BACKGROUND: In this study, we investigated the early time course of expression of the major histocompatibility (MHC) antigens, intercellular adhesion molecule-1 (ICAM-1), vascular cell adhesion molecule-1 (VCAM-1), interleukin-6 and the histopathological changes in the coronary arteries of cardiac allografts exchanged between inbred mice strains that differ in one loci of class I major histocompatibility antigen (B10.BR to B10.A). MATERIAL AND METHOD: No immunosuppressive therapy was used. Both allografts and the hearts of the recipients were harvested at 7 (group 1, n=6), 15 (group 2, n=6), 21 (group 3, n=6), and 30 (group 4, n=6) days after transplantation. They were examined by immunohistochemistry, microscopy and morphometry. All allografts had contractions at the time of harvest. RESULT: A strong MHC class I antigen expression was present on the endothelial and medial cells of the coronary arteries in group 1 and remained unchanged in the rest of the groups. However, MHC class II reactivity was none or very little at any time. Mild to moderate ICAM-1 expression was observed on the endothelial cells, but not on the medial cells at any time by 30 days. VCAM-1 expression was strong both on the endothelial and medial cells at any time. Moderate degree expression of interleukin-6 was observed from 7 to 30 day specimens. Histopathologically, percentage of affected vessels (vessels with intimal thickening) was less than 10 % in 7 day group and increased up to 50 % at 30 days. Mean percent narrowing of the lumen of the affected vessels revealed less than 20 % at 7 days and 40 % at 30 days. The area occupied by tropomyosin positive cells in the intimal lesion, graded from 0 to 3, showed gradual increase but remained between grade 0 to 1 by 30 days. Medial integrity was also well preserved at any time. Moderate perivascular mononuclear cell infiltration was observed at 7 days and it was progressively increased upto 30 days. Recipients' heart revealed no positive immunopathologic findings. CONCLUSION: In this study, the early time course of progression of the transplantation vasculopathy was demonstrated in the murine heterotopic heart transplant model.
Allergy and Immunology ; Allografts ; Animals ; Atherosclerosis ; Coronary Vessels* ; Endothelial Cells ; Heart* ; Histocompatibility ; Histocompatibility Antigens ; Immunohistochemistry ; Intercellular Adhesion Molecule-1 ; Interleukin-6 ; Mice* ; Microscopy ; Transplantation ; Tropomyosin ; Vascular Cell Adhesion Molecule-1

No abstract available.
Erythrocytes* ; Extracorporeal Circulation*

Hemangiopericytoma was first described by Stout & Murray in 1942 and was an uncommon soft tissue tumor thought to be derived from vascular pericytes. Approximately 10-15% of the cases occur in children have a propensity to develop in the region of head, neck and lower extremities. We experienced a case of congenital hemangiopericytoma of small bowel in a male neonate who showed vomiting and abdorninal distension. We reported a case of congenital hemangiopericytoma of small bowel with brief review of related literature.
Child ; Head ; Hemangiopericytoma* ; Humans ; Infant, Newborn ; Intestinal Obstruction* ; Intestine, Small ; Lower Extremity ; Male ; Neck ; Pericytes ; Vomiting

Intranasal corticosteroid injection has been used for the control of allergic rhinitis or polypoid inflammation of the nasal cavity. Transient or permanent visual loss after therapeutic intranasal injection of corticosteroid is an extremely rare but well-known disease. In this report, we present a 54-year-old male patient with chronic sinusitis with nasal polyposis who had right visual loss after bilateral intranasal triamcinolone injection. Clinical examination and fluorescent angiography revealed vascular occlusions, which involved multiple small branches of right retinal circulations. Full recovery of vision occurred 3 months after the onset of the symptom. Extreme care should be exercised to avoid visiual complication when intranasal corticosteroid injection is performed.
Angiography ; Blindness* ; Humans ; Inflammation ; Male ; Middle Aged ; Nasal Cavity ; Retinaldehyde ; Rhinitis ; Sinusitis ; Triamcinolone

Abscess ; Drainage ; Exophthalmos ; Headache ; Hospitalization ; Humans ; Middle Aged ; Molar ; Orbit ; Periodontal Diseases ; Tomography, X-Ray Computed ; Toothache ; Visual Acuity

