It is generally accepted that in acute pancreatitis, the enzymes normally excreted by the pancreas are released from the disrupted parenchyma into the extraductal space and taken up by way of the lymphatics and capillaries. The enzymes in the blood stream may appear in high concentration in the serum. Therefore, serum amylase and lipase determinations has long been a mainstay in the diagnosis of acute pancreatitis and other pancreatic diseases. However, many investigators have claimed that the urinary output of amylase may be elevated more consistently in acute pancreatitis than in the serum concentration of either amylase or lipase, and urinary amylase measurement is a more sensitive reflection of the presence of pancreatitis and of its clinical course than is the measurement of serum amylase or lipase. Clinically, one of the ominous signs which may develop during the early course of acute pancreatitis is severe hypotension. But, no agreement has been reached among investigators as to the cause of the hypotension, although several investigators have implicated a blood volume deficiency resulting form inflammatory process, and hypercalcemia. Perhaps, the majority have attributed the hypotension to systemic effect of some of the pancreatic enzymes, especially trypsin. Nevertheless, the correction of these factors sometimes fail to restore a normal blood pressure clinically. The purpose of the present investigation was to observe the relationships between serum concentration and urinary output of pancreatic enzymes, and to determine the degree of hypotension resulting from the systemic administration of pancreatic enzymes. These experimental procedures, consisted of heteroinfusion of human pancreatic juice and homoinfusion of canine pancreatic emulsion intravenously, and pancreatic ductal ligation in dogs. Blood and urine samples for the enzyme analysis were collected serially thorough the femoral vein and ureteral catheter before and after the procedure. Blood pressure was measured consistently by the kymograph before and after infusion of pancreatic juice. Activities of amylase and lipase were determined by methods of Nelson and, Cherry and Crandall, respectively. The results obtained are summarized as follows; 1. Following intravenous infusions of pancreatic juice exogenously. serum and urine concentrations of amylase and lipase increased rapidly, but these enzymes decreased rapidly in urinary excretion and gradually in serum concentration. Urinary recovery of amylase was approximately 10% of the total infused amount of pancreatic juice at the end of 4 hours. 2. Following ligation of the pancreatic duct, the amylase and lipase levels of serum rose gradually and reached the maximum at 24-48 hours after ligation and then gradually fell. The output of these enzymes in the urine were relatively constant while serum enzymes were increased. 3. When the human pancreatic juice was infused, hypotension was pronounced, and it was deeper and more prolonged in hypotensive effect with infusion of highly concentrated juice in the enzyme activities. With human pancreatic juice, a more sustained hypotension occurred than was observed after infusion of canine pancreatic emulsion. As a result of this investigation, it is felt that the hypotension in acute pancreatitis is probably the result of pancreatic enzymes itself. 4. In postinfusion period, the urine volume was markedly decreased following hypotension, and the urine volume was increased following blood pressure to normal level. This suggests that urine volume may diminish resulting from transient acute renal failure due to hypotensive effect by pancreatic enzymes.
Acute Kidney Injury ; Amylases ; Animals ; Blood Pressure ; Blood Volume ; Capillaries ; Diagnosis ; Dogs* ; Femoral Vein ; Humans ; Hypercalcemia ; Hypotension ; Infusions, Intravenous ; Ligation ; Lipase ; Pancreas ; Pancreatic Diseases ; Pancreatic Ducts ; Pancreatic Juice ; Pancreatitis ; Prunus ; Research Personnel ; Rivers ; Trypsin ; Urinary Catheters

