BACKGROUND: There is a lack of basic epidemiological information on bacterial meningitis in children and adults in Korea. Therefore, more research is needed to investigate the causative organisms, clinical manifestations, and prognosis in Korean children and adults. METHODS: We analyzed retrospectively 148 medical records with final diagnosis of bacterial meningitis. The diagnosis of bacterial meningitis was based on culture-positive cases. RESULTS: Out of a total 148 patients, 71 were children and 77 were adults. In the children with community acquired meningitis, infection-related meningitis was the most common predisposing factor (23.3%). In adults, otitis media was the most common (21.7%). There were more frequent seizures in children than adults (38.1%, 17.1%, p<0.05). In community-acquired meningitis, Streptococcus pneumoniae was the most common type. However, in nosocomial meningitis, gram-negative bacilli was the most common type. The prognostic factors associated with mortality rate in adults were old age (>50 years), seizure (p<0.05), and mental change (p<0.001). CONCLUSIONS: Although a causative organism is not documented, we believe that our study will help to properly treat acute bacterial meningitis in children and adults regardless if it is community acquired or nosomial.
Adult ; Causality ; Child ; Cross Infection ; Diagnosis ; Epidemiology ; Humans ; Korea ; Medical Records ; Meningitis ; Meningitis, Bacterial* ; Meningitis, Pneumococcal ; Mortality ; Otitis Media ; Prognosis* ; Retrospective Studies ; Seizures

To study the site of release and factors affecting the release of the atrial natriuretic peptide(ANP) in the pediatric patients, we measured the plasma ANP concentrations in 23 normal healthy children, 19 patients with congestive heat failure and 16 patients with cardiac disease undergoing diagnostic cardiac catheterization. The following results were obtained. 1) The plasma ANP concentrations of the vein(226.3(74.9pg/ml)in patients with congestive heart failure were significantly higher than those(p<0.01)of the mormal healthy children(13.4 (7.9pg/ml)and those(43.3 40(.7pg/ml)in patients undergoing cardiac catheterization. The plasma ANP concentrations of the femoral vein in patients undergoing cardiac catheterization were also significantly higher than that of the peripheral vein in the normal healthy children(p<0.01). 2) The plasma ANP concentrations of the pulmonary artery(110.9( 80.7pg/ml)were 2 to 3 times higher than that of the femoral vein(43.3( 40.3pg/ml, p<0.01). However there were no significant differences of the plasma ANP concentrations between pulmonary artery and aorta(65.4 (36.1pg/ml),and between aorta and femoral vein. 3) There was a significant correlations of the plasma ANP concentrations vetween pulmonary artery and femoral vein, and pulmonary artery and aorta, but no correlation of those between femoral vein and aorta. 4) The plasma ANP concentrations of the vein were over 3 times more higher in cases of left atrial area over 20 cm2/M2 measured by 2-dimensional echocardiography(213.2 (292.9pg/ml)than those in cases of left atrial area under 20(65.0 66.9pg/ml, p<0.05). The plasma ANP concentrations of the vein were over 3 times more highger in cases of left atrial area over 20 cm2/M2(88.6(19.1pg/ml) than those in cases of left atrial area under 14(57.1 (39.5pg/ml,p<0.05), and in cases of the sum of both atrial mean pressure over 11mmHg(189.5( 42.8pg/ml) than those in cases of the sum under 11(79.3 (52.3pg/ml, p<0.01). The plasma ANP cocentrations of the aorta were significantly higher in cases of left atrial area over 14 cm2/M2(88.6 (19.1pg/ml)than those in cases of left atrial area under 14(57.1 (39.5pg/ml;p 0.05), in cases of the sum of both atrial area over 25cm2/M2(93.9 (21.7pg/ml)those in cases of the sum under 25(46.6 (33.8pg/ml, p<0.01), in cases of sum of mean atrial pressure over 11 mmHg(90.5 (30.3pg/ml)than those in cases of under 11(53.8( 24.6pg/ml, p<0.05),in cases of the sum of both atrial wall stress over 190 mmHg.cm2/M2(101.4 (23.5pg/ml) than those in cases of the sumunder 190(57.5 (26.4pg/ml, p<0.01), and also in cases of pulmonary artery mean pressure over 20mmHg(83.3( 18.2pg/ml) than those in cases o pulmonary artery under 20(47.8( 39.8pg/ml, p<0.05). In conclusion, the plasma ANP concentrations of the pulmonary artery were significantly higher than those of the frmoral vein and the aorta, which indicater that the ANP is predominantly secreted via coronary sinus into the right atrium. The plasma ANP concentrations of the peripheral and femoral vein, the pulmonary artery and the aorta, especially that of the aorta, correlated well with the atrial pressure, the area and the wall stress. This suggests that the arterial blood may be the most appropriate sample for measurement of the ANP.
Aorta* ; Atrial Natriuretic Factor ; Atrial Pressure ; Cardiac Catheterization ; Cardiac Catheters ; Child* ; Coronary Sinus ; Estrogens, Conjugated (USP) ; Femoral Vein ; Heart Atria ; Heart Diseases ; Heart Failure ; Hot Temperature ; Humans ; Plasma* ; Pulmonary Artery* ; Veins*

