The capillary hemangioblastoma, as originally defined by Lindau and by Cushing and Bailey, is widely regarded as being of Vascular origin and relatively uncommon. The most frequent site of this neoplasm is the cerebellum and second frequency is the spinal cord. We experienced a case of capillary hemangioblastoma arising at the upper thoracic spinal cord with the paraplegia and the sensory disturbance below the nipple line. The total laminectomy with mass excision was taken and the patient have shown good improvement of the neurological defecits in postoperative period.
Capillaries ; Cerebellum ; Hemangioblastoma ; Humans ; Laminectomy ; Nipples ; Paraplegia ; Postoperative Period ; Spinal Cord

No abstract available.

An attenuated classical swine fever virus (CSFV), Suri strain, is a va.iant derived from a vaccine virus, LOM strain. This study was performed to elucidate the molecular biologcal properties of CSFV Suri strain, and to obtain the basic data for molecular epidemiological approaches for the disease. The truncated form of gp55 gene without the C-terminal transmembrane domain, in size of 1,023bp, was amplified by RT-PCR and sequenced by dye terminator cyclic sequencing method, and inserted into BamHI site of pAcGP67B baculovirus vector, establishing a cloned pAcHEG plasmid. By the nucleotide sequences determined, 341 amino acid sequences were predicted. As compared the nucleotide and amino acid sequences of gp55 of Suri with the various CSFV, Suri strain showed the high homology over 99.1% with ALD and LOM strains, but comparably the lower homology with Alfort and Brescia. In comparison of amino acid sequence in variable domain of gp55 protein, the similar tendency of homology was observed. In hydrophobicity analysis, all of four CSFV strains revealed the analogous patterns of hydrophobicity. The numbers and locations of N-glycosylation site and cysteine residues in gp55 were analyzed, those of Suri strain being coincident with ALD and LOM strains. The results suggest that gp55 in Suri strain has the high similarity to those in ALD and LOM strains in terms of the nucleotide and amino acid sequences and the functional properties of gp55 protein..
Amino Acid Sequence ; Animals ; Baculoviridae ; Base Sequence ; Classical swine fever virus ; Classical Swine Fever* ; Clone Cells ; Cysteine ; Hydrophobic and Hydrophilic Interactions ; Plasmids ; Sequence Analysis* ; Swine

BACKGROUND: Orthotopic liver transplantation is widely regarded as the only effective treatment for many acute or chronic end-stage liver diseases. However, the shortage of cadaveric organs is one of the most crucial limitations to the liver transplantation. Recently, in our hospital, living-related liver transplantation (LR LT) cases have remarkably increased during the last two years. Because there are differences in the surgical procedure and graft volume between the cadaveric donor liver transplantation (Cd LT) and LRLT, the intraoperative coagulation status may be different, too. With the knowledge of coagulation status, the anesthetic mangement of liver transplantation will be improved. METHODS: A retrospective evaluation was performed on 36 patients, who underwent an orthotopic liver transplantation between October 1999 and April 2001. Seventeen patients received a Cd LT and 19 patients underwent a LRLT. We compared the two groups in the aspects of coagulation related parameters; 1) ischemic time, 2) venovenous bypass (VVB) flow, 3) the percentages of occurrence of postreperfusion syndrome (PRS), 4) the ratio of activated clotting time (ACT) exceeding 200 seconds after reperfusion, 5) the ratio of hyperfibrinolysis, LY60 > 20%, on a thromboelastograph (TEG) after reperfusion, and 6) the amounts of transfusion and fluid administration before and after reperfusion. RESULTS: The ischemic time was shorter in the LR LT group than the Cd LT group (115.4 +/- 25.4 min versus 409.2 +/- 115.6 min). The VVB flow was greater in the Cd LT group than the LR LT group. The ratio of occurrence of PRS was also lower in the LR LT group (11%) than the Cd LT group (53%). The percentage of ACT exceeding 200 seconds after reperfusion was only 11% in the LR LT group, but 59% in the Cd LT group. The percentages of LY 60 > 20% on the TEG after reperfusion were not statistically different in each group, but the percentage of tranexamic acid administration due to persistent, severe hyperfibrinolysis was higher in the Cd LT group than the LR LT group. The amounts of transfusion and fluid administration were significantly smaller in the LR LT group compared to those in the Cd LT group. CONCLUSIONS: We found that there were many differences in the coagulation status between the Cd LT and the LR LT groups. Therefore, anesthesiologists should consider these differences and manage each case of liver transplantation properly.
Cadaver* ; Humans ; Liver Diseases ; Liver Transplantation* ; Liver* ; Reperfusion ; Retrospective Studies ; Tissue Donors* ; Tranexamic Acid ; Transplants

