Heterotopic partial liver transplantation(HLT) in the rat is relatively simple method to orthotopic liver transplantation. Addition of mesocaval shunt which diverts almost intestinal blood to systemic circulation provides only splenopancreaticoduodenal blood for the graft. The usefulness of our novel model is first, evaluating the pure effect of pancreaticoduodenal blood to liver regeneration, second, evaluating the contribution of splanchnic viscera to liver reperfusion injury. In the first group (conventional HLT, C-HLT), the thirty percent graft liver was transplanted just below the host liver with whole portal blood input. In the second group(mesocaval shunt added HLT, M-HLT), the superior mesenteric vein was diverted to systemic circulation and portal blood from the spleen-pancreas-duodenum supplied the graft. The graft weight at 2 posttransplant weeks was significantly increased in the C-HLT group compared with the M-HLT group, which suggests pancreatic blood alone is not sufficient to regenerate the partial liver grafts. There was no significant difference in the graft survival between two groups, which implies the influence of intestine to postreperfusion injury is negligible.
Animals ; Graft Survival ; Intestines ; Liver Regeneration ; Liver Transplantation* ; Liver* ; Mesenteric Veins ; Models, Animal* ; Rats* ; Reperfusion Injury ; Transplants ; Viscera

PURPOSE: By analysing frequency and disease progression, this study aimed to investigate and predict the prognosis of mycoplasma pneumonia according to radiographic pattern. MATERIALS AND METHODS: We retrospectively reviewed plain chest radiographs of 230 patients in whom mycoplasm pneumonia had been serologically confirmed.Their age ranged from two months to 14 years and two months, and 203(88.3%) were younger than eight years. Radiographic patterns were classified as air space consolidation, bronchopneumonic, interstitial pneumonic ordiffuse mixed infiltrating type. The radiologic resolution period for each type was analysed by the resolution of symptoms and normalization of radiologic findings. RESULTS: The bronchopneumonic type, which was the most common, was seen in 82 patients (35.6%), airspace consolidation in 58 (25.2%), interstitial in 55 (23.9%), and diffuse mixedin 22 (9.57%). In thirteen patients (5.7%), chest radiographs were normal, though the clinical and radiologic resolution period for each type was variable. The mean resolution period of the air space consolidation type was 14.5 days, bronchopneumonic, 7.6 days ; interstitial, 10.5 days, and diffuse mixed, 15.6 days. The airspace consolidation type needed the longest recovery period, exceeded only by the diffuse mixed type. CONCLUSION: The bronchopneumonic type was the most common radiographic pattern of mycoplasma pneumonia. The prognosis of the airspace consolidation type seems to be poorest, since this required the longest recovery period.
Child* ; Disease Progression ; Humans ; Mycoplasma* ; Pneumonia ; Pneumonia, Mycoplasma* ; Prognosis ; Radiography, Thoracic ; Retrospective Studies

