BACKGROUND: Airway obstruction due to blood clot occurs unusually but in a variety of clinical settings. Initial efforts for removal of the endobronchial blood clot involve flexible bronchoscopic evaluation with saline lavage and suctioning and then forceps extraction. If unsuccessful, further options include rigid bronchoscopy, Fogarty catheter dislogement of the clot, and topical thrombolytic agents. The several successful uses of endobronchial streptokinase or urokinase to dissolve an endobronchial blood clot have been previously reported, but not yet in Korea. Herein we describe a 51-year old man with superior vena cava thrombosis secondary to Behcet's disease who experienced life threatening airway obstruction after hemoptysis due to a large organized blood clot in left main bronchus. Urokinase(260,000 U), injected through a fiberoptic bronchoscope, totally dissolved the clot. No complications occured.
Airway Obstruction ; Bronchi ; Bronchoscopes ; Bronchoscopy ; Catheters ; Fibrinolytic Agents ; Hemoptysis ; Humans ; Korea ; Middle Aged ; Streptokinase ; Suction ; Superior Vena Cava Syndrome ; Surgical Instruments ; Therapeutic Irrigation ; Urokinase-Type Plasminogen Activator*

OBJECTIVE: The aim of this study was to investigate whether embryonic stem (ES) cells can be established from isolated blastomeres of mouse embryos. METHODS: Blastomeres were separated from mouse (C57Bl/6J) 2- or 4-cell embryos. Isolated blastomeres or whole 4-cell embryos were co-cultured with mitosis-arrested STO feeder cells in DMEM supplemented with recombinant murine leukemia inhibitory factor and ES-qualified fetal bovine serum. After the tentative ES cell lines were maintained from isolated blastomeres or whole embryos, some of them were frozen and the others were sub-cultured continually. Characteristics of tentative ES cell lines as were evaluated for specific gene expressions with immunocytochemistry and RT-PCR. RESULTS: One ES cell line (3.0%) was established from isolated blastomere of 2-cell embryo and one cell line (4.0%) from isolated two blastomeres of 4-cell embryo. And five cell lines (16.7%) were established from whole 4-cell embryos. Both cell lines from isolated blastomere and whole embryo expressed mouse ES cells specific markers such as SSEA-1, Oct-4 and alkaline phosphatase. Marker genes of three germ layers were expressed from embryoid bodies of both cell lines. CONCLUSION: This study suggests that mouse ES cells could be established from isolated blastomeres, although the efficiency is lower than whole embryos. This animal model could be applied to establishment of autologous human ES cells from biopsied blastomeres of preimplantation embryos in human IVF-ET program.
Alkaline Phosphatase ; Animals ; Antigens, CD15 ; Blastocyst* ; Blastomeres* ; Cell Line ; Embryoid Bodies ; Embryonic Stem Cells* ; Embryonic Structures ; Feeder Cells ; Gene Expression ; Germ Layers ; Humans ; Immunohistochemistry ; Leukemia Inhibitory Factor ; Mice* ; Models, Animal

We report a case of catheter-related bacteremia due to Tsukamurella pulmonis. T. pulmonis is a rare cause of opportunistic infection in immunosuppressed patients and in cases of indwelling foreign materials. This infection was nearly impossible to identify using conventional phenotyping methods because of its similarities to the related genera Nocardia, Rhodococcus, Gordonia, Streptomyces, Corynebacterium, and Mycobacterium. This organism was initially misidentified as Mycobacterium aubagnense through PCR-RFLP analysis. We correctly identified this organism using 16S rRNA sequencing combined with phenotyping tests.
Bacteremia ; Catheters ; Corynebacterium ; Humans ; Korea ; Mycobacterium ; Nocardia ; Nontuberculous Mycobacteria ; Opportunistic Infections ; Rhodococcus ; Streptomyces

BACKGROUND: We investigated effects of short- and long-term exposure to sidestream smoke on the bronchiolar and alveolar cells in Sprague-Dawley rats. METHODS: Rats were divided into five experimental groups: groups 1, 2, and 3 (1-month exposure to 3, 5, and 7 cigarettes a day, respectively), groups 4 and 5 (3- and 6 month exposure to five cigarettes a day, respectively). We examined the morphologic changes, the expressions of tumor necrosis factor alpha (TNF-alpha), tumor growth factor beta1 (TGF-beta1), interlekin (IL)-1alpha, IL-1beta, Ki-67, and cytokeratin 14 and in situ apoptosis in the bronchiolar and alveolar cells on light microscopy (LM) and electron microscopic (EM) terminal deoxynucleotidyl transferase dUTP nick end labeling (TUNEL) staining. RESULTS: LM showed the respiratory bronchiolar dilatation and alveolar wall collapse. In groups 3, 4, and 5, EM showed loss of the cilia and Clara cells with irregular size, more prominent alveolar wall collapse and dilation of alveolar duct than those of groups 1 and 2. Bronchiolar and alveolar cells showed increased expressions of TNF-alpha and TGF-beta in groups 4 and 5. LM and EM TUNEL stains showed increased apoptosis in groups 3, 4, and 5. CONCLUSIONS: Sidestream smoke causes a bronchiolar and alveolar cell injury and the severity correlates strongly the volume and duration of exposure to sidestream smoke.
Animals ; Apoptosis ; Cilia ; Coloring Agents ; Dilatation ; DNA Nucleotidylexotransferase ; Electrons ; Immunohistochemistry ; In Situ Nick-End Labeling ; Keratin-14 ; Light ; Microscopy ; Rats ; Smoke ; Tobacco Products ; Transforming Growth Factor beta ; Tumor Necrosis Factor-alpha

