Myeloid body formation is an ultrastructural feature of gentamicin induced nephrotoxicity in human being and experimental animals. The origin of the myeloid body is not satisfactorily understood and morphological verification of the developing process of this structure is not fully accomplished. We injected 100 mg/kg/12 hour of gentamicin in 20 Spraque-Dawley rats and examined the ultrastructural feature of the proximal convoluted tubular cells of the kidney every 30 minutes in the first 4 hours, and in 5 hours, 6 hours, 12 hours, 24 hours and 48 hours after injection of gentamicin, with a TEM and a SEM. Myeloid bodies were noted as concentric layers of membranous structures of degenerated endoplasmic reticulum and mitochondria in the lysosome. The number and size of the myeloid body containing lysosomes were increased with time. We can deduce from this observation that injured cell organelles by diffusible gentamicin within the cells are autophagocytosed by lysosomes which were also injured by the drug from pinocytotic vesicles, and incompletely digested organellar remnants are retained in the lysosomes as myeloid bodies. So we think that the myeloid body formation is a result of an exaggerated and a pathologic autophagocytic process due to cell injury induced by gentamicin.
Animals ; Endoplasmic Reticulum ; Gentamicins* ; Humans ; Kidney ; Lysosomes ; Mitochondria ; Organelles ; Rats*

Shwachman-Diamond syndrome (SDS) is a rare genetic disorder of unknown pathogenesis involving exocrine pancreatic insufficiency and hematological and skeletal abnormalities. About 25% of patients develop hematopoietic malignancies. We report on a case of acute myeloid leukemia (M2) in a 21-year-old woman affected by SDS. She was treated with conventional chemotherapy (idarubicin plus cytarabine) and reached complete remission of leukemia. After induction chemotherapy, she underwent allogeneic bone marrow transplantation (BMT). The BMT preparative regimen consisted of total body irradation (TBI) followed by cyclophosphamide. Cyclosporin A and short term methotrexate were used for graft-versus-host disease prophylaxis. After a follow-up of 12 months, she is alive leukemia free off any immunosuppressive agent. Although experience in this field is scarce, we speculate that bone marrow failure in SDS is an indication for BMT which is the only curative trentment option.
Adult ; *Bone Marrow Transplantation ; Case Report ; *Cell Transformation, Neoplastic ; Female ; Human ; Leukemia, Myelocytic, Acute/*pathology/*therapy ; Myelodysplastic Syndromes/*complications/*therapy ; Pancreatic Insufficiency/complications/therapy ; Syndrome ; Transplantation, Homologous

OBJECTIVES: The purpose of this study is to evaluate the clinical applicability of cognitive evoked potentials (CEPs) to identify the cognitive disorder in cerebrovascular diseases (CVD). METHODS: The P3 latencies, amplitudes and latency to amplitude ratios (LARs) of CEPs were measured in 25 healthy controls and 35 patients with CVD. The association of CEPs with variables including age, sex, Mini-Mental State Examination (MMSE), CVD types, loci of hemiplegic limbs, duration, education, Brief Psychiatric Rating Scale (BPRS), and Instrumental Activities of Daily Living (IADL) were also analyzed. RESULTS: 1) The P3 latencies (447.87+/-113.06 msec) and LARs (65.83+/-43.25) were prolonged in CVD (p<0.01), while the amplitudes (8.18+/-2.51 microV) were not changed. 2) The P3 latencies (537.31+/-101.14 msec) and LARs (94.89+/-46.44) in CVD with MMSE <24 were prolonged, and the amplitudes (6.45+/-1.98 microV) were reduced significantly (p<0.01, respectively), as compared with those in CVD with MMSE> or =24 (363.39+/-19.67 msec, 38.40+/-8.37 and 9.81+/-1.76 microV, respectively). 3) The BPRS and IADL in CVD with MMSE<24 were significantly (p<0.01) different from those in CVD with MMSE> or =24. 4) On analyzing the association of CEPs with variables in CVD, the P3 latencies were correlated positively with age, BPRS and IADL, while negatively with MMSE and DLFA. The amplitudes were correlated positively with MMSE, while negatively with age, BPRS and IADL. The LARs were correlated positively with age, BPRS and IADL, while negatively with MMSE. 5) On analyzing the association of CEPs with variables in CVD with MMSE> or =24, the P3 latencies were correlated positively with age, while negatively with MMSE. The amplitudes and LARs were not correlated with variables. 6) On analyzing the association of CEPs with variables in CVD with MMSE<24, the P3 latencies were correlated positively with BPRS, while negatively with MMSE. The amplitudes were positively correlated with age. The LARs were positively correlated with IADL. CONCLUSIONS: The P3 latencies and LARs of cognitive evoked potentials seemed to a useful clinical measures to assess cognitive disorders in CVD.
Activities of Daily Living ; Brief Psychiatric Rating Scale ; Education ; Evoked Potentials* ; Extremities ; Humans

