No abstract available.
Arthritis* ; Knee Joint* ; Knee* ; Salmonella typhi* ; Salmonella*

OBJECTIVE: Stenotrophomonas maltophilia has been emerging as an important nosocomial pathogen in recent years in patients with impaired host- defense mechanism or who has been exposed to large amount of inocula. This organism is usually resistant to multiple (commonly used) antimicrobial agents, particularly to those of the beta-lactam class. To evaluate the clinical feature of Stenotrophomonas maltophilia infection and in vitro anti- microbial susceptibility, we performed a retrospective study. METHODS: We analyzed the result of in vitro antimicrobial susceptibility test for 200 isolates of S. maltophilia and the annual isolation rate during the period between January 1990 and December 1994 in our institution, and performed a retrospective study for the available records of 165 cases among them. The data were obtained with only the first isolation of the organism for each patients. RESULTS: Total of 165 initial isolates, the isolates were from wounds in 50(30.3%), urine in 47(28.5%), the respiratory tract in 37(22.4%), blood in 9(5.5%), bile in 6(3.6%), and miscellaneous sources in 16(9.7%). The 84.2% of isolates were hospital-acquired isolate and 58.3% of these patients had received antecedent antibiotic therapy: polymicrobial growth was demonstrated in 61.9% of the cases. In vitro antimicrobial susceptibiiity test, ofloxacin was active against the isolates in 89.2%, moxalactam in 85.9%, ciprofloxacin in 83.9%, TMP-SMX(trimethoprim-sulfamethoxazole) in 64.2%, As expected, S. maltophilia isolates were, in general, not susceptible to cephalosporins, penicillins. The annual isolation rate at Kyung Hee University hospital was not increased significantly from 1990 to 1994, 19.53 per 10,000 patients dismissals in 1990, 13.56 in 1994. The major underlying diseases of patients were malignancy(17.6%), cerebrovascular disorder(17%), diabetic mellitus(13.3%). Mortality rate is 10.3%. CONCLUSION: S. maltophilia has been emerging as an important nosocomial pathogen in immunocompromised patients, especially those receiving broad-spectrum antimicrobial therapy. And this organism is resistant to multiple antimicrobial agents, particularly to those of the beta-lactam class. When antimicrobial treatment is necessary, the clinician should be guided by results of in vitro susceptibility testing because of the notable in vitro resistance of S. maltophilia to commonly used antibiotics. And when S. maltophilia has been recovered from a patient, wound and contact isolation is warranted.
Anti-Bacterial Agents ; Anti-Infective Agents ; Bile ; Cephalosporins ; Ciprofloxacin ; Humans ; Immunocompromised Host ; Mortality ; Moxalactam ; Ofloxacin ; Penicillins ; Respiratory System ; Retrospective Studies ; Stenotrophomonas maltophilia ; Stenotrophomonas* ; Wounds and Injuries

OBJECTIVE: To identify differences in the expression of the genes for peroxisome proliferator-activated receptor (PPAR)-γ, cyclooxygenase (COX)-2, and the proinflammatory cytokines interleukin (IL)-6 and tumor necrosis factor (TNF)-α in granulosa cells (GCs) from polycystic ovary syndrome (PCOS) patients and controls undergoing controlled ovarian stimulation. METHODS: Nine patients with PCOS and six controls were enrolled in this study. On the day of oocyte retrieval, GCs were collected from pooled follicular fluid. Total mRNA was extracted from GCs. Reverse transcription was performed and gene expression levels were quantified by realtime quantitative polymerase chain reaction. RESULTS: There were no significant differences in age, body mass index, and total gonadotropin dose, except for the ratio of luteinizing hormone to follicle-stimulating hormone between the PCOS and control groups. PPAR-γ and COX-2 mRNA was significantly downregulated in the GCs of PCOS women compared with controls (p=0.034 and p=0.018, respectively), but the expression of IL-6 and TNF-α mRNA did not show significant differences. No significant correlation was detected between the expression of these mRNA sequences and clinical characteristics, including the number of retrieved oocytes, oocyte maturity, cleavage, or the good embryo rate. Positive correlations were found among the PPAR-γ, COX-2, IL-6, and TNF-α mRNA levels. CONCLUSION: Our data may provide novel clues regarding ovarian GC dysfunction in PCOS, and indirectly provide evidence that the effect of PPAR-γ agonists in PCOS might result from alterations in the ovarian follicular environment. Further studies with a larger sample size are required to confirm these proposals.
Body Mass Index ; Cyclooxygenase 2* ; Cytokines* ; Embryonic Structures ; Female ; Follicle Stimulating Hormone ; Follicular Fluid ; Gene Expression ; Gonadotropins ; Granulosa Cells* ; Humans ; Interleukin-6 ; Interleukins ; Luteinizing Hormone ; Oocyte Retrieval ; Oocytes ; Ovulation Induction ; Peroxisomes* ; Polycystic Ovary Syndrome* ; Polymerase Chain Reaction ; PPAR gamma ; Prostaglandin-Endoperoxide Synthases ; Reverse Transcription ; RNA, Messenger ; Sample Size ; Tumor Necrosis Factor-alpha

