No abstract available.
Erythropoietin* ; Humans* ; Renal Dialysis*

We report a case of Waardenburgs syndrome in 18-year-old male patient who has total deafness of the right ear, heterochromia irides, hypopigmented patches on the face and trunk, and disseminated lentigines on the entire body surface since birth. His 51-year-old mother also has total deafness, heterochromia irides, white foreloek, and disseminated lentigines on the entire body surface. The patient with this disorder may complain of pigmentary abnormalities, and we believe dermatologists should pay more attention to systemic signs of the congenital pigmentary disorders.
Adolescent ; Deafness ; Ear ; Humans ; Lentigo ; Male ; Middle Aged ; Mothers* ; Parturition ; Waardenburg Syndrome*

BACKGROUND: Multidrug-resistant tuberculosis(MDR-TB) in patients is mainly caused by acquired drug resistance, However, a small proportion of MDR-TB is caused by initial drug resistance(IDR), which may be somewhat different from acquired drug resistance. This study analyzed the clinical characteristics of IDR in MDR-TB patients to use the results as basic data in managing the disease. METHODS: A retrospective study of 30 IDR cases in MDR-TB patients from Jan. 1995 to Dec. 1998 was perormed. In order to analyzed the clinical charcteristics, the age, sex, family history, duration of negative conversion, number of resistant drugs, treatment regimens, duration of treatment, extent of disease and cavitary lesion on the chest X-ray was examined. In order too analyzed the level of improvement, the extent of the disease and cavitary lesion on the chest X-ray, tested by Wilcoxon signed rank sum test, and the disease free interval rate of 1-year and 4-year was examined using the Kaplan-Meier method. RESULTS: The mean age of the patients was 46.6 years and the sex ratio 1:1. Six(20%) patients had a family history. The mean negative conversin of the sputum AFB stain was 2.6 months. The number of resistant drugs was 7.6 and the number of used drugs 3.6. Twenty-three(67%) patients were treated for less than 12months and 28(93%) patients were treated with first-line drugs. The extent of the disease and the cavitary lesion on the chest X-ray improved after treatment(p<0.05). Among 13 patients who were followed up for 22.6 months, 2(15%) patients relapsed and the disease free interval rate of 1-year and 4-year was 85%. CONCLUSION: It is recommended that the duration of treatment of IDR in MDR-TB with first-line drugs be 9-12 months even if the extent of disease and cavitary lesion on the chest X-ray improves.
Drug Resistance* ; Humans ; Retrospective Studies ; Sex Ratio ; Sputum ; Thorax ; Tuberculosis, Multidrug-Resistant

Synovial sarcoma is a very rare malignant tumor which arising from the synovial lining connective tissue, tendon sheaths and bursae. However, there are a few case reports of this tumor arising from the bone. We have experienced 3 cases of the tumor from the bone, i. e. the head of the left fibula, the sacrum and the right ileum, and the distal end of the left femur. Microscopically they showed typical slit like spaces, lined by epitheloid cells or cuboidal cells and one could easily find out spindle, polygonal, or giant cells. The proximal third of the left fibula was excised, and the other case arising from the sacrum & right ilium was treated with radiation therapy. Another case refused hip disarticulation, The effectiveness of the treatment is uncertain.
Connective Tissue ; Disarticulation ; Femur ; Fibula ; Giant Cells ; Head ; Hip ; Ileum ; Ilium ; Sacrum ; Sarcoma, Synovial ; Tendons

Type IV collagenases are thought to play a role in the proteolysis of the basement membrane and the extracellular matrix by the malignant cells that occur early in the development of invasive tumors. In several human tumors, including breast, colonic, ovarian, and hepatocellular carcinomas, type IV collagenase expression has been positively correlated with tumor invasiveness. In this study, we examined the expression and the activation of 72 kDa type IV collagenase in cancerous and normal tissues of the colon and, we attempted to clarify its clinical significance in 45 cases of human colorectal cancer by using northern blot analysis and gelatin zymography.This study showed that the level of 72 kDa type IV collagenase mRNA was increased in colorectal cancer and that this increase was associated with increased enzymatic activity. While there was a difference in the expression and the activation of this enzyme between T2 and T3, this enzyme activity did not show a definite correlation with cancer progress as measured by the depth of tumor invasion and lymph node metastasis.
Basement Membrane ; Blotting, Northern ; Breast ; Carcinoma, Hepatocellular ; Collagenases ; Colon ; Colorectal Neoplasms* ; Extracellular Matrix ; Gelatin ; Humans* ; Lymph Nodes ; Matrix Metalloproteinase 2* ; Neoplasm Metastasis ; Proteolysis ; RNA, Messenger

