Cartilage is commonly used autogenous material for aesthetic and reconstructive surgery and major donor sites of cartilage are ear, nasal septum, and rib. As the cartilage correlates with ossification and can be used for joint reconstruction. Many growth factors influencing growth and differentiation of chondrocytes have been reported, and matrix composition produced by chondrocytes may vary in types and quantity according to culture duration. Initially the chondrocytes in culture aggregate, then secrete type I collagen. Type II collagen is produced during differentiation process, and synthesis of type X collagen is the last step. In this study, chondrocytes were isolated from ear cartilage of the New Zealand white rabbit weighing 400 gm. We performed high density culture using penicylinder and pellet method. The cells were polygonal in morphology and viable under the inverted microscope. This experiment was designed to evaluate the effect of IGF-I, TGF- p, and b- FGF on the synthesis of collagen in chondrocyte culture. Optimal concentration of growth factors was determined using H-thymidine incorporation into DNA. After the addition of optimal concentration of each growth factors in experimental groups, the uptake of H-proline was measured. Only IGF-I showed a statistically significant increase of collagen synthesis. We observed how subtypes of collagen were influenced by growth factors in two culture methods and by differing the addition timing of growth factors. SDS-PAGE was adopted for subtyping of collagen. All subtypes of collagen were found in both culture methods and all growth factors facilitated the production of type II and type X collagen and may be devoted to the differentiation of chondrocytes. Immunohistochemical staining for type I, and type II collagen was examined to confirm the above result. In pellet culture, type II collagen was stained densely in response to the addition of three kinds of growth factors. The results of penicylinder culture showed similar outcome to those from pellet cultured group. From the above results, we concluded as follows; First, IGF-I generally influence the synthesis of type I and II collagen. Second, TGF beta increased the synthesis of collagen. Third, b-FGF increased the synthesis of type II and type X collagen. We concluded that IFG-I is the only growth factor which is effective regardless of culture duration and method. TGF- beta and b-FGF, which are potent mitogen, facilitate the secretion of collagen.
Cartilage ; Chondrocytes* ; Collagen Type I ; Collagen Type II ; Collagen Type X ; Collagen* ; DNA ; Ear ; Ear Cartilage ; Electrophoresis, Polyacrylamide Gel ; Humans ; Insulin-Like Growth Factor I ; Intercellular Signaling Peptides and Proteins* ; Joints ; Nasal Septum ; New Zealand ; Ribs ; Tissue Donors

BACKGROUND: The pathological significance of adolescent obesity is increasing, as research results indicate that about 80 percent of obese teenager becomes obese as adults. However, most studies on obesity have been mainly centered on the biomolecular aspect of obesity, thereby offering little solution to the clinical application and the promotion of overall health for people. This study investigates into the psychological factors of adolescent obesity, mainly that relating to stress. METHODS: After having chosen 14 third year classes from two middle schools, one from the Kang nam and the other from the Kang puk region of Seoul, I have distributed questionnaires to the total of 501 students. For calculating the degree of stress among the students, I have employed the BEPSI (Brief Encounter Psychosocial Instrument) K, transforming each 5 positive questions into 1 point, which were summed up and divided by 5 (the BEPSI K score). RESULTS: Controlling the confounding factor, the regression coefficient regarding the Body Mass Index of the BEPSI K score was 0.661, t as 3.122, and R Square as 0.05, indicating the statistical relevance of the two factors. A multiple linear regression analysis of theses data yielded the following equation: Body Mass Index=15.6+0.661 x BEPSI K score(R2=0.05) Although the R Squre, as 0.05, was relatively low, this statistical result proves that the rise in stress contributes to the increase of Body Mass Index, thereby indicating that stress functions as an important factor for adolescent obesity. CONCLUSION: For remedying and preventing adolescent obesity, one must make use of the BEPSI K examination and calculate the degree of stress among the adolescent. This study further implies that the best solution to the problems of obesity among adolescent is for the family members, the educational institutions, and the society as a whole to understand and to help the adolescent overcome frequent mental stress resulting from their daily living.
Adolescent* ; Adult ; Body Mass Index* ; Humans ; Linear Models ; Obesity ; Pediatric Obesity ; Psychology ; Seoul ; Surveys and Questionnaires

