BACKGROUND/AIMS: Multidrug-resistant tuberculosis (MDR-TB) is an important public health problem in South Korea. MDR-TB is difficult to control, and treatment is less effective than for drug-sensitive tuberculosis. The aim of this report is to determine the risk factors for poor outcomes for MDR-TB. METHODS: We retrospectively and consecutively analyzed the clinical outcomes of MDR-TB patients registered at a single tuberculosis-specialized hospital in South Korea from January 2005 to February 2011. We used standard treatment outcome definitions for MDR-TB and used the combination of “defaulted”, “treatment failed”, and “died” as a composite poor outcome variable. We analyzed the risk factors associated with poor outcome. RESULTS: Among the 258 patients sampled, 91 (35.3%) had MDR-TB on their first tuberculosis infection, while 167 patients (64.7%) who had previously been treated for tuberculosis had MDR-TB over the study period. Treatment outcomes revealed that 207 patients (80.2%) were cured of their infection, 15 (5.8%) completed their treatment, one (0.4%) defaulted treatment, 6 (2.3%) died, and treatment failed for 29 patients (11.3%). Multivariate Cox proportional-hazards regression analysis found that poor outcome were associated with a body mass index <18.5 kg/m2 (hazard ratio [HR]: 2.57; 95% confidence interval [CI]: 1.28-5.15, p = 0.008), being susceptible to four or fewer drugs at the start of treatment (HR: 3.89; 95% CI: 1.38-10.96, p = 0.01), and ofloxacin resistance (HR: 2.49; 95% CI: 1.06-5.81, p = 0.035). CONCLUSIONS: Being underweight, susceptibility to four or fewer drugs, and ofloxacin resistance are independent prognostic factors of poor outcome for MDR-TB patients.
Body Mass Index ; Humans ; Korea* ; Ofloxacin ; Public Health ; Retrospective Studies ; Risk Factors* ; Thinness ; Treatment Outcome ; Tuberculosis ; Tuberculosis, Multidrug-Resistant*

BACKGROUND/AIMS: Multidrug-resistant tuberculosis (MDR-TB) is an important public health problem in South Korea. MDR-TB is difficult to control, and treatment is less effective than for drug-sensitive tuberculosis. The aim of this report is to determine the risk factors for poor outcomes for MDR-TB. METHODS: We retrospectively and consecutively analyzed the clinical outcomes of MDR-TB patients registered at a single tuberculosis-specialized hospital in South Korea from January 2005 to February 2011. We used standard treatment outcome definitions for MDR-TB and used the combination of “defaulted”, “treatment failed”, and “died” as a composite poor outcome variable. We analyzed the risk factors associated with poor outcome. RESULTS: Among the 258 patients sampled, 91 (35.3%) had MDR-TB on their first tuberculosis infection, while 167 patients (64.7%) who had previously been treated for tuberculosis had MDR-TB over the study period. Treatment outcomes revealed that 207 patients (80.2%) were cured of their infection, 15 (5.8%) completed their treatment, one (0.4%) defaulted treatment, 6 (2.3%) died, and treatment failed for 29 patients (11.3%). Multivariate Cox proportional-hazards regression analysis found that poor outcome were associated with a body mass index <18.5 kg/m2 (hazard ratio [HR]: 2.57; 95% confidence interval [CI]: 1.28-5.15, p = 0.008), being susceptible to four or fewer drugs at the start of treatment (HR: 3.89; 95% CI: 1.38-10.96, p = 0.01), and ofloxacin resistance (HR: 2.49; 95% CI: 1.06-5.81, p = 0.035). CONCLUSIONS: Being underweight, susceptibility to four or fewer drugs, and ofloxacin resistance are independent prognostic factors of poor outcome for MDR-TB patients.
Body Mass Index ; Humans ; Korea* ; Ofloxacin ; Public Health ; Retrospective Studies ; Risk Factors* ; Thinness ; Treatment Outcome ; Tuberculosis ; Tuberculosis, Multidrug-Resistant*

No abstract available.

