Metabolic acidosis (MA) is associated with increased proteolysis, increased osteoclast activity and blunted cardiac muscle response, but the effect of MA on various clinic al parameters in CAPD patients is not well known. To evaluate the effects of MA on serum albumin level and other nutritional parameters in CAPD patients, we studied 106 CAPD patients retrospectively who have had monthly biochemical measurement and urea kinetic studies every 6 months for more than 2 years. The patients were divided into three groups according to their mean total CO2 (tCO2) level of the 2-year follow-up (Group l; mean tCO2 < 22mM/L, Group ll; 22mM/L < or = mean tCO2 < 26mM/L, and Group lll; mean tCO2 > or = 26mM/L), and the clinical, biochemical, and urea kinetic data were compared among the three groups. 1)The mean age of the subjects was 46.9+/-12.2 years with a sex ratio of 1.2:1, the mean CAPD duration 28.3+/-21.8 months, mean body weight (Bwt) 59.0+/-8.9kg, %Bwt/IBW 104.1+/-11.5%, %LBM/Bwt 75.5+/-11.1% and well-nourished patients by subjective global assessment (SGA) were 65%. 2)The mean BUN, creatinine, total protein and albumin of all patients were 55.6+/-13.6mg/dL, 12.3+/-3.5mg/dL, 6.6+/-0.7g/dL and 4.0+/-0.4g/dL, respectively. In urea kinetic study, the mean NPCR, weekly Kt/ Vurea, SCCr and RRF were 0.96+/-0.16g/kg/day, 2.02+/-0.37, 63.7+/-18.4L/week/1.73m2, and 0.99+/-1.32ml/ min, respectively. 3)The mean age was significantly higher in group l (51.0+/-10.8) than those of group ll (47.0+/-12.4) and lll (42.6+/-11.4) (P<0.05). %Bwt/IBW of group l (114.4+/-15.8%) was also significantly higher than those of group ll (104.6+/-12.6%) and lll (103.5+/-13.7 %) (P<0.05), but there were no significant differences in sex ratio, CAPD duration, %LBM/Bwt, and SGA among the three groups. 4)The mean tCO2 in group l, group ll, and group lll were 20.6+/-1.2mM/L, 23.9+/-1.1mM/L, and 27.3+/-0.8mM/L, respectively. Compared to group lll, group l had significantly higher BUN (61.1+/-14.3 vs. 46.1+/-7.2mg/dL, P<0.05) and serum albumin (4.04+/-0.31 vs. 3.75+/-0.39g/dL, P<0.05), in spite of comparable dialysis dose and albumin loss into dialysate. 5)NPCR (1.02+/-0.21g/kg/day vs. 0.88+/-0.14g/kg/ day, P<0.05) and ultrafiltration volume (1.4+/-0.4 vs. 1.0+/-0.3, P<0.05) were significantly higher in group l than those of group lll. But there were no significant differences in Kt/Vurea, SCCr, RRF, and 24-hour dialysate loss of protein/albumin among the three groups. 6)No differences were observed among the three groups in the changes of body weight, %Bwt/IBW, %LBM/Bwt, BUN, albumin, NPCR, and RRF from the baseline values after the 2-year follow-up. 7)There were significant inverse correlations between the mean tCO2 level and NPCR (r=-0.33, P<0.001), %Bwt/IBW (r=-0.32, P<0.001), RRF (r=-0.29, P<0.005), and serum albumin level (r=-0.24, P<0.05). But, creatinine, %LBM/Bwt, and Kt/Vurea did not show any correlation with the mean tCO2 level. 8)Using stepwise multiple regression analysis, NPCR (beta=-0.3491, P<0.001), %Bwt/IBW (beta=-0.046, P<0.001), and ultrafiltration volume (beta=-0.0012, P< 0.005) were independent factors affecting the mean tCO2 level. In conclusion, low total CO2 level in long-term CAPD patients may reflect increased protein intake and mild to moderate degree of metabolic acidosis may not affect the nutritional status of well-dialyzed CAPD patients.
Acidosis* ; Body Weight ; Creatinine ; Dialysis ; Follow-Up Studies ; Humans ; Myocardium ; Nutritional Status ; Osteoclasts ; Peritoneal Dialysis, Continuous Ambulatory* ; Proteolysis ; Retrospective Studies ; Serum Albumin* ; Sex Ratio ; Ultrafiltration ; Urea

