No abstract available.

There are some emergency situations when untested fresh blood should be transfused. Emergency blood donor tests(EBDT) have been done as an effort to protect these blood recipients from contracting transfusion associated infections in Seoul National University, Hospital. EBDT includes HBsAg, anti-HlV, STS, and ALT test. Anti-HCV test is not included because of the absence of appropriate test kit. A total of 534 tests have been done from June 1993 to August 1995. Among these, 495 tests(92.7%) have been done for blood donor screening, and 39 tests(7.3%) for emergency organ transplantation. Sensitivity and specificiy of the emergency HBsAg test were 69% and 98%, respectively. There were two RPR reactive blood donors, but no anti-HIV positive cases. Among 458 blood donors, 37 donors(8.1%) showed increased ALT level(> 45IU/L). The percent of agreement in HBsAg, elevated ALT and anti-HIV tests between emergent and routine blood donor tests, were 97.0%, 98.9% and 100%, respectively. Although false positive and false negative EBDT result may is useful, although limited, we think that EBDT is useful in protecting blood recipient from transfusion associated infections.
Blood Donors* ; Emergencies* ; Hepatitis B Surface Antigens ; Humans ; Mass Screening ; Organ Transplantation ; Seoul ; Transplants

Recurrent abortion has been defined as the occurrence of three or more clinically recognized pregnancy loss before 20 weeks and it occurs in 1% of women. The chromosomal abnormalities of abortuses have been suggested as the most common causes of recurrent abortion. We have studied the incidence of chromosomal abnormalities in 57 patients with recurrent abortion using the chorionic villi samples. Of the 57 abortuses analysed, 32 (56.1%) had chromosomal abnormalities. Trisomy was predominant (23 cases, 40.4%), followed by mosaicism 3 (5.2%), tetraploidy 2 (3.5%), monosomy 2 (3.5%), and structural anomaly 1 (1.8%). Trisomy for the chromosome 16 was most prevalent among trisomies. The incidence of trisomy was positively related to matemal age above 35 year-old. But there is not statistically significant. And there are no correlation between gestational age and chromosomal abnormalities. In conclusion, the incidence of chromosomal abnormalities of recurrent abortuses was 56.1% which was similar to that of the other reports. This means that the analysis of karyotype of chorionic villi, as the first test to investigate the cause of recurrent abortion, may be not useful, however, it will require further.
Abortion, Habitual ; Adult ; Chorion* ; Chorionic Villi Sampling ; Chorionic Villi* ; Chromosome Aberrations ; Chromosomes, Human, Pair 16 ; Female ; Gestational Age ; Humans ; Incidence ; Karyotype ; Monosomy ; Mosaicism ; Pregnancy ; Tetraploidy ; Trisomy

PURPOSE : In a recent study of Wilms' tumors, a new X chromosome gene, Wilms' tumor gene on the X chromosome (WTX), was discovered that was found to harbor small deletions and point mutations. The WTX protein negatively regulates Wnt/beta-catenin signaling, and is considered to be a tumor suppressor gene. One of the questions about the WTX gene is whether the genetic alterations of the WTX gene are specific only to Wilms' tumors. The aim of this study was to explore whether the WTX gene mutation is a characteristic of human non-small cell lung cancer (NSCLC). MATERIALS AND METHODS : In the current study, we analyzed the part of the WTX gene encoding the N-terminal of WTX, where most of the WTX point mutations have been detected in Wilms' tumors. Forty-eight NSCLC tissues were analyzed by a single-strand conformation polymorphism assay and DNA sequencing. RESULTS : SSCP analysis revealed no evidence of somatic mutations in the DNA sequences encoding the N-terminal of the WTX gene in the 48 NSCLC tissues. CONCLUSION : The data presented here indicate that the WTX gene may not be somatically-mutated in human NSCLCs, and suggest that NSCLCs may not utilize mutational events of the WTX gene in the process of pathogenesis
Base Sequence ; Carcinoma, Non-Small-Cell Lung ; Genes, Tumor Suppressor ; Humans ; Point Mutation ; Polymorphism, Single-Stranded Conformational ; Sequence Analysis, DNA ; Wilms Tumor ; X Chromosome

