PURPOSE: To determine whether initial corrected anion gap (C(o)AG), base excess caused by unmeasured anions (BEua), and strong ion gap (SIG) can predict the morbidity of critically ill patients admitted to emergency department (ED). METHODS: 138 patients who visited the critical section of the ED and were admitted to intensive care unit (ICU) were enrolled. We calculated the C(o)AG, BEua, and SIG from the initial blood samples of the patients and initial logistic organ dysfunction score (LODS) also. Then we measured the LODS at the last day of ICU stay again. Comparing with the initial LODS, we divided the patients into two groups based on the changes of the values: favorable group and poor group. RESULTS: There was a significant difference in the mean AGcorr (p=0.007), BEua (p=0.008), SIG (p=0.037) between favorable and poor group. The area under the receiver operating characteristic (AUROC) curves for morbidity prediction were relatively small: 0.66 (95% CI, 0.56-0.77) for C(o)AG, 0.65 (95% CI, 0.54-0.76) for BEua, and 0.59 (95% CI, 0.49-0.70) for SIG. CONCLUSION: We found the initial unmeasured anions at the ED of the patients who eventually showed improved LODS during ICU period are significantly different to those of the other patients. But they failed to show enough capability of discriminating the morbidities between two groups.
Acid-Base Equilibrium ; Anions* ; Critical Illness* ; Emergencies* ; Emergency Service, Hospital* ; Humans ; Intensive Care Units ; Organ Dysfunction Scores ; Organization and Administration ; ROC Curve

PURPOSE: We studied to determine whether the degenerative spondylolisthesis has rotary deformity in addition to forward displacement. MATERIALS AND METHODS: We have made an analysis of difference of rotary deformity between the 31 study groups of symptomatic degenerative spondylolisthesis and 31 control groups without any symptom,statistically. We also reviewed CT findings in 15 study groups. RESULTS: The mean rotary deformity in study groups was 6.1 degree(the standard deviation is 5.20), and the mean rotary deformity in control groups was 2.52 degree(the standard deviation is 2.16)(p <0.01) CONCLUSION: The rotary deformity can be accompanied with degenerative spondylolisthesis. We may consider the rotary deformity as a cause of symptomatic degenerative spondylolisthesis in case that any other cause is not detected.
Congenital Abnormalities* ; Spondylolisthesis*

No abstract available.
Magnetic Resonance Imaging* ; Spinal Cord*

Interstitial cystitis is an inflammatory disease of unknown etiology. To facilitate the study of the pathophysiology of interstitial cystitis, an animal model that correlates with the etiology of interstitial cystitis and expresses histologic features consistent with those observed in interstitial cystitis patients was developed. Changes in permeability and histology were investigated in experimental cystitis induced by intravesical antigen challenge following sensitization. Rats were sensitized by intraperitoneal injection of ovalbumin (10mg/ml/kg) given on days 1, 3 and 5. The experiments were performed 4 weeks after the last injection. Controls were run simultaneously with the sensitized animals. Each group ( unsensitized and sensitized) was divided into two subgroups; Rats treated with intravesical ovalbumin (10mg/ml, 1ml) or those receiving 1ml saline intravesically. After antigen (or saline) challenge for one hour, 1ml of 14C-urea was placed into the bladder for two hours. We examined the peripheral blood concentration of 14C-urea at periods up to 120 minutes. There was a progressive increase in the blood level of 14C-urea with time only in the sensitized ovalbumin group. There was no 14C-urea present in the blood of the sensitized saline or in any unsensitized groups. We also measured mast cell density in the submucosa and detrusor muscle layer with Leiz light microscope (x 200). There was no statistical difference in submucosal mast cell densities among all groups. There was a significant increase in detrusor mast cell density only in the sensitized-ovalbumin when compared to the other groups. And degranulated mast cells in the detrusor and submucosa were found only in sensitized-ovalbumin group. With the method employed in this study, we could successfully induce cystitis in rats, without any chemical or mechanical damage to the bladder, by immunologic methods that depends on an allergic response of bladder mucosa. This experimental cystitis expresses histologic features similar to interstitial cystitis of human that increases the bladder mucosal permeability and increases the mast cell numbers in the detrusor muscle.
Animals ; Cystitis* ; Cystitis, Interstitial ; Humans ; Injections, Intraperitoneal ; Mast Cells ; Models, Animal ; Mucous Membrane ; Ovalbumin ; Permeability* ; Rats* ; Urinary Bladder*