Tumor-draining lymph node (TDLN) lymphocytes contain immunologically sensitized to tumor but functionally deficient T cells. The 30 kDa protein antigen, a major secreted protein antigen of Mycobacterium tuberculosis, exhibits strong T cell stimulatory effect. In this study, it examined that the feasibility of using M tuberculosis 30 kDa antigen to stimulate tumor-draining lymph node cells for the generation of specific immune effector cells. Freshly isolated TDLN lymphocytes could directly respond to the 30 kDa antigen alone and their proliferative responses were markedly augmented by stimulation with rIL-2. TDLN cells were stimulated with the 30 kDa antigen for various time intervals and examined for the induction of IFN-r and IL-4 mRNA using RT-PCR. The expression of IFN-r mRNA was greatly augmented after 1 wk, whereas IL-4 mRNA is markedly decreased after 1 wk. Cytotoxic T cell activities induced by the 30 kDa antigen was also evaluated. TDLN cells stimulated with the 30 kDa antigen alone were able to generate remarkable cytotoxic response to K562 or Daudi cell lines after 6 days of culture. And their cytotoxic effects were highly augmented by stirnulation with rIL-2. These results suggest that the 30 kDa antigen of M. tuberculosis may selectively activate Thl cells of TDLN lymhocytes and induce the cytotoxic T cell activities. In conclusion, the 30 kDa antigen can be used as a biologic response modifier in tumor immunology.
Allergy and Immunology ; Cell Line ; Interleukin-4 ; Lymph Nodes* ; Lymphocytes* ; Mycobacterium tuberculosis* ; Mycobacterium* ; RNA, Messenger ; T-Lymphocytes ; Th1 Cells* ; Tuberculosis

Although a lot of articles examining concomitant intrauterine and ectopic pregnancy have been presented, we have not found any reports on ectopic implantation of chorionic villi in the vagina with normal intrauterine pregnancy. We experienced a case of chorionic villi on the vaginal wall as a hemorrhagic mass during the second trimester of pregnancy. A pregnant woman (gestational age of 16 weeks and 1 day) visited our hospital due to vaginal bleeding. There was no abnormal finding except vaginal hemorrhagic mass, and the mass revealed a product of conception.
Chorion* ; Chorionic Villi* ; Female ; Fertilization ; Humans ; Pregnancy ; Pregnancy Trimester, Second* ; Pregnancy* ; Pregnancy, Ectopic ; Pregnant Women ; Uterine Hemorrhage ; Vagina

No abstract available.
Biopsy, Fine-Needle* ; Pancreas*

The first ray, including the hallux and first metatarsal, has historically been the most common location of congenital and functionally acquired deformities of the lower extremity. It has been the subject of extensive historical review and study as an untold number of authors and surgeons have directed their talents toward the comprehension and correction of the condition. But, few reports have been made on that subject in Korean population. So, we made a clinical and radilogical study of the hallux valgus angle (HVA), intermetatarsal angle (IMA) and hallux valgus in 200 Korean population. The results obtained were as follows: 1. The mean value of HVA was 14.8°±4.6° in male and 17.6°±5.4°in female. The mean value of HVA of the hallux valgus patient was 33° 2. The mesn value of IMA was 8.6°±1.9°in male and 10.2°±2.2°in female. The mean value of IMA of the hallux valgus patient was 14° 3. The incidence of hallux valgus was 11% in male, 37% in female and female was 77% of all hallux vslgus patient. 4. The family history of hallux valgus was found in 63% and 94% of patients has bilateral involvement. 5. The most common chief complaint was pain over the medial side of the first MP joint or base of the other metatarsal bone. Symptoms were not correlated with angle value. 6. In the first MP joint of hallux valgus by Piggott, the deviated joint was most common (52%). 7. In the three basic MP joint types by Haas, the round metatarsal head was most common. 8. DASA was ranged from 0°to 7°in normal persons and from 2°to 16°in hallux valgus patients. 9. PASA was ranged from 1°to 9°in normsl persons and from 3°to 35°in hallux valgus patient. 10. The tibial sesamoid displacement more than grade 4 by Haas rating system was found 63% of hallux valgus patients.
Aptitude ; Asian Continental Ancestry Group ; Comprehension ; Congenital Abnormalities ; Female ; Hallux Valgus ; Hallux ; Head ; Humans ; Incidence ; Joints ; Lower Extremity ; Male ; Metatarsal Bones ; Surgeons

No abstract available.

