Pelvic actinomycosis is a rare disease, and has variable clinical manifestations and courses, which make it difficult to diagnose the disease initially. We experienced a pelvic actinomycosis in a woman who complained vaginal discharge and lower abdominal pain, and had not been carring a intrauterine contraceptive device. This infection results in tissue destruction, fibrosis, and the formation of draining sinuses. We describe the case with brief review of clinical diagnosis and management.
Abdominal Pain ; Actinomycosis* ; Diagnosis ; Female ; Fibrosis ; Humans ; Intrauterine Devices ; Rare Diseases ; Vaginal Discharge

Osteopoikilosis is a rare, benign hereditary disease, which presents multiple osteosclerotic, and small round nodules in the bone. It is usually detected incidentally by radiological examination. A radionuclide bone scintigraphy is essential in distinguishing osteopoikilosis from osteoblastic metastases, because scintigraphic findings are usually normal in patients with osteopoikilosis. However, there have been no reports about F-18 fluorodeoxyglucose (FDG) PET findings in osteopoikilosis. Herein, we wish to report a case of osteopoikilosis with breast cancer, which could not be seen in either bone scintigraphy or F-18 FDG PET/CT.
Breast ; Breast Neoplasms ; Genetic Diseases, Inborn ; Humans ; Neoplasm Metastasis ; Osteoblasts ; Osteopoikilosis

BACKGROUND: Head and neck anatomy affects the laryngeal mask airway (LMA) cuff volume. The purpose of this study was to identify physical parameters that can be standardized to predict LMA cuff volume and measure the optimal and minimal LMA cuff volume in adults. METHODS: The predictors of volume or pressure of the LMA cuff were investigated in 167 patients. Manufacturers recommend a maximal cuff pressure (MCP) (i.e., 40 ml for size 5, 30 ml for size 4), an optimal cuff volume (OCV) at a cuff pressure of 60 cmH2O, and a minimal cuff volume (MCV) just before audible air leakage. The physical parameters measured included height, weight, body mass index, modified Mallampati classification (MMP), neck circumference, neck length, and thyro-mental distance. Data were analyzed by stepwise multilinear analysis. RESULTS: The regression equations (REs) were as follows: OCV (1.2 + [0.1 × height] + [0.5 × neck length]); MCV for men (−35.7 + [0.25 × height] + [0.7 × neck length] − [4.1 × MMP]); and MCV for women (−42.5 + [0.27 × height] + [0.75 × neck length] − [2.5 × MMP]). The mean values were as follows: MCP > 200 cmH2O, minimal cuff pressure < 20 cmH2O, OCV of 24.7 ml for men and 15.9 ml for women, and MCV of 12.1 ml for men and 7.1 ml for women. CONCLUSIONS: LMA cuff volume is estimated from the patient's height, neck length, and MMP. The RE for calculating the MCV shows a high correlation with height, neck length, and MMP.
Adult ; Airway Management ; Body Weight ; Classification ; Female ; Head ; Humans ; Laryngeal Masks* ; Male ; Neck ; Physical Examination*

BACKGROUND: Head and neck anatomy affects the laryngeal mask airway (LMA) cuff volume. The purpose of this study was to identify physical parameters that can be standardized to predict LMA cuff volume and measure the optimal and minimal LMA cuff volume in adults. METHODS: The predictors of volume or pressure of the LMA cuff were investigated in 167 patients. Manufacturers recommend a maximal cuff pressure (MCP) (i.e., 40 ml for size 5, 30 ml for size 4), an optimal cuff volume (OCV) at a cuff pressure of 60 cmH2O, and a minimal cuff volume (MCV) just before audible air leakage. The physical parameters measured included height, weight, body mass index, modified Mallampati classification (MMP), neck circumference, neck length, and thyro-mental distance. Data were analyzed by stepwise multilinear analysis. RESULTS: The regression equations (REs) were as follows: OCV (1.2 + [0.1 × height] + [0.5 × neck length]); MCV for men (−35.7 + [0.25 × height] + [0.7 × neck length] − [4.1 × MMP]); and MCV for women (−42.5 + [0.27 × height] + [0.75 × neck length] − [2.5 × MMP]). The mean values were as follows: MCP > 200 cmH2O, minimal cuff pressure < 20 cmH2O, OCV of 24.7 ml for men and 15.9 ml for women, and MCV of 12.1 ml for men and 7.1 ml for women. CONCLUSIONS: LMA cuff volume is estimated from the patient's height, neck length, and MMP. The RE for calculating the MCV shows a high correlation with height, neck length, and MMP.
Adult ; Airway Management ; Body Weight ; Classification ; Female ; Head ; Humans ; Laryngeal Masks* ; Male ; Neck ; Physical Examination*

