PURPOSE: Neuronal damage induced by febrile seizure(FS) has been implicated in the pathogenesis of medial temporal sclerosis, the pathologic hallmark of temporal lobe epilepsy. Recent data indicate that prolonged FSs induce transient structural changes of some hippocampal pyramidal neurons and long-term functional changes of hippocampal circuitry. In this study we have investigated the expression of brain-derived neurotrophic factor(BDNF) in the hippocampal formation after FSs with in situ hybridization histochemistry using riboprobe. METHODS: FSs were induced in 21 day-old male Sprague-Dawley rats(five rats for each group), which had a mean weight of about 100g. Exposure to hyperthermia was achieved by maintaining the water in the beaker at a temperature of 45 degrees C by pacing it in a temperature-controlled water bath. The rats were decapitated at appropriate times(0 hr, 30 min, 1 hr, 2 hr, 3hr, 6 hr, 12 hr and 24 hr) after FSs. In situ hybridization histochemistry was performed. The probe used in these studies were riboprobe complementary to the sequence 641-729 of rat BDNF. RESULTS: The induction of BDNF mRNA was observed in the dentate gyrus at 30 min after FSs. The expression in the dentate gyrus was gradually increased, peaked at 3 hr after FSs, and almost returned to basal level at 24 hr after FSs. The significant induction of BDNF mRNA was also observed in the CA3 area of hippocampus from 2 hr to 3 hr after FSs. CONCLUSION: These observations suggest that BDNF is the gene whose expression can be altered by FSs and these gene might be related to pathologic alterations after FSs.
Animals ; Baths ; Brain-Derived Neurotrophic Factor* ; Dentate Gyrus ; Epilepsy, Temporal Lobe ; Fever ; Hippocampus* ; Humans ; In Situ Hybridization ; Male ; Neurons ; Rats ; Rats, Sprague-Dawley ; RNA, Messenger* ; Sclerosis ; Seizures, Febrile* ; Water

Osseointegration ; Transplants ; Vertical Dimension

One of the most difficult problems to damage in dentistry is an odontogenic infection. These infections may range from low-grade, well-localized infections that require only minimal treatment to a severe, life-threatenig fascial space infection. Although the overwhelming majority of odontogenic infections are easily managed by minor surgical procedures and supportive medical therapy that includes antibiotic administration, the practitioner must constantly bear in mind that these infections may become severe in a very short time. We made an investigation was targeting on 78 male and 47 female patients (125 patients in total) who had been hospitalized because of the fascial space abscess on the oral and maxillofacial area and gained a complete recovery in Daegu Catholic University Hospital, Oral and Maxillofacial Surgery from January 1999 to December 2003. By tracing their charts, we could grasp the characteristics such as age, gender, the time of breakout and specific areas of the attacks, making a conclusive study of the statistical analysis and finally, we could reach conclusions. Now, we report the conclusion from the investigation with the literature. The proportion of males and females was approximately 3 to 2, and in age group, patients under 10 years old marked the highest, 22.4%. The patients between the age of 10 and 40 were only 14.4%, yet those who were between 40 and 80 marked 53.6% in contrast. In the monthly distribution, the order was Dec.(13.6%)-Sep.(12%)-Jan.(10.4%) and in seasonal distribution, it was winter(30.4%)-fall(28%)- summer(24.4%)- spring(19.2%). Considering the medical history, D.M. was the highest which was 30.3%, hypertension marked 24.4%, and the patients with both D.M. and hypertension were 9.0%. The major cause of infection of oral and maxillofacial areas was odontogenic infection, which marked about 96%, and especially the cases related to dental caries occurred most frequently, which was 51.2%. In the number of relaxed fascial space, single fascial space was 81.6%, and in the degree of relaxation of fascial space, the buccal space abscess marked 40.8%, following submandibular space abscess, which was 30.4%.
Abscess* ; Child ; Daegu ; Dental Caries ; Dentistry ; Female ; Hand Strength ; Humans ; Hypertension ; Inpatients* ; Male ; Relaxation ; Seasons ; Surgery, Oral ; Surgical Procedures, Minor

