BACKGROUND: A positive reaction at flow cytometry crossmatch (FCXM) has been highlighted by its predictive value for clinical outcome in kidney transplantation after accumulation of large clinical data. The detection of de novo development of anti-HLA antibodies after transplantation is associated with increased rejection and decreased graft survival. In this study, we report the experience for the detection of anti-donor specific antibody (DSA) by more sensitive FCXM methods in renal transplantation patients. METHODS: T and B cell FCXMs were performed on 11 pretransplant and 51 posttransplant sera from 11 patients who received renal grafts between 2004 and 2005. The posttransplant sera were collected in specific and regular intervals from posttranspant 1 week to 1 year. RESULTS: Among 62 sera, four (7.8%) from 2 patients showed positive FCXM. In one patient, pretransplant serum which was negative at previous CDCXM, and 2 consecutive sera collected at 1 week and 1 month after transplantation were positive at FCXM. And the antibody identified was B51 which was specific for one of donor alleles (DSA). In another patient, FCXM became positive 1 week after transplantation although pretransplant serum had negative results at both CDCXM and FCXM. Both patients had experienced more than one rejection episodes. CONCLUSIONS: Detection of DSA with more sensitive technique such as flow cytometry based method clearly displayed a beneficial effect for prediction of clinical outcome as a part of pretransplant compatibility test, and also as a posttransplant monitoring test to identify the de novo production of clinically significant DSA.
Alleles ; Antibodies ; Flow Cytometry ; Graft Survival ; Humans ; Kidney ; Kidney Transplantation ; Rejection (Psychology) ; Tissue Donors ; Transplants

PURPOSE: This study examined the clinical success rate of Mg titanate implants (M Implant system, Shinhung, Korea), which employ a Mg coating method, by evaluating the marginal bone loss and implant stability using radiographs and Osstell(R), over a 1 year. MATERIALS AND METHODS: The locations of the implants placement were divided into 4 areas; the maxillary and mandibular premolars and molars. In the maxilla, 8 and 9 implants were inserted in the premolar and molar areas, respectively. In the mandible, 11 and 51 implants were inserted in the premolar and molar areas. Marginal bone loss and ISQ of all implants (79) were measured after insertion, mounting the prosthetic appliance, and 1, 3, 6, and 12 months after loading. The marginal bone loss was measured from the radiograph using XCP bite, which was customized, and the implant stability measured using Osstell(R). Fisher's exact test (alpha=.05) was used to compare the success rates of each region. RESULTS: The mean marginal bone loss for the upper and lower jaws were 1.537 mm and 1.172 mm. The mobility showed a non-significant reduction or increase according with time. The success rates were accounted for 94.12% and 98.39% in the upper and lower jaws; the premolars and molars were accounted for 100% and 96.67%. The two cases of early failure resulted from failure of primary stability during implant insertion. The late failures were not observed for 1 year after adding a loading to the implants. CONCLUSION: The Mg titanate implant showed good primary stability and good clinical results in both healing and function.
Bicuspid ; Bites and Stings ; Jaw ; Mandible ; Maxilla ; Molar ; Prospective Studies ; Saturn

PURPOSE: We'd like to know the relationship between the changes of cardiac function and systemic O2 consumption according to the increasing dose of dopamine. METHODS: Ten rabbits(from 2kg to 2.8kg) were used in this experiment. Anesthesia was induced with intraperitoneal pentobarbital sodium(35mg/kg) and tracheostomy was done. It was maintained by ventilation with a mixture of 1-3% halothane and 67-69% oxygen. Polyvinyl catheters were inserted into the femoral artery and vein and to check blood pressure and arterial blood gas analysis during the surgical procedure. Two other catheters were inserted into the internal carotid artery and external jugular vein and advanced into left ventricle and right atrium to check the pressure of each chamber, LV maximal dP/dt and to obtain blood samples of each chamber. Thoracotomy was done to expose aorta and coronary artery to check the cardiac output and coronary blood flow. We injected dopamine every 10 minutes according to the scheduled dose through external jugular vein and recorded heart rate, cardiac output, aortic pressure, maximal dP/dt, coronary blood flow by computer. Systemic O2 consumption was calculated by Fick method RESULTS: The heart rate and mean aortic pressure increased slowly according to the dose of dopamine from 20 microgram/kg/min. The cardiac otuput the maximal dP/dt and coronary blood flow was not changed until 5 microgram/kg/min, but from 7.5microgram/kg/min, it increased according to the dose of dopamine. CONCLUSION: Dopamine was a powerful inotrophic agent without increasing the systemic O2 consumption until 20microgram/kg/min, but systemic O2 consumption increased markedly at more than 20 microgram/kg/min of dopamine.
Anesthesia ; Aorta ; Arterial Pressure ; Blood Gas Analysis ; Blood Pressure ; Cardiac Output ; Carotid Artery, Internal ; Catheters ; Coronary Vessels ; Dopamine* ; Femoral Artery ; Halothane ; Heart Atria ; Heart Rate ; Heart Ventricles ; Jugular Veins ; Oxygen Consumption* ; Oxygen* ; Pentobarbital ; Polyvinyls ; Thoracotomy ; Tracheostomy ; Veins ; Ventilation

