OBJECTIVES: This study was carried out to survey the prevalence of Helicobacter pylori infection and the incidence of vacuolating toxin producing H. pylori. A further aim of this study was to evaluate the quantitative assay for cell vacuolation on the basis of the rapid uptake of neutral red dye by vaculoes of the cells. METHODS: We studied the gastric biopsy specimens of patients with 154 cases of gastritis, 74 cases of gastric ulcer, and 167 cases of gastric cancer and in 44 cases of healthy persons. One of the biopsy specimen was placed into a CLOtest plate for rapid urease test and the other one of the biopsy spcimen was inoculated on Brain Heart Infusion blood agar for culture. The culture supernatant of isolated H. pylori was serially diluted with BHI broth. After 24 hour incubation of cultured RK-13 cells treated with the culture supernatant of H. pylori, cytoplasmic vacuolation of the cells were observed microscopically. RESULTS: The positivity of urease test and the rate of isolation of H. pylori from urease positive gastric biopsy materials were 34.1% and 93.3% in healthy person, 55.8% and 70.9% in gastritis, 60.8% and 71.1% in gastric ulcer, and 56.3% and 96.8% in gastric cancer. The isolation rate of H. pylori from patients between 20 and 39 years old was 16.8%, for patients between 40 and 59 years old it was 51.9%, and for patients above 60 years old it was 31.2%. The isolation rate of the vacuolating toxin producing H. pylori from gastric biopsy specimens was 66.7% in a healthy person, 76.6% in gastritis, 79.4% in gastric ulcer, and 80% in gastric cancer. CONCLUSIONS: The isolation rate of H. pylori from the patients with gastric diseases is higher than the rate of H. pylori from healthy persons, but the isolation rate of the vacuolating toxin producing H. pylori is not different between the patients with gastric diseases and healthy persons. The titers of vacuolating toxin produced by some H. pylori isolated from the patients with gastric diseases are higher than those from healthy persons.
Adult ; Agar ; Biopsy ; Brain ; Cytoplasm ; Gastritis ; Heart ; Helicobacter pylori* ; Helicobacter* ; Humans ; Incidence* ; Middle Aged ; Neutral Red ; Prevalence ; Stomach Diseases* ; Stomach Neoplasms ; Stomach Ulcer ; Urease

PURPOSE: Nitric oxide (NO) and phosphodiesterases (PDEs) play key roles in mediating relaxation of corpus cavernosal smooth muscle by increasing intracellular cGMP level. Here, we investigated effects of NO-donor (sodium nitroprusside, SNP) and penile specific type-V PDE inhibitor (zaprinast) in human and rabbit corpus cavernosal cells and tissues in vitro. MATERIALS AND METHODS: The cultured smooth muscle cells and tissues of human and rabbit corpus cavernosum were treated with increasing concentrations of SNP or zaprinast for 5 and 20 minutes, respectively, and intracellular cGMP levels were measured by radioimmunoassay. Organ bath study was performed to measure the relaxation effects of drugs on precontracted corpus cavernosal muscle strips. RESULTS: Although both NO-donor and type-V PDE inhibitor effectively stimulated the accumulation of cGMP in a dose-dependent manner, magnitude of cGMP increase and specificity of drug were found to be species-dependent. In human corpus cavernosal tissues, cGMP was increased upto 10- and 5-folds by SNP and zaprinast, respectively. However, magnitude of increase was much less in cultured smooth muscle cells. In rabbit, SNP effect was most prominent in cultured cells and effects of SNP and zaprinast were modest in tissues. Both agents also resulted in effective relaxation of human and rabbit cavernosal tissue strips. Similar patterns of dose-response curves were shown between results from the organ bath studies and cGMP radioimmunoassay with cavernosal smooth muscle cells. CONCLUSIONS: Present results show that effects of SNP and zaprinast are not coincident in different species, suggesting possible species-specificities of these two agents. Measurement of cGMP changes in cultured cavernosal smooth muscles cells could be reflected to the relaxation effects of drugs on corpus cavernosal muscle strips.
Baths ; Cells, Cultured ; Cyclic GMP ; Erectile Dysfunction ; Humans* ; Male ; Muscle, Smooth* ; Myocytes, Smooth Muscle ; Negotiating ; Nitric Oxide ; Nitroprusside ; Phosphoric Diester Hydrolases ; Radioimmunoassay ; Relaxation* ; Sensitivity and Specificity ; Signal Transduction*

