No abstract available.
Gastric Outlet Obstruction*

BACKGROUND: Serratia marcescens proliferates well in a humid environment or soil and is recently considered as an important pathogen for the severe nosocomial infections. this organism is spreads easily by hand-to-hand transmission, and contaminates medical equipment used for invasive procedures, working environment, medications, and soap. METHODS: We investigated the source of an outbreak of bloodstream infections by S. marcescens isolated that occurred during the period from July to December, 2004, at a university hospital in Gyeonggi Province and attempted to intervene in the outbreak and control it. RESULTS: From July to December, 2004, S. marcescens grew from 296 blood culture from 283 patients. The medical charts of the patients were reviewed, and surveillance cultures were taken to identify the outbreak of nosocomial infections and risk factors. Only four cases of infection were identified and all remaining positive blood cultures were due to contamination. Nine isolates randomly selected from the 296 S. marcescens showed an identical pulsed-field gel electrophoresis pattern. To identify the source of infection, environmental culture and hand cultures of the related medical workers were carried out, but S. marcescens was not isolated. CONCLUSION: As the result of aggressive infection control activities, such as re-education on environmental management methods, hand washing techniques, and blood culture sampling techniques, no more S. marcescens had been grown in blood culture since January, 2005.
Cross Infection ; Electrophoresis, Gel, Pulsed-Field ; Gyeonggi-do ; Hand ; Hand Disinfection ; Humans ; Infection Control ; Risk Factors ; Serratia marcescens ; Serratia* ; Soaps ; Soil

There is growing evidence that crosstalk between mantle cell lymphoma (MCL) cells and stromal microenvironments, such as bone marrow and secondary lymphoid tissues, promotes tumor progression by enhancing survival and growth as well as drug resistance of MCL cells. Recent advances in the understanding of lymphoma microenvironment have led to the identification of crucial factors involved in the crosstalk and subsequent generation of their targeted agents. In the present study, we evaluated the combinatory effect of blocking antibodies (Ab) targeting CXCR4 and VLA-4, both of which were known to play significant roles in the induction of environment-mediated drug resistance (EMDR) in MCL cell line, Jeko-1. Simultaneous treatment with anti-CXCR4 and anti-VLA-4 Ab not only reduced the migration of Jeko-1 cells into the protective stromal cells, but also enhanced sensitivity of Jeko-1 to a chemotherapeutic agent to a greater degree than with either Ab alone. These combinatorial effects were associated with decreased phosphorylation of ERK1/2, AKT and NF-kappaB. Importantly, drug resistance could not be overcome once the adhesion of Jeko-1 to the stromal occurred despite the combined use of Abs, suggesting that the efforts to mitigate migration of MCLs should be attempted as much as possible. Our results provide a basis for a future development of therapeutic strategies targeting both CXCR4 and VLA-4, such as Ab combinations or bispecific antibodies, to improve treatment outcomes of MCL with grave prognosis.
Antibodies, Bispecific ; Antibodies, Blocking ; Bone Marrow ; Cell Line ; Drug Resistance ; Drug Therapy* ; Integrin alpha4beta1* ; Lymphoid Tissue ; Lymphoma ; Lymphoma, Mantle-Cell* ; NF-kappa B ; Phosphorylation ; Prognosis ; Stromal Cells

Acute calcific retropharyngeal tendinitis, also known as calcific tendinitis of the longus colli, is an underrecognized inflammatory condition by deposition of calcium hydroxyapatite in the tendon fibers of the longus colli muscles. This disease entity may occur in any part of the body, however, rarely occur in the prevertebral musculature. Symptoms and signs of this disease are neck pain and stiffness associated with odynophagia and retropharyngeal soft tissue swelling. Because of self-limiting disease, the symptoms resolve usually with or without anti-inflammatory medication and analgesics within days or weeks. We report a case of acute calcific retropharyngeal tendinitis with a reviews of the related literatures.
Analgesics ; Durapatite ; Muscles ; Neck Pain ; Tendinopathy* ; Tendons

