OBJECTIVE: This study was designed to compare pegfilgrastim and filgrastim in diffuse large B-cell lymphoma (DLBCL) patients treated with a rituximab with cyclophosphamide, hydroxydaunorubicin, oncovin, and prednisone (R-CHOP) regimen in terms of clinical efficacy and cost-effectiveness. METHOD: Clinical efficacy was measured by trough level of absolute neutrophil count (ANC), days of ANC under 50% of baseline value, days of ANC under 90% of baseline value, duration of ANC recovery to baseline value, days of ANC less than 0.5 x 109 cells/L, and difference of peak and trough level of ANC during 1 cycle of R-CHOP regimen. To evaluate cost-effectiveness, total prices of used filgrastim and pegfilgrastim within 1 cycle of R-CHOP were analyzed. RESULTS: In terms of clinical efficacy, trough level of ANC and days to ANC recovery showed statistical significance. The median trough levels of ANC with administration of filgrastim and pegfilgrastim were 0.18 and 1.94 (p = 0.021), respectively, and the median durations of ANC recovery to baseline value were 5.5 days and 2 days (p = 0.023), respectively. For the median days of ANC under 50% of baseline value, days of ANC under 90% of baseline value, days of ANC less than 0.5 x 109 cells/L, and difference of peak and trough level of ANC during 1 cycle of R-CHOP, the pegfilgrastim group performed better than the filgrastim group. However the difference was not statistically significant. In terms of overall expense during 1 cycle of R-CHOP, pegfilgrastim is about 3.43 times more expensive than filgrastim. CONCLUSION: Pegfilgrastim is more efficient than filgrastim in terms of clinical efficacy. In terms of prices, pegfilgrastim is more expensive than filgrastim for patients, but it is more convenient in clinical use. Therefore, pegfilgrastim should be the preferred choice of G-CSF for neutropenic patients. Further comparative study of pegfilgrastim and filgrastim is needed.
Cyclophosphamide ; Granulocyte Colony-Stimulating Factor ; Humans ; Lymphoma, B-Cell ; Neutropenia ; Neutrophils ; Prednisone ; Vincristine ; Filgrastim ; Rituximab

OBJECTIVES: In order to obtain information useful in setting up occupational rehabilitation programs, an evaluation was conducted to determine predictive factors of workers' return to work after an occupational injury. METHODS: 13, 903 records of registered occupationally injured cases identified to have received disability compensation in 1998 were collected from the 36 branch of Korean Labor Welfare Corporation(KLWC). Through simple systematic sampling, a total of 3, 658 cases were selected as final subjects. Status of return to work, general characteristics, workplace characteristics, disability characteristics and disability outcome characteristics were collected from the KLWC and National Health Insurance Corporation records(NHIC). For statistical analyses, chi-square test and stepwise multiple logistic regression analysis were applied using the SAS software package program. RESULTS: Negatively affecting significant predictive factors for return to work were included the female gender, age of 50 years or older, 6 month or less of work duration, 1 or less family dependents, workplace with 200 or less employees, electric, gas, waterwork companies, foot injuries compared to finger injuries, fall from elevation, high degree of disability claims(1~4 grade), and period of medical care more than 181 days. CONCLUSIONS: The results suggest that the poor rate return to work in occupationally injured workers' is particularly affected by female gender, older-aged employees, and workers employed by electric, gas, waterwork companies. Also, it was more difficult to return to work for workers who received injuries from a fall from elevation and who had longer period of medical care(more than 181days). It is strongly recommended that more efficient and systematic occupational rehabilitation programs be set up, taking into consideration the above mentioned factors.
Compensation and Redress ; Female ; Finger Injuries ; Foot Injuries ; Humans ; Logistic Models ; National Health Programs ; Occupational Injuries ; Occupations ; Rehabilitation ; Return to Work*

PURPOSE: To correlate SOhographic and pathologic findings of gallbladder adenoma, and to evaluate the clinical significance of sonographic findings. MATERIALS AND METHODS: Ultrasound findings of twenty gallbladder adenomas were retrospectively reviewed to evaluate the size, shape and echogenicity of the adenoma, and was correlated with the pathological finding. RESULTS: Among 14 patients, 11 patients had single lesion and 3 patients had multiple lesions. Three patients showed 2, 3 and 4 adenomas, respectively. Nine of 20 lesions showed focal dysplasia pathologically. Among the nine adenomas with dysplasia, two adenomas showed focal cancerous change. The nine adenomas showing focal dysplasia measured 25.6mm (14-35mm) in mean diameter, while the mean diameter of adenomas without dysplasia was 8.7 mm (3-13mm). The echogenicity of adenoma with focal dysplasia were hyperechoic in 8, isoechoic in 1. The echogenicity of adenomas without dysplasia were hyperechoic in 7, isoechoic in 4. Sessile(7/9) and papillary shape(6/9) were predominant in adenoma with dysplasia, but smooth shape(8/11) and stalked type(9/11) were predominant in adenoma without dysplasia. Two adenomas with focal cancerous change showed histological transition from cancer to dysplasia and to adenomatous tissue. In adenoma with dysplasia, the diameter more than 14 mm on sonography was statistically significant (p<0. 005). Also age of patient was significantly different between the two groups (p<0.01), while echogenicity and associated stone were not statistically significant. CONCLUSION: As gallbladder adenoma more than 14ram in diameter on US is suggestive of dysplasia on pathology, so, close follow up US or surgery is recommended.
Adenoma* ; Follow-Up Studies ; Gallbladder* ; Humans ; Pathology ; Retrospective Studies ; Ultrasonography

