BACKGROUND: Paraquat is a widely used herbicide, known to cause lethal toxicity in humans. Most studies about paraquat have concentrated on systemic toxicity, however several cases of paraquat-induced dermatitis have been reported. OBJECTIVE: The purpose of this study was to confirm the cutaneous toxic effect of paraquat and to select potential antidotes in paraquat-induced dermatitis. METHODS: Keratinocyte toxicity due to paraquat and the toxicity reduction capacity of several drugs were investigated in eitro. Topical effects of these drugs on paraquat-induced dermatitis in guinea pig skin was also investigated. RESULTS: Over 50% of keratinocytes failed to survive at a concentration of 2X10-4M paraquat by a neutral red uptake assay. Skin irritation by paraquat was observed at 2% concentration by non-invasive methods as well as a skin biopsy. Dexamethasone, glutathione and tocopherol showed some capacity to reduce paraquat-induced keratinocyte toxicity in vitro. Only dexamethasone, however, showed a reduction of cutaneous blood flow volume and dermal inflammatory cell infiltration in the guinea pig study. CONCLUSION: This result indicates the possible in eitro protective effect of paraquat toxicity in glutathione and tocopherol. Dexamethasone was capable of reducing paraquat-induced cytotoxicity and dermatitis both in vitro and in vivo.
Animals ; Antidotes* ; Biopsy ; Dermatitis ; Dexamethasone ; Glutathione ; Guinea Pigs ; Humans ; In Vitro Techniques ; Keratinocytes ; Neutral Red ; Paraquat* ; Skin* ; Tocopherols

No abstract available.
Cardiopulmonary Bypass* ; Lipoproteins* ; Plasma*

No abstract available.
Idiopathic Pulmonary Fibrosis*

No abstract available.
Child* ; Heart Diseases* ; Heart* ; Humans ; Physical Examination

No abstract available.
Intussusception* ; Peutz-Jeghers Syndrome*

PURPOSE: Despite modern pathologic techniques, GISTs pose a dilemma in nomenclature, cellular origin, diagnosis, classification, and prognostication. The authors attempted to elucidate the clinical applications of known prognostic factors at our hospital on the basis of CD34 or CD117 positivity. METHODS: Immunostaining was done on 24 cases of GI tract tumor including leiomyoma, leiomyosarcoma, and GISTs treated in our hospital between 1991 and 2000. 20 cases that showed positive reactivity to either CD34 or CD117 were chosen, and a retrograde evaluation of the clinical characteristics and pathological characteristics was done. RESULTS: 16 of 24 cases (66.7%) showed a positive reactivity to CD34, 18 cases (75%) to CD117, and 20 cases (83.3%) to both CD34 and CD117. Complete resection was performed on all, with exception of one in which intraperitoneal metastasis was detected. The mean age of the patients was 58.9 (19~74) years, the mean tumor size was 8.1 cm (3~20) and there was no significant difference between the sexes. The overall survival rate was 80%. The difference of cumulative survival rate was significant when tumor size was 10 cm or greater (p=0.0021), mitotic count was 5/50 HPF or over (p<0.0001), or severe cellularity (p=0.0001), invasion (p<0.0001), necrosis (p=0.0185) or atypism (p<0.0001) were accompanied. CONCLUSION: Authors defined GIST as those case that were immunohistochemically positive to either CD34 or CD117. The prognostic factors those affected 5-year survival rate were tumor size, mitotic count, intratumoral necrosis, severecellularity, atypism and invasion. Additionally, the surgical treatment for this condition should be a complete resection of macroscopically identified tumor with adequate margin secured. Finally, a long term follow-up for the recurrence should be carried out.
Classification ; Diagnosis ; Gastrointestinal Stromal Tumors* ; Gastrointestinal Tract ; Humans ; Leiomyoma ; Leiomyosarcoma ; Necrosis ; Neoplasm Metastasis ; Recurrence ; Stomach* ; Survival Rate

