Urea reduction ratio (URR) and Kt/Vurea are objective parameters of dialysis delivery in hemodialysis patients and correlate with nutritional status and patient outcome. URR and Kt/Vurea depend on postdialysis blood urea nitrogen (BUN). In patients with severe postdialysis urea rebound (PDUR), these parameters do not accurately reflect dialysis adequacy. We measured PDUR 30 minutes after dialysis in 26 chronic stable hemodialysis patients. The impact of PDUR on dialysis delivery assessed by URR and Kt/Vurea and the independent factors affecting on PDUR were evaluated. All patients had been dialyzed for 4 hours thrice a week using hemophan membrane. 1) The mean age of patients was 48.6+/-14.8 years and sex ratio was 1:2.3. The mean duration of hemodialysis was 42.7+/-45.0 months. Primary renal diseases were chronic glomerulonephritis 11 (42.3%), diabetic nephropathy 7 (26.9%), and hypertension 4 (15.4%). 2) The mean blood flow was 209.2+/-17.4ml/min. URR, Kt/Vurea, and nPCR using immediate postdialysis BUN were 60+/-7%, 1.13+/-0.21, 1.09+/-0.28g/kg/ day, respectively. The mean recirculation rate was 4.4+/-2.3%. 3)The mean PDUR was 12.2+/-4.6% (range:6-22 %). URR, Kt/Vurea, and nPCR using BUN 30 minutes after dialysis were 55+/-7%, 0.99+/-0.18, and 1.02+/-0.25 g/kg/day, respectively and were significantly lower than those using immediate postdialysis BUN (P<0.05). 4) When the patients were divided according to the degree of PDUR (low PDUR group:<12%, high PDUR group: > or = 12%), high PDUR group was significantly higher than low PDUR group in hematocrit (27.0+/-2.6 vs. 23.5+/-3.6%, P=0.008), URR (64.3+/-5.4 vs. 55.8+/-6.8%, P=0.002), Kt/Vurea (1.26+/-0.17 vs. 1.03+/-0.18, P=0.002), and total recirculation rate (5.6+/-2.7 vs. 3.6+/-1.7%, P=0.05). There were no differences in age, sex, postdialysis body weight, ultrafiltration rate, blood flow, serum albumin, predialysis BUN, creatinine, and nPCR. 5) In multiple regression analysis, the independent factors affecting on PDUR were Kt/Vurea (beta=0.546, P<0.001), recirculation rate (beta=0.422, P<0.001), and hematocrit (beta=0.366, P=0.0017). In conclusion, we think that PDUR should be considered in hemodialysis patients when estimating dialysis delivery, especially if they had high Kt/ Vurea, recirculation rate, and hematocrit.
Blood Urea Nitrogen ; Body Weight ; Creatinine ; Diabetic Nephropathies ; Dialysis* ; Glomerulonephritis ; Hematocrit ; Humans ; Hypertension ; Membranes ; Nutritional Status ; Renal Dialysis* ; Serum Albumin ; Sex Ratio ; Ultrafiltration ; Urea*

No abstract available.
Emergencies* ; Emergency Service, Hospital* ; Epilepsy* ; Humans ; Seizures*

No abstract available.
Emergencies* ; Emergency Service, Hospital* ; Violence*

A rare variant of glioblastoma characterized by giant or monster cells is now well recognized. However, this tumor had been remained in controversy on its pathogenesis, and the tumor had been considered to be a sarcoma until 1968, when the electronemicroscopic study demonstrated the presence of filaments mesuring 80 in diameter in the perikarya in giant cells as well as in smaller, better differentiated cells. The peroxidase antiperoxidase stain of glial fibrillary acid protein shows positive glial fibrillary fibers in their cytoplasm, accordingly the giant cells has been recognized as being of astrocytic origin. This concept has been redocumented by light microscopy since PTAH-positive astrocytic fibers are present in large numbers of neoplastic cells. The two cases reported here were frontal and occipital giant cell glioblastomas in 58 years old male and 44 years old women, respectively. On light microscopy, the tumor showed numberous characteristic giant or monster cells as well as the same features seen in the usual glioblastoma. The electron microscopy and special stains, PTAH and GFAP confirmed that the giant cells were in glial origin.
Female ; Male ; Humans

Blood group isoantigens (BGS) A, B and H comprise a group of carbohydrate cell surface markers found not only on the erythrocytes but in wide variety of epithelial cells and body fluid on 80% of the human population. There has been increasing interest in the changes in blood group A, B and H antigen expression in various epithelial malignancies. These changes included deletion of A, B determinants, accumulation of precursor substances, increment or neosynthesis of imcomplete blood group antigens and synthesis of sialylated substances bearing blood group carbohydrate chains. Also these changes have been explained as an evidence of immunologic dedifferentiation analogous to the morphologic dedifferenctiation of anaplasia. isoantigens may be altered in epithelial tissues that show repair and regeneration, metaplastic changes and dysplasia. We studied that the changes of blood group isoantigens A, B and H in 30 cases of adenocarcinoma of the colon, 27 cases of adjacent mucosa and 19 cases of metastatic lymph nodes by immunohistochemical study. In ascending, transverse and rectosigmoid colon, the blood group isoantigens A, B and H are positive in 57.1%, 0% and 57.1% of adenocarcinomas and 100%, 50% and 0% in adjacent mucosae, respectively. In ascending colon,the frequency of the metastasis and recurrences in Blood group isoantigen positive and negative cases are 75% and 66.6% and in rectosigmoid colon, those are 50.5% and 90.0%, respectively. In tumors of the ascending colon, there was no significant correlation between antigen content and frequency of metastasis. However, the cancer of the rectosigmoid colon with bloodgroup isoantigen positive were associated with a lower frequency of metastasis than those without blood group isoantigen. (p=0.045). The data suggests that the immunohistochemical studies of blood group isoantigen may be of value in estimating the clinical behavior of certain colon carcinoma.
Humans ; Adenocarcinoma ; Neoplasm Metastasis

