Ectopic pregnancies are unsuccessful pregnancies that result from implantation of fertilized ovum occurring inan aberrant area. Aside from an emergency case, the early diagnosis of ectopic pregnancy is very difficultparticularly in a case with insidious onset and mild clinical manifestations. Early diagnosis not only reduces thedanger, but also simplifies the management of ectopic pregnancy. Ultrasonography has been an indispensablediagnostic tool in obstetrics and Gynecology. In the authors' experience, clinical suspected ectopic pregnancy wasone of the common indications for performing ultrasonography. Since Kobayashi et al. reported the appearances ofextopic preganancy utilizing bistable B-scan ultrasonography, the ultrasonic findings of ectopic pregnancy havebeen reported by many authors. But, its accuracy and reliablity in the diagnosis of ectopic pregancy are stillopen to controversy. The authors studied 65 cases of clinically suspected ectopic pregnancy with Picker 80 L grayscale ultrasonography from Aug. 1982 to Jun. 1983. There were 29 confirmed cases, of which 15 were proved to haveextopic pregnancy and 14 were proved to have disease other than ectopic pregnancy by surgical andhistopathological study or by laparoscopy and histopatholoigcal study or by laparoscopy and follow up study. 29confirmed cases were reviewed. The resuls were as follows; 1. Among 15 ectopic pregnancies, there were 12ampullary pregnancies, 2 isthmic pregnancies and 1 interstitial pregancy. Among 14 cases of no ectopic pregnancy,there were 5 intrauterine pregnancies, 3 myoma uteri, 2 P.I.D., and 1 case of dermoid cyst, cystic teratoma,h-mole and tubal hematoma due to previous tubal ligation, respectively. 2. The age distribution of ectopicpregnancy was from 22 to 41 years. The common clinical manifestations of extopic pregnancy were lower abdominalpain (73.3%), vaginal spotting or bleeding (73.3%) and amenorrhea(66.7%). 3. Positive results of urine immunologicpregnancy test was 28.6% in ectopic pregnancy. 4. Ultrasonic findings of ectopic preganncy were as follows; 1) Nointrauterine gestational sac was observed in all cases except 1 interstitial pregnancy. Intrauterine fluidcollection was observed in 3 cases. Uterine displacement was observed in 10 cases. 2) Among 5 cases of rupturedtubal pregnancy, we observed predominantly cystic adnexal mass in 3 cases, mixed echogenic adnexal mass in 2cases, and cul-de-sac fluid in all cases. Among 9 cases of unruptured tubal pregnancy, we observed predominantlycystic adnexal mass in 2 cases, mixed echogenic adnexal mass in 7 cases, and cul-de- sac fluid in 3 cases. 3) Anechodense ring like structure was observed outside the uterus in 9 cases of tubal pregnancy. 4) In the case ofinterstitial pregnancy, eccentrically located gestational sac with overlying thin myometrium was observed withinthe uterus. 5) Fetal heart activity was noted outside the uterus with real time scanning in only 1 case of ectoicpregnancy. 5. Of 19 sonographically ectopic pregnancies, a correct positive ultrasonic diagnosis was made n 14cases (73.7%). Of 29 confirmed cases, overall diagnostic accuracy of ultrasound was 79.3%. 6. By demonstrationintrauterine pregnancy or disease other than ectopic pregnancy such as myoma uteri, homole or ovarian cyst,ectopic pregnancy was ultrasonically excluded in 10 cases. Among above 10 cases, 1 case of ultasonically bilateralovarian cyst was proved to have ruptured tubal pregnancy combined with ovarian cyst. The accuracy of ultrasonicexclusion of ectopic pregnancy was 90%. In the authors'experience, ultrasonography was very helpful in theexclusion of extopic pregnancy.
Age Distribution ; Animals ; Dermoid Cyst ; Diagnosis ; Early Diagnosis ; Emergencies ; Female ; Fetal Heart ; Follow-Up Studies ; Gestational Sac ; Gynecology ; Hematoma ; Hemorrhage ; Laparoscopy ; Metrorrhagia ; Mice ; Myoma ; Myometrium ; Obstetrics ; Ovarian Cysts ; Pregnancy ; Pregnancy ; Pregnancy, Ectopic ; Pregnancy, Interstitial ; Pregnancy, Tubal ; Sterilization, Tubal ; Ultrasonics ; Ultrasonography ; Uterus ; Zygote

