BACKGROUND: The objective of this study was to determine the sensitivity, specificity of the ultrasound examination performed by emergency physicians in patients with altered mental state due to trauma. METHODS: From July 1998 until June 2000, a total number of 59 patients showing altered mental state were examined using emergency ultrasound at the time of primary survey. Their medical records were reviewed, and the interpretations of the emergency ultrasound were compared with the abdominal CT scan or clinical results. RESULTS: Of the 59 patients, 3 were excluded due to incomplete records. Among the 56 remaining patients, 9 patients had intra-abdominal problems. The sensitivity and specificity were 77% and 95.7%, respectively. Abdominal CT was not required in 41 (73.2%) patients. CONCLUSION: Emergency ultrasonography can serve as a useful screening tool in detecting free fluid in trauma victims who are not mentally alert.
Emergencies* ; Humans ; Mass Screening ; Medical Records ; Sensitivity and Specificity ; Tomography, X-Ray Computed ; Ultrasonography*

The ras-related GTP binding protein, rab6, is located in late Golgi compartment. Modulation of beta-and gamma-secretase activity may lead to production of beta-amyloid fragments that are ultimately deposited in senile plaques at the brain of Alzheimer patients. Because modulation of rab6-mediated intracellular transport has been known to affect amyloid precursor protein (APP) processing, we investigated the rab6 immunoreactivity on the hippocampal neurons in the Alzheimer brains, according to the pathological staging of the disease. A total of 30 brains were used for this study. Campbell's silver stain for beta-amyloid and immunohistochemistry for rab6 protein were employed. The cortices of the hippocampal formation and the neighboring temporal neocortex were observed. The results are obtained as follows: 1. In normal elderly brains, no amyloid plaque is seen. In Alzheimer brains, a number of amyloid plaques are seen at the temporal neocortex and dentate gyrus. 2. In normal elderly brains, the perikaria of the pyramidal cells at the CA1 sector shows weak rab6 immunoreactivity. At the CA2 and CA3 sectors, trace immunoreactivity is observed in the pyramidal cells. 3. In preclinical Alzheimer brains, the perikaria of the pyramidal cells at the CA1 sector shows moderate rab6 immunoreactivity and the cells at the CA2 sector show weak immunoreactivity. A weak to moderate imunoreactivity is seen in the pyramidal cells of the CA3 sector. 4. In clinical Alzheimer brains, the pyramidal cells at the CA1 and CA3 sectors show strong rab6 immunoreactivity, but the cells at the CA2 sector shows moderate immunoreactivity. It is suggested that alteration of intracellular protein transport caused by abnormal rab6 activity may modulate amyloid precursor protein processing, which results in beta-amyloid production.
Aged ; Amyloid ; Amyloid Precursor Protein Secretases ; Brain* ; Dentate Gyrus ; GTP-Binding Proteins ; Hippocampus ; Humans ; Immunohistochemistry ; Neocortex ; Neurons ; Plaque, Amyloid ; Protein Transport ; Pyramidal Cells ; Silver

Granulomatosis with polyangiitis (GPA) is a disease characterized by a granulomatous necrotizing vasculitis of the small vessels, along with the presence of antineutrophil cytoplasmic antibody (ANCA), serologically. GPA is a multisystem disease, in which the diagnosis is frequently based on respiratory and renal manifestations, with rare breast invasion. To date, several cases of breast invasion by GPA have been published, and most cases have been positive for ANCA. However, ANCA-negative forms of breast invasion by GPA are extremely rare and have not been reported in Korea thus far. Therefore, we report a case of ANCA-negative GPA in a 70-year-old woman, who was initially presented with a localized palpable mass in the left breast.
Aged ; Antibodies ; Antibodies, Antineutrophil Cytoplasmic ; Breast* ; Cytoplasm* ; Diagnosis ; Female ; Humans ; Korea ; Vasculitis

