BACKGROUND: Infectious complications frequently occur after cardiac arrest and may be even more frequent after therapeutic hypothermia. Pneumonia is the most common infectious complication associated with therapeutic hypothermia, and it is unclear whether prophylactic antibiotics administered during this intervention can decrease the development of early-onset pneumonia. We investigated the effect of antibiotic prophylaxis on the development of pneumonia in cardiac arrest patients treated with therapeutic hypothermia. METHODS: We retrospectively reviewed the medical records of patients who were admitted for therapeutic hypothermia after resuscitation for out-of-hospital cardiac arrest between January 2010 and July 2015. Patients who died within the first 72 hours or presented with pneumonia at the time of admission were excluded. Early-onset pneumonia was defined as pneumonia that developed within 5 days of admission. Prophylactic antibiotic therapy was defined as the administration of any parenteral antibiotics within the first 24 hours without any evidence of infection. RESULTS: Of the 128 patients admitted after cardiac arrest, 68 were analyzed and 48 (70.6%) were treated with prophylactic antibiotics within 24 hours. The frequency of early-onset pneumonia was not significantly different between the prophylactic antibiotic group and the control group (29.2% vs 30.0%, respectively, p = 0.945). The most commonly used antibiotic was third-generation cephalosporin, and the class of prophylactic antibiotics did not influence early-onset pneumonia. CONCLUSION: Antibiotic prophylaxis in cardiac arrest patients treated with therapeutic hypothermia did not reduce the frequency of pneumonia.
Anti-Bacterial Agents ; Antibiotic Prophylaxis* ; Heart Arrest* ; Humans ; Hypothermia* ; Medical Records ; Out-of-Hospital Cardiac Arrest ; Pneumonia* ; Resuscitation ; Retrospective Studies

BACKGROUND: To identify the expression patterns and usefulness of various antibodies in making diagnoses and predicting prognoses, an immunohistochemical study was performed on thymic epithelial tumors (TETs). METHODS: Forty-two cases of TETs were reclassified according to the new World Health Organization (WHO) classifications. CD3, CD5, CD79a, CD99, pan-, high- and low-molecular weight cytokeratins, EMA, vimentin, MIB-1 (Ki67) and p53 immunostaining were carried out. RESULTS: There were two, twelve, eight, two, thirteen and one case for type A, AB, B1, B2, B3 and C, respectively. Combined B1/B2 and B2/B3 were 2 cases each. Fourteen cases (33.3%) had myasthenia gravis. CD99 was immunoreactive mainly in cortically derived lymphocytes, while CD3 and CD5 were immunoreactive in medullary-derived lymphocytes. CD5 immunoreactivity was negative in all thymic epithelial cells, except for one case of type B3. MIB-1 indices were highly expressed in cortical lymphocytes and some thymic epithelial cells, but did not show any correlation with grades. p53 in thymic epithelial cells was expressed in 6 (46%) out of 13 cases of type B3 and one case of type C, and it was negative in all other subtypes. CONCLUSIONS: Only p53 was helpful for predicting high grades (B3 and C) (P<0.05). By MIB-1 indices, we could tell how many cortical immature lymphocytes were occupied in TETs, however, grading could not be achieved.
Antibodies ; Classification ; Diagnosis ; Epithelial Cells ; Immunohistochemistry ; Keratins ; Lymphocytes ; Myasthenia Gravis ; Prognosis ; Thymus Gland ; Vimentin ; World Health Organization* ; World Health*

We evaluated Immunochromatographic assay kit to screen HBsAg in human serum. When the reference HBsAg was applyed to ICA, HA and EIA kits, the limit of detection for HBsAg were found out to be 4, 2 and 0.25 ng/ml respectively. But ICA kit required 5 minutes to read the result whereas HA and EIA kit more than one hour. The sensitivity was 97% (29 of 30 samples) and the specificity 100% (45 samples) compared with conventional EIA. The ICA kit needs no instrument or machine to perform the test contrary to the conventional methods. Therefore, this rapid and sensitive ICA kit can be used for HBsAg-screening, especially in the emergency room and in the scene of the accident.
Emergency Service, Hospital ; Hepatitis B Surface Antigens* ; Hepatitis B* ; Hepatitis* ; Humans ; Immunochromatography* ; Limit of Detection ; Sensitivity and Specificity

