The infection with tapeworm of the Mesocestodes sp. has been rarely reported and only 8 cases of human infection were found in the world up to date. This is to report the first case of human infection with this tapeworm belonged to Cyclophyllidea in Korea. In January 1967, a 45 years old man visited to the out clinic of St. Mary's Hospital with the complaints of intermittent indigestion and abdominal distension nearly for 1 year. Laboratory findings appeared almost normal except increased eosinophils up to 14 per cent. The characteristic ova of Mesocestoides sp. were found by the serial stool examinations, which contained hexacanth larva inside the egg shell without operculum as in Cyclophyllidea. It was failed to reveal the scolex by the first evacuation, but one among 3 worms evacuated by the treatment with atabrine and enough purgations 2 months later, has been found the characteristic scolex. They were 85 cm to 136 cm long and the scolex had 4 distinct suckers but no rostellum, the matured proglottid had numerous testes bilaterally and ovary with yolk glands in central parts, and in the gravid proglottid spiral uterus was opened to uterine pore and characterized by the spherically distended uterine capsules. The patient had the history of ingestion of 15 snakes as raw about 1 year ago as usually seen in Japanese cases.
parasitology-helminth-cestoda-Mesocestodes sp. ; case report

Synthetic genes encoding the gag p24 and the part of the envelope protein gp41 of the human immunodeficiency virus (HIV-1) were cloned and overexpressed as fusion proteins in Escherichia coli, using an expression vector carrying 77 promoter and the poly-histidine leader sequence. The overexpressed p24 fusion protein was purified by centrifugation, Ni-affinity chromatography and CM-sepharose chromatography The overexpressed gp41 fusion protein was purified by centrifugation, C4 chromatography and DEAE-sepharose chromatography. The purified fusion proteins showed a high level of purity and immunoreactivity in SDS-polyacrylamide gel electrophoresis and western blot analysis. These results suggest that this prokaryotic expression-purification method is suitable for obtaining a large amount of the viral antigen which may be useful for screening of antibodies to HIV-1 in human blood samples.
Antibodies ; Blotting, Western ; Centrifugation ; Chromatography ; Clone Cells ; Electrophoresis ; Escherichia coli ; Genes, Synthetic ; HIV* ; HIV-1* ; Humans* ; Mass Screening

BACKGROUND AND OBJECTIVE: Transient global amnesia(TGA) is a neurological syndrome affecting preferentially middle-aged or elderly people and characterized by sudden onset of transient impairment of antegrade amnesia with variably retrograde amnesia. TGA was defined over 30 years ago, but the etiology remain unclear. Several mechanisms have been proposed, including arterial thromboembolic ischemic attacks in both posterior cerebral artery territories, epilepsy, and migraine. Although many studies have reported TGA, only a few reported cerebral perfusion studies using SPECT because of the brief duration of the episode. Technetium-99m-ethyl cysteinate dimmer(ECD) is superior to sensitivity of lesion detection and lesion to normal contrast, probably due to lower back diffusion from the brain to the blood and its excellent radiochemical stability. So we evaluate pathophysiologic mechanism of TGA by using 99mTC-ECD SPECT with or without acetazolamide(ACZ) stress. METHODS: We evaluated six patients with transient global amnesia, four women and two men, age ranges 56 to 78 years, mean 62.2 years. Measurements of CBF and vascular reserve using 99mTC-ECD with or without ACD stress were performed during or after TGA episode. RESULTS: One patient, who was evaluated in TGA episode showed that regional cerebral blood flow was decreased in both anteroinferior frontal, both temporal, right thalamus, both inferior parietal and left parietal region with impaired vascular reserve in left inferior temporal and right thalamus. Others, who were evaluated more than 6days in TGA episode showed that regional cerebral blood flow was decreased in left temporal (4), both temporal region (1), left thalamus (2) and both basal ganglia (1) with preserved vascular reserve except one, showed impaired vascular reserve in left thalamus. CONCLUSION: This result show that severe hypoperfusion of bilateral temporal region and impaired vascular reserve in left temporal region in TGA episode. Other patients who were recovered from TGA showed hypoperfusion of left temporal region and preserved vascular reserve. 99mTc-ECD with acetazolamide SEPCT that sensitively detects localized impaired cerebraovascular reserve should help elucidate these processes. But further study with more cases is necessary for evaluation of pathophysiology of TGA.
Acetazolamide ; Aged ; Amnesia ; Amnesia, Retrograde ; Amnesia, Transient Global* ; Basal Ganglia ; Brain ; Diffusion ; Epilepsy ; Female ; Humans ; Male ; Migraine Disorders ; Perfusion ; Posterior Cerebral Artery ; Rabeprazole ; Technetium* ; Thalamus ; Tomography, Emission-Computed, Single-Photon*

