No abstract available.
Humans

No abstract available.

Discoid meniscus is a congenital morphological variable anomaly of meniscus which is often asymptomatic. Arthroscopic surgeries on 91 symptomatic lateral discoid menisci of 84 patients were performed at the Department of Orthopedic Surgery, Seoul National University Hospital during the period of Jan. 1987 to Jan. 1994, which equals 19.2% of arthroscopic meniscectomies performed. Follow up was done from minimum of 1 year to maximum of 8 years, with an average period of 3 years and 10 months. Retrospective study was done with the review of clinical records, roentgenograms, MRI, and arthroscopic findings on recorded videotapes to evaluate the clinical and radiological features, results of arthroscopic treatment and possible prognostic factors. The followings are the results: 1. The lateral discoid meniscus encompassed 19.2% of arthroscopic meniscectomies performed at the same period, which was relatively high incidence. Arthroscopic partial and subtotal menis- cectomy resulted in satisfactory results. 2. Since 8 (11%) knees were not diagnosed preoperatively as discoid meniscus due to type being incomplete or torn meniscus displacement, these points should be considered with clinical findings at diagnosis of discoid meniscus. 3. 34.9% of 83 menisci with tear had previous trauma history which showed high vulnerability to tear. Discoid menisci without tears but with grade II intrasubstance increased signal and symptoms were treated with arthroscopic meniscectomy and showed good results. Therefore discoid menisci without tears should be considered of arthroscopic meniscectomy in the presence of clinical symptoms and MRI findings. 4. Lysholm total and pain scores were significantly improved at postop. 1 year and at the final follow up with p<0.05. Factors such as degenerative changes, sex, age, duration of preoperative symptoms, presence of tears and types of meniscectomy gave no significant influence on the results and the prognosis.
Arthroscopy ; Diagnosis ; Follow-Up Studies ; Humans ; Incidence ; Knee* ; Magnetic Resonance Imaging ; Orthopedics ; Prognosis ; Retrospective Studies ; Seoul ; Videotape Recording

No abstract available.
Blood Transfusion* ; Humans ; Infant*

BACKGROUND AND OBJECTIVES: Recent studies have shown that many kinds of K+ channels, including the muscarinic K+ channel (KACh), are activated in the ischemic heart. It is known that these channels can be modulated by phosphorylation. However, little is known about the function of the KACh in ischemic hearts. In this study, we examined whether the KACh channel is mediated by protein kinase C (PKC) activation in rat atrial myocytes under ischemic conditions. MATERIALS AND METHODS: Single atrial cells of adult rat heart were prepared by collagenase digestion. Channel activity of KACh was recorded by cell-attached configuration from single atrial cells under ischemic conditions, using a patch clamp technique. To simulate ischemia, adenosine or potassium cyanide (KCN) was applied to atrial myocytes, and Western blot was performed to specify PKC isoforms. RESULTS: Adenosine and KCN markedly increased KACh channel activity. The responses to adenosine and KCN were increased 3-fold at mean open time from that observed with control. Channel activity of KACh was blocked by pretreatment with PKC antagonists such as sphingosine, Go 6976, and rottlerin. PKC alpha and PKC betaI isoform levels were increased in the membrane fraction of ischemic heart, indicating that ischemic stress might trigger translocation of cytosolic PKC to the cell membrane. CONCLUSION: These results show that KACh channels are modulated by PKC activation under ischemic conditions induced by adenosine or KCN. Therefore, the channels can protect the heart from ischemic stress by increasing channel activity.
Adenosine ; Adult ; Animals ; Blotting, Western ; Cell Membrane ; Collagenases ; Cytosol ; Digestion ; Heart ; Humans ; Ischemia ; Membranes ; Muscle Cells* ; Phosphorylation ; Potassium Cyanide ; Protein Isoforms ; Protein Kinase C* ; Protein Kinases* ; Rats* ; Sphingosine

