PURPOSE: To evaluate mortality and morbidity of very low birth weight infants (VLBWI) in Cheongju area from 2002 to 2004. METHODS: Two neonatal intensive care units (NICU), 1 university hospital and 1 general hospital in Cheongju participated in this study. We performed a retrospective review of medical records of VLBWIs in 2 NICUs with literature review. Survival rate, neonatal morbidity, cause of death, and risk factors contributing mortality and neurodevelopmental complications were analyzed. RESULTS: The total number of VLBWI was 152 (4.65%) including 43 (1.31%) extremely low birth weight infants (ELBWI) who were less than 1,000 g of birth weight. The survival rates were 82.9% and 69.8% for VLBWI and ELBWI, respectively. The incidence of respiratory distress syndrome was 60%, bronchopulmonary dysplasia 20.6%, severe retinopathy of prematurity 24%, and severe intravetricular hemorrhage 7.3%. More than half of death occurred in the first week of life, and the main causes were respiratory distress syndrome and sepsis. The major risk factors contributing mortality and neurodevelopmental complications were birth weight, gestational age, Apgar score, respiratory distress syndrome, and high-grade intraventricular hemorrhage. CONCLUSION: Survival rate (82.9%) of VLBWI in Cheongju area, although lower than those of certain NICUS in Seoul, was comparable to those from nation-wide statistics. The incidence of major morbidity seemed somewhat higher than those of other areas in Korea. A systematic national support would be strongly needed for the balanced development of regional NICUs by means of their facilities, personal resources and financial support, etc.
Apgar Score ; Birth Weight ; Bronchopulmonary Dysplasia ; Cause of Death ; Chungcheongbuk-do* ; Financial Support ; Gestational Age ; Hemorrhage ; Hospitals, General ; Humans ; Incidence ; Infant* ; Infant, Low Birth Weight ; Infant, Newborn ; Infant, Very Low Birth Weight* ; Intensive Care Units, Neonatal ; Korea ; Medical Records ; Mortality ; Retinopathy of Prematurity ; Retrospective Studies ; Risk Factors ; Seoul ; Sepsis ; Survival Rate

PURPOSE: Blowout fracture is an outward fracture of the orbital wall. That usually occurs at inferior or medial wall of the orbit. The main pathophysiology is high intraocular pressure derived from impact of trauma. Among the four orbital wall, the medial wall is thinnest and most vulnerable to trauma. Many kinds of methods were introduced for correction of medial orbital wall fracture. Recently, transnasal endoscopic reconstruction methods were widely used. Endoscopic methods had many advantages. However, we experienced some cases of postoperative maxillary sinusitis. This study was planned to find out the effectiveness of middle meatal antrostomy after endoscopic reconstruction of medial orbital wall fracture. METHODS: This study was retrospective analysis of 28 patients who underwent transnasal endoscopic repair of medial orbital wall fracture. The 18 male and 10 female patients were ranged from 17 to 57 years of age(mean, 30.9 years). Among 28 patients, randomly selected 17 patients underwent middle meatal antrostomy as additional procedure by the same surgeon. After at least 12 months of follow-up period, we examined the nasal symptom, endoscopic and CT findings. RESULTS: One patient complained of nasal obstruction in middle meatal antrostomy group and four patients complained nasal symptoms in non middle meatal antrostomy group. On the endoscopic findings, three patients of non middle meatal antrostomy group had continuous nasal discharge. But middle meatal antrostomy group had no abnormal endoscopic findings. The abnormal CT finding(abnormal mucosal hypertrophy) were detected in four patient of non middle meatal antrostomy group. There were no abnormal CT findings in middle meatal antrostomy group. The data were statistically significant at comparative study. CONCLUSION: Authors think that the middle meatal antrostomy has some advantages as a additional procedure of endoscopic reconstruction of medial orbital wall fracture. Especially, it is good at preventing post- operative maxillary sinusitis. But, more larger group and strict application of disease entity are need for correct evaluation of middle meatal antrostomy effect.
Female ; Follow-Up Studies ; Humans ; Intraocular Pressure ; Male ; Maxillary Sinus ; Maxillary Sinusitis ; Nasal Obstruction ; Orbit* ; Orbital Fractures* ; Retrospective Studies