We clinically reviewed four patients who were suffering from aseptic meningitis combined with polio-like paralysis and performed radiological. neurological and virological studies on them. Three patients were admitted to the department of Pediatrics. Asan Medical Center from March to August 1990, and one patient was admitted to the department of Pediatrics. Kangnam General Hospital. The results were as follows; 1) During the period of study, 18 patients (10.1%)out of 178 aseptic meningitis patients also suffered from hand, foot and mouth disease, and three patients (1.69%) out of 178 patients also suffered from polio-like paralysis. 2) The age of the patients who also suffered from polio-like paralysis were eight months, 22 months, 23 months and four years old respectively. Three patients were male and one patient was female. 3) Paralysis developed three to five days after aseptic meningitis infection. 4) In two cases, Magnetic Resonance Imaging (MR) showed two small cavitary lesions that means anterior horn cell necrosis in concordant with residual paralysis. Axial T1-weighted image showed decreased signal intensity and axial T2-weighted image showed increased signal intensity. In another case 20 days after onset of illness MR was performed, the transverse myelitis showed mild swelling of cornus medullaris. Follow up MR in 2 months revealed atropic change in lower thoracic spinal cord. 5) The electromyography and nerve conduction velocity test revealed acute polyradiculoneuropathy. 6) Serologic virus study were carried out in three cases for Coxsackievirus A16 and Enterovirus 71. The Enterovirus 71 antibody titer were 1:128 in two cases and 1:64 in one case. The Coxsackievirus A16 antibody titer were less than 1:4. This study showed that the causative agents for polio-like paralysis during this period seemed to be the Enterovirus 71 infection.
Anterior Horn Cells ; Chungcheongnam-do ; Cornus ; Electromyography ; Enterovirus ; Female ; Follow-Up Studies ; Hand, Foot and Mouth Disease ; Hospitals, General ; Humans ; Magnetic Resonance Imaging ; Male ; Meningitis, Aseptic* ; Myelitis, Transverse ; Necrosis ; Neural Conduction ; Paralysis* ; Pediatrics ; Polyradiculoneuropathy ; Spinal Cord

Nevus lipomatosus cutaneous superficialis is a very rare disorder characterized by nevoid fatty growth in the dermis. It usually arises in the pelvic girdle, so is unfamiliar to most otolaryngologists. A case of a 72-year-old male with nevus lipomatosus cutaneous superficialis in the nasal cavity is presented with a brief review of the disease.
Aged ; Dermis ; Humans ; Male ; Nasal Cavity ; Nevus*

PURPOSE: Previous abdominal surgery has been one of the relative contraindications of laparoscopic cholecystectomy (LC). Recently, the accumulation of experience and the development of skill have widened the indications of LC. The aim of this study was to elucidate the effectiveness and safety of LC in patients with a history of previous abdominal surgery. METHODS: The medical records of patients treated with LC at Ewha Womans University, Mokdong Hospital from March 1997 to December 2000 were reviewed. Operative results were compared between the previous abdominal-surgery group (Group A) and the non-operative history group (Group B). Group A consisted of 99 cases: 91 cases with one operation history, 7 with two, and 1 with three. Group B consisted of 99 cases randomly selected out of 437 cases without a history of previous abdominal surgery in the same period. We compared the mean operative time, conversion rate, rate of drain insertion, starting day of postoperative diet and hospital stay. RESULTS: In groups A and B, the mean ages were 52 and 51.4 years olds, the male to female ratios 1 : 2.7 and 1 : 1.08, and the mean operative times 88.8 and 91.1minutes (P=0.740), respectively. The conversion rates were 3% and the time of postoperative diet was 2.3 days in both groups. The rates of drain insertion were 21% and 15% (P=0.372), the hospital stay was 5.4 days and 5.6 days (P=0.769), the morbidity was 4% and 1% (P=0.371), respectively. There were no cases of mortality in either group. CONCLUSION: The operative results of the patients with a history of previous abdominal surgery were similar to those of the patients without an operative history. Laparoscopic cholecystectomy was an effective and safe method in the patients with a history of previous abdominal surgery.
Cholecystectomy, Laparoscopic* ; Diet ; Female ; Humans ; Length of Stay ; Male ; Medical Records ; Mortality ; Operative Time

