The hemostatic effect of endoscopic microwave coagulation method for upper gastrointestinal bleeding was evaluated clinically. Hemostasis over 72 hours was achieved in 18 of 20 cases (90%) with upper gastrointestinal bleeding by the endoscopic microwave coagulation method. It is noteworthy that this method was effective in all 4 cases of pulsatile bleeding from exposed vessels. We conclude that this method is useful for emergency endoscopic hemostasis on upper gastrointestinal bleeding, especially bleeding from exposed vessels.
Emergencies ; Hemorrhage* ; Hemostasis ; Hemostasis, Endoscopic ; Microwaves*

BACKGROUND: Pneumonia is the most common cause of death among patients with infectious disease in Korea. However, studies of pneumonia with septic shock in patients presenting to the emergency department are limited. The aim of this study was to investigate the prognostic factors associated with pneumonia with septic shock in patients presenting to the emergency department. METHODS: From January 2008 to September 2014, patients with pneumonia with septic shock admitted through the emergency department were retrospectively examined. RESULTS: Of the 561,845 patients who visited the emergency department, 398 were admitted for pneumonia with septic shock. The 28-day mortality rate in these patients was 36.4%. The independent prognostic factors were old age (>70 yrs) (odds ratio [OR], 2.42; 95%, confidence interval [CI], 1.35-4.32), Acute Physiology and Chronic Health Evaluation (APACHE) II score (OR, 1.04; 95% CI, 1.01-1.08), leukopenia (OR, 3.63; 95% CI, 1.48-8.94), prolonged PT-INR (OR, 2.53; 95% CI, 1.41-4.54), and hypoxemia (OR, 2.88; 95% CI, 1.30-6.38). CONCLUSIONS: A poor prognosis of patients with pneumonia is associated with old age (>70 yrs), increased APACHE II score, leukopenia, prolonged PT-INR, and hypoxemia.
Anoxia ; APACHE ; Cause of Death ; Communicable Diseases ; Emergencies* ; Emergency Service, Hospital* ; Humans ; Korea ; Leukopenia ; Mortality ; Pneumonia* ; Prognosis ; Retrospective Studies ; Shock, Septic*

Both genetic and environmental factors are involved in establishing a behavior. An animal study was done to determine the characteristics of interaction between genetic (nature) and environmental (nurture) factors. Delivery of footshocks (0.8 mA x 60 times, at random) early in life was used as the environmental stimulus. As the footshock was delivered repeatedly, a rat showed helplessness behavior and the number of shocks necessary to elicit helplessness was measured to quantify the trait of an animal in coping with the aversive environmental stimulus. The nocturnal ambulatory activity at adulthood was measured as a behavioral expression of the nature-nurture interaction. Although the experience of footshocks early in life did not significantly alter average activity levels at adulthood, the activity was positively correlated with the number of shocks necessary to elicit helplessness (nature) while receiving footshocks (nurture) on postnatal day 14. Additionally, a second exposure to identical shock parameters on postnatal day 21 reversed the relationship. These results clearly showed that an interaction between nature and nurture during infancy leads to substantial behavioral alterations later in life, and suggest that the nature-dependent determination of an adult behavior can be modified in different directions by the conditions of an environmental experience early in life.
Aging/physiology* ; Animal ; Animals, Newborn/physiology* ; Animals, Newborn/growth & development ; Electroshock* ; Foot* ; Motor Activity/physiology* ; Rats ; Rats, Sprague-Dawley

