No abstract available.
Humans* ; Keratinocytes* ; Protein-Serine-Threonine Kinases* ; Serine* ; Threonine*

PURPOSE: To investigate the change in mitogen-activated protein kinase pathways in the brain tissue after therapeutic hypothermia in the swine cardiac arrest model. METHODS: After the return of spontaneous circulation by cardiopulmonary resuscitation, following a 6 min of no-flow time induced by ventricular fibrillation, pigs (n=24) were randomly assigned to one of four groups (sham, normothermia, 24 hr of therapeutic hypothermia, 48 hr of therapeutic hypothermia). After 24 or 48 hr of therapeutic hypothermia (core temperature 32-34℃), the pigs were then rewarmed to 36℃ for a period of 8 hr. At 60 hr upon the return of spontaneous circulation, the pigs were sacrificed and brain tissues were harvested. RESULTS: We measured the tissue levels of p38, JNK, and ERK pathway expressions from the hippocampus of the swine brain in all four groups. The phosphorylated p38-to-p38 ratio and phosphorylated JNK-to-JNK ratio were significantly increased in all of the intervention groups compared with the sham group. The phosphorylated ERK-to-ERK ratio was increased only in the therapeutic hypothermia groups (p-value=0.026 in the 24 hr of therapeutic hypothermia group and p-value=0.002 in the 48 hr of therapeutic hypothermia group, compared with the sham group). CONCLUSION: The p38 and JNK pathways were also activated during therapeutic hypothermia and normothermia. However, the ERK pathway was activated only in therapeutic hypothermia. Therapeutic hypothermia activated the ERK pathway in ischemia-reperfusion injury of the brain tissue after cardiac arrest, which seemed to be dependent on the duration of therapeutic hypothermia.
Brain* ; Cardiopulmonary Resuscitation ; Heart Arrest* ; Hippocampus ; Hypothermia, Induced* ; MAP Kinase Signaling System ; Mitogen-Activated Protein Kinases ; Protein Kinases* ; Reperfusion Injury ; Swine* ; Ventricular Fibrillation

OBJECTIVE: To determine pathologic variables associated with overall survival and disease free survival of patients with endometrial cancer. METHODS: Survival of 81 endometrial cancer patients treated with primary surgery between January 1997 and December 2003 at our center was compared about various histopathologic variables. All patients underwent complete surgical staging including pelvic +/- paraaortic lymph node dissection. Survival analyses were performed by the Kaplan-Meier curves and the log-rank test. Independent prognostic factors were determined by Cox's proportional hazards model using likelihood-ratio statistics based on the conditional parameter estimate (Conditional). RESULTS: With regard to disease free survival, univariate analysis revealed no significant differences in subgroups according to age category, grade and adjuvant radiotherapy. However, significant differences in disease free survival were found between stage I+II and stage III, and between endometrioid type and the others type. Among these significant subgroups, the Cox-proportional hazards model showed that stage was the only independent prognostic factor. There were no significant differences in the overall survival of patients in subgroups according to age category and adjuvant radiotherapy. But, significant differences in overall survival were found in subgroups according to stage, histology and grade. Multivariate analysis revealed that stage was the only independent significant adverse prognostic effect. CONCLUSION: Our results showed that only stage was an independent prognostic factor of disease free survival and overall survival in endometrial cancer patients.
Disease-Free Survival ; Endometrial Neoplasms* ; Female ; Humans ; Lymph Node Excision ; Multivariate Analysis ; Proportional Hazards Models ; Radiotherapy, Adjuvant

