No abstract available.
Genetic Therapy* ; Oligonucleotides*

Syphilitic aortitis, passing out of our mind, is the most common systemic manifestation of late syphilis and is more typically manifestated 10 to 30 years afterward. This diagnosis has been made less frequently in recent decades than in the past, because of public awareness of syphilis and screening program. Treponema pallidum lodge within vasa vasorum, especially ascending aorta cause the histologic changes, which are responsible for the three major forms of symptomatic cardiovascular syphilis, including aortic insufficiency, coronary ostial stenosis, and aortic aneurysm. We experienced a case of syphilitic aortitis with aortic insufficiency and aortic aneurysm in a 48-year-old man presented with progressive dyspnea. Echocardiography, chest CT, and later surgical correction were performed and surgical specimen revealed the histologic finding consistent with syphilitic aortitis. We report this case with a review of the literature.
Aorta ; Aortic Aneurysm* ; Aortitis ; Constriction, Pathologic ; Diagnosis ; Dyspnea ; Echocardiography ; Humans ; Mass Screening ; Middle Aged ; Syphilis ; Syphilis, Cardiovascular* ; Tomography, X-Ray Computed ; Treponema pallidum ; Vasa Vasorum

BACKGROUND AND OBJECTIVES: Endoscopic sinus surgery (ESS) was introduced to Korea in the 1980s and has since developed rapidly. There have been many changes in ESS over this period. Thus, in this paper, we explore trends in the clinical characteristics of ESS. SUBJECTS AND METHOD: We retrospectively reviewed patients who underwent the ESS at 000 Hospital performed by a single surgeon at a 10-year interval. By comparing 106 patients who underwent ESS in 2003 and 108 patients who underwent ESS in 2013, we investigated changes in ESS in terms of the target group of surgical indications, CT scores, range of operation and complications. RESULTS: With regard to surgical indications, the proportion of patients who underwent surgery due to nasal polyps in 2013 (32.4%) was lower than in 2003 (59.4%), while the proportion of patients undergoing fungal sinusitis surgery in 2013 (13.9%) was higher than in 2003 (0.0%). In terms of preoperative CT evaluation, Lund-Mackay scores for the maxillary sinus, ethmoid sinus, and ostiomeatal unit were lower in 2013 than in 2003. The proportion of ESS performed only in the maxillary sinus in 2013 (20.0%) was higher than in 2003 (10.0%). CONCLUSION: According to this study, the range and extent of sinusitis was favorable in 2013 compared to in 2003. The group of patients requiring treatment for only maxillary sinus disease accounted for a larger proportion of patients in 2013 than in 2003.
Ethmoid Sinus ; Humans ; Korea ; Maxillary Sinus ; Methods ; Nasal Polyps ; Observational Study* ; Polyps ; Retrospective Studies* ; Sinusitis

The treatment outcomes with conventional second-line chemotherapy or radiotherapy aregenerally very poor for patients with relapsed primary CNS lymphoma (PCNSL). We treated three relapsed PCNSL patients with high-dose cytarabine plus etoposide (CYVE) chemotherapy, and this was followed by autologous stem cell transplantation (ASCT). The salvage CYVE chemotherapy consisted of cytarabine 2g/m2/d on days 2 to 5 in a 3-hour infusion and 50mg/m2/d on days 1 to 5 in a 12-hourinfusion, and etoposide 200mg/m2/d on days 2 to 5 in a 2-hour infusion. After two cycles of CYVE chemotherapy, two patients achieved a complete response (CR), and one patient achieved a partial response (PR). All three patients experienced febrile neutropenia and grade 4 thrombocytopenia with the CYVE chemotherapy. However, the hematologic toxicities were well managed without any complications. The conditioning regimen for ASCT consisted of BCNU 300mg/m2 on day -7, etoposide 100mg/m2 on days -6 to -3, cytarabine 100mg/m2 on days -6 to -3, and cyclophosphamide 35mg/kg on days -6 to -3 (BEAC). After ASCT, the patient who initially showed a PR with CYVE chemotherapy then achieved a CR. At the time of this report, one patient remained alive in CR for 41 months after CYVE chemotherapy. The remaining two patients experienced relapse 5 months and 4 months after ASCT, respectively, and they ultimately died of disease progression 18 months and 8 months after ASCT, respectively. In our cases, the CYVE chemotherapy+ASCT was well tolerated, and this induced the complete disappearance of the tumor, and one patient showed prolonged disease-free survival. CYVE chemotherapy+ASCT could be a treatment option for relapsed PCNSL.
Anemia, Hemolytic, Autoimmune ; Carmustine ; Cyclophosphamide ; Cytarabine* ; Disease Progression ; Disease-Free Survival ; Drug Therapy ; Etoposide* ; Febrile Neutropenia ; Humans ; Lymphoma* ; Radiotherapy ; Recurrence ; Stem Cell Transplantation* ; Stem Cells* ; Thrombocytopenia ; Waldenstrom Macroglobulinemia

