One hundred seven isolates of Staphylococcus aureus from bovine mastitis were investigated for colony morphology in serum-soft agar (SSA), autoagglutination in salt, and capsular serotype. Capsular polysaccharide (CP) was purified and quantified from the extracts of clinical isolates. Overall, 89 isolates (83.2%) were diffuse in the SSA, without any difference in the proportion of diffuse colony between type 5 and type 8 strains. Some strains exhibited compact colonies in the SSA and expressed CP as determined by an enzyme-linked immunosorbent assay, indicating that compact morphology does not exclude encapsulation. The majority of the strains (11/12) showed autoagglutination in the salt aggregation test. The serotype 336 accounted for 46.7% of the isolates followed by serotype 5 (12.1%) and serotype 8 (12.1%). Particularly, twenty-six (24.3%) isolates reacted with two serotypes; 7 for type 8/336 and 19 for type 5/336. Five isolates (4.7%) were nontypeable with monoclonal antibodies specific for CP serotype 5, 8, or 336. The CP concentration in culture supernatants varied with the serotypes, and the total amount of CP produced by cells grown in a liquid medium was much less than that produced by cells grown on a solid medium. The Western blotting indicated that the CP bands of S. aureus serotype 5 and 8 were ranged in the molecular mass of 58-84 kilodalton (kDa), with additional bands in the region of approximately >or= 48 or Agglutination Tests ; Animals ; Bacterial Vaccines/administration & dosage ; Cattle ; Cattle Diseases/immunology/microbiology ; Female ; Mastitis, Bovine/*microbiology ; Polysaccharides, Bacterial/*classification/isolation & purification ; Serotyping/methods/veterinary ; Staphylococcal Infections/immunology/*veterinary ; Staphylococcus aureus/*classification/*immunology/isolation & purification

The developmental changes of convergence ratios of medial nucleus of trapezoid body (MNTB) axons to single lateral superior olive (LSO) neuron were investigated using voltage clamp technique in homologous (cir/cir) circling mice, animal model for the congenital deafness with autosomal recessive inheritance. As the developmental reduction of convergence ratio reported in rats indicates the presence of synaptic refinement, we aimed to find out whether the similar reduction of convergence ratio also occurs in circling mice. Heterologous (+/cir) mice were used as control and mice younger than postnatal (P) day 4 or older than P9 were used. The convergence ratios of MNTB axons to single LSO neuron were 29.16+/-2.7 (n=12, P9) in homologous (cir/cir) mice, while they were 37.89+/-3.8 (n=9, P9) in heterozygous (+/cir) mice. The significant changes were observed only in heterozygous (+/cir) mice, which indicated that synaptic refinement of MNTBLSO synapses occurs in heterozygous (+/cir) mice, not in homozygous (cir/cir) mice. Considering homologous (cir/cir) mice being animal model for the congenital deafness, our data might contribute to the understanding of developmental changes of brain stem auditory circuits of congenitally deaf patients.
Animals ; Axons ; Brain Stem ; Deafness ; Humans ; Mice ; Models, Animal ; Neurons ; Olea ; Rats ; Synapses ; Wills

Cerebral arterial embolism which resulted in total occlusion of right proximal middle cerebral artery was occured in 33 years old female patients with severe mitral stenosis and atrial fibrillation during percutaneous mitral balloon valvuloplasty(PMV). The occluded artery could be detected by transfemoral carotid angiography and recanalized immediately by intra-arterial infusion of urokinase. There were no cerebral hemorrhage by CT scan after intra-arterial urokinase infusion and the patients discharged without any neurologic sequale 7 days after thrombolysis. We report a case of successful recanalization with intraarterial infusion of urokinase in patient with cerebral arterial embolism occurred during PMV.
Adult ; Angiography ; Arteries ; Atrial Fibrillation ; Cerebral Hemorrhage ; Embolism* ; Female ; Humans ; Infusions, Intra-Arterial* ; Intracranial Embolism ; Middle Cerebral Artery ; Mitral Valve Stenosis ; Tomography, X-Ray Computed ; Urokinase-Type Plasminogen Activator*

Carcinoma of Gall bladder remains a terminal illness in most patients despite improved diagnostic capabilities, better perioperative care and a more aggresive surgical approch based on improved knowledge of this tumors natural histiory. Overall 5-year survival rates remain below 5%. This failure to significantly improve patient oucome is largely due to late recognition of gall badder cancer. Authors experienced 21 cases of gall bladder cancer confirmed by operation at the Kwang Ju Christian hospital from march 1983 to March 1991, and the results obtained were summarized as follows. (continue...)
Gallbladder Neoplasms ; Gwangju ; Humans ; Perioperative Care ; Survival Rate ; Urinary Bladder*