BACKGROUND AND OBJECTIVES: Concerns about the quality of indoor air have increased recently. However, there has not been any significant research conducted concerning the patterns of histologic and organic changes induced in humans by indoor air pollution. The aim of the study is to investigate the organic changes of nasal mucosa and nasal symptoms due to exposed concentrations of indoor air pollution. SUBJECTS AND METHOD: We studied fourteen people from four families, all of whom had plans to move into new apartments. We measured the quantities of indoor air pollution before their move, one week after moving in, and then one month after the move. Other clinical tests such as an acoustic rhinometry, olfactory tests and nasal smears were performed. RESULTS: Mean concentrations of Total Volatile Organic Chemicals (TVOCs) and aldehydes showed an increase after moving into the new apartments. Post-move acoustic rhinometry, Connecticut Chemosensory Clinical Research Center (CCCRC) test and endoscopic findings showed a decrease in nasal function and patency. Additionally, in nasal smears, eosinophils with bilobulated nuclei were observed, and eosinophil count showed a pattern of increase. CONCLUSION: High concentrations of indoor air pollutants could induce organic changes of the nasal cavities and cause the recession of olfactory function. Due to indoor air pollutants, hypersensitivity of nasal mucosa was induced, and histological changes of nasal mucosa as well as hematological changes were observed. These indicate that indoor air pollution impinges on the nasal mucosa and cause nasal symptoms.
Air Pollutants ; Air Pollution, Indoor ; Aldehydes ; Connecticut ; Eosinophils ; Humans ; Hypersensitivity ; Nasal Cavity ; Nasal Mucosa ; Organic Chemicals ; Rhinitis, Allergic, Perennial ; Rhinometry, Acoustic ; Sick Building Syndrome

PURPOSE: Primary total knee arthroplasty (TKA) can be an alternative method for treating distal femoral fractures in elderly patients with knee osteoarthritis. The purpose of this study was to evaluate the clinical and radiographic results in patients with knee osteoarthritis who underwent TKA with the Medial Pivot prosthesis for distal femoral fractures. MATERIALS AND METHODS: Eight displaced distal femoral fractures in 8 patients were treated with TKA using the Medial Pivot prosthesis and internal fixation. The radiographic and clinical evaluations were performed using simple radiographs and Hospital for Special Surgery (HSS) knee scores during a mean follow-up period of 49 months. RESULTS: All fractures united and the mean time to radiographic union was 15 weeks. The mean range of motion of the knee joint was 114.3degrees and the mean HSS knee score was 85.1 at the final follow-up. CONCLUSIONS: Based on the radiographic and clinical results, TKA with internal fixation can be considered as an option for the treatment of simple distal femoral fractures in elderly patients who have advanced osteoarthritis of the knee with appropriate bone stock.
Aged ; Arthroplasty ; Femoral Fractures ; Follow-Up Studies ; Humans ; Knee ; Knee Joint ; Osteoarthritis ; Osteoarthritis, Knee ; Prostheses and Implants ; Range of Motion, Articular

OBJECTIVE: Decompression and/or fusion have traditionally been used to treat the spinal stenosis and spondylosis. Recently, several devices for dynamic posterior stabilization have been developed in treatment of lumbar spinal stenosis and degenerative spine diseases. This special technique of dynamic posterior stabilization of the lumbar spine may be defined as a system that would alter favorably the movement and load transmission of a spinal motion segment, without the fusion. At present, the 'interspinous U' has been using as one of favor device for dynamic posterior stabilization. METHODS: From January 2003 to November 2004, we have used the 'interspinous U' for 48 patients with lumbar spinal stenosis with mild segmental instability, after bilateral foraminotomy. All patients were checked the follow-up simple X-ray stress view after more than 12 months and evaluated the stability and the outcome of the patients. RESULTS: The patients were consisted of 26 men and 22 women, and mean ages was 55.3 years. The average follow- up period was approximately 22 months. The clinical outcomes were evaluated as excellent 15, good 19, fair 12 and poor 2. Especially, the patient group of unsatisfactory outcome(fair and poor) mainly complained the sudden burst back pain with the position change and this symptom was aggravated more and more during follow-up periods. In the flexion/extension lateral X-ray view, the evidence of bony absorption of the spinous process at the contacting side with 'interspinous U' device was found in 15 cases and also the minor instability was seen. CONCLUSION: 'interspinous U' is harder than any other ones for dynamic posterior stabilization, it is difficult to act like the "shock-absorber" and so the power to clamp the spinous process might be weak in spacer. Our preliminary results suggest that the late complications of the 'interspinous U' device in posterior dynamic stabilization may be the bone absorption of spinous process and minor instability, that is bone-implant interface failure.
Absorption ; Back Pain ; Decompression ; Female ; Follow-Up Studies ; Foraminotomy ; Humans ; Male ; Spinal Stenosis ; Spine ; Spondylosis

