No abstract available.
Antibody Formation* ; Heat-Shock Proteins* ; Hot Temperature* ; Mucocutaneous Lymph Node Syndrome*

BACKGROUND: Many factors affecting the spread of spinal anesthesia have been investigated. But L3-4 or L4-5 interspace was choosen which was known as the site of buffering, in their study. We investigated the effect of some of these factors on sensory blockade level by using L2-3 interspace. METHODS: Eightyfive patients, ASA physical status I - Il, were involved in our study. Sensory blockade level was checked with pinprick test at 10 minutes and 30 minutes. The effect of age, sex, height, weight, CSF pressure and pressure difference generated when full flexed and non-full flexed lateral position on sensory blockade level was studied whereas other factors such as puncture technique, dosage and concentration of drug and patients position after injection, were kept constant under the same condition. And also studied the effect of degree of flexion at injection on the sensory blockade level. RESULTS: Height and CSF pressure were correlated with sensory blockade level at 10 minutes after injection(R2=0.14, P<0.01). Only height was correlated with sensory blockade level at 30 minutes after injection(R2=0.09, P<0.0l). CONCLUSIONS: Only height was correlated with sensory blokade level at 30 minutes. So, height might be considered as the most impressive minor factor affecting the extent of sensory blockade level.
Anesthesia, Spinal* ; Humans ; Punctures

BACKGROUND: Temporary occlusion of hepatic blood inflow and vascular exclusion are effective for reduction of intraoperative bleeding which is a major problem during hepatic resection. But it might be suggested that they resulted in hemodynamic, electrolyte and blood gas changes. This study was designed for investigating those changes during liver resection using portal triad clamping and/or right, left or both hepatic vein clamping. METHODS: Forty one patients, diagnosed as hepatoma and intrahepatic duct stone, were involved in this study. Duration of liver ischemia was 48.7+/-14.8 min. Hemodynamic variables, electrolytes and arterial blood gas were measured before portal triad clamping and at 10, 30 min after clamping, and 10, 30, and 120 min after declamping, and were compared with each other. Bicarbonate was given when its value was below 20 mEq/L. RESULTS: In the changes of hemodynamics, diastolic blood pressure was decreased significantly at 10 and 30 min after declamping compared with before clamping. In the changes of ABG and electrolytes, pH, bicarbonate and chloride ion were changed significantly at 10 min after clamping compared with before clamping. pH at 10 min after declamping was decreased more associated with increasing anion gap without change of the bicarbonate and increased PaCO2. CONCLUSION: From these results, hemodynamic changes are not remarkable but metabolic acidosis is occurred from 10 minutes after portal triad clamping and more acidotic change was developed at 10 min after declamping, immediate treatment of metabolic acidosis is needed.
Acid-Base Equilibrium ; Acidosis ; Blood Pressure ; Carcinoma, Hepatocellular ; Constriction ; Electrolytes ; Hemodynamics ; Hemorrhage ; Hepatic Veins ; Humans ; Hydrogen-Ion Concentration ; Ischemia ; Liver

Brain-MR studies are sensitive to intracranial ischemia and vascular flow. However, brain MR study for brain death is clinically limited because keeping the ventilation is difficult during study. In our hospital, three 'brain death patients' brain-MR studies were performed under the anesthetic Mapleson's circuit-F system. Three patients' clinical states were not changed after the studies. We confirmed that brain herniation, absent intracranial flow void, no intracranial contrast enhancement, poor gray/white matter differentiation, and prominent nasal enhancement findings. The value of brain-MR study for brain death may be possible.
Brain ; Brain Death ; Ischemia ; Ventilation

Multiple simultaneous cranial neuropathies occur rarely in diabetes patients. In general, diabetic cranial neuropathy presents in an isolated form and frequently involves oculomotor or facial nerves. We report a 73-year-old man with known type 2 diabetes mellitus who presented with severe dizziness, diplopia and third, fourth and sixth nerve ophthalmoplegia of both eyes. Radiological, laboratory and ophthalmic work-up including magnetic resonance imaging and angiography (MRI and MRA) revealed no specific tumor, aneurysm, or inflammation findings, except for a previous cerebral infarction and atherosclerotic changes in the internal carotid and vertebral arteries. After strict blood glucose control, the multiple cranial nerve palsies spontaneously resolved in 12 weeks. We report the case with a review of the literature.
Abducens Nerve* ; Aged ; Aneurysm ; Angiography ; Blood Glucose ; Cerebral Infarction ; Cranial Nerve Diseases ; Diabetes Mellitus ; Diabetes Mellitus, Type 2 ; Diabetic Neuropathies* ; Diplopia ; Dizziness ; Facial Nerve ; Humans ; Inflammation ; Magnetic Resonance Imaging ; Ophthalmoplegia ; Vertebral Artery

BACKGROUND/AIMS: The insulin-like growth factor (IGF) system has been implicated in tumor growth, invasion, and metastasis. However, reports on the IGF-1 receptor (IGF-1R) based on radioimmunoassays are conflicting, and its prognostic implications in non-small-cell lung cancer (NSCLC) are still controversial. METHODS: Seventy-one paraffin-embedded tissue sections from stage I NSCLC patients were stained using a mouse monoclonal antibody against human IGF-1R. RESULTS: The intensity and frequency of IGF-1R expression on the membrane and cytoplasm of cancer cells was evaluated and scored using a semiquantitative system. IGF-1R expression was detected in nine of 71 (12.7%) cases. No significant relationship was found between clinical/histopathological parameters and IGF-1R expression. None of the patients whose tumor expressed IGF-1R had experienced distant metastasis or cancer-related death, although the difference did not reach statistical significance. CONCLUSIONS: We conclude that IGF-1R expression may not be a major prognostic factor for stage I NSCLC.
Adult ; Aged ; Aged, 80 and over ; Animals ; Carcinoma, Non-Small-Cell Lung/*immunology/mortality/pathology ; Female ; Humans ; Immunohistochemistry ; Insulin-Like Growth Factor I/*biosynthesis ; Male ; Mice ; Middle Aged ; Neoplasm Metastasis ; Neoplasm Staging ; Prognosis ; Receptor, IGF Type 1/*biosynthesis