PURPOSE: Stercoral perforation of colon is a rare disease with poor prognosis. But according to recent reports, the incidence of stercoral perforation in the colon seemed to have been underestimated. The reason might be the lack of recognition and overlook by surgeons. The purposes of this study were to represent the definition of stercoral perforation, and to help the diagnosis and treatment of stercoral perforation. METHODS: Among the patients who underwent emergency operation for colon perforation at the Department of Surgery, Korea University College of Medicine, from January 1992 to December 2001, 9 patients were diagnosed as stercoral perforation and their medical records were reviewed retrospectively regarding the clinical characteristics, managements and mortality. RESULTS: The age distribution of the patients was from 32 to 76 years. Male to female ratio was 1.3:1. All patients had history of chronic constipation. Six cases (33.3%) had free air, and 5 cases (55.6%) had fecaloma at preoperative simple X-ray. The site of perforation were sigmoid colon (8 cases) and descending colon (1 case). The size of perforation ranged from 1 cm to 6.5 cm (mean: 3.1 2.7 cm). The methods of operation were Hartmann's procedure (8 cases), primary repair and sigmoid loop colostomy (1 case). There were two deaths for sepsis. CONCLUSIONS: The stercoral perforation is not rare as commonly thought. If elderly patients who had history of chronic constipation and symptoms of panperitonitis visit hospital, surgeon should be aware of the possibility of this fatal disease and do early surgical intervention with the aggressive therapy for reducing the mortality.
Age Distribution ; Aged ; Colon* ; Colon, Descending ; Colon, Sigmoid ; Colostomy ; Constipation ; Diagnosis ; Emergencies ; Female ; Humans ; Incidence ; Korea ; Male ; Medical Records ; Mortality ; Prognosis ; Rare Diseases ; Retrospective Studies ; Sepsis

BACKGROUND: We compared the effects of different remifentanil effect-site concentrations on intubating conditions, and cardiovascular and bispectral index score (BIS) responses to intubation at a fixed effect-site concentration of propofol without muscle relaxants. METHODS: Sixty-four patients were randomly assigned to one of three groups: remifentanil 2 (group R2, n = 22), 4 (group R4, n = 21), or 6 ng/ml (group R6, n = 21). Anesthesia was induced using target-controlled infusion of propofol 5 microgram/ml and each concentration of remifentanil. Laryngoscopy and intubation was attempted at 2.5 min following induction. Intubating conditions were assessed as excellent, good or poor using a standard scoring system. Mean arterial pressure (MAP), heart rate (HR), and BIS values were assessed. RESULTS: Excellent or good intubating conditions were obtained in 91% of group R4 and 95% of R6, both of which are higher compared with 32% of R2 (P < 0.01). MAP and HR decreased significantly after induction in all groups. After intubation, they recovered to baseline value in group R2 and R4 but were significantly less than baseline values in R6. BIS response to intubation was attenuated in group R4 and R6 but not R2. Hypotension was more frequent in group R6 than R2. CONCLUSIONS: Remifentanil target concentrations of 4 or 6 ng/ml combined with 5 microgram/ml propofol provided good or excellent conditions for tracheal intubation and prevented cardiovascular and BIS response during induction without muscle relaxants. However, the use of 6 ng/ml dose was associated with frequent occurrence of hypotension and bradycardia requiring treatment.
Anesthesia ; Arterial Pressure ; Bradycardia ; Heart Rate ; Hemodynamics ; Humans ; Hypotension ; Intubation ; Laryngoscopy ; Muscles ; Piperidines ; Propofol