The optimal and alternative antimicrobial regimens to treat neurosyphilis in human immunodeficiency virus (HIV) infected patients remain controversial. Little is known concerning the efficacy of ceftriaxone. A 75-year-old heterosexual man visited an outpatient clinic due to incidentally detected positive serum Venereal disease research laboratory (VDRL) and Fluorescent treponemal antibody absorbed tests in routine preoperative checkup. Because of benzathine penicillin was unavailable to use, 4-week regimen with doxycycline was started. After 2 weeks doxycycline treatment, a severe headache suddenly occurred. Cerebrospinal fluid (CSF) analysis showed mild lymphocyte-dominant pleocytosis, increased protein, and weakly reactive VDRL test. ELISA for HIV antibody and Western blot assay revealed he is infected with HIV. Initial CD4+ T cell count was 220/mm3 and the load of HIV RNA was 5,200 copies/mL. The most probable diagnosis was deemed to be neurosyphilis, considering the possibilities of Jarisch-Herxheimer reaction or doxycycline-induced pseudotumor cerebri. In the absence of procaine penicillin G in our hospital, intravenous ceftriaxone was administered and highly active antiretroviral therapy was started. After 14days of treatment, the patient no longer had a headache and the CSF profile was improved. Additional follow-up CSF analysis was done 3months after treatment. CSF pleocytosis and protein level were decreased and the CSF VDRL was converted to negative. Ceftriaxone may be a good alternative in the treatment of neurosyphilis in HIV infected patient.
Aged ; Ambulatory Care Facilities ; Antiretroviral Therapy, Highly Active ; Blotting, Western ; Ceftriaxone ; Cell Count ; Doxycycline ; Enzyme-Linked Immunosorbent Assay ; Ethylenediamines ; Follow-Up Studies ; Headache ; Heterosexuality ; HIV ; Humans ; Leukocytosis ; Neurosyphilis ; Penicillin G Benzathine ; Penicillin G Procaine ; Pseudotumor Cerebri ; RNA ; Sexually Transmitted Diseases

OBJECTIVE: To examine the effect of resveratrol on cell proliferation and cell cycle progression in the human uterine leiomyoma cells. METHODS: MTS [3-(4,5-dimethylthiazol-2-yl)5-(3-carboxymethoxyphenyl)-2-(4-sulfophenyl)-2H-tetrazolium] reduction assay was carried out to determine the viability of human uterine leiomyoma cells. Western blot analysis was done using anti pRB, anti-p21cip1/waf1, anti-p53, anti-cyclin E, anti CDK2 antibodies to detect the presence and expression of these proteins in treatment with resveratrol. DNA fragmentation assay was done to find the rate of apoptosis. Cell cycle analysis for resveratrol treated in human uterine leiomyoma cells was done by FACS (fluorescence-activated cell sorter) analysis. RESULTS: Resveratrol induced growth inhibition in a dose dependent manner, treatment with 100 ?M/L resveratrol blocked 30% cell growth. From Western blot analysis it revealed resveratrol induced the expression of p53 increasing. Caspase pathway was activated and cleavage of PARP was occurred. Apoptosis took place but in a reduced manner. FACS results showed that resveratrol increased the percentage of cells in sub G1 phase. CONCLUSION: Resveratrol, a dietry phytoalexin, inhibited cell proliferation and induced cell cycle arrest at sub G1 by enhancing the production of p53. These results indicate that resveratrol will be a promising agent chemopreventives or therapeutics against human uterine leiomyoma cells.
Antibodies ; Apoptosis ; Blotting, Western ; Cell Cycle ; Cell Cycle Checkpoints ; Cell Proliferation ; DNA Fragmentation ; G1 Phase ; Humans ; Leiomyoma*

BACKGROUND: Hydroxyethyl starch (HES), a widely used plasma volume expander, has been associated with platelet dysfunction and inhibition of coagulation. Six% HES (Molecular weight 670 kd, molar substitution 0.75) is a plasma volume expander in a physiologically balanced medium of electrolytes, lactate and glucose. The aim of this study is to evaluate the effect of 6% HES (670/0.75) on hemostasis during acute normovolemic hemodilution (ANH). METHODS: Eighteen healthy adult male patients scheduled for spine surgery were enrolled in this study. Before general anesthesia, patients underwent ANH with 20 ml/kg of 6% HES (670/0.75). Hemoglobin, platelet count, plasma fibrinogen concentration, factor VII activity, prothrombin time (PT), activated partial thromboplastin time (aPTT) and thromboelastography (TEG) were measured before and 120 minutes after the completion of ANH. RESULTS: Hb, Hct, platelet, plasma fibrinogen concentration and factor VII activity decreased significantly (P < 0.05) after ANH. Compared with pre-ANH values, only maximal amplitude decreased significantly (P = 0.001) among post-ANH thromboelastographic parameters. CONCLUSIONS: Except maximal amplitude, significant difference were not observed in CI (Coagulation Index) which represents general coagulation state and other thromboelastographic parameters between pre and post ANH. ANH with 20 ml/kg of 6% HES (670/0.75) didn't cause impairment of TEG parameters.
Adult ; Anesthesia, General ; Blood Platelets ; Electrolytes ; Factor VII ; Fibrinogen ; Glucose ; Hemodilution ; Hemoglobins ; Hemostasis ; Hetastarch ; Humans ; Lactic Acid ; Male ; Molar ; Partial Thromboplastin Time ; Plasma ; Plasma Volume ; Platelet Count ; Prothrombin Time ; Spine ; Thrombelastography

