To determine relationships of supposed risk factors to positives for HBsAg and Anti-HBs and also relationships of subjective symptoms to positives for HBsAg and Anti-HBs, study of 658 people working in the hospital, university, bank and other office was performed. Positive rate for HBsAg was about 7.9% and positive rate for Anti-HBs was about 20.0%. Odds ratio of HBsAg was high and significant in individuals who are married and who have previous hepatitis B(P<0.001), medical personnel in family, more than 4 people in a room.(0.01 Odds ratio of Anti-HBs was also significant in individuals who have previous hepatitis B, liver disease in family, more than 4 people in a room.(0.01 Epidemiologic Studies* ; Hepatitis ; Hepatitis B ; Hepatitis B Surface Antigens* ; Humans ; Liver Diseases ; Odds Ratio ; Risk Factors ; Vaccination

PURPOSE: Totally extraperitoneal (TEP) hernia repair has gained in popularity in the past two decades. Despite the advantages TEP hernia repair, the approach is hindered by the relatively long learning curve of the surgery. We tried to estimate the necessary number of repetitions of TEP hernia repair in the learning curve using logarithmic and exponential function models. METHODS: We performed a retrospective review of all patients who underwent TEP hernia repair by a single surgeon consecutively at a single center. We calculated how many operations were needed to achieve a reduction in the expected operating time to mean operating time using logarithmic and exponential function models. RESULTS: In the 91 patients, the logarithmic function model predicted that 37 cases were needed to overcome the learning curve for TEP hernia repair while the exponential model predicted that 39 cases were needed. CONCLUSION: According to this study, at least 37 to 39 cases are needed in the overcome learning curve of TEP hernia repair. Further studies are needed to optimize surgical education and maximize quality.
Education ; Herniorrhaphy* ; Humans ; Learning Curve* ; Learning* ; Likelihood Functions ; Retrospective Studies

Streptococcus pneumoniae causes many people to suffer from pneumonia, septicemia, and other diseases worldwide. To identify the difference in susceptibility of and treatment efficacy against S. pneumoniae in three ICR mouse stocks (Korl: ICR, A:ICR, and B:ICR) with different origins, mice were infected with 2 × 106, 2×107, and 2×108 CFU of S. pneumoniae D39 intratracheally. The survival of mice was observed until three weeks after the infection. The three stocks of mice showed no significant survival rate difference at 2 × 106 and 2 × 107 CFU. However, the lung and spleen weight in the A:ICR stock was significantly different from that in the other two stocks, whereas the liver weight in B:ICR stock was significantly lower than that in the other two stocks. Interestingly, no significant CFU difference in the organs was observed between the ICR stocks. The level of interferon gamma inducible protein 10 in Korl:ICR was significantly lower than that in the other two stocks. The level of granulocyte colony stimulating factor in B:ICR was significantly lower than in the other two stocks. However, tumor-necrosis factor-alpha and interleukin-6 levels showed no significant difference between the ICR stocks. In the vancomycin efficacy test after the S. pneumoniae infection, both the single-dose and double-dose vancomycin-treated groups showed a significantly better survival rate than the control group. There was no significant survival difference between the three stocks. These data showed that Korl:ICR, A:ICR, and B:ICR have no susceptibility difference to the S. pneumoniae D39 serotype 2.
Animals ; Colony-Stimulating Factors ; Granulocytes ; Interferons ; Interleukin-6 ; Liver ; Lung ; Mice ; Mice, Inbred ICR ; Pneumonia ; Sepsis ; Serogroup ; Spleen ; Streptococcus pneumoniae ; Streptococcus ; Survival Rate ; Treatment Outcome ; Vancomycin ; Virulence

Cerebrovascular disease refers to disorder of one or more blood vessels of the brain, and the majority of lesions that arise from these are from arterial diseases. The occurrence of cerebral venous thrombosis is clearly linked to the puerperal state, and pregnancy may increase the risk of subarachnoid hemorrhage. The most common cause is rupture of arterial aneurism. Hemodynamic, hormonal or other physiological changes of pregnancy may play a role in aneurysmal rupture. We report two cases of cerebrovascular diseases in the puerperium with a brief review of concerned literatures
Aneurysm ; Blood Vessels ; Brain ; Hemodynamics ; Postpartum Period* ; Pregnancy ; Rupture ; Subarachnoid Hemorrhage ; Venous Thrombosis

