No abstract available.
Humans ; Inpatients*

Intramural duodenal hematoma (IDH) is a quite rare disese entity which results from the collection of blood and body fluid between mucosa and serosa. Various degrees of duodenal obstruction may be caused by IDH as it gradually enlarges and compresses the mucosa against the opposite side of duodenum. The most common cause of IDH is blunt abdominal trauma and the spontaneous IDHs are generally casused by coagulation disorder such as blood dyscrasia, anticoagulation treatment or pancreaticoduodenal aneurysm. The diagnosis is usually made by the typical imaging on abdominal computed tomographic scan with a previous history of blunt abdominal trauma. For spontaneous IDH without coagulation disorder, an abdominal angiogram may be considered to exclude vascular anomalies. Medical treatment is recommended unless the associated visceral injuries require immediate laparotomy. Here, we report a case of acute duodenal obstruction due to IDH which had resolved completely without an operative management.
Aneurysm ; Body Fluids ; Diagnosis ; Duodenal Obstruction* ; Duodenum ; Hematoma* ; Laparotomy ; Mucous Membrane ; Serous Membrane

Background: Prolactin(PRL) secretion is tonically inhibited by doparnine that originates from the hypothalamic tuberoinfundibular tract and reaches the lactotroph via the hypophyseal portal vessel. Hyperprolactinemia associated with oligomenorrhea-amenorrhea, galactorrhea and/or infertility is mainly due to PRL-secreting pituitary adenoma(PA). The diagnosis of idiopathic hyperprolac- tinemia(IHP) is made, when hyperprolactinemia is sustained and all causes of hyperprolactinemia are excluded without radiological abnormality. It is not known, whether IHP and PA are two distinct entities or two subsequent phases of the same disease. The etiology of both disorders remains unresolved. We investigated that PRL hypersecretion in patients with IHP and PA may be the result of a defect in the central nervous system(CNS)-dopamine release, and that there may be some differences in pathogenesis of both diseases. Methods: We measured 24 hour-urinary dopamine, norepinephrine, epinephrine, and serum and 24 hour-urinary VMA(vanillyl rnandelic acid), HVA(homovanilic acid), DOPAC(3,4-dihydroxy phenylaceticacid), MHPG(3-methoxy 4-hydroxy phenylglycol) in 10 normal controls, 9 patients with IHP, and 17 patients with PA in the early follicular phase. Results: Urinary HVA and DOPAC concentrations, the major metabolites of CNS dopaminergic activity, were signficantly lower in both patients with IHP and PA compared with those in normal controls(p 0.05), whereas they were not different in both disease groups. Dopamine, norepine-phrine, epinephrine, MHPG concentrations were similar to those of the normal controls. Although VMA concentrations of both disease groups were significantly higher than those of normal controls, all of them were within normal range. Conelusion: Although our data are unable to establish the precise biochemical defect responsible for central dopamine deficiency in pathogensis of IHP and PA, we can support the presence of a pathological reduction of brain dopamine activity in IHP and PA.
3,4-Dihydroxyphenylacetic Acid ; Brain ; Diagnosis ; Dopamine ; Epinephrine ; Female ; Follicular Phase ; Galactorrhea ; Humans ; Hyperprolactinemia ; Infertility ; Lactotrophs ; Methoxyhydroxyphenylglycol ; Norepinephrine ; Pregnancy ; Prolactinoma ; Reference Values

OBJECTIVE: To assess the reliability of triple marker screening test in midtrimester pregnancy for fetal Down syndrome. METHODS: From October 1, 1996 to May 31, 1998 at Nowon Eulji Hospital, 3700 Pregnant women underwent serum tiple marker screening for Down syndrome during 15-20weeks of gestational age. The results of serum triple marker screenig tests for Down syndrome and the outcomes of pregnancies were retrospectively assesed. RESULTS: Sixty seven of 3700 cases(1.81%) were positive in screening test, and 3633(98.18%) cases were negative. Among 67 cases of positive screening test, 1 case(1.49%) was diagnosed as Down syndrome. Among 3633 cases of negative screening test, 4 cases(0.1%) were diagnosed as chromosomal abnormalies postnatally. Two of these 4 cases of chromosomal abnormalies were Down syndrome. CONCLUSION: With this results, sensitivity of triple marker screeing test for Down syndrome is very low as 33.3%. In order to increase the sensitivity, some compensatory adjustment is required in triple marker screening test.
Down Syndrome* ; Equidae ; Female ; Gestational Age ; Humans ; Mass Screening* ; Pregnancy ; Pregnancy Outcome ; Pregnancy Trimester, Second* ; Pregnant Women ; Retrospective Studies

