No abstract available.
Empyema* ; Fistula*

PURPOSE: Klotho mutant mice showed abnormal calcium and vitamin D metabolism, hyperphosphatemia and vascular calcification. We observed the frequencies of klotho gene polymorphism and investigated their relation with some clinical parameters including serum osteoprotegerin (OPG) levels in maintenance hemodialysis (HD) patients. METHODS: Total 88 patients (mean age 58+/-13 years, male:female=47:41) on maintenance HD were enrolled. The genotypings for G-395A in promoter and C1818T in exon 4 of klotho gene were performed with real-time polymerase chain reaction. We measured blood pressure, body mass index (BMI), and serum calcium, phosphorus, parathyroid hormone (PTH), alkaline phosphatase, hs-CRP, lipid profiles and OPG. RESULTS: In G-395A in promoter, the distribution of genotypes was GG 66% (n=58), GA 23% (n=20) and AA 11% (n=10), respectively and the allele frequencies were 0.773 for G allele and 0.227 for A allele. In C1818T in exon 4, the distribution of genotypes was CC 63% (n=55), CT 30% (n=26), and TT 7% (n=7), and the frequencies were 0.773 for C allele and 0.227 for T allele. G-395A shows correlations with BMI and HDL-cholesterol (p<0.005). G-395A and C1818T in klotho gene show no statistical correlation with other clinical parameters of vascular calcification including OPG. CONCLUSION: Klotho G-395A and C1818T polymorphisms are not correlated with OPG in maintenance HD patients. Further research needs for the other klotho polymorphisms on chronic kidney disease and end-stage renal disease.
Alkaline Phosphatase ; Alleles ; Animals ; Blood Pressure ; Body Mass Index ; Calcium ; Exons ; Gene Frequency ; Genotype ; Glucuronidase ; Humans ; Hyperphosphatemia ; Mice ; Osteoprotegerin ; Parathyroid Hormone ; Phosphorus ; Real-Time Polymerase Chain Reaction ; Renal Dialysis ; Renal Insufficiency, Chronic ; Vascular Calcification ; Vitamin D

The lung nodule is one of the pleuropulmonary menifestations in rheumatoid arthritis. We report here a case exhibiting hydropneumothorax due to a bronchoplerual fistula resulting from a ruptured rheumatoid lung nodule complicated with a aspergilloma in it. A 39 year-old man with rheumatoid arthritis was admitted because of cough for one month. Multiple subcutaneous nodules were noted and multiple lung nodules were seen on chest X-ray, Peripheral white cells were 9,600/mm3 with 1896 of eosinophils. The percutaneous needle aspiration biopsy of the largest lung nodule of right upper lobe showed massive necrosis without acid fast bacillus, fungus, or malignant cell. Three months after discharge, air-meniscus sign was seen on the biopsied lung nodule on X-ray. Five months later, the patient was readmitted due to dyspnea and chest pain and simple chest X-ray showed hydropneumothorax on the right side. The pneumothorax was not healed after closed thoracotomy and tube drainage, and high fever developed. The pleural fluid culture revealed Pseudomonas aeroginosa and Aspergillus fumigatus. Seventy days after admission, exploratory thoracotomy was done. Aspergilloma was found in the cavitated lung nodule which was ruptured into the pleural cavity through bronchopleural fistula.
Adult ; Arthritis, Rheumatoid* ; Aspergillus fumigatus ; Bacillus ; Biopsy, Needle ; Chest Pain ; Cough ; Drainage ; Dyspnea ; Eosinophilia* ; Eosinophils ; Fever ; Fistula* ; Fungi ; Humans ; Hydropneumothorax ; Lung* ; Necrosis ; Needles ; Pleural Cavity ; Pneumothorax ; Pseudomonas ; Thoracotomy ; Thorax

Small cell carcinoma in the ampulla of Vater is rare, and the concurrent occurrence of adenocarcinoma and small cell carcinoma is extremely rare. We report the case of a double primary tumor, adenocarcinoma and small cell carcinoma, in the ampulla of Vater.
Adenocarcinoma ; Ampulla of Vater ; Carcinoma, Small Cell