PURPOSE: Although hydrocelectomy is commonly performed in general urological practice, the incidence of complications and the outcomes of this procedure seem to be underreported in the literature. We evaluated the incidence of complications and the outcomes of patients who underwent hydrocelectomy. MATERIALS AND METHODS: Between January 1996 and December 2005, 289 patients with hydrocele were retrospectively assigned into three groups according to the degree of dissection or the amount of the excision of the hydrocele sac. Group 1 included 78 patients who were treated by dissection and excision of the entire hydrocele sac. Group 2 consisted of 149 patients who were treated by dissection and eversion of the hydrocele sac. The 62 patients in group 3 underwent operations in which there was little or no dissection of the hydrocele. We analyzed the complications, the effects of surgical treatment and the results according to the surgical techniques. RESULTS: The duration of recovery showed no differences among the three groups. The overall complication rate was 36.3%. Transient scrotal swelling occurred in 28.0% of the patients, hematoma in 2.7%, wound infection in 1.7%, and injury to the epididymis or testis, chronic pain and persistent swelling occurred in 1.3%. The overall incidence of postoperative complications was significantly lower among the patients in group 3. The rate of scrotal swelling was significantly correlated to the volume of the hydroceles and the amount of the excision of the hydrocele sac. CONCLUSIONS: The long term results of hydrocelectomy were good. The most common complications following scrotal surgery for hydroceles were scrotal swelling, hematoma, wound infection and injury to the epididymis and testis. Most of the complications were treated by conservative management.
Adult ; Chronic Pain ; Epididymis ; Hematoma ; Humans ; Incidence ; Male ; Postoperative Complications ; Retrospective Studies ; Testis ; Wound Infection

STUDY DESIGN: To study the correlation between the clinical outcomes and neovascularization and bFGF expression in the herniated disc tissues. OBJECTIVES: To study the difference of neovascularization and bFGF expression according to the types of disc herniation, and to study the correlation between the duration of radiculopathy, post-operative results and neovascularization and bFGF expression in the herniated disc tissues. SUMMARY OF LITERATURE REVIEW: Neovascularization has been found in herniated disc tissue. bFGF(basic Fibroblast Growth Factor) in the intervertebral disc has been implicated in the pathogenesis of injury and repair associated with granulation and neovascularization. There is no information on the relationship between clinical outcome and the neovascularization and bFGF expression in the herniated disc tissue. MATERIALS AND METHODS: Among 112 specimens, there are 48 cases in protrusion, 36 in extrusion and 28 in sequestration. Hematoxylin-eosin stain and immunochemical stain with CD 31 and bFGF were used. For the evaluation of post-operative results, Kirkaldy-Willis method was used. The results were analyzed with Chisquare test and t-test. RESULTS: Statistically there is no correlation between the types of disc herniation, duration of radiculopathy and post-operative outcomes and neovascularization and bFGF expression. CONCLUSIONS: The neovascularization and bFGF expression in herniated disc tissue are correlated with the injury of disc tissue. There are no correlation with the clinical outcomes and neovascularization and bFGF expression in herniated disc tissues.
Fibroblasts ; Intervertebral Disc ; Intervertebral Disc Displacement ; Radiculopathy

Numerous studies have shown neovascularization and basic fibroblast growth factor(bFGF) expression in herniated nucleus pulposus. It is not clear whether the neovascularization and bFGF expression are due to herniated nucleus pulposus with secondary reaction phenomenon or due to disc aging and degeneration. The purpose of this study is to investigate neovascularization and bFGF expression in both nucleus pulposus and anulus fibrosus tissues from aging and degenerated discs and compare it to neonate intervertebral disc. Thirty disc blocks obtained during anterior interbody fusion of the lumbar spine with degenerative spine disease were studied by immunochemical stains to observe neovascularization with vascular endothelial cell growth factor(VEGF) and bFGF expression. There were 8 disc blocks from the patients with degenerative disc disease, 15 with spondylolytic spondylolisthesis, and 7 with spinal stenosis with instability. For the control group, 12 neonate disc blocks obtained at autopsy. The neovascularization and bFGF expression were observed in the outer one half layer of the anulus fibrosus in the disease group but not in the nucleus pulposus. The neovascularization and bFGF expression were not observed in the control group. There was a statistical significant difference of neovascularization and bFGF expression between the control and disease group(p<0.05). There was no statistical significant difference of neovascularization and bFGF expression among the disease group(p>0.05). The results of this study suggest that neovascularization and bFGF expression are inherently related to aging and degeneration of the intervertebral disc.
Aging* ; Autopsy ; Coloring Agents ; Endothelial Cells ; Fibroblast Growth Factors ; Fibroblasts* ; Humans ; Infant, Newborn ; Intervertebral Disc Degeneration* ; Intervertebral Disc* ; Spinal Stenosis ; Spine ; Spondylolisthesis

