No abstract available.
Epidemiology*

BACKGROUND: Antibiotics are used prophylactically in surgery to prevent postoperative infection. However, antibiotics administered in large doses can cause a bleeding diathesis as a result of platelet dysfunction. We wondered whether these antibiotics might impair platelet function by interfering with the initial step of platelet activation: the binding of agonists to their specific receptors on the platelet surface. METHODS: In 30 patients (male 18, women 12) undergoing primary elective knee arthroscopic surgery, the whole blood coagulation system was prospectively evaluated before, and 10 and 40 minutes after administration of 1 g of augmentin. All patients who had abnormal preoperative coagulation profiles or who received anticoagulant or antiplatelet, antibiotics therapy within 7 days prior to surgery were precluded. RESULTS: At 10 minutes after augmentin administration 25 of 30 patients had a significant impairment in all phases of whole blood coagulation as monitored by thromboelastography. In contrast, three of 30 patients had a significantly decreased coagulation time. Two of 30 patients had no significant changes of TEG variables. TEG variables were restored toward baseline in fourty minutes after augmentin administration. CONCLUSIONS: Augmentin can cause a significant but transient change in the viscoelastic properties of blood. Coagulation parameters of the TEG should be measured prior to augmentin administration to prevent and prospect a bleeding diathesis as a result of platelet dysfunction.
Amoxicillin-Potassium Clavulanate Combination ; Anti-Bacterial Agents ; Arthroscopy ; Blood Coagulation ; Blood Platelets ; Disease Susceptibility ; Female ; Hemorrhage ; Humans ; Knee ; Platelet Activation ; Prospective Studies ; Thrombelastography*

BACKGROUND: Epidural anesthesia is becoming an increasingly important aspect of anaesthetic practice because it has many advantages. To achieve the appropriate sedation, various methods have been described. The authors applied the ketamine for this purpose in subanesthetic dose and compared with the midazolam that has been most commonly used for intravenous sedation. METHODS: Fifty-seven adult patients undergoing lower abdominal and extremity surgery who were receiving epidural anesthesia were randomely enrolled into this clinical study. They were allocated to three groups to receive only normal saline (group C), midazolam 0.05 mg/kg (group M) and ketamine 0.5 mg/kg midazolam 0.05 mg/kg (group K) in normal saline 10ml, respectively. Hemodynamic and respiratory measurements were recorded at baseline, 1 minute, 3 minute, 5 minute, 10 minute, 20 minute and 30 minute after sedation. The degree of sedation was assessed by a blinded observer using sedation score. RESULTS: There were no significant differences for hemodynamic and respiratory parameters, but decrements of arterial pressure at 1 minute after sedation were most remarkable in the group M. Sedation was satisfactorily achieved by combination of ketamine and midazolam without significant emergence reaction. CONCLUSIONS: The combination of ketamine and midazolam was judged to be suitable alternative for sedation during epidural anesthesia.
Adult ; Anesthesia, Epidural* ; Arterial Pressure ; Extremities ; Hemodynamics ; Humans ; Ketamine* ; Midazolam*

BACKGROUND: For HLA-DR typing, PCR-SSO (sequence specific oligonucleotide) kits are most commonly used in Korea. However, the PCR-SSO method generally shows more ambiguities than PCR-SSP (sequence specific primer) method in generic-level typing of HLA-DRB1 alleles. We evaluated the newly developed NeoDin SSP(TM) HLA-DR Typing kit based on the PCR-SSP method. METHODS: A total of 118 selected samples with known DRB1 alleles were tested with the NeoDin SSP(TM) HLA-DR Typing kit and the band patterns were interpreted by two investigators in a blind manner. RESULTS: Correct assignment of HLA-DRB1 alleles at a generic level was possible in 117 (99.2%)out of 118 samples tested. Only one sample carrying DRB1*1403 as a homozygote showed ambiguity: DR14 homozygote versus DR14, DR13. Some HLA-DR specificities (DR8, DR11-14) were dividied into 2-11 allelic groups and the typing results (allelic groups) were fully concordant with the known DRB1 allelic specificities. When a proper concentration of DNA with good purity was used, band patterns were clear and easy to read and no false positive or false negative band was observed in the DRB1 assignments. The occasional presence of 1-2 faint nonspecific bands did not much influence the correct assignments of specific bands. In a small proportion (5 samples, 4%) of samples tested, a random occurrence of PCR failure of 1-2 internal control bands was observed; however it did not affect the correct assignments of DRB1 alleles. CONCLUSIONS: When a proper concentration of DNA with good purity is used, the correct assignments of HLA-DRB1 alleles at a generic level are possible in >99% of the samples without ambiguity, using the NeoDin SSP kit.
Alleles ; DNA ; HLA-DR Antigens* ; HLA-DRB1 Chains ; Homozygote ; Humans ; Korea ; Polymerase Chain Reaction ; Research Personnel

