The angiopathy and neuropathy is the basic mechanism causing diabetic gangrene, but the exact mechanism is still unknown. The foot is especially susceptible to diabetic complication of angiopathy and neuropathy. In such a vulnerable foot, trivial trauma may quickly lead the foot to ulceration, infection, gangrene, and to the cataclysmic amputation. Twenty nine patients with diabetic gangrene were studied, the conclution were as follow. 1. Overall incidence is 1.8%, most common age over 50 years of age, and the most common disease durstion is from 10 to 14 years. 2. The most common site is toe (56% of cases). 3. The most common predisposing factor was local pressure (41% of cases), the radiographic bone change was seen in 14% of cases. 4. The FBS level is from 200 to 300 in 35% of cases. 5. Bacterial infection was seen in 80%, and staphylococcal aureus was most common. 6. The surgical or conservative treatment were effective in 80% of cases and mortality was 14%. 7. Diabetic retinopathy was most common associated complication (47% of cases).
Amputation ; Bacterial Infections ; Causality ; Diabetes Complications ; Diabetes Mellitus ; Diabetic Retinopathy ; Foot ; Gangrene ; Humans ; Incidence ; Mortality ; Toes ; Ulcer

No abstract available.
Adult* ; Extracorporeal Membrane Oxygenation* ; Humans ; Liver Transplantation* ; Liver* ; Pulmonary Embolism*

Hantaviruses are distributed in rodent population world-widely even in geographical areas where hemorrhagic fever with renal syndrome (HFRS) has not been reported. Va.ictus species of Family Muridae and Arvicolidae serve as the natural reservoirs of hantaviruses. Hantaan virus, Seoul virus, Puumala virus, Prospect Hll virus, Sin Hombre virus and New York virus are members of genus Hantavirus and isolated from lungs of A. agrarius, C glareolus, M. pennsylvanicus, P. maniculatus and P. leucopus respectively. This experiment was intended to find the distribution of hantavirus infection among wild rodents and isolate the hantavirus from lung tissue of seropositve Apodemus peninsulae, and compared the nucleotide and amino acid sequences with prototype of hantaan virus 76-118 strain. Hantaviral sequences were amplified from lung tissues of A. peninsulae by reverse-transcriptase polymerase chain reaction. Alignment and comparison of the 324 nucleotide of G2 region of M-genomic segment diverged 4.6% and 0% at the nucleotide and amino acid levels, and complete N protein-coding region of S-genomic segment diverged 3.7% and 1.4% nucleotide and amino acid levels, respectively. This is the report to spill-over on the hantaan virus from A. peninsulae to A. peninsulae in Korea.
Amino Acid Sequence ; Animals ; Gyeonggi-do* ; Hantaan virus ; Hantavirus Infections ; Hantavirus* ; Hemorrhagic Fever with Renal Syndrome ; Humans ; Korea ; Lung ; Muridae ; Murinae* ; Polymerase Chain Reaction ; Puumala virus ; Rodentia ; Seoul virus

Multiple species of muridae and arvicolidae rodents serve as the natural reserviors of hantaviruses. Hantaviruses are distributed in rodent populations world-widely even in geographical areas where hemorrhagic fever with renal syndrome (HFRS) has not been reported. Serologic diagnosis of infection, using hantaviral antigen, indicates that hantaviruses are wider distributed in wild rodents. This study was designed to intended the hantavirus infection among wild rodents captured in Kyebang mountain, Kangwon-do in Korea. A total of 216 wild rodents in 3 species were trapped in July and September in 1995. Serological evidence for hantaviruses infection were tested against five hantavirus antigens by indirect immunofluorescent antibody technique (IFA). Among 100 Eothenomys regulus, 78 Apodemus peninsulae and 38 Apodemus agrarius (IFA). Among 100 Eothenomys regulus, 78 Apodemus peninsulae and 38 Apodemus agrarius; 12 C. regulus, 15 A. peninsulae and 6 A. agrarius were IF antibody positive against hantaviruses. This data suggest that Eothnomys regulus and Apodemus peninsulae would be a natural reservoir of hantaviruses.
Animals ; Diagnosis ; Gangwon-do ; Hantavirus Infections* ; Hantavirus* ; Hemorrhagic Fever with Renal Syndrome ; Korea ; Muridae ; Murinae ; Rodentia*

