PURPOSE: A clinical review was performed to evaluate the importance and effectiveness of early nephrectomy & the result of short-term chemotherapy on unilateral, nonfunctioning tuberculous kidneys. METHODS: Retrospective study was made on 34 patients with nonfunctioning tuberculous kidneys who underwent nephrectomy from February 1986 to December 1998. All patients were evaluated by annual frequency, age, sex and site distribution, presenting symptoms, tuberculous lesion on organs other than kidney, cystoscopic finding, urinalysis and urine AFB smear & culture, urine Tb-PCR, CBC & ESR finding, perioperative morbidity and mortality, treatment distribution(Group 1 and 2) and drug toxicity. RESULTS: In pathologic findings of the 39 cases in which nonfunctioning tuberculous kidneys were suspected, 5 cases had no evidence of tuberculosis. Those were xanthogranulomatous pyelonephritis(2 cases), chronic pyelonephritis with hydronephrosis(2 cases) and complicated multilocular cyst(1 case). Coexisting renal cell carcinoma was found in 1 case. 4 cases(11.7%) were hypertensive at the time of presentation and 3 cases of them had a decrease in blood pressure after nephrectomy. 7 cases(20.5%) had febrile symptom, 5 cases of them had renal & perirenal abscess(4 cases) and cutaneous fistula(1 case). No perioperative mortality occurred and perioperative complications(sinus arrhythmia, wound infection, wound dehiscence, ileus) were in 5 cases(14.7 %). There was no evidence of recurrence during follow-up periods(Follow-up mean periods : 18.5 months). CONCLUSION: Early nephrectomy is an effective treatment in the comprehensive management of the unilateral, nonfunctioning tuberculous kidneys, for accurate diagnosis, removal of infection focus, early control of presenting symptoms and prevention of tuberculosis recurrence. And this should be followed by postoperative, acceptable short-term antitubercul ous chemotherapy.
Arrhythmias, Cardiac ; Blood Pressure ; Carcinoma, Renal Cell ; Diagnosis ; Drug Therapy* ; Drug-Related Side Effects and Adverse Reactions ; Follow-Up Studies ; Humans ; Kidney* ; Mortality ; Nephrectomy* ; Pyelonephritis ; Recurrence ; Retrospective Studies ; Tuberculosis ; Urinalysis ; Wound Infection ; Wounds and Injuries

One hundred sixteen C57 BL mice were painted with either 8-MOP, 5-MOP or TMP solution in concentrations of 0.02%, 0.1%, and 0.5% each and UVA irradiated. Skin biopsies were performed at 1, 3, 5 and 7 weeks after LJVA irradiation. The results measuring the number, area, and perimeter of the melanocytes after topical PLJVA were higher in the TMP-painted group than in the 8-MOP or 5-MOP painted groups. In all groups, the weekly changes showed an increasing value through five weeks. In comparing the drug concentrations used, 0.1% of chemicals produced the same or higher values than 0.5%. There have been few studies on the effects of 5-MOP in photochemotherapy. In tho study 5-MOP produced a pigment-producing effect similar to 8-MOP. Therefore, if topical PIJVA with 5-MOP is used in clinical practice, we could expect a significant therapeutic effect in vitiligo.
Animals ; Biopsy ; Melanocytes* ; Methoxsalen ; Mice* ; Paint ; Photochemotherapy ; Skin ; Thymidine Monophosphate ; Vitiligo

OBJECTIVE: This study aimed to evaluate attention, memory and executive function in patients with narcolepsy. METHODS: This study included 23 narcoleptic patients whose diagnosis were confirmed by the International Classification of Sleep Disorders(ICSD) at Chonnam National University Hospital Sleep Disorders Clinic or an other hospital in Korea, from 2005 to 2008, as well as 23 normal controls. All participants were given an IQ test for Korean-Wechsler Adult Intelligence Scale and several neuropsychological function tests (the d2 test for attention function, the Rey Complex Figure Test for nonverbal memory, the Korean-California Verbal Learning Test [K-CVLT] for verbal memory, and the Wisconsin Card Sorting Test for executive function). Clinical features of narcoleptic patients, including the frequency of excessive daytime sleepiness, cataplexy, sleep paralysis and hypnagogic hallucination, were investigated by a structured clinical interview administered by a neuropsychiatist. Excessive daytime sleepiness was evaluated by the Epworth sleepiness scale. RESULTS: Characteristic symptoms of narcolepsy observed in this study included excessive daytime sleepiness (n=23, 100.0%), cataplexy (n=19, 82.6%), hypnagogic hallucination (n=5, 21.7%) and sleep paralysis (n=12, 52.2%). In nocturnal polysomnographic findings, stage 2 sleep and REM latency were found to be significantly decreased in narcoleptic patients compared with the control group, and were accompanied by significant increases in stage 1 sleep. Narcoleptic patients had lower scores than the control group on total number, Total Number-Total Error, Concentration Performance and Fluctuation Rate on the d2 test, which measures attention. Also, there were significant differences between the performance of patient and control groups on the B list of the K-CVLT, which measures verbal memory. CONCLUSION: Narcoleptic patients showed decreased attention and verbal memory performance compared to the control group; however, in many areas, narcoleptic patients still demonstrated normal cognitive function.
Adult ; Cataplexy ; Executive Function ; Hallucinations ; Humans ; Intelligence ; Korea ; Memory ; Narcolepsy ; Sleep Paralysis ; Sleep Wake Disorders ; Verbal Learning ; Wisconsin

