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Biomedical subjects

S R Cho

Publications and source records attributed to S R Cho.

At least 19 recordsLinked to original sources

The effect of heterogeneous hyperimmune IgG antibody on prophylaxis and treatment of Pneumocystis carinii infection in rats.

Immunotherapy has been used in support of trimethoprim-sulfamethoxazole treatment for Pneumocystis carinii pneumonia. The present study investigated the therapeutic or preventive effects of heterogeneous hyperimmune IgG antibody (HIA) in experimental rats. Their immunity was suppressed by steroid injection, and they were also injected peritoneally with HIA which reacted with 40-55, 92, 116, and 200 kDa bands of the crude antigen. All rats were infected by P. carinii and the cystic forms on lung impression smears were counted. The count was 20.5-76.5 (mean 52.5 + 19.3) in those which received steroid only, but decreased to 6.0-21.0 (mean 13.5 + 10.6) in those of group 3 which received HIA for the same duration. In other groups, the mean count ranged from 29.9 + 32.9 to 54.1 + 47.7, and in those which received 13.7 mg HIA the reduction effect was greater than in those which received 6.8 mg or 20.5 mg HIA. The present finding confirmed that in rats during the early stage of infection, the heterogeneous HIA to MSG antigen bands had a partial effect on P. carinii pneumonia, both prophylactically and therapeutically.

Animals

Short-course doxycycline treatment versus conventional tetracycline therapy for scrub typhus: a multicenter randomized trial.

To assess the clinical efficacy of short-course doxycycline in the treatment of scrub typhus, we compared conventional 7-day tetracycline therapy with 3-day doxycycline therapy in 116 patients. Patients were randomized to receive either tetracycline (500 mg four times daily; n = 50) or doxycycline (100 mg twice daily; n = 66) and were followed for 4 weeks after the completion of treatment. The cure rate was 100% in the tetracycline group and 93.9% in the doxycycline group (P > .05). The two groups did not differ significantly in terms of the interval required for defervescence or for the alleviation of symptoms. There were no relapses in either group. These data suggest that 3-day doxycycline therapy is as effective as conventional 7-day tetracycline therapy for the cure of scrub typhus and the prevention of relapses.

Adult

[Infection status of the sea eel (Astroconger myriaster) purchased from the Noryangjin fish market with anisakid larvae].

Although the sea eel (Astroconger myriaster) is suspected as one of the most important fish host for human anisakiasis in Korea, no report has been made on the infection status of the sea eel with anisakid larvae. In the present study, 26 sea eels (Astroconger myriaster) were purchased from the Noryangjin fish market in Seoul, and anisakid larvae were collected from their viscera, muscle, head and skin. The collected larvae were classified by their morphological types. A total of 1,351 anisakid larvae were collected from 15 of 26 fish examined. Among them, 1,269 were recovered from the viscera, 66 from the muscle, and 16 from the head and skin. Morphologically, most of the anisakids were classified into 6 known larval types, Anisakis type I (564 larvae) of Berland (1961), Contracaecum type A (409) and type D (5) of Koyama et al. (1969), Contracaecum type C' (83) and type D' (117) of Chai et al. (1986), and Contracaecum type V (1) of Yamaguti (1935). Remaining 172 specimens were new in the available literature, hence, designated as Contracaecum type A' (new type). The present results revealed that the sea eels caught in the Korean waters are heavily infected with anisakid larvae, not only in their viscera but also in the muscle, and Anisakis type I was the most common among the 7 larval types.

Animals

Treatment of biliary obstruction caused by metastatic cancer.

Over an 8-year period, among 41 patients with obstructive jaundice caused by metastases to the liver or lymph nodes adjacent to the porta hepatis, palliative biliary decompression was established surgically in 11, by percutaneous transhepatic biliary drainage (PTBD) in 25, and by both methods in 2. Three patients had no drainage procedure performed. Early mortality after drainage occurred in 6 of 38 patients, and the median survivals (actuarial) for the remaining 32 patients were 4.5 months for the surgical group (range 2 to 21 months) and 4 months for the PTBD group (range 2 to 14 months). Although there were trends toward more frequent hospital readmissions and episodes of cholangitis in the PTBD group, the only statistically significant difference was in the number of catheter manipulations required. We concluded that when patients develop obstructive jaundice as a manifestation of metastatic cancer, useful palliation can be achieved by either surgical or percutaneous decompression.

Adult

Percutaneous retrieval of a broken Lunderquist guidewire from the pelvicalyceal system.

The stiff Lunderquist guidewire may occasionally be needed during percutaneous insertion of a nephrostomy catheter, especially in patients with a large amount of subcutaneous fat or with a hard renal capsule. This wire may fracture at the junction of its stiff portion with the flexible tip. We have reported such an occurrence, in which an operative procedure was avoided by successful percutaneous retrieval of the broken wire tip, using the loop-snare technique.

Female

Treatment of peripheral arterial obstruction with streptokinase: results in arterial vs graft occlusions.

