In this study, we are to produce the single chain variable fragment (scFv) antibodies against surface protein of hepatitis B virus (HBV) using antibody phage display technique. Balb/c mice were immunized with preS1 and cDNAs of heavy and light chains of splenic B cells from immunized mice were prepared using RT-PCR. Two cDNAs were linked with (64S) linker DNA under recombination PCR to produce single chain Fv DNA. After digestion of scFv DNA with Sp 1 and Not 1, the digested DNA was ligated into pCANTAB 5E and electroporated into E. coli XL1-Blue to prepare scFv-library. The size of library was 1 * 10' pfu/ml. Phage antibodies (phabs) against preS1 were rescued with M13K07 helper phages, and preS1-binders were selected through 3 times of panning using 96 well microtitre plates. Phage antibody clones were assayed directly for the ability to bind preS1 by ELISA. And then 7 phage antibody clones had high ELISA signals against preS1. Phabs from preS1-specific pMsc-17 had the strongest ELISA signal to preS1. Phabs from pMsc-17 were used for Western blot to preS1 and the results revealed that it was specific to preS1. To prepare the soluble scFv antibody, phabs from pMsc-17 were transfected into non-suppressor E. coli HB2151, and grown under 1 mM IPTG. Soluble scFv antibody was mainly accumulated in the periplasmic space, but small amount of antibody was secreted into culture media.
Animals ; Antibodies ; B-Lymphocytes ; Bacteriophages* ; Blotting, Western ; Cell Surface Display Techniques ; Clone Cells ; Culture Media ; Digestion ; DNA ; DNA, Complementary ; Enzyme-Linked Immunosorbent Assay ; Hepatitis B virus* ; Hepatitis B* ; Hepatitis* ; Isopropyl Thiogalactoside ; Mice* ; Periplasm ; Polymerase Chain Reaction ; Recombination, Genetic ; Single-Chain Antibodies*

As the incidence of acute myocardial infarction been increasing with prolongation of life spans, improvement in foods and life styles in Korea, rapid diagnosis and treatment is critical in survival of acute myocardial infarction patient. Most of the acute myocardial infarction result from atherosclerotic plaque forming thrombus and occlusion of coronary artery. Because early thrombolytic therapy is important to maintain the left ventricular function and survival rate, there have been many trials to reperfuse the occluded coronary artery. We have studied the many aspects of acute myocardial infarction such as sex, age, infarction site, chief complaints, change of ECG, change of serum enzyme, time delay on emergency room arrival, and compared the effectiveness of thrombolytic therapy. Total number of patient was 212, and males were 141(66.5%) and females were 71(33.5%). The most common infarction site was ant, fuel wall(102 cases,48%)of the heart and the most common chief complaint was chest pain(204 cases,97%). Among the 106 patients who received thrombolytic therapy, 101 patients(95%) had survived and 5 patients(5%) had died. Among the 64 patients who didn't receive thrombolytic therapy, 56 patients (87.5%) were alived and 8 patients(12.5%) were dead.
Ants ; Coronary Vessels ; Diagnosis* ; Electrocardiography ; Emergency Service, Hospital ; Female ; Heart ; Humans ; Incidence ; Infarction ; Korea ; Life Style ; Life Support Care ; Male ; Myocardial Infarction* ; Plaque, Atherosclerotic ; Survival Rate ; Thorax ; Thrombolytic Therapy ; Thrombosis ; Ventricular Function, Left

Human monoclonal antibodies have considerable potential in the prophylaxis and treatment of viral disease. By cloning human Ig gene segments from the B cells of volunteer into pComb3 phagemid vector, antibody library was created of filamentous phage particles displaying Fab fragments on their surface after being rescued with M13KO7 helper phages. The size of library was 7x10' pfu. Phage antibodies (phabs) were panned against biotinylated preS1 using streptavidine coated Dynabead. The soluble Fab antibodies were prepared from phagemid colonies and assayed directly for the ability to bind preS1 by ELISA. And then 3DW and SGW specific to preS1 which have both heavy and light chain to form Fab fragment, were selected. The soluble Fab antibody from 3DW was expressed highly at the concentration of 0.1 - 1.0 mM of IPTG, and 5 hours postinduction. The soluble antibodies from 3DW and SGW showed their relative affinities of 2x10' M ', and Sx10 M ', respectively, and the specificities to preS1 on ELISA. Our results suggest that antibody phage display library is very useful method to generate the human monoclonal antibody and that the human Fab monoclonal antibodies specific to preS1 selected in this study open the way to treat hepatitis B as a component of passive irnmunotherapeutics.
Antibodies ; Antibodies, Monoclonal ; B-Lymphocytes ; Bacteriophages* ; Clone Cells ; Cloning, Organism ; Enzyme-Linked Immunosorbent Assay ; Genes, Immunoglobulin ; Hepatitis B virus* ; Hepatitis B* ; Hepatitis* ; Humans* ; Immunoglobulin Fab Fragments ; Isopropyl Thiogalactoside ; Streptavidin ; Virus Diseases ; Volunteers

