No abstract available.
Meconium* ; Peritonitis*

BACKGROUND: Rapid and accurate identification of Mycobacterium tuberculosis complex is important in the diagnosis, treatment, and assessment of prognosis of tuberculosis. But, the conventional identification procedures such as niacin test usually requires considerable time. In this study, we compared the diagnostic value of a gene probe method with that of the niacin test for the differentiation of M. tuberculosis complex from mycobacteria other than tuberculosis (MOTT). METHODS: Commercially available gene probe kit(AccuProbeTM, Gen-Probe, Inc. , San Diego, Calif.) and Niacin test strip were used to identify 78 strains of mycobacteria isolated from patients at Asan Medical Center. One ATCC strain (M. tuberculosis complex) and one MOTT strain were used as controls. Polymerase chain reaction(PCR) was used when the above two tests yielded discordant results. RESULTS: Fifty isolates were identified as M. tuberculosis complex by both gene probe method and niacin test. Likewise 25 isolates were identified as MOTT by the both methods. For the remaining 5 isolates, the results of the two tests differed from each other: M. tuberculosis complex by gene probe and MOTT by niacin test. By PCR, however. these strains were identified as M. tuberculosis. The time required for identification was 1 to 2 hours by gene probe method and 1 to 3 weeks by niacin test. CONCLUSION: Gene probe is simple, rapid and reliable and is a very practical diagnostic tool that can be used in any clinical laboratory.
Chungcheongnam-do ; Diagnosis ; Genes, vif* ; Humans ; Mycobacterium tuberculosis* ; Mycobacterium* ; Niacin ; Polymerase Chain Reaction ; Prognosis ; Tuberculosis

Primary aortoenteric fistulae (AEFs) are extremely rare vascular disease entities, with a mortality ranging from 33 to 85%. Only two cases of Salmonella mycotic aortic aneurysms causing primary AEFs have been reported. We experienced a rare case of a 57-year-old man with intermittent gastrointestinal bleeds and who was diagnosed as having primary aortoenteric fistula with abdominal aortic aneurysm, confirmed by CT. In the operation room, the fistula was closed and a temporary proximal duodenojejunostomy was created. The aneurysm was replaced with an aorto-biiliac bypass using Dacron Graft with an inter-positioning omental flap. The microbiology report of aneurysm wall, blood and periaortic tissue showed infection with group D salmonella. He was treated with ciprofloxacin and discharged in good general condition on the 21st post-operative day.
Aneurysm ; Aortic Aneurysm* ; Aortic Aneurysm, Abdominal ; Ciprofloxacin ; Fistula* ; Humans ; Middle Aged ; Mortality ; Polyethylene Terephthalates ; Salmonella* ; Transplants ; Vascular Diseases

Nitric oxide synthases (NOSs) that catalyzed the conversion of L-arginine to nitric oxide and L-citrulline play a role in ischemic-reperfusion injury. The purpose of this study was to observe the expression patterns of nNOS, iNOS and eNOS in the rat tibialis anterior and soleus muscles after multiple cyclic episodes of ischemic preconditioning (IP). Nine weeks old male SD rats were divided into control and IP groups. The IP group was further divided into 3 groups based on cycle of IP. For IP, left commom iliac artery was occluded 3, 6 and 10 times for 5 minutes ischemia followed by 5 minutes reperfusion using rodent vascular clamps. The animals were sacrificed at 0, 3, 6, 24 and 72 hours of reperfusion and the left tibialis anterior and soleus muscles were removed. The expression of nNOS, iNOS and eNOS were examined with immunohistochemical methods and Western blot analysis. IP increased the expression of nNOS, compared with the control. In the tibialis anterior muscle, the levels of nNOS in the 3IP and 6IP were higher than that in 10IP. IP increased the expression of iNOS, compared with the control, and the levels of iNOS in tibialis anterior muscle were higher than that in soleus muscle. The level of iNOS in the 10IP was higher than those in the 3IP and 6IP. IP increased the expression of eNOS, compared with the control, and the level of eNOS in soleus muscle were higher than that in tibialis anterior muscle. At 0 and 3 hours after reperfusion, the level of eNOS in 6IP and 10IP were higer than that in 3IP. In summary, these results suggest that the ischemic preconditioning increases the expression of nNOS, iNOS and eNOS, and 10 times of ischemic preconditioning may induce ischemic injury through upregulation of iNOS. And tibialis anterior muscle is more susceptabile to ischemic injury than soleus muscle.
Animals ; Arginine ; Blotting, Western ; Humans ; Iliac Artery ; Ischemia ; Ischemic Preconditioning* ; Male ; Muscle, Skeletal ; Muscles* ; Nitric Oxide Synthase* ; Nitric Oxide* ; Rats* ; Reperfusion ; Rodentia ; Up-Regulation

