No abstract available.
Pregnancy*

OBJECTIVE: Activated endothelial cells mediate the cascade of reactions in response to hypoxia for adaptation to the stress. It has been suggested that hypoxia, by itself, without reperfusion, can activate the endothelial cells and initiate complex responses. In this study, we investigated whether hypoxia-induced endothelial products alter the endothelial permeability and have a direct cytotoxic effect on nerve cells. METHODS: Hypoxic condition of primary human umbilical vein endothelial cells(HUVEC) was induced by CoCl2 treatment in culture medium. Cell growth was evaluated by 3,4,5-dimethyl thiazole-3,5-diphenyl tetrazolium bromide (MTT) assay. Hypoxia-induced products (IL-1beta, TGF-beta1, IFN-gamma, TNF-alpha, IL-10, IL-6, IL-8, MCP-1 and VEGF) were assessed by enzyme-linked immunosorbent assay. Endothelial permeability was evaluated by Western blotting. RESULTS: Prolonged hypoxia caused endothelial cells to secrete IL-6, IL-8, MCP-1 and VEGF. However, the levels of IL-1, IL-10, TNF-alpha, TGF-beta, IFN-gamma and nitric oxide remained unchanged over 48 h hypoxia. Hypoxic exposure to endothelial cells induced the time-dependent down regulation of the expression of cadherin and catenin protein. The conditioned medium taken from hypoxic HUVECs had the cytotoxic effect selectively on neuroblastoma cells, but not on astroglioma cells. CONCLUSION: These results suggest the possibility that endothelial cell derived cytokines or other secreted products with the increased endothelial permeability might directly contribute to nerve cell injury followed by hypoxia.
Anoxia ; Astrocytoma ; Blotting, Western ; Culture Media, Conditioned ; Cytokines ; Down-Regulation ; Endothelial Cells* ; Enzyme-Linked Immunosorbent Assay ; Humans ; Interleukin-1 ; Interleukin-10 ; Interleukin-6 ; Interleukin-8 ; Neuroblastoma ; Neurons* ; Nitric Oxide ; Permeability ; Reperfusion ; Stroke* ; Transforming Growth Factor beta ; Transforming Growth Factor beta1 ; Tumor Necrosis Factor-alpha ; Umbilical Veins ; Vascular Endothelial Growth Factor A

Ullrich's disease is a congenital muscular dystrophy clinically characterized by generalized muscle weakness, multiple contractures of the proximal joints, and hyperextensibility of the distal joints. All the patients develop rigidity of spine, often assoicated with scoliosis, failure to thrive, and early and severe respiratory involvement, irrespective of their levels of motor function. Intellectual development is normal. The biopsied muscles show dystrophies including remarkable variation in the fiber size, notably proliferated endomysial connective tissues, and a lot of degenerated and regenerated fibers. The expression of merosin and dytrophin is normal. Recent studies have demonstrated that collagen VI is deficient in the muscles of the patients with Ullrich's disease, and some result from recessive mutations of the collagen VIalpha 2 gene(COL6A2). And a marked reduction of fibronectin receptors in the extracellular matrix of skin and cultured fibroblasts of these patients is also reported. These results suggest that collagen VI deficiency may lead to the reduction of fibronectin receptors and that any abnormalities of cell adhesion may be involved in the pathogenesis of the disease. A case of Ullrich's disease has not been reported yet in Korea. So, we describe a male patient with Ullrich's disease with a brief review of the literature.
Cell Adhesion ; Collagen ; Connective Tissue ; Contracture ; Extracellular Matrix ; Failure to Thrive ; Fibroblasts ; Humans ; Integrin alpha5beta1 ; Joints ; Korea ; Laminin ; Male ; Muscle Weakness ; Muscles ; Muscular Dystrophies ; Receptors, Fibronectin ; Scoliosis ; Skin ; Spine