To evaluate the degree of competitive exclusion against Salmonella gallinarum(S. gallinarum) of Salmonella enteritidis(S. enteritidis) infected chickens, fifty-six, 4-week old Hyline layer suspected of S. enteritidis infection were challenged with S. gallinarum. All chickens were tested for S. enteritidis isolation using cloacal swabs and serum plate agglutination test using S. enteritidis Ag. before challenge and classified into four groups(SE isolated, SE nonisolated, SE seropositive and SE seronegative). None of the SE isolated and the SE seropositive groups died after challenge and the average weight gains were 245.5g and 254.6g, respectively. But in the SE nonisolated and the SE seronegative groups, mortality was 18.2% and 20.6% and the average weight gains were 150.1g and 111.2g. The incidence of reisolation of S. gallinarum of the SE isolated and the SE seropositive groups were 41.7% and 47.6% from liver, 33.3% and 47.6% from spleen and 8.3% and 14.3% from cecum, respectively, and the SE nonisolated and the SE seronegative group were 63.6% and 64.7% from liver, 84.1% and 88.2% from spleen and 47.7% and 52.9% from cecum. The serological response of the SE isolated and the SE seropositive groups hardly changed from 75.0 and 81.8% before challenge to 75.0 and 85.7% after. But, the other two groups were found to be significantly higher after challenge and increased from 0 and 18.2% to 100%. Consequently, S. enteritidis preinfected chickens were found to be significant different in terms of mortality, weight gain, reisolation of S. gallinarum and serological response compared to noninfected chickens. Moreover, our study shows that S. enteritidis infected chickens appear strong competitive exclusion against the colonization of S. gallinarum.
Animals ; Chickens ; Disease Outbreaks/veterinary ; Korea/epidemiology ; Oviposition ; Poultry Diseases/*microbiology ; Salmonella/*classification/*isolation & purification ; Salmonella Infections, Animal/*microbiology ; Salmonella enteritidis/*classification/*isolation & purification ; Serotyping ; Weight Gain

Transforming growth factor (TGF)-beta1 plays an important role in hepatocarcinogenesis and has been described as a useful tumor marker and one of the poor prognostic indicators in patients with hepatocellular carcinoma (HCC). To investigate the role and cellular localization of TGF-beta1 during multistep hepatocarcinogenesis we performed a quantitative analysis of TGF-beta1 mRNA and immunohistochemical expression of TGF-beta1 and TGF-beta receptor II (TGF-betarII) in female Sprague-Dawley rats. The experimental groups included neoplastic lesions produced by Solt-Farber's protocol, regenerating liver after partial hepatectomy, and normal control. Quantitative change of TGF-beta1 mRNA was analysed by competitive reverse-transcription polymerase chain reaction (RT-PCR). TGF-beta1 protein and TGF-betarII expression were evaluated by immunohistochemical stain. The discrete tumor nodules were detected on 14th day and then increased in number and size. Three HCCs were induced on 8th or 9th month. RT-PCR demonstrated TGF-beta1 mRNA band in all examples of the normal and regenerating liver, nodules and HCCs. Competitive RT-PCR displayed higher TGF-beta1 mRNA in nodules, HCCs and regenerating liver than in normal controls. Hepatocytes from control and regenerating livers showed weak immunoreactivity for TGF-beta1. In contrast, the cytoplasm of hepatocytes of nodules in 7th, 8th and 9th month and HCCs were intensely stained for TGF-beta1. Some sinusoidal cells showed immunoreactivity for TGF-beta1 in all experimental groups. In early phase of carcinogenesis, the cytoplasm of hepatocytes in liver of 12h, 1d and 3d showed transiently increased immunoreactivity for TGF-beta1 and The immunoreactivity decreased thereafter. TGF-beta1 mRNA was also detected in the neoplastic hepatocytes by in-situ hybridization. Although TGF-betarII expression was correlated with TGF-beta1 immunoreactivity during early phase of carcinogenesis, hepatocytes in most nodules in 7th, 8th, 9th month and carcinomas showed decreased or little immunoreactivity for TGF-betarII. Based on the above results, it is concluded that TGF-beta1 expression increases not only in precancerous nodules but also in HCCs and its increase seems to be correlated with decrease or loss of TGF-betarII expression although its mechanism remains unclear. Hepatocytes may be a major cellular source of TGF-beta1 during hepatocarcinogenesis.
Carcinogenesis ; Carcinoma, Hepatocellular ; Cytoplasm ; Diethylnitrosamine* ; Female ; Hepatectomy ; Hepatocytes ; Humans ; Liver ; Polymerase Chain Reaction ; Rats, Sprague-Dawley* ; Receptors, Transforming Growth Factor beta* ; RNA, Messenger* ; Transforming Growth Factor beta* ; Transforming Growth Factor beta1* ; Transforming Growth Factors*