BACKGROUND: Use of universal leukoreduction for prevention of leukocyte associated transfusion reactions is common practice in many countries. This study was conducted in order to evaluate the performance of a newly developed leukoreduction filter for red blood cells (RBCs), the RF300 (Kolon Industries, Inc, Gumi, Korea). METHODS: Filtration time, RBC recovery, residual leukocyte count, and leukocyte removal rate were evaluated. To assess the quality of RBCs after filtration, percent hemolysis was monitored for a period of 21 days. Performance of the RF300 (N=78) was compared with that of the Bio-R O2 plus (Fresenius, Hamburg, Germany), the Pall Purecell RC (Pall Co., Washington, USA), and the Sepacell R-500N (Asahi, Tokyo, Japan). RESULTS: The shortest filtration time was observed using the RF300 (P<0.05). Using the RF300, recovery of RBC was 96.5%, which was higher than that of two filters (P<0.05). Mean residual leukocyte count was 0.26x10(6)/unit, with a leukocyte removal rate of 3 log. Using the RF300, mean percent hemolysis was 0.32% at day 21, which was comparable with that of two filters, but lower than that of one filter (P<0.05). CONCLUSION: The RF300 meets all established quality requirements for conduct of safe and effective leukoreduction of RBCs.
Blood Group Incompatibility ; Collodion ; Erythrocytes ; Filtration ; Hemolysis ; Leukocyte Count ; Leukocytes ; Tokyo ; Washington

PURPOSE: We aimed to elucidate the expression and intracellular localization of sperm-specific cation channel CatSper in human spermatozoa. Moreover, the relationship between the expression of CatSper mRNA and the motility of ejaculated human spermatozoa were investigated. MATERIALS AND METHODS: Using cDNAs extracted from the ejaculated sperm of patients (n=39), the expression of CatSper mRNA was observed by RT-PCR. Semi-quantitative analysis of the CatSper mRNA expression was performed by comparing with the expression of GAPDH mRNA. To elucidate the expression and intracellular localization of CatSper protein, double fluorescent immunocytochemistry for CatSper and beta-tubulin was performed. RESULTS: The CatSper mRNA was expressed in all of the sperm samples. Using semi-quantitative analysis for the amount of CatSper mRNA expression, no significant difference was found between the normozoospermia and asthenozoospermia groups (1.5+/-0.6 vs. 1.4+/-0.6, p=0.623). Polyclonal antiserum, generated against a recombinant protein of the N-terminal 160 amino acids of human CatSper, was used. In double fluorescent immunocytochemistry, CatSper protein was found to be expressed in the flagellum of the ejaculated human spermatozoa, and localized in the connecting piece, mid-piece and principal piece, with the exception of the end piece of the flagellum. Moreover, the proportion of CatSper-positive sperm was similar in both the normozoospermia and asthenozoospermia groups. CONCLUSIONS: To the best of our knowledge, this is the first time ejaculated human spermatozoa have been shown to express the mRNA and protein of CatSper. The results of our RT-PCR and immunocytochemistry suggest that CatSper may play a role in the motility of ejaculated human spermatozoa.
Amino Acids ; Asthenozoospermia ; DNA, Complementary ; Flagella ; Humans* ; Immunohistochemistry ; RNA, Messenger ; Sperm Motility ; Spermatozoa* ; Tubulin

Purpose: To investigate growth response in children with either idiopathic short stature (ISS) or growth hormone (GH) deficiency (GHD). Methods: The data of prepubertal GHD or ISS children treated using recombinant human GH were obtained from the LG Growth Study database. GHD children were further divided into partial and complete GHD groups. Growth response and factors predicting growth response after 1 and 2 years of GH treatment were investigated. Results: This study included 692 children (98 with ISS, 443 partial GHD, and 151 complete GHD). After 1 year, changes in height standard deviation score (ΔHt-SDS) were 0.78, 0.83, and 0.96 in ISS, partial GHD, and complete GHD, respectively. Height velocity (HV) was 8.72, 9.04, and 9.52 cm/yr in ISS, partial GHD, and complete GHD, respectively. ΔHt-SDS and HV did not differ among the 3 groups. Higher initial body mass index standard deviation score (BMI-SDS) and midparental height standard deviation score (MPH-SDS) were predictors for better growth response after 1 year in ISS and the partial GHD group, respectively. In the complete GHD group, higher Ht-SDS and BMI-SDS predicted better growth response after 1 year. After 2 years of GH treatment, higher BMI-SDS and MPH-SDS predicted a better growth outcome in the partial GHD group, and higher MPH-SDS was a predictor of good growth response in complete GHD. Conclusion Clinical characteristics and growth response did not differ among groups. Predictors of growth response differed among the 3 groups, and even in the same group, a higher GH dose would be required when poor response is predicted.

