Hypoxia is one of the major causes of neonatal mortality. Hypoxia-induced tissue injuries are resulted from complex mechanisms such as DNA damage and apoptosis. In this study, we aimed to elucidate the changes in the expression of DNA repairing enzymes such as 8-hydroxyguanine glycosylase 1 (OGG1) and apurinic/apyrimidinic endonuclease 1 (APE1) and brain derived neurotrophic factor (BDNF) in the fetal cerebral tissue after intrauterine hypoxic injury. For this study, pregnant Sprague-Dawley rats were exposed to hypoxic gas (10% O2, 5% CO2, 85% N2) for 2 or 4 hours at postconception day 14.5 and 15.5. After 24 hours, the animals were anesthetized with ethyl ether and fetuses were obtained by laparatomy. Hematoxylin-eosin stain, immunohistochemical stain, and western blot were employed for analysis. The caspase-3 immunolabeled cells were significantly increased within the cerebral cortex after hypoxic injury. The expressions of OGG1, APE1, and BDNF were also increased in the cerebral tissue after hypoxic injury at post-conception day 14.5, in a dose-dependent manner. However, the expression of BDNF was significantly decreased in the cortical tissue exposed to hypoxic injury at postconception day 15.5. These results demonstrate that fetal hypoxic injury induces apoptosis of the nerve cells and promotes the expressions of the DNA repairing enzymes and neurotrophic factors. In addition, these results suggest that protection mechanisms against hypoxic injury alter along the progression of the fetal development.
Animals ; Anoxia ; Apoptosis ; Blotting, Western ; Brain-Derived Neurotrophic Factor ; Caspase 3 ; Cerebral Cortex ; DNA ; DNA Damage ; DNA Repair ; Ether, Ethyl ; Fetal Development ; Fetus ; Guanine ; Humans ; Infant ; Infant Mortality ; Nerve Growth Factors ; Neurons ; Rats ; Rats, Sprague-Dawley

BACKGROUND: Allogeneic or autologous bone marrow transplantation (BMT) or peripheral blood stem cell transplantation (PBSCT) has been settled a modality of treatment in hematologic malignantdisorders or solid tumors. Because engraftment or not was important for the direction of treatment and prognosis of the patients, various methods, judging it early were groped. Instead of an absoluteneutrophil count (ANC) or platelet count in PB, we used reticulocyte parameters as early predictors of hematopoietic engraftment. METHODS: We measured the ANC with reticulocyte parameters daily in 25 patients receiving allogeneic BMT or PBSCT (n=17, 30.82+/-9.97 years old) and autologous PBSCT (n=8, 30.63+/-8.55 years old) from January 2002 to February 2003 in Kyungpook National University Hospital. Wedefined erythroid engraftment as the first day of a mean corpuscular volume of reticulocyte (MCVr)>or=105 fL and immature reticulocyte fraction (IRF) >or=10% in the second rising peak and myeloid engraftment as the first day of ANC >or=500/microL. RESULTS: The erythroid engraftment occurred after a mean time of 16.24+/-4.16 days in allogeneic graft and 14.00+/-3.55 days in autologous graft and the myeloid engraftment occurred 17.94+/-3.23 days and 15.00+/-2.78 days, respectively. In the allogeneic graft, the erythroid engraftment occurred earlier than the myeloid engraftment (P=0.03). In the autologous graft, the erythroid engraftment preceded the myeloid engraftment; however, it was not statistically significant (P=0.47). Among 3 cases, wherein the erythroid engraftment occurred later than the myeloid engraftment in allogeneic graft, 2cases were ABO-incompatible PBSCT. CONCLUSIONS: Considering that the successive increase of immature reticulocytes preceded that of ANC in most cases, we concluded that as an early indicator of hematopoietic engraftment, reticulocyte parameters such as IRF and MCVr were useful especially observing them simultaneously.
Bone Marrow Transplantation ; Erythrocyte Indices ; Gyeongsangbuk-do ; Humans ; Peripheral Blood Stem Cell Transplantation ; Platelet Count ; Prognosis ; Reticulocytes* ; Stem Cell Transplantation* ; Transplants