No abstract available.
Bezoars*

The fibroepithelial polyp of the ureter is a rare, benign tumor. Its pathogenesis is unclear, but most investigators agree that it arises from elements of mesodermal origin within the ureteral wall. Symptoms include hematuria and intermittent flank pain secondary to partial ureteral obstruction. Correct radiologic assessment is crucial to direct surgical management. We report a case of a fibroepithelial polyp of the ureter in a child in whom correct preoperative diagnosis was made by correlating the results of excretory urography, sonography, CT and urine cytology.
Child* ; Diagnosis ; Flank Pain ; Hematuria ; Humans ; Mesoderm ; Polyps* ; Research Personnel ; Ureter* ; Ureteral Obstruction ; Urography

PURPOSE: We tried to determine whether six-hour fasting before abdominal computed tomography (CT) scan is necessary to prevent aspiration of gastric contents in patients with acute abdominal pain. METHODS: Adult patients with acute abdominal pain who were checked abdominal CT were enrolled. Exclusion criteria were age <15 years, pregnancy, traumatic cause of symptoms, chronic pain(>7 days), renal impairment and hypersensitivity to contrast media. We compared Group-I (<6-hour fasting) with Group-II(> or =6-hour fasting). We collected the demographic and clinical data on the causes of abdominal pain, pain duration, presence of nausea and vomiting, and use of medications before and after abdominal CT. In order to estimate the volume of gastric contents, we measured the area on the CT image which showed the largest volume of gastric contents. RESULTS: Among the 122 patients, Group-I consisted of 38 patients(31.1%) and Group-II included 84(68.9%). The demographic makeups of the two groups were similar, except for gender proportion (more males in Group-I). Group-I showed significantly greater gastric contents compared than Group-II(46.8+/-32.1 vs. 33.7+/-28.3, p=0.024). A slightly negative correlation (r=-0.2313; 95% CI=-0.3929 to -0.0559) was observed between the fasting time and the volume of gastric contents. However, the frequencies of the nausea [13/38 (34.2%) vs. 26/84 (31%), p=0.721] and vomiting [6/38 (15.8%) vs. 18/84 (21.4%), p=0.468] showed no difference between two groups. There were no aspiration events in either groups. CONCLUSION: Six hours of fasting before abdominal CT may not be required to prevent aspiration of gastric contents in patients with acute abdominal pain.
Abdomen, Acute ; Abdominal Pain ; Adult ; Contrast Media ; Fasting ; Humans ; Hypersensitivity ; Male ; Nausea ; Pregnancy ; Tomography, Spiral Computed ; Vomiting

Renal cysts are frequently seen in the general population. Most small simple renal cysts are managed by conservative treatment. A renal cell carcinoma (RCC) presenting as a renal cyst is extremely uncommon, and collecting duct carcinoma is a rare type of RCC. This report describes a collecting duct carcinoma initially presnted as a renal cyst. The patient was a 52-year-old man who had been diagnosed with a renal cyst in the left lower pole 8 years earlier but was not regularly follow-up. He presented with left flank pain and gross hematuria. Computed tomography revealed a heterogeneous enhanced mass in the left lower pole and multiple para-aortic lymph nodes. He underwent radical nephrectomy and lymph nodes dissection which confirmed collecting duct carcinoma with sarcomatoid differentiation.
Carcinoma, Renal Cell* ; Flank Pain ; Follow-Up Studies ; Hematuria ; Humans ; Lymph Nodes ; Middle Aged ; Neoplasm Metastasis ; Nephrectomy