BACKGROUND: The use of uncrossmatched group O, Rh-negative RBCs has enabled immediate transfusion of patients who need critical care in life-threatening situations. We examined our 1-year experience with uncrossmatched group O, Rh-negative RBC transfusion in a tertiary care university hospital. METHODS: Uncrossmatched group O, Rh-negative RBCs were available for immediate transfusion upon request without performing any of the following pretransfusion tests: ABO and RhD typing, irregular antibody screening, crossmatching test. The characteristics of the transfused patients were studied retrospectively. RESULTS: Twenty-five patients received 56 units of uncrossmatched group O, Rh-negative RBCs from November 2005 to October 2006. An average of 2.24 units was issued to each patient, with no more than 4 units per patient being given; subsequent transfusion was done with type-specific, crossmatched blood. The average turnaround time for the release of uncrossmatched group O, Rh-negative RBCs was 1.8 minutes (mean+/-standard deviation: 1.8+/-1.96, range: 0~7 minutes). Seventeen patients died (68%), which included 16 patients who had received cardiopulmonary resuscitation. CONCLUSION: Patients admitted for traffic accident, falling down injury, gastrointestinal bleeding and aortic dissection received 72% of the emergency group O, Rh-negative RBCs, with a 72.2% mortality rate, which indicates the dire condition of these patients. The majority of RBCs for transfusion were available within 5 minutes upon request. Though group O, Rh-negative RBCs are recommended in emergency situations in which the blood group of the patient is unknown, the use of group O, Rh-positive RBCs may be an alternative blood supply, when considering the short supply of Rh-negative RBCs.
Accidents, Traffic ; Cardiopulmonary Resuscitation ; Critical Care ; Emergencies* ; Hemorrhage ; Humans ; Mass Screening ; Mortality ; Retrospective Studies ; Tertiary Healthcare

No abstract available.
Acromegaly* ; Fibrous Dysplasia, Polyostotic*

A 38-year old female was admitted to our hospital for further evaluation of an incidentally found cardiac murmur. She had been in a hypertensive state for 5 years but had taken antihypertensive drugs intermittently on her own. Her history revealed that she had become amenorrheic for 7 months and had, had headaches for a few months. Physical examination revealed central obesity and a moon face, but no hirsuitism. When she first visited our hospital, her blood pressure was 260/170 mmHg and grade 2 systolic murmur was audible along the left sternal border. Laboratory studies revealed high levels of 24-hour urine-free cortisol and plasma aldosterone, but a very low level of plasma adrenocorticotropic hormone and plasma renin activity. A low-dose and a high-dose dexamethasone suppression tests, adrenal venous sampling, inferior petrosal sinus sampling, and a renin stimulation test were performed. Bilateral adrenal masses were found on computerized tomographic scanning and magnetic resonance imaging but there was no abnormality of the pituitary gland. The uncontrollable blood pressure and the elevated 24-hour urine-free cortisol and plasma aldosterone levels were corrected by a right-total and left-subtotal adrenalectomy. Pathologic findings were bilateral adrenal cortical adenomas of different cell types. These findings indicate that the adrenal cortical adenomas were tumors that functioned differently, causing Cushing's syndrome and primary aldosteronism in the same patient. A review of, the literature published in English showed that this is the first reported case, of bilateral adrenal adenomas functioning differently.
Adenoma ; Adrenalectomy ; Adrenocortical Adenoma* ; Adrenocorticotropic Hormone ; Adult ; Aldosterone ; Antihypertensive Agents ; Blood Pressure ; Cushing Syndrome* ; Dexamethasone ; Female ; Headache ; Heart Murmurs ; Humans ; Hydrocortisone ; Hyperaldosteronism* ; Magnetic Resonance Imaging ; Obesity, Abdominal ; Petrosal Sinus Sampling ; Physical Examination ; Pituitary Gland ; Plasma ; Renin ; Systolic Murmurs

