BACKGROUND AND OBJECTIVES: This study was designed to examine whether the multifractal Hurst exponents of heart rate can estimate activating and deactivating spontaneous baroreflex sensitivity (SBRS). SUBJECTS AND METHODS: Age and sex matched 24 healthy volunteers were placed in the supine position and head-up tilt position for 30 minutes, and the systolic blood pressure and heart rate were measured in an noninvasive manner. When the RR interval (RRI) sequence and systolic pressure sequence simultaneously increased or decreased for more than three successive beats, the slope of the linear regression line of systolic blood pressure and RR interval sequence was defined as the value of spontaneous baroreflex sensitivity (SBRS). From the RR intervals, very short-term (alpha range, < or =12 heartbeats), short-term (beta range, > or =12 heartbeats), and the multrifractal Hurst exponents were calculated to determine the linear correlation.coefficients for SBRS. RESULTS: In the supine position, the linear correlation coefficients (p) of SBRS and H-5alpha, H-4alpha, H-3alpha, H-2alpha, H-1alpha, H1alpha, H2alpha, H3alpha, H4alpha, H5alpha were -0.195 (NS), -0.207 (NS), -0.232 (NS), -0.282 (NS), -0.355 (NS), -0.621 (0.003), -0.650 (0.001), -0.677 (0.001), -0.699 (0.0006) and -0.708 (0.0005), respectively. In the tilting position, the linear correlation coefficients of SBRS and H-5beta, H-4beta, H-3beta, H-2beta, H-1beta, H1beta, H2beta, H3beta, H4beta, H5beta were 0.024 (NS), 0.020 (NS), 0.010 (NS), -0.028 (NS), -0.193 (NS), -0.627 (0.0034), -0.607 (0.0045), -0.598 (0.0053), -0.572 (0.0084) and -0.539 (0.0141), respectively. CONCLUSION: Some of the very short-term and short-term generalized Hurst exponents, such as H5alpha and H1beta, can be used for the estimation of spontaneous baroreflex sensitivity during patient placement in the supine and head-up tilt position, respectively.
Baroreflex* ; Blood Pressure ; Healthy Volunteers ; Heart Rate* ; Heart* ; Humans ; Linear Models ; Supine Position

No abstract available.
Lymphoma ; Lymphoma, Large-Cell, Anaplastic

Glycoprotein (GP) IIb/IIIa inhibitors, such as abciximab, are used as adjunctive therapy for percutaneous coronary intervention (PCI) in high-risk non-ST-elevation myocardial infarction (NSTEMI) and in ST-elevation myocardial infarction (STEMI), although their effects when used for STEMI are less clear. As the use of GP IIb/IIIa inhibitors becomes more widespread, determining the risks associated with them becomes more important. The major risks associated with the use of GP IIb/IIIa inhibitors are the potential for major bleeding and thrombocytopenia. This is the first reported case in Korea of hemorrhagic pericarditis resulting in cardiac tamponade associated with the use of abciximab, a commonly used GP Ilb/IIa inhibitor, following PCI.
Aged ; Angioplasty, Transluminal, Percutaneous Coronary/*adverse effects ; Antibodies, Monoclonal/*adverse effects ; Anticoagulants/*adverse effects ; Cardiac Tamponade/*etiology/therapy ; Emergency Medical Services ; Hemorrhage/*etiology/therapy ; Humans ; Immunoglobulin Fab Fragments/*adverse effects ; Korea ; Male ; Pericardiocentesis ; Pericarditis/*etiology/therapy ; Platelet Aggregation Inhibitors/*adverse effects ; Risk Factors

Four cases of atypical chronic myeloid leukemia (aCML), which were compatible with the FAB guideline for the classification of chronic myeloid leukemia (CML), are presented. All 4 patients showed the onset in old age, leukocytosis with an increase in the number of immature granulo-cytes, monocytosis, a low basophil count, and a dysgranulopoiesis in the peripheral blood, a nega-tivity of the bcr-abl gene rearrangement, and a hypercellular marrow with marked granulocytic hyperplasia and dyshemopoietic features. Two patients died within 3 months and the other 2 are currently under observation after a partial response to hydroxyurea. aCML is known to have a poor therapeutic response and outcome without a blastic crisis. A greater deal of concern regarding aCML is required for an accurate diagnosis and classification.
Basophils ; Bone Marrow ; Classification ; Diagnosis ; Gene Rearrangement ; Humans ; Hydroxyurea ; Hyperplasia ; Leukemia, Myelogenous, Chronic, BCR-ABL Positive ; Leukemia, Myeloid, Chronic, Atypical, BCR-ABL Negative* ; Leukocytosis