PURPOSE: Current study was designed to understand the personality and emotional composition of patients with chronic constipation. Specifically, the personality differences were evaluated in the ramified subgroups based on the physiologic characteristics. METHODS: Forty patients (31 females and 9 males) of a mean age of 48 (range, 16~86) years underwent the MMPI among 310 patients with chronic constipation. MMPI (Minnesota Multiphasic Personality Inventory) profiles were utilized for psychologic assessment for all patients prior to making diagnosis. Three validity scales of MMPI included L (Lie scale), F (Infrequency scale), K (Suppressor scale). Ten clinical scales included HS (hypochondriasis), DP (depression), HY (hysteria), PD (psychopathic deviant), MF (masculinity- feminity), PA (paranoia), PT (psychasthenia), SC (schizophrenia), MA (mania), SI (social introversion). On the basis of findings with use of anorectal physiologic studies, subgroups were categorized as patients with rectocele (A1, n=22), patient without rectocele (A2, n=18), patients with nonrelaxing puborectalis syndrome (B1, n=10), patients without nonrelaxing puborectalis syndrome (B2, n=30). The MMPI profiles were compared between subgroup patients. RESULTS: In overall patients, mean scores for scales HS, DP were elevated as compared with mean profiles (60~65 and 45~55, respectively). Male patients showed higher mean scores for scale SI than those of female patients (male vs. female; 63.5 vs. 53.9, P<0.05). A1 group showed higher mean scores for PD scale than those of A2 group (A1 vs. A2; 57.4 vs. 49.8, P=0.01). B1 group showed higher mean scores for DP scale than those of B2 group (B1 vs. B2; 67.5 vs. 59.8, P<0.05). CONCLUSIONS: Present series provided that the MMPI is a valuable tool for assessing the psychologic functioning of patients with chronic constipation. It has revealed a different personality and emotional composition in the subgroup patients based on the anorectal physiologic studies. An aspect of social introversion, psychopathic deviant and depression should be emphasized. These findings can provide the fundamental information for guideline of future diagnostic evaluation and therapy in the patients with chronic constipation.
Constipation* ; Depression ; Diagnosis ; Female ; Humans ; Introversion (Psychology) ; Male ; Minnesota* ; MMPI* ; Psychology ; Rectocele ; Weights and Measures

PURPOSE: Our purpose was to evaluate F-18 FDG uptake in pulmonary lymphangitic carcinomatosis (PLC) according to CT findings and histology of lung cancer. Materials and METHODS: Thirty-three lung cancer patients with PLC were enrolled in this retrospective study. All the patients had a CT-based diagnosis of PLC. Chest CT findings of PLC were classified on the basis of involvement of axial interstitium. We categorized the involvement of axial interstitium as group 1, and the involvement of peripheral interstitium only as group 2. Visual and semiquantitative analyses by F-18 FDG PET/CT were performed in the PLC lesions. At first, we analyzed the F-18 FDG uptake in the PLC by visual assessment. If abnormal uptake was seen in the PLC, we drew regions of interest in the PLC lesions to obtain the maximum SUVs (maxSUVs). RESULTS: Of the 33 patients, 22 had abnormal F-18 FDG uptake in the visual assessment. There was no significant difference in the frequency of abnormal F-18 FDG uptake between group 1 and group 2 (p=0.17), although the frequency of group 1 tended to be higher than group 2 (15/19 (78.9%) in group 1, 7/14 (50.0%) in group 2). However, group 1 had a higher maxSUV than group 2 (p<0.01, group 1: 2.9+/-1.4, group 2: 1.5+/-0.6). There was no significant difference in the frequency of abnormal F-18 FDG uptake and maxSUV among the histology of the lung cancers. CONCLUSION: The involvement of axial interstitium in the PLC by lung cancer has a higher maxSUV than the involvement of only peripheral interstitium.
Carcinoma ; Humans ; Lung ; Lung Diseases, Interstitial ; Lung Neoplasms ; Retrospective Studies ; Thorax

BACKGROUND: Psoriasis is a chronic and intractable disease that drives patients to seek a complete cure. Recently, the patients who have failed with conventional medicine increasingly appear to be turning to complementary and alternative medicine (CAM), yet little is known of CAM's prevalence of use, and its effectiveness and safety, and especially for treating psoriasis. OBJECTIVE: The aim of this study was to qualify and quantify the usage of CAM for the treatment of psoriasis, and to offer valid information for dermatologists. METHODS: A total of 158 patients suffering from psoriasis were interviewed and they filled out a face-to-face structured questionnaire. RESULTS: Sixty-nine of 158 (43.7%) psoriasis patients reported the current or previous use of CAM. In the order of frequency, oriental medicine (49, 31.0%) was the most commonly used, followed by spa and bath therapy (31, 19.6%), health food supplements (28, 17.7%), topical applications (14, 8.9%) and dietary therapy (14, 8.9%). The majority of patients (60.9%) used CAM from the 'Desire to try everything'. The subjective therapeutic effect and satisfaction with CAM were predominant with health food supplements (57.1% and 53.6%, respectively). After the use of CAM, the patients most frequently complained of 'aggravation of psoriasis' as a side effect of CAM (14.0%). CONCLUSION: These results indicate that CAM is being widely used by patients with psoriasis. However, the use of CAM seems to not be very effective and it is not free of risks. Thus, the direct and indirect risks, and the merits and disadvantages of CAM should always be considered with prudence before using CAM in clinical practice.
Baths ; Complementary Therapies ; Food, Organic ; Humans ; Medicine, East Asian Traditional ; Prevalence ; Psoriasis ; Stress, Psychological