PURPOSE: This study evaluated the treatment effectiveness and proper radiation dose of helical tomotherapy (HT) in spine oligometastases from gastrointestinal cancers. MATERIALS AND METHODS: From 2006 to 2010, 20 gastrointestinal cancer patients were treated with HT for spine oligometastases (31 spine lesions). The gross tumor volume (GTV) was the tumor evident from magnetic resonance imaging images fused with simulation computed tomography images. Clinical target volume (CTV) encompassed involved vertebral bodies or dorsal elements. We assumed that the planning target volume was equal to the CTV. We assessed local control rate after HT for 31 spine metastases. Pain response was scored by using a numeric pain intensity scale (NPIS, from 0 to 10). RESULTS: Spine metastatic lesions were treated with median dose of 40 Gy (range, 24 to 51 Gy) and median 5 Gy per fraction (range, 2.5 to 8 Gy) to GTV with median 8 fractions (range, 3 to 20 fraction). Median biologically equivalent dose (BED, alpha/beta = 10 Gy) was 52 Gy10 (range, 37.5 to 76.8 Gy10) to GTV. Six month local control rate for spine metastasis was 90.3%. Overall infield failure rate was 15% and outfield failure rate was 75%. Most patients showed pain relief after HT (93.8%). Median local recurrence free survival was 3 months. BED over 57 Gy10 and oligometastases were identified as prognostic factors associated with improved local progression free survival (p = 0.012, p = 0.041). CONCLUSION: HT was capable of delivering higher BED to metastatic lesions in close proximity of the spinal cord. Spine metastases from gastrointestinal tumors were sensitive to high dose radiation, and BED (alpha/beta = 10 Gy) higher than 57 Gy10 could improve local control.
Disease-Free Survival ; Gastrointestinal Neoplasms ; Humans ; Magnetic Resonance Imaging ; Neoplasm Metastasis ; Radiotherapy, Intensity-Modulated ; Recurrence ; Spinal Cord ; Spine ; Treatment Outcome ; Tumor Burden

PURPOSE: Assessment of the burn size in the Accident and Emergency Department is one of the most important aspects in the initial care of a burn victims. The purpose of this study was to examine in the Emergency Department the accuracy of burn size estimates and the adequacy of burn-patient fluid resuscitation in relationship to the Parkland formula. METHODS: A retrospective study was conducted of 52 adult burn patients who visited the Emergency Department of Keimyung University Dongsan Medical Center during 2003 year. A substratification of the data was undertaken to compare total burn surface area as estimated by the Emergency-Department staff with that determined by the Burn-Care-Unit staff. RESULTS: The average length of stay in the Emergency Department was 394.04 minutes (range: 150~1055 minutes). The average total body surface area evaluated by the Emergency-Department staff was 33.31% compared with the Burn-Care-Unit staff's average of 29.77%, and the difference was statistically significant (p<0.05). During their stays in the Emergency Department, burn patients were underresuscitated based on the fluid volume calculated by using the Parkland formula. CONCLUSION: Early communication with the Burn-Care-Unit staff in the Emergency Department and better education of Emergency-Department physicians will markedly improve the overall care of burn patients.
Adult ; Body Surface Area ; Burns* ; Education ; Emergencies* ; Emergency Service, Hospital* ; Humans ; Length of Stay ; Resuscitation* ; Retrospective Studies

The studies of the occurrence and changes of experimental brain edema have been observed by calculating wet weight, volume, dry weight, per cent water content and swelling per cent in 12 normal rabbits as a control group and 24 rabbits of experimental group. The brain edema was induced by expansion of laminaria which resulted in brain compression, that was inserted into the supratentorial extradural space of rabbit. The piece of section of laminaria which is a sea weed and used for the purpose of slow expanding space-occupyin gmass has a characteristic mode of slow expansion in volume on contact with water. The average wet weight of cerebral hemisphere of normal rabbits was 3.30+/-0.19 gm. The average dry weight of unilateral hemisphere of 156 from 78 rabbits was 0.69+/-0.04 gm, while its volume was 2.97+/-0.29 ml and the percentages of water content was 78.92+/-1.36 per cent. The weight, volume and percentages of water content and swelling in the compressed sides of hemisphere showed higher values compared them to the opposite noncompressed hemisphere in the "laminaria-compression" group and showed gradually increasing tendency in the values as the time elapsed.
Brain ; Brain Edema* ; Cerebrum ; Laminaria ; Rabbits ; Water

