Human parvovirus B19 is a single-strand DNA virus which causes erythema infectlosum, arthralgia, aplastic crisis in patients with red cell defect, chronic anemia in immunocompromised patients, and fetal hydrops in pregnant women . A 16-year-old women was referred to our hospital with pancytopenia and splenomegaly. In peripheral blood, spherocytosis and reitculocytopenia were observed. Many giant pronormoblasts with prominent inclusion bodies and deeply blue cytoplasm were observed but late erythroblasts were not observed in bone marrow smear. Osmotic fragility of patient's red cells was significantly increased. Human parvovirus Bl9 DNA was detected by polymerase chain reaction. Only with supportive therapy, pancytopenia was spontaneously resolved.
Adolescent ; Anemia ; Arthralgia ; Bone Marrow ; Cytoplasm ; DNA ; DNA Viruses ; Erythema ; Erythroblasts ; Female ; Humans* ; Hydrops Fetalis ; Immunocompromised Host ; Inclusion Bodies ; Osmotic Fragility ; Pancytopenia ; Parvovirus B19, Human ; Parvovirus* ; Polymerase Chain Reaction ; Pregnant Women ; Splenomegaly

An accurate and relatively simple method for estimating the amount of acute blood loss is essential in the hemorrhagic shock patients. Conventional physiologic parameters, blood pressure, pulse rate and CVP, could not serve for evaluation of the adequate oxygen transport in the tissue. Pulmonary artery catheter is a best tool for evaluating the cardiopulmonary function and the oxygen transport system, and mixed venous oxygen saturation(SvO2) monitoring have made a great advances for early detection of cardiovascular dysfunction and the changes in peripheral tissue oxygenation. But pulmonary artery catheterization is complicated procedure in emergency setting. Although the central venous oxygen saturation(ScvO2) cannot completely replace the SvO2 value, it has a close relation with SvO2 change in variable clinical situations. We testify the usefulness of ScvO2 monitoring in 24 patients of the hemorrhagic shock. Initial resuscitation was performed with ATLS standard and continuous ScvO2 was monitored. Systolic blood pressure and pulse rate were recorded for one hour from initial resuscitation in each 15 minutes. Nineteen patient was traumatic hemorrhagic shock and five was non traumatic. Twelve of 19 patients was blunt trauma, and remains were stab in injury mechanism. Mortality rate was 29.2%. Initial ScvO2 of nonsurvivor was 43.6%, and 51.3% in survivor groups(p>0.05). In the group of stab wound and non-traumatic hemorrhage, the ScvO2 was gradually increase by time. But ScvO2 in survivors of blunt trauma was increased first 30 minutes and decrease afterthen. Continuous monitoring of ScvO2 may by partly useful in resuscitation for hemorrhagic shock. It is more valuable in the blunt trauma than in the penetrating injury or non-traumatic hemorrhage.
Blood Pressure ; Catheterization, Swan-Ganz ; Catheters ; Emergencies ; Heart Rate ; Hemorrhage ; Humans ; Mortality ; Oxygen* ; Pulmonary Artery ; Resuscitation ; Shock, Hemorrhagic* ; Survivors ; Wounds, Stab

No abstract available.
Staphylococcus aureus* ; Staphylococcus* ; Streptomyces*

This study was designed to validate the usefulness of the near point of convergence(NPC)test in determination of dominant & non-domnant eyes in intermittent exotropia patients. We performed NPC test in 36 intermittent exotrpic patients, and then, determined the non-dominant eye which deviated outward beyond the NPC. The dominant eyes determined by the NPC were compared to those that were determined by amblyopia, sensory fusion and photophobia. Best corrected visual acuity was used to divide patients into two groups : 26 patients without amblyopia, and 10 with amblyopia. Among the amblyopia group, if the eyes with better visual acuity were taken as dominant eyes, then eight(80%)cases were identical with the NPC test and two(20%)cases were different. Ten patients had sensory anomaly, and among then, nine(90%)cases were identical with the NPC test and one(10%)case was different. Twenty six(64%)patients had photophobia in one eye and all(100%)cases were identical with the NPC test. In intermittent exotropia, determination of dominant eye by the NPC test showed high coincidence with other tests. Therefore, we suggest that the NPC test is an easy and accurate method in determining either the dominant or non-dominant eye for surgery.
Amblyopia ; Dominance, Ocular* ; Exotropia* ; Humans ; Photophobia ; Visual Acuity