Minor histocompatibility antigens are MHC-bound peptides and contribute to the generation of allo-responses after allogeneic transplantation. H60 is a dominant minor H antigen that induces a strong CD8 T-cell response in MHC-matched allogeneic transplantation settings. Here, we report establishment of a TCR transgenic mouse line named J15, wherein T cells express TCRs specific for H60 in complex with H-2K(b), and different fates of the thymocytes expressing J15 TCRs in various thymic antigenic environments. Thymocytes expressing the J15 TCRs were positively selected and differentiated into CD8+ single positive (SP) cells in the thymus of C57BL/6 mice, wherein the cognate antigen H60 is not expressed. However, thymocytes were negatively selected in thymus tissue where H60 was transgenically expressed under the control of the actin promoter, with double-positive stages of cells being deleted. Despite the ability of the H60H peptide (LTFHYRNL) variant to induce cytotoxic activity from H60-specific CTL lines at ~50% of the activity induced by normal H60 peptides (LTFNYRNL), J15-expressing thymocytes were positively selected in the thymus where the variant H60H was transgenically expressed. These results demonstrate that a single amino-acid change in the H60 epitope peptide influences the fate of thymocytes expressing the cognate TCR.
Actins ; Animals ; Histocompatibility Antigens* ; Histocompatibility* ; Mice ; Mice, Transgenic ; Minor Histocompatibility Antigens ; Peptides ; T-Lymphocytes ; Thymocytes* ; Thymus Gland ; Transplantation, Homologous

There have been many reports about infections in patients with rheumatoid arthritis (RA) being more frequent than general population. Increased susceptability to infections in RA could be related to disease itself, comorbid conditions, and use of immunosuppressive drugs and steroid. Herpes zoster viral infections also have been reported to be more frequent in RA. We describe a case of 60-year-old woman with RA presented with ophthalmoplegia associated with herpes zoster ophthalmicus. Initially she complained of right orbital and periorbital pain. Six days later, she noted a cutaneous herpes zoster eruption involving the right 1st division of trigeminal nerve. Three days after developing skin eruption, she developed a right ptosis with external ophthalmoplegia and pupil dilatation resulting from the 3rd and 6th cranial nerve involvement. She was placed on intravenous acyclovir for 7days. Eight weeks after the onset of ophthalmoplegia, she recovered nearly completely.
Acyclovir ; Arthritis, Rheumatoid* ; Cranial Nerves ; Dilatation ; Female ; Herpes Zoster Ophthalmicus* ; Herpes Zoster* ; Humans ; Middle Aged ; Ophthalmoplegia* ; Orbit ; Pupil ; Skin ; Trigeminal Nerve

Ischemic-reperfusion injury of skeletal muscles takes place in the phase of reperfusion and induces cellular damages through activating various transcription factors and genes, which initiate signal transduction. The purpose of this study was to observe changes of expression of NF-kappa B and AP-1, which are known as a redox sensitive transcription factors in ischemic-reperfused rat skeletal muscles, and PKC theta which activate NF-kappa B and AP-1. Sprague-Dawley male rats of nine, thirty, and sixty-five weeks old were divided into control and ischemia groups. Ischemia was performed by occlusion of left common iliac artery for 4 hours using rodent vascular clamps. The animals were sacrificed at hours 0, 1, 3 and 6 after onset of reperfusion and tibialis anterior and soleus muscles were removed. The distributions of PKC theta, NF-kappa B, and AP-1 immunoreactivity (IMR) were examined using immunohistochemical methods. The results as follows; In control groups, PKC theta IMR was decreased with age and was higher in tibialis anterior than that in soleus muscles. In ischemia groups, PKC theta IMR was increased with age and was higher in soleus than that in tibialis anterior muscles. In control groups, NF-kappa B IMR was decreased with age. In ischemia groups, NF-kappa B IMR was increased with age and was higher in soleus than that in tibialis anterior muscles. In control groups, AP-1 IMR was decreased with age. In ischemia groups, AP-1 IMR was increased with age and was higher in tibialis anterior than that in soleus muscles. Increase or decrease of PKC theta IMR was associated with the increase or decrease of NF-kappa B and AP-1 IMR in ischemic-reperfused rat skeletal muscles, respectively. These results suggested that the increased expression of PKC theta may induce the upregulations of NF-kappa B and AP-1 in ischemic-reperfusion injury of rat skeletal muscle. It is also suggested that the ischemic injury may be increased with age, and tibialis anterior muscle is more susceptabile to ischemic-reperfusion injury than soleus muscle.
Animals ; Humans ; Iliac Artery ; Ischemia ; Male ; Muscle, Skeletal ; Muscles* ; NF-kappa B* ; Oxidation-Reduction ; Rats* ; Rats, Sprague-Dawley ; Reperfusion ; Rodentia ; Signal Transduction ; Transcription Factor AP-1* ; Transcription Factors