BACKGROUND: Admission blood glucose (BG) level is a predictor of mortality in critically ill patients with various conditions. However, limited data are available regarding this relationship in critically ill patients with cardiovascular diseases according to diabetic status. METHODS: A total of 1,780 patients (595 with diabetes) who were admitted to cardiac intensive care unit (CICU) were enrolled from a single center registry. Admission BG level was defined as maximal serum glucose level within 24 hours of admission. Patients were divided by admission BG level: group 1 (< 7.8 mmol/L), group 2 (7.8–10.9 mmol/L), group 3 (11.0–16.5 mmol/L), and group 4 (≥ 16.6 mmol/L). RESULTS: A total of 105 patients died in CICU (62 non-diabetic patients [5.2%] and 43 diabetic patients [7.9%]; P = 0.105). The CICU mortality rate increased with admission BG level (1.7%, 4.8%, 10.3%, and 18.8% from group 1 to group 4, respectively; P < 0.001). On multivariable analysis, hypertension, mechanical ventilator, continuous renal replacement therapy, acute physiology and chronic health evaluation II (APACHE II) score, and admission BG level significantly influenced CICU mortality in non-diabetic patients (group 1 vs. group 3: hazard ratio [HR], 3.31; 95% confidence interval [CI], 1.47–7.44; P = 0.004; group 1 vs. group 4: HR, 6.56; 95% CI, 2.76–15.58; P < 0.001). However, in diabetic patients, continuous renal replacement therapy and APACHE II score influenced CICU mortality but not admission BG level. CONCLUSION: Admission BG level was associated with increased CICU mortality in critically ill, non-diabetic patients admitted to CICU but not in diabetic patients.
APACHE ; Blood Glucose ; Cardiovascular Diseases ; Critical Care ; Critical Illness ; Diabetes Mellitus ; Humans ; Hypertension ; Intensive Care Units ; Mortality ; Prognosis ; Renal Replacement Therapy ; Ventilators, Mechanical

BACKGROUND AND OBJECTIVES: Identification of primary maxillary sinus hypoplasia (PMSH) is important diagnostically and therapeutically. Recently, the clinical significance of associated abnormalities in PMSH has been suggested. The aim of this study is to investigate the incidence of PMSH, their associated abnormalities and relationship of anatomical variations and paranasal sinusitis. MATERIALS AND METHODS: We evaluated radiologic diagnostic criteria of PMSH and analyzed the relationship of the anatomical variations of nasal cavity and paranasal sinuses in paranasal sinus CT scans, retrospectively. We measured the volume estimated ratio (VER) in PMSH cases. RESULTS: The incidence of unilateral and bilateral PMSH were 11 cases (5.9%) and 10 cases (5.3%). respectively. According to the Bolger's classification, there were 13 sites (41.9%) of type I with the mean VER of 0.71, 14 sites (45.2%) of type II with the mean VER 0.50, and 4 sites (12.9%) of type III with the mean VER of 0.27. The most common anatomical anomalies in both of the unilateral and bilateral PMSH were zygomatic (90.3%) and alveolar pneumatization (90.3%); the second most common abnormal finding was high maxillary sinus floor (77.4%). Of the anatomical variations, the frequency of uncinate process abnormalities (41.9%), paradoxical middle turbinate (32.3%) and Haller's cell (19.4%) were statistically significant. CONCLUSION: These results suggest that zygomatic and alveolar pneumatization, and high maxillary sinus floor are additionally important anatomical abnormalities associated with PMSH. Careful preoperative assessment of anatomical variations in the paranasal sinus CT scans may be essential to avoid incidental iatrogenic complications during functional endoscopic sinus surgery (FESS) or Caldwell-Luc operation in patients with PMSH.
Classification ; Humans ; Incidence ; Maxillary Sinus* ; Nasal Cavity ; Paranasal Sinuses ; Retrospective Studies ; Sinusitis ; Tomography, X-Ray Computed* ; Turbinates