PURPOSE: To compare optical performances in eyes implanted with aspheric and spherical intraocular lenses (IOLs) after cataract surgery. METHODS: In 88 eyes of 69 patients, spherical (Sensar AR40; Acrysof natural SN60AT) or aspherical (Tecnis ZA9003; Acrysof IQ SN60WF) IOLs were implanted. After one month, contrast sensitivity, depth of focus, and spherical aberration were measured and compared between the groups. RESULTS: Contrast sensitivities of ZA9003 and SN60WF were significantly higher in 12,18 cycles per degree (CPD) under photopic conditions and were also higher in 6,12,18 CPD under mesopic conditions compared to those of respective spherical IOLs. Depths of focus were 1.31 D in ZA9003, 1.67 D in SN60WF, 1.52 D in AR40, and 1.49 in SN60AT, and the differences were not significant. Spherical aberration (Z40) with a 4 mm pupil was -0.032 microm in ZA9003, 0.022 microm in SN60WF, 0.076 microm in AR40, and 0.072 microm in SN60AT. Spherical aberration of SN60WF was significantly lower than spherical IOLs, and that of ZA9003 had the lowest among all IOL groups. Depth of focus significantly correlated with spherical aberration. CONCLUSIONS: Aspheric IOLs were superior in mesopic contrast sensitivity and equal in depth of focus to spherical IOLs. Individual corneal spherical aberration should be considered in the choice of IOLs.
Cataract ; Contrast Sensitivity ; Eye ; Humans ; Lenses, Intraocular ; Pupil

No abstract available.
Child* ; Humans

Intracranial chordoma is a rare tumor, originating from embryonic remnants of the primitive notochord. It typically appears as an enhancing extradural midline tumor with bone involvement. We introduce a rare case of a 27-year-old male who had a nonenhancing intradural chordoma showing paramedian location, involving the left cavernous sinus, Meckel's cave, and prepontine cistern. The pathologic diagnosis was confirmed as an intradural chordoma. The imaging findings of this unusual case of a nonenhancing intradural paramedian chordoma will be presented with the differential diagnosis focused on the epidermoid cyst.

Therapeutic hypothermia in cardiac arrest patients is associated with favorable outcomes mediated via neuroprotective mechanisms. We report a rare case of a 32-year-old male who demonstrated complete recovery of signal changes on perfusion-weighted imaging after therapeutic hypothermia due to cardiac arrest. Brain MRI with perfusion-weighted imaging, performed three days after ending the hypothermia therapy, showed a marked decrease in relative cerebral blood flow (rCBF) and delay in mean transit time (MTT) in the bilateral basal ganglia, thalami, brain stem, cerebellum, occipitoparietal cortex, and frontotemporal cortex. However, no cerebral ischemia was not noted on diffusion-weighted imaging (DWI) or fluid-attenuated inversion recovery (FLAIR) sequences. A follow-up brain MRI after one week showed complete resolution of the perfusion deficit and the patient was discharged without any neurologic sequelae. The mechanism and interpretation of the perfusion changes in cardiac arrest patients treated with therapeutic hypothermia are discussed.
Adult ; Basal Ganglia ; Brain ; Brain Ischemia ; Brain Stem ; Cerebellum ; Cerebrovascular Circulation ; Follow-Up Studies ; Heart Arrest ; Humans ; Hypothermia ; Hypothermia, Induced ; Magnetic Resonance Imaging ; Male ; Perfusion

