Esophageal ulcers induced by doxycycline is a rare complication. These patients usually complain of sudden onset of symptoms, ie acute substernal or chest pain and odynophagia without prior hietory of esophageal syraptoms. On esophagoscopic examination, there are upper or midesophageal ulcers, which heal after diseontinuation of the drug within 2 weeks. A history of ingestion of the doxycycline,with liquid jost before bedtime can be elicited. The exact eause of the xaucosal ulceration is not clear, but a direct irritant effeet on esophageal mucosa seems most likely. We report 5 cases of esophageal uleeration secondary to the ingestion of doxycydine. Esophagoscopy revealed esophageal ulcers in all patients and the patients hecame asymptomatic following stopping of tbe drugs and taking antacids.
Antacids ; Chest Pain ; Doxycycline* ; Eating ; Esophagoscopy ; Humans ; Mucous Membrane ; Ulcer*

The objective of this study is to present a new approach to the development of national health insurance rate-setting system using data mining technique. In particular, this paper examines the feasibility of applying the rate-setting system for the regional insurance program to the insureds of the workman' s insurance program, so that the unified rate-setting system can be developed. The subjects of the study were the beneficiaries(sample size = 234,224) of the workman' s insurance program(excluding government officials and teachers) residing in Goyang City. 1998 data from Korean Medical Insurance Corporation were analyzed through various data mining techniques such as Decision Tree, Regression, Assessment and SCORE. Major results and conclusions are as follows: 1) On average, the insured' s property element of insurance fee, automobile element of insurance fee, property score of income assessment, and automobile score of income assessment together accounted for only 16% of the actual income, which implies that we need more precise data in order to develop an equitable rate-setting system. 2) To do so, it is necessary to gather all the income-related data(property income, financial income, earnings, ...) in a timely manner. Since current computer and information system would not allow efficient maintenance and utilization of such data, it would also be necessary to establish data warehouse for this purpose. 3) In developing the rate-setting system on the basis of data warehouse, various data mining techniques should be employed to ensure the equity of insurance rates among different classes of insureds.
Automobiles ; Data Mining* ; Decision Trees ; Fees and Charges ; Humans ; Information Systems ; Insurance ; Insurance, Health* ; National Health Programs ; Occupational Groups

No abstract available.
Rho(D) Immune Globulin*

No abstract available.
Cell Line* ; Cell Proliferation* ; Cytokines ; Leukemia, Erythroblastic, Acute*

Intravesical bacillus Calmette-Guerin (BCG) administration has been used as an adjuvant therapy after transurethral resection for superficial bladder cancer, but the exact mechanisms of its antitumor activity are not yet known. The aim of this study was to characterize the immunologic aspects of antitumor activity of BCG using an animal model. C3H/He inbred mice and murine bladder tumor cell line, MBT-2 were used. The changes in immune cells such as helper T cells, suppressor T cells, macrophages and natural killer cells in the bladder and spleen were analysed by immunohistochemical method in intravesical BCG instilled in normal bladder, MBT-2 implanted after electrocauterization of the bladder mucosa and MBT-2 implanted and intravesical BCG treated group. The changes in natural killer cell activity of the splenocytes and peritoneal lymphocytes were evaluated using 51chromium release assay at regular time intervals following intraperitoneal BCG instillation. The prophylactic anticancer effect was evaluated by observing the tumor growth in the intravesically BCG treated group after intravesical MBT-2 implantation. In immunohistochemical examination, a remarkable infiltration of macrophage and helper T cell was observed in the lamina propria of the bladder, and the helper and suppressor T cells ratio (Th/Ts ratio) was increased after intravesical BCG therapy. In 51chromium release assay, enhanced natural killer cell activity of the splenocytes and peritoneal lymphocytes was observed after intraperitoneal BCG inoculation. The growth of implanted tumor was suppressed following intravesical instillation of BCG. These results suggest that the antitumor activity of BCG is not related to the simple inflammatory reaction but to the local and systemic immune response in which helper T lymphocytes and mononuclear cells play an important role.
Animals ; BCG Vaccine/administration & dosage/*therapeutic use ; Cells, Cultured ; Female ; Killer Cells, Natural/immunology ; Mice ; Mice, Inbred C3H ; Spleen/pathology ; T-Lymphocytes/*immunology ; Urinary Bladder/pathology ; Urinary Bladder Neoplasms/immunology/pathology/*therapy

