No abstract available.
Aged* ; Humans ; Hyperhomocysteinemia*

No abstract available.
Sarcoma*

PURPOSE: Epilepsy is generally defined as a chronic condition characterized by recurrent unprovoked seizure. It is still controversial whether the long-term antiepileptic drugs(AED) treatment will be necessary in children with first unprovoked seizure. Cognitive and behavioral side effects of AEDs are especially important in developing children. Therefore the rationale of AED treatment in the children with first unprovoked seizure depends upon the seizure recurrence rate and presence of risk factors related with seizure recurrence. We are going to evaluate the risk of seizure recurrence and risk factors after a first unprovoked seizure in children. METHODS: One hundred fifty eight patients presented with a first unprovoked seizure from July, 1994 to June, 1999 were prospectively followed by regular epilepsy clinic visit or telephone interview for a mean of 27 months. We analyzed overall recurrence risk and risk factors of seizure recurrence(EEG finding, etiology of seizure, seizure type, history of prior febrile convulsions, neurodevelopmental status prior to first seizure, presence of a Todd's paresis, family history of seizures, a seizure occuring while asleep, and duration of seizure) by Cox's proportional hazards model and Kaplan-Meier survival analysis. RESULTS: In 158 patients with first unprovoked seizure, 61 (39%) patients experienced subsequent seizure. The cumulative risk of seizure recurrence was 28.5, 37.6, and 42.3% at 6, 12, and 18 months. The median time to recurrence was 3 months, with 72% of recurrence occurring within 6 months, 92% within 1 year, and 100% within 2 years. On univariate analysis, risk factors for seizure recurrence included an etiology of seizure and abnormal EEG. In idiopathic cases, the risk factor was an EEG abnormality. CONCLUSION: Many of the children with a first unprovoked seizure will not have recurrences. The recurrence risk of a first unprovoked seizure in children have statistically correlated with the etiology of seizure(cryptogenic and symptomatic) and abnormal EEG. Children with an idiopathic first seizure and a normal EEG have a particularly favorable prognosis.
Ambulatory Care ; Child ; Electroencephalography ; Epilepsy ; Humans ; Interviews as Topic ; Paresis ; Prognosis ; Proportional Hazards Models ; Prospective Studies* ; Recurrence* ; Risk Factors ; Seizures* ; Seizures, Febrile

No abstract available.
Autoradiography* ; DNA* ; Ultraviolet Rays*

Adult wounds heal with scar-tissue formation, whereas fetal wounds heal without scarring and with a lesser inflammatory and cytokine response. The unique fetal wound repair process is not dependent on the sterile, aqueous intrauterine environment. The differences between fetal and adult wound healing appear to reflect processes intrinsic to fetal tissue, such as the unique fetal fibroblast, a more rapid and ordered deposition and turnover of tissue components, and, particularly, a markedly reduced inflammatory infiltrate and cytokine profile. Among these cytokines, the transforming growth factor-beta(TGF-beta) is a growth factor which plays an important role in the regulation of cell growth and differentiation. The fibrosis characteristic of adult wound repair may be associated with TGF-betaexcess. Recent experimental studies have focused on the specific anti-TGF-beta strategies for scarless wound healing. Decorin, a proteoglycan, is known to regulate TGF-beta. This factor antagonizes the action of TGF-betain tissues. However, little is known about the functions of this factor in vivo. The objects of the present study were to analyze the effects of TGF-beta, an important regulatory molecule in adult healing events, and the effects of decorin, known inhibitor against TGF-beta, on the fetal tissue response following wounding. Fetal cellular and extracellular matrix response to injury were evaluated by treating the wound with TGF-beta and decorin in fetal rat at 14 days gestation (term = 21 days). Histologic response and histomorphometric analysis two to eight weeks later were compared between TGF-betaonly treated wound and TGF-betawith decorin treated wound.The histologic finding of the TGF-beta treated wound was characterized by an early acute inflammatory response : by week 6 fibroblasts and collagen were predominant. In contrast, TGF-beta with decorin treated wound had no remarkable histologic evidence of acute inflammation or fibroblast penetration and few collagen was deposited. These observations demonstrate that the fetal response becomes adultlike with fibroblast proliferation and collagen accumulation when TGF-betais added, thus documenting the responsiveness of the fetal system to adult repair signals. Such responsiveness thus suggests a critical difference in the fetal wound environment. Fetal repair may proceed in the absence of trophic factors like TGF-beta, thus accounting for optimal "healing" in the absence of excessive fibrosis. And these observations also confirmed the inhibitory action of decorin against TGF-beta in rat fetus model. We can suggest that the decorin minimize the inflammatory response and subsequent cellular proliferation in wound healing process, thus eventually prevent collagen deposition and scar tissue formation.
Adult ; Animals ; Cell Proliferation ; Cicatrix ; Collagen ; Cytokines ; Decorin ; Extracellular Matrix ; Fetus ; Fibroblasts ; Fibrosis ; Humans ; Inflammation ; Pregnancy ; Proteoglycans ; Rats* ; Transforming Growth Factor beta ; Wound Healing* ; Wounds and Injuries*

