The truncated E1192-283 and E2384-649 genes of hepatitis C virus (HCV) linked to the gene for glutathione 5-transferase (GST) were constructed and their expressions were analyzed. The GST-E1192-283 fusion gene overexpressed the fusion protein in E. coli as a soluble form, while the GST-E1192-383 plasmid did not express expected fusion protein. The purified GST-E1192-283 fusion protein was efficiently cleaved by thrombin. More than 90% pure, HCV E1192-283 protein was obtained by GST-agarose chromatography. The truncated GST-E2384-649 fusion gene expressed the fusion protein mainly as an insoluble form, whereas the GST-E2384-740 did not express the fusion protein. The truncated GST-E1 182-283 and GST-E2384-649 fusion proteins reacted specifically with an HCV patient serum. In addition, mice immunized with either the purified E1192-283 or GST-E2384-649 proteins generated specific antibodies to each antigen. The results suggested that hydrophobic carboxyl portions of the E1 and E2 proteins might affect expression levels as well as the solubility of each fusion protein in bacteria. Also, the truncated E1 protein with Tyr-192 to Ser-283 contained antigenic epitope(s) which could be specifically recognized by an HCV patient serum.
Animals ; Antibodies ; Bacteria ; Chromatography ; Glutathione ; Hepacivirus* ; Hepatitis C* ; Hepatitis* ; Humans ; Mice ; Plasmids ; Solubility ; Thrombin

BACKGROUND: The present study was carried out in association with neutrophilic respiratory burst in the lung in order to clarify the pathogenesis of acute respiratory distress syndrome(ARDS) following acute severe hemorrhage. Because oxidative stress has been suggested as one of the principal factors causing tissue injury, the role of free radicals from neutrophils was assessed in acute hemorrhage-induced lung injury. METHOD: In Sprague-Dawley rats, hemorrhagic shock was induced by withdrawing blood(20 ml/kg of B.W) for 5 min and the hypotensive state was sustained for 60 min. To determine the mechanism and role of oxidative stress associated with phospholipase A2(PLA2) by neutrophils, the level of lung leakage, pulmonary myeloperoxidase(MPO), and the pulmonary PLA2 were measured. In addition, the production of free radicals was assessed in isolated neutrophils by cytochemical electron microscopy in the lung. RESULTS: In hypotensive shock-induced acute lung injury, the pulmonary MPO, the level of lung leakage and the production of free radicals were higher. The inhibition of PLA2 with mepacrine decreased the pulmonary MPO, level of lung leakage and the production of free radicals from neutrophils. CONCLUSION: A. neutrophilic respiratory burst is responsible for the oxidative stress causing acute lung injury followed by acute, severe hemorrhage. PLA2 activation is the principal cause of this oxidative stress.
Acute Lung Injury* ; Free Radicals ; Hemorrhage ; Lung ; Lung Injury ; Microscopy, Electron ; Neutrophils* ; Oxidative Stress ; Phospholipases A2* ; Phospholipases* ; Quinacrine ; Rats, Sprague-Dawley ; Respiratory Burst* ; Shock, Hemorrhagic

Results of 170 total knee arthroplasties(TKAs) performed from 1986 to 1995, followed up for at least one year, were reviewed. Lateral retinacular release was performed in 76 knees(45%) and not performed in 94 knees(55%). We compared the results of TKAs combined with lateral retinacular release with those without lateral retinacular release. The clinical results of TKAs were evaluated by the Knee Scoring System of Hospital for Special Surgery(HSS). The average follow-up period was 34 months. The clinical results assessed by HSS score, pain score and range of motion improved postoperatively in both groups, but there was no significant difference between the two groups. There were 8(4.7%) with patellar subluxations in 170 TKAs, one(1.3%) in the group with lateral retinacular release and 7(7.5%) in the group without lateral retinacular release(t-test; p<0.05). Analysis of lateral tilt of patella on roentgenographs also showed a significant difference between the two groups. 7 knees(9.2%) with lateral tilt were observed in the group with lateral retinacular release and 22 knees(23.4%) with lateral tilt in the group without lateral retinacular release(t-test; p<0.05). There was no osteonecrosis or fracture of patella in either group. In summary, lateral retinacular release might improve the patellar tracking and lower the incidence of patellar subluxation and lateral tilt of patella. Lateral retinacular release alone did not seem to cause patellar osteonecrosis and subsequent patellar fracture which were detectable in plain roentgenographs. So, we suggest that lateral retinacular release can be performed without great risk of potential patellar complications in TKAs requiring lateral retinacular release for proper patellar tracking.
Arthroplasty* ; Follow-Up Studies ; Incidence ; Knee* ; Osteonecrosis ; Patella ; Range of Motion, Articular

