To assess the prognostic value of the 14 ECG variables obtained from the pre-discharge ECG, 35 patients were followed up for at least one year among the 80 patients of the acute myocardial infarction admitted at Seoul Paik Hospital from Sep. 1983 to Aug. 1986. The following results were obtained. 1) The overall in-hospital mortality rate was 20% and the mortality rate tended to decline year by year. 2) The one-year mortality and morbidity rate of the followed patients was 31.4%. 3) Among the 14 variables obtained from the pre-discharge ECG, T-negativity was the only statistically significant (p<0.05) one to predict the one-year prognosis in the patients after the first myocardial infarction, and we could not derive any meaningful datd from the analysis of the combined effects of the three ECG variables (PTF, ST depression and ST elevation).
Depression ; Electrocardiography* ; Hospital Mortality ; Humans ; Mortality ; Myocardial Infarction* ; Prognosis ; Seoul

PURPOSE: Mutations in the p53 gene have been recognized in brain tumor, and clonal expansion of p53 mutant cells has been shown to be associated with glioma progression. However, studies on the p53 gene have been limited by the need for fresh frozen tissues. We have tried a method utilizing polymerase chain reaction (PCR) for the direct DNA sequecing of the p53 gene using a single 10 m paraffin-embedded tissue section. We applied this method to detect for p53 gene mutations in exons 5~8 in human astrocytoma utilizing paraffin-embedded tissues. MATERIALS AND METHODS: Twenty paraffin blocks containing tumor were selected from surgical specimens from twenty different cases. Tumors included 10 astrocytomas and 10 anaplastic astrocytomas. Ten controls were also selected among autopsy cases showing normal brain in light microscopy. The tissue section on the stained glass slide was used to guide microdissection of an unstained adjacent tissue section to ensure above 90% of the tumor cell population for p53 mutational analysis. RESULT: Mutation in the p53 gene was identified in 1 of 10 (10%) anaplastic astrocytomas. Mutations in the p53 gene were identified in 1 of 10 cases (10%) by PCR and direct DNA sequencing. Mutation in exon 7 resulting in amino acid substitution was found in one anaplastic astrocytoma (codon 245, GGC-->GAC: glycine-->aspartic acid). Ten control cases, ten astrocytomas and nine anaplastic astrocytomas were confirmed to be negative by direct sequencing of amplified DNA. CONCLUSION: This study demonstrates the feasibility of evaluating p53 gene mutations in archived astrocytoma specimens using PCR and direct DNA sequencing on paraffin sections. Application of this method should facilitate investigation of the role of p53 gene mutations in tumor biology.
Amino Acid Substitution ; Astrocytoma ; Autopsy ; Biology ; Brain ; Brain Neoplasms ; DNA* ; Exons ; Genes, p53* ; Glass ; Glioma ; Humans ; Microdissection ; Microscopy ; Paraffin ; Polymerase Chain Reaction ; Sequence Analysis, DNA*

Porphyromonas gingivalis is strongly implicated in the pathogenesis of adult periodontitis, the major cause of tooth loss in adults. Use of an antibacterial agent controlling P. gingivalis as a periodontal therapeutic agent has been rationalized. The present study was performed to observe the antibacterial effect of inorganic polyphosphates (polyP) on P. gingivalis. P. gingivalis 2561 was grown in half-strength brain-heart infusion broth containing hemin and vitamin K with or without polyP. Minimal inhibitory concentration (MIC) of polyP with various chain lengths was determined by measuring the absorbance of the grown cells at 540 nm. MIC of polyP for the bacterium was determined to be 0.05%. The effect of polyP with a chain length of 75 (polyP 75) was further examined. PolyP 75 added to the growing culture of P. gingivalis at its exponential phase was as effective in inhibiting the growth of P. gingivalis as polyP 75 added at the very beginning of the culture. More than 99% of the cells lost their viability determined by viable cell count when polyP 75 was added to the culture of growing P. gingivalis at the concentration of 0.06%, suggesting that polyP 75 has a bactericidal effect on the bacterium. Intracellular nucleotide release from the cells was increased by approx. 20% in the presence of polyP 75 but was not reversed by the addition of divalent cations like Ca++ and Mg++. Under the transmission electron microscope, only a small number of the growing P. gingivalis cells were actually lysed. However, the majority of the cells appeared to be atypical in their shape, demonstrating accumulation of highly electron-dense granules and bodies of condensed nucleic acid-like material in the cytoplasm. In the presence of polyP 75, the protein profile of P. gingivalis was changed as determined by SDS-polyacrylamide gel electrophoresis and immunoblot, and the proteolytic activity of the bacterium demostrated on the zymograms was decreased. The overall results suggest that polyP have a strong bactericidal activity against P. gingivalis in which lysis in relation to chelation may not play the major role but unknown mechanism that possibly affects the viability of the bacterium may be involved. PolyP may be used as an agent for prevention and treatment of periodontitis.
Adult ; Cations, Divalent ; Cell Count ; Chronic Periodontitis ; Cytoplasm ; Electrophoresis ; Hemin ; Humans ; Periodontitis ; Polyphosphates* ; Polyps ; Porphyromonas gingivalis* ; Porphyromonas* ; Tooth Loss ; Vitamin K

