To analyse the age of onset, etiologic microorganisms, clinical manifestations, managements and genetic variation of chromic granulomatous disease, the authors reviewed four patients who were diagnosed as CGD at Department of Pediatrics, Seoul National Univesity Children's Hospital. They were siblings in relationship-two of them were brothers, the others were brother-sister. @ES The results were as follows; 1) Initial manifestations developed within 1 year old, and lymphadenopathy associated with BCG vaccination was the most common. 2) In culture study of micro-organism, catalase positive microorganisms such as Staphylococcus aureus, Serratia marcescens, Coagulase (-) Staphylococcus, Enterococcus, Proleus vulgaris, Klebsiella pneumoniae, E. coli and fungus such as Candida albicans were isolated. In 2 cases, culture study revealed no growth. 3) Fever, lymphadenopathy, hepatomegaly, suppurative dermatitis and pneumonia were the most common manifestations. In most of cases, antituberculous medications were administered under the impression of tuberculosis without response. 4) Immunologic screening tests including B-cell system, T-cell system, and complement system were within normal limit except NBT test. 5) In spite of severe infections, NBT scores of all the cases were less than those of controls. Liver biopsies of 3 cases showed granuloma formation with characteristic yellow brown pigment-laden macrophages.
Age of Onset ; B-Lymphocytes ; Biopsy ; Candida albicans ; Catalase ; Coagulase ; Complement System Proteins ; Dermatitis ; Enterococcus ; Fever ; Fungi ; Genetic Variation ; Granuloma ; Hepatomegaly ; Humans ; Klebsiella pneumoniae ; Liver ; Lymphatic Diseases ; Macrophages ; Mass Screening ; Mycobacterium bovis ; Pediatrics ; Pneumonia ; Seoul ; Serratia marcescens ; Siblings ; Staphylococcus ; Staphylococcus aureus ; T-Lymphocytes ; Tuberculosis ; Vaccination

Collagen is the major component of scar tissue. Considerable progress of fibroblast growth kinetics and of collagen synthesis has been achieved in the past decade. We have been interested in fibroblasts activities as they are expressed by cells cultured in collagen substrate. This study is to examine the effects of collagen substrate and peptide growth factors In culture medium on DNA and protein synthesis of human dermal fibroblasts. Collagen, interleukin-1(IL-1) and transforming growth factor-beta(TGF-beta) were added to fibroblast culture media according to the designed experiment model and DNA and protein synthesis were measured by [3H]-thymidine, [3H]-leucine, and [3H]-proline incorporation method. The morphological features of fibroblasts were observed by light microscope. The results were as follows ; 1) There were significant decreases of DNA and protein synthesis of cultured fibroblasts in the presence of collagen substrate compared with those in Control groups(p<0.01). 2) DNA and protein synthesis were decreased as dose dependant manner of collagen density in culture media. 3) Morphological features of fibroblasts became less stellate and flat, more spindle-like in the presence of collagen. 4) In responsiveness to IL-1, collagen non-treated groups responded to IL-1 but collagen treated groups were unresponsive to IL-1 (P<0.05). 5) Cells In collagen non-treated groups responded to TGF-beta as dose-related manner(P<0.01). Collagen treated groups desponded to TGF-beta but did not show TGF-beta dose-dependant relationship. In Conclusion, collagen substrate in the culture medium could lower the DNA and protein synthesis of fibroblasts. Cells in collagen substrate were unresponsive or less responsive to peptide growth factors than those in non-collagen substrate.
Cicatrix ; Collagen* ; Culture Media ; DNA* ; Fibroblasts* ; Humans ; Intercellular Signaling Peptides and Proteins ; Interleukin-1 ; Kinetics ; Transforming Growth Factor beta

No abstract available.
Complement System Proteins* ; Otitis Media with Effusion* ; Otitis Media* ; Otitis*

For the treatment of coarction of aorta, surgical intervention has been known as a standard therapy.During last decade balloon angioplasty for coarctation of the aorta has been reported as a successful and safe procedure in about 300 cases. This angioplasty was done mainly in infants and children, and little cases in adults and adolescents. A 22 year-old adult with coarctation of aorta have recieved balloon angioplasty. He visited to emergency room due to severe headache and the blood presure of arm was 240/130mmHg at emergency room. The blood pressure at ward was 168/92mmHg in upper extremities, 104/82mmHg in lower extrimities. His aortogram showed coarctation of thoracic aorta below left subclavian artery. The pressure gradient beween ascending aorta and right femoral artery was decreased from 60mmHg to 0mmHg after balloon dilatation (2 times, balloon diameter 18mm). There were no significant complications. The follow-up magnetic resonance image in 4 month after balloon angioplasty showed no evidence of restenosis or saccular aneurysm. Initial hypertension turned to normal blood pressure in 4 months after balloon angioplasty. This adult case of successful balloon angioplasty for coarctation of aorta is the first case reported in Korea.
Adolescent ; Adult* ; Aneurysm ; Angioplasty ; Angioplasty, Balloon* ; Aorta ; Aorta, Thoracic ; Aortic Coarctation* ; Arm ; Blood Pressure ; Child ; Dilatation ; Emergency Service, Hospital ; Femoral Artery ; Follow-Up Studies ; Headache ; Humans ; Hypertension ; Infant ; Korea ; Subclavian Artery ; Upper Extremity ; Young Adult

