Acute appendicitis is the most common operative disease in general surgery, but it is not also rate disease to see in other clinical department such as Internal Medicine and Obstetric and Gynecology, because it reqnires to differenciate from many other diseases which have similar symptoms. Expecially, because the clipical aymptoms of acute appendicitis are not typieal in children, elderly, and women, it is hard to be diagnosed as acute appendicitis and it is often misdiagnosed as other disease. We performed colonoscopy due to be interpretated aa one of the colon diseases rather than acute appendicitis. But in colonoscopic findings, there were hyperemie and edematous change on the appendiceal orifice of cecum(cherry or acorn shape). So we report 5 cases of acute appendicitis diagnosed br colonoscopy.
Aged ; Appendicitis* ; Child ; Colon ; Colonoscopy* ; Female ; Gynecology ; Humans ; Internal Medicine

No abstract available.
Child* ; Hair* ; Humans

PURPOSE: In mammals, alphaand beta-defensins are antimicrobial peptides that are expressed in various epithelial and phagocytic cells. Human beta-defensin-1 and -2 (hBD-1, hBD-2) have recently been shown to be expressed in various epithelial cells. Vaginal mucosa can be a target of vaginitis and the site of uropathogens' colonization that precedes urinary tract infections. Therefore, innate host defense mediators like antimicrobial peptides in the vaginal mucosa are important. Estrogen and progesterone receptors have been shown to be expressed in the vaginal squamous epithelium. Sex hormones like estrogen and progesterone may cause vaginal atrophy or susceptibility to uropathogens. So, we performed this study to investigate the expression patterns of hBD-1 and -2 mRNA in vaginal squamous epithelium (VSE) with using lipopolysaccharide (LPS), 17beta-estradiol and progesterone. MATERIALS AND METHODS: Normal VSE cells that were retrieved from vaginal tissue during vaginoplasty were primarily cultured in keratinocyte growth medium and they we allowed to undergo their 3rd passage. Modulation of the expressions of hBD-1 and -2 mRNA by various stimuli (LPS 0.5microgram/ml, E2 2nM, P 1micrometer) was measured by semiquantitative reverse transcription polymerase chain reaction (RT-PCR). RESULTS: HBD-1 and -2 were constitutively expressed in the normal VSE cell lines, but the hBD-2 expression was not significant. A marked increase of the constitutive expression of hBD-2 mRNA was observed upon stimulation with LPS, but not upon stimulation with E2. A moderate decrease of the constitutive expression of hBD-2 mRNA upon stimulation with LPS was observed with administering progesterone. CONCLUSIONS: These expressions of hBD-2 mRNA may have important roles in the innate host defense of the urogenital area. Artificial intake of progesterone may lead to susceptibility via a decrease of defensins.
Atrophy ; beta-Defensins ; Cell Line ; Colon ; Defensins ; Epithelial Cells* ; Epithelium ; Estrogens ; Gonadal Steroid Hormones ; Humans ; Keratinocytes ; Mammals ; Mucous Membrane ; Peptides ; Phagocytes ; Polymerase Chain Reaction ; Progesterone* ; Receptors, Progesterone ; Reverse Transcription ; RNA, Messenger ; Urinary Tract Infections ; Vagina ; Vaginitis

Objective To investigate the clinical outcomes of an invasive strategy for elderly (aged≥75 years) patients with acute ST-segment elevation myocardial infarction (STEMI) complicated by cardiogenic shock (CS). Methods Data on 366 of 409 elderly CS patients from a total of 6,132 acute STEMI cases enrolled in the Korea Acute Myocardial Infarction Registry between January 2008 and June 2011, were collected and analyzed. In-hospital deaths and the 1-month and 1-year survival rates free from major adverse cardiac events (MACE;defined as all cause death, myocardial infarction, and target vessel revascularization) were reported for the patients who had undergone invasive (n=310) and conservative (n=56) treatment strategies. Results The baseline clinical characteristics were not significantly different between the two groups. There were fewer in-hospital deaths in the invasive treatment strategy group (23.5%vs. 46.4%, P＜0.001). In addition, the 1-year MACE-free survival rate after invasive treatment was significantly lower compared with the conservative treatment (51%vs. 66%, P=0.001). Conclusions In elderly patients with acute STEMI complicated by CS, the outcomes of invasive strategy are similar to those in younger patients at the 1-year follow-up.

In Korea, all domestic made test systems for detecting antibodies in HIV-1 contain the antigens from human immunodeficiency type 1 (HIV-1) subtype B. However, because HIV-1 subtype O is significantly different in amino acid sequences from all other subtypes of HIV-1, there has been a need for developing a test for detecting antibodies in subtype O. For this purpose, the entire nucleotide sequence corresponding to the extracellular domain of the transmembrane glycoprotein of HIV-1 subtype O was synthesized with consideration of Escherichia coli cordon usage. Various regions of the extracellular domain were cloned into E. coli expression vectors and tested for levels of protein production. The nucleotide sequence, named ECTM, that can encode a 129 amino acid-long peptide, was found to be expressed at a high level in E. coli. The protein of approximately 17 kDa specifically reacted with sera from individuals infected with HIV-1 subtype O. The ECTM protein was purified to near homogeneity by the CM-T gel chromatography, using concentrated, denatured inclusion bodies. In Western blot analysis, the purified viral antigen reacted with sera from individuals infected with subtype O more efficiently than subtype B. The enzyme linked immunoabsorbent assay (ELISA) system was developed using the subtype O viral protein and compared with the commercially available kit lacking the antigens from subtype O. The ELISA kit containing the subtype O antigen ECTM alone efficiently reacted with sera from individuals infected with subtype O. The subtype O antigen-containing kit produced a positive absorbence even when sera were diluted 512-fold, suggesting a high sensitivity. The commercially available kit also reacted with subtype O sera, but produced a negative result at a dilution of 8-fold. Our results suggest that the currently available kit may not be able to efficiently detect subtype O sera and that the viral protein developed in this study may be added to the current system to maximize the detection of sera from individuals infected with subtype O.
Amino Acid Sequence ; Antibodies ; Base Sequence ; Blotting, Western ; Chromatography, Gel ; Clone Cells ; Enzyme-Linked Immunosorbent Assay ; Escherichia coli ; Glycoproteins ; HIV* ; HIV-1* ; Humans* ; Inclusion Bodies ; Korea ; O Antigens