Spontaneous rupture of the kidney, Wonderlich syndrome, is a rare event but potentially life-threatening condition. The most comman causes are clear cell carcinoma, benign angiomyolipoma and vascular disease. Among this event, acute pyelonephritis is a very unusual cause. A 67-year-old diabetic woman was admitted with high fever and left flank pain due to acute pyelonephritis. She had uterine prolapse for 10 years with both renal hydronephrosis before this event. Abdominal ultrasonography and CT scan showed fluid collection around left kidney with a rupture of renal parenchyme at lower pole. The renal angiography showed displaced capsular artery due to subcapsular hematoma and decreased blood flow at lower pole. The percutaneous needle aspiration revealed blood collection around left kidney, which confirmed spontaneous rupture of the kidney. We report this case with a review of the relevant literature.
Aged ; Angiography ; Angiomyolipoma ; Arteries ; Female ; Fever ; Flank Pain ; Hematoma ; Humans ; Hydronephrosis ; Kidney* ; Needles ; Pyelonephritis* ; Rupture ; Rupture, Spontaneous* ; Tomography, X-Ray Computed ; Ultrasonography ; Uterine Prolapse ; Vascular Diseases

The term ""collagenous colitis"" was coined by Lindstrom in 1976 to describe the patient with chronic watery diarrhea who had normal rectal mucosa by proctoscopy but who had a thick subepithelial collagenous deposit on biopsy, and now collagenous colitis is recognized as one of the more common causes of chronic diarrhea of obscure origin. But in this country only a few case has been reported. We have seen a 68-year-old man with chronic watery diarrhea with abdominal pain. Physical examination, laboratory and radiologic studies were no abnormal finding. Colonoscopy disclosed grossly normal mucosa through the entire colon but by histologic examination there are chronic inflammation in the lamina propria and thickened subepithelial collagen layer. Symptoms and pathologic findings of patient improved after treatment with sulfasalazine and prednisolone.
Abdominal Pain ; Aged ; Biopsy ; Colitis, Collagenous* ; Collagen* ; Colon ; Colonoscopy ; Diarrhea ; Esophagus* ; Humans ; Inflammation ; Intestines* ; Mucous Membrane ; Numismatics ; Physical Examination ; Prednisolone ; Proctoscopy ; Stomach* ; Sulfasalazine

No abstract available.
Hyperplasia*

BACKGROUND: Stellate ganglion block has been proposed as one of the effective therapetic modalities for herpes zoster. However, the effect on the reduction of acute herpes zoster pain and postherpetic neuralgia is not well known. OBJECTIVE: To evaluate the reduction of acute herpes zoster pain and the prevention of postherpetic neuralgia by stellate ganglion block. METHODS: Twenty one patients with herpes zoster were included in this study, and were divided into two groups: the group treated with I.V acyclovir, analgesics and stellate ganglion block during 7-days of a hospitalization period, and a control group which were treated with I.V acyclovir and analgesics alone. To evaluate it's effect on pain, the score of pain presented by patients, where initial pain was defined as 100 and no pain defined as 0, was recorded and compared between the groups. RESULTS: An average day required for the relief of pain was significantly shorter in the treated group than the control group: the average number of days needed to reduce the pain score from 100 to 50, implicating relief of acute pain, was 2.3 days, compared to 3.7 days in the control group (p=0.036). The total duration of pain, implicating postherpetic neuralgia, was also significantly shorter in the treated group (17.4 days) than the control group (42.3 days) (p=0.035). CONCLUSION: Stellate ganglion block is an effective method which can be used to relieve acute herpes zoster pain involving the trigerminal and cervical nerves, and can prevent postherpetic neuralgia.
Acute Pain ; Acyclovir ; Analgesics ; Herpes Zoster* ; Hospitalization ; Humans ; Neuralgia, Postherpetic ; Stellate Ganglion*

