OBJECTIVE: Reactive oxygen metabolites and polymorphonuclear leukocytes have been implicated in the pathophysiology of reperfusion injury. The mechanisms involved in superoxide-mediated leukocyte adherence remain unclear, however, nitric oxide(NO) may contribute to this response. The present study is undertaken to elucidate mechamisms controlling NO based mechanisms that regulated leukocyte-endothelial interactions in the cerebral vasculature after global cerebral ischemia and reperfusion. METHODS: Pial venular leukocyte adherence of anesthetized newborn piglets was quantified by in situ fluorescence videomicroscopy through closed cranial windows during basal conditions and during 2hours of reperfusion after global ischemia induced by 9minutes of asphyxia. Nitric oxide synthase(NOS) was inhibited by local window superfusion of L-nitroarginine(NA); superfusion of sodium nitroprusside(SNP) was used to donate NO. RESULTS: The mean number of adherent leukocytes to cerebral venules in the 9minutes asphyxia and 2hours reperfusion group were 161+/-19 compared with 13+/-4 in the nonasphyxial group. Superfusion of L-NA through the cranial window for 2hours resulted in leukocyte adherence similar to that observed during the initial 2hours of reperfusion after asphyxia. Leukocyte adherence was not additionally increased in asphyxic animal treated with L-NA. SNP inhibited asphyxia induced leukocyte adherence back to control levels. CONCLUSIONS: Nitric oxide inhibits leukocyte adherence to cerebral venules during the initial hours of reperfusion after asphyxia, and that NO supplementation inhibit asphyxia induced leukocyte adherence back to control levels. These results indicate that NO is an important factor in ischemia-reperfusion induced leukocyte adherence.
Animals ; Arginine ; Asphyxia ; Brain Ischemia ; Fluorescence ; Humans ; Infant, Newborn ; Ischemia* ; Leukocytes ; Microscopy, Video ; Neutrophils ; Nitric Oxide* ; Nitroprusside ; Oxygen ; Reperfusion Injury ; Reperfusion* ; Sodium ; Venules*

The authors analyzed 19 cases of unstable cervical spine injuries who had been treated by anterolateral approach with Caspar plate at the department of neurosurgery of Hangang Sacred Heart hospital during 3 years from 1989. The results were as follows: 1) The unstable cervical spine injury was most common in 3rd decade of age. Male to female ratio was 3.75:1. 2) Regarding the level of injury, C5-6 injury was most common. 3) The most common cause of injury was fall down from height(47.4%) and the next was traffic accident(36.8). 4) In all cases received anterior reconstructive surgery using Caspar plate showed significant neurologic improvement. 5) In all cases received anterior reconstructive surgery showed a good restoration of cervical spinal stability. 6) The major surgical complication was esophageal fistula and all complications were treated without any sequelae. 7) Anterior reconstructive surgery using Caspar plate is considered one of the surgical options in patient of cervical spine injury with severe instability.
Esophageal Fistula ; Female ; Heart ; Humans ; Male ; Neurosurgery ; Spine*

No abstract available.
Apoptosis* ; Female ; Hypertension, Pregnancy-Induced* ; Placenta* ; Pregnancy*

BACKGROUND: The criteria set by the International Society on Thrombosis and Hemostasis (ISTH) with the criteria of the Korean Society on Thrombosis and Hemostasis (KSTH) for the diagnosis of DIC was compared to evaluate the agreement between two criteria and the characteristics of each criteria. METHODS: Two hundred ninety-six adult patients with sepsis (57 pneumonia, 75 hepatobiliary and gastrointestinal infection, 25 urinary tract infection, 51 infection associated with malignant diseases and 84 other causes) were studied. The rate of agreement in the diagnosis of DIC by the two diagnostic systems was analyzed. Characteristics of each criteria was also analyzed by the comparison of laboratory criteria. RESULTS: The kappa coefficient and concordance rate, agreement parameters in the diagnosis of DIC by the two diagnostic systems was 0.78 and 89.5%, respectively. The median platelet count was lower and FDP level was higher in the patients diagnosed by ISTH criteria than in patients diagnosed by KSTH criteria. CONCLUSION: The agreement between ISTH and KSTH criteria was significantly high.
Adult ; Dacarbazine ; Diagnosis ; Disseminated Intravascular Coagulation* ; Hemostasis* ; Humans ; Platelet Count ; Pneumonia ; Sepsis ; Thrombosis* ; Urinary Tract Infections

