No abstract available.
Kidney* ; Nephrectomy*

The prognosis of Behcet's disease characterized by recurrent orogenital ulcers and ocular and skin lesions depends upon the complications in the central nervous system, the gastrointestinal tract and the vascular system. Cardiac involvement, especially aortic regurgitation, is quite uncommon and hemodynamic instability is usually treated with open heart surgery. But serious postoperative complications had been reported in many cases, which are prosthetic valve detachment, paravalvular leakage, conduction disturbance, and false aneurysm. Many efforts to prevent the complications have been made such as application of cryopreseved homograft. We have described an experience of root replacement with homograft in a 39 year-old male patient for prosthetic valve detachment because of Behcet's aortitis with a review of the literatures regarding treatment, complication, and prognosis.
Adult ; Allografts* ; Aneurysm, False ; Aortic Valve Insufficiency ; Aortitis ; Central Nervous System ; Gastrointestinal Tract ; Hemodynamics ; Humans ; Male ; Postoperative Complications ; Prognosis ; Skin ; Thoracic Surgery ; Ulcer

Aneurysms of sinus of Valsalva often remain undiagnosed until they rupture. A huge, heavily calcified unruptured aneurysm originating from the right sinus of Valsalva was detected incidentally in a 61-year-old man. Chest X-ray showed cardiomegaly and 10 cm sized huge calcified mass lesion around the cardiac shadow. Two-dimensional echocardiogrm revealed pericardial effusion with huge calcified mass compressing right ventricular outflow and color-flow Doppler echocardiogram visualized blood flow from aortic root into aneurysm. Chest CT scan and MRI revealed a large thrombosed aneurysm arising from aortic root measuring 1010cm. After pericardiocentesis cardiac catheterization was performed, which showed elevated right ventricular systolic pressure up to 80 mmHg. Aortic root angiogram revealed huge unruptured calcified aneurysm in the sinus of Valsalva arising from the right coronary sinus. The patient underwent surgical correction for the prevention of aneurysmal rupture and the relief of right ventricular outflow obstruction.
Aneurysm* ; Blood Pressure ; Cardiac Catheterization ; Cardiac Catheters ; Cardiomegaly ; Coronary Sinus ; Humans ; Magnetic Resonance Imaging ; Middle Aged ; Pericardial Effusion ; Pericardiocentesis ; Rupture ; Sinus of Valsalva* ; Thorax ; Tomography, X-Ray Computed ; Ventricular Outflow Obstruction

PURPOSE: There are many articles describing about Guyon canal compression syndrome. Until recently, most of these articles have been presented about the symptoms of ulnar nerve compression, but there have been no reports about ulnar artery compression. In this article, besides the nerve compression symptoms in the Guyon's canal, we represented the symptoms and treatments based on the ulnar artery obstruction. METHODS: Guyon canal is composed of the hamate and pisiform, and the ligaments which connect them. The course of the ulnar nerve and artery, which passes through this narrow canal, is affected by the anatomical structure of the base of the canal. Out of 14 patients (21 cases) were retrospectively reviewed in this study from 2006 to 2009. Of 14 patients, there were 5 men and 9 women with ages between 21 to 61 years old. The symptoms had volar sensory loss of ulnar sided digits, with muscular atrophy of hypothenar muscles. Prior to surgery, most of these patients had vascular disorders which was diagnosed definitively by angiography and electromyogram. RESULTS: The release of Guyon canal and interposition graft of the obstructed arteries was carried out to 11 patients (15 cases) who had artery (vascular) occlusive disorder, and. 12 cases had sympathectomy and interposition graft after resection of obstructed ulnar artery. Six cases had release of carpal tunnel performed simultaneously. There were no major complications after surgery. The circulation of the ulnar artery was improved along with the patients' symptoms. CONCLUSION: The pre-existing articles about Guyon canal compression syndrome were mainly focused on ulnar nerve compression. This study, which was carried out by our department, showed that most of these patients had ulnar artery obstruction or stenosis simultaneously with ulnar nerve compression. The vascular disorder was corrected by interposition graft after the resection of the site of ulnar artery occlusion. And to conclude, When we resolve the ulnar nerve compression, the proper diagnosis & treatment of impaired ulnar artery circulation should be carried out concomitantly.
Angiography ; Arteries ; Constriction, Pathologic ; Female ; Humans ; Ligaments ; Male ; Muscles ; Muscular Atrophy ; Retrospective Studies ; Sympathectomy ; Transplants ; Ulnar Artery ; Ulnar Nerve ; Ulnar Nerve Compression Syndromes