PURPOSE: We evaluated the importance of redistribution and 24 hour reinjection images in Tl-201 SPECT assessment of myocardial viability after acute myocardial infarction (AMI). MATERIALS AND METHODS: We performed dipyridamole stress-4 hour redistribution-24 hour reinjection Tl-201 SPECT in 43 patients with recent AMI (4-16 days). The myocardium was divided into 16 segments and perfusion grade was measured visually with 4 point score from 0 to 3 (absent uptake to normal uptake). A perfusion defect with stress score 2 was considered moderate. A defect was considered severe if the stress score was 0 or l (absent uptake or severe perfusion decrease). Moderate defect on stress image were considered viable and segments with severe defect were considered viable if they showed improvement of 1 score or more on redistribution or reinjection images. We compared the results of viability assess-ment in stress-redistribution and stress-reinjection images. RESULTS: On visual analysis, 344 of 688 segments (50%) had abnormal perfusion. Fifty two (15%) had moderate perfusion defects and 292 (85%) had severe perfusion defects on stress image. Of 292 severe stress defects, 53 were irreversible on redistribution and reversible on reinjection images, and 15 were reversible on redistribution and irreversible on reinjection images. Two hundred twenty four of 292 segments (76.7%) showed concordant results on stress-redistribution and stress-reinjection images. Therefore 24 hour reinjection image changed viability status from necrotic to viable in 53 segments of 292 severe stress defect (18%). However, myocardial viability was underestimated in only 5% (15/292) of severe defects by 24 hour reinjection. CONCLUSION: The 24 hour reinjection imaging is useful in the assessment of rnyocardial viability. It is more sensitive than 4 hour redistribution imaging. However, both redistribution and reinjection images are needed since they complement each other.
Complement System Proteins ; Dipyridamole ; Humans ; Myocardial Infarction* ; Myocardium ; Perfusion ; Tomography, Emission-Computed, Single-Photon

No abstract available.
Blood Pressure* ; Body Mass Index*

The Korea Acute Myocardial Infarction Registry (KAMIR) is the first nationwide registry that reflects current therapeutic approaches and acute myocardial infarction (AMI) management in Korea. The results of the KAMIR demonstrated different risk factors and responses to medical and interventional treatments. The results indicated that the incidence of ST-elevation myocardial infarction (STEMI) was relatively high, and that the prevalence of dyslipidemia was relatively low with higher triglyceride and lower high-density lipoprotein cholesterol levels. Percutaneous coronary intervention (PCI) rates were high for both STEMI and non-ST-elevation myocardial infarction (NSTEMI) with higher use of drug-eluting stents (DESs). DES were effective and safe without increased risk of stent thrombosis in Korean AMI patients. Triple antiplatelet therapy, consisting of aspirin, clopidogrel, and cilostazol, was effective in preventing adverse clinical outcomes after PCI. Statin therapy was effective in Korean AMI patients, including those with very low levels of low-density lipoprotein cholesterol and those with cardiogenic shock. The KAMIR score had a greater predictive value than Thrombolysis in Myocardial Infarction (TIMI) and Global Registry of Acute Coronary Events (GRACE) scores for long-term mortality in AMI patients. Based on these results, the KAMIR will be instrumental for establishing new therapeutic strategies and effective methods for secondary prevention of AMI and guidelines for Asian patients.
Asian Continental Ancestry Group ; Aspirin ; Cholesterol ; Drug-Eluting Stents ; Dyslipidemias ; Humans ; Hydroxymethylglutaryl-CoA Reductase Inhibitors ; Incidence ; Korea* ; Lipoproteins ; Mortality ; Myocardial Infarction* ; Percutaneous Coronary Intervention ; Prevalence ; Registries* ; Risk Factors ; Secondary Prevention ; Shock, Cardiogenic ; Stents ; Thrombosis ; Triglycerides