Benzbromarone is a uricosuric agent for hyperuricemia and gout. Some of its well-known side effects include hypersensitivity, renal calculi, and gastrointestinal problems. Although the drug was withdrawn from U.S. market due to severe hepatotoxicity, it is still available in some countries including Korea. We describe a 19-year-old male who was admitted with general weakness and azotemia after use of benzbromarone. A kidney biopsy revealed acute tubular necrosis without an evidence of urate nephropathy. After discontinuation of benzbromarone, the renal function returned to baseline. This is the first case of acute tubular necrosis associated with benzbromarone use.
Azotemia ; Benzbromarone ; Biopsy ; Gout ; Humans ; Hypersensitivity ; Hyperuricemia ; Kidney ; Kidney Calculi ; Korea ; Male ; Necrosis ; Transplants ; Uric Acid ; Young Adult

Tissue engineering has the potential to provide cartilaginous constructs capable of restoring the normal function of native articular cartilage following joint injury or degradation. One approach to functional tissue engineering of cartilage involves the in vitro cultivation of tissue constructs by using: (i) chondrogenic cells that can be selected, expanded, and transfected to overexpress the genes of interest, (ii) scaffolds that provide a defined three-dimensional structure for tissue development and biodegrade at a controlled rate. Understanding the functional potential of the cells and the signaling mechanisms underlying their differentiation should lead to innovative protocols for clinical orthopaedic interventions. A large number of growth factors and hormones have been implicated in the regulation of chondrocyte biology, relatively little is known about the intracellular signaling pathways involved. We have tried to define the roles of specific TGF-betadependent signaling pathways involved in the regulation of chondrogenesis from human mesenchymal stem cells. Chondrogenesis induced by TGF-beta in alginate bead system was confirmed by examining cartilage specific type II collagen expression and aggrecan, whereas type I collagen expression was not affected by TGF-beta. Type II collagen mRNA expression was expressed strongly during chondrogenesis and MEK inhibition (U0126) resulted in complete down-regulation of type II collagen. In contrast, aggrecan expression was detected in same level by treatment of U0126. These results strongly suggest that the ERK signaling cascade is involved in TGF-beta induced-chondrogenesis signaling pathways and a role of its pathway is necessary over a longer period to promote type II collagen expression. However, their end product properties in vivo have not been well known. In this study, an articular cartilage from chondrogenic MSCs with PLGA scaffolds (75:25 and 65:35) were made and analyzed its biochemical, histological and mechanical properties in vitro and in vivo. And also, we evaluated the cartilage formation in vivo through the injection of cell-thermosensitive gel complex, a newly developed injectable material. At 12 weeks after PLGA scaffolds containing chondrogenic MSCs transplantation, the separated rabbit distal femur showed a good gross articular cartilage appearance in the transplanted site. In indentation test, compare to the native articular cartilage, the engineered cartilage from two types of (75:25 and 65:35) achieved up to 30-60% in mechanical stiffness. And also, a new model for cartilage formation in bladder, at 14 weeks after injection, we could find out mass formation in the submucosal area grossly. H&E staining, alcian blue staining and other special staining confirmed the chondrogenic differentiation in the mass. These cell therapy technologies can provide the possibility of clinical applications for vesicoureteral reflux and reflux esophagitis, and urinary incontinence as well as articular cartilage regeneration.
Animals ; Cell Differentiation ; Chondrocytes/*cytology ; Humans ; Mesenchymal Stem Cells/*cytology ; Research Support, Non-U.S. Gov't ; *Tissue Engineering

Necrotizing fasciitis (NF) is an uncommon, life-threatening infection of the subcutaneous tissue and superficial fascia. The clinical course of NF is rapid and progressive, and it is often fatal despite the appropriate therapy. The prognosis of NF depends on a timely diagnosis and then proper treatment. At onset it may not be possible to clearly distinguish NF from minor soft-tissue infections. Although infection are common due to the use of steroids and immunosuppressive agents in patients with systemic lupus erythematous (SLE), it is interesting that NF has rarely been reported with SLE. Here, we present two cases of NF with SLE.
Fasciitis, Necrotizing ; Humans ; Immunosuppressive Agents ; Prognosis ; Steroids ; Subcutaneous Tissue