A retrospective study of the efficacy of local low-dose intraarterial streptokinase for the treatment of peripheral arterial occlusion was performed in 60 cases. The results of treatment of occlusion of native arterial and arterial graft occlusions were compared. Twenty-two (73%) of 30 cases of arterial occlusion showed complete or partial angiographic resolution, compared with 16 (53%) of 30 cases of arterial graft occlusion. Ten (71%) of 14 patients with venous arterial grafts were successfully treated vs only six (38%) of 16 patients with prosthetic arterial grafts. These results suggest that streptokinase is an effective fibrinolytic agent for the treatment of arterial occlusion and arterial graft occlusion. Its effectiveness in arterial graft obstruction is comparatively low, although patients with venous grafts respond much more favorably than those with synthetic conduits.

Angiography

Percutaneous transluminal angioplasty following endarterectomy.

Prior to the introduction of percutaneous transluminal angioplasty (PTA), bypass grafting or endarterectomy was the treatment of choice for aortoiliofemoral atherosclerotic occlusive disease. Currently, PTA is a well-established procedure for the treatment of aortoiliofemoral atherosclerotic occlusive disease. PTA is as effective as, and safer than, surgery in these cases. Percutaneous transluminal angioplasty and endarterectomy cause similar trauma to the arterial wall, i.e., intimal denudation, plaque disruption and splitting, and medial disruption, splitting, and overstretching. Both PTA and endarterectomy heal in a similar manner, i.e., neointima formation and scarring. Both PTA and endarterectomy can be repeated. Therefore, PTA can be performed after endarterectomy or vice versa. Several patients with recurrent occlusive disease after endarterectomy have been safely treated with PTA. Our results obtained with PTA in patients who had a prior endarterectomy are comparable to the results obtained in patients who did not have a prior endarterectomy. No complications have been encountered. A previous endarterectomy does not preclude a subsequent PTA, or vice versa, in patients with recurrent occlusive disease.

Angioplasty, Balloon

Transcatheter embolotherapy of massive bleeding after surgery for benign gynecologic disorders.

Transcatheter embolotherapy is a well-established technique for control of bleeding in patients with pelvic trauma and pelvic malignancies, but it has been rarely used in massive vaginal bleeding after surgery for benign gynecologic disorders. We report five patients with massive post-operative vaginal hemorrhage following total abdominal hysterectomy (n = 3), repeated dilatation and curettage (n = 1) and cesarean section (n = 1), all successfully controlled with transcatheter embolization after many operative procedures had failed to stop the hemorrhage. The age of the patients ranged from 21 to 36 years. All patients underwent embolization of both internal iliac arteries with Gelfoam alone or in combination with stainless steel coils. The bleeding stopped immediately in all patients. Four patients recovered completely and one patient died of disseminated intravascular coagulation and multi-organ failure.

Adult

Undigested vegetable matter identified on barium-enema examination.

Undigested vegetable matter may reach the colon intact and be discovered on barium-enema examination. The authors demonstrate several examples of filling defects in the colon caused by vegetable matter. The characteristic shape and corresponding dietary history should allow for an appropriate diagnosis.

Barium Sulfate

Dilatation of a stenotic esophageal segment containing a diverticulum.

Dilatation of stenotic esophageal lesions containing diverticula has not been previously addressed in the literature. We report a case of successful dilatation. With increased intraluminal pressures, there is an increased risk of esophageal rupture in this situation. We suggest that dilatation can be safely done in this situation, and we recommend the use of a Gruntzig balloon catheter because of its unique properties.

Aged

Inflammatory aneurysm of the abdominal aorta: diagnosis by computerized tomography and ultrasonography.

We correctly diagnosed seven cases of inflammatory aneurysm of the abdominal aorta preoperatively by computerized tomography (CT) and ultrasonography (US). Excessive thickening of the aneurysmal wall and conspicuous enhancement on CT are the characteristic features that led to the correct diagnosis. Ultrasonographic findings are nonspecific, but US is the screening method of choice. If US shows a sonolucent zone anterior or anterolateral to an atherosclerotic aneurysm, CT should be used to delineate the perivascular abnormalities.

Aged

Pitfalls in cholangiographic interpretation.

Cholangiography is a well established method of evaluating the biliary tract, and the typical appearances of the more commonly encountered biliary tract disorders have been well described. There are many pitfalls, however, in the interpretation of cholangiograms that become apparent as large numbers of patients are examined. These pitfalls may be secondary to: congenital anatomic alteration, failure to appreciate normal biliary ductal anatomy, technical errors, and interpretative confusion. Awareness of these pitfalls is emphasized to avoid serious cholangiographic misdiagnosis.

Bile Duct Diseases

Splanchnic artery aneurysms and pseudoaneurysms: transcatheter embolization.

Over the past 7 years, eight patients with splanchnic artery aneurysms and pseudoaneurysms were studied and treated. Transcatheter embolization resulted in occlusion of the lesions in all eight patients. Potentially risky and difficult surgery was avoided completely in four patients. Three patients had elective surgery at a later date when their condition was more stable. The remaining patient had definitive surgery after embolization. Transcatheter embolization should be the initial treatment of choice in splanchnic artery aneurysms and pseudoaneurysms.

Aneurysm