To reveal the association between blood selenium level and the gastric diseases, 180 persons received the gastrofiberscopic examination at the outpatients department of the two university hospitals from July to September 1987, after the exclusion of the persons having the esophageal varix, were randomly selected. Their general characteristics such as age, sex and educational level and so on, were investigated. Five microliter venous blood was collected from each subjects and stored at 0 degrees C in heparinized vaccum tube. The blood selenium level was measured by the flameless atomic absorption spectrophotometry. In the procedure of data analysis, five subjects having benign tumor and anomaly of the stomach, were also excluded. The mean blood selenium levels of the 155.5 microgram/l among gastritis cases, the 154.8 microgram/l gastric ulcer and the 133.0 microgram/l gastric malignancy were significantly lower(p<0.05) than that of the 173.3 microgram/l among normal controls. In men the mean blood selenium levels among gastritis, gastric ulcer and gastric malignancy cases were significantly lower(p<0.05) than that among normal controls. In females, the mean blood selenium levels among gastritis and gastric maligancy cases were significantly lower(P<0.05) than that among normal controls(169.7 microgram/l), buy that among gastric ulcer cases(177.7 microgram/l) was not significantly higher. In the logistic analysis, coefficient of the blood selenium level was -0.0436(p<0.05 ; odds ratio 0.957) for gastritis, -0.0197(p=0.17 ; 0.981) for gastric ulcer, -0.4876(p<0.05 ; 0.614) for gastric malignancy and -0.0411(p<0.05 ; 0.960) for gastric diseases including the gastritis, the gastric ulcer and the gastric malignancy. These data support the hypothesis that the gastric diseases are to be associated with the low selenium level but, for the gastric ulcer, the further research is recommended.
Esophageal and Gastric Varices ; Female ; Gastritis ; Heparin ; Hospitals, University ; Humans ; Male ; Odds Ratio ; Outpatients ; Selenium* ; Spectrophotometry, Atomic ; Statistics as Topic ; Stomach ; Stomach Diseases* ; Stomach Ulcer

No abstract available.
Fingers*

No abstract available.
Occupational Health*

BACKGROUND: Sustained-release theophylline, which is generally prescribed as a twice-daily equal-dose regimen, is one of the more common asthma treatments. the development of a sustained-release drug delivery technology that enables improved control of the theophylline blood levels represents a significant advancement in both the efficacy and safety of dosing. METHOD: A crossover study was conducted with 25 adult chronic asthmatic patients requiring daily bronchodilator therapy. The study group included thirteen males and twelve females with ages ranging from 19 to 71 years. The overall approach was to place the patients first on the twice-daily preparation(Etheophyl®) for 28 days at 8 AM and 8 PM, and measure the pulmonary function and theophylline level on the 28th day. the patients were subsequently switched to the once-daily preparation(Uniphyl®) in the same daily dose at 8 PM on the 29th day and the same parameters were measured on the 56th day. RESULTS: the mean serum levels of theophylline were 8.18±1.66µg/ml in the Etheophyl®-treated period and 8.00±1.75µg/ml in the Uniphyl®-treated period. In addition, the FEV1 showed 71.40±7.48 percent in the Etheophyl®-treated and 69.18±9.00 percent in the Uniphyl®-treated period. Thus there were no significant differences between the once-daily and twice-daily preparation. CONCLUSION: The results indicated little clinical differences between the two medication. The two drugs are equally effective in controlling asthma over the four weeks of treatment.
Adult ; Asthma* ; Cross-Over Studies ; Female ; Humans ; Male ; Theophylline

PURPOSE: To determine the necessity of site-specific bone mineral density(BMD) measurement and the difference between the BMD of the two femora using DXA in the evaluation of osteoporosis. MATERIALS & METHODS: Total BMD and regional BMD(Lumbar spine, femoral neck, Ward's area, intertrochanter area) were measured on seventy-eight healthy persons without previons diseases, and the statistical significance analyzed. RESULTS: Total BMD did not reliably reflect the site-specific BMD. There was a high correlation between BMD in opposing femora. Correlation coefficients between the femoral neck, Ward's area, trochanter area were 0. 939, 0.874 and 0.916 respectively. CONCLUSION: We conclude that a measuremnt of site-specific BMD is necessory because the total BMD can not reliably predict the regional BMD. The measurement of BMD in one femur can predict the BMD of the contralateral femur. If there is no history of femoral neck disease, unilateral BMD measurement is recommended for femoral evaluation.
Absorptiometry, Photon* ; Femur ; Femur Neck ; Humans ; Osteoporosis ; Spine