Spontaneous bacterial peritonitis (SBP) is an ascitic fluid infection as a complication of end stage liver disease. The outcome is related to the severity of hepatorenal function, gastrointestinal bleeding, and many others; however it is not well known whether the infection acquisition sites have an effect on the prognosis of SBP. In order to identify the prognostic significance of the acquisition sites, we studied 106 patients who were diagnosed as culture positive SBP between October 1998 and August 2003. Thirty-two episodes were nosocomial and 74 were community acquired. Gramnegative bacilli such as Escherichia coli were dominant in both of the nosocomial and community-acquired SBPs. Despite significantly higher resistance to cefotaxime in nosocomial isolates compared to community-acquired isolates (77.8% vs. 13.6%, p=0.001), no difference was found regarding short or long term prognosis. Infection acquisition sites were not related to short or long term prognosis either. Shock, gastrointestinal bleeding and renal dysfunction were related to short term prognosis. Only Child-Pugh class C was identified as an independent prognostic factor of long-term survival.
Time Factors ; Survival Rate ; Shock/etiology/mortality ; Prognosis ; Peritonitis/complications/microbiology/*pathology ; Multivariate Analysis ; Middle Aged ; Male ; Klebsiella pneumoniae/drug effects/growth & development ; Kidney Diseases/etiology/mortality ; Humans ; Gastrointestinal Hemorrhage/etiology/mortality ; Female ; Escherichia coli/drug effects/growth & development ; Drug Resistance, Bacterial ; Cross Infection/complications/microbiology/pathology ; Community-Acquired Infections/complications/microbiology/pathology ; Ciprofloxacin/pharmacology ; Cefotaxime/pharmacology ; Bacterial Infections/complications/microbiology/*pathology ; Anti-Bacterial Agents/pharmacology ; Aged

Operators of hospital sterilizers who use ethylene oxide (EtO) were studied to determine the exposure of EtO level and the frequency of sister chromatid exchanges (SCEs) from June 12 to July 20, 1997. To evaluate SCEs in the peripheral blood cells, we selected 22 workers at the central supply room of 4 university hospitals and 22 unexposed workers at the same hospitals according to match sex, age, and smoking habit and also did questionnaires. The mean air concentrations (8-hr TWA) of EtO at 4 university hospitals were less than 1 ppm. The SCE frequencies in exposed workers to EtO and controls were normally distributed. The SCE frequencies in exposed workers to EtO and controls were 6.42+/-.63, 5.86+/-.69, respectively and their differences were statistically significant (p=0.0093). But there were no statistically significant differences in smoking, alcohol intake, coffee drinking. Especially smokers who exposed to EtO were increased SCE statistically significant than the exposed group who did not smoke.
Blood Cells ; Coffee ; Drinking ; Ethylene Oxide* ; Hospitals, University ; Humans ; Occupations* ; Questionnaires ; Siblings* ; Sister Chromatid Exchange* ; Smoke ; Smoking

Since coronary arteriovenous fistula(CAVF) was first reported by Krause in 1865, more than 400 cases have been reported. It is relatively rare disease and originates more commonly in the right than in the left coronary artery. We report a case of CAVF between right coronary artery and right ventricular inflow tract with significant left to right shunt in a 34-year old female who was admitted for the cardiomegaly on routine chest X-Ray. It was detected by transthoracic and transesophageal echocardiography, and confirmed by cardiac catheterization and coronary angiography. The opening of the fistula draining into the right ventricle was obliterated with sutures. There was no significant shunt in postoperative cardiac catheterization and coronary angiography.
Adult ; Arteriovenous Fistula* ; Cardiac Catheterization ; Cardiac Catheters ; Cardiomegaly ; Coronary Angiography ; Coronary Vessels ; Echocardiography ; Echocardiography, Transesophageal* ; Female ; Fistula ; Heart Ventricles ; Humans ; Rare Diseases ; Sutures ; Thorax