Epidermal growth factor receptor(EGFR) mRNA was assessed in 7, 12-dimethylbenz(a) anthracene(DMBA)-induced squamous cell carcinomas(SCC) in the hamster buccal pouch model to elucidate the role and timing of histologic changes and differentiation during carcinogenesis. In situ reverse-transcriptase polymerase chain reaction was used to identify the EGFR. DMBA(0.5%) in heavy mineral oil was applied to the right buccal pouch 3 times per week for up to 16 weeks. Hyperplasia was detected by histologic analysis at 4 weeks, dysplasia with or without papillomatous changes at 8 weeks, and SCC at 16 weeks. Paraffin embedded sections of the tumors were used for EGFR mRNA and immunohistochemical determinations. EGFR cDNA was synthesized in situ by reverse transcription using an EGFR-specific oligonucleotide primer. In situ PCR amplification in the presence of digoxigenin-11-dUTP and subsequent binding with an antidigoxigenin antibody conjugated to alkaline phosphatase allowed direct visualization. EGFR mRNA was localized in the nuclei of the basal cell layer of normal squamous epithelium but is expanded to the superficial squamous cell layer as well as the basal cell layer in hyperplasia and dysplasia and is diffusely expressed in squamous cell carcinoma. EGFR protein, detected by immunostaining using a monoclonal antibody, was expressed mainly in the cytoplasm of superficial squamous cell layers(not in the basal cell layer) in normal squamous epithelium. It increased gradually in level and amount through the stages of hyperplasia and dysplasia to invasive squamous cell carcinoma. These results suggest that the biological markers EGFR mRNA and EGFR protein may be used for assessing intermediate end points in tests of various chemopreventive agents on oral carcinogenesis in the hamster buccal pouch model as well as in human clinical trials.
Alkaline Phosphatase ; Animals ; Biomarkers ; Carcinogenesis ; Carcinoma, Squamous Cell* ; Cricetinae* ; Cytoplasm ; DNA, Complementary ; Epidermal Growth Factor* ; Epithelium ; Humans ; Hyperplasia ; Mineral Oil ; Paraffin ; Polymerase Chain Reaction ; Receptor, Epidermal Growth Factor* ; Reverse Transcriptase Polymerase Chain Reaction* ; Reverse Transcription ; RNA, Messenger ; RNA-Directed DNA Polymerase*

Background: Health disparity is defined as a difference in the accessibility of medical resources among regions or other factors. In South Korea, there might be a disparity because of the low proportion of public medical institutions. This study aimed to investigate the geographic distribution of rehabilitation treatment and examine the factors associated with the rates of rehabilitation treatment in Korea. Methods: We used administrative claims data in 2007, 2012, and 2017 from the National Health Insurance Database in Korea. We defined physical therapy and occupational therapy as rehabilitation treatments and analyzed the rate of rehabilitation treatments for administrative districts in 2007, 2012, and 2017. Interdecile range and coefficient of variation were used to investigate the geographic distribution of rehabilitation treatment over time. We applied multiple random intercept negative binomial regression to examine the factors associated with rehabilitation treatment. A total of 28,319,614 inpatient and outpatient claims were submitted for 874 hospitals that provided rehabilitation treatment in 2007, 2012, and 2017. Results: The increase in the mean rates of physical therapy inpatients and outpatients was greater than those for occupational therapy inpatients and outpatients from 2007 to 2017. Both physical therapy and occupational therapy were concentrated in the Seoul Capital Area and other large urban areas. More than 30% of the districts received no rehabilitation treatment. The interdecile range and coefficient of variation for physical therapy declined more than those for occupational therapy from 2007 to 2017. The deprivation index was negatively correlated with physical therapy inpatients, physical therapy outpatients, occupational therapy inpatients, and occupational therapy outpatients. Furthermore, a 1-unit increase in the number of hospital beds per 1,000 people was associated with 1.42 times higher physical therapy inpatient, 1.44 times higher physical therapy outpatient, 2.14 times higher occupational therapy inpatient, and 3.30 times higher occupational therapy outpatient treatment. Conclusion To reduce the geographic inequality in rehabilitation treatment, it is necessary to narrow the gap between the supply and demand of rehabilitation services. Providing incentives or direct provisions from the government might be an alternative.

