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

Secondary amyloidosis is characterized by accumulation of an amorphous proteineous material in the various tissue and orgrans with infectious or inflammatory disease. Renal amyloidosis in Crohn's disease is a rare condition with proteinuria in the most cases and serious clinical complication due to the unfavorable prognosis. We are reporting a case of secondary renal amyloidosis in a 30-year old man with Crohn's disease presenting with nephrotic syndrome and renal failue.
Adult ; Amyloidosis* ; Crohn Disease* ; Humans ; Nephrotic Syndrome ; Prognosis ; Proteinuria

PURPOSE: The mortality rate in critically ill patients with acute renal failure (ARF) remains unacceptably high, despite numerous advances in dialysis techniques and intensive care medicine. We evaluated clinical characteristics and prognostic factors in ICU patients with ARF requiring continuous renal replacement therapy (CRRT). METHODS: We retrospectively reviewed the medical records of all ICU patients who received CRRT at the Keimyung University Dongsan Hospital from September 2002 to October 2007. RESULTS: Total number of patients who required CRRT in ICU was 58. The mean age was 58.3+/-14.8 years. The treatment duration of CRRT was 63.5+/-40.7 hours. The mechanical ventilation rate was 82.8%, vasoactive drug 79.3%, sepsis 39.7%. APACHE II score was 25.2+/-7.9, SAPS II score 48.1+/-15.1, CCF score 9.3+/-3.6, the number of organ dysfunction 2.1+/-1.3. Overall mortality rate was 48%. When we compared sepsis group with non-sepsis group, the number of organ dysfunction and severity of illness were significantly higher in sepsis group than that of non-sepsis group. A mortality rate of sepsis group was significantly higher than non-sepsis group (82.6% vs 31.3%, p<0.001). In univariate analysis, significant risk factors for mortality were the number of organ dysfunction, severity of illness, MAP, platelet count, serum albumin level, and a type of hemofilter. Significances of all these factors were lost in multiple linear regression analysis. CONCLUSION: A large scaled, prospective randomized multi-center trials are needed to confirm the beneficial effect of CRRT in patient with ARF in ICU.
Acute Kidney Injury ; APACHE ; Critical Illness ; Dialysis ; Humans ; Critical Care ; Intensive Care Units ; Linear Models ; Medical Records ; Platelet Count ; Renal Insufficiency ; Renal Replacement Therapy ; Respiration, Artificial ; Retrospective Studies ; Risk Factors ; Sepsis ; Serum Albumin

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

BACKGROUND: Peritoneal solute transport rate, assessed by PET, varies widely among patients and has been shown to differ significantly among different ethnic groups. The aim of the present study is to investigate the peritoneal transport characteristics in Korean peritoneal dialysis (PD) patients and factors that predict peritoneal transport status. METHODS: Between May 2001 and February 2006, 141 patients on PD performed a standard 4-hour PET within the first 6 months after initiation of PD therapy. RESULTS: Of these 141 patients, there were 71males and 70 females. The mean age of the patients was 51.2+/-12.5 years and the etiology of renal failure was diabetes in 67 patients (47.5%). The mean 4-hour D/P creatinine ratio was 0.68+/-0.11. Compared with a mean of 0.65+/-0.15 as determined by Twardowski et al, our patients have significantly higher mean solute transport rate (p<0.05). Numbers of low (L), low-average (LA), high-average (HA), and high (H) transporters were 15 (10.6%). 68 (48.2 %), 53 (37.6%) and 5 (3.5%), respectively. However, according to our own data, the number of L, LA, HA and H were 18 (12.8%), 42 (29.8%), 64 (45.4%) and 17 (12.1%), respectively, significantly different from those classified by Twardowski et al. In univariate analysis, older age, hypoalbuminemia and lower BMI were predictive of high transport status. Using multiple linear regression, only hypoalbuminemia was independently predictive of higher 4-hour D/Pcr (p=0.000). CONCLUSION: Korean PD patients have a higher mean solute transport rate than Twardowskis data, and serum albumin is an independent predictor of high transport status. Further prospective studies with a large number of patients are needed for evaluating the diversity of peritoneal transport characteristics in different ethnic populations.
Female ; Male ; Humans