Radiological manifestations on plain films of the abdomen in 75 cases with proven typhoid perforation of distal ileum, in Kyungpook National University Hospital between Oct. 1972 and Sep. 1981, were analyzed and discussed. Some clinical and laboratory findings which may be helpful in diagnosis of this condition were also analyzed. Typhoid perforation was occurred most frequently in those between 2nd and 4th decades, and the male to female ratio was 4:1. Typhoid perforation was occurred most frequently in summer, but was occurred in all seasons. Radiological findings were free intraperitoneal gas (64%), loss of preperitoneal fat line (62.7%), free abdominal fluid (53.3%), distention of gas-filled bowel (94.7%), elevation of diaphragm (8%) and fixation of small bowel segments in right lower abdomen (43.7%). We concluded that a large amount of intraperitoneal gas with gas-filled distention of small bowel and findings of peritonitis are highly suggestive of typhoid perforation when the patient has acute abdomen.
Abdomen ; Abdomen, Acute ; Diagnosis ; Diaphragm ; Female ; Gyeongsangbuk-do ; Humans ; Ileum ; Male ; Peritonitis ; Seasons ; Typhoid Fever

The genetic status of cagA, vacA subtype, iceA1, and babA, and the relationship to gastroduodenal diseases were assessed in Helicobacter pylori isolates in Korea. Seventy-six strains of H. pylori were isolated from the antrum and the corpus of 41 adult patients (22 with peptic ulcer and 19 with gastritis). The cagA, iceA1, and babA genes were assessed by polymerase chain reaction and the vacA subtypes were determined by reverse hybridization-line probe assay. The positive rates of 349-bp cagA, 208-bp cagA, iceA1, and babA genes were 97.4%, 96.1%, 84.2%, and 36.1%, respectively. The vacA s1a, s1b, s1c, and s2 variants were detected in 11.8%, 3.9%, 80.4%, and 1.3%, respectively. m1 (78.9%) is more prevalent than m2 (5.3%). The most common vacA genotype was s1c/m1 (61.9%), and 14 isolates (18.4%) contained mixed vacA genotypes from a single biopsy specimen. Twenty-one (60%) of 35 patients were infected with more than two strains of different cagA, iceA1, babA, and vacA genotypes. None of cagA, iceA1, babA, and vacA s1/m1 were associated with peptic ulcer. In conclusion, most H. pylori isolates in Korea carry cagA, iceA1, and vacA s1c/m1 genes, and reside with multiple strains. These genes do not correlate with the peptic ulcer in the Korean patients.
Adult ; Aged ; Bacterial Proteins/*genetics ; Female ; Genotype ; Helicobacter pylori/*classification/genetics/pathogenicity ; Human ; Male ; Middle Age ; Peptic Ulcer/*etiology/microbiology

Henoch-Shonlein purpura(HSP) is a systemic small-vessel vasculitis that primarily affects the skin, gastrointestinal tract, joints, and kidneys. The nervous system may be involved, less commonly than other organs. When the central nervous system(CNS) was involved, headache, changes in mental status, seizures, and focal neurologic deficits have been reported. Hypertension, uremic encephalopathy, metabolic abnomalities, electrolyte abnormalities, or cerebral vasculitis were suggested as possible causes of the neurologic manifestation. Diagnosis of vasculitic involvement of CNS is difficult. Magnetic resonance imaging of the brain is the modality of choice for the evaluation of the CNS disease. Steroid or plasmapheresis are used in treatment of cerebral vasculitis. We experienced a case of 9-year-old boy who had presented with Henoch-Schonlein purpura nephritis complicating encephalopathy accompanied by hypertension and cerebral vasculitis. Brain MRI showed multiple small nodular-linear pattern enhancing lesions in whole cerebral hemispheres and focal increased T2 signal in the right basal ganglia. We used intravenous immunoglobulin in treatment of cerebral vasculitis. We report this case with a brief review of related literature.
Basal Ganglia ; Brain ; Brain Diseases, Metabolic ; Central Nervous System Diseases ; Cerebrum ; Child ; Diagnosis ; Gastrointestinal Tract ; Headache ; Humans ; Hypertension* ; Immunoglobulins ; Joints ; Kidney ; Magnetic Resonance Imaging ; Male ; Nephritis* ; Nervous System ; Neurologic Manifestations ; Plasmapheresis ; Purpura, Schoenlein-Henoch* ; Seizures ; Skin ; Vasculitis ; Vasculitis, Central Nervous System*

