No abstract available.
Gait* ; Humans ; Spinal Cord Diseases*

BACKGROUND: Shigellosis is one of the most important contagious diseases in Korea. Especially, Jeju island has been known as the main and large outbreak area in Korea. The purpose of this study was to investigate the epidemiologic characteristics of shigellosis in Jeju island, 2003. METHODS: Patients with shigellosis, confirmed by culture in Jeju island in 2003, were included in this study. We retrospectively reviewed epidemiologic questionnaires, medical records, and official documents. We also collected data from direct interview with the patients with shigellosis. Epidemiological analysis was performed by 3 categorized events and ages. RESULTS: Ninety-nine patients were included in this study. S. sonnei was identified in all of the patients. Shigellosis mainly occurred in preschool-aged children. However, there was no statistical difference according to sex. Although there were asymptomatic cases (15.15%), the chief complaints were loose stool (69.7%) and abdominal pain (12.12%). Initial symptoms in symptomatic patients were abdominal pain (43.43%) and fever (31.31%). The median duration of isolation in the hospital was 7 days. CONCLUSION: Large and chronic epidemic outbreaks of shigellosis have occurred in Jeju island. Throughout this survey, we could show the epidemiological characteristics and the nature of shigellosis in Jeju island.
Abdominal Pain ; Child ; Disease Outbreaks ; Dysentery, Bacillary* ; Fever ; Humans ; Korea ; Medical Records ; Retrospective Studies ; Surveys and Questionnaires

BACKGROUND: Shigellosis is one of the most important contagious diseases in Korea. Especially, Jeju island has been known as the main and large outbreak area in Korea. The purpose of this study was to investigate the epidemiologic characteristics of shigellosis in Jeju island, 2003. METHODS: Patients with shigellosis, confirmed by culture in Jeju island in 2003, were included in this study. We retrospectively reviewed epidemiologic questionnaires, medical records, and official documents. We also collected data from direct interview with the patients with shigellosis. Epidemiological analysis was performed by 3 categorized events and ages. RESULTS: Ninety-nine patients were included in this study. S. sonnei was identified in all of the patients. Shigellosis mainly occurred in preschool-aged children. However, there was no statistical difference according to sex. Although there were asymptomatic cases (15.15%), the chief complaints were loose stool (69.7%) and abdominal pain (12.12%). Initial symptoms in symptomatic patients were abdominal pain (43.43%) and fever (31.31%). The median duration of isolation in the hospital was 7 days. CONCLUSION: Large and chronic epidemic outbreaks of shigellosis have occurred in Jeju island. Throughout this survey, we could show the epidemiological characteristics and the nature of shigellosis in Jeju island.
Abdominal Pain ; Child ; Disease Outbreaks ; Dysentery, Bacillary* ; Fever ; Humans ; Korea ; Medical Records ; Retrospective Studies ; Surveys and Questionnaires

No abstract available
Adenocarcinoma*

PURPOSE: The aim of this study is to determine whether the serum apolipoprotein A1(apoA1) level, as measured at different time points after hepatectomy and liver transplantation, can predict the synthesis ability of the liver and the nutritional status. We also investigated the usefulness of regions of interest(ROIs) as an indicator of the recovery status of the liver after liver transplantation. METHODS: 93 patients (21: laparoscopic cholecystectomy, 53: partial hepatectomy, 19: liver transplantation) were operated on under general anesthesia. The serum levels of apoA1, prealbumin, albumin, aspartate aminotransferase and alanine aminotransferase and the prothrombin time were measured at pre- and post-operation. The liver conditions were a normal liver (50 cases), hepatitis (16 cases) and liver cirrhosis (28 cases). The mean hepatic attenuation was calculated by averaging the ROI values that were obtained at different hepatic segments. RESULTS: The serum apoA1 level was minimally changed during the perioperative period in the laparoscopic cholecystectomy group. Yet in most cases, the serum apoA1 level after partial hepatectomy and liver transplantation was decreased on postoperative days (PODs) 1 and 7, but it nearly recovered to the preoperative level on POD 30. There were significant differences in the values of apoA1 between the normal liver and co-existent liver disease at the various time points. The ROI value after transplantation gradually increased and it reached a normal level by POD 30. CONCLUSION: The serum apoA1 level can be an indicator of liver's ability to synthesize protein and the nutritional status after partial hepatectomy. In addition, ROIs of the unenhanced CT image can reflect the recovery status of the liver after transplantation.
Alanine Transaminase ; Anesthesia, General ; Apolipoprotein A-I ; Apolipoproteins ; Aspartate Aminotransferases ; Cholecystectomy, Laparoscopic ; Hepatectomy ; Hepatitis ; Humans ; Liver ; Liver Cirrhosis ; Liver Diseases ; Liver Transplantation ; Nutritional Status ; Perioperative Period ; Prealbumin ; Prothrombin Time ; Transplants