BACKGROUND: Tramadol is a centrally acting analgesic with weak opioid agonist properties and has effect on the spinal inhibition of pain. This study was designed to evaluate the efficacy of tramadol in the treatment of postanesthetic shivering. METHODS: Sixty patients (ASA class I/II) who showed postanesthetic shivering were randomly assigned into three groups (n=20): Normal saline group; normal saline 10 ml, tramadol (TRD) 0.5 mg/kg group; tramadol 0.5 mg/kg, TRD 1.0 mg/kg group; tramadol 1.0 mg/kg. And all patients received standard postoperative management in the recovery room. Evaluation of the grade of shivering was done at 30 seconds, 2, 5 and 10 minutes from the beginning of the treatment by the same investigator who had injected the drug. The age, sex, weight, duration of anesthesia and axillary temperature were recorded. RESULTS: By 30 seconds, 2 minutes, 5 minutes, and 10 minutes, 0, 4, 9, 9 patients of the 0.5 mg/kg tramadol group (n=20) and 7, 18, 19, 19 patients of the 1.0 mg/kg tramadol group (n=20) stopped the shivering respectively. But in 3 patients of 0.5 mg/kg tramadol group who stopped shivering by 5 minutes, shivering was recurred within 10 minutes and in 3 patients who had not stopped shivering by 5 minutes, shivering stopped by 10 minutes. In the placebo group, only 1 patient stopped shivering by 5 minutes. CONCLUSION: 1.0 mg/kg of tramadol was effective for the treatment of postanesthetic shivering but 0.5 mg/kg of tramadol was ineffective.
Anesthesia ; Humans ; Recovery Room ; Research Personnel ; Shivering* ; Tramadol*

BACKGROUND: Tramadol is a centrally acting analgesic with weak opioid agonist properties and has effect on the spinal inhibition of pain. This study was designed to evaluate the efficacy of tramadol in the treatment of postanesthetic shivering. METHODS: Sixty patients (ASA class I/II) who showed postanesthetic shivering were randomly assigned into three groups (n=20): Normal saline group; normal saline 10 ml, tramadol (TRD) 0.5 mg/kg group; tramadol 0.5 mg/kg, TRD 1.0 mg/kg group; tramadol 1.0 mg/kg. And all patients received standard postoperative management in the recovery room. Evaluation of the grade of shivering was done at 30 seconds, 2, 5 and 10 minutes from the beginning of the treatment by the same investigator who had injected the drug. The age, sex, weight, duration of anesthesia and axillary temperature were recorded. RESULTS: By 30 seconds, 2 minutes, 5 minutes, and 10 minutes, 0, 4, 9, 9 patients of the 0.5 mg/kg tramadol group (n=20) and 7, 18, 19, 19 patients of the 1.0 mg/kg tramadol group (n=20) stopped the shivering respectively. But in 3 patients of 0.5 mg/kg tramadol group who stopped shivering by 5 minutes, shivering was recurred within 10 minutes and in 3 patients who had not stopped shivering by 5 minutes, shivering stopped by 10 minutes. In the placebo group, only 1 patient stopped shivering by 5 minutes. CONCLUSION: 1.0 mg/kg of tramadol was effective for the treatment of postanesthetic shivering but 0.5 mg/kg of tramadol was ineffective.
Anesthesia ; Humans ; Recovery Room ; Research Personnel ; Shivering* ; Tramadol*