BACKGROUND: Malnutrition among inflammatory bowel disease (IBD) may arise from factors including inadequate dietary intake, malabsorption, and progression of disease. IBD has been reported an increased prevalence of low bone mass. The aims of the present study were to evaluate the nutritional status and to investigate the correlation between bone mineral density (BMD) and nutrient factors in patients with IBD. METHODS: A total of 41 subjects were classified into normal group (n=21) and malnourished group (n=20) by the subjective global assessment result. We surveyed the dietary habit, nutrient intake, and BMD. RESULTS: Subjects' average age was 36.7 years old, and included 26 ulcerative colitis and 15 Crohn's disease. The serum C-reactive protein (CRP) was significantly higher and serum calcium was significantly lower in the malnourished group. Lower bone density subjects were more in the malnourished group but no significant difference. Intake of energy, protein, carbohydrate, fiber, iron, sodium, potassium, zinc, vitamin B6, vitamin C and folate were significantly lower in the malnourished group. The BMD of malnourished group showed correlation with triceps skin fold thickness (TSF), CRP, dietary calcium, phosphorous, iron, animal iron, zinc and vitamin. CONCLUSIONS: The results suggested that adequate intake of nutrients is important to prevent bone loss and systemic education programs are need for IBD patients.
Animals ; Ascorbic Acid ; Bone Density* ; C-Reactive Protein ; Calcium ; Calcium, Dietary ; Colitis, Ulcerative ; Crohn Disease ; Education ; Folic Acid ; Food Habits ; Humans ; Inflammatory Bowel Diseases* ; Iron ; Malnutrition ; Nutritional Status* ; Potassium ; Prevalence ; Skin ; Sodium ; Vitamin B 6 ; Vitamins ; Zinc

To elucidate iron utilization patterns of Staphylococcus aureus according to the growth, we checked the residual iron concentration and the production of siderophores at the indicated times while culturing S. aureus ATCC 6538 and 25923 strains in brain heart infusion broth. By using streptonigrin susceptibility test and investigating growth curves in three culture media of which iron concentration is 0.2, 20, 45 uM, respectively, we found out that iron metabolism of 6538 strain was more active than that of 25923 strain. In point of tendency of iron consumption, 6538 strain steeply consumed iron just before the onset of stationary phase, but 25923 strain did gradually iron throughout the growth phase. Nevertheless, total amount of iron consumed by each strain during the growth was almost no difference between the strains. CAS diffusion assay in detecting siderophores showed that siderophore production followed iron consumption. These results suggest that the siderophores play significant role in iron utilization in vitro.
Brain ; Culture Media ; Diffusion ; Heart ; Iron* ; Metabolism ; Siderophores ; Staphylococcus aureus* ; Staphylococcus* ; Streptonigrin

No abstract available.

Megacystis Microcolon Intestinal Hypoperistalsis(MMIH) Syndrome is a rare cause of functional neonatal bowel obstruction, characterized by hypoperistalsis, narrow distal ileum and colon, and bladder distension. We report a case of MMIH syndrome and review the literature. The patient was born after 34 weeks of gestation with marked abdominal distension. Her birth weight was 2,830g with 276ml of urine drained by catheter. Prenatal ultrasonic findings were bladder distension, hydronephrosis and possible intraabdominal mass. Supine view of abdomen on third day of life showed dilated loops of proximal small bowel and stomach without colonic gas shadow. Preoperative diagnosis was intestinal obstruction. When the abdomen was opened, the distal ileum was filled with meconium and postoperative diagnosis was meconium plug syndrome. Ganglion cells were present in the ileal biopsy. All postoperative attempts to feed her resulted in bilous vomiting. Voiding cystourethrography done on the 4th day after colon study showed markedly distended bladder, contrast enhanced microcolon and hypoperistalsis. She was dischaged against medical advice by her parents at the age of 23 days and died at home at the age of 33 days.
Abdomen ; Biopsy ; Birth Weight ; Catheters ; Colon ; Diagnosis ; Ganglion Cysts ; Humans ; Hydronephrosis ; Ileum ; Intestinal Obstruction ; Meconium ; Parents ; Pregnancy ; Stomach ; Ultrasonics ; Urinary Bladder ; Vomiting

This study was designed to investigate the peri-implant tissue reaction in ovariectomized osteoporotic female rats, and to evaluate effects of estrogen, calcitonin, parathyroid hormone on the bone - implant interface in osteoporotic rats. 120 Sprague - Dawley rats were used in this experiments. Osteoporosis was induced by bilateral ovariectomy. They were divided 5 groups ; sham-operated control group(Sham), ovariectomized group (OVX), OVX and estrogen treated group (OVX+E), OVX and PTH treated group (OVX+PTH), and OVX and calcitonin treated group (OVX+CT). Eight weeks after ovariectomy, two titanium screw implants were inserted into the left tibia of each rat. Eight weeks after the insertion of the implants, the periotest values (PTV) of implant were examined, and the rats were sacrificed, and examined the reaction of bone tissue surrounding the implant both histologically and histomorphometrically. The bone density and ash weight of opposite right tibia were examined. Over 40 rats were fractured on left tibia that was implant inserted. On histologically finding, all groups were osseointegrated well, especially in OVX+PTH group. In OVX group, tibial cortical bone showed many large harversian canal and microfracture lines. The OVX+PTH group showed the lowest mean PTV (-2.33) (p<0.05), and the hightest mean bone - implant contact percentage (89%) (p>0.05). But the OVX+CT group showed the highest mean bone density (5.45mg/cm3) and ash weight (56.12%) (p<0.05). The results indicate that PTH treatment enhances osseointegration of implant in OVX rats, and CT treatment depresses bone turnover and prevent the development of osteopenia in OVX rats.
Animals ; Bone and Bones ; Bone Density ; Bone Diseases, Metabolic ; Calcitonin ; Estrogens ; Female ; Humans ; Osseointegration ; Osteoporosis ; Ovariectomy ; Parathyroid Hormone ; Rats* ; Tibia ; Titanium