PURPOSE: Epileptic patients have a increasing tendency to develop seizure attack in high temperature. This finding suggests that high temperature may have an effect on neuronal hyperexcitability and injury of epileptic brain. Therefore, the influence of high temperature on normal and epileptic brain was studied in organotypic explant cultures of rat. METHODS: Fourteen days-in-vitro cultures from 8 day-old rat pups were perfused with standard aCSF bubbled with 95%/5% O2/CO2 in a microchamber. Stimulus train(0.3 sec, 60 Hz) was applied to Schaffer collaterals in CA3 and extracellular field potential was recorded in the CA1 pyramidal layer. At 36degrees C initially, AD was evoked. In high temperature(HT) group, the cultures were subjected to 39degrees C for a period of 8 min before the second stimulus train was applied. They were then restored to 36degrees C for 10 min. In normal temperature group, temperature was maintained at 36degrees C for the second stimulus train. The cultures were returned to the incubator and observed serially for neuronal damage. Intensity of propidium iodide fluorescence indicative of neuronal injury was quantitated by digital image analysis. The cultures on the same insert that were not stimulated served as the unstimulated groups. RESULTS: There was not a statistically significant difference in neuronal damage between the unstimulated high-temperature(HT) and normal-temperature(NT) group. In CA1 sector, % damage(mean+/-SEM) was 0.42+/-0.20 vs 0.27+/-0.05 at 24 hrs(HT vs NT group, n=16 each, P>0.05, Student t-test); 1.81+/-0.79 vs 1.43+/-0.27 at 48 hrs(P>0.05); 3.50+/-1.32 vs 3.35+/-0.56 at 72 hrs(P>0.05). In CA3 sector, % damage was 0.34+/-0.10 vs 0.20+/-0.03 at 24 hrs(P>0.05); 0.99+/-0.20 vs 0.83+/-0.23 at 48 hrs(P>0.05); 2.00+/-0.38% vs 2.26+/-0.35% at 72 hrs(P>0.05). Neuronal damage on AD induced cultures during febrile setting(n=16) was significantly higher than in nonfebrile setting(n=16). In CA1 sector, % damage was 6.63+/-2.56 vs 0.92+/-0.45 at 24 hrs(febrile setting vs nonfebrile setting, P= 0.036); 26.37+/-7.44 vs 4.99+/-2.23 at 48 hrs(P=0.010); 38.59+/-9.63 vs 6.48+/-2.30 at 72 hrs (P=0.003). In CA3 sector, % damage was 1.23+/-0.48 vs 3.91+/-2.37 at 24 hrs(P=0.277); 13.09+/-5.75 vs 5.93+/-3.27 at 48 hrs(P=0.288); 27.86+/-8.68 vs 7.54+/-3.74 at 72 hrs(P=0.04). CONCLUSION: At high temperature, seizures in epileptic brain may be more injurious than seizures in normal temperature.
Animals ; Brain ; Fluorescence ; Hippocampus* ; Humans ; Incubators ; Neurons* ; Propidium ; Rats* ; Seizures

OBJECTIVE: A Multicenter open-label study was conducted to evaluate the clinical efficacy and safety of venlafaxine for the treatment in patients with major depression. METHOD: The study was done in patients with major depression diagnosed by DSM-IV who accepted venlafaxine medication. In cases of the patients taking other antidepressants, 6 weeks of venlafaxine medication was carried out after 14 days of drug excretion period and evaluation using HAM-D, MADRS, and CGI was done at baseline, and after 1, 2, 4, and 6 weeks. Regarding all side effects that had occurred during the period of our study such as their developed/disappeared time, severities, incidences, relationship with venlafaxine, managements and results have been putted into the records. RESULTS: A total of 141 patients were enrolled. Among 94 of them finished the 6 weeks of research and 41 of them did not make it through the research. Total HAM-D scores showed significant decrease after 1 week of venlafaxine medication and continous decrease through the study period. Total scores of MADRS also showed significant improvement after 1 week and continuous decrease through the study period. Similarly, CGI showed significant improvement between baseline, 1, 2, 4, and 6 weeks. There were no significant changes in vital sign, CBC, chemistry, and EKG. The commonly reported side effects of venlafaxine were nausea (10.6%), indigestion (9.5%), constipation (8.5%), and dizziness (8.5%). CONCLUSION: According to the results, venlafaxine was effective and safe in the treatment of patients with major depression.
Antidepressive Agents ; Chemistry ; Constipation ; Depression* ; Diagnostic and Statistical Manual of Mental Disorders ; Dizziness ; Dyspepsia ; Electrocardiography ; Humans ; Incidence ; Nausea ; Vital Signs ; Venlafaxine Hydrochloride

