The standard iron-chelator deferoxamine is known to prevent the growth of coagulase-negative staphylococci (CoNS) which are major pathogens in iron-overloaded patients. However, we found that deferoxamine rather promotes the growth of coagulase-positive Staphylococcus aureus. Accordingly, we tested whether deferiprone, a new clinically-available iron-chelator, can prevent the growth of S. aureus strains as well as CoNS. Deferiprone did not at least promote the growth of all S. aureus strains (n=26) and CoNS (n=27) at relatively low doses; moreover, it could significantly inhibit the growth of all staphylococci on non-transferrin-bound-iron and the growth of all CoNS on transferrin-bound iron at relatively high doses. At the same doses, it did not at least promote the growth of all S. aureus strains on transferrin-bound-iron. These findings indicate that deferiprone can be useful to prevent staphylococcal infections, as well as to improve iron overload, in iron-overloaded patients.
Deferoxamine/pharmacology ; Humans ; Iron/metabolism ; Iron Chelating Agents/*pharmacology ; Iron Overload/metabolism ; Microbial Sensitivity Tests ; Pyridones/*pharmacology ; Staphylococcus/*drug effects/growth & development ; Staphylococcus aureus/drug effects/growth & development ; Transferrin/metabolism

The adrenocartical carcinoma is a rare tumor with an estimated incidence of 1 case per 1,700,000 population. Despite its rarity, a large number of investigators have studied this neoplasm for the following two reasons. The First is the occasional difficulty of differentiation between careinoma and adenoma at the time of initial surgery, even by histopathologic examination. The other is its unique feature of corticosteroidogenesis. Steroid metabolism of adrenocortieal carcinoma is characterized by its low efficiency of steroid production due to deficiency of steroidogenic enzyme. The deficieney of 11 B-hydroxylase has been indieated in case of adrenoeortical carcinoma by several investigators. In this study, the serum level of cortisol was within normal range, but the serum level of 11-deoxycortisol was 50 times higher than normal. After the removal of tumor, the serum level of ll-deoxycortisol was markedly decm. In conclusion, the results from the this case suggest that measurement of serum 11-deoxy- cortisol may be a useful tool in the diagnosis and follow-up of adrenocortical carcinoma.
Adenoma ; Adrenocortical Carcinoma* ; Cortodoxone ; Diagnosis ; Follow-Up Studies ; Humans ; Hydrocortisone ; Incidence ; Metabolism ; Reference Values ; Research Personnel

We identified 6 sucrose-fermenting Vibrio vulnificus strains and examined their virulence characteristics. They were all encapsulated, motile, capable of producing toxins and utilizing transferrin-bound iron, cytotoxic to cultured cells, and virulent enough to kill mice. They could be definitely identified only by genetic identification methods such as PCR, and not by conventional culture-based identification methods such as API 20E (bioMerieux, France). These results indicate that it is essential to adopt genetic approaches as early as possible in order to avoid misdiagnosis of such strains, especially in clinical situations.
Animals ; Bacterial Proteins/genetics ; Fermentation ; Mice ; RNA, Ribosomal, 16S/genetics ; Sequence Analysis, DNA ; Sucrose/*metabolism ; Vibrio vulnificus/genetics/growth & development/*pathogenicity ; Virulence