Anti-Müllerian hormone (AMH) is now accepted as an important clinical marker of ovarian reserve and is increasingly measured as an initial evaluation at infertility clinics. The aim of this study was to establish reference values for the revised second generation (Gen II) assay using population-based data. In this population-based cohort study, AMH data from unselected infertile women aged 25–45 years from June 2013 to June 2014 (n = 15,801) were collected. The AMH values were measured using the revised Gen II assay. We established and validated 5 AMH-age regression models. Based on the optimal AMH-age model, reference values and centile charts were obtained. The quadratic model (log AMH = 0.410 × age − 0.008 × age²− 3.791) was the most appropriate for describing the age-dependent decrease in AMH measured using the revised Gen II assay. This is the largest population-based study to establish age-specific reference values of AMH using the revised Gen II assay. These reference values may provide more specific information regarding the ovarian reserve estimation of infertile women.
Biomarkers ; Cohort Studies ; Female ; Humans ; Infertility ; Ovarian Reserve ; Reference Values*

No abstract available.
Humans*

Carcinoid tumors are the most common endocrine tumors of gastrointestinal tract. Argentaffin cells are the origin of carcinoids. These cells belong to the amino precursor uptake and decarboxylation (APUD) system. These cells give the tumor its most distinguishing feature: the ability to produce biogenic amines and polypeptide hormones that, in turn, give rise to the dramatic carcinoid syndrome. We treated a case of multi-centric carcinoid tumor of the duodenum in a 63-year-old male patient. He was admitted to the hospital because of epigastric pain. On the gastrofiberscopic examination, 1.0 x1.5 cm and 0.7 x0.8 cm sized two polyps (Yamada type II, I) were noticed on the duodenal bulb. The biopsy specimen showed carcinoid tumors of different histologic types. The level of 24-hour urine 5-HIAA of this case was normal. He was treated with subtotal gastrectomy with Billroth-II anastomosis. We report this case with literature review.
Biogenic Amines ; Biopsy ; Carcinoid Tumor* ; Decarboxylation ; Duodenum ; Enterochromaffin Cells ; Gastrectomy ; Gastrointestinal Tract ; Humans ; Hydroxyindoleacetic Acid ; Male ; Middle Aged ; Peptide Hormones ; Polyps

The purpose of this study was to investigate whether sperm selection by hyaluronic acid (HA) binding could improve fertilization rate and embryo quality in intracytoplasmic sperm injection (ICSI) cycles. Two hundred nineteen oocytes obtained from eighteen women were injected with either HA-bound (n = 107) or conventionally selected spermatozoa (n = 112) in a randomized way. All of the participants were infertile couples who had normal sperm parameters but low fertilization rate in previous in vitro fertilization (IVF) cycle (n = 5) or experienced multiple IVF failures (n = 13). Lower fertilization (75.7% vs 83.0%) and cleavage rate on day 2 (72.9% vs 83.0%) was observed in oocytes injected with HA-bound spermatozoa than the conventional group, but the difference was not significant. Significantly lower cleavage rate was observed on day 3 in HA group (56.0% vs 69.6%, P = 0.038). Blastocyst formation rate and the number of transferred embryos were similar in both groups. In multiple IVF failure patients, significantly reduced fertilization rate (71.8% vs 85.3%, P = 0.046) and cleavage rate on day 2 (70.4% vs 85.3%, P = 0.029) and day 3 (53.5% vs 77.3%, P = 0.002) were noticed in HA group. Five women achieved pregnancy continuing more than 12 weeks after transfer (27.8%). Success of ICSI was not related with the number of embryos fertilized by HA-bound spermatozoa. Application of ICSI by sperm selection using HA binding is not helpful in couples with repeated poor fertilization or implantation despite normal sperm parameters.
Adult ; Blastocyst/cytology ; Embryo Transfer ; Female ; *Fertilization in Vitro ; Humans ; Hyaluronic Acid/*pharmacology ; Infertility, Male/therapy ; Male ; Oocytes/cytology/physiology ; Pregnancy ; Pregnancy Rate ; Prospective Studies ; *Sperm Injections, Intracytoplasmic ; Spermatozoa/*drug effects/physiology

