No abstract available.
Arthritis, Rheumatoid* ; Humans ; Hyperplasia* ; NF-kappa B*

BACKGROUND: The information on nasal transport and the metabolism of peptides have been obtained from pharmacokinetic investigations in experimental animals. However, there are no transport and metabolic studies of human nasal epithelial cells. In this study, the permeability characteristics and the metabolic properties of in vitro human nasal cell monolayers were investigated. Material and METHODS: Normal human inferior nasal conchal tissue samples were obtained from patients undergoing endoscopic nasal cavitary surgery. The specimens were cultured in a transwell using an air-liquid interface (ALI) culture, and the transepithelial electrical resistance (TEER) value of the blank filter and confluent cell monolayers were measured. To determine the % leakage of mannitol, 4µmol 14C-labelled mannitol was added and the % leakage was measured every 10 minute for 1 hour. RESULT: Human nasal epithelial cells in the primary culture grew to a confluent monolayer within 7 days and expressed microvilli. The tight junction between the cells was confirmed by transmission electron microscopy. The TEER value of the blank filter, fifth day and seventh day reached 108.5 ohm.cm2, 141 ohm.cm2 and 177.5 ohm.cm2, respectively. Transcellular % leakage of the 14C-mannitol at 10, 20, 30, 40, 50 and 60 minutes was 35.67±5.43, 34.42±5.60, 32.75±5.71, 31.76±4.22, 30.96±3.49 and 29.60±3.68 %, respectively. CONCLUSION: The human nasal epithelial monolayer using ALI using techniques is suitable for a transcellular permeability study. The data suggests that human nasal epithelial cells in as ALI culture technique shows some promise for a nasal transport and metabolism study.
Animals ; Culture Techniques* ; Electric Impedance ; Epithelial Cells* ; Humans* ; Mannitol ; Metabolism ; Microscopy, Electron, Transmission ; Microvilli ; Peptides ; Permeability ; Tight Junctions

BACKGROUND: Mycoplasma spp. occasionally colonize the genital tract and these organisms are some of the most important contaminants in cell culture laboratories and cell banks. We analyzed the Mycoplasma contamination rates in the donated cord blood units (CBUs) before cell processing. METHODS: A total of 151 CBUs that were donated with informed consent (November 3rd~December 28th, 2006) were randomly selected and enrolled in the study. We performed blood culture and Mycoplasma DNA PCR assay with using samples from the collection bags before processing. RESULTS: All of the CBUs were obtained from full-term (gestational age 37~42 weeks) deliveries. Two units showed positive results on blood culture however, Mycoplasma DNA is not found in the tested samples. CONCLUSION: The contamination rates of Mycoplasma in the CBUs, which are donated from the mothers who have full-term delivery and no pregnancy complications, are extremely low. The donated CBUs could be used in culture and for an expansion process without concern of incurring pre-processing Mycoplasma contamination. The rate of Mollicute contamination in the CBUs could become clear with the results of performing Ureaplasma assay.
Cell Culture Techniques ; Colon ; DNA ; Fetal Blood ; Humans ; Informed Consent ; Mothers ; Mycoplasma ; Polymerase Chain Reaction ; Pregnancy Complications ; Ureaplasma

The aim of this study was to examine the incidence and trends of clinically relevant venous thromboembolism (VTE) including deep vein thrombosis (DVT) and pulmonary embolism (PE) after hip and knee replacement arthroplasty (HKRA) in Korea. Between January 1 and December 31, 2010, 22,127 hip replacement arthroplasty (HRA) patients and 52,882 knee replacement arthroplasty (KRA) patients were enrolled in the analysis using the administrative claims database of the Health Insurance Review and Assessment Service (HIRA). All available parameters including procedure history and clinically relevant VTE during the 90 days after HKRA were identified based on diagnostic and electronic data interchange (EDI) codes. The overall incidence of VTE, DVT, and PE during the 90 days was 3.9% (n=853), 2.7% (n=597), and 1.5% (n=327) after HRA, while the incidence was 3.8% (n=1,990), 3.2% (n=1,699), and 0.7% (n=355) after KRA. The incidence of VTE after HKRA was significantly higher in patients who had previous VTE history (odds ratio [OR], 10.8 after HRA, OR, 8.5 after KRA), chronic heart failure (2.1, 1.3), arrhythmia (1.8, 1.7), and atrial fibrillation (3.4, 2.1) than in patients who did not. The VTE incidence in patients with chemoprophylaxis was higher than that in patients without chemoprophylaxis. The incidence of VTEs revealed in this retrospective review was not low compared with the results of the studies targeting other Asian or Caucasian populations. It may warrant routine prevention including employment of chemoprophylaxis. However, the limitation of the reviewed data mandates large scale prospective investigation to affirm this observation.
Adult ; Aged ; Aged, 80 and over ; *Arthroplasty, Replacement, Hip ; *Arthroplasty, Replacement, Knee ; Databases, Factual ; Female ; Humans ; Incidence ; Male ; Middle Aged ; National Health Programs ; Odds Ratio ; Republic of Korea/epidemiology ; Retrospective Studies ; Risk Factors ; Venous Thromboembolism/*diagnosis/epidemiology