BACKGROUND: There is a recent trend of increased use of the gel test for the detection of unexpected antibodies (Abs) because of its simplicity and ease with which definitive interpretation can be made. However, because of the low insurance payments in Korea, only the LISS/Coombs card is used and thus the detection rate of the cold Abs has decreased. We have studied the detection rates of the Abs in patients by using the LISS/Coombs gel test and thus evaluated the clinical usefulness of the LISS/Coombs gel test. METHODS: Abs screening tests have been carried out using the DiaMed(TM) LISS/Coombs gel card test (Murten, Switzerland) on 14,942 patients for whom blood transfusions were ordered between July 1, 1997 and March 31, 2001. When the test for Abs was positive, Ab identification tests were further carried out with the DiaMed(TM) LISS/Coombs gel card and the ID-DiaPanel 1-11. RESULTS: Eighty-one out of 14,942 patients (0.54%) revealed positive results. Of these, 15 showed anti-E, 5 showed anti-E+c, 4 showed anti-C, 3 showed anti-D, 2 showed anti-Jk(a), 1 each showed anti-c, anti-M, anti-Lu(a), and anti-K Abs. CONCLUSIONS: Although the detection rate for the cold Abs of the LISS/Coombs gel test was low, it is considered to be highly useful because of the high detection rate for the clinically important warm Abs, the simplicity in carrying out the test, and the easy readability of test results.
Antibodies ; Blood Transfusion ; Comprehension ; Humans ; Insurance ; Korea ; Mass Screening

Plasma carotenoid levels were compared among 64 healthy male subjects (control) and 38 patients of ischemic heart disease(IHD) and 20 ones of cerebral infarction(CI) all of whom were over 50years of age. Another 98 healthy male subjects aged 23 to 58 were selected to compare their plasma carotenoid levels by age groups, Levels of lutein, zeaxanthin and crpytoxanthin were lower in IHD(34+/-2, 13+/-1 and 62+/-7 microgram/dl)and CI(36+/-3, 12+/-2 and 41+/-6 microgram/dl)patient groups than in control group (84+/-5, 16+/-2 and 69+/-3 microgram/dl) while those of lycopene, alpha-and beta-carotene varied little among the three groups. The sum of the six carotenoid levels were levels were, therefore,highest(205+/-14 microgram/dl) in the control group followed by IHD(155+/-15 microgram/dl) and CI(128+/-17 microgram/dl) patient groups, Among the 98 healthy male subject for the age group study, levels of the three major carotenoids increased with age from the twenties to the fifities ; lutein, from 64+/-6 to 89+/-8 microgram/dl, cryptoxanthin, 57+/-8 to 73+/-4 microgram/dl and beta-carotene were more significantly correlated(r=0.30 to 0.61, p<0.01), whereas levels of lycopene and alpha-caroteme were significantly(r=0.21 - 0.23, p<0.05) correlated.
beta Carotene ; Cardiovascular Diseases* ; Carotenoids ; Cerebral Infarction ; Daegu* ; Heart ; Humans ; Lutein ; Male ; Myocardial Ischemia ; Plasma*

OBJECTIVES: Cognitive behavioral therapy of schizophrenia has been developed as a psychological therapy for drug resistant patients with schizophrenia. However, there are some controversial issues regarding the size and mode of the therapeutic effect. The aim of this study is to compare the effect of cognitive behavioral therapy with supportive therapy after treatment. METHODS: Patients with drug resistant schizophrenia were randomly allocated, and stratified according to two mental health institutes to two different therapy groups. We used four assessment scales to evaluate residual symptoms of patients in detail. Patients were assessed twice by a blind rater, at baseline and after treatment. RESULTS: No significant differences in the change of PANSS (Positive and Negative Syndrome Scale) scores were observed between the cognitive behavioral therapy and supportive therapy groups at one month after treatment. There was no significant difference in change of K-PSYRATS (Korean-Psychotic Symptom Rating Scale)-Delusion score, however, a trend toward significance in K-PSYRATS - Hallucination was observed between the two groups. In the aspect of insight, a significant difference in the change of SDMD-K (The Scale to assessment Unawareness of Mental Disorder-Korean version) score was observed between the two groups after treatment. CONCLUSION: Despite remarkable development of pharmacotherapy for schizophrenia, many patients still suffer from residual symptoms. Findings of this study showed that cognitive behavioral therapy can improve the insight of patients and reduce the severity of residual positive symptoms, especially hallucination. Cognitive behavioral therapy should be practiced effectively in the psychiatric clinic and community mental health system.
Academies and Institutes ; Cognitive Therapy ; Hallucinations ; Humans ; Mental Health ; Schizophrenia ; Weights and Measures

