In Korea, all domestic made test systems for detecting antibodies in HIV-1 contain the antigens from human immunodeficiency type 1 (HIV-1) subtype B. However, because HIV-1 subtype O is significantly different in amino acid sequences from all other subtypes of HIV-1, there has been a need for developing a test for detecting antibodies in subtype O. For this purpose, the entire nucleotide sequence corresponding to the extracellular domain of the transmembrane glycoprotein of HIV-1 subtype O was synthesized with consideration of Escherichia coli cordon usage. Various regions of the extracellular domain were cloned into E. coli expression vectors and tested for levels of protein production. The nucleotide sequence, named ECTM, that can encode a 129 amino acid-long peptide, was found to be expressed at a high level in E. coli. The protein of approximately 17 kDa specifically reacted with sera from individuals infected with HIV-1 subtype O. The ECTM protein was purified to near homogeneity by the CM-T gel chromatography, using concentrated, denatured inclusion bodies. In Western blot analysis, the purified viral antigen reacted with sera from individuals infected with subtype O more efficiently than subtype B. The enzyme linked immunoabsorbent assay (ELISA) system was developed using the subtype O viral protein and compared with the commercially available kit lacking the antigens from subtype O. The ELISA kit containing the subtype O antigen ECTM alone efficiently reacted with sera from individuals infected with subtype O. The subtype O antigen-containing kit produced a positive absorbence even when sera were diluted 512-fold, suggesting a high sensitivity. The commercially available kit also reacted with subtype O sera, but produced a negative result at a dilution of 8-fold. Our results suggest that the currently available kit may not be able to efficiently detect subtype O sera and that the viral protein developed in this study may be added to the current system to maximize the detection of sera from individuals infected with subtype O.
Amino Acid Sequence ; Antibodies ; Base Sequence ; Blotting, Western ; Chromatography, Gel ; Clone Cells ; Enzyme-Linked Immunosorbent Assay ; Escherichia coli ; Glycoproteins ; HIV* ; HIV-1* ; Humans* ; Inclusion Bodies ; Korea ; O Antigens

PURPOSE: Splenectomy, pancreas-preserving splenectomy, pancreato-splenectomy are common combined operations of a total gastrectomy for gastric cancer. We attempted to determine the efficacy of these procedures after comparing and analyzing the complication rate and the five-year survival rate from the gastric cancer patients. METHODS: 121 advanced gastric cancer patients, except T4 patients, underwent radical total gastrectomy accompanied with splenectomy. and analyzed the clinical findings eg. age, sex, location of tumor, histological differentiation, lymph node metastasis, number of dissected LN, complication and the 5-year survival rate. RESULTS: 44 out of 121 patients underwent a pancreato- splencetomy, 53 patients underwent a pancreas-preserving splenectomy, and 24 patients underwent a simple splenectomy. There were no statistical difference in the patient's age, sex, location of tumor, histological differentiation, lymph node metastasis, the number of dissected LN and the 5 year-survival rate in stage II, IV with each operation. However, a pancreas-preserving splenectomy showed a better 5-year survival rate (53.7%) than a simple splenectomy (25.0%) and pancreato-splenectomy (32.1%) in stage III. The complication rate was 25% in a simple splenectomy, 17% in a pancreas-preserving splenectomy, 30% in a pancreato- splenectomy. Diabetes mellitus occurred in 3 patients who underwent a pancreato-splenectomy, in 1 patient with an iatrogenic splenic vein excision during a pancreas-preserving splenectomy. CONCLUSION: A pancreas-preserving splenectomy is the best choice in stage IIIa total gastrectomy patients with the lowest complication rate.
Diabetes Mellitus ; Gastrectomy* ; Humans ; Lymph Nodes ; Neoplasm Metastasis ; Splenectomy* ; Splenic Vein ; Stomach Neoplasms ; Survival Rate