PURPOSE: Dendritic cells (DCs) are the most potent antigen presenting cells and should be differentiated to mature form to induce primary T cell response. In this study, we intended to generate mature DCs from peripheral blood mononuclear cells (PBMCs), so that develope the basis for immunotherapy using DCs. METHODS: PBMCs were isolated from 25 mL of normal adults' peripheral blood and evenly distributed in 5 wells of a 6-well plate. Nonadherent cells were gently aspirated after 2 hour-incubation under humidified 5% CO2 at 37degrees C. Adherent monocytes were cultured in 3 mL of 10% fetal bovine serum plus RPMI-1640 media containing granulocyte/macrophage-colony stimulating factor (GM-CSF) 200 ng/mL and interleukin (IL)-4 20 ng/mL. To assess the effect of tumor necrosis factor (TNF)-alpha and interferon (IFN)-alpha on DC maturation, either or both were added on day 4 of culture. Cells were harvested on day 4 and 7 to calculate the cell counts, CD83 /HLA-DR cells, and CD86 /HLA-DR cells. RESULTS: On day 4, large amounts of DCs were observed. CD83 /HLA-DR cells and CD86 / HLA-DR cells were 11.6% and 16.6% of total cells counted and yields were 1.3% and 2.0%, respectively. On day 7, DCs were more frequently observed in all instances and purity ranged from 24.0% to 31.0% as a mean value. The final yields of matue DCs were 2.9~3.4% of PBMCs inoculated. Adding TNF-alpha plus IFN-alpha led to the best yield. But, IFN-alpha alone did not increase the mature DCs compared to the control. CONCLUSION: We successfully cultured large quantities of mature DCs from PBMCs using GM-CSF and IL-4. IFN-alpha seems to have a synergistic effect when added with TNF-alpha, but further studies are required to prove the clinical significance.
Antigen-Presenting Cells ; Cell Count ; Dendritic Cells* ; Granulocyte-Macrophage Colony-Stimulating Factor ; HLA-DR Antigens ; Immunotherapy ; Interferon-alpha ; Interferons ; Interleukin-4 ; Interleukins ; Monocytes ; Tumor Necrosis Factor-alpha

Immunosuppressive agent has been used as a therapeutic agent for Endogeneous posterior uveitis[EPU]. But serious side effect of steriod or cyclosporine and frequent recurrence of ocular inflammation warrant the addition of other immunosuppressive agents. In this study, we evaluated the therapeutic effectiveness of low dose triple therapy using steroid, cyclosporine and azathioprine when combination therapy with steroid and cyclosporine had failed. We reviewed the records of 10 Behcet's patients[18 eyes]and 2 sympathetic ophthalmia patients[2 eyes]who had been resistant to steroid and cyclosporine combination therapy. The median follow up duration of triple therapy was 16.3 months. Recurrence, severity of inflammation, systemic manifestations associated with Behcet's disease, and side effect of therapeutic agents were evaluated. There was a significantly decrease in the frequency[0.37/month during pretriple therapy and 0.14/month after triple therapy]and severity of ocular inflammation[p<0.01]. The frequency and severity of systemic manifestations also decreased. Visual acuity remained stable in 7 eyes[35%]and improved in 13 eyes[65%]. No serious side effects or newly developed side effect were developed during triple therapy except reversible mild anemia in 1 patient. The results of our study suggest that triple agent immunosuppressive therapy is well tolerated and appears to be effective for the severe uveitis which is refraction to steroid and cyclosporine combination therapy.
Anemia ; Azathioprine ; Cyclosporine* ; Follow-Up Studies ; Humans ; Immunosuppressive Agents ; Inflammation ; Ophthalmia, Sympathetic ; Recurrence ; Uveitis* ; Visual Acuity

PURPOSE: The expression of natriuretic peptides in the neural bundles of the anterior portion of the optic nerves and their functions in regulating vessel tone and blood flow may suggest a possible role in the pathogenesis of glaucoma. The purpose of this study was to investigate the association between normal-tension glaucoma and the genetic variations of atrial natriuretic peptide (Nppa) and natriuretic peptide receptor A (Npr1) gene. METHODS: Sixty-seven Korean normal-tension glaucoma (NTG) patients and 100 healthy subjects (as normal controls) were enrolled. DNA from peripheral blood leukocytes was extracted, and the genotypes of five polymorphisms (c.94G>A, c.454T>C, IVS1+16C>T, IVS2+701G>A, and c.-764C>G) in the Nppa gene and one polymorphism (c.1023G>C) in the Npr1 gene were determined using the restriction fragment length polymorphism and the SNaPshot methods. The genotype and allele frequencies of these polymorphisms in patients with NTG and normal controls were compared using the Fisher's exact test and the chi-square test. RESULTS: In both groups, the genotype distributions were in accordance with the Hardy-Weinberg equilibrium. There was no significant difference in the frequency of the Nppa and Npr1 alleles or genotypes in the normal-tension glaucoma group as compared to the control group. CONCLUSIONS: Nppa and Npr1 gene polymorphisms are not associated with normal-tension glaucoma, suggesting that this gene does not have an important role in the pathogenesis of optic neuropathy in this disease.
Receptors, Atrial Natriuretic Factor/*genetics ; *Polymorphism, Single Nucleotide ; Middle Aged ; Male ; *Intraocular Pressure ; Humans ; Guanylate Cyclase/*genetics ; Glaucoma/genetics/*physiopathology ; Genotype ; Gene Frequency ; Female ; Atrial Natriuretic Factor/*genetics ; Adult

