No abstract available.
Female* ; Humans ; Neck* ; Urinary Bladder* ; Urinary Incontinence*

BACKGROUND AND OBJECTIVES: Many studies report changes in the expressions of nasal secretory proteins which play important roles in the evaluation of sinonasal mucosal status. The biomarkers in nasal secretions provide valuable information on pathophysiological status of the rhinosinusitis. We have monitored the level and ratio of nasal secretion markers, especially secretory IgA (sIgA) and lactoferrin as markers of sinonasal submucosal glands to evaluate mucosal status for chronic sinonasal diseases and allergic rhinitis. SUBJECTS AND METHOD: Samples were obtained with the filter paper absorption method from 20 normal healthy controls (Group I), 20 patients with chronic rhinosinusitis (Group II), 20 patients with allergic rhinitis (Group III), 20 normalized persons of chronic rhinosinusitis patients treated with antibiotics, previously (Group IV). We estimated concentrations of sIgA and lactoferrin determined by enzyme-linked immunosorbent assay method. RESULTS: The concentration of sIgA and lactoferrin in nasal secretion showed a significant difference between the control group and other groups (p<0.05). The sIgA/lactoferrin ratio was more highly significant in the normal group and normalized in chronic rhinosinusitis patients treated with antibiotics (Group IV) than other groups (p<0.05). CONCLUSION: In this study, sIgA and lactoferrin are useful secretion markers and the levels of sIgA, lactoferrin and sIgA/lactoferrin ratios in nasal secretions seem to be very useful parameters for monitoring and assessing the conditions of the sinonasal mucosal diseases.
Absorption ; Anti-Bacterial Agents ; Biomarkers ; Enzyme-Linked Immunosorbent Assay ; Humans ; Immunoglobulin A, Secretory ; Lactoferrin ; Rhinitis

Dectin-1 is a major receptor that recognizes fungal cell wall β-glucan. We previously reported that heat-killed Saccharomyces cerevisiae (HKSC), a Dectin-1 agonist, selectively induces IgG1 class switching in mouse B cells. Dectin-1 is also expressed on human B cells; however, Dectin-1 function in human B cells remains unknown. This study aimed to investigate the direct effect of in vitro stimulation using HKSC on Ig class switching in human B cells. HKSC selectively induced the expression of germline γ4 transcripts (GLTγ4) by human B cell line 2E2, and HKSC significantly augmented GLTγ4 promoter activity. Moreover, HKSC selectively enhanced GLTγ4 expression and IgG4 production by anti-CD40-activated human tonsillar resting B cells. Thus, these results suggest that Dectin-1 maybe involved in selective IgG4 class switching by human B cells.
Animals ; B-Lymphocytes* ; Cell Line ; Cell Wall ; Humans* ; Immunoglobulin Class Switching ; Immunoglobulin G* ; In Vitro Techniques ; Mice ; Saccharomyces cerevisiae* ; Saccharomyces*

OBJECTIVE: Interspinous devices for dynamic stabilization of lumbar spine are undergoing development and clinical trials. A few short-term outcomes of interspinous devices have been reported but little has been mentioned about longterm outcomes. We reviewed 19 cases of interspinous implantation (Coflex Paradigm spine, Germany) to evaluate clinical long-term outcome and radiologic features. METHODS: From January 2003 to March 2004, 19 patients (13 female and 6 male) who underwent interspinous implantation were included and follow-up data on clinical and radiologic outcomes were obtained at last clinic visit (mean follow-up: 38 months). Clinical outcomes were assessed by Visual analogue scale (VAS) score and Odom..s criteria. RESULTS: Preoperative VAS score for low back pain and leg pain was improved from 4.9+/-2.4 and 7.5+/-2.4 to 2.6+/-1.2 and 3.0+/-1.8 respectively at postoperative last clinic visit (p<0.01). Using Odom..s criteria, 7 and 9 patients showed excellent (36.8%) and good (47.3%) results for low back pain and 7 and 11 showed excellent (36.8%) and good (57.9%) results for leg pain. Anterior and posterior disc height were decreased significantly on postoperative follow-up radiologic data due to discectomy at the level of instrumentation (p<0.01). There were no complications such as infection or device failure. CONCLUSIONS: In this long-term follow-up study, clinical outcome was good but disc degeneration after discectomy at instumented level resulting in decrease of disc height was observed.
Ambulatory Care ; Diskectomy ; Female ; Follow-Up Studies ; Humans ; Intervertebral Disc Degeneration ; Leg ; Low Back Pain ; Spine

