Spinal epidural emphysema is rare and has been described secondary to following medical intervention, such as lumbar puncture and epidural analgesia, pneumothorax or pneumomediastinum, degenerative disk disease, epidural abscess, and trauma. Rarely, it occurs after chest tube placement. We report a case of spinal epidural emphysema incidentally noted on HRCT after chest tube placement.
Analgesia, Epidural ; Chest Tubes ; Emphysema ; Epidural Abscess ; Epidural Space ; Mediastinal Emphysema ; Pneumothorax ; Spinal Puncture ; Subcutaneous Emphysema ; Thorax ; Tomography, X-Ray Computed

OBJECTIVE: Invasive cancer cells penetrate the extracellular matrix(ECM), including basement membrane during the metastatic cascades. Matrix metalloproteinases(MMPs) play a critical role in tumor invasion and metastasis and their activities are regulated by specific tissue inhibitors of metalloproteinase(TIMPs). Aberrant ECM degradation in tumor biology is attributed to an imbalance in local MMP and TIMP activity, resulting in the overexpression or enhanced activation of MMPs or reduced TIMP expression. The aim of this study was to compare the MMP-2 & -9, TIMP-1 & -2 mRNA expression in cervical cancer with those in normal cervix and to investigate that their expression is related to cancer stages and other prognostic factors. METHODS: The normal cervix and cervical cancer tissues were obtained from healthy women(n=14), and the patients with cervical cancer(n=31), respectively. Total RNA was extracted and reverse transcribed into cDNA. The expression of MMP-2 & -9, TIMP-1 & -2 mRNA was examined by quantative competitive PCR(QC PCR) and each results were analyzed by t-test and univariate analysis. RESULTS: The expression of MMP-2, TIMP-1 mRNA in cervical cancer was higher than that in nomal cervix(p<0.05). The TIMP-2 mRNA expression was elevated in cervical cancer while that was not shown in normal cervix. The MMP-9 mRNA expression was not statistically different between normal cervix and cervical cancer(p>0.05). CONCLUSIONS: These results suggested that increased MMP-2, TIMP-1 & -2 mRNA expression is an early event during malignant transformation of cervical cancer.
Basement Membrane ; Biology ; Cervix Uteri ; DNA, Complementary ; Female ; Humans ; Matrix Metalloproteinase 2* ; Matrix Metalloproteinases ; Neoplasm Metastasis ; RNA ; RNA, Messenger* ; Tissue Inhibitor of Metalloproteinase-1* ; Tissue Inhibitor of Metalloproteinase-2 ; Uterine Cervical Neoplasms*

A pregnane steroid, 3α-hydroxy-pregn-7-ene-6,20-dione (1), was isolated from a Hydractinia-associated Cladosporium sphaerospermum SW67 by repetitive column chromatographic separation and highperformance liquid chromatography (HPLC) purification. The planar structure of 1 was elucidated from the analysis of the spectroscopic data (1D and 2D NMR spectra) and LC-MS data. The absolute configuration of 1 was determined by interpretation of ROESY spectrum of 1, together with the comparison of reported spectroscopic values in previous studies. To the best of our knowledge, this is the first report of the identification of the pregnane scaffold from C. sphaerospermum, a natural source. Compound 1 was evaluated for its effects on lipid metabolism and adipogenesis during adipocyte maturation and showed that compound 1 substantially inhibited lipid accumulation compared to the control. Consistently, the expression of the adipocyte marker gene (Adipsin) was reduced upon incubation with 1. Further, we evaluated the effects of 1 on lipid metabolism by measuring the transcription of lipolytic and lipogenic genes. The expression of the lipolytic gene ATGL was significantly elevated upon exposure to 1 during adipogenesis, whereas the expression of lipogenic genes FASN and SREBP1 was significantly reduced upon treatment with 1. Thus, our findings provide experimental evidence that the steroid derived from Hydractinia-associated C. sphaerospermum SW67 is a potential therapeutic agent for obesity.

Clearance of a difficult biliary stone can be obtained using various interventional techniques such as endoscopic sphincterotomy followed by endoscopic papillary large balloon dilation, mechanical lithotripsy, peroral cholangioscopy-assisted intraductal electrohydraulic/laser lithotripsy, temporary plastic stent insertion, percutaneous transhepatic cholangioscopy-guided lithotripsy, and extracorporeal shock wave lithotripsy. We hereby describe the successful endoscopic treatment using various currently available interventional techniques in a case with multiple difficult common bile duct stones. Furthermore, we discuss the countermeasures to overcome the hurdles of each procedure.

Peritonitis is one of the major complications of CAPD (continuous ambulatory peritoneal dialysis). Among its causative organisms, vancomycin-resistant enterococcus (VRE) is rare, but serious causative organism, because it is refractory to antibiotics commonly used for CAPD peritonitis. Some drugs such as linezolid and dalfopristin have been introduced for VRE infections nowadays, but reports about usefulness of those drugs in VRE peritonitis are rare. We experienced a case of CAPD peritonitis caused by VRE, which was treated successfully with removal of CAPD catheter and use of linezolid. We report our experience with review of the literature.
Anti-Bacterial Agents ; Catheters ; Enterococcus ; Humans ; Peritoneal Dialysis, Continuous Ambulatory* ; Peritonitis* ; Linezolid

