No abstract available.
Aged* ; Femur* ; Humans ; Osteoporosis*

Donor-specific anti-human leukocyte antigen antibodies (DSA) following kidney transplantation predict the evolution of humoral rejection and reduced graft survival. Rapid, complete elimination of DSA during antibody-mediated rejection (AMR) is rarely achieved with traditional antihumoral therapies. We report the case of a 39-year-old female who was admitted for increasing azotemia and diagnosed with AMR based on diffusely positive histological changes on C4d immunostaining. In this case, bortezomib reversed the histological changes and induced a reduction in DSA. Proteasome-inhibitor-based combination therapy is a potential means for rapid DSA elimination in antibody-mediated rejection in renal transplant recipients.
Adult ; Antibodies ; Azotemia ; Boronic Acids ; Complement C4b ; Female ; Graft Survival ; HLA Antigens ; Humans ; Kidney Transplantation ; Leukocytes ; Peptide Fragments ; Proteasome Inhibitors ; Pyrazines ; Rejection (Psychology) ; Transplants ; Bortezomib

Donor-specific anti-human leukocyte antigen antibodies (DSA) following kidney transplantation predict the evolution of humoral rejection and reduced graft survival. Rapid, complete elimination of DSA during antibody-mediated rejection (AMR) is rarely achieved with traditional antihumoral therapies. We report the case of a 39-year-old female who was admitted for increasing azotemia and diagnosed with AMR based on diffusely positive histological changes on C4d immunostaining. In this case, bortezomib reversed the histological changes and induced a reduction in DSA. Proteasome-inhibitor-based combination therapy is a potential means for rapid DSA elimination in antibody-mediated rejection in renal transplant recipients.
Adult ; Antibodies ; Azotemia ; Boronic Acids ; Complement C4b ; Female ; Graft Survival ; HLA Antigens ; Humans ; Kidney Transplantation ; Leukocytes ; Peptide Fragments ; Proteasome Inhibitors ; Pyrazines ; Rejection (Psychology) ; Transplants ; Bortezomib

PURPOSE: The purpose of this study is to enhance the quality of data by performing a methodological assessment of medical records reviews. METHODS: We reviewed the articles published in the Journal of the Korean Society of Emergency Medicine between January 2001 and December 2003 that used a retrospective medical records review as the study method. We assessed data collector's training, descriptions of inclusion/ exclusion criteria, definitions of important variables, use of standardized case record forms, monitoring the data collectors' performance, blind data collecting, inter-rater reliability/ test of inter-rater agreement, intra-rater reliability/test of intra-rater agreement, selection bias from consent, and rules regarding management of missing data. RESULTS: There were 111 articles that used retrospective medical records reviews during the study period. In 111 (100%) articles, inclusion/exclusion criteria were described, in 98 (88.3%), important variables were defined, and in 4 (3.6%), standardized case record forms were used. However no articles addressed the other items on the checklist. CONCLUSION: Study conductors should design studies to enhance the quality of data, and detailed descriptions are necessary to improve the reproducibility of the study.
Checklist ; Emergencies* ; Emergency Medicine* ; Medical Records* ; Retrospective Studies ; Selection Bias

Loeys-Dietz syndrome (LDS) is an autosomal dominant connective tissue disorder that is characterized by aggressive arterial and aortic disease, often involving the formation of aortic aneurysms. We describe the cases of two children with LDS who were diagnosed with aortic root aneurysms and successfully treated by valve-sparing aortic root replacement (VSRR) with a Valsalva graft. VSRR is a safe and suitable operation for children that avoids prosthetic valve replacement.
Aneurysm ; Aorta ; Aortic Aneurysm ; Aortic Diseases ; Child* ; Connective Tissue ; Humans ; Loeys-Dietz Syndrome* ; Transplants

Purpose: To investigate the 5-year outcome of dental implants placed in a grafted maxillary sinus using recombinant human bone morphogenetic protein-2 (rhBMP-2). Materials and Methods: We retrospectively analyzed 27 implants after maxillary sinus floor augmentation (MSFA) using rhBMP-2 in 16 patients between January 2016 and March 2017. The study evaluated two outcome variables: (1) 5-year cumulative survival and success rate of the implant after functional loading and (2) marginal bone loss (MBL) for implant failure. Results: The average residual bone height was 4.78±1.53 mm. The healing period before loading was 8.35±2.34 months. The crown-to-implant ratio was 1.31±0.26. The 5-year cumulative survival and success rate after functional loading were 100% and 96.3%, respectively. The 5-year average MLB was 0.89±0.82 mm. Conclusion Placing dental implants with MSFA using rhBMP-2 is a reliable procedure with favorable long-term survival and success rates.