PURPOSE: Life-threatening effects from poisonous snakebites seem to be relatively rare in Korea. Therefore, the purpose of our study is to verify a new triage system by using mainly the local effect scoring system to determine whether it may be used as a general guide for snakebite toxicity in the early injury stage. METHODS: A retrospective study of 108 snakebite patients who visited the Emergency Department of Keimyung University Dongsan Medical Center from April 2000 to December 2003 was conducted. A local effect scoring system was used to grade the toxicity, and the results was compared with those obtained using the traditional grading system. RESULTS: According to the grading system for severity, grades 0, I and II was most common ones whereas and grades III and IV were relatively rare (9.3%, 1.9%). Local effect scores of 9 to 16, which were considered to correspond to grades III & IV, were documented in 15 cases (13.9%). For the patients with scores from 9 to 16, the average length of stay and the average dosage of the antivenin were 4.54 days and 2.0 vials compared with 1.43 days and 0.73 vials for those with a score of 8 or less, and these differences were statistically significant (p<0.05). There were 9 complicated cases, but they were not considered to be life-threatening. CONCLUSION: The local effect scoring system correlated well with the traditional grading system for snakebite severity and may provide an instrument for evaluating the severity of snakebites in the early injury stage. Also, our study supports the conclusion that snakebites in Korea should be reevaluated for the severity.
Emergency Service, Hospital ; Humans ; Korea ; Length of Stay ; Retrospective Studies ; Snake Bites* ; Triage

A teratoma is a true tumor or neoplasm composed of multiple tissue of kinds foreign to the part in which it arises. Predilection site of intracranial teratoma are the pineal body, the pituitary region and the posterior fossa in order of frequency. We have reported a case of teratoma experienced in a boy aged 12 who disclosed various clinical manifestations of right frontal lobe tumor. The teratoma was malignant histologically and located deeply in the white matter of the right posterior frontal lobe.
Frontal Lobe ; Humans ; Male ; Pineal Gland ; Teratoma*

Abscess formation within the sellar turcica is a rather entity. The development of such as abscess may be due to a direct extension of adjacent infections, such as sphenoid sinusitis, osteomyelitis of the floor of the sella or infections of other sinuses, or may be transmitted through the blood stream. Several intrinsic lesions of the pituitary gland may favor the development of infections. A case of pituitary abscess is reported in which the clinical history, manifestation and laboratory data of 32 year-old Korean female showed a strong resemblance to those in pituitary adenomas. At operation a soft cystic mass was exposed and identified in the pituitary fossa of which content was yellow pus and drained. Studies of the cyst wall and content demonstrated non-specific inflammation of the pituitary gland. A brief review of abscess in the pituitary fossa is presented.
Abscess* ; Adult ; Female ; Humans ; Inflammation ; Osteomyelitis ; Pituitary Gland ; Pituitary Neoplasms ; Rivers ; Sphenoid Sinus ; Sphenoid Sinusitis ; Suppuration

BACKGROUND: Mushroom poisonings are infrequent but potentially fatal. Most fatalities are due to the amatoxin containing species, particularly Amanita phalloides, Amanita virosa, Amanita verna which cause fulminant hepatic failure often with encephalopathy. METHODS: We experienced twenty two patients with acute mushroom poisoning admitted to Dong San hospital, Keimyung University through emergency department between January 1990 and September 1997. RESULTS: Mean age of the patients was 40.0 years and the ratio of male to female was 1 : 0.83. Seasonal distribution is 10 patients in July, 3 in August and 9 in September. The mean interval between ingestion and early symptom onset was 9.7 hours. Most of the patients had early gastrointestinal symptoms; abdominal pain, nausea, vomiting and diarrhea. except for a patient with associated mental change. The subsequent symptoms and signs follow up admission were fulminant hepatic failure(72.7%), renal failure(31.8%), mental change(27.3%), acute pancreatitis(9.1%), pericardial effusion(4.5%) and erythematous rash(4.5%). The outcomes of the patients were recovery(72.7%), death(18.2%) and hopeless discharge(9.1%). CONCLUSION: The patients who have mushroom poisoning are misdiagnosed as having viral gastroenteritis and are discharged frequently. The doctors and people should be educated not to overlook the severity of mushroom poisoning.
Abdominal Pain ; Agaricales* ; Amanita ; Diarrhea ; Eating ; Emergency Service, Hospital ; Female ; Follow-Up Studies ; Gastroenteritis ; Humans ; Liver Failure, Acute ; Male ; Mushroom Poisoning* ; Nausea ; Seasons ; Vomiting