BACKGROUND: We investigated the interactions between spontaneous apoptosis-induced neutrophils and autoantibodies with attention to the reactivities of each autoantibody against intracellular antigenssuch as the antinuclear antibody (ANA) and the anti-neutrophil cytoplasmic antibody (ANCA) and the applicability as a conventional test for autoantibody detection. METHODS: The 127 serum samples from patients with autoimmune disease were mixed with whole blood from healthy donors and incubated for 20 hours. The bound antibody against substrate neutrophils was detected with anti-IgG-FITC by flow cytometry. The results of this anti-long incubated neutrophil antibody (ALINA) testing were compared with ANA, ANCA and clinical manifestations. RESULTS: The positivity rate was significantly higher in the 20 hour incubation than that of a 30 minute incubation (100% and 18%, respectively; P<0.000005). Agreement analyses between ANCA and ALINA (k=0.34) and between ANA and ALINA (k=0.39) were poor. In comparison, among the autoimmune diseases, systemic lupus erythematosus had a significantly higher ALINA positivity rate than did other diseases (P<0.000005). In patients with SLE, higher mean fluorescence intensity was significantly associated with the presence of lupus nephritis (11/12 cases vs. 2/10 cases, P<0.005). CONCLUSIONS: We detected antibodies against neutrophil antigens expressed by long incubation with patient sera. Those detected autoantibodies were significantly associated with SLE, especially lupus nephritis. Therefore, further studies are necessary to devise optimal protocols and to clarify specificities for detected autoantibodies or their target antigens.
Antibodies* ; Antibodies, Antineutrophil Cytoplasmic ; Antibodies, Antinuclear ; Autoantibodies ; Autoimmune Diseases ; Flow Cytometry* ; Fluorescence ; Humans ; Lupus Erythematosus, Systemic ; Lupus Nephritis ; Neutrophils* ; Tissue Donors