Mesenchymal stem cells (MSCs) are attractive candidates for clinical repair or regeneration of damaged tissues. Oct4 and Sox2, which are essential transcription factors for pluripotency and self-renewal, are naturally expressed in MSCs at low levels in early passages, and their levels gradually decrease as the passage number increases. Therefore, to improve MSC proliferation and stemness, we introduced human Oct4 and Sox2 for conferring higher expansion and differentiation capabilities. The Oct4-IRES-Sox2 vector was transfected into human adipose tissue MSCs (ATMSCs) by liposomal transfection and used directly. Oct4 and Sox2 were successfully transfected into ATMSCs, and we confirmed maintenance of MSC surface markers without alterations in both red fluorescent protein (RFP) (control) and Oct4/Sox2-ATMSCs. Enhanced proliferative activity of Oct4/Sox2-ATMSCs was shown by WST-1 assay, and this result was further confirmed by cell counting using trypan blue exclusion for a long period. In addition, FACs cell cycle analysis showed that there was a reduction in the fraction of Oct4/Sox2-ATMSCs in G1 with a concomitant increase in the fraction of cells in S, compared with RFP-ATMSCs. Increased levels of cyclin D1 were also seen in Oct4/Sox2-ATMSCs, indicating acceleration in the transition of cells from G1 to S phase. Furthermore, Oct4/Sox2-overexpressing ATMSCs showed higher differentiation abilities for adipocytes or osteoblasts than controls. The markers of adipogenic or osteogenic differentiation were also upregulated by Oct4/Sox2 overexpression. The improvement in cell proliferation and differentiation using Oct4/Sox2 expression in ATMSCs may be a useful method for expanding the population and increasing the stemness of ATMSCs.
Adipose Tissue/cytology ; *Cell Differentiation ; *Cell Proliferation ; Cells, Cultured ; Humans ; Mesenchymal Stromal Cells/cytology/*metabolism/physiology ; Octamer Transcription Factor-3/genetics/*metabolism ; SOXB1 Transcription Factors/genetics/*metabolism

OBJECTIVES: The purposes of this study were to evaluate the possible role of Tumor necrotic factor-alpha (TNF-alpha) in development of preeclampsia, and to define the alteration of plasma TNF-alpha concentration in association with fetal growth restriction in preeclamptic women. METHODS: Maternal blood samples were retrieved from 10 normal pregnancies, 10 pregnancies complicated with small for gestational age neonate of unknown cause, 10 preeclampsia with fetal growth restriction, and 10 preeclampsia without fetal growth restriction. The concentrations of TNF-alpha were measured by ELISA. RESULTS: The plasma concentrations of TNF-alpha were significantly increased in preeclamptic women (p<0.05). However, there were no major differences in relation to fetal growth restriction. In idiopathic SGA group, the cytokine levels were significantly decreased compared to normal pregnancy (p<0.05). CONCLUSIONS: The increased concentrations of maternal plasma TNF-alpha in preeclamptic women suggest that preeclampsia may be an immunologic disorder. Though TNF-alpha influences on the fetal growth, it may not play a major role in the pathophysiology of fetal growth restriction in preeclampsia.
Cytokines ; Enzyme-Linked Immunosorbent Assay ; Female ; Fetal Development* ; Gestational Age ; Humans ; Infant, Newborn ; Plasma ; Pre-Eclampsia ; Pregnancy* ; Tumor Necrosis Factor-alpha*

OBJECTIVES: The purposes of this study were to evaluate the possible role of Tumor necrotic factor-alpha (TNF-alpha) in development of preeclampsia, and to define the alteration of plasma TNF-alpha concentration in association with fetal growth restriction in preeclamptic women. METHODS: Maternal blood samples were retrieved from 10 normal pregnancies, 10 pregnancies complicated with small for gestational age neonate of unknown cause, 10 preeclampsia with fetal growth restriction, and 10 preeclampsia without fetal growth restriction. The concentrations of TNF-alpha were measured by ELISA. RESULTS: The plasma concentrations of TNF-alpha were significantly increased in preeclamptic women (p<0.05). However, there were no major differences in relation to fetal growth restriction. In idiopathic SGA group, the cytokine levels were significantly decreased compared to normal pregnancy (p<0.05). CONCLUSIONS: The increased concentrations of maternal plasma TNF-alpha in preeclamptic women suggest that preeclampsia may be an immunologic disorder. Though TNF-alpha influences on the fetal growth, it may not play a major role in the pathophysiology of fetal growth restriction in preeclampsia.
Cytokines ; Enzyme-Linked Immunosorbent Assay ; Female ; Fetal Development* ; Gestational Age ; Humans ; Infant, Newborn ; Plasma ; Pre-Eclampsia ; Pregnancy* ; Tumor Necrosis Factor-alpha*