PURPOSE: To determine the efficacy of 4-haptic bitoric intraocular lens (IOL) implantation in Asian patients with cataract and astigmatism. METHODS: A total of 19 eyes with ≤25.0 mm axial length and ≥0.75 diopters (D) corneal astigmatism were included in this prospective non-comparative study. All subjects underwent phacoemulsification with implantation of an AT Torbi 709M IOL. Visual and refractive outcomes as well as toric IOL axis were evaluated during a 3-month follow-up. Errors in predicted residual spherical equivalent were calculated by subtracting predicted residual spherical equivalent from postoperative refraction. RESULTS: Uncorrected and corrected distance visual acuity improved significantly 3 months after surgery, from 0.43 to 0.05 and from 0.24 to −0.05, respectively. Mean refractive cylinders also decreased significantly, from −1.91 preoperatively to −0.54 D 3 months after surgery. Mean J0 and J45 decreased 3 months postoperatively, from 0.26 to 0.03 D and from 0.24 to −0.06 D, respectively. After 3 months, mean absolute IOL rotation was 1.81°. Errors in predicted residual spherical equivalent showed a hyperopic shift of 0.35 D. CONCLUSIONS: Implantation of 4-haptic bitoric IOL proved to be effective for correcting astigmatism in Asian eyes during cataract surgery.
Asian Continental Ancestry Group ; Astigmatism ; Cataract ; Follow-Up Studies ; Humans ; Lens Implantation, Intraocular ; Lenses, Intraocular ; Phacoemulsification ; Prospective Studies ; Visual Acuity

Bacillus anthracis is the causative agent of anthrax primarily in animals and rarely in humans. B. anthracis producing 'anthrax toxin', however, could be a major agent of biological warfare. Anthrax toxin is produced from the pXO1 plasmid encoding the lethal toxin (LeTx) consisted of the protective antigen (PA) and the lethal factor (LF). In this study, we tested whether specific antisense oligonucleotide could inhibit the gene expression in B. anthracis. The antisense oligonucleotide was forced into bacterial cells either by lipofection or heat shock method. The expression of LeTx in B. anthracis was analyzed by the Western blot analysis and the MTT assay using to Raw 264.7 cells. The LeTx protein was purified and used for the production of specific antibodies. The expression of LeTx could be confirmed only in B. anthracis strains haboring pXO1 plasmid. B. anthracis treated with the antisense oligonucleotide through heat shock method markedly inhibited the production of PA. In the Western blot analysis, the expression of PA was inhibited from 25 micrometer and was completely inhibited at 50 micrometer of the antisense oligonucleotide. In the MTT assay, the cytotoxicity was reduced to 20% at 20 micrometer of the antisense oligonucleotide. Above results suggest that the antisense technology would be applied for the research on gene function in B. anthracis.
Animals ; Anthrax ; Antibodies ; Bacillus anthracis* ; Bacillus* ; Biological Warfare ; Blotting, Western ; Gene Expression ; Hot Temperature ; Humans ; Plasmids ; Shock

PURPOSE: This study investigated interleukin (IL)-17-secreting cell involvement in sterile inflammation, and evaluated the effect of mesenchymal stem cells (MSCs) on IL-17-secreting cell immunologic profiling. METHODS: Twenty mice were sacrificed at time points of 6 hours, 1 day, 1 week, and 3 weeks (each group, n = 5) after the cornea was chemically injured with 0.5N NaOH; IL-17 changes in the cornea were evaluated using enzyme-linked immunosorbent assay. Further, IL-17 secreting cells were assessed in the cervical lymph nodes by a flow cytometer. Rat MSCs were applied intraperitoneally in a burn model (n = 10), IL-17-secreting T helper 17 (Th17) cell and non-Th17 cell changes were checked using a flow cytometer in both cornea and cervical lymph nodes at 1week, and compared with those in the positive control (n = 10). RESULTS: IL-17 was highest in the cornea at 1 week, while, in the cervical lymph nodes, IL-17-secreting cells showed early increase at 6 hours, and maintained the increase through 1 day to 1 week, and levels returned to the basal level at 3 weeks. Specifically, the non-Th17 cells secreted IL-17 earlier than the Th17 cells. When the MSCs were applied, IL-17 secretion was reduced in CD3(+)CD4(-)CD8(-), CD3(+)CD4(+)CD8(-), and CD3(+) CD4(-)CD8(+) cells of the cervical lymph nodes by 53.7%, 43.8%, and 50.8%, respectively. However, in the cornea, IL-17 secretion of CD3(+)CD4(-)CD8(-) cells was completely blocked. CONCLUSIONS: The results indicated that both IL-17-secreting non-Th17 and Th17 cells were involved in the chemical burn model, and MSCs appeared to mainly modulate non-Th17 cells and also partially suppress the Th17 cells.
Animals ; Burns, Chemical/*immunology/metabolism/pathology ; Cells, Cultured ; Disease Models, Animal ; Enzyme-Linked Immunosorbent Assay ; Eye Burns/*immunology/metabolism/pathology ; Flow Cytometry ; *Immunity, Cellular ; Interleukin-17/*secretion ; Male ; Mesenchymal Stromal Cells/immunology/pathology/*secretion ; Mice ; Mice, Inbred C57BL