OBJECTIVE: To elucidate the role of aquaporin-4(AQP4) in cerebral edema formation, we studied the expression and subcellular localization of AQP4 in astrocytes after focal cerebral ischemia. METHODS: Cerebral ischemia were induced by permanent middle cerebral artery(MCA) occlusion in rats and estimated by the discoloration after triphenyltetrazolium chloride(TTC) immersion. Change of AQP4 expression were evaluated using western blot. Localization of AQP4 was assessed by confocal microscopy and its interaction with alpha-syntrophin was analyzed by immunoprecipitation. RESULTS: After right MCA occlusion, the size of infarct and number of apoptotic cells increased with time. The ratio of GluR1/GluR2 expression also increased during ischemia. The polarized localization of AQP4 in the endfeet of astrocytes contacting with ventricles, vessels and pia mater was changed into the diffuse distribution in cytoplasm. The interactions of AQP4 and Kir with alpha-syntrophin, an adaptor of dystrophin complex, were disrupted by cerebral ischemia. CONCLUSION: The deranged spatial buffering function of astrocytes due to mislocalized AQP4/Kir4.1 channel as well as increased assembly of Ca2+ permeable AMPA receptors might contribute to the development of edema formation and the excitotoxic neuronal cell death during ischemia.
Animals ; Apoptosis ; Aquaporin 4 ; Astrocytes ; Blotting, Western ; Brain Edema* ; Brain Ischemia* ; Cell Death ; Cerebral Infarction ; Cytoplasm ; Dystrophin ; Edema ; Immersion ; Immunoprecipitation ; Ischemia ; Microscopy, Confocal ; Neurons ; Pia Mater ; Rats* ; Receptors, AMPA ; Receptors, KIR

Clinical features, laboratory and operative findings were reviewed in 17 cases adult Ebstein's anomaly admitted to Seoul National University Hospital from Feburary,1979 to October, 1987. 1) Mean age of first diagnosis was 28.6 tears old(range ; 14-57 years old). 2) Exertional duspnea(88.2%) and palpitation(64.7%) were the predominant symptoms, and PSVT was documented in 4 cases among 11 patoents with palpitation. 3) Echocardiogram showed displacement or delayed closure of the tricuspid valve in 13 cases. 4) On similtaneous recording of the intracardiac ECG and pressure, right ventricular electrogram with atrial pressure in atrialized right ventricle was observed in all cases. 5) Right ventriculogram revealed displacement of the tricuspid valve in 9 cases and tricuspid regurgitation in 10 cases. 6) Interatrial communication via ASD(8) and PFO(3) was present in 11 cases(64.7%). 7) Operative finding of 9 cases showed abnormalities of septal leaflet in 9(100%), posterior leaflet in 8(88.8%), and anterior leaflet in 2 cases(22.2%).
Adult* ; Atrial Pressure ; Diagnosis ; Ebstein Anomaly* ; Electrocardiography ; Heart Ventricles ; Humans ; Seoul ; Tricuspid Valve ; Tricuspid Valve Insufficiency

BACKGROUND: In 2000~2001 there was a nationwide outbreak of measles in the Republic of Korea. Since supplementary vaccination program was implemented in 2001, the control strategy of this measles outbreak has been stepped up from the control phase to the elimination phase. We here present the result of survey for the epidemiologic characteristics of the nationwide outbreak of measles in 2000~2001. METHODS: Using the data based on the sheet of epidemiologic investigation, incidences rates per 100,000 population and distributions of cases with vaccination history were investigated by the age. The seasonal or regional distribution were also studied with the onset days of cases. RESULTS: In 2000~2001, a measles outbreak occurred with 52,897 reported cases. The incidence rate per 100,000 population of measles was 111.9 cases and that of geopolitical unit (province) was high nationwide, 35.9~386.3 cases. The incidence rates were very high in less than 12 months and 10 years of age, 954.4 and 714.9, respectively. The 1st vaccination rate of measles/mumps/rubella (MMR) in 1~3 years old was 26.3~77.1%, and especially, that of 1 year old showed very low coverage, 26.3%. However, there was no special propensity in the 1st vaccine coverage in the age of 7~15 years, which had 87.7~91.4%. On the other hand, the 2nd MMR vaccination rate of the cases was very low, 17.7% at the age of 7~10 years. From the 21st May, 2001 a mass catch-up campaign with measles/rubella (MR) vaccine was launched, resulting in prominent reduction in the incidence of measles case. CONCLUSION: This survey showed that the measles outbreak in 2000~2001 had a high incidence nationwide from October 2000 to April 2001 and in less than 12 month and 10 years of age. Our results also showed that no routine immunization made the age group under 1 year vulnerable to measles infection. In cases of school-age group after 7 years of age, some cases with vaccination history were also infected. The characteristics of recent outbreaks indicates the need for the introduction of a specific vaccination programme at that age group. This survey was helpful to establish the effective vaccination strategy and it would be used as reference data on survey continuously for the epidemiologic characteristics of measles case for elimination of indigenous measles transmission in Republic of Korea.
Disease Outbreaks ; Epidemiology ; Hand ; Humans ; Immunization ; Incidence ; Korea* ; Measles* ; Republic of Korea ; Seasons ; Vaccination

