BACKGROUND: Since free light chain (FLC) is metabolized in the kidney, serum FLC concentration and kappa/lambda ratio are increased in patients with decreased renal function, even in the absence of monoclonal protein. In this study, we measured serum FLC levels to investigate the change in kappa/lambda ratios in relation to the severity of renal dysfunction. METHODS: Serum FLC concentrations were measured in 92 archived serum samples from patients diagnosed with chronic kidney disease using the Freelite assay (The Binding Site Group Ltd., UK), and kappa/lambda ratios were calculated. Serum creatinine levels were assayed to calculate estimated glomerular filtration rate (eGFR), and patients were divided into subgroups according to Kidney Disease Improving Global Outcomes (KDIGO) guidelines. We analyzed the difference in serum FLC levels and kappa/lambda ratios between subgroups. RESULTS: Serum FLC levels and kappa/lambda ratios increased depending on the severity of renal dysfunction. When patients were classified by setting cut-off value of eGFR as 60 mL/min/1.73 m2 (group A: eGFR ≥60 mL/min/1.73 m2, group B: < 60 mL/min/1.73 m2), the kappa/lambda ratio of group B was significantly higher than that of group A (group B: 1.60±0.46 vs. group A: 1.35±0.27, P=0.018). Serum FLC kappa/lambda ratios were within the previously determined renal reference interval (0.37–3.1). CONCLUSIONS: When interpreting results of serum FLC kappa/lambda ratio, renal function status should be considered in addition to hematological findings. If renal function deteriorates, a wider renal reference interval is preferred instead of the usual reference interval.
Binding Sites ; Creatinine ; Glomerular Filtration Rate ; Humans ; Kidney ; Kidney Diseases ; Renal Insufficiency, Chronic

PURPOSE: We evaluated the long-term results of endoscopic Deflux(R) injection for treating vesicoureteral reflux (VUR) in children. METHODS: Between September 2004 and September 2014, 243 children (137 boys and 106 girls) with a mean age of 53 months underwent Deflux(R) injection. Our clinical protocol included radionuclide voiding cystography (RNC) at postoperative 3 months, 1 year and 3 years to assess the VUR resolution. RESULTS: The cure rates at 3 months, 1 year, and 3 years by patients were 70.8%, 64.3%, and 65.6% for the total patients and 79.2%, 75.2%, and 76.4%, for the ureters, respectively. The recurrence rate of postoperative febrile urinary tract infection (UTI) was 20% in patients without VUR at postoperative 1 year. Twenty patients undergoing ureteroneocystostomy (UNC) significantly had younger age (P=0.003), higher VUR grade (P<0.001), and lower success rates of Deflux(R) injection (P<0.05). On univariate analysis, older age (P=0.014) and lower grade of VUR (P=0.031) were the significant predictors of a successful outcome. But there was none on multivariate analysis. Younger age, especially age of 0-12 month-old, was the only significant predictor of postoperative febrile UTI recurrence on both univariate and multivariate analysis. CONCLUSION: Deflux(R) injection is efficacious with a low complication rate for the anti-reflux procedure in children. There is low recurrence rate of UTI though VUR persists, and high probability of no VUR at 3 years if no VUR at 1 year. It is recommendable not to perform follow-up RNC at 3 years routinely if no VUR at 1 year.
Child* ; Clinical Protocols ; Humans ; Multivariate Analysis ; Recurrence ; Ureter ; Urinary Tract Infections ; Vesico-Ureteral Reflux*

PURPOSE: We evaluated the long-term results of endoscopic Deflux(R) injection for treating vesicoureteral reflux (VUR) in children. METHODS: Between September 2004 and September 2014, 243 children (137 boys and 106 girls) with a mean age of 53 months underwent Deflux(R) injection. Our clinical protocol included radionuclide voiding cystography (RNC) at postoperative 3 months, 1 year and 3 years to assess the VUR resolution. RESULTS: The cure rates at 3 months, 1 year, and 3 years by patients were 70.8%, 64.3%, and 65.6% for the total patients and 79.2%, 75.2%, and 76.4%, for the ureters, respectively. The recurrence rate of postoperative febrile urinary tract infection (UTI) was 20% in patients without VUR at postoperative 1 year. Twenty patients undergoing ureteroneocystostomy (UNC) significantly had younger age (P=0.003), higher VUR grade (P<0.001), and lower success rates of Deflux(R) injection (P<0.05). On univariate analysis, older age (P=0.014) and lower grade of VUR (P=0.031) were the significant predictors of a successful outcome. But there was none on multivariate analysis. Younger age, especially age of 0-12 month-old, was the only significant predictor of postoperative febrile UTI recurrence on both univariate and multivariate analysis. CONCLUSION: Deflux(R) injection is efficacious with a low complication rate for the anti-reflux procedure in children. There is low recurrence rate of UTI though VUR persists, and high probability of no VUR at 3 years if no VUR at 1 year. It is recommendable not to perform follow-up RNC at 3 years routinely if no VUR at 1 year.
Child* ; Clinical Protocols ; Humans ; Multivariate Analysis ; Recurrence ; Ureter ; Urinary Tract Infections ; Vesico-Ureteral Reflux*

