PURPOSE: It is not clear that the development of glomerular injury and aggravation by tumor necrosis factor alpha (TNF-alpha) is related to intrarenal or serum concentration of TNF-alpha. So, we studied the relationship between the concentration of TNF-alpha and aggravation of glomerular damage in the Henoch-Schonlein nephritis(HSN) and idiopathic nephrotic syndrome(INS). METHODS: We collected the sera and urines of 21 patients with Henoch-Schonlein purpura(HSP) and 22 patients with INS visited Chungbuk National University hospital from March 1998 to March 2001. The concentration of TNF-alpha in the sera and urines were measured by sandwich ELISA. RESULTS: Serum TNF-alpha levels in the HSP patients with renal involvement were significantly higher than those without renal involvement(P=0.009). But urine TNF-alpha levels have no correlation with renal involvement(P=0.088). In the HSN patients, proteinuria have a significant correlation with serum TNF-alpha levels(P=0.004) but less correlation with urine TNF-alpha levels(P=0.053). Otherwise, proteinuria have no correlation with serum TNF-alpha levels(P=0.763) but have a significant correlation with urine TNF-alpha levels(P=0.007) in INS. CONCLUSION: These result suggest that the serum concentration of TNF-alpha would be important to glomerular involvement in HSP. And, it is interesting that proteinuria shows a significant relation with serum TNF-alpha levels in the HSN, but with urine TNF-alpha levels in the INS. This means the major production of TNF-alpha may be originated by extrarenal inflammation in the HSN and by intrarenal tubulo-interstitial damage due to proteinuria in the INS.
Chungcheongbuk-do ; Enzyme-Linked Immunosorbent Assay ; Humans ; Inflammation ; Nephritis* ; Nephrotic Syndrome* ; Proteinuria* ; Tumor Necrosis Factor-alpha*

No abstract available.

No abstract available.
Broad Ligament* ; Female ; Leiomyosarcoma*

No abstract available.
Female ; Fetal Heart* ; Hearing* ; Heart Rate, Fetal* ; Pregnancy

Severe neurologic complication after epidural anesthesia is very rare. We experinced a case of cauda equina syndrome following epidural anesthesia with 2% lidocaine 20 ml, alkalinized with sodium bicarbonate and 1: 200,000 epinephrine added in female patient underwent abdominal hysterectomy. She complained hypoesthesia of buttock, perineum, left leg and weakness of left leg. She also suffered from urinary retension and defecation difficulty and abdominal discomfort 2 days after epidural block. In MRI taken 4 days after block, spinal stenosis (L4-5) and mild disc bulging (L3-4) were noted. She was treated with medication, bladder training and physical therapy and recovered slowly but gradually, finally discharged 2 months after block with mild weakeness of left leg. We suggest the causative factors are the temporary neural compression due to spinal stenosis and the spinal cord ischemia due to vascular spasm because of added epinephrine.
Anesthesia, Epidural* ; Buttocks ; Cauda Equina* ; Defecation ; Epinephrine ; Female ; Humans ; Hypesthesia ; Hysterectomy ; Leg ; Lidocaine ; Magnetic Resonance Imaging ; Perineum ; Polyradiculopathy* ; Sodium Bicarbonate ; Spasm ; Spinal Cord Ischemia ; Spinal Stenosis ; Urinary Bladder

PURPOSE: The purpose of this study was to explore ways to define the concept of health inequality. METHODS: The concept analysis process by Walker and Avant was used to clarify the meaning of health inequality. RESULTS: Defining attributes of health inequality included differences in health status between individuals or groups, infringement of fundamental rights to health, unfair use of medical services, and social discrimination. The antecedents of health inequality included differences in demographic characteristics (age, gender, education, occupation, residential location), limitations in accessibility to health care, and social exclusion. Consequences of health inequality were increased costs for medical care, decreased health-related quality of life, and lack of ability to cope with health problems resulting in crisis situations, increases in morbidity and mortality, and shortening of life span. The concept was clarified through presentation of model, borderline, related, and contrary cases. CONCLUSION: Results of this study can be used to guide the direction of future studies through concept analysis in which conceptual attributes in the context of health inequality are examined. Also, based on the result of this study, development of standardized tools to measure health inequality is recommended as well as development of educational programs to reduce health inequalities.
Delivery of Health Care ; Education ; Human Rights ; Mortality ; Occupations ; Quality of Life ; Social Discrimination ; Socioeconomic Factors*

OBJECT: This study was performed in order to examine the correlation between acute neuroleptic-induced dystonic reactions and serum iron level. METHOD: Serum iron levels were measured in psychiatric inpatients who had developed acute neuroleptic-induced dystonia(N=41) and in control patients with no history of acute dystonic reactions(N=37). Serum iron levels were compared in acute dystonic inpatients before starting treatment with neuroleptics and after acute dystonic reaction. RESULTS: The patients exhibiting acute dystonic reactions had significantly lower serum iron levels than the patients without acute dystonic reactions. CONCLUSION: This result supports an association between low serum iron and the occurrence of neuroleptic-induced acute dystonic reactions.
Antipsychotic Agents ; Dystonia* ; Humans ; Inpatients ; Iron*

No abstract available.
Animals ; Mucous Membrane* ; Rats*

PURPOSE: In order to obtain basic data for treatment plan in radiosurgery, we measured small fields of 6 MV X-rays and compared the measured data with our Monte Carlo simulations for the small fields. MATERIALS AND METHODS: The small fields of 1.0, 2.0 and 3.0 cm in diameter were used in this study. Percentage depth dose (PDD) and beam profiles of those fields were measured and calculated. A small semiconductor detector, water phantoms, and a remote control system were used for the measurement. Monte Carlo simulations were performed using the EGS4 code with the input data prepared for the energy distribution of 6 MV X-rays, beam divergence, circular fields and the geometry of the water phantoms. RESULTS: In the case of PDD values, the calculated values were lower than the measured values for all fields and depths, with the differences being 0.3 to 5.7% at the depths of 2.0 to 20.0 cm and 0.0 to 8.9% at the surface regions. As a result of the analysis of beam profiles for all field sizes at a depth of 10cm in water phantom, the measured 90% dose widths were in good agreement with the calculated values, however, the calculated penumbra radii were 0.1 cm shorter than measured values. CONCLUSION: The measured PDDs and beam profiles agreement with the Monte Carlo calculations approximately. However, it is different when it comes to calculations in the area of phantom surface and penumbra because the Monte Carlo calculations were performed under the simplified geometries. Therefore, we have to study how to include the actual geometries and more precise data for the field area in Monte Carlo calculations. The Monte Carlo calculations will be used as a useful tool for the very complicated conditions in measurement and verification.
Radiosurgery ; Semiconductors ; Water

Acute thyroid abscess is an uneommon type of neck infection. We experieneed a case of staphylococcal thyroid abscess in 29 year old man, diagnosed by needle aspira~tion and culture of the aspirate. The patient had complained fever and slowly growing anterior neck swelling. Needle aspiration of the cold nodule prior to broad spectrum antibiotics was performed. After Surgical excision combined with antibiotics, he was discharged with elinical improvement. The laboratory diagnosis and clinical course was summarized and is reported with relevent references.
Abscess ; Anti-Bacterial Agents ; Clinical Laboratory Techniques ; Fever ; Humans ; Neck ; Needles ; Staphylococcus aureus ; Staphylococcus ; Thyroid Gland