Leiomyosarcoma (LMS) of the small intestine is a rare tumor, accounting for about 1% of all malignant mesenchymal lesions in the gastrointestinal tract. Since small bowel tumors are initially asymptomatic and nonspecific, delayed diagnosis and treatment are common. We found that a 44-year-old male patient who came in for lower abdominal pain had partial obstruction in the small bowel. Multiple ascites and ileal tumors involving peritoneal seeding were observed from his abdominal computed tomography. He was diagnosed as epithelioid LMS involving peritoneal transition after surgical resection, and the outpatient department has planned for a conservative therapy with observation. To the best of our knowledge, ileal epithelioid LMS accompanying a huge omental mass, with a size of 18 cm in dimension, and peritoneal seeding has not yet been reported in Korea. We report this rare case with literature review.
Abdominal Pain ; Adult ; Ascites ; Delayed Diagnosis ; Gastrointestinal Tract ; Humans ; Ileum ; Intestine, Small ; Korea ; Leiomyosarcoma* ; Male ; Outpatients

Leiomyosarcoma (LMS) of the small intestine is a rare tumor, accounting for about 1% of all malignant mesenchymal lesions in the gastrointestinal tract. Since small bowel tumors are initially asymptomatic and nonspecific, delayed diagnosis and treatment are common. We found that a 44-year-old male patient who came in for lower abdominal pain had partial obstruction in the small bowel. Multiple ascites and ileal tumors involving peritoneal seeding were observed from his abdominal computed tomography. He was diagnosed as epithelioid LMS involving peritoneal transition after surgical resection, and the outpatient department has planned for a conservative therapy with observation. To the best of our knowledge, ileal epithelioid LMS accompanying a huge omental mass, with a size of 18 cm in dimension, and peritoneal seeding has not yet been reported in Korea. We report this rare case with literature review.
Abdominal Pain ; Adult ; Ascites ; Delayed Diagnosis ; Gastrointestinal Tract ; Humans ; Ileum ; Intestine, Small ; Korea ; Leiomyosarcoma ; Male ; Outpatients

Gradual mortality of look down fish (Selene vomer) was observed in a private aquarium in Seoul, showing abnormal swimming behavior and lethargy. A bacterial pathogen from kidney was cultured, identified, and confirmed as Vibrio harveyi using Vitek System 2 and 16S rRNA gene sequencing. A predominant bacterial strain, SNUVh-LW2 was proved to be most closely related to isolates from China by phylogenetic analysis with minimum evolution method. Also, tetracycline was considered as the most sensitive antibiotic agent via antibiotic usceptibility test. The group of fish was treated according to the diagnostic result and no more mortality was observed.
China ; Genes, rRNA ; Kidney ; Lethargy ; Methods ; Mortality ; Seoul ; Swimming ; Tetracycline ; Vibrio*

For several days, there was a series of mortalities of chub mackerel (Scomber japonicus) that were reared for public exhibition in a private aquarium in Seoul, Korea. As part of the diagnosis of the dead fish, a bacterial isolate from the kidney was cultured, identified, and confirmed to be Vibrio (V.) harveyi using Vitek System 2 and 16S rRNA gene sequencing. Phylogenetic analysis was also performed by the neighbor-joining method. As a result, the V. harveyi isolated from chub mackerels of a private aquarium in Korea, called as SNUVh-LW1, was clustered in the same group with V. harveyi ATCC33843.
Cyprinidae* ; Diagnosis ; Genes, rRNA ; Kidney ; Korea ; Mortality ; Perciformes* ; Seoul ; Vibrio*