No abstract available.
Adult* ; Fetus* ; Humans ; Humerus* ; Radius* ; Ulna*

No abstract available.
Osteomyelitis* ; Skull Base* ; Skull*

No abstract available.
Aged* ; Femur Neck* ; Fractures, Spontaneous* ; Humans

Leukocytes, when subjected to phagocytic, immunologic or chemical stimuli, are known to exhibit a sequence of morphological and biochemical events which lead to the production of H₂, O₂, O₂⁻, and even OH as well as the secretion of various lysosomal lytic enzymes into the extracellular environments. It was been proposed that some antiinflammatory drugs may exert their therapeutic effects by inhibiting the production of reactive oxygen species or by abrogating the effects of reactive oxygen species ontissue components. In the present study, effects of various quenchers and antiinflammatory drugs were observed on the changes of viscosity of hyaluronate and collagen gelation by oxygen radicals generated by xanthine and xanthine oxidase. Quenching effects of antiinflammatory drugs on reactive oxygen species were also observed with gas chromatography. 1. Decrease of viscosity of hyaluronate and inhibition of collagen gelation by xanthine and xanthine oxidase were inhibited by various quenchers. 2. Several oxygen radical quenchers and antiinflammatory drugs did not affect viscosity of hyaluronate and collagen gelation. 3. Reactive ouygen species generated by xanthine and xanthine oxidase affected both viscosity of hyaluronate and collagen gelation with similar pattem. Therefore, in this study quenching effects of antiinflammatory drugs on reactive oxygen species have been examined by observing viscosity changes of hyaluronate. Sodium salicylate, acetylsalicylic acid, indomethacin and hydrocortisone affected viscosity changes of hyalumnate by xanthine and xanthine oxidase. The pattem of inhibition of hyaluronate degradation by these drugs were comparable to the inhibition produced by OH scavengers and singlet oxygen quencher. 4. To danonstrate the generation of OH ethylene was determined from methional incubated with xanthine and xanthine oxidase according to gas chromatography method. Xanthine and xanthine oxidase produced ethylene fmm methional and the production was inhibited by antiinflammatory drugs. The result obtained in this study suggest that action of antiinflammatory drugs may, to some event, be attributed to their ability to intercept reactive oxygen species in addition to inhibition of synthesis of prostaglandin.
Aspirin ; Chromatography, Gas ; Collagen ; Hydrocortisone ; Indomethacin ; Leukocytes ; Methods ; Oxygen ; Reactive Oxygen Species ; Singlet Oxygen ; Sodium Salicylate ; Therapeutic Uses ; Viscosity ; Xanthine ; Xanthine Oxidase