PURPOSE: Growth inhibitory effects of lipid soluble components of the Korean red ginseng and the antineoplastic mechanism against human melanoma cell lines were investigated. To examine molecular mechanism of growth inhibitory effects of GX-PE, we analyzed the effect of GX-PE on cell cycle progression and expression of cell cycle regulatory factors such as retinoblastoma gene product (Rb), p27 (Kip1), p21 (WAF1), cdk2, cdk4 and cyclin D1 which are known to regulate cell cycle progression. MATERIALS AND METHODS: Petroleum ether extract of the Korean red ginseng (GX-PE) was added to cultures of three human melanoma cell lines, SK-MEL-1, SK-MEL-2, and SK-MEL-5. Proliferation was measured by 3H-thymidine incorporation assay. Cell cycle and expression of cell cycle regulatory factors were analyzed by flow cytometry and Western blotting, respectively. RESULTS: Growth of melanoma cells was inhibited by GX-PE in proportion to the concentration. GX-PE significantly inhibited cell cycle progression at G1 phase. GX-PE increased expression of negative cell cycle regulators, i.e., p27 (Kip1) in SK-MEL-2 and p21 (WAF1) and Rb in SK-MEL-1. CONCLUSION: These results suggest that GX-PE inhibits proliferation of melanoma cells at a G1-S transition point of the cell cycle. The effect of GX-PE is most likely due to induction of negative cell cycle regulatory factors.
Blotting, Western ; Cell Cycle* ; Cell Line* ; Cyclin D1 ; Ether ; Flow Cytometry ; G1 Phase ; Genes, Retinoblastoma ; Humans* ; Melanoma* ; Panax* ; Petroleum

PURPOSE: Conventional hemorrhoidectomy is inevitably painful as a result of an anodermal wound. Circumferential stapled hemorrhoidectomy may be associated with less postoperative pain than conventional hemorrhoidectomy. The aim of this study is to evaluate whether a circumferential stapled hemorrhoidectomy, which uses PPH (Procedure for Prolapse and Hemorrhoids), offers any advantage over the conventional hemorrhoidectomy. METHODS: We analyzed the clinical results of hemorrhoidectomy of 122 patients with symptomatic hemorrhoids. There were two categories of patients: those receiving a circumferential stapled hemorrhoidectomy (n=50) and those receiving a conventional hemorrhoidectomy (n=72). The majority of cases were carried out under spinal anesthesia. The operation time, hospital stay, pain score, complications, and the number of days before returning to normal activity were recorded. A follow up was done using a questionnaire or through a telephone interview two weeks and six weeks after the operation. RESULTS: The mean distance from the dentate line to the completion line of stapling was 1.3+/-0.1 cm. There were two cases of the incomplete doughnut. The circumferential stapled hemorrhoidectomy took less time to perform (20.5+/-4.5 vs. 24.3+/-7.1 min). The mean visual analogue pain score (0~10) on the 2nd day and two weeks after operation was lower in the stapled group (4.1 and 1.5 vs. 6.1 and 3.1)(P<0.05). The stapled group had a shorter duration of hospital stay (4.1 days vs. 5.3 days)(P<0.05) and had a faster recovery to normal activity (7.6 days vs. 13.6 days)(P<0.05). Circumferential stapled hemorrhoidectomy controlled the symptoms of prolapse, pain, and bleeding in all patients. There were 2 cases of urinary retention in both groups, respectively, but there were no postoperative bleeding. CONCLUSION: Even though long term follow up is required, no major complications were observed in our series. The results of our experience for circumferential stapled hemorrhoidectomy appear encouraging. We assume that circumferential stapled hemorrhoidectomy is a safer and faster technique which can replace conventional hemorrhoidectomy techniques.
Anesthesia, Spinal ; Follow-Up Studies ; Hemorrhage ; Hemorrhoidectomy* ; Hemorrhoids ; Humans ; Interviews as Topic ; Length of Stay ; Pain, Postoperative ; Prolapse ; Surveys and Questionnaires ; Urinary Retention ; Wounds and Injuries

