No abstract available.
Acupuncture ; Sarcoidosis

No abstract available.
Lymphoma*

Background: Delta checks increase patient safety by identifying automated hematology analyzer errors. International standards and guidelines for the complete blood count (CBC) delta check method have not been established. We established an effective, practical CBC delta check method and criteria. Methods: We assessed five delta check methods for nine CBC items (Hb, mean corpuscular volume, platelet count, white blood cell [WBC] count, and five-part WBC differential counts) using 219,804 blood samples from outpatients and inpatients collected over nine months. We adopted the best method and criteria and evaluated them using 42,652 CBC samples collected over two weeks with a new workflow algorithm for identifying test errors and corrections for Hb and platelet count. Results: The median delta check time interval was 1 and 21 days for inpatients and outpatients (range, 1–20 and 1–222 days), respectively. We used delta values at 99.5% as delta check criteria; the criteria varied among the five methods and between outpatients and inpatients. The delta percent change (DPC)/reference range (RR) rate performed best as the delta check for CBC items. Using the new DPC/RR rate method, 1.7% of total test results exceeded the delta check criteria; the retesting and resampling rates were 0.5% and 0.001%, respectively. Conclusions We developed an effective, practical delta check method, including RRs and delta check time intervals, and delta check criteria for nine CBC items. The criteria differ between outpatients and inpatients. Using the new workflow algorithm, we can identify the causes of criterion exceedance and report correct test results.

BACKGROUND: We hypothesized that the direction of the J-tip of the guidewire during insertion into the internal jugular vein (IJV) might determine its ultimate location. METHODS: In this study, 300 patients between the ages of 18 and 99 years who required central venous catheterization via IJV in the emergency department enrolled for randomization. IVJ catheterization was successful in 285 of 300 patients. An independent operator randomly prefixed the direction of the J-tip of the guidewire to one of three directions. Based on the direction of the J-tip, patients were allocated into three groups: the J-tip medial-directed group (Group A), the lateral-directed group (Group B), or the downward-directed group (Group C). Postoperative chest radiography was performed on all patients in order to visualize the location of the catheter tip. A catheter is considered malpositioned if it is not located in the superior vena cava or right atrium. RESULTS: Of the total malpositioned catheter tips (8 of 285; 2.8%), the majority (5 of 8; 62.5%) entered the contralateral subclavian vein, 2 (25.0%) were complicated by looping, and 1 (12.5%) entered the ipsilateral subclavian vein. According to the direction of the J-tip of the guidewire, the incidence of malpositioning of the catheter tip was 4 of 92 in Group A (4.3%), 4 of 96 in Group B (4.2%), and there were no malpositions in Group C. There were no significant differences among the three groups (p = 0.114). CONCLUSIONS: The direction of the J-tip of the guidewire had no statistically significant effect on incidence of malpositioned tips.
Catheterization ; Catheterization, Central Venous ; Catheters* ; Central Venous Catheters ; Emergency Service, Hospital ; Heart Atria ; Humans ; Incidence ; Jugular Veins* ; Radiography ; Random Allocation ; Subclavian Vein ; Thorax ; Vena Cava, Superior

Systemic lupus erythematosus (SLE) which is thought to be autoimmune in nature affects multiple organs and produces a diversity of signs and symptoms. However, cardiovascular manifestations of SLE are manifested more frequently by autopsy. Recently, with the prolonged survival and improvement of diagnostic methods in SLE including echocardiography, the morbidity and mortality associated with cardiovascular manifestations of SLE became more apparent and increased. Simultaneous involvement of the pulmonary artery and the myopericardium in SLE is known to be rare. Pulmonary hypertension is known to be associated with poor prognosis. We report a 27 year-old female patient of SLE with pulmonary hypertension, pericarditis and left ventricular systolic dysfunction.
Adult ; Autopsy ; Echocardiography ; Female ; Humans ; Hypertension, Pulmonary* ; Lupus Erythematosus, Systemic* ; Mortality ; Pericarditis* ; Prognosis ; Pulmonary Artery