No abstract available.
Animals ; Dogs* ; Heart* ; Heart-Lung Transplantation*

OBJECTIVE: Many recent reports have shown that the mature mammalian brain harbors multipotent stem cells, rendering the brain capable of generating new neurons and glia throughout life. Harvested stem cells from an adult rat are transplanted in order to evaluate the cell survival and differentiation. METHODS: Using a percoll gradient with a high speed centrifugation method, we isolate neural stem/progenitor cells were isolated from the subventricular zone(SVZ) of a syngeneic adult Fisher 344 rats brain. For 14days expansion, the cultured cells comprised of a heterogeneous population with the majority of cells expressing nestin and/or GFAP. After expanding the SVZ cells in the presence of basic fibroblast growth factor-2, and transplanting then into the hippocampus of normal rats, the survival and differentiation of those cells were examined. For transplantation, the cultured cells were labeled with BrdU two days prior to use. In order to test their survival, the cells were transplanted into the dorsal hippocampus of normal adult Fisher 344 rats. RESULTS: The preliminary data showed that at 7days after transplantation, BrdU+ transplanted cells were observed around the injection deposition sites. Immuno-fluorescent microscopy revealed that the cells co-expressed BrdU+ and neuronal marker beta-tubulin III. CONCLUSION: The data demonstrate that the in vitro expanded SVZ cells can survive in a heterotypic environment and develop a neuronal phenotype in the neurogenic region. However more research will be needed to examine the longer survival time points and quantifying the differentiation in the transplanted cells in an injured brain environment.
Adult* ; Animals ; Brain* ; Bromodeoxyuridine ; Cell Survival* ; Cells, Cultured ; Centrifugation* ; Fibroblast Growth Factor 2 ; Hippocampus ; Humans ; Microscopy ; Multipotent Stem Cells ; Nestin ; Neural Stem Cells ; Neuroglia ; Neurons ; Phenotype ; Rats* ; Stem Cells ; Transplantation ; Tubulin

PURPOSE: It is necessary to confirm of the reliability and the validity of health-related quality of life (HRQOL) methods, because there could be some difference according to the underlying diseases, languages and cultures. METHODS: To assess the reliability, we did the test-retest by using the WHO-QOL (Korean version) and the SF-36 (Korean version) in the maintain hemodialysis (HD) patients (N=57). And then, we measured the Cronbach coefficient in the domains of both HRQOL methods. To assess the validity, we compared the result of both HRQOL methods in HD group with control group (N=60). We analyzed the inter-relationship of the domains which keep identical meanings in both methods. RESULT: 1. The test-retest showed high correlation between two tests, except the two domains of SF- 36 which are the role limitation-physical activity (RP) domain and the role limitation-emotion (RE) domain. The Cronbach coefficients are range of 0.749-0.862 in the WHO-QOL, and 0.666-0.944 in the SF-36 (p<0.05). 2. We found that HRQOL of HD group was lower than that of control group except in the RP domain and the RE domain of SF-36. And there was the highest correlation between the domains which keep identical meaning of both HRQOL methods. CONCLUSION: The Korean WHO-QOL and SF-36 are reliable and valid to measure the QOL of ESRD patients except in the RP domain and the RE domain of SF-36. We expect these methods will be used easily in the evaluation of the HRQOL in HD patients.
Humans ; Kidney Failure, Chronic ; Quality of Life ; Renal Dialysis

OBJECTIVE: Upper-body fat distribution, hyperhomocysteinemia and a depletion in antioxidant status are considered risk factors for atherosclerosis and these factors are related to alcohol consumption and cigarette smoking. The purpose of this study was to determine the influence of alcohol consumption and smoking habits on cardiovascular risk factors in healthy men by using a cross-sectional design. METHODS: Smokers were defined as heavy smokers when they smoked more than 15 cigarettes per day. Group subdivision of drinkers were none, moderate (10-25g alcohol/d) and heavy(>25g alcohol/d) alcohol consumption. Subjects were divided into 6 groups: nondrinker-nonsmoker(n=33), nondrinker-heavy smoker (n=11), moderate drinker-nonsmoker (n=46), moderate drinker- heavy smoker(n=33), heavy drinker-nonsmoker (n=14) and heavy drinker-heavy smoker(n=15). Adipose tissue and muscle areas were calculated from computed tomography scans made at four body levels, first and forth lumbar vertebrae, mid portion of thigh and calf. Fasting serum levels of lipids, proteins, hormones and antioxidants and plasma level of homocysteine were determined. RESULTS: Heavy drinker-heavy smokers showed similar intake of daily calorie and protein to other groups and 65% of them supplemented their diet with synthetic vitamin preparation. Heavy drinker-nonsmokers(36g/d) consumed nearly twice as much alcohol as moderate drinkers(16-18g/d) and heavy drinker-heavy smokers (53g/d) nearly three times as much. In comparison with non and moderate drinker-heavy smokers, heavy drinker-heavy smokers smoked more cigarettes(19 vs 26 cigarettes/d, p<0.05). Although there were no differences among 6 groups in means of age, body mass index, blood pressure and serum GOT and GPT levels, heavy drinkers showed the highest mean value of waist to hip ratio and subcutaneous fat area at first and forth lumbar vertebrae. Heavy drinker-heavy smokers showed higher serum levels of triglyceride and HDL-cholesterol but lower serum levels of transferrin and IGF-1, compared with nondrinkers. Plasma homocysteine level was higher in heavy drinker-heavy smokers than in nondrinker- nonsmokers. Serum levels of beta-carotene, cryptoxanthin and lycopene in heavy smokers or heavy drinkers showed a decrease by about 50% of those in men who did not drink and smoke and these levels were the lowest in heavy drinker-heavy smokers among 6 groups. CONCLUSION: Our results show that heavy alcohol consumption can result in abdominal obesity, hypertriglyceridemia and a decrease in serum carotenoid levels, even though it can cause an increase in HDL-cholesterol level. In addition, a further decrease in serum carotenoids and an increase in plasma homocysteine level in heavy drinker-heavy smokers indicate the increased risk for atherosclerosis in the simultaneous heavy consumption of alcohol and cigarette.
Adipose Tissue ; Alcohol Drinking* ; Antioxidants ; Atherosclerosis ; beta Carotene ; Blood Pressure ; Body Mass Index ; Carotenoids ; Diet ; Fasting ; Homocysteine ; Humans ; Hyperhomocysteinemia ; Hypertriglyceridemia ; Insulin-Like Growth Factor I ; Lumbar Vertebrae ; Male ; Obesity, Abdominal ; Plasma ; Risk Factors* ; Smoke* ; Smoking* ; Subcutaneous Fat ; Thigh ; Tobacco Products ; Transferrin ; Triglycerides ; Vitamins ; Waist-Hip Ratio