The major goals of periodontal therapy are the functional regeneration of periodontal supporting structures already destructed by periodontal disease. There have been many efforts to develop materials and therapeutic methods to promote periodontal wound healing. With the development of non-resorbable membrane, GTR has proved to be the representive technique of periodontal regeneration. However, due to various clinical problems of non-resorbable membrane, resorbable membrane was developed and it showed to be clinically effective. The newly developed Para-Dioxanone membrane has a characteristic of non-woven fabric structures which is different from the generally used membranes with structure of mesh form. In addition, Chitosan membrane has been developed to apply its adventage maximally in GTR. Although a number of different types of membranes had been clinically used, researches on absorption rate of membranes were inadequate and limited to subjective opinions. However, since long term period of resorption and space maintenance are required in implant or ridge augmentation, accurate verification of resorption rate is clinically important. In this study, we had implanted Resolut(R), Biomesh(R), Para-Dioxanone membrane and Chitosan membrane (Size : 4mmx4mm) on dorsal side of Sprague Dawley rat, and sacrificed them after 4 weeks, 8 weeks, 12 weeks respectively. Histologic observation was carried out, and the following results were obtained by calculating the objective resorption rate. 1. In case of Resolut(R), external resorption took place initially, followed by internal resorption. Surface area are 5.76+/-2.37mm2, 4.91+/-1.06mm2, 4.90+/-0.98mm2 at 4 weeks, 8 weeks, 12 weeks respectively, and invasion rate of connective tissue to membrane are 31.6+/-4.5%, 52.8+/-9.4%, 56.4+/-5.1% respectively. 2. Biomesh(R) showed a pattern of folding, relatively slow resorption rate with small size of membrane. Surface area are 3.62+/-0.82mm2, 3.63+/-0.76mm2, 4.07+/-1.14mm2 at 4 weeks, 8 weeks, 12 weeks respectively, and invasion rate of connective tissue to membrane are 26.1+/-5.8%, 30.9+/-3.4%, 29.2+/-3.6%, respectively. 3. Para-Dioxanone membrane was surrounded by fibrous conncetive tissue externally, and resorption took place internally and externally. Surface area are 5.96+/-1.05mm2, 4.77+/-0.76mm2, 3.86+/-0.84mm2 at 4 weeks, 8 weeks, 12 weeks respectively, and invasion rate of connective tissue to membrane are 30.7+/-5.1%, 53.3+/-4.4%, 69.5+/-3.1%, respectively. 4. Each fiber of Chitosan membrane was surrounded by connective tissue and showed external resoption pattern. It showed little invasion of inflammatory cells and excellent biocompatability. The resorption rate was relatively slow. Surface area are 6.01+/-2.01mm2, 5.49+/-1.3mm2, 5.06+/-1.38mm2 at 4 weeks, 8 weeks, 12 weeks respectively, and invasion rate of connective tissue to membrane are 31.3+/-3.6%, 38.4+/-3.8%, 39.7+/-5.6%, respectively. Consequently, Para-Dioxanone membrane and Chitosan membrane are found to be clinically effective for their excellent tissue reaction and biocompatibility. Futhermore, the advantage of bone regenerating ability as well as the relatively long resorption period of Chitosan membrane, it might be widely used in implant or ridge augmentation.
Absorption ; Animals ; Chitosan ; Connective Tissue ; Membranes* ; Periodontal Diseases ; Rats ; Regeneration ; Space Maintenance, Orthodontic ; Wound Healing

The major goals of periodontal therapy are the functional regeneration of periodontal supporting structures already destructed by periodontal disease as well as the reduction of signs and symptoms of progressive periodontal disease. There have been many efforts to develop materials and therapeutic methods to promote periodontal wound healing. Bone graft & guided tissue are being used for the regeneration of destroyed periodontium these days. Non-resorbable membranes were used for Guided tissue regeneration in early days, however more researches are focused on resorbable membranes these days. The aim of this study is to evaluate the osteogenesis of paradioxanone membrane on the calvarial critical size defect in Sprague Dawley rats. An 8 mm diameter surgical defect was produced with a trephine bur in the area of the midsagittal suture. The rats were divided into three groups: Untreated control group, Biomesh(R) group and paradioxanone group. The animals were sacrificed at 4, 8 and 12 weeks after surgical procedure. The specimens were examined by histologic, histomorphometric analyses. The results are as follows: 1. In histological view on Biomesh(R), no visible signs of resorption was observed at 4 weeks but progressive resorption was observed at 8 weeks through 12 weeks. Paradioxanone membrane expanded at 4 weeks, and rapid resorption was observed at 8 weeks. In both the membranes, inflammatory cells were observed around them. Inflammatory cells decreased with time but were still present at 12 weeks. More inflammatory cells were observed in paradioxanone membranes than in Biomesh(R) membrane. 2. The area of newly formed bone in the defects were 0.001+/-0.001, 0.006+/-0.005, 0.002+/-0.003 at the 4 weeks, 0.021+/-0.020, 0.133+/-0.073, 0.118+/-0.070 at the 8 weeks and 0.163+/-0.067, 0.500+/-0.197, 0.487+/-0.214 at the 12 weeks in the control group, Biomesh(R) group and experimental group respectively. Compared to the control group, Biomesh(R) group displayed significant differences at 4,8, and 12 weeks and the paradioxanone group at 8 and 12 weeks.(P<0.05) 3. The area of residual membranes were 1.143+/-0.499, 2.599+/-1.012, at the 4 weeks, 0.666+/-0.140, 0.314+/-0.131 at the 8 weeks and 0.365+/-0.110, 0.076+/-0.050 at the 12 weeks in the Biomesh(R) group and experimental group respectively. Between the two groups, significant differences were displayed at 4 weeks.(P<0.05) According to the results, when paradioxanone membrane was used in calvarial critical size defect in Sprague Dawley rat, initially the membrane expaned and regeneration of newly formed bone was small however after 8weeks new bone was formed with simultaneous resorption for the membrane. If a few problems could be solved, previously used membranes could be replaced in periodontal guided tissue regeneration.
Animals ; Guided Tissue Regeneration ; Guided Tissue Regeneration, Periodontal ; Membranes ; Osteogenesis ; Periodontal Diseases ; Periodontium ; Rats ; Rats, Sprague-Dawley* ; Regeneration ; Sutures ; Transplants ; Wound Healing

