BACKGROUND: Flecainide is an antiarrhythmic agent that is used primarily in the treatment of cardiac arrhythmias. Some evidences also suggest that flecainide can participate in alveolar fluid clearance and inflammatory responses. This experiment was aimed to evaluate the effects of flecainide on sepsis induced acute lung injury in a rat model. METHODS: Rats were treated with subcutaneous infusion of saline or flecainide (0.1 or 0.2 mg/kg/hr) by a mini-osmotic pump. Subcutaneous infusion was started 3 hours before and continued until 8 hours after intraperitoneal injection of saline or endotoxin. Animals were sacrificed for analyses of severity of acute lung injury with wet to dry (W/D) ratio and lung injury score (LIS) in lung and inflammatory responses with level of leukocyte, polymorphonuclear neutrophils (PMNs) and inteleukin-8 (IL-8) in bronchoalveolar lavages fluid (BALF). RESULTS: Flecainide markedly improved dose dependently sepsis induced acute lung injury as analysed by W/D ratio (from 2.24 ± 0.11 to 1.76 ± 0.09, p < 0.05) and LIS (from 3 to 1, p < 0.05), and inflammatory response as determined by leukocyte (from 443 ± 127 to 229 ± 95, p < 0.05), PMNs (from 41.43 ± 17.63 to 2.43 ± 2.61, p < 0.05) and IL-8 (from 95.00 ± 15.28 to 40.00 ± 10.21, p < 0.05) in BALF. CONCLUSIONS: Flecanide improve sepsis induced acute lung injury in rats by controlling inflammatory responses.
Acute Lung Injury* ; Animals ; Arrhythmias, Cardiac ; Bronchoalveolar Lavage ; Flecainide* ; Infusions, Subcutaneous ; Injections, Intraperitoneal ; Interleukin-8 ; Leukocytes ; Lung ; Lung Injury ; Models, Animal ; Neutrophils ; Rats ; Sepsis*

Purpose: To report a case of contact lens-related infectious keratitis caused by three different bacterial species.Case summary: A 40-year-old man presented with pain and redness in his left eye. His best-corrected visual acuity (BCVA) in the affected eye was 20/25. Slit-lamp examination revealed a 3 × 3 mm corneal epithelial defect with infiltration located 1 mm inferior to the pupil. Following admission, a microbial culture test was performed, and empirical antibiotic therapy was initiated. On the fourth day, Pseudomonas aeruginosa was isolated from the corneal sample and the contact lens, while Serratia marcescens and Stenotrophomonas maltophilia were isolated from the contact lens case. Based on the results of the antibiotic susceptibility tests, 0.5% moxifloxacin, fortified amikacin, and ceftazidime were administered topically and intravenously. The corneal epithelial defect reduced to 1 × 1 mm by the eleventh day of admission. After two months, BCVA improved to 20/20 with no remaining corneal epithelial defect, although an inactive corneal opacity persisted at the previous ulcer site. Conclusions Contact lens wear can be associated with polymicrobial keratitis involving three distinct Gram-negative bacteria, which may present greater treatment challenges compared to monomicrobial keratitis. Microbial culture testing of the contact lens, its case, and corneal scrapings is essential for identifying the causative organisms and selecting appropriate antibiotic therapy.

OBJECTIVE: To investigate the expression of fragile histidine triad (FHIT) protein and the possible relationship between FHIT expression and clinicopathological indices in cervical adenocarcinoma. METHODS: FHIT protein expression was examined in 40 cases of cervical adenocarcinoma stage Ia to IIa and 28 cases of corresponding normal endocervical tissue by immunohistochemical method. We analyzed the relationship between the reduction of FHIT protein expression and several prognostic factors such as histological grade, lymph node metastasis, tumor size, cervical invasion depth and parametrial invasion. We used Fisher's exact test for statistical analysis. RESULTS: The FHIT protein expression was positive in 77.5% (31/40) of cervical adenocarcinoma tissue, and reduced its expression in 22.5% (9/40) whereas positive in 100% (28/28) cases of adjacent normal endocervical gland. The FHIT expression was decreased in 14.3% (4/28) of cancers without lymph node metastasis but 55.5% (5/9) of those with metastasis (p=0.023). And the reduction of FHIT expression was found in 34.8% (8/23) of grade II and III cancers and only 6.3% (1/16) of grade I (p=0.056). CONCLUSION: Loss of FHIT protein expression may be associated with metastasis and poor prognosis of cervical adenocarcinoma.
Adenocarcinoma* ; Histidine ; Immunohistochemistry ; Lymph Nodes ; Neoplasm Metastasis ; Prognosis

