No abstract available.
Hepatitis B e Antigens* ; Hepatitis B Surface Antigens* ; Hepatitis B virus* ; Hepatitis B* ; Hepatitis*

Wilms' tumor is composed of a mixture of epithelial, stromal and blastematous elements in varing proportions. Adult Wilms' tumor, unlike that of childhood is a rare disease. Spontaneous rupture of the kidney with subcapsular or perirenal hematoma also is rarely seen in malignant renal tumor. A case of adult Wilms' tumor in 65-year old female is here reported, associated with spontaneous renal rupture, which was treated with radical nephrectomy and chemotherapy (vincristine, actinomycin D and doxorubicin).
Adult* ; Aged ; Dactinomycin ; Drug Therapy ; Female ; Hematoma ; Humans ; Kidney ; Nephrectomy ; Rare Diseases ; Rupture* ; Rupture, Spontaneous ; Wilms Tumor*

No abstract available.
Nickel ; Titanium

BACKGROUND: We established a bloodless center at Soonchunhyang University Hospital (SCH) in 1996 and have provided medical and surgical care for Jehovah's Witness patients. In this study, we evaluated their outcomes to provide the basis of bloodless medicine and surgery in Korea. METHODS: A retropective review of the medical records of 757 Jehovah's Witness patients admitted in the SCH Bloodless Center from December 1996 to July 2003 was performed. RESULTS: Among 757 patients, 19 (2.5%) expired during treatment and 4 of them died of cardiopul-monary dysfunction secondary to anemia. As alternatives to blood transfusion, 85 (11.2%) patients were treated with iron, 81 (10.7%) with erythropoietin, 49 (6.5%) with aprotinin, 31 (4.1%) with hemodilution and 28 (3.7%) with cell saver. Four hundreds fifteen (54.8%) of 757 patients underwent surgery. The most frequently involved cinical department was Obstetric/Gynecology (23.8%). The ratio of female and the percentage of cases treated with alternatives to blood transfusion were higher in surgery group than non-surgery group patients.(Chi-square test, P<0.01) CONCLUSIONS: Most Jehovah's Witness patients were treated successfully in our bloodless center with various alternatives to blood transfusion, such as erythropoietin, intraoperative autotransfusion, acute normovolemic hemodilution etc. Collaboration and good communication among surgeons, anesthesiologists, hematologists and blood bank physicians are very important to provide qualified medical or surgical treatment to the patients who have a religious objection to receiving blood or blood-related products.
Anemia ; Aprotinin ; Blood Banks ; Blood Transfusion ; Blood Transfusion, Autologous ; Cooperative Behavior ; Erythropoietin ; Female ; Hemodilution ; Humans ; Iron ; Korea ; Medical Records

BACKGROUND/AIMS: Our aim was to assess whether short-term treatment with soluble tumor necrosis factor (TNF) receptor affects circulating markers of bone metabolism in rheumatoid arthritis (RA) patients. METHODS: Thirty-three active RA patients, treated with oral disease-modifying antirheumatic drugs (DMARDs) and glucocorticoids for > 6 months, were administered etanercept for 12 weeks. Serum levels of bone metabolism markers were compared among patients treated with DMARDs at baseline and after etanercept treatment, normal controls and naive RA patients not previously treated with DMARDs (both age- and gender-matched). RESULTS: Bone-specific alkaline phosphatase (BSALP) and serum c-telopeptide (CTX)-1 levels were lower in RA patients treated with DMARDs than in DMARD-naive RA patients. After 12 weeks of etanercept treatment, serum CTX-1 and sclerostin levels increased. In patients whose DAS28 improved, the sclerostin level increased from 1.67 +/- 2.12 pg/mL at baseline to 2.51 +/- 3.03 pg/mL, which was statistically significant (p = 0.021). Increases in sclerostin levels after etanercept treatment were positively correlated with those of serum CTX-1 (r = 0.775), as were those of BSALP (r = 0.755). CONCLUSIONS: RA patients treated with DMARDs showed depressed bone metabolism compared to naive RA patients. Increases in serum CTX-1 and sclerostin levels after short-term etanercept treatment suggest reconstitution of bone metabolism homeostasis.
Adult ; Alkaline Phosphatase/blood ; Arthritis, Rheumatoid/blood/diagnosis/*drug therapy ; Biological Markers/blood ; Bone Morphogenetic Proteins/blood ; Bone Remodeling/*drug effects ; Collagen Type I/blood ; Female ; Genetic Markers ; Homeostasis ; Humans ; Immunoglobulin G/*administration & dosage ; Immunosuppressive Agents/*administration & dosage ; Inflammation Mediators/blood ; Male ; Middle Aged ; Peptides/blood ; Receptors, Tumor Necrosis Factor/*administration & dosage ; Time Factors ; Treatment Outcome ; Tumor Necrosis Factor-alpha/antagonists & inhibitors