Background/Aims: Frailty increases the risks of in-hospital adverse events such as delirium, falls, and functional decline in older adults. We assessed the feasibility and clinical relevance of frailty status in Korean older inpatients using the Clinical Frailty Scale (CFS) and Korean version of the Fatigue, Resistance, Ambulation, Illnesses, & Loss of Weight scale (K-FRAIL) questionnaires. Methods: Frailty status was measured using the Korean-translated version of the CFS and K-FRAIL questionnaire within 3 days from admission in 144 consecutive patients aged 60 years or older. The correlation between CFS and K-FRAIL score was assessed. The criterion validity of CFS was assessed using receiver operating characteristic analysis. As outcomes, delirium, bedsore, length of stay (LOS), in-hospital mortality, and unplanned 30-day readmission were measured by reviewing medical records. Results: The mean age of the study population was 70.1 years (range, 60 to 91), and 75 (52.1%) were men. By linear regression analysis, CFS and K-FRAIL were positively correlated (B = 0.72, p < 0.001). A CFS cutoff of ≥ 5 maximized sensitivity + specificity to classify frailty using K-FRAIL as a reference (C-index = 0.893). Higher frailty burden by both CFS and K-FRAIL was associated with higher LOS and bedsores. Unplanned readmission and in-hospital mortality were associated with higher CFS score but not with K-FRAIL score, after adjusting for age, gender, polypharmacy, and multimorbidity. Conclusions Frailty status by CFS was associated with LOS, bedsores, unplanned readmission, and in-hospital mortality. CFS can be used to screen high-risk patients who may benefit from geriatric interventions and discharge planning in acutely hospitalized older adults.

Background/Aims: Frailty increases the risks of in-hospital adverse events such as delirium, falls, and functional decline in older adults. We assessed the feasibility and clinical relevance of frailty status in Korean older inpatients using the Clinical Frailty Scale (CFS) and Korean version of the Fatigue, Resistance, Ambulation, Illnesses, & Loss of Weight scale (K-FRAIL) questionnaires. Methods: Frailty status was measured using the Korean-translated version of the CFS and K-FRAIL questionnaire within 3 days from admission in 144 consecutive patients aged 60 years or older. The correlation between CFS and K-FRAIL score was assessed. The criterion validity of CFS was assessed using receiver operating characteristic analysis. As outcomes, delirium, bedsore, length of stay (LOS), in-hospital mortality, and unplanned 30-day readmission were measured by reviewing medical records. Results: The mean age of the study population was 70.1 years (range, 60 to 91), and 75 (52.1%) were men. By linear regression analysis, CFS and K-FRAIL were positively correlated (B = 0.72, p < 0.001). A CFS cutoff of ≥ 5 maximized sensitivity + specificity to classify frailty using K-FRAIL as a reference (C-index = 0.893). Higher frailty burden by both CFS and K-FRAIL was associated with higher LOS and bedsores. Unplanned readmission and in-hospital mortality were associated with higher CFS score but not with K-FRAIL score, after adjusting for age, gender, polypharmacy, and multimorbidity. Conclusions Frailty status by CFS was associated with LOS, bedsores, unplanned readmission, and in-hospital mortality. CFS can be used to screen high-risk patients who may benefit from geriatric interventions and discharge planning in acutely hospitalized older adults.