Pheochromocytoma is an uncommon tumor that originates in the adrenal medulla or in other paraganglia of the sympathetic nervous system. If a hypertensive crisis occurs during general anesthesia in incidental or untreated pheochromocytoma, it is a life-threatening event with a mortality rate of about 80%. Anesthetic drugs such as pancuronium, atracurium, and metoclopromide can exacerbate the potentially lethal cardiovascular effects of catecholamines. We report a case of a patient with pheochromocytoma who display abrupt increases in systolic arterial pressure and plasma norepinephrine following rocuronium administration. This case indicates the possible involvement of elevated sympathetic nervous system to a catecholamine crisis triggered by rocuronium in pheochromocytoma.
Adrenal Medulla ; Androstanols ; Anesthesia, General ; Anesthetics ; Arterial Pressure ; Atracurium ; Catecholamines ; Humans ; Norepinephrine ; Pancuronium ; Pheochromocytoma ; Plasma ; Sympathetic Nervous System

BACKGROUND: In this era of donor shortage, use of organs from living donors has increased significantly. Nonetheless, less than 1% of pancreas transplantations involve living donors, despite the immunological benefits, reduced cold ischemic time, and decreased waiting time. One reason for the paucity of donors is the high morbidity after open surgery. Using hand-assisted laparoscopic donor surgery (HALDS) can be a favorable technique for living donors. METHODS: Using HALDS, we performed three Simultaneous pancreas-kidney transplantations (SPKs) involving living donors. Two donors were women; one was a man. RESULTS: Their mean age was 34.3±4.7 years, and their body mass index was 23.2±2.36 kg/m². The mean operation time was 241±19.0 minutes and the mean cold-ischemic time of the kidney was 42.7±9.8 minutes, while that of the pancreas was 64.3±5.2 minutes. One donor developed a pancreatic fistula, which was controlled using conservative management. The donors' pancreatic and renal functions were well preserved postoperatively. CONCLUSIONS: HALDS for SPKs can be performed without significant complications if the surgeon has sufficient skill.
Body Mass Index ; Cold Ischemia ; Female ; Hand-Assisted Laparoscopy ; Humans ; Kidney Transplantation* ; Kidney* ; Living Donors* ; Pancreas Transplantation ; Pancreas* ; Pancreatic Fistula ; Tissue Donors*

BACKGROUND: Candida species are not only the leading cause of nosocomial fungal infections but also the important cause of infections in the immunocompromised hosts. Epidemiologic study of nosocomial candidiasis has been difficult because of the lack of a reliable typing system. We performed molecular epidemiologic study by using RFA and Southem hybridization for typing of candida isolates from patiients. METHODS: A total of 27 candida isolates from 19 immunocompromised patients were studied. Morphotyping and biotyping were done by germ tube test and API 20C system, respectively. Candidial chromosomal DNA was extracted, digested with EcoRI, HindalII and RFA was done. Southem hybridization of chromosomal DNA was also done with digoxigen-labelled Candial albicans-specific DNA probe. RESULTS: The time-period of development of oral candidiasis after admission was 5-14 days (mean: 8 days). C.albicans was the most common species (19), followed by C tropiadis (2), C glabn#zta (2), C.paratropicalis (2), and C parapsilosis (1). The subtypes of Candida species by RFA of chromosomal DNA were C. albieans, 12 types , C tropicalis, 2 types, C glabrata, 2 types ; C.parapsilasis, 1 type ; C. paratropicalis, 1 type. For 7 (87.5%) of 8 patients, RFA pattern of one isolate was identical to that of the other isolates. CONCLUSION: RFA of candidial chromosomal DNA results were obtainable within days. RFA showed high reproducibility, typeability and good discrimination power between isolates, provided a robust system that may be used rapidly to identify outbreaks of nosocomial candidiasis.
Candida ; Candidiasis* ; Candidiasis, Oral ; Cross Infection ; Discrimination (Psychology) ; Disease Outbreaks ; DNA ; Epidemiologic Studies* ; Epidemiology ; Humans ; Immunocompromised Host