BACKGROUND: For HLA-DR typing, PCR-SSO (sequence specific oligonucleotide) kits are most commonly used in Korea. However, the PCR-SSO method generally shows more ambiguities than PCR-SSP (sequence specific primer) method in generic-level typing of HLA-DRB1 alleles. We evaluated the newly developed NeoDin SSP(TM) HLA-DR Typing kit based on the PCR-SSP method. METHODS: A total of 118 selected samples with known DRB1 alleles were tested with the NeoDin SSP(TM) HLA-DR Typing kit and the band patterns were interpreted by two investigators in a blind manner. RESULTS: Correct assignment of HLA-DRB1 alleles at a generic level was possible in 117 (99.2%)out of 118 samples tested. Only one sample carrying DRB1*1403 as a homozygote showed ambiguity: DR14 homozygote versus DR14, DR13. Some HLA-DR specificities (DR8, DR11-14) were dividied into 2-11 allelic groups and the typing results (allelic groups) were fully concordant with the known DRB1 allelic specificities. When a proper concentration of DNA with good purity was used, band patterns were clear and easy to read and no false positive or false negative band was observed in the DRB1 assignments. The occasional presence of 1-2 faint nonspecific bands did not much influence the correct assignments of specific bands. In a small proportion (5 samples, 4%) of samples tested, a random occurrence of PCR failure of 1-2 internal control bands was observed; however it did not affect the correct assignments of DRB1 alleles. CONCLUSIONS: When a proper concentration of DNA with good purity is used, the correct assignments of HLA-DRB1 alleles at a generic level are possible in >99% of the samples without ambiguity, using the NeoDin SSP kit.
Alleles ; DNA ; HLA-DR Antigens* ; HLA-DRB1 Chains ; Homozygote ; Humans ; Korea ; Polymerase Chain Reaction ; Research Personnel

Forty eight female Sprague-Dawley rats received a subcutaneous implant containing 12.5 mg estradiol ant the age of 3 weeks. Three rats were killed in 1, 2, 3, 4, 6 weeks and in every month during 2~12 months after implantation, and the breasts were examined by light microscope. In all rats, enlargement of terminal end buds was obseved in 1~2 weeks, maximum development of hyperplastic alveolar nodules in 3 weeks, and marked dilatation and secretion of alveoli or ducts in 1~12 months after implantation. Ductal epithelial hyperplasia was observed in 27 rats and carcinomas developed in 23 rats in 2~12 months after implantation. It was thought that the changes induced by estradiol are more similar to the human breast lesions, compared with changes induced by chemical carcinogens such as dimethylbenzanthracene(DMBA), because breast carcinomas developed in close relationship with ductal epithelial hyperplasia in both estradiol-treated rats and humans, but not in DMBA-treated rats.
Female ; Humans ; Rats ; Animals ; Carcinogens

Transfer of large quantities of fetal blood across the placental barrier to the maternal circulation is a rare occurrence which results in severe anemia in the newborn infants. This phenomenon is believed to occur most often during labor and delivery and apparently, is more frequent when abnormal obstetric conditions are present. However, fetal erythrocytes have been identified in the naternal circulation throughout most of pregnancy indicating some degree of constant or intermittent transplacental transfusion. We experienced a case of stillbirth due to large amount of fetomaternal transfusion. Acid elutionl test of maternal blood was positive and direct and indirect Coombs test was negative. Ultrasonographic finding on abdomen and cranium to rule out the internal hemorrhage was normal. We report a case of stillbirth due to fetomaternal transfusion with a brief review of related literatures.
Abdomen ; Anemia ; Coombs Test ; Erythrocytes ; Female ; Fetal Blood ; Fetomaternal Transfusion* ; Hemorrhage ; Humans ; Infant, Newborn ; Pregnancy ; Skull ; Stillbirth*