No abstract available.
Free Tissue Flaps*

BACKGROUND: Disialoganglioside GD2 is a tumor-associated antigen that is overexpressed on tumor cells of neuroectodermal origin, such as melanoma, small cell lung carcinoma and neuroblastoma. Immunity against GD2 has anti-tumor activities, but GD2 is poorly immunogenic. Anti-idiotypic antibodies that mimic GD2 may induce more effective immune responses than GD2 antigen itself, because they are protein antigens and are known to be able to break immune tolerance. In our previous study, we produced anti-idiotypic antibodies mimicking GD2 (3A4 and 3H9), which induced humoral immunity. However, cellular immunity is essential to eradicate tumor cells in vivo as well as humoral immunity. In the present study, we investigated whether these anti-idiotypic antibodies 3A4 and 3H9 could induce cellular immunes responses. METHODS: BALB/C mice were immunized with anti-idiotypic antibody 3A4 or 3H9, or normal mouse IgG as a negative control. Lymphoproliferative responses, cytokine production responses, and delayed-type hypersensitivity reactions were measured in mice immunized with the anti-idiotypic antibodies. RESULTS: Both the anti-idiotypic antibody 3A4 and 3H9 induced GD2-specific lymphoproliferative responses and IFN-gamma production of lymph node lymphocytes in BALB/C mice. Only anti-idiotypic antibody 3H9 induced significant GD2-specific delayed-type hypersensitivity in the mice. CONCLUSION: These results show that anti-idiotypic antibodies 3A4 and 3H9 have the potentiality of inducing GD2-specific cellular immune responses that cannot be induced by the native antigen GD2 itself.
Animals ; Antibodies, Anti-Idiotypic* ; Hypersensitivity ; Immune Tolerance ; Immunity, Cellular* ; Immunity, Humoral ; Immunoglobulin G ; Lymph Nodes ; Lymphocytes ; Melanoma ; Mice ; Neural Plate ; Neuroblastoma ; Small Cell Lung Carcinoma

Lymphangiomas are congenital malformations that occur most commonly in the head, neck or axilla and 80-90% of lesions are detected by the age of two years. Cystic lymphangioma of the breast in a 37-year-old woman ; it showed typical well-defined tubular and nodular opacity on mammogram, a multilocular septated anechoic mass on ultrasonogram, and low and high signal intensity on T1- and T2-weighted MR images, respectively. These findings before surgery indicated cystic lymphangioma.
Adult ; Axilla ; Breast* ; Female ; Head ; Humans ; Lymphangioma ; Lymphangioma, Cystic* ; Mammography* ; Neck