BACKGROUND: In 2001, the third report the National Cholesterol Education Program (NCEP) has concluded that LDL cholesterol levels should be a major goal for preventing coronary artery disease and atherosclerotic events. Those in the higher risk groups should then have lipoprotein analysis to determine LDL cholesterol levels. LDL cholesterol has traditionally been estimated by the Friedwald forrmula : LDL-C=total cholesterol-[high density lipoprotein cholesterol (HDL-C)+trigryceride/5]. However, when trigryceride level is >400 mg/dL, this formula is inaccurate. Therefore, We have compared the direct LDL cholesterol immunoseparation method with Friedwald formula from both normotriglyceridemic (triglyceride400 mg/dL). METHODS: The direct LDL cholesterol immunoseparation method was performed on 53 sera with triglyceride levels 61 to 1,684 mg/dL (classified as400 mg/dL : 31). Total cholesterol was measured enzymatic colorimetry. HDL cholesterol was measured in the supernatant after precipitating LDL by HDL cholesterol precipitating reagent containing dextran sulfate and magnesium chloride for serum. Direct LDL cholesterol was measured by immunoseparation method (Sigma Diagnostics, St Louis, Mo) that is based on selective absorption of HDL cholesterol and VLDL cholesterol by polystylene beads coated with goat polyclonal antibodies to human apolipoproteins. The cholesterol was measured by an enzamatic method on Hitachi 747. The linear regression and paird t-test were performed to evaluate the differences of data from Immunoseparation method and Friedwald formula. RESULTS: In triglyceride400 mg/dL, the LDL cholesterol value obtained by the direct LDL-C assay on the 31 frozen sera studied was significantly different from that of Friedwald formula (103+/-38.4; 50.4+/-56.2 mg/dL). Therefore, Friedwald formula is unreliable in triglyceride>400 mg/dL. CONCLUSION: Guidelines for treatment decisions, including diet and drug initiation, and therapeutic goals for high risk groups are based entirely on the LDL cholesterol level. At triglyceride levels >400 mg/dL, Friedwald fomula is inaccurate. Immunoseparation method is more rapid, higher specific, precise and helps monitor LDL lowering drugs and diets in triglyceride level>400 mg/dL.
Absorption ; Antibodies ; Apolipoproteins ; Cholesterol* ; Cholesterol, HDL ; Cholesterol, LDL ; Cholesterol, VLDL ; Colorimetry ; Coronary Artery Disease ; Dextran Sulfate ; Diet ; Education ; Goats ; Humans ; Linear Models ; Lipoproteins* ; Magnesium Chloride ; Triglycerides

Thelper (Th) cells play a pivotal role in the regulation of immune responses. Since Th epitopes in adenovirus have not yet been defined, in this study, it was attempted to search for Th epitopes of adenovirus antigens that are restricted by MHC class II (H-2E). Among candidate viral proteins to be screened for Th epitopes, structural protein was selected, since they induced strong IL-2 release from adenovirus immune lyrnph node (LN) cells and the presence of E1 protein, which contains immunodominant cytotoxic T lymphocyte epitopes, did not potentiate the T cell responses. To confirm the presence of Th epitopes in the structural protein, virions were trypsinized and the resulting polypeptides whose molecular weights were lower than 5,000 were fractionated by HPLC. Some of the HPLC fraction turned out to induce LN cell proliferation. Ten synthetic peptides were designed as candidate Th epitopes from the primary amino acid sequences of adenovirus hexon and penton protein which are major constituents of the virion. The selected sequences share the common features of other known H-2E' binding ligands. Among these ten synthetic peptides, peptide of hexon protein amino acid residue 709-721 induced noticeable proliferation of LN cells from preimmune mice, and also able to induce IL-2 secretion from adenovirus-specific T hybridomas, suggesting that the peptide was the most immunodominant Th epitope. Hexon protein 221-233 and hexon protein 676-688 are considered as epitopes also. This study revealed three epitope sequences from adenovirus structural protein that are presented by class II MHC, H-2E.
Adenoviridae* ; Amino Acid Sequence ; Animals ; Cell Proliferation ; Chromatography, High Pressure Liquid ; Epitopes ; Epitopes, T-Lymphocyte* ; Hybridomas ; Interleukin-2 ; Ligands ; Mice ; Molecular Weight ; Peptides ; Trypsin ; Viral Proteins ; Virion

Allogenic bone marrow chimera has been used to study the differentiation of donor-derived bone marrow cells under the recipient thymic environment, tolerance generaion between recipient and donor cells. We prepared H-2' to H-2 allogenic chimera by transfering bone marrow cells from H-2dmice to r-irradiated H-2k mice, and examined the differentiation ofthe bone marrow cells under allogenic environment. Complete reconstitution with H-2d+ phenotype cells in the thymus of the chimera mice was observed. However, the number of CD4- CD8+ cells dramatically decreased under the recipient thymic environment, CD8+ cells significantly reduced also in spleen and lymph node, compared with that of normal mice. Interestingly, we also observed coexistence of donor-derived cells (H-2k) and recipient derived cells (H-2d) in lymph node and spleen in the chimera. These results suggested that the decrease of CD4-CD8+ cells could be caused by r-irradiation by affecting the recipient thymic environment, and that in this chimera, tolerance between donor-derived cells and recipient-derived cells was maintained.
Animals ; Bone Marrow Cells ; Bone Marrow* ; Chimera* ; Humans ; Lymph Nodes ; Mice ; Phenotype ; Spleen ; Thymus Gland ; Tissue Donors

