BACKGROUND: Human high density lipoprotein (HDL) is known to stimulate endothelin-1 (ET-1) production through the phospholipase C (PLC)/Ca2+/ protein kinase C (PKC) pathway. Calcium channel blockers may be involved in the decrease of HDL- induced ET-1 production. This study was designed to evaluate whether HDL-induced ET-1 production was affected by Ca2+ channel blockers in cultured human proximal tubular cells (PTC). METHODS: The human PTC were obtained from human nephrectomized tissues, and cultured in six different media, which were bovine serum free (SF) DMEM/F12 medium alone, and five other SF DMEM/F12 media with 200 microgram/ml of HDL, with 200 microgram/ml of HDL and each 10 micrometer of diltiazem, nifedipine, and verapamil solved in 100% ethanol 0.1 volume%, and with 200 microgram/ml of HDL and 0.1 volume% of 100% ethanol as a control. After 24 hours of exposure, ET-1 in the supernatant was measured by radioimmunoassay, and ET-1 level in each well were marked as pg ET-1/mg cell protein/ 24 hr in consideration of cell count. RESULTS: In SF medium, ET-1 production was 1.803+/-0.295pg/mg cell protein/24 hr. In SF medium with 200 microgram/ml of HDL, ET-1 production significantly increased from 1.803+/-0.295 to 10.860+/-0.476 pg/mg cell protein/24 hr (P<0.05). In SF medium with 200 microgram/ml of HDL and 100% ethanol 0.1 volume%, ET-1 production significantly decreased from 10.860+/-0.476 to 6.700+/-1.273pg/mg cell protein/ 24 hr (P<0.05). In SF media with 200 microgram/ml of HDL and each 10 micrometer of diltiazem, nifedipine, and verapamil solved in 100% ethanol 0.1 volume%, ET- 1 production was decreased from 6.700+/-1.273 to 4.043+/-1.550 by diltiazem (P<0.05), to 3.260+/-0.752pg/ mg cell protein/24 hr by verapamil (P<0.05), and to 4.414+/-1.567pg/mg cell protein/24 hr by nifedipine (P=0.067). CONCLUSION: These results suggest that the HDL- induced ET-1 production in cultured human PTC was significantly decreased by diltiazem and verapamil, and it seemed to be decreased by nifedipine.
Calcium Channel Blockers* ; Calcium Channels* ; Calcium* ; Cell Count ; Diltiazem ; Endothelin-1* ; Ethanol ; Humans* ; Lipoproteins ; Nifedipine ; Protein Kinase C ; Radioimmunoassay ; Type C Phospholipases ; Verapamil

Systemic sclerosis is a generalized connective tissue disorder. It is characterized by fibrosis, degenerative changes and vascular lesions affecting the skin, joints, skeletal muscles and multiple internal organs. Clinical renal disease in systemic sclerosis ranges from scleroderma renal crisis to more subtle abnormalities. Scleroderma renal crisis is characterized by malignant hypertension and rapidly progressive renal failure. It can be successfully treated with angiotensin converting enzyme inhibitors, but remains the most feared complication of systemic sclerosis. We have experienced a 57 year old female patient who visited emergency room with a sudden onset of mental deterioration, azotemia and oliguria. She was under symptomatic treatment for Raynaud's phenomenon for 2 years. Renal biopsy of the patient showed onion-skin configuration in the interlobular arteries which is characteristic of scleroderma renal crisis. She proceded to maintenance hemodialysis despite a angiotensin converting enzyme inhibitor treatment. We report a case of SRC with a brief review of literature.
Angiotensin-Converting Enzyme Inhibitors ; Arteries ; Azotemia ; Biopsy ; Connective Tissue ; Emergency Service, Hospital ; Female ; Fibrosis ; Humans ; Hypertension ; Hypertension, Malignant ; Joints ; Middle Aged ; Muscle, Skeletal ; Oliguria ; Peptidyl-Dipeptidase A ; Renal Dialysis ; Renal Insufficiency ; Scleroderma, Systemic ; Skin

Two distinct hantaviruses have been isolated from Apodemus agrarius in 1976 and Rattus norvegicus in 1980 in Korea. Since our serosurveys conducted in 1994, a genetically distinct hantavirus from Apodemus peninsulae has been investigated. To isolate hantavirus from A. peninsulae captured in Korea, the lung homogenate of seropositive A. peninsulae inoculted Vero E6 cells. Viral antigen was detected in a progressively higher percentage of cells with subsequent passage after 80 days postinoculation. The new isolate from seropositive Apodemus peninsulae was designated Suchong virus after Suchong valley located in northeastern region of South Korea. Comparing with hantaan virus 76-118 strain, Suchong virus-1, 2, 3 and 4 showed the similarity of 71.0~91.8% at nucleotide and 90.9~94.8% at amino acid sequences in 231 nucleotides region of M segment, and the similarity of 75.1~81.0% at nucleotide and 97.5~100% at amino acid sequences in 237 nucleotides of S segment.
Amino Acid Sequence ; Animals ; Hantaan virus ; Hantavirus* ; Korea ; Lung ; Murinae* ; Nucleotides ; Population Characteristics* ; Rats