PURPOSE:Temporal lobe epilepsy(TLE) is now recognized as a distinct syndrome in adults. The seizure evolution in adult patients is well characterized, manifesting initially with an aura, behavioral arrest, automatism, and secondary generalized tonic-clonic seizures. In contrast, relatively few studies are available for the pediatric age group. In the present study, we investigated children undergoing temporal lobectomy for refractory seizures and correlated the pathologic findings with clinical presentations. METHODS:The records of the pediatric patients admitted at the Seoul National Children's Hospital for epilepsy surgery between January 1995 and December 2005 were reviewed. Then, eighteen patients were included in this study. The clinical records were reviewed in terms of the patient profiles imaging findings, surgical techniques, and pathologic findings. The seizure outcomes were described according to the Engel's classification. RESULTS:The postsurgical outcomes were favorable. Lateral temporal epilepsy was more common in childhood than in adulthood. Dual pathology was commonly found. Arm dystonia or tonic arm elevation have a lateralizing value. Head turning may have a lateralizing value based upon a time sequence. The brain MRI was less predictable for pathologic findings. The ictal EEG cannot always have a localizing value. Delta beginning in the ictal rhythm may suggest lateral lobe epilepsy. Anterior temporal beginning of the ictal location may suggest mesial temporal lobe epilepsy. Ganglioglioma tends to cause rhythmic beta activities at the beginning of the ictal event. CONCLUSION:TLE in childhood shows more complex and atypical clinical manifestations and have more variable etiologies. No single presurgical investigation can be a good predictable value to localization or lateralization.
Adult ; Arm ; Automatism ; Brain ; Child ; Classification ; Dystonia ; Electroencephalography ; Epilepsy ; Epilepsy, Temporal Lobe* ; Ganglioglioma ; Head ; Humans ; Magnetic Resonance Imaging ; Pathology ; Seizures ; Seoul ; Temporal Lobe*

PURPOSE: Pompe disease is one of the glycogen storage diseases caused by a deficiency of acid alpha-glycosidase. This enzyme defect results in lysosomal glycogen accumulation in many tissues and shows a various spectrum of clinical features from early infantile hypotonia to mild weakness. For the investigation of the clinical characteristics of Pompe disease, we reviewed 6 cases of childhood Pompe disease diagnosed by muscle biopsy and acid alpha-glycosidase assay. METHODS: We reviewed the medical records of 6 childhood Pompe disease patients in Seoul National University Children's Hospital, retrospectively from January 2001 to October 2006. RESULTS: The age of the symptom onset was 1 month to 11 years(mean 2.2 years) and the diagnosis was made at the age of 8 months to 14 years(mean 5.3 years). The patients showed delayed motor development, motor weakness, hypotonia, cardiomegaly, hypertrophic cardiomyopathy, hepatomegaly, recurrent pulmonary infections but the severity was very diverse. Liver transaminase and CK levels were elevated in all of the patients. Their muscle biopsy showed the characteristic accumulation of purple colored glycogen granules and the degeneration of myofibers. CONCLUSION: Childhood Pompe disease had various clinical features and severities depending on the age of onset, organ involvement and the rate of progression. Enzyme replacement therapy may modify the disease courses, so we need to diagnose earlier for the treatment at an optimal time.
Age of Onset ; Biopsy ; Cardiomegaly ; Cardiomyopathy, Hypertrophic ; Diagnosis ; Early Diagnosis ; Enzyme Replacement Therapy ; Glycogen ; Glycogen Storage Disease ; Glycogen Storage Disease Type II* ; Hepatomegaly ; Humans ; Liver ; Medical Records ; Muscle Hypotonia ; Retrospective Studies ; Seoul

Endoscopic retrograde cholangiopancreatography is widely used for diagnosis and treatment of pancreatobiliary diseases and associated with a spectrum of complications such as pancreatitis, hemorrhage, and so on. Endoscopic papillary balloon dilatation (EPBD) has an advantage over endoscopic sphincterotomy in complication of bleeding. We report here on a 68-year-old woman who developed metabolic encephalopathy due to massive bleeding after EPBD. Massive bleeding was controlled after selective embolization and metabolic encephalopathy was improved after conservative management. Metabolic encephalopathy due to massive bleeding after EPBD has not been reported. We report on this unusual case along with a review of the related literatures.
Aged ; Brain Diseases, Metabolic* ; Cholangiopancreatography, Endoscopic Retrograde ; Diagnosis ; Dilatation ; Female ; Hemorrhage* ; Humans ; Pancreatitis ; Sphincterotomy, Endoscopic

