS. NF023 (10(-7)~10(-4) M), a selective P2X antagonist, inhibited the contraction evoked by EFS. Reactive blue (10(-6)~10(-4) M), selective P2Y antagonist, also blocked the contraction in a dose-dependent manner. In addition, P2X agonist alpha,beta-methylene 5'-adenosine triphosphate (alphabetaMeATP, 10(-7)~10(-5) M) potentiated EFS-induced contraction in a dose-dependent manner. P2Y agonist adenosine 5'-[beta-thio]diphosphate trilithium salt (ADPbetaS, 10(-7)~10(-5) M) also potentiated EFS-induced contractions in a dose-dependent manner. Ecto-ATPase activator apyrase (5 and 10 U/ml) reduced EFS-induced contractions. Inversely, 6-N,N-diethyl-D-beta,gamma-dibromomethylene 5'-triphosphate triammonium (ARL 67156, 10(-4) M) increased EFS-induced contraction. These data suggest that endogenous ATP plays a role in EFS-induced contractions which are mediated through both P2X-receptors and P2Y-receptors stimulation in cat esophageal smooth muscle.
Adenosine ; Adenosine Triphosphatases ; Adenosine Triphosphate ; Animals ; Apyrase ; Calcitonin Gene-Related Peptide ; Calcium ; Cats ; Contracts ; GTP-Binding Proteins ; Muscle, Smooth ; Neurotransmitter Agents ; Polyphosphates ; Substance P ; Suramin

Congenital Abnormalities ; Facial Asymmetry ; Humans ; Imaging, Three-Dimensional ; Lip ; Mouth ; Orthognathic Surgery ; Osteotomy

PURPOSE: To evaluate the MR findings of septic thrombosis of the cavernous sinus. MATERIALS AND METHODS: Eleven MR images of six patients with septic cavernous sinus thrombosis obtained over a five-year period and proven clinically or radiologically were retrospectively reviewed. The contour and enhancement pattern of the cavernous sinus, changes in the internal carotid artery, orbit, pituitary gland and sphenoid sinus, and intracranial abnormalities were analyzed and compared with the findings of follow-up studies. RESULTS: In all six patients, contrast study revealed asymmetrical enlargement of the ipsilateral cavernous sinus and multiple irregular filling defects within it. Narrowing of the cavernous portion of the ipsilateral internal carotid artery was noted in five patients, upward displacement of the ipsilateral internal carotid artery in four, ipsilateral proptosis with engorgement of the superior ophthalmic vein in two, pituitary enlargement in five, and inflammatory change in the sphenoid sinus in six. Associated intracranial abnormalities included edema and enhancement in the meninx, temporal lobe, or pons adjacent to the cavernous sinus in four patients, hydrocephalus in one, and cerebral infarction in one. Follow-up MR imaging indicated that the extent of asymmetrical enlargement of the cavernous sinus, filling defects within it, as seen on contrast study, and enlarged pituitary glands had all decreased, without significant interval change. CONCLUSION: MR imaging is useful in the diagnosis of septic cavernous sinus thrombosis. Asymmetrical enlargement of the cavernous sinus, multiple irregular filling defect within it, as seen on contrast study, and changes in the internal carotid artery are characteristic findings.
Carotid Artery, Internal ; Cavernous Sinus Thrombosis* ; Cavernous Sinus* ; Cerebral Infarction ; Diagnosis ; Edema ; Exophthalmos ; Follow-Up Studies ; Humans ; Hydrocephalus ; Magnetic Resonance Imaging ; Orbit ; Pituitary Gland ; Pons ; Retrospective Studies ; Sphenoid Sinus ; Temporal Lobe ; Thrombophlebitis ; Thrombosis ; Veins