Antibiotics were reported to be able to alter bacterial surface properties in subinhibitory concentrations (sub-MICs). The effects of sub-MICs of certain antibiotics on a bacterial surface property such as hemagglutination, as well as on the cell morphology were studied using Streptococcus gordonii and Staphylococcus aureus. The effect of sub-M1Cs of antibiotics on the binding of these bacteria to immobilized fibrinogen were also investigated. The MICs of antibiotics were determined by culturing S. gordonii and S. aureus in media supplemented with serially diluted drug solutions, and one-half the MIC was used as the sub-MIC of the drugs, unless stated otherwise. Sub-MICs of antibiotics did not affect bacterial agglutination of erythrocytes. Microscopic observation of S. gordonii grown at sub-MIC concentration of 0.02 ug/ml of amoxicillin revealed cell enlargement of 1.6 times those grown without the drug. When grown in the sub-MIC amount of 0.08 ug/ml of cefazolin, most S. gordonii cells were enlarged and elongated into rod-shape, resulting in 3 times the size of the cells grown without the antibiotic. The data from the fibrinogen-binding experiments showed that the binding of S. gordonii to immobilized fibrinogen was increased with all the B-lactam drugs tested; the binding of S. aureus to immobilized fibrinogen, on the other hand, was decreased with the same drugs. The results show that low concentrations of certain B-lactam antibiotics are able to cause alterations in cellular morphology of S. gordonii and affect the binding of S. gordonii and S. aureus to immobilized fibrinogen.
Agglutination ; Amoxicillin ; Anti-Bacterial Agents* ; Bacteria ; Cefazolin ; Cell Enlargement ; Erythrocytes ; Fibrinogen ; Hand ; Hemagglutination ; Staphylococcus aureus* ; Staphylococcus* ; Streptococcus gordonii* ; Streptococcus* ; Surface Properties*

No abstract available.

No abstract available.
Acetabulum* ; Arthroplasty, Replacement, Hip*

BACKGROUND: Despite improvement of mortality in acute myocardial infarcrtion, high mortality rate associated with cardiogenic shock remains essentially unchanged. We have reviewed our result of coronary intervention in 15 patients and found relative survival advantage. METHODS: Between Sep. 1992 and Aug. 1995, 15 consecutive patients(M. 10, F. 5) with cardiogenic shock in acute myocardial infarction were treated with coronary intervention using ballon PTCA. IABP was inserted in all patients prior to PTCA. RESULTS: 1) Most commonly found infarct related artery was left anterior descending artery(11) followed by right coronary artery(3) and left main coronary artery(1). 2) Successful reperfusion rate was 86.7%(13/15), and in-hospital mortality rate was 26.7%(4/15). 3) In-hospital mortality was higher in elderly patients compared with less than 70yaer old patients(0%(0/11)vs. 75.0%(3/4)(P < 0.05). 4) Mortality rate was lower in single vessel disease than multivessel disease(11.1%(1/9) vs. 50%(3/6) p<0.05). CONCLUSION: Although this study is uncontrolled, the date suggest that urgent coronary intervention for improving coronary perfusion may reduce mortality of acute myocardial infarction complicated by cardiogenic shock, particularly with single vessel disease and young age group.
Aged ; Arteries ; Hospital Mortality ; Humans ; Mortality ; Myocardial Infarction* ; Perfusion ; Reperfusion ; Shock, Cardiogenic*

Hemangioma in the esophagus is an uncommon tumor. There have only been about 30 cases reported in the world literatures. It occurs predominantly in men and although majority are asymptomatic, may cause bleeding and dysphagia. Hemangioma in the esophagus was diagnosed with a barium swallowed esophagography and endoscopy. The main treatment modes recommended are surgery and endoscopic resection. We experienced one case of cav ernous hemangioma occurring at the distal esophagus. The patient was a forty-six year old male with dysphagia and indigestion. Barium esophagogram showed a filling defect at the distal portion. Esophagoscopy showed a bluish polypoid mass. Surgical resection was per formed and the pathologic diagnosis was confirmed as cavernous hemangioma. Postoperative course was uneventful and the patient had been followed up without any problems.
Barium ; Deglutition Disorders ; Diagnosis ; Dyspepsia ; Endoscopy ; Esophageal Neoplasms ; Esophagoscopy ; Esophagus* ; Hemangioma ; Hemangioma, Cavernous* ; Hemorrhage ; Humans ; Male