Lysophosphatidic acid (LPA) is a bioactive phospholipids and involves in various cellular events, including tumor cell migration. In the present study, we investigated LPA receptor and its transactivation to EGFR for cyclooxygenase-2 (COX-2) expression and cell migration in CAOV-3 ovarian cancer cells. LPA induced COX-2 expression in a dose-dependent manner, and pretreatment of the cells with pharmacological inhibitors of Gi (pertussis toxin), Src (PP2), EGF receptor (EGFR) (AG1478), ERK (PD98059) significantly inhibited LPA- induced COX-2 expression. Consistent to these results, transfection of the cells with selective Src siRNA attenuated COX-2 expression by LPA. LPA stimulated CAOV-3 cell migration that was abrogated by pharmacological inhibitors and antibody of EP2. Higher expression of LPA2 mRNA was observed in CAOV-3 cells, and transfection of the cells with a selective LPA2 siRNA significantly inhibited LPA-induced activation of EGFR and ERK, as well as COX-2 expression. Importantly, LPA2 siRNA also blocked LPA-induced ovarian cancer cell migration. Collectively, our results clearly show the significance of LPA2 and Gi/Src pathway for LPA-induced COX-2 expression and cell migration that could be a promising drug target for ovarian cancer cell metastasis.
Butadienes/pharmacology ; Cell Line, Tumor ; Cell Movement/drug effects/*physiology ; Cyclooxygenase 2/*biosynthesis ; Extracellular Signal-Regulated MAP Kinases/antagonists & inhibitors/metabolism ; Female ; Flavonoids/pharmacology ; GTP-Binding Protein alpha Subunits, Gi-Go/antagonists & inhibitors/*metabolism ; Humans ; Lysophospholipids/pharmacology ; Nitriles/pharmacology ; Ovarian Neoplasms/metabolism/*pathology ; Pertussis Toxin/pharmacology ; Protein-Tyrosine Kinases/antagonists & inhibitors/*metabolism ; Proto-Oncogene Proteins/antagonists & inhibitors/*metabolism ; Pyrimidines/pharmacology ; Receptor, Epidermal Growth Factor/antagonists & inhibitors/metabolism ; Receptors, Lysophosphatidic Acid/*metabolism ; Receptors, Prostaglandin E/metabolism ; Signal Transduction ; Transcriptional Activation ; Tyrphostins/pharmacology

OBJECTIVE: The purpose of this study was to evaluate the efficiency of transvaginal ultrasonography for detection of fetal anomalies in first trimester. METHODS: This cohort included pregnant women between 9~14 weeks of gestation from April 2000 to April 2002 at department of Obstetrics and Gynecology, Sanggye Paik hospital, Inje university. Besides ACOG (1993) criteria, we scan nuchal translucency, FHR, cranium, abdominal wall and nuchal lesion using transvaginal sonography. If the anatomical survey was normal, the women underwent routine 18~24 weeks anomaly scans. RESULTS: 20 fetuses were identified as having 21 anomalies. Central nervous system anomaly (38%: 8/21) was the most frequent type of malformation. The other detected anomalies were isolated disorders of the lymphatic system 28% (6/21: two cystic hygromas and four nuchal edema), cystic hygroma associated with hydrops 14% (3/21), abdominal wall defects 14% (3/21), skeletal dysplasia 5% (1/21). Of the 20 fetuses that was diagnosed, 14 patients had elective first-trimester abortion, two had spontaneous fetal deaths, four were delivered at term. CONCLUSION: Besides offering the possibility of early termination, first trimester sonography has the advantage of identifying a transient sonographic sign, nuchal edema, which can be used as a marker in screening for fetal chromosomal abnormalities.
Abdominal Wall ; Central Nervous System ; Chromosome Aberrations ; Cohort Studies ; Edema ; Female ; Fetal Death ; Fetus ; Gynecology ; Humans ; Lymphangioma, Cystic ; Lymphatic System ; Mass Screening ; Nuchal Translucency Measurement ; Obstetrics ; Pregnancy ; Pregnancy Trimester, First* ; Pregnant Women ; Skull ; Ultrasonography

OBJECTIVES: To examine the effects of the oligohydramnios on perinatal outcome and latency period in patients with preterm premature rupture of membranes. METHODS: We performed a retrospective analysis of 98 singleton pregnancies complicated by preterm premature rupture of membranes, with delivery between 26 and 35 weeks' gestation. Amniotic fluid index was determined using transabdominal ultrasound at admission. All medical records of mothers and neonates were reviewed. Oligohydramnios was defined as amniotic fluid index less or equal to 5.0 cm and latency period was defined as time interval from membrane rupture to delivery. Chi-spuare test, Fisher's exact test, Student-t test, Mann-Whitney U test were used for statistical analysis. RESULTS: 1) Of the 98 patients, 59 patients(60%) were oligohydramnios group(AFI< or =5.0) and 39 patients(40%) were non-oligohydramnios group(AFI>5.0). Both groups were similar with respect to selected dermographics, gestational age at rupture of the membranes, chorioamnionitis, 1 min Apgar score and 5 min Apgar score. Patients with oligohydramnios demonstrated a lower gestatoinal age at birth and lower birth weight. There were no statistically significant correlations in neonatal morbidity and perinatal mortality between both groups. 2) For comparing latency period, we excluded deliveries of Cesarean section or induction. Comparing the remained group(25 patients), median of latency period in oligohydramnios group were 41.5 hours and median of latency period in non-oligohydramnios group were 44 hours. There were no statistically significant correlations in oligohydramnios and latency period. CONCLUSION: There were no significant effects of the oligohydramnios on poor perinatal outcome and latency period in patients with preterm premature rupture of membranes
Amniotic Fluid ; Apgar Score ; Birth Weight ; Cesarean Section ; Chorioamnionitis ; Female ; Gestational Age ; Humans ; Infant, Newborn ; Latency Period (Psychology)* ; Medical Records ; Membranes* ; Mothers ; Oligohydramnios* ; Parturition ; Perinatal Mortality ; Pregnancy ; Retrospective Studies ; Rupture* ; Ultrasonography