PURPOSE: Preservation of adequate vascular access is of vital importance for patients undergoing chronic dialysis in renal failure. The aim of this study is to evaluate the successful access rate and risk factors of arteriovenous fistula (AVF) in the arm for dialysis at a single center. MATERIALS AND METHODS: Patients undergoing vascular access operation between January 2006 and December 2011 were retrospectively identified. RESULTS: A total of 362 vascular access operations were performed. There were 338 autologous AVFs (93.4%) and 24 prosthetic grafts (6.6%). Men comprised 58.3% of all subjects. Mean age was 59.5+/-14.7 years. There were 187 diabetes mellitus patients (51.7%). There was a mean duration of 70.3+/-21.1 days between access creation to first cannulation. Overall successful access rate for dialysis was 95.9%. Of 338 autologous AVFs, 326 patients had patent AVFs for dialysis (96.4% surgical success rate), while 21 of 24 prosthetic grafts were patent (87.5% surgical success rate). A total of 141 patients (38.9%) came to surgery with preoperative central venous catheters (CVC) of which 130 (35.9%) AVFs had a patent fistula in the arm. The only risk factor related to successful access rate of AVF was preoperative CVC placement (P=0.012). CONCLUSION: Successful vascular access rate was 95.9%. The only risk factor related to patent access of AVF was preoperative CVC placement. At least 6 months prior to expected dialysis, AVF surgery is recommended, which may overcome the challenge of co-morbid conditions from having a preoperative CVC.
Arm* ; Arteriovenous Fistula ; Catheterization ; Central Venous Catheters ; Diabetes Mellitus ; Dialysis* ; Fistula ; Humans ; Male ; Renal Insufficiency ; Retrospective Studies ; Risk Factors* ; Transplants

Osteoporosis has been described as the most common disease in the old age group. As the bone mineral density decreases, the skeleton becomes more prone to fracture. Hip fractures occur late in life following substantial reduction in skeletal mass. So the incidence of hip fracture is increasing due to prolongation of average life span. The bone density of femoral neck, Ward triangle, and trochanteric region were measured by dual energy x-ray absorptiometry (DEXA) in 15 patients with femoral neck fractures and in 58 patients with intertrochanteric fractures to evaluate the relationship between bone mineral density (BMD) value and fracture type. The results were as follows 1. In femoral neck fracture group, the mean BMD value was 0.59+/-0.02 g/cm2 in femoral neck, 0.38+/-0.08 g/cm2 in Ward triangle and 0.48+/-0.09 g/cm2 in trochanteric region. In intertrochanteric fracture group, the mean BMD value was 0.57+/-0.09 g/cm2 in femoral neck, 0.39+/-0.10 g/cm2 in Ward triangle, and 0.47+/-0.13 g/cm2 in trochanteric region. 2. In femoral neck fracture group, the fracture threshold value was 0.75 g/cm 2 in femoral neck, 0.60 g/cm2 in Ward triangle and 0.67 g/cm2 in trochanteric region. In intertrochanteric fracture group, the fracture threshold value was 0.63 g/cm2 in femoral neck, 0.51 g/cm2 in Ward triangle, and 0.57 g/cm2 in trochanteric region. In conclusion, there was no statistical relationship in BMD value between neck fracture and intertrochanter fracture group, and no statistical relationship between BMD value and each fracture type in femoral neck and intertrochanter fracture. The type of hip fracture may be related to the degree of trauma rather than the value of the BMD.
Absorptiometry, Photon ; Bone Density* ; Femoral Neck Fractures ; Femur ; Femur Neck ; Hip Fractures ; Hip* ; Humans ; Incidence ; Neck ; Osteoporosis ; Skeleton

BACKGROUND: Superior migration of humeral head has been conventionally determined by measuring the acromiohumeral distance (AHD), We sought to devise a novel measurement system more reliably and accurately than AHD. We described a structural landmark called 'C-line'. In this study, we investigated the clinical usefulness of 'step-off of the C-line (SOC)' compared to that of AHD. METHODS: The C-line formed from the medial margin of the proximal humeral head continuing up to the inferior margin of the articular glenoid and then to the lateral border of the scapula. The superior migration of the humeral head triggered by a rotator cuff tear introduces a discontinuity in this C-line. We measured the distance of this discontinuity. We enrolled 144 patients who underwent a rotator cuff repair. We selected 58 controls who didn't have any cuff lesions apparent on magnetic resonance imaging. Using radiographs derived from standardized true anteroposterior views of the shoulder, we measured the SOC and the AHD. We used t-tests for statistical analyses. RESULTS: A rotator cuff tear was associated with an increase in SOC and a decrease in AHD. In control group, the mean SOC was 1.29 ± 1.71 mm and AHD was 9.71 ± 2.65 mm. In cuff tear group, the mean SOC was 3.15 ± 3.41 mm and AHD was 8.28 ± 1.76 mm. The mean SOCs of the patient group in relation to the mean SOC of the control group according to tear size, the SOCs of medium tear and lager groups showed statistically significant increase (p<0.05). CONCLUSIONS: The SOC may be a similarly effective to diagnose cuff tears of medium size and larger compared with AHD.
Humans ; Humeral Head* ; Magnetic Resonance Imaging ; Methods* ; Rotator Cuff ; Scapula ; Shoulder ; Tears

No abstract available.
Bronchopulmonary Sequestration* ; Lung* ; Ultrasonography, Prenatal*

OBJECTIVE: This study is proposed to examine the relationship between bone loss after hormone replacement therapy for one year and initial bone markers. METHODS: One hundred postmenopausal women were studied for one year. At first visit, measurements were made of bone mineral density(BMD) at the lumbar spine and femoral neck, and of serum osteocalcin and urine deoxypyridinoline. After hormone replacement therapy was done for one year, BMD was rechecked. RESULTS: Serum osteocalcin was correlated with the rate of bone change(r=0.150, 0.262) and urine deoxypyridinoline was weakly correlated(r=-0.003, 0.038). The changes of femoral BMD in women with higher concentration of osteocalcin and deoxypyridinoline were significant different from those in women with normal concentration. At the lumbar spine, no significant differences were showed. In women with higher concentration of osteocalcin, the incidence of subjects with increased spine BMD was increased up to around 71.1%, which showed not significant increase compared with normal concentration of osteocalcin. And the incidence of increased spine BMD in women with higher concentration of osteocalcin was marked increased compared with the incidence of normal concentration. The level of the osteocalcin with increased spine BMD was 11.5+/-6.6 ng/ml, and the level with decreased spine BMD was 9.2+/-4.7 ng/ml, respectively. And the level of the deoxypyridinoline was 7.2+/-4.2 pmol/ mol cr in women with increased spine BMD and 7.2+/-2.7 pmol/ mol cr in women with decreased spine BMD, which was not statistically different. The concentration of deoxypyridinoline with increased and decreased in BMD in spine and femur was not statistically different. but the concentration of osteocalcin was 12.2 +/-5.5 ng/ml in significantly increased in BMD and 8.5 +/-4.5ng/ml in significantly decreased in BMD, which was showed significant different. CONCLUSION: Present study indicates that the serum osteocalcin more reflcets bone turnover changes at the menopause than deoxypyridinoline, however, the clinical utility of measurements of osteocalcin only to response to therapy is uncertain.
Bone Density* ; Female ; Femur ; Femur Neck ; Hormone Replacement Therapy* ; Humans ; Incidence ; Menopause ; Osteocalcin ; Spine