Vibrio vulnificus, a gram-negative halophilic marine bacterium and opportunistic human pathogen, must withstand various environmental changes, especially simultaneous changes in temperature and salinity, from 25degrees C/2.5% to 37degrees C/0.9% (SCTS) upon entering the human body. In our previous study, SCTS stimulated vvpE expression even in the background of a mutation in luxS encoding LuxS enzyme for the biosynthesis of quorum-sensing (QS) signal molecule autoinducer-2 (AI-2), suggesting that the A1-2-mediated QS system is partially involved in the SCTS-mediated change of vvpE expression. In this study, we examined the effects of the QS master regulator SmcR on SCTS-mediated changes in vvpE expression and extracellular VvpE production. SCTS stimulated V. vulnificus growth, but with no increase in maximal growth levels. The SCTS-mediated prolongation of the stationary growth phase resulted in a significant increase in growth phase-dependent smcR and vvpE expressions. A mutation in smcR seriously repressed vvpE expression, but had no significant effect on V. vulnificus growth. However, the smcR mutation only partially attenuates SCTS-mediated changes in vvpE expression. These results indicate that SCTS stimulates the expressions of smcR and vvpE by stimulating V. vulnificus growth, and that SmcR is only partially involved in SCTS-mediated changes in vvpE expression.
Human Body ; Humans ; Salinity ; Vibrio ; Vibrio vulnificus

BACKGROUND: Due to the increase in average life expectancy, the number of elderly people in the population has also increased and it is argued that this has led to a rise in chronic regression type diseases or dementia and related psychoneurological diseases, together with the growing occurrence of cognitive function disorders. However, it can be said that research in Korea towards systematic general function assessment or machinery for diagnosis is insufficient. Accordingly, the authors of this paper, investigated elderly people, both institutionalized and shill living in the community for their cognitive functions and their ability to carry out daily life skills. Afterwards, the early diagnosis of mental illness and rehabilitation management for elderly patients was put into operation for this research. METHODS: During October of 1997 a certain retirement home in Kyonggi-do and a public health centre in Seoul were visited and forty patients from the home, and forty-five patients from the health centre, all over 65 years of age, were the objects of tests for cognition functions using the mini-mental status examination -Korea(MMSE-K), Their ability to carry out activity of daily living was tested through the modified Ballhel index for measurement, comparison and analysis. RESULTS: The group from the institution had an average MMSE-K of 24.05 with no significant difference between gender, age and degree of education. The health centre group's MMSE-K of 26.16 was a higher ,score(p<0.05), by men and by at least elementary ,school education. If we look at different classifications, the institutionalized group included 13 people(32.5%) ar a normal level, 18 people (45.0%) with mildly impairments, 9 people(17.5%) had moderately impairments and no severly handicapped patients. Looking at the community elderly, 23 people(51.1%) were at a normal level, 19 people (42.2%) had middle impairments, 3 people(6.7%) had moderately impairments and there were no severly impairments. With the MBI, the institutionalized group had an average of 95.9 and the community group had an average of 98.62 so both ,scored highly(p<0.05). If the MBI of the two group's dependency is compared, 17 people(42.5%) of the institution's elderly were independent in activity of daily living, 17 people(42.5%) were minimal dependent and the remaining 6 people(15.%) were mild dependent. 30(66.7%) of the community elderly were independent in daily living activity, 14 people (31.1%) were mild dependent and 1 people(2.2%) war mild dependent. Even the elderly with normal cognitive functions had disorders with their daily living activity Therefore a sample of the patients have above average damaged cognitive functions and severe living activity disorders are being seen in both groups. CONCLUSION: Both the community and institutionalized elderly had resonable cognition and the institutionalized groups had especially high levels. It is now believed that there is a relation between this and the lack of suitable evaluation in Korea. Even if the daily living activity disorders were not severe, they were observed in both groups, so henceforth, if cognitive function tests were made with consideration given to age and gender, and activity of daily living tests were implemented efficiently, the overall health and well-being of the elderly, and therefore demands for medical treatment and social services, could be decided and put into operation.
Activities of Daily Living ; Aged* ; Classification ; Cognition ; Dementia ; Diagnosis ; Disabled Persons ; Early Diagnosis ; Education ; Gyeonggi-do ; Humans ; Korea ; Life Expectancy ; Male ; Nursing Homes* ; Nursing* ; Public Health ; Rehabilitation ; Retirement ; Seoul ; Social Work