Prostate cancer commonly manifests with bony metastases. Visceral metastasis can also occur in the lungs and liver. However, stomach metastasis related to prostate cancer is rare. Here, we report a case of prostate cancer metastatic to the stomach. A 66-year-old male was diagnosed with prostate adenocarcinoma. He was noted as having abdominal discomfort, nausea, and vomiting 18 months after the diagnosis. A histopathologic examination and an esophagogastroduodenoscopic gastric biopsy revealed stomach-metastatic adenocarcinoma. He was also noted as having cerebellar metastatic lesions, which were identified by using a brain magnetic resonance imaging (MRI) scan. The patient died of cardiovascular complications 5 months after the diagnosis of stomach metastasis.
Adenocarcinoma ; Aged ; Biopsy ; Brain ; Humans ; Liver ; Lung ; Magnetic Resonance Imaging ; Male ; Nausea ; Neoplasm Metastasis ; Prostate ; Prostatic Neoplasms ; Stomach ; Vomiting

Emerging resistance to trimethoprim/sulfamethoxazole (SXT) poses a serious threat to the treatment of Stenotrophomonas maltophilia infections. We determined the prevalence and molecular characteristics of acquired SXT resistance in recent clinical S. maltophilia isolates obtained from Korea. A total of 252 clinical isolates of S. maltophilia were collected from 10 university hospitals in Korea between 2009 and 2010. Antimicrobial susceptibility was determined by using the CLSI agar dilution method. The sul1, sul2, and sul3 genes, integrons, insertion sequence common region (ISCR) elements, and dfrA genes were detected using PCR. The presence of the sul1 gene and integrons was confirmed through sequence analysis. Among the 32 SXT-resistant isolates, sul1 was detected in 23 isolates (72%), all of which demonstrated high-level resistance (> or =64 mg/L) to SXT. The sul1 gene (varying in size and structure) was linked to class 1 integrons in 15 of the 23 isolates (65%) harboring this gene. None of the SXT-susceptible isolates or the SXT-resistant isolates with a minimum inhibitory concentration of 4 and 8 mg/L were positive for sul1. Moreover, the sul2, sul3, and dfrA genes or the ISCR elements were not detected. The sul1 gene may play an important role in the high-level SXT resistance observed in S. maltophilia.
Anti-Bacterial Agents/pharmacology ; Bacterial Proteins/*genetics ; Drug Resistance, Bacterial/genetics ; Gram-Negative Bacterial Infections/microbiology/pathology ; Humans ; Integrons/*genetics ; Microbial Sensitivity Tests ; Stenotrophomonas maltophilia/*drug effects/genetics/isolation & purification ; Trimethoprim, Sulfamethoxazole Drug Combination/*pharmacology

The Iinvolvement of subaortic structures in the aortic valve endocarditis appears more commonly than previously recognized. These subaortic complications are most commonly located in the mitral-aortic intervalvular fibrosa and may be presented as abscess, or as pseudoaneurysm with or without perforation. Perforated pseudoaneurysm can lead to the development of communication between the left ventricular outflow tract and various cardiac chambers, most commonly the left atrium. These complications are related with poor prognosis. Early and precise recognition of these complications is important for optimal treatment. At present, transesophageal echocardiography (TEE) has been validated as the technique of choice. We describe a case of infectious pseudoaneurysm of mitral-aortic intervalvular fibrosa featuring the connection of the fistulous simultaneously to the left atrium and aorta. In our case, accurate interpretation of TEE imaging revealing the subaortic structures was not so easy due to interference of both aortic and mitral prosthetic valves. We expect the further development of (Ed-confirming that here you don't intend, "We expect to further develop") TEE and other imaging modalities to substantially improve the future diagnosis of these undesirable complications.
Abscess ; Aneurysm, False* ; Aorta ; Aortic Valve* ; Diagnosis ; Echocardiography, Transesophageal ; Endocarditis* ; Fistula* ; Heart Atria ; Prognosis

