The purpose of this study was to investigate the immunohistochemical reaction of calcitonin-gene-related peptide (CGRP) and type II collagen and also morphological changes of cartilage implants and cultured chondrocytes isolated from the articular and costal cartilages. The chondrocytes were isolated from the head of the femur and the 11th costal cartilage of the 6 months old rabbits. De novo implants were prepared from the chondrocytes cultured on the perichondrium by culturing isolated articular chondrocytes. Cultured chondrocytes and implants were evaluated by immunohistochemical staining of CGRP and type II collagen and electron microscopy. Articular chondrocytes maintained the typical phenotype in the 1st and 2nd subcultures, but the costal chondrocytes were transformed into fibroblast-like cells. The articular chondrocytes cultured on the perichondrium were more flattened and formed the cartilage. Most chondrocytes were no loss of type II collagen immunostaining by culturing. Implants replaced by the cultured articular chondrocytes were generally increased CGRP and decreased type II collagen immunoreaction. Electron microscopically the cultured articular chondrocytes had a large euchromatic nucleus, a few granules, and abundant vesicles. During culture, the nucleus became atropy and the cytoplasm contained many large vacuoles. The chondrocytes cultured on the perichondrium showed a lot of segmented rough endoplasmic reticulum and fine short microvilli. During culture, articular chondrocytes maintained typical phenotype and type II collagen reaction. The cultured articular chondrocytes had some organelles and euchromatic nucleus with prominent nucleolus. The chondrocytes cultured on the perichondrium showed active secretion of the matrix with small vesicles and well developed endoplasmic reticulum. The implanted articular chondrocytes showed the decrease of their organelles after secretion of the marix and became increased CGRP and decreased type II collagen immunoreaction.
Cartilage* ; Chondrocytes* ; Collagen Type II* ; Cytoplasm ; Endoplasmic Reticulum ; Endoplasmic Reticulum, Rough ; Femur ; Head ; Humans ; Infant ; Microscopy, Electron ; Microvilli ; Organelles ; Phenotype ; Rabbits ; Vacuoles

Intracranial headaches, including migraines, are mediated by nociceptive activation of the trigeminal nucleus caudalis (TNC), but the precise mechanisms are poorly understood. We previously demonstrated that selective blockage of spinal sigma-1 receptors (Sig-1R) produces a prominent antinociceptive effect in several types of pain models. This study evaluates whether the Sig-1R antagonist (BD1047) has an antinociceptive effect on capsaicin (a potent C-fiber activator) induced headache models in rats. Intracisternal infusion of capsaicin evoked pain behavior (face grooming), which was significantly attenuated by BD1047 pretreatment. BD1047 consistently reduced capsaicin-induced Fos-like immunoreactivity (Fos-LI), a neuronal activator, in the TNC in a dose-dependent manner. Moreover, capsaicin-induced phosphorylation of N-methyl-D-aspartate receptor subunit 1 was reversed by BD1047 pretreatment in the TNC. These results indicate that the Sig-1R antagonist has an inhibitory effect on nociceptive activation of the TNC in the capsaicin-induced headache animal model.
Animals ; Capsaicin ; Headache ; Migraine Disorders ; Models, Animal ; N-Methylaspartate ; Neurons ; Phosphorylation ; Rats ; Receptors, sigma ; Trigeminal Nuclei