BACKGROUND: Defensins are small (3.5~5 kDa) cationic antimicrobial peptides that have a broad spectrum of activity that includes gram-negative bacterias, yeasts and enveloped viruses. The defensins contain six cysteine residues forming three disulfide bridges depending on the spacing of the cysteine residues and the connectivity of the disulfide bridge, defensins are classified into two families, the alpha-defensins (HNP) and beta-defensins (HBD). Recently two human epithelial beta defensins, HBD-1 and HBD-2 have been identified. HBD-1 has been detected in a number of normal mucosal sites, but HBD-2 is highly restricted in its expression by inflammatory stimulations. we invesigated the expression of hunam beta defensin in human male urogenital organs. METHODS: Specimens of normal human male testis, epididymis, prostate, seminal vesicles, vas deferens, urethra, bladder, ureter, kidney, pyelonephritis, epididymitis, clear renal cell carcinoma and transitional cell carcinoma of bladder were obtained as discarded material from urological surgery. Each sample was stored at snap frozen in liquid nitrogen subsequent to RNA extraction. Reverse transcription polymerase chain reaction (RT-PCR) was used to semiquantitate HBD-1 and HBD-2 mRNA using the housekeeping gene beta-actin as an internal control. Southern blotting and sequencing showed HBD-1, 2 expressions in male urogenital organs. RESULTS: We checked the expression of HBD-1, 2 mRNA in all specimen of normal human male urogenital organ, pyelonephritis, epididymitis, clear renal cell carcinoma and transitional cell carcinoma of bladder by RT-PCR and southern blotting analysis. We checked the homolgy of HBD-1, 2 by bands sequencing. CONCLUSION: Our study indicated that the normal male urogenital organs, infection and neoplasm in male urogenital organs expresses antimicrobial peptides. These may play an important role in the prevention of infections by bacterias, antimicrobial effects in infection and anticancer effects in neoplasm of male urogenital organs. These natural endogenous antibiotic peptides could be developed as novel therapeutic agents for fighting infections and neoplasms of the human male urogenital organs.
Actins ; alpha-Defensins ; Antimicrobial Cationic Peptides ; Bacteria ; beta-Defensins ; Blotting, Southern ; Carcinoma, Renal Cell ; Carcinoma, Transitional Cell ; Cysteine ; Defensins ; Epididymis ; Epididymitis ; Genes, Essential ; Gram-Negative Bacteria ; Humans* ; Kidney ; Male* ; Nitrogen ; Peptides ; Polymerase Chain Reaction ; Prostate ; Pyelonephritis ; Reverse Transcription ; RNA ; RNA, Messenger ; Seminal Vesicles ; Testis ; Ureter ; Urethra ; Urinary Bladder ; Vas Deferens ; Yeasts

BACKGROUND: One of the important factors in the prognosis of chronic hepatitis B patient is the degree of replication of hepatitis B virus (HBV). It has been known that HBV DNA polymerase plays the essential role in the replication of HBV. HBV DNA polymerase is composed of four domains, TP (Terminal protein), spacer, RT (Reverse transcriptase) and RNaseH. Among these domains, tyrosine, the 65th residue of TP is an important residue in protein-priming reaction that initiates reverse transcription. If monoclonal antibody that recognizes around tyrosine residue were selected, it could be applied to further study of HBV replication. METHODS: To produce TP-specific scFv (single-chain Fv) by phage display, mice were immunized using synthetic TP-peptide contains 57~80th amino acid residues of TP domain. After isolation of mRNA of heavy-variable region (VH) and light-chain variable region (VL) from the spleen of the immunized mouse, DNA of VH and VL were obtained by RT-PCR and joined by a DNA linker encoding peptide (Gly4Ser)3 as a scFv DNA fragments. ScFv DNA fragments were cloned into a phagemid vector. ScFv was expressed in E.coli TG1 as a fusion protein with E tag and phage gIII. To select the scFv that has specific affinity to TP-peptide from the phage-antibody library, we used two cycles of panning and colony lift assay. RESULTS: The TP-peptide-specific scFv was isolated by selection process using TP-peptide as an antigen. Selected scFv had 30 kDa of protein size and its nucleotide sequences were analyzed. Indirect- and competitive-ELISA revealed that the selected scFv specifically recognized both TP-peptide and the HBV DNA polymerase. CONCLUSION: The scFv that recognizes the TP domain of the HBV DNA polymerase was isolated by phage display.
Animals ; Bacteriophages* ; Base Sequence ; Clone Cells ; DNA ; DNA Polymerase I ; Hepatitis B virus ; Hepatitis B, Chronic ; Humans ; Mice ; Prognosis ; Protein S ; Reverse Transcription ; RNA, Messenger ; Spleen ; Tyrosine