OBJECTIVE: To evaluate the effect of aerobic exercise training on the cardiovascular system in the early stroke patients by bicycle ergometer exercise test. METHOD: 16 stroke patients without cardiac disease were randomly assigned to exercise training group (8 patients) and control group (8 patients). The time interval between the onset of stroke and exercise training was within 90 days. Exercise tests by bicycle ergometer using Astrand-Ryhming protocol were performed twice before and after training. Exercise training was consisted with the intensity of 60~70% of maximal heart rate, 30 minutes per day, 3 times per week for 6 weeks using bicycle ergometer. Modified Barthel Index (MBI) score and blood lipid profile were recorded before and during training. Blood pressure and heart rate were checked before and during exercise test. RESULTS: In a training group, maximal systolic blood pressure and rate pressure product were decreased immediately after exercise test after 6-weeks exercise training (p<0.05). The MBI score and lipid profile were not changed after training. CONCLUSION: Early exercise training in the stroke patients for 6 weeks have beneficial effects on the cardiovascular system.
Blood Pressure ; Cardiovascular System* ; Exercise Test ; Exercise* ; Heart Diseases ; Heart Rate ; Humans ; Stroke

Purpose: The purpose of this study is to find out the current status of toxicology laboratory operated by six locations nationwide and to investigate the satisfaction of emergency medical professionals who working at local and regional emergency medical centers. Methods: This survey was conducted prospective. It was conducted on 665 emergency medical professionals working at regional and regional emergency medical centers across the South Korea. Among them, the analysis was conducted with data that 510 emergency medical professionals who respond to this survey. The questionnaire was conducted on an online basis for a month. To ensure statistical significance, consider a dropout rate of 10% based on a minimum response recovery rate of 70%. 506 people were selected for the survey. Results: According to a survey on the status of addiction analysis room usage, the average monthly usage of addiction test rooms among respondents were 406 cases.71.0 cases (17.4%) of toxicology laboratory in Seoul and 71 cases (17.4%) in Gwangju. 32 cases (7.8%), 118 cases (29.0%) requested by toxicology laboratory in Busan, and the toxicology laboratory in Daegu. Eighty two cases (20.1%), Daejeon area 25 cases (6.1%), Wonju area toxicology laboratory was 78 (19.6%). According to a survey on the satisfaction of the addiction analysis room,Seoul (4.9±2.71) and Gwangju (4.8±2.52) showed high satisfaction. Conclusion Due to the limited operation time of the four addiction analysis rooms currently in operation, the satisfaction level of addiction analysis by emergency medical professionals in the area is low due to the delay until the result is notified.

Extended-spectrum beta-lactamase (ESBL) producing bacterial infection causes delayed response to antibiotic treatment and consequently results in serious problem, because it can hydrolyze the majority of beta-lactam antibiotics. Here we report a case of multiple renal abscess by ESBL producing Escherichia coli in a patient with diabetes mellitus who had a history of repetitive urinary tract infection. A 49-year old woman was admitted to our hospital because of intermittent fever, left flank pain, and vomiting. She had been diagnosed as acute pyelonephritis and treated with the first and third cephalosporin for 1 month at a clinic. At admission, urinary bacterial culture revealed Escherichia coli resistant to both the first and third cephalosporin such as cefotaxime, ceftriaxone, and ceftazidime. Double disk synergy test confirmed ESBL. Abdominal computed tomography demonstrated multiple renal abscess. After treatment of imipenam for 4 weeks, she discharged with improved condition.
Abscess* ; Anti-Bacterial Agents ; Bacterial Infections ; beta-Lactamases* ; Cefotaxime ; Ceftazidime ; Ceftriaxone ; Diabetes Mellitus ; Escherichia coli* ; Escherichia* ; Female ; Fever ; Flank Pain ; Humans ; Middle Aged ; Pyelonephritis ; Urinary Tract Infections ; Vomiting