We investigated acute effects of intermittent large dose bisphophonate therapy in osteoporotic patients. Peripheral blood mononuclear cells were incubated with alendronate (100 micrometer) for 18 hr, in vitro and cytokine expressions were measured by real-time RT-PCR. Pamidronate 30 mg was administered on 26 osteoporotic patients; and acute phase reactants, inflammatory cytokines and bone biomarkers were measured. The in vitro study showed significant increase in mRNA expression of IL-6, TNF-alpha and IFN-gamma. A notable rise in serum C-reactive protein (CRP) was observed over 3 days after pamidronate infusion (P=0.026). Serum levels of TNF-alpha, IL-6 and IFN-gamma were also significantly increased (P=0.009, 0.014, 0.035, respectively) and the increase in IL-6 levels were strongly correlated with CRP levels (P=0.04). Serum calcium and c-telopeptide levels rapidly decreased after the treatment (P=0.02, <0.001, respectively). This study showed that mRNA expression of inflammatory cytokines at peripheral blood mononuclear cells (PBMC) level were observed within 18 hr and marked elevation of inflammatory cytokines and acute phase reactants were demonstrated after pamidronate infusion at the dose for osteoporosis. Our studies confirmed that intermittent large dose aminobisphosphonate causes acute inflammation.
Acute-Phase Proteins/biosynthesis/genetics ; Adult ; Aged ; Aged, 80 and over ; Alendronate/pharmacology ; Biological Markers/blood ; Blood Cells/drug effects ; Bone Density Conservation Agents/*administration & dosage ; C-Reactive Protein/genetics/metabolism ; Calcium/blood ; Collagen Type I/blood ; Diphosphonates/*administration & dosage ; Female ; Humans ; Injections, Intravenous ; Interferon-gamma/blood/genetics ; Interleukin-6/blood/genetics ; Male ; Middle Aged ; Osteoporosis/*drug therapy ; Peptides/blood ; RNA, Messenger/metabolism ; Tumor Necrosis Factor-alpha/genetics/metabolism

The aim of this study was to determine whether skin temperature measurement by digital thermography on hands and feet is useful for diagnosis of Raynaud's phenomenon (RP). Fifty-seven patients with RP (primary RP, n = 33; secondary RP, n = 24) and 146 healthy volunteers were recruited. After acclimation to room temperature for 30 min, thermal imaging of palmar aspect of hands and dorsal aspect of feet were taken. Temperature differences between palm (center) and the coolest finger and temperature differences between foot dorsum (center) and first toe significantly differed between patients and controls. The area under curve analysis showed that temperature difference of the coolest finger (cutoff value: 2.2degrees C) differentiated RP patients from controls (sensitivity/specificity: 67/60%, respectively). Temperature differences of first toe (cutoff value: 3.11degrees C) also discriminated RP patients (sensitivity/specificity: about 73/66%, respectively). A combination of thermographic assessment of the coolest finger and first toe was highly effective in men (sensitivity/specificity : about 88/60%, respectively) while thermographic assessment of first toe was solely sufficient for women (sensitivity/specificity: about 74/68%, respectively). Thermographic assessment of the coolest finger and first toe is useful for diagnosing RP. In women, thermography of first toe is highly recommended.
Adult ; Diagnosis, Differential ; Female ; Fingers/*physiology ; Humans ; Male ; Middle Aged ; ROC Curve ; Raynaud Disease/*diagnosis ; Sensitivity and Specificity ; Skin Temperature ; *Thermography ; Toes/*physiology

No abstract available.
Arthritis* ; Dermatitis* ; Humans ; Neutrophils*

No abstract available.
Hemangioma, Cavernous* ; Occipital Lobe* ; Status Epilepticus*

Several ways of curing are being tried to improve material's properties and reduce marginal gap. However, all are considering about the pattern of light intensity. It was noted from the preliminary study the change of light wavelength from filter changing may give an impact on material's property and microleakage. The object of this study was to verify the effect of filters with various wavelength width on the microhardness and microleakage of composite resin; hybrid type of DenFil and submicron hybrid type of Esthet X. Composite resins were cured using 3 kinds of filter; narrow-banded(465-475 nm), mid-banded(430-470 nm), wide-banded(400-500 nm). After the estimation of microhardness, degree of dye penetration and the maximum gap from SEM evaluation were done between 4 groups that showed no difference in microhardness value of the lower surface. The results were as follows: 1. Adequate microhardness could not be gained with a narrow-banded filter irrespective of curing time. At the upper surface, DenFil should be polymerized with middle or wide-banded filter for 20 seconds at least, while Esthet X be cured with middle or wide-banded filter for 30 seconds at least to get similar hardness value to control group. 2. There was little dye penetration in enamel margin, but all dentin margins showed much more dye penetration irrespective of curing conditions. Although there was no statistical difference, groups cured with mid-banded filter for 40 seconds and with wide-width filter for 20 seconds showed relatively less dye penetration. 3. It was revealed from the SEM examination that group cured with wide-banded filter had the smallest gap without statistical significance. Spearman's rho test showed that the correlation between the results of dye penetration and SEM examination was very low. From these results, it could be concluded that curing with wide-width filter would be better than the other techniques, even though the curing technique using mid-width filter seems to have its own unique advantage.
Chimera ; Composite Resins ; Dental Enamel ; Dentin ; Hardness ; Imidazoles ; Light ; Nitro Compounds ; Polymers