No abstract available.
Cytomegalovirus Infections* ; Cytomegalovirus*

PURPOSE: The purpose of this study is to induce the differentiation of mast cells from human umbilical cord blood. METHODS: Mononuclear cells and CD34+ cells were obtained from cord blood and were cultured in the presence of stem cell factor, IL-3 and IL-6 in liquid suspension culture for 8 weeks. Mast cell was confirmed by Wright-Giemsa staining, immuno-histochemistry for tryptase and flowcytometry. RESULTS: When mononuclear cells were cultured for 4 weeks, the percentage of CD34-, CD117+ cells increased up to 8% in the presence of SCF only and 6.6% in the presence of SCF and IL-6. After 8 weeks of culture of CD34+ cells, the percentage of CD34-, CD117+ cells was highest at an average of 14.8% when cultured with SCF only, although absolute number of CD34-, CD117+ cells was higher when cultured in the presence of SCF, IL-3 and IL-6. CONCLUSION: We developed human mast cells from umbilical cord blood. However, some other factors such as combination or concentration of cytokines should be considered to enhance the efficiency of mast cell culture. In addition, mature cultured mast cells should be evaluated by flowcytometry as well as a special staining including immunohistochemistry.
Cytokines ; Fetal Blood* ; Humans* ; Immunohistochemistry ; Interleukin-3 ; Interleukin-6 ; Mast Cells* ; Stem Cell Factor ; Tryptases ; Umbilical Cord*

PURPOSE: We prospectively determined the value of a non-enhanced spiral CT (NESCT) in the diagnosis of suspected urolithiasis by a comparison with excretory urography (EU). MATERIALS AND METHODS: After giving informed consents, 114 and 103 patients, with suspected urolithiasis, underwent either NESCT or EU, respectively. All the NESCT and EU films were assessed by 2 urologists and 1 radiologist with no knowledge of the clinical histories. The sensitivity, specificity, positive and negative predictive value, diagnostic accuracy and other valuable diagnostics in each group were compared. RESULTS: The sensitivity, specificity and accuracy of NESCT in diagnosing urinary calculi were 96.8, 95.2 and 96.5%, and for EU, were 75.3, 90.9 and 78.6%, respectively. The examinations were performed with an average of less than 5 minutes for the NESCT versus 113+/-31 minutes for the EU, and the times taken to a definitive diagnosis in the two groups were 2.4+/-0.3 and 59+/-5.2 hours, respectively. In the EU group, 24 patients (23.3%) had revisited and 11 (10.6%) were admitted for pain control, prior to the imaging evaluation, only 2 patients (1.7%) revisited, and none were admitted in the NESCT group. In our institution, the cost of a NESCT was more expensive than that of an EU (140,000 vs. 35,790 Won), however the cost-effectiveness is enhanced by the accuracy of NESCT, which lead to fewer ancillary studies. CONCLUSIONS: NESCT is accurate, reliable and safe, and has many advantages over EU, and therefore could be recommended as a first diagnostic modality for the evaluation of patients with suspected urolithiasis.
Diagnosis* ; Humans ; Prospective Studies ; Sensitivity and Specificity ; Tomography, Spiral Computed* ; Urinary Calculi ; Urography ; Urolithiasis*