Drug-induced acute interstitial nephritis is characterized by renal interstitial inflammatory cell infiltration and commonly presents as acute renal failure. This is caused mainly by methicillin, non-steroidal antiinflammatory drugs, sulfonamide diuretics such as thiazide, but cases induced by furosemide are rare. We report a patient with acute interstitial nephritis causing reversible acute renal failure and dermatitis while she was taking furosemide. A 37-year old woman was referred to our hospital because of generalized skin rash and non-oliguric acute renal failure. She had peripheral eosinophilia (1,577/mm3) and serum creatinine level of 6.8mg/dL. Skin biopsy showed leukoclastic vasculitis and percutaneous renal biopsy showed severe interstitial infiltration of lymph ocyte and mild interstitial fibrosis with focal tubular atrophy. After withdrawal of furosemide, renal function and skin lesions were completely recovered.
Acute Kidney Injury ; Adult ; Atrophy ; Biopsy ; Creatinine ; Dermatitis ; Diuretics ; Eosinophilia ; Exanthema ; Female ; Fibrosis ; Furosemide* ; Humans ; Methicillin ; Nephritis, Interstitial* ; Skin ; Vasculitis

BACKGROUND: It has long been suggested that neutrophils and their products are implicated as the central mediators of the acute lung injuries. Contrary to the dominant role of neutrophils in ARDS, many cases of ARDS has occurred in the setting of severe neutropenia without pufrnonary neutrophil infiltration. Therefore it is certain that effector cell(s) other than neutrophil play an important role in the pathogenesis of ARDS. This experiment was performed to define the mechanism of ARDS in the setting of neutiopenia, 1) by comparing the severity of endotoxin-induced lung injury, 2) by measurement of hydrogen peroxide production and cytokine concentration in the bronchoalveolar lavage cells and fluids obtained from different rats with and without cyclophosphamide-pretreatment. METHOD: The male Sprague-Dawleys were divided into the normal control (NC)-, endotoxin (ETX)-, and cyclophosphamide (CPA)-group in which neutropenia was induced by injecting cyclophosphamide intraperitoneally. Acute lung injury was evoked by injecting lipopolysaccharide (LPS) into a tail vein. The bronchoalveolar lavage (BAL) was performed at 3 and 6 hour after administration of LPS to measure the change of cell counts and concentrations of protein and cytokines, tumor necrosis factor-alpha (TNF-alpha) and interleukin-6 (IL-6). Hydrogen peroxide (HPO) production from BAL cel]s was measured at 6 hour after LPS administration by phenol red microassay with and without zymosan stimulation. RESULTS: The results were as follows. A change of leukocyte counts in the peripheral blood after treatment with CPA More than 95% of total leukocytes and neutrophils were reduced after CPA administration, resulting in severe neutropenia. A change of BAL cells In the ETX-group, the number of total cells (p<0.01) and of macrophage and neutrophll (p<0.05) were increased at 3 and 6 hour after LPS administration compared to those of NC- group. In the CPA-group, the number of total leukocyte and macrophage were not changed after LPS administration, but neutrophil counts were significantly reduced and jt took part in less than 0.1% of total BAL cells (p<0.01 vs NC-group). BAL cells in this group were almost all macrophages (99.7%). A change of protein concentration in the BALF In the ETX-group, protein concentration was increased at 3 hour and was more increased at 6 hour after LPS administration (p<0.05 and <0.01 vs NC-group, respectively). In the CPA-group, it was also significantly elevated at 3 hour after LPS administration (p<0.05 vs NC-group) , but the value was statistically not different from that of ETh-group. The value measured at 6 hour after LPS administration in the CPA-group became lower than that of ETX-group (p<0.05), but showed still a higher value compared to that of NC-group (p<0.05). A change of cytokine concentration in the BALF TNF-alpha and IL-6 were elevated in the ETX- and CPA-group compared to those of NC-group at both time intervals. There was no statistical difference in the values of both cytokines between the ETX- and CPA-groups. Measurement of hydrogen peroxide production from BAL cells There was no intergroup difference of HPO production from resting cells. HPO production after incubation with opsonized zymosan was significantly elevated in all groups. The percent increment of HPO production was highest in the ETX-group (89.0%, p<0.0008 vs NC-group ), and was 42.85 in the CPA-group (p = 0.003 vs NC-group ). Conclusion Acute lung injury in the setting of neutropenia might be caused by functional activation of resident alveola r macrophages.
Acute Lung Injury* ; Animals ; Bronchoalveolar Lavage ; Cell Count ; Cyclophosphamide ; Cytokines ; Humans ; Hydrogen Peroxide ; Interleukin-6 ; Leukocyte Count ; Leukocytes ; Lung Injury ; Macrophages* ; Male ; Neutropenia ; Neutrophil Infiltration ; Neutrophils ; Phenolsulfonphthalein ; Rats* ; Tumor Necrosis Factor-alpha ; Veins ; Zymosan