In order to investigate the risk factors of retinopathy of prematurity[ROP], we retropspectively reviewed the medical records of 425 premature babies who had been admitted in our neonate intensive care unit between January 1994 and December 1998.After excluding 33 babies who had serious congenital anomalies, 83 out of 392 babies[20.7%]developed various stages of ROP.Gestational age and birthweight were the most significant risk factors. Among postnatal factors use of ventilator for 48 hours orlonger, apnea, and use of surfactant were independently increasing the progression of ROP in a linear logistic regression analysis.Other factors such as history of transfusion and sepsis had a tendency to worsen the retinopathy.On the other hand, fluctuation in blood gas, low apgar score or anemia did not seem to effect the progression of retinopathy. In conclusion, careful monitoring would be warrented when the premature babies had additional risk factors as listed above.
Anemia ; Apgar Score ; Apnea ; Birth Weight ; Gestational Age ; Hand ; Humans ; Infant, Newborn ; Intensive Care Units ; Logistic Models ; Medical Records ; Retinopathy of Prematurity* ; Risk Factors* ; Sepsis ; Ventilators, Mechanical

BACKGROUND: Most current reseatch using prognostic scoring systems in critically ill patients have focused o prediction using the first intensive care unit(ICU) day data or daily updated data. Usually the mean ICU length of stay in Korea is longer than in the western world. Consequently, a more cost-effective and practical prognostic parameter is required. The principal aim of this study was to assess the prognostic value of the seventh day(7th day : the average mean ICU length of stay) APACHE III score in a medical intensive care unit. METHODS: 241 medical ICU patients from July 1997 to April 1998 were enrolled. The 1st and 7th scores were measured by using the APACHE III scoring system and compared between survivors and non-survivors. Logistic regression analysis was performed to determine the relationship between the 1st and 7th APACHE III scores and the mortality risk. RESULTS: 1) The mean length of stay in the ICU was 10.3±13.8 days. 2) The mean 1st and 7th day APACHE III scores were 59.7±30.9 and 37.9±27.7. 3) The mean 1st day APACHE III scores was significantly lower in survivors than in non- survivors(49.9±23.8 vs 86.3±32.3 P<0.0001). 4) The mean 7th day APACHE III scores was significantly lower in survivors than in non- survivors(30.1±18.5 vs 80.1±30.4, P<0.0001). 5) The odds ratios among the 1st and 7th day APACHE III scores and the mortality rate were 1.0507 and 1.0779 respectively. CONCLUSION: These results suggest that the seventh day APACHE III scores is as useful in predicting the outcome as is such like the first day APACHE III score. Therefore, in comparison to the daily APACHE III score, measuring the 1st and 7th day APACHE III scores are also useful for predicting the prognosis of critically ill patients in terms of cost-effectiveness. It is suggested that the 7th day APACHE III score is useful for predicting the clinical outcome.
APACHE* ; Critical Illness ; Humans ; Intensive Care Units* ; Critical Care* ; Korea ; Length of Stay ; Logistic Models ; Mortality ; Odds Ratio ; Prognosis ; Survivors ; Western World

This study was designed to investigate the effects of burn injury of the leg on the growth plate of proximal tibia in the immature rat. The procedure for burn injury of left leg was performed at the thigh, knee and lower leg under the general anesthesia with inhalation of ether. After the burn injury, follow up observations were made at second day, 1st, 4th, and 6th weeks with histological examination. The results were as follows. During postburn 4 weeks, height of the proximal tibial epiphyseal plates of the experimental group showed significant increment, comparing with control group. At postburn 6th weeks, it revealed no significant difference, comparing with control group (Wilcoxon rank sum test, p<0.05). During postburn 4 weeks, cell numbers in column of the proximal tibial epiphyseal plates of the experimental group showed significant increment, c omparing with control group. At postburn 6th weeks, it revealed no significant difference comparing with control group (Wilcoxon rank sum test, p<0.05).
Anesthesia, General ; Animals ; Burns* ; Cell Count ; Ether ; Follow-Up Studies ; Growth Plate ; Inhalation ; Knee ; Leg ; Rats* ; Thigh ; Tibia*