Renal allograft recipients are at risk for Pneumocystis carinii pneumonia (PCP) within the first year following transplantation and during treatment for graft rejection. We experienced two cases of PCP in renal allograft recipients. The first case was a 39-year-old female who had received renal allograft 7 years before. At the time of traosplantation, she was a carrier of hepatitis B surface (HBs) antigen. After transplantation, she had been received the rnaintenance dose of cyclosporine and oral prednisolone. Three months before adrnission, dosage of prednisolone was increased because of the increased serum creatinine level and gene-ralized edema. A week before admission, syrnptom of exertional dyspnea, dry cough, and fever was developed. Chest X-ray film showed streaky interstitial infiltration in both lung fields and chest CT showed diffuse ground-glass appearance. Rroncho- alveolar lavage revealed positive Grocott's methenamine silver stain for numerous clumps of pneumocystis carinii cysts. Despite the aggressive treatment, she died of respiratory and hepatic failure and GI bleeding. Another case was a 40-year-old male who had received renal allograft S years before. He had been received maintenance immune suppressive therapy with cyclosporine and oral prednisolone. He was admitted for evaluation of hypertension and elevated serum creatinine level. After several days of admission, he complained fever, dry cough and dyspnea. X-ray film showed pneumonic infiltration and the bronchial brushing and washing fluid revealed the Pneumocystis carinii cysts that were stained by methenamine silver. He was treated with the full dose of trimethoprim-sulfamethoxazole and clindamycin. Sacrificing the renal allograft, he recovered from Pneumocystis carinii pneumonia.
Adult ; Allografts* ; Clindamycin ; Cough ; Creatinine ; Cyclosporine ; Dyspnea ; Edema ; Female ; Fever ; Graft Rejection ; Hemorrhage ; Hepatitis B ; Humans ; Hypertension ; Liver Failure ; Lung ; Male ; Methenamine ; Pneumocystis carinii* ; Pneumocystis* ; Pneumonia, Pneumocystis* ; Prednisolone ; Therapeutic Irrigation ; Thorax ; Tomography, X-Ray Computed ; Transplantation ; Trimethoprim, Sulfamethoxazole Drug Combination ; X-Ray Film

OBJECTIVE: To assess the visualization rate and size of the cavum septum pellucidum (CSP) by transabdominal sonography in normal fetuses in the second and third trimesters of pregnancy. METHODS: The CSP was prospectively researched and measured using an axial transventricular plane in 308 consecutive uncomplicated singleton pregnancies between 15 and 41 weeks of gestation. RESULTS: The CSP was seen in 42.5% of cases at 15 weeks, 84.78% at 16-17 weeks, 100% at 18-37 weeks and 81.25% at 38-41 weeks. Compared to biparietal diameter (BPD), the visualization rate was 35.29% between 31 and 32 mm, 47.8% between 33 and 34 mm, 84% between 35 and 43 mm, 100% between 44 and 88 mm and 87.5% between 89 and 101 mm. Mean CSP width was 5.5+/-1.7 mm (range 2-9 mm). The CSP width was increased with gestational age and BPD, but with a slight decrease around term. CONCLUSION: In normal fetuses the CSP should always be visualized between 18 and 37 weeks, or with a BPD of 44-88 mm. Failure to observe the CSP in this interval, or possibly the presence of a large CSP, may indicate abnormal cerebral development and warrant further investigation. Conversely, absence of the CSP prior to 18 weeks, or later than 37 weeks, is a normal finding.
Female ; Fetus* ; Gestational Age ; Humans ; Pregnancy ; Pregnancy Trimester, Third* ; Pregnancy* ; Prospective Studies ; Septum Pellucidum*

Although dysphagia in patients with acute leukemia is usually related to reflux esophagitis, infectious esophagitis, chemotherapy1) and leukemic infiltration2), acute esophageal stricture resulting from chemotherapy in the patient with leukemia is very rare. A 40-year-old man with acute myelogenous leukemia was admitted for operation of esophageal stricture which was developed within 1 month of chemotherapy. An esophagectomy and esophagogastrostomy with pyloroplasty was carried out. Histology showed mucosal infiltration of mononuclear cells and transmural fibrosis involving submucosa and the muscle layer.
Adult ; Deglutition Disorders ; Drug Therