No abstract available.
Intervertebral Disc*

BACKGROUND: As the pleural inflammation progresses, exudative pleural fluid becomes loculated rapidly with pleural thickening. Complete drainage is important 13 prevent pleural fibrosis, entrapment and depression of lung function Intrapleural urokinase instillation therapy has been advocated as a method to facilitate drainage of gelatinous pleural fluid and to allow enzymatic debriment of pleural surface. This study was designed to investigate the Predictors of effeotiveness of intrapleural urokinase in treatment of loculated pleural effusion METHOD: Thirty-five patients received a single radiographically guided pig-tail catheter ranging in size from 10 to 12 French Twenty-two patients had tuberculous pleural effusions, and 13 had non-tuberculous postpneumonic empyemas. A total of 240,000 units of urokinase was dissolved in 240 ml of normal saline and the aliquots of 80mL was instilled into the pleura1 cavity via pig-tail catheter per every 8hr. Effectiveness of intrapleural urokinase instillation therapy was assessed by biochemical markers, ultrasonography, and technical details. A greater than 50% improvement on follow-up chest radiographs was defined as success group. RESULT: Twenty-seven of 35 (77.1%) patients had successful outcome to urokinase instillation therapy. Duration of symptoms before admission was shorter in sucess group (11.8α6.9day) than in failure group (26.62α16.5day) (P<0.05). Amount of drained fluid during urokinsse therapy was larger in success group (917.1α392.7ml) than in failure group (613.8α259.7ml) (P<0.05). Pleural fluid glucose was higher in success group (89.7 α35.9mg/dl) than in failure group (41.2α47.1mg/dl) (P<0.05). Pleural fluid LDH was lower in success group (878.4α654.31U/L) than in failure group (2711.1α973.1IU/L) (P<0.05). Honeycomb septated pattern on chest ultrasonography was observed in six of eight failure group, but none of success group(P<0.05). CONCLUSION: Longer duration of symptoms before admission smaller amount of drained fluid during urokinase therapy, lower glucose value, higher LDH value in pleural fluid examination and honeycomb septation pattern on chest ultrasonography were predictors for failure group of intrapleural urokinase instillation therapy.
Biomarkers ; Catheters ; Depression ; Drainage ; Empyema ; Fibrosis ; Follow-Up Studies ; Gelatin ; Glucose ; Humans ; Inflammation ; Lung ; Pleural Effusion* ; Radiography, Thoracic ; Thorax ; Ultrasonography ; Urokinase-Type Plasminogen Activator*

BACKGROUND: Neopterin is released from monocytes/macrophages specifically by stimulation with interferon-γ. Therefore the increase refers to the activation of T lymphocytes. OBJECTIVE: Our objective was to examine the potential role of neopterin in the cell mediated immune response to Behçet's disease. METHODS: We studied 67 patients of Behçet's disease classified by Shimizu and a control group of 30 normal healthy people. Serum neopterin was detected by radioimmunoassay technique. RESULTS: The serum neopterin concentration of the group with Behçet's disease was significantly elevated, compared with the control group (6.36 nmol/ml vs 3.63 nmol/ml). The increase of neopterin concentration was well correlated to the clinical severity of the diseases in increasing order. CONCLUSION: Our data suggest that the T lymphocyte derived IFN-γ which stimulates the production of neopterin has some role in the pathogenesis and clinical severity of Behçet's disease.
Humans ; Interferon-gamma ; Lymphocytes ; Neopterin* ; Radioimmunoassay ; T-Lymphocytes