BACKGROUND: Massive hemoptysis is one of the major medical emergency with high risk of mortality. Though the best predictor of mortality associated with hemoptysis appears to be the amount of bleeding within the first 24 hours, catastrophic hemorrhage could be occurred to the patients who were apparently in a stable condition with scanty hemoptysis at the time of admission. We evaluated APACHE III score system to find if it could be a prognostic index that can predict the mortality of the patients with hemoptysis. METHODS: We identified all the patients who had admitted with hemoptysis in the Medical Intensive Care Unit of Asan Medical Center between May 25, 1989, and July 31, 1995. A retrospective analysis was done in 66 patients with hemoptysis on APA- CHE III score. RESULTS: The overall mortality rate was 17.4% (12/69). In univariate analysis of possible prognostic factors, independent predictors of mortality were age(P=0.016), amount of hemoptysis(P=0.012), AaDO2 (P=0.017), requirement of transfusion(P=0.036), mechanical ventilatory care(P<0.05) and APACHE III score(P=0.02), In multivariate analysis with sex, age, amount of hemoptysis, AaDO2, requirement of transfusion and APACHE III score, APACHE III score was the only independent predictor of mortality(P=0.015, odd ratio=19.3, 95% confidence interval, 3.4 to 249.7) CONCLUSION: APACHE IU score may be a clinically significantly important independent predictor of outcome in the patients with hemoptysis. In addition, invasive procedure, such as bronchial artery embolizaticn or operation, could be considered in advance in the patients with more than 30 points of APACHE III.
APACHE* ; Bronchial Arteries ; Chungcheongnam-do ; Emergencies ; Hemoptysis* ; Hemorrhage ; Humans ; Intensive Care Units* ; Critical Care* ; Mortality ; Multivariate Analysis ; Prognosis ; Retrospective Studies

Although ischemic colitis is often considered to be a condition occurred in elderly patients or in patients with vascular diseases, it also can occur in younger healthy persons. Some drugs, such as oral contraceptives, may play an important role in the development of ischemic colitis in young women. However, constipation also can play an important role in this condition. We recently experienced a case of reversible ischemic colitis of a young woman, who had been suffered from obstructive type of chronic constipation, after taking a laxative and enema. We report this case with literature review. Proper managements and educations in patients with chronic constipation should be emphasized.
Aged ; Colitis, Ischemic* ; Constipation* ; Contraceptives, Oral ; Enema ; Female ; Humans ; Vascular Diseases

The mechanism of apoptosis was first discovered at the end of the 19th century, but it was only recently that its importance was recognized. Not only in a pathologic environment but also in a normal environment, apoptosis has an important role in homeostasis. The number of cells is restricted by apoptosis which is controlled by several SlgBS lll VlVO. In pregnancy, the placenta regulates the maternal-fetal exchange of molecules and functions as a barrier for the protection of the fetus. As the pregnancy proceeds, changes occur in the number and components of placental cells. Observing the placental tissues, apoptosis was found in the syncytiotrophoblasts of early and late pregnancy. In particular, the fact that apoptosis observed in the placenta of late pregnancy supports the hypothesis that pmgrammed cell death is a normal sequence. Pregnancy-induced hypertension is usually accompanied by abnormal placenta and intrauterine growth restriction. In this study, using the TdT-FragEL DNA fragmentation detection kit, the changes in the nucleus by apoptosis in the placental tissues of 23 to 40 gestational weeks in preeclampsia and eclampsia were compared with normal placenta. Apoptosis was observed in the normal term placenta and in pregnancy-induced hypertension patients, regardless of whether vasculopathy was observed in Doppler ultrasound or confirmed by pathology, more apoptoses were observed aside from the number of gestational weeks.
Apoptosis ; Cell Death ; DNA Fragmentation ; Eclampsia ; Female ; Fetus ; Homeostasis ; Humans ; Hypertension, Pregnancy-Induced* ; Maternal-Fetal Exchange ; Pathology ; Placenta* ; Pre-Eclampsia ; Pregnancy ; Trophoblasts ; Ultrasonography