BACKGROUND: Mitral regurgitation is a valvular heart disease that produce complex hemodynamic alternations and myocardial dysfunction occurs subclinically, so result in a high incidence of left ventricular dysfunction that might affect postoperative result. In order to assess preoperative factors affecting the outcome of mitral valve replacement in patients with chronic mitral regurgitaion, we evaluated prognostic factors from preoperative clinical, laboratory, and echocardiographic findings in 71 patients with chronic mitral regurgitation who received mitral valve replacement. METHODS: From 1985 to 1994, 71 patients with chronic mitral regurgitation, who received mitral valve replacement, were included in this study. The patients were defined as group I who had improved symptom and / or decreased left ventricular end-diastolic dimension after operation, and group II who had persistent symptom and / or over 60mm of left ventricular end-diastolic dimension after operation. RESULTS: 1) In clinical findings, preoperative systolic blood pressure was higher in Group I patients(p<0.05). 2) Hemoglobin, serum creatinine, and blood urea nitrogen level were not significantly different in both groups. 3) In echocardigraphic findings, left atrial dimension, left ventricular end-systolic / end-diastolic dimension, and left ventricular volume index of Group II were much higher than those of Group I patients(p<0.05). 4) In the discriminant analysis, left ventricular end-diastolic dimension, age, NYHA functional class, and left ventricular mass index were defined as important prognostic factors. CONCLUSION: According to the above results, preoperative age, NYHA functional class are significant prognostic factors in clinical and laboratory findings. And left atrial dimension, left ventricular end-systolic and end-diastolic dimensions, left ventricular volume index, and left ventricular mass index are significant prognostic factors in echocardiographic findings.
Blood Pressure ; Blood Urea Nitrogen ; Creatinine ; Echocardiography ; Heart Valve Diseases ; Hemodynamics ; Humans ; Incidence ; Mitral Valve Insufficiency* ; Mitral Valve* ; Ventricular Dysfunction, Left

PURPOSE: An optimal treatment for Helicobacter pylori (H. pylori) infection in children has not yet been established. In this study, the efficacy and the tolerability of triple therapy with colloidal bismuth subcitrate (CBS), amoxicillin and metronidazole, were evaluated in comparison with dual therapy with CBS and amoxicllin. METHODS: Eighty-six children with H. pylori infection, aged 6 years to 14 years, were enrolled in this study. H. pylori infection was confirmed by endoscopic antral biopsy with an rapid urease test, culture and a modified Giemsa stain. The children were considered positive for H. pylori infection if culture was positive or if both modified Giemsa staining and CLO test were positive. The children were treated with one of the following three regimens. Dual therapy with CBS for 4 weeks and amoxicillin for 2 weeks (Group I. n=57: 1993.8-1995.1), Triple therapy with CBS for 4 weeks, amoxcillin for 2 weeks and metronidazole for 2 weeks (Group IIa. n=11: 1995.2-1995.7), and Triple therapy with CBS for 2 weeks, amoxicillin for 2 weeks and metronidazole for 2 weeks (Group IIb. n=18 : 1995. 8-1996. 6). A 50mg/kg/d dose of amoxcillin was aclministered, and that of CBS was 7-8mg/kg/d, and that of metronidazole was 20mg/kg/d. About one month after the cessation of treatment, eradication of H. pylori was evaluated with repeated endoscopic biopsy. RESULTS: H. pylori eradication rate was 61.4% (35/57) in Group I, 90.9% (10/11) in Group IIa, and in the absence of H. pylori 88.9% (16/18) of Group IIb was done by means of an urease test, culture and a modified Giemsa stain (P=0.012). The overall proportion of eradication of H. pylori infection was 89.7% (26/29) by triple therapy and 61.4% (35/57) by dual therapy (P=0.007). However, there was no statistically significant difference in eradication rate between the 2-week triple therapy (IIb) and the Denol 4-week triple therapy (IIa)(P=0.86). Side effects : All patients in three treatment groups were tolerated well with little and mild side effects (P=0.258). CONCLUSION: The 2-week triple therapy with CBS, amoxcillin, and metronidazole would be a highly effective and safe treatment regimen for H. pylori infection in children.
Amoxicillin ; Azure Stains ; Biopsy ; Bismuth ; Child* ; Colloids ; Helicobacter pylori* ; Helicobacter* ; Humans ; Metronidazole ; Urease ; Withholding Treatment