OBJECTIVE: We undertook this study to find out clinical characteristics and prognostic factors of neonatal survival in nonimmune hydrops fetalis (NIHF). METHODS: From Oct. 1988 to Feb. 2001, 54 cases of nonimmune hydrops fetalis diagnosed at Seoul National University Hospital (SNUH) were included in our study. The incidence and perinatal mortality were investigated. The diagnostic work-up for associated conditions (or etiology) included detailed ultrasonography, karyotyping, fetal echocardiography, infection work-up (TORCH, parvovirus), and autopsy (if fetus was dead). Among 54 cases, 20 cases of liveborns were divided into two groups. Group I survived beyond neonatal period (survived>28 days) and group II did not (expired3 (OR=21, CI 1.77, 248.1; p<0.05), and 5-min AS>3 (p<0.01). CONCLUSION: Over 3 of 1-min and 5-min AS were meaningful factors for neonatal survival in NIHF.
Apgar Score ; Autopsy ; Echocardiography ; Female ; Fetofetal Transfusion ; Fetus ; Gestational Age ; Hydrops Fetalis* ; Incidence ; Karyotyping ; Parturition ; Perinatal Mortality ; Pleural Effusion ; Polyhydramnios ; Pregnancy ; Seoul ; Ultrasonography

PURPOSE: This study aimed to set priorities for improving the medical device distribution structure and to suggest an innovative improvement plan for the distribution structure using the analytic hierarchy process (AHP) method, focusing on stakeholders in the medical device industry. METHODS: This study conducted a survey with 35 specialists using the AHP method, which is a multiple-criteria decisionmaking methodology, in order to set priorities for improvement plans to address the problems faced by the medical device distribution structure. RESULTS: The AHP analysis showed that supply stability was the most important factor, followed by greater transparency, efficiency, smart supply, and cost reduction. CONCLUSIONS: It is necessary to establish a stable supply system and manage crises through supply stability, as well as to provide opportunities for fair trade through greater transparency. As steps towards those goals, we propose establishing a unique device identification system, an information disclosure system, online distribution, and a group purchasing organization system in Korea.
Disclosure ; Group Purchasing ; Korea ; Methods ; Online Systems ; Specialization

BACKGROUND: IgA nephropathy (IgAN) is the most frequent primary glomerulonephritis in the world. Despite 20 years of research into this condition, much remains unknown about its pathogenesis and therapy. One major problem is that the prognostic evaluation and renal survival of IgAN is unreliable. METHODS: A retrospective study was performed to clarify the prognostic factors and the long-term renal survival rates of this disease. RESULTS: One hundred fifty-two patients with IgAN who followed-up at least 3 years after renal biopsy were included in this study. During a mean followed-up of 9.3 years after their renal biopsy (range:36-215 months), 33 of them (21.7%) had progressed to end-stage renal disease (ESRD). The actuarial renal survival rate was 97% at 5 years, and 85% at 10 years. Using univariate analysis, 5 risk factors for developing ESRD were identified:male sex, hypertension, heavy proteinuria, renal insufficiency at the time of biopsy, severe histopathologic findings such as subclass IV/V lesions by Haas' subclassification were associated with significant risk factors for developing ESRD. In multivariate regression analysis, only Haas' subclass IV/V lesions and renal insufficiency at the time of biopsy were the independent prognostic factors of IgAN. CONCLUSION: In conclusion, further long-term prospective study with larger number of patients would be necessary to assess the prognostic factors in IgAN.
Biopsy ; Glomerulonephritis ; Glomerulonephritis, IGA ; Humans ; Hypertension ; Immunoglobulin A* ; Kidney Failure, Chronic ; Prognosis* ; Proteinuria ; Renal Insufficiency ; Retrospective Studies ; Risk Factors ; Survival Rate