The ischemic preconditioning was initially identified as a protective maneuver induced by brief periods of ischemia followed by reperfusion. Although ischemic preconditioning can reduce ischemic injury of heart, skeletal muscle and neuronal tissue, it's protective mechanism remains elusive. Recently, several investigations suggest the associations of nitric oxide with protection from ischemic injury. Nitric oxide synthesized by a member of nitric oxide synthase (NOS) family has been known to increase or decrease the ischemic injury. The purpose of this study was to observe the expression patterns of NOS 1, NOS 2 and NOS 3 in the rat skeletal muscle after cyclic episodes of short ischemia and reperfusion. Nine and thirty-five weeks-old male Sprague-Dawley rats were divided into control and cyclic short ischemia and reperfusion groups. The experimental group was further divided into 3 groups based on cycles of short ischemia and reperfusion. For cyclic short ischemia and reperfusion, left commom iliac artery was occluded 3, 6 and 10 times for 5 minutes ischemia followed by 5 minutes reperfusion using rodent vascular clamps. The animals were sacrificed at hours 0, 3, 6, 24 and 72 after reperfusion and the left rectus femoris muscles were removed. The expression profiles and distribution of NOS 1, NOS 2 and NOS 3 were examined with immunohistochemical staining. The results were as follows; In the cyclic of short ischemia and reperfusion groups, the mortality was increased with increasing of cyclic episodes at 72 hours after reperfusion, and aging. In the control group, NOS 1, NOS 2 and NOS 3 immunoreactivities showed no differenes with aging. In the 9 weeks-old rats, NOS 1 immunoreactivities were observed moderate at 24 hours after 6 times of short ischemia and reperfusion, and moderate and strong at 24 hours after 10 times of short ischemia and reperfusion. In the 35 weeks-old rats, NOS 1 immunoreactivities were observed trace or mild at 24 hours after 6 and 10 times of short ischemia and reperfusion. At 3 hours after 3 times of short ischemia and reperfusion, NOS 2 immunoreactivities were observed moderate or strong, and trace in the 9 and 35 weeks-old rats, respectively. At 3 hours after 10 times of short ischemia and reperfusion, NOS 3 immunoreactivities were observed mild or moderate, and trace or negative in the 9 and 35 weeks-old rats, respectively. In summary, the expression profile of NOS 1, NOS 2 and NOS 3 were observed differently with increasing episodes of short ischemia and reperfusion. The alteration was the most prominent in NOS 3 than in NOS 1 and NOS 2. These results suggest that the alteration of NOS 3 known to protect tissue against ischemic injury may be associated with increasing mortality after multiple episodes of short ischemia and reperfusion.
Aging ; Animals ; Heart ; Humans ; Iliac Artery ; Ischemia* ; Ischemic Preconditioning ; Male ; Mortality ; Muscle, Skeletal* ; Muscles ; Neurons ; Nitric Oxide Synthase ; Nitric Oxide* ; Quadriceps Muscle ; Rats* ; Rats, Sprague-Dawley ; Reperfusion* ; Rodentia