BACKGROUND AND OBJECTIVES: Malignant lymphoma is the most common type of cancer in the immunologic system. There have been many reports about malignant lymphoma, but etiologies and prognosis of malignant lymphoma remain controversial. This study was designed to carry out an immunohistochemical classification of malignant lymphoma and to define the relationship between Epstein-Barr virus (EBV) and malignant lymphoma by using the polymerase chain reaction (PCR), which is known to be more sensitive than than any other methods for detection of EBV. MATERIALS AND METHODS: Thirty six cases of cervical nodal non-Hodgkin's lymphoma tissue and twenty five cases of normal neck node tissue were used. RESULTS: We observed 72.7% (26 cases/36 cases) B-cell lineage expression and 27.8% (10 cases/36 cases) T-cell lineage expression in the cervical nodal of non-Hodgkin's lymphoma. The detection rate of EBV in the malignant lymphoma tissue was 27.8% (10 cases/36 cases) and 7.1% (2 cases/36 cases) in the normal neck node tissue. Of the B-cell lineage expression, EBV was detected in 6 cases (23.1%) and 4 cases (40.0%) in T-cell league expression. There was no statistical significance between the malignant lymphoma group and the normal group in the detection rate of EBV. However, the detection rate of EBV of the T-cell malignant lymphoma group was significantly higher compared with the normal group (p<0.05). CONCLUSION: These results suggest that the T-cell expression group of cervical nodal non-Hodgkin's lymphoma may be related to EBV.
B-Lymphocytes ; Classification* ; Herpesvirus 4, Human* ; Lymphoma* ; Lymphoma, Non-Hodgkin ; Neck ; Polymerase Chain Reaction ; Prognosis ; T-Lymphocytes

BACKGROUND: Isoniazid(INH) and rifampicin(RFP) are potent antituberculous drugs which have made tuberculous disease become decreasing. In Korea, prescribed doses of INH and RFP have been different from those recommended by American Thoracic Society. In fact they were determined by clinical experience rather than by scientific basis. Even there has been. few reports about pharmacokintic parameters of INH and RFP in healthy Koreans. METHOD: Oral pharmacokinetics of INH were studied in 22 healthy native Koreans after administration of 300mg and 400mg of INH to each same person successively at least 2 weeks apart. After an overnight fast, subjects received medication and blood samples were drawn at scheduled times over a 24-hour period. Urine college lion was also done for 24 hours. Pharmacokinetics of RFP were studied in 20 subjects in a same fashion with 450mg and 600mg of RFP. Plasma and urinary concentrations of INH and RFP were determined by high-performance liquid chromatography(HPLC). RESULTS: Time to reach peak serum concentration (Tmax) of INH was 1.05α0.34 hrs at 300mg dose and 0.98α0.59 hrs at 400mg dose. Half-life was 2.49α0.88 hrs and 2.80α0.75 hrs, respectively. They were not different significantly(p>0.05) Peak serum concentration(Cmax) after administration of 400mg of INH was 7.14α 1.95mcg/mL which was significantly higher than Cmax (4.37α1.28mcg/mL) by 300mg of INH(p<0.01). Total clearance(CLtot) of INH at 300mg dose was 26.76α11.80mL/hr. At 400mg dose it was 21.09α8.31mL/hr which was significantly lower(p<0.01) than by 300mg dose. While renal clearance(CLr) was not different among two groups nonrenal clearance(CLnr) at 400mg dose (18.18α8.36mL/hr) was significantly lower than CLnr (23.71α11.52mL/hr) by 300mg dose(p<0.01). Tmax of RFP was 1.11α0.41 tut at 450mg dose and 1.15 α0.43 hrs at 600mg dose. Half-life was 4.20α0.73 hrs and 4.95α2.25 hrs, respectively. They were not different significantly(p>0.05). Cmax after administration of 600mg of RFP was 13.61 α3.43mcg/mL which was significantly higher than Cmax(10.12α2.25mcg/mL) by 450mg of RFP(p<0.01). CLtot of RFP at 450mg dose was 7.60α1.34mL/hr. At 600mg dose it was 7.05α 1.20mL/hr which was significantly lower(p<0.05) than by 450mg dose. While CLr was not different among two groups, CLnr at 600mg dose(5.36α1.20mL/hr) was significantly lower than CLnr(6.19α 1.56mL/hr) by 450mg dose(p<0.01). CONCLUSION: Considering Cmax and CLnr, 300mg, of INH and 450mg RFP might be sufficient doses for the treatment of tuberculosis in Koreans. But it remains to be clarified in the patients with tuberculosis.
Half-Life ; Humans ; Isoniazid* ; Korea ; Lions ; Pharmacokinetics ; Plasma ; Rifampin* ; Tuberculosis ; Volunteers*