BACKGROUND: Although the precise pathogenesis of the Behçet's disease is not yet undertween the severity of Behçet's disease and the serum cytokine level. development of cytokine research has made it possible to find out if there is an association between the severity of Behçet's syndrome and the serum cytokine level. OBJECTIVE: Our purpose was to elucidate whether the immunopathological mechanism is associated with the serum tumor necrosis factor (TNF) and interleukin-1β (I1,1β) which are predominantly produced by monocytes/macrophages, and mterleukm-6 (IL-6). METHOD: Sixty seven patients of Behçet's disease and ten healthy adults as a control group were studied. Serum TNF and IL-6 levels were detected by enzyme immunoassay and serum IL-lβ levels by radioimmunoassay. RESULTS: There were no statistically significant differences in the serum levels of TNF, IL-1β, TL-6 compared with the control group. CONCLUSION: These data suggest that the immunopathological reactions of the Behçet's disease are not associated with a monocyte/macrophage dependent mechanism, possibly due to other immunocompetent cells.
Adult ; Humans ; Immunoenzyme Techniques ; Interleukin-6* ; Methods ; Necrosis* ; Radioimmunoassay ; Tumor Necrosis Factor-alpha

Thirty-two patients with transitional cell carcinoma of the renal pelvis and ureter were analyzed to determine whether there was any correlation between tumor characteristics and patient survival. The patients consisted of 26 male and 6 female. Patient age ranged from 12 to 80 years with a mean of 53.6 years. Of these patients. 28 were followed for 1 to 10 years. The most common presenting symptom was hematuria (87.5% ). Excretory urogram demonstrated NVK (nonvisualization or the kidney) in 16 patients and filling defect in 10. Pathologically. 31% of the patients were stage T1. 46% stage T2, 12% stage T3 and l6% stage T4. Histologically, 16% of the patients had grade I . 47% grade II and 37% grade III disease. Recently 6 patients, of whom 5 presented with stage T2 and 1 with stage T4. were treated postoperatively with adjuvant M-VAC (methotrexate, vinblastine. adriamycin and cisplantin) chemotherapy. H these 6 patients, 3 had subsequently recurrent tumor and their mean survival was 15 months. The 2 years survival rates of 28 patients follow-up were 90.0, 45.5, 33.3 and 0% for stage T1, T2, T3 and T4 disease, respectively, and 100, 66.7 and 10% for grade I to III disease, respectively. Overall 2 years and 5 years survival rates were 53.6% and 23.1% respectively. It is concluded from this study that age, sex. NVK on excretory urogram. synchronous or metachronous bladder tumors seem to have no influence on patient survival while patient survival correlates with stage and grade of tumor.
Carcinoma, Transitional Cell* ; Doxorubicin ; Drug Therapy ; Female ; Follow-Up Studies ; Hematuria ; Humans ; Kidney Pelvis* ; Male ; Survival Rate ; Ureter* ; Urinary Bladder Neoplasms ; Vinblastine

BACKGROUND: Interleukin-2 receptor (IL-2) is expressed and released predominantly activated T lymphocyte. Increased serum levels of soluble IL-2R have been noted in a variety of autoimmune diseases and in conditions associated with T lymphocyte activation. OBJECTIVE: We aimed to examine whether the T lymphocyte activation has any association with the pathogenesis of Behçet's disease. METHOD: We have measured the serum level of soluble IL-2R in serum samples obtained from 67 patients with Behçet's disease and 30 healthy people as a control group, using a double-antibody sandwich enzyme-linked immunosorbent assay technique. RESULTS: Serum soluble IL-2R levels were found to be significantly elevated in the group of Behçet's disease as compared with the control group. No significant differences were found within clinical subtypes of Behçet's disease. CONCLUSION: These findings suggest the presence of an ongoing T lymphocyte activation in this disease process.
Autoimmune Diseases ; Enzyme-Linked Immunosorbent Assay ; Humans ; Interleukin-2* ; Lymphocyte Activation ; Lymphocytes ; Methods ; Receptors, Interleukin-2*