BACKGROUND/AIMS: The c-met proto-oncogene encodes the tyrosine kinase receptor for hepatocyte growth factor (HGF), a potent mitogen and motogen for epithelial cells. Because of its profound effects on cell growth and motility, HGF may be important in the development of cancer metastases in hepatocellular carcinoma (HCC). We examined the expression of the c-met proto-oncogene product (c-Met) in the patients with HCCs to determine the relationship between the level of expression of c-Met and clinicopathological features, and patient outcome following hepatectomy. METHODS: Fifty patients with surgically resected hepatocellular carcinoma at Seoul National University Hospital from January 1997 to December 1998 were included in this study. Western blotting was used to examine the c-Met expression of tumor and surrounding tissues. The clinicopathologic features and treatment results of the patients were analyzed by medical records. Patients were divided into two groups, low c-met HCC and high c-met HCC. RESULTS: c-Met was not overexpressed in HCC compared to surrounding tissue. The expression of c- Met in tumor tissue was correlated with well-differentiated HCCs, and adversely correlated with tumor necrosis by transcatheter arterial chemoembolization (TACE). There was no correlation between c-Met expression and intrahepatic recurrence. CONCLUSION: In conclusion, these results indicate that c-Met expression in HCC is not correlated with intrahepatic recurrence, and tumor necrosis by TACE reduces c-Met expression in tumor tissue. More large-scaled study is needed for exact relation between c-Met expression and clinicopathologic features of HCCs.
Blotting, Western ; Carcinoma, Hepatocellular* ; Epithelial Cells ; Hepatectomy ; Hepatocyte Growth Factor ; Humans ; Medical Records ; Necrosis ; Neoplasm Metastasis ; Protein-Tyrosine Kinases ; Proto-Oncogenes ; Recurrence ; Seoul

BACKGROUND: The purpose of this study was to investigate how educational status influences cardiovascular risk factors and care of diabetes mellitus and hypertension. METHODS: From Korean National Health and Nutrition Survey IV, we obtained survey results of 6,835 men and 9,067 women more than 30 years old. We performed multivariate logistic regression to compare cardiovascular risk factors and care of hypertension and diabetes respective to educational status. RESULTS: There were disparities in cardiovascular risk factors by educational status. In men, impaired fasting glucose, high triglyceride, and smoking were less frequently found in the highest educated group than in the middle educated group. In women, the prevalence of abdominal obesity, impaired fasting glucose, high blood pressure, high triglyceride, and metabolic syndrome among the highest educated group were significantly lower. The proportion of those with proper physical activity in the highest educated group was found to be less than that of the middle educated group, regardless of gender. For care of diabetes mellitus and hypertension, disease recognition and treatment were lower among the lowest educated group in men, while these disparities were not shown in women. Instead, the lowest educated group in diabetic women received screening exams for eye and kidney complications less than the middle education group. In both genders, the high education group had a higher chance of receiving education about diabetes mellitus. CONCLUSION: There were educational disparities in cardiovascular risk factors and care of hypertension and diabetes mellitus. The disparities were found to be different by gender.
Cardiovascular Diseases ; Diabetes Mellitus ; Educational Status ; Eye ; Fasting ; Female ; Glucose ; Humans ; Hypertension ; Kidney ; Logistic Models ; Male ; Mass Screening ; Motor Activity ; Nutrition Surveys ; Obesity, Abdominal ; Prevalence ; Quality of Health Care ; Risk Factors ; Smoke ; Smoking

