Kawasaki disease (KD) is an immune-mediated disease which is a leading cause of acquired cardiovascular disease in developed country. Recently, tumor necrosis factor-alpha (TNF-alpha) blocker, infliximab has been considered a promising option for patients with refractory KD. Although chronic use of a TNF-alpha blocker could increase risk of opportunistic infections, a few studies have documented that use of infliximab was safe without serious adverse effects in patients with KD. We observed serious bacterial infection after infliximab treatment in an infant with refractory KD. Our patient was a 5-month-old male infant diagnosed with KD who did not respond to repeated doses of intravenous immunoglobulin. We effectively treated him with a single infusion of infliximab (5 mg/kg), but gram-negative (Acinetobacter lwoffii) septicemia developed after infliximab infusion. Therefore, we report a case of serious septicemia after treatment with infliximab, and suggest considering the risk of severe infection when deciding whether to prescribe infliximab to an infant with refractory KD.
Bacterial Infections ; Cardiovascular Diseases ; Developed Countries ; Humans ; Immunoglobulins ; Infant* ; Male ; Mucocutaneous Lymph Node Syndrome* ; Opportunistic Infections ; Sepsis* ; Tumor Necrosis Factor-alpha ; Infliximab

Data pools and their integration are fueling the big data revolution in health care with the recent advances in information technology. Korea has shown tremendous promise in the utilization of big data for its advanced technology, computerized health data, and unique identifiers. However, the Personal Information Protection Act (PIPA) severely limits access to personal identifiers, which has discouraged the use of health data even for the public good. In contrast, western countries have focused on research without the use of identifiers, which has augmented the use of the available data while maintaining and respecting privacy; they have allowed some exemptions of informed consent and utilized limited data sets, which have the identifiers removed. The amount of research output has increased rapidly and an in-depth understanding of cancer has been made possible based on the linkage of Surveillance, Epidemiology, and End Results (SEER) and Medicare in the US. More than 700 projects covering a wide range of medical areas have been conducted, which has led to changes in clinical practice based on the Western Australian Data Linkage System. Although rare, evidence-driven decisions based on data linkage have been found in some cases in Korea; the adoption of prostate cancer screening as a national screening program was suspended as its cost-effectiveness has not been verified on the basis of data linkage by the National Evidence-Based Healthcare Collaboration Agency. For the active use of health data, there is an urgent need to amend PIPA, prepare regulations for data analysis, and foster collaboration among data-related institutions. Great projects based on data linkage will guarantee the world's leading research output and will be major sources for moving forward to success.
Computer Security ; Cooperative Behavior ; Dataset ; Delivery of Health Care* ; Epidemiology ; Evidence-Based Practice ; Humans ; Information Storage and Retrieval ; Informed Consent ; Korea ; Mass Screening ; Medicare ; Privacy ; Prostatic Neoplasms ; Social Control, Formal ; Statistics as Topic

Cutis verticis gyrata is a descriptive term for the condition characterized by ridges and furrows of the scalp resembling the convolutions of the brain. Cutis verticis gyrata can be categorized into primary and secondary types according to various etiologic factors and associated conditions capable of inducing the disease process. We report a case of essential primary cutis verticis gyrata in a 29-year-old male who did not have any other underlying or associated conditions.
Adult ; Brain ; Humans ; Male ; Scalp

No abstract available.

Ground-glass opacity is a frequent but nonspecific finding seen on high-resolution CT scans of lung parenchyma. Histologically, this appearance is observed when thickening of the alveolar wall and septal interstitium is minimal or the alveolar lumen is partially filled with fluid, macrophage, neutrophils, or amorphous material. It has been shown that ground-glass opacity may be caused not only by an active inflammatory process but also by fibrotic processes. When a focal area of ground-glass opacity persists or increases in size, the possibility of neoplasm-bronchioloalveolar carcinoma or adenoma, or lymphoma, for example- should be considered. Diffuse nonsegmental ground-glass opacity in both lung fields was incidentally found on follow up abdominal CT in a stomach cancer patient and signet-ring cell-type metastatic lung cancer was confirmed by transbronchial lung biopsy. We report a case of diffuse ground-glass opacity seen in metastatic lung cancer from adenocarcinoma of the stomach.
Adenocarcinoma* ; Adenoma ; Biopsy ; Follow-Up Studies ; Humans ; Lung Neoplasms ; Lung* ; Lymphoma ; Macrophages ; Neoplasm Metastasis* ; Neutrophils ; Stomach Neoplasms ; Stomach* ; Tomography, X-Ray Computed