BACKGROUND: Plasmid-mediated AmpC beta-lactamases (PABLs) have been detected in the strains of Escherichia coli, Klebsiella spp., Proteus mirabilis, and Salmonella spp. PABLs may be difficult to detect and might interfere in the therapeutic and infection-control processes. Although several PABL-detection methods based on phenotypes have been reported, the Clinical and Laboratory Standards Institute currently does not recommend a routine detection method for PABLs. The aim of this study is to compare the performances of 3 phenotypic PABL detection methods. METHODS: Total 276 non-duplicated clinical isolates of E. coli (N=97), K. pneumoniae (N=136), and P. mirabilis (N=43) were collected from 14 hospitals in Korea between April and June 2007 in a non-consecutive and non-random manner. Multiplex PCR was performed to detect the PABL genes. Further, 3 phenotypic detection methods-cephamycin-Hodge test, Tris-EDTA (TE) disk test, and combination-disk test with 3-aminophenylboronic acid (BA)-were performed using cefoxitin and cefotetan disks. RESULTS: PABL genes were detected by multiplex PCR in 122/276 isolates, including 14/97 E. coli, 105/136 K. pneumoniae, and 3/43 P. mirabilis isolates. The combination-disk test with BA showed higher sensitivity (98.4%), specificity (92.2%), and efficiency (96.3%) than the cephamycin-Hodge (76.2%, 96.1%, and 88.6%, respectively) and the TE-disk (80.3%, 91.6%, and 87.9%, respectively) tests. CONCLUSIONS: The combination-disk test with BA is a simple, efficient, and interpretable test that can be applicable in clinical laboratories involved in the detection of PABLs in clinical isolates of E. coli, K. pneumoniae, and P. mirabilis.
Anti-Bacterial Agents/pharmacology ; Bacterial Proteins/*analysis ; Cefotetan/pharmacology ; Cefoxitin/pharmacology ; Disk Diffusion Antimicrobial Tests/*methods ; Escherichia coli/genetics/*isolation & purification ; Humans ; Klebsiella pneumoniae/genetics/*isolation & purification ; Phenotype ; Plasmids ; Proteus mirabilis/genetics/*isolation & purification ; Sensitivity and Specificity ; beta-Lactamases/*analysis

BACKGROUND: In general, higher resistance rates are observed among intensive care unit (ICU) isolates than non-ICU isolates. In this study, resistance rates of isolates from ICUs and non-ICUs were compared using the data generated from 20 hospitals in Korea. METHODS: Susceptibility data were collected from 20 hospitals participating in the Korean Nationwide Surveillance of Antimicrobial Resistance (KONSAR) program. Duplicate isolates were excluded from the analysis. The resistance rates did not include intermediate susceptibility. RESULTS: The most prevalent bacteria in the ICUs were Staphylococcus aureus (21%) and Acinetobacter spp. (19%), and those in non-ICU were Escherichia coli (27%) and S. aureus (14%). The resistance rates were higher in ICUs than in non-ICUs at 84% and 58% for methicillin-resistant S. aureus, 86% and 70% for methicillin-resistant coagulase-negative Staphylcoccus (CNS), 34% and 19% for vancomycin-resistant Enterococcus faecium, 38% and 19% for cefotaxime-resistant E. coli, 45% and 25% for cefotaxime-resistant Klebsiella pneumoniae, 42% and 24% for ceftazidime-resistant Enterobacter cloacae, 29% and 11% for ceftazidime-resistant Serattia marcescens, 83% and 44% for imipenem-resistant Acinetobacter spp., and 32% and 17% for imipenem-resistant Pseudomonas aeruginosa, respectively. CONCLUSION: The most prevalent bacteria in ICUs were S. aureus, CNS, and Acinetobacter spp., and high multi-drug resistance rates were observed in the Acinetobacter isolates. Therefore, infection control should be practiced in ICUs to prevent infections caused by multi-drug resistant bacteria.
Acinetobacter ; Bacteria ; Drug Resistance, Multiple ; Enterobacter cloacae ; Enterococcus faecium ; Escherichia coli ; Infection Control ; Intensive Care Units* ; Klebsiella pneumoniae ; Korea ; Methicillin Resistance ; Pseudomonas aeruginosa ; Staphylococcus aureus