PURPOSE: To evaluate the severity of tissue necrosis of liver according to various kinds of contrast materials used in percutaneous transhepatic procedure. MATERIALS AND METHODS: Four kinds of commercially available contrast material were used in the this study :meglumine ioxithalamate (ionic monomer, Telebrix 30, Guerbet, France), meglumine ioglicinate (ionic dimer, Rayvist 300, Schering, Germany), iopromide (nonionic monomer, Ultravist 300, Schering, Germany), and iotrolan (nonionic dimer, Isovist 300, Schering, Germany). The same amount(0.1 ml) of each contrast material was directly injected into the liver of Sprongue-Dawley rats. After two days and four weeks, the histopathologic findings of resected liver were assessed and analysed with special emphasis on the difference in the area of tissue necrosis between each group. RESULTS: In the liver resected 48 hours later, the area of necrosis was related to the osmolality and ionicity of contrast material used :the higher the osmolality, the wider the area of necrosis and ionic contrast material exhibited wider area of necrosis than nonionic contrast material. In the liver resected four weeks later, almost complete recovery was seen at the site of necrosis in all groups. CONCLUSION: Nonionic contrast materials caused less tissue necrosis than ionic contrast materials in percutaneous transhepatic procedure because of their lower osmolality.
Animals ; Contrast Media* ; Liver* ; Meglumine ; Necrosis ; Osmolar Concentration ; Rats*

BACKGROUND: To determine whether nitric oxide (NO) could inhibit activation of platelets stored in a cold or frozen state, we measured platelet P-selectin expression and platelet-bound fibrinogen in platelet-rich plasma (PRP) with S-nitrosoglutathione (GSNO) (Sigma, USA) by flow cytometry. METHODS: PRP was prepared by centrifuging venous blood collected in a 3.2% sodium citrate tube from 10 healthy donors. It was aliquotted into 4 groups (no cryoprotectant, GSNO, GSNO/dimethyl sulfoxide [DMSO] [Sigma], and DMSO), and stored at room, cold and freezing temperatures for 24 hrs. We performed a flow cytometric analysis of all specimens stained with FITC-fibrinogen and PE-CD62P monoclonal antibodies (Becton Dickinson, USA). The results were compared according to the storage temperature and agonist among 4 groups. RESULTS: GSNO inhibited significantly the activation of frozen platelets, but not in the presence of DMSO. GSNO was also shown to preserve the aggregability of frozen platelets because in the presence of GSNO the delta percent change of P-selectin expression and fibrinogen binding of frozen platelets increased significantly irrelevant to DMSO. CONCLUSIONS: GSNO inhibited the activation of frozen platelets and preserved the platelet aggregability; therefore, it may be used as a protectant for platelet cryopreservation.
Adult ; Blood Platelets/*drug effects/metabolism ; Cryopreservation/*methods ; Female ; Fibrinogen/metabolism ; Flow Cytometry ; Free Radical Scavengers/pharmacology ; Humans ; Male ; Nitric Oxide/metabolism ; Nitric Oxide Donors/*pharmacology ; P-Selectin/metabolism ; Platelet Aggregation/drug effects ; Platelet Aggregation Inhibitors/pharmacology ; S-Nitrosoglutathione/*pharmacology

To formulate treatment strategies for poor-grade patients after aneurysmal subarachnoid hemorrhage(SAH), medical records were analyzed for 166 patients who were in Hunt and Hess grade IV or V among 588 consecutive aneurysmal SAH patients admitted during the past 5 years. Causes for unfavorable outcome(poor or dead) in these 166 patients were carefully evaluated to improve the management outcome. Overall management results were favorable(good or fair) in 71(42.8%), and unfavorable in 95(78 dead, 17 poor). Direct clipping was performed in 90 patients, and the surgical results were favorable in 69(76.7%) and unfavorable in 21(23.3%). Surgery was not performed in 76 patients because of moribund state on arrival in 41, neurological deterioration due to rebleeding in 15, massive brain swelling in seven, serious medical illness in five, severe delayed ischemic deficit in one, and massive cerebral infarction following angiography in one, and refused surgery in six. Seven patients survived from non-surgery group(2 fair, 5 poor). Direct effects of aneurysm rupture(34.8%) and early rebleeding(34.8%) were the causes of unfavorable outcome in grade IV patients, while it was direct effect of aneurysm rupture(91.8%) in grade V patients. It is suggested that since rebleeding is the only preventable factor of unfavorable outcome, urgent management seems necessary to prevent rebleeding, especially for grade IV patients. Grade IV patients should be treated aggressively with direct clipping for non-complex aneurysms or for patients with hematoma, and with coil embolization for complex aneurysms without hematoma.
Aneurysm ; Angiography ; Brain Edema ; Cerebral Infarction ; Embolization, Therapeutic ; Hematoma ; Humans ; Intracranial Aneurysm* ; Medical Records