Kawasaki diseases occur frequently in children beyond the age of 4 years, but classic Kawasaki disease in newborns are rare and have not been reported in Korea yet. We report a case of classic Kawasaki disease in neonate who is 21 days old girl and has no response to gamma-globulin although early diagnosis and treatment. Her clinical features met typical Kawasaki disease, but unusually she had a non suppurative labia major erythema and severe edema instead of cervical lymphadenitis. She had persistent fever and progressive carditis with coronary dilatation in spite of 3 doses of gamma globulin. Her fever was subsided after 3 doses of intravenous methyl prednisolone. In the subacute stage her other symptoms subsided and appeared typical desquamation of fingers and toe. Finally she had mild mitral regurgitation and diffuse coronary dilatation when she was discharged. Since one year follow up, with continuous aspirin medication, now she is very healthy, and her coronary dilatation was normalized and not any more valvular regurgitation.
Aspirin ; Child ; Dilatation ; Early Diagnosis ; Edema* ; Erythema* ; Female ; Fever ; Fingers ; Follow-Up Studies ; gamma-Globulins ; Humans ; Infant, Newborn* ; Korea ; Lymphadenitis ; Mitral Valve Insufficiency ; Mucocutaneous Lymph Node Syndrome* ; Myocarditis ; Prednisolone ; Toes

PURPOSE: Kawasaki disease is a systemic vasculitis, leading cause of pediatric acquired heart disease. Vascular endothelial growth factor (VEGF) has functions as vascular permeability factor, plays an important role in coronary artery lesion (CAL). We studied the clinical significance of serum VEGF in Kawasaki disease. METHODS: Kawasaki group was 49 patients, and control group was 15 patients. Diagnosis followed AHA (American Heart Association) diagnostic criteria, with blood sampling in acute, subacute, and convalescent phase. Echocardiographic abnormalities were defined and the definition of intravenous gamma globulin (IVGG)-responsive and IVGG-resistant was determined. RESULTS: Serum VEGF of Kawasaki group was significantly higher than of control group. Comparison of serum VEGF between CAL and non-CAL group, between carditis group and non-carditis group showed no significant differences. Subacute serum VEGF was statistically higher in IVGG-resistant group than in IVGG-responsive group, and serum VEGF of IVGG-resistant group in subacute phase was statistically higher than in the other phases. Serum VEGF of convalescent CAL and non-CAL group in acute and subacute phase had meaningful differences. Total fever duration and subacute serum VEGF had positive correlation. Acute serum VEGF had positive correlation with ESR and CRP, all phases serum VEGF had also positive correlation with WBC. Acute and subacute serum VEGF had negative correlations with hemoglobin and albumin. CONCLUSION: Serum VEGF can help to determine the severity of Kawasaki disease, especially subacute serum VEGF seems to be used as a prognostic factor of coronary complication. Afterward, further studies needed with more strict diagnostic criteria and more study groups.
Coronary Vessels ; Diagnosis ; Echocardiography ; Fever ; gamma-Globulins ; Heart ; Heart Diseases ; Humans ; Mucocutaneous Lymph Node Syndrome* ; Myocarditis ; Systemic Vasculitis ; Vascular Endothelial Growth Factor A*

PURPOSE: Kawasaki disease (KD) is known as an acute multi-systemic vasculitis with various immunologic abnormalities. Adhesion of leukocyte to endothelial cells is a key event in the sequence of inflammatory response. This study was performed to investigate the clinical significance of serum soluble intercellular adhesion molecule-1 (sICAM-1) and soluble vascular cell adhesion molecule-1 (sVCAM-1) in acute and subacute stages of typical KD for diagnostic and prognostic value. METHODS: A typical KD group was 32 patients who were hospitalized from Jan 2002 to Jun. 2004 was enrolled. Control was 16 non-KD patients with febrile illness. sICAM-1 and sVCAM-1 were measured and compared by Echocardiographic and clinical findings and cardiac troponin T and I. RESULTS: sICAM-1 and sVCAM-1 levels of acute KD were significantly elevated over control (P= 0.019 vs. P=0.049, respectively) and sICAM-1 was significantly decreased in subacute stage (P= 0.0015). sICAM-1 and sVCAM-1 had positive correlation with each other in both stages (P=0.0067, P=0.015, retrospectively). Neither sICAM-1 nor sVCAM-1 correctly reflected the coronary abnormalities and responsiveness to intravenous gammaglobulin (IVGG) in both stages. But sVCAM-1 was significantly increased in the carditis group in both stages (P=0.025, P=0.014, retrospectively) and had a positive correlation with troponin T (r=0.63, P=0.00063). CONCLUSION: The levels of sICAM-1 and sVCAM-1 were not very useful tools for detecting and predicting subsequent coronary abnormalities and responsiveness to IVGG in KD patients. However, sVCAM-1 appears to play a significant role in carditis of KD. Further studies are needed about various adhesion molecules and cytokines in the pathogenesis of KD.
Coronary Disease ; Cytokines ; Echocardiography ; Endothelial Cells ; Humans ; Intercellular Adhesion Molecule-1* ; Leukocytes ; Mucocutaneous Lymph Node Syndrome* ; Myocarditis ; Troponin T ; Vascular Cell Adhesion Molecule-1* ; Vasculitis