PURPOSE: Post-authorization survey(PAS) is a useful tool for obtainting wider range of data on the safety and efficacy of new drugs following their approval, as they can detect uncommon, unreported adverse events(AEs), which enables more attention to be directed to the practioners. Especially, the limited number of patients in oncology trial cannot usually give the actual incidence of AEs. METHODS: Since Nov. 1998, when docetaxel gained Korean approval in the treatment of breast cancer, a PAS to investigate its safety profiles has been conducted targeting more than 600 patients over 4 calendar years. RESULTS: Case report forms from 626 out of 646 patients were assessable for safety and 444 for efficacy. The patient characteristics are: mean age, 48.1 years; male/female 4/622; Wt/Ht/BSA 57.9 kg/156.1 cm/1.56 m2 ; stage I-II/III/IV 109 (18.2%)/125 (20.8%)/366(61.0%). In 344 patients, 960 AEs were reported in severity of mild/moderate/severe in 6.7, 40.9 and 51.1 % of cases. From AE results, 36.0% needed dose reduction; 34.3% transient interruption of the cycle; and 1.3% permanent discontinuation of docetaxel. Thirty five serious AEs such as febrile neutropenia, alopecia, diarrhea, abdominal pain and headache were reported in 21 patients. Unexpected AEs such as skin ulcer, discoloration of skin, H. Zoster infection, ulticaria, facial flush, chest pain, hemoptysis, pneumonia, stridor, nasal bleeding, photophobia, haematuria, Cushing's syndrome, hyperglycemia and insomnia were reported regardless of any causal relationship. Factors affecting the development of AEs were age, stage, concomitant medication other than chemotherapeutic agents and the number of cycles treated. The efficacy was evaluable in 444 patients with overall response rate of 36.5% (CR/PR 6.3/30.2%). Factors affecting the efficacy were stage, concommitant medication other than chemotherapeutic agents and the number of treatment cycles. CONCLUSION: This post-authorization survey on the safety and efficacy of docetaxel in breast cancer offers oncology practice in the real world without subject selection as is the case in clinical trials, although it was performed to fulfill the registrative requirement of the Korean health authority with limited data. The efficacy and safety profile of docetaxel in breast cancer was no much different from those reported in clinical trials.
Abdominal Pain ; Alopecia ; Breast Neoplasms* ; Breast* ; Chest Pain ; Cushing Syndrome ; Diarrhea ; Epistaxis ; Febrile Neutropenia ; Headache ; Hemoptysis ; Herpes Zoster ; Humans ; Hyperglycemia ; Incidence ; Photophobia ; Pneumonia ; Respiratory Sounds ; Skin ; Skin Ulcer ; Sleep Initiation and Maintenance Disorders

BACKGROUND/AIMS: A self-report questionnaire is frequently used to measure symptoms reliably and to distinguish patients with functional gastrointestinal disorders (FGIDs) from those with other conditions. We produced and validated a cross-cultural adaptation of the Rome III questionnaire for diagnosis of FGIDs in Korea. METHODS: The Korean version of the Rome III (Rome III-K) questionnaire was developed through structural translational processes. Subsequently, reliability was measured by a test-retest procedure. Convergent validity was evaluated by comparing self-reported questionnaire data with the subsequent completion of the questionnaire by the physician based on an interview and with the clinical diagnosis. Concurrent validation using the validated Korean version of the Short Form-36 Health Survey (SF-36) was adopted to demonstrate discriminant validity. RESULTS: A total of 306 subjects were studied. Test-retest reliability was good, with a median Cronbach's alpha value of 0.83 (range, 0.71-0.97). The degree of agreement between patient-administered and physician-administered questionnaires to diagnose FGIDs was excellent; the kappa index was 0.949 for irritable bowel syndrome, 0.883 for functional dyspepsia and 0.927 for functional heartburn. The physician's clinical diagnosis of functional dyspepsia showed the most marked discrepancy with that based on the self-administered questionnaire. Almost all SF-36 domains were impaired in participants diagnosed with one of these FGIDs according to the Rome III-K. CONCLUSIONS: We developed the Rome III-K questionnaire though structural translational processes, and it revealed good test-retest reliability and satisfactory construct validity. These results suggest that this instrument will be useful for clinical and research assessments in the Korean population.
Dyspepsia ; Gastrointestinal Diseases* ; Health Surveys ; Heartburn ; Humans ; Irritable Bowel Syndrome ; Surveys and Questionnaires*