The p16 is a cyclin-dependent kinase inhibitor(CDKI) that inhibits cell cycle progression. In recent studies, homozygous deletions of p16 gene have been noted in some cancer cell lines, which implies the deletion or mutation of p16 gene may contribute to the malignant progression of cells in some ways. This study was to investigate the frequency of p16 gene mutation in breast cancer patients by using polymerase chain reaction-single stranded confromational polymorphysm(PCR-SSCP) analysis. Examination of 24 blood samples and corresponding 16 tissue samples from 24 breast cancer patients were performed by PCR-SSCP method. Four from 24 blood samples(16.7%) disclosed 3 abnormal bands and one band shifting. Among 13 tissue samples revealed three conformational changes(23.1%). In two cases, there were abnormal bands in both blood samples and cancer tissues. One case with no products by PCR in the tissue sample showed a band shifting in the blood sample. Three cases with no PCR products in tissue samples may considered as total allelic deletion of the p16. The cases of abnormal PCR-SSCP results show some abnormalities on direct sequencing by Sanger method as T base insertion, C/T and A/G bases substitution. The results may suggest some of breast cancer patients have germline mutations of the p16 gene and some have somatic mutations. In the carcinogenesis of some breast cancers, p16 gene mutation may dysregulates the cell cycle, that may play an important role in the unlimited tumor cell proliferations.
Breast Neoplasms* ; Breast* ; Carcinogenesis ; Cell Cycle ; Cell Line ; Genes, p16 ; Germ-Line Mutation ; Humans* ; Phosphotransferases ; Polymerase Chain Reaction

OBJECTIVE: The purpose of this study was to investigate the methods for analysis of restriction fragment length polymorphisms of hemophilia B (coagulation factorIX) gene in Korean population. METHODS: Genomic DNAs were extracted from 40 Korean females. In order to amplify genomic DNAs at the region of the polymorphic sites, two sets of primers (Hha I and Dde I) were synthesized. The primers were named as FIX1, FIX2 for Hha I, and Dde I 59, Dde I 39 for Dde I, respectively. Hha I primers annealed 3'-flanking region of the FactorIX gene and amplified 230 bp long fragment. The PCR fragment (230 bp) treated with Hha I endonuclease produced two fragments (150 bp and 80 bp), when the polymorphic site existed. Dde I primers annealed the region of the first intron of Factor IX gene and amplified 319 bp long fragments. People cases with Dde I polymorphic site are supposed to produce 369 bp long fragment. Results: It has been found that seven (14 X chromosomes) out of forty individuals showed Hha I polymorphism. However, none of the experimental People cases showed the Dde I polymorphism. CONCLUSIONS: By the analysis of 80 chromosomes, the PICs calculated from allele frequency of Hha I-RFLP (0.175/0.825) and that of Dde I-RFLP (0.0/1.0) were 0.289=[1-(0.1752+0.8252)] and 0=[1-(02+12)], respectively. From these results, it can be postulated that Hha I and Dde I polymorphisms of the Factor IX gene in Korean exhibited different patterns from those of Caucasian.
Blood Coagulation Factors* ; Blood Coagulation* ; Dichlorodiphenyl Dichloroethylene ; DNA ; Factor IX* ; Female ; Gene Frequency ; Genes, vif* ; Hemophilia B ; Humans ; Introns ; Polymerase Chain Reaction ; Polymorphism, Restriction Fragment Length*