In vitro study was performed to evaluate the effect of combination therapy with vinblastine. adriamycin and interferon-alpha, gamma on human renal cell carcinoma cell lines. Three renal cell carcinoma cell lines. Caki-1, Caki-2, A498, were used. The cytotoxicity was measured by MTT assay. The concentrations of vinblastine and adriamycin was fixed to IC50 after cytotoxicity assessment and 10, 100, 1.000, 10.000 IU/ml of interferon alpha, gamma were combined. The cytotoxicity by interferon alpha or gamma alone increased according b the concentration and 10 to 30% cytotoxicity were showed in all three renal cell carcinoma cell lines. The synergistic effect was found in interferon alpha plus adriamycin and interferon gamma plus Vinblastine in Caki-2. The additive effects was found in interferon alpha plus vinblastine in Caki-2. interferon gamma plus vinblastine and interferon alpha plus adriamycin in Cancer cell line. Interferon gamma showed more tan additive effect in all three cell lines combined with adriamycin. These findings suggest that interferon alpha or gamma could be used in combination with adriamycin. Further studies including in vivo studies are mandatory before human application.
Carcinoma, Renal Cell* ; Cell Line* ; Doxorubicin* ; Humans* ; Inhibitory Concentration 50 ; Interferon-alpha* ; Interferons ; Triacetoneamine-N-Oxyl ; Vinblastine*

It is well known that renal cell carcinoma shows poor responses upon chemotherapy, and a multidrug-resistance has been suggested as one of the possible mechanisms of these resistances to chemotherapeutics of renal cell carcinoma as well as other malignancies. We tried to measure the expressions of the multidrug resistance gene and p-glycoprotein in human renal cell carcinoma cell lines, and to evaluate whether various multidrug resistance modulators could enhance the cytotoxicity of adriamycin. Four human renal cell carcinoma cell lines, A-498, A-704, Caki-1, Caki -2, were used and verapamil, cyclosporin A, cefoperazone, quinidine were used as the multidrug resistance modulating agents. Polymerase chain reaction was used to detect the expression of MDR1 mRNA, and measurement of p-glycoprotein was done by FACScan using JSB-1 monoclonal antibody. Cytotoxicity of adriamycin was measured by MTT colorimetric assay. Expression of MDR1 mRNA was observed in A-704, and A-498, but was not detected in Caki-1 and Caki-2. Expression of p-glycoprotein was found in A-498 and A-704, but not in Caki-1 and Caki-2. The relative expression rates of MDR1 and p-glycoprotein in A-498, A-704, Caki-1 and Caki-2 comparing to KB-3-1, the negative control cell line were 1.75, 2.44, 0.98, 0.97 and 1.31, 1.12, 1.08, 0.78 respectively. From these observations, A-498 was selected as MDR positive cell line and Caki-2 as MDR negative cell line, and then a study was performed to evaluate the effect of multidrug resistance modulators on the cytotoxicity of adriamycin upon these cell lines. Verapamil, in concentration of 0.1/microM, did not enhance the anticancer effect of adriamycin on A -498 cells, but with the concentration of 1 microM and 10microM, it decreased IC(50) of adriamycin from 0.43 microgram/ml when only adriamycin was used to 0.21 and 0.16, showing the dose modification effect of 2. 05 and 2.68 respectively (p<0.05, by Mann Whitney test). Cyclosporin A, in all the concentration of 0.3, 1, 3 microM, also decreased IC(50) of adriamycin on A-498 cells to 0.17, 0.14, 0.15 microgram/ml respectively, showing the dose modification effect of 2.53 to 3.07 (p<0.05, by Mann Whitney test). But the cytotoxicity of adriamycin was not influenced by cefoperazone and quinidine. In Caki-2 cells, in which MDR1 and p-glycoprotein expression were barely detected, verapamil and cyclosporin A as well as cefoperazone and quinidine did not show any effect upon the cytotoxicity of adriamycin. Considering above results, verapamil and cyclosporin A seem to be an effective multidrug resistance modulating agents to enhance the cytotoxicity of adriamycin in renal cell carcinoma showing MDR1 and p-glycoprotein expression, and further studies including in vivo study are needed before clinical trials to improve chemotherapeutic effect upon renal cell carcinoma.
Carcinoma, Renal Cell* ; Cefoperazone ; Cell Line* ; Cyclosporine ; Doxorubicin* ; Drug Resistance, Multiple* ; Drug Therapy ; Genes, MDR ; Humans* ; P-Glycoprotein ; Polymerase Chain Reaction ; Quinidine ; RNA, Messenger ; Verapamil