No abstract available.
Animals ; Epidermal Growth Factor* ; Gene Expression* ; Gonadotropin-Releasing Hormone* ; Pituitary Adenylate Cyclase-Activating Polypeptide* ; Rats*

Transforming growth factor (TGF)-beta1 is a key cytokine producing extracellular matrix. We evaluated the effect of TGF-beta1 gene polymorphism at codon 10 on the development of cirrhosis in patients with chronic hepatitis B. One hundred seventy eight patients with chronic hepatitis (CH, n=57) or liver cirrhosis (LC, n=121), who had HBsAg and were over 50 yr old, were enrolled. The genotypes were determined by single strand conformation polymorphism. There were no significant differences in age and sex ratio between CH and LC groups. HBeAg positivity and detection rate of HBV DNA were higher in LC than in CH groups (P=0.055 and P=0.003, respectively). There were three types of TGF-beta1 gene polymorphism at codon 10: proline homozygous (P/P), proline/leucine heterozygous (P/L), and leucine homozygous (L/L) genotype. In CH group, the proportions of P/P, P/L, and L/L genotype were 32%, 51%, and 17%, respectively. In LC group, the proportions of those genotypes were 20%, 47%, and 33%, respectively. The L/L genotype was presented more frequently in LC than in CH groups (P=0.017). Multivariate logistic regression analysis confirms that detectable HBV DNA (odds ratio [OR]: 3.037, 95% confidence interval [CI]: 1.504-6.133, P=0.002) and L/L genotype (OR: 3.408, 95% CI: 1.279-9.085, P=0.014) are risk factors for cirrhosis.
Aged ; Asian Continental Ancestry Group/genetics ; *Carrier State ; *Codon ; Female ; Genetic Predisposition to Disease ; Genotype ; Hepatitis B virus/genetics ; *Hepatitis B, Chronic/genetics/virology ; Humans ; *Liver Cirrhosis/genetics/virology ; Male ; Middle Aged ; Odds Ratio ; *Polymorphism, Genetic ; Risk Factors ; Transforming Growth Factor beta1/*genetics

BACKGROUND AND PURPOSE: Recent randomized clinical trials (RCTs) have demonstrated benefits of endovascular recanalization therapy (ERT) contrary to earlier trials. We aimed to estimate the benefits of ERT added to standard therapy in acute ischemic stroke. METHODS: From a literature search of RCTs testing ERT, we performed a meta-analysis to estimate an overall efficacy and safety of ERT for all trials, stent-retriever trials, and RCTs comparing ERT and intravenous tissue plasminogen activator (IV-TPA). RESULTS: We identified 15 relevant RCTs including 2,899 patients. For all trials, ERT was associated with increased good outcomes (odds ratio [OR] 1.79; 95% confidence interval [CI] 1.34, 2.40; P<0.001) compared to the control. ERT also increased no or minimal disability outcomes, good neurological recovery, good activity of daily living, and recanalization. ERT did not significantly increase symptomatic intracranial hemorrhage (SICH) (OR 1.19; 95% CI 0.83, 1.69; P=0.345) or death (OR 0.87; 95% CI 0.71, 1.05; P=0.151). In contrast, ERT significantly reduced extreme disability or death (OR 0.77; 95% CI 0.61, 0.97; P=0.025). Restricting to five stent-retriever trials comparing ERT plus IV-TPA vs. IV-TPA alone, the benefit was even greater for good outcome (OR 2.39; 95% CI 1.88, 3.04; P<0.001) and extreme disability or death (OR 0.57; 95% CI 0.41, 0.78; P=0.001). Restricting to eight RCTs comparing ERT (plus IV-TPA in six trials) with IV-TPA alone showed similar efficacy and safety. CONCLUSIONS: This updated meta-analysis shows that ERT substantially improves clinical outcomes and reduces extreme disability or death without significantly increasing SICH compared to standard therapy.
Humans ; Intracranial Hemorrhages ; Stroke* ; Thrombectomy ; Tissue Plasminogen Activator