BACKGROUND/AIMS: Viral breakthrough has been considered a major limitation of lamivudine in the treatment of hepatitis B virus related chronic liver disease. Its clinical meaning has not been thoroughly assessed. METHODS: 64 patients who showed viral breakthrough during lamivudine treatment were retrospectively reviewed. We evaluated the rate of HBeAg seroconversion and hepatic decompensation after viral breakthrough. RESULTS: After viral breakthrough, serum alanine transaminase (ALT) elevation more than 1.2X upper limit of normal (ULN) was noticed in 40 patients (62.5%). Acute flare (serum ALT elevation >X5 ULN, or serum bilirubin >3 mg/dL) occured in 15 patients (23.4%). During the period of follow up (15.0 +/- 9.7 months; range, 0-31 months) since viral breakthrough, decreased serum HBV-DNA level to below the detection limit and serum ALT normalization was seen in 15 patients (23.4%). HBeAg seroconversion was noticed in 7 (13.7%) of a total of 51 HBeAg positive patients at base line; in 4 (15.4%) of 26 patients with non-hepatic failure (chronic hepatitis or Child-Pugh class A liver cirrhosis) at base line; and in 2 (40.0%) of 5 patients with non-hepatic failure at base line and acute flare after viral breakthrough. During this period, terminal hepatic decompensation (Child-Pugh class C) or death was noticed in 9 (90.0%) of 10 patients who had hepatic decompensation (Child-Pugh class B or C) at baseline and acute flare after viral breakthrough. CONCLUSIONS: Acute flare after viral breakthrough seemed to continue during HBeAg seroconversion and rarely developed into terminal hepatic decompensation or death in patients with non-hepatic decompensation at baseline. Its incidence is not only high but lethal to most patients with hepatic decompensation at baseline.
Acute Disease ; Adult ; Aged ; Antiviral Agents/*therapeutic use ; DNA, Viral/blood ; English Abstract ; Female ; Hepatitis B e Antigens/blood ; Hepatitis B virus/genetics/isolation & purification ; Hepatitis B, Chronic/complications/drug therapy/*virology ; Humans ; Lamivudine/*therapeutic use ; Male ; Middle Aged ; Reverse Transcriptase Inhibitors/*therapeutic use

No abstract available.
Biomarkers, Tumor/analysis ; Biopsy ; Carcinosarcoma/chemistry/*secondary/surgery ; Chemoradiotherapy, Adjuvant ; Fatal Outcome ; Humans ; Immunohistochemistry ; Lung Neoplasms/chemistry/*pathology/surgery ; Male ; Middle Aged ; Mouth Floor/chemistry/*pathology/surgery ; Mouth Neoplasms/chemistry/*secondary/surgery ; Pneumonectomy ; Time Factors ; Tomography, X-Ray Computed ; Treatment Outcome

The aim of this case study was to report the clinical outcome of immediate provisionalization using one-piece narrow diameter (3.0mm) implants in missing maxillary lateral or mandibular incisors. The present study included 36 patients who were treated with 62 one-piece narrow diameter implants. After implant placement, immediate provisional restorations were delivered. All implants showed favorable osseointegration and after progressive loading from 3 months to 9 months (average of 5 months), final restorations were completed without failure in all cases. A survival rate of 100 % (62 of 62) was observed up to 23 months of observation (average of 12.6 months).
Humans ; Incisor ; Osseointegration ; Survival Rate

BACKGROUND: Numerous reports suggest the role of oxygen in melanogenesis. However, little has been reported on the effect of a hypoxic environment on cellular melanogenesis. OBJECTIVE: The effect of low oxygen tension on cellular melanogenesis was investigated in B16 murine melanoma cells. METHODS: Using cells cultured under an ambient (21% O2) or hypoxic (5% O2) condition, melanin content and tyrosinase activity were measured spectrophotometrically. The expression of tyrosinase, tyrosinase-related protein (TRP)- 1, and TRP-2 were analyzed by RT-PCR and Western blot. RESULTS: Culture of cells under hypoxic conditions caused significant inhibition of isobutylmethylxanthine (IBMX)- induced increase of melanin content. No cytotoxicity was observed during the hypoxic culture periods. Decreased melanin content occurred through the decrease of tyrosinase protein and activity (p<0.01). The mRNA levels of tyrosinase and TRP-2 were also decreased by hypoxia, while that of TRP-1 was unchanged. Similar inhibitions of melanin content and tyrosinase activity were observed in the cells stimulated with dibutyryl-cAMP. CONCLUSION: IBMX-induced melanogenesis in B16 cells was significantly inhibited under hypoxic culture conditions, suggesting the important role of oxygen tension in cellular melanogenesis.
Anoxia* ; Blotting, Western ; Melanins ; Melanoma ; Melanoma, Experimental* ; Monophenol Monooxygenase ; Oxygen ; RNA, Messenger

