No abstract available.
Humans ; Liver Cirrhosis, Biliary* ; Male*

BACKGROUND: It has been reported that Cortex mori ( Morus alba L, Sangbaikpi ; CM ), the root bark of mulberry tree, plays a role in inhibiting mast cell activation. Human seminal plasma ( HSP ) modulates immune systems and activates rat peritoneal mast cells ( RPMC ). However, the inhibitory agents of HSP - induced mast cell activation have not been disclosed yet. OBJECTIVE AND METHOD: This study was undertaken to determine the effects of CM on HSP-induced mast cell activation by morphologic and functional methods. Morphological changes of RPMC by HSP alone or CM plus HSP were observed with the inverted light microscope. And the amounts of histamine and calcium were measured by radioisotopic enzymatic histamine and radioisotopic calcium assays. RESULTS: By inverted microscopy, HSP-induced RPMC degranulation occurred in a dose-dependent fashion. After pretreatment of RPMC with CM, there was no HSP-induced degranulation. Degranulation index (DI) of RPMC treated with Hanks balanced salt solution (HBSS), CM or HSP was 7.0+/-4.3, 9.0+/-6.2, 56.5+/-16.9, respectively. After pretreatment of RPMC with CM, HSP-induced DI was 11.0 +/-7.1. These results indicate that CM inhibited HSP-induced degranulation of RPMC. HSP-induced RPMC histamine release (HR) was dose-dependent. HR of RPMC treated with HBSS, CM or HSP was 0.18+/-0.10, 0.30+/-0.19, 4.48+/-0.86 ug/ml, respectively. After pretreatment of RPMC with CM, HSP-induced HR was 0.52+/-0.21 ug/ml. These results indicate that CM inhibited HSP-induced HR from RPMC. Intracellular calcium level ( ICL) of RPMC was also increased according to the concentration of HSP. ICL of RPMC treated with HBSS, CM or HSP was 6.1+/-1.0, 9.0+/-2.1, 30.2+/-6.5 pmole, respectively. After pretreatment of RPMC with CM, HSP-induced ICL of RPMC was 11.6 +/- 3.3 pmole. These results indicate that CM inhibited HSP-induced calcium uptake of RPMC. CONCLUSION: From these results, it is suggested that CM contains some substances which inhi-
Animals ; Calcium ; Histamine ; Histamine Release ; Humans* ; Immune System ; Mast Cells* ; Microscopy ; Morus ; Rats* ; Semen* ; Trees

BACKGROUND: Some investigators have done several studies on the frequency and distribution of unexpected antibodies in Korea. But more studies are necessary to estimate the precise frequency of unexpected antibodies. METHOD: In order to determine the frequency of unexpected antibodies, we analyzed the results from 23,735 antibody-screening tests performed for transfusion candidates at Yonsei University Severance Hospital during a recent two-year period (March 1998~ Feb 2000). Screening and identification of unexpected antibodies were carried out using a gel agglutination technique with DiaMed-ID system (DiaMed, Murten, Switzerland). RESLUT: Out of all 23,735 serum samples, positive results were obtained from 109 sera (0.46%). Clinically significant antibodies were found from 0.29% of all the population. Antibodies that were detected most frequently were anti-E+c (33 sera), followed by anti-E (19 sera) and anti-Lea (12 sera). CONCLUSION: We found that Rh antibodies, clinically significant unexpected antibodies, are detected frequently in Korea, too. So we consider that unexpected antibody screening test must be included in pre-transfusion test in Korea and this information is reassuring in assessing the risk associated with blood transfusion in many hospitals of Korea.
Agglutination ; Antibodies* ; Blood Transfusion ; Humans ; Incidence* ; Korea ; Mass Screening ; Research Personnel

The goal of surgical stone management is to achieve maximal stone clearance with minimal morbidity to the patient. Because of its efficacy, efficiency and low morbidity, extracorporeal shock wave lithotripsy(ESWL) is the first-line treatment for almost all urinary calculi. However, stone clearance after ESWL has been shown to be affected by the stone burden, location, chemical composition and kidney anatomy. Especially, the success rate for ESWL is reduced in lower pole stone(LPS). Percutaneous nephrolithotomy(PNL) and retrograde ureteroscopic intrarenal surgery(RIRS) are alternative treatment options for stones refractory to ESWL such as LPS. Although effective, PNLsubjects the patient to increased morbidity compared to ESWL and RIRS. Because of its low morbidity and relatively high success rate, RIRS for LPS is an attractive treatment modality in selective patients. We report a case of multiple renal pelvis and lower calyceal stones treated with ureteroscopy.
Humans ; Kidney ; Kidney Calculi ; Kidney Pelvis* ; Shock ; Ureteroscopy ; Urinary Calculi