OBJECTIVE: This study was designed to evaluate the efficacy and safety of tianeptine and sertraline in the treatment of patients with depression. METHOD: The study was done on the patients with major depression diagnosed by DSM-IV, who had a Hamilton Rating Scale for Depression(HAM-D) score > OR =14 on the first 17 items of the HAM-D. A total of 40 patients were randomly assigned to tianeptine group and sertraline group. Tianeptine and sertraline were prescribed to each group. 6 weeks of each medication was carried out after 7 days of drug excretion period. Evaluation using 17 item HAM-D, Montgomery and {0c5}sberg Depression Rating Scale(MADRS), Clinical Global Impression Scale(CGI), and Covi Scale was done on the baseline and after 1 week, 2 weeks, 4 weeks, and 6 weeks. Regarding all side effects that had occurred during the period of our study such as their developed/disappeared time, severities, incidences, managements and results have been recorded. RESULTS: A total of 30 patients(tianeptine group 15;sertraline group 15) finished the 6 weeks of research. 37.5mg of the daily dose was regularly prescribed to the tianeptine group, the average amount of 64.0+/-22.5mg of the final daily dose was prescribed to the sertraline group. Total 17 item HAM-D scores, total points of MADRS and CGI showed significant decrease after 1 week in each treatment group and continous decrease after 2, 4 and 6 weeks;and no difference was found between tianeptine group and sertraline group in the antidepressant efficacy. Also there were no significant changes in vital sign, CBC, chemistry, and EKG in each treatment group. The common reported side effects of tianeptine were nausea(33.3%), epigastic distress(26.7%), dry mouth(20.0%), headache(13.3%) and those of sertraline were dry mouth(53.3%), headache(46.7%), nausea(33.3%), anorexia(33.3%). CONCLULSION: According to the results, tianeptine was effective in improvement of depressive symptoms and was well tolerated and safe in patients with depression.
Chemistry ; Depression* ; Diagnostic and Statistical Manual of Mental Disorders ; Electrocardiography ; Humans ; Incidence ; Sertraline* ; Vital Signs

The population of the elderly and neuropsychiatric elderly patients increases radically, but realistic management in the welfare and medical dimensions are not adequate. Especially, the treatment and care for the neuropsychiatric geriatric patients have not been achieved properly for the lack of good medical facilities and heavy economic burden. Therefore, this paper will propose a model of specialized neuropsychiatric geriatric hospital suited to our reality for the welfare of the elderly themselves and their families. For this, we investigated the needs of medical consumers through surveys. Our subjects are 41 families of neuropsychiatric elderly patients in admission and 51 caregivers. In these surveys, patrons expect the establishment of specialized geriatric hospital proper to the characteristics of neuropsychiatric elderly patients. In addition, they hope patients adminssion fee to be reduced as difficulty and specialty of neuropsychiatric geriatric patient treatment are actively applied to the medical insurance fee and national support system. According to our examination of the caregeivers for the neuropsychiatric elderly patients, caregivers didn't receive systematized training, but only brief care-giving education. Their status is also unstable and their pay is low. These issues are very important for the quality of care-giving work. Therefore, specialized neuropsychiatric geriatric hospitals should be established properly to our social reality and request, and national and social supports for the training and education of medical staffs and quite necessary.
Aged* ; Caregivers ; Education ; Fees and Charges ; Hope ; Humans ; Insurance ; Medical Staff

BACKGROUND: For securing FTSG, bolus tie-over dressing is a universally accepted method, but it has some definite disadvantages. For example, bulky dressing inhibits the drainage from graft bed and can lead to maceration by occlusion. Time and effort is necessary to secure dressing and the help of an assistant is also mandatory to tie the suture much easier. OBJECTIVES: In an attempt to find a better dressing material, we evaluated the usefulness of thermoplastic nasal splints (Aquaplast(R)) for securing graft in FTSG reconstruction. METHODS: Thirteen patients with surgical defects following tumor excision from the nose(9 patients), forehead(1), lip(1), hand(1), shin(1) ranging from 12mm to 40mm in the largest diameter were reconstructed with a FTSG. For securing FTSG, a heat-moldable nasal splint was heated, contoured in place over sutured graft on recipient area with/without suture of the splint with skin. RESULTS: All of the 13 FTSG secured with nasal splints showed a good take with a satisfactory cosmetic results. Except hypertrophic scars in 4 patients, which were not significant and improved with several times intralesional injection of triamcinolone, there were no other complications. CONCLUSION: We have found a heat-moldable nasal splint to be useful material to secure FTSG, especially for the complex contoured area such as nose or ear. This technique saves time and effort and there is no need of an assistant.
Bandages ; Cicatrix, Hypertrophic ; Drainage ; Ear ; Hot Temperature ; Humans ; Injections, Intralesional ; Nose ; Skin* ; Splints* ; Sutures ; Transplants* ; Triamcinolone