STUDY DESIGN: A retrospective analysis was performed to identify the diagnostic and therapeutic factors related to postoperative compressive neuropathy by hematoma after posterior spinal decompressive surgery. OBJECTIVES: To document by analysis the clinical course of postoperative compressive neuropathy by hematoma, the efficacy of early surgical decompression, and to recommend methods of prevention. SUMMARY OF LITERATURE REVIEW: Various diagnostic and treatment modalities have been applied to postoperative compressive neuropathy after spinal surgery. However, the timing of surgical decompression remains controversial. MATERIALS AND METHODS: Five cases of postoperative compressive neuropathy after posterior spinal decompressive surgery, which occurred from May 1996 to May 2000, were investigated in terms of causes, clinical courses, and management profiles after early surgical decompression, and final outcome. RESULTS: Five cases (2.14%) among 234 patients were managed by re-decompression including the evacuation of hematoma. Four cases, which had been managed by earlier surgical decompression showed neurologic improvement after 2 postoperative weeks, and achieved favorable clinical results without grave neurologic sequelae. However, in one case, in which surgical decompression had been delayed, weakness of the peroneii remained. CONCLUSION: Early evacuation of hematoma achieved a more favorable result than a delayed operation. Early diagnosis and prompt surgical decompression is recommended to reduce neurologic sequelae.
Decompression, Surgical ; Early Diagnosis ; Hematoma* ; Humans ; Retrospective Studies

BACKGROUND: Hypoxic pulmonary vasoconstriction (HPV) is unique to pulmonary circulation. Recent hypotheses have emerged indicating that O2 levels per se can regulate ion channel activity. The modulation of both cation channels differs according to the conduit or resistance pulmonary vessel type. However, it is not yet studied that the cation channel blocker has the same effect in an animal experimental model, which can exclude several factors that may influence on HPV. The purpose of the present study was, therefore, to determine the effect of nonspecific cation blocker, Gadolinium, on HPV in a rabbit model of isolated lung perfusion. METHODS: In adult white rabbits (n = 6), lungs were isolated and perfused with the constant pulmonary perfusate flow. Acid-base status and electrolytes of perfusate also constantly maintained. Thirty minutes after, baseline hypoxic pulmonary vasoconstriction (HPV) was measured as the difference of pulmonary artery pressure between a period of 21% normoxic gas inhalation and that of 3% hypoxic gas inhalation. After another thirty minutes, Gadolinium 50microgram were mixed to the perfusate, and then HPV were measured three times. After then Gadolinium 100, 200, 400microgram were mixed to the perfusate and HPV were measured. RESULTS: Gadolinium decreased the HPV response according to the dose. The ED50 of the response was 143microgram/100 ml. CONCLUSIONS: The regulation of HPV is based on the cation channel in the isolated rabbit lung.
Adult ; Animal Experimentation ; Electrolytes ; Gadolinium* ; Humans ; Inhalation ; Ion Channels ; Lung* ; Perfusion ; Pulmonary Artery ; Pulmonary Circulation ; Rabbits ; Vasoconstriction*

OBJECTIVES: This study was to investigate the verbal memory and learning ability in remitted schizophrenic patients and euthymic bipolar patients in order to explore trait-dependent cognitive deficits of each disorder. METHODS: Verbal memory was assessed with KAVLT(the Korean version of Rey Auditory Verbal Learning Test) in outpatients with remitted schizophrenia(N=30), euthymic bipolar disorder(N=28), and normal control(N=72). KAVLT is made for assessment of immediate supraspan memory, registration, retention, retrieval, recognition, learning strategy, and interference effect. Several confounding factors including age, sex, educational level, attention span, residual psychopathology, and extrapyramidal symptoms were controlled among 3 groups. Patient groups were matched according to the age of onset, duration of illness, and frequency of hospitalization. RESULTS: 1) The performance of bipolar group generally fall between the performance of schizophrenia and normal controls, while being most impaired in retroactive interference. Schizophrenic group showed significant impairment on most variables of KAVLT in comparison with the groups of bipolar disorder and normal control. 2) Within group analysis revealed that residual negative symptoms, duration of illness, and number of admission were highly correlated with the impairment of verbal memory and learning in schizophrenics. Number of depressive episodes and age were negatively correlated with verbal memory and learning among bipolar disorder patients. CONCLUSIONS: Both remitted schizophrenia and euthymic bipolar patients showed distinctive impairment in verbal memory and learning compared with controls. These results suggest that specific impairment of verbal memory and learning in remitted state can be a trait-dependent marker in both diseases. These deficits can give clues to the understanding of the pathophysiology and searching for more appropriate therapeutic interventions of mental disorders to improve cognitive deficits in remitted patients.
Age of Onset ; Bipolar Disorder ; Hospitalization ; Humans ; Learning* ; Memory* ; Mental Disorders ; Outpatients ; Psychopathology ; Schizophrenia ; Verbal Learning