OBJECTIVES: Implants connect the internal body to its external structure, and is mainly supported by alveolar bone. Stable osseointegration is therefore required when implants are inserted into bone to retain structural integrity. In this paper, we present an implant with a "wing" design on its area. This type of implant improved stress distribution patterns and promoted changes in bone remodeling. MATERIALS AND METHODS: Finite element analysis was performed on two types of implants. One implant was designed to have wings on its cervical area, and the other was a general root form type. On each implant, tensile and compressive forces (30 N/m2, 35 N/m2, 40 N/m2, and 45 N/m2) were loaded in the vertical direction. Stress distribution and displacement were subsequently measured. RESULTS: The maximum stresses measured for the compressive forces of the wing-type implant were 21.5979 N/m2, 25.1974 N/m2, 29.7971 N/m2, and 32.3967 N/m2 when 30 N/m2, 35 N/m2, 40 N/m2, and 45 N/m2 were loaded, respectively. The maximum stresses measured for the root form type were 23.0442 N/m2, 26.9950 N/m2, 30.7257 N/m2, and 34.5584 N/m2 when 30 N/m2, 35 N/m2, 40 N/m2, and 45 N/m2 were loaded, respectively. Thus, the maximum stresses measured for the tensile force of the root form implant were significantly higher (about three times greater) than the wing-type implant. The displacement of each implant showed no significant difference. Modifying the design of cervical implants improves the strength of bone structure surrounding these implants. In this study, we used the wing-type cervical design to reduce both compressive and tensile distribution forces loaded onto the surrounding structures. In future studies, we will optimize implant length and placement to improve results. CONCLUSION: 1. Changing the cervical design of implants improves stress distribution to the surrounding bone. 2. The wing-type implant yielded better results, in terms of stress distribution, than the former root-type implant.
Bone Resorption ; Dental Implants ; Displacement (Psychology) ; Finite Element Analysis ; Osseointegration

BACKGROUND/OBJECTIVES: Vascular inflammation is an important feature in the atherosclerotic process. Recent studies report that leaves and branches of Carpinus turczaninowii (C. turczaninowii) have antioxidant capacity and exert anti-inflammatory effects. However, no study has reported the regulatory effect of C. turczaninowii extract on the arterial inflammatory response. This study therefore investigated modulation of the arterial inflammatory response after exposure to C. turczaninowii extract, using human aortic vascular smooth muscle cells (HAoSMCs). MATERIALS/METHODS: Scavenging activity of free radicals, total phenolic content (TPC), cell viability, mRNA expressions, and secreted levels of cytokines were measured in LPS-stimulated (10 ng/mL) HAoSMCs treated with the C. turczaninowii extract. RESULTS: C. turczaninowii extract contains high amounts of TPC (225.6 ± 21.0 mg of gallic acid equivalents/g of the extract), as well as exerts time-and dose-dependent increases in strongly scavenged free radicals (average 14.8 ± 1.97 µg/mL IC50 at 40 min). Cell viabilities after exposure to the extracts (1 and 10 µg/mL) were similar to the viability of non-treated cells. Cytokine mRNA expressions were significantly suppressed by the extracts (1 and 10 µg/mL) at 6 hours (h) after exposure. Interleukin-6 secretion was dose-dependently suppressed 2 h after incubation with the extract, at 1–10 µg/mL in non-stimulated cells, and at 5 and 10 µg/mL in LPS-stimulated cells. Similar patterns were also observed at 24 h after incubation with the extract (at 1–10 µg/mL in non-stimulated cells, and at 10 µg/mL in the LPS-stimulated cells). Soluble intracellular vascular adhesion molecules (sICAM-1) secreted from non-stimulated cells and LPS-stimulated cells were similarly suppressed in a dose-dependent manner after 24 h exposure to the extracts, but not after 2 h. In addition, sICAM-1 concentration after 24 h treatment was positively related to IL-6 levels after 2 h and 24 h exposure (r = 0.418, P = 0.003, and r = 0.524, P < 0.001, respectively). CONCLUSIONS: This study demonstrates that C. turczaninowii modulates the arterial inflammatory response, and indicates the potential to be applied as a therapeutic use for atherosclerosis.
Antioxidants ; Arteries ; Atherosclerosis ; Betulaceae ; Cell Survival ; Cytokines ; Free Radicals ; Gallic Acid ; Humans ; Inflammation ; Inhibitory Concentration 50 ; Interleukin-6 ; Muscle, Smooth, Vascular ; Phenol ; RNA, Messenger