BACKGROUND: Early reperfusion therapy with thrombolytic agents or primary PTCA is most important to salvage ischemic myocardium in acute myocardial infarction(AMI). Timely reperfusion of jeopardized myocardium clearly improves hemodynamics, decreases infarct size and improves survival. The extent of protection appears to be directly related to the rapidity of reperfusion after onset of coronary occlusion. Although the intravenous thrombolysis is a feasible therapy in the patients with evolving AMI, the benifit of thrombolytic therapy decreases because of the time delay after onset of symptom. This study was perfomed to analyze the factors time delay between onset of symptom and the thrombolytic therapy with retrospective and prospective questionaire in the patients with AMI. METHOD: Eighty one patients with AMI were included in this study who came to the emergency room(ER) of Chungnam National University Hospital(CNUH) from Feburary 1995 to October 1996. Delay between door and thrombolytic therapy was defined as hospital time delay. RESULTS: Thrombolytic therapy(rt-PA or urokinase iv) was done in 60 patients(74.1%) and mean prehopital time delay was significantly decreased in the patients with thrombolytic therpapy when compared with those without thormbolytic threapy(462+/-90 vs 1375+/-473 minutes, p=0.005). There were no singificant factors for prehospital time delay such as age, sex, redsidence, ER near residence, transfer time to ER near residence, family status, family history of AMI, severity of chest pain, presence of risk factors of cardiovascular disease(CVD), previous CVD, degree of education, history of other disease and routine check, transfer methods. The only 8 patients(9.8%) knew about AMI and 7 patients among these patient came to ER earlier and received thrombolytic therapy. From 57 referred patients, 40 patients(70.2%) received reperfusion therapy and only 30 patients(52.6%) had recored EKG in the referred hospital. In the analysis of hospital delay from patient's arrival to the thrombolytic therapy, the arrival time at weekdays and weekend had no differences, but hospital delay were significantly prolonged when patients arrived at ER in the night. CONCLUSION: Since prehospital time delay is a most important factor of time delay for the effective thrombolytic therapy in AMI, the pubic education program and effective transport system are needed. And routine record of EKG in patient with chest pain in the local hospital is very helpful to start effective thromolytic therapy at ER. The well designed prospective study with more patinets in our local region is essential to get more accurate information about transport system and to improve survival rate in patients with AMI.
Chest Pain ; Chungcheongnam-do ; Coronary Occlusion ; Education ; Electrocardiography ; Emergencies ; Fibrinolytic Agents ; Hemodynamics ; Humans ; Myocardial Infarction* ; Myocardium ; Prospective Studies ; Reperfusion ; Retrospective Studies ; Risk Factors ; Survival Rate ; Thrombolytic Therapy* ; Urokinase-Type Plasminogen Activator

No abstract available.
Neurofibroma

No abstract available.
Breast ; Cautery

No abstract available.
Breast ; Cautery

PURPOSE: The objective of this study is to report our initial experience about the feasibility, effectiveness, and safety of transobturator tension-free vaginal mesh (Prolift(TM)) and concomitant tension-free vaginal tape (TVT) as a treatment of female anterior vaginal wall prolapse associated with stress urinary incontinence (SUI). MATERIALS AND METHODS: We reviewed the charts of patients who underwent Prolift(TM) and TVT between April 2009 and March 2010. All patients had a physical examination and staging of cystocele. According to the International Continence Society system 2, 5 and 3 women had stage grade II, III and IV respectively. All the patients underwent pelvic examination 1, 3, 6 month and 1 year after operation and anatomical and functional outcomes were recorded. An anatomic cure after intervention was defined as stage 0 and an improvement was defined as stage I. Anatomic failures were defined as stage II or higher on the last physical examination. RESULTS: The mean follow-up was 7.1 (1-11) months. Overall success rate of cystocele repair was 90%. The anatomical cure rate of cystocele was 50%. The cystocele repair improved 4 patients, but failed in 1. SUI was cured in all patients. No significant complications including bladder or vessel injury and mesh related erosion occurred. The postoperative complication was transient voiding difficulty (2 cases). CONCLUSIONS: These preliminary results suggest that Prolift(TM) and TVT offer a safe and effective treatment for female anterior vaginal wall prolapse and SUI. However, a long-term follow up is necessary in order to support the good result maintenance.
Cystocele ; Female ; Follow-Up Studies ; Glycosaminoglycans ; Gynecological Examination ; Humans ; Physical Examination ; Postoperative Complications ; Prolapse ; Suburethral Slings ; Urinary Bladder ; Urinary Incontinence

PURPOSE: The use of synthetic mesh to reinforce the anterior vaginal wall support for cystocele repair has been proposed to prevent recurrence. We evaluated the efficacy and safety of cystocele repair using monofilament polypropylene mesh (Gynemesh PS(TM)). MATERIALS AND METHODS: This study was performed in 53 patents who underwent cystocele repair using monofilament polypropylene mesh between January 2006 and January 2009. According to the ICS (International Continence Society) stage classification, 33, 17 and 3 women had stage II, III and IV cystocele. The operation were performed through the vaginal approach. Patients were followed up for 9 to 36 months. We defined the cure of cystocele as stage 0, improvement as stage I, and failed as stage II or greater RESULTS: The mean follow-up was 23.8 months. At follow-up, 41 women were anatomically cured (77.4%), 12 women were improved as stage I (22.6%) and no one was failed. Six cases were previously ICS stage II, 5 cases were stage III and 1 case was stage IV in improved group. No significant intraoperative complications occurred. The postoperative complications were de novo urgency (4 cases, 7.6%), erosion of mesh (2 cases, 3.8%) and anterior vaginal wall hematoma (1 case, 1.9%). CONCLUSION: The use of polypropylene mesh for correction of cystocele by transvaginal route with tension free technique seems to be a safe and effective procedure.
Classification ; Cystocele* ; Female ; Follow-Up Studies ; Hematoma ; Humans ; Intraoperative Complications ; Polypropylenes* ; Postoperative Complications ; Recurrence