PURPOSE: To report a case of infectious crystalline keratopathy caused by Alternaria in the corneal center. CASE SUMMARY: A 66-year-old male visited our clinic with right ocular pain and visual loss after corneal trauma caused by a foreign body hitting his right eye while performing farm work 1 month prior to his visit. The patient had no history of corneal surgery and long-term use of topical corticosteroid. A corneal epithelial defect and whitish snowflake margin infiltration around the corneal stroma were observed in the corneal center, but there was an absence of conjunctival injection and anterior segment inflammation. Cultures and a biopsy of the corneal scrapings revealed Alternaria species fungus. The patient was treated with 1% topical voriconazole and 0.5% moxifloxacin, together with oral voriconazole (400 mg/day). After 2 months of treatment, the disease was completely cured, with a minute corneal opacity. CONCLUSIONS: We successfully treated a rare case of infectious crystalline keratopathy caused by Alternaria, which has not been previously reported in the Republic of Korea.
Aged ; Agriculture ; Alternaria ; Biopsy ; Corneal Injuries ; Corneal Opacity ; Corneal Stroma ; Crystallins ; Foreign Bodies ; Fungi ; Humans ; Inflammation ; Male ; Republic of Korea ; Voriconazole

BACKGROUND: Defects in apoptotic signaling pathways play important role in tumor initiation, progression, metastasis and resistance to treatment. Several proteins which may promote tumorigenesis by inhibiting apoptosis were identified. The survivin protein is the member of inhibitor of apoptosis protein(IAPs) family which inhibits apoptosis. Unlike other IAPs, it is expressed in during the fetal period but not in adult differentiated tissues. Many reports have stated that survivin is selectively expressed in many cancer cell lines and cancer tissues. We performed immunohistochemical analysis for survivin expression in non-small cell lung cancer to get evaluate its clinical implication. METHODS: Twenty nine surgically resected lung cancers were examined. Immunohistochemical staining were performed by immuno-peroxidase technique using avidin-biotinylated horseradish peroxidase complex in the formalin-fixed, paraffin-embedded tissue 4 µm section. Anti-survivin polyclonal antibody was used for primary antibody and anti-p53 monoclonal antibody was also used to analyze the correlation between survivin and p53 expression. The survivin expression scores were determined by as the sum of the stained area and intensity. RESULTS: Immunohistochemical analysis showed cancer specific expression of survivin in 20 of 29 cases (69.0%). Western blot analysis also showed the selective survivin expression in turmor tissue. There was no correlation between survivin expression and clinicopathological parameters and prognosis. We analyzed the correlated between survivin expression and p53 expression, but found none. CONCLUSION: We confirmed the tumor specific expression of survivin in non-small cell lung cancer But this pression was not correlated with clinical parameters as well as histlogy, tumor stage recurrence, and sur rate. Also it ws not statistically correlated with the expression of p53.
Adult ; Apoptosis ; Blotting, Western ; Carcinogenesis ; Carcinoma, Non-Small-Cell Lung* ; Cell Line ; Horseradish Peroxidase ; Humans ; Immunohistochemistry ; Inhibitor of Apoptosis Proteins* ; Lung Neoplasms ; Neoplasm Metastasis ; Prognosis ; Recurrence

PURPOSE: Tumor necrosis factor (TNF)-alpha and transforming growth factor (TGF)-beta1 have been shown to play important roles in allograft rejection of various organs. This study was performed to evaluate the association of TNF-alpha and TGF-beta1 genes and renal allograft dysfunction. METHODS: Five TNF-alpha ( 1,031 T/C, 863 C/A, 857 C/T, 308 G/A, 238 G/A) and two TGF-beta1 (codon 10 T/C, codon 25 G/C) single nucleotide polymorphism (SNP) sites were studied using PCR-SSCP and PCR-RFLP methods in 100 controls and 165 patients underwent renal transplantation. For the TGF-beta1 gene, we also studied the polymorphism of donors. RESULTS: The allele frequencies of each SNP sites in controls were not different from those of patients. The phenotype frequency of TNF-alpha high producer type, 308 A was significantly higher in the patients with recurrent acute rejection episodes (REs) compared with patients with no or one RE (38.5% vs. 9.2%, P=0.007). The frequency of TGF-beta1 low producer genotype, codon 10 CC was also significantly higher in the patients with recurrent REs (53.8% vs. 22.4%, P=0.029). Analysis of chronic renal allograft dysfunction (CRAD) revealed that the TGF-beta1 high producer type, codon 10 T allele in donors was associated with CRAD (66.7% vs. 48.2%, P=0.043). This association was significant only among patients with recurrent REs. Occurrence of CRAD was not influenced by TGF-beta1 polymorphisms in the patients. CONCLUSION: These results would be useful for predicting high risk group for acute rejection or CRAD in renal transplantation and might be useful for implying individualized immunosuppressive therapy.
Alleles ; Allografts* ; Codon ; Gene Frequency ; Genotype ; Humans ; Kidney Transplantation ; Phenotype ; Polymorphism, Single Nucleotide ; Tissue Donors ; Transforming Growth Factor beta1* ; Transforming Growth Factors ; Tumor Necrosis Factor-alpha*