The synthetic, tension-free midurethral sling procedure using transobturator tape (TOT) was introduced in 2001. Since then, it has become a mainstream modality in patients with stress urinary incontinence. But, it has been reported to produce many complications such as mesh erosion, hematoma formation, and abscess. We experienced a case of abscess formation in the peritoneal cavity and left internal obturator muscle seven days after the TOT sling procedure, for which we performed a complete removal of mesh and a percutaneous drainage of the peritoneal abscess using 10.2-F drain-fix at the department of interventional radiology. To our knowledge, our case is one of the serious complications of the TOT procedure. Here, we report our case with a review of literatures.
Abscess* ; Drainage ; Hematoma ; Humans ; Peritoneal Cavity* ; Radiology, Interventional ; Suburethral Slings* ; Urinary Incontinence

Kasabach-Merritt syndrome presents various problems for anesthetic management, which include thrombocytopenia, bleeding tendency, and problems arising from the hemangioma mass itself. A 1-month-old male was given sclerotherapies, platelet transfusions, steroid, interferon alpha, vincristine because of the bleeding from the right lower leg hemangioma, but platelet numbers were decreased and seizures occurred due to frontal lobe focal hemorrhage. After all, he was scheduled for his right lower leg amputation when he was 7 months old. Anesthesia was carefully induced with thiopental, rocuronium, fentanyl, and flexible bronchoscope. It was maintained with sevoflurane and air/oxygen with fentanyl injection. Although excessive bleeding was expected during anesthesia and surgery, the operation was performed without correction of platelet number. Two days later, postoperative course was improved almost normal.
Amputation ; Androstanols ; Anesthesia ; Bronchoscopes ; Fentanyl ; Frontal Lobe ; Hemangioma ; Hemorrhage ; Humans ; Infant, Newborn ; Interferon-alpha ; Kasabach-Merritt Syndrome ; Leg ; Male ; Methyl Ethers ; Platelet Count ; Platelet Transfusion ; Sclerotherapy ; Seizures ; Thiopental ; Thrombocytopenia ; Vincristine

OBJECTIVE: We analyzed the association between regional weather and temporal changes on the daily occurrence of trauma emergencies and their severity. METHODS: In this cross-sectional prospective study, we investigated daily atmospheric patterns in trauma episodes in 1,344 patients in Cheongju city, South Korea, from January 2016 to December 2016 and analyzed the association of trauma occurrence and Injury Severity Scores (ISS) with weather conditions on a daily scale. RESULTS: The mean age of trauma patients was 53.0±23.8 years and average ISS was 9.0±2.0. Incidence of trauma was positively correlated with average temperature (r=0.512, P < 0.001) and atmospheric pressure (r=0.332, P=0.010) and negatively correlated with air pollutants (particulate matter less than 2.5 µm³ [PM2.5], r=−0.629, P < 0.001; particulate matter less than 10 µm³ [PM10], r=−0.679, P < 0.001). ISS was not significantly correlated with climate parameters and air pollutants, and variability was observed in the frequency and severity of trauma by time of day (highest occurrence, 16–20 pm; highest ISS, 4–8 am), day of the week (highest occurrence and highest ISS, Saturday), month of the year (highest occurrence, July; highest ISS, November), and season (highest incidence, summer; highest ISS, autumn). CONCLUSION: The study shows a positive relationship between trauma occurrence and specific weather conditions, such as atmospheric temperature and pressure. There was a negative relationship between concentrations of PM2.5 or PM10, and trauma occurrence. However, no correlation was observed between weather conditions or the concentrations of air pollutants and ISS. In addition, seasonal, circaseptan, and circadian variations exist in trauma occurrence and severity. Thus, we suggest that evaluation of a larger, population-based data set is needed to further investigate and confirm these relationships.
Air Pollutants* ; Atmospheric Pressure ; Chungcheongbuk-do ; Climate ; Dataset ; Emergencies ; Humans ; Incidence ; Injury Severity Score ; Korea ; Particulate Matter ; Prospective Studies ; Seasons* ; Weather

Anti-tuberculosis drugs can produce levels of hepatotoxicity ranging from mild elevation of aminotransferase to severe acute hepatitis. A few cases of drug-induced autoimmune hepatitis or the drug reaction with eosinophilia and systemic symptom (DRESS) syndrome by anti-tuberculosis medications have been reported. However, concomitant occurrence of these two disorders has not been reported. Here, we present a case of severe acute hepatitis with DRESS syndrome and autoimmune hepatitis resulting from primary standard anti-tuberculosis drugs. Both conditions were successfully treated with a systemic steroid regimen.
Antitubercular Agents ; Drug Hypersensitivity Syndrome ; Eosinophilia* ; Ethambutol* ; Hepatitis ; Hepatitis, Autoimmune* ; Isoniazid*