Prolymphocytic leukemia is a chronic lymphoproliferative disorder, characterized by prominent splenomegaly, prolymphocytes accounting for more than 55% of circulating lymphocytes, no significant peripheral lymphadenopathy and short term survival with terminal fatal multi-organ failure. We report a case of B-cell prolymphocytic leukemia in a 57-year-old woman who presented with easy bruising and arthritis for 1 year and low abdominal pain for 2 months. Physical examination revealed gingival hypertrophy and mild splenomegaly. On peripheral blood smears the leukocytes were markedly increased in number due to leukemic cells that count about 62% of leukocytes. The bone marrow aspiration smear and biopsy revealed diffuse infiltration of medium to large prolymphocytes having moderate amount of basophilic cytoplasm, round to oval nuclei with coarse chromatin, and prominent nucleoli. Abdominal pain aggravated despite chemotherapy, and pelvic computed tomography (CT) revealed a huge lobular pelvic mass which had increased in size on the follow-up CT. Total hysterectomy with bilateral adnexectomy was performed. Microscopic findings included massive infiltration of prolymphocytic cells in the uterus, upper vaginal wall, bilateral ovaries, and bilateral mesosalpinges. On immunohistochemistry, the leukemic cells showed B cell gamma light chain phenotype.
Abdominal Pain ; Arthritis ; B-Lymphocytes* ; Basophils ; Biopsy ; Bone Marrow ; Chromatin ; Cytoplasm ; Drug Therapy ; Female* ; Follow-Up Studies ; Gingival Hypertrophy ; Humans ; Hysterectomy ; Immunohistochemistry ; Leukemia, Prolymphocytic ; Leukemia, Prolymphocytic, B-Cell* ; Leukocytes ; Lymphatic Diseases ; Lymphocytes ; Lymphoproliferative Disorders ; Middle Aged ; Ovary ; Phenotype ; Physical Examination ; Splenomegaly ; Uterus

OBJECTIVE: This study was designed to estimate the chemosensitivity by a quantitative evaluation of the apoptotic cell fractions using flow cytometry. METHODS: The OVCAR-3 cells were exposed to 20 nM or 30 nM taxol for 0 (control), 24 and 48 hours, then removed the taxol contained media, and cultured further with fresh media without taxol. (1) Fluorescein isothiocyanate-conjugated Annexin V (Annexin V-FITC) and propidium iodide (PI) were added to one test tube to detect the apoptotic cell fractions and at the same time, PI was added to the other tube to stain the DNA. (2) Annexin V-FITC and cytokeratin (clone CAM5.2 and MNF116) were added to the test tube. They were fixed and permeabilized with 1% paraformaldehyde solution and 100% methanol. They were then incubated with phycoerythrin (PE)-conjugated goat anti-mouse immunoglobulin G (GAM IgG1-PE or GAM IgG2a-PE) and sequentially stained with PI for DNA. All the stained cells were analyzed by a FACScan flow cytometer. RESULTS: (1) After treatment of 20 nM or 30 nM of taxol, G2M arrest was observed in both of treatment groups, which increased with time. (2) The G0G1 sub-fraction indicative of apoptosis increased with increase of culturing time from 24 hrs to 48 hrs. (3) The early apoptotic cell fraction with positive annexin V-FITC and negative PI increased with increase of culturing time. (4) In cells stained sequentailly with annexin V-FITC, cytokeratin (CAM5.2 and MNF116), and PI after 30 nM taxol treatment, the early apoptotic cell fractions increased with increase of culturing time. However, their extent was somewhat lower than those observed by positive annexin V-FITC and negative PI in cells treated with 20 nM of taxol. CONCLUSION: The results of sequential stainings with annexin V-FITC, cytokeratin, and PI were consistent with the those of annexin V-FITC and PI with parallel DNA staining. Our results suggested that the level of apoptosis detected by flow cytometry could be a marker of chemosensitivity which could select the sensitive anti-cancer agents before administration to gynecologic cancer patients.
Annexin A5* ; Apoptosis* ; Cell Line* ; DNA ; Evaluation Studies as Topic ; Flow Cytometry ; Fluorescein ; Goats ; Humans ; Immunoglobulin G ; Keratins* ; Methanol ; Ovarian Neoplasms* ; Paclitaxel ; Phycoerythrin ; Propidium*