We retrospectively evaluated datas on 61 cases of neonatal sepsis confirmed by clinical symptoms and blood cultures at the NICU of Gil general hospital From Mar. 1989, to Fed. 1992. The results obtained were as follows: 1) The mean gestational age was 32.7+/-2.6 Weeks in preterm infants, and 39+/-1.5 weels on term infants. The mean birth weight was 1,701.4+/-422.4 g in preterm infants, and 3,232+/-581.7 g in term infants. 2) There were 61 infants with neonatal sepsis identified among 13, 486 live births, resulting in an incidence of 0.45%. The sex ratio of male to female was 1.2:1. The incidencdence was higher in preterm infants (2.21%) than in term infants (0.27%). 3) The most commom presenting symptoms of neonatal sepsis were apnea and bradycardia (53.6%) in preterm infants, jaundice (33.3%) in term infants 4) The concurrent diseases in neonatal sepsis were urinary tract infection (UT)(25%), pneumonia (21%), hyaline membrane disease (21%) in the order of frequency. Hyaline membrane disease (33.3%) was the most frequently associated disease in preterm infants, UTI (41.4%) in term infants 5) Gram positive organisms were isolated in 33 casess (52%), gram negative organisms in 30 cases (48%). The most common ortanism isolated from blood cultures was CONS (28.6%). The more common organisms in preterm infants were CONS (26.7%), Enterococcus (23.3%) and Klebsiella (10%). CONS (30.3%), E. Coli (27.3%) and Staphylococcus aureus (12%) were more frequent in term infants. 6) The significant diagnostic laboratory findings for neonatal sepsis were leukopenia ( < or =5000), I:T 0.16, thrombocytopenia ( <150,000/mm3), CRP> or =1+.2 or more of abnormal hematologic values were significantly more frequent in preterm infants (P< 0.05). 7) The risk factors associated with neonatal sepsis were endotracheal intubation (57%), birth ashyxia (Apgar score< or =6 at 5 min.)(39%) and umbilical catheterization (35.7%) in preterm infants, while endotrachial intubation (12.1%), birth ashyxia (12.1%) and premature rupture of membrane ( > or =24hrs)(9.0%) in term infants. 8) Early onset neonatal sepsis (72< or =hr of age) was found in 40 cases (65.6%). 9) The overall mortality rate of neonatal sepsis was 26.0%(39,3% in preterm infants, 15.2% in term infants). The mortality rate was significantly high in pseudomonas infection. 10) In low birth weight infants, the susceptibility to neonatal sepsis was greatest in the infants of lowest birth weight (1,00-1,500 gm) and the mortality rate was inversely proportional to birth weight. 11) Sensitivity to antibiotics in gram postitive organisms were chlorampjenicol (37%), Erythromycin (29%), ampicillin (26%) and cephalothin (26%). It clearly showed that newer antibiotics such as vancomycin is neccessary. In cases of gram negative organisms, sensitivity to antibiotics were amikacin (85%), gentamicin (65%), tobramycin (58%) and cephalothin (54%).
Amikacin ; Ampicillin ; Anti-Bacterial Agents ; Apnea ; Birth Weight ; Bradycardia ; Catheterization ; Catheters ; Cephalothin ; Enterococcus ; Erythromycin ; Female ; Gentamicins ; Gestational Age ; Hospitals, General ; Humans ; Hyaline Membrane Disease ; Incidence ; Infant* ; Infant, Low Birth Weight ; Infant, Newborn ; Infant, Premature ; Intubation ; Intubation, Intratracheal ; Jaundice ; Klebsiella ; Leukopenia ; Live Birth ; Male ; Membranes ; Mortality ; Parturition ; Pneumonia ; Pseudomonas Infections ; Retrospective Studies ; Risk Factors ; Rupture ; Sepsis* ; Sex Ratio ; Staphylococcus aureus ; Thrombocytopenia ; Tobramycin ; Urinary Tract Infections ; Vancomycin