A clinical observation was made on 23 patients with tuberculous non-functioning kidneys who underwent nephrectomy during the period from February 1986 to June 1992. We reviewed these cases according to primary nephrectomy on tuberculous non-functioning kidneys. The following results were obtained. In pathologic findings of the 27 cases in which tuberculous non-functioning kidneys were suspected, 4 cases were no evidence of tuberculosis. Those were xanthoeranulomatous pyelonephritis (2 cases) and chronic pyelonephritis with hydronephrosis (2 cases). Coexisting renal cell carcinoma was found in 1 case. 4 cases (17.1%) were hypertensive at the time of presentation and 3 cases or them had a decrease in blood pressure after nephrectomy. No perioperative mortality occurred and perioperative complications (sinus arrhydrmia, wound infection, wound dehisdence, ileus) were in 4 cases (17.4 %). There was no evidence of recurrence during follow-u periods. (Follow-up mean periods: 18.5 months) Thus, it is concluded that primary nephrectomy is an important adjunct in the comprehensive management of the unilateral, tuberculous non-functioning kidneys, for accurate diagnosis, removal of infection source, early control and prevention of presenting symptoms.
Blood Pressure ; Carcinoma, Renal Cell ; Diagnosis ; Humans ; Hydronephrosis ; Kidney* ; Mortality ; Nephrectomy* ; Pyelonephritis ; Recurrence ; Tuberculosis ; Wound Infection ; Wounds and Injuries

The differential diagnosis of benign tumors from other intra-ureteric lesions was difficult. But. recently. it is easy due to developed diagnostic procedures. such as ureteroscopy. We herein report a case of fibroepithelial polyp of the left ureteropelvic junction which was diagnosed with ureteroscopic finding and biopsy with brief review or literatures.
Biopsy* ; Diagnosis, Differential ; Polyps* ; Ureter* ; Ureteroscopy

No abstract available.
Hypersensitivity* ; Phenobarbital*

Background: Desflurane, a fluorinated methyl-ethyl ether, has some advantageous properties including low blood solubility, stability in soda lime, and resistance to biodegradation. Desflurane in vivo has demonstrated myocardial depressant property. The purpose of this study was to test the direct effects of desflurane on myocardial contractile function and coronary flow in the isolated heart. Methods: Twelve isolated rat hearts were continuously perfused with modified Krebs solution containing 6, 9 and 12 vol% of desflurane for 10 min at each concentration. Systolic left ventricular pressure and rate of change of ventricular pressure (dp/dt) were measured. Heart rate and coronary flow were also measured. To differentiate direct vasodilatory effect of desflurane from an indirect metabolic effect due to autoregulation of coronary flow, oxygen delivery, myocardial oxygen consumption and percent oxygen extraction were calculated. Results: Heart rate (control 266+/-22 beats/min) decreased to 250+/-23 beats/min at 6 vol%, 236+/-26 beats/min at 9 vol% and 223+/-22 beats/min at 12 vol% of desflurane. Systolic left ventricular pressure and dp/dt decreased in a concentration-dependent manner. In spite of decrement of myocardial oxygen consumption, coronary flow (control 12.0+/-1.2 ml/min) increased to 12.8+/-1.6 ml/min at 6 vol%, 12.9+/-1.6 ml/min at 9 vol% and 13.7+/-1.4 ml/min at 12 vol% of desflurane. Oxygen delivery increased proportionally with coronary flow. Percent oxygen extraction decreased in a concentration-dependent manner. Conclusion: These results suggest that desflurane has a direct myocardial depressing and coronary vasodilating effect in a concentration-dependent manner.
Animals ; Ether ; Heart Rate ; Heart* ; Homeostasis ; Oxygen ; Oxygen Consumption ; Rats* ; Solubility ; Ventricular Pressure