Sparganosis usually means the plerocercoid larval infection of Spirometra species. It is endemic mainly in countries where the habit of eating raw snake or frog, or the habit of poulticing with snake skin exists. The most common endemic area is Korea, Japan and China, and the most common localizations are subcutaneous connective tissue and superficial muscles. We experienced a case of scrotal sparganosis in a 32-year-old man presenting with painless hard masses in left scrotum. He underwent by serum Enzyme Linked Immunosorbent Assay (ELISA) and was treated by surgical excision.
Adult ; China ; Connective Tissue ; Eating ; Enzyme-Linked Immunosorbent Assay* ; Humans ; Japan ; Korea ; Muscles ; Scrotum ; Skin ; Snakes ; Sparganosis* ; Spirometra

PURPOSE: Reports of clinical findings and treatment for pediatric urinary stone have been published relatively infrequently. Extracorporeal shock-wave lithotripsy (SWL) is a minimally invasive method of treating urinary stone and has been shown to be effective in the pediatric population. We evaluated the clinical characteristics of patients with pediatric urinary stone and compared the therapeutic results of two SWLs, LT-01+ and Modulith SLX lithotriptors. MATERIALS AND METHODS: The records of 57 children treated by SWL were analyzed retrospectively. Twenty-five patients were treated by LT-01+ (group I) and 32 by Modulith SLX (group II) lithotriptor. The outcomes, including the number of treatment sessions, stone free rate and complications, were assessed. RESULTS: The average age of all 57 children, 36 male and 21 female, was 14.3 years. Chief complaints were flank pain (71.9%), gross hematuria (10.5%) and urinary tract infection (12.3%). The average stone size was 8.2mm (2-15mm). The success rates of each SWL were similar in both groups (group I: 88.0%, group II: 90.6%). However the average number of treatment sessions/patient in Group I was significantly smaller than that of Group II (group I: 2.92, group II: 1.35, p<0.05). Flank pain and gross hematuria were developed similarly after treatment in both groups, and needed only conservative therapy and was resolved within three days. CONCLUSIONS: Clinical characteristics of urinary stone in children were similar to those of adults. There was no significant difference in treatment success rate between the two types of lithotriptors but the number of treatment sessions was smaller in patients treated by Modulith SLX lithotriptor.
Adult ; Child ; Female ; Flank Pain ; Hematuria ; Humans ; Lithotripsy* ; Male ; Retrospective Studies ; Shock* ; Urinary Calculi* ; Urinary Tract Infections

Background : There is a substantial body of evidence that intraocular pressure increase with age among western population. However, Japanese study showed that intraocular pressure was inversely related with age. So we investigated whether intraocular pressure is related with age for Koreans. Methods : Between March, 1996 and February, 1997, 6201 subjects underwent comprehensive health examinationinthe Kyung Hee medical screening center in Seoul, Korea. The intraocular pressure was measured with pneumatonograpyh. At the same time blood pressure, body weight, height, serum osmolarity, fasting blood glucose, T3, T4, TSH(thyroid stimulating hormone), hematocrit measurements were performed. We selected 250 case randomly and investigated whether the distribution of C/D ration(cup/disk ratio), smoking status, alcohol drinking amount are uniform by aged group. So we measured C/D ratio by fundusphotograph and investigated smoking and drinking habits by questionnaires. Results : In the randomly sampled 250 cases, the amounts of smoking and alcohol consumption were lower in the elderly group. But, the C/D ration didn't show any difference between young and elderly group. In a multivariable analysis, both right and left intraocular pressure showed significantly inverse correlations with aged and visual acuity. Male had significantly higher intraocular pressure than female. Both right and left intraocular pressure showed significant positive correlations with body mass index, fasting blood glucose, hematocrit and systolic blood pressure. Diastolic blood pressure, serum osmolarity, T3 and T4 were not associated with intraocular pressure. TSH had significant positive correlation with right intraocular pressure, but no correlation with left intraocular pressure. Conclusion : Age was independently and inversely related with intraocular pressure for Koreans.
Aged ; Aging* ; Alcohol Drinking ; Asian Continental Ancestry Group ; Blood Glucose ; Blood Pressure ; Body Mass Index ; Body Weight ; Drinking ; Fasting ; Female ; Hematocrit ; Humans ; Intraocular Pressure* ; Korea ; Male ; Mass Screening ; Osmolar Concentration ; Surveys and Questionnaires ; Seoul ; Smoke ; Smoking ; Visual Acuity