BACKGROUND AND OBJECTIVES: The most common cause of thyrotoxicosis is Graves' disease (GD), while painless thyroiditis (PT) comes in second. In Korea, the treatment of choice for GD is antithyroid drugs (ATDs). Since most cases of PT spontaneously improve, an accurate diagnosis is very important for the proper management of patients presenting with thyrotoxicosis. MATERIALS AND METHODS: Ninety-nine thyrotoxic patients were routinely checked with 99m Technetium (99mTc) thyroid scan except in pregnant or lactating women. We assessed the patients' clinical characteristics, serum levels of free T4 (FT4), thyroid stimulating hormone (TSH), thyroid peroxidase antibody (TPOAb), thyroglobulin antibody (TGAb), thyrotropin-binding inhibitory immunoglobulin (TBII), and findings of 99mTc thyroid scan. RESULTS: Among the 99 thyrotoxic patients, 69 were diagnosed with GD and 30 had PT. All of the patients with GD, diagnosed by scan, improved clinically and the thyroid hormone returned to normal with ATDs. All patients with PT improved spontaneously without ATDs. TPOAb and TGAb were positive in 13 (43.3%) and 20 (66.7%) patients with PT, respectively. TPOAb and TGAb were positive in 45 (65.2%) and 44 (63.8%) patients with GD, respectively. TBII was positive in only 73.5% of GD, and was entirely negative in the PT group. Mean FT4 level in GD was higher than in PT, but some patients with PT showed the highest level of FT4. CONCLUSION: PT accounted for a very high proportion of thyrotoxicosis in this study. All parameters investigated such as age, sex, goiter size or nature, level of FT4, TPOAb or TGAb, and TBII were unable to differentiate GD from PT. Considering the increased proportion of PT in the current study, we recommend routine thyroid scan in all thyrotoxic patients except in pregnant or lactating women.
Antithyroid Agents ; Diagnosis ; Female ; Goiter ; Graves Disease ; Humans ; Immunoglobulins ; Iodide Peroxidase ; Korea ; Technetium ; Thyroglobulin ; Thyroid Gland* ; Thyroiditis* ; Thyrotoxicosis* ; Thyrotropin

PURPOSE: Acute lower respiratory tract infections (LRI) are important causes of pediatric morbidity and mortality. Recently among the common pathogens causing acute LRI in children respiratory viruses are apparently increasing rather than bacteria and mycoplasma in Korea. This study was aimed to define the distribution of age, seasonal variation and clinical manifestation of respiratory virus in children. METHODS: All 328 children in Seoul, who had hospitalized at the Pediatric ward of Hanyang University (138 children), Hallym University (61 children) and Sungkunkwan University (129 children) for the treatment of respiratory diseases were studied from March, 1997 to February, 1998. In nasopharyngeal aspirates obtained from these patients viral agents were detected by virus isolation and/or antigen detection by indirect immunofluorescent staining. But the subjects who was not found respiratory virus were excluded, although respiratory symptoms were present. RESULTS: 1) One or more agents were identified in 328 subjects. 2) The pathogens identified were Respiratory syncytial virus (RSV : 44.7%), influenza A virus (25.6 %), parainfluenza virus (14.6%), influenza B virus (14.3%), adenovirus (4.3%) and two or more viruses (3%). 3) Infections with RSV, parainfluenza virus and influenza A and B virus occured in epidemics, while adenovirus was isolated sporadically throughout the study period. 4) Clinical patterns of viral LRI were pneumonia (39%), bronchiolitis (34%), croup (18%), acute pharyngitis (7%) and asthma (2%). CONCLUSIONS: RSV was the most important in viral respiratory tract infection in children. Clinical manifestation and epidemic characterics were variable according to the agent. Accordingly, we should acknowledge the importance of respiratory virus to cause the repiratory tract diseases in children.
Adenoviridae ; Asthma ; Bacteria ; Bronchiolitis ; Child ; Croup ; Epidemiology* ; Herpesvirus 1, Cercopithecine ; Humans ; Influenza A virus ; Influenza B virus ; Influenza, Human ; Korea ; Mortality ; Mycoplasma ; Paramyxoviridae Infections ; Pharyngitis ; Pneumonia ; Respiratory Syncytial Viruses ; Respiratory System* ; Respiratory Tract Infections* ; Seasons ; Seoul*

PURPOSE: All IgG subclasses such as IgG1, IgG2, IgG3 and IgG4 can be transferred from mother to fetus through the placenta, though the amount of each IgG subclass is different from one another. Maternally acquired immunity might have an important role for the protection against the infections. We studied transplacental passage of IgG subclasses. METHODS: In this study, we observed the transplacental passage of IgG-subclasses in 22 paired samples of maternal and full- term fetal cord sera. Gestational ages varied from 37 to 42 weeks. The concentrations of IgG subclasses were analyzed by radial immunodiffusion method using commercialized Human IgG Subclass Combi kit. RESULTS: The concentrations of IgG subclasses, IgG1, IgG3 and IgG4 in cord sera exceed the maternal concentration, while IgG2 did not. The ratio of serum levels of cord to maternal were 1.330+/-0.067 for IgG1, 0.859+/-0.039 for IgG2, 1.258+/-0.058 for IgG3 and 1.159+/-0.038 for IgG4. CONCLUSION: This result suggested that the placenta may play a selective barrier for passage of IgG2.
Fetus* ; Gestational Age ; Humans ; Immunity, Maternally-Acquired ; Immunodiffusion ; Immunoglobulin G* ; Mothers ; Placenta

