BACKGROUND/AIMS: The Rockall risk assessment score was developed to predict the risk of rebleeding and death in patients with upper GI hemorrhage. The validity of this score, however, was not established in Korea. We tried to assess the reliability of the Rockall score to predict outcomes in patients with bleeding peptic ulcer. METHODS: Medical records of 175 patients with benign peptic ulcer bleeding treated in Samsung Medical Center from January 2000 to May 2003 were retrospectively analyzed. They were classified into three groups: no rebleeding rebleeding, and death and mean Rockall score was compared. Forrest classification was also compared with the Rockall score regarding the clinical usefulness of predicting poor outcomes in patients with bleeding peptic ulcer. RESUTLS: One hundred forty five patients did not show rebleeding, with mean Rockall score of 3.5 (SD=1.5). On the other hand, rebleeding occurred in 25 patients and the mean score was 6.4 (SD=1.44). There were 13 deaths with mean score of 7.0 (SD=1.08). The differences between the three groups were significant (p<0.001). In multivariate analysis, Rockall score was a independent risk factor of rebleeding and mortality (odds ratio, OR=2.73 and OR=8.74). CONCLUSIONS: The Rockall scoring system is useful to predict poor outcome such as rebleeding and death in patients with bleeding peptic ulcer.
Comparative Study ; English Abstract ; Female ; Humans ; Male ; Middle Aged ; Peptic Ulcer Hemorrhage/*classification/mortality/therapy ; Recurrence ; Risk Factors ; Survival Rate

PURPOSE: The human genetic disorder ataxia-telangiectasia (AT) is a multisystem disease characterized by extreme radiosensitivity. The recent identification of the gene mutated in AT, ATM, and the demonstration that it encodes a homologous domain of phosphatidylinositol 3-kinase (PI3-K), the catalytic subunit of an enzyme involved in transmitting signals from the cell surface to the nucleus, provide support for a role of this gene in signal transduction. Although ionizing radiation was known to induce c-fos transcription, nothing is known about how ATM or PKCI mediated signal transduction pathway modulates the c-fos gene transcription and gene expression. Here we have studied the effect of PKCI on radiation sensitivity and c-fos transcription in normal and AT cells. MATERIALS AND METHODS: Normal (LM217) and AT (AT5BIVA) cells were transfected with PKCI expression plasmid and the overexpression and integration of PKCI was evaluated by northern blotting and polymerase chain reaction, respectively. 5 Gy of radiation was exposed to LM and AT cells transfected with PKCI expression plasmid and cells were harvested 48 hours after radiation and investigated apoptosis with TUNEL method. The c-fos transcription activity was studied by performing CAT assay of reporter gene after transfection of c-fos CAT plasmid into AT and LM cells. RESULTS: Our results demonstrate for the first time a role of PKCI on the radiation sensitivity and c-fos expression in LM and AT cells. PKCI increased radiation induced apoptosis in LM cells but reduced apoptosis in AT cells. The basal c-fos transcription activity is 70 times lower in AT cells than that in LM cells. The c-fos transcription activity was repressed by overexpression of PKCI in LM cells but not in AT cells. After induction of c-fos by Ras protein, overexpression of PKCI repressed c-fos transcription in LM cells but not in AT cells CONCLUSION: Overexpression of PKCI increased radiation sensitivity and repressed c-fos transcription in LM cells but not in AT cells. The results may be a reason of increased radiation sensitivity of AT cells. PKCI may be involved in an ionizing radiation induced signal transduction pathway responsible for radiation sensitivity and c-fos transcription. The data also provided evidence for novel transcriptional difference between LM and AT cells.
Animals ; Apoptosis ; Ataxia Telangiectasia ; Blotting, Northern ; Catalytic Domain ; Cats ; Gene Expression ; Genes, fos ; Genes, Reporter ; Humans ; In Situ Nick-End Labeling ; Phosphatidylinositol 3-Kinase ; Plasmids ; Polymerase Chain Reaction ; Protein Kinase C* ; Protein Kinases* ; Radiation Tolerance* ; Radiation, Ionizing ; Signal Transduction ; Transfection

Three patients development subdural pneumocephalus after undergoing posterior fossa surgery performed in sitting position. The mechanism for entry of air into the intracranial compartment is analogous to the entry of air into an inverted bottle. As the fluid pours out, air bubbles to the top of the container. A brow-up lateral skull radiograph with a horizontal beam provided prompt diagnosis and confirmed brain displacement as well as computerized tomography did. Tension pneumocephalus appears to be another potential complication of posterior fossa surgery in sitting position. This condition is easily diagnosed and treated, and should be considered whenever a patient fails to recover as expected following posterior fossa surgery.
Brain ; Diagnosis ; Humans ; Pneumocephalus* ; Skull