Condylomata acuminata are benign tumors which are mostly venereally transmitted. Common sites were coronal sulcus, perisnal area and prepuce. Among 28 patients, 21 acuminate lesions and 10 papular lesions were found. Twenty eight human genital warts in Korean were analysed by Southern blot hybridization. Sequences related to HPV6/11 are found in 89.3%(25/28) of the condylomata. HPV16 DNA was not found at sll. Subtype of HPV was determined by the restriction pattern of DNA cleaved with PstI restriction enzyme in 7 cases. Six cases of HPV6a and one case of HPV6c are found. The above results suggest that most of condylomata acuminata are caused by HPV6 and HPV11 in Korea.
Blotting, Southern ; Condylomata Acuminata* ; DNA* ; Humans* ; Korea

BACKGROUND: To examine the influencing factors on patients' satisfaction in the emergency department(ED) far quality assurance. METHODS: Patients who visited to the ED were prospectively investigated from November 1 to December 31,1997. Authors developed questionnaire to investigate influencing factors on patients' satisfaction.4 Chi-square test and 115-REL 7.0 were applied far statistical analysis. RESULTS: Patients' satisfaction was significantly related to physical environment variables, accessibility variables, kindness of hospital personnel variables, and patient's trust for doctors variables. In path analysis, willingness for revisit was influenced by patients' satisfaction, accessibility, physical environment, patients' trust for doctors in order, and willingness for recommendation was influenced by accessibility, patients' satisfaction, and kindness of hospital personnel in order. CONCLUSIONS : The influencing factors on patients' satisfaction are physical environment, accessibility, kindness of hospital personnel, and patient's trust far doctors. Willingness far revisit and willingness far recommendation are influenced by patients' satisfaction. In spite of some limitations, the results of this study can be used as a baseline information for exploring the influencing factors on patients' satisfaction. Further comprehensive research efforts should be made on the study of patients' satisfaction in the ED.
Emergencies* ; Emergency Service, Hospital* ; Humans ; Personnel, Hospital ; Prospective Studies ; Surveys and Questionnaires

The dumping syndrome has been a known complication of gastric surgery in adults, but it is recognized as a very rare disease in the pediatric population, especially in Korea. We report a case of dumping syndrome in a 10-month-old infant, who underwent Nissen fundoplication for the treatment of gastroesophageal reflux(GER). He was admitted because of aspiration pneumonia, and diagnosed as GER by 24-hour ambulatory esophageal pH monitoring test. For the treatment of GER, Nissen fundoplication was performed. After the operation, symptoms occurred within 30 minutes of meals, such as diaphoresis, palpitation, weakness, abdominal fullness, nausea, and diarrhea. The gastric emptying scan showed very rapid gastric emptying. His oral glucose tolerance tests revealed early-onset hyperglycema followed by delayed-onset hypoglycemia, which was the characteristic finding of the dumping syndrome. We introduced uncooked cornstarch to resolve symptoms and maintain the serum glucose level. After the feeding of uncooked cornstarch, his symptoms subsided and normal oral glucose test was restored. After the six months of treatment, his weight and height were increased dramatically from below 3 percentiles up to the normal range. The dumping syndrome should be considered when an infant suffers from the feeding difficulties after the gastric surgery like Nissen fundoplication, and the diet therapy including uncooked cornstarch could be applied as an effective measure.
Adult ; Blood Glucose ; Diarrhea ; Diet Therapy ; Dumping Syndrome* ; Esophageal pH Monitoring ; Fundoplication* ; Gastric Emptying ; Gastroesophageal Reflux ; Glucose ; Glucose Tolerance Test ; Humans ; Hypoglycemia ; Infant* ; Korea ; Meals ; Nausea ; Pneumonia, Aspiration ; Rare Diseases ; Reference Values ; Starch