PURPOSE: We aimed to assess the incidence of methicillin-resistant Staphylococcus aureus (MRSA) colonization and infection in a neonatal intensive care unit (NICU) by using various decolonization methods and to evaluate their efficacy. METHODS: Medical records of all neonates who were admitted to the NICU of Seoul National University Children's Hospital were retrospectively reviewed. Surveillance culture were obtained for all neonates in the NICU 48 hours after admission. Three periods with different decolonization methods were compared; Period 1 was without any decolonization measures (July 1, 2009 to August 26, 2010). In period 2, intranasal mupirocin and chlorhexidine gluconate bathing were administered to MRSA-colonized neonates (August 27, 2010 to September 6, 2011). In period 3, only chlorhexidine bathing was performed for MRSA-colonized infants (September 7, 2011 to August 31, 2012). RESULTS: A total of 1,378 infants were admitted to the NICU during the study period. Baseline demographic and clinical characteristics were similar among the 3 periods. The incidence of MRSA colonization per 1,000 patient-days was 6.27 for period 1, 7.02 for period 2, and 6.29 for period 3; however, these values were not significantly different. The incidence of MRSA infection was highest in period 3, with 0.69 cases per 1,000 patient-days; however, this finding was not significant. The MRSA infection/colonization ratio also did not differ significantly among the 3 study periods. CONCLUSION: Decolonization of MRSA in the NICU with the application of chlorhexidine gluconate bathing alone or in combination with intranasal mupirocin were not effective in decreasing the incidence of MRSA colonization and infection.
Baths ; Chlorhexidine ; Colon ; Humans ; Incidence ; Infant ; Infant, Newborn ; Intensive Care, Neonatal* ; Medical Records ; Methicillin Resistance* ; Methicillin* ; Methicillin-Resistant Staphylococcus aureus ; Mupirocin ; Retrospective Studies ; Seoul ; Staphylococcus aureus* ; Staphylococcus*

PURPOSE: Gastrointestinal stromal tumors (GISTs) are mesenchymal neoplasms of the gastrointestinal tract. GISTs are positive for the expression of c-Kit protein at immunohistochemistry, and their clinical presentations vary. This retrospective study was performed to evaluate the clincopathologic characteristics of GISTs and to define the prognostic factors. MATERIALS AND METHODS: 40 patients who underwent a complete resection of a GIST during the period 1996~2003 at the Department of Surgery, Korea University College of Medicine, were studied. We divided them into low- and high-risk groups by using tumor size and mitotic count: 23 cases were low risk, and 17 were high risk. Clinicopathologic features, immunohistochemical findings, and prognoses were compared between the low- and the high-risk groups. RESULTS: The mean age of the 40 patients was 61.3+/-11.1 years, and the male-to-female ratio was 1:1.1. There was no significant difference in age and sex between the groups. A comparative analysis revealed tumor size, mitotic count, clinical symptoms, preoperative pathologic diagnosis, ulceration, and necrosis to be variables that had statistically significant differences between the high- and the low-risk groups. In the univariate analysis, tumor size, mitotic count, ulceration, necrosis, and abnormal endoscopic ultrasound findings were associated with disease-free survival, but in the multivariate analysis, mitotic activity was the only independent factor associated with disease-free survival. 8 patients had recurrences during the follow-up period, and four of them were treated with STI-571 (imatinib mesylate, Gleevec(R)). The treated patients have survived until now; however, two of non-treated patients died from disease progression. CONCLUSION: Based on this study, tumor size, ulceration, and necrosis are significant factors affecting survival, and mitotic activity may be a useful prognostic marker. STI-571 may be used in an adjuvant setting because the drug has shown anticancer activity in patients with recurrence or metastasis.
Diagnosis ; Disease Progression ; Disease-Free Survival ; Follow-Up Studies ; Gastrointestinal Stromal Tumors* ; Gastrointestinal Tract ; Humans ; Immunohistochemistry ; Korea ; Mesylates ; Multivariate Analysis ; Necrosis ; Neoplasm Metastasis ; Prognosis ; Proto-Oncogene Proteins c-kit ; Recurrence ; Retrospective Studies ; Stomach* ; Ulcer ; Ultrasonography ; Imatinib Mesylate

