No abstract available.
Polycystic Kidney Diseases* ; Ultrasonography*

No abstract available.
Gardnerella vaginalis* ; Gardnerella*

BACKGROUND: Paradoxical embolism through the patent foramen ovale (PFO) is a well-recognized mechanism for otherwise unexplained ischemic stroke. Although transthoracic contrast echocardiography (TCE) has been used frequently for noninvasive diagnosis of right to left shunt through PFO, its diagnostic accuracy appears limited, especially in patients with poor acoustic window. Since harmonic imaging (HI) can enhance the definition of contrast microbubbles, theoretical advantages of HI in the detection of right to left shunt through PFO using microbubbles can be considered. However, there are few data regarding the diagnostic efficacy of HI in the detection of right to left shunt through PFO. The purpose of this study was to compare the diagnostic value of transthoracic HI in the detection of right to left shunt through PFO in patients with stroke with that of fundamental imaging (FI). Methods: One hundred thirty-six consecutive patients with stroke (82 male, mean age:9) underwent TCE in both HI and FI and transesophageal echocardiography (TEE) during rest and Valsalva maneuver with intravenous administration of agitated saline. PFO was judged to be present if microbubbles appeared in the left atrium within 3 cardiac cycles of their appearance in the right atrium. TEE was regarded as the gold standard for assessing the diagnostic accuracy of TCE. Results: Right to left shunt through PFO was detected in 40 of 136 patients by TEE (29.4%). FI of TCE detected shunt through PFO in only 9 of 136 patients (6.6%). In contrast, HI detected shunt through PFO in 25 of 136 patients (18.4%). The overall sensitivity and specificity of FI and HI for detection of right to left shunt through PFO were 22.5%, 62.5% (p<0.05) and 100%, 100%, respectively. Valsalva maneuver during HI significantly increased the detection rate of shunt through PFO (during rest in 9 and during Valsalva maneuver in 25, p<0.05). CONCLUSION: HI with contrast microbubble injection significantly enhanced the detection of right to left shunt through PFO in patients with ischemic stroke compared with FI by transthoracic approach.
Acoustics ; Administration, Intravenous ; Diagnosis ; Dihydroergotamine ; Echocardiography* ; Echocardiography, Transesophageal ; Embolism, Paradoxical ; Foramen Ovale, Patent* ; Heart Atria ; Humans ; Male ; Microbubbles ; Sensitivity and Specificity ; Stroke ; Valsalva Maneuver

PURPOSE: To evaluate the function of Trp-Lys-Tyr-Met-Val-D-Met (WKYMVm) in human neonatal monocytes. METHODS: The peptide, Trp-Lys-Tyr-Met-Val-D-Met (WKYMVm), was synthesized, purified, and prepared in the Peptide Library Support Facility at Pohang University of Science and Technology. Female Sprague-Dawley rats (200+/-10 g) were preinfected with S. aureus and treated with WKYMVm through femoral vein. At various time points, blood samples were obtained by puncture of femoral artery and the serum was plated on the nutrient agar plate. The number of viable bacteria was determined by counting the number of bacterial colonies. In addition, using S. aureus and C. albicans, we evaluated the bactericidal and fungicidal activities of neonatal monocytes, which were separated from umbilical cord blood by Ficoll gradient. RESULTS: The numbers of bacteria in the blood of WKYMVm-treated rats were rapidly decreased with time, as compared with those of the untreated rats. The peptide treatment enhanced the bactericidal activity in vivo within 10 minutes. In neonatal monocytes, WKYMVm stimulated the intracellular killing of S. aureus in a dose dependent manner, showing the maximum effect at 100 nM. WKYMVm stimulated the phagocytic and fungicidal activities against C. albicans in a dose dependent manner, with the maximum effect at the 100 nM. CONCLUSION: These results suggest that WKYMVm may be an effective agent against the neonatal infections.
Agar ; Animals ; Bacteria ; Female ; Femoral Artery ; Femoral Vein ; Fetal Blood ; Ficoll ; Gyeongsangbuk-do ; Homicide ; Humans ; Monocytes* ; Peptide Library ; Punctures ; Rats ; Rats, Sprague-Dawley