BACKGROUND/AIMS: Wilson's disease (WD) is an inherited disorder of copper metabolism caused by alteration of the P-type adenosine triphosphatase (ATP) 7B gene. In this study, we analyzed the frequency of well-known mutations and constructed the first haplotypes for Koreans. In addition, we evaluated whether a founder effect existed in Korean patients with WD. METHODS: We obtained DNA samples from 21 patients with WD and their parents (total cohort n=63). ATP7B gene mutations were identified by direct sequencing methods, and microsatellite typing was performed at D13S315, D13S1325, and D13S316 with fluorescent dye-labeled primers. Any founder effect was identified by using 42 normal alleles from parents with a normal phenotype as a control group. The chi-square test and Fisher's exact test were used for statistical analysis. RESULTS: Three common mutations were found in 23 chromosomes obtained from 21 patients: the R778L mutation at exon 8 (15/23, 65.2%), the A874V mutation at exon 11 (6/23, 26.1%), and the N1270S mutation at exon 18 (2/23, 8.7%). D13S315 and D13S316 showed linkage disequilibrium at alleles 5 and 4, respectively, in patients with the R778L mutation (P=0.0157 and 0.0001, respectively). The haplotype made up of these two alleles occurred significantly more frequently in patients with the R778L mutation (5-R778L-4, D13S315-mutation-D13S316) than in the controls (P=0.0018). CONCLUSIONS: The arche haplotype of the ATP7B gene in Korean patients with WD may be 5-R778L-4 (D13S315.mutation.D13S316), and it might illustrate a founder effect.
Adenosine Triphosphatases/*genetics ; Amino Acid Substitution ; Cation Transport Proteins/*genetics ; *Founder Effect ; Gene Frequency ; Genotype ; Haplotypes ; Hepatolenticular Degeneration/diagnosis/*genetics ; Humans ; Microsatellite Repeats ; *Mutation ; Republic of Korea

BACKGROUND: As Korea red ginseng has been reported to show a significant protective effect against H. pylori-induced cytotoxicity and DNA damage in vitro, we designed a study to assess the efficacy of red ginseng treatment in patients with H. pylori-associated chronic gastritis. METHODS: A total of 84 patients with H. pylori-associated chronic gastritis were recruited and randomly divided into two groups. During the trial, 34 patients out of 42 patients in the placebo control group and 36 patients out of 42 patients in the red ginseng group completed the protocol. The patients received a one week triple therapy for the eradication of H. pylori and then received either placebo capsules that were composed of flour for the placebo group or red ginseng capsules for the treatment group, which were administered for 10 weeks. An endoscopic examination of gastritis with a visual analogue scale, a test for detection of H. pylori, immunohistochemistry of 8-OHdG, the 8-OHdG immunohistochemical staining for assessing oxidative DNA damage and TUNEL staining for apoptosis were performed, respectively. RESULTS: H. pylori eradication rates were augmented in the red ginseng group as compared to the placebo group (91.7% in the red ginseng group and 79.4% in the placebo group), but there was no statistical significance (p=0.147). For an analysis of gastritis based on Updated Sydney System, the red ginseng group showed significant improvement in neutrophil infiltrations (p=0.008) and intestinal metaplasia (p=0.005). An attenuation of 8-OHdG immunohistostaining after treatment was seen more frequently in the red ginseng group (p<0.001). An attenuation of DNA damage and apoptosis was seen for the red ginseng group as compared to the placebo group (p<0.001). CONCLUSIONS: Supplementary administration of red ginseng augmented eradication rates of H. pylori, attenuated gastric inflammation, and reduced oxidative DNA damage and apoptosis, suggesting the clinical usefulness of red ginseng.
Apoptosis ; Capsules ; DNA Damage ; Flour ; Gastritis* ; Helicobacter pylori ; Helicobacter* ; Humans ; Immunohistochemistry ; In Situ Nick-End Labeling ; Inflammation ; Korea* ; Metaplasia ; Neutrophils ; Panax*