Mosquitoes secrete saliva that contains biological substances, including anticoagulants that counteract a host's hemostatic response and prevent blood clotting during blood feeding. This study aimed to detect heparin, an anticoagulant in Aedes togoi using an immunohistochemical detection method, in the salivary canal, salivary gland, and midgut of male and female mosquitoes. Comparisons showed that female mosquitoes contained higher concentrations of heparin than male mosquitoes. On average, the level of heparin was higher in blood-fed female mosquitoes than in non-blood-fed female mosquitoes. Heparin concentrations were higher in the midgut than in the salivary gland. This indicates presence of heparin in tissues of A. togoi.
Aedes/*metabolism ; Animals ; Anticoagulants/*isolation & purification ; Blood Coagulation/physiology ; Female ; Gastrointestinal Tract/*metabolism ; Heparin/*isolation & purification ; Male ; Salivary Ducts/metabolism ; Salivary Glands/*metabolism

Metastatic cancers of the stomach are rare. Metastatic diseases of the stomach can occur with melanoma and other primary tumors of the breast, lung, ovary, liver, colon, and testis; however, breast cancer is the most common. Other rare malignant tumors that can involve the stomach include Kaposi's sarcoma, myenteric schwannoma, glomus tumor, small cell carcinoma, and parietal cell carcinoma. On the other hand, solitary fibrous tumors of the pleura are rare soft tissue sarcomas, and most are benign; however, 13 to 36% may be malignant. Metastases may occur in extrathoracic sites, such as the liver, central nervous system, spleen, adrenal gland, and bone. We herein report a case of a 75-year-old man with previously diagnosed brain and liver metastases. He developed a stomach metastasis from a malignant solitary fibrous tumor and presented with gastrointestinal bleeding symptoms.
Adrenal Glands ; Aged ; Brain ; Breast ; Breast Neoplasms ; Carcinoma, Small Cell ; Central Nervous System ; Colon ; Endoscopy ; Female ; Gastrointestinal Hemorrhage ; Glomus Tumor ; Hand ; Hemorrhage ; Humans ; Liver ; Lung ; Melanoma ; Neoplasm Metastasis ; Neurilemmoma ; Ovary ; Pleura ; Sarcoma ; Sarcoma, Kaposi ; Solitary Fibrous Tumors ; Spleen ; Stomach

Little is known about the prevalence and seroprevalence of low-risk human papillomavirus (HPV) and the risk factors for HPV infection in Korean women. We determined the prevalence of low-risk HPV among 902 women aged 20-59 yr and the seroprevalence of low-risk HPV subtypes 6 and 11 among 1,094 women aged 9-59 yr in the general population. Genital low-risk HPV DNA was assessed by liquid hybridization and polymerase chain reaction. Antibody titers against HPV 6 and 11 were measured by a multiplexed competitive luminex technique. The prevalence of genital low-risk HPV was 4.9%. It reached its highest peak of 10.3% at 20-29 yr of age and a second peak of 3.2% at 50-59 yr of age. The seroprevalence of HPV 6 or 11 was 9.4%. It reached its highest peak of 12.7% at 25-29 yr of age and a second peak of 12.3% at 50-59 yr of age. In multivariable analysis, the number of lifetime sexual partners and past history of sexually transmitted diseases were associated with the seroprevalence but not prevalence of HPV. It is suggested that younger women should receive prophylactic HPV vaccination before they become sexually active and exposed to HPV in their 20s. This study provides baseline data for developing HPV vaccination programs and monitoring vaccine efficacy in Korea.
Adolescent ; Adult ; Antibodies/blood/immunology ; Child ; DNA, Viral/analysis ; Female ; Human papillomavirus 11/genetics/immunology ; Human papillomavirus 6/genetics/immunology ; Humans ; Middle Aged ; Odds Ratio ; Papillomavirus Infections/diagnosis/*epidemiology ; Prevalence ; Republic of Korea/epidemiology ; Risk Factors ; Seroepidemiologic Studies ; Sexual Behavior ; Young Adult

