STUDY DESIGN: The ingrowth of the nociceptive nerve ending into intervertebral disc was examined using immunohistochemistry and quantified using western blotting. OBJECTIVES: To determine if the nociceptive nerve innervates into the intervertebral discs of internal disc disruption (IDD). SUMMARY AND LITERATURE REVIEW: Nociceptive nerve ending and vessel ingrowth into intervertebral disc is associated with IDD and HNP. Substance P is a neurotransmitter that is found in the nociceptive nerve endings. Immunohistochemistry has confirmed the presence, and western blot has isolated the target. The localization of novel nociceptive innervation, and a quantitative comparison was made according to the original pathology is of interest. MATERIALS AND METHODS: 10 specimens of intervertebral disc were collected from IDD during total disc replacement surgery , and another 10 specimens of intervertebral disc from HNP were collected during discectomy. The control samples of intervertebral disc were obtained from 3 adolescent patients with idiopathic scoliosis, and 2 patients with a lumbar bursting fracture. Standard immunohistochemical techniques were used to test for the nociceptive neurotransmitter (substance P), which is a protein expressed during axonogenesis (growth-associated protein 43, GAP43), and a general nerve marker (protein gene produce 9.5, PGP9.5). The expression of substance P protein was quantified using western blot for its polyclonal antibody. RESULTS: In IDD (n=10), substance P was expressed in 6 cases of outer annulus fibrosus (AF), 5 cases of inner AF, and 3 cases of nucleus pulposus (NP). In HNP (n=10), substance P was expressed in 4 cases of outer AF, 3 cases of inner AF, and 2 cases of NP. In the control group, only 2 cases expressed substance P in outer AF. GAP43 was only positive in outer AF as follows: IDD 3 cases, HNP 1 case, and control 1 case. None of the specimens showed localized PGP 9.5. Substance P was localized significantly in larger quantities in IDD than in the control group (p=0.002). In HNP, the expression level was larger than the control and lower than the IDD group but this was not statistically significant (p=0.158, p=0.108). CONCLUSIONS: Innervation of nociceptive nerve endings was identified at the degenerative intervertebral disc of IDD, which may contribute to back pain.
Adolescent ; Back Pain ; Blotting, Western ; Diskectomy ; Humans ; Immunohistochemistry ; Intervertebral Disc Degeneration ; Intervertebral Disc* ; Nerve Endings ; Neurotransmitter Agents ; Pathology ; Scoliosis ; Substance P ; Total Disc Replacement

The effect of intranasal nifedipine drops in 20 randomly chosen patients with diethyl-ether induced hypertension by inhalation anesthesia was observed. Patients were placed in two groups: the first group received intranasal nifedipine at the time of induction and the second group received intranasal nifedipine at the time to skin incision. The change in mean arterial pressure in the first group was not significant, but in the second group, the increase in mean arterial pressure was significant immediately after intranasal administration of nifedipine at the time of skin incision. An increase in pulse rate was noted with the increase in mean arterial pressure and this is thought to result from the stimulation of catecholamine secretion and baroreceptor reflex. Since the difference in mean arterial pressure between the two groups was minimal at ten minutes and twenty minutes after skin incision, it is suggested that the onset of intranasal nifedipine is quite fast. Based on the authors' experience, intranasal administration of nifedipine is very useful in preventing or treating hypertension during inhalation anesthesia using diethyl-ether.
Administration, Intranasal* ; Anesthesia, Inhalation ; Arterial Pressure ; Baroreflex ; Ether* ; Heart Rate ; Humans ; Hypertension ; Nifedipine* ; Skin