PURPOSE: The aim of present investigation was to find out the influence of several times iatrogenic mobilization in the initial stage of implant installation on bone-implant osteointegration. MATERIALS AND METHODS: The experimental implants (3.75 mm in diameter, 8.0 mm in length) were made of commercially pure (Grade IV) titanium, and were treated with RBM (MegaGen(R): Ca-P) on lower 4.0 mm part. Only lower part of implant was inserted to bone and the implants were nonsubmerged. The 130 implants (two in each tibia) were inserted into the monocortical tibias of 33 rabbits which each weighed more than 3.5 kg (Female, New Zealand White). According to the removal torque interval, the groups were divided into 13 groups, group I (1 day), group II (1 day + 2 days), group III (1 day + 2 days + 3 days), group IV (1 day + 2 days + 3 days + 4 days), group V (2 days), group VI (2 days + 4 days), group VII (2 days + 4 days + 6 days), group VIII (2 days + 4 days + 6 days + 8 days), group IX (4 days), group X (4 days + 7 days), group XI (4 days + 7 days + 10 days), group XII (4 days + 7 days + 10 days + 14 days) and control group. In the control group, the removal torque was measured at 8 weeks with a digital torque gauge (Mark-10, USA). In the experimental groups, the removal torque was given once, twice, three times or four times by experiment design before the final removal torque and the value was measured each time. The implants were then screwed back to their original positions. All the experimental groups were given a final healing time of 8 weeks after placement, in which values were compared with the control groups and the 1st, 2nd, 3rd or 4th removal torque values in each experimental group. RESULTS: In comparison of the final removal torque tests among experimental groups, the removal torque value of experimental groups except group XII were not statistically different that of control group. And the values of group I and II were significantly higher than the values of group VI, VIII, X, XI, and XII. In addition, the values of group III, IV, and V were significantly higher than group XI and XII. In comparison of the removal torque in the each experimental group, the final removal torque were significantly higher in all groups except group VIII, X, XI, and XII. CONCLUSION: If sufficient healing time was allowed, a few mobilization of fixture at the very early stage after the implant placement in the rabbits didn't interrupt the final bone to implant osseointegration.
Dental Implants ; Implants, Experimental ; New Zealand ; Osseointegration ; Rabbits ; Tibia ; Titanium ; Torque

PURPOSE: The aim of this study was to evaluate the stress concentration and distribution whether restoring the cavity or not while restoring with metal ceramic crown on tooth with abfraction lesion using finite element analysis. MATERIALS AND METHODS: Maxillary first premolar was selected and made a total of 10 finite element model. Model 1 was natural tooth; Model 2 was tooth with metal ceramic crown restoration which margin was positioned above 2 mm from CEJ; Model 3 was tooth with metal ceramic crown restoration which margin was positioned on CEJ; Model 4 was natural tooth which has abfraction lesion; Model 5 and 6 had abfraction lesion and the other condition was same as model 2 and 3, respectively; Model 7 was natural tooth which had abfraction lesion restored with composite resin; Model 8 and 9 was tooth with metal ceramic crown after restoring on abfraction lesion with composite resin; Model 10 was restored tooth on abfraction lesion with composite resin and metal ceramic crown restoration which margin is positioned on lower border of abfraction lesion. Load A and Load B was also designed. Von Mises value was evaluated on each point. RESULTS: Under load A or load B, on tooth with abfraction lesion, stress was concentrated on the apex of lesion. Under load A or load B, on tooth that abfraction lesion was restored with composite resin, the stress value was reduced on the apex. CONCLUSION: In case of abfraction lesion was restored with composite resin, the stress was concentrated on the apical border of restored cavity regardless of marginal position. It was favorable to place crown margin on the enamel for restoring with metal ceramic crown.
Bicuspid ; Ceramics ; Crowns ; Dental Enamel ; Dental Stress Analysis ; Finite Element Analysis* ; Prostheses and Implants* ; Tooth Cervix ; Tooth*

PURPOSE: To identify the recognition of patients, families, nurses, and physicians about clinical decision-making and biomedical ethics. METHODS: Data were collected from October 23 to 30, 2012 using the structured questionnaires. A total of 200 data were analyzed using SPSS 20.0 version. RESULTS: Response about 'who should receive the first notice of a cancer diagnosis?' was significant difference statistically. Cancer patients had preferences to be notified their diagnosis first. Patients responded the person who made decision of treatment options would be physician first and then themselves. Families, nurses, and physicians answered that decision-maker would be both of patient and family. All four groups answered that the person who made decision about care-giver after discharge was patient and their family. Nurses and physicians who didn't aware of the advanced directive were over 30.0%, and patients and family who didn't aware of that were over 60.0%. Lastly, the rate of positive answer about making attempt of advanced directive after legalization was over 80.0%. CONCLUSION: Patient's attitude about making decisions is different from family's attitude. Nurses and physicians have to put emphasis on the patient's autonomy & self-determination and family members' needs.
Bioethics* ; Diagnosis ; Humans ; Surveys and Questionnaires

