BACKGROUND/AIMS: Inflammation plays a key role in ischemic acute renal failure (ARF). The present study investigated the infiltration of macrophages in the early phase of ischemic ARF in mice. METHODS: Ischemic ARF was induced by renal clamping for 22 min, while the control mice underwent sham surgery (no clamping). The serum creatinine and blood urea nitrogen (BUN) levels were measured in the control and post-ischemia mice. Immunofluorescence staining was used to measure the number of CD 11b-positive cells in the kidney tissue sections to determine the amount of post-ischemic macrophage infiltration. Lipo-Cl2MBP (clodronate) for macrophages depletion was injected via a tail vein 5 d before ischemia induction and again 2 d before ischemia induction. RESULTS: The study found that the post-ischemia mice had higher levels of serum creatinine and BUN at 16 and 24 h compared to the controls. Immunofluorescence staining showed there were more macrophages in the post-ischemic tissue at 2, 8, 16 and 24 h compared to the control tissue, and that most of these macrophages were located in the outer medulla. The mice treated with clodronate prior to ischemia induction were found to have lower levels of serum creatinine compared to those mice that weren't treated with clodronate. CONCLUSIONS: There was significant infiltration of macrophages from the early phase of ischemic ARF, and this peaked at 16-24 h. Macrophage depletion using clodronate was protective against ischemic ARF.
Animals ; Antigens, CD11b ; Blood Urea Nitrogen ; Clodronic Acid ; Creatinine/blood ; Fluorescent Antibody Technique ; Inflammation/*physiopathology ; Ischemia/*complications/pathology/physiopathology ; Kidney Failure, Acute/blood/etiology/*pathology/physiopathology ; Kidney Medulla/*pathology ; *Macrophages ; Male ; Mice ; Mice, Inbred C57BL ; Perfusion ; Time Factors

PURPOSE: To evaluate the findings and the role of CT in plexiform neuro-fibromatosis of the mediastinum. MATERIALS AND METHODS: We retropectively reviewed the CT scans of five patients with plexiform neurofibromatosis of the mediastinum. The CT scans were reviewed with attention to the distribution of the lesions, appearance and attenuation of mediastinal lesions, enhancement pattern after intravenous contrast infusion and associated findingssuch as intercostal neurofibroma. RESULTS: In all five patients CT scans demonstrated fusiform low attenuated masses which were oriented longitudinally and extended over multiple contiguous scans along the distribution of major mediastinal nerves. In four patients, mediastinal lesions appeared infiltrative, obliterating adjacent mediastinal fat plane. One patient had well defined fusiform masses along the major mediastinal nerves. Postcontrast enhanced CT scans revealed slight central enhancement in two patient and no contrast enhancement in three patients. Associated findings such as neurofibromas of intercostal nerves and sympathetic trunk, or subcutaneous neurofibromas were detected on CTscans in all five patients. CONCLUSION: Characteristic CT findings of low attenuation masses along the major mediastinal nerves are helpful to differentiate plexiform neurofibromatosis from mediastinal lymphadenopathy and to prevent from misreading as a malignant disease.
Humans ; Intercostal Nerves ; Lymphatic Diseases ; Mediastinum* ; Neurofibroma ; Neurofibromatoses* ; Tomography, X-Ray Computed

A case with typical skin lesions of incontinentia pigmeti showed progressing retinal vascular abnormalities. So cryotherapy was done on avascular peripheral retina, and retinal vascular changes ceased. We propose that cryotherapy may be a good treatment method for progressing retinal vascular lesions of incontinentia pigmenti.
*Cryosurgery ; Female ; Fundus Oculi ; Humans ; Incontinentia Pigmenti/*surgery ; Infant, Newborn ; Retinal Diseases/*surgery