BACKGROUND: The optimum surgical treatment for rectal prolapse is controversial, and many different operations have been described. The aim of this study is to evaluate the results of a perineal procedure for the treatment of rectal prolapse. METHODS: Between February 1990 and March 1997, 16 consecutive patients underwent perineal rectosigmoidectomy for a complete rectal prolapse. One patient was lost to follow up. The remaining 15 patients were followed up for an average of 58.4 (9~94) months, and clinical and functional outcomes were evaluated. RESULTS: There were 8 males and 7 females, and ages ranged from 18 to 65 years. The mean prolapse duration was 10.7 (0.25~30) years. There were no postoperative deaths. Two patients developed postoperative complications (one wound infection and the other wound hematoma). Five patients had fecal incontinence prior to surgery. Three of the five patients had improved fecal incontinence after the procedure. There were three recurrences (recurrence rate of 20%): one of them underwent a Delorme operation at our institution and others had no treatment. CONCLUSION: A perineal rectosigmoidectomy is a safe and effective operation for the primary treatment of rectal prolapse and has low mortality and morbidity.
Fecal Incontinence ; Female ; Humans ; Lost to Follow-Up ; Male ; Mortality ; Postoperative Complications ; Prolapse ; Rectal Prolapse* ; Recurrence ; Wound Infection ; Wounds and Injuries

BACKGROUND: The aim of this study was to investigate the demographic and clinical characteristics of patients with primary frozen shoulder in a Korean population. METHODS: A total of 1,373 patients whose shoulders were diagnosed with primary frozen shoulder across 11 resident-training hospitals were reviewed retrospectively. Various demographic characteristics and clinical characteristics according to gender and presence of diabetes were evaluated. RESULTS: The average age of patients was 55.4 years. Gender proportion was 58.3% females and 41.7% males. The frozen shoulder involved the non-dominant arm in 60.7% of patients and the bilateral arms in 17.6% of patients. The average duration of symptoms was 8.9 months, and 51.3% of patients had experienced nocturnal pain. Comorbidities associated with frozen shoulder in our sample of patients included diabetes (18.7%), cardiovascular diseases (17.7%), thyroid diseases (5.4%), and cerebrovascular diseases (3.6%). The diabetic group was correlated with the following demographic and clinical characteristics: old age, involvement of the dominant arm, nocturnal pain, long duration of symptoms, and no history of trauma. Further, we found that, in males, having a frozen shoulder was significantly correlated with a history of trauma; in females, having a frozen shoulder was significantly correlated with having thyroid diseases. CONCLUSIONS: These demographic data of primary frozen shoulder in the Korean population were consistent with those of previously reported epidemiologic studies. Primary frozen shoulder with diabetes was correlated with old age, bilateral involvement, long duration of symptoms, and nocturnal pain.
Arm ; Bursitis* ; Cardiovascular Diseases ; Comorbidity ; Diabetes Mellitus ; Epidemiologic Studies ; Female ; Humans ; Male ; Retrospective Studies* ; Risk Factors ; Shoulder ; Thyroid Diseases

PURPOSE: Spontaneous intracranial hemorrhage (ICH) is not an uncommon cause of cardiac arrest. The purpose of this study was to identify the prognosis of patients with ICH for Out-of-Hospital Cardiac arrest (OHCA). METHODS: From January 2008 to December 2010, a total of 214 patients were checked brain computed tomography (CT) in OHCA. The majority of patients were male (136, 63.8%), and the median age was 55.0 (+/-16.7). We included all patients who were checked through brain CT for non-traumatic OHCA. Data were collected from electronic medical records and pre-hospital records. Demographic, clinical and laboratory data were compared between the ICH and non-ICH group. RESULTS: The detection of ICH by clinical manifestations and laboratory data was difficult. Out of 214 patients, 21 (9.8%) patients were positive for ICH and 193(90.2%) patients had a normal brain CT. In demographic and clinical data, the neurological outcome (CPC score, p=0.009) and 30-day survival rate (p<0.001) were statistically different between the two groups. Using the Cox proportional hazards model, the ICH group had a 3.54 hazard ratio compared with non-ICH group. In addition, pH (p=0.033), lactate (p=0.023) in ABGA, potassium (p=0.008), glucose (p=0.026), and S-100 (p=0.047) showed significant results. CONCLUSION: The prognosis of ICH patients in OHCA is poor; further studies are needed to improve the prognosis of ICH patients after ROSC in OHCA.
Brain ; Electronic Health Records ; Glucose ; Heart Arrest ; Humans ; Hydrogen-Ion Concentration ; Intracranial Hemorrhages ; Lactic Acid ; Male ; Out-of-Hospital Cardiac Arrest ; Potassium ; Prognosis ; Proportional Hazards Models ; Retrospective Studies ; Survival Rate