It is well known that renal cell carcinoma shows poor responses upon chemotherapy, and a multidrug-resistance has been suggested as one of the possible mechanisms of their resistances to chemotherapeutics of renal cell carcinoma as well as other malignancies. In our previous study, MDR was expressed relatively high in A-498 cell line, low in Caki-2 cell line. From these observation A-498 was selected as the MDR positive cell line and Caki-2 as the MDR negative cell line and then a study was performed to evaluate the effect of verapamil and cyclosporin A on the cytotoxicity of vinblastine, which are known as the most effective chemotherapeutic agent on human renal cell carcinoma, upon these cell lines. And we tried to evaluate the effect of combination of verapamil and cyclosporin A on the cytotoxicity of vinblastine. Verapamil, in concentration of 0.1 uM, did not enhance the anticancer effect of vinblastine on A-498 cells but with the concentration of 1uM and 10uM, it decreased IC50 of vinblastine from 0.4 ug/ml when only vinblastine was used to 0.05 and 0.08, showing the dose modification effect of 8.40 and 5.25 respectively (p<0.05, by Mann Whitney test) Cyclosporin A, in all the concentration of 0.3, 1, 3uM, also decreased IC of vinblastine on A-498 cells to 0.08, 0.05, 0.08 ug/ml respectively, showing the dose modification effect of 5.25 to 8.40 (p<0.05, by Mann Whiney test). In caki-2 cells in which MDR1 and p-glycoprotein expression were barely detected, verapamil and cyclosporin A did not show any effect upon the cytotoxicity of vinblastine. Combination of 0.3uM of cyclosporin A and 0.1uM or 1uM of verapamil did not resistance modulating agents to enhance the cytotoxicity of vinblastine in renal cell carcinoma with enhanced multidrug resistance, but the combination of these drugs did not show any synergistic effect. And further studies including in vivo study and combination of cyclosporin A are needed before clinical trials to improve chemotherapeutic effect upon renal cell carcinoma.
Carcinoma, Renal Cell* ; Cell Line* ; Cyclosporine* ; Drug Resistance, Multiple ; Drug Therapy ; Humans* ; Inhibitory Concentration 50 ; P-Glycoprotein ; Verapamil* ; Vinblastine*

PURPOSE: North Koreans could be at higher risk for their bone health because of previous periods of severe famine and the continuing low availability of food. This study determined the bone mineral density (BMD) status and its relationship with dietary behaviors and nutrient intake of North Korean refugees (NKR) in South Korea (SK). METHODS: This cross-sectional study analyzed 110 female NKR from a NORNS cohort of a non-probability sample of adult NKR in Seoul. BMD examined by DEXA was used to divide participants into the normal group (NG) and the non-normal group (NNG) according to the WHO guideline. A self-administered questionnaire included questions on age, the socioeconomic situation in North Korea (NK) and SK, the food security in NK and SK, and the health behaviors, dietary behaviors, and food frequency questionnaire administered in SK. A one-day 24-hr recall was conducted and the results were analyzed by using CanPro. SPSS was used to analyze whether BMD and related dietary behaviors and nutrient intakes differed according to the groups. RESULTS: NG (62.7%) was significantly younger and had a lower abdominal obesity score than NNG (p < 0.001). While 14.5% of NG reported experiencing menopause, all of NNG reported experiencing menopause. The NG more frequently consumed the dairy group of foods (9.6 times a week) than did the NNG (4.8 times a week) after the statistics were adjusted for age (p < 0.007). The NG consumed significantly more animal protein and animal calcium than did the NNG (p = 0.01, p = 0.009, respectively). Calcium intake was low with 49.3% of NG, and 78.0% of the NNG reported consuming calcium lower than the estimated average requirement. Only calcium showed an index of nutrient quality lower than one in both groups. CONCLUSION: These results showed that NKR women and possibly all North Korean women are at high risk for bone health and they consumed low levels of bone-related nutrients, and this should be considered for the nutrition policy for NKR and North Korea.
Adult ; Animals ; Bone Density ; Calcium ; Cohort Studies ; Cross-Sectional Studies ; Democratic People's Republic of Korea ; Diet ; Female ; Food Supply ; Health Behavior ; Humans ; Korea ; Menopause ; Nutrition Policy ; Nutritional Status ; Obesity, Abdominal ; Refugees ; Seoul ; Starvation