BACKGROUND: Early T-lymphocyte activation-1 (Eta-1) is a secreted phosphoprotein which regulates a variety of cells involved in the immune and nonimmune systems. It is unique in the sense that it regulates various immune functions, as well as acting as an extracellular matrix protein. The Eta-1 gene has been mapped to the same genetic locus as the Rickettsia resistance gene (Ric), and Eta-1 expression is a part of an early T-dependent response to Orientia tsutsugamushi infection in susceptible hosts. In an initial effort to study Eta-1's mechanism of protection against Orientia tsutsugamushi infection, we attempted to produce Eta-1 in E. coli and to produce monoclonal antibodies against recombinant Eta-1. METHODS: Expression plasmids containing GST-Eta-1 were generated by cloning the polymerase chain reaction-amplified N-and C-terminal Eta-1 fragments into the cloning sites of pGEX-3X. The expressed protein was purified using a GST column and injected into BALB/c mice. Hybridoma clones reactive to Eta-1 were produced and analyzed with ELISA and Western blot. RESULTS: Expression plasmids containing GST-Eta-1 were generated by cloning the polymerase chain reaction-amplified N-and C-terminal Eta-1 fragments into the cloning sites of pGEX-3X. N-and C-terminal fragments of Eta-1 were generated as bacterially expressed GST fusion proteins. However, the expression of full-length Eta-1 was very poor. We immunized BALB/c mice with purified Eta-1 N-terminal fragments. Their spleen cells were used for cell fusion. We obtained two hybridoma cell lines secreting antibodies against Eta-1, but not against GST. Conclusions:We produced Eta-1 protein produced in E. coli. The expression of C-terminal Eta-1 fragments was poor, therefore it appeared that this part of Eta-1 was toxic to E. coli. We obtained monoclonal antibodies which were reactive in ELISA test and Western blot. These monoclonal antibodies could be useful in the analysis of the function of Eta-1 in the pathogenesis of tsutsugamushi disease as well as other diseases.
Animals ; Antibodies ; Antibodies, Monoclonal ; Blotting, Western ; Cell Fusion ; Cell Line ; Clone Cells ; Cloning, Organism ; Enzyme-Linked Immunosorbent Assay ; Escherichia coli* ; Escherichia* ; Extracellular Matrix ; Genetic Loci ; Hybridomas ; Mice ; Orientia tsutsugamushi ; Osteopontin ; Plasmids ; Rickettsia ; Scrub Typhus ; Spleen ; T-Lymphocytes

OBJECTIVE: The purpose of this study was to study the clinical efficacy of Levonorgestrel-releasing intrauterine system (Mirena(R)) for patients who have abnormal uterine bleeding before menopause or sustaining vaginal spotting during postmenopaual hormone replacement therapy. METHODS: Between June, 2001 and June, 2003, forty six premenopausal women with abnormal uterine bleeding such as menorrhagia and intermenstrual bleeding who did not prefer surgical treatment (Group 1) and twenty four postmenopausal patients with vaginal spotting (Group 2) were included in this study. The various parameters such as uterine bleeding, dysmenorrhea, volume changes of myoma or adenomyosis, and endometrial thickness were evaluated by transvaginal ultrasound examination before and after Levonorgestrel- releasing intrauterine system usage. RESULTS: A significant reduction in abnormal bleeding (26.3 vs 11.0) (p<0.0001) and dysmenorrhea (11.6 vs 6.1) (p<0.0001) were noticed. However, there was no significant change in volume of uterine myoma (40.0 vs 11.3) (p=0.282) and adenomyosis (103.0 vs 95.83) (p=0.266) before and after Mirena(R) insertion in Group 1. Vaginal spotting during hormone replacement therapy disappeared completely in 18/24. Also there was a significant reduction in endometrial thickness (6.3 vs 4.9) (p<0.0001) after Mirena(R) insertion in both group 1 and group 2. CONCLUSION: Levonorgestrel-releasing intrauterine system insertion was acceptable and convenient therapeutic modality for abnormal uterine bleeding of premenopausal abnormal uterine bleeding and vaginal spotting during the postmenopausal hormone replacement therapy.
Adenomyosis ; Dysmenorrhea ; Estrogen Replacement Therapy ; Female ; Hemorrhage ; Hormone Replacement Therapy ; Humans ; Leiomyoma ; Menopause ; Menorrhagia ; Metrorrhagia ; Myoma ; Ultrasonography ; Uterine Hemorrhage*