BACKGROUND/AIMS: The prognosis of primary hepatocellular carcinoma is extremely poor because of its large size, portal vein thrpombosis, extrahepatic metastasis and underlying liver cirrhosis. The aim, of this study is to evaluate the usefulness of ultrasound screening test for early detection of hepatocellular carcinoma in high-ridk populations. METHODS: We analysed 119 patients who were diagnosed with hepatocellular carcinoma by ultrasonography screening test in Yonsei University Severance Hospital from the period of January 1990 to December 1996. RESULT: The mean follow-up duration to the diagnosis of hepatocellular carcinoma was 30 months (range 3-75). The number of patients with single lesion was 89(75%). The mean diameter of the tumor was 3.0 cm (range 1-10) , 82 patients (70%) had masses measured less than 3cm in diameter. The Number of patients with elevated serum alphafetoprotein level above 400ng/ml was 29(25%). The median survival was 28 months in screening group, significant compared with 7 months in control group (p<0.001). CONCLUSIONS: Ultrasound follow-up in high-ridk group of hepatocellular carcinoma mede it possible to detect small tumors in a high percentage of cases. This may lead to an increase in the number of potentially curable tumors and hence an increase in the overall survival rate. So ultrasound screening test is important in the high-ridk group of hepatocellular carcinoma.
Carcinoma, Hepatocellular* ; Diagnosis ; Early Diagnosis ; Follow-Up Studies ; Humans ; Liver Cirrhosis ; Mass Screening* ; Neoplasm Metastasis ; Portal Vein ; Prognosis ; Survival Rate ; Ultrasonography*

BACKGROUND: Intravenous (IV) morphine is commonly used for postoperative pain management. Ketorolac has been proposed as a potent analgesic for treatment of moderate to severe pain. The purpose of this study was to determine the equianalgesic dose of morphine and ketorolac using intravenous patient-controlled analgesia (IV-PCA) system in human volunteers. METHODS: Fourty-five patients undergoing elective total abdominal hysterectomy were randomly assigned to receive either morphine (n=22) or ketorolac (n=23) when postoperative pain first increased to 40/100 mm (by visual analogue scale; VAS). Until postoperative pain decreased to 40/100 mm, morphine and ketorolac group received repeated IV boluses of 3 mg of morphine and 18 mg of ketorolac respectively and then followed by a IV-PCA with morphine (basal infusion 0 mg/hr, PCA dose 1 mg/1 ml, lock-out interval 5 min) and ketorolac (basal infusion 0 mg/hr, PCA dose 5 mg/1ml, lock-out interval 5 min). Analgesic efficacy with VAS (0~100 mm), PCA demand ratio and rate, analgesics consumptions, patient satisfaction and side effects were compared. RESULTS: There were no significant differences in VAS, PCA demand ratio and patient satisfaction. Mean 48-hour morphine and ketorolac consumptions were 35 (SEM=2.9) mg and 224 (SEM=16.5) mg, respectively (ratio=1:6.4). Morphine group experienced side effects such as pruritus (45%), nausea and vomiting (41%) and respiratory depression (5%). However, ketorolac group only showed side effects such as nausea and vomiting (26%). CONCLUSION: We concluded the ratio of equianalgesic dose of morphine versus ketorolac using intravenous patient-controlled analgesia (IV-PCA) after total abdominal hysterectomy was 1 versus 6.4.
Analgesia, Patient-Controlled* ; Analgesics ; Healthy Volunteers ; Humans ; Hysterectomy* ; Ketorolac* ; Morphine* ; Nausea ; Pain, Postoperative ; Passive Cutaneous Anaphylaxis ; Patient Satisfaction ; Pruritus ; Respiratory Insufficiency ; Vomiting