BACKGROUND: It is known that magnesium can inhibit platelet function in vitro and ADP-induced platelet activation. We wished to demonstrate if magnesium could inhibit activation of platelets preserved at cold temperature. METHODS: We incubated each mixture of platelets and various concentrations of magnesium sulfate (0~10 mM) at room temperature and at a cold temperature (4oC). On days 1, 3, 5, 7 and 9, we measured the platelet count, pH, LD level, glucose level, HCO3?? level, lactate level, expression of CD62P, expression of annexin V, and ADP-induced aggregation of platelets. RESULTS: The platelets stored at 4oC showed a similar LD level but a lower platelet count, lactate level, and expression of CD62P and annexin V, and a higher pH and glucose level than platelets stored at room temperature. With an increasing magnesium concentration, expression of CD62P in the platelets stored at 4oC was slightly decreased, but expression of annexin V was increased. ADP-induced aggregation of the platelets stored at 4oC was not affected by magnesium. CONCLUSION: Magnesium did not effectively inhibit activation of platelets during preservation at cold temperature (4oC).
Annexin A5 ; Blood Platelets ; Cold Temperature* ; Glucose ; Hydrogen-Ion Concentration ; Lactic Acid ; Magnesium Sulfate* ; Magnesium* ; Platelet Activation ; Platelet Count

The 2016–2017 surveys on the external quality assessment scheme for serologic tests for syphilis in Korea were conducted by the Korean Association of External Quality Assessment Service. Proficiency testing (PT) panels consisting of three pooled serum samples were shipped to 430 and 432 laboratories participating in the program in the 1st and 2nd trials of 2016 and 465 and 503 laboratories in the 1st and 2nd trials of 2017, respectively. The rates of returning results were 94.2% and 50.2% for non-treponemal and treponemal tests, respectively, in the 1st trial of 2016; 94.7% and 49.5% in the 2nd trial of 2016; 94.2% and 49.5% in the 1st trial of 2017; and 92.8% and 48.7% in the 2nd trial of 2017, respectively. The most commonly used methods for non-treponemal tests were rapid plasma reagin (RPR) card test, followed by RPR turbidoimmunoassay and venereal disease research laboratory tests. The most commonly used methods for treponemal tests were Treponema pallidum particle agglutination, followed by immunochromatographic assay, Treponema pallidum latex agglutination, chemiluminescence immunoassay, and fluorescent treponemal antibody-absorption. The accuracy rates of the 2017 PT for non-treponemal and treponemal tests were 92.5%–99.8% and 93.3%–100.0%, respectively, which were significantly lower compared to the 98.4%–100.0% and 97.0%–100.0% in 2016. A possible explanation for the lower accuracy rates in the 2017 PT survey is the matrix effect caused by pooling multiple individual serum samples. These data suggest that pooling of serum samples obtained from a small number of donors may help avoid the matrix effect affecting standard materials used for syphilis serology PT.
Agglutination ; Humans ; Immunoassay ; Immunochromatography ; Korea* ; Latex ; Luminescence ; Plasma ; Serologic Tests* ; Sexually Transmitted Diseases ; Ships ; Syphilis* ; Tissue Donors ; Treponema pallidum

Immune thrombocytopenia is a rare complication associated with vancomycin. A 76-year-old male patient who was treated with vancomycin experienced severe thrombocytopenia and refractoriness as a result of platelet transfusion. Vancomycin-dependent antibodies in his thrombocytopenic serum were detected by flow cytometric analysis. The mechanism of thrombocytopenia is probably related to immunological destruction, as strongly suggested by its association with a specific drug-dependent anti-platelet antibody.
Aged ; Antibodies ; Humans ; Male ; Platelet Transfusion ; Thrombocytopenia ; Vancomycin

