No abstract available.
Methotrexate*

OBJECTIVE: Sonography is a noninvasive and safe bedside imaging modality that provides rapid and repeatable real-time radiological evaluations without a radiation hazard. However, sonography has not gained widespread acceptance as a diagnostic tool in adult brain disease because of limited imaging resolution through the bony window. We investigated the diagnostic potential and clinical usefulness of bedside brain sonography through surgical bone defects in neurosurgical patients. METHODS: We evaluated twelve patients, each of whom had undergone a decompressive craniectomy, via bedside sonography, and performed comparison CT or MRI for all patients. RESULTS: We obtained reliable information regarding anatomical structure displacement, ventricle systems, intracranial fluid collection, presence and distribution of cerebral infarctions, and hemorrhages. We performed several interventional trials under sonography guidance, including aspiration of entrapped fluid collection and insertion of an external ventricular drainage catheter into a collapsed and displaced ventricle cavity. CONCLUSION: Bedside sonography through surgically created bone defects is a non-invasive method that physicians can repeat as required with no radiation hazard, and it is of particular value in emergent and critical situations when conventional neuroimages are unobtainable. Bedside sonography can be a first-line monitoring tool, in lieu of CT, for critically ill patients with surgical cranial defects.
Adult ; Brain ; Brain Diseases ; Catheters ; Cerebral Infarction ; Critical Illness ; Decompressive Craniectomy ; Displacement (Psychology) ; Drainage ; Hemorrhage ; Humans ; Neurosurgery ; Ultrasonography, Doppler

BACKGROUND: It is necessary to protect patient from white blood cells (WBC) caused side effects of platelet transfusion by reducing the WBC contamination in single donor platelets (SDPs). Objective of the new software is to improve WBC depletion performance and collection efficiency. Revised software version, LDP Rev. C2 was installed in our MCSR+ (Hemonetics, USA). We compared the newly introduced software version with the previous software LDP Rev. C. METHOD: SDPs were collected from registered and random repeat donors who visited our blood center. After 49 single needle collections by MCSR+ (software LDP Rev. C) were performed, revised software (LDP Rev. C2) was installed and 48 single needle collections were carried out. The platelet count of donors were measured electronically. The target platelet yields were 3.0x10(11). All units of SDPs were tested for platelet yields and residual WBC. And other parameters were also evaluated. RESULTS: The MCSR+ LDP collected platelets with mean platelet yields of 3.3x10(11)(Rev. C) and 3.4x10(11)(Rev. C2). The total processing blood volume and collection time were significantly reduced in Rev. C2. The collection efficiency was also significantly improved in Rev. C2 (64% vs 57%). Residual WBC in all product collected from software Rev. C2 were below 1 106 and 71% of the products revealed residual WBC below 1 105, respectively. Citrate toxicity was not observed during the apheresis by Rev. C2. CONCLUSION: Revised software LDP Rev. C2 in MCSR+ showed improved collection efficiency and leukocyte depletion performance compared to the Rev. C. And optional control of citrate re-infusion rate seemed to reduce donor citrate reactions during the apheresis.
Blood Component Removal ; Blood Platelets ; Blood Volume ; Citric Acid ; Humans ; Leukocytes ; Needles ; Platelet Count ; Platelet Transfusion ; Tissue Donors

BACKGROUND: Recently introduced plateletpheresis systems (AmicusTM software version 2.41 and MCS + LDP Rev. C) were evaluated for their performance. METHOD: Single-needle procedure was used for all donors, 127 with the AmicusTM and 85 with the MCS +. The targeted platelet yield was 3.2x1011. Components were evaluated for component yields, collection time, collection efficiency and incidence of donor reactions due to citrate. RESULTS: The collection time was significantly shorter with the AmicusTM (mean 57 min vs. 71 min, p< 0.05), and in 9 donors with a mean preapheresis platelet count of 325x103 /microliter the whole procedure could be completed within 40 minutes. However, the total processing time, including preprocessing and postprocessing time, between AmicusTM (78.0 min) and MCS + (74.3 min) was not statistically different. Mean platelet yield for AmicusTM and MCS + were 3.6x1011 and 3.4x1011, respectively. With 82.4% of SDPs collected with the MCS + having a platelet count of 3.0~3.9x1011, compared to 65.4% with the AmicusTM, the MCS + was more accurate in predicting the platelet yield of the final products. All components showed a residual WBC count of 5.0x106, and in 99.2% and 97.6% of components collected with the AmicusTM and MCS +, respectively, had a residual WBC count of less than 1.0x106. Mild donor reactions due to citrate tended to be more common on the MCS + (14.1%), which also used significantly more ACD (mean 342.5 mL vs. 268.0 mL, p< 0.05), than on the AmicusTM (5.5%). CONCLUSION: The plateletpheresis systems evaluated in this study allow the collection of leukoreduced SDPs of high quality within a reasonable time.
Blood Platelets ; Citric Acid ; Humans ; Incidence ; Platelet Count ; Plateletpheresis* ; Tissue Donors