BACKGROUND: Because of its protean clinical manifestations, diagnosis of acute myocarditis is quite limited unless proved by endomyocardial biospy. However endomyocardial biopsy is not always applicable in these patients. Neither there have been clear clinical criteria for diagnosis nor studies in regard to prognostic factors are available. We retrospectively evaluated clinical features and prognosis of patients with biopsy proven and/or clinically suspected acute myocarditis according to the status of the left ventricular systolic function. METHOD: Thirty six patients of acute myocarditis were enrolled. Eighteen patients were diagnosed by endomyocardial biopsy. We selected clinical diagnostic criteria for this disorder based on the clinicalpaboratory, echocardiographic and ECG findings obtained from this biopsy-proven acute myocarditis. Another 18 patients were selected matching these diagnostic criteria. We divided these thirty-six patients into two groups depending on the left ventricular systolic function : Group 1, EF(3)40(n=20); Group 2, EF<40(n=16). We compared clinical features and prognosis between the two groups. RESULTS: 1) The mean age of Group 1 was 39.7+/-13.6 years(male 12). The mean age of Group 2 was 34.0+/-14.7 years(male 11). Diastolic blood pressure at admission was significantly lower in Group 2 than in Group 1(82+/-10mmHg vs 67+/-15mmHg, p<0.05). 2) In transmitral Doppler findings, Group 1 had 4 patients(25%) with restrictive physiology while Group 2 had 12 patients(75%)(p<0.05). Global LV hypokinesia was more frequent in Group 2 than in Group 1(11/16(69%) vs 3/11(27%), p<(0.05). 3) During the follow up, there was no death in Group 1. But there were 5 deaths in Group 2. Three-year survival rate of Group 1 was better than that of Group 2(100% vs 75%, p<(0.05). In the eleven surviving patients in Group 2, seven patients(64%) showed recovery of the left ventricular systolic function. CONCLUSION: In acute myocarditis, patients who presented with depressed systolic function showed lower diastolic blood pressure at admission, more frequent occurrence of restrictive physiology, more global hypokinesia rather than regional asynergy, and poorer prognosis.
Biopsy ; Blood Pressure ; Diagnosis ; Echocardiography ; Electrocardiography ; Follow-Up Studies ; Humans ; Hypokinesia ; Myocarditis* ; Physiology ; Prognosis* ; Retrospective Studies ; Survival Rate ; Ventricular Function, Left*

BACKGROUND: The purpose of this study was to evaluate risk factors, angiographic characteristics and long-term prognosis of young adults with myocardial infarction(MI). METHODS: Of the 2,680 patients with a history of MI, there were 148 patients 40 years old(Group 1). Risk factors, angiographic characteristics, cardiac events and long-term prognosis of group 1 were compared with those of randomly selected 149 patients between 41 years to 70 years old(Group 2) for a mean follow-up duration of 38 months(1-147 months). Cardiac events include death, reinfarction, coronary artery bypass grafting, percutaneous transluminal coronary angioplasty, congestive heart failure, stroke, and angina. RESULTS: Smoker and male gender were more frequent in group 1(p<0.001). In group 2, hypertension and diabetes were more frequently observed(p<0.001). Angiographically normal coronary arteries, nonobstructive disease(<70% stenosis) and single-vessel disease were more frequent in group 1 than those in group 2 (p<0.001). There was no significant difference of overall survival at 7 years between the two groups(group 1; 95%, group 2; 89%, p>0.05). If hospital deaths were excluded, the 7-year survival was better in group 1(group 1; 99%, group 2; 92%, p<0.01). The cardiac event free survial at 7 years was not different between two groups(p>0.05). Although a better left ventricular(LV) systolic function (ejection fraction(EF) 40%) showed more favorable survival in group 2(EF40%: 94%, EF<40%: 80%, p<0.05), survival was not influenced by LV systolic function in group 1. CONCLUSION: Young patients with MI have a more favorable long-term survival after discharge compared with that of the older patients regardless of LV systolic function. Cardiac event free survival was, however, not different between two groups.
Adolescent ; Angioplasty, Balloon, Coronary ; Coronary Artery Bypass ; Coronary Vessels ; Disease-Free Survival ; Follow-Up Studies ; Heart Failure ; Humans ; Hypertension ; Male ; Myocardial Infarction* ; Prognosis ; Risk Factors ; Stroke ; Young Adult*