BACKGROUND AND OBJECTIVES: Recent studies indicate that in response to vasoconstrictor stimuli, the small GTPase RhoA and its down-stream effector, Rho-associated kinase 2 (ROCK)/Rho-kinase, are associated with hypercontraction of the vascular smooth muscle of coronary arteries through augmentation of myosin light chain phosphorylation and Ca2+ sensitization. Expression of ROCK/Rho-kinase mRNA was significantly increased and up-regulated in the spastic coronary artery in a porcine model, and a specific inhibitor of ROCK/Rho-kinase inhibited coronary artery spasm in humans. We therefore explored the role of ROCK2 polymorphisms in the pathogenesis of vasospastic angina (VA). SUBJECTS AND METHODS: We studied 106 patients with VA who exhibited spontaneous or provoked coronary spasm during coronary angiography and compared the prevalence of ROCK2 polymorphisms between this group of patients with VA and controls whose angiograms were normal, and in whom the ergonovine test did not cause spasm (n=107). Five single nucleotide polymorphisms (SNPs) of the ROCK2 gene were selected. SNPs were genotyped by high-resolution melting. Linkage disequilibrium and haplotype analyses were performed using the SHEsis program. RESULTS: The prevalence of genotypes of the 5 interesting SNPs in patients with VA was not different from that in the control group. In haplotype analysis, the haplotype G-T-C-T-G (in order of rs978906, rs2271621, rs2230774, rs1515210, and rs3771106) was significantly associated with a decreased risk of VA (p=0.007). CONCLUSION: The haplotype G-T-C-T-G in the ROCK2 gene had a protective effect against VA, suggesting the involvement of ROCK2 in VA pathogenesis.
Coronary Angiography ; Coronary Vasospasm ; Coronary Vessels ; Ergonovine ; Freezing ; Genotype ; GTP Phosphohydrolases ; Haplotypes ; Humans ; Linkage Disequilibrium ; Muscle Spasticity ; Muscle, Smooth, Vascular ; Myosin Light Chains ; Phosphorylation ; Polymorphism, Single Nucleotide ; Prevalence ; rho-Associated Kinases ; RNA, Messenger ; Spasm

No abstract available.

Metastatic thyroid papillaty carcinoma was diagnosed in a 54-year-old woman. The cancer had present in many lymph nodes. After her surgical procedure, she was advised to have radioiodine treatment. However, the patient had chronic renal failure and was on hemodialysis. We tried radioiodine therapy of usual dose for remove of residual tumor burden. Hemodialysis treatments of 4hours and 2 hours performed each 24 and 48 hours after the administration of 131I resulted in a 66% and 80% reduction in total body radiation levels. All contaminated wastes were disposed of by the hospital's department of radiation safety. Postdialysis monitoring revealed no residual radiation contamination of dialysis machines or radiation exposure to the dialysis staff. It is needed more experiences about dose of radioiodine and timing, blood flow rate and duration of hemodialysis.
Carcinoma, Papillary* ; Dialysis ; Female ; Humans ; Kidney Failure, Chronic* ; Lymph Nodes ; Middle Aged ; Neoplasm, Residual ; Renal Dialysis* ; Thyroid Gland*

STATEMENT OF PROBLEM: Surface texture of the implant is one of the important factors of the implant success, especially in the immediate implant loading. Many methods of the surface treatment of implant have developed and introduced. PURPOSE: This study was to evaluate the effects of the Ca-P coating implant crystallized the hydroxyapatite on the surface by the removal torque test and the histomorphometric analysis in vivo. Material and methods: 135 screw type implants, 4.0mm in length and 3.75mm in diameter were used in this study. Implants were divided into 3 groups and treated in the different methods. Group I was not treated, Group II was treated in the SLA method, and Group III was treated in the Ca-P coating with the anodizing method and the hydroxyapatite was crystallized on the surface with the hydrothermal treatment. Firstly, the surface roughness of each group was measured. 45 rabbits were used in this experiment. Two implants were inserted on right tibial metaphysis and one implant was inserted on left side with the alternating order. After the healing periods of 3, 5, and 12 weeks, the rabbits were sacrificed to evaluate the osseointergration by the removal torque test and the histomorphometric analysis. RESULTS: 1. In the analysis for the surface roughness, Group II showed the highest roughness. And Group III showed higher secondly. There was a significant difference one another statistically. 2. In the removal torque test, Group III and II were significantly higher than Group I. There was no statistical difference between Group III and Group II. 3. For all Groups, the removal torque values at 12th week were significantly higher than at 3rd and 5th week. 4. In histomorphometric analysis, the bone implant contact rates of Group III and II were higher than that of Group I at 3rd and 5th week. There was a significant difference at 5th week. 5. In histomorphometric analysis, the bone implant contact rate of Group III and II increased from 3rd week to 5th week, but decreased at 12th week. In Group I, the contact rate at 12th week was significantly higher than at 3rd week and 5th week.
Durapatite ; Rabbits ; Tibia* ; Torque*