Thirty two cases of the cervical spinal injury have been collected except those which associated with the injury on the other sites, such as head or internal organs. Nine cases of them were managed with surgery anterior and/or posterior approaches. The others were only immobilized by traction. Independent of operative method, we acquired slight to moderate improvement in all operative cases. Two cases with skeletal traction, however, became more aggravated. Indication of operation has much controversies as yet. A Major problem at present falls on the difficulty of functional recovery.
Head ; Immobilization ; Laminectomy ; Spinal Injuries ; Spine* ; Traction

BACKGROUND: The development of new drugs or alternative therapies effective against methicillin-resistant Staphylococcus aureus (MRSA) is of great importance, and various natural anti-MRSA products are good candidates for combination therapies. We evaluated the antibacterial activities of a Phellinus baumii ethyl acetate extract (PBEAE) and its synergistic effects with beta-lactams against MRSA. METHODS: The broth microdilution method was used to determine the minimal inhibitory concentration (MIC) and minimal bactericidal concentration (MBC) of the PBEAE. The PBEAE synergistic effects were determined by evaluating the MICs of anti-staphylococcal antibiotic mixtures, with or without PBEAE. Anti-MRSA synergistic bactericidal effects of the PBEAE and beta-lactams were assessed by time-killing assay. An ELISA was used to determine the effect of the PBEAE on penicillin binding protein (PBP)2a production. RESULTS: The MICs and MBCs of PBEAE against MRSA were 256-512 and 1,024-2,048 microg/mL, respectively. The PBEAE significantly reduced MICs of all beta-lactams tested, including oxacillin, cefazolin, cefepime, and penicillin. However, the PBEAE had little or no effect on the activity of non-beta-lactams. Time-killing assays showed that the synergistic effects of two beta-lactams (oxacillin and cefazolin) with the PBEAE were bactericidal in nature (Deltalog10 colony forming unit/mL at 24 hr: 2.34-2.87 and 2.10-3.04, respectively). The PBEAE induced a dose-dependent decrease in PBP2a production by MRSA, suggesting that the inhibition of PBP2a production was a major synergistic mechanism between the beta-lactams and the PBEAE. CONCLUSIONS: PBEAE can enhance the efficacy of beta-lactams for combined therapy in patients infected with MRSA.
Acetates/chemistry ; Agaricales/*chemistry/metabolism ; Anti-Infective Agents/chemistry/*pharmacology ; Drug Synergism ; Enzyme-Linked Immunosorbent Assay ; Methicillin-Resistant Staphylococcus aureus/*drug effects/metabolism ; Microbial Sensitivity Tests ; Penicillin-Binding Proteins/analysis/metabolism ; Plant Extracts/chemistry/*pharmacology ; beta-Lactams/*pharmacology

OBJECTIVES: The aim of this study was to investigate whether the ciliary activity of respiratory epithelium is affected in allergic rhinitis. METHODS: Twenty Wistar rats were divided into an unsensitized control group and sensitized allergic group. The sensitized group was immunized intraperitoneally with ovalbumin, followed by intranasal administration of ovalbumin. Allergy was determined by an increase in nasal symptoms, the number of tissue eosinophils and a positive result to a passive cutaneous anaphylaxis (PCA) test. Nasal, nasopharyneal, tracheal, and bronchial epithelial cells were obtained from both the control and allergic groups. Ciliary beat frequency (CBF) was measured using a video-computerized analysis technique in vitro. We compared the CBF of two groups in each site. We also evaluated the findings of the nasal mucosa of both groups with an scanning electron microscope. RESULTS: In vitro CBF measurement demonstrated that the CBF of the control and allergic groups did not differ significantly (p>0.05). CONCLUSION: CBF is not affected by respiratory allergy.
Administration, Intranasal ; Animals ; Eosinophils ; Epithelial Cells* ; Hypersensitivity ; Nasal Mucosa ; Ovalbumin ; Passive Cutaneous Anaphylaxis ; Rats* ; Rats, Wistar ; Respiratory Mucosa ; Rhinitis*

PURPOSE: Vertigo and dizziness are not common complaints in childhood, but are present more often than formerly thought. A detailed interview and otoneurological examination are important for reaching a specific diagnosis and treatment. The purpose of our study was to obtain our own etiological, clinical and diagnostic statistics, and to review the major related pathologies. METHODS: We investigated eighty-five children who visited Dankook University Hospital with a chief complaint of vertigo. Presenting symptoms, the result of diagnostic tests, and etiologic diagnoses were evaluated. RESULTS: Benign paroxysmal vertigo in childhood was the most common etiology of childhood vertigo accounting for about 38.8%, and migrainous vertigo and post-traumatic vertigo were present in 17.6% and 12.9% respectively. In vestibular function testings, electronystagmography and rotating chair test were abnormal in 11.2% and 21.2%, and the score of sensory organization test in posturography was lower than 50 in 44.4%. Other clinical diagnostic tests were informative for elucidation of individual etiologies. CONCLUSION: Benign paroxysmal vertigo in childhood and migrainous vertigo were the most common etiologies in childhood vertigo, with the former more common in under 12 years and the latter more common in over 12 years. Vestibular function tests were not so informative in diagnostic approach of childhood vertigo.
Child ; Diagnosis ; Diagnostic Tests, Routine ; Dizziness ; Electronystagmography ; Humans ; Pathology ; Vertigo* ; Vestibular Function Tests