PURPOSE: The aim of this study is to evaluate the value of pleural adenosine deaminase (ADA) in differentiating tuberculous pleural effusion from non tuberculous pleural effusion of children. METHODS: We measured pleural ADA activity in patients with pleural effusion whose age were from seven months to seventeen years from January 1995 to October 2001. By some criteria the patients were grouped to tuberculous pleural effusion, bacterial effusion, mycoplasma effusion, malignant effusion, and other effusion. RESULTS: The mean pleural ADA activity in tuberculous pleural effusion was 86.2+/-27.3 U/L. Pleural ADA activities in bacterial effusion, mycoplasma effusion, malignant effusion, other effusion were 32.6+/-20.1, 22.1+/-15.4, 23.1+/-10.9, 36.7+/-28.4 U/L, respectively. Pleural ADA activity in tuberculous pleural effusion was significantly higher than in any other group(P<0.001). At a level of 50 U/L, the sensitivity, specificity, positive predictive value (ppv), and and negative predictive value(npv) for the identification of tuberculous pleural effusion from nontuberculous pleural effusion were calculated at 93.8%, 84.8%, 81.1%, 95.1%, respectively. CONCLUSION: Pleural ADA is a useful test in the diagnosis of tuberculous pleural effusion of children from nontuberculous pleural effusion.
Adenosine Deaminase* ; Adenosine* ; Child* ; Diagnosis* ; Humans ; Mycoplasma ; Pleural Effusion* ; Sensitivity and Specificity

BACKGROUND: Use of venous catheter is associated with increased mortality in hemodialysis patients, but little data are available on impact of vascular access type on the discrepancy between dialysis prescription and dose. Dialysis prescription commonly exceeds the delivered dialysis dose. The purpose of this study are to evaluate the dialysis dose and efficiency between a tunneled cuffed catheters (TCCs) and arteriovenous fistulas (AVF) to the same patients on different dialysis days. METHODS: This study enrolled 35 hemodialysis patients. All patients started dialysis via tunneled cuffed catheters (Permcath(R)) in the internal jugular vein and a vascular surgeon created AVF later. We investigated prescribed spKT/V (pKt/V) and delivered spKt/V (dKt/V) within 2 months after the TCCs placement and after the AVF cannulation. Dialysis efficiencies (dKt/V/pKt/V) were compared over this two distinct times. RESULTS: Patient demographics were similar between two distinct times. The mean age of patients was 52.7 years (18 men, 17 women) and mean BMI was 21.9. 17 patients (48.6%) were diabetics. The mean pKt/V was not different (TCCs 1.63+/-0.30; AVF 1.62+/-0.29) but mean dKt/V was significantly different (TCCs 1.38+/-0.31; AVF 1.46+/-0.34) (p<0.05). The dialysis efficiencies were 85.14% for TCCs and 90.74% for AVF (p<0.05). There were no differences in sex, or diabetics. Underdialysis (delivered spKt/V <1.3) was greater in TCCs (17/35; 48.6 %), compared to AVF (10/35; 28.6%). Underdialysis was more common in larger patients. CONCLUSION: Our data suggest that AVF tend to receive more dialysis dose than tunneled cuffed catheters and underdialysis exposure are more common with catheter use.
Arteriovenous Fistula ; Catheterization ; Catheters ; Demography ; Dialysis* ; Humans ; Jugular Veins ; Male ; Mortality ; Prescriptions ; Renal Dialysis*