BACKGROUND: Ineffective cell-mediated immune response in human tuberculosis is associated with a depressed Th1 cytokine response and reduced production of IFN-gamma. Most persons infected with Mycobacterium tuberculosis are healthy tuberculin reactors with protective immunity, but a minority with ineffective immunity develop extensive pulmonary tuberculosis. The cell-mediated immune response is an important aspect of host resistance to mycobacterial infection and is believed to be tightly regulated by a balance between Th1 cytokines including IFN-gamma IL-12, IL-18, regulated on activation, normal T cell expressed and secreted (RANTES) and Th2 counterparts such as IL-4, monocyte chemoattractant protein-1 (MCP-1). METHODS: Proliferation and mRNA expression of IFN-gamma RANTES and MCP-1 by RT-PCR in peripheral blood mononuclear cells (PBMCs) in response to in vitro stimulation with mycobacterial antigens were compared in pulmonary tuberculosis patients with cured and treatment failure and in tuberculin-positive and tuberculin-negative healthy subjects. RESULTS: Defective proliferative responsiveness to aqueous TSP antigen was involved with treatment failure tuberculosis patients. Aqueous TSP antigen-induced IFN-gamma and RANTES mRNA expression was decreased in treatment failure tuberculosis patients compared with healthy tuberculin reactors and cured tuberculosis patients (23.1% versus 90.0% for IFN-gamma and 46.2% versus 70.0% versus 46.2% for RANTES). The frequency of MCP-1 mRNA expression to aqueous TSP antigen in treatment failure tuberculosis patients was greater than in healthy tuberculin reactors and cured tuberculosis patients (76.9% versus 40.0%). CONCLUSION: The increasing expression of MCP-1 mRNA in response to aqueous TSP antigen might be predicted to favor Th2 responses and restricted Th1 responses in treatment failure of pulmonary tuberculosis.
Chemokine CCL2 ; Chemokine CCL5 ; Cytokines ; Humans ; Immunity, Cellular* ; Interleukin-12 ; Interleukin-18 ; Interleukin-4 ; Mycobacterium tuberculosis ; RNA, Messenger ; Treatment Failure* ; Tuberculin ; Tuberculosis ; Tuberculosis, Pulmonary*

BACKGROUND/AIMS: Pancreatic acini of streptozotocin (STZ)-induced diabetic rats release amylase less than normal acini on cholecystokinin (CCK) stimulation. Pancreatic enzyme secretion has been closely related to the intracellular calcium concentration ([Ca2+]i) of the acinar cell. In the present study, sequential changes of the intracellular calcium signal which probably underlie the altered enzyme secretion in response to CCK-8 were investigated using pancreatic acini from diabetic rats. METHODS: Diabetic rats were prepared by single intravenous injection of STZ (70 mg/kg). Stimulating experiments with CCK-8 were performed 7 days later. Pancreatic acini were isolated by collagenase digestion. Amylase release and [Ca2+]i were measured by colorimethod and calcium imaging, respectively. The geometry of intracellular calcium signal was analyzed. RESULTS: Normal acini exhibited concentration-dependent [Ca2+]i increase and regular oscillatory calcium signal on CCK-8 stimulation. Amylase release was also concentration-dependent. However, diabetic acini showed significantly less [Ca2+]i increase, prolonged time to peak [Ca2+]i, decreased calcium spikes number, and decreased amylase release compared with normal acini. The decreased [Ca2+]i in diabetic acini was restored significantly by insulin treatment. CONCLUSIONS: Relatively decreased amylase release in diabetic pancreatic acini in response to CCK, appears to be associated with altered calcium signal due to insulin deficiency.
Amylases/*secretion ; Animals ; Calcium Signaling/*drug effects ; Diabetes Mellitus, Experimental/*physiopathology ; Pancreas/cytology/metabolism/*secretion ; Rats ; Rats, Sprague-Dawley ; Sincalide/*pharmacology