Endosseous implants are used in the treatment of various types of tooth loss, and numerous long-term studies have demonstrated the excellent reliability of this method of treatment. However, the increase of implant failure are associated with inadequate quality and/or height of bone. At the end of the 1980s, Wide(>3.75mm) implants were initially used for managing these difficult bone situations. The recommended indications for its use included poor bone quality, inadequate bone height, immediate placement in fresh extraction sockets, and immediate replacement of failed implants. At the 2000s, wider implants(6.0mm and 6.5mm) were used in a few studies. Although good clinical outcomes have been reported in recent years, there is still a controversy on this topic. Therefore, the purpose of this study was to estimate the survival rate of wide implants(6.0~8.0mm) in molar regions, evaluating the clinical outcome. In this study, 1135 RBM surfaced wide implants(Rescue(TM), MEGAZEN Co., Korea/ 595 maxillary, 540 mandibular) were placed in 650 patients(403 male, 247 female/age mean: 51.2+/-11.1 years, range 20 to 83 years). Of the total, 68.3% were used to treat fully or partially edentulous situations, including single-tooth losses and 31.7% were placed immediately after teeth extraction or removal of failed implants, of which all were in the molar regions. Implant diameter and length ranged from 6.0 to 8.0mm and from 5.0 to 10.0mm, respectively. The implants were followed for up to 42 months (mean: 14.6+/-9.5 months). Of 1135 placed implants, 58 implants were lost. Among them, 53 implants were lost within 12 months after implant placement. The survival rate was 93.6% in the maxilla and 96.3% in the mandible, yielding an overall survival rate of 94.9%, for up to 42 months. As the result of Cox regression model, prosthetic type, sinus graft, and patient gender have an statistical significance on the implant survival rate in this study. This study suggests that the use of wide implants(6.0~8.0mm) would provide a predictable treatment alternative in posterior areas.
Humans ; Male ; Mandible ; Maxilla ; Molar* ; Retrospective Studies* ; Survival Rate ; Tooth ; Tooth Loss ; Transplants

PURPOSE: This study evaluated the effect of polishing techniques on surface roughness of polymethyl methacrylate (PMMA), as well as the influence of light-cured surface glaze and subsequent brushing on surface roughness. MATERIALS AND METHODS: A total of 60 PMMA specimens (10x10x5 mm) were made and then divided into 6 groups of 10 each according to the polymerization methods (under pressure or atmosphere) and the surface polishing methods (mechanical or chemical polishing) including 2 control groups. The mechanical polishing was performed with the carbide denture bur, rubber points and then pumice and lathe wheel. The chemical polishing was performed by applying a light-cured surface glaze (Plaquit(R); Dreve-Dentamid GmbH). Accura 2000(R), a non-contact, non-destructive, optical 3-dimensional surface analysis system, was used to measure the surface roughness (Ra) and 3-dimensional images were acquired. The surface roughness was again measured after ultrasonic tooth brushing in order to evaluate the influence of brushing on the surface roughness. The statistical analysis was performed with Mann-Whitney test and t-test using a 95% level of confidence. RESULTS: The chemically polished group showed a statistically lower mean surface roughness in comparison to the mechanically polished group (P = .0045) and the specimens polymerized under the atmospheric pressure presented a more significant difference (P = .0138). After brushing, all of the groups, except the mechanically polished group, presented rougher surfaces and showed no statistically significant differences between groups. CONCLUSION: Although the surface roughness increased after brushing, the chemical polishing technique presented an improved surface condition in comparison to the mechanical polishing technique.
Atmospheric Pressure ; Dentures ; Polymerization ; Polymers ; Polymethyl Methacrylate ; Rubber ; Silicates ; Tooth ; Ultrasonics

Extramedullary plasmacytoma involves organs outside the bone marrow, but involvement of the pancreas is very rare. We present the imaging findings of extramedullary plasmacytoma of the pancreas in a patient with multiple myeloma. Mixed echogenecity was noted at US, and marked enhancement at CT and MR.
Bone Marrow ; Humans ; Multiple Myeloma ; Pancreas* ; Plasmacytoma*