BACKGROUND: There are few recent studies on transfusion practice and blood use with regard to diagnoses of Korean recipients. We conducted a survey of blood component use in Yonsei University Medical Center in Seoul, Korea. METHODS: A survey was carried out on blood component transfusion from January 2000 to June 2000. Transfused components were listed by broad diagnostic categories formed from the principal diagnoses of the recipients according to the ICD-10. RESULTS: Of all investigated components (67,433 units), 18,623 units of RBCs (27.6%), 10,203 units of FFP (15.1%), 38,547 units of platelets (57.2%), and 60 units of whole blood (0.1%) were transfused. The transfusion rate in relation to sex was 1.7:1 and the majority of all blood units were transfused to patients aged <65 yrs (85.9%). The rate of blood component transfusion was the highest in the department of internal medicine (47,451 units, 70.4%). Of 18,623 RBCs units and 10,203 FFP units, 70.8% and 74.5% were transfused to patients in four diagnostic categories; neoplasms, digestive system diseases, circulatory system diseases, and leukemia or lymphoma. Of 38,547 platelets units, 87.8% were used in patients with neoplasms, leukemia or lymphoma, digestive system diseases and diseases of the blood and blood-forming organs. CONCLUSIONS: This survey provides information on the blood component usage in tertiary-care teaching hospital in Seoul, Korea. It demonstrates the concentration of today's blood utilization among a few diagnostic categories. This information is relevant for quality management of transfusion practice, cost analyses and for planning local and regional blood donation programs.
Academic Medical Centers ; Blood Component Transfusion ; Blood Donors ; Classification* ; Costs and Cost Analysis ; Diagnosis ; Digestive System Diseases ; Digestive System Neoplasms ; Hospitals, Teaching ; Humans ; Internal Medicine ; International Classification of Diseases ; Korea ; Leukemia ; Lymphoma ; Seoul

PURPOSE: Many studies have shown that therapeutic hypothermia (TH) administration to non-ventricular fibrillation (Vf) cardiac arrest survivors or non-cardiac origin arrest survivors leads to good neurological outcomes. Therefore, TH has been regarded as a standard therapy for cardiac arrest survivors. Our study was designated to analyze predictors of neurological outcomes in out-of-hospital cardiac arrest (OHCA) survivors throughout the duration of the event, from the detection of arrest to the end of TH. METHODS: We retrospectively reviewed the cases of sixty OHCA survivors treated with TH between January 2006 and December 2008. We divided the patients into two groups according to the Cerebral Performance Categories scale at discharge and statistically compared the factors associated with neurological outcomes. RESULTS: Younger age, absence of diabetes mellitus, Vf of initial rhythm, and cardiac origin of cardiac arrest were associated with good neurological outcomes. The frequency of witnessed arrest was higher in the good outcomes group. The time intervals from detection of arrest to emergency department arrival (EDA) and performance of advanced cardiac life support were shorter in the good outcomes group. Mean blood pressure at implementation of TH and the frequency of hypomagnesemia were higher in the poor outcomes group. Logistic regression revealed that an independent predictor of good outcomes was the time interval from the detection of arrest to EDA (95% CI, 0.792-0.988). CONCLUSION: An independent predictor of good neurological outcomes is the time interval from detection of arrest to EDA. Improvable components of TH were early implementation of TH, avoiding hypomagnesemia, and slow rewarming.
Advanced Cardiac Life Support ; Blood Pressure ; Cardiopulmonary Resuscitation ; Diabetes Mellitus ; Emergencies ; Heart Arrest ; Humans ; Hypothermia ; Hypothermia, Induced ; Logistic Models ; Out-of-Hospital Cardiac Arrest ; Prognosis ; Retrospective Studies ; Rewarming ; Survivors ; Wit and Humor as Topic

The results of rotation chair test were known to variable by many parameters such as eye opening and alertness, etc. The situational change in rotation chair test must be considered to interpretation of its result. But in Korea, there were no reports or articles about parameters which influence the result of rotation chair test. So, we assumed that eye opening and alertness were main parameters and took rotation chair test in neurotologically normal subjects. For evaluation of the effect of eye-open or eye-closure and alertness on the rotational vestibular stimulation, we have taken sinusoidal harmonic acceleration test in 30 otoneurologically normal subjects. The maximal slow phase eye velocity, gain and asymmetry were obtained and compared with each other in four different conditions with properly fixed conditions such as in darkness and 0.05Hz frequency. At least five minutes interval was given between the tests and recalibrations were done before each tests. The results of this test were as follows. 1) Vestibular-ocular reflex(VOR) changes according to eye open or closure. In cases of examinees which were given alerting tasks, larger gain was obtained with eyes opened than with eyes closed, and that was statistically significant(p<0.05). In cases of examinees which were not given alerting tasks, larger gain was obtained with eyes opened than with eyes closed, but that was not statistically significant(p>0.05). 2) VOR changes according to alertness. In cases of examinees which opened their eyes, larger gain was obtained with alerting tasks than without alerting tasks, and that was statistically significant(p<0.05). In cases of examinees which closed their eyes, larger gain was obtained with alerting tasks than without alerting tasks, and that was statistically significant(p<0.05). 3) There was no significant changes of asymmetry according to the conditions. Therefore, from above results, we recommend the condition in which examinees open their eyes and be given alerting tasks as one of the optimal condition in sinusoidal harmonic acceleration test.
Acceleration* ; Darkness ; Korea ; Plastics* ; Reflex, Vestibulo-Ocular*