The pathogenesis of thrombocytopenia in the gestational thrombocytopenia is not understood.This syndrome may represent either the de novo development of ITP or an accelerationof the physiologic pattern of increased platelet destruction that occurs during gestation. Thisdisorder is not easily distinguishable from classical ITP. However, the recognition and diagnosisof this syndrome is important because infants born to individuals with gestational thrombocytopeniaappear to have a markedly reduced risk of developing thrombocytopenia when comparedto infants born to patients with a history of ITP antedating pregnancy. We represent a caseof delivery in severe gestational thrombocytopenia with brief review of the literature.
Blood Platelets ; Humans ; Infant ; Pregnancy ; Thrombocytopenia*

OBJECTIVE: This study was to examine the in vitro neural cell differentiation patterns of human embryonic stem (hES) cells following treatment of various neurotrophic factors [basic fibroblast growth factor (bFGF), retinoic acid (RA), brain derived neurotrophic factor (BDNF) and transforming growth factor (TGF)-alpha], particulary in dopaminergic neuron formation. METHODS: The hES cells were induced to differentiate by bFGF and RA. Group I) In bFGF induction method, embryoid bodies (EBs, for 4 days) derived from hES were plated onto gelatin dish, selected for 8 days in ITSFn medium and expanded at the presence of bFGF (10 ng/ml) for another 6 days followed by a final differentiation in N2 medium for 7, 14 and 21 days. Group II) For RA induction, EBs were exposed of RA (10-6 M) for 4 days and allowed to differentiate in N2 medium for 7, 14 and 21 days. Group III) To examine the effects of additional neurotrophic factors, bFGF or RA induced cells were exposed to either BDNF (10 ng/ml) or TGF-alpha (10 ng/ml) during the 21 days of final differentiation. Neuron differentiation and dopamine secretion were examined by indirect immunocytochemistry and HPLC, respectively. RESULTS: The bFGF or RA treated hES cells were resulted in similar neural cell differentiation patterns at the terminal differentiation stage, specifically, 75% neurons and 11% glial cells. Additionally, treatment of hES cells with BDNF or TGF-alpha during the terminal differentiation stage led to significantly increased tyrosine hydroxylase (TH) expression of a dopaminergic neuron marker, compared to control (p<0.05). In contrast, no effect was observed on the rate of mature neuron (NF-200) or glutamic acid decarboxylase-positive neurons. Immunocytochemistry and HPLC analyses revealed the higher levels of TH expression (20.3%) and dopamine secretion (265.5+/-62.8 pmol/mg) in bFGF and TGF-alpha sequentially treated hES cells than those in RA or BDNF treated hES cells. CONCLUSION: These results indicate that the generation of dopamine secretory neurons from in vitro differentiated hES cells can be improved by TGF-alpha addition in the bFGF induction protocol.
Brain-Derived Neurotrophic Factor ; Cell Differentiation ; Chromatography, High Pressure Liquid ; Dopamine* ; Dopaminergic Neurons ; Embryoid Bodies ; Embryonic Stem Cells* ; Fibroblast Growth Factor 2 ; Fibroblast Growth Factors ; Gelatin ; Glutamic Acid ; Humans* ; Immunohistochemistry ; Nerve Growth Factors* ; Neuroglia ; Neurons* ; Transforming Growth Factor alpha ; Transforming Growth Factors ; Tretinoin ; Tyrosine 3-Monooxygenase