While the frequency of primary carcinoma of the lung has recently increased in adults, it is rare in the pediatric age group. The various adult types of bronchogenic carcinoma such as squamous cell, small cell, large cell, and adenocarcinoma, are extremely rare in children. Twenty to 30 cases of primary bronchogenic carcinoma of the lung in children under 15 years of age have been reported in the English-language literature. We have experienced a small cell bronchogenic carcinoma detected by fiberoptic bronchoscopy with bronchial biopsy in a 14-year-old boy with chief complaint of hemoptysis, lung mass and persistent pneumonitis. To the best of our knowledge, this is the first reported case of primary small cell bronchogenic carcinoma in childhood under 15 years of age. We report this case with a brief review of related literatures.
Adenocarcinoma ; Adolescent ; Adult ; Biopsy ; Bronchoscopy* ; Carcinoma, Bronchogenic* ; Child* ; Hemoptysis ; Humans ; Lung ; Male ; Pneumonia

BACKGROUND: Recombinant human erythropoietin (rHuEPO) has become attractive option of anemia therapy in chronic hemodialysis patients, but the use of rHuEPO is primarily limited by its high cost. So, the current cost-containment policy renders valuable any strategies that enhances the erythropoietic response to rHuEPO, thus resulting in lower rHuEPO dosing. Before the widespread availability of rHuEPO, androgen was the mainstay of nontransfusional therapy for the anemia of end-stage renal failure. However, previous studies that used androgen to enhance the response to rHuEPO showed variable results. METHODS: We carried out a prospective study to examine the effect of adjuvant androgen on anemia and nutritional parameters in chronic hemodialysis patients using low-dose rHuEPO. Studies were performed in seventeen hemodialysis patients previously treated with low-dose rHuEPO (1,000 U rHuEPO subcutaneously three times a week), mean hemoglobin < 9.0 g/dL for 6 months (group A: before adjuvant androgen therapy). Same patients received the same dose of rHuEPO plus nandrolone decanoate 100 mg intramuscularly weekly for 6 months (group B: after adjuvant androgen therapy). RESULTS: Transferrin saturation, serum ferritin, intact serum parathyroid hormone, plasma aluminium, ALT, ESR, albumin, PCRn and Kt/V were not significantly changed before and after adjuvant androgen therapy. The increase in hemoglobin and hematocrit in the group B was statistically greater than in the group A, respectively (8.99+/-1.39 g/dL vs 7.75+/-0.90 g/dL; p=0.001, 26.66+/-3.91% vs 23.68+/-2.85%; p= 0.003, respectively). With the exception of mild discomfort at the injected site, there were no significant side effects from nandrolone decanoate. CONCLUSION: Adjuvant androgen in patients treated with low-dose rHuEPO is effective treatment for the anemia of poor responsive patients to low-dose rHuEPO and lower the economical cost compared with the higher dose rHuEPO treatment alone.
Anemia* ; Erythropoietin* ; Ferritins ; Hematocrit ; Humans ; Humans* ; Kidney Failure, Chronic ; Nandrolone ; Parathyroid Hormone ; Plasma ; Prospective Studies ; Renal Dialysis* ; Transferrin