BACKGROUND: Intravenous (IV) morphine is commonly used for postoperative pain management. Ketorolac has been proposed as a potent analgesic for treatment of moderate to severe pain. The purpose of this study was to determine the equianalgesic dose of morphine and ketorolac using intravenous patient-controlled analgesia (IV-PCA) system in human volunteers. METHODS: Fourty-five patients undergoing elective total abdominal hysterectomy were randomly assigned to receive either morphine (n=22) or ketorolac (n=23) when postoperative pain first increased to 40/100 mm (by visual analogue scale; VAS). Until postoperative pain decreased to 40/100 mm, morphine and ketorolac group received repeated IV boluses of 3 mg of morphine and 18 mg of ketorolac respectively and then followed by a IV-PCA with morphine (basal infusion 0 mg/hr, PCA dose 1 mg/1 ml, lock-out interval 5 min) and ketorolac (basal infusion 0 mg/hr, PCA dose 5 mg/1ml, lock-out interval 5 min). Analgesic efficacy with VAS (0~100 mm), PCA demand ratio and rate, analgesics consumptions, patient satisfaction and side effects were compared. RESULTS: There were no significant differences in VAS, PCA demand ratio and patient satisfaction. Mean 48-hour morphine and ketorolac consumptions were 35 (SEM=2.9) mg and 224 (SEM=16.5) mg, respectively (ratio=1:6.4). Morphine group experienced side effects such as pruritus (45%), nausea and vomiting (41%) and respiratory depression (5%). However, ketorolac group only showed side effects such as nausea and vomiting (26%). CONCLUSION: We concluded the ratio of equianalgesic dose of morphine versus ketorolac using intravenous patient-controlled analgesia (IV-PCA) after total abdominal hysterectomy was 1 versus 6.4.
Analgesia, Patient-Controlled* ; Analgesics ; Healthy Volunteers ; Humans ; Hysterectomy* ; Ketorolac* ; Morphine* ; Nausea ; Pain, Postoperative ; Passive Cutaneous Anaphylaxis ; Patient Satisfaction ; Pruritus ; Respiratory Insufficiency ; Vomiting

PURPOSE: Foreign body aspiration in the tracheobronchial tree is a common medical emergency in children and represents an important cause of morbidity and mortality. This study was aimed to analyze the clinical spectrum of tracheobronchial foreign bodies in children and to evaluate the causes of late diagnoses. METHODS: A total of 108 patients with foreign body aspiration were recruited in the last 10 years, who had a flexible or rigid bronchoscopic examination. The age, sex, symptoms, causes of aspiration, radiologic findings, and clinical courses were investigated retrospectively. Patients were divided into 2 groups according to the elapsed time from aspiration to a definite diagnosis as early (< or =24 hours after aspiration) and late diagnoses (>24 hours after aspiration). The two groups were compared for clinical courses, radiologic findings, and the duration of admission of early- and late-diagnosed foreign body aspiration. RESULTS: Approximately 80% of the patients were less than 24 months of age and the most common symptoms were the sudden onset of a cough. Hyperinflation or obstructive emphysema (52.8%) and normal chest radiographs (19.4%) were the most frequent radiologic findings. Plain chest radiographies revealed visible foreign bodies in 7.4% of all patients with foreign body aspiration. Nuts were the most common foreign bodies aspirated. Sudden onset of a persistent cough and fever were predominant in the late-diagnosed group.(P<0.05) CONCLUSION: Our results suggest that clinical suspicion upon interviewing is enough to indicate bronchoscopy. The best way to reduce the number of accidents and deaths associated with foreign body aspiration is to promote public prevention polices.
Bronchoscopy ; Child ; Cough ; Delayed Diagnosis ; Diagnosis* ; Emergencies ; Emphysema ; Fever ; Foreign Bodies* ; Humans ; Mortality ; Nuts ; Radiography, Thoracic ; Retrospective Studies ; Thorax