BACKGROUND: The proper management of the patients with hypotention remains a difficult clinical problem. This study was designed to evaluate the efficacy and safety of gepefrin in the treament of symptomatic hypotensive patients in outpatient clinic of university hospital. METHODS: Thirty milligrams of Gepefrin was given twice daily for 4 weeks in 30 patients with hypotension(6 males, 24 females ; 23-60 years of age). Blood pressure, heart rate, subjective symptoms and side effects were checked before medication and at the end of 1st, 2nd, 3rd, 4th week of medication. RESULTS: 1) Grpefrin increased sitting systolic blood pressure significantly(p<0.05) by the end of 1st week and thereafter. 2) Hypotensive symptoms were improved in 76% of hypotensive patients and overall rate of usefulness was 70%. 3) Heart rate did not change significantly. 4) One patient complained of loose bowel movement and another one, of anorexia among 30 study patients and all laboratory parameters were within normal limits before and after drug treatment, thus the rate of safety was 93%. CONCLUSION: Results from this study suggests that gepefrin 60mg daily increases the blood pressure mildly and improves the symptoms moderately in symptomatic hypotensive patients.
Ambulatory Care Facilities ; Anorexia ; Blood Pressure ; Female ; Heart Rate ; Humans ; Hypotension* ; Male ; Quality of Life

This study was conducted to determine the effect of oxantel/pyrantel tablets, oxantel suspension, pyrantel dry syrup and pyrantel tablets against T. trichiurus and A. lumbricoides infections. Twenty-four cases of mixed infections of T. trichiurus and A. lumbricoides were treated with oxantel/pyrantel tablets at a single dose of 20 mg/kg of body weight, and 49 cases of single infection of T. trichiurus were administered oxantel suspension at a single dose of 15 mg/kg of body weight. On the other hand, single infection of A. lumbricoides in 18 cases was administered pyrantel dry syrup at a single dose of 5 mg/kg of body weight. In the above 91 cases, the negative conversion rate and the egg reduction rate of egg out-put before and after the drug administration were examined by the cellophane thick smear method and Stoll's egg counting technique. A follow-up examination was carried out 3-4 weeks after the drug administration. Other 59 cases of single and mixed infection of T. trichiurus and A. lumbricoides were examined by the cellophane thick smear method only and administered pyrantel tablets at a single dose of 2.5 mg/kg of body weight. The results were summarized as follows: The prevalence rates of T. trichiurus and A. lumbricoides infection in this study were 42.8% and 27.2% respectively by the cellophane thick smear method among 1,066 stool specimens. The egg negative conversion rate and the egg reduction rate in the administration of oxantel/pyrantel tablets at a single dose of 20 mg/kg body weight were 75.0% and 97.8% respectively in T. trichiurus infection and 100% each in A. lumbricoides. The egg negative conversion rate and the egg reduction rate in the administration of oxantel suspension at a single dose of 15 mg/kg body weight were 85.7% and 93.0% respectively in sinlge infection of T. trichiurus. The egg negative conversion rate and the egg reduction rate in the administration of pyrantel dry syrup at a single dose of 5 mg/kg body weight were 100% each in single infection of A. lumbricoides. The qualitative evaluation in cases of single and mixed infection of T. trichiurus and A. lumbricoides were by means of pyrantel tablets at a single dose of 2.5 mg/kg body weight, the cure being 100% against A. lumbricoides but 17.0% against T. trichiurus. There were no undesirable side effects in this study and oxantel suspension and pyrantel dry syrup were well accepted and tolerated.
parasitology-helminth-nematoda ; Trichuris trichiurus ; Ascaris lumbricoides ; chemotherapy ; oxantel ; pyrantel