PURPOSE: Acute liver failure after massive partial hepatectomy is critical condition with high mortality. To prevent postoperative liver failure from being induced by a massive partial hepatectomy, many doctors do a minimal resection on the single lobe of the liver that might cause postoperative bleeding from the remaining ruptured parenchyma. The objective of this study was to assess clinical experience with postoperative hepatic arterial embolization to control bleeding from the remaining ruptured liver during the postoperative period. METHODS: This retrospective 4-year study was conducted from May 2002 to April 2006 and included consecutive patients who had sustained massive hepatic injuries and who had undergone a laparotomy, followed by postoperative hepatic arterial angiographic embolization to control bleeding. Data on the injury characteristics, the operative treatment and embolization, and the amount of transfused packed red cells (PRBC) were gathered and analyzed. In addition, data on the overall complications and survival rate were collected and analyzed. RESULTS: Every case showed severe liver injury, higher liver injury scaling grade IV. Only ten cases involved a ruptured bilateral liver lobe. A lobectomy was done in 6 cases, a left lobectomy was done in 3 cases, and a primary suture closure of the liver was done in 2 cases. Suture closure was also done on the remaining ruptured liver parenchyma in cases of lobectomies. The postoperative hepatic arterial embolizations were done by using the super-selection technique. There were some cases of arterio-venous malformations and anomalous vessel branches. The average amount of transfused PRBC during 24 hours after embolization was 2.36+/-1.75, which statistically significantly lower than that before embolization. Among the 11 cases, 9 patients survived, and 2 died. There was no specific complications induced by the embolization. CONCLUSION: In cases of postoperative bleeding in severe hepatic injury, if there is still a large amount of bleeding, postoperative hepatic arterial embolization might be a good therapeutic option.
Hemorrhage* ; Hepatectomy ; Humans ; Laparotomy ; Liver ; Liver Failure ; Liver Failure, Acute ; Mortality ; Postoperative Period ; Retrospective Studies ; Survival Rate ; Sutures

BACKGROUND/AIMS: Endoscopic aspiration mucosectomy (EAM) can always lift up the lesion by suction regardless of its location and does not injure the mucosal surface. The clinical usefulness of this method was evaluated as follows. METHODS: Thirty two patients with gastric adenoma (35 lesions) and 6 patients with early gastric carcinoma were treated by EAM from March 1997 to February 1999. Their characteristics (diameter, macroscopic appearance, and histologic diagnosis) were verified at endoscopy with a biopsy specimen. The complete resection was defined as the presence of normal mucosa at the resected margin. RESULTS: The average size of the resected specimens was 17.8 mm in antrum and 16.5 mm in body. The ratio of complete resection by location was 67% in anterior wall, 88% in posterior wall, 86% in lesser curvature and 92% in greater curvature. The complete resection rate for smaller lesions (< or =15 mm) was highly distinguished from that of larger lesions (>15 mm). No serious complication was encountered. CONCLUSIONS: EAM is suitable for the treatment of gastric tumors. Lesions 15 mm or less in diameter can be resected easily by single procedure regardless of its location.
Adenoma* ; Biopsy ; Endoscopy ; Humans ; Mucous Membrane ; Stomach Neoplasms* ; Suction

BACKGROUND/AIMS: Azathioprine (AZA) has been widely used in the therapy of inflammatory bowel disease (IBD) and autoimmune hepatitis (AIH). However, studies evaluating the adverse effects of AZA in these two diseases are lacking. The aim of this study was to compare the adverse effects of AZA in Korean IBD and AIH patients. METHODS: Patients with IBD or AIH who were treated with AZA at Keimyung University Dongsan Medical Center (Daegu, Korea) between January 2002 and March 2011 were enrolled. Their medical records were reviewed retrospectively in terms of clinical characteristics and adverse effects of AZA. RESULTS: A total of 139 IBD patients and 55 AIH patients were finally enrolled. Thirty IBD patients (21.6%) and eight AIH patients (14.5%) experienced adverse effects of AZA. In particular, the prevalence of leukopenia was significantly higher in the IBD group than in the AIH group (p=0.026). T474C mutation was observed in three of 10 patients who were assessed for thiopurine methyltransferase (TPMT) genotype. CONCLUSIONS: IBD patients are at increased risk for the adverse effects of AZA compared with AIH patients, of which leukopenia was the most commonly observed. Therefore, IBD patients receiving AZA therapy should be carefully monitored.
Adolescent ; Adult ; Aged ; Azathioprine/adverse effects/*therapeutic use ; Base Sequence ; Female ; Genotype ; Hepatitis, Autoimmune/*drug therapy ; Humans ; Immunosuppressive Agents/adverse effects/*therapeutic use ; Inflammatory Bowel Diseases/*drug therapy ; Leukopenia/epidemiology/etiology ; Male ; Methyltransferases/chemistry/genetics ; Middle Aged ; Polymorphism, Single Nucleotide ; Republic of Korea ; Retrospective Studies ; Young Adult