PURPOSE: The purpose of this study was to analyze the diagnostic availability and to examine the co-relation between pedobaragraphy and radiography of pediatric flexible flatfoot. MATERIALS AND METHODS: Seventeen patients and ten normal children were studied. In radiographic evaluation, the talo-1st metatarsal angle was measured on anteroposterior radiographs; and the talo-1st metatarsal angle, the talo-horizontal angle, the calcaneal pitch, and the talocalcaneal angle were measured on lateral radiographs. In pedobarography, foot pressures were subdivided into eight areas for measurement of contact time, ratio of measured area and to investigate the relation between the degree of the medial deviation of the Center of pressure line and the radiographic measurements. RESULTS: Flat foot group and normal group showed statistically significant difference in every angle measured in lateral radiographs. The foot pressure ratios of the lateral sides in forefoot and the medial and lateral sides of midfoot and the medial side of hindfoot between the flexible flatfoot group and normal group showed statistically significant difference in pedobarography and ratio of contact area in forefoot and hindfoot showed significant change in statistics but no changes in contact time. The relation between pedobarography and radiography was investigated: foot pressure of the medial and lateral side of forefoot and the talocalcaneal angle showed significant relation in statistics and foot pressure of the medial and lateral side of mid foot and every angle measured in lateral radiographs showed significant relation in statistics. Contact time of midfoot and every radiographic value measured in lateral radiograph showed significant relation in statistics and contact area of forefoot and midfoot showed significant relation with every radiographic value measured in lateral radiographs. In addition, medial deviation of center of pressure line showed significant relation in statistics with talus-first metatarsal angle measured on anteroposterior radiographs and talo-horizontal angle and talus-first metatarsal angle measured on lateral radiographs. CONCLUSION: The results of this study showed correlation between radiologic methods and pedobarography in diagnosis of pediatric flexible flatfoot and pedobarography is an useful tool in quantitative and qualitative analysis of the degree of foot deformity and medial deviation of center of pressure line.
Child ; Diagnosis ; Flatfoot* ; Foot ; Foot Deformities ; Humans ; Metatarsal Bones ; Radiography

BACKGROUND: In recent years, knowledge of bacterial resistance to antimicobials has expanded in important ways. Availability of an increasing number of antibiotics allows more precise individualization of resistance phenotypes and recording susceptibility results as patterns or phenotypes is valuable for both surveillance and patient care. If the patterns of resistance to panels of related antimicrobials are considered the underlying mechanisms can often be inferred. And the inferred mechanisms make the clinician to be advised to use alternative treatment. Interpretation of resistance phenotypes is based on the comparison of clinical isolates with prototype susceptible bacteria belonging to the same species. But interpretative reading of antimicrobial susceptibility tests requires an immense knowledge of antibiotics. Such interpretative reading is best achieved by computerized expert systems. METHODS: The authors attempt to determine phenotypes for the clinically isolated strains for each class of drugs tested by the Vitek 2 systemTM(bioMerieux, Marcy I'Etoile, France) using the Advanced Expert SystemTM(AES, bioMerieux, Marcy I'Etoile, France). A total of 91, 107, 89, 65, 251, 113, 47, 33, 23, 122 and 110 isolates of Staphylococcus aureus, coagulase negative staphylococci, Enterococcus faecalis, Enterococcus facium, Escherichia coli, Klebsiella pneumoniae, Serratia marcescens, Enterobacter cloacae, Enterobacter aerogenes, Pseudomonas aeruginosae and Acinetobacter baumannii, were examined respectively. RESULTS: Biological correction based on the phenotype was recommended from 2.2% of E. faecalis to 46.8% of S. marcescens and therapeutic correction, from 7.3% of A. baumannii to 60.9% of E. aerogenes. A total of 25, 26, 18, 19, 22, 22, 15, 15, 17, 19, 19 phenotypes of S. aureus, coagulase negative staphylococci, E. faecalis, E. facium, E. coli, K. pneumoniae, S. marcescens, E. cloacae, E. aerogenes, P. aeruginosa and A. baumannii, were detected respectively. Association of resistance mechanism from S. aureus, coagulase negative staphylococci, E. coli, K. pneumoniae, S. marcescens, show 10, 11, 6, 4 and 3 pairs from resistant phenotypes, respectively. CONCLUSION: Vitek AES potentially provides a tool to assist the development of antimicrobial susceptibility interpretation in the clinical microbiology laboratory. The inferred mechanisms make the clinician to be advised to use alternative treatment.
Acinetobacter baumannii ; Anti-Bacterial Agents ; Bacteria ; Cloaca ; Coagulase ; Enterobacter aerogenes ; Enterobacter cloacae ; Enterococcus ; Enterococcus faecalis ; Escherichia coli ; Expert Systems ; Klebsiella pneumoniae ; Patient Care ; Phenotype* ; Pneumonia ; Pseudomonas aeruginosa ; Serratia marcescens ; Staphylococcus aureus