PURPOSE: Conventional hemorrhoidectomy is inevitably painful as a result of an anodermal wound. Circumferential stapled hemorrhoidectomy may be associated with less postoperative pain than conventional hemorrhoidectomy. The aim of this study is to evaluate whether a circumferential stapled hemorrhoidectomy, which uses PPH (Procedure for Prolapse and Hemorrhoids), offers any advantage over the conventional hemorrhoidectomy. METHODS: We analyzed the clinical results of hemorrhoidectomy of 122 patients with symptomatic hemorrhoids. There were two categories of patients: those receiving a circumferential stapled hemorrhoidectomy (n=50) and those receiving a conventional hemorrhoidectomy (n=72). The majority of cases were carried out under spinal anesthesia. The operation time, hospital stay, pain score, complications, and the number of days before returning to normal activity were recorded. A follow up was done using a questionnaire or through a telephone interview two weeks and six weeks after the operation. RESULTS: The mean distance from the dentate line to the completion line of stapling was 1.3+/-0.1 cm. There were two cases of the incomplete doughnut. The circumferential stapled hemorrhoidectomy took less time to perform (20.5+/-4.5 vs. 24.3+/-7.1 min). The mean visual analogue pain score (0~10) on the 2nd day and two weeks after operation was lower in the stapled group (4.1 and 1.5 vs. 6.1 and 3.1)(P<0.05). The stapled group had a shorter duration of hospital stay (4.1 days vs. 5.3 days)(P<0.05) and had a faster recovery to normal activity (7.6 days vs. 13.6 days)(P<0.05). Circumferential stapled hemorrhoidectomy controlled the symptoms of prolapse, pain, and bleeding in all patients. There were 2 cases of urinary retention in both groups, respectively, but there were no postoperative bleeding. CONCLUSION: Even though long term follow up is required, no major complications were observed in our series. The results of our experience for circumferential stapled hemorrhoidectomy appear encouraging. We assume that circumferential stapled hemorrhoidectomy is a safer and faster technique which can replace conventional hemorrhoidectomy techniques.
Anesthesia, Spinal ; Follow-Up Studies ; Hemorrhage ; Hemorrhoidectomy* ; Hemorrhoids ; Humans ; Interviews as Topic ; Length of Stay ; Pain, Postoperative ; Prolapse ; Surveys and Questionnaires ; Urinary Retention ; Wounds and Injuries

OBJECTIVE: This study was performed to evaluate the diagnostic value of polymerase chain reaction (PCR) for multiple microorganisms in female lower genital infection, because infections of the vaginal are caused by multiple microorganisms. METHODS: A total of 222 patients (161 cases of gynecologic patients and 61 cases of obstetric patients) who complained of profuse vaginal discharge or had excessive vaginal discharge were evaluated for detection of Chlamydia trachomatis, Ureaplasma urealyticum, Mycoplasma hominis, and Trichomonas vaginalis infections using PCR. RESULTS: Infecting microorganisms by PCR were found in 61 out of 161 gynecologic patients (37.6%). Among the 61 patients, single infection was present in 45 patients (78.3%), and infection by multiple microorganisms (26.6%) in the remaining 16. In these same patients, 72 showed an abundance of WBCs with the Gram stain. Among these 72 patients, 26 (74.3%) were infected with a single microorganism, and 9 (25.7%) were infected with multiple microorganisms. In 61 pregnant women, 26 patients (42.6%) were positive for infection. Single infection was found in 25 patients (96.2%) and infection by multiple microorganisms was present in one patient (3.8%). Many WBCs were observed in 19 out of the 61 pregnant women with the detection of single infection in 9 patients and none of the mixed forms. CONCLUSION: The majority of female lower genital infections are due to multiple organisms. Individual tests, cultures, and Gram staining must be done in order to detect all involved organisms which may potentially double cost and time loss. However, with the use of PCR, this can be achieved all at once. We therefore suggest that PCR may be precise and economically beneficial in the detection of female lower genital infection.
Chlamydia trachomatis ; Female* ; Humans ; Mycoplasma hominis ; Polymerase Chain Reaction* ; Pregnant Women ; Trichomonas vaginalis ; Ureaplasma urealyticum ; Vaginal Discharge