STUDY DESIGN: Mechanical study of polymethylmetacrylate (PMMA) mixed with blood as a filler. PURPOSE: An attempt was made to modify the properties of PMMA to make it more suitable for percutaneous vertebroplasty (PVP). OVERVIEW OF LITERATURE: The expected mechanical changes by adding a filler into PMMA included decreasing the Young's modulus, polymerization temperature and setting time. These changes in PMMA were considered to be more suitable and adaptable conditions in PVP for an osteoporotic vertebral compression fracture. METHODS: Porous PMMA were produced by mixing 2 ml (B2), 4 ml (B4) and 6 ml (B6) of blood as a filler with 20 g of regular PMMA. The mechanical properties were examined and compared with regular PMMA(R) in view of the Young's modulus, polymerization temperature, setting time and optimal passing-time within an injectable viscosity (20-50 N-needed) through a 2.8 mm-diameter cement-filler tube. The porosity was examined using microcomputed tomography. RESULTS: The Young's modulus decreased from 919.5 MPa (R) to 701.0 MPa (B2), 693.5 Mpa (B4), and 545.6 MPa (B6). The polymerization temperature decreased from 74.2degrees C (R) to 59.8degrees C (B2), 54.2degrees C (B4) and 47.5degrees C (B6). The setting time decreased from 1,065 seconds (R) to 624 seconds (B2), 678 seconds (B4), and 606 seconds (B6), and the optimal passing-time decreased from 75.6 seconds (R) to 46.6 seconds (B2), 65.0 seconds (B4), and 79.0 seconds (B6). The porosity increased from 4.2% (R) to 27.6% (B2), 27.5% (B4) and 29.5% (B6). A homogenous microstructure with very fine pores was observed in all blood-mixed PMMAs. CONCLUSIONS: Blood is an excellent filler for PMMA. Group B6 showed more suitable mechanical properties, including a lower elastic modulus due to the higher porosity, less heating and retarded optimal passing-time by the serum barrier, which reduced the level of friction between PMMA and a cement-filler tube.
Elastic Modulus ; Fractures, Compression ; Friction ; Heating ; Hot Temperature ; Polymerization ; Polymers ; Polymethyl Methacrylate ; Porosity ; Vertebroplasty ; Viscosity ; X-Ray Microtomography

STUDY DESIGN: This is a mechanical study of polymethylmetacrylate(PMMA) mixed with blood as a filler. OBJECTIVE: We tried to change the properties of PMMA so that it is more suitable to use for percutaneous vertebroplasty (PVP). SUMMARY OF THE LITERATURE REVIEW: The mechanical changes by adding a filler into PMMA were expected to decrease the Young's modulus, the polymerization temperature and the setting time. These changes of PMMA were considered to be more suitable and adaptable conditions for PVP for treating osteoporotic vertebral compression fracture. MATERIALS AND METHODS: Porous PMMA was produced by mixing 2 ml (B2), 4 ml (B4) and 6 ml (B6)-blood as a filler, and the mechanical properties were investigated in comparison with regular PMMA(R) in view of Young's modulus, the polymerization temperature, the setting time and the optimal passing-time within the injectable viscosity (20~50N-needed) through a 2.8mm-diameter cement-filler tube. Porosity was inspected by performing microcomputated tomography (micro-CT). RESULTS: Young's modulus was decreased from 919.5 MPa (R) to 701 MPa (B2), 693.5 MPa (B4) and 545.6 MPa (B6) in each group. The polymerization temperature decreased from 74.2degrees C (R) to 59.8degrees C (B2), 54.2degrees C (B4) and 47.5degrees C(B6), respectively. The setting time decreased from 1065sec (R) to 624sec (B2), 678sec(B4) and 606sec (B6), respectively, and the optimal passing-time decreased from 75.6sec (R) to 46.6sec (B2), 65.0sec (B4) and 79.0sec(B6), respectively. The porosity increased from 4.2%(R) to 27.6%(B2), 27.5%(B4) and 29.5%(B6), respectively. A homogenous microstructure with very fine pores was seen on inspection of all the blood-mixed PMMAs. CONCLUSION: Blood mixed with PMMA was considered as an excellent filler that was easy to make and had good biocompatibility. The 6ml blood-mixed PMMA (B6) showed more suitable mechanical properties, including a decreased elastic modulus due to more porosity, less heating and a retarded optimal passing-time by the serum barrier, which diminished the friction between the PMMA and a cement-filler tube.
Elastic Modulus ; Fractures, Compression ; Friction ; Heating ; Hot Temperature ; Polymerization ; Polymers ; Polymethyl Methacrylate ; Porosity ; Vertebroplasty ; Viscosity