BACKGROUND: Dermatophytoses are infections of keratinized tissues, that is, the epidermis, hair and nails, caused by a group of specialized fungi, the dermatophytes. Laboratory diagnoses of dermatophytes such as Tricophyton, Microsporum and Epidermophyton are made by microscopic examination and in vitro culture but they are either time consuming of lacking specificity. OBJECTIVE: In order to develop and apply more rapid and precise diagnostic tests for fungal pathogens to facilitate the improved identification of dermatophytes, we investigated random amplified polymorphism DNA for classification and identification of dermatophytes. METHODS: Amplification reactions were performed in volumes of 5011 containing 10mM Tris-HCl(pH 8.3), 50mM KCl, 1.5mM MgCl2, 0.01% (w/v), gelatin, 200mM dNTP mixture, 50pM primer, Taq polymerase (0.025 units/ microliter), DNA 0.001 microgram/microliter. The optimal condition to. PCR was 2 cycles (denaturing 94 degrees C 2min, annealing 33 degrees C 2min, extension 72 degrees C 4min), 40 cycles, and extension (72 degrees C 10min). RESULTS: RAPD showed interspecies polymorphism in but it had identical patterns in intraspecies. CONCLUSION: It was confirmed that RAPD PCR analysis with optimal conditions is a fast, economical and reproducible method for identification and classification of dermatophytes isolates.
Arthrodermataceae* ; Classification* ; Clinical Laboratory Techniques ; Diagnostic Tests, Routine ; DNA* ; Epidermis ; Epidermophyton ; Fungi ; Gelatin ; Hair ; Magnesium Chloride ; Microsporum ; Polymerase Chain Reaction ; Sensitivity and Specificity ; Taq Polymerase ; Tinea

BACKGROUND: The early diagnosis of invasive candidiasis is the most important for reducing of morbidity and mortality rates in the immunocompromised patients. The study of antigen detection was performed by Cand-Tec kit, but antibody detection by Western blot, had not been reported. OBJECTIVE: We reviewed 62 cases of suspected invasive candidiasis(10), immunocompromised patients with leukemia, leukopenia, pneumonia, et al(44) and normal colonization control(8) in the urine and sputum for the immunological diagnosis of invasive candidiasis by Cand-Tec and Western blot assays. METHODS: The antigen and antibody detection were done by both Cand-Tec kit and Western blot assay, in the sera of the patients collected from several hospitals. RESULTS: The sera from 4(40%) and 8(80%) of 10 suspected invasive candidiasis had a threshold positive titers of > or = 1:4 by latex agglutination (Cand-Tec) and the results of positive antibody to the immunodominant antigen (47KDa) of Candida spp. by Western blot assay, each other. Both antigen and antibody we.e detected from 21(47%) of 44 patients in the immunocompromised group and 1(12%) of 8 cases with normal flora, separately, but the antibodies from 3(18%) of 16 healthy controls were detected by Western blot analysis, only. CONCLUSION: This study confirm that the Western blot method of detecting antibody against immunodominant antigen(47KDa) of Candida spp. was more effective than antigen detection by Cand-Tec method for immunodiagnosis of invasive candidiasis.
Agglutination ; Antibodies ; Blotting, Western ; Candida ; Candidiasis, Invasive* ; Colon ; Diagnosis* ; Early Diagnosis ; Humans ; Immunocompromised Host ; Immunologic Tests ; Latex ; Leukemia ; Leukopenia ; Mortality ; Pneumonia ; Sputum

BACKGROUND: Basal cell carcinoma (BCC) is the most common skin cancer. About 74% cases of basal cell cancer occur on the head and neck. Basal cell carcinoma on the face may have a higher degree of subclinical spread than tumors arising elsewhere. And incompletely excised BCCs become more aggressive when they recur. So the surgical removal and reconstruction of BCC located on the face are important to make perfect curing and cosmetic results. METHODS: A retrospective study was done with 128 patients (137 cancers) who were treated with BCC on the face since 1987 to 2011. General data of these cases such as the primary site of cancer, age and sex of the patients, operative methods, and recurrence rate were reviewed. RESULTS: The ratio of men to women was 1:1.4. And 86.9% of the patients with BCC were older than the age of 50 years with the mean age of 65.8 years. The distribution of facial basal cell carcinoma was on the nose, eyelids, cheek, and nasolabial fold. Surgical methods for treatment were local flap, full thickness skin graft, primary closure, and split thickness skin graft. Specifically, local flap consists of V-Y advancement flap, cheek advancement flap, limberg flap, forehead flap, nasolabial flap, rotation flap, transposition flap, bilobed flap, and island flap. Six cases recurred and all of them were treated with reoperation. CONCLUSION: The authors reviewed facial basal cell carcinoma cases in our hospital. This study might be helpful to choose appropriate operation method to manage BCC on face in Korea.
Carcinoma, Basal Cell* ; Cheek ; Eyelids ; Female ; Forehead ; Head ; Humans ; Korea ; Male ; Nasolabial Fold ; Neck ; Neoplasms, Basal Cell ; Nose ; Recurrence ; Retrospective Studies ; Skin ; Skin Neoplasms ; Transplants