OBJECTIVES: From February 1995 to April 1998, those patients who had visited for evaluation of infertility, shown abnormal endometrial pattern on hysterosalpingography underwent resectoscopic operation. We evaluated about its therapeutic effect, recurrence rate of uterine adhesion and effectiveness of its assisted method. METHOD: We have reviewed 45 cases of intrauterine adhesion, classified as a central type, marginal type and multiple type. We used 26F resectoscope made in Storz for operation and inserted Lippes loop or pediatric foley catheter for prevention of readhesion. For promoting reepithelialization, conjugated estrogens(premarin) 5mg daily for 30 - 50 days were given and then 10mg of medroxyprogesterone acetate(provera) were added daily for the last 10 days. We evaluated the uterine cavity condition preoperatively and postoperatively by using hysterosalpingography. RESULT: In 45 cases, 41 cases were followed up postoperatively. 21 cases were markedly improved, 12 cases were improved and 8 cases were not improved or recurred on hysterosalpingography. In 41 cases, for prevention of readhesion 20 cases were used pediatric foley catheter and 5 cases(25%) were recurred. 21 cases were used Lippes loop and 3 cases(14%) were recurred. Pregnancy outcome was as follows;15 cases were pregnant and 10 cases delivered a viable infant, 3 cases aborted spontaneously, 1 case was ectopic pregnancy and laparoscopic salpingectomy was done, 1 case was ongoing pregnancy. CONCLUSION: This report suggests that resectoscopic operation is very effective in the treatment of intrauterine adhesion(therapeutic rate of 81%) and that the use of Lippes loop seems like to have the less recurrence rate than the use of pediatric foley catheter in prevention of postoperative readhesion, but more experience and further follow-up are necessary to obtain more detailed conclusions.
Catheters ; Female ; Follow-Up Studies ; Humans ; Hysterosalpingography ; Infant ; Infertility ; Medroxyprogesterone ; Pregnancy ; Pregnancy Outcome ; Pregnancy, Ectopic ; Recurrence ; Salpingectomy

Three cDNA fragments located within NS5 region of HCV were synthesized by RT using viral RNA extracted from blood sample of Korean patient as a template. The cDNAs were amplified by PCR, cloned into the T-vector, and the nucleotide sequences were determined. Comparative a analysis of the nucleotide and amino acid sequence of NS5 cDNAs showed that it is closely related with HCV type 1b. The cloned NS5 cDNA showed 91-94% homology at the nucleotide sequence level and 96-98% homology at the amino acid sequence level with several strains of the HCV type 1b. The NS5 cDNAs were subcloned into E. coli expression vectors to construct pRSETA5-1, pTHAN5-1, pRSETC5-2, pRSETBB1, pRESTCB1 and PRSETB-H3. Expression of the NS5 proteins was achieved by inducing the promoter with isopropyl-thio-P-D-galactoside (IPTG) and confirmed by SDS-polyacrylamide gel electrophoresis. The NS5 proteins were immunoreactive against sera from Korean hepatitis C patients in Western blot analysis. Among the recombinant NS5 proteins, pRSETA5-1 plasmid derived protein, coded from aa2022 to aa2521 of HCV polyprotein, showed the strongest immunoreactivity against sera from Korean hepatitis C patients in immunoblot analysis. These results suggest that NS5 proteins would be useful as an antigen for detection of antibody against HCV in the blood samples.
Amino Acid Sequence ; Base Sequence ; Blotting, Western ; Clone Cells* ; Cloning, Organism* ; DNA, Complementary ; Electrophoresis ; Hepacivirus* ; Hepatitis C* ; Hepatitis* ; Humans ; Plasmids ; Polymerase Chain Reaction ; RNA, Viral

