To investigate the mechanism of crescent formation, sequential pathologic changes from the New Zealand White rabbits with anti-GBM antibody induced GN by administration of guinea pig anti-GBM IgG were studied by light (LM), immunofluorescent (IF) and electron (EM) microscopy. Although no glomerular changes were observed in LM, swelling of the endothelial cells and the epithelial cells were noted in EM by day 2. By day 7, early and cellular crescents were evident. Proteinaceous materials and fibrins were noted in the glomerular capillary lumina (GCL) and Bowman's space (BS) associated with segmental hypercellularity. The GBM damage became progressively severe, followed by focal detachment of the visceral epithelial cells from the GBM. At day 14, fibrin strands, mononuclear cells and collagen fibrils were present between the proliferating extracapillary cells. At day 31, fibrocellular crescents were predominated. Elongated spindle cells, morphologically resembling myofibroblasts, were noted near the Bowman's capsule (BC). A degree of tubular atrophy, interstitial fibrosis, and inflammatory infiltrates increased as it did with fibrous organization of crescent. Intense linear IF staining for IgG and C3 were seen throughout the experiments along the GBM. In conclusion, the progression of crescent from an early "proteinaceous" stage through cellular, fibrocellular and fibrous stages was well documented in this study. Inflammatory cells and coagulation mechanism may activate the initiation of the GBM damage at the early stage. Activated periglomerular mononuclear cells may also cause disruption of BC which facilitates entry of activated periglomerular cells and fibroblasts into BS leading to progressive fibrous crescent formation.
Animals ; Atrophy ; Bowman Capsule ; Capillaries ; Collagen ; Endothelial Cells ; Epithelial Cells ; Fibrin ; Fibroblasts ; Fibrosis ; Glomerulonephritis ; Guinea Pigs ; Immunoglobulin G ; Microscopy ; Myofibroblasts ; Rabbits*

Unilateral or, particularly, bilateral congenital agenesis of the internal carotid artery is a rare anomaly. We report an occurrence of the condition, arising bilaterally, and report the findings of magnetic resonance imaging and magnetic resonance angiography.
Carotid Artery, Internal* ; Magnetic Resonance Angiography ; Magnetic Resonance Imaging

The propose of this study is to give a theoretical basis for better home health service by looking at the subjective structure the collaboration between the home health nurse and doctor and at how collaboration can be improved. There are at least three types of recognition that can help the collaboration. The first type is to put more weight on the relationship between doctors and home health care nurses. This means that doctors and home health care nurses should make an effort to improve, their collaboration. The second type is to put more weight on the reward for doctors' participation. Reward will help collaboration. The third type is to put more weight on organization support. Organization support will bring about trust between doctors and home health care nurses The following conclusion were reached: 1) Trust should exist between doctors and home health care nurses. 2)Doctors should maintain an equal relationship with home health care nurses and accept them as professionals. 3) Appropriate reward should be given to doctors for their participation. 4)Home health care nurses should reinforce their skills through education, training, and professionalization. 5) Home health care nurses should cooperate with doctors by building a system that centers on patients. 6) Collaboration between doctors and home health care nurses is important because it is useful to recognize patients and their families in a broader light. 7) Doctors and home health care nurses need to be more concerned about patients. 8)More active support of hospital administrators and systems is needed to enhance collaboration between doctors and home health care nurses. 9) The present legal system for collaboration between doctors and home health care nurses can be a factor. The nine nursing strategies above will help doctors and home health care nurses build more positive relations and get closer to their patient, more effective home healthcare will get closer to people who want quality medical service.
Cooperative Behavior* ; Delivery of Health Care ; Education ; Health Services* ; Hospital Administrators ; Humans ; Nurses, Community Health ; Nursing ; Reward

Intrathecal administration of methotrexate(IT-MTX) has constituted the standard approach to prophylaxis and treatment of central nevous system(CNS) leukemia. We experienced a quadriplegia and motor aphasia in a 14-year-old boy following repeated IT-MTX for the prophylaxis of meningeal leukemia. He was diagnosed as ALL without CNS involvement and treated by CCG- 1882 protocol. IT-MTX was administered for CNS prophylaxis. The patient began complaining of urinary incontinence, motor aphasia and weakness in his right leg from 12 days after the 5th dose of the IT-MTX therapy. Even though the IT-MTX was discontinued, loss of muscle power progressed upward resulting in quadriplegia. The patient showed slow and partial recovery on right extremities over 3 months. We report this case with brief review of literature.
Adolescent ; Aphasia, Broca* ; Extremities ; Humans ; Leg ; Leukemia ; Male ; Methotrexate* ; Quadriplegia* ; Urinary Incontinence