A pathological study was done to elucidate sequential changes of the lungs in various time intervals following experimental paragonimiasis in 15 dogs and 15 cats. The dogs and cats were fed with 30-50 metacercariae of Paragonimus westermani, and were sacrificed at 15, 20, 30, 45, 60, 90 and 120 days after infection respecively. Autopsies were performed immediately after death. Gross and microscopic examination of the lungs showed following findings: There were no qualitative difference in pathological findings between dogs and cats. Pathological findings were first noticed at 20 days of infection in thoracic cavity, which consisted of fibrinous plueritis along with superficial hemorrhage. Although no worm was found in the lung parenchyma at this period, juveniles were seen in pleural cavity together with turbid effusion. Paragonimus juveniles were first recognized inside the lung parenchyma by 30 days of infection. This was the period when the lungs showed multiple areas of hemorrhage and probably active penetration by smaller worms. Hemorrhagic bronchopneumonia was quite pronounced from this stage through 45 days of infection. Paragonimus worm cyst was essentially composed of fibrous scar and heavy inflammatory cellular infiltrate. The lining epithelial cells were first became noticed by 2 months of infection. And these epithelial cells were thought to be probably transformed alveolar lining cells rather than bronchiolar epithelial cells. As the infection progress, the cyst wall became more stabilized and often showed squamous metaplasia. Fibrinous pleuritis with pleural effusion was very prominent finding in early periods of infection. Bronchiolitis and focal vascular sclerosis were often seen in experimental paragonimiasis.
parasitology-helminth-trematoda ; Paragonimus westermani ; paragonimiasis ; pneumonia ; cyst ; hemorrhage ; pleuritis ; effusion ; bronchiolitis ; sclerosis

OBJECTIVE: To evaluate the changing pattern of serum leptin level and the correlation between estradiol level during the clomiphene citrate challenge test(CCCT) or controlled ovarian hyperstimulation(COH) cycle. METHODS: Twenty-seven women who underwent CCCT and fourteen women who underwent controlled ovarian hyperstimulation were recruited to measure the serum leptin level. After correction of serum concentration with body mass index(BMI), changes of leptin level and correlation with serum estradiol level during CCCT and COH cycle were analyzed. RESULTS: Circulating leptin levels were significantly correlated with BMI at each time point in CCCT cycle(P<0.01). In CCCT cycle, leptin/BMI level was significantly increased at midluteal phase compared to that of menstrual cycle day 3 and 10(p<0.05). In women with regular menstruation, leptin/BMI level at midluteal phase was significantly higher than that of menstrual day 3 and 10, but this difference was not seen in women with irregular menstruation. The leptin/BMI level in COH cycle showed increasing tendency throughout ovarian stimulation. But there was no significant correlation between leptin/BMI and estradiol level in CCCT and COH cycle. CONCLUSION: There is a significant correlation between BMI and circulating leptin level. Midluteal leptin level is significantly higher than that of follicular phase in CCCT cycle, and there is an increasing tendency in leptin level after ovarian stimulation in CCCT and COH cycle without statistical significance. These findings suggest that circulating estradiol concentration has no major influence on circulating leptin level.
Clomiphene* ; Estradiol ; Female ; Follicular Phase ; Humans ; Leptin* ; Menstrual Cycle ; Menstruation ; Ovulation Induction

PURPOSE: The purpose of this study was to develop a Problem-Based Learning (PBL) package, test its application and evaluate students' recognition of the effectiveness of PBL in nursing colleges. METHOD: Thirteen steps were used in the process developing the PBL package. After its application, the first questionnaire for self-evaluation and satisfaction with PBL class was given to 94 nursing students in December, 2005. To further evaluate the students' recognition of the effectiveness of PBL, a second questionnaire was given to 83 nursing students out of the 96 in May, 2007 after clinical practice. Data analysis was conducted using means with standard deviation. RESULTS: The results of students' self-evaluation showed high achievement in learning outcome and process using the PBL method. Also, they expressed satisfaction with the subject management, the lecturer and their peers after the PBL class. Students recognized that the PBL class had positive effectiveness in clinical practice and wanted more PBL classes and the inclusion of complex cases from well designed packages. CONCLUSION: PBL class could be considered as an opportunity to fortify student nurses' abilities to adjust to the real clinical situation.
Diagnostic Self Evaluation ; Humans ; Learning ; Nursing ; Problem-Based Learning ; Questionnaires ; Statistics as Topic ; Students, Nursing