BACKGROUND: Malnutrition in maintenance hemodialysis(HD) patients has been referred to underdialysis with low protein intake and to metabolic acidosis. However, the respective effects of underdialysis, protein intake and metabolic acidosis have not been clearly demonstrated. To evaluate the role of the dialysis dose, protein intake and metabolic acidosis on nutrition, we measured the predialysis serum HCO3, pH, serum albumin, PCRn, Kt/V, and BMI in 41 uremic patients on maintenance bicarbonate HD for 66.93+/-51.86 months. Patients with chronic liver diseases, malignancies, diabetes and cachexia were excluded. RESULTS: Mean age was 46+/-13 years; Kt/V, 1.22+/-0.27; PCRn, 0.90+/-0.16g/kg/day; serum albumin, 4.2+/-0.21g/dL; BMI, 20.47+/-2.09kg/m2; HCO3, 18.4+/-2.9mEq/L; Serum albumin showed a significant direct correlation with PCRn(p=0.001), and a significant inverse correlation with serum HCO3(r=0.43, p<0.01) but no correlation with Kt/V and BMI. PCRn showed a significant inverse correlation with serum HCO3(p<0.01), and a direct correlation with Kt/V(p<0.05). Multiple regression analysis confirmed the significant role of protein intake but not of Kt/V and serum bicarbonate, on serum albumin concentrations. Dividing patients into two groups, serum albumin was 4.05+/-0.34g/dL in those with HCO3 <20mEq/L and 3.95+/-0.24g/dL in those with HCO3 >or=20mEq/L. PCRn in the former was 0.94+/-0.6g/kg/day and in the latter 0.80+/-0.14g/kg/day(p<0.05). The role of PCRn appeared to be more important than metabolic acidodsis in determining the serum albumin levels. CONCLUSIONS: In patients hemodialyzed with relatively adequate Kt/V and whose serum bicarbonate levels maintained within mild acidosis range, PCRn may exert a detrimental effect on serum albumin concentration.
Acidosis ; Cachexia ; Dialysis ; Humans ; Hydrogen-Ion Concentration ; Liver Diseases ; Malnutrition* ; Renal Dialysis* ; Serum Albumin

Void-free impression taking is important for the fabrication of accurate dental restorations.One of the essential properties of an impression material used for indirect fabrication of precision castings is the reproduction of the fine detail. The objective in this study was to determine the influence of mixing methods on the number of voids and surface detail reproduction.The number of voids and surface detail reproduction were evaluated with the stereomicroscope SZ-PT and photographed. The results were as follows; 1.In comparison of the void formation according to mixing methods of all impression materials,mechanical mixing was better than hand mixing and there was significant difference(P<0.05). 2.In comparison of the void formation according to hand mixing of alginate impression materials(TOKUSO A-1 alpha ,CAVEX IMPRESSIONAL ,AROMA FINE DF III), there was no significant difference among alginate groups.But the number of void was increased in the order of Panasil contact,TOKUSO A-1alpha , Permlastic light bodied and there was significant difference(P<0.05). 3.In comparison of the void formation according to mechanical mixing of alginate impression materials(TOKUSO A-1 alpha, CAVEX IMPRESSIONAL, AROMA FINE DF III), there was no significant different among alginate groups.But the number of void was decreased in order of TOKUSO A-1 alpha, Permlastic light bodied,Panasil contact and there was significant difference(P<0.05). 4.In comparison of the surface detail reproduction according to mixing methods of 3 types of impression materials(TOKUSO A-1 alpha, Permlastic light bodied,Panasil contact), there was no significant difference between hand mixing and mechanical mixing method 5.The surface detail reproduction was only influenced by impression materials,and produced better in order of TOKUSO A-1alpha, Panasil contact,Permlastic light bodied.There was significat difference among 3 type of impression materials(P<0.05). From the above results,void formation is influenced by mixing methods and surface detail reproduction is influenced by impression materials than mixing methods.Therefore,to fabricate accurate restorations,proper impression material and mechanical mixing method are more effective and available clinically.
Hand ; Reproduction*

BACKGROUND: Recombiant human erythropoietin (epoetin) has greatly contributed to improvement of the anemia of chronic renal failure patients on hemodialysis. However, the reduced erythropoietic effect to epoetin and its high cost have induced lots of supplementary treatments. Therefore, we performed a prospective study to evaluate the effects of adjuvant low-dose androgen therapy in patients using a lower-dose of epoetin than the commonly recommended dose on anemia and the nutritional parameters. METHODS: 17 patients of hemoglobin (Hgb) less than 9 g/dL even after being treated with 1,000 U epoetin subcutaneously (s.c.) 3 times per week on a stable status for more than 6 months, who were on hemodialysis at our institution were examined. They were injected with the same dose of epoetin s.c. and nandrolone decanoate 100 mg intramuscularly (i.m) weekly for another 6 months. Blood test was performed every month before therapy for 6 months and after therapy for 6 months and the mean values were reviewed for comparison. RESULTS: Hgb (7.75+/-0.9 vs 8.99+/-1.39 g/dL, p < 0.01) and hematocrit (Hct) (23.68+/-2.85 vs 26.66+/-3.91%, p < 0.01) were apparently changed before and after adjuvant therapy. Hgb and Hct, weekly dose of epoetin were not statistically different in 9 male patients before and after adjuvant therapy. The weekly dose of epoetin was not statistically different in 8 female patients, but Hgb and Hct (8.02+/-0.6 vs 9.72+/-1.31 g/dL, 24.54+/-1.7 vs 28.74+/-3.06%, p < 0.01) were statistically different before and after adjuvant therapy. In comparison between male and female groups, weekly doses of epoetin and nandrolone decanoate were significantly greater in the female group than the male group (epoetin; 50.66+/-6.23 vs 61.18+/-8.76 U/kg/week, nandrolone decanoate; 1.69+/-0.2 vs 2.04+/-0.29 mg/kg/week, p < 0.05). CONCLUSION: Our data show that the adjuvant androgen therapy is effective for the anemia of hemodialysis patients who did not recover from anemia even after being continuously treated with low-dose epoetin.
Adult ; Anabolic Steroids/*administration & dosage/blood ; Anemia, Aplastic/blood/*drug therapy ; Chemotherapy, Adjuvant ; Erythropoiesis/drug effects ; Erythropoietin, Recombinant/*administration & dosage/blood ; Female ; Human ; Kidney Failure, Chronic/blood/drug therapy ; Male ; Middle Age ; Nandrolone/*administration & dosage/blood ; Nutritional Status ; Prospective Studies ; *Renal Dialysis