PURPOSE: Rett syndrome (RS) is an X-linked dominant neurodevelopmental disease. The patients with RS have normal early development, however, experience gradual regression of speech and motor development. About 2/3 of the patients develop seizures and usually show characteristic EEG findings. This study was performed to investigate whether there is correlation between clinical staging and EEG features in RS. METHODS: Thirty-five patients diagnosed as having RS from 2003 to 2007 at Seoul National University Children's Hospital were retrospectively evaluated. Diagnosis of RS was made according to consensus diagnostic criteria in 2001. RESULTS: Epileptic seizures were present in 30 patients (85.7%). The seizure onset according to the clinical staging was as follows: 3 patients (10%) in stage I, 9 (30%) in stage II, 18 (60%) in stage III. Twenty-two patients had two or more seizure types. EEG patterns get worse deterioration of background activity and decrease epileptiform discharges by clinical stage evolution. Sixteen patients (53%) achieved seizure freedom with antiepileptic drugs at clinical stage III and IV. CONCLUSIONS: EEG features were neither diagnostic nor pathognomonic in epilepsy due to RS. However, EEG patterns and response to treatment changed according to the clinical staging. Therefore, AED therapy should be decided considering the clinical courses of RS.
Anticonvulsants ; Consensus ; Electroencephalography ; Epilepsy ; Freedom ; Humans ; Retrospective Studies ; Rett Syndrome ; Seizures

PURPOSE: We aimed to investigate the electroclinical characteristics of patients having persistent seizures with fever after 5 years of age, which has not been elucidated well. METHODS: We identified 101 patients over 5 years (M : F=64 : 37, range: 5.0-11.0), visited our hospital for febrile seizure. Their medical records for clinical features and EEG findings at last seizure were retrospectively reviewed. RESULTS: The mean onset age of seizure of total patients was 3.0 years (range: 0.3-8.3). The complex features were noted in 15.8%. Family history were in 53.3%. Neurologic abnormalities were in 10.9%. Abnormal EEGs were in 36.7% (generalized spike or polyspike-waves: 10, focal epileptic discharges: 16, others: 3). When we compare the patients of 5.0-5.9 years (Group A, n=48) to the patients after 6 years (Group B, n=53), complex features (20.8% vs 37.8%, p=0.063) and AED treatments (6.3% vs 18.9%, p=0.059) were more common in Group B. Among group B, patients after 8 years were more apt to be treated by AED than youngers (6.1% vs 40.0%, p=0.002). When we compare the patients starting their first seizure before 5.0 years (Group C, n=78) to the patients after 5.0 years (Group D, n=23), Group C had more frequent seizures (6.6 vs 2.3, p= < 0.0001) and family history (58.3% vs 25.0%, p=0.039). Group D had more common abnormal neurologic findings (7.7% vs 21.7%, p=0.057). CONCLUSION: Febrile seizures in older age group are more associ-ated with complex features, EEG abnormalities and AED treatments. The patients with seizure onset before 5.0 years had more seizure frequency and family histories.
Age of Onset ; Child ; Dimaprit ; Electroencephalography ; Epilepsy ; Fever ; Humans ; Medical Records ; Neurologic Manifestations ; Retrospective Studies ; Seizures ; Seizures, Febrile

Purpose: This study evaluated how artificial intelligence-based computer-assisted diagnosis (AICAD) for breast ultrasonography (US) influences diagnostic performance and agreement between radiologists with varying experience levels in different workflows. Methods: Images of 492 breast lesions (200 malignant and 292 benign masses) in 472 women taken from April 2017 to June 2018 were included. Six radiologists (three inexperienced [<1 year of experience] and three experienced [10-15 years of experience]) individually reviewed US images with and without the aid of AI-CAD, first sequentially and then simultaneously. Diagnostic performance and interobserver agreement were calculated and compared between radiologists and AI-CAD. Results: After implementing AI-CAD, the specificity, positive predictive value (PPV), and accuracy significantly improved, regardless of experience and workflow (all P<0.001, respectively). The overall area under the receiver operating characteristic curve significantly increased in simultaneous reading, but only for inexperienced radiologists. The agreement for Breast Imaging Reporting and Database System (BI-RADS) descriptors generally increased when AI-CAD was used (κ=0.29-0.63 to 0.35-0.73). Inexperienced radiologists tended to concede to AI-CAD results more easily than experienced radiologists, especially in simultaneous reading (P<0.001). The conversion rates for final assessment changes from BI-RADS 2 or 3 to BI-RADS higher than 4a or vice versa were also significantly higher in simultaneous reading than sequential reading (overall, 15.8% and 6.2%, respectively; P<0.001) for both inexperienced and experienced radiologists. Conclusion Using AI-CAD to interpret breast US improved the specificity, PPV, and accuracy of radiologists regardless of experience level. AI-CAD may work better in simultaneous reading to improve diagnostic performance and agreement between radiologists, especially for inexperienced radiologists.