PURPOSE: There are no specific clinical and histopathologic characteristics of malignant pheochromocytoma and the optimal treatment modality has not been established yet. We analyzed the clinical and histopathologic features of malignant pheochromocytoma and treatment results. MATERIALS AND METHODS: We reviewed the clinical records of 10 patients with malignant pheochromocytoma diagnosed at Seoul National University Hospital from March 1987 to June 1998. RESULTS: Nine of 10 (90%) patients had functional tumors. The biochemical laboratory findings showed elevated 24-hour urine VMA level in nine patients available. The median size of the tumors was 11x11 cm. Six of 10 (60%) patients were initially diagnosed as malignant tumors because of direct invasions to adjacent tissues or distant metastases. On the other hand, remaining 4 patients were initially diagnosed as benign, but the distant metastases developed metachronously after resection of the primary lesion. The median duration between the initial operation and the detection of metastases was 57 months (range: 47~72 months) in these patients. The liver was the most common site of metastases (60%). With regards to the histopathological features, most of the tumors (87.5%) showed capsulation, necrosis and hemorrhage. The findings of lymphatic invasion, angio-invasion, and mitosis were found in 62.5% of the cases. All but 2 patients were initially treated with radical operation for the primary lesions. The disease recurrences or metastases occurred in 7 out of 10 patients. Of these, 4 patients were treated with chemotherapy or interferon- a after recurrences. Overall, the median survival for all patients was 82 months (range: 37~143 months). Two patients is alive and only one patient is alive without recurrence. CONCLUSION: The careful follow-up for at least 5 years and the aggressive multi-disciplinary therapy may be needed for the diagnosis and the management of malignant pheochromocytoma.
Diagnosis ; Drug Therapy ; Follow-Up Studies ; Hand ; Hemorrhage ; Humans ; Liver ; Mitosis ; Necrosis ; Neoplasm Metastasis ; Pheochromocytoma* ; Recurrence ; Seoul

BACKGROUND: A papillary carcinoma in the breast is a rare carninoma with a predominantly papillary growth patttern. Its incidence is said to be 1% to 2% of all breast carcinomas in women. Because of its rarity, little is known about its histopathological features. This study was undertake to analyze the histopathological characteristics of papillary breast cancer. METHODS: During the 17 years from January 1980 through December 1996, among 2166 primary breast cancer patients, 26 patients, who had been diagnosed with papillary breast cancer pathologically at the Department of Surgery, Seoul National University Hospital, were elegible for this study. The histopathological characteristics of the tumors in these patients, including immunohistochemically stained tumor marker-e.g., bcl2, c-erbB2, cathepsin D, and p53-were compared to those of patients with an invasive ductal carcinoma, NOS (IDC). RESULTS: The mean age of the patients was 47 years old, ranging from 28 to 74 years. There was no statistically significant difference in the primary tumor size between the papillary cancer and the IDC (2.62 cm vs 3.33 cm, p=0.127). Twenty-four of the papillary cancer patients had no metastatic axillary node, and metastatic nodes were present in the papillary cancer than in the IDC, with statistical significance (0.27+/-0.19 vs 3.43+/-0.08, p=0.023). Papillary cancer seemed to have more frequent ER and PgR (60%, 77.8%) than IDC (44.1%, 56.1%), but there was no significance to these results (p=0.351, 0.309). In terms of tumor markers, the positivity of bcl2, c-erbB2, cathepsin D, and p53 in papillary cancer were 42.9%, 100%, 85.5%, and 66.7%, respectively. Of all significance, immunohistochemically determined tumor markers, c-erbB2 expression was observed with statistical significance, more frequently in papillary cancer (100% vs 68.5%, p=0.044). Patients with papillary cancer had an overall 10-year survival rate of 83.3%. CONCLUSION:Papillary breast cancer had fewer metastatic axillary node, but with little statistical significance for a more favorable outcome. The relation between c-erbB2 expression and papillary cancer seems to be interesting and needs to be further elucidated.
Biomarkers, Tumor ; Breast Neoplasms ; Breast* ; Carcinoma, Ductal ; Carcinoma, Papillary ; Cathepsin D ; Female ; Humans ; Incidence ; Middle Aged ; Seoul ; Survival Rate

Spinal epidural and subdural hematomas are uncommonly recognized conditions. These conditions can result in severe irreversible neurologic deficits, if left untreated. Like intracranial lesions, these hematomas can expand rapidly and cause sudden spinal cord and/or cauda equina compression. This case is very rare in which is a concurrence of cervical spinal epidural and subdural hematoma after motor vehicle accident without spine fracture. The pathophysiology of these entities are discussed and the radiologic diagnosis focused on MR findings are reviewed. The importance of prompt surgical treatment is emphasized to facilitate good postoperative outcome.
Cauda Equina ; Diagnosis ; Hematoma ; Hematoma, Epidural, Spinal ; Hematoma, Subdural* ; Hematoma, Subdural, Spinal ; Motor Vehicles ; Neurologic Manifestations ; Spinal Cord ; Spine*