Clopidogrel is an oral agent that blocks ADP receptor-mediated platelet aggregation. Clopidogrel along with aspirin was shown by the CURE trial to result in a 20% relative reduction of cardiovascular death, myocardial infarction or stroke. Ticlopidine has been shown to reduce the incidence of stent thrombosis compared with warfarin, but it may cause serious hematological side effects. However, the reported neutropenia has been similar to clopidogrel and aspirin treatment groups (0.01 vs 0.17%, respectively) with corresponding rates (0.05 vs 0.04%, respectively) of severe neutropenia. We treated a 72-year-old female patient with severe neutropenia who underwent percutaneous coronary intervention with drug-eluting stent placement and had no neutrophils in the peripheral blood at 11 days after clopidogrel use. Therefore, clinicians should be alerted to the possibility of severe neutropenia with clopidogrel treatment.
Adenosine Diphosphate ; Aged ; Aspirin ; Drug-Eluting Stents ; Female ; Humans ; Incidence ; Myocardial Infarction ; Neutropenia* ; Neutrophils ; Percutaneous Coronary Intervention ; Platelet Aggregation ; Stents ; Stroke ; Thrombosis ; Ticlopidine ; Warfarin

PURPOSE: In the present study, the clinical characteristics and outcomes of neuroretinitis in Korea were investigated. METHODS: Seven consecutive patients with neuroretinitis from 2012 to 2015 were retrospectively reviewed. RESULTS: The present study included 9 eyes of 7 patients. The subjects consisted of 5 males and 2 females and the mean age was 45.1 ± 13.2 years. Two patients had Influenza-like symptoms and the others had no specific general symptoms. The mean best corrected visual acuity was logMAR 0.48 ± 0.55 (0-1.6) on the initial visit. Four patients 40 years of age or under had no abnormal findings in laboratory work-up. Conversely, 3 patients over 40 years of age were positive for Toxocara based on enzyme-linked immunosorbent assay (ELISA). Two of 3 patients positive for Toxocara were treated with albendazole and 1was not. Eight eyes had good visual recovery over 20/30 except for 1 patient who did not take the albendazole despite being positive for Toxocara detected using ELISA. CONCLUSIONS: Three of 7 patients with neuroretinitis in Korea showed positive results for Toxocara based on ELISA. In cases with seropositive Toxocara ELISA results, albendazole treatment should be considered.
Albendazole ; Enzyme-Linked Immunosorbent Assay ; Female ; Humans ; Korea* ; Male ; Optic Neuritis ; Retinitis* ; Retrospective Studies ; Toxocara ; Toxocariasis ; Visual Acuity

Interneuron diversity is one of the key factors to hinder understanding the mechanism of cortical neural network functions even with their important roles. We characterized inhibitory interneurons in layer II/III of the rat primary visual cortex, using patch-clamp recording and confocal reconstruction, and classified inhibitory interneurons into fast spiking (FS), late spiking (LS), burst spiking (BS), and regular spiking non-pyramidal (RSNP) neurons according to their electrophysiological characteristics. Global parameters to identify inhibitory interneurons were resting membrane potential (> -70 mV) and action potential (AP) width (< 0.9 msec at half amplitude). FS could be differentiated from LS, based on smaller amplitude of the AP (< ~50 mV) and shorter peak-to-trough time (P-T time) of the afterhyperpolarization (< 4 msec). In addition to the shorter AP width, RSNP had the higher input resistance (> 200 M omega) and the shorter P-T time (< 20 msec) than those of regular spiking pyramidal neurons. Confocal reconstruction of recorded cells revealed characteristic morphology of each subtype of inhibitory interneurons. Thus, our results provide at least four subtypes of inhibitory interneurons in layer II/III of the rat primary visual cortex and a classification scheme of inhibitory interneurons.
Action Potentials ; Animals ; Classification* ; Interneurons* ; Membrane Potentials ; Neurons ; Rats* ; Visual Cortex*

To examine the localization pattern of phospholipase D2 (PLD2) in the pancreatic islet (the islet of Langerhans) depending on species, we conducted a morphological experiment in the rat and guinea pig. Since individual islets display a typical topography with a central core of B cell mass and a peripheral boundary of A, D, and PP cells, double immunofluorescent staining with a panel of antibodies was performed to identify PLD2-immunoreactive cells in the islets PLD2 immunoreactivity was mainly present in A and PP cells of the rat pancreatic islets. And yet, in the guinea pig, PLD2 immunoreactivity was exclusively localized in A cells, and not in PP cells. These findings suggest a possibility that PLD2 is mainly located in A cells of rodent pancreatic islets, and that the existence of PLD2 in PP cells is not universal in all species. Based on these results, it is suggested that PLD2 may play a significant role in the function of A and/or PP cells via a PLD-mediated signaling pathway.
Animals ; Antibodies ; Guinea Pigs* ; Guinea* ; Islets of Langerhans* ; Phospholipases* ; Rats* ; Rodentia