Testicular torsion is the most common cause of acute scrotal pain in prepubertal and adolescent boys. The overall testicular salvage rate with acute torsion is only 20 to 50 per cent. However, up to 50 percent of the patients with acute torsion have experienced previous episodes of acute testicular pain. Intermittent testicular torsion is a separate entity that should be considered in all young males with a history of scrotal pain and swelling. interspersed with long interval without symptoms. Most males with testicular torsion have aberrant anatomy for the testes to be more susceptible to torsion. Bell-clapper deformity and long mesorchium have been typically described at exploration. On reviewing the medical records. elective orchiopexy was performed on l2 patients under the diagnosis of intermittent testicular torsion during the recent 5 years at Yonsei University Hospital. The features and pathological anatomy of intermittent testicular torsion in these l2 patients are described. Awareness of intermittent testicular torsion as a definite entity and early elective orchiopexy will improve testicular salvage rate.
Adolescent ; Congenital Abnormalities ; Diagnosis ; Humans ; Male ; Medical Records ; Orchiopexy ; Spermatic Cord Torsion* ; Testis

To investigate the pathogenicity, genomic pattern, and o-like hemolysin of Staphylococcus lugdunensis (S. lugdunensis) in acute oral infection, S. lugdunensis was isolated from patients with an acute oral infection and from healthy persons. Antibiotic susceptibility, in vitro cellular toxicity, in vivo virulence, and hemolytic activity were tested, and plasmid DNA and restriction pattern of whole genomic DNA were analyzed to characterize the staphylococci. The dot blot and Southern blot hybridization analysis of staphylococcal DNA were performed with o-hemolysin gene probe. The isolation ratio of S. lugdunensis in the patients was higher than that in the healthy persons. S. lugdunensis from the patients with an acute oral infection showed resistance to penicillin, ampicillin, methicillin, cephalothin, and clindamycin. In the analysis of plasmid, there was a clear band about 6.5 kb in three strains of S. lugdunensis isolated from the patients with infection. S. lugdunensis in the patients had cellular toxicity in vitro and virulence in vivo. All strains of S. lugdunensis had o-like hemolysin activity against rabbit erythrocytes. Four of the six strains of S. lugdunensis gave synergistic hemolysis with Staphylococcus aureus (S. aureus) on sheep blood agar plates. In the analysis of genomic pattern, four strains of S. lugdunensis that gave synergistic hemolysis with S. aureus showed a similar genetic pattern with HindIII enzyme digests. In dot blot analysis, all strains of S. lugdunensis showed a positive reaction with the probe of 5-hemolysin gene in S. aureus. In Southern blot analysis, a 7.3 kb HindIII fragment was observed in DNA of S. lugdunensis that gave synergistic hemolysis with S. aureus, and a 2.5 kb band was observed in HindIII digests of S. aureus in the patients. These results suggest that S. lugdunensis may be an important pathogen in an acute oral infection and the 7.3 kb HindIII fragment from S. lugdunensis DNA may contain o-like hemolysin gene.
Agar ; Ampicillin ; Blotting, Southern ; Cephalothin ; Clindamycin ; DNA ; Erythrocytes ; Hemolysis ; Humans ; Methicillin ; Penicillins ; Plasmids ; Sheep ; Staphylococcus aureus ; Staphylococcus lugdunensis* ; Staphylococcus* ; Virulence