The ocurrence of complications after brain tumor surgery often lead to death. To decrease the incidence of complications, it is desirable to identify patients at risk as early as possible prior to surgery. It can be achieved by determining preoperatively those factors known to be of prognostic relevance in the development of such postoperative complications. The prognostic factors may be differ considerably depending on the population studied but the homogeneous population studied in this analysis may help to contribute to the reference guide in identifying those factors. Authors have retrospectively analysed the major complications developed after performing on 150 brain tumor surgeries during last five years to identify the prognostic factors.
Brain Neoplasms* ; Brain* ; Humans ; Incidence ; Postoperative Complications ; Retrospective Studies

Objective: : Hemorrhagic transformation (HT) can be occurred after acute cerebral infarction. HT can worse symptoms in severe cases and adversely affect long-term prognosis. As bone and vascular smooth muscle are composed of type 1 collagen, we aimed to identify a potential relationship between bone mineral density (BMD) and HT after acute cardioembolic stroke. Methods: : As an indicator of BMD, we used mean frontal skull Hounsfield unit (HU) values on brain computed tomography (CT). Multivariative hazard ratios were calculated using Cox regression analysis to identify whether the osteoporotic condition was an independent predictor of HT after acute cardioembolic stroke. Results: : This 11-year analysis enrolled 506 patients who diagnosed as acute cardioembolic infarction. The first tertile of skull HU value was an independent predictor of HT development compared to the third tertile (hazard ratio, 2.12; 95% confidence interval, 1.13–3.98; p=0.020). We observed no interactions between age and skull HU with respect to HT statistically. Conclusion : The results of this study revealed an association between osteoporotic conditions and HT development after acute cardioembolic stroke. A convenient method to measure the cancellous bone HU value of the frontal skull using brain CT images may be useful for predicting HT in patients with acute cerebral infarction.

Objective: : Hemorrhagic transformation (HT) can be occurred after acute cerebral infarction. HT can worse symptoms in severe cases and adversely affect long-term prognosis. As bone and vascular smooth muscle are composed of type 1 collagen, we aimed to identify a potential relationship between bone mineral density (BMD) and HT after acute cardioembolic stroke. Methods: : As an indicator of BMD, we used mean frontal skull Hounsfield unit (HU) values on brain computed tomography (CT). Multivariative hazard ratios were calculated using Cox regression analysis to identify whether the osteoporotic condition was an independent predictor of HT after acute cardioembolic stroke. Results: : This 11-year analysis enrolled 506 patients who diagnosed as acute cardioembolic infarction. The first tertile of skull HU value was an independent predictor of HT development compared to the third tertile (hazard ratio, 2.12; 95% confidence interval, 1.13–3.98; p=0.020). We observed no interactions between age and skull HU with respect to HT statistically. Conclusion : The results of this study revealed an association between osteoporotic conditions and HT development after acute cardioembolic stroke. A convenient method to measure the cancellous bone HU value of the frontal skull using brain CT images may be useful for predicting HT in patients with acute cerebral infarction.

PURPOSE: The distribution of pollens in the air is mainly related to the weather conditions, especially temperature and humidity. This study focused on the evaluation of the relationship between pollen count and the outbreak of allergic diseases (symptom index) from allergic patients in Korea in order to determine Korean own allergy risk grade for the pollen forecasting system. METHODS: Airborne particles carrying allergens were collected daily in nationwide 8 stations (Seoul, Guri, Daejeon, Daegu, Kwangju Busan, Kangneung, and Jeju) by using 7 day- Burkard sampler in South Korea for 8 months (March 1, 2008-October 31, 2008). They were counted and recorded along with weather factors. Symptom index was calculated and recorded by phone calling to allergic patients 3 times a week. RESULTS: Airborne pollens have 2 peak seasons (May and September) in Korea. In the skin prick test, ragweed was the highest sensitization rate (5.9%), followed by mugwort (5.8 %), alder (4.9%), birch (4.8%) and oak grasses among the pollen extracts in Korean school-aged children. There are significant relationship between symptom index of allergic patients and allergic pollen concentrations. Korean own risk grade of pollen allergy was made by using the data from this study. CONCLUSION: Risk grade of pollens for allergy pollen forecast among each allergic plant was established. Further studies are needed to confirm it our result.
Allergens ; Alnus ; Ambrosia ; Artemisia ; Betula ; Child ; Forecasting ; Humans ; Humidity ; Hypersensitivity ; Korea ; Lifting ; Plants ; Poaceae ; Pollen ; Republic of Korea ; Rhinitis, Allergic, Seasonal ; Seasons ; Skin ; Weather