OBJECTIVE: Anterior cervical discectomy and fusion(ACDF) is a highly successful surgical treatment for nerve root or spinal cord compression caused by disc herniation or spondylosis. Multilevel cervical discectomy usually requires plate and screw fixation for adequate bony fusion and stability. But the use of plate and screw fixation may cause some post-operative complications. So in this study we evaluate the safety and effectiveness of two-level ACDF with carbon or polyetheretherketone(PEEK) cages without cervical plate in cervical degenerative disc disease. METHODS: We retrospectively analyzed 18 patients who underwent two-level ACDF with carbon or PEEK cages from February 2002 to August 2008. The mean follow-up period was 31months. Clinical, radiologic and surgical morbidities were assessed in all cases. Outcome assessment was done using Odom's criteria and visual analogue scale(VAS) score. Radiological assessment was done with bony fusion rate, linear measure of cervical lordosis, cervical lordotic angle and cage subsidence. RESULTS: Radiculopathy was improved in all cases(100%) after surgery, whereas myelopathy was resolved in three of five patients(60%). Radiographic evidence of fusion was found in all patients(100%) at last follow-up. Preoperative mean VAS score was 8.1 compared with a postoperative score 2.5(p<0.05). The clinical outcome was excellent or good in 16 cases(89%). There were no serious complications such as dislodgement of cages, hardware failure, infection and neurologic deterioration. Linear measure of cervical lordosis at last follow-up was increased from 2.72+/-1.12mm to 7.84+/-1.09mm. Cervical lordotic angle at last follow-up was increased from 8.9+/-2.76 degrees to 15.1+/-2.38 degrees. The mean loss of disc height was 1.40mm during the follow-up period. However development of subsidence did not influence on clinical outcomes. CONCLUSION: ACDF in two-level stand-alone cages is a safe and effective procedure in multilevel cervical degenerative diseases. In spite of subsidence, interbody fusion with cages provides load-sharing function and stabilization of the cervical spine by increasing segmental rigidity, thus yielding excellent fusion rates and less graft failure, even in two- level cervical diseases.
Animals ; Carbon ; Diskectomy ; Follow-Up Studies ; Humans ; Ketones ; Lordosis ; Polyethylene Glycols ; Radiculopathy ; Retrospective Studies ; Spinal Cord Compression ; Spinal Cord Diseases ; Spine ; Spondylosis ; Transplants

OBJECTIVE: To determine effect of concurrent chemoradiotherapy (CCRT) in treatment of FIGO stage IIB cervical cancer the uterus and of consolidation chemotherapy using same chemotherpeutic regimens. METHODS: The study population consisted of total number of 41 patients diagnosed as having cervical cancer FIGO stage IIB between January 1999 and December 2003 and treated with CCRT. We were divided into 2 groups according to number of cycles of chemotherapy received [e.g., < or =3 (n=19, cases) cycles versus >3 (n=22, controls) cycles]. Both groups had received the chemotherapeutic regimens which consist of cisplatin 60 mg/m2 followed by five consecutive daily infusions of 5-fluorouracil (5-FU) 1,000 mg/m2 every 3 weeks. RESULTS: 5 years survival rate and 3 years progression free survival are 80.1% and 60.6% in 45 months median follow up duration (range 6-81 months). The median duration of follow up for case and control is 42 months (range 6-81 months) and 52.5 months (range 11-74 months) respectively (p=0.89). Both progression free survival rate (p=0.77) and survival rate (p=0.39) of the groups were revealed to be without statistical significance. CONCLUSION: This study shows similar results to compare with previous CCRT reports and that CCRT is primary treatment of cervical cancer IIB.We may not improve remarkably survival with many chemotherapy cycles. But because of small population and retrospective study, further study of a large number of patients,prospective and long term follow up will be necessary to test the efficacy of the consolidation chemotherapy.
Cervix Uteri* ; Chemoradiotherapy* ; Cisplatin* ; Consolidation Chemotherapy ; Disease-Free Survival ; Drug Therapy ; Female ; Fluorouracil* ; Follow-Up Studies ; Humans ; Retrospective Studies ; Survival Rate ; Uterine Cervical Neoplasms ; Uterus