Pulmonary embolism is not a frequent cause of morbidity and mortality in patients with or without malignancies. Pulmonary embolism should be ruled out when sudden tachypnea and pulmonary hypertension develop in leukemic children, and chest radiograph shows no or minimal abnormalities. A 14-year-old girl with acute lymphoblastic leukemia was admitted due to neutropenic fever and dyspnea. Chest computed tomography and ventilation/perfusion scan showed pulmonary embolism, and embolectomy revealed aspergillosis. Invasive aspergillosis is the major opportunistic fungal pathogen in neutropenic patient and an important cause of death. The critical elements of successful management of invasive aspergillosis complicating neutropenia and pulmonary embolism are early diagnosis, initiation of aggressive doses of amphotericin B, reversal of immune suppression and feasible surgical resection of the lesions. To the best of our knowledge, this is the first report of pulmonary embolism caused by Aspergillus in an immunocompromised setting in Korea and we present a case report with a brief review.
Adolescent ; Amphotericin B ; Aspergillosis ; Aspergillus* ; Cause of Death ; Child* ; Dyspnea ; Early Diagnosis ; Embolectomy ; Female ; Fever ; Humans ; Hypertension, Pulmonary ; Korea ; Mortality ; Neutropenia ; Precursor Cell Lymphoblastic Leukemia-Lymphoma* ; Pulmonary Embolism* ; Radiography, Thoracic ; Tachypnea ; Thorax

BACKGROUND AND OBJECTIVES: Primary percutaneous coronary intervention (PCI) has been found to be superior, in terms of hospital mortality and long-term follow-up, compared with thrombolytic therapy for acute myocardial infarction (AMI). However, the clinical benefits of primary PCI have not been precisely evaluated in elderly patients. SUBJECTS AND METHODS: Two hundred and twenty three patients (Group I: n=66, age> or =75 years, Group II: n=157, age<75 years), who underwent primary PCI for AMI at Chonnam National University Hospital, between 2000 and 2002, were analyzed according to their clinical, angiographic characteristics, inhospital and one-year survival. RESULTS: Group I had a higher percentage of women (45.5% vs. 19.1%, p=0.00), multi-vessel disease (42% vs. 28%, p=0.031), right coronary artery disease (52% vs. 33%, p=0.021), and more frequent histories of diabetes mellitus (35% vs. 22%, p=0.039) and less smoking (38% vs. 60%, p=0.003) than Group II. Successful reperfusion by PCI was achieved in 97 and 96 %, respectively (p=NS). The rates of in-hospital mortality were similar in both groups (12.1% vs. 8.2%, p=NS). There were no significant differences in the major adverse cardiac events between the two groups during the one-year clinical follow-up (31.4 % vs. 36.9 %, p=NS). CONCLUSION: Primary PCI in AMI patients older than 75 years can be performed with comparable procedural success rates and long-term clinical outcomes to those of younger patients.
Aged ; Angioplasty ; Coronary Artery Disease ; Diabetes Mellitus ; Female ; Follow-Up Studies ; Hospital Mortality ; Humans ; Jeollanam-do ; Myocardial Infarction* ; Percutaneous Coronary Intervention* ; Reperfusion ; Smoke ; Smoking ; Thrombolytic Therapy

BACKGROUND: VRE have become an emerging nosocomial pathogen in Korea, but there has not been nationwide study on the colonization of VRE among high risk groups of hospitalized patients. The purpose of this study was to determine the prevalence of rectal colonization of VRE among patients hospitalized in the intensive care unit (ICU), to study the risk factors for nosocomial acquisition of VRE among those patients, to define the genetic diversity of VRE strains in major hospitals in Korea. METHODS: Between January the 20th and 30th of 2000, a point surveillance study was conducted in the ICU of the ten large hospitals, which were located nationwide. Surveillance rectal swab cultures for detecting VRE were obtained among 214 patients admitted to the ICU during the study period. To isolate VRE, rectal swab cultures were performed on Enterococcosel(R) agar that containing 6 microgram/mL of vancomycin. Minimal inhibitory concentrations (MICs) of vancomycin and teicoplanin were determined by agar dilution method. For the genotyping of VRE isolates, the detection of vanA, vanB, vanC1 and vanC2 gene by polymerase chain reaction was done. Pulsed-field gel electrophoreis (PFGE) was used for elucidating the genetic relatedness of VRE isolates. To identify the risk factors for rectal VRE colonization, patients harboring VRE were compared to patients who were not colonized with this organism. RESULTS: The rectal colonization rate of VRE was variable from 9.7% to 51.9% according to hospital. 64 VRE strains which were isolated from 63 patients included 37 E. feacium. 26 E. gallinarum and 1 E. casseliflavus isolates. Therefore the colonization rate of clinically significant vanA type VRE was 17.3% (37/ 214). 37 E. feacium. 26 E. gallinarum and 1 E. casseliflavus isolates were presented as vanA, vanC1 and vanC2 genotypes, respectively. Risk factors for rectal VRE colonization included the presence of chronic illness, previous use of broad spectrum antibioitcs es-pecillay vancomycin, and prolonged stay in ICU. Various PFGE patterns are noted among vanA type VRE isolates, so individual acquisition of VRE during stay in the majority of ICUs were suggested. But there is some evidence of focal VRE spread within the ICU and between hospitals. CONCLUSION: This study demonstrated the high rectal colonization rate (17.3%) of clinically significant vanA type VRE among patients admitted to the ICUs of ten large hospitals located nation-widely. This study suggested that practicing HICPAC guidelines, restricted vancomycin usage and periodic surveillance cultures in patients with high risk factors are important in preventing the emergence and spread of VRE infection among ICU patients.
Agar ; Chronic Disease ; Colon* ; Genetic Variation* ; Genotype ; Humans ; Intensive Care Units ; Korea* ; Polymerase Chain Reaction ; Prevalence ; Risk Factors* ; Teicoplanin ; Vancomycin

