No abstract available.
Osteoarthritis*

Cyclosporine(CsA) has been known to cause an endothelial dysfunction following its use as an immunosuppressive agent. On the other hand, the vascular endothelium has been recognized as an endocrine organ in its own right, i.e., it releases vasoactive factors such as nitric oxide(NO) and hyperpolarizing factor(EDHF). NO is synthesized by at least three isoforms of NO synthases(NOS), among which ecNOS is constitutively expressed in the endothelium. The principle of EDHF has not been determined. The present study was aimed at further investigating the mechanisms underlying the CsA-induced vasculopathy. Rats were treated with CsA (25mg/kg/day, subcutaneous) for one week and their thoracic aortae were isolated. Their changes of iso-metric tension in responses to acetylcholine, diazoxide, and high concentrations of calcium were recorded. The expression of ecNOS mRNA and protein was determined by reverse transcription-polymerase reaction and Western blot analysis, respectively. The acetylcholine-induced relaxation of the aortic rings was significantly diminished follawing the CsA-treatment, which was prevented by L-arginine supplemented along with the CsA-treatment. The relaxation of the thoracic aorta in response to either diazoxide or high concentrations of extracellular calcium was not affected by CsA-treatrnent. The vascular tissue contents of NO metabolites were significantly decreased following the CsA-treatment, which was also prevented by L-arginine-supple-mentation. Neither ecNOS mRNA nor protein expression was significantly altered following the CsA-treatment. It is suggested that CsA induces an endothelial dysfunction, which cannot be attributed to an altered role of EDHF, but to an impairment in L-arginine/NO pathway at the steps beyond NOS protein expression.
Acetylcholine ; Animals ; Aorta, Thoracic ; Arginine ; Blotting, Western ; Calcium ; Diazoxide ; Endothelium ; Endothelium, Vascular ; Hand ; Protein Isoforms ; Rats* ; Relaxation ; RNA, Messenger

No abstract available.
Child* ; Humans ; Immunocompromised Host ; Neutropenia ; Sepsis*

PURPOSE: The aim of this study was to develop a baptist electronic Nutritional Screening Program (B-eNSP) that could be easily used to identify patients with nutrition at risk or malnutrition on their admission to hospital using an integrated medical information system and to evaluate validity, reliability and efficiency of B-eNSP. METHODS: From June 1 2009 to June 21 2009, we enrolled 496 patients for prospective research. We analyzed age, sex, weight, height, weight loss in the last 3 months, serum albumin, alteration of dietary intake, gastrointestinal symptom, functional capacity, diagnosis and its relationship to nutritional requirements, physical examination and Subjective Global Assessment (SGA). B-eNSP included body mass index (BMI), weight loss in the last 3 months, serum albumin. Each component was scored. Sensitivity and specificity were calculated to evaluate the validity of the B-eNSP. The receiver operating characteristic (ROC) curve was drawn by using B-eNSP to choose a cut-off value that maximizes sensitivity and specificity and Yoden Index. Comparison with SGA and the reliability of the B-eNSP was done using kappa statistics. RESULTS: The maximum Yoden Index was 0.866 and the cut-off value of the ROC curve was 2. A B-eNSP score higher than 2 was defined as nutrition at risk or malnutrition. Reliability of the B-eNSP was in accordance with SGA by kappa 0.845. CONCLUSION: The B-eNSP can be used efficiently to identify patients with nutrition at risk or malnutrition by simply using an integrated medical information system.
Body Mass Index ; Electronics ; Electrons ; Humans ; Information Systems ; Malnutrition ; Mass Screening ; Nutritional Requirements ; Physical Examination ; Prospective Studies ; Protestantism ; ROC Curve ; Sensitivity and Specificity ; Serum Albumin ; Weight Loss

No abstract available.
Skin Diseases*

PURPOSE: The aim of the study was to evaluate the clinical outcome and complications of tension free vaginal tape (TVT) procedure for the surgical treatment of female stress urinary incontinence. MATERIALS AND METHODS: Between April 1999 and May 2000, 41 women with stress urinary incontinence underwent TVT procedure. Preoperative evaluation included questionnaires study, physical examination, one hour pad test and urodynamic study. Postoperative clinical outcome, patient's satisfaction and complications were checked after 3-months. RESULTS: The mean age of patients was 51.6 years (range 40-76) and mean hospital stay 2.1 days (range 1-10). The mean follow-up period was 9.9 months (range 3-15). Thirty six patients (87.8%) were cured, 2 patients (4.9%) were improved. Two of 3 patients with failed operation who developed postoperative urge incontinence had grade III cystocele. Five bladder perforations and 1 obturator nerve injury occurred. The abdominal leak point pressure (LPP) increased from 50.6cmH20 to 110.8cmH2O, detrusor pressure of maximal flow rate (Pdet.Qmax) increased from 15.8cmH2O to 28.6cmH2O and maximal flow rate (Qmax) decreased from 32.8ml/s to 22.5ml/s after operation. CONCLUSIONS: The TVT procedure is an effective and feasible surgical treatment for female stress urinary incontinence. However, in patients with grade III cystocele, postoperative urge incontinence may develop after the procedure. Since TVT procedure involves securing the mid-urethra, urinary obstruction may also occur, necessitating the need for continued follow-up as well as a careful comparison with other sling procedure.
Cystocele ; Female ; Follow-Up Studies ; Humans ; Length of Stay ; Obturator Nerve ; Physical Examination ; Surveys and Questionnaires ; Suburethral Slings* ; Urinary Bladder ; Urinary Incontinence ; Urinary Incontinence, Urge ; Urodynamics