OBJECTIVES: The aim of this study was to compare the efficacy and safety of magnesium sulfate, ritodrine hydrochloride and nifedipine in the management of preterm labor. MATERIALS AND METHODS: 180 women with documented preterm labor were randomly assigned to receive magnesium sulfate (n=60), ritodrine hydrochloride (n=60) and nifedipine (n=60) as initial tocolytic therapy. 30 women with documented preterm labor were allocated to administer fluid only and bed rest as control group. Patient could be switched to another tocolytic regimen if they continued to have contractions or side effects. The main outcome variables examined were days gain in utero, success rate, side effects and neonatal outcome. RESULTS: There were no significant differences in maternal characteristics between the groups. The days gain in utero was no statistically different in the three groups(magnesium sulfate, ritodrine hydrochloride and nifedipine) but markedly longer in the three groups than the control group (p<.01). The total success rate was similar in the three groups, but side effects were much more in the magnesium sulfate and ritodrine group than the nifedipine group (p<.05). The respiratory distress syndrome in neonate was decreased in the three groups than the control group without statistical significance. CONCLUSION: Nifedipine is an effective, safe, and well-tolerated tocolytic agent. In this retrospective study, total success rate of controlling preterm labor was similar in the three groups, but patients who received nifedipine were less side effects than magnesium sulfate or ritodrine group.
Bed Rest ; Female ; Humans ; Infant, Newborn ; Magnesium Sulfate ; Magnesium* ; Nifedipine ; Obstetric Labor, Premature* ; Pregnancy ; Retrospective Studies ; Ritodrine* ; Tocolysis

Purpose: Netarsudil is a Rho kinase inhibitor and the first new class of clinically useful ocular hypotensive agents. In this study, we conducted a systematic literature review and meta-analysis to summarize and synthesize the available evidence on the efficacy and safety of fixed-dose combination (FDC) therapy with netarsudil/latanoprost in patients with glaucoma. Methods: We identified relevant studies in PubMed, Ovid Medline, Embase, and Cochrane Central until April 2021. The quality of the studies and the level of evidence were assessed using the Risk of Bias tool. Efficacy was measured as the mean difference in reducing intraocular pressure (IOP), and safety was assessed by the risk of conjunctival hyperemia (CH) due to FDC therapy, netarsudil monotherapy, or latanoprost monotherapy. Results: Four studies met the predefined eligibility criteria and were included in the meta-analysis. The mean difference in the reduction in IOP after 2 weeks and 4 to 6 weeks of drug administration was -2.41 mmHg (95% confidence interval [CI], -2.95 to -1.87) and -1.77 mmHg (95% CI, -2.31 to -1.87), respectively, in patients receiving FDC therapy versus those receiving latanoprost monotherapy. On the other hand, latanoprost monotherapy had a greater effect in reducing IOP than netarsudil monotherapy after 4 to 6 weeks of administration (mean difference, 0.95 mmHg; 95% CI, 0.43 to 1.47). The risk of CH was significantly higher with both FDC therapy and netarsudil monotherapy compared to latanoprost monotherapy in week 12, where the relative ratio was 3.01 (95% CI, 1.95 to 4.66) and 2.33 (95% CI, 1.54 to 3.54), each. Conclusions Netarsudil/latanoprost FDC therapy has a significantly greater effect on reducing IOP than latanoprost alone. The symptoms of CH were mostly mild, and only a few glaucoma patients discontinued the medication owing to CH in earlier clinical trials. Therefore, it would be beneficial to consider the administration of netarsudil/latanoprost FDC therapy in patients with glaucoma.

Background: and Purpose Spinocerebellar ataxias (SCAs) are the most common form of hereditary ataxias. Extracerebellar signs have been well described and are helpful in differentiating the SCA subtypes. However, there are few reports on the early-stage extracerebellar signs in various SCA subtypes. This study explored the clinical and magnetic resonance imaging (MRI) characteristics of early-stage SCAs in the Korean population. Methods: We retrospectively reviewed the medical records of genetically confirmed SCA patients with a disease duration of <5 years. Data on baseline characteristics, extracerebellar signs, and initial MRI findings were organized based on SCA subtypes. Results: This study included 117 SCA patients with a median age at onset of 40.6 years. The family history was positive in 71.8% of the patients, and the median disease duration and the score on the Scale for the Assessment and Rating of Ataxia at the initial visit were 2.6 years and 5.0, respectively. SCA3 was the most prevalent subtype, and oculomotor abnormalities were the most frequent extracerebellar signs in early-stage SCAs. Saccadic slowing was characteristic of SCA2 and SCA7, and gaze-evoked nystagmus was prominent in SCA6. Parkinsonism was relatively frequent in SCA8 and SCA3. Decreased visual acuity was specific for SCA7. Dementia was not an early manifestation of SCAs. Brain MRI revealed a pattern of pontocerebellar atrophy in SCA2 and SCA7, while SCA6 demonstrated only cerebellar cortical atrophy. Conclusions SCA patients exhibited diverse extracerebellar signs even in the early stage.Specific extracerebellar signs were characteristic of specific subtypes, which could facilitate differential diagnoses of early-stage SCAs.