Urea reduction ratio (URR) and Kt/Vurea are objective parameters of dialysis delivery in hemodialysis patients and correlate with nutritional status and patient outcome. URR and Kt/Vurea depend on postdialysis blood urea nitrogen (BUN). In patients with severe postdialysis urea rebound (PDUR), these parameters do not accurately reflect dialysis adequacy. We measured PDUR 30 minutes after dialysis in 26 chronic stable hemodialysis patients. The impact of PDUR on dialysis delivery assessed by URR and Kt/Vurea and the independent factors affecting on PDUR were evaluated. All patients had been dialyzed for 4 hours thrice a week using hemophan membrane. 1) The mean age of patients was 48.6+/-14.8 years and sex ratio was 1:2.3. The mean duration of hemodialysis was 42.7+/-45.0 months. Primary renal diseases were chronic glomerulonephritis 11 (42.3%), diabetic nephropathy 7 (26.9%), and hypertension 4 (15.4%). 2) The mean blood flow was 209.2+/-17.4ml/min. URR, Kt/Vurea, and nPCR using immediate postdialysis BUN were 60+/-7%, 1.13+/-0.21, 1.09+/-0.28g/kg/ day, respectively. The mean recirculation rate was 4.4+/-2.3%. 3)The mean PDUR was 12.2+/-4.6% (range:6-22 %). URR, Kt/Vurea, and nPCR using BUN 30 minutes after dialysis were 55+/-7%, 0.99+/-0.18, and 1.02+/-0.25 g/kg/day, respectively and were significantly lower than those using immediate postdialysis BUN (P<0.05). 4) When the patients were divided according to the degree of PDUR (low PDUR group:<12%, high PDUR group: > or = 12%), high PDUR group was significantly higher than low PDUR group in hematocrit (27.0+/-2.6 vs. 23.5+/-3.6%, P=0.008), URR (64.3+/-5.4 vs. 55.8+/-6.8%, P=0.002), Kt/Vurea (1.26+/-0.17 vs. 1.03+/-0.18, P=0.002), and total recirculation rate (5.6+/-2.7 vs. 3.6+/-1.7%, P=0.05). There were no differences in age, sex, postdialysis body weight, ultrafiltration rate, blood flow, serum albumin, predialysis BUN, creatinine, and nPCR. 5) In multiple regression analysis, the independent factors affecting on PDUR were Kt/Vurea (beta=0.546, P<0.001), recirculation rate (beta=0.422, P<0.001), and hematocrit (beta=0.366, P=0.0017). In conclusion, we think that PDUR should be considered in hemodialysis patients when estimating dialysis delivery, especially if they had high Kt/ Vurea, recirculation rate, and hematocrit.
Blood Urea Nitrogen ; Body Weight ; Creatinine ; Diabetic Nephropathies ; Dialysis* ; Glomerulonephritis ; Hematocrit ; Humans ; Hypertension ; Membranes ; Nutritional Status ; Renal Dialysis* ; Serum Albumin ; Sex Ratio ; Ultrafiltration ; Urea*

No abstract available.
Dental Arch* ; Humans

A retrospective study was made of 10 consecutive patients who underwent mandibular reconstruction with PCBM from December 1994 to July 1996. Free autogenous iliac bone in the from of particulate cancellous bone and marrow was densely packed into the crib that was adapted to bridge the mandibular discontinuity defect. Frozen-treated autogenous mandibular bone, splitted autogenous rib, and titanium mesh(Dumbach, Leibinger) were used as cribs carrying the PCBM. All ten cases underwent successful healing with the formation of a continuous bony union with the remaining mandible. The rate of resorption was assessed by sequential panoramic radiographs. The mean horizontal dimension of the madibular defects was 44mm and the mean vertical dimension of the reconstructed segments was 23mm. The bony height of the reconstructed segments retained about 90% of the bony height of over a 1-year period. We confirmed that PCBM grafts were the most successful and predictable grafts in mandibular discontinuity reconstruction.
Bone Marrow* ; Humans ; Infant Equipment ; Mandible ; Mandibular Reconstruction* ; Retrospective Studies ; Ribs ; Titanium ; Transplants ; Vertical Dimension

BACKGROUND: To evaluate the effect of preoperative fatty degeneration of deltoid and teres minor muscles on the clinical outcome in patient with reverse total shoulder arthroplasty (RTSA). METHODS: Nineteen patients with RTSA were enrolled. The mean follow-up period was 16.1 months. The fatty degeneration of three distinct parts in each deltoid and the teres minor muscle was measured using a preoperative magnetic resonance imaging. Postoperatively, the muscle strengths for forward elevation (FE), abduction (Abd), and external rotation (ER) were measured using a myometer at the last follow-up. The parameters for clinical outcome were Constant Score (CS) and Korean Shoulder Score (KSS). RESULTS: The number of cases was 10 in group 1 and 9 in group 2. The strength of FE and Abd were significantly higher in group 1 (p<0.001 and p<0.001, respectively), and the strength of ER was not different significantly between two groups (p=0.065). For the clinical outcome, both CS and KSS were higher in group 1 (p=0.002 and p=0.002, respectively). The number of patients in group A was 11, and group B was 8. Although there was not a significant difference in terms of FE and Abd between group A and B (p=0.091, p=0.238), ER was significantly higher in group A (p=0.012). We did not find a significant difference in the clinical scores (CS, p=0.177 and KSS, p=0.238). CONCLUSIONS: These findings suggest the importance of a preoperative evaluation of the fatty degeneration of deltoid and teres minor muscles for predicting postoperative strength and clinical outcome.
Arthroplasty* ; Follow-Up Studies ; Humans ; Magnetic Resonance Imaging ; Muscle Strength ; Muscles* ; Shoulder*