BACKGROUND: The New Bethesda System terminology has opened a series of problems about the atypical squamous cells of undetermined significance and low grade squamous intraepithelial lesion categories, particularly on their follow up. METHODS: We observe 12300 Pap smear examination, from jan 1995 to Dec 1999, in the Health promotion Center in a university hospital. Subjects were defined a the Health Promotion Center in a university hospital by electrical record and chart review. RESULTS: We find 48 cases of ASCUS and 33 cases of LSIL. When it is followed up by Pap smear, 34 cases of ASCUS are confirmed normal 19 cases(55.9%), benign cellular change 6 cases(17.6%), ASCUS 5 cases(14.7%), HSIL 4 cases(11.8%) and 27 cases of LSIL are confirmed normal 11 cases(40.7%), benign cellular change 3 cases(11.1%), ASCUS 3 cases(11.1%), LSIL 8 cases(29.6%), HSIL 2 cases(7.4%). 14 cases of ASCUS and 23 cases of LSIL are diagnosed by biopsy. Hostologic results of 14 cases of ASCUS are confirmed cervicitis 10 cases(71.4%), Moderate dysplasia 2 cases(14.3%), carcinoma in sute 2 cases(14.3%) and histologic results of 23 cases of LSIL are confirmed cervicitis 15 cases(65.2%), mild dysplasia 3 cases(13%), moderated dysplasia 3 cases(13%), sever dysplasia 1 cases(4.3%), carcinoma in situ 1 case(4.3%). Pap smear only was used for follow-up at family medicine clinic and 14 cases(29.2%), 4 cases(12.1%) are follow-up loss. CONCLUSION: After it is diagnosed ASCUS or LSIL Lesion of Pap smear in healthy care visitors, Follw-up loss is high in only follow-up Pap smear examination and follow-up results are presented more we severe lesions. To reduce follow-up loss, aggressive diagnosis and managements may be needed more than Pap smear follow-up examination.
Biopsy ; Carcinoma in Situ ; Diagnosis ; Follow-Up Studies* ; Health Promotion ; Humans ; Uterine Cervicitis

BACKGROUND: The intrathecal grafting of adrenal chromaffin cells as a potential analgesic source, to delivery analgesic substances such as catecholamines and opioid peptides, is known to be effective at treating acute and chronic pain in several animal pain models. We tested whether the intrathecal implantation of encapsulated bovine chromaffin cells reduces cold allodynia in a rat model of neuropathic pain induced by chronic constriction injury of the sciatic nerve. METHODS: Bovine adrenal medullary chromaffin cells microencapsulated in sodium alginate-poly-l-lysin-alginate (APA) were implanted into the subarachnoid space of rats (n = 10) and foot cold sensitivity was investigated using an acetone test. At the end of the study, histology and capsule catecholamine production were evaluated. RESULTS: A significant reduction in cold allodynia was observed in animals implanted with chromaffin cells. In addition, the suppression of cold allodynia was reversed by naloxone. Abundant clusters of viable chromaffin cells stained with neutral red, were observed in the retrieved implants and after nicotine stimulation, and catecholamine was quantified. An ultrastructural study showed no fibrotic reaction against capsules, or disorganised capsules. CONCLUSIONS: These results suggest that intrathecal encapsulated chromaffin cells act as "mini pumps", which continuously deliver analgesic substances and produce analgesia in this chronic pain model of nerve injury-without immunosuppressant.
Acetone ; Analgesia ; Animals ; Capsules ; Catecholamines ; Chromaffin Cells* ; Chronic Pain ; Constriction ; Foot ; Hyperalgesia* ; Models, Animal ; Naloxone ; Neuralgia ; Neutral Red ; Nicotine ; Opioid Peptides ; Rats* ; Sciatic Nerve ; Sodium ; Spinal Cord* ; Subarachnoid Space ; Transplants

PURPOSE: The purpose of this study was to assess the statistical methods used in the Journal of the Korean Society of Emergency Medicine (JKSEM) and to identify the types of errors in statistical analysis. METHODS: We reviewed quantitative articles that were published in the JKSEM from January 1998 through December 2002. Editorials, review articles, and case reports were not included in this analysis. A total of 319 articles was reviewed. We focused on the methods of inferential statistics in these articles. We evaluated the adequacy and the validity of the statistical techniques with our criteria, which were established by modifying Ahn's checklist. RESULTS: Of the 319 articles, 222 used inferential statistics. The t-test was the statistic of choice overall (45.1%), followed by the chi-square test (23.9%). Errors of omission (70.3%) were more frequent than errors of commission. Of the errors of omission, incomplete description of the basic data was the most common. CONCLUSION: We found various mistakes or misuses in the applications of statistical methodologies in the articles published in the JKSEM. The present study suggests that additional efforts should be focused on the appropriateness of the statistical analysis used in JKSEM articles to improve their value, and during the review process, editorial attention should be paid to the validity of the statistical methodologies used in the articles.
Checklist ; Emergencies* ; Emergency Medicine*

PURPOSE: This research investigated the extent of telephone advisers'satisfaction with respect for giving telephone advice and the working environment at 12 emergency medical information centers. METHODS: During July 2004, we approached 12 emergency medical information centers. We sent a three page postal questionnaire to each worker. The questionnaire had three parts questions about the working environment, giving telephone advice, and demographic characteristics. RESULTS: The response rate was 81.8%. The hundred (100) workers selected for this study were telephone advisers. As to the working environment, they were unsatisfied with the small workspace and the poor ventilation. Sixty-three (63) workers had telephone advice education. They felt that 'callers' overstatements' and 'not seeing the patients' left them stressed when giving telephone advice. They anticipated that 'protocol' and 'education about medical knowledge' were necessary for improving telephone advice. Seventy-three (73) workers had experienced burnout syndrome. CONCLUSION: Based on this survey on the extent of satisfaction with giving telephone advice and with the working environment, we think that improvements in the working environment and in the professional education for telephoneadvice skills are necessary. Also, we suggest that education to improve advisers'medical knowledge, development of advice protocols, and a program to prevent and manage burnout syndrome are required for enhanced work satisfaction in the future.
Burnout, Professional ; Counseling ; Education ; Education, Professional ; Emergencies* ; Information Centers* ; Job Satisfaction* ; Surveys and Questionnaires ; Telephone* ; Ventilation