BACKGROUND AND OBJECTIVES: Although it is well known that mitral valve repair provides a better postoperative outcome than valve replacement for mitral valve prolapse with mitral regurgitation, there haven't been much studied the nature of remnant regurgitation and the change of heart function and structure by remnant regurgitation after mitral valve repair surgery. We tried to research for it. METHODS AND RESULTS: Retrospective analysis of echocardiographic data and medical records was done in patients who underwent repair surgery for mitral valve prolapse with significant mitral regurgitation at the Keimyung University Dong-san Medical Center from February 1996 to February 2000. Patients who underwent echocardiography before and after the surgery were selected for the analysis. Of patients who underwent mitral valve repair surgery for mitral valve prolapse with mitral regurgitation during that period, 30 patients (male 15, female 15) were included in this study. The average age of them was 44.30+/-14.30 year old. After surgery, heart chamber size was decreased significantly in all patients (e. g. LVDd 6.25+/-1.06 cm vs. 5.14+/-0.62 cm, LV mass 272.46+/-107.36 gm vs. 197.30+/-75.16 gm). Remnant mitral regurgitation after repair surgery was found in 22 patients (73.3%). Remnant mitral regurgitation above trivial flow was found in 10 patients. Such case as involving ant. leaflet was found in 5 patients (16.7%), as involving post. leaflet, in 2 patients (6.7%), as involving both leaflet, in 3 patients (10%) among 10 ones. Eccentric flow among remnant regurgitation, was observed in 2 patients who underwent repair surgery for ant. leaflet, 1 patient who underwent repair surgery for both leaflet. CONCLUSION: Mitral valve repair surgery reduce the left ventricular chamber size and left ventricular mass. Postoperatively, patients who involve ant. leaflet were much remnant regurgitation above trivial flow more than others.
Ants ; Echocardiography ; Female ; Heart ; Humans ; Medical Records ; Mitral Valve Insufficiency* ; Mitral Valve Prolapse* ; Mitral Valve* ; Retrospective Studies ; Thoracic Surgery

Hyponatremia and hyperkalemia in infancy can be attributed to various causes, originating from a variety of renal and genetic disorders. Pseudohypoaldosteronism type 1 (PHA1) is one of these disorders, causing mineralocorticoid resistance that results in urinary salt wasting, failure to thrive, metabolic acidosis, and dehydration. PHA1 is heterogeneous in etiology. Inactivating mutations in the NR3C2 gene (4q31.1), which encodes the mineralocorticoid receptor, causes a less severe autosomal dominant form that is restricted to the kidney, while mutations in the amiloride-sensitive epithelial sodium channel gene (alpha subunit=SCNN1A, 12p13; beta subunit=SCNN1b, 16p12.2-p12.1; gamma subunit=SCNN1G, 16p12) causes a more severe autosomal recessive form, which has systemic effects. Here we report a neonatal case of kidney restricted PHA1 (renal type of PHA1) who first showed laboratory abnormalities before obvious PHA1 manifestations, with two functional polymorphisms in the NR3C2 gene. This is the second genetically confirmed case in Korea and the first to show functional polymorphisms that have previously been reported in the literature.
Acidosis ; Dehydration ; Epithelial Sodium Channels ; Failure to Thrive ; Humans ; Hyperkalemia ; Hyponatremia ; Infant, Newborn* ; Kidney ; Korea ; Male* ; Pseudohypoaldosteronism* ; Receptors, Mineralocorticoid*

We report a case of tick bite caused by Haemaphysalis flava which have never been reported in Korean medical literature. An 31-year-old woman had a asymptomatic erythematous indurated plaque with central crust by tick bite on the left upper back. A excisional biopsy specimen from the skin lesion showed eosinophilic degeneration with thrombosed blood vessels and dense inflammatory cells infiltration mainly composed of eosinophils in the reticular dermis. We could identify this causative tick as Hamaphysalis flava by using the scanning electron microscopic examination.
Adult ; Biopsy ; Blood Vessels ; Dermis ; Eosinophils ; Female ; Humans ; Skin ; Tick Bites* ; Ticks*

BACKGROUND: The ComboStick Reader 720(R)(DFI Co., Ltd. Korda) is a newly developed automated urine analyzer. The objective of this analysis was to evaluate the analytical performance of the Combostick Reader 720 and ComboStick 10 reagent strips and to compare the results using the Uriscan Pro II and Uriscan Gen 10 SGL strips (YD Diagnostics, Korea). METHODS: The Dipstick urinalyses were performed on a ComboStick Reader 720(R) using ComboStick 10 strips and on a Uriscan Pro II(R) using Uriscan 10 SGL strips. Precision was evaluated with commercial control materials. The sets of results were analyzed for concordance with weighted kappa values or intraclass correlation coefficients (ICCs). The microscopic urine analysis was carried out to confirm the results from both automated urine analyzers. Agreement between the dipstick methods and the microscopic method was evaluated by kappa values and the McNemar test. RESULTS: Within and between-run precisions of the ComboStick Reader 720(R) were 90.0% to 100%. A comparison of results from 1,700 urine samples using the ComboStick Reader 720(R) and Uriscan Pro II(R) revealed a very high concordance rate of > or = 91.0% on consideration of neighboring blocks for all analytes of the dipstick urinalysis. There was a good association between the microscopic method and the dipstick methods of the two automated urine analyzers. The ComboStick Reader 720(R) revealed a statistically higher degree of agreement for leukocytes. CONCLUSIONS: The ComboStick Reader 720(R) and ComboStick 10 strips showed good precisions and revealed a statistically significant agreement with the Uriscan Pro II(R) and Uriscan 10 SGL strips. For leukocytes, the ComboStick Reader 720(R) was superior to the Uriscan Pro II(R) in comparing the agreement between the microscopic and dipstick methods. The overall performance of the ComboStick Reader 720(R) and ComboStick 10 strips were satisfactory.
Leukocytes ; Reagent Strips ; Urinalysis