BACKGROUND: In spite of the development of diagnostic tools, gallbladder carcinoma is often diagnosed at a late stage because of the lack of symptomatic awareness of patients in early stage. Early diagnosis and proper resectional treatment is, therefore, the most important factor for the prognosis. This study aims at the analysis of clinical characteristics and the effect of various modes of surgical treatment on long-term survival. METHODS: From January 1989 to December 1997 we operated on 132 patients with gallbladder carcinoma. Age, sex, stage distribution, clinical manifestations and mode of operations were analyzed. The cumulative survival rates were also analyzed for 107 patients who had been finally followed up, and the significance of survival difference was tested (p<0.05). RESULTS: The average age of 132 patients was 64 years old, and female patients suffered more frequent incidence than male patients by a ratio of 1.7:1. The distribution of patients according to the pathologic TNM staging showed early stage (stage 0 & I) accounted for only 9.8% whereas the advanced stages (stage II, III, IVa, IVb) accounted for the majority of the patients (90.2%). The chief complaints were abdominal pain (84.8%), indigestion, weight loss, palpable mass and so forth in a decreasing frequency order. Among the patients, 30 cases (22.7%) were irresectable, 50 cases (38%) were curative resected, and 52 cases (39%) were palliative resected. The overall cumulative survival rates of 107 patients were 53.7%, 41.7% and 30.1% for 1-year, 2-year and 5-year survival respectively. Although the 5-year survival rate of curative resected patients showed a significantly better survival rate (p<0.005) than that of non-curative resected patients, the different modes of combined radical surgery did not affect the survival rates. CONCLUSION: Combined curative resection ameliorated long-term survival of patients with gallbladder carcinoma. For the further evaluation of the efficacy of combined radical surgery on survival, more extensive data needs to be accumulated.
Abdominal Pain ; Dyspepsia ; Early Diagnosis ; Female ; Gallbladder* ; Hospital Distribution Systems ; Humans ; Incidence ; Male ; Middle Aged ; Neoplasm Staging ; Prognosis ; Survival Rate ; Weight Loss

OBJECTIVE: S100B is a neurotrophic factor that is involved in neuroplasticity. Neuroplasticity is disrupted in depression; however, treatment with antidepressants can restore neuroplasticity. S100B has previously been used as a biological marker for neuropathology and neuroplasticity; therefore, in this study, we compared serum S100B levels in depressive patients to those of normal controls. In addition, we compared the serum S100B levels of antidepressant responders to those of nonresponders. METHODS: Thirty five normal controls and 59 depressive patients were enrolled in this study. Depressive patients entered a 6 week clinical trial that included treatment with antidepressants. The serum S100B levels and clinical assessments, which included Hamilton depression rating scores, were measured at baseline and after 6 weeks of treatment with antidepressants. The difference in the serum S100B levels between depressive patients and normal controls and between antidepressant responders and nonresponders was then compared. RESULTS: There were no significant differences in the serum S100B levels of normal controls and depressive patients. In addition, 30 of the depressive patients responded to antidepressant treatment while 29 did not. Finally, the responders had significantly higher baseline serum S100B levels than the nonresponders. CONCLUSION: The results of this study suggest that the baseline serum S100B level is associated with the subsequent response to antidepressants. In addition, the high baseline serum S100B level that was observed in depressive patients may enhance neuroplasticity, which results in a favorable therapeutic response to antidepressants.
Antidepressive Agents ; Biomarkers ; Depression ; Depressive Disorder, Major* ; Humans ; Neuronal Plasticity

PURPOSE: The purposes of this study were to evaluate the plain radiologic findings of the childhood intussusception and to evaluate the role of plain abdominal films in predicting the success of air or barium reduction. SUBJECTS AND METHODS: We retrospectively reviewed 140 cases with the diagnosis of intussusception in children. The radiological signs that included soft tissue mass, dilatation of small bowel suggesting obstruction, crescent sign, and target sign were evaluated in terms of frequency. The relationship between radiological findings and outcome of reduction was analyzed. The site of soft tissue mass or crescent sign seen on plain radiographs was correlated with the position of the apex of the intussusceptum seen at the beginning of barium enema. The degree of dilated small bowel was evaluated by calculating the proportion of air-filled small bowel occupying peritoneal cavity and measuring the maximal diameter of dilated bowel lumen. The radiological finding for small bowel obstruction is determined by observation of the degree of small bowel dilatation and/or air-fulid levels. RESULTS: Ninety-two cases out of 140 showed one or more radiographic signs. Two most common signs were soft tissue mass and small bowel obstruction. The success rate of air or barium reduction was significantly lower in patients with most severe degree of dilatation of small bowel and/or more than 7 air-fulid levels on erect view. The suspected location of intussusception on plain radiographs correlated well with the true location of intussusception seen in the first few seconds of barium reduction. CONCLUSION: Plain abdominal radiography is useful in the diagnosis of intussusception and provides helpful informations for the reduction procedure as well as for the exclusion of the contraindications such as bowel perforation.
Barium ; Child ; Diagnosis ; Dilatation ; Enema ; Humans ; Intussusception* ; Peritoneal Cavity ; Radiography, Abdominal ; Retrospective Studies