No abstract available.
Abscess* ; Thyroid Gland*

Vibrio vulnificus, a gram-negative halophilic marine bacterium and opportunistic pathogen, must withstand various environmental changes, especially the simultaneous change of temperature and salinity (SCTS) from 25degrees C/2.5% to 37degrees C/0.9% upon entering the human body. Previous studies have suggested that temperature and salinity may affect the production of metalloprotease VvpE via the LuxS-mediated autoinducer-2 quorum sensing system (AI-2-QSS). However, this hypothesis remains to be verified through coherent experiments. In this study, SCTS stimulated V. vulnificus growth with no increase in total growth levels. The SCTS-mediated prolongation of the stationary growth phase resulted in a significant increase in growth phase-dependent luxS and vvpE transcriptions; however, SCTS did not affect luxS or vvpE transcription levels during the exponential growth phase. SCTS also advanced extracellular VvpE production, which was consistent with vvpE transcription and V. vulnificus growth. SCTS-mediated modulation of vvpE expression was slightly attenuated but still observed in the background of a luxS mutation which seriously repressed vvpE expression. These results indicate that SCTS stimulates luxS and vvpE expression by stimulating V. vulnificus growth; however, the LuxS-mediated AI-2-QSS plays only a minor role, if any, in the SCTS-mediated modulation of vvpE expression.
Human Body ; Quorum Sensing ; Salinity ; Vibrio ; Vibrio vulnificus

Analgetic effect of small amount of morphine on spinal and epidural anesthesia was investigated. Patients who received morphine showed marked analgetic effect compared to control group. It was found that the amount of morphine needed was larger for epidural anesthesia than for spinal anesthesia, the former being more than 2mg, and the latter less than 0.5mg. Spinal and epidural morhphine caused complications on several occasions: pruritis, respiratory depression with pinpoint pupil and urinary retention in spinal anesthesia, and nauses and pruritis in epidural anesthesia.
Anesthesia, Epidural ; Anesthesia, Spinal ; Humans ; Injections, Epidural* ; Morphine* ; Pruritus ; Pupil ; Respiratory Insufficiency ; Urinary Retention

This is a case report of a 61 years old man with suprasellar and pituitary metastasis from bronchogenic adenocarcinoma who developed polyuria and polydipsia. The clinical diagnosis has been made by bronchoscopy with washing cytology, biopsy of cervical lymph node, and brain MRI scan. Brain MRI scan showed metastatic tumor in the suprasellar area and pituitary gland with invasion of pituitary stalk. Light microscopic findings revealed adenocarcinoma in bronchoscopic washing cytology, and metastatic adenocarcinoma in the cervical lymph node. The combined pituitary stimulation test showed decreased reserve capacity of anterior pituitary hormones. And the water deprivation test also showed complete central diabetes inspidus. We report a case of suprasellar and pituitary metastasis from bronchogenic adenocarcinoma with a review of the literature.
Adenocarcinoma ; Biopsy ; Brain ; Bronchoscopy ; Diabetes Insipidus* ; Diagnosis ; Humans ; Hypopituitarism ; Lung Neoplasms ; Lung* ; Lymph Nodes ; Magnetic Resonance Imaging ; Middle Aged ; Neoplasm Metastasis* ; Pituitary Gland ; Pituitary Hormones, Anterior ; Polydipsia ; Polyuria ; Water Deprivation

Cushing's syndrome that is caused by an adenoma of the corticotrape cells of the anterior pituitay or, rarely, by couticotrope hyperplasia is refered to as Cushing's disease. Cushings disease is usually characterized by chronic, moderate hypersecretion of ACTH and other POMC derived peptide. Most patients have ACTH-secreting anterior pituitary corticotrope microadenomas, but a small minority have a pituitary macroadenoma. We recently experenced two cases of Cushings disease due to pituitary macroadenoma. and report this cases with review of literatures.
Adenoma ; Adrenocorticotropic Hormone* ; Cushing Syndrome ; Humans ; Hyperplasia ; Pro-Opiomelanocortin