It is now well established that acute subarachnoid hemorrhage secondary to rupture of a cerebral aneurysm can precipitate life-threatening cardiac arrhythmia. We experienced a 60 year old patient with a subarachnoid hemorrhage (neurologic grade III) due to rupture of anterior communicating artery aneurysm who presented with such intraoperative electrocardiographic changes as ST segment elevation and T wave inversion which are hallmark of acute myocardial infarction. The operation was uneventfully ended. On the postoperative laboratory examination about suspected acute myocardial infarction, the patient was found to have normal triple enzyme study and echocardiographic finding. The electrocardiogram three days after subarachnoid hemorrhage due to cerebral aneurysm returned to normal sinus rhythm. This case suggests that this patient's electrocardiographic change simulating acute myocardial infarction is transient change due to subarachnoid hemorrhage.
Arrhythmias, Cardiac ; Echocardiography ; Electrocardiography* ; Humans ; Intracranial Aneurysm ; Middle Aged ; Myocardial Infarction* ; Rupture ; Subarachnoid Hemorrhage*

Mechanical valves have generally good hemodynamic function and indefinite durability, but they have a higher thromboembolic potential and thus a requirement for permanent anticoagulation, because thrombotic occlusion is a potentially fatal complication of heart valve replacement surgery. We had experienced mitral valve replacement because of thrombosis around the replaced prosthetic valve. The patient's mechanical prosthetic valve was acutely obstructed by thrombosis, and it was a life threatening condition. We performed partial bypass through femorofemoral bypass for life saving. Femorofemoral bypass improved oxygenation and cardiovascular stability, and mitral valve replacement was successfully performed without complication.
Cardiopulmonary Resuscitation ; Embolism ; Emergencies* ; Heart ; Heart Valves ; Hemodynamics ; Mitral Valve* ; Oxygen ; Thromboembolism ; Thrombosis

OBJECTIVE: To evaluate the relationship between uterine weight and morbidity in women undergoing vaginal total hysterectomy. METHODS: A retrospective chart review of 549 cases of patients with vaginal totoal hysterectomy was performed. Patients included in this study underwent vaginal total hysterectomy as benign uterine tumors at Kangnam Sacred Heart Hospital, Hallym University, Seoul, Korea from June 2003 through June 2004. These patients were stratified into four groups; Group I patients with uterine weight of <180 gm (n=132), Group II patients with uterine weight of between 180 gm to 280 gm (n=238), Group III 280 gm to 380 gm (n=100), Group IV patients with uterine weight of >380 gm (n=79). The groups were compared as regard age, paturity, previous pelvic operations, postoperative discharge day, postoperation hemoglobin change, operation time, postoperative complications. RESULTS: There was no significant difference between the four groups with repect to postoperative discharge day (Mean=9.08 day), concurrent surgical procedure, age (M=45.96 years old), parturity (M=1.88). The overall complication rate was not significantly different (postoperation hemoglobin change (M=1.25), Complication). But the morcellation rate increased 8.33% in group I, 34.18% in group II, 55% in group III, 83.5% in group IV, respectively. The operation time prolonged as uterus weight increased.; 73 minutes in group I, 79 minutes in group II, 85 minutes in group III, 91 minutes in group IV. CONCLUSION: The vaginal total hysterectomy can be performed successfully in case of greatly enlarged uterus. Uterus enlargement is not an absolute contraindication.
Female ; Heart ; Humans ; Hysterectomy ; Hysterectomy, Vaginal* ; Korea ; Leiomyoma* ; Postoperative Complications ; Retrospective Studies ; Seoul ; Uterus