Abducens Nerve Diseases ; Abducens Nerve ; Aneurysm ; Angiography ; Balloon Occlusion ; Carotid Artery, Internal ; Carotid-Cavernous Sinus Fistula ; Cavernous Sinus ; Diagnosis ; Diplopia ; Fistula ; Headache ; Humans ; Lacerations ; Ophthalmoplegia ; Orbit ; Orthognathic Surgery ; Osteotomy ; Skull ; Visual Acuity

BACKGROUND: Antimicrobial resistance (AMR) is an issue not only with regard to public health, but also in terms of economic impact. AMR surveillance has mainly been carried out in general hospitals, and not in nursing hospitals. This study was conducted to investigate the AMR rate for bacterial strains isolated from nursing hospital samples.METHODS: Antimicrobial susceptibility testing (AST) results from a total of 23,518 bacterial isolates recovered from clinical specimens taken in 61 nursing hosals were analyzed. AST was conducted using Vitek 2 with AST cards specific for the bacterial strains.RESULTS: A total of 19,357 Gram-negative and 4,161 Gram-positive bacterial strains were isolated. Pseudomonas aeruginosa (n=6,384) and Escherichia coli (n=5,468) were the most prevalent bacterial species and, among Gram-positive bacteria, Staphylococcus aureus (n=1,565) was common. The AMR rate was high for the following strains: cefotaxime-resistant Klebsiella pneumoniae, 77.4%; cefotaxime-resistant E. coli, 70.6%; imipenem-resistant Acinetobacter baumannii, 90.3%; imipenem-resistant P. aeruginosa, 49.3%; oxacillin-resistant S. aureus, 81.1%, penicillin-resistant Enterococcus faecalis, 44.8%, and vancomycin-resistant Enterococcus faecium, 53.5%. AMR rate change varied by bacterial species and antimicrobial drug.CONCLUSION: AMR rates of major pathogens from nursing hospitals were higher than those from general hospitals with the exception of imipenem-resistant A. baumannii. Continuous monitoring and infection control strategies are needed.
Acinetobacter baumannii ; Enterococcus faecalis ; Enterococcus faecium ; Escherichia coli ; Gram-Positive Bacteria ; Hospitals, General ; Infection Control ; Klebsiella pneumoniae ; Nursing ; Pseudomonas aeruginosa ; Public Health ; Staphylococcus aureus

Aneurysms of the posterior inferior cerebellar artery are uncommon, comprising between 0.5 and 0.7% of all intracranial aneurysms and are usually tightly confined to the medulla oblongata, the anterolateral base of the skull, and the lower cranial nerves. During the period from January 1983 to December 1997, about 1,600 aneurysms were operated on the department of neurosurgery, Pusan Paik hospital, Inje University. Of these, there were 8 cases of aneurysms in the posterior inferior cerebellar artery(PICA). The average age was 43.2 years, with a range from 11 months to 56 years, and male to female ratio was equal. Presenting signs and symptoms on admission were mental deterioration and/or headache after subarachnoid hemorrhage in 7 cases and suboccipital headache due to mass effect in 1 case. The locations of these aneurysms were in the anterior-medullary segment in 4 cases, in the lateral medullary segment in one case, and telovelotonsillar segment in 3 cases. Surgical methods were as followed; unilateral suboccipital craniectomy or craniotomy(right side in 3 cases and left side in 2 cases) in lateral or park bench position was performed in 5 cases and suboccipital craniectomy in prone position was in 3 cases. Direct neck clipping were done in 5 cases, proximal ligation in 1 case, coating and trapping in 1 case each. Surgical results were good in 5 cases, fair in 2 cases, dead in a case. Although clipping of the aneurysm neck was preferable in the aneurysm of PICA, trapping was useful when neck clipping was impossible in segments distal to the choroidal arch.
Aneurysm* ; Arteries* ; Busan ; Choroid ; Cranial Nerves ; Female ; Headache ; Humans ; Intracranial Aneurysm ; Ligation ; Male ; Medulla Oblongata ; Neck ; Neurosurgery ; Pica ; Prone Position ; Skull ; Subarachnoid Hemorrhage