No abstract available.
Biofeedback, Psychology* ; Electric Stimulation* ; Pelvic Floor* ; Urinary Incontinence*

No Abstract Available.
Hepacivirus* ; Hepatitis C* ; Hepatitis*

PURPOSE: To compare the incidence between author's first and current report on urinary tract stone in patient with spinal cord injury and to evaluate the effectiveness of recent developed in medical technology and care on in treating the patients. MATERIALS AND METHODS: We reviewed urinary tract stone in 257 patients with paraplegia or quadriplegia after spinal cord injury. These patients were diagnosed retrospectively by KUB and intravenous urography at the Korea Veterans Hospital during 10years from January, 1984 to December, 1993. We evaluated and compared the overall incidence, incidence of specific location of urinary tract, recurrent rate, incidence according to the level of spinal cord injury, and the duration of development in urinary tract stone. RESULTS: Total patients were 257 with 186(72.4%) paraplegia and 71(27.6%)quadriplegia. Overall incidence of the stone was 16.0% in this study and 38.1% in the first study. Incidence of the stone in individual organ ;5.5% in kidney, 1.2% in ureter, and 13.6% in urinary bladder. The recurrent rate was 29.3% in this study and 40.6% in the first study. Incidence of the stone according to the level of spinal cord injury was as follows;15.6% in cervix, 17.1% in upper thorax, 17.9% in lower thorax and 13.9% in lumbar. The stone developed during the first 4 years and between 12 to 16 years following spinal cord injury was 28.3% each. CONCLUSION: Overall incidence and recurrent rate of urinary tract stone was obviously decreased since the first study. Highest incidence of the stone occurred in urinary bladder and in patient with lower thoracic spinal cord injury, which is similar to first report. Peak incidence of the stone was in the first 4years, and another peak was in 12-16years after spinal cord injury. The decreased overall incidence of urinary tract stone maybe attributable to the development in medical technology and care, and active rehabilitation.
Cervix Uteri ; Female ; Hospitals, Veterans ; Humans ; Incidence ; Kidney ; Korea ; Paraplegia ; Quadriplegia ; Rehabilitation ; Retrospective Studies* ; Spinal Cord Injuries* ; Spinal Cord* ; Thorax ; Ureter ; Urinary Bladder ; Urinary Calculi* ; Urinary Tract* ; Urography

PURPOSE: To compare the incidence between author's first and current report on urinary tract stone in patient with spinal cord injury and to evaluate the effectiveness of recent developed in medical technology and care on in treating the patients. MATERIALS AND METHODS: We reviewed urinary tract stone in 257 patients with paraplegia or quadriplegia after spinal cord injury. These patients were diagnosed retrospectively by KUB and intravenous urography at the Korea Veterans Hospital during 10years from January, 1984 to December, 1993. We evaluated and compared the overall incidence, incidence of specific location of urinary tract, recurrent rate, incidence according to the level of spinal cord injury, and the duration of development in urinary tract stone. RESULTS: Total patients were 257 with 186(72.4%) paraplegia and 71(27.6%)quadriplegia. Overall incidence of the stone was 16.0% in this study and 38.1% in the first study. Incidence of the stone in individual organ ;5.5% in kidney, 1.2% in ureter, and 13.6% in urinary bladder. The recurrent rate was 29.3% in this study and 40.6% in the first study. Incidence of the stone according to the level of spinal cord injury was as follows;15.6% in cervix, 17.1% in upper thorax, 17.9% in lower thorax and 13.9% in lumbar. The stone developed during the first 4 years and between 12 to 16 years following spinal cord injury was 28.3% each. CONCLUSION: Overall incidence and recurrent rate of urinary tract stone was obviously decreased since the first study. Highest incidence of the stone occurred in urinary bladder and in patient with lower thoracic spinal cord injury, which is similar to first report. Peak incidence of the stone was in the first 4years, and another peak was in 12-16years after spinal cord injury. The decreased overall incidence of urinary tract stone maybe attributable to the development in medical technology and care, and active rehabilitation.
Cervix Uteri ; Female ; Hospitals, Veterans ; Humans ; Incidence ; Kidney ; Korea ; Paraplegia ; Quadriplegia ; Rehabilitation ; Retrospective Studies* ; Spinal Cord Injuries* ; Spinal Cord* ; Thorax ; Ureter ; Urinary Bladder ; Urinary Calculi* ; Urinary Tract* ; Urography