Infliximab, a TNF-alpha antagonist, has been used to treat refractory rheumatoid arthritis, ankylosing spondylitis, Crohn's disease and Behcet's disease. Tuberculosis (TB) is a well-known opportunistic infection in patients receiving infliximab. Therefore, patients should be screened and treated for latent or active TB infection before being administered infliximab. Recently, we encountered a case of military TB during infliximab therapy in a patient suffering from Behcet's disease and uveitis. We report this case with a review of the relevant literature.
Antibodies, Monoclonal ; Arthritis, Rheumatoid ; Crohn Disease ; Humans ; Military Personnel ; Opportunistic Infections ; Spondylitis, Ankylosing ; Stress, Psychological ; Tuberculosis ; Tuberculosis, Miliary ; Tumor Necrosis Factor-alpha ; Uveitis ; Infliximab

Infliximab, a TNF-alpha antagonist, has been used to treat refractory rheumatoid arthritis, ankylosing spondylitis, Crohn's disease and Behcet's disease. Tuberculosis (TB) is a well-known opportunistic infection in patients receiving infliximab. Therefore, patients should be screened and treated for latent or active TB infection before being administered infliximab. Recently, we encountered a case of military TB during infliximab therapy in a patient suffering from Behcet's disease and uveitis. We report this case with a review of the relevant literature.
Antibodies, Monoclonal ; Arthritis, Rheumatoid ; Crohn Disease ; Humans ; Military Personnel ; Opportunistic Infections ; Spondylitis, Ankylosing ; Stress, Psychological ; Tuberculosis ; Tuberculosis, Miliary ; Tumor Necrosis Factor-alpha ; Uveitis ; Infliximab

Aberrant expression of BORIS/CTCFL (Brother of the Regulator of Imprinted Sites/CTCF-like protein) is reported in different malignancies. In this study, we characterized the entire promoter region of BORIS/CTCFL, including the CpG islands, to assess the relationship between BORIS expression and lung cancer. To simplify the construction of luciferase reporter cassettes with various-sized portions of the upstream region, genomic copies of BORIS were isolated using TAR cloning technology. We analyzed three promoter blocks: the GATA/CCAAT box, the CpG islands and the minisatellite region BORIS-MS2. Polymorphic minisatellite sequences were isolated from genomic DNA prepared from the blood of controls and cases. Of the three promoter blocks, the GATA/CCAAT box was determined to be a critical element of the core promoter, while the CpG islands and the BORIS-MS2 minisatellite region were found to act as regulators. Interestingly, the polymorphic minisatellite region BORIS-MS2 was identified as a negative regulator that repressed the expression levels of luciferase reporter cassettes less effectively in cancer cells compared with normal cells. We also examined the association between the size of BORIS-MS2 and lung cancer in a case–control study with 590 controls and 206 lung cancer cases. Rare alleles of BORIS-MS2 were associated with a statistically significantly increased risk of lung cancer (odds ratio, 2.04; 95% confidence interval, 1.02–4.08; and P=0.039). To conclude, our data provide information on the organization of the BORIS promoter region and gene regulation in normal and cancer cells. In addition, we propose that specific alleles of the BORIS-MS2 region could be used to identify the risk for lung cancer.
Alleles ; Clone Cells ; Cloning, Organism ; CpG Islands ; DNA ; Gene Expression* ; Luciferases ; Lung Neoplasms* ; Lung* ; Minisatellite Repeats* ; Promoter Regions, Genetic

PURPOSE: To investigate the effects of repeated photodynamic therapy (PDT) for subfoveal choroidal neovascularization secondary to age-related macular degeneration (AMD) in Korean patients. METHODS: Clinical data of patients who were treated with repeated (3 times or more) PDT for subfoveal choroidal neovascularization secondary to AMD and followed up for more than 6 months were collected from 17 hospitals around the country. Visual outcomes at 12 and 24 months, follow-up were compared between subtypes of choroidal neovascularization. The factors related to final visual prognosis and PDT-related adverse effects were evaluated. RESULTS: 244 patients (244 eyes) were recruited (male: 60%, age: 67.7+/-9.1 years). The portion of patients with predominantly classic, minimally classic, and occult without classic choroidal neovascularization was 57%, 13%, and 24%, respectively and that of patients with visual improvements or less than moderate visual loss at 24 months follow-up were 28%, 38%, 30% and 47%, 56%, and 65%, respectively. Baseline visual acuity and age were significantly related to the final visual prognosis (p<0.05). PDT-related adverse events developed in 15 (6.1%) patients, but most were mild and transient. CONCLUSIONS: Repeated PDT for subfoveal choroidal neovascularization secondary to AMD has effects comparable to those of previous prospective, controlled trials without any significant safety concerns in Korea.
Choroid* ; Choroidal Neovascularization* ; Follow-Up Studies ; Humans ; Korea ; Macular Degeneration* ; Photochemotherapy* ; Prognosis ; Visual Acuity