Sixty-three patients with permanent sigmoid colostomy were surveyed to evaluate their satisfaction and complications with the "irrigation technique" and the "atural evacuation" of the colostomy management (irrigation technique; 32 patients, natural evacuation; 31 patients). All patients had colostomy for at least 12 months without disease recurrence. Each patient was interviewed in addition to standard questionnaire. The irrigation was not associated with any major complication including colonic perforation. The irrigation was used younger age group than the natural evacuation (53+/-10 vs. 62+/-12, P=0.01). The frequency of bowel movement was lower in the irrigation than in the natural evacuation (5.1+/-2.5/wk vs. 10.8+/-9.0/wk, P=0.04). Five patients (16%) of the irrigation experienced spontaneous bowel action but only one patient suffered from it. The time spent for managing irrigation was 59+/-13 minutes. Twenty-three patients (74%) of the natural evacuation suffered from one or moreproblems such as expensive apparatus, leakage, skin irritation or odor. Sixteen patients (52%) of the natural evacuation and 2 patients (6%) of the irrigation were restricted in social activity (P=0.0001). Thirteen patients (42%) of the natural evacuation and 1 patient (3%) of the irrigation were dissatisfied with colostomy management (P=0.002). Thus, the irrigation technique seems to be more effective and satisfactory method for managing colostomy without compromising patient's social activity when it is performed in appropriately selected patients.
Colon ; Colon, Sigmoid ; Colostomy* ; Humans ; Odors ; Surveys and Questionnaires ; Rectal Neoplasms ; Recurrence ; Skin

No abstract available.
Diagnosis*

The authors report seven cases of carotid-ophthalmic artery aneurysms who were surgically treated using the combined extradural-intradural or intradural approach from March, 1991, to December, 1993. Carotid-ophthalmic artery aneurysms are of considerably surgical interest because some of these were considered to have technical difficulties of clipping and disastrous surgical results. Removal of the anterior clinoid process and unroofing of the optic canal are the key points to exposure the operative field adequately. On the basis of these experiences, authors concluded that this approach is very useful, because of adequate surgical field and better mobilization of the internal carotid artery and optic nerve for direct clipping of carotid-ophthalmic artery aneurysm and basilar tip aneurysm.
Aneurysm* ; Arteries* ; Carotid Artery, Internal ; Optic Nerve

To examine the effectiveness and safety of erythropoietin on the anemia of end-stage chronic renal failure, we administered recombinant human erythropoietin(rHuEPO), Eporon(R), to 66 patients with anemia and chronic renal failure who were undergoing hemodialysis or peritoneal dialysis. All received Eporon(R) intravenously, two or three times per week at 150unit/kg, and then the dose of Eporon(R) was adjusted to 75-300unit/kg/week according to the hemoglobin response. The results of this study judged 19(39.6%) of 48 patients as being in a "markedly improved" condition while 23(47.9%) of 48 patients were judged as being in an "improved" condition. At results, the response rate of this study was 87.5%(42/48 patients). This was the same as the target response rate, 90%(p= 0.564). Serious adverse events occured in 6 cases during the study, but all proved to be unrelated to Eporon(R). These events included itching 1(1.5%), urticaria 1(1.5%) and headache 1(1.5%). No patients discontinued to participate in the study except one patient who withdrew from the study voluntarily. The symptoms of all adverse events eventually decreased and disappeared during the clinical study. No factors in the clinical laboratory tests changed significantly (p<0.05) except for the decrease of TSR and ferritin, a consequence of using iron hemoglobin synthesis caused by Eporon(R) administration. The significant increase in blood pressure, which could not be proved to be related to Eporon(R), disappeared during the study. Anti-Epo antibody was not detected in any samples. These results demonstrate that Eporon(R) is effective in many patients with the anemia of end-stage chronic renal failure.
Anemia* ; Blood Pressure ; Erythropoietin ; Ferritins ; Headache ; Humans* ; Iron ; Kidney Failure, Chronic* ; Peritoneal Dialysis ; Pruritus ; Renal Dialysis ; Urticaria

