Bacteroides fragilis is a Gram negative nonsporulating anaerobic rod bacterium that makes up about 1 to 2% of the norrnal human colonic microflora. In 1984, Myer et al. reported that some strains of B. fragilis produce enterotoxin and cause diarrheal disease in cattle and human. Since then it has been termed enterotoxigenic B. fragilis (ETBF). In this study, we tried to detect enterotoxin gene from 37 B. fragilis strains, isolated in Korean patients, to confirm the existence of ETBF and usefulness of PCR as a rapid diagnosis method. By this method, we identified 9 ETBF strains and confirmed their pathogenesis by cytotoxicity test. No significant cross- reactivity with other anaerobes or aerobes was observed. Thus, the PCR method may be considered useful for the sensitive and rapid detection of anaerobic infections. And the entire amplified PCR mixture was ligated into a pT7Blue T-vector and transformed into E. coli. When the nucleotide sequences of cloned PCR products were compared with reported enterotoxin gene, pBF529 inserted DNA sequence was nearly in good agreement with it but pBF570 inserted DNA sequence showed some difference at nucleotide 270-300. A search for nucleotide sequence homologies revealed that pBF529 exhibited 99%, but pBF570 indicated only 90% identity with reported enterotoxin gene. According to these results, it was suggested that ETBF toxin can be differentiated into at least 2 subtypes.
Animals ; Bacteroides fragilis* ; Bacteroides* ; Base Sequence ; Cattle ; Clone Cells ; Colon ; Diagnosis ; Enterotoxins* ; Humans ; Korea* ; Polymerase Chain Reaction*

Targetoid hemosiderotic hemangioma is a benign vascular tumor with a peculiar clinical presentation and histologic features sometimes difficult to differentiate from the patch stage of Kaposi's sarcoma, progressive lymphangioma, eosinophilic hemangioma, retiform hemangioendothelioma. We report a case of targetoid hemosiderotic hemangioma on upper back and right upper arm of a 28-year-old male. He has a 5mm × 5mm sized slightly raised violaceous papule surrounded by an ecchymotic halo on upper back and right upper arm. We took a biopsy of the lesion and identified it as targetoid hemosiderotic hemangioma. This is a case of targetoid hemosiderotic hemangioma with typical clinical and histopathological findings.
Adult ; Arm ; Biopsy ; Eosinophils ; Hemangioendothelioma ; Hemangioma* ; Humans ; Lymphangioma ; Male ; Sarcoma, Kaposi

No abstract available.
Leptospira interrogans* ; Leptospira*

Sertolifonn endometrioid carcinoma (SEC) is a very rare malignant neoplasm arising from the surface epithelium of the ovary. We report one case of SEC occuring in the left ovary of a 73-year-old woman. The left ovary was totally replaced by a yellowish tan lobulated solid mass with focal cystic areas. Small tubules and elongated solid cord-like structures resembling a Sertoli-Leydig cell tumor or a Sertoli cell tumor were found microscopically. In some areas, confluent typical endometrioid carcinoma, adenofibromatous stroma, squamoid foci, and lutenizing stromal cell nests were noted. The tumor also demonstrated strong immunoreactivity with EMA (epithelial membrane antigen). Certain points of differentiation between SEC and SertoliLeydig or Sertoli cell tumors are discussed.
Aged ; Carcinoma, Endometrioid* ; Epithelium ; Female ; Humans ; Immunohistochemistry ; Membranes ; Ovary ; Sertoli Cell Tumor ; Sertoli-Leydig Cell Tumor ; Stromal Cells ; Triacetoneamine-N-Oxyl

In the orthopaedic field, some elective surgery such such as joint replacement, spinal surgery and limb sparing procedures for musculoskeletal tumors frequently need various amounts of blood trans- fusion. But homologous transfusion occasionally result in various side effect including allergic reaction, febrile reaction, coagulopathies due to reduced platelets and coagulating factors, graft versus host disease(GVHD) and transmission of infectious diseases such as malaria, syphilis, hepatitis and AIDS. Recently these complications especially in elective surgery might result in medicolegal and social problem. Risks of transfusion could be minimized with autologous blood. So many authors are interested in prebanked autologous transfusion in elective orthopaedic surgery to prevent these problems. But there might be need of additional homologous blood transfusion because of the time limited and low yield of autologous blood. Recombinant human erythropoietin(4-HuEPO) has been shown to increase erythropoiesis. The authors could yield 5 units during 14 days using r-HuEPO without any adverse reactions. Therefore we could performed decompression, posterolateral fusion with pedicular screw fixation in spondylolisthesis without additional homologous transfusion.
Blood Transfusion ; Communicable Diseases ; Decompression ; Erythropoiesis ; Erythropoietin ; Extremities ; Hepatitis ; Humans ; Hypersensitivity ; Joints ; Malaria ; Social Problems ; Spondylolisthesis ; Syphilis ; Transplants