Background: Remdesivir is widely used for the treatment of coronavirus disease 2019 (COVID-19), but controversies regarding its efficacy still remain. Methods: A retrospective cohort study was conducted to evaluate the effect of remdesivir on clinical and virologic outcomes of severe COVID-19 patients from June to July 2020. Primary clinical endpoints included clinical recovery, additional mechanical ventilator (MV) support, and duration of oxygen or MV support. Viral load reduction by hospital day (HD) 15 was evaluated by calculating changes in cycle threshold (Ct) values. Results: A total of 86 severe COVID-19 patients were evaluated including 48 remdesivirtreated patients. Baseline characteristics were not significantly different between the two groups. Remdesivir was administered an average of 7.42 days from symptom onset. The proportions of clinical recovery of the remdesivir and supportive care group at HD 14 (56.3% and 39.5%) and HD 28 (87.5% and 78.9%) were not statistically different. The proportion of patients requiring MV support by HD 28 was significantly lower in the remdesivir group than in the supportive care group (22.9% vs. 44.7%, P = 0.032), and MV duration was significantly shorter in the remdesivir group (average, 1.97 vs. 5.37 days; P = 0.017). Analysis of upper respiratory tract specimens demonstrated that increases of Ct value from HD 1–5 to 11–15 were significantly greater in the remdesivir group than the supportive care group (average, 10.19 vs. 5.36; P = 0.007), and the slope of the Ct value increase was also significantly steeper in the remdesivir group (average, 5.10 vs. 2.68; P = 0.007). Conclusion The remdesivir group showed clinical and virologic benefit in terms of MV requirement and viral load reduction, supporting remdesivir treatment for severe COVID-19.

Background: Remdesivir is widely used for the treatment of coronavirus disease 2019 (COVID-19), but controversies regarding its efficacy still remain. Methods: A retrospective cohort study was conducted to evaluate the effect of remdesivir on clinical and virologic outcomes of severe COVID-19 patients from June to July 2020. Primary clinical endpoints included clinical recovery, additional mechanical ventilator (MV) support, and duration of oxygen or MV support. Viral load reduction by hospital day (HD) 15 was evaluated by calculating changes in cycle threshold (Ct) values. Results: A total of 86 severe COVID-19 patients were evaluated including 48 remdesivirtreated patients. Baseline characteristics were not significantly different between the two groups. Remdesivir was administered an average of 7.42 days from symptom onset. The proportions of clinical recovery of the remdesivir and supportive care group at HD 14 (56.3% and 39.5%) and HD 28 (87.5% and 78.9%) were not statistically different. The proportion of patients requiring MV support by HD 28 was significantly lower in the remdesivir group than in the supportive care group (22.9% vs. 44.7%, P = 0.032), and MV duration was significantly shorter in the remdesivir group (average, 1.97 vs. 5.37 days; P = 0.017). Analysis of upper respiratory tract specimens demonstrated that increases of Ct value from HD 1–5 to 11–15 were significantly greater in the remdesivir group than the supportive care group (average, 10.19 vs. 5.36; P = 0.007), and the slope of the Ct value increase was also significantly steeper in the remdesivir group (average, 5.10 vs. 2.68; P = 0.007). Conclusion The remdesivir group showed clinical and virologic benefit in terms of MV requirement and viral load reduction, supporting remdesivir treatment for severe COVID-19.