There has been suggested to contain neovascularization reported mainly in the extruded and sequestrated disc herniations. This study is the observation of neovascularization of the blood vessels and cells in the protruded disc herniations. The first objective is the observation of the angiogenesis and the bFGF expression in the protruded disc herniations. The second objective is to study the correlation between the age distribution, sex and bFGF expression in the protruded disc herniations. Fourty-eight patients with protruded disc herniation underwent the posterior disectomy at the Ajou university Hospital from Jun. 1994 to Jun 1996. The mean period of postoperative follow-up was 24.5 months. We used the Hematoxylin-eosin stain to confirm the blood vessel formation and a fibroblast growth factor(bFGF) to observe the immunoexpression of the blood vessels and cells in the protruded disc herniation. For the control group, 12 disc specimens were obtained from patients who underwent the anterior interbody fusion for the lumbar burst fracture. The results of staining for the blood vessels or cells were 32 cases in HE stain, and 26 with bFGF. Out of 48 cases, the bFGF expression revealed in 26 cases(54.2%). Neither the correlation between sex and bFGF expression nor age-dependency and bFGF expression was statistically significant(both: chi-square test: p>0.05). The twelve control disc tissues showed the there was no blood vessels in the disc tissues.
Age Distribution ; Blood Vessels ; Fibroblast Growth Factors ; Fibroblasts ; Follow-Up Studies ; Humans

Periostitis is one of the human diseases commonly encountered in archaeological samples. It is known to be an important health indicator for paleopathologists examining skeletal remains. In our recent study on a Joseon skeletal series (n=101), non-specific, primary periostitis was observed only in five individuals (#4, #29, #137, #175, and #290). Notably, there were no secondary periostitis-suggestive signs (e.g. syphilis), except for those caused by fractures (#33 and #41). As this is the inaugural Korean-skeletal-series report on periostitis, the results presented in these pages should prove significant to interested paleopathologists.
Humans ; Paleopathology ; Periostitis ; Skeleton ; Syphilis

Spinal osteophytic changes are known to be affected by differences in age, sex, population, and mechanical stress. We examined Joseon skeletons (n=87) to obtain vertebral osteophytosis data on a pre-modern Korean population. The mean osteophytic value (MOV) of vertebrae increased in the cervical-thoracic-lumbar order. More severe osteophytosis was found in the vertebrae (C5, T9, T10, and L4) farthest from the line of gravity, while the general pattern of vertebral osteophytosis appeared similar to those of previous reports on other skeletal series. More severe osteophytes were much more common in the males, possibly due to their engaging in more strenuous physical labor than that of females. We also observed MOV patterns seemingly unique to the Joseon people, and findings not typically reported in previous studies. Although a full explanation of the factors contributing to vertebral-osteophytic development in Joseon Koreans will require further studies, the present results are meaningful to anatomists and anthropologists interested in osteophytic patterns occurring in an East Asian population.
Anatomists ; Asian Continental Ancestry Group ; Female ; Gravitation ; Humans ; Korea ; Male ; Osteophyte ; Skeleton ; Spine ; Stress, Mechanical

A 20-year-old young man who had undergone treatment for a suprasellar/perichiasmal tumor 2 years before, was presented with a huge palpable splenic mass. A fine needle aspiration cytology from the splenic mass showed dissociated large pleomorphic tumor cells having irregular nuclear outline, coarse chromatin, and one or two macronucleoli, and scattered small lymphocytes in fine granular background. Above cytologic findings were regarded as the characteristics of germinoma. Differential diagnosis from the large cell lymphoma of spleen was emphasized.
Biopsy, Fine-Needle ; Chromatin ; Diagnosis, Differential ; Germinoma* ; Humans ; Lymphocytes ; Lymphoma ; Neoplasm Metastasis ; Spleen* ; Young Adult