BACKGROUND: It is not clear whether polymorphism of the apolipoprotein E (ApoE) gene influences the cognition of community residents. The aim of this study was to establish the association between ApoE gene polymorphism and cognitive function in an elderly rural community in Korea. METHODS: A total of 388 subjects aged 65 and over were recruited. Demographic characteristics, past history of illness, and scores on the Korean version of the Mini Mental State Examination (K-MMSE), the Geriatric Depression Scale . Short Form (GDS-S), and the Korean version of Instrumental Activities of Daily Living (K-IADL) were evaluated. The lipid profile and ApoE genotype were sampled from 377 of the participants. RESULTS: Of the entire cohort, 75% had less than 6 years of education, and 30% were illiterate. The frequencies of the ApoE epsilon2, ApoE epsilon3, and ApoE epsilon4 alleles were 48 (6.6%), 372 (86.9%), and 49 (6.5%), respectively. The K-MMSE score was much lower in those with two ApoE epsilon3 alleles than in those with only one ( p=0.046). However, the numbers of ApoE epsilon2 alleles (p=0.976) and ApoE epsilon4 alleles (p=0.934) carried by the individual were not associated with K-MMSE score. Both K-IADL (p<0.001) and GDS-S (p<0.001) scores were significantly correlated with K-MMSE score. Grouping of the participants into three groups according to K-MMSE score (i.e., 0-17 , 18-24, and 25-30) also revealed that this score was correlated with K-IADL score (p<0001), GDS-S score (p<0.001), and the ApoE epsilon3 allele (p=0.035). CONCLUSIONS: These results suggest that the ApoE epsilon3 allele has a negative influence on cognitive function (K-MMSE) in this rural community. Surprisingly, we were unable to detect any relationship between the ApoE epsilon4 allele and cognitive function. There was a positive correlation between K-MMSE, K-IADL, and GDS-S scores.
Activities of Daily Living ; Aged ; Alleles ; Apolipoprotein E2 ; Apolipoprotein E3 ; Apolipoproteins ; Apolipoproteins E ; Cognition ; Cohort Studies ; Depression ; Genotype ; Humans ; Rural Population

Objective of this study was to compare the color stability, mechanical and chemical properties of three different types of temporary crown resins. Commercially available powder-liquid (Group PL), light-cured (Group LC) and auto-mix syringe (Group AM) types' temporary crown resins were used as experimental groups for each of the evaluation. All the test groups were evaluated after 1 day and 7 days of immersion in various staining solutions. The colors of all groups before and after storage in the staining solutions were measured by a spectrophotometer based on CIE Lab system, and the color differences (ΔE(*)) thereby calculated. Micro hardness test was performed before water storage and aging after 7 days at 37 ℃. In addition, flexural strength, water sorption and solubility tests were performed according to international standard, ISO 10477. All experimental groups showed significant color change in staining solutions when compared to those stored in the control solution (distilled water) (p<0.05). Group PL showed the least color change among the three groups followed by Group AM (p<0.05). This tendency was observed after 7 days of immersion. In terms of the micro hardness test, Group PL showed the highest value among the three groups followed by Group AM (p<0.05). Additionally, the flexural strength decreased in the following order: AM > PL > LC (p<0.05). Water sorption and solubility increased in the following order: AM < PL < LC (p<0.05). The results of this study would provide useful information when choosing temporary crown resin types in various clinical situations.
Aging ; Crowns ; Hardness Tests ; Immersion ; Solubility ; Syringes ; Water

We report a 52-yr-old Korean woman with cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL) whose diagnosis was confirmed by skin biopsy and the presence of a novel mutation in the NOTCH3 gene. The patient's clinical features were rather unusual in that 1) clinical presentations were only two episodes of stroke and mild dementia unaccompanied by mood disturbances or migraine, and 2) there was no family history. Brain MRI showed T2 hyperintensities in both temporal pole areas in line with the recent suggestion by O'Sullivan et al. that the abnormality could be a radiologic marker of CADASIL. FDG-PET also showed a hypometabolism in the temporal pole areas with an abnormal finding on MRI in addition to the hypometabolism in cortical and subcortical regions. We could learn from this case that CADASIL may be included in the differential diagnoses in patients with vascular dementia associated with a small vessel disease, even in the absence of a family history, especially when there are no known stroke risk factors and when the MRI shows T2 hyperintensity in the temporal pole regions.
Amino Acid Substitution ; Biopsy ; Brain/pathology ; Codon/genetics ; Dementia, Multi-Infarct/diagnosis ; Dementia, Multi-Infarct/genetics* ; Dementia, Multi-Infarct/pathology ; Dementia, Multi-Infarct/radionuclide imaging ; Female ; Human ; Korea ; Magnetic Resonance Imaging ; Middle Aged ; Mutation, Missense* ; Neuropsychological Tests ; Point Mutation* ; Proto-Oncogene Proteins/genetics* ; Skin/pathology ; Tomography, Emission-Computed

