No abstract available.
Aneurysm* ; Hydrocephalus*

PURPOSE: It is not clear that the development of glomerular injury and aggravation by tumor necrosis factor alpha (TNF-alpha) is related to intrarenal or serum concentration of TNF-alpha. So, we studied the relationship between the concentration of TNF-alpha and aggravation of glomerular damage in the Henoch-Schonlein nephritis(HSN) and idiopathic nephrotic syndrome(INS). METHODS: We collected the sera and urines of 21 patients with Henoch-Schonlein purpura(HSP) and 22 patients with INS visited Chungbuk National University hospital from March 1998 to March 2001. The concentration of TNF-alpha in the sera and urines were measured by sandwich ELISA. RESULTS: Serum TNF-alpha levels in the HSP patients with renal involvement were significantly higher than those without renal involvement(P=0.009). But urine TNF-alpha levels have no correlation with renal involvement(P=0.088). In the HSN patients, proteinuria have a significant correlation with serum TNF-alpha levels(P=0.004) but less correlation with urine TNF-alpha levels(P=0.053). Otherwise, proteinuria have no correlation with serum TNF-alpha levels(P=0.763) but have a significant correlation with urine TNF-alpha levels(P=0.007) in INS. CONCLUSION: These result suggest that the serum concentration of TNF-alpha would be important to glomerular involvement in HSP. And, it is interesting that proteinuria shows a significant relation with serum TNF-alpha levels in the HSN, but with urine TNF-alpha levels in the INS. This means the major production of TNF-alpha may be originated by extrarenal inflammation in the HSN and by intrarenal tubulo-interstitial damage due to proteinuria in the INS.
Chungcheongbuk-do ; Enzyme-Linked Immunosorbent Assay ; Humans ; Inflammation ; Nephritis* ; Nephrotic Syndrome* ; Proteinuria* ; Tumor Necrosis Factor-alpha*

No abstract available.
Mycobacterium tuberculosis* ; Mycobacterium*

No abstract available.
Cerebrospinal Fluid* ; Diagnosis* ; Enzyme-Linked Immunosorbent Assay* ; Mycobacterium tuberculosis* ; Mycobacterium* ; Tuberculosis, Meningeal*

No abstract available.
Mycobacterium tuberculosis* ; Mycobacterium* ; Polymerase Chain Reaction* ; Sputum*

No abstract available.
Humans* ; Lymphokines* ; Monocytes* ; Mycobacterium tuberculosis* ; Mycobacterium*

No abstract available.
Enterotoxigenic Escherichia coli*

The management of skin and soft tissue defects on the buttock, perineum and lower abdomen has been improved through the development of myocutaneous flap. However, sacrifice of the deep muscles causes some problems such as intraoperative bleeding and functional disabilities of donor sites. And we can not also control the volume of the flap for the skin reliability of myocutaneous flaps. To overcome these disadvantages, we tried perforator-based myocutaneous island flaps for the reconstruction of the sacral, ischial sores or deep wounds of the perineum and lower abdomen. During the dissection of the flap, we could control the volume and shape of the flap exactly depending on the perforators. Clinically, total of 14 cases were treated with 10 parasacral perforator-based myocutaneous island flaps and 4 perforator-based extended myocutaneous island flaps. Parasacral flap is based on the parasacral perforators along the lateral sacral border and, the degree of containing muscles can be easily decided according to the depth of wound. In the cases of the extended myocutaneous flaps, we could design the perforator-based skin flap on the tip of myocutaneous island flap and appropriate volume of skin falp was obtained with the wide arc of rotation. Finally, the donor defect could be closed primarily and there was no significant sequela. There perforator-based myocutaneous island flaps require no significant sacrifice of the muscles and can be easily dissected and applied with the appropriate volumes for the reconstruction of the defect on the buttocks, perineum and lower abdomen.
Abdomen ; Buttocks ; Hemorrhage ; Humans ; Muscles ; Myocutaneous Flap ; Perineum ; Skin ; Surgical Flaps ; Tissue Donors ; Wounds and Injuries*

The reconstruction of pressure sore is often complicated problem due to underlying disease and general condition of the patients. Sometimes, it is too radical to use the muscle or musculocutaneous flap for the patients who has severe systemic disease and can not withstand the lengthy operation or the patients who already recovered from paraplegic condition and has no risk recurrence. To get over these problems, we recently have used the parasacral perforator-based island skin flaps for the sacral pressure sores. This flap is based on the axial pattern perforators originating from the internal pudendal artery and lateral sacarl artery. We performed this operation for 11 sacral sores with reasonable results. There was no significant complication, and duration of operation was relatively short and blood loss was a little. We concluded that this flap was useful for the patient with sacral pressure sore who could be categorized nontraumatic nonparaplegic group(NTNP group) or nontraumatic paraplegic group(NTP group). But this island flap has drawback, which is elimination of sensory nerve within the flap.
Arteries ; Humans ; Myocutaneous Flap ; Pressure Ulcer* ; Recurrence ; Skin*

Intentional delay of aftercoming siblings in multiple gestation is an infrequent occurrence in obstetrics. After delivery of an immature twin, conventional treatment calls for induction and delivery of the aftercoming sibling. However, several case reports have documented the feasibility of an expectant management. And also, as in our case, an aggressive treatment consisting of cerclage, tocolysis, and broad-spectrum antibiotics has been shown to prolong pregnancy. We experienced an unavoidable delivery of a nonviable first twin after premature rupture of membranes at 16 weeks' of gestation. The placenta was left undisturbed. Twin B was confirmed to be alive within the intact second sac. Tocolysis was started and cervical cerclage was done directly after delivery of twin A. Pregnancy was successfully prolonged, which enabled the second fetus to remain in utero and grow for another 145 days. To our knowledge, this was the longest interval between deliveries in a twin pregnancy reported in the literature. A healthy 3,050 gm male was delivered by cesarean section at 37 weeks' of gestation. Below we present this case in detail and discussed with respect to the aggressive approach undertaken to prolong gestation.
Anti-Bacterial Agents ; Cerclage, Cervical ; Cesarean Section ; Female ; Fetus ; Humans ; Male ; Membranes ; Obstetrics ; Placenta ; Pregnancy* ; Pregnancy, Twin ; Rupture ; Siblings ; Tocolysis ; Twins*