Primary carcinoma of the fallopian tube is an extremely rare malignancy of the female genital tract. We have experienced two cases of primary carcinoma in the fallopian tube. One case with huge mass which was diagnosed incidentally on the basis of the biopsy findings, and the other case of the 3 years follow-up. We reported the cases with a brief review of the concemed literatures.
Biopsy ; Fallopian Tubes* ; Female ; Follow-Up Studies ; Humans

BACKGROUND: LORETA (Low Resolution Electromagnetic Tomography) produces a three-dimensional current density mapping from digitized EEG (electroencephalography) data. A comparison between visual waveform analysis of scalp EEG and LORETA method may be helpful for the exact localization of epileptiform discharges. METHODS: Digital EEG data from 20 subjects showing epileptiform discharges that were localized in the left or right frontotemporal regions (F7, F8) were studied. Those EEG waves were recorded using international 10~20 system. Phase reversals in bipolar montage were converted to referential montage and waveforms were analyzed visually. Those spike waves were converted into three-dimensional potential density mapping by LORETA method and maximum negative potential density region was determined. RESULTS: The same localization in the frontotemporal region (F7, F8) between two methods was noted in 16 subjects (80.0%). The discordant localization by LORETA method was noted in 4 subjects (20.0%). In different localiza-tion subjects, their locations were frontopolar region (Fp1, Fp 2) in 2 subjects, lateral temporal region (T7, T8) in 1 and posterior temporal region (P7, P8) in 1 subject, respectively. CONCLUSIONS: Even though the localization of epileptiform discharges by visual waveform analysis is a traditional method, electrical potential density mapping by LORETA can be a useful adjunctive localization method. If detailed localization is needed, LORETA method should increase accuracy.
Electroencephalography ; Magnets* ; Scalp

Using 3D ultrasound, bilateral chylothorax was diagnosed antenatally in the second trimester. Apparently stable, bilateral pleural effusion progressed rapidly to severe hydrops with facial edema during observation, and then we decided bilateral pleural-amniotic shunt operation. Here we present a case where drainage of pleural effusion by a double reverse pig tail stent made by ourself was achieved, although placement of the thoracoamniotic shunt resulted in near complete drainage of bilateral pleural effusion with normalization of intrathoracic anatomic relationships, subsequent resolution of fetal hydrops, but the ultimate outcome was unsuccessful due to the internalization of one catheter and unknown sudden death. We think that ongoing research is required to further evaluation about complications associated with this procedure, specifically failure of function due to obstruction, migration of the catheter,
Catheters ; Chylothorax* ; Death, Sudden ; Drainage ; Edema ; Female ; Humans ; Hydrops Fetalis ; Pleural Effusion ; Pregnancy ; Pregnancy Trimester, Second ; Stents ; Tail ; Ultrasonography

BACKGROUND: White blood cell count is an independent risk factor for cardiovascular disease. Several lifestyle and metabolic factors such as cigarette smoking and obesity are known to be associated with an elevated white blood cell count. However, the joint effect of cigarette smoking and obesity on white blood cell count has not yet been fully described. METHODS: We explored the joint effect of cigarette smoking and obesity on white blood cell count using multiple logistic regression analyses after adjusting for confounding variables in a population-based, cross-sectional study of 416,065 Korean adults. RESULTS: Cigarette smoking and body mass index have a dose-response relationship with a higher white blood cell count, but no synergistic interaction is observed between them (men, P for interaction=0.797; women, P for interaction=0.311). Cigarette smoking and body mass index might have an additive combination effect on high white blood cell count. Obese male smokers were 2.36 times more likely and obese female smokers 2.35 times more likely to have a high white blood cell count when compared with normal body mass index non-smokers. CONCLUSION: Cigarette smoking and body mass index are independently associated with an elevated white blood cell count in both men and women.
Adult* ; Body Mass Index* ; Cardiovascular Diseases ; Confounding Factors (Epidemiology) ; Cross-Sectional Studies ; Female ; Humans ; Joints* ; Leukocyte Count* ; Leukocytes* ; Life Style ; Logistic Models ; Male ; Obesity ; Risk Factors ; Smoking* ; Tobacco Products*