Poor dietary habits and inadequate nutrient intakes are of concern in the elderly, even it is worse in rural areas. In the present study, we conducted the anthropometric measurement and the dietary intakes including macronutrients, minerals and vitamins to assess the nutrient intakes and nutritional risk in elderly people in rural kyungpook province in South Korea. Subjects (n = 168, mean age, 67.3 yrs) were interviewed using d general questionnaire and 3 days of 24-hours recall for dietary intake. Nutrient intakes were analyzed using CAN-pro soft program and compared to Korean RDA and nutrition reference values (NRV). The anthropometric measurement showed that the weight and the height of the subjects in the rural area were below the average of the same age of Korean elderly people. The energy and protein intakes were 85% and 90% of Korean RDA, respectively. The intakes of lipid, cholesterol and dietary fiber were 62%, 40% and 22% of NRV for Korean adults. Main sources for protein and lipid intakes came from the vegetable sources and this pattern was more prominent in female elderly people. Ca intake was half of Korean RDA (56%), while P intake was 132% of Korean RDA. For the antioxidant trace mineral (Fe, Cu, Mn, Zn, and Se) intakes, Fe and Zn intakes were 78% and > 103% of Korean RDA. Cu, Mn and Se intakes were > 113%, > 275%, and > 185% of Korean NRV. Thiamin, niacin and vitamin C intakes were above Korean RDA, but the intakes of vitamin A and riboflavin were 88% and 63% of Korean RDA, respectively. On summarizing the results of the present study, the elderly people in rural area consume less lipid, cholesterol, Ca, and dietary fiber. Ca intake is lower, while P intake is higher, and this would be the potential risk for bone health. Also, Na intake was high, which can be the potential risk for the cardiovascular disease prevailance. Vitamin intakes were fairly good status, excepting riboflavin. Antioxidant mineral intakes were much higher than Korean NRV, unexpectedly. The results suggest that the elderly people in rural area have inadequate intakes of protein, lipid, dietary fiber and Ca, which mainly should be supplied from animal products. Recommendations to increase diet variety would be emphasized for this nutritionally poor-conditioned subjects, specially including animal food products and high dietary fiber food.
Adult ; Aged* ; Animals ; Ascorbic Acid ; Cardiovascular Diseases ; Cholesterol ; Diet ; Dietary Fiber ; Female ; Food Habits ; Gyeongsangbuk-do* ; Humans ; Korea* ; Minerals ; Niacin ; Surveys and Questionnaires ; Reference Values ; Riboflavin ; Vegetables ; Vitamin A ; Vitamins*

Thymomas are associated with different paraneoplastic syndromes, with the most clinically important association being with myasthenia gravis, hypogammaglobulinemia, and pure red cell aplasia (PRCA). The optimal therapy for PRCA that complicates a thymoma is unknown, given the rarity of the clinical situation. It has been suggested that remission following surgery alone is uncommon and most patients will require some other form of therapy. We report a case of PRCA with a thymoma in a 59-year-old man who remained in complete remission of the PRCA after surgical resection of the thymoma.
Agammaglobulinemia ; Humans ; Middle Aged ; Myasthenia Gravis ; Paraneoplastic Syndromes ; Red-Cell Aplasia, Pure* ; Thymoma*