PURPOSE: Variable changes occur in the progression from normal gastric epithelium to cancer, including many tumor, tumor suppressor and DNA repair genes, as well as growth factor and its receptors. The mutation and protein expression of the p53 gene may be useful prognostic factors, but their significance is still uncertain. METHODS: Specimens from 296 gastric cancer patients, treated by a curative gastrectomy, between March 1999 and April 2001, at Kyungpook National University Hospital, were used. The p53 gene mutation was assessed using a polymerase chain reaction-single strand conformation polymorphism (PCR-SSCP) analysis, and the overexpression of tumor p53 protein using immunohistochemistry. The correlation between the results and clinicopathological parameters were then analyzed. RESULTS: The mutation and protein overexpression of the p53 gene were shown in 61 (20.6%) and 124 (41.9%) tumors, respectively. Of the 61 cases with a p53 mutation, 43 (70.5%) showed overexpression of the p53 protein, and of the 235 without mutation of the p53 gene, 81 (34.5%) had no overexpression of the p53 protein, and also showed statistical significance (P< 0.001). The mutation and protein overexpression of the p53 gene showed no significant differences according to age, gender, stage, location and gross type, but of the 138 intestinal and 128 of the diffuse types, 33 (23.9%) and 18 (14.1%) cases, respectively, showed p53 mutation (P=0.027); whereas, of the 150 well differentiated and 142 poorly differentiated tumors, 75 (50%) and 18 (33.8%), respectively, showed overexpression of the p53 protein. Also, of the 138 intestinal and 128 diffuse types, 71 (51.4%) and 43 (33.6%) showed overexpression of the p53 protein. There were no significant differences in the 5 year survival according to the mutation and protein overexpression of the p53 gene. CONCLUSION: The mutation and protein overexpression of the p53 gene, as assessed by PCR-SSCP and immunohistochemistry, respectively, showed a statistically significant correlation, but had little value as prognostic factors following a curative gastrectomy.
DNA Repair ; Epithelium ; Gastrectomy ; Genes, p53 ; Genes, vif ; Gyeongsangbuk-do ; Humans ; Immunohistochemistry ; Stomach Neoplasms*

BACKGROUND: There is an increasing interest in physical activity as a preventive and/or therapeutic option of non alcoholic fatty liver disease (NAFLD). The aim of this study was to examine the association between physical activity and ultrasound-diagnosed NAFLD. METHODS: From April to June 2007, 198 clients who had consumed alcohol less than 140 gram per week among 598 clients who visited a general hospital for medical check-up were enrolled in this study. Clinical, biochemical variables and physical activity were compared. Physical activity was measured by self-reported questionnaire using IPAQ-short form in Korean version. Multiple logistic regression analysis was used to identify independent association. RESULTS: The prevalence of NAFLD was significantly lower in the physical active group (more than 1500 MET- minutes per week) compared to the inactive group (9.6% vs 19.2%, P<0.05). This association was not attenuated when adjusted for age, BMI, HDL cholesterol, triglycerides, fasting glucose, and HOMA2-IR (Odds Ratio 0.23 [95% CI 0.07~0.77, P<0.05]). CONCLUSION: Compared to the physically inactive group, the risk of NAFLD was lower in the physically active group. Our data suggests that regular and moderate physical exercise can prevent the development of fatty liver disease.
Cholesterol, HDL ; Exercise ; Fasting ; Fatty Liver ; Fatty Liver, Alcoholic ; Glucose ; Hospitals, General ; Logistic Models ; Motor Activity ; Obesity ; Prevalence ; Triglycerides ; Surveys and Questionnaires

Hem-o-Lok clips (Weck Surgical Instruments, Teleflex Medical, Durham, NC, USA) are widely used in robot-assisted laparoscopic radical prostatectomy because of their easy application and secure clamping. To date, there have been some reports of intravesical migration of these clips causing urethral erosion, bladder neck contractures, and subsequent calculus formation. We report the first case of bladder migration of Hem-o-Lok clips without stone formation after robot-assisted laparoscopic radical prostatectomy. The Hem-o-Lok clips were found during urethral dilation with a guide wire for bladder neck contracture under cystourethroscopy. The Hem-o-Lok clips were floating in the bladder without stone formation and were removed by a cystoscopic procedure.
Calculi ; Constriction ; Contracture ; Neck ; Prostatectomy ; Robotics ; Surgical Instruments ; Urinary Bladder