OBJECTIVES: To evaluate the annual visit days, the annual prescription days and the medical costs of hypertensive patients. METHODS: The medical insurance records of 40,267 incident patients with the diagnostic code of hypertension from September 1998 through August 1999 in Daegu city were reviewed. RESUJLTS: The proportion of the most proper medical care pattern group (Group VIII) who visited for 6-15 days with 240 prescription days or more a year was only 6.2%. The proper care group (Group IX) who visited for more than 16 days with 240 prescription days or more a year was 9.3%. The overall proper care group (Group VIII+IX) was therefore 15.5%. The proportion of the insufficient care group (Group I,IV) in both the number of visiting days and prescription days was 57.4%. The mean prescription day of the most proper group (Group VIII) was 29 days; the mean annual medical expenses, 453,587won; the mean annual amount paid by patients, 218,013won; and mean medical expenses per prescription day, 1,483won. The proportion of the overall proper care group (Group VIII+IX) was significantly higher in adults aged 50-59, those who were enrolled in industrial workers health insurance as well as government employees and private school teachers health insurance, and those who made a higher contribution per month (p<0.01). According to the type of medical facilities, the proportion of the most proper medical care pattern group was highest in the general hospitals (9.3%) but the overall proper care group was higher in the public health centers (22.1%) and private clinics (17.1%). CONCLUSIONS: The management system of hypertension should be reinforced urgently. Therefore, it is necessary to develop guidelines including the number of visiting days per year and prescription days per visit day, and make the system provide medical facilities to more properly care for hypertensive patients.
Adult ; Ambulatory Care ; Daegu ; Direct Service Costs ; Hospitals, General ; Humans ; Hypertension ; Insurance ; Insurance, Health ; Prescriptions* ; Public Health

OBJECTIVES: To evaluate the annual visit days, the annual prescription days and the medical costs of hypertensive patients. METHODS: The medical insurance records of 40,267 incident patients with the diagnostic code of hypertension from September 1998 through August 1999 in Daegu city were reviewed. RESUJLTS: The proportion of the most proper medical care pattern group (Group VIII) who visited for 6-15 days with 240 prescription days or more a year was only 6.2%. The proper care group (Group IX) who visited for more than 16 days with 240 prescription days or more a year was 9.3%. The overall proper care group (Group VIII+IX) was therefore 15.5%. The proportion of the insufficient care group (Group I,IV) in both the number of visiting days and prescription days was 57.4%. The mean prescription day of the most proper group (Group VIII) was 29 days; the mean annual medical expenses, 453,587won; the mean annual amount paid by patients, 218,013won; and mean medical expenses per prescription day, 1,483won. The proportion of the overall proper care group (Group VIII+IX) was significantly higher in adults aged 50-59, those who were enrolled in industrial workers health insurance as well as government employees and private school teachers health insurance, and those who made a higher contribution per month (p<0.01). According to the type of medical facilities, the proportion of the most proper medical care pattern group was highest in the general hospitals (9.3%) but the overall proper care group was higher in the public health centers (22.1%) and private clinics (17.1%). CONCLUSIONS: The management system of hypertension should be reinforced urgently. Therefore, it is necessary to develop guidelines including the number of visiting days per year and prescription days per visit day, and make the system provide medical facilities to more properly care for hypertensive patients.
Adult ; Ambulatory Care ; Daegu ; Direct Service Costs ; Hospitals, General ; Humans ; Hypertension ; Insurance ; Insurance, Health ; Prescriptions* ; Public Health