We report here on a case of acute aortic dissection after intravenous tissue plasminogen activator (t-PA) administration in a patient with acute ischemic stroke. A 75-year-old woman with a history of hypertension and diabetes mellitus presented with left hemiplegia and a decreased mentality. The admission studies revealed severe stenosis of the right middle cerebral artery and decreased cerebral perfusion. Initial chest radiography showed hypertensive cardiovascular changes and increased interstial markings on both lung fields. Cyanosis and cardiac arrest occurred 80 minutes after intravenous t-PA administration. Emergency cardiopulmonary resuscitation was done and chest CT showed a dissection involving the whole aorta and pericardial effusion due to bleeding. In spite of our earnest efforts, the patient died. It should be kept in mind that aortic dissection can occur after intravenous t-PA administration and an early clinical suspicion and diagnosis is needed to avoid this devastating complication.
Aged ; Aorta ; Cardiopulmonary Resuscitation ; Constriction, Pathologic ; Cyanosis ; Diabetes Mellitus ; Emergencies ; Female ; Heart Arrest ; Hemiplegia ; Hemorrhage ; Humans ; Hypertension ; Lung ; Middle Cerebral Artery ; Perfusion ; Pericardial Effusion ; Stroke ; Thorax ; Tissue Plasminogen Activator

Cerebral venous sinus thrombosisis an uncommon entity and its clinical presentations are highly variable. We present the case of superior sagittal sinus thrombosis. Although it was medical refractory, successfully treated with mechanical thrombectomy using the Solitaire FR device. A 27-year-old man who presented with venous infarction accompanied by petechial hemorrhage secondary to the superior sagittal sinus (SSS) thrombosis. Due to rapid deterioration despite of anticoagulation therapy, the patient was taken for endovascular treatment. We deployed the Solitaire FR device (4×20 mm) in the anterior portion of the thrombosed SSS, and it was left for ten minutes before the retraction. Thus, we removed a small amount of thrombus. But the sinus remained occluded. We therefore performed the thrombectomy using the same methods using the Solitaire FR (6×20 mm). Thus, we were successful in removing larger clots. Our case highlights not only that the mechanical thrombectomy using the Solitaire FR is effective in achieving revascularization both rapidly and efficiently available, but also that it might be another option in patients with cerebral venous sinus thrombosis who concurrently had rapid clinical deterioration with devastating consequences.
Adult ; Hemorrhage ; Humans ; Infarction ; Sinus Thrombosis, Intracranial ; Superior Sagittal Sinus* ; Thrombectomy* ; Thrombosis*