BACKGROUND: This study investigated the effect of fine dust concentrations in the air on the incidence of viral respiratory infections in the Republic of Korea.METHODS: A time series analysis using R statistics was performed to determine the relationship between weekly concentrations of fine dust in the air and the incidences of acute respiratory tract infections caused by the respiratory syncytial virus (RSV), adenovirus (HAdV), rhinovirus (HRV), human metapneumovirus (HMPV), human coronavirus (HCoV), human bocavirus (HBoV), human parainfluenza virus (HPIV), and influenza virus (IFV), from the beginning of 2016 to the end of 2017. Correlations between various meteorological factors and the amount of fine dust were analyzed using the Spearman's rank correlation coefficient. To analyze the relationship between viral infections and fine dust, a quasi-poisson analysis was performed.RESULTS: The incidence of the HAdV was proportional to fine dust and air temperature. The IFV was proportional to fine dust and relative humidity and was inversely proportional to temperature. The HMPV was proportional to fine dust, wind speed, and inversely proportional to relative humidity. The HCoV was proportional to micro dust, relative humidity, and inversely proportional to temperature. Both the HBoV and HPIV were directly proportional to fine dust, temperature, wind speed, and inversely proportional to relative humidity. The RSV was inversely proportional to fine dust, temperature, wind speed. A lag effect was observed for the influenza virus, in that its incidence increased 2–3 weeks later on the cumulative lag model.CONCLUSION: As the weekly average concentration of fine dust increases, the incidence of HAdV, HMPV, HCoV, HBoV, HPIV, and influenza increase.
Adenoviridae ; Air Pollution ; Coronavirus ; Dust ; Human bocavirus ; Humans ; Humidity ; Incidence ; Influenza, Human ; Metapneumovirus ; Meteorological Concepts ; Orthomyxoviridae ; Paramyxoviridae Infections ; Particulate Matter ; Republic of Korea ; Respiration Disorders ; Respiratory Syncytial Viruses ; Respiratory Tract Infections ; Rhinovirus ; Wind

Objective: To investigate the clinical features and associated underlying conditions of isolated tuberculous myositis (ITBM), a rare extrapulmonary tuberculosis (TB). Methods: A systematic literature search and a multicenter survey were performed using a triangulation strategy. Data from the identified ITBM cases were extracted and analyzed to determine the underlying conditions, clinical presentations, treatments, and outcomes. Results: Based on the systematic review, we identified 58 ITBM, including 9 pediatric, cases in the literature published from 1981 to 2021: 25 (43.1%) immunocompromised and 33 (56.9%) non-immunocompromised patients. Immunocompromised cases had a significant shorter symptom duration (median 30.0 vs. 75.0 days) and a higher prevalence of multilocular involvement (20.8% vs. 0%). Among 24 immunocompromised adult patients, dermatomyositis/polymyositis (DM/PM; n=10, 41.7%) were the most common underlying diseases in adults with ITBM identified in the systematic review. Over the past 20 years, 11 Korean adults with ITBM were identified in the multicenter survey. Of 7 immunocompromised cases, two (28.6%) were DM/PM patients. TB death rate of immunocompromised patients was 0.0% and 5/23 (21.7%) in the pediatric and adult ITBM cases identified in the systematic review, respectively, and 3/7 (42.9%) in survey-identified ITBM cases. Conclusion ITBM has a unique clinical presentation including fever, tenderness, local swelling, overlying erythema, abscess formation and was associated with a grave outcome, especially in immunocompromised hosts. DM/PM was a highly prevalent underlying disease in both systematic review-identified and survey-identified immunocompromised ITBM patients.