The nephrotic syndrome in association with extrarenal malignancy is not an uncommon event. The membranous nephropathy is most frequently associated with various carcinomas of the lung, breast, stomach and colon. Though the exact causal relationship has not been determined completely, deposition of the immune complexes composed of antitumor antibody and tumor antigens in the subepithelium is most favorably accepted. We experienced a patient with previously diagnosed membranous nephropathy and subsequently demonstrated early gastric cancer during patient follow-up. After surgical resection proteinuria improved significantly. All physicians are strongly recommended to examine thoroughly and search carefully for possibility of concomitant occult malignancy when an aged patient, especially over 40 years old, is diagnosed as a nephrotic syndrome.
Adult ; Antigen-Antibody Complex ; Antigens, Neoplasm ; Breast ; Colon ; Follow-Up Studies ; Glomerulonephritis, Membranous* ; Humans ; Lung ; Nephrotic Syndrome ; Proteinuria ; Stomach ; Stomach Neoplasms*

OBJECTS: To assess risk factors related to the occurrence of rebleeding in patients with aneurysmal subarachnoid hemorrhage (SAH) who had been planned to the early surgery, this study was conducted retrospectively. MATERIAL AND METHODS: During the period from January, 1993 to December, 1995, 258 patients with aneurysmal SAH who admitted within 3 days of their SAH and had been planned to early surgery were selected as study population. Ten variables including age, sex, hypertension history, rebleeding before admission, systolic blood pressure on admission, intracerebral or intraventricular hematoma, clinical grade, computed tomographic (CT) grade, admission time after SAH, hemostatic parameter were analyzed by the univariate and multivariate logistic regression method using the Statistical Analysis System (SAS). RESULTS: Of the 258 patients, 25 (9.69%) patients had rebleeding. Admission within 2 hours after SAH (p=0.001), clinical grade IV-V (p=0.015), rebleeding before admission (p=0.000), and intracerebral or intraventricular hematoma (p=0.04) appeared to be associated with a higher risk of rebleeding on the univariate analysis. Particularly, the patients who admitted to hospital within 2 hours after SAH and who are clinical grade IV or V appeared to be more likely to have early rebleeding. Rebleeding before admission was revealed as a independent factor associated with rebleeding on the multivariate logistic regression analysis. CONCLUSION: The short course use of antifibrinolytics, 3-dimensional CT angiography and endovascular surgery should be considered for the patients with aneurysmal SAH who have rebleeding history before admission, intracerebral or intraventricular hematoma, who admit to hospital within 2 hours after SAH, and who are clinical IV or V to minimize rebleeding in the interval between SAH attack and early surgery.
Aneurysm* ; Angiography ; Antifibrinolytic Agents ; Blood Pressure ; Hematoma ; Humans ; Hypertension ; Intracranial Aneurysm ; Logistic Models ; Retrospective Studies ; Risk Factors ; Subarachnoid Hemorrhage*

BACKGROUND AND OBJECTIVES: Vestibular toxicity can be usually monitored by a caloric test, but measuring eye movements including nystagmus is also helpful in the evaluation of vestibulotoxic process. To understand the vestibular signs during bilateral vestibulotoxic process, we observed three dimensional serial changes of eye movements and the results of caloric test in cats using a magnetic search coil system. MATERIALS AND METHODS: Three-dimensional (3-D) eye movement responses to ice water caloric stimulus and spontaneous, positional, positioning, and post head shaking nystagmus in five cats were serially evaluated at 3, 7, 10, 14, 21, 28 days, 2, 3, 4, 5, 6 months after inducing bilateral vesitibulotoxicity by subcutaneous injection of streptomycin. Histologic changes of vestibular system were also observed. RESULTS: Bilateral vestibulotixicity which showed no response to ice water caloric stimulus was induced within 2 weeks with streptomycin injection. Positional, positioning and post head shaking nystagmus were present during vestibulotoxic process. Caloric nystagmus did not reappear within 6 months and histologic finding in crista ampullaris of lateral semicircular canal showed marked degeneration of the hair cells and nerves. CONCLUSION: Observation of positional, positioning and post head shaking nystagmus as well as ice water caloric test will be helpful to monitor vestibulotoxic process.
Animals ; Caloric Tests ; Cats* ; Eye Movements ; Hair ; Head* ; Ice ; Injections, Subcutaneous ; Nystagmus, Physiologic ; Semicircular Canals ; Semicircular Ducts ; Streptomycin ; Water