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

No abstract available.
Baclofen* ; Drug Therapy, Combination* ; Hiccup* ; Omeprazole*

PURPOSE: Hyperhomocysteinemia is known as an independent risk factor for cardiovascular diseases such as atherosclesosis and myocardiac infarct. A common mutation in 5, 10-methylenetetrahydrofolate reductase(MTHFR) gene results in a valine for alanine substitution, which makes enzyme thermolabile and reduces enzymal activity. We examined the relation of MTHFR genetic mutation and Kawasaki disease. METHODS: We extracted DNA from the peripheral blood of Kawasaki disease patients who were treated in Ewha University Mokdong Hospital between January 2000 and June 2003, and normal children. We genotyped for the polymorphism by using PCR of known alleic varients and digested them with Hinfl restriction enzyme. Products were visualized after electrophoresis in 2.5% agarose gel. RESULTS:The respective prevalence of the homozygous and heterozygous genotypes(CC genotype, CT genotype, TT genotype) was 33.3%, 38.9%, and 27.8% in the control group and 31.3%, 47.9%, and 20.8% in the Kawasaki disease group(P>0.05). CONCLUSION:The mutation of MTHFR gene shows no relation to development of coronary artery complications in Kawasaki disease.
Alanine ; Cardiovascular Diseases ; Child ; Coronary Vessels ; DNA ; Electrophoresis ; Gene Expression* ; Genotype ; Humans ; Hyperhomocysteinemia ; Methylenetetrahydrofolate Reductase (NADPH2) ; Mucocutaneous Lymph Node Syndrome* ; Polymerase Chain Reaction ; Prevalence ; Risk Factors ; Sepharose ; Valine

PURPOSE: To evaluate microvascular change (microaneurysm) in diabetic retinopathy patients who undergo intravitreal bevacizumab injection using fluorescein angiography (FAG). METHODS: Thirty one eyes of 31 diabetic retinopathy patients undergoing intravitreal bevacizumab injection (1.25 mg/0.05 mL) in only 1 eye were included in this study. The control group (31 eyes) consisted of the fellow eyes. We excluded cased with intravitreal bevacizumab injection in both eyes and medial opacity obscuring three fundus image due to vitreous hemorrhage. The microaneurysmal change was analyzed at the same site the circle with optic disc radius and macula using FAG 2 to 4 months after injection. RESULTS: The average number of microaneurysms was 42.58 +/- 33.93 and significantly decreased to 28.74 +/- 28.06 after intravitreal bevacizumab injection (p < 0.05). The decrease of 35.70 +/- 24.79% in the treatment group was statistically higher than 13.95 +/- 38.21% in the control group with the fellow eyes (p < 0.05). CONCLUSIONS: In the present study, intravitreal bevacizumab injection reduced neovascularization, cystoid macular edema. Therefore this data can be used for future research on microvascular changes in the retina.
Diabetic Retinopathy* ; Fluorescein Angiography ; Humans ; Macular Edema ; Radius ; Retina ; Vitreous Hemorrhage ; Bevacizumab

Purpose : The purpose of this study was to obtain epidemiologic data and overall risk of complications of short term peripheral intravenous catheters. METHODS: The data was collected prospectively from August 19 to september 13, 2002. The subjects of this study were 350 adult patients hospitalized to the internal medicine a surgical general ward. Catheter sites were inspected daily from insertion to removal by infection control nurses, and characteristics of patients and catheters were recorded. Phlebitis was defined as one of the followings along the course of the vein: erythema, warmth. swelling or tenderness. RESULTS: Overall incidence of the phlebitis associated with short-term catheter was 23.7%. Catheters were removed when routine catheter replacement (every 72 hours) was occurred in 24.9%, phlebitis 23.7%. discharge of patients 13.1%, change of heparin cap 9.7%, others 28.6%. There were no significant differences in the incidence of the phlebitis by sex, age, the type of dressing, the duration of catheter placement insertion site, the type of hospitalized ward' and the size of cannula. The incidence of phlebitis was the highest (36.1%) within 48-72 hours after insertion. There was significant difference in the incidence of phlebitis according to the types of infusate. 75 of 83 phlebitis cases (90.4%) were received chemical infusates. Especially glucose/aminoacid, TPN and intralipose were attributed to major risk factor of phlebitis associated with short-term catheter (P<0.05). CONCLUSION: The incidence rate of phlebitis associated with short-term catheter was 23.7%. In this study, the type of infusate was the significant risk. factor related to phlebitis. Consequently, in order to prevent and detect the phlebitis associated with short-term catheter early, a consistent, organized assessment and evaluation of the above factors during the intravenous therapy is needed.
Adult ; Bandages ; Catheters* ; Epidemiologic Studies* ; Erythema ; Heparin ; Humans ; Incidence ; Infection Control ; Internal Medicine ; Korea* ; Patients' Rooms ; Phlebitis* ; Prospective Studies ; Risk Factors ; Seoul* ; Veins

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*

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: 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