PURPOSE: This study investigated the incidence trends and associated factors of type 1 (T1DM) and type 2 diabetes mellitus (T2DM) in children and adolescents under 15 years of age in Busan and Gyeongnam, Korea from 2001 to 2010. METHODS: Medical records of newly diagnosed diabetes patients (n=328; 160 males, 168 females) were collected in questionnaire form from 5 tertiary and 42 general hospitals in Busan and Gyeongnam. RESULTS: The average crude incidence rate of T1DM and T2DM was 2.01/100,000 (95% confidence interval [CI], 1.76-2.28) and 0.75/100,000 (95% CI, 0.60-0.92), respectively. The incidence rate ratio (IRR) of T1DM was 1.31 (95% CI, 1.01-1.69), and that of T2DM was 1.97 (95% CI, 1.25-3.11) in the latter half-decade (2006 to 2010) compared to the early half-decade (2001 to 2005). There were gradually increasing incidence trends in both T1DM and T2DM over the 10-year period (P for trend: T1DM, 0.0009; T2DM, <0.0001). Age-specific IRR was highest in the 10- to 14-year-old group, regardless of diabetes type. In particular, a rapid increase in incidence of T2DM occurred in the 10- to 14-year-old group. IRR for females was 1.07 (95% CI, 0.83-1.38) for T1DM and 1.56 (95% CI, 1.01-2.41) for T2DM. IRR for Busan (urban) was 1.41 (95% CI, 1.09-1.83) for T1DM and 1.49 (95% CI, 0.96-2.30) for T2DM. CONCLUSION: T1DM and T2DM incidence both increased over time in youth under age 15 living in Busan and Gyeongnam; in particular, the incidence of T2DM in adolescents increased more rapidly.
Adolescent* ; Busan* ; Child* ; Cohort Studies* ; Diabetes Mellitus* ; Diabetes Mellitus, Type 2 ; Female ; Hospitals, General ; Humans ; Incidence* ; Korea ; Male ; Medical Records ; Retrospective Studies*

The type III histone deacetylase silent information regulator 1 (SIRT1) is an enzyme that is critical for the modulation of immune and inflammatory responses. However, the data on its role in rheumatoid arthritis (RA) are limited and controversial. To better understand how SIRT1 regulates adaptive immune responses in RA, we evaluated collagen-induced arthritis (CIA) in myeloid cell-specific SIRT1 knockout (mSIRT1 KO) and wild-type (WT) mice. Arthritis severity was gauged on the basis of clinical, radiographic and pathologic scores. Compared with their WT counterparts, the mSIRT1 KO mice exhibited less severe arthritis, which was less destructive to the joints. The expression levels of inflammatory cytokines, matrix metalloproteinases and ROR-γT were also reduced in the mSIRT1 KO mice compared with the WT mice and were paralleled by reductions in the numbers of Th1 and Th17 cells and CD80- or CD86-positive dendritic cells (DCs). In addition, impaired DC maturation and decreases in the Th1/Th17 immune response were observed in the mSIRT1 KO mice. T-cell proliferation was also investigated in co-cultures with antigen-pulsed DCs. In the co-cultures, the DCs from the mSIRT1 KO mice showed decreases in T-cell proliferation and the Th1/Th17 immune response. In this study, myeloid cell-specific deletion of SIRT1 appeared to suppress CIA by modulating DC maturation. Thus, a careful investigation of DC-specific SIRT1 downregulation is needed to gauge the therapeutic utility of agents targeting SIRT1 in RA.
Animals ; Arthritis ; Arthritis, Experimental* ; Arthritis, Rheumatoid ; Coculture Techniques ; Cytokines ; Dendritic Cells* ; Down-Regulation ; Histone Deacetylases ; Joints ; Matrix Metalloproteinases ; Mice* ; T-Lymphocytes ; Th17 Cells