To investigate epithelial cell proliferation reactivity in the odontogenic cysts, the expression of c-erbB-2 oncoprotein by epithelial lining was studied in odontogenic keratocyst(OKC, n=10), dentigerous cyst(DC, n=12), radicular cyst(RC, n=12) and normal dental follicle(n=7). The c-erbB-2 immunoreactivity was studied using a streptavidine- biotin- peroxidase method with polyclonal rabbit anti-human antibody to c-erbB-2 oncoprotein which is known to react with formalin fixed, paraffin-embedded sections and the intensity of staining was determined by manually. In all of 10(100%) OKCs, showed positive expression for c-erbB-2 oncoprotein compared with 10/12(83.3%) in DCs, 11/12(91.7%) in RCs and 5/7(71.4%) in normal dental follicles. The expression within OKC was higher than that of DC, RC and dental follicle but statistically not significant(p>0.05) and but may reflects underlying genetic defect. These results demonstrate differences in c-erbB-2 expression between the epithelial linings of the three major odontogenic cyst types, indicating differences in proliferation activity and differentiation processes within these lesions. And, in particular, these results are able to explain the peculiar aggressive growth pattern of OKC.
Dental Sac ; Epithelial Cells ; Formaldehyde ; Immunohistochemistry ; Odontogenic Cysts* ; Peroxidase

PURPOSE: To seek adequate sequence of MR angiography (MRA) on developmental venous anomaly in the brain. MATERIAL AND METHODS: We collected ten cases who demonstrated developmental venous anomaly on MR image. Eight patients among them, both 3D time-of-flight (TOF) with or without Gadolinium-DTPA enhancement and phase contrast(PC) were performed: TOF without enhancement in five, TO F with enhancement in six, and PC with 10 cm/sec in five, PC with 30 cm/sec in three, and PC with 5 cm/sec velocity encoding (VNEC) in two cases. RESULTS: On enhanced 3D TOF, both dilated collecting veins and medullary veins were well depicted in five of six cases, however, the signal intensity of the collecting and medullary veins are less than arteries. Dilated hyperintense collecting veins were well demonstrated on 3D PC with below the 10cm/sec VNEC in all seven cases, but the medullary veins were poorly defined. Unenhanced 3D TOF IVIRA could not reveal any dilated collecting and medullary veins in all five cases. CONCLUSION: Enhanced 3D TO F could demonstrate the collecting and medullary veins of developmental venous anomaly, however, 3D PC with below the 10 cm/sec VN EC could showthe dilated collecting and larger draining veins. We considered that combined enhanced 3D TOF MRA and PC with VENC 10cm/sec can substitute for conventional anglogram in the diagnosis of developmental venous anomaly.
Angiography* ; Arteries ; Brain ; Central Nervous System Venous Angioma* ; Diagnosis* ; Humans ; Veins

