No abstract available.
Animals ; Indomethacin* ; Killer Cells, Lymphokine-Activated* ; Mice*

From January to December 1984, 191 patients with associated ventricular septal defect(VSD) were studied in the cardiac cathetherization laboratory. Among theses 191 cases, 58 cases(30.4%) of subpulmonic VSD were identified by angiocardiography. Among the 59 cases of subpulmonic VSD, 12 cases(20.6%) were complicated with aortic infficiency(AI). The relative frequency of subpulmonic VSD increased with the increase of age and the frequency of complication of AI with the subpulmonic VSD also increased with the increase of age. The amount of left to right shunt in the patients with subpulmonic VSD and AI was small and Qp/Qs ratio was less than 2.0 in all of the 12 cases. Among the 12 patients 4 cases had a pressure gradient greater than 20 mmHg across the infundibular region of the right ventricle.
Angiocardiography ; Heart Septal Defects, Ventricular* ; Heart Ventricles ; Humans

The purpose of this study is to evaluate the prognostic significance of argyrophilic nucleoalr organizer regions (AgNORs) and proliferating cell nuclear antigen (PCNA) by using DMBA hamster buccal pouch carcinogenesis which provides a good experimental model in reproducing steps from precancerous lesions to invasive squamous cell carcinomas. The buccal pouches of 50 Syrian hamsters were applied with 0.5% DMBA in mineral oil three times a week to reproduce various lesions from precancerous ones such as hyperkeratosis or epithelial dysplasia to invasive squamous cell carcinomas. Their sections were stained with H & E, and silver colloid, and processed immunohistochemically by being applied with monoclonal antibody to PCNA. The histopathologic examainations were done and the counts of AgNORs were evaluated. The PCNA labelling indices on each lesions were evaluated. The correlation between histopathological grades and counts of AgNORs or PCNA labelling indices were evaluated. The number of AgNORs was 2.22+/-0.22 in control group, 3.46+/-0.72 in carcinoma in situ (CIS), 3.78+/-0.63 in squamous cell carcinoma (SCC), respectively. AgNORs significantly increased in severe epithelial dysplasia, CIS, and SCC compared with normal tissue (P<0.05). The PCNA Labeling Index (LI) was 39.47+/-6.68% in control group, 79.61+/-4.14% in CIS, and 85.43+/-6.25% in SCC, respectively. PCNA LI also significantly increased in epithelial dysplasia, CIS, and SCC compared with normal tissue (P<0.05). The number of AgNORs, AgNOR area, and PCNA LI slightly increased in the advancing front than in the center of SCC, but, it was not statistically significant. It appeared that there were a good correlation between the number of AgNORs and PCNA LI (Pierson correlation coefficient : 0.649, P<0.001). These results suggested that the number of AgNORs and the PCNA LI could be useful markers for evaluating the risk of malignant transformation and prognosis of SCC. It was thought that the clinical usefulness of these markers should be verified by using human tissue specimens.
9,10-Dimethyl-1,2-benzanthracene ; Animals ; Carcinogenesis* ; Carcinoma in Situ ; Carcinoma, Squamous Cell ; Colloids ; Cricetinae* ; Humans ; Mesocricetus ; Mineral Oil ; Models, Theoretical ; Prognosis ; Proliferating Cell Nuclear Antigen* ; Silver