BACKGROUND: Korea is an endemic area of viral hepatitis B. In spite of the HBV vaccination program since 1983, the prevalence of HBV antigen had remained high, which was 3.9% in male, 2.7% in female in 1994. But there is no approved management guideline on isolated anti-HBc and the meaning of which is not clear except the evidence of past infection. Therefore, we tried to investigate the factors which influence the seroconversion of anti-HBs during follow-up period. METHODS: Medical records of 239 subject with isolated anti-HBc, who visited a health promotion center from 1995 to 1997 and who were retested at least once during the 1-3 years' follow-up period, were analyzed. RESULTS: The seroconversion rate of anti-HBs was 45.61%(109/239) on the follow-up test. The number of newly vaccinated or non-newly vaccinated subjects during the follow-up period was 156 and 72, respectively. The seroconversion rate of anti-HBs of each group were 57.69%(90/156) and 22.22% (16/72) respectively(p<0.01). The subjects without previous history of HBV vaccination was 103. Among them the seroconversion rate of anti-HBs of the newly vaccinated or the non newly vaccinated group were 59.70%(40/67) and 22.22% (8/36), respectively(p<0.01). Sex, age, BMI, smoking, previous history of HBV vaccination did not influence significantly on the seroconversion rate of anti-HBs among the subjects with isolated anti-HBc. CONCLUSIONS: The seroconversion rate in people with isolated anti-HBc was significantly higher in the newly vaccinated than the non-newly vaccinated regardless of the previous history of HBV vaccination in this study. In spite of the non-differentiation of an-amnestic response from primary antibody response, we can expect to benefit from HBV vaccination in those with isolated anti-HBc.59.70%(40/67) and 22.22% (8/36), respectively(p<0.01). Sex, age, BMI, smoking, previous history of HBV vaccination did not influence significantly on the seroconversion rate of anti-HBs among the subjects with isolated anti-HBc. CONCLUSIONS: The seroconversion rate in people with isolated anti-HBc was significantly higher in the newly vaccinated than the non-newly vaccinated regardless of the previous history of HBV vaccination in this study. In spite of the non-differentiation of an-amnestic response from primary antibody response, we can expect to benefit from HBV vaccination in those with isolated anti-HBc.
Antibody Formation ; Female ; Follow-Up Studies ; Health Promotion ; Hepatitis B ; Humans ; Korea ; Male ; Medical Records ; Prevalence ; Smoke ; Smoking ; Vaccination

A 50-year-old woman who had chronic headache was admitted to the hospital. Stent-assisted coil embolization of the aneurysm in the right vertebral artery was performed. After the procedure, the patient experienced a transient memory impairment. A microembolic lesion in the right medial temporal lobe and cerebral hemisphere was observed on diffusion-weighted imaging. We report a case of transient global amnesia caused by microembolus in the medial temporal lobe after embolization of an aneurysm.
Amnesia, Transient Global* ; Aneurysm ; Cerebrum ; Embolization, Therapeutic* ; Female ; Headache Disorders ; Humans ; Intracranial Aneurysm* ; Memory ; Middle Aged ; Temporal Lobe ; Vertebral Artery

BACKGROUND: The current various case-finding instruments for detecting depression in Korea are too cucumbersome and time-consuming for routine use in primary care or student and soldier groups because of too many questions. We carried out this study in order to investigate the validity of the two-question case-finding instrument for detecting depression easily in the primary care or the mentioned groups. METHODS: We selected one boy high school in Seoul and 155 sophomer students answered the questionnaire by self-report. The questionnaire included two questions about depressed mood and anhedonia: (1) "During the past month, have you often been bothered by feeling down, depressed or hopeless?" (2) "During the past month, have you often been bothered by little interest or pleasure in doing things(e.g., studying, playing or talking with friends) ?". And then a resident of family medicine interviewed them and made a diagnosis for depression using the diagnostic criteria of DSM-IV. Simultaneously we compared the test characteristics of a two-question case-finding instrument with those of a previously validated Beck Depression Inventory as a currently world-wide used screening instrument for depression. RESULTS: The prevalence of major depression as determined by the interview was 6.6%(10 of 151). The two-question case finding instrument had a Cronbach's alpha of 0.663-internal consistency, a sensitivity of 100%, a specificity of 54.6%, a positive likelihood ratio of 2.20 and a negative predictive value of 1.00.(A "yes" answer to either of the two questions was considered a positive test.) And the BDI had a sensitivity of 90%, a specificity of 68.1%, a positive likelihood ratio of 3.63 and a negative predictive value of 0.99(cut-off point=15). Area under the ROC curves of the two-question case-finding instrument was 0.882, greater than that of the BDI, 0.834. CONCLUSIONS: The test characteristics of a two-question case-finding instrument were higher compared to those of BDI for major depression. Therefore, the two-question case-finding instrument is a useful measure for detecting depression and less time-consuming in primary care and certain groups.
Adolescent ; Anhedonia ; Depression* ; Diagnosis ; Diagnostic and Statistical Manual of Mental Disorders ; Humans ; Korea ; Male ; Mass Screening* ; Military Personnel ; Pleasure ; Prevalence ; Primary Health Care ; ROC Curve ; Sensitivity and Specificity ; Seoul ; Surveys and Questionnaires