PURPOSE: It has not been clearly investigated how iodine can be trapped from the extracellular space into thyroid follicular cells, the defective iodide-trapping mechanism appears to be an early and constant feature during oncogenic transformation of thyroid cells. In recent studies, NIS and pendrin are associated with the trapping process. Thus, in order to reveal this uncertain relationship, each of the quantitative expressions of NIS and pendrin in various thyroid tissues were evaluated by real time RT-PCR. METHODS: This study included 63 patients who had undergone thyroidectomy in Uijongbu St. Mary's hospital from Jan. 2000 to Jan. 2003. 13 cases of normal thyroid, 17 cases of hypofunctioning thyroid adenomas, and 33 cases of thyroid cancer were examined. The thyroid cancer group was further divided into high and low risk group according to the AMES score, and the NIS and pendrin levels were compared between the two groups. Real time RT-PCR was conducted with the extracted RNAs, using GAPDH as the control. RESULTS: As for pendrin, its expression was decreased by 7% in the thyroid adenoma group compared with that of normal thyroid, while there was a 59% decrease in thyroid cancer cases. NIS expression was decreased by 20% in the thyroid adenoma group, and a 40% decrease was found in thyroid cancer group. Due to the impediment of pendrin in both high and low risk group of thyroid cancer, there was a 19% decrease in the high risk group compared with the low risk group. As for the impediment of NIS in the high risk group, an increase of 30% was found. However, no statistical significance was shown (P=0.344 vs P=0.688). CONCLUSION: According to this study, it can be inferred that the decrease in the expressions of NIS and pendrin are related to tumorigenesis of thyroid cancer. Also, further research is needed to reveal the cause of genetic transformation, as well as the value of utilization of NIS and pendrin as tumor markers.
Biomarkers, Tumor ; Carcinogenesis ; Extracellular Space ; Humans ; Iodine ; RNA ; Thyroid Gland* ; Thyroid Neoplasms* ; Thyroidectomy ; Transformation, Genetic

We developed a Rapid Diagnostic Test (RDT) kit for detecting IgG/IgM antibodies against Zika virus (ZIKV) using monoclonal antibodies to the envelope (E) and non-structural protein 1 (NS1) of ZIKV. These proteins were produced using baculovirus expression vector with Sf9 cells. Monoclonal antibodies J2G7 to NS1 and J5E1 to E protein were selected and conjugated with colloidal gold to produce the Zika IgG/IgM RDT kit (Zika RDT). Comparisons with ELISA, plaque reduction neutralization test (PRNT), and PCR were done to investigate the analytical sensitivity of Zika RDT, which resulted in 100% identical results. Sensitivity and specificity of Zika RDT in a field test was determined using positive and negative samples from Brazil and Korea. The diagnostic accuracy of Zika RDT was fairly high; sensitivity and specificity for IgG was 99.0 and 99.3%, respectively, while for IgM it was 96.7 and 98.7%, respectively. Cross reaction with dengue virus was evaluated using anti-Dengue Mixed Titer Performance Panel (PVD201), in which the Zika RDT showed cross-reactions with DENV in 16.7% and 5.6% in IgG and IgM, respectively. Cross reactions were not observed with West Nile, yellow fever, and hepatitis C virus infected sera. Zika RDT kit is very simple to use, rapid to assay, and very sensitive, and highly specific. Therefore, it would serve as a choice of method for point-of-care diagnosis and large scale surveys of ZIKV infection under clinical or field conditions worldwide in endemic areas.
Antibodies ; Antibodies, Monoclonal ; Baculoviridae ; Brazil ; Cross Reactions ; Dengue Virus ; Diagnosis ; Diagnostic Tests, Routine ; Enzyme-Linked Immunosorbent Assay ; Flavivirus ; Gold Colloid ; Hepacivirus ; Immunoglobulin G ; Immunoglobulin M ; Korea ; Methods ; Neutralization Tests ; Point-of-Care Systems ; Polymerase Chain Reaction ; Reagent Kits, Diagnostic ; Sensitivity and Specificity ; Sf9 Cells ; Yellow Fever ; Zika Virus