Stem cells are used for the investigation of developmental processes at both cellular and organism levels and offer tremendous potentials for clinical applications as an unlimited source for transplantation. Gangliosides, sialic acid-conjugated glycosphingolipids, play important regulatory roles in cell proliferation and differentiation. However, their expression patterns in stem cells and during neuronal differentiation are not known. Here, we investigated expression of gangliosides during the growth of mouse embryonic stem cells (mESCs), mesenchymal stem cells (MSCs) and differentiated neuronal cells by using high-performance thin-layer chromatography (HPTLC). Monosialoganglioside 1 (GM1) was expressed in mESCs and MSCs, while GM3 and GD3 were expressed in embryonic bodies. In the 9-day old differentiated neuronal cells from mESCs cells and MSCs, GM1 and GT1b were expressed. Results from immunostaining were consistent with those observed by HPTLC assay. These suggest that gangliosides are specifically expressed according to differentiation of mESCs and MSCs into neuronal cells and expressional difference of gangliosides may be a useful marker to identify differentiation of mESCs and MSCs into neuronal cells.
Neurons/*cytology/*metabolism ; Mice ; Mesenchymal Stem Cells/*cytology/*metabolism ; Gangliosides/*metabolism ; Embryonic Stem Cells/*cytology/*metabolism ; Cells, Cultured ; Cell Differentiation ; Animals

PURPOSE: To evaluate whether Extracorporeal Shock Wave Therapy (ESWT) is an effective treatment without side effects for chronically painful calcifying tendinitis. MATERIALS AND METHODS: Study subjects were 72 patients (17 males and 55 females) aged 37-64 years, with a mean of 48, showing chronic, symptomatic, calcifying tendinitis of the shoulder refractory to other conventional conservative therapies. Calcifications were type I or type II according to the classification of Gartner, and with a minimum diameter of 10 mm. Patients with type 3 calcific tendinitis were excluded, because this type has a strong tendency to spontaneous resolution. Extracorporeal shock wave therapy comprised one or two treatments, each consisting of 800 shocks, with a frequency of 120 impulse per minute and the energy density of 0.14 mJ/mm2. We assessed the presence and size of calcified deposits at 1, 3, 6 and 12 months by conventional radiography. All patients also underwent clinical examination, and the Constant (and Murley) score and pain were calculated. The intensity of pain was measured with the visual analogue scale (VAS) from 0 to 10 points, where 0 represents the absence of pain and 10 unbearable pain. RESULTS: One month after the treatment, complete resorption of the calcium deposits was observed in 19 patients (26%), partial resorption was observed in 26 patients (36%), and no modification in the calcium deposits was observed in 27 patients (38%). At six months the complete disappearance of the calcium deposits was noted in 42 patients (68%), but in the 10 patients (14%), calcium deposit appeared unchanged. This result is remained unvaried after 6 month follow-up. Using the Constant and Murley score, this study showed a significant decrease in pain and a significant increase in shoulder function (p<0.001). At six months, 76% of the patients presented satisfactory functional result. About 15% reported a subjective and objective recovery, and only 6 patients (8%), classified as poor result but in our series no differences were found between results at 6 month and 12 month follow-up. At 12 month follow-up there were differences in the Constant score between treated shoulder and contralateral side, respectively 77.6 (59-91) and 87.2 (74-96), but not significant. There were no side effects. CONCLUSION: ESWT is an effective treatment without side effects and an alternative therapy for chronically painful calcifying tendinitis of the shoulder refractory to conventional therapies.
Calcium ; Classification ; Follow-Up Studies ; Humans ; Male ; Radiography ; Shock* ; Shoulder* ; Tendinopathy*