PURPOSE: Along with the development of minimally invasive surgery, laparoscopic surgery has recently been adopted worldwide. In cases of laparoscopic appendectomy, single port appendectomy is increasingly being adopted due to its cosmetic advantages and reduced pain. This study was conducted to evaluate the risk factors associated with post-operative complications in single port appendectomy. METHODS: Forty-nine consecutive patients who underwent transumbilical single port appendectomy (TUSPLA) were enrolled in this study. We reviewed the initial WBC count, hsCRP, position of the appendix, and intra operative findings and then analyzed the data by univariate and multivariate analysis. RESULTS: Complications were observed in five of the 49 patients (10.2%). Specifically, wound complications were observed in three patients (6.1%), and periappendiceal fluid collection occurred in two patients (4.1%). Univariate analysis revealed a retrocecal type appendix (p=0.046) and overweight (BMI> or =23, p=0.034) as risk factors significantly correlated with the occurrence of complications. Conversely, retrocecal type appendix (p=0.121) and overweight (BMI> or =23, p=0.329) were not significantly correlated with complications upon multivariate analysis. CONCLUSION: For patients with a high risk of postoperative complications, including those with retrocecal appendix undergoing TUSPLA and obese patients, sufficient informed consent is necessary, and intensive monitoring for the incidence of complications must be considered postoperatively. However, further studies enrolling larger groups of patients should be conducted to confirm these findings.
Appendectomy ; Appendix ; Cosmetics ; Humans ; Incidence ; Informed Consent ; Laparoscopy ; Overweight ; Postoperative Complications ; Risk Factors

We report here on a case of genetically confirmed type Ia glycogen storage disease (GSD) that was diagnosed in the military hospital. A twenty-year old soldier was admitted to the hospital with abdominal fullness. He had a past medical history of hepatomegaly that was firstly recognized at six months after birth, and he had been followed-up at an outpatient clinic with the presumptive diagnosis of type III GSD. He also had a history of growth hormone therapy because of growth retardation. However, he arbitrarily refused medical observation from 14 years of age. On the physical examination, the height of the patient was 163.1 cm and significant hepatomegaly was observed. Significantly abnormal liver-associated paramters were observed on the laboratory findings and multiple hepatic adenomas were observed on the CT exam and MRI scan. To determine the proper treatment, we tried to confirm the exact type of GSD in the patient. By mutational analysis, we found the c.648G>T homozygote splicing mutation in the G6PC gene and the patient was confirmed as having the type Ia GSD.
Adenoma ; Ambulatory Care Facilities ; Chromosome Disorders ; Glycogen ; Glycogen Storage Disease ; Growth Hormone ; Hepatomegaly ; Homozygote ; Hospitals, Military ; Humans ; Magnetic Resonance Imaging ; Military Personnel ; Parturition ; Physical Examination

BACKGROUND: A phosphodiesterase 5 inhibitor, sildenafil, has been effective against nociception. Several lines of evidence have demonstrated the role of the GABAergic pathway in the modulation of nociception. The impact of the GABA receptors on sildenafil was studied using the formalin test at the spinal level. METHODS: Male SD rats were prepared for intrathecal catheterization. The formalin test was induced by subcutaneous injection of formalin solution. The change in the activity of sildenafil was examined after pretreatment with GABA receptor antagonists (GABAA receptor antagonist, bicuculline; GABAB receptor antagonist, saclofen). RESULTS: Intrathecal sildenafil dose-dependently attenuated the flinching observed during phase 1 and 2 in the formalin test. The antinociceptive effect of sildenafil was reversed by the GABAB receptor antagonist (saclofen) but not by the GABAA receptor antagonist (bicuculline) in both phases. CONCLUSIONS: Intrathecal sildenafil suppressed acute pain and the facilitated pain state. The antinociception of sildenafil is mediated via the GABAB receptor, but not the GABAA receptor, at the spinal level.
Acute Pain ; Animals ; Bicuculline ; Catheterization ; Catheters ; Cyclic Nucleotide Phosphodiesterases, Type 5 ; Formaldehyde* ; GABA Antagonists ; Humans ; Injections, Subcutaneous ; Male ; Nociception ; Pain Measurement* ; Rats* ; Receptors, GABA ; Sildenafil Citrate

OBJECTIVE: Post-marketing surveillance (PMS) is an adverse events monitoring practice of pharmaceutical drugs on the market. Traditional PMS methods are labor intensive and expensive to perform, because they are largely based on manual work including phone-calling, mailing, or direct visits to relevant subjects. The objective of this study was to develop and validate a PMS methodology based on the clinical data warehouse (CDW). METHODS: We constructed a archival DB using a hospital information system and a refined CDW from three different hospitals. Fluoxetine hydrochloride, an antidepressant, was selected as the target monitoring drug. Corrected QT prolongation on ECG was selected as the target adverse outcome. The Wilcoxon signed rank test was performed to analyze the difference in the corrected QT interval before and after the target drug administration. RESULTS: A refined CDW was successfully constructed from three different hospitals. Table specifications and an entity-relation diagram were developed and are presented. A total of 13 subjects were selected for monitoring. There was no statistically significant difference in the QT interval before and after target drug administration (p=0.727). CONCLUSION: The PMS method based on CDW was successfully performed on the target drug. This IT-based alternative surveillance method might be beneficial in the PMS environment of the future.
Electrocardiography ; Fluoxetine ; Hospital Information Systems ; Postal Service ; Retrospective Studies