INTRODUCTION: Adult stem cells generate differentiated cells beyond their own tissue boundaries. To prove that stem cells derived from bone marrow is capable of therapeutic application in cerebral ischemic patients, we performed this study. MATERIAL AND METHOD: We transplanted adult stem cells derived from bone marrow of the patient's iliac bone to 5 patients with cerebral infarction. Of 5 patients, two patients had internal carotid artery occlusion, two patients had severe stenosis of the middle cerebral artery, remaining one patient had occlusion of the branch of the middle cerebral artery. At first, we performed extracranial-intracranial bypass surgery in all patients, and then implanted bone marrow stem cell in the infarcted brain and boder zone area directly under the microscopic navigator and also injected bone marrow stem cells through the grafted vessel to the infarcted area. Two weeks after bypass surgery, we confirmed the patency of bypass graft with external carotid angiography. In the same setting, mesenchymal stem cells acquired from autologous bone marrow were superselectively injected into the bypass graft via a microcatheter. Postoperative evaluation of the patients was decided to the neurological status and the degree of reduction of the high signal area on the T2 image of the postoperative MRI. RESULT: All patients who underwent bypass surgery with stem cell implantation had an uneventful postoperative course and showed some improvement of preoperative neurologic dysfunction. Postoperative significant improvement of cerebral vasoreactivity to acetazolamide was showed in all patients. On postoperative 3 months MRI, three patients showed significant reduction of the high signal area on the T2 image, and also improved neurological status on those patients. Other one patient showed moderate degree of the reduction of the high signal area on T2 image of the postoperative MRI, but neurological status of that patient slightly improved. Remaining one patient who showed poor circulation via bypass graft does neither reduction of the high signal area on T2 image of the postoperative MRI nor improvement of the neurological status of that patient. CONCLUSION: In patients of fixed cerebral infarction with major neurologic deficit, EC-IC bypass surgery is not effective, even though infarcted area filled by grafted vessel extensively. In those patients, autologous bone marrow stem cell implantation combined with bypass seems to be expect neuronal regeneration.
Acetazolamide ; Adult Stem Cells ; Angiography ; Bone Marrow* ; Brain ; Carotid Artery, Internal ; Cerebral Infarction* ; Constriction, Pathologic ; Humans ; Magnetic Resonance Imaging ; Mesenchymal Stromal Cells ; Middle Cerebral Artery ; Neurologic Manifestations ; Neurons* ; Regeneration* ; Stem Cell Transplantation* ; Stem Cells* ; Transplants

BACKGROUND: Multiple myeloma (MM) is a heterogeneous and ultimately fatal disease. Risk stratification using prognostic biomarkers is crucial to individualize treatments. We sought to investigate the role of CD99, a transmembrane protein highly expressed in many hematopoietic cells including subpopulations of normal and neoplastic plasma cells, for MM risk stratification. METHODS: CD99 expression was measured in paraffin samples of bone marrow and extramedullary biopsies of 170 patients with MM. Patients were divided into those with high score (moderately and strongly positive) and low score (negative and weakly positive), with all staining being cytoplasmic and/or membranous. RESULTS: High anti-CD99 immunostaining was observed in 72 of 136 (52.9%) bone marrow biopsies and 24 of 87 (27.6%) extramedullary biopsies in MM. High CD99 expression of extramedullary specimens was associated with significantly longer overall survival (OS; p=.016). High CD99 expression of extramedullary specimens was also associated with better prognosis in the nonautologous stem cell transplantation group of MM patients (p=.044). In multivariate analysis, International Staging System stage was an independent prognostic factor, whereas CD99 expression was no longer statistically significant. CONCLUSIONS: Expression of CD99 in extramedullary specimens was correlated with longer OS, suggesting that CD99 may be a helpful immunohistochemical marker for risk stratification.
Biomarkers ; Biopsy ; Bone Marrow ; Cytoplasm ; Humans ; Multiple Myeloma* ; Multivariate Analysis ; Paraffin ; Plasma Cells ; Prognosis ; Stem Cell Transplantation

Boerhaave's syndrome, spontaneous esophageal rupture, is lethal and associated with a 70% survival rate despite emergent surgical management in recent reports. Early diagnosis and management is critical for more favorable outcome. But, it is difficult to diagnose early because of the low incidence and lack of specific symptoms and signs. We experienced 37 year-old male patient with Boerhaave's syndrome who was heavy drinker, and suffered from chronic renal failure. He visited a hospital because of hematemesis and severe back pain. He was transferred to our hospital with a nasogastric tube insertion, which was penetrating the distal esophagus. A radiologic examination revealed that the distal tip was located in the left pleural cavity. It was assumed that the tube had passed through the preexisting perforation site. Operation was not performed emergently due to delay in diagnosis and severe hyperkalemia. The patient was in a septic condition, but had recovered slowly after systemic broad spectrum antibiotic therapy, pleural drainage and intrapleural antibiotic injections. An esophagography revealed no leakage of gastro-grafin on the 14th hospital day, and he later completely recovered from sepsis.
Adult ; Back Pain ; Diagnosis ; Drainage ; Early Diagnosis ; Esophageal Perforation ; Esophagus ; Hematemesis ; Humans ; Hyperkalemia ; Incidence ; Kidney Failure, Chronic ; Male ; Pleural Cavity* ; Rupture ; Sepsis ; Survival Rate