OBJECT: It is reported that the effect of antipsychotics on the extracellular dopamine levels in the prefrontal cortex is related to the their effect on the negative symptoms. Therefore, we investigated the acute and chronic effects of olanzapine and risperidone on the extracellular dopamine concentrations in the prefrontal cortex of rat. Samples were obtained using in vivo brain microdialysis. METHOD: Dopamine levels in the samples were measured by high pressure liquid chromatography with electrochemical detection. RESULTS: 1) Both the acute treatment of olanzapine and risperidone increased the extracellular dopamine concentrations in the prefrontal cortex, dose-dependently. 2) There was a no significant difference in the maximal change of the extracellular dopamine concentrations in the prefrontal cortex induced by the acute treatment of olanzapine and risperidone. 3) Both the chronic treatment of olanzapine and risperidone also increased the extracellular dopamine concentrations in the prefrontal cortex, but they showed the tolerance effect that the degree of increase was smaller than that of the acute treatment. 4) As for the maximal changes of the extracellular dopamine concentrations in the prefrontal cortex induced by the chronic treatment of olanzapine and risperidone, the effect of the former was greater than that of the latter. CONCLUSION: These results suggest that the effects of olanzapine and risperidone on the negative symptoms are related to the increased extracellular dopamine concentrations in the prefrontal cortex induced by these drugs.
Animals ; Antipsychotic Agents ; Brain ; Chromatography, Liquid ; Dopamine* ; Microdialysis ; Prefrontal Cortex* ; Rats* ; Risperidone*

BACKGROUND: Clostridium difficile is known as the major cause of nosocomially acquired diarrhea. Various phenotypic and genotypic methods have been used to subtype C. difficile strains. The purpose of the present study is to evaluate several typing methods which can be used as tools for subtyping C. difficile isolates for epidemiological studies. METHODS: In two Korean tertiary care hospitals, a total of 81 C. difficile isolates were collected from symptomatic, hospitalized patients in 1998. All isolates were examined for the release of toxin A and toxin B by PCR assay and cell culture assay. Also arbitrarily primed-PCR and PCR-ribotyping profiles were determined for the typing of C. difficile strains on a genetic level. RESULTS: The toxin B gene was detected in 65.4% (54/81) of isolates by both PCR assay and cell cultureassay. Nine types were identified with T-7 primer, and 13 types were identified with PG-05 primer in AP- PCR. Sixteen types were identified in PCR-ribotyping. When two typing methods were compared, reproducibility by PCR-ribotyping was 100%, while it was only 83% and 33% AP-PCR with primer T-7, and PG-05, respectively. The discrimination index was 0.88 for PCR-ribotyping, 0.82 for AP-PCR with primer T-7 and 0.81 with primer PG-05. CONCLUSION: These data suggest that PCR-ribotyping provides a reproducible, discriminatory, and simple alternative to conventional molecular approaches for typing strains of C. difficile.
Cell Culture Techniques ; Clostridium difficile* ; Clostridium* ; Diarrhea ; Discrimination (Psychology) ; Epidemiologic Studies ; Humans ; Polymerase Chain Reaction ; Tertiary Healthcare