No abstract available.
Female ; Leiomyosarcoma* ; Ovary*

PURPOSE: To assess the signal enhancement by gadolinium-DTPA-polylysine (Gd-polylysine) as compared to gadopentetate (Gd-DTPA) in MR imaging of heart that have undergone ischemia-reperfusion, and to estimate the extent of myocardial damage covered bythe MR signal enhancement. MATERIALS AND METHODS: A series of contrast enhanced cardiac MR images were obtained from 17 cats subjected to a 90 minutes of occlusion of the left anterior descending coronary artery (LAD) followed by a 90 minutes of raperfusion. Time courses of changes in the signal intensity (Sl) of the ischemic area were measu red in Gd-polylysine group (8 cats) and Gd- DTPA group (9 cats). The size of U R signal enhanced area was then compared to the sizes of infarction and the area at risk revealed byTTC histochemical staining. RESULTS: Maximum Sis were obtained at 60 minutes and 30 minutes after injection of the contrast material, respectively for Gd-polylysine group and Gd-DTPA group. Signal enhancement was stronger and persistent for a longer period in Gd-polylysine group than in GD-DTPA group. Sizes of the enhanced area, the infarction, and the area at risk were about 30%, 15%, and 50% of the total left ventricle (LV) area; the difference between the groups was statistically insignificant. CONCLUSION: Gd-polylysine can be used better for a blood pool marker than Gd-DTPA in MR imaging of myocardial ischemia, due to its strong and persistent signal enhancement. The MR signal enhanced area includes both the infarcted area and a portion of the area at risk.
Animals ; Cats* ; Coronary Vessels ; Gadolinium DTPA ; Gadolinium* ; Heart ; Heart Ventricles ; Infarction ; Magnetic Resonance Imaging* ; Myocardial Ischemia ; Pentetic Acid ; Polylysine*

BACKGROUND: Intracellular ionized calcium plays a central role in the transduction of external stimuli as a critical second messenger. The spectral properties of fluo-3 allows the analysis of intracellular ionized calcium level by flow cytometers. The aim of this study is to assess the performance of flow cytometer for measuring intracellular ionized calcium level using fluo-3 and to define the reference interval of intracellular ionized calcium level of lymphocytes from healthy people, and to find out the clinical implications according to various disorders. METHODS: For the analytical performance of flow cytometer on determining the concentration of intracellular ionized calcium, precision study, lowest limit of detection, analytical range, and the loading stability of fluo-3 were per foamed. Fifty-four cases of healthy people, 52 cases of renal transplant patients, and 20 cases of diabetes mellitus patients were included in this study. RESULTS: Loading effect of fluo-3 at room temperature was stable upto 5 hours. Lowest limit of detection of ionized calcium concentration was 4.34 nM at in-situ calibration procedure. Within-run and among-day intraindividual CVs of in-situ calibration procedure were 6.67% and 13.99% respectively, and of optical calibration procedure were 13.86% and 16.12% respectively. The reference interval of cytosolic free calcium level for healthy people ranged 73.54 - 155.09 nM without sexual differences. The level of intracellular ionized calcium was lowered by 36.9% on renal transplant group in comparison with healthy control group. But, level of cytosolic free calcium was Increased upto 276.0% on acute rejection group and 159.1% on diabetes mellitus group compared to control group. CONCLUSIONS: These results reveal that in-situ calibration method for intra cellular ionized calcium using flow cytometry with flue-3 can be regarded as an accurate and standardized method. Quantitation of intracellular ionized calcium level might be used as the monitoring test for early detection of acute rejection after renal transplantation.
Calcium* ; Calibration ; Cytosol ; Diabetes Mellitus ; Flow Cytometry* ; Humans* ; Kidney Transplantation ; Limit of Detection ; Lymphocytes* ; Second Messenger Systems

No abstract available.
Orthopedics*

BACKGROUND: The effects of the inhibitor of nitric oxide synthase (NOS) in cerebral ischemia have been debated. Recently, it has been suggested that it depends on the amount of the inhibitor used. Therefore, this study was carried out to evaluate the effects of the NOS in the acute ischemia-reperfusion of the cat model using variable amounts of the inhibitor. METHODS: Nineteen cats were divided into 3 groups: group 1 (n = 6), 10 mg/kg of N-nitro-L-arginine methyl ester (L-NAME); group 2 (n = 7), 0.5 mg/kg; group 3 (n = 6), control group. Incomplete global cerebral ischemia was induced by ligation of both carotid arteries with arterial hypotension (-40 mmHg) for 30 minutes followed by 3 hours of reperfusion. The NOS inhibitor (L-NAME), was injected intraperitoneally 5 minutes before reperfusion. 31P and 1H MR spectroscopy were performed. A series of spectra was acquired in the time intervals before ligation, during ischemia, and after reperfusion. RESULTS: Phosphocreatine/inorganic phosphate (PCr/Pi) ratios for group 1 were significantly lower than for groups 2 and 3 (P < 0.05), and there was no significant difference between groups 2 and 3. Lactate/N-acetyl aspartate (Lac/NAA) and lactate/creatine (Lac/Cr) ratios at 180 minutes after reperfusion were higher for group 1 than for groups 2 and 3 (P < 0.05). There were no significant differences in pH and lactate/choline (Lac/Cho) ratios among the 3 groups. CONCLUSIONS: It is demonstrated that the effect of the NOS inhibitor is dosage dependent. A high dose (10 mg/kg) of L-NAME seems to have an adverse effect on recovery of the ischemia, but a low dose (0.5 mg/kg) seems to have no effect.
Animals ; Aspartic Acid ; Brain Ischemia ; Brain* ; Carotid Arteries ; Cats* ; Energy Metabolism* ; Hydrogen-Ion Concentration ; Hypotension ; Ischemia ; Ligation ; Magnetic Resonance Spectroscopy* ; NG-Nitroarginine Methyl Ester ; Nitric Oxide Synthase* ; Nitric Oxide* ; Reperfusion