BACKGROUND: We investigated the interactions between spontaneous apoptosis-induced neutrophils and autoantibodies with attention to the reactivities of each autoantibody against intracellular antigenssuch as the antinuclear antibody (ANA) and the anti-neutrophil cytoplasmic antibody (ANCA) and the applicability as a conventional test for autoantibody detection. METHODS: The 127 serum samples from patients with autoimmune disease were mixed with whole blood from healthy donors and incubated for 20 hours. The bound antibody against substrate neutrophils was detected with anti-IgG-FITC by flow cytometry. The results of this anti-long incubated neutrophil antibody (ALINA) testing were compared with ANA, ANCA and clinical manifestations. RESULTS: The positivity rate was significantly higher in the 20 hour incubation than that of a 30 minute incubation (100% and 18%, respectively; P<0.000005). Agreement analyses between ANCA and ALINA (k=0.34) and between ANA and ALINA (k=0.39) were poor. In comparison, among the autoimmune diseases, systemic lupus erythematosus had a significantly higher ALINA positivity rate than did other diseases (P<0.000005). In patients with SLE, higher mean fluorescence intensity was significantly associated with the presence of lupus nephritis (11/12 cases vs. 2/10 cases, P<0.005). CONCLUSIONS: We detected antibodies against neutrophil antigens expressed by long incubation with patient sera. Those detected autoantibodies were significantly associated with SLE, especially lupus nephritis. Therefore, further studies are necessary to devise optimal protocols and to clarify specificities for detected autoantibodies or their target antigens.
Antibodies* ; Antibodies, Antineutrophil Cytoplasmic ; Antibodies, Antinuclear ; Autoantibodies ; Autoimmune Diseases ; Flow Cytometry* ; Fluorescence ; Humans ; Lupus Erythematosus, Systemic ; Lupus Nephritis ; Neutrophils* ; Tissue Donors

PURPOSE: Estrogen signal transduction plays very important roles in both normal mammary development and neoplastic progression. Since the discovery of estrogen receptor-beta (ER-beta) there have been many controversial reports on the role of ER-beta in breast carcinogenesis and progression, and prognostic implications. ER-beta mRNA levels were investigated in various mammary tissues in order to verify the role of ER-beta expression in breast carcinogenesis. METHODS: Using messenger RNA (mRNA) in situ hybridization, we examined ER-beta expression in 60 paired normal and cancer tissues, 11 paired normal and benign breast tumor tissues, and 10 metastatic lymph nodes. We determined the intensity and extent (proportion of cells with positive hybridization) of the mRNA hybridization signals and gave scores 0 to 3; no hybridization (0), minimal (1), moderate (2), and strong (3) by the hybridization intensity and no hybridization (0), hybridization in less than 10% of cells (1), 10~50% (2), and more than 50% of cells (3) by the proportion of positively hybridized cells. Chi-square test, independent t-test or one-way ANOVA test was used for the statistical analysis and differences were considered to be significant with a p-value of less than 0.05. RESULTS: There was no statistically difference in ER-beta expression between normal and benign mammary tissues. ERbeta expression was significantly decreased in breast cancer and metastatic lymph node tissues compared with normal mammary and benign breast tumor tissues (P<0.01). The intensity and extent of ER beta expression were also significantly lower in breast cancer and metastatic lymph node tissues than in the normal mammary and benign breast tumor tissues (P<0.01). In cases of positive hybridization, the sum of scores of intensity and area were also significantly higher in normal and fibroadenoma tissues than in cancer or metastatic lymph nodes (P<0.01). CONCLUSION: ER beta transcription decreases in the process of breast cancer development, which suggests a protective role of ER beta in breast carcinogenesis.
Breast ; Breast Neoplasms ; Carcinogenesis ; Estrogen Receptor beta ; Estrogens* ; Fibroadenoma ; In Situ Hybridization ; Lymph Nodes ; RNA, Messenger* ; Signal Transduction

Crohn's disease is a rare inflammatory bowel disease in Korea which requires a differential diagnosis with intestinal tuberculosis. In the early stages of Crohn's diseaae, the combiation of bowel wall edema and spasm produces intermittent obstructive manifestations, so the usual subjective symptoms were appeared long standing diarrhea, low grade fever and abdominal pain and distension. We recently experienced a case of Crohn's colitis with repeated bowel obstruction in female adult who underwent surgical resection.
Abdominal Pain ; Adult ; Colitis ; Crohn Disease* ; Diagnosis, Differential ; Diarrhea ; Edema ; Female ; Fever ; Humans ; Inflammatory Bowel Diseases ; Korea ; Spasm ; Tuberculosis