Objective: To investigate the epidemiologic and demographic characteristics of patients with spinal cord injury (SCI) who were admitted to a department of rehabilitation of a university hospital. Methods: This was a descriptive cross-sectional study. Medical records including sex, age at injury, type of disability, traumatic or non-traumatic etiology and presence of ossification of posterior longitudinal ligament (OPLL) of patients with SCI who were admitted to the department of rehabilitation between 2012 and 2018 were reviewed. Results: Of the 221 cases of SCI, 161 were traumatic and 60 were non-traumatic. The mean age at injury was 52.8 years. People aged 40–49 years showed highest proportion among overall SCI patients (19.0%). The proportion of male patients was higher in traumatic SCI at 4.96:1 than in non-traumatic SCI at 1.30:1. The most common cause of traumatic SCI was falling off (37.3%), followed by motor vehicle crash (35.4%) and tripping over (19.3%). Meanwhile, the most common cause of non-traumatic SCI was neoplasm (35.0%). Tripping over was the leading cause of traumatic SCI in patients aged ≥60 years (42.6%). A high proportion of traumatic SCI patients were found to have underlying OPLL (26.1%), particularly those who were injured by tripping over (64.5%). Conclusion The mean age of SCI patients was higher than that of previous studies. Falls was the single most common cause of traumatic SCI, and tripping over was the most common cause of injury in the elderly patients. OPLL was prevalent in patients who were injured from tripping over.

BACKGROUND AND OBJECTIVES: Standard unfractionated heparin (UFH) has long been used to prevent death and myocardial infarction in patients with acute coronary syndrome and acute occlusion undergoing percutaneous revascularization. However, UFH binds to several plasma proteins, platelets, and endothelial cells producing a highly variable anticoagulant response. In contrast, Low molecular weight heparin (LMWH) exhibits less protein binding and provides more predictable anticoagulant response with reduced need for patient monitoring and dosage adjustment. The purpose of this study was to assess the anti-Xa activities of LMWH in Korean patients with acute coronary syndrome after recommended dose for caucasians and to determine an optimal method of administration of LMWH. MATERIALS AND METHODS: Twenty five patients with acute coronary syndrome were enrolled and allocated to five separate groups (5 patients in each group) by types according to molecular weight (LMWH (A): (molecular weight of 4500 daltons, LMWH (B): molecular weight of 6400 daltons) and methods of administration (Group 1A and 1B: Subcutaneous and subcutaneous injections (SC-SC), Group 2: Intravenous and subcutaneous injections (IV-SC), Group 3A and 3B: Intravenous, subcutaneous and subcutaneous injections (IV-SC-SC). Five groups were as follows: Group 1A: LMWH (A) 1 mg/kg SC every 12 hours, Group 1B: LMWH (B) 100 IU/kg SC every 12 hours, Group 2: LMWH (A) 1 mg/kg IV bolus and 1 mg/kg SC 12 hours later, Group 3A: LMWH (A) 0.5 mg/kg IV bolus, 3 hours later 1 mg/kg SC every 12 hours, Group 3B: LMWH (B) 50 IU/kg IV bolus, 3 hours later 100 IU/kg SC every 12 hours. Anti-Xa activity was measured by amidolytic assay method (Rotachrome, Stago, France) in 555 samples from 25 patients. All the data of anti-Xa activity in each group were plotted along the sequential time and mean values of them were analyzed by Wilcoxon signed rank test. RESULTS: 1)The anti-Xa activity (mean 0.6216+/-0.238 IU/mL) of LMWH (A) was greater than that of LMWH (B)(mean 0.2587+/-0.1709 IU/mL) in the conventional SC-SC method (p<0.001). 2) The anti-Xa activity of LMWH (A) (mean 0.6203+/-0.2383 IU/mL) was also greater than that of LMWH (B)(mean 0.468+/-0.2428 IU/mL) in the IV-SC-SC method (p<0.001). 3) More rapid and effective anti-Xa activities were achieved by IV-SC-SC method compared with conventional SC-SC method. CONCLUSION: This study suggests that immediate achievement and optimum maintenance of anticoagulant activity can be accomplished by IV-SC-SC method rather than conventional SC-SC method in patients of acute coronary syndrome.
Acute Coronary Syndrome* ; Blood Proteins ; Endothelial Cells ; Heparin ; Heparin, Low-Molecular-Weight* ; Humans ; Injections, Subcutaneous ; Molecular Weight ; Monitoring, Physiologic ; Myocardial Infarction ; Protein Binding

Combination therapy with pegylated interferon (IFN) and ribavirin is the mainstay of treatment for chronic hepatitis C. An important side effect of IFN is the induction of an autoimmune disease such as autoimmune thyroid disease or, rarely, rheumatoid arthritis. However, the introduction of pegylated formulations of IFN can minimize the risk of autoimmune induction by reducing immunogenicity. Detection of anti-cyclic citrullinated peptide (anti-CCP) antibodies can help distinguish rheumatoid arthritis from hepatitis C-related arthritis. Here, we report the first Korean case of a 48-year-old female who developed anti-CCP antibody-positive rheumatoid arthritis following peginterferon alpha-2a therapy for hepatitis C.
Antibodies ; Arthritis ; Arthritis, Rheumatoid ; Autoimmune Diseases ; Female ; Hepatitis ; Hepatitis C ; Hepatitis C, Chronic ; Hepatitis, Chronic ; Humans ; Interferons ; Middle Aged ; Ribavirin ; Thyroid Diseases

