PURPOSE: Vascular smooth muscle cells (VSMCs) migration and proliferation are important for neointimal formation after arterial injury. Migration of VSMCs requires degradation of basement membrane and extracelluar matrix surrounding the cell, and there is increasing evidence that VSMCs produce extracelluar matrix-degradating proteinases, such as matrix metalloproteinases (MMPs) after arterial injury. To assess the role of MMPs in VSMCs proliferation, migration and intimal thickening, we measured the expression of MMP-2 and MMP-9 in the balloon-injured rat aorta model. METHOD: Twenty-five male Sprague-Dawley rats weighting of 250~300 gm were underwent aortic intimal denudation with 2F balloon catheter. Aorta was harvested at various time intervals of 1, 3, 5, 7, 21 days and then analyzed the MMP expression used by gelatin zymography. Intimal hyperplasia caused by balloon injury was confirmed by microscopic examination. RESULT: MMP-2 (72 kD) was constitutively expressed in the normal aorta and was not increased substantially after injury. But the expression of 62 kd forms, which is activated form of MMP-2, was significantly increased during the period of 5 through 7 days after injury (P<0.05). The expression of MMP-9 (92 kD) was significantly increased at 1st day after injury and diminished thereafter (P<0.05). CONCLUSION: These results suggest that activated MMP-2 (62 kD) and MMP-9 (92 kD) may play an important role in VSMCs migration and formation of intimal hyperplasia after arterial injury. And the activated form of MMP-2 (62 kD) seems to be involved mainly in degradation of basement membrane and matrix.
Animals ; Aorta* ; Basement Membrane ; Catheters ; Gelatin ; Humans ; Hyperplasia* ; Male ; Matrix Metalloproteinases* ; Muscle, Smooth, Vascular ; Peptide Hydrolases ; Rats* ; Rats, Sprague-Dawley

Purpose: Liver transplantation (LT) is now considered as a standard treatment modality for patients with end-stage liver disease. The number of patients waiting for liver graft is continuosly increasing as there is a shortage of brain-dead donors, living donor liver transplantation has been regarded as an alternative. Furthermore, China where donors are more readily available is quickly growing as a place to travel for transplantation. Methods: Twenty-eight patients who were on follow up after LT in China were enrolled. Pre-transplantation state of donors and recipients, surgical problems at the time of arrival, and complications that were detected on follow up were evaluated and analyzed. Results: All patients did not have the information of donors and knowledge of their transplanted state. All patients were received conventional deceased donor LT and the type of duct anastomosis was duct to duct technique. Hepatitis B virus (HBV) recurrence was detected in two patients, various prophylaxes were used, and inappropriate modalities were detected. Biliary complications occurred in 6 patients, who were treated with percutanous or endoscopic method. There were 5 patients mortalities: 3 patient-hepatocellular carcinoma recurrence, 1- post-transplant lymphoproliferative disease, 1-cardiac arrhythmia after retransplantation. Conclusion: The shortage of deceased donor resulted in more and more travel to China for liver transplantation. However, we have problems to solve: lack of donor information, insufficient techniques of transplantation, inappropriate post-transplantation care, and lack of education for immunosuppression and prophylaxis of HBV recurrence. In addition, the efforts to increase donations should be continued.
Arrhythmias, Cardiac ; China* ; Education ; Follow-Up Studies ; Hepatitis B virus ; Humans ; Immunosuppression ; Liver Diseases ; Liver Transplantation* ; Liver* ; Living Donors ; Mortality ; Recurrence ; Tissue Donors ; Transplants

No abstract available.
Leukemia, Myelomonocytic, Acute* ; Skin*

No abstract available.
Leukemia, Myelomonocytic, Acute* ; Skin*

Haemophilus aphrophilus, a fastidious, gram-negative oropharyngeal species grouped as a HACEK organism, is a rare cause of infective endocarditis. Three cases of endocarditis with Haemophilus aphrophilus were reported in Korea, and all of them required valve replacement surgery. We describe a case of native valve infective endocarditis with cerebral embolism and infarction caused by Haemophilus aphrophilus in a 61-year-old woman who was successfully treated with antibiotic therapy for 6 weeks without valve replacement surgery.
Embolism ; Endocarditis ; Female ; Haemophilus ; Humans ; Infarction ; Intracranial Embolism ; Korea ; Middle Aged

Coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus-2 not yet has established its treatment, but convalescent plasma has been expected to increase survival rates as in the case with other emerging viral infections. We describe two cases of COVID-19 treated with convalescent plasma infusion. Both patients presented severe pneumonia with acute respiratory distress syndrome and showed a favorable outcome after the use of convalescent plasma in addition to systemic corticosteroid. To our knowledge, this is the first report of the use of convalescent plasma therapy for COVID-19 in Korea.