OBJECTIVES: Aneurysms of the anterior cerebral circulation are usually found on the anterior communicating artery (ACoA) or peripheral portion (A2) of the anterior cerebral artery (ACA). Infrequently, they are found on proximal segment (A1) of the ACA. These are presented 0.88-2.1% of all intracranial aneurysm cases. There are few describing a series of patient with A1 aneurysms. In this report, we present our surgical experience of the 27 A1 aneurysms. MATERIAL AND METHODS: 27 patients with aneurysm of proximal segment of anterior cerebral artery were operated on between January 1983 and September 2004. Retrospective analysis of clinical characteristics, radiologic findings, operation method, clinical outcomes and complications were performed. RESULTS: 27 patients with aneurysm of proximal segment of anterior cerebral artery, male was 11 cases, female was 16 cases. Relatively, predominantly occurred in female. In preoperative Hunt-Hess grade (H-H grade) of the patient, H-H grade I was 10, gradeII in 13, grade III in 3, grade IV in 1 case. In CT findings, 23 cases presented only SAH, SAH and ICH in 4, accompanying hydrocephalus in 3 cases. In angiographics and surgical findings, according to aneurysm site, proximal type was 9 cases, middle type in 8, distal type in 10 cases, and compared with each clinical outcomes. In 9 patients, aneurysms was found in right side and 7 patients of these had favorable outcomes. In left side, 12 of 18 patients had favorable outcomes. Postoperative complication occurred in 8 cases, postoperative infarction in 3 case. vasospasm in 4 cases, hydrocephalus, meningitis in 4 cases. 5 patients had multiple aneurysms. In 2 cases of these, A1 aneurysm was ruptured. In 3 cases, other aneurysm was ruptured and A1 aneurysm was incidental finding. In total 27 patients, 19 patients had favorable outcomes and unfavorable outcomes in 8. CONCLUSION: Aneurysms of proximal segment (A1) of the anterior cerebral artery occur very infrequently and in this report, These are presented 3.9% (27 out of 680) in anterior cerebral artery aneurysms. 19 patients underwent direct surgery had good outcomes after the surgery. As causes of unfavorable outcomes, poor preoperative general condition, injury of perforating artery during operation and vasospasm. Comparison with other aneurysms, relative good outcomes can be obtained by direct surgery.
Aneurysm* ; Angiography ; Anterior Cerebral Artery* ; Arteries ; Female ; Humans ; Hydrocephalus ; Incidental Findings ; Infarction ; Intracranial Aneurysm ; Male ; Meningitis ; Postoperative Complications ; Retrospective Studies

OBJECTIVES: Aneurysms of the anterior cerebral circulation are usually found on the anterior communicating artery (ACoA) or peripheral portion (A2) of the anterior cerebral artery (ACA). Infrequently, they are found on proximal segment (A1) of the ACA. These are presented 0.88-2.1% of all intracranial aneurysm cases. There are few describing a series of patient with A1 aneurysms. In this report, we present our surgical experience of the 27 A1 aneurysms. MATERIAL AND METHODS: 27 patients with aneurysm of proximal segment of anterior cerebral artery were operated on between January 1983 and September 2004. Retrospective analysis of clinical characteristics, radiologic findings, operation method, clinical outcomes and complications were performed. RESULTS: 27 patients with aneurysm of proximal segment of anterior cerebral artery, male was 11 cases, female was 16 cases. Relatively, predominantly occurred in female. In preoperative Hunt-Hess grade (H-H grade) of the patient, H-H grade I was 10, gradeII in 13, grade III in 3, grade IV in 1 case. In CT findings, 23 cases presented only SAH, SAH and ICH in 4, accompanying hydrocephalus in 3 cases. In angiographics and surgical findings, according to aneurysm site, proximal type was 9 cases, middle type in 8, distal type in 10 cases, and compared with each clinical outcomes. In 9 patients, aneurysms was found in right side and 7 patients of these had favorable outcomes. In left side, 12 of 18 patients had favorable outcomes. Postoperative complication occurred in 8 cases, postoperative infarction in 3 case. vasospasm in 4 cases, hydrocephalus, meningitis in 4 cases. 5 patients had multiple aneurysms. In 2 cases of these, A1 aneurysm was ruptured. In 3 cases, other aneurysm was ruptured and A1 aneurysm was incidental finding. In total 27 patients, 19 patients had favorable outcomes and unfavorable outcomes in 8. CONCLUSION: Aneurysms of proximal segment (A1) of the anterior cerebral artery occur very infrequently and in this report, These are presented 3.9% (27 out of 680) in anterior cerebral artery aneurysms. 19 patients underwent direct surgery had good outcomes after the surgery. As causes of unfavorable outcomes, poor preoperative general condition, injury of perforating artery during operation and vasospasm. Comparison with other aneurysms, relative good outcomes can be obtained by direct surgery.
Aneurysm* ; Angiography ; Anterior Cerebral Artery* ; Arteries ; Female ; Humans ; Hydrocephalus ; Incidental Findings ; Infarction ; Intracranial Aneurysm ; Male ; Meningitis ; Postoperative Complications ; Retrospective Studies