Tumor necrosis factor-related apoptosis-inducing ligand (TRAIL) serves as an extracellular signal triggering apoptosis in tumor cells. To characterize the molecular events involved in TRAIL-induced apoptotic signaling, we investigated the role of extracellular signal-regulated kinase 1/2(ERK1/2) in the apoptosis using HeLa cells. Here we show that TRAIL pronounced ERK1/2 activation through a tyrosine kinase-dependent mechanism, subsequently elevated anti-apoptotic Bcl-2 protein levels. Pretreatment with Genistein, an inhibitor of tyrosine kinase, significantly attenuated ERK1/2 activation and enhanced cell death. Moreover, inhibition of ERK1/2 with PD98059 promoted apoptotic cell death through the down-regulation of ERK1/2 activity and Bcl-2 protein levels. Taken together, our results suggest that the activation of ERK1/2 via tyrosine kinase pathway plays a protective role as the mechanism of cellular defense through the up-regulation of Bcl-2 protein levels in TRAIL-induced apoptosis.
Apoptosis* ; Cell Death ; Down-Regulation ; Genistein ; HeLa Cells* ; Humans ; Necrosis ; Phosphotransferases ; Protein-Tyrosine Kinases* ; Tyrosine* ; Up-Regulation

Various factors such as senescence, stress, neurodegenerative diseases including Alzheimer's disease (AD) contribute to the impairments of organs, especially brain. Also, they should be negative factors on normal brain function, like as memory and cognition. In this study, the neuroprotective role of BF-7, extracted from Bombyx mori, was examined agaist scopolamine-induced neurotoxicity in SK-N-SH cells. In order to know if the BF-7 has positive role on the cognition and memory, we examined using SD rat model and human. Scopolamine-induced memory impairments were observed, as measured by the passive avoidance and water maze tests, but treatment with BF-7 significantly improved memory and cognitive function. Moreover, the memory index and memory preservation of clinical experiments using MMSE-K tests were significantly improved memory and cognitive function. This results strongly represent that the BF-7 play effectively positive role in the improvement of brain function including learning and memory. Taken together, our results suggested that the BF-7 should be useful for developing strategies protecting nervous system and improving brain function.
Aging ; Alzheimer Disease ; Bombyx ; Brain ; Cognition ; Humans ; Learning ; Memory* ; Models, Animal ; Nervous System ; Neurodegenerative Diseases ; Scopolamine Hydrobromide

PURPOSE: Because of the disappointing long-term results of transvaginal bladder neck suspension surgery for anatomical incontinence (AI), a pubovaginal sling, which was formerly operated for sphincteric incontinence (SI), was used to treat AI. The results of the pubovaginal sling for treating AI and the risk factors that affect the result were evaluated. MATERIALS AND MTHODS: A total 39 women with AI underwent a pubovaginal fascial sling using a strip of autologous rectus muscle fascia. The urethral sphincteric function was assessed by measuring the Valsalva leak point pressure. Fifteen patients has type I and 24 patients type II stress incontinence. The results of the pubovaginal sling were compared with those of 51 women who received the Raz precedure. The risk factors for the pubovaginal fascial sling were evaluated. RESULTS: The success rate of an autologous pubovaginal sling (95.6%) at mean follow-up period of (21 months) was significantly higher than that of the Raz bladder neck suspension (80.4%) during the same follow-up period (p<0.05). The success rate of the Raz procedure - 80.4%, 70.8% and 60.7% at 21, 36, 72 months - was decreased after months. The predictive factors for the pubovaginal sling - the number of deliveries, history of hystectomy, the type of stress incontinence, cystocele, urge incontinence, and age - had no significant effect on the success rate of the pubovaginal sling (p<0.05). CONCLUSIONS: A pubovaginal fascial sling may be an effective surgical treatment not only for treating sphincteric incontinence but also anatomical incontinence.
Cystocele ; Fascia ; Female* ; Follow-Up Studies ; Humans ; Neck ; Risk Factors* ; Urethra ; Urinary Bladder ; Urinary Incontinence, Urge