BACKGROUND: Left ventricular diastolic dysfunction may precede systolic dysfunction and play a major role in producing the signs and symptoms of congestive heart failure. Ischemic heart disease can cause impairment of left ventricular filling without any alteration in systolic function so it is very important to evaluate relationship of left ventricular diastolic dysfunction and ischemic heart disease. The purpose of this study is to investigate left ventricular diastolic dysfunction during transient myocardial ischemia caused by balloon occlusion. METHODS: We prospectively studied 20 patients(11 males and 9 females, mean age : 58.5+/-5.9 years) who had been undergone coronary angiography and confirmed significant luminal stenosis(> or =75%)in proximal or middle portion of left anterior descending artery. After coronary angiography, percutaneous transluminal coronary angioplasty were performed all patients. We measured early propagation slope of left ventricular inflow, time difference(TD) between occurrence of peak velocity in the apical region and at the mitral tip and normalized TD(nTD) which dividing TD by the distance of mitral opening to apical region using color M-mode Doppler echocardiography, peak earaly diastolic transmitral inflow velocity(E), peak velocity during atrial contraction(A), E to A ratio, acceleration time of E wave and deceleration time of E wave using pulsed wave Doppler echocardiography, left ventricular end diastolic pressure using left heart catheterization. A color M-mode Doppler echocardiography, pulsed wave Doppler echocardiography and left ventricular end diastolic pressure were recorded before, during 30sec, 60sec & 90sec and after 60sec & 180sec balloon occlusion. RESULTS: Early propagation slope of left ventricular inflow was significantly decreased during 30sec & 60sec balloon occlusion and significantly increased after 60sec & 180sec balloon occlusion, respectively (64.45+/-28.23cm/sec, 39.37+/-11.77cm/sec, 32.78+/-11.77cm/sec, 51.86+/-19.78cm/sec, 65.05+/-29.99cm/sec, p<0.05). Time difference(TD) between occurrence of peak velocity in the apical region and at the mitral tip was significantly increased during 30sec & 60sec balloon occlusion and significantly decreased after 60sec & 180sec balloon occlusion, respectively(60+/-20msec, 90+/-30msec, 110+/-30msec, 80+/-20msec, 60+/-20msec, p<0.05). Normalized time difference(nTD) was significantly increased during 30sec & 60sec balloon occlusion and significantly decreased after 60sec & 180sec balloon occlusion, respectively(11.24+/-3.87msec/cm, 17.76+/-6.67msec/cm, 21.51+/-6.67msec/cm, 15.22+/-4.00msec/cm, 12.63+/-3.59msec/cm, p<0.05). Left ventricular end diastolic pressure was significantly increased during 30sec & 60sec balloon occlusion and significantly decreased after 60sec & 180sec balloon occlusion, respectively(9.70+/-3.88mmHg, 14.15+/-6.49mmHg, 17.00+/-7.14mmHg, 10.20+/-3.68mmHg, 8.75+/-3.16mmHg, p<0.05). Peak early diastolic transmitral inflow velocity(E), peak velocity during atrial contraction(A), E to A ratio, acceleration time of E wave and deceleration time of E wave were not significantly different(p>0.05). CONCLUSIONS: These data suggest that transient myocardial ischemia can cause left ventricular diastolic dysfunction and color M-mode Doppler echocardiography is very sensitive diagnostic method to detect early diastolic dysfunction compare to other echocardiographic diastolic indices.
Acceleration ; Angioplasty, Balloon, Coronary ; Arteries ; Balloon Occlusion ; Blood Pressure ; Cardiac Catheterization ; Cardiac Catheters ; Coronary Angiography ; Deceleration ; Echocardiography ; Echocardiography, Doppler* ; Echocardiography, Doppler, Pulsed ; Female ; Heart Failure ; Heart Ventricles* ; Humans ; Male ; Myocardial Ischemia* ; Phenobarbital ; Prospective Studies