PURPOSE: To evaluate the diagnostic efficacy and complications of ultrasound-guided percutaneous renal biopsy using automatic biopsy gun in patients with pediatric diffuse renal disease. MATERIALS and METHODS: Using an 18G automatic biopsy gun, biopsies were performed on 97 pediatric patients with clinically suspicious diffuse renal disease. The acquired tissue specimens were analyzed by photomicroscopy, immunofluorescence, and electron microscopy to support the diagnosis. In the 97 biopsies, the success of the histologic diagnosis, number of glomeruli, and complication rates were retrospectively evaluated by analyzing the variable exams and clinical records. RESULTS: Adequate tissue for histologic diagnosis was obtained in 91 of 97 biopsies (94%) and the mean number of glomeruli was 9.6. Complications such as minute pain, gross hematuria, and small perirenal hematoma presented in 22 of the 97 biopsies (23%), all of which either improved within 5-72 hours or did not need specific treatment. CONCLUSION: Ultrasound-guided percutaneous renal biopsy using 18G automatic biopsy gun is an effective and safe method for the histologic diagnosis of pediatric diffuse renal disease without any major complication.
Biopsy* ; Diagnosis ; Fluorescent Antibody Technique ; Hematoma ; Hematuria ; Humans ; Microscopy, Electron ; Retrospective Studies

No abstract available.
Carcinoma, Transitional Cell* ; Tuberculosis, Renal* ; Ureter*

Systemic hypotension is commonly observed in association with the administration of protamine after cardiopulmonary bypass. To elucidate the circulatory changes and arterial blood gas changes of protamine sulfate administration, we studied 27 patients following cardiopulmonary bypass. In the intraaortic protamine administration group (N=5), the mean arterial pressure decreased significantly (p<0.05) in 5 minutes during protamine infusion and after protamine, infusion respectively. Heart rate, central venous pressure and blood gas analysis did not change significantly. In intravenous protamine administration group (N=22), the arterial oxygen tension increased significantly(p<0.05 %amp; p<0.01) in 10 minutes during protamine infusion and after protamine infusion respectively. There were no special changes when the more than 0.3mg/kg/min rate of protamine was injected but the mean arterial pressure decreased significantly(p<0.05) in 5 minutes during the protamine infusion. Mean arterial pressure, heart rate, central venous pressure and blood gas analysis did not change in the less than 0.3mg/kg/min rate of protamine was injected. There were no circulatory changes in the less than one hour CPB time group but the arterial oxygen tension increased significantly in 5 minutes and 10 minutes during the protamine infusion and after the protamine infusion. But in the more than one hour CBP time group, the mean arterial pressure decreased significantly in 10 minutes during the protamine infusion and after protamine infusion.
Arterial Pressure ; Blood Gas Analysis* ; Cardiopulmonary Bypass* ; Central Venous Pressure ; Heart Rate ; Humans ; Hypotension ; Oxygen ; Protamines

Adaptive responses to diverse microbial pathogens might be limited in relatively few types. Host cell responses to pathogens are believed to be patterned or stereotyped along with species or class. We tried to compose the host response to Mycoplasma in terms of cellular gene expression. Although gene expression profile of two host HeLa and 293 cells were quite different each other, 30 genes were differentially expressed by mycoplasma infection in both of HeLa and 293 cells. Six of them (PR48, MADH4, MKPX, CRK, RBM7, NEK3) were related to cell cycle or proliferation. Another category of genes like IL1HY1, KLRF1, TNFSF14, GBP1 were host defense to elicit immune responses. With this set of genes, we establish the prediction model for mycoplasma contamination.
Cell Cycle ; Cells, Cultured* ; Gene Expression ; Mycoplasma Infections* ; Mycoplasma* ; Oligonucleotide Array Sequence Analysis ; Transcriptome