The intramedullary nailing is one of the most available method in the treatment of femoral shaft fracture. Since the development of Küntscher nail in 1940, new designs such as the Grosse-Kempf interlocking femoral nail, Ressell-Taylor Femoral nial, AO/ASIF universal nail, ACE titanium nail became widely used by more applicable level of femoral shaft fracture. But complication of intramedullary nailing was rarely seen. The authors analyzed the clinical and mechanical factors predisposing to failures of intramedullary interlocking nails in 6 cases whom treated the comminuted fracture of the femoral shaft, at the department of orthopaedic surgery, Sun General Hospital from 1991 to 1995 and the following results are obtained. 1. Initial fracture patterns were comminuted in all 6 cases. 2. The implant nails were AO nail in 4 cases, Grosse-Kempf nail in 1 case, Russell-Taylor nail in 1 case(nail diameter was 10mm to 12mm). 3. The failure sites of the interlocking nail were the initial bone fracture site in 2 cases, distal to the proximal screw hole in 1 case, proximal to the distal screw hole in 2 cases, fracture site and distal to the proximal screw hole in 1 case. 4. The average time to failure of implants were 11.5 months. 5. The average times to partical weight bearing were 6.3 weeks. In the analy of above results, by using diameter of nail more than 13mm and delaying weight bearing on the injured limb until there is clear radiographic evidence of early union of the femur fracture, we may reduce the metal failures of intramedullary interlocking nail in comminuted femoral shaft fractures.
Extremities ; Femur ; Fracture Fixation, Intramedullary ; Fractures, Bone ; Fractures, Comminuted ; Hospitals, General ; Methods ; Solar System ; Titanium ; Weight-Bearing

A case of Nelson's syndrome in 23 year-old female, developing 6 years after bilateral adrenalectomy for Cushing's syndrome, is reported. Presenting symptoms were headache and hyperpigmentation of the skin and mucous membrane. Serum ACTH level was markedly elebated above 1000 pg/ml, but serum cortisol level diminished markedly. Transsphenoidal approach (TSA) with removal of gushing out hematoma and tumor underwent. Postoperatively, headache subsided and hyperpigmentation of the skin markedly improved.
Adrenalectomy ; Adrenocorticotropic Hormone ; Cushing Syndrome ; Female ; Headache ; Hematoma ; Humans ; Hydrocortisone ; Hyperpigmentation ; Mucous Membrane ; Skin ; Young Adult

PURPOSE: This study aimed at evaluating the therapeutic outcome, cost effectiveness and recurrence rate in children with H. pylori infection after the treatment using various medications. METHODS: Seventy five children (mean age 11.4+/-2.5 years) were given an endoscopy with biopsy and H. pylori status assessed by CLO test and histologic examination (Warthin Starry stain). Children were given one of following medications such as DA (Denol(R) and amoxycillin), OA (omeprazole and amoxycillin), DC (Denol(R) and clarithromycin) as primary treatment. And one of following medications such as DAM (Denol(R), amoxycillin and metronidazole), DC, OA, OC (omeprazole and clarithromycin) were used in children who failed the eradication of H. pylori. RESULTS: The endoscopic diagnoses were: nodular gastritis (46 cases), gastric ulcer (9), duodenal ulcer (6), superficial gastritis (6), and normal (8). H. pylori eradication rate was 91% (63 of 69 children) on 4 weeks course of DA, 50% (1 of 2 cases who had treatment failure on DA) on DAM, and 75% (3 of 4 cases who treated on DC primarily) and 50% (1 of 2 cases who had treatment failure on DA) on DC, and 100% on OA (all of 2) and on OC (all of 1 who failed on DA). In 3 of 7 children in whom H. pylori had not been eradicated by primary medications (DA 6 and DC 1 case), H. pylori was re-eradicated by secondary medications (DA 1, DAM 1 and DC 1 case). But in remaining 4 cases, H. pylori infection persisted. Reinfection of H. pylori was found in 4 of 75 children between 3 months and 3 years after completion of the treatment of DA, yielding recurrence rate of 5.3%. In 2 of 4 cases who had relapsed, H. pylori was re-eradicated by secondary medications (OC 1 and DA 1 case). But in remaining 2 cases, H. pylori infection persisted. CONCLUSION: These results suggest that dual therapy with Denol(R) and amoxycillin is the effective medications in treating H. pylori infection in children. Concerning the cost effectiveness, it can Austrabe recommended as first line treatment of choice as well.
Amoxicillin ; Biopsy ; Child* ; Cost-Benefit Analysis ; Diagnosis ; Duodenal Ulcer ; Endoscopy ; Gastritis ; Helicobacter pylori* ; Helicobacter* ; Humans ; Recurrence* ; Stomach Ulcer ; Treatment Failure

A case of Paragonimus westermani cysts found deep inside the spleen is described. This spleen was from a dog that was experimentally infected via oral route with a hundred metacercariae and was killed 3 months after. At autopsy, beside the usual lesions due to Paragonimus in the lungs, the spleen was the site of multiple parasitic cysts. The involved spleen was slightly enlarged and showed an area of hemorrhagic dome on the capsular surface. There found a total of 8 adult worms in four well demarcated parasitic cysts containing a pair of worms each. All of them were found deep into the splenic parenchyme and were surrounded by a well formed connective tissue wall, thus resembling the features of the pulmonary paragonimiasis. The route of infection was assumed to be a direct transcapsular invasion during the phase of larval migration.
parasitology-helminth-trematoda ; paragonimiasis ; Paragonimus westermani ; dog ; case report ; spleen