OBJECTIVE: To evaluate the relationship between uterine weight and morbidity in women undergoing vaginal total hysterectomy. METHODS: A retrospective chart review of 549 cases of patients with vaginal totoal hysterectomy was performed. Patients included in this study underwent vaginal total hysterectomy as benign uterine tumors at Kangnam Sacred Heart Hospital, Hallym University, Seoul, Korea from June 2003 through June 2004. These patients were stratified into four groups; Group I patients with uterine weight of <180 gm (n=132), Group II patients with uterine weight of between 180 gm to 280 gm (n=238), Group III 280 gm to 380 gm (n=100), Group IV patients with uterine weight of >380 gm (n=79). The groups were compared as regard age, paturity, previous pelvic operations, postoperative discharge day, postoperation hemoglobin change, operation time, postoperative complications. RESULTS: There was no significant difference between the four groups with repect to postoperative discharge day (Mean=9.08 day), concurrent surgical procedure, age (M=45.96 years old), parturity (M=1.88). The overall complication rate was not significantly different (postoperation hemoglobin change (M=1.25), Complication). But the morcellation rate increased 8.33% in group I, 34.18% in group II, 55% in group III, 83.5% in group IV, respectively. The operation time prolonged as uterus weight increased.; 73 minutes in group I, 79 minutes in group II, 85 minutes in group III, 91 minutes in group IV. CONCLUSION: The vaginal total hysterectomy can be performed successfully in case of greatly enlarged uterus. Uterus enlargement is not an absolute contraindication.
Female ; Heart ; Humans ; Hysterectomy ; Hysterectomy, Vaginal* ; Korea ; Leiomyoma* ; Postoperative Complications ; Retrospective Studies ; Seoul ; Uterus

BACKGROUND: High risk myelodysplastic syndrome has various clinical courses and refractoriness to various therapies. It is important to analyze clinical characteristics and therapeutic responses in high risk myelodysplastic syndrome. METHODS: Sixty nine cases of primary high risk myelodysplastic syndrome at diagnosis were enrolled in this study at Kyungpook National University Hospital and Taegu Hyosung- Catholic University Hospital from January 1987 to June 1996. We have investigated the clinical characteristics and therapeutic outcomes after low dose cytarabine chemotherapy. RESULTS: 1) The median age of the patients was 48 years. Male to female ratio was 2.1:1. The each numbers of RAEB, CMML and RAEB-T patients were 38, 11 and 20, respectively. 2) The most common chief complaint was dyspnea on exertion. General weakness, fever and dizziness were also observed. The most common physical finding was pallor. 3) The peripheral blood findings showed anemia in 65 cases (94.2%), thrombocytopenia in 64 cases (92.8%), leukopenia in 32 cases (46.4%) and pancytopenia in 26 cases (37.7%). 4) Twenty two cases transformed to acute myelogenous leukemia during the follow-up periods. Chemotherapy was done in 18 cases among 22 cases of transformed acute myelogenous leukemia. Complete remission was achieved in 3 cases (16.7%), partial remission in 4 cases (22.2%) and no response in 11 cases (61.1%). 5) Forty seven cases were treated by low dose cytarabine chemotherapy. Complete response was achieved in 11 cases (23.4%), partial response in 13 cases (27.7%) and no response in 23 cases (48.9%). Median duration of complete response was 12 weeks. 6) We made score system, which based on Sanz score and Gattermann score, according to age, hemoglobin, platelet and bone marrow blast. Overall survival was higher in group A (score< or = 5) than group B (score> or = 6). Complete response of low dose cytarabine chemotherapy was higher in group A than group B but overall survival according to low dose cytarabine chemotherapy was not different in group A and group B. CONCLUSION: Low dose cytarabine chemotherapy was not effective in survival benefit. Score system according to prognostic factors was important to predict therapeutic response and prognosis. In the future, more intensive therapeutic plan and analysis of prognostic factors should be considered.
Anemia ; Anemia, Refractory, with Excess of Blasts ; Blood Platelets ; Bone Marrow ; Cytarabine* ; Daegu ; Diagnosis ; Dizziness ; Drug Therapy ; Dyspnea ; Female ; Fever ; Follow-Up Studies ; Gyeongsangbuk-do ; Humans ; Leukemia, Myeloid, Acute ; Leukopenia ; Male ; Myelodysplastic Syndromes* ; Pallor ; Pancytopenia ; Prognosis ; Thrombocytopenia