Isoniazid is a first-line drug in the treatment of tuberculosis. A variety of adverse reactions of isoniazid have been reported. These include hepatitis, peripheral neuropathy, skin rashes, neurologic disturbances and hematologic alterations. Among these, acute pancreatitis due to isoniazid is very rare. We report a case of acute pancreatitis due to isoniazid confirmed by rechallenge test with review of some literatures.
Exanthema ; Hepatitis ; Isoniazid* ; Pancreatitis* ; Peripheral Nervous System Diseases ; Rifampin ; Tuberculosis

BACKGROUND/AIMS: This study investigated the clinical features and prognosis of primary biliary cirrhosis (PBC) in Korea. METHODS: Clinical data of patients diagnosed as PBC between 1997 and 2008 at eight referral hospitals were analyzed retrospectively. PBC was diagnosed based on liver function tests, presence of serum antimitochondrial antibody (AMA), and histopathological findings. RESULTS: In total, 251 patients (218 females, 33 males; mean age 54 years) were enrolled, and the mean follow-up duration was 33.5 months. At the diagnosis, 61% of the patients were asymptomatic, 12% had decompensated liver cirrhosis, and 98% were positive for AMA. The serum alkaline phosphate (ALP) level was 2.6 times the upper limit of normal, aspartate aminotransferase was 105 U/L, and bilirubin was 2.0 mg/dL. The mean Mayo risk score was 5.5, and the Child-Pugh class was A, B, and C in 79%, 19%, and 2% of the patients, respectively. Ursodeoxycholic acid (UDCA) was used for treatment in 88% of the patients, among which 70% exhibited biochemical responses defined as normalization or a >40% decrease in ALP at 6 months. Eight deaths occurred during the follow-up; the causes were variceal bleeding, hepatic failure, and sepsis. The overall 5-year survival rate was 95%. The poor prognostic factors were being older than 60 years, high bilirubin, low albumin, ascites, high Mayo risk score, Child-Pugh class C, and initial presence of hepatic decompensation. CONCLUSIONS: Most patients diagnosed as PBC were asymptomatic, and these patients had a favorable short-term prognosis. The prognosis of PBC was dependent on the initial severity of liver disease.
Adult ; Age Factors ; Aged ; Aged, 80 and over ; Autoantibodies/metabolism ; Bacterial Proteins/blood ; Endopeptidases/blood ; Female ; Humans ; Liver Cirrhosis, Biliary/*diagnosis/drug therapy/mortality ; Liver Function Tests ; Male ; Middle Aged ; Prognosis ; Republic of Korea ; Retrospective Studies ; Severity of Illness Index ; Survival Rate ; Ursodeoxycholic Acid/therapeutic use

ADP-ribosyl cyclase (ADPR-cyclase) produces a Ca2+-mobilizing second messenger, cyclic ADP- ribose (cADPR), from beta-NAD+. A prototype of mammalian ADPR-cyclases is a lymphocyte antigen CD38. Accumulating evidence indicates that ADPR-cyclases other than CD38 are expressed in various cells and organs. In this study, we discovered a small molecule inhibitor of kidney ADPR-cyclase. This compound inhibited kidney ADPR-cyclase activity but not CD38, spleen, heart or brain ADPR-cyclase activity in vitro. Characterization of the compound in a cell-based system revealed that an extracellular calcium-sensing receptor (CaSR)- mediated cADPR production and a later long-lasting increase in intracellular Ca2+ concentration ([Ca2+]i) in mouse mesangial cells were inhibited by the pre-treatment with this compound. In contrast, the compound did not block CD3/TCR-induced cADPR production and the increase of [Ca2+]i in Jurkat T cells, which express CD38 exclusively. The long-lasting Ca2+ signal generated by both receptors was inhibited by pre-treatment with an antagonistic cADPR derivative, 8-Br-cADPR, indicating that the Ca2+ signal is mediated by the ADPR-cyclse metabolite, cADPR. Moreover, among structurally similar compounds tested, the compound inhibited most potently the cADPR production and Ca2+ signal induced by CaSR. These findings provide evidence for existence of a distinct ADPR-cyclase in the kidney and basis for the development of tissue specific inhibitors.
Receptors, Calcium-Sensing/metabolism ; Rats, Sprague-Dawley ; Rats ; Mice ; Kidney/*enzymology ; Humans ; Enzyme Inhibitors/chemistry/*pharmacology ; Cyclic ADP-Ribose/*metabolism ; Cell Line ; *Calcium Signaling ; Azo Compounds/chemistry/*pharmacology ; Animals ; ADP-ribosyl Cyclase/*antagonists & inhibitors/*metabolism