BACKGROUND: To reduce massive blood loss during a hepatectomy, many anesthesiologists have used the technique of low central venous pressure maintenance by administration of low dose nitroglycerin (NTG) and/or intravenous fluid reduction. However, so far there have been no studies about local liver perfusion (LLP) changes after hepatic artery (HA) or portal vein (PV) reperfusion in patients receiving nitroglycerin administration. In this study, the changes in hemodynamics and LLP following HA and PV reperfusion along with low dose (2micro gram/kg/min) NTG administration in dogs were observed. METHODS: A total of 20 mongrel dogs were divided into four groups; HA occlusion and reperfusion group (H, n = 5), NTG administration group during the reperfusion on H (H-NTG, n = 5), PV occlusion and reperfusion group (P, n = 5), NTG administration group during the reperfusion on P (P-NTG, n = 5). After femoral and pulmonary arterial catheterization, a midline abdominal incision was made. HA and PV were exposed to clamp and declamp. A thermal diffusion microprobe was inserted in the liver parenchyme to measure LLP. RESULTS: The PV blood flow was not changed after HA occlusion, but HA blood flow increased after PV occlusion. The LLP decreased after HA and PV occlusion. The LLP recovered to the baseline level in group H-NTG after HA reperfusion, but the LLP was more increased compared to the baseline level in group H. In group P, the LLP did not recover after PV reperfusion, but the LLP in group P-NTG recovered to the baseline level after PV reperfusion. CONCLUSIONS: In conclusion, it was observed that the LLP recovered to the baseline level by administration of NTG after PV reperfusion. However, the LLP did not increase after HA reperfusion by administration of low dose NTG.
Animals ; Catheterization ; Catheters ; Central Venous Pressure ; Dogs* ; Hemodynamics* ; Hepatectomy ; Hepatic Artery* ; Humans ; Liver* ; Nitroglycerin* ; Perfusion* ; Portal Vein* ; Reperfusion* ; Thermal Diffusion

Langerhans Cell Histiocytosis (LCH) is a pathologic proliferation and infiltration of various organs by Langerhans' cells of unknown cause. Incidence rate of one million parties 3~4 is seen in young child but the incidence is not sure in adult. Organ systems involved by LCH may include skin, ear, bone marrow, liver, spleen, lung, pituitary gland-hypothalamus and GI tracts. In case pituitary-hypothalamus axis are involved, diabetes insipidus happened. Primary Pulmonary Langerhans Cell Histiocytosis(PLCH) with uninvolvement of other organs is rare and accompanied diabetes insipidus is more rare. There are many cases of LCH with diabetes insipidus involve such as central nervous system except lung. PLCH accompany central diabetes insipidus is only 1 case. We report a case of PLCH that accompany central diabetes insipidus with literature investigation inDepartment of Thoracic and Cardiovascular Surgery, Hallym University.
Adult* ; Axis, Cervical Vertebra ; Bone Marrow ; Central Nervous System ; Child ; Diabetes Insipidus ; Diabetes Insipidus, Neurogenic* ; Ear ; Gastrointestinal Tract ; Histiocytosis ; Histiocytosis, Langerhans-Cell* ; Humans ; Incidence ; Liver ; Lung ; Lung Neoplasms ; Skin ; Spleen