BACKGROUND: The emergence of non-typhoidal Salmonella (NTS) with decreased susceptibilities to fluoroquinolone, ampicillin, or ceftriaxone has been reported worldwide. However, current surveillance studies of resistance among NTS in Korea are limited. Thus, the antimicrobial susceptibilities; resistance mechanisms such as extended-spectrum beta-lactamase (ESBL), plasmid-mediated AmpC beta-lactamase (PABL), and plasmid-mediated quinolone resistance (PMQR); and molecular epidemiologic characteristics were investigated in the present study. METHODS: National Institute of Health and National Veterinary Research and Quarantine Service collected NTS strains from 219 clinical and 293 non-clinical specimens from 2006 to 2008. The antimicrobial susceptibilities were determined using the Clinical and Laboratory Standards Institute disk diffusion test. ESBL, PABL, and qnr genotyping were performed using PCR and nucleotide sequencing. Pulsed-field gel electrophoresis was used for the molecular epidemiologic study. RESULTS: The resistance to ampicillin in clinical and non-clinical NTS was 49% and 18 to 47%, respectively. The resistance rates to trimethoprim-sulfamethoxazole in clinical and non-clinical NTS were 8% and 0 to 41%, respectively. The rates to extended-spectrum cephalosporin were 0 to 1%. One CTX-M-15-producing isolate and four CMY-2-producing isolates were detected. Notably, PFGE analysis showed four isolates carrying bla CMY-2, including one non-clinical strain had high clonality. Although the rate of ciprofloxacin resistance was very low, two qnrS1-carrying NTS strains were detected in non-clinical specimens. CONCLUSION: The resistance rates to ampicillin in both clinical and non-clinical NTS were high, while those to trimethoprim-sulfamethoxazole varied depending on the specimen. NTS strains harboring CTX-M-15-type ESBL or CMY-2-type PABL were detected even though the resistance rates to cephalosporins were very low. Four NTS strains carrying the blaCMY-2-gene implied zoonotic infection. Continuous effort to minimize transfer of resistance genes in NTS is necessary.
Ampicillin ; Animals ; Bacterial Proteins ; beta-Lactamases ; Ceftriaxone ; Cephalosporins ; Ciprofloxacin ; Diffusion ; Electrophoresis, Gel, Pulsed-Field ; Humans ; Korea ; Lifting ; Polymerase Chain Reaction ; Quarantine ; Salmonella ; Sprains and Strains ; Trimethoprim, Sulfamethoxazole Drug Combination

Pulmonary mucormycosis is an opportunistic infection in patients with severe underlying illness such as immunocompromised diseases or uncontrolled diabetes mellitus. While patients with leukemia and lymphoma usually resent with diffuse parenchymal disease, diabetic patients usually have a localized endobronchial disease involving central airways. We report upon a case of pulmonary mucormycosis in diabetes mellitus patient presenting as an endobronchial mass, which was cured with antifungal therapy, rigid bronchoscopic mass removal and right pneumonectomy.
Diabetes Mellitus ; Humans ; Leukemia ; Lymphoma ; Mucormycosis* ; Opportunistic Infections ; Pneumonectomy

BACKGROUND: Diffuse alveolar hemorrhage (DAH) is rare but often fatal. To determine the clinical manifestations of DAH, its etiology, clinical course and prognosis were studied. METHODS: A retrospective analysis was performed in 21 patients that were diagnosed as DAH. Diagnosis of DAH was based on the presence of the "classical triad" of hemoptysis, anemia, and rapidly progressive infiltrates on chest X-ray and a finding of bronchoalveloar lavage or lung biopsy. RESULTS: Thirteen patients (61.9%) had collagen vascular diseases (CVDs) as underlying disease and 10 patients had systemic lupus erythematosus. Females were more prevalent in CVD than in non-collagen vascular disease (NCVD). Otherwise, there were no significant differences between the two groups in terms of clinical manifestations. Dyspnea (95.2%), cough (76.2%), hemoptysis (61.9%), and fever (33.0%) were frequent symptoms. The initial creatinine level was higher in CVD than in NCVD (3.27±3.15 mg/dl vs. 1.19±0.94 md/dl, p=0.030). The corresponding drop in hemoglobin level was 2.69±1.26 g/dl. Maximal drop in hemoglobin preceded the progression of infiltrates on the chest radiograph by 1.38±4.22 days. The mortality rate was higher in the patients with NCVD than in those with CVD (50.0% vs. 23.1%). CONCLUSION: The DAH can occur not only in patients with CVD but also in those with NCVD. Higher creatinine level CVD in patients is associated with renal involvement in conjunction with DAH. The maximal drop in hemoglobin preceeding the progression of infiltrates on the chest radiograph suggests that the drop in hemoglobin is important for diagnosing DAH.
Anemia ; Biopsy ; Collagen ; Cough ; Creatinine ; Diagnosis ; Dyspnea ; Female ; Fever ; Hemoptysis ; Hemorrhage* ; Humans ; Lung ; Lupus Erythematosus, Systemic ; Mortality ; Prognosis ; Radiography, Thoracic ; Retrospective Studies* ; Therapeutic Irrigation ; Thorax ; Vascular Diseases