PURPOSE: Since the introduction of newborn screening, the detection rate of transient hypothyroidism has been increased. Therefore, we aimed to reevaluate the prevalences of congenital hypothyroidism according to etiology and to evaluate the clinical characteristics to differentiate between transient and permanent hypothyroidism before L-thyroxine withdrawal to avoid unnecessary prolonged treatment. METHODS: We retrospectively reviewed medical records of 25 male and 46 female patients diagnosed as congenital hypothyroidism by newborn screening from 1992 to 2002. We performed thyroid function test such as T3, TSH and total T4 before 1997, and free T4 from 1997. RESULTS: Since the introduction of newborn screening, the prevalences of permanent congenital and transient hypothyroidism were 53.5% and 46.5%, respectively. Thyroid dysgenesis was more common in females (males 3, females 22, P<0.05). Among 58 patients, who were not confirmed as thyroid dysgenesis at L-thyroxine therapy, the proportion of transient and permanent hypothyroidism were 32 (55.2%) and 26 (44.8%) respectively. There were no significant differences in free T4, total T4, TSH levels at initial diagnosis between transient and permanent hypothyroidism patients. Permanent hypothyroidism patients could not withdraw L-thyroxine during the first 3 years. Among 32 patients with transient hypothyroidism, 30, 23, and 17 patients continued L-thyroxine therapy at 1, 2, and 3 years of age, respectively. The mean duration of L-thyroxine therapy was 26.4+/-11.8 months. The dose of L-thyroxine had been significantly decreased since 6 months of age in the patients with transient hypothyroidism (P<0.05). The patients with thyroid aplasia received the highest dose of L-thyroxine from 6 to 36 months of age (P<0.05). Among 13 patients who were confirmed as thyroid dysgenesis at L-thyroxine therapy, 12 patients were confirmed as permanent hypothyroidism, while one patient, who was diagnosed as thyroid aplasia by thyroid scan, revealed normal thyroid gland and could be ceased thyroid hormone therapy at 3 years of age. CONCLUSION: We could not differentiate between transient and permanent hypothyroidism by free T4, total T4 and TSH levels at the initial diagnosis. We could diagnose as permanent hypothyroidism in patients with thyroid dysgenesis and with higher or appropriate L-thyroxine doses for weight to maintain euthyroid during follow-up. We therefore suggest that diagnostic test maybe done before 3 years of age in some patients who had the histories of suspecting transient hypothyroidism and significantly low L-thyroxine doses for weight.
Congenital Hypothyroidism* ; Diagnosis ; Diagnostic Tests, Routine ; Female ; Follow-Up Studies ; Humans ; Hypothyroidism* ; Infant, Newborn* ; Male ; Mass Screening* ; Medical Records ; Neonatal Screening ; Prevalence ; Retrospective Studies ; Thyroid Dysgenesis ; Thyroid Function Tests ; Thyroid Gland ; Thyroxine

OBJECTIVE: Early progressive infarction (EPI) is frequently observed and related to poor functional outcome in patients with middle cerebral artery (MCA) infarction caused by MCA occlusion. We evaluated the perfusion parameters of magnetic resonance imaging (MRI) as a predictor of EPI. METHODS: We retrospectively analyzed patients with acute MCA territory infarction caused by MCA occlusion. EPI was defined as a National Institutes of Health Stroke Scale increment ≥2 points during 24 hours despite receiving standard treatment. Regional parameter ratios, such as cerebral blood flow and volume (rCBV) ratio (ipsilateral value/contralateral value) on perfusion MRI were analyzed to investigate the association with EPI. RESULTS: Sixty-four patients were enrolled in total. EPI was present in 18 (28%) subjects and all EPI occurred within 3 days after hospitalization. Diabetes mellitus, rCBV ratio and regional time to peak (rTTP) ratio showed statically significant differences in both groups. Multi-variate analysis indicated that history of diabetes mellitus [odds ratio (OR), 6.13; 95% confidence interval (CI), 1.55-24.24] and a low rCBV ratio (rCBV, <0.85; OR, 6.57; 95% CI, 1.4-30.27) was significantly correlated with EPI. CONCLUSION: The incidence of EPI is considerable in patients with acute MCA territory infarction caused by MCA occlusion. We suggest that rCBV ratio is a useful neuro-imaging parameter to predict EPI.
Cerebrovascular Circulation ; Diabetes Mellitus ; Hospitalization ; Humans ; Incidence ; Infarction* ; Infarction, Middle Cerebral Artery* ; Magnetic Resonance Imaging* ; Middle Cerebral Artery* ; National Institutes of Health (U.S.) ; Perfusion ; Retrospective Studies ; Stroke