Cryptosporidium, a coccidian parasite first described by Tyzzer (1907) from a laboratory mouse, has become an important human enteric pathogen causing overwhelming diarrhea especially in immunocompromised patients such as AIDS. This parasite has been reported from over 20 countries and is recognized as a cosmopolitan species. In Korea, however, there has been no report on human as well as animal cryptosporidiosis. This study was performed so as to verify the presence of Cryptosporidium in Korea by activating the parasite from laboratory mice by immunosuppression. Total 65 conventionally-bred ICR mice including a control (5 mice) and 3 experimental groups (20 each) were used for this study. Group I was immunosuppressed with prednisolone injection (1 mg IM, every other day) for 7 weeks. Group II (prednisolone injection and tetracycline administration) and Group III (prednisolone injection and trimethoprim-sulfamethoxazole administration) were prepared to observe the effect of antibacterial agents on the activation of cryptosporidiosis. In fecal examinations of mice Cryptosporidium oocysts (4-6 microns in size) were detected from 1 week after the start of immunosuppression and the mice began to die. In H-E stained tissue sections of the lower jejunum, numerous very small (2-4 microns), dense, ovoid or spherical, slightly basophilic bodies were seen attached on the free border of mucosal epithelial cells. In scanning and transmission electron microscopic observations, these organisms were identified as various developmental stages of Cryptosporidium. The species is considered to be C. parvum.(ABSTRACT TRUNCATED AT 250 WORDS)
Cryptosporidiosis-etiology ; Cryptosporidiosis-immunology ; Cryptosporidium-growth-and-development ; English-Abstract ; Immune-Tolerance ; Intestinal-Diseases,-Parasitic-etiology ; Intestinal-Diseases,-Parasitic-immunology ; Mice- ; Mice,-Inbred-ICR ; *Cryptosporidiosis-parasitology ; *Cryptosporidium-pathogenicity ; *Immunosuppression- ; *Intestinal-Diseases,-Parasitic-parasitology

PURPOSE: This study was performed to examine if CT classification of renal blunt injury could aid in expectation of hemodynamic stability and clinical decision of whether to intervene surgically. MATERIALS AND METHODS: Over a 80-month period between July 1987 and March 1994, 41 patients were admitted to our hospital with the diagnosis of renal blunt injury. The renal blunt injuries were classified on Fedede's three-point scale CT classification methods :grade I, contusion, intrarenal hematoma, segmental infarction, and small subcapsular hematoma;grade II, complete or incomplete laceration, large subcapsular hematoma, and renal fracture;grade Ill, shattered kidney and renal pedicle injury. Hemodynamic stability, treatment method and clinical outcome of the patients with different CT grade were analyzed retrospectively. RESULTS: All 34 patients with grade I or II CT findings were hemodynamically stable and were successfully managed with conservative method. Among 7 patients with grade III CT findings, 6 patients were hemodynamically unstable. Out of the 6, One patient with grade IIIb or renal pedicle injury was expired before surgical intervention due to ischemic shock. Four patients were intervened surgically with one failure to thrive. The remaining one patient refused to be intervened surgically, and was discharged against medical advice. Only one out of 7 patients was hemodynamically stable and was managed conservatively. CONCLUSION: The patients with grade I or II CT findings are prone to be hemodynamically stable and to be managed with conservative method. But the patients with grade III CT findings are more likely to be hemodynamically unstable. Therefore patients with grade III CT findings should be closely monitored and be pre- pared for the possibility of immediate surgical intervention
Classification* ; Contusions ; Diagnosis ; Failure to Thrive ; Hematoma ; Hemodynamics ; Humans ; Infarction ; Kidney ; Lacerations ; Retrospective Studies ; Shock ; Wounds, Nonpenetrating

No abstract available.