OBJECTIVE: The purpose of this study is to evaluate the application rate and effectiveness of endoscopic operations based on 6,017 cases in the field of gynecology. METHODS: Six-thousand-seventeen cases of endoscopic operations were performed from March 1993 to June 2004 in the department of Obstetrics and Gynecology, Center for Endoscopy, Good Moonhwa Hospital. Endoscopic operations were done on the majority of patients who had benign gynecologic diseases. We applied "two-surgeons system" and simplified methods of operation consisted of endoloop-ligation, endosuture and endotying. RESULTS: Our endoscopic operations were successful in 5,994 cases (99.62%) out of 6,017 attempts. Twenty-three cases (0.38%) were converted to laparotomy due to severe pelvic adhesion, excessive bleeding or difficulty in accessibility. In the first year endoscopic operations were done in 29.0% of the total gynecologic operations, but was increased to 52.9% during the next 4 years. In 2003, 93.0% and in 2004, 99.0% of the total gynecologic operations were done by endoscope. While the simple technique surgeries showed a high application rate, the more complicated technique surgeries, which began at a lower rate, showed a steady increase up to 89.3%. Blood loss and operation time were markedly declined during 3 year period and maintained at a low level thereafter. A 3 years' period of endoscopic operations (about 500 cases) is necessary for a hospital learning curve while, 26.4 cases is necessary an individual surgeon's learning curve. The major complications during the study period was 28 cases (0.47%). CONCLUSION: Endoscopic operations can be applied in almost all benign gynecologic diseases. In particular, "two-surgeons system" is a safe method with few complications and minimal learning period. These results suggest that if appropriate techniques could be learned, endoscopic operation might be preferred to laparotomy for both surgeons and patients.
Endoscopes ; Endoscopy ; Female ; Genital Diseases, Female* ; Gynecology ; Hemorrhage ; Humans ; Laparotomy ; Learning ; Learning Curve ; Obstetrics

In spite of decrease in prevalence, yet tuberculosis is not rare disease in Korea and the morbidity is over one percent. Because extrapulmonary tuberculosis is less common than that of lung, quick and accurate diagnosis is not easy and there may be some problems in selecting the methods and the times to treat it. Especially, each or combination of abdominal lymphadenitis and duodenal tuberculosis are so rare that differential diagnosis from other common or rare diseases is difficult, and much attention is required to diagnose and treat those. Recently we experienced a case of tuberculous lymphadenitis accompanied by duodenal bulbar tuberculosis which had been conceived as submucosal tumor at endoscopy and diagnosed by explorative operation. So we report this case with review of related literatures.
Diagnosis ; Diagnosis, Differential ; Endoscopy ; Korea ; Lung ; Lymphadenitis ; Prevalence ; Rare Diseases ; Tuberculosis* ; Tuberculosis, Lymph Node*