Metabolic syndrome is an important long term complication in chronic asymptomatic HIV-infected subjects under highly active antiretroviral therapy (HAART), because it can contribute to morbidity and mortality via cardiovascular disease (CVD). Therefore, a predictive marker for early detection of metabolic syndrome may be necessary to prevent CVD in HIV-infected subjects. Retinol-binding protein-4 (RBP-4) has been shown to be associated with metabolic syndrome in various non-HIV-infected populations. We performed a cross-sectional study to evaluate whether serum RBP-4 levels are correlated with metabolic syndrome in HIV-infected subjects receiving HAART. In total, 98 HIV-infected Koreans who had been receiving HAART for at least 6 months were prospectively enrolled. Metabolic syndrome was diagnosed according to the Adult Treatment Panel III criteria, and serum RBP-4 concentrations were measured using human RBP-4 sandwich enzyme-linked immunosorbent assay. Serum RBP-4 levels were significantly higher in HIV-infected subjects receiving HAART with metabolic syndrome (n=33, 33.9+/-7.7 microg/mL) than in those without it (n=65, 29.9+/-7.2 microg/mL) (p=0.012). In multivariate linear regression analysis, the number of components of metabolic syndrome presented and waist circumference were independently, significantly correlated with RBP-4 (p=0.018 and 0.030, respectively). In conclusion, we revealed a strong correlation between RBP-4 and the number of components of metabolic syndrome in HIV-infected subjects receiving HAART.
Adult ; *Antiretroviral Therapy, Highly Active ; Enzyme-Linked Immunosorbent Assay ; Female ; HIV Infections/*blood/*drug therapy ; Humans ; Male ; Metabolic Syndrome X/*blood/*drug therapy ; Middle Aged ; Retinol-Binding Proteins, Plasma/*metabolism

PURPOSE: To identify the clinical features and outcomes of endogenous endophthalmitis in Korea. MATERIALS AND METHODS: We reviewed 18 patients with endogenous endophthalmitis at 2 Korean hospitals, treated over a 14 year period between January 1993 and December 2006. RESULTS: The comorbidities observed in these cases were diabetes mellitus and liver cirrhosis. The most common pathogens, which were found in 7 patients each (38.9%), were Klebsiella pneumonia and Pseudomonas aeruginosa. All patients were treated with systemic antibiotics and fortified topical antibiotics. A surgical approach including vitrectomy was performed in 9 cases (50.0%). The prognosis was generally poor, and visual acuity improved slightly in 6 patients (33.3%). CONCLUSION: In this study, diabetes mellitus and Klebsiella pneumonia showed a close relationship with endogenous endophthalmitis, respectively. Endogenous endophthalmitis is a serious risk to sight and careful attention to establishing the diagnosis and management may decrease the ocular morbidity.
Aged ; Diabetes Complications/*epidemiology/microbiology ; Endophthalmitis/complications/*epidemiology/microbiology ; Female ; Humans ; Incidence ; Klebsiella pneumoniae/isolation & purification ; Liver Cirrhosis/*complications/epidemiology/microbiology ; Male ; Middle Aged ; Pseudomonas aeruginosa/isolation & purification ; Republic of Korea/epidemiology ; Retrospective Studies

Achromobacter xylosoxidans is an uncommon cause of peritonitis in patients on maintenance continuous ambulatory peritoneal dialysis (CAPD). CAPD peritonitis caused by Achromobacter xylosoxidans carries high mortality and recurrence rates because of its virulence and resistance to most antimicrobial agents. We experienced a case of CAPD peritonitis caused by Achromobacter xylosoxidans in a patient with hypertension, diabetes mellitus, and end stage renal disease. The patient was treated with intravenous imipenem/cilastatin, and the CAPD catheter was removed. However, the patient died by aspiration pneumonia on the 34th day of hospitalization.
Achromobacter ; Achromobacter denitrificans ; Anti-Infective Agents ; Catheters ; Diabetes Mellitus ; Hospitalization ; Humans ; Hypertension ; Kidney Failure, Chronic ; Peritoneal Dialysis, Continuous Ambulatory ; Peritonitis ; Pneumonia, Aspiration ; Recurrence

PURPOSE: To investigate different emergency medical centers' (EMCs) preparedness for a biological disaster in Korea. METHODS: A survey of 120 EMCs in Korea was done through questionnaire. We examined facilities, equipments and supplies, and emergency personnel training and drill. RESULTS: Ninety (75%) EMCs participated in the survey. Sixteen were from regional/specialized EMCs and 74 were from local EMCs. The median for the number of staffed beds were 680(range, 200~2200) and the median for patient visits were 73(range, 24~210) per day. Ten(11%) of the 90 participating EMCs had personal protective equipments (PPEs); 7(8%) had wet decontamination units; 11(12%) had independent ventilation systems; 15(17%) had mechanical ventilator; 9(10%) had life lines; 39(43%) had alternative care sites and none (0%) had triage tag with presence of contamination. At least one drill was conducted annually in 11(12%). When the availability of resources needed in a biological disaster between regional/specialized EMCs and local EMCs were compared, the regional/specialized EMCs had PPEs(38% vs. 5%, p<0.01), wet decontamination unit(44% vs. 0%, p<0.01), independent ventilation systems (31% vs. 8%, p<0.05), and drills (38% vs. 7%, p<0.01) more frequently than local EMCs. Approximately 70% of the respondents attributed the above passive preparedness results from a lack of budget and the notion that only the minimum preparedness is necessary for the possibility of a biological disaster. Also, half of the respondents agreed that new infectious diseases will occur with a possibility of more than 50% in the future. CONCLUSION: Our data indicated that preparedness of EMCs for a biological disaster in Korea was low. Therefore, we should develop comprehensive plans to remedy the identified deficiencies.
Biological Warfare ; Budgets ; Civil Defense ; Communicable Diseases ; Surveys and Questionnaires ; Decontamination ; Disaster Planning ; Disasters ; Emergencies ; Equipment and Supplies ; Humans ; Korea ; Mandrillus ; Triage ; Ventilation