No abstract available.
Dilatation* ; Kidney* ; Pelvis*

No abstract available.
Diabetes Mellitus* ; Humans ; Neutrophils* ; Superoxides*

OBJECTIVE: Closure of a low transverse cesarean incision with one layer and two layer, we compared operative time, hemostasis, blood loss and postoperative sonohysteroperitoneographic findings. Study design: At our hospital 103 women were randomized to closure of a low transverse cesarean incision with either one continuous layer of a locking No. 1 chromic suture or two continuous of No. 1 chromic suture with the first layer locked between Mar. 1, 1998 and Dec. 31, 1998. After three months later, sonhysteroperitoneography was taken and then we evaluated uterus indirectly. RESULTS: A one layer closure required less operative time, 16 versus 20.8 minutes (p<0.01), less hemoglobin change, 0.44 versus 1.3 (p<0.01) and less suture materials (p<0.01). But postoperative follow up sonohysteroperitoneography, a one layer closure shows slightly thinning of isthmic layer of myometrium, two layer closure shows more adhesional band and both are similar other findings. CONCLUSION: A one layer does not significantly affect the clinical course than traditional two layer closure. So we recommended a one layer closure when its use is anatomically feasible.
Animals ; Female ; Follow-Up Studies ; Hemostasis ; Humans ; Mice ; Myometrium ; Operative Time ; Sutures ; Uterus

BACKGROUND/AIMS: It is unknown whether the prokinetics improve the quality of life in patients with functional dyspepsia. Thus, we evaluate the effect of the mosapride, selective 5-HT4 agonist, on the symptom and life quality of patients with functional dyspepsia using the Nepean dyspepsia index-Korean version (NDI-K), a reliable and validated disease-specific quality of life questionnaire. METHODS: A single, open trial was performed in 129 patients with functional dyspepsia. Patients were received mosapride 5 mg t.i.d before each meal for 4 weeks. The symptoms and quality of life were measured with the NDI-K at baseline and 4 weeks. The responsiveness of the NDI-K was evaluated by correlation with symptom scores. RESULTS: All the 15 symptom scores and the dyspepsia score decreased after treatment (p<0.05). The total symptom score decreased from 60.9 +/- 25.8 to 24.7 +/- 20.4 (p=0.001). Correlations were observed between the total symptom score and the NDI-K score (r=0.47, p=0.001), and between the total symptom score and each score in 5 subscales (r=0.25-0.44, p=0.001). The NDI-K score was significantly increased in the effective group whose dyspepsia score decreased more than 50% of the score at baseline, compared with that of ineffective group. Any significant adverse effect and prolongation of QT interval were not occurred in all patients. CONCLUSIONS: A prokinetic drug, mosapride improves the symptoms and the quality of life in patients with functional dyspepsia.
Adult ; Aged ; Benzamides/*therapeutic use ; Dopamine Antagonists/*therapeutic use ; Dyspepsia/diagnosis/*drug therapy ; English Abstract ; Female ; Gastrointestinal Agents/*therapeutic use ; Humans ; Male ; Middle Aged ; Morpholines/*therapeutic use ; *Quality of Life ; Questionnaires

BACKGROUND/AIMS: Percutaneous endoscopic gastrostomy (PEG) has been widely used for long term enteral nutrition. The most common complication is peristomal wound infection. The aim of this study is to investigate the risk factors for peristomal wound infection after PEG. METHODS: We reviewed the records of 55 patients who had undergone PEG placement at Kangnam St. Mary's hospital via the Pull-string technique. We analyzed the underlying disease, the performance status and the nutritional state of the patients to determine the risk factors for wound infection. RESULTS: Peristomal wound infection after PEG occurred in 20 (36.4%) of the 55 patients. Methicillin resistant Staphylococcus aureus (MRSA) was the most common isolated microorganism. On univariate analysis, the underlying CNS disease, non-malignant disease and a decreased performance status (ECOG 3, 4) were correlated with wound infection. On multivariate analysis, a decreased performance status was an independent risk factor for wound infection after PEG (p=0.007, OR=6.011, CI: 1.64~22.09). CONCLUSIONS: A decreased performance status was an independent risk factor for peristomal wound infection after PEG.
Central Nervous System Diseases ; Enteral Nutrition ; Gastrostomy* ; Humans ; Methicillin Resistance ; Multivariate Analysis ; Risk Factors* ; Staphylococcus aureus ; Wound Infection* ; Wounds and Injuries*