BACKGROUND AND OBJECTIVES: Vestibulo-ocular reflex and vestibulo-spinal reflex are induced by transmatoid galvanic stimulation of vestibular system. Nystagmus and body sway are result of each reflex. Recently, videooculograph possible to record a minute ocular movement was commonly used, vestibulo-ocular reflex induced by galvanic simualtion is easily documented. The purposes of this study are to evaluate the galvanic nystagmus in nomal persons in order to better understand the physiology of the vestibular system. MATERIALS AND METHODS: Eye movement of 20 neurootologic normal subjects by both side transmstoid galvanic stimulation (40cases) were analyzing by videonystagmography. RESULT: The direction of nystagmus in fast phase was to the negative electrode. Galvanic nystagmus was occured all normal subjects when stimulus intensity was more than 2mA. There was positive correlation between slow phase velocity(SPV) and electric current but negative correlation was noted between asymmery of SPV and electric current. CONCLUSION: It is suggested that the galvanic nystagmus test could be a new diagnostic tool for evaluation of vestibular status.
Electrodes ; Eye Movements ; Humans ; Physiology ; Reflex ; Reflex, Vestibulo-Ocular

PURPOSE: We assessed the efficacy of radical prostatectomy (RP) in prostate cancer patients with preoperative prostate-specific antigen (PSA) levels > or = 20 ng/ml and no distant metastases. MATERIALS AND METHODS: The records of 132 prostate cancer patients undergoing RP with preoperative PSA levels > or =20 ng/ml and no distant metastases were reviewed. Sixty-six patients received preoperative neoadjuvant hormonal therapy. Pathologic and clinical outcomes were compared between the groups with PSA of 20-40 ng/ml and > or =40 ng/ml. RESULTS: There were no statistical differences in age, prostate volume, or the frequency of neoadjuvant hormonal therapy between the two groups. The PSA > or =40 ng/ml group had a higher RP Gleason score, tumor stage, and extracapsular extension. After a mean follow-up of 47.0 months, 73 (55.3%) patients had PSA progression with a median time of 37.0 months. Fifty-six patients received adjuvant hormonal therapy, and 19 received salvage external beam radiation therapy. Clinical disease progression developed in 10 patients (7.6%). During follow-up, 8 patients died, 1 of prostate cancer and 7 of other causes. Preoperative PSA was a significant predictor of PSA progression and time to PSA progression after RP, whereas there were no differences in distant metastasis, local recurrence, hormone-refractory prostate cancer progression, and overall or prostate cancer-specific death between the 2 groups. CONCLUSIONS: On the basis of the favorable postoperative outcomes of RP in patients with preoperative PSA > or =20 ng/ml and no distant metastases, we suggest that RP has a role in treating these high-risk prostate cancer patients and that preoperative PSA is a significant predictor of postoperative PSA progression.
Disease Progression ; Follow-Up Studies ; Humans ; Neoplasm Grading ; Neoplasm Metastasis ; Prostate ; Prostate-Specific Antigen ; Prostatectomy ; Prostatic Neoplasms ; Recurrence ; Treatment Outcome

BACKGROUND AND OBJECTIVES: The simultaneous binaural bithermal caloric test is performed by stimulating both ear canals with the water of same temperature at the same time. There are some reports that the simultaneous binaural bithermal caloric test appears to be more sensitive than the alternative bithermal caloric test in detecting caloric vestibular abnormalities. However, it is not well known yet what effect simultaneous binaural bithermal caloric test has on the vestibulo-ocular reflex. We attempted to verify the clinical usefulness of the simultaneous binaural bithermal caloric test. MATERIALS AND METHODS: Otoneurologically normal subjects (n=20) and patients who have complaints of dizziness (n=141) were tested. The regular bithermal caloric test was performed, using Life-Tech water irrigator and the water of temperatures 30degreesC and 44degreesC. The simultaneous binaural bithermal test was performed using Brooker-Grams closed loop irrigator with 27degreesC and 44degreesC water. The irrigation time was 40 seconds and nystagmus was detected for more than 120 seconds by electronystagmography. We divided the test response into six types with the reference value of canal paresis (CP) of the regular bithermal caloric test. RESULTS: The distribution of nystagmus type did not show regular pattern in the normal controls. The distribution of type I and II was 77.4% when CP was more than 25% in patients, 50.6% when CP was less than 25% in patients, and 42.5% in the normal group. The maximal velocity of slow component increased in the unilateral canal paresis patients (CP>25%), compared with the normal controls and no unilateral canal paresis patients (Cp<0.05). CONCLUSION: We observed that the simultaneous binaural bithermal caloric test has advantages of being less time-consuming and more comfortable. When the maximal velocity of slow component is more than 22.6 deg/sec with type I or II response, we could predict canal paresis; however, further studies should be made for abnormal response of simultaneous caloric response on the central nervous ststem.
Caloric Tests* ; Dizziness ; Ear Canal ; Electronystagmography ; Humans ; Paresis ; Reference Values ; Reflex, Vestibulo-Ocular ; Water