BACKGROUND: Cat scratch disease (CSD) manifests as a self-limiting, regional lymphadenopathy, fever and constitutional symptoms following a cat scratch or close contact with cats. Bartonella henselae is a causative agent of CSD that is globally distributed. In Korea there are no case report of CSD and no reports on the seroprevalence of Bartonella henselae in patients with suspected CSD. In this study the prevalence of antibodies to Bartonella in patients with lymphadenopathies was evaluated. METHODS: We evaluated serological responses of 31 patients (8 male, 23 female) with regional lymphadenopathies. The age of the patients ranged from 6 to 76 years old (mean+/-S.D., 30.6+/-14.3 years). Final diagnoses on the lymphadenopathies were tuberculous lymphadenopathy, Kikuchi's disease, Kawasaki's disease, and viral infection, but considerable cases remained undiagnosed. All sera were examined using MRL Diagnostics Bartonella IgG indirect immunofluorescent antibody (IFA) test kits (MRL Diagnostics, Cypress, California, USA) according to the manufac-turer's instructions. RESULTS: Of the 31 patients, 21 (67.7%) patients showed positive titers of immunoglobulin G (IgG) to B. henselae (1 : 64 or higher). Twelve (38.7%) had IgG titers of 1 : 128 and four (12.9%) had titers of 1 : 256. Among these patients, three patients had a history of close contact with a cat or cat scratch. Twenty patients (64.5%) showed positive reactions against B. quintana. CONCLUSION: This study revealed possible patients with cat scratch disease, but, unlike other countries, Bartonella seropositivity was not closely associated with cat contact. The further studies should be performed in a large number of patients including a control group and be accompanied with culture or polymerase chain reaction of extirpated lymph node.
Aged ; Animals ; Antibodies* ; Bartonella henselae* ; Bartonella quintana* ; Bartonella* ; California ; Cat-Scratch Disease ; Cats ; Cupressus ; Diagnosis ; Fever ; Histiocytic Necrotizing Lymphadenitis ; Humans ; Immunoglobulin G ; Korea ; Lymph Nodes ; Lymphatic Diseases* ; Male ; Polymerase Chain Reaction ; Prevalence* ; Seroepidemiologic Studies

BACKGROUND: Cat scratch disease (CSD) is an emerging disease worldwide and is mainly caused by Bartonella henselae, a gram-negative bacterium. The most common clinical manifestation is regional lymphadenopathy, though clinical recognition may be difficult, as atypical manifestations occur. The condition can be complicated by neuroretinitis, endocarditis, and sometimes fatal encephalopathy. The reservoir of B. henselae is the cat, and the prevalence rates of B. henselae infection in cat populations range from 4 to 70%. The prevalence of Bartonella infection in Korea has not been studied, thus, in this study Bartonella infection was investigated in cats captured in the Inchon and Ansan areas. METHODS: Twenty wild cats were captured and their livers and spleens were examined by polymerase chain reaction (PCR), bacterial culture, and histopathologically. PCR used two primers: Cat (sense:5'-GAT TCA ATT GGT TTG AA(G/A) GAG GCT-3', antisense:5'-TCA CAT CAC CAG G(A/G)C GTA TTC- 3') and Barto (sense:5'-(C/T) CT TCG TTT CTC TTT CTT CA-3', antisense:5'-AAC CAA CTG AGC TAC AAG CC-3'). Culture was performed by inoculating sliced spleen and liver into the ECV304 cell line and bacterial growth was observed over a period of 3 weeks. If no visible bacterial growth was identified, the presence of bartonella was examined by DNA staining, indirect immunofluorescent staining, and PCR. Liver and spleen were stained with H&E and scrutinized under the light microscope. RESULTS: Nine pairs of culture cells inoculated with liver and spleen were examined by indirect immunofluorescent staining and PCR; no positive case was found. In addition, no positive case was identified by PCR in the liver and spleen specimens of eleven cats. Spleen and liver specimens of eleven cats were examined by light microscopy and none showed granuloma. CONCLUSION: This preliminary study suggests that the Bartonella infection is probably uncommon in the cat population of the Inchon and Ansan areas. Further studies should be undertaken to detail the prevalence of Bartonella infection in other areas and in human.
Animals ; Bartonella henselae* ; Bartonella Infections ; Bartonella* ; Cat-Scratch Disease ; Cats* ; Cell Line ; DNA ; Endocarditis ; Granuloma ; Gyeonggi-do ; Humans ; Incheon ; Korea ; Liver ; Lymphatic Diseases ; Microscopy ; Polymerase Chain Reaction ; Prevalence* ; Retinitis ; Spleen