There are 82 dental hygiene departments and clinical training institutes across the country with a very wide range of clinical practice content and evaluation methods, making standardization difficult. Therefore, there is a need to establish a standard protocol outlining clinical practice content and evaluation methods for systematic and efficient operation of clinical practice. Thus, this study attempted to propose such a protocol for standardization of dental hygiene clinical practice in dental clinics and hospitals to examine the contents of clinical practice by reviewing relevant literature, and relating it to professional practice within the dental hygienic curriculum to facilitate enhancement of expertise. Clinical practice content was extracted from 74 cases, and was consisted of classifying mandatory and optional clinical practice, training time, and activity methods for each component. To standardize effective clinical practice, it is necessary to organize the components acquired in the course of clinical dentistry training in line with their arrangement on each university's curriculum, in order to learn all components step by step. To do this, it is necessary to present a standardized clinical practice protocol and a organic cooperation between educational institutions and clinical training institutions.
Academies and Institutes ; Curriculum ; Dental Clinics ; Dentistry ; Oral Hygiene* ; Professional Practice

There have been some reports on schistosomiasis of school children in Sudan’s Nile River basin area; however, information about the infection status of Schistosoma species and intestinal helminths among village residents of this area is very limited. Urine and stool samples were collected from the 1,138 residents of the Al Hidaib and Khour Ajwal villages of White Nile State, Sudan in 2014. The prevalence of overall schistosomiasis and intestinal helminthiasis was 36.3% and 7.7%, respectively. Egg positive rates were 35.6% for Schistosoma haematobium, 2.6% for S. mansoni, and 1.4% were mixed. The prevalence of schistosomiasis was significantly higher in men (45.6%) than in women (32.0%), in Khou Ajwal villagers (39.4%) than in Al Hidaib villagers (19.2%), and for age groups ≤15 years old (51.5%) than for age groups >15 years old (13.2%). The average number of eggs per 10 ml urine (EP10) of S. haematobium infections was 18.9, with 22.2 eggs in men vs 17.0 in women and 20.4 in Khou Ajwal villagers vs 8.1 in Al Hidaib villagers. In addition to S. mansoni eggs, 4 different species of intestinal helminths were found in the stool, including Hymenolepis nana (6.6%) and H. diminuta (1.0%). Collectively, urinary schistosomiasis is still prevalent among village residents in Sudan’s White Nile River basin and was especially high in men, children ≤15 years, and in the village without a clean water system. H. nana was the most frequently detected intestinal helminths in the 2 villages.
Child ; Eggs ; Female ; Helminthiasis ; Helminths ; Humans ; Hymenolepis nana ; Male ; Ovum ; Prevalence ; Rivers ; Schistosoma ; Schistosoma haematobium ; Schistosoma mansoni ; Schistosomiasis haematobia ; Schistosomiasis ; Sudan ; Water

We experienced a case of pyridoxine refractory hereditary sideroblastic anemia (HSA) in a 4 year-old girl and; therefore, conducted a study of her family. She was admitted to hospital for anemia, which was uncorrected by iron treatment. The peripheral blood smears showed hypochromic microcytic anemia. The results of the biochemical study indicated serum iron of 80 microgram/dL, TIBC of 275 microgram/dL and serum ferritin of 67ng/dL. The bone marrow smears showed 80% cellularity, with mild dyserythropoiesis. Many ringed sideroblasts, 45% of normoblasts and an increased amount of hemosiderin particles were observed with iron staining. Despite high-dose pyridoxine therapy, the anemia was not corrected. In the peripheral blood and iron studies conducted on her family members, the mother, maternal aunt and aunt's son showed microcytic hypochromic anemia and normal iron metabolism. Her mother's brother had died of acute myeloid leukemia that had transformed from myelodysplastic syndrome. From a search of the Korean literature, this is the first reported case of HSA with pedigree.
Anemia ; Anemia, Hypochromic ; Anemia, Sideroblastic* ; Bone Marrow ; Child, Preschool ; Erythroblasts ; Female ; Ferritins ; Hemosiderin ; Humans ; Iron ; Leukemia, Myeloid, Acute ; Metabolism ; Mothers ; Myelodysplastic Syndromes ; Pedigree ; Pyridoxine ; Siblings