BACKGROUND: Korea is a highly prevalent area of isolated anti-HBc with a rate of 15%, but there is neither vaccination nor management guideline agreed. To know the management for Hepatitis B Vaccination for adults with isolated anti-HBc, we investigated immune response to hepatitis B vaccination in adults with isolated anti-HBc. METHODS: The 23 adults with persistent isolated anti-HBc, who visited a health promotion center from Dec. 1998 to Aug. 1999, were vaccinated with Hepavax?-B by the standard schedule (0, 1, 6 month) and anti-HBs titers were measured 1 month after 1st and 3rd vaccinations (1, 7 month). RESULTS: After the 1st vaccination, 18 (78.26%) developed anti-HBs seroconversion. Among them, 4 (17.39%) had titers of 10~49 mIU/ml, 8 (34.78%) 50~99 mIU/ml, and 6 (26.09%) more than 100 mIU/ml. All non-responders after the 1st vaccination remained as such even with 3 doses of complete vaccination. The majority of seroconverted group did not show more anti-HBs response with further vaccination. CONCLUSIONS: Since none of adults with isolated anti-HBc had a primary response, which indicated few false positive results. Therefore they should be excluded on vaccination programs in Korea. To differentiate between immunity and occult infections, a single dose of vaccine with a follow-up anti-HBs test is preferable for adults with isolated anti-HBc. If the test shows a seroconversion it would indicate protective immunity, if not, then occult infection may be suspected.
Adult* ; Appointments and Schedules ; Follow-Up Studies ; Health Promotion ; Hepatitis B Core Antigens* ; Hepatitis B* ; Humans ; Korea ; Vaccination*

Purpose: The safety and efficacy of minimally invasive techniques in congenital heart surgery were tested in this study. Materal and method: Between July 1997 and November 1997, a total of 46 children were underwent minimally invasive cardiac operations at Seoul National University Children's Hospital. Age and body weight of the patients averaged 34.6+/-41.8 (Range: 1~148) months and 14.5+/-9.9 (Range: 3.0~40.0) kg, respectively. Twenty eight patients were male. Preoperative surgical indications included 15 atrial septal defects, 25 ventricular septal defects, 1 foreign body in aorta, 3 partial atrioventricular septal defects, 1 total anomalous pulmonary venous connection (cardiac type), and 1 tetralogy of Fallot. After creating a small lower midline skin incision starting as down as possible from the sternal notch, a vertical midline sternotomy extended from xyphoid process to the level of the second intercostal space, where one of the T-, J-, I-or inverted C-shaped lower lying mini-sternotomy was completed with a creation of unilateral right or bilateral trap door sternal opening. A conventional direct aortic and bicaval cannulation was routine. RESULT: A mean length of skin incision was 6.1+/-1.0 (range: 4.0~9.0) cm. A mean distance between the suprasternal notch and the upper most point of the skin incision was 4.0+/-1.1 (range: 2.0~7.0) cm. Mean cardiopulmonary bypass time, aortic cross-clamp time, and the operation time were 62.9+/-20.0 (range: 28~147), 29.8+/-12.8 (range: 11~79), and 161.1+/-34.5 (range: 100-250) minutes. A mean total amount of postoperative blood transfusion was 71.0+/-68.1 (range: 0~267) cc. All patients were extubated mean 11.3+/-13.8 (range: 1~73) hours after operation. A mean total amount of analgesics used was 0.8+/-1.8 (range: 0~9) mg of morphine. The mean duration of stay in intensive care unit and hospital stay were 35.0+/-32.2 (range: 10~194) hours and 6.2+/-2.0 (range: 3~11) days. There were no wound complications and hospital deaths. CONCLUSION: This short-term experience disclosed that the minimally invasive technique can be feasibly applied in a selected group of congenital heart disease as well as is cosmetically more attractive approach.
Analgesics ; Aorta ; Blood Transfusion ; Body Weight ; Cardiopulmonary Bypass ; Catheterization ; Child* ; Deception ; Foreign Bodies ; Heart Defects, Congenital ; Heart Septal Defects, Atrial ; Heart Septal Defects, Ventricular ; Humans ; Intensive Care Units ; Length of Stay ; Male ; Morphine ; Seoul ; Skin ; Sternotomy ; Surgical Procedures, Minimally Invasive ; Tetralogy of Fallot ; Thoracic Surgery* ; Wounds and Injuries