BACKGROUND: To interpret lung function tests, it is necessary to determine the lower limits of normal (LLN) and to derive a consensus on the interpretative algorithm. '0.7 of LLN for the FEV1/FVC' was suggested by the COPD International Guideline (GOLD) for defining obstructive disease. A consensus on a new interpretative algorithm was recently achieved by ATS/ERS in 2005. We evaluated the accuracy of '0.7 of LLN for the FEV1/FVC' for diagnosing obstructive diseases, and we also determined the effect of the new algorithm on diagnosing ventilatory defects. METHODS: We obtained the age, gender, height, weight, FEV1, FVC, and FEV1/FVC from 7362 subjects who underwent spirometry in 2005 at the Asan Medical Center, Korea. For diagnosing obstructive diseases, the accuracy of '0.7 of LLN for the FEV1/FVC' was evaluated in reference to the 5th percentile of the LLN. By applying the new algorithm, we determined how many more subjects should have lung volumes testing performed. Evaluation of 1611 patients who had lung volumes testing performed as well as spirometry during the period showed how many more subjects were diagnosed with obstructive diseases according to the new algorithm. RESULTS: 1) The sensitivity of '0.7 of LLN for the FEV1/FVC' for diagnosing obstructive diseases increased according to age, but the specificity was decreased according to age; the positive predictive value decreased, but the negative predictive value increased. 2) By applying the new algorithm, 34.5% (2540/7362) more subjects should have lung volumes testing performed. 3) By applying the new algorithm, 13% (205/1611) more subjects were diagnosed with obstructive diseases; these subjects corresponded to 30% (205/681) of the subjects who had been diagnosed with restrictive diseases by the old interpretative algorithm. CONCLUSION: The sensitivity and specificity of '0.7 of LLN for the FEV1/FVC' for diagnosing obstructive diseases changes according to age. By applying the new interpretative algorithm, it was shown that more subjects should have lung volumes testing performed, and there was a higher probability of being diagnosed with obstructive diseases.
Chungcheongnam-do ; Consensus ; Humans ; Korea ; Lung* ; Pulmonary Disease, Chronic Obstructive ; Respiratory Function Tests* ; Spirometry

PURPOSE: Respiratory failure arises from derangements in pulmonary gas exchange. The causes may be classified as due to either lung disease or respiratory pump dysfunction. Problems with lung mechanics is an important cause of acute respiratory failure in children clinically. The aims of this study were to survey the cause and prognosis of children diagnosed with acute respiratory failure by intrapulmonary lesion. METHODS: We performed a retrospective study of 52 children(M:F=31:21) diagnosed with acute respiratory failure by intrapulmonary lesion in Gyeongsang National University Hospital from January, 1989 to July, 2003. The age distribution was from 0.1 to 12 years old(2.6+/-3.3 yr). RESULTS: The causes of acute respiratory failure were bronchiolitis and infectious pneumonia(24 cases, 46.1%), acute respiratory distress syndrome(14 cases, 26.9%), near drowning(seven cases, 13.5%), aspiration pneumonia(three cases, 5.8%), sepsis with intrapulmonary lesion(three cases, 5.8%) and croup(one case, 1.9%). The underlying diseases of acute respiratory distress syndrome were aspiration pneumonia(four cases, 28.6%), near drowning(three cases, 21.4%), pneumonia(three cases, 21.4%), sepsis with pneumonia(two cases, 14.3%), and shock(two cases, 14.3%). The survival rate of all subjects was 67.3%. The survival rate of underlying diseases were:83.3% in cases of bronchiolitis and infectious pneumonia, 57.1% in near drowning, 42.8% in acute respiratory distress syndrome, 33.3% in sepsis, and 100% in aspiration pneumonia and croup. CONCLUSION: The major cause of acute respiratory failure by intrapulmonary lesion in children was respiratory infection. And acute respiratory distress syndrome and sepsis with intrapulmonary lesion had relatively poor prognoses, thus active and prompt intervention is important in these conditions.
Age Distribution ; Bronchiolitis ; Child ; Croup ; Humans ; Lung ; Lung Diseases ; Mechanics ; Near Drowning ; Pneumonia ; Pneumonia, Aspiration ; Prognosis* ; Pulmonary Gas Exchange ; Respiratory Distress Syndrome, Adult ; Respiratory Insufficiency* ; Retrospective Studies ; Sepsis ; Survival Rate