BACKGROUND: The studies on prediction equations of pulmonary function parameters for adults in Korea have been performed in a reference population mainly consisted of young and middle ages. So they included a relatively few elderly who conducted pulmonary function test frequently in clinic. We established prediction equations of pulmonary function parameters for healthy adults over 50 years old in rural area and compared this results with those of other studies. Therefore we attempted to consider normative values of pulmonary function tests for elderly in Korea. METHOD: Five hundred thirty-three women and men over 50 years old in rural area were participated. A "healthy" subgroup of 110 women and 32 men were identified by excluding those who had conditions that negatively influenced pulmonary function. We derived prediction equations for FVC, FEV1, and FEV1% by multiple linear regression method from their age, heights and weights in each sex. RESULTS: Prediction equations for FVC and FEV1 in each sex were derived as follows Male; FVC (L) = 0.02488Height(cm) - 0.0269Age(years) + 0.493 FEV1(L) = 0.01874Weight(kg) - 0.0282Age(years) + 2.906 Female; FVC(L) = 0.02160Height(cm) - 0.0192Age(years) - 0.0125 FEV1 (L) = 0.01720Height(cm) - 0.0194Age(years) + 0.3890 Prediction equations for FEV1 % were not derived because FEV1 % didn't have statistically significant terms. Comparing Predicted values that were calculated by substitution into the equations of various studies of mean values of age, heights and weights from this study, FVC and FEV1 values in men of this study were lower than those of other studies. In women, FVC and VEV1 values of this study were as similar as or lower than those of the study conducted for healthy elderly blacks in U.S.A respectively. CONCLUSION: We have got prediction equations of pulmonary function parameters which were driven from forced expiratory spirogram in adults over 50 years old in rural area. Predicted values of this study were lower than those of other studies which were conducted in Korea. So we consider that the study for spirometry reference values for elderly Korean using the method compatible with ATS recommendation need to be conducted more frequently forward.
Adult* ; African Continental Ancestry Group ; Aged ; Female ; Humans ; Korea ; Linear Models ; Male ; Middle Aged* ; Reference Values ; Respiratory Function Tests ; Spirometry ; Weights and Measures

OBJECTIVES: In this study, we evaluated the efficacy of nebulized bovine pulmonary surfactant on experimentally induced otitis media with effusion (OME) in guinea pigs. METHODS: Twenty guinea pigs were divided into three groups. Four untreated animals served as normal controls. Experimental OME was established in both ears of the remaining 16 animals by a transbullar injection of 10 microL of Pseudomonas aeruginosa lipopolysaccharide in saline. Thereafter, the guinea pigs received nebulized phosphate buffered saline (n=8) or nebulized bovine pulmonary surfactant (n=8). Nebulization was given daily for 7 days. On day 8, all the animals' passive opening pressure (POP) of the Eustachian tube was measured and histopathological observations of the bulla were made by light microscopy. RESULTS: Nebulized bovine pulmonary surfactant significantly reduced the POP compared to that of saline nebulization. The bovine pulmonary surfactant improved the tubal patency and produced less histopathologcally-evident edematous bullar mucosa. CONCLUSION: Nebulization of bovine pulmonary surfactant plays an important role in treating otitis media with effusion in guinea pigs. Our results suggest that the chosen nebulized bovine pulmonary surfactant can be of good clinical benefit for treating OME in the future.
Animals ; Blister ; Ear ; Eustachian Tube ; Guinea ; Guinea Pigs ; Light ; Microscopy ; Mucous Membrane ; Otitis ; Otitis Media ; Otitis Media with Effusion ; Pseudomonas aeruginosa ; Pulmonary Surfactants

Livedo vasculitis is a chronic dermatosis characterized by recurrent painful ulceration of the lower limbs, which heals to leave atrophie blanche. The precise pathophysiology is not known. Antiplatelet, anticoagulant, fibrinolytic therapies and anabolic steroids have been reported to be helpful in this syndrome. However, no consistent benefit has been demonstrated with any treatment modality. Recently, pulsed intravenous immunoglobulin therapy has been reported to be effective in some refractory cases. We herein report two cases of recalcitrant livedo vasculitis which were effectively treated with pulsed intravenous immunoglobulin therapy. These were the first trials carried out in Korea.
Immunization, Passive* ; Immunoglobulins* ; Korea ; Lower Extremity ; Skin Diseases ; Steroids ; Thrombolytic Therapy ; Ulcer ; Vasculitis*