BACKGROUND AND AIM: Hepatitis B virus and hepatitis C virus were known as risk factors of hepatocellular carcinoma( HCC). Through past epidemiological and molecular biologic studies, the pathogenesis of HCC related with hepatitis viruses has been investigated. However the clinical features of the patients with HCC according to viral infections have not been established well. The aim of this study was to evaluate the clinical features and surgical outcomes in hepatocellular carcinoma related with hepatitis B and/or C. METHODS: We retrospectively reviewed the medical records of 411 patients who underwent the hepatic resections for hepatocellular carcinoma at Seoul National University Hospital between 1990 and 1997. We checked preoperative clinical features, preoperative laboratory tests, operative findings, postoperative pathologic reports, recurrences and survivals. According to the presence of hepatitis B surface antigen(HbsAg) and antibody of heptitis C virus(anti-HCV Ab), we divided into 4 groups: Non B C group(HbsAg(-) and anti-HCV Ab (-) n=61), B group (HBsAg (+) and anti-HCV Ab (-) n=275), C group(HBsAg (-) and anti-HCV Ab (+) n=62), B C group(HBsAg (+) and anti-HCV Ab (+) n=13). RESULTS: C group were older than B group (62.6+/-6.0 years vs. 50.5+/-9.3 years, p=0.005) and had poorer hepatic functions than B group; serum albumin level(3.52+/-0.32 g/dl vs. 3.69+/-0.40 g/dl, p=0.006), aspatate aminotransferase (108.50+/-114.36 IU/L vs. 59.63+/-60.80 IU/L, p=0.015), alanine aminotransferase (99.477+/- 7.82 IU/L vs. 65.59+/-86.39 IU/L, p=0.032), prothrombin time (83.2+/-16.4% vs. 91.3+/-14.4%, p=0.006), ICG R15 ( 18.83+/-9.02% vs. 9.19+/-7.98%, p=0.001). Pathologic results showed that C group has smaller sizes(3.5+/-2.6 cm vs. 4.6+/-3.0 cm, p<0.05), less encapsulated (68.2% vs. 80.9%, p=0.001), more multiple lesions(27.4% vs. 9.1%, p=0.001) than B group. The survival rate of B,C group was significantly lower than that of B group(5- year cumulative survival rate: 32.0% vs. 58.0%, p=0.029). Otherwise, there were no differences in recurrence rates, disease free survival rates and overall survival rates among four groups. CONCLUSION: The patients with anti-HCV Ab positive had poorer hepatic functions and older age than other patients. And the patients who had combined infections with hepatitis B and C had poorer outcome. More careful pre- and post- operative follow-up is needed in these patients.
Alanine Transaminase ; Carcinoma, Hepatocellular* ; Disease-Free Survival ; Follow-Up Studies ; Hepacivirus ; Hepatitis B virus ; Hepatitis B* ; Hepatitis C ; Hepatitis Viruses ; Hepatitis* ; Humans ; Medical Records ; Prothrombin Time ; Recurrence ; Retrospective Studies ; Risk Factors ; Seoul ; Serum Albumin ; Survival Rate

The purpose of this study was to compare the performance of different commercial quality assurance (QA) systems for the pretreatment verification plan of stereotactic body radiotherapy (SBRT) with volumetric arc therapy (VMAT) technique using a flattening-filter-free beam. The verification for 20 pretreatment cancer patients (seven lung, six spine, and seven prostate cancers) were tested using three QA systems (EBT3 film, I’mRT MatriXX array, and MapCHECK). All the SBRT-VMAT plans were optimized in the Eclipse (version 11.0.34) treatment planning system (TPS) using the Acuros XB dose calculation algorithm and were delivered to the Varian TrueBeam® accelerator equipped with a high-definition multileaf collimator. Gamma agreement evaluation was analyzed with the criteria of 2% dose difference and 2 mm distance to agreement (2%/2 mm) or 3%/3 mm. The highest passing rate (99.1% for 3%/3 mm) was observed on the MapCHECK system while the lowest passing rate was obtained on the film. The pretreatment verification results depend on the QA systems, treatment sites, and delivery beam energies. However, the delivery QA results for all QA systems based on the TPS calculation showed a good agreement of more than 90% for both the criteria. It is concluded that the three 2D QA systems have sufficient potential for pretreatment verification of the SBRT-VMAT plan.
Humans ; Lung ; Prostate ; Radiosurgery* ; Spine