PURPOSE: This study was to assess clinically the success rates and technical complications of cement-retained implant-supported single crowns and splinted crowns with zirconia frameworks. MATERIALS AND METHODS: 75 (single crowns: 51, splinted crowns: 24) cement-retained implant-supported single crowns and splinted crowns with zirconia frameworks which were restored in 67 patients were investigated for the evaluation of the success rates and technical complications. All restorations were cemented with temporary cement. Age, gender, restoration position, opposing teeth, restoration type were assessed as possible factors affecting technical complications. RESULTS: During the mean observation period of 22.2 months, cumulative success rates of all restorations were 66.9 (73.2 - 60.6)%. Retention loss was found in 16 restorations (single crowns: 14, splinted crowns: 2), abutment screw loosening and veneer porcelain fracture were found in each 2 single crowns, respectively. According to a Kaplan-Meier survival analysis of single crowns and splinted crowns, the cumulative success rates were 58.9 (66.6 - 51.2)%, 87.5 (96.1 - 78.9)%, respectively. There was a statistically significant difference. The other possible factors did not have a significant effect on the technical complications. CONCLUSION: Retention loss was the most frequent technical complication. Abutment screw loosening and veneer porcelain fracture were found rarely in single crowns only. Age, gender, restoration position, and antagonist did not have significant effect on the technical complications. Splinted crowns had a higher success rate than single crowns.
Crowns* ; Dental Porcelain ; Humans ; Splints* ; Tooth

BACKGROUND: Phyllodes tumors are relatively rare fibroepithelial tumors of the breast. There are no strict criteria for the classification of benign and malignant phyllodes tumor. The recurrence rate is relatively high, and no single criterion for predicting recurrence has yet been established. In an attempt to define the clinical features and their histopathological correlations, we have reviewed a total of 38 patients with original pathological diagnoses of cystosarcoma phyllodes and phyllodes tumors. METHODS: Thirty-eight cases of phyllodes tumors were reviewed. Microscopic slides were re-examined and reclassified using newly defined histologic criteria which were modified from those of Pietruszka et al. The pathologic criteria examined were the number of mitoses, the invasiveness of the tumor border, the stromal overgrowth, and the stromal cellular pleomorphism. The clinical features evaluated included age, incidence, clinical manifestation, surgical procedure, and recurrence. RESULTS: The mean age was 34.9 +/- 12.4 years with the peak age between 40 and 49. The yearly incidence trend showed a slow increase. Twenty-three tumors (62%) fullfilled the criteria for benign phyllodes tumors, seven tumors (19%) were borderline, and seven tumors (19%) were malignant. The mean ages of the patients with benign, borderline, and malignant phyllodes tumors were 31.9, 39.1, and 40.9 years, respectively. The sizes of the benign phyllodes tumors were smaller than those of the borderline or the malignant tumors. Recurrence was found after initial excision in two patients with benign phyllodes tumors. However, after an initial wide excision, there was no recurrence in five patients with borderline and malignant tumors. CONCLUSIONS: There were no dependable histopathological features to predict recurrence; that is, histologic type does not influence the rate of recurrence or the prognosis after an adequate excision.
Breast* ; Classification ; Diagnosis ; Humans ; Incidence ; Mitosis ; Phyllodes Tumor* ; Prognosis ; Recurrence

Astragalus membranaceus is used as a natural herbal medicine in East Asia for preventing carcinogenesis and reducing side effects induced by chemotherapy in cancer patients. Although the mechanism of anti-tumor activity is not known, the polysaccharides may potentiate the host defense mechanism through the activation of immune system. The objective of this study is to investigate the mechanism by which APS activates macrophages. To analyze macrophage activation and iNOS gene expression, we performed nitrite generation assay, immunohistochemistry, and RT-PCR. In the present study we show that a polysaccharide isolated from the Astragalus membranaceus (Astragalus Polysaccharide, APS) significantly induces nitric oxide (NO). Immunohistochemical staining of inducible NO synthase (iNOS) showed that the increase of NO was due to the induction of iNOS production. To further study the mechanism responsible for the induction of iNOS, we investigated the effect of APS on the iNOS mRNA expression. RT-PCR analysis showed that APS produced significant induction of iNOS gene expression. In conclusion, we demonstrate that a polysaccharide isolated from Astragalus membranaceus stimulates macrophages to generate NO through the activation of iNOS gene expression.
Astragalus membranaceus* ; Carcinogenesis ; Drug Therapy ; Far East ; Gene Expression ; Herbal Medicine ; Humans ; Immune System ; Immunohistochemistry ; Macrophage Activation ; Macrophages ; Nitric Oxide ; Nitric Oxide Synthase ; Polysaccharides ; RNA, Messenger