BACKGROUND:CAVI, Cardio Ankle Vascular Index, has been proposed as an independent marker of arterial stiffness regardless of the blood pressure. We measured the CAVI of hemodynamically unstable patients on maintenance hemodialysis and at the same time measured other pulse pressure-related parameters in order to study their correlations with each other. METHODS:We studied 85 patients undergoing maintenance hemodialysis over 3 months. We categorized patients into 4 subgroups: Diabetes+Hypotension (N= 12), Diabetes+Normal blood pressure (N=16), Non- diabetes+Hypotension (N=15), and Non-diabetes+Normal blood pressure (N=42). Using automatic waveform analyzer, we measured CAVI and pulse pressure- related markers twice, before and after the hemodialysis session, and observed the change. RESULTS:After the dialysis, CAVI did not change despite the decreased mean blood pressure. Yet both brachial and ankle pulse pressure dropped significantly (4.34+/-15.22 mmHg, 11.50+/-20.65 mmHg, p<0.01). PEP (Pre-Ejection Period) on the other hand, remarkably increased (12. 13+/-22.18 msec) while ET (Ejection Time) showed considerable decrease (35.86+/-45.68 msec), and PEP/ ET ratio increased as well. Predialysis CAVI was significantly higher in Diabetes group than in Non-diabetes (11.02+/-2.33 vs. 8.20+/-1.87, p<0.001). However, no significant difference of CAVI was observed between Hypotension and Normal blood pressure groups. Diabetes+Hypotension Group displayed reduction in CAVI after dialysis with marginal significance (0.68+/-1.07, p=0.05) whilst PEP, ET and PEP/ET ratio showed no significant change compared to other groups. CONCLUSION:CAVI, a newly developed marker of arterial stiffness, is expected to be useful in prediction of the cardio-vascular risk and prognosis of patients undergoing hemodialysis.
Ankle ; Blood Pressure ; Dialysis ; Hand ; Humans ; Hypotension ; Prognosis ; Renal Dialysis* ; Vascular Stiffness

Four hundred and sixty five randomly selected clones from a cDNA library of Blattella germanica were partially sequenced and searched using BLAST as a means of analyzing the transcribed sequences of its genome. A total of 363 expressed sequence tags (ESTs) were generated from 465 clones after editing and trimming the vector and ambiguous sequences. About 42% (154/363) of these clones showed significant homology with other data base registered genes. These new B. germanica genes constituted a broad range of transcripts distributed among ribosomal proteins, energy metabolism, allergens, proteases, protease inhibitors, enzymes, translation, cell signaling pathways, and proteins of unknown function. Eighty clones were not well-matched by database searches, and these represent new B. germanica-specific ESTs. Some genes which drew our attention are discussed. The information obtained increases our understanding of the B. germanica genome.
Sequence Alignment ; Reverse Transcriptase Polymerase Chain Reaction ; Molecular Sequence Data ; Male ; Female ; *Expressed Sequence Tags ; Blattellidae/*genetics ; Base Sequence ; Animals

To know the causes and visual prognosis of ectopia lentis in children, medical records of 41 patients (82 eyes) were retrospectively analysed.The patients were divided into systemic disease-associated, simple, and familial types according to the causes and directions of lens deviation were compared.Surgical methods, pre-and post-operative corrected vision, and complications were investigated. The mean age at diagnosis was 45/12 years old. The decreased vision (87%) and the presence of family history (7.3%) werethe chief complaints on the first examination. According to the causes, 19patients had Marfan syndrome, 14 simple type, and 8 familial type respectively. The directions of lens deviation in Marfan syndrome were different from in simple and familial types. Surgical management have been per-formed in twenty-six patients (44 eyes) on the average 6years of age, and all but one showed an improvement of postoperative corrected vision. One eye presented a dyscoria as a complication. These results are the first report in Korea about the causes and the visual prognosis of ectopia lentis in children and may give us a reference for further management of these patients.
Child* ; Diagnosis ; Ectopia Lentis* ; Humans ; Korea ; Marfan Syndrome ; Medical Records ; Prognosis ; Retrospective Studies