OBJECTIVE: Breast cancer is one of the most common cancers affecting women. Both physicians and patients have concerned about breast cancer survivability. Many researchers have studied the breast cancer survivability applying artificial nerural network model (ANN). Usually ANN model outperformed in classification of breast cancer survivability than other models such as logistic regression, Bayesian network (BN), or decision tree models. However, physicians in the fields hesitate to use ANN model, because ANN is a black-box model, and hard to explain the classification result to patients. In this study, we proposed a hybrid model with a degree of the accuracy and interpretation by combining the ANN for accuracy and BN for interpretation. METHODS: We developed an artificial neural network, a Bayesian network, and a hybrid Bayesian network model to predict breast cancer prognosis. The hybrid model combined the artificial neural network and the Bayesian network to obtain a good estimation of prognosis as well as a good explanation of the results. The National Cancer Institute's SEER program public-use data (1973-2003) were used to construct and evaluate the proposed models. Nine variables, which are clinically acceptable, were selected for input to the proposed models' nodes. A confidence value of the neural network served as an additional input node to the hybrid Bayesian network model. Ten iterations of random subsampling were performed to evaluate performance of the models. RESULTS: The hybrid BN model achieved the highest area under the curve value of 0.935, whereas the corresponding values of the neural network and Bayesian network were 0.930 and 0.813, respectively. The neural network model achieved the highest prediction accuracy of 88.8% with a sensitivity of 93.7% and a specificity of 85.4%. The hybrid Bayesian network model achieved a prediction accuracy of 87.2% with a sensitivity of 93.3% and a specificity of 83.1%. The results of the hybrid Bayesian network model were very similar to the neural network model. CONCLUSION: In the experiments, the hybrid model and the ANN model outperformed the Bayesian network model. The proposed hybrid BN model for breast cancer prognosis predictin may be useful for clinicians in the medical fields, as the model provides both high degree of performance inherited from ANN and good explanation power from BN.
Breast Neoplasms* ; Classification ; Decision Trees ; Female ; Humans ; Logistic Models ; Neural Networks (Computer) ; Prognosis* ; SEER Program ; Sensitivity and Specificity

PURPOSE: To report a case of acute interstitial keratitis as the first clinical sign in a patient with latent syphilis. CASE SUMMARY: A 23-year-old female presented with visual impairment and discomfort in her right eye that developed 3 days earlier. The visual acuity in the right eye was 20/200 and corrected to 20/100, and slit lamp examination showed round sub-epithelial opacification in the central cornea with stromal edema and neovascularization on the cornea of the right eye. Whole body tests including serological tests were performed. Under the suspicion of acute interstitial keratitis, topical antibiotics and steroids were applied 4 times a day initially. Serological tests were reactive for venereal disease research laboratory test (VDRL). Under the suspicion of acute interstitial keratitis due to syphilis, fluorescent treponemal antibody absorption test IgM/IgG (FTA-ABS IgM/IgG) was performed; a positive result for FTA-ABS IgG led to diagnosis of acute interstitial keratitis with latent syphilis. During treatment, systemic doxycycline 200 mg for 4 weeks with topical antibiotics and steroids were administered, the opacity and edema of the cornea regressed after 2 weeks of treatment, and visual acuity in the patient's right eye improved to 20/20. CONCLUSIONS: We report an unusual case of acute interstitial keratitis as the first clinical manifestation of latent syphilis in an immunocompetent patient.
Anti-Bacterial Agents ; Cornea ; Diagnosis ; Doxycycline ; Edema ; Female ; Fluorescent Treponemal Antibody-Absorption Test ; Humans ; Immunoglobulin G ; Keratitis* ; Patient Rights ; Serologic Tests ; Sexually Transmitted Diseases ; Slit Lamp ; Steroids ; Syphilis* ; Syphilis, Latent ; Treponema pallidum ; Vision Disorders ; Visual Acuity ; Young Adult

After the establis banent for the necessity of denitrogenation in rebreathing anesthesia circuits some decades ago, many techniques were recommended for venilation with oxygen before induction of anestesia for the purpose of maintaining arterial oxygenation during laryngoscopy and tracheal intubation. For this point of view, we compared PaO2, MAP, PaCO2, pH of non-preoxygenation group (oxygen was given after succinylcholine was injected) with those of preoxygenation group (oxygen was given after thiopental sodium was injected). The cases were selected randomly ASA class I or II (without cardiopulmonary abnormalities) and ages between 27 years and 66 years old. Before induction of general anesthesia, we cannulated the radial artery after Allen's test and sampled arterial blood before anesthesia, after thiopenthal and succinylcholine were injected respectively, and when tracheal intubation was done in the two groups and measured PaO2, PaCO2, MAP, pH respectively. PaCO2, MAP, pH changes in the two groups were not significant and of no clinical significance. PaO2 after tracheal intubation showed a marked increase in the preoxygenation group compared to the non-preoxygenation group but the mean PaO2, remained within normal range in the non-preoxygenation group with the apneic period of taecheal intubation. We found that non-preoxygenated patients also had a normal range of PaO2 during the whole process of induction of anesthesia. But we think preoxygenation technique of any method can reserve more time and will do more effeclively, especially when time consuming events of difficult intubation of any reason occur.
Aged ; Anesthesia ; Anesthesia, Closed-Circuit ; Anesthesia, General* ; Humans ; Hydrogen-Ion Concentration ; Intubation ; Laryngoscopy ; Oxygen ; Radial Artery ; Reference Values ; Succinylcholine ; Thiopental