Hemolytic uremic syndrome is characterized by the symptoms of microangiopathic hemolytic anemia, thrombocytopenia and renal failure. The incidence of hemolytic uremic syndrome associated with pregnancy is 10 to 25 percent. Hemolytic uremic syndrome is treated with adjunctive therapies, such as anti-platelet agents, glucocorticoid and plasma exchange. However, many patients experience a residual impairment in renal function and some of them progress to end-stage renal disease requiring dialysis or renal transplantation. Immunosuppression with cyclosporine has been implicated as a significant risk factor for post- transplant hemolytic uremic syndrome. A number of reports on transplant recipients have recognized cyclosporine-induced hemolytic uremic syndrome as a distinct entity and a potentially serious complication of cyclosporine administration.We report a case of a patient with successful renal transplantation using cyclosporine who had a severe case of post-partum hemolytic uremic syndrome that progressed to end-stage renal disease. After cadaver-donor renal transplantation using cyclosporine, mycophenolate mofetil and prednisolone her graft function at two years is normal with serum creatinine 1.0 mg/dl.
Anemia, Hemolytic ; Creatinine ; Cyclosporine* ; Dialysis ; Hemolytic-Uremic Syndrome* ; Humans ; Immunosuppression* ; Incidence ; Kidney Failure, Chronic* ; Kidney Transplantation* ; Plasma Exchange ; Postpartum Period* ; Prednisolone ; Pregnancy ; Renal Insufficiency ; Risk Factors ; Thrombocytopenia ; Transplantation ; Transplants

CD99 plays an critical role in the diapedesis of monocytes, T cell differentiation, and the transport of MHC molecules. Engagement of CD99 by agonistic monoclonal antibodies has been reported to trigger multifactorial events including T cell activation as well as cell-cell adhesion during hematopoietic cell differentiation. In this study, to identify the functional domains participating in the cellular events, we mapped the epitopes of CD99, which are recognized by two agonistic CD99 monoclonal antibodies, DN16 and YG32. Using recombinant fusion proteins of GST with whole or parts of CD99, we found that both antibodies interact with CD99 molecules independently of sugar moieties. DN16 mAb detected a linear epitope located in the amino terminal region of CD99 while YG32 mAb bound another linear epitope in the center of the extracellular domain. To confirm that the identified epitopes of CD99 are actually recognized by the two mAbs, we showed the presence of physical interaction between the mAbs and the fusion proteins or synthetic peptides containing the corresponding epitopes using surface plasmon resonance analyses. The dissociation constants of DN16 and YG32 mAbs for the antigen were calculated as 1.27 X 10(-7) and 7.08 X 10(-9) M, respectively. These studies will help understand the functional domains and the subsequent signaling mechanism of CD99.
Amino Acid Sequence ; Antibodies, Monoclonal/*immunology ; Antigens, CD/*chemistry/*immunology ; Blotting, Western ; Cell Adhesion Molecules/*chemistry/*immunology ; *Epitope Mapping ; Epitopes/*chemistry/*immunology ; Glutathione Transferase ; Human ; Molecular Sequence Data ; Peptide Fragments/chemistry/immunology ; Recombinant Fusion Proteins/chemistry/immunology