BACKGROUND: Recently, many institutions have acquired multi-detector computed tomography (MDCT) systems. This made it easier and more convenient to use MDCT as a initial diagnostic modality for hemoptysis. The purpose of this study was to evaluate the usefulness of MDCT before bronchoscopy and/or bronchial arterial embolization (BAE) for hemoptysis. METHODS: We studied a total of 125 patients with hemoptysis who underwent, between 2006 and 2008, MDCT in a routine protocol before bronchoscopy and/or BAE. One hundred two patients underwent bronchoscopy and 29 patients underwent BAE. We compared the usefulness of MDCT and bronchoscopy for detecting the bleeding site and identifying the cause. We also evaluated our ability, using MDCT, to detect instances where the bronchial artery caused hemoptysis. RESULTS: The rate of detection of a bleeding site was 75.5% on MDCT and 50.9% on bronchoscopy. MDCT and bronchoscopy detected the bleeding site in agreement in 62.7% of patients. MDCT alone found the bleeding site in 27.5% of cases. MDCT identified the cause of hemoptysis in 77.5% and bronchoscopy in 11.8%. In 29 patients who underwent BAE, we detected a total of 37 hypertrophied bronchial arteries that were causing hemoptysis. Of 37 bronchial arteries, 23 (62.2%) were depicted on MDCT. CONCLUSION: MDCT is superior to bronchoscopy for detecting the bleeding site and identifying the cause of hemoptysis. MDCT can also predict the side of affected bronchial artery with depiction of hypertrophied bronchial artery and localizing the bleeding site. Doing MDCT before bronchoscopy and BAE can provide a guideline for the next step.
Bronchial Arteries ; Bronchoscopy ; Hemoptysis ; Hemorrhage ; Humans ; Tomography, X-Ray Computed

Iron supplements such as ferrous sulfate tablets are usually used to treat iron-deficiency anemia in some elderly patients with primary neurologic disorders or decreased gag reflexes due to stroke, senile dementia, or parkinsonism. While the aspiration of ferrous sulfate is rarely reported, it is a potentially life-threatening condition that can lead to airway necrosis and bronchial stenosis. A detailed history and high suspicion of aspiration are required to avoid delays in diagnosis and treatment. The diagnosis can be confirmed by bronchoscopic examination and a tissue biopsy. Early removal of the aspirated tablet prevents acute complications, such as bronchial necrosis, hemoptysis, and lobar consolidation. Tablet removal is also necessary to prevent late bronchial stenosis. We presented the first case in Korea of a ferrous sulfate tablet aspiration that induced severe endobronchial inflammation.
Aged ; Alzheimer Disease ; Anemia, Iron-Deficiency ; Biopsy ; Bronchi ; Bronchoscopy ; Constriction, Pathologic ; Diagnosis ; Foreign Bodies ; Hemoptysis ; Humans ; Inflammation* ; Iron ; Korea ; Necrosis ; Nervous System Diseases ; Parkinsonian Disorders ; Reflex ; Respiratory Aspiration ; Stroke ; Tablets

Polymerase chain reaction (PCR) has been used as a substitute for conventional serological methods in order to provide blood or blood products free from contaminating viruses and recently attempts have focused to detect 2 or 3 viruses by a single multiplex PCR (M-PCR) reaction. We were able to detect human immunodeficiency virus type 1 (HIV-1), hepatitis C virus (HCV), hepatitis B virus (HBV) and human cytomegalovirus (HCMV) simultaneously by a single M-PCR. However detection by gel electrophoresis of the products from M-PCR suffers from drawbacks such as low sensitivity and product sizes. Here we report enhanced detection systems of M-PCR based on nucleic acid hybridization with arrays built on membrane. Membrane array was manufactured by spotting appropriate probe DNAs on nylon membrane. Single or multiplex PCR was performed and the PCR products were labeled with DIG and allowed to hybridize with the membrane array. Results indicate that nonspecific hybridization was not observed for membrane DNA array. Additionally, membrane array method could detect small amount of viruses that were not detectable by conventional gel electrophoresis. At least 25-fold, and in some cases more than 125-fold increases in sensitivity was obtained with DNA array method. Thus, the nucleic acid hybridization with membrane array could be applied for the detection of M-PCR of viruses in blood or blood products.
Cytomegalovirus ; DNA ; Electrophoresis ; Female ; Hepacivirus ; Hepatitis B virus ; HIV-1 ; Humans ; Membranes ; Metrorrhagia ; Multiplex Polymerase Chain Reaction* ; Nucleic Acid Hybridization* ; Nylons ; Oligonucleotide Array Sequence Analysis ; Polymerase Chain Reaction

Many researchers have reported that smoking enhanced psychomotor performance in healthy subjects, but little is known about the effects of cigarette smoking on psychomotor performance in schizophrenic patients who have a high prevalence of smoking and various psychomotor dysfunctions. The author investigated the effects of cigarette smoking on psychomotor performance in schizophrenic patients. Subjects were grouped into (1) smokers with no smoking for 90 minutes prior to testing, (2) smokers with smoking a cigarette after 90 minutes abstinence prior to testing and (3) nonsmokers. The scores of Motor performance series(MPS) and Decision-reaction timer(DRT) were compared among these three groups. No significant differences were found in MPS. In DRT, schizophrenic smokers with smoking a cigarette after 90 minutes abstinence prior to testing showed significantly shorter reaction time and decision time but no significant differences in motor time and correct response rate. In conclusion, this study suggests that smoking enhances cognitive processes in schizophrenic patients but does not influence motor performance.
Humans ; Prevalence ; Psychomotor Performance* ; Reaction Time ; Schizophrenia ; Smoke ; Smoking* ; Tobacco Products*