BACKGROUND: Capsaicin has been shown to have different biologic and toxic effects, depending on non-neuronal cells and several transformed cells, however no study has been reported from cultured human skin fibroblast. OBJECTIVE: Present study was aimed to evaluate the cytotoxicity and its mechanism of capsacin on the cultured human skin fibroblast. MATERIAL AND METHOD: Normal neonatal human fibroblasts were used, and changes of cell survival were measured by MTT assay after the cells were pre-treated with growth factors, receptor antagonist, antioxidants, calcium modulators were pre-treated or co-treated with capsaicin. RESULTS: Suvival of fibroblast was significantly increased by treatment with EGF (10ng/ml), bFGF (10ng/ml), capsazepine (10M) but inhibited by cycloheximide (1g/ml). When 200 M capsaicin was added to fibroblasts, chromatin condensations were observed at 12 hours and cell survival rate was reduced to 25-50% at 24 hours. Vanilloid receptor antagonists, capsazepine and ruthenium red, did not prevent the toxic effect of capsaicin, and 10M capsazepine paradoxically rather enhanced the cytotoxicity. In contrast to bFGF (10ng/ml), EGF (10, 100ng/ml) enhanced the cytotoxicity of capsaicin. Neuropeptides, substance P (1, 10nM) and CGRP (1, 10nM), and a structural analogue to capsaicin, tyrosine (0.3-1.2mM) did not affect the cytotoxicity. However, antioxidants such as trolox (100M) and ascorbic acid (0.1, 0.3 mM) reduced the capsaicin cytotoxicity. Of calcium modulating agents, nifedifine, a Ca2+ channel blocker (10, 20M) and cyclopiazonic acid, a Ca2+-ATPase inhibitor in ER (10M) did not influence the cytotoxicity, however BAPTA/AM (10M) as a chelater for cytoplasmic free calcium ion (10M) significantly decreased capsaicin cytotoxicity. Unlike cycloheximide, z-VAD-FMK, a protein synthesis inhibitor and a non-specific caspase inhibitor, prevented the capsaicin cytotoxicity. The DNA ladder and TUNEL positive cells were observed among the capsaicin treated fibroblasts and Western blot revealed caspase-3 activity. CONCLUSION: The capsaicin-induced cytotoxicity on human skin fibroblasts is likely to suggest the mechanism of an apoptotic pathway, which can possibly be prevented by antioxidants.
Antioxidants ; Ascorbic Acid ; Blotting, Western ; Calcium ; Capsaicin* ; Caspase 3 ; Cell Survival ; Chromatin ; Cycloheximide ; Cytoplasm ; DNA ; Epidermal Growth Factor ; Fibroblasts* ; Humans* ; In Situ Nick-End Labeling ; Intercellular Signaling Peptides and Proteins ; Neuropeptides ; Ruthenium Red ; Skin* ; Substance P ; Tyrosine

Segmental neurofibromatosis is a rare disorder characterized by cafe-au-lait spots and neurofibrobmas, or only neurofibroma, limited to one region of the body. Disease-associated systemic involvement is uncommon. Most patients with segmental neurofibromatosis do not have a family history of neurofibromatosis. In Korea, there have been 3 reported cases of segmental neurofibromatosis. None of them had caf6-au-fait spots, systemic involvement, or family history. This report describes a case of segmental neurofibromatosis in a 25-year-old woman who had Becker's nevus-like cafe-au-lait spots and this was linked to the presence of Fanconi's syndrome in a second degree relative of the patient.
Adult ; Cafe-au-Lait Spots ; Female ; Humans ; Korea ; Neurofibroma ; Neurofibromatoses* ; Neurofibromatosis 1

BACKGROUND AND OBJECTIVES: Traumatic tympanic membrane (TM) perforatons are encountered relatively often in clinical practice. We carried out a retrospective study of TM perforation according to different injury types, age and sex distribution, and relationship between size of perforation, degree of hearing loss and duration of spontaneous healing. MATERIALS AND METHODS: A retrospective review was performed on 152 cases of traumatic TM perforation diagnosed in the emergency room from January, 1992 to December, 1997. RESULTS: There was follow up loss in 109 out of 152 cases. Its incidence was predominant in males, acounting for the ratio of male to female being about 2:1. Injury to the left side was predominant, there being 112 cases (79%), compared to 40 cases (31%) to the right side. Perforation of Grade I was most common, with 86 cases (57%). Among them, with 54 cases (35.5%), antero-inferior perforation constituted about one third of all cases. The mean air-conduction difference was 14.7dB, and showed a tendency to increase as the size of perforation increased. Spontaneous healing rate was 76%, and the mean duration for complete healing was 22.1 days. There was also a tendency for the duration of healing to increase as the size of perforation increased. In the case of complication with otorrhea, there was a tendency for the duration of healing to be shorter. CONCLUSION: Although traumatic TM perforations have good prognosis, it is necessary to induce patients with profuse explanations for possible complications to visit the out-patient clinic until the wound has healed completely.
Emergency Service, Hospital ; Female ; Follow-Up Studies ; Hearing Loss ; Humans ; Incidence ; Male ; Outpatients ; Prognosis ; Retrospective Studies ; Sex Distribution ; Tympanic Membrane Perforation* ; Tympanic Membrane* ; Wounds and Injuries