BACKGROUND: High glucose in peritoneal dialysis solution has been implicated in the pathogenesis of peritoneal fibrosis. Macrophages in peritoneal cavity seem to participate in the process of peritoneal fibrosis through the production of various cytokines and growth factors. Monocyte chemoattractant protein-1(MCP-1) plays a key role in the recruitment of monocytes toward the peritoneal cavity. Vascular cell adhesion molecule-1(VCAM-1) is assumed to be important in the transmigration of monocytes. MCP-1 and VCAM-1 can be induced by various cytokines and growth factors in human peritoneal mesothelial cells(HPMC). However, effect of high glucose on the expression of MCP-1 and VCAM-1 in HPMC has not been known well. METHODS: Cultured HPMC were conditioned with glucose(5-100mM) or mannitol for varying periods up to 7 days. Cell proliferation and mRNA expression of MCP-1 and VCAM-1 were assessed by MTT assay and Northern blot analysis respectively. MCP-1 protein was measured using ELISA. Chemotactic activity of high glucose-conditioned culture supernant were evaluated by chemotactic assay. Effect of protein tyrosine kinase(PTK) inhibitor on the high glucose-induced MCP-1 mRNA expression was examined. RESULTS: Glucose inhibited the cell proliferation in a time and dose dependent manner. Northern blot analysis showed that high glucose increased the MCP-1 mRNA expression in a time(2-7days) and dose(15-100mM) dependent manner, but not VCAM-1 mRNA expression. MCP-1 protein in cell culture supernant was also increased. Equivalent osmotic concentration of mannitol had no significant effect. High glucose-conditioned supernant had an increased chemotactic activity for monocyte, which was neutralized by specific anti-MCP-1 antibody. PTK inhibitors such as genistein and herbimycin A suppressed the high glucose-induced MCP-1 mRNA expression in a dose dependent manner. CONCLUSION: High glucose induced MCP-1 expression in HPMC partly via pathways involving PTK.
Blotting, Northern ; Cell Adhesion ; Cell Culture Techniques ; Cell Proliferation ; Cytokines ; Enzyme-Linked Immunosorbent Assay ; Genistein ; Glucose* ; Humans* ; Intercellular Signaling Peptides and Proteins ; Macrophages ; Mannitol ; Monocytes ; Peritoneal Cavity ; Peritoneal Dialysis ; Peritoneal Fibrosis ; Protein-Tyrosine Kinases ; RNA, Messenger ; Tyrosine ; Vascular Cell Adhesion Molecule-1*

BACKGROUND: We evaluated the effect of two drugs with anti-inflammatory action, dexamethasone and ketorolac, on reduction of postoperative sore throat (POST) after general anesthesia with endotracheal intubation in patients undergoing thyroidectomy. METHODS: One hundred and ninety-two female patients scheduled to undergo general anesthesia with endotracheal intubation for thyroidectomy were enrolled in this prospective study. Participants were randomly allocated to receive intravenous medication; placebo (Group C, n = 45), ketorolac 30 mg immediately before intubation (Group Kpre, n = 47), ketorolac 30 mg at the end of surgery (Group Kpost, n = 45) and dexamethasone 10 mg (Group D, n = 43). The incidence and severity of POST and hoarseness were evaluated at 1, 6 and 24 hours after surgery. RESULTS: Incidences and severities of POST at rest and during swallowing in first 6 hours after extubation were comparable among 4 groups. At 24 hours postextubation, the incidence (P = 0.002, 95% CI of proportion differences; 0.05–0.39) and severity (P = 0.008) of POST during swallowing were significantly lower in group D than in group C. Kpre and Kpost groups did not show a greater reduction in POST than group C, despite lower rescue analgesic requirement at 1 hour after extubation in group Kpre (P = 0.006; 95% CI of proportion differences; 0.07–0.38). No intergroup differences were observed in incidences of hoarseness or adverse events. CONCLUSIONS: Intravenous administration of dexamethasone 10 mg, but not ketorolac, before induction of anesthesia reduces the incidence and severity of POST during swallowing at 24 hours after thyroidectomy.
Administration, Intravenous ; Anesthesia ; Anesthesia, General ; Deglutition ; Dexamethasone* ; Female ; Hoarseness ; Humans ; Incidence* ; Intubation ; Intubation, Intratracheal ; Ketorolac* ; Pharyngitis* ; Prospective Studies* ; Thyroidectomy*