PURPOSE: This study was conducted from January to March, 2004 to examine the effect of telephone follow-up on the performance of self-care in cancer patients undergoing chemotherapy and on role stress of family caregivers. METHOD: Research design was a nonequivalent control group non-synchronized design. Seventy-two participants were assigned to either the experimental group (18 cancer patients, 18 family caregivers) or the control group (18 cancer patients, 18 family caregivers). Data were collected before and after the intervention and were analyzed with paired t-test, t-test, Mann-Whitney U Test & Wilcoxon Signed Ranks Test. RESULTS: Performance of self-care in the experimental group undergoing telephone follow-up was significantly higher than that of the control group (t=8.016, p=0.000). Role stress of family members in the experimental group was also significantly higher than that of the control group (t=2.133, p=0.042). CONCLUSION: This results suggest that the telephone follow-up is effective for cancer patients undergoing chemotherapy and their family caregivers. Telephone follow-up can be recommended as an effective nursing intervention for self-care performance in cancer patients undergoing chemotherapy and to reduce role stress of family caregivers.
Caregivers* ; Drug Therapy* ; Follow-Up Studies* ; Humans ; Nursing ; Research Design ; Self Care* ; Telephone*

BACKGROUND: Recurrent, often unpredictable, migraine attacks significantly interfere with daily functioning and productivity of patients with migraine. Quality of life measurement represents an important tool for evaluating migraine therapy and judging the impact of headache either on individuals or on society. The objective of this study was to test the reliability and validity of the translated version of MSQoL (Migraine-Specific Quality of Life) in Korean migraine patients. METHODS: Participants, migraineurs from the Samsung Medical Center Migraine Clinic, were screened using the International Headache Society migraine criteria prior to enrollment through direct interview. This survey included the MSQoL, MIDAS (Migraine Disability assessment) and STAI (State-Trait Anxiety Inventory). RESULTS: Sixty-five migraineurs were recruited. For the MSQoL, Cronbach's alpha was 0.93. Frequency and number of accompanying symptoms were predictive of the MSQoL. The negative correlation between the MSQoL scores and the MIDAS score was seen (r=-0.585, p<0.01). Similarly a negative correlation between the MSQoL scores and duration of headache was also observed (r=-0.38, p<0.01). Although a significant negative correlation between the MSQoL and STAI scores was present (r=-0.47, p<0.01), correlation between the MIDAS and the STAI scores was not significant. CONCLUSIONS: The MSQoL is a reliable and valuable migraine-specific quantitative tool to assess the degree of quality of life in Korean migraineurs. It has a potential to provide valuable information on migraineur's disability and anxiety level. The MSQoL has acceptable psychometric properties and can be used to estimate long-term outcome of migraine therapy in Korean population.
Anxiety ; Efficiency ; Headache ; Humans ; Migraine Disorders* ; Psychometrics ; Quality of Life* ; Surveys and Questionnaires* ; Reproducibility of Results*

Earlier study showed that glucocorticoid induced tumor necrosis factor receptor (GITR), a new TNFR family, activated murine macrophages to express inducible nitric oxide synthase (iNOS) and to generate nitric oxide (NO). A possible involvement of pro-inflammatory cytokines on NO production by GITR was investigated in vitro systems and signaling molecules contributing to sGITR-induced iNOS production are determined in Raw 264.7 cells, a murine macrophage cell line. The result showed that the synergy was afforded by the combination of GITR with IFN-gamma in a dose-dependent manner but IFN-gamma alone was not able to induce NOS. No effects were observed with TNF-alpha, IL-1beta, or IL-6 co-treated with GITR. To determine signaling molecules contributing to sGITR-induced iNOS production, a specific inhibitor for signal pathway proteins tested showed that PDTC (NF- kB) and genistein (tyrosine kinase) inhibited NOS induction significantly, while sodium orthovanadate (tyrosine phosphatase) potentiated NOS expression. These results suggest that activations of NF-kB were involved in induction of iNOS by GITR and IFN-gamma priming caused earlier and stronger NF-kB activation.
Animals ; Cells, Cultured ; Cytokines/*metabolism ; Enzyme Induction ; Interferon Type II/pharmacology ; Macrophages/*enzymology/physiology ; Mice ; NF-kappa B/metabolism ; Nitric Oxide/metabolism ; Nitric-Oxide Synthase/*biosynthesis ; Protein-Tyrosine Kinase/metabolism ; Protein-Tyrosine-Phosphatase/metabolism ; Receptors, Nerve Growth Factor/*metabolism ; Receptors, Tumor Necrosis Factor/*metabolism