BACKGROUND: The presence of infiltrated mediastinal lymph nodes is a crucial factor for the prognosis of lung cancer. The aim of our study is to investigate the pattern of metastatic non-small cell lung cancer that spreads to the mediastinal lymph nodes, in relation to the primary tumor site, in patients who underwent major lung resection with complete mediastinal lymph node dissection. MATERIAL AND METHOD: We retrospectively studies 293 consecutive patients [mean age 63.0+/-8.3 years (range 37~88) and 220 males (75.1%)] who underwent major lung resection due to non-small cell lung cancer from January 1998 to December 2005. The primary tumor and lymph node status was classified according to the international TNM staging system reported by Mountain. The histologic type of the tumors was determined according to the WHO classification. Fisher's exact test was used; otherwise the chi-square test of independence was employed. A p-value <0.05 was considered significant. RESULT: Lobectomy was carried out in 180 patients, bilobectomy in 50, sleeve lobectomy in 10 and pnemonectomy in 53. The pathologic report revealed 124 adenocarcinomas, 138 squamous-cell tumors, 14 adenosquamous tumors, 1 carcinoid tumor, 8 large cell carcinomas, 1 carcinosarcoma, 2 mucoepidermoid carcinomas and 5 undifferentiated tumors. The TNM stage was IA in 51 patients, IB in 98, IIB in 41, IIIA in 71, IIIB in 61 and IV in 6. 25.9 % of the 79 patients had N2 tumor. Most common infiltrated mediastinal lymph node was level No.4 in the right upper lobe, level No. 4 and 5 in the left upper lobe and level No. 7 in the other lobes, but no statistically significant difference was observed. Thirty-six patients (12.3%) presented with skip metastasis to the mediastinum. CONCLUSION: Mediastinal lymph node dissection is necessary for accurately determining the pTNM stage. It seems that there is no definite way that non-small cell lung cancer spreads to the lymphatics, in relation to the location of the primary cancer. Further, skip metastasis to the mediastinal lymph nodes was present in 12.3% of our patients.
Adenocarcinoma ; Carcinoid Tumor ; Carcinoma, Large Cell ; Carcinoma, Mucoepidermoid ; Carcinoma, Non-Small-Cell Lung ; Carcinosarcoma ; Humans ; Lung ; Lung Neoplasms ; Lymph Node Excision ; Lymph Nodes ; Lymphatic Metastasis ; Male ; Mediastinum ; Neoplasm Metastasis ; Neoplasm Staging ; Prognosis ; Retrospective Studies

PURPOSE: Pressure garment is the most effective tool in treatment of burn scar hypertrophy. But most patients feel discomfort to pressure garment. So tubular compressive bandage (TCB; Tubifast™) is widely used as a substitute. We checked daily pressure of tubular pressure bandage for 6 days and tried to find out the proper use. METHODS: Three doctors and two nurses were included in this study. They wore the TCB on both arms. One arm worn with one layer and the other arm with two layers. For six days, we checked the average pressure on arm and forearm with Picopress®. We used the SPSS (PASW statistics 18) as a statistics. RESULTS: During the first three days the pressure was markedly declined on both arm and forearm when with two layers. After then the pressure showed plateau. But one layer showed slow and continuous declining. The plateau pressure was above 10 mmHg with two layers and below 7 mmHg with one layer. CONCLUSION: Wearing the tubular compressive bandage (TCB; Tubifast™) is better with two layers than one layer and must be changed it in every 4 days.
Arm ; Bandages* ; Burns ; Cicatrix ; Cicatrix, Hypertrophic ; Clothing ; Forearm ; Humans ; Hypertrophy