PURPOSE: To obtain the findings of normal variant types of lower cervical body configuration for the purpose of differention from compression fracture. MATERIALS AND METHODS: We retrospectively analysed simple true lateral radiographs of cervical spine from C3 to C7 in 157 pediatric patients who did not have definitive clinical symptoms of cervical spinal injury. We classified the variations of normal cervical spine into 5 types by their configuration. In case of rounded upper corner or anteriorly wedged type, we measured the height and the width of vertebral body to classify these types, and undertook ANOVA test and multiple range test to determine the correlation between the gross configuration and the measured values. RESULTS: Type 1 was similarly observed at each of C3 to C7 in age of 1-4 group but the frequency was markedly decreased in age of 5-8 group. Type 2a was frequently observed at both age groups, and its incidence increased considerally at C3 and C4 with advancing age. Type 2b was more frequently observed at C3 body and Type 3 was observed only at C3 body in age group 1-4. Type 4 was markedly increased at 5-8 age group. Type 2b and 3 were seen mostly at C3, but sometimes at C4 body. Height of body was statistically more significant than width of body in classification of type 2a, 2b and 3. CONCLUSION: The configuration of lower cervical spine in infants and children changes from immature oval type(type 1) to mature rectagular type(type 4) with increasing age. Among the 4 types, the rounded upper corner type or anterior wedging type of lower cervical spine should be differentiated from compresson fracture. We concluded that the height of cervical body is more significant than the width of body in simple radiographic classification of types 2a, 2b and 3.
Child* ; Classification ; Fractures, Compression ; Humans ; Incidence ; Infant* ; Retrospective Studies ; Spinal Injuries ; Spine

No abstract available.
Heart* ; Thoracic Surgery*

Loss of E-cadherin (E-cad) expression has been found in multiple cancers and is postulated to facilitate tumor cell dissociation and metastais. Promotor methylation may provides an alternative pathway for loss of gene function. This study evaluated the role of hypermethylation in the down-regulation of E-cad in oral squamous cell carcinoma (OSCC). We examined the E-cad expression by immunohistochemical staining and detected methylation status by methylation-specific polymerase chain reaction (MSP) in 20 OSCC tissues. Overally, 12 (60 %) cases of hypermethylation of E-cad were detected and we found there were no correlation between methylation and age, histologic grade, lympn node metastasis, tumor size and clinical stage. However, Eleven (73.3 %) of 15 samples which was negative for E-cad staining showed hypermethylation of E-cad promotor region. On the other hand, only one (20 %) of 5 E-cad positive sample was observed with methylated status. The underexpression of E-cad was found to be related to promotor hypermethylation (p=0.035). In conclusion, we suggest that hypermethylation play a role in inactivation of E-cad gene and may be a appreciable biomarker for diagnosis and treatment of OSCC.
Cadherins ; Carcinoma, Squamous Cell ; Dissociative Disorders ; Down-Regulation ; Hand ; Methylation ; Neoplasm Metastasis ; Polymerase Chain Reaction ; Promoter Regions, Genetic

Loss of E-cadherin (E-cad) expression has been found in multiple cancers and is postulated to facilitate tumor cell dissociation and metastais. Promotor methylation may provides an alternative pathway for loss of gene function. This study evaluated the role of hypermethylation in the down-regulation of E-cad in oral squamous cell carcinoma (OSCC). We examined the E-cad expression by immunohistochemical staining and detected methylation status by methylation-specific polymerase chain reaction (MSP) in 20 OSCC tissues. Overally, 12 (60 %) cases of hypermethylation of E-cad were detected and we found there were no correlation between methylation and age, histologic grade, lympn node metastasis, tumor size and clinical stage. However, Eleven (73.3 %) of 15 samples which was negative for E-cad staining showed hypermethylation of E-cad promotor region. On the other hand, only one (20 %) of 5 E-cad positive sample was observed with methylated status. The underexpression of E-cad was found to be related to promotor hypermethylation (p=0.035). In conclusion, we suggest that hypermethylation play a role in inactivation of E-cad gene and may be a appreciable biomarker for diagnosis and treatment of OSCC.
Cadherins ; Carcinoma, Squamous Cell ; Dissociative Disorders ; Down-Regulation ; Hand ; Methylation ; Neoplasm Metastasis ; Polymerase Chain Reaction ; Promoter Regions, Genetic