Anti-idiotype antibody (anti-id Ab) which recognizes idiotope in the variable region of immunoglobulin (Ig) can regulate Ab production by B cells in vivo and in vitro. Although it has been reported that anti-id Ab can suppress IgM production by lymphocytes or hybridoma cells without suppression of cell proliferation, the regulatory mechanism of anti-id Ab is not completely understood. We studied the effects of anti-id Ab on the production of IgG class anti-DNA Ab by hybridoma cells, on the proliferation of cells, and on the transcription levels of Ig genes. In contrast to suppressive effect of anti-id Ab on the production of IgM previously reported by others, stimulatory effects of anti-id Ab on the production of IgG by hybridoma cells as well as the proliferation of these .cells were observed. However, little effect of anti-id Ab on the transcription levels of Ig genes was observed. These results suggest that anti-id Ab can increase Ab production by stimulation of cell proliferation. Furthermore, these results suggest that the effect of anti-id Ab on the production of Ab may be determined by the difference in class of Ab produced by hybridoma cells following the treatment with anti-id Ab.
Antibody Formation* ; B-Lymphocytes ; Cell Proliferation ; DNA* ; Genes, Immunoglobulin ; Hybridomas* ; Immunoglobulin G ; Immunoglobulin M ; Immunoglobulins ; Lymphocytes

Sheehans syndrome is a known complication of pregnancy, It was described as a syndrome of hypopituitarysm due to acute ischemic necrosis of the anterior pituitary gland secondary to severe postpartum bleeding and shock. The neurophysis is usually preserved. But it can be involved in severe cases manifesting as diabetes insipidus. Because of its rare coexistence with Sheehans syndrome, diabetes insipidus is seldom recognized as a potential postpartum complication. The report describes a patient who developed Sheehans syndrome and diabetes insipidus immediately following delivery. Diabetes insipidus resolved spontaneously after 15 months, while panhypopituitarysm is persistent.
Diabetes Insipidus ; Hemorrhage ; Humans ; Hypopituitarism ; Necrosis ; Pituitary Gland, Anterior ; Postpartum Hemorrhage ; Postpartum Period ; Pregnancy ; Shock

PURPOSE: Placement of an arteriovenous fistula (AVF) before initiation of chronic hemodialysis (HD) is recommended to avoid the use of a dialysis catheter. However, many patients use temporary catheter at the start of HD for many reasons. We conducted a study to examine the reasons for use of temporary catheter instead of AVF at initial HD therapy. METHODS: We investigated 61 chronic renal failure (CRF) patients who started HD from January 2001 to August 2004 at Daegu Fatima Hospital. Fourty one of them used temporary catheter (catheter group) and 20 used AVF (AVF group) at initial HD. The causes of CRF, clinical presentation at initial HD, reasons that required start of HD and reasons for use of temporary catheter were investigated. RESULTS: The reasons that required start of HD were dyspnea (23), uremic symptoms (11), severe edema (4) and metabolic abnormalities (3) in catheter group and uremic symptoms (8), progression of CRF with minimal uremic symptoms (8) in AVF group. Those causes of unpreparedness of AVF in catheter group were delayed referral (12), rapid progression of CRF (12), unawareness of CRF (10), and noncompliance (7). The systolic and diastolic blood pressure were higher in catheter group than AVF group (171.3+/-33.5 vs 146.0+/-18.0 mmHg, 94.0+/-18.5 vs 80.6+/-10.8 mmHg, respectively). Serum albumin level was lower (3.0+/-0.6 vs 3.4+/-0.7 g/dL) and serum phosphorus level was higher (6.8+/-1.9 vs 5.7+/-1.7 mg/dL) in catheter group. CONCLUSION: To avoid temporary vascular catheter, early diagnosis of CRF, early referral to nephrologist and preparation of AVF is essential.
Arteriovenous Fistula* ; Blood Pressure ; Catheters* ; Daegu ; Dialysis ; Dyspnea ; Early Diagnosis ; Edema ; Humans ; Kidney Failure, Chronic ; Phosphorus ; Referral and Consultation ; Renal Dialysis* ; Serum Albumin ; Vascular Access Devices

Cytomegalovirus (CMV) pneumonia is an important cause of treatment related mortality after allogeneic stem cell transplantation (SCT) and autologous SCT, particularly in a CD34 selected setting. There is little known about the immune reconstitution pertaining to the CMV after CD34 selected SCT. However, several studies have suggested there is more profound immunodeficiency early in the CD34 selected population compared with the unselected population. We encountered two fatal cases of CMV pneumonia at the CD34 selected SCT for T-cell lymphoblastic lymphoma and high-risk breast cancer that was confirmed through a lung biopsy and bronchoalveolar lavage. In conclusion, autologous CD34 selected CMV seropositive recipients need to be monitored in a similar manner to allogeneic recipients.
Biopsy ; Breast Neoplasms ; Bronchoalveolar Lavage ; Cytomegalovirus* ; Lung ; Mortality ; Pneumonia* ; Precursor Cell Lymphoblastic Leukemia-Lymphoma ; Stem Cell Transplantation* ; Stem Cells* ; T-Lymphocytes