OBJECTIVES: Aminoglycosides are commonly used antibiotic agents, and they are known to generate free oxygen radicals within the inner ear and to cause vestibulo-cochlear toxicity and permanent damage to the sensory hair cells and neurons. Melatonin, a pineal secretory product, has the properties of being a powerful direct and indirect antioxidant. The aim of the present study was to prove the antioxidant effect of melatonin against gentamicin-induced ototoxicty. METHODS: The utricular maculae of Sprague-Dawley rats were prepared from postnatal day 2-4, and these maculae were were divided into 6 groups as follows: 1) control, 2) melatonin only, 3) gentamicin only, and 4), 5), and 6) gentamicin plus melatonin (10, 50, and 100 micrometer, respectively). To count the number of hair cells, 5 utricles from each group were stained with phalloidin-FITC on the 1st, 4th, and 7th days after drug administration. Reactive oxygen species (ROS) was assessed by using the fluorescent probe hydrofluorescent diacetate acetyl ester. The caspase-3 activity was also examined with using the fluorescent caspase-3 substrate and performing Western blotting. RESULTS: The result of this study showed that gentamicin induced the loss of utricular hair cells, and this loss of hair cells was significantly attenuated by co-administration of melatonin. Melatonin reduced ROS production and caspase-3 activation in the gentamicin treated utricular hair cells. CONCLUSION: Our findings conclusively reveal that melatonin has protective effects against gentamicin-induced hair cell loss in the utricles of rat by inhibiting both ROS production and caspase-3 activity.
Aminoglycosides ; Animals ; Antioxidants ; Blotting, Western ; Caspase 3 ; Ear, Inner ; Gentamicins ; Hair ; Hair Cells, Vestibular ; Melatonin ; Neurons ; Rats ; Rats, Sprague-Dawley ; Reactive Oxygen Species ; Saccule and Utricle

Prolymphocytic leukemia (PLL) is a member of chronic lymphoproliferative disorders with relatively distinct clinical, morphologic, immunologic and prognostic features. The diagnosis of PLL is determined by more than 55% of prolymphocytes in the peripheral blood. It is characterized by leukocytosis, massive splenomegaly with little or no lymphadenopathy, and male prevalence. In immunophenotyping, the majority (80%) of the cases express B cell markers and the rest (20%), T cell type. We experienced a case of B-PLL. The patient was a 65 year-old man who presented with marked leukocytosis (110.5x109/L) and 78% of characteristic prolymphocytes in the peripheral blood. The bone marrow aspirate showed 13.6% of prolymphocytes and coarse granular positivity of prolymphocytes in PAS stain. The immunophenotyping of the leukemic prolymphocytes revealed the positivity of surface immunoglobulin (IgM, lambda type), HLA- DR and CD19. The monoclonal gammopathy (IgM, lambda type) was also detectable in the patient's serum.
Aged ; Bone Marrow ; Diagnosis ; Humans ; Immunoglobulins ; Immunophenotyping ; Leukemia* ; Leukemia, Prolymphocytic ; Leukocytosis ; Lymphatic Diseases ; Lymphoproliferative Disorders ; Male ; Paraproteinemias ; Prevalence ; Splenomegaly

BACKGROUND AND OBJECTIVES: The purpose of this study was to investigate the effects of low level laser for the prevention and treatment of aminoglycoside-induced vestibular ototoxicity. MATERIALS AND METHOD: An organotypic culture of 2 to 4 days old rat utricular maculae was established. Rats were divided into 6 groups according to the treadtment of the utricles: G (gentamicintreated), L (laser-irradiated), LG (laser-irradiated and gentamicin-treated), GL (gentamicin-treated and laser-irradiated), LGL (gentamicin-treated during laser-irradiated) and C (control). After organotypic culture, the utricles of 6 groups were examined by confocal laser scanning electron microscope and scanning electron microscope. The results of each group were compared with each other by statistical methods. RESULTS: The number of vestibular hair cells of the group G was smaller compared to that of the group C. The group L had no difference compared with the group C. The groups LG and GL showed more vestibular hair cells compared with the group G. The group LG showed more vestibular hair cells than the group GL. The group LGL showed most vestibular hair cells compared to that of the groups G, LG, and GL. CONCLUSION: The most effective treatment of aminoglycosideinduced vestibular otoxicity is the irradiation of low level laser before and after the insult of the aminoglycoside. Further clinical studies using low level laser were needed to prevent aminoglycoside-induced ototoxicity and to promote the regeneration of vestibular hair cells.
Animals ; Electrons ; Gentamicins ; Hair Cells, Vestibular ; Rats ; Regeneration ; Saccule and Utricle