BACKGROUND: Interleukin-2 receptor (IL-2) is expressed and released predominantly activated T lymphocyte. Increased serum levels of soluble IL-2R have been noted in a variety of autoimmune diseases and in conditions associated with T lymphocyte activation. OBJECTIVE: We aimed to examine whether the T lymphocyte activation has any association with the pathogenesis of Behçet's disease. METHOD: We have measured the serum level of soluble IL-2R in serum samples obtained from 67 patients with Behçet's disease and 30 healthy people as a control group, using a double-antibody sandwich enzyme-linked immunosorbent assay technique. RESULTS: Serum soluble IL-2R levels were found to be significantly elevated in the group of Behçet's disease as compared with the control group. No significant differences were found within clinical subtypes of Behçet's disease. CONCLUSION: These findings suggest the presence of an ongoing T lymphocyte activation in this disease process.
Autoimmune Diseases ; Enzyme-Linked Immunosorbent Assay ; Humans ; Interleukin-2* ; Lymphocyte Activation ; Lymphocytes ; Methods ; Receptors, Interleukin-2*

Clinical findings, electrocardiographic voltage and left ventricular function were evaluated in 104 patients with percardial effusion. Patients were classified into three groups by the amounts of pericardial effusion measured by two-dimensional echocardiography. 49 patients had small pericardial effusion, 31 moderate effusion and 24 large effusion. In 47 patients the effusions were clinically unsuspected prior to echocardiographic examination. Pericardial friction rub was noted in 14 patients, two-thirds of whom had moderate to large effusions. There was no relationship between the size of effusion and the presence of friction rub. Total QRS amplitudes were lower in patients with moderate to large effusions than those in control group. Maximum diastolic endocardial velocity(DEVM) and E-F slope of the anterior mitral leaflet were decreased significantly in patients with moderate to large effusions as compared with those with small effusions. As a result, authors concluded that reduction in the QRS voltages in serial ECGs may suggest the presence and the amount of pericardial effusion and also DEVM and E-F slope of the anterior mitral leaflet can be sensitive measures of left ventricular relaxation in patients with pericardial effusion.
Echocardiography* ; Electrocardiography* ; Friction ; Humans ; Pericardial Effusion* ; Relaxation ; Ventricular Function, Left*

Multinucleate cell angiohistiocytoma is a rare benign fibrohistiocytic vascular condition with distinctive histologic features. It tends to occur more frequently in middle-aged women, to favor the extremities, and to appear as grouped reddish-brown papules. We describe a case of solitary multinucleate cell angiohistiocytoma that appeared as a papule on the upper lip of a 24-year-old man.
Extremities ; Female ; Humans ; Lip ; Young Adult

PURPOSE: To evaluate the values of C-reactive proteins(CRP) for predicting the severity and results of treatment for acute pyelonephritis in women, we compared the severity of symptoms and signs, the laboratory findings and the initial serum CRP according to the early response to treatment. MATERIALS AND METHODS: We retrospectively analyzed 298 female patients who were diagnosed with acute uncomplicated pyelonephritis between January 2002 and Match 2007. All the medical records were reviewed for a variety of factors, and the baseline characteristics and CRP level were compared between the patients with an early response to treatment and those without according to the 3rd hospital day urine analysis. RESULTS: The initial white blood cell(WBC) counts, the CRP level, the neutrophil ratio and severity of symptoms were significantly higher in the delayed response groups than those in the early response groups. The age, history of previous pyelonephritis, symptom duration, body mass index(BMI), and the number of positive blood and urine cultures were not different between the two groups. According to the results of the multivariate logistic regression analysis, the CRP level, neutrophil ratio and mild symptoms were independent predictive variables that affected the delayed response. The odds ratios(95% CI) were 1.078(1.028-1.131) for the CRP, 1.030(1.001-1.060) for the neutrophil ratio and 9.268(1.072-80.166) for the severe symptoms. The differences between the areas under the ROC curves for CRP and the WBC counts and for the CRP level and neutrophil ratio were statistically significant(p<0.001 and p<0.05, respectively). CONCLUSIONS: We found that the discriminatory power of the initial CRP level was high with regard to predicting an early response. So, we were able to determine a CRP level that would be useful in guiding hospitalization.
Acute-Phase Proteins ; C-Reactive Protein* ; Female ; Hospitalization ; Humans ; Logistic Models ; Medical Records ; Neutrophils ; Pyelonephritis* ; Retrospective Studies ; ROC Curve