Primary intestinal lymphangiectasia is a rare congenital cause of protein losing enteropathy that is characterized by chronic diarrhea, generalized edema, ascites, hypoproteinemia, hypoalbuminemia, and lymphopenia. We encountered an 18-year-old woman who suffered from longstanding diarrhea and progressive leg edema. The laboratory findings showed the typical features of this disorder. The presence of enteric protein loss was documented with the 24 hour fecal clearance of alpha(1)-antitrypsin and (99m)Tc human serum albumin scintigraphy. A duodenoscopy and biopsy showed scattered white spots and markedly dilated lymphatics in the tips of the villi, respectively. The patient's clinical symptoms improved after placing her on a high protein and low fat diet with medium chain triglyceride supplements.
Adolescent ; Ascites ; Biopsy ; Dental Caries ; Diarrhea ; Diet ; Duodenoscopy ; Edema ; Female ; Humans ; Hypoalbuminemia ; Hypoproteinemia ; Leg ; Lymphopenia ; Protein-Losing Enteropathies* ; Radionuclide Imaging ; Serum Albumin ; Triglycerides

OBJECTIVES: To evaluate the clinical significance of abnormal bronchi originating from the trachea or main bronchi. METHODS: 21 patients (male:female ratio, 13:8; mean age, 58.2 years, range 34-77), who were diagnosed with major tracheobronchial anomalies by bronchoscopy from January 2001 to March 2005, were enrolled in this study. The anomalous bronchi consisted of 13 tracheal bronchi and 8 cardiac accessory bronchus. The clinical features, bronchoscopic findings, and outcomes were analyzed retrospectively. RESULTS: Common symptoms, including hemoptysis, cough and dyspnea, resulted from the underlying lung disease regardless of the bronchial anomalies. In this series of 13 tracheal bronchi, 7 cases originated from the trachea within 1cm of the carina (carinal type) and 6 cases originated at a higher level(tracheal type). Most patients had favorable outcome with conservative treatment for the underlying lung disease. CONCLUSION: Most tracheobronchial anomalies are found incidentally in the process of diagnosing lung disease. The clinical outcome of patients with a bronchial anomaly depends on the underlying lung disease.
Bronchi* ; Bronchoscopy ; Cough ; Dyspnea ; Hemoptysis ; Humans ; Lung Diseases ; Retrospective Studies ; Trachea*

No abstract available.
Biopsy* ; Leukemic Infiltration* ; Renal Insufficiency*

The mortality of acute pancreatitis complicated by acute renal failure (ARF) remains high. Among several therapeutic modalities, peritoneal dialysis (PD) has advantages due to its ability to remove toxic materials in the peritoneal exudate as well as urotoxic substances in the blood. We report successful treatment with PD in a patient with acute pancreatitis and ARF. A 41-year-old heavy drinker was admitted due to acute pancreatitis complicated by ARF. A therapeutic plan of PD was designed. A Tenckhoff PD catheter was used, considering its lower potential for infection compared to conventional catheters. The frequency of PD was set at 8 times per day, considering the catabolic state in pancreatitis. The clinical symptoms and biochemical parameters showed remarkable improvement during the follow up period. In conclusion, PD is one of the effective treatment modalities for treating ARF in patients with pancreatitis.
Acute Kidney Injury ; Adult ; Catheters ; Exudates and Transudates ; Follow-Up Studies ; Humans ; Pancreatitis ; Peritoneal Dialysis

The closed suction drain is commonly inserted after various surgical procedures. It has an important role to prevent possible hematoma or seroma that can cause postoperative wound problems. But there is still no consensus on managing the insertion site of suction drain after operation. Suture-tie fixation of drain to skin and classical Y shape gauze dressing is a usually accepted method, but it has many limitations. We introduce a new approach to the care for the insertion site of suction drain by using occlusive transparent film dressing, IV3000(R)(Smith & Nephew, London, UK). By using transparent film, insertion site of drain can be easily checked without removal of dressing. Because it can reduce the tension of suture-tie fixation, it helps to prevent skin injury. Furthermore, occlusive film dressing can block air leakage from insertion site of drain, and the water-proof character of film allows patients to take a shower without dressing change. This new method is more convenient, more efficient, and less harmful to skin than classic one.
Bandages* ; Consensus ; Hematoma ; Humans ; Occlusive Dressings ; Seroma ; Skin ; Suction* ; Wounds and Injuries

Heparin, a widely used anticoagulant, is currently the anticoagulant of choice in long-term hemodialysis (HD). Heparin-induced thrombocytopenia (HIT) is one of the most serious side effects of heparin which can cause arterial or venous thromboembolism associated with substantial morbidity and mortality. We experienced two patients who had thrombocytopenia and vascular access occlusion during the induction period of HD with the use of unfractionated heparin. Thrombocytopenia was improved after discontinuation of heparin. HIT was confirmed with anti-heparin/platelet factor 4 antibody test. HD was conducted and arteriovenous fistula was created successfully after switch of heparin to argatroban (Novastan(R)) or nafamostat mesilate (Futhan(R)). Nephrologist should rule out HIT first when thrombocytopenia and thromboembolic complications occur after use of heparin, especially during the induction period of HD. For suspicious patients, immediate cessation of heparin and switch to alternative anticoagulant is very important to avoid serious complications.
Arteriovenous Fistula ; Heparin ; Humans ; Mesylates ; Mortality ; Renal Dialysis* ; Thrombocytopenia* ; Venous Thromboembolism