OBJECTIVE: To examine the association between hospital procedure volume and treatment outcomes following allogeneic bone marrow transplantation (allo-BMT). METHODS: Out of 1, 050 patients who received allo-BMTs between 1998 and 2000 in 21 Korean hospitals, 752 with first allo-BMT and complete data were included in this study. Study subjects were divided into the following three groups according to cumulative hospital experience of all-BMTs during the study period: low (< 30 cases), medium (30-49) and high (> or =50 cases) volume. Patient outcome was defined as early survival at day 100 and one-year survival. Multiple logistic regression analyses were performed to examine the association between hospital experience and survival at day 100 and one year. RESULTS: When the low volume group was defined as the reference group, the adjusted relative risks (RR) of survival at day 100 for the high volume group were 2.46 (95% CI, 1.13-5.36) for all patients, 2.61 (1.04-6.57) for those with leukemia, and 2.20 (0.47-10.32) for those with aplastic anemia. For one-year survival, adjusted RR for the high volume group were 2.52 (1.40-4.51) for all patients, 1.99 (1.01-3.93) for leukemia, and 6.50 (1.57-26.80) for aplastic anemia. None of the RR for the medium volume group was statistically significant. Patient factors showing significant relationship with survival were donor-recipient relation, human leukocyte antigen matching status, time from diagnosis to transplant, and disease stage. CONCLUSION: The study results suggest that the cumulative experience of hospitals in providing allo-BMT is positively associated with patient survival.
Anemia, Aplastic ; Bone Marrow Transplantation* ; Bone Marrow* ; Diagnosis ; Humans ; Leukemia ; Leukocytes ; Logistic Models

BACKGROUND: Extracellular nucleotides act as agonists to regulate a broad range of physiological processes by interacting with P2 receptors in various tissues including the kidney tubules. This study was undertaken to evaluate the effect of P2 receptor activation on PTH-dependent regulation of phosphate transport in the renal proximal tubular cells. METHODS: Proximal tubular cells were isolated from the rabbit kidney and grown as monolayers on 24 well culture plates. Phosphate uptake was determined by measuring the uptake of radiolabeled phosphate into cell monolayers. Cyclic AMP content was determined by radioimmunoassay using [3H]cAMP assay kit. RESULTS: Activation of P2 receptors with ATP exerted differential effects on phosphate uptake and cAMP generation. In the absence of PTH, it inhibited phosphate uptake and stimulated cAMP generation. In contrast, in the presence of PTH, it attenuated PTH-induced stimulation of cAMP generation and inhibition of phosphate uptake. The profile of the effects of different P2 agonists suggested that P2Y1- and P2Y2-like receptors are involved in the effects of ATP. The effect of ATP to interfere with the PTH-induced regulation was significantly blocked by calphostin C, pertussis toxin or PKC-depletion, whereas, the effects of ATP in the absence of PTH were abolished by indomethacin. CONCLUSION: Our results suggest that PKC-dependent modification of Gi proteins and, subsequently, reduced responsiveness of adenylate cyclases is responsible for the attenuating effect of ATP on the PTH-dependent regulation of phosphate transport in rabbit proximal tubule cells.
Adenosine Triphosphate ; Adenylyl Cyclases ; Cyclic AMP ; Indomethacin ; Kidney ; Kidney Tubules ; Nucleotides ; Parathyroid Hormone ; Pertussis Toxin ; Physiological Processes ; Radioimmunoassay

Ameloblastoma is the most common odontogenic tumor of the jawbones, but the origin of this tumor has been remained to be unproven. Cytokeratins (CKs) are specific intermediate filament of epithelial cells, and vimentin is expressed in mesenchymal cells. The immunohistochemical detection of different CKs and vimentin has made it easier to know the origin of tumor. Paraffin-embedded tissue sections from 15 ameloblastomas and 1 ameloblastic carcinoma were used for immunohistochemical evaluation of CK 7, 8, 13, 14, 19 and vimentin. Their expression is evaluated in different tumor cells, which are observed in different type of tumors. In the follicular and reticular subtype, central stellate cells of tumor nests expressed CK 8, 14, 19 and peripheral columnar cells expressed CK 14. CK 7, and 13 were not expressed. Vimentin was detected in fibrous stroma around tumor nest, not in tumor cells. The tumor cells of ameloblastic carcinoma expressed CK 7, 14 and 19, but CK 8 was more weakly stained than that in ameloblastoma. Central stellate cells and peripheral columnar cells of acanthomatous subtype showed same expression pattern with others. Meta plastic squamous cells expressed CK 8, 14, 19 and keratinizing squamous cells expressed CK 13, 19. CK 7 and vimentin were not detected in tumor cells and vimentin was expressed in fibrous stroma. Most of the tumor cells of ameloblastoma showed CK 14 and CK 19 and did not express CK 7 and vimentin. These findings were similar to the immunophenotype of dental lamina. And these results will be beneficial to differential diagnosis of odontogenic tumors and other kind of tumors arising at the oral cavity.
Ameloblastoma* ; Ameloblasts ; Diagnosis, Differential ; Epithelial Cells ; Intermediate Filaments ; Keratins* ; Mouth ; Odontogenic Tumors ; Plastics ; Vimentin*