Therapeutic endoscopy in patients with pancreas divisum has continued to evolve with the availability of minor papilla endoscopic sphincterotomy, stenting, or sphinteroplasty. A combination of a sphincterotomy followed by balloon/basket deployment and emergency mechanical lithotripsy had facilitated the removal of impacted or large stones in the pancreatic and biliary ducts. The impaction of the basket with captured stones or rupture of the basket traction-wire during mechanical lithotripsy are rare complications. We report the successful retrieval of a center-severed and impacted lithotomy basket in the duct of Santorini in a 47-year-old patient with pancreas divisum. Endobiliary biopsy forceps were introduced into minor papilla, the basket was drawn and the stone was removed successfully after 2 months. To the best of our knowledge, this is a first report of the removal of a center-severed and impacted lithotomy basket in the pancreatic duct.
Biopsy ; Emergencies ; Endoscopy ; Humans ; Lithotripsy ; Middle Aged ; Pancreas* ; Pancreatic Ducts* ; Rupture ; Sphincterotomy, Endoscopic ; Stents ; Surgical Instruments

PURPOSE: The purpose of this study is to assess the utility of PTBD spiral CT cholangiography, after infusion of contrast media through a PTBD tube, for evaluation of a biliary lesion after emergency PTBD due to severe jaundice. MATERIALS AND METHODS: Forty patients with emergency PTBD due to extrahepatic biliary obstruction were transferred to our clinic and prospectively studied. The causes of obstruction were 17 extrahepatic cholangiocarcinomas (including three Klatskin's tumors), seven pancreatic head carcinomas, six calculous diseases of the common bile duct, six periampullary lesions, two ampulla of Vater carcinomas, one gall bladder carcinoma with invasion of the common hepatic duct, and one cholangitis. Diagnosis was on the basis of pathologic, radiologic, and clinical findings. Pre-contrast CT scanning was performed. After the infusion of contrast media (iothalamate : normal saline=1:10) through a PTBD tube, spiral CT scans were obtained. After IV infusion of contrast media (Ultravist, 100cc), early- and delayed-phase spiral CT scans were obtained at 45 and 210 seconds, respectively, with an interscan interval of 5mm. 3-D CT cholangiograms were then reconstituted. Spiral CT without infusion of contrast media through a PTBD tube and PTBD spiral CT cholangiography were performed in 14 cases. The level of extrahepatic biliary obstruction was categorized as either upper, middle, or lower third. In 21 surgically confirmed cases, we evaluated the accuracy with which the level and cause of obstruction was determined; levels and causes during surgery and by as seen on PTBD cholaniography were compared. RESULTS: The levels of obstruction diagnosed on PTBD spiral CT cholangiography and on 3-D CT cholangiography corresponded in all cases to the levels during surgery and on PTBD cholangiography [upper third (n=7), middle third (n=12), lower third (n=21)], and the level diagnosed on spiral CT without infusion of contrast media through a PTBD tube corresponded to the level during surgery in ten of 14 cases. The cause of obstruction diagnosed on PTBD spiral CT cholangiography corresponded to pathologic findings in 19 of 21 cases. In 15 cases, 3-D CT cholangiography was diagnostically helpful. CONCLUSION: PTBD spiral CT cholangiography is a useful diagnostic method for determining the level and cause of biliary obstruction.
Ampulla of Vater ; Cholangiocarcinoma ; Cholangiography* ; Cholangitis ; Common Bile Duct ; Contrast Media ; Diagnosis ; Emergencies ; Head ; Hepatic Duct, Common ; Humans ; Jaundice ; Prospective Studies ; Tomography, Spiral Computed* ; Tomography, X-Ray Computed ; Urinary Bladder