Crohn's disease is a rare inflammatory bowel disease in Korea which requires a differential diagnosis with intestinal tuberculosis. In the early stages of Crohn's diseaae, the combiation of bowel wall edema and spasm produces intermittent obstructive manifestations, so the usual subjective symptoms were appeared long standing diarrhea, low grade fever and abdominal pain and distension. We recently experienced a case of Crohn's colitis with repeated bowel obstruction in female adult who underwent surgical resection.
Abdominal Pain ; Adult ; Colitis ; Crohn Disease* ; Diagnosis, Differential ; Diarrhea ; Edema ; Female ; Fever ; Humans ; Inflammatory Bowel Diseases ; Korea ; Spasm ; Tuberculosis

A 55-year-old male presented with dysesthesia of the right anteromedial thigh. A magnetic resonance image revealed a globular mass at the right extraforaminal area of the L3/4 level. Based on the diagnosis of neurogenic tumor, surgical excision was performed. The surgical impression and pathology confirmed extrusion of intervertebral disc. In a retrospective review of the magnetic resonance image, we noticed a fibrillary pattern directed from the intervertebral disc space to the lesion, and disrupted annulus fibrosus and indentation caused by the ring apophysis. We suggest aforementioned features, indicative of intervertebral disc lesions, to be checked when interpreting mass lesions around the intervertebral foramen.
Diagnosis ; Humans ; Intervertebral Disc* ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Paresthesia ; Pathology ; Retrospective Studies ; Thigh

A 55-year-old male presented with dysesthesia of the right anteromedial thigh. A magnetic resonance image revealed a globular mass at the right extraforaminal area of the L3/4 level. Based on the diagnosis of neurogenic tumor, surgical excision was performed. The surgical impression and pathology confirmed extrusion of intervertebral disc. In a retrospective review of the magnetic resonance image, we noticed a fibrillary pattern directed from the intervertebral disc space to the lesion, and disrupted annulus fibrosus and indentation caused by the ring apophysis. We suggest aforementioned features, indicative of intervertebral disc lesions, to be checked when interpreting mass lesions around the intervertebral foramen.
Diagnosis ; Humans ; Intervertebral Disc* ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Paresthesia ; Pathology ; Retrospective Studies ; Thigh

BACKGROUND: Analysis of reticulated platelets (RPs) is useful for discriminating the causes of thrombocytopenia and monitoring the thrombopoiesis. In the patients with severe thrombocytopenia, we evaluated the thrombopoiesis-discriminating ability of several indices applying forward scatter (FSC) and thiazole orange (TO) fluorescence in addition to the percentage of reticulated platelets (RPs%). METHODS: Forty cases with decreased thrombopoiesis, twenty cases with increased thrombopoiesis and twenty cases with liver cirrhosis were selected. By flow cytometry with two analytic methods, dependent on or independent of the staining of CD41-PE as a platelet marker, the primary parameters including RPs% were measured and the applied parameters were calculated from them. And we compared the diagnostic efficiency of each parameter and analyzed the purity of platelet light scatter gate. RESULTS: The purity of platelet light scatter gate was significantly lower in patients with severe thrombocytopenia than in healthy persons with normal platelet counts (P<10(-6)), so the use of CD41-PE for platelet gating improved the diagnostic efficiency of RPs%. Compared to the primary parameters, the applied parameters originated from RPs%, FSC and TO fluorescence improved diagnostic efficiency significantly (RPs%: 55%, RPs%xs delta MFI: 80%) between decreased and increased thrombopoiesis groups. CONCLUSIONS: In the patients with severe thrombocytopenia, the estimate of the thrombopoiesis by a flow cytometric analysis can be more predictable by using platelet markers and by considering the fluorescence intensity of TO together with the RPs%.
Blood Platelets ; Citrus sinensis ; Flow Cytometry ; Fluorescence ; Humans ; Liver Cirrhosis ; Platelet Count ; Thrombocytopenia* ; Thrombopoiesis*