Newborn premature babies have lwo levels of transplacentally acquired maternal immunoglobulin which is mostly transferred after 32~34 weeks gestaton, therefore they may have IgG deficiencies that increase their susceptibility to bacterial infection. We performed this study to determine whether intravenous immunoglobulin (IVIG) therapy improves mortality or infection occurrance rate. From 1 october 1991 to 31 July 1992, 73premature newborn infants with gestational age< or =34weeks were enrolled: the theatment group, consisting of 43infants who received prophylactic intravenous immunoglobulin therapy (500mg/kg/week) and the control group, consisting of 30infants who did not receive. prophylactic intravenous administration of immunoglobulin to preterm infants with a gestational ageage< or =34week, at a dose of 500mg/kg/week, results in maintenance of a satisfactory serum IgG level throughout the high-risk period for infection. But the incidence rates of proven or very probable sepsis, mortality for sepsis and total mortality in the infants receiving intravenous immunoglobulin were not significant differences when compared with those in the control infants. No adverse effects were noted after immunoglobulin transfusions in our subjects. In conclusion, our study does not show any decrease in bacterial infection rate or in mortality rate, and no study in the literature has shown absolute proof of the prophylactic efficacy of IVIG in premature newborns. Larger studies are necessary to confirm these observations and to determine more effective dosing schedules and the optimal levels of orhanism-spectific antibodies. And specific hyperimmnue of monoclonal antibody preparations may be required to provide reliable sources of effective prophylactic to premature neonate with high risk in bacterial sepsis.
Administration, Intravenous ; Antibodies ; Appointments and Schedules ; Bacterial Infections ; Humans ; IgG Deficiency ; Immunization, Passive ; Immunoglobulin G ; Immunoglobulins* ; Immunoglobulins, Intravenous ; Incidence ; Infant ; Infant, Newborn ; Infant, Premature* ; Mortality ; Sepsis*

Two-hundred cases of brachial plexus block by parascalene technique for the surgery of upper extremity, shoulder and/or neck were evaluated for the period from November, 1989 to October, 1990 at the Department of Anesthesiology, Hallym University, Kangdong Sacred Heart Hosipital in Seoul, Korea. Local anesthetics we used in this technique were mixture of equal amount of 2% lidocaine and 0.5% bupivacaine with 1: 200,000 epinephrine. Total amount of local anesthetics injected were varies from 20 to 40 ml for each block. The results were as follows: 1) Of the 200 Patietns, 153(76,5%) were male and 47(23.5%) were female. Their ages ranged from 5 to 83 years. One hundred twenty-one or 60.5% of this total group's ages fell between 20 to 39 years. 2) The most common site of operation was the hand; ll6 cases of the 200 blocks(55.3%). 3) Paresthesia was most often elicited at the superior nerve trunk; 80 cases of the 200 blocks (40%). 4) The average depth of needle from the skin to eliciting the parethesia is 1.954 cm. 5) The onset of anesthesia was within 5 minutes in 166.cases(84,4%). 6) The duration of anesthesia ranged from 180 to 1,800 minutes, and average was 657+/-113 minutes. 7) The extent of anesthesia by sensory dermatomes were average from cervical 2.3+/-1.0 to thoracic 2.90+/-5. 8) Shoulder surgery(e.g. clavicle fracture) and neck biopsy were performed successfully by this technique. 9) Parascalene approach to the brachial plexus has proven both safe and reliable. It provide satisfactory anesthesia of the upper extremity, shoulder and neck in 98.5%(l97 cases) of the 200 patients. 10) Complications of parascalene brachial plexus block were 2 cases of Horners syndrom, 1 cases of recurrent laryngeal nerve paralysis and 2 cases of subclavian artery puncture. We presumed that the complications other than Horners syndrome were due to technical error.
Anesthesia ; Anesthesiology ; Anesthetics, Local ; Biopsy ; Brachial Plexus* ; Bupivacaine ; Clavicle ; Epinephrine ; Female ; Hand ; Heart ; Horner Syndrome ; Humans ; Korea ; Lidocaine ; Male ; Neck ; Needles ; Paralysis ; Paresthesia ; Punctures ; Recurrent Laryngeal Nerve ; Seoul ; Shoulder ; Skin ; Subclavian Artery ; Upper Extremity