OBJECTIVES: The clinical manifestations of gout in Korea would be changed lately according to the rapid economical development and the development of diagnostic methods. This study was done to reveal the late clinical features of gout in Korea. METHODS: A retrospective study was done for the 90 gout patients who had been treated in Seoul Paik Hospital from March 1974 to August 1994. Age of onset, sex, duration of disease, serum uric acid level, uric acid concentration of 24 hour urine, joint of first attack, recurrently involved joints, X-ray of involved joint, frequency of tophi, renal ultrasonography, and associated diseases were analyzed. The uric acid levels of the 808 civilians who visited our hospital for the periodic health examination were used as a control value. RESULTS: 1) The serum uric acid level in Korean adults was 5.2+/-1.1mg/dL in male, 3.8+/-0.7mg/dL in female, and 4.7mg/dL in general. The serum uric acid concentration of the gout patients was 8.6+/-2.2mg/dL in male, 6.1+/-2.1mg/dL in female, and 8.5+/-2.3mg/dL in general. The age of onset was 46.4+/-12.9 years old and male to female ratio was 44: 1 2) The renal excretion of uric acid was 470+/-173 mg/day in gout patients. 3) The sites of first attack were first MTP joint(76%), tarsal joint(13%), knee(5%), and other MTP joints(5%) 4) The involved joints during the repeated attacks were first MTP joint(84%), tarsal joint(23%), and fingers(23%), The duration of disease was significantly longer and the serum uric acid concentration was higher in the patients with tophi than they are in the patients without. 5) The 4l% of patients showed hone change in X-ray. 6) The renal ultrasound examinations were abnormal in 42% of the patients and the serum uric acid concentrations were significantly higher. 7) Obesity was found in 68% of patients, hypertension in 39%, hyperlipidemia in 16%, and chronic renal disease in 12%. CONCLUSION: The clinical features of gout in our study were similar to those of others done in and out of Korea, except that the frequency of hypertringlyceridemia was much lower than that of the foreign countries.
Adult ; Age of Onset ; Arthritis, Gouty ; Female ; Gout* ; Humans ; Hyperlipidemias ; Hypertension ; Hyperuricemia ; Joints ; Korea* ; Male ; Obesity ; Renal Insufficiency, Chronic ; Retrospective Studies ; Seoul ; Ultrasonography ; Uric Acid

PURPOSE: Sling operation has been known the best treatment of woman with anatomical urinary incontinence(AI) and intrinsic sphincteric deficiency(ISD). We evaluated the clinical outcome of anterior vaginal wall sling as a treatment for stress urinary incontinence. MATERIALS AND METHODS: Thirty three patients with stress urinary incontinence who treated with anterior vaginal wall sling from October 1995 to March 2000 were analyzed. Patients were evaluated preoperatively with history, physical examination, voiding cystourethrography, evaluation with SEAPI classification and urodynamic study including of Valsalva leak point pressure(VLPP) and maximal urethral closing pressure(MUCP). All patients were assessed for the outcome of the procedure and subjective satisfaction by questionnaires. Surgical outcomes were then analyzed in relation to VLPP , MUCP and subjective SEAPI score. Of the total 33 patients, 26(78.8%) had AI and 7(21.2%) had ISD. According to the Stamey grades, 6(18.2%) were grade I, 23(69.7%) were grade II and 4(12.1%) were grade III. RESULTS: With a mean follow-up of 42.4 months (range 14 to 66). Urinary incontinence completely disappeared in 20 patients(60.6%), significantly improved in 8 patients(24.2%), failed in 5 patients(15.2%). Complication included urinary retention in two patients, suprapubic pain in two patients, and urge incontinence in two patients. Pre- and postoperative urge incontinence was major factor for failure rate. CONCLUSIONS: Anterior vaginal sling operation is a simple, safe and effective procedure for treatment of both AI and ISD. The urge incontinence is closely related to success rate.
Classification ; Female ; Follow-Up Studies* ; Humans ; Physical Examination ; Surveys and Questionnaires ; Urinary Incontinence* ; Urinary Incontinence, Urge ; Urinary Retention ; Urodynamics