PURPOSE: We performed this study to evaluate the usefulness and the limitation of magnetic resonance angiography in imaging portal vein and hepatic vein. MATERIALS AND METHODS: Magnetic resonance portography was performed in five normal subjects and seven patients with hepatomas, two patients with Budd-Chiari syndromes, one patient with liver cirrhosis and one patient with hepatic metastasis from stomach cancer. Magnetic resonance angiography was done with a 1.5-T Scanner. Breath-hold two-dimensional time-of flight images with spoiled gradient echo technique were acquired. Scan parameters were 34/8/40degrees(TR ms/TE ms/flip angle). The portal vein and the hepatic vein were selectively imaged by applying two presaturation bands. These images were then postprocessed by a maximum intensity projection algorithm. MRA findings were compared with ultrasonography in all cases of the hepatic disease, and conventional angiography (SMA portography) in four cases. RESULTS: In normal subjects, the splenic vein, intrahepatic and extrahepatic portions of the portal vein, and the hepatic veins were well visualized. In the patients with hepatic diseases, the varices (4 cases), the splenorenal shunts (2 cases), and the recanalized umbilical vein (1 case) were demonstrated. There were portal vein thrombosis in the cases of hepatomas and hepatic metastasis. In the cases of Budd-Chiari syndrome, the hepatic veins were not visualized and there were inferior vena cava obstructions with multiple collateral vessels. CONCLUSION: Compared with ultrasonography, MRP may be useful in evaluation of varices, splenorenal shunts, and other collaterals, though less accurate than conventional angiography. MRP can be useful as a noninvasive screening alternative in the evaluation of portal vein and hepatic veins.
Angiography ; Budd-Chiari Syndrome ; Carcinoma, Hepatocellular ; Hepatic Veins ; Humans ; Liver Cirrhosis ; Magnetic Resonance Angiography ; Mass Screening ; Neoplasm Metastasis ; Portal Vein ; Portography* ; Splenic Vein ; Splenorenal Shunt, Surgical ; Stomach Neoplasms ; Ultrasonography ; Umbilical Veins ; Varicose Veins ; Vena Cava, Inferior ; Venous Thrombosis

BACKGROUND: Tumor necrosis factor(TNF)-alpha and Interleukin(IL)-1beta are thought to play a major role in the pathogenesis of the septic syndrome, which is frequently associated with adult respiratory distress syndrome(ARDS). In spite of many reports for the role of TNF-alpha in the pathogenesis of ARDS, including human studies, it has been reported that TNF-alpha is not sensitive and specific marker for impending ARDS. But there is a possibility that the results were affected by the diversity of pathogenetic mechanisms leading to the ARDS because of various underlying disorders of the study group in the previous reports. The purpose of the present study was to evaluate the roles of TNF-alpha and IL-lbeta as a predictable marker for development of ARDS in the patients with septic syndrome, in which the pathogenesis is believed to be mainly cytokine-mediated. METHODS: Thirty-six patients of the septic syndrome hospitalized in the intensive care units of the Asan Medical Center were studied. Sixteens suffered from ARDS, whereas the remaining 20 were at the risk of developing ARDS(acute hypoxemic respiratory failure, AHRF). In all patients venous blood sample were collected in heparin-coated tubes at the time of enrollment, at 24 and 72 h thereafter. TNF-alpha and IL-lbeta was measured by an enzyme-linked immunosorbent assay (ELISA). All data are expressed as median with interquartile range. RESULTS: 1) Plama TNF-alpha levels: Plasma TNF-beta levels were less than 10pg/mL, which is lowest detection value of the kit used in this study within the range of the mean+/-2SD, in all of the normal controls, 8 of 16 subjects of ARDS and in 8 in 20 subjects of AHRF. Plasma TNF-alpha levels from patients with ARDS were 10.26pg/mL(median;<10-16.99pg/mL, interquartile range) and not different from those of patients at AHRF(10.82, <10-20.38pg/mL). There was also no significant difference between pre-ARDS(<10, <10-15.32pg/mL) and ARDS(<10, <10-10.22pg/mL). TNF-alpha levels were significantly greater in the patients with shock than the patients without shock(12.53pg/mL vs. <10pg/mL) (P<0.01). There was no statistical significance between survivors(< 10, <10-12.92pg/mL) and nonsurvivors(11.80, <10-20.8pg/mL) (P=0.28) in the plasma TNF-alpha levels. 2) Plasma IL-lbeta levels: Plasma IL-1beta levels were less than 0.3ng/mL, which is the lowest detection value of the kit used in this study, in one of each patients group. There was no significant difference in IL-1beta levels of the ARDS(2.22, 1.37-8.01ng/mL) and of the AHRF(2.13, 0.83-5.29ng/mL). There was also no significant difference between pre-ARDS(2.53, <0.3-8.34ng/mL) and ARDS(5.35, 0.66-11.51ng/mL), and between patients with septic shock and patients without shock (2.51, 1.28-8.34 vs 1.46, 0.15-2.13ng/mL). Plasma IL-19 levels were significantly different between survivors(1.37, 0.4-2.36ng/mL) and nonsurvivors(2.84, 1.46-8.34ng/mL). CONCLUSION: Plasma TNF-alpha and IL-1beta level are not a predictable marker for development of ARDS. But TNF-alpha is a marker for shock in septic syndrome. These result could not exclude a possibility of pathophysiologic roles of TNF-alpha and IL-1beta in acute lung injury because these cytokine could be locally produced and exert its effects within the lungs.
Acute Lung Injury ; Adult* ; Chungcheongnam-do ; Enzyme-Linked Immunosorbent Assay ; Humans ; Intensive Care Units ; Interleukin-1beta* ; Lung ; Lymphotoxin-alpha ; Necrosis ; Plasma ; Respiratory Distress Syndrome, Adult* ; Respiratory Insufficiency ; Shock ; Shock, Septic ; Tumor Necrosis Factor-alpha*