OBJECTIVE: Our aim was to report an effective procedure of injection of large amount of diluted vasopressin in the treatment of interstitial pregnancy using endoscopic cornuotomy METHODS: This is an uncontrolled retrospective study of 17 patients interstitial pregnancies treated of by endoscopic cornuotomy from June 2001 to June 2004 in our hospital. All cases were applied by the large amount of diluted vasopressin injection. RESULTS: Among 446 ectopic pregnancies, interstitial pregnancies were 17 (3.81%). Fourteen patients (82.4%) were unruptured, three patients (17.6%) were ruptured. Mean (+/-SD) age and parity of patients were 35.6+/-3.9 years (range 30-40 years), 1.5+/-2.1 (range 0-3), respectively. At the time of operation the duration of amenorrhea and mean size of ectopic gestation were 54.5+/-9.6 day and 2.6 x 2.6 cm, respectively. The amount of injected vasopressin was 190.0+/-55.5 cc. For the cornual closure, the endosuture method was applied in 10 patients (59%), and the endoloop method was applied in 7 patients (41%) The mean (+/-SD) blood loss and operation time were 18.2+/-15.9 cc and 28.3+/-7.8 minute, respectively. In fifteen patients (88%), serum beta-hCG level from the preoperative base was declined 90% or more within postoperative day 4 and in 2 patients (12%), it was decreased within postoperative day 60. CONCLUSION: Endoscopic cornuotomy using the large amount of diluted vasopressin injection procedure is a safe and effective in the interstitial pregnancy.
Amenorrhea ; Female ; Humans ; Parity ; Pregnancy* ; Pregnancy, Ectopic ; Retrospective Studies ; Vasopressins*

BACKGROUND: Behcet's disease has features consistent with an immunopathogenic mechanism, but the autoreactivity in pathogenesis is unclear. OBJECTIVE: This study was to investigate the association of antinuclear antibodies (ANA) with Behcet's disease. METHODS: The patients in this study were diagnosed at Severance Hospital Behcet's Disease Specialty Clinic from May, 1998 to May, 2002. We evaluated the frequency, titers and immunofluorescence patterns of ANA in patients with Behcet's disease, and compared the frequency with a healthy control group. According to the positivity of ANA, we compared the frequency of minor symptoms to investigate the association of the severity of disease with ANA. RESULTS: 1. Of the 554 cases of Behcet's disease, 46 cases (8.3%) were ANA positive, however, of the 271 cases of healthy control group, only 5 cases (1.8%) were ANA positive. (p=0.0003) 2. In ANA titers 38 cases (82.6%) showed low titer (1: 40+, 1: 160-), 5 cases (10.9%) intermediate titer (1: 160+, 1: 640-), and 3 cases high titer (>1: 640+). There was no significant difference in intermediate and high titers between complete (17.9%) and incomplete type (14.3%). 3. In immunofluorescence patterns of ANA, 17 cases (37%) were speckled pattern, 5 cases (10.9%) homogeneous pattern, 3 cases (6.5%) centromere pattern, 2 cases (4.3%) nucleolar pattern and 19 cases (41.3%) unknown pattern. 4. Of 508 cases with negative ANA patients, 272 cases (53.5%) had minor symptoms, however, of 46 cases with positive ANA patients, 14 cases (30.4%) had minor symptoms (p=0.0027). CONCLUSION: From this study ANA was more prevalent in Behcet's disease. However, it was not related to severity of disease and most of them were low titer. ANA, herein, might play a minor role in pathogenesis of Behcet's disease.
Antibodies, Antinuclear* ; Centromere ; Fluorescent Antibody Technique ; Humans

Liver failure is one of the main risks of death worldwide, and it originates from repetitive injuries and inflammations of liver tissues, which finally leads to the liver cirrhosis or cancer. Currently, liver transplantation is the only effective treatment for the liver diseases although it has a limitation due to donor scarcity. Alternatively, cell therapy to regenerate and reconstruct the damaged liver has been suggested to overcome the current limitation of liver disease cures. Several transplantable cell types could be utilized for recovering liver functions in injured liver, including bone marrow cells, mesenchymal stem cells, hematopoietic stem cells, macrophages, and stem cell-derived hepatocytes. Furthermore, paracrine effects of transplanted cells have been suggested as a new paradigm for liver disease cures, and this application would be a new strategy to cure liver failures. Therefore, here we reviewed the current status and challenges of therapy using stem cells for liver disease treatments.
Bone Marrow Cells ; Cell- and Tissue-Based Therapy ; Hematopoietic Stem Cells ; Hepatocytes ; Humans ; Inflammation ; Liver Cirrhosis ; Liver Diseases* ; Liver Failure ; Liver Regeneration ; Liver Transplantation ; Liver* ; Macrophages ; Mesenchymal Stromal Cells ; Stem Cell Transplantation ; Stem Cells* ; Tissue Donors