Cerebral venous sinus thrombosis (CVST) is a rare disease. Early diagnosis and treatment are important, as CVST is potentially fatal. Pregnancy and puerperium are known risk factors for CVST. Here, we report the case of a patient who developed superior sagittal sinus thrombosis after a normal vaginal delivery. A 20-year-old woman presented with a headache and seizures two days after a normal vaginal delivery. Initially, brain computed tomography (CT) showed a subarachnoid hemorrhage in the right parietal lobe and sylvian fissure, together with mild cerebral edema. CT angiography revealed superior sagittal sinus thrombosis. Multiple micro-infarctions were seen on diffusion-weighted magnetic resonance images. An intravenous infusion of heparin and mannitol was administered immediately. Two days after treatment initiation, the patient showed sudden neurological deterioration, with left-sided hemiplegia. Brain CT showed moderate brain edema and hemorrhagic densities. Emergency decompressive craniectomy was performed, and heparin was re-administered on post-operative day (POD) 1. On POD 9, the patient's mental state improved from stupor to drowsy, but the left-sided hemiplegia persisted. CT angiography showed that the superior sinus thrombosis had decreased. Superior sagittal sinus thrombosis is an uncommon complication, with an unfavorable outcome, after delivery. Timely diagnosis and treatment are important for preventing neurological deterioration.
Angiography ; Brain ; Brain Edema ; Cerebral Infarction ; Decompressive Craniectomy ; Diagnosis ; Early Diagnosis ; Emergencies ; Female ; Headache ; Hemiplegia ; Heparin ; Humans ; Infusions, Intravenous ; Mannitol ; Parietal Lobe ; Postpartum Period* ; Pregnancy ; Rare Diseases ; Risk Factors ; Seizures ; Sinus Thrombosis, Intracranial ; Stupor ; Subarachnoid Hemorrhage ; Superior Sagittal Sinus* ; Thrombosis* ; Young Adult

We investigated the role of Ca2+ and protein kinases/phosphatases in the stimulatory effect of insulin on glucose transport. In isolated rat adipocytes, the simple omission of CaCl2 from the incubation medium significantly reduced, but did not abolish, insulin-stimulated 2-deoxy glucose (2-DG) uptake. Pre-loading adipocytes with intracellular Ca2+ chelator, 5,5'-dimethyl bis (o-aminophenoxy)ethane-N,N,N'N' tetraacetic acetoxymethyl ester (5,5'-dimethyl BAPTA/AM) completely blocked the stimulation. Insulin raised intracellular Ca2+ concentration ((Ca2+)i) about 1.7 times the basal level of 72+/-5 nM, and 5,5'-dimethyl BAPTA/AM kept it constant at the basal level. This correlation between insulin-induced increases in 2-DG uptake and (Ca2+)i indicates that the elevation of (Ca2+)i may be prerequisite for the stimulation of glucose transport. Studies with inhibitors (ML-9, KN-62, cyclosporin A) of Ca2+-calmodulin dependent protein kinases/phosphatases also indicate an involvement of intracellular Ca2+. Additional studies with okadaic acid and calyculin A, protein phosphatase-1 (PP-1) and 2A (PP-2A) inhibitors, indicate an involvement of PP-1 in insulin action on 2-DG uptake. These results indicate an involvement of Ca2+-dependent signaling pathway in insulin action on glucose transport.
Adipocytes* ; Animals ; Cyclosporine ; Glucose* ; Insulin* ; Okadaic Acid ; Rats ; Staphylococcal Protein A