The authors reviewed 102 cases of craniopharyngiomas with primary onset, which had occurred during a recent 15-year period. Among the 42 women and 60 men, 34 patients were children(aged 15 or less) and 68 were adults. The children showed clinical characteristics different from those of adults. With regard to initial presentation, headache was the most frequent chief complaint in children, while visual disturbance was most common in adults. The incidence of growth hormone deficiency was high in children, while in adults, adrenal corticosteroid deficit was most common. As seen on CT or MRI, the tumor was larger and calcification was more abundant in children than in adults. Gross total resection(GTR) was achieved in 46 cases. The main causes for incomplete removal were severe adhesion to the hypothalamus(31.3%) and the midbrain(18.8%), and heavy calcification(20.8%). The extent of surgery showed no significant influence on the Karnofsky Performance Score(KPS) on discharge, and in 82.4% of patients the results were good(KPS 80 or more). Postoperative endocrinological disturbances requiring hormonal replacement therapy were more common in the GTR group(p<0.01). In 22 recurrent cases, the median time from initial operation to recurrence was 18.5 months. Among patients who did not undergo postoperative radiation therapy, the recurrence rate was lower in those who had undergone GTR(p<0.05). An analysis of histological characteristics revealed that the adamantinomatous-type tumor recurred more frequently than the squamous papillary type. In conclusion, it is suggested that there is a difference in the growth pattern and clinical behavior of the tumor between adult and childhood craniopharyngioma. The authors recommend that unless expected postsurgical complications are detrimental to the patients, radical total resection should be attempted during the first operation, especially in patients who are under 15 and whose craniopharyngioma is of the adamantinomatous type. Radiation therapy should be considered for patients with a residual tumor and the treatment should be tailored to the individual.
Adult ; Child ; Craniopharyngioma* ; Female ; Growth Hormone ; Headache ; Humans ; Incidence ; Magnetic Resonance Imaging ; Male ; Neoplasm, Residual ; Recurrence

Eosinophilic gastroenteritis is a relatively uncommondisease of unknown etiology and pathogensis. It is characterized by massive tissue eosinophilia, that can involve any layers of the gastrointestinal tract wall. The gastrointestinal signs and symptoms usually reflect the layer which is most severly affected. Eosinophilic gastroenteritis can be rarely accompanied by extraintestinal involvement. We report a case of a 19-year-old male with repeated epigastric and low abdominal pain. An abdominal computed tomography showed diffused wall thickeningof esophagus, small bowel and bladder with ascites. Esosinophilic infiltration was shown by multiple biopsies of the esophagus, duodenum on esophagogastroduodenoscopy and peritoneal fluid analysis. The patient was diagnosed with eosinophilic gastroenteritis, accompanied by esosinophilic ascites and cystitis and was treated with corticosteroid and ketotifen. Abdominal pain was improved dramatically.
Abdominal Pain ; Ascites ; Ascitic Fluid ; Biopsy ; Cystitis ; Duodenum ; Endoscopy, Digestive System ; Enteritis ; Eosinophilia ; Eosinophils ; Esophagus ; Gastritis ; Gastroenteritis ; Gastrointestinal Tract ; Humans ; Ketotifen ; Male ; Urinary Bladder ; Young Adult

A 84-year-old woman visited by back and pubic pain. Abdominal CT showed 10cm sized abdominal mass with calcified component. At bone scan, multiple bone absorption was seen. T2 weighted MRI revealed heterogeneous high signal mass on pubis. Aspiration cytology reported only blood and exudate without malignant cells. Other 88-year-woman visited by systemic arthralgia and dysbasia. Abdominal CT revealed pubic bone fracture, surrounded by soft tissue, and relatively low density on lumbar spine. Bone scan showed increased absorption at multiple bone and joints. Enhanced chest CT revealed only consolidation, no malignant component was seen. Aspiration cytology reported degenerative bone tissue without malignant cell. At these cases, mass like lesion was looked like malignant tumors, but final diagnosis was insufficiency fractures. Aware these cases, we emphasize avoid misunderstanding for malignancy, may read to unnecessary and excessive evaluation before making the correct diagnosis, at insufficiency fracture.
Absorption ; Aged, 80 and over ; Arthralgia ; Bone and Bones ; Exudates and Transudates ; Female ; Fractures, Stress ; Humans ; Joints ; Pubic Bone ; Spine ; Thorax