Bacterial peritonitis is a well-recognized complication of continuous ambulatory peritoneal dialysis (CAPD) in patients with end-stage renal failure. Chryseobacterium indologenes is a non-fermentative Gram-negative bacillus that is a rare pathogen in humans and Sphinomomas paucimobilis has rarely been reported as an opportunistic human pathogen. We present a case of peritonitis due to unusual pathogens, C. indologenes and S. paucimobilis, unresponsive to the standard antibiotics therapy. A 51-year-old diabetic man undergoing CAPD for 45 days developed the first peritonitis due to C. indolegenes. Although he had received intraperitoneal antibiotics with good in vitro activity against organism, the signs of peritonitis persisted. S. paucimobilis was isolated from dialysate sample. The Tenckhoff catheter was finally removed on 19th day of hospitalization and the fever and abdominal pain subsided.
Abdominal Pain ; Anti-Bacterial Agents ; Bacillus ; Catheters ; Chryseobacterium* ; Fever ; Hospitalization ; Humans ; Kidney Failure, Chronic ; Middle Aged ; Peritoneal Dialysis ; Peritoneal Dialysis, Continuous Ambulatory* ; Peritonitis* ; Sphingomonas*

BACKGROUND AND OBJECTIVES: Nasal mucosal pH have a direct effect on the alteration of the physio-chemical characteristics of the nasal mucosa. Previous studies have reported the normal mucosal pH to be within the range of 5.3-7.0, mucosal pH with sinusitis to be within 6.8-7.6 and mucosal pH with rhinitis to be within 7.2-8.3. However, no consideration was paid to the conditions that influence the pH and there were no measured pH value by different methods. This study was therefore designed with the latest trend method in pH measurement with the purpose of evaluating pH in nasal secretion and creating an objective parameter for a beneficial manifestation of mucosa. MATERIALS AND METHODS: We measured the pH values from 30 normal control group (group 1), 30 patients with chronic sinusitis (group 2), and 30 patients with allergic rhinitis (group 3). Nasal secretion was obtained through filter paper absorption method and, using a micro pH electrode with pH meter, pH was measured in nasal secretion. RESULTS: pH in nasal secretion in this study was higher than the nasal mucosal pH from previously reported studies. pH values in nasal secretion showed a significant difference between three groups (group 1:7.86, group2:8.06, group 3:8.24) in this study (p<0.01). CONCLUSION: The measurement of pH in nasal secretion seems to be a useful parameter for monitoring and assessing the state of nasal mucosa. And we recommend this study as a method for obtaining an objective parameter for pH measurement in nasal cavity.
Absorption ; Electrodes ; Humans ; Hydrogen-Ion Concentration ; Nasal Cavity ; Nasal Mucosa ; Rhinitis ; Rhinitis, Allergic, Perennial ; Sinusitis

PURPOSE:Renal disease is the major cause of mortality and morbidity in systemic lupus erythematosus. The aim of this study was to examine the therapeutic outcome of patients with lupus nephritis (LN) for 21 years. METHODS:We conducted a retrospective study of 100 patients with biopsy proven LN who were admitted at Keimyung University Dongsan Hospital between 1985 and 2006, and were followed with a mean of 73 months. We diagnosed renal pathology according to WHO 1995 classification, and analyzed the therapeutic and long-term outcome of patients with LN treated with steroid alone or steroid with intravenous cyclophosphamide (CYC). RESULTS:The mean age at the time of renal biopsy was 28. 3 years and male to female ratio was 1:9.9. The initial therapy consisted of steroid alone in 69 patients and steroid with intravenous CYC in 31 patients. The proportion of diffuse proliferative LN and titer of anti ds-DNA were significantly higher in patients treated with steroid and CYC than in patients with steroid alone. The percentage of patients with clinical response was significantly higher in patients with steroid and CYC than in patients with steroid alone (p=0.018). The patients who experienced clinical response had an excellent long term outcome compared with those who had no clinical response. CONCLUSION:The clinical response was significantly higher in CYC combination regimen than steroid alone. The response to therapy in LN was an important factor for long-term prognosis. The early diagnosis and aggressive treatment with immunosupppressive agents are valuable for better outcome in patient with LN.
Biopsy ; Cyclophosphamide ; DNA ; Early Diagnosis ; Female ; Humans ; Lupus Erythematosus, Systemic ; Lupus Nephritis ; Male ; Prognosis ; Retrospective Studies