Mucosal bridge, endoscopically observed, is a cord-like mucosal connection across the lumen. The bridge is very elastic and stretches easily, unlike granulation tissue. Mucosal bridges of the esophagus have been occasionally described in various circumstances, particularly in congenital or acquired origin as the inflammatory diseases. The occurrence of mucosal bridges due to inflammatory process may arise anywhere from the esophagus to the colon. It has been more frequently reported in the colon than in the esophagus, stomach, and duodenum. We experienced four cases of esophageal mucosal bridges and three of them were accompanied by esophageal diverticulum. We report these cases with a review of relevant literatures.
Colon ; Diverticulum ; Diverticulum, Esophageal ; Duodenum ; Esophagus* ; Granulation Tissue ; Stomach

Mucosal bridge, endoscopically observed, is a cord-like mucosal connection across the lumen. The bridge is very elastic and stretches easily, unlike granulation tissue. Mucosal bridges of the esophagus have been occasionally described in various circumstances, particularly in congenital or acquired origin as the inflammatory diseases. The occurrence of mucosal bridges due to inflammatory process may arise anywhere from the esophagus to the colon. It has been more frequently reported in the colon than in the esophagus, stomach, and duodenum. We experienced four cases of esophageal mucosal bridges and three of them were accompanied by esophageal diverticulum. We report these cases with a review of relevant literatures.
Colon ; Diverticulum ; Diverticulum, Esophageal ; Duodenum ; Esophagus* ; Granulation Tissue ; Stomach

BACKGROUND: All types of membranoproliferative glomerulonephritis (MPGN) are progressive diseases with poor prognoses. Recently, a newly proposed classification of these diseases separated them into immune complex- and complement- mediated diseases. We investigated the frequency of C3 glomerulonephritis among previously diagnosed MPGN patients. METHODS: We conducted a retrospective study of patients diagnosed with MPGN at three tertiary care institutions between 2001 and 2010. We investigated the incidence of complement-mediated disease among patients diagnosed with MPGN. Progressive renal dysfunction was defined as a 50% reduction in the glomerular filtration rate or the need for renal replacement therapy. RESULTS: Among the 3,294 renal biopsy patients, 77 (2.3%) were diagnosed with MPGN; 31 cases were excluded, of which seven were diagnosed with systemic lupus nephritis, and the others were not followed for a minimum of 12 months after biopsy. Based on the new classification, complement-mediated MPGN was diagnosed in two patients (4.3%); only one patient developed progressive renal dysfunction. Among the immune complex-mediated MPGN patients, 17 patients developed progressive renal dysfunction. Serum albumin and creatinine levels at the time of MPGN diagnosis were risk factors of renal deterioration, after adjusting for low C3 levels and nephrotic syndrome. CONCLUSION: Complement-mediated glomerulonephritis was present in 4.3% of patients previously diagnosed with MPGN.
Biopsy ; Classification* ; Complement C3 ; Creatinine ; Diagnosis ; Glomerular Filtration Rate ; Glomerulonephritis ; Glomerulonephritis, Membranoproliferative* ; Glomerulonephritis, Membranous ; Humans ; Incidence ; Lupus Nephritis ; Nephrotic Syndrome ; Prognosis ; Renal Replacement Therapy ; Retrospective Studies ; Risk Factors ; Serum Albumin ; Tertiary Healthcare

Becker's nevus is a relatively common acquired focal epidermal melanotic hypermelanosis usually found in the region of the shoulder girdle of young men. Various skeletal malformations and cutaneous dermatoses have been reported in Becker's nevus. Osteoma cutis is a rare disorder characterized by compact bone formation in the dermis or subcutaneous tissue. Secondary ossification on nevi has been reported, but not with Becker's nevus. Herein, we report a case of Becker's nevus with accompanying osteoma cutis in an 18-year-old female.
Adolescent ; Bone Diseases, Metabolic ; Bone Neoplasms ; Dermis ; Female ; Humans ; Hyperpigmentation ; Male ; Nevus ; Ossification, Heterotopic ; Osteogenesis ; Osteoma ; Shoulder ; Skin Diseases ; Skin Diseases, Genetic ; Subcutaneous Tissue