BACKGROUND: This study reports the incidences of measles in Koea and the epidemiologic characteristics for the incidence reported for the period 1980~1999. It provides the epidemeologic adta for measles before implementing the catch-up campaign in 2001. METHODS: We obtained information for the survey from the data for the incidence reported from health centers. Incidences per 100,000 population were calculated for the 1963~1999. And the following variables were studied: seasonal or regional distribution for the 1980~1999. RESULTS: The incidence rate of measles declined after the systemic immunization in 1990, the outbreak of measles occurred periodically and incidences per 100,000 population increased from 8.4 cases in 1990 to 17.7 in 1994. In 1990 and 1994, measles cases centered around the 5~6th month. On the other hand, in non-epidemic year measles cases were scattered around the year. The incidence rates of measles by the province were greatly defferent whenever the outbreak of measles occurred. CONCLUSION: In 1990s, the outbreak of measles occurred periodically at the interval of 4 years until 1994. The seasonal distribution may be caused by Iimitation of transmission due to the increased measles immunity in outbreak region. Our results showed that the measles outbreak did not occur in the specific province, but it occurred nationwide whenever measles outbreak occurred, even though the incidence rates of the provinces were different.
Epidemiology ; Hand ; Immunization ; Incidence* ; Korea* ; Measles* ; Seasons

We experienced the case of infected mesh with subsequent infective cellulitis of obturator foramen after a TOT procedure. We reported our case of a 47-year-old woman who presented with persistent vaginal discharge, pain and motion limitation of left leg after having a TOT placed for stress incontinence. Inflammation around obturator foramen was demonstrated on computed tomography (CT) scan. We performed total excision of the mesh material. She ultimately had an uneventful postoperative course and no recurrence of incontinence after follow-up 1 month.
Cellulitis* ; Female ; Follow-Up Studies ; Humans ; Inflammation ; Leg ; Middle Aged ; Recurrence ; Suburethral Slings* ; Vaginal Discharge

BACKGROUND: Continuous ambulatory peritoneal dialysis (CAPD) is an important method of renal replacement therapy in chronic renal failure, and reduction of dialysis-associated complication is essential to successful peritoneal dialysis. But catheter related infection is a major cause of catheter loss and transferring to hemodialysis. We use an unique catheter revision method for the treatment of intractable exit-site/tunnel infection in CAPD patients. METHODS: We reviewed 322 CAPD patients on the ESI/TI from May 1995 to January 2003 at Yeungnam University Hospital. Forty-four patients had exit-site infection more than one times. Prevalence of exit-site infection, kinds of causative micro- organism and results of catheter revision were analyzed retrospectively. RESULTS: Total follow-up was 5, 834 patient months. ESI occurred on 141 occasions in 44 patients out of 322 patients and cumulative incidence of ESI was 1 per 41.4 patient months. We started empiric antibiotic therapy with oral penicillinase- resistant penicillin and quinolones, thereafter adjusted antibiotics according to the results of culture and sensitivity. The most common organism responsible for ESI was Staphylococcus aureus (MSSA, 34.8%), followed by Pseudomonas aeruginosa (25.5%). Nineteen patients had to be treated with catheter revision to control intractable ESI/TI. With analysis of ten patients who showed relapsed ESI after catheter revision, 5 patients improved with antibiotic therapy and 3 patients improved with additional secondary revision, but remaining 2 patients showed removal of peritoneal catheter to treat combined peritonitis. CONCLUSION: Catheter revision technique can be regarded as an effective alternative method to treat intractable exit site/tunnel infection before removal of catheter in CAPD patients.
Anti-Bacterial Agents ; Catheters* ; Follow-Up Studies ; Humans ; Incidence ; Kidney Failure, Chronic ; Penicillins ; Peritoneal Dialysis ; Peritoneal Dialysis, Continuous Ambulatory* ; Peritonitis ; Prevalence ; Pseudomonas aeruginosa ; Quinolones ; Renal Dialysis ; Renal Replacement Therapy ; Retrospective Studies ; Staphylococcus aureus

Hemangiomas result from proliferation of immature capillary vessels. This disorder in the genitourinary tract is a rare lesion. We experienced one case of a 31 years old man suffered from cavernous hemangioma of the penis shaft with painful erection. He was treated successfully with surgical excision. Herein, we report our experience and a critical review of the literature.
Capillaries ; Caves ; Hemangioma ; Hemangioma, Cavernous ; Male ; Penis