BACKGROUND: Heparin salts induce negative proportional bias according to anticoagulant concentration for analysis of ionized calcium (iCa) However, D-phenylalanyl -L-prolyl- L-arginine chloromethyl ketone (PPACK), a selective thrombin inhibitor, do not bind to ionized calcium. Therefore, we evaluated PPACK as an alternative anticoagulant to lithium heparin (Li-Hep) for analysis of ira, blood gases and electrolytes. METHODS: The concentration of iCa in whole blood anticoagulated with heparin was compared with that in serum of patients admitted to Chungbuk National University Hospital (n=27). The blood gases, electrolytes and iCa according to each anticoagulant concentration (Ll-Hep or PFACK) were analyzed. The concentrations of anticoagulated whole blood (Li-Hep; 50 kIU/L, PPACK ; 75 mumol/L) were compared with those of nonanticoagulated whole blood for blood gases, electrolytes and iCa (n=17), RESULTS: The results were as follows; whole blood anticoagulated with Li-Hep demonstrated -0.28+/-0.15 mmol/L (26.6%) bias for ira compared with serum. No bias according to each anticoagulated concentrations were observed in analysis of blood gases, potassium and chloride. Negative proportional bias for iCa and sodium in serum anticoagulated with Li-HeP was observed. In comparison, no bias for ira and sodium was observed with PPACK. No bias was observed in analysis of blood gas or electrolytes with each anticoagulated whole blood except for sodium and chloride that had clinically nonsignificant bias. Whole blood anticoagulated with Li-Hep demonstrated a consistent -0.08+/-0.02 mmol/L (6.3%) bias for ira compared with nonanticoagulated whole blood. In comparison, no bias was observed with PPACK-anticoagulated whole blood for iCa. CONCLUSIONS: We concluded that PPACK is an ideal anticoagulant without bias for analysis of iCa, blood gases and electrolytes.
Arginine ; Bias (Epidemiology) ; Calcium* ; Chungcheongbuk-do ; Electrolytes* ; Gases ; Heparin* ; Humans ; Lithium ; Potassium ; Salts* ; Sodium ; Thrombin

BACKGROUND: This study was carried out in order to find an efficient and reliable method for genotyping Serratia marcescens, which frequently causes a nosocomial infection, by PCR-based methods. METHODS: The DNA fingerprinting by RAPD, ERIC and REP-PCR was performed for 24 isolates of S. marcescens obtained from 24 patients hospitalized at Chungbuk National University Hospital from March to May 2001. Reproducibility of the methods and minimum inhibitory concentration (MIC) of antibiotics against the isolates were also determined. RESULTS: The patients bearing epidemic S. marcescens were catheterized in their urinary tracts and admitted to the ICU or neurosurgical ward. All of the epidemic isolates showed the same susceptibility pattern. The epidemic isolates demonstrated resistance to all the test antibiotics except imipenem. The non-epidemic isolates showed variable susceptibility with a low MIC, except for one isolate. The DNA fingerprints by RAPD, ERIC and REP-PCR demonstrated an identical band pattern in epidemic strains but demonstrated different band patterns in non-epidemic strains. The PCR-based methods were found to be easy to manipulate, rapid in reaching conclusions, powerful in discrimination, and reproducible in results. CONCLUSIONS: RAPD, ERIC-PCR and REP-PCR are proved to be a reliable and efficient method for genotyping the epidemic S. marcescens in the laboratory.
Anti-Bacterial Agents ; Catheters ; Chungcheongbuk-do ; Cross Infection ; Discrimination (Psychology) ; DNA Fingerprinting ; Epidemics ; Humans ; Imipenem ; Microbial Sensitivity Tests ; Molecular Typing* ; Serratia marcescens* ; Urinary Tract

In adults, it is known that tetastatic tumor to the eye and its adnexa is rare compared with other sites. Orbital tumors can be classified as primary, secondary, and metastatic. Secondary orbital tumors are those that extend to the orbit from a contiguous structure. Metastatic tumors are those that spread to the orbit from more distant site in the body. and their prognosis for life is poor because of widespread systemic malignancy. We experienced a case of metastatic uterine cervical carcinoma of the orbit in a 33-year-old female patient who came to us with a history of sudden proptosis and decreased vision. Eighteen months earlier, the patient had been diagnosed with squamous cell carcinoma of the uterine cervix, and she had undergone chemotherapy, irradiation and surgical intervention. Lung and parametrium metastases were also found six months previously. We report a case of metastatic uterine cervical cancer of the orbit with a review of the literature.
Adult ; Carcinoma, Squamous Cell ; Cervix Uteri ; Drug Therapy ; Exophthalmos ; Female ; Humans ; Lung ; Neoplasm Metastasis ; Orbit* ; Prognosis ; Uterine Cervical Neoplasms