Medical education in Je Joong Won was proposed and initiated by Dr. HN Allen. In his proposal of building a new hospital, submitted to the king in 1885, he expressed his wish to teach Western medicine to young Koreans at the hospital. The king welcomed his proposal and the plan was soon realized. Je Joon Won, the first modern hospital in Korea, opened on April 10th, 1885. The following year, on March 29th, Dr. Allen began medical school attached to the hospital. Many applicants were recruited by the government and 16 students were selected through the entrance examination. At first, they were taught English and finally 12 students out of them were selected after three months of teaching. The selected students were taught arithmetic, physics, chemistry, anatomy and physiology. The medical education at this period cannot be evaluated entirely successful since none of the 12 students was presumed to have worked as a practitioner.
Education, Medical/*history ; English Abstract ; History of Medicine, 19th Cent. ; History of Medicine, 20th Cent. ; Hospitals/history ; Korea ; Mentors/*history ; Missions and Missionaries/*history ; United States ; Western World

PURPOSE: To determine the helmet use rate, factors affecting helmet use in Korea, and the effects of helmet use on injuries. METHODS: This is a prospective study with patients who visited two emergency centers in Seoul during 7 months due to accidents that they had while riding a motorcycle. We examined the patients' general characteristics, whether to wear a helmet, Glasgow Coma Scale (GCS), Revised Trauma Score (RTS), Abbreviated Injury Score (AIS) and Injury Severity Score (ISS) on admission, and whether to be hospitalized. In addition, factors such as the patients' position, accident season, day of the week, hour and whether to drink were analyzed to see if they affect helmet use and injuries. RESULTS: A total of 178 patients participated in this study, and 57.3% wore a helmet. Around 20% of patients had head injuries. Head injuries were more frequent in those who did not wear a helmet. According to the result of analyzing factors affecting helmet use, the helmet non-use rate was high in patients whose age was 30 or less and drinkers. For the two groups, the odds ratios for helmet non-use were 2.3 (95% CI 1.2~4.5) and 4.2 (95% CI 1.2~ 15.2), respectively. CONCLUSION: This study shows that helmet use can prevent head injuries in motorcycle patients. Thus, in order to prevent head injuries, helmet use should be increased and, for this, education and regulation on helmet use should be reinforced, particularly for those aged 30 or younger and drinkers.
Craniocerebral Trauma ; Education ; Emergencies ; Glasgow Coma Scale ; Head Protective Devices* ; Humans ; Injury Severity Score ; Korea* ; Motorcycles* ; Odds Ratio ; Prospective Studies ; Seasons ; Seoul