BACKGROUND: We have recently reported that airway epithelial cells can produce RANTES and IL-8 in response to the stimulation of tubercle bacilli wuggesting a certain role of airway epithelial cells in the pathogenesis of pulmonary tuberculosis. The pathogenesis of tuberculosis is determined by several factors including phagocytosis, immunological response of host, and virulence of tubercle bacilli. Interestingly, there have been reports suggesting that difference in immunological response of host according to the virulence of tubercle bacilli may be related with the pathogenesis of tuberculosis. We, therfore, studied the expressions and productions of RANTES and IL-8 in airway epithelial cells in response to tubercle bacilli(H37Rv, virulent strain and H37Ra, avirulent strain), in order to elucidate the possible pathophysiology of pulmonary tuberculosis. METHODS: Peripheral blood monocytes were isolated from normal volunteers. Peripheral blood monocytes(OBM) were stimulated with LPS(10 micrograms/ml), H37Rv, or H37Ra(5X10(5) bacilli/well) along with normal control for 24 hours. A549 cells were stimulated with supernatants of cultured PBM for 24 hours. ELISA kit was used for the measurement of TNFalpha and IL-1beta production in supernatants of cultured PBM and for the measurement of RANTES and IL-8 in supernatants of cultured A549 cells. Northern blot analysis was used for the measurement of RANTES and IL-8 mRNA expression in cultured A549 cells. RESULTS: TNFalpha and IL-1beta productions were increased in cultured PBM stimulated with LPS or tubercle bacilli(H37Rv or H37Ra) compared with the control. There was, however, no difference in TNFalpha and IL-1beta production between cultured PBM stimulated with H37Rv and H37Ra. RANTES and IL-8 expressions and productions were also increased in cultured A549 cells stimulated with LPS or tubercle bacilli compared with the control. RANTES and IL-8 mRNA expressions were significantly increased in cultured A549 cells stimulated with H37Ra-conditioned media(CM) compared with A549 cells stimulated with H37Rv-CM (p<0.05). However, there was no difference in RANTES and IL-8 productions between A549 cells stimulated with H37Rv-CM and H37Ra-CM. CONCLUSION: Airway epithelial cells can produce the potent chemokines such as RANTES and IL-8, in response to the stimulation of tubercle bacilli. These results suggest that airway epithelial cells may play a certain role in the pathogenesis of pulmonary tuberculosis. However, the role of airway epithelial cells in the pathogenesis of tuberculosis according to the virulence of tubercle bacilli was not clear in this study.
Blotting, Northern ; Chemokine CCL5 ; Chemokines ; Enzyme-Linked Immunosorbent Assay ; Epithelial Cells* ; Healthy Volunteers ; Interleukin-8 ; Monocytes ; Phagocytosis ; RNA, Messenger ; Tuberculosis ; Tuberculosis, Pulmonary ; Tumor Necrosis Factor-alpha ; Virulence*

BACKGROUND: The fungal sinusitis is relatively rare but its incidence is increasing due to increasing use of antibiotics, steroids, and chemotherapheutic agents. It is reported that aspergillosis is the most common fungal infection among the fungi which involve the nasal cavity and paranasal sinuses. The surgical treatment of Aspergillus sinusitis were traditional Caldwell-Luc's operation with or without intranasal ethmoidectomy, or endoscopic sinus surgery. OBJECTIVES: The postoperative results and complications of Caldwell-Luc's operation in Aspergillus sinusitis have been enough to report, but there were a few reports about the endoscopic sinus surgery. So, we reported postoperative outcomes and complications of endoscopic sinus surgery in Aspergillus sinusitis. MATERIALS AND METHODS: Eleven cases of Aspergillus sinusitis of paranasal sinuses from April 1994 through April 1996 were analyzed on their clinical features, radiologic findings, operative findings, postoperative results, and complications. RESULTS: All cases were treated successfully by endoscopic sinus surgery. No recurrence and postoperative complications were observed. CONCLUSION: These results suggest that endoscopic sinus surgery is successful surgical method in Aspergillus sinusitis.
Anti-Bacterial Agents ; Aspergillosis ; Aspergillus* ; Fungi ; Incidence ; Nasal Cavity ; Paranasal Sinuses ; Postoperative Complications ; Recurrence ; Sinusitis* ; Steroids