BACKGROUNDS/AIMS: The epidemiology of hepatitis A is associated with socioeconomic and hygiene status. Recently, the prevalence of hepatitis A in young adults has been steadily increasing in Korea. This study is to investigate the age-specific seroprevalence of hepatitis A virus in Korea. METHODS: Stored sera from 250 healthy adult subjects who visited the health promotion center in Samsung Medical Center between July and August 2006 were tested for IgG hepatitis A virus antibody (anti-HAV). RESULTS: The prevalence of anti-HAV was 2%, 72%, 92%, 94%, 100% in 20's, 30's, 40's, 50's, and 60's, respectively. The prevalence of anti-HAV was significantly lower in subjects below age 40 compared to those above 40 (37.0% vs. 95.3%, p<0.001). The seroprevalence was higher in area outside of Seoul compared to those living in Seoul in age group below 40 (25.6% vs. 55.6%, p=0.01). In Seoul area, the prevalence was significantly lower in Kangnam-Gu, Seocho-Gu, and Songpa-Gu district compared to the other areas of Seoul in the age group below 40 (20.0% vs. 42.1%, p<0.05). CONCLUSION: The seroprevalence of hepatitis A virus antibody in Korean population below 40 is quite low and immunity to hepatitis A virus in those subjects can be a public health issue. In view of changing seroepidemiology, a policy for hepatitis A vaccination in population below 40 might be warranted.
Adult ; Age Factors ; Aged ; Demography ; Female ; Hepatitis A/prevention & control ; Hepatitis A Antibodies/*blood ; Hepatitis A Virus, Human/*immunology ; Humans ; Korea ; Male ; Middle Aged ; Seroepidemiologic Studies

The author surveyed overall obesity indicies and factors concerned with obesity such as dietary intake, physical activity, stress and life style with the subject of doctors. The number of subjects was total 508 with 396 men and 112 women. They were subgrouped into surgical part, medical part and service and basic part by speciality. And also subgrouped into intern and resident, pay doctor, and practitioner by working type. The results were as follows. 1) Obesity indices: BMI of total doctor was 23.1+/-2.8, and WHR was 0.87+/-0.08 and overweight prevalence(BMI>25.0) was 23.6 %. It was within normal limit but slightly over the Korean standard. The degree of obesity indices of subgroups by speciality was "surgical part > medical part > service and basic part", and by working type was "practitioner > pay doctor > intern and resident". 2) Dietary intake and Physical activity: Average dietary intake was 2148+/-451 kcal/day. The degree of dietary intake by speciality was "surgical part > medical part > service and basic part". By working type it was "practitioner > pay doctor > intern and resident". Average physical activity was 29+/-5 METs/day. The degree of physical activity also showed similar pattern. But there was no significant difference among each groups. 3) Comparison between over-weight and non-over-weight group: The items that showed significant difference between two groups were dietary intake, skip breakfast, regular exercise, smoking, heavy drinking, chronic disease etc.
Breakfast ; Chronic Disease ; Drinking ; Female ; Humans ; Life Style ; Male ; Motor Activity ; Obesity* ; Overweight ; Smoke ; Smoking

BACKGROUND: Gallbladder (GB) polyps are now increasingly detected by ultrasonography. We investigated the prevalence and risk factors of GB polyps in health screening population. METHODS: An ultrasonographic study of GB polyps were conducted in 35,012 subjects who received a paid health screening examination at Samsung Medical Center. Controls, twice the subjects with GB polyp, were randomly selected from the cases with normal GB. The demographic characteristics and biochemical parameters were recorded. RESULTS: The overall prevalence of GB polyps was 2.94% (1,330/15,573). Among them, 3.63% were men, 2.09% were women. In both males and females, the prevalence was highest in their 40s. The diameter of GB polyps ranged from 2 mm to 20 mm (mean 4.5 mm). Most polyps (98.3%) were less than 10 mm in diameter. Of 1,030 subjects, 64% had a single polyp and 36% had multiple polyps. Multiple logistic regression, with reference group of body mass index (BMI, <22.5 kg/m2), showed odds ratio of 1.074 and 1.864 for BMI groups of 22.5-24.9 and 25 or more respectively. In contrast, other demographic characteristics and biochemical parameters, such as age, smoking, alcohol use, glucose, liver function tests, lipid profiles and HBsAg carriage were lack of any relation to GB polyps. CONCLUSIONS: GB polyps are not likely to be rare in Korean adults despite their low prevalence compared to other reports. The body mass index may be a risk factor for GB polyps.
Adult ; Body Mass Index ; Female ; Gallbladder* ; Glucose ; Hepatitis B Surface Antigens ; Humans ; Liver Function Tests ; Logistic Models ; Male ; Mass Screening* ; Odds Ratio ; Polyps* ; Prevalence* ; Risk Factors* ; Smoke ; Smoking ; Ultrasonography