PURPOSE: We retrospectively investigated to find out the equation of calculating the probability of minimal change nephrotic syndrome (MCNS) using clinical parameters. We prospectively investigated to determine the usefulness of the mathematical model. METHODS: We retrospectively examined 56 patients with nephrotic syndrome (NS) (30 MCNS and 26 non-MCNS) diagnosed by kidney biopsy. A mathematical model for calculating the probability of MCNS was obtained through multiple logistic analysis in SAS statistics package. In addition, we prospectively studied 28 patients with NS. Clinical MCNS and non-MCNS were classified according to the probability of 85% in the mathematical model. Kidney biopsy was performed, and serum albumin and urinalysis were measured after 2 weeks of steroid treatment. RESULTS: In the retrospective study, the mathematical model was P=ea/(1+ea), a=17.2507 - 5.5777xON - 4.2256xALB-0.000579x24PROT - 1.2569xUBL+2.1703xUAL. The mode of onset (ON), 24 hours urine protein (24PROT), serum albumin concentration (ALB), the grade of hematuria (UBL) and proteinuria (UAL) were included as clinical parameters. At the probability of 85%, the sensitivity and specificity for predicting MCNS was 73.3% and 100% respectively. In the prospective study, the result of kidney biopsy was consistent with clinical MCNS and non-MCNS according to a mathematical model. All clinical MCNS showed negative proteinuria on urinalysis and a significant increase in serum albumin after 2 weeks treatment (1.85+/-0.30 g/dL to 2.88+/-0.26 g/dL, p<0.05). CONCLUSION: We conclude that the mathematical model for predicting the probability of MCNS may be useful in diagnosis of the MCNS.
Biopsy ; Diagnosis ; Hematuria ; Humans ; Kidney ; Models, Theoretical* ; Nephrosis, Lipoid* ; Nephrotic Syndrome ; Prospective Studies ; Proteinuria ; Retrospective Studies ; Sensitivity and Specificity ; Serum Albumin ; Urinalysis

PURPOSE: To determine optimal scan time for the early phase of two-phase spiral CT and to evaluate its usefulness in the detection and assessment of extension of urinary bladder lesions. MATERIALS AND METHODS: In four normal adults, we performed dynamic scanning and obtained time-density curves for internal and external iliac arteries and veins, and the wall of the urinary bladder. Sixty patients with 68 lesions of the urinary bladder or prostate underwent precontrast and two-phase spiral CT scanning. After injection of 100ml of noninonic contrast material, images for the early and delayed phases were obtained at 60 seconds and 5 minutes, respectively. We measured CT H.U. of the wall, the lesion, and lumen of urinary bladder as seen on axial scanning, in each image in which the lesion was best shown. For the detection of bladder lesions and assessment of their extension, precontrast, early-, and delayed phase images were compared. RESULTS: Dynamic study of normal adults showed maximum enhancement of bladder wall between 60 and 100 seconds. The difference of CT H.U. between bladder wall and the lesion was greatest in the early phase. The best detection rate (98.5%) was seen during this phase, and for the detection of bladder lesion, this same phase was superior or equal (66/68,97.1%) to the delayed phase. The precontrast image was also superior or equal (31/68,45.6%) to that of the delayed phase. For the assessment of extension of bladder lesion, the early phase was superior (36/68,52.9%) to the delayed phase, and precontrast image was superior (1/68, 1.5%) to that of the delayed phase. For determining the stage of bladder cancer, the early phase was most accurate if the stages was below B2 or D, while for stage C, the delayed phase was most accurate. CONCLUSION: In two-phase spiral CT scanning, we consider the optimal time for the early phase to be between 60 and 100 seconds after injection of contrast material. For the detection and assessment of extension of urinary bladder lesion, the early phase was superior to the late phase, and for evaluation of the ureter, the delayed phase was useful. The precontrast image was inferior to that of the delayed phase. We suggest that for the detection and assessment of extension of urinary bladder lesion without scanning of the precontrast image, two-phase spiral CT is reliable.
Adult ; Humans ; Iliac Artery ; Prostate ; Tomography, Spiral Computed* ; Ureter ; Urinary Bladder Neoplasms ; Urinary Bladder* ; Veins