PURPOSE: Asthmatic patients show marked circadian variation in disease severity, with bronchospasm far worse between midnight and 8 a.m. than at other times of the day. And many studies have demonstrated that symptoms are much relieved in the day-time while they worsen at night. Our study was conducted to examine the circadian variation of peak expiratory flow rate (PEFR) in asymptomatic asthmatic children after proper treatment by mini-Wright peak flow meter. METHODS: Thirty four asthmatic patients who have had no respiratory symptoms for the past one month were enrolled to our study. Control group included 25 patients who were admitted to Wonju Christian Hospital for inguinal hernia, aseptic meningitis, etc., but without respiratory symptoms. RESULTS: The mean age was 6.3 years, ranging from 4 to 11 years, in the stable asthmatic group. In control group, the mean age was 8.7 years ranging from 4 to 14 years. PEFR was checked at every 2 hours from 8 a.m. to 10 p.m. for 4 days. There were no significant differences in PEFR checked at all times between the asthma group and the control group except for the PEFR checked at 8 a.m. in moderate persistent asthma group. PEFR reached the nadir at 8 a.m. in both asthma and control groups. It rose to the highest level in the afternoon, then, it slightly fell in the evening and at night. There were significant differences between the PEFR checked at 8 a.m. and the PEFR checked at any other period of the day in each group (P< 0.05). The circadian variation in moderate persistent asthma group is much greater than that of other groups. CONCLUSION: Our study indicates that the moderate persistent asthma group with no current symptoms of asthma has an increased circadian variability. It is recommended, therefore, that special attention be paid to preventive treatment for the moderate persistent asthma group.
Asthma* ; Bronchial Spasm ; Child ; Circadian Rhythm* ; Gangwon-do ; Hernia, Inguinal ; Humans ; Meningitis, Aseptic ; Peak Expiratory Flow Rate*

BACKGROUND: Angiogenesis is an essential process for the growth and metastatic ability of solid tumors. One of the key factors known to be capable of stimulating tumor angiogenesis is the vascular endothelial growth factor (VEGF). The serum VEGF concentration has been shown to be a the malignant pleural effusion showing a correlation with the biochemical parameters. The VEGF has been shown to play a role in the inflammatory diseases, but rarely in the tuberculosis (TB). The serum and pleural fluid VEGF levels were measured in patients with lung cancer and TB. Their relationship with the clinical and laboratory parameters and repeated measurement 3 months after various anticancer treatments were evaluated to assess the utility of the VEGF as a tumor marker. METHODS: Using a sandwich enzyme-linked immunosorbent assay, the VEGF concentration was measured in both sera and pleural effusions collected from a total of 85 patients with lung cancer, 13 patients with TB and 20 healthy individuals. RESULTS: The serum VEGF levels in patients with lung cancer (619.9±722.8ph/ml) were significantly higher than those of healthy controls (215.9±191.1pg/ml), However, there was no significant difference between the VEGF levels in the lung cancer and TB patients. The serum VEGF levels were higher in large cell and undifferentiated carcinoma than in squamous cell carcinoma and adenocarcinoma. The serum VEGF levels of lung cancer patients revealed no significant relationship with the various clinical parameters. The VEGF concentrations in the malignant effusion (2,228.1±2,103.0pg/ml) were significantly higher than those in the TB effusion (897.6±978.8pg/ml). In the malignant pleural effusion, the VEGF levels revealed significant correlation with the number of red blood cells (r=0.75), the lactate dehydrogenase (LDH)(r=0.70), and glucose concentration (r=-0.55) in the pleural fluid. CONCLUSION: The serum VEGF levels were higher in the lung cancer patients. The VEGF levels were more elevated in the malignant pleural effusion than in the tuberculous effusion. In addition, the VEGF levels in the pleural fluid were several times higher than the matched serum values suggesting a local activation and possible etiologic role of VEGF in the formation of malignant effusions. The pleural VEGF levels showed a significant correlation with the numbers of red blood cells, LDH and glucose concentrations in the pleural fluid, which may represent the tumor burden.
Adenocarcinoma ; Carcinoma ; Carcinoma, Squamous Cell ; Enzyme-Linked Immunosorbent Assay ; Erythrocytes ; Glucose ; Humans ; L-Lactate Dehydrogenase ; Lung Neoplasms* ; Lung* ; Pleural Effusion ; Pleural Effusion, Malignant ; Tuberculosis ; Tuberculosis, Pleural* ; Tumor Burden ; Vascular Endothelial Growth Factor A*