PURPOSE: The purpose of the present study is to determine the relation between in vitro resistance to 9 drugs, measured with colorimetric methylthiazol tetrazolium(MTT) assay and prognostic factors. METHODS: Thirty children with leukemia were evaluated at the pediatric department of Dongsan Medical Center. All samples tested with the MTT assay contained 80% or more leukemic cells, which were isolated by Ficoll density gradient centrifugation, and were incubated with 9 drugs for 4 days. The optical density(OD) of the wells was measured with microplate spectrophotometer. Leukemic cell survival(LCS) was calculated by OD treated well/OD control wellsx100(%). LD50 was calculated from the dose-response curve and used as a measure of resistance. RESULTS: Among the 30 children with leukemia, 16 were ALL, 14 were AML. Seventeen boys and thirteen girls ranged in age from 9 months to 16 years. Comparing LD50 values according to leukemic type, AML revealed relatively high LD50 values for all drugs, except VCR. But there were no significant differences between ALL and AML(P>0.05). Male showed high LD50 values for ASP, DET, ARA-C, VP16, ADR and 6TG. Age<2 and >10 years children showed high LD50 values for all drugs, except 6TG. Patients with a leukocyte count>100,000/mm3 at diagnosis showed high LD50 values for VCR, ASP, DET, MTX, ARA-C, ADR, and 6TG. Patients with normal chromosome showed higher LD50 values. CONCLUSION: Our study showed higher LD50 values at AML, male, age<2 and 10>years old, leukocyte count>100,000/mm3, and normal karyotype. The MTT test may contribute to the selection of effective chemotherapeutic agent for children with acute leukemia.
Centrifugation, Density Gradient ; Child ; Cytarabine ; DEET ; Diagnosis ; Etoposide ; Female ; Ficoll ; Humans ; Karyotype ; Lethal Dose 50 ; Leukemia ; Leukocytes ; Male ; Viperidae

PURPOSE: This study was designed to evaluate the usefulness of 3T-TOF MR angiography (3T-TOF MRA) compared with transcranial Doppler sonography (TCD) and conventional angiography (CA) in patients with suspected cerebral infarction. MATERIALS AND METHODS: Fifty four patients with clinical symptoms of cerebral infarction were involved in this study, and had undergone 3T-TOF MRA and TCD, with CA in 11 patients. On the basis of divisions of the carotid artery, four groups were designated: group I, both vertebral arteries and basilar artery; group II, segment between 2 cm below bifurcation of common carotid artery and genu portion of internal carotid artery; group III, segment between petrous portion of internal carotid artery and bifurcation of anterior and middle cerebral artery; group IV, from bifurcation of anterior and middle cerebral artery to thier distal branches. Two radiologists retrospectively reviewed the vascular imaging and stenosis in 3T-TOF MRA, TCD, and CA. RESULTS: A total of 432 arteries, 108 in each group, were available. The assessment of vascular imaging quality in 3T-TOF MRA is scored 2.98, 2.96, 2.91, 2.88 in 4 groups, respectively. Agreement among 3TTOF MR angiography, TCD, and CA was high. CONCLUSION: 3T-TOF MR angiography may be useful method for the assessment of stenotic lesions of cranial vasculature in patients with cerebral infarction.
Angiography* ; Arteries ; Basilar Artery ; Carotid Arteries ; Carotid Artery, Common ; Carotid Artery, Internal ; Cerebral Infarction* ; Constriction, Pathologic ; Humans ; Middle Cerebral Artery ; Retrospective Studies ; Ultrasonography, Doppler, Transcranial ; Vertebral Artery

OBJECTIVE: To present the profiles of spinal cord tumors that can be removed through a unilateral hemilaminectomy and to demonstrate its usefulness for benign spinal cord tumors that significantly occupy the spinal canal. METHODS: From June 2004 to October 2010, 25 spinal cord tumors were approached with unilateral hemilaminectomy. We calculated the cross-sectional occupying ratio (CSOR) of tumor to spinal canal before and after the operations. RESULTS: The locations of the tumors were intradural extramedullary in 20 cases, extradural in 2, and intramedullary in 3. The levels of the tumors were lumbar in 12, thoracic 9, and cervical 4. In all cases, the tumor was removed grossly and totally without damaging spinal cord or roots. The mean height and width of the lesions we195re 17.64 mm (3-47.5) and 12.62 mm (4-32.7), respectively. The mean CSOR was 69.40% (range, 27.8-96.9%). Postoperative neurological status showed improvement in all patients except one whose neurologic deficit remained unchanged. Postoperative spinal stability was preserved during the follow-up period (mean, 21.5 months) in all cases. Tumor recurrence did not develop during the follow-up period. CONCLUSION: Unilateral hemilaminectomy combined with microsurgical technique provides sufficient space for the removal of diverse spinal cord tumors. The basic profiles of the spinal cord tumors which can be removed through the unilateral hemilaminectomy demonstrate its role for the surgery of the benign spinal cord tumors in various sizes.
Follow-Up Studies ; Humans ; Laminectomy ; Microsurgery ; Neurologic Manifestations ; Recurrence ; Spinal Canal ; Spinal Cord ; Spinal Cord Neoplasms*