BACKGROUND: It is known that pain after a laparoscopic cholecystectomy is less compared with an open cholecystectomy. There are various methods of pain relief used but a controversy exists over the effectiveness and value of intraperitoneal local anesthetics. The aim of this study was to investigate which components of pain were more predominant for pain after a laparoscopic cholecystectomy, somatic pain or visceral pain. METHODS: Twenty-four patients who received an elective laparoscopic cholecystectomy were selected. General anesthesia was induced with thiopental sodium and succinylcholine, and maintained with vecuronium and isoflurane. After surgery, the degree of postoperative somatic pain (superficial, sharp and definite in the abdominal wall) and visceral pain (dull, vague and/or colicky in the peritoneal cavity) was assessed at postoperative 1, 3, 6, 9, 24 and 36-hour by a 10 cm-visual analogue scale (VAS) scores and other complaints were recorded. RESULTS: VAS scores of somatic pain were significantly higher than those of visceral pain at all the recorded times. CONCLUSIONS: Somatic pain was predominant after a laparoscopic cholecystectomy compared with visceral pain and it should be helpful to treat pain after a laparoscopic cholecystectomy.
Anesthesia, General ; Anesthetics, Local ; Cholecystectomy ; Cholecystectomy, Laparoscopic* ; Humans ; Isoflurane ; Nociceptive Pain* ; Succinylcholine ; Thiopental ; Vecuronium Bromide ; Visceral Pain*

BACKGROUND: Urinary retention after anorectal surgery is thought to be a mild complication but has a high incidence. Since anal pain and distention can contribute to the urethral spasm reflex which may cause urinary retention, we investigated the effect of absorbable gelatin sponge (Gelfoam(R)) used for anal packing postoperatively on urinary retention after hemorrhoidectomy under spinal anesthesia. METHODS: One hundred and nineteen ASA Physical Status I patients scheduled for hemorrhoidectomy were selected. Patients were randomly divided into Group A, postoperative anal packing free group and Group B, postoperative anal packing group and studied prospectively. Spinal anesthesia was performed with the bevel of 25 gauge Quincke needle parallel to dura fibers at lumber 3 4 intervertebral space and the injection of hyperbaric 0.5% tetracaine 6 mg (1.2 ml) to patients in sitting position. After hemorrhoidectomy, all patients were permitted to ambulate as soon as possible and urinate spontaneously. If urinary retention occurred, urinary catheterization was done temporarily. The number of patients who received urinary catheterization were recorded. Surgical technique and the total amount of intravenous fluid during the operation were controlled. RESULTS: The incidence of urinary retention in Group A (11/57, 19.3%) was similar to that in Group B (10/62, 16.1%) (P = 0.651, chi 2 = 0.205, degree of freedom = 1). CONCLUSIONS: Our study did not indicate the clue that the absence of anal packing helped to reduce the incidence of urinary retention after hemorrhoidectomy under spinal anesthesia.
Anesthesia, Spinal* ; Freedom ; Gelatin Sponge, Absorbable ; Hemorrhoidectomy* ; Humans ; Incidence ; Needles ; Prospective Studies ; Reflex ; Spasm ; Tetracaine ; Urinary Catheterization ; Urinary Catheters ; Urinary Retention*

BACKGROUND: There is growing evidence linking infection with Chlamydophila pneumoniae with vascular diseases, such as atherosclerosis and myocardial infarction. However, the data remain inconclusive and the clinical importance of C. pneumoniae as vasculopathic is unclear. So, we intend to detect C. pneumoniae in acute myocardial infarction patients by microimmunofluorescence (mIF) and polymerase chain reaction (PCR). METHODS: Blood and peripheral mononuclear cells (PMNCs) of 24 myocardial infarction patients and 100 normal controls were collected. Serum were used in mIF and PMNCs in PCR. PMNC sample were tested for C. pneumoniae by 'touchdown 'nested PCR. The first round PCR amplified DNA from both C. pneumoniae and Chlamydophila psittaci, while the second round specially targeted C. pneumoniae allowing the two species to be differentiated. RESULTS: Seropositivity of IgG and IgM anti-Chlamydophila pneumoniae antibody titers were 95.8% and 25% in myocardial infarction patients and 61% and 16% in control group, respectively. Positive rates of PCR of PMNCs were 8.3% in the patients and 15% in control group. CONCLUSION: The results of mIF show that mIF positive rate in myocardial infarction was much higher than control group. So an association between C. pneumoniae and myocardial infarction can be concluded. But the opposite results of PCR of PMNCs needed further studies.
Atherosclerosis ; Chlamydial Pneumonia* ; Chlamydophila pneumoniae* ; Chlamydophila psittaci ; Chlamydophila* ; DNA ; Humans ; Immunoglobulin G ; Immunoglobulin M ; Myocardial Infarction* ; Pneumonia ; Polymerase Chain Reaction ; Vascular Diseases