Adenoid basal cell tumor of the prostate is a rare tumorous lesion that can be misdiagnosed as adenocarcinoma of the prostate. The malignant potential of adenoid basal cell tumor remains uncertain due to small number of reported cases. This 66-year-old man presented with symptoms of urinary tract obstruction. Under the impression of benign prostatic hyperplasia, a transurethral resection of the prostate (TURP) was performed. The patient was alive with no evidence of recurrence or metastasis 15 months after TURP. Microscopically, most of the lesions were composed of nodular collections of small nests of basaloid cells with peripheral palisading, and clusters of tumor cells forming cribriform pattern. Multiple areas of basal cell hyperplasia and atypical basal cell hyperpalsia were also observed. The coexistence of basal cell hyperplasia, atypical basal cell hyperpalsia, and adenoid basal cell tumor with cribriform pattern in this case supports a morphologic continuum from the benign hyperplastic lesion to malignant neoplasia.
Adenocarcinoma ; Adenoids* ; Aged ; Humans ; Hyperplasia ; Neoplasm Metastasis ; Prostate* ; Prostatic Hyperplasia ; Recurrence ; Transurethral Resection of Prostate ; Urinary Tract

Background : It has been suggested that thrombospondin (TSP) is a p53-dependent negative regulator of tumor angiogenesis. TSP expression and localization in hepatocellular carcinomas (HCCs) and its association with overexpression of p53 protein were investigated. Methods : TSP-1 and -2 expressions were examined in 40 HCC specimens by immunohistochemical staining and in 4 HCC cell lines by Western blotting. In addition, p53 protein expression and microvessel density (MVD) were correlated with the TSP expression. Results : Strong immu- nopositivity for TSP-1 was observed in fibroblasts, vascular endothelial cells, and some vas- cular smooth muscle cells of the stroma in 18 cases (45%), and in tumor cells in 3 cases (7.5%) of 40 cases of HCC. Immunoreactivity for TSP-2 was observed in only the sinusoidal lining cells of the tumor in 15 cases (46%), and in tumor cells in 2 cases (6%) of 32 cases of HCC. TSP-1 expression was inversely correlated with MVD (p=0.028), but TSP-2 expression did not show any correlation with MVD. Although p53 was overexpressed in 17 cases, there was no significant correlation between TSP and p53 expressions. None of the HCC cell lines expressed TSP-1 or -2. Conclusions : These findings indicate that TSP-1 is mainly derived from nonparenchymal cells, and may decrease tumor angiogenesis in HCC.
Angiogenesis Inhibitors ; Blotting, Western ; Carcinoma, Hepatocellular* ; Cell Line ; Endothelial Cells ; Fibroblasts ; Microvessels ; Myocytes, Smooth Muscle ; Thrombospondin 1 ; Thrombospondins

PURPOSE: To analyze the morphologic changes of the eyelids among different age groups in Korean, and also th find out factors that influence there changes. METHODS: Tow hundred thirty six subjects without any ocular diseases were selected, and sorted by the age (ranging from teenage to the sixties and above), the gender, and according to the existence of the double fold. The pictures of frontal and lateral side of the subjects were taken. After scanning the pictures, MRD1 (marginal reflex distance 1), MRD2 (marginal reflex distance 2), the vertical distance from upper eyelid to eyebrow, the vertical and horizontal distance from medial to lateral canthus, and the horizontal distance between lateral canthus and corneal center were measured using computer-based AutoCAD R14. The measured distances were compared in each subjects. RESULTS: MRD1, MRD2, the vertical distance between medial and lateral canthus, and the horizontal distance between lateral canthus and corneal center were longest in people of the 3rd and 4th decade, and decreased. The horizontal distance between medial and lateral canthus was longest in people of the 5th decade, and decreased thereafter. The vertical distance between upper eyelid and eyebrow was shortest in people of the 4th decade and increased with aging. CONCLUSIONS: It is essential to acknowledge and understand the morphologic changes of the eyelids according to aging so that more satisfactory surgical outcomes may be achieved in cosmetic eyelid operation.
Aging ; Eyebrows ; Eyelids* ; Humans ; Reflex

No abstract available.
Aged ; Cysts/*pathology ; Humans ; Immunohistochemistry ; Liver Diseases/*pathology ; Male ; Muscle, Smooth/pathology ; Tomography, X-Ray Computed

Human papillomavirus (HPV) 16/18 is a causative agent of uterine cervical carcinoma. HPV 16/18 can alter cell cycle regulation through apoptosis. Bcl-2 is an important regulatory gene of apoptosis. A study was done to evaluate the relation between HPV 16/18 and bcl-2 and apoptosis in 21 cases of carcinoma in-situ (CIS), 5 cases of microinvasive carcinoma and 23 cases of invasive squamous cell carcinoma. HPV 16/18 was detected by hybrid capture system (HCS), bcl-2 protein by immunohistochemical method and apoptosis by using the hematoxylin-eosin stained slide. The results were as follows: Expression of the bcl-2 protein was 43% (9/21) in CIS and 26% (6/23) in invasive carcinoma. Expression of the bcl-2 protein was 42% (5/12) in CIS with HPV 16/18 infection, 44% in CIS without HPV 16/18 infection, 20% (2/10) in invasive carcinoma with HPV 16/18 infection and 31% (4/13) in invasive carcinoma without HPV 16/18 infection. Mean apoptotic index (mAI) was 3.36 in CIS, 5.23 in microinvasive and 6.25 in invasive carcinoma. mAI was 3.66 in CIS with HPV 16/18 infection, 2.86 in CIS without HPV 16/18 infection, 6.18 in invasive carcinoma with HPV 16/18 infection and 6.30 in invasive carcinoma without HPV 16/18 infection. Based on these results, we conclude that there are no correlation between HPV infection and bcl-2, and between HPV infection and apoptosis in invasive and in situ carcinoma of the uterine cervix, and apoptosis is increased according to tumor progression.
Apoptosis* ; Carcinoma, Squamous Cell* ; Cell Cycle ; Cervix Uteri* ; Female ; Genes, Regulator ; Humans

BACKGROUND : Treatment of a severe burn injury with total parenteral nutrition can produce bacterial translocation to mesenteric lymph nodes through the intestinal mucosa due to permeability changes. Early enteral feeding will help to restore the mucosal barrier function. Certain nutrients may have a beneficial effect on bacterial translocation and gut immunity. METHODS : We choose the glutamine and korean cabbage as dietary factors to study the beneficial effect on gut immunity of feeding different dietary formulations of low amino acid concentrated total parenteral nutritional fluids in burned rats. Forty-eight (48) male pathogen-free Sprague-Dowley rats were allocated in 4 groups(group A, control chow diet and water ad libitum; group B, oral TPN diet; group C, oral TPN diet supplemented with 2% glutamine; and group D, oral TPN diet supplemented with korean cabbage). All groups, except control group A, recieved 40% total body surface area, full-thickness burn injury. Group A received sham burn injury. Bacterial translocation to mesenteric lymph nodes, the cecal bacterial population level, the intestinal mucosal protein content, and the total IgA of the intestinal luminal washing fluid were measured and light-microscope changes of the small intestine were observed in the rats on the 4th and the 7th days after corresponding diet intake. RESULTS : The incidence of bacterial translocation in the oral TPN diet group B was reduced signifi cantly compared with control group A and glutamine supplemented group C on 4th day postburn (p< 0.05) The cecal bacterial population level of control group A showed significant lower values, compared with the other groups, in total aerobic (on 4th day p<0.01, on 7th day p<0.01) and gram-negative enterics species (on 4th day p<0.01, on 7th day p<0.05). The mucosal protein amount per cm of length of intestine was decreased slightly in groups B, C, and D, compared with the control group A, but without statistical significance, on the 7th day postburn. The total (serum and secretary) IgA per cm of length of intestine was increased significantly in the glutamine-supplemented group C and the cabbage- sup plemented group D on the 7th day postburn, compared with the oral TPN group B (p<0.05). However,there was no corresponding decrease in the bacterial translocation ratio or the cecal bacterial population level. Histologic observations on the 4th and the 7th days of glutamine-supplemented group C & cabbage- supplemented group D revealed increases in the villous height, and the numbers of villous cells and goblet cells, compared with the oral TPN group B. A slight desquamation of the villous cells was observed in the cabbage-supplemented group on the 7th day. CONCLUSION : In summary, early enteral feeding is not sufficient to avoid bacterial translocation. Certain nutritional factors such as glutamine are helpful in overcoming the bacterial translocation in burned rats. Korean cabbage was beneficial became promoted an IgA increase in the intestine without a direct effect on the bacterial translocation.
Animals ; Bacterial Translocation* ; Body Surface Area ; Brassica ; Burns ; Diet ; Enteral Nutrition ; Food, Formulated ; Glutamine* ; Goblet Cells ; Humans ; Immunoglobulin A ; Incidence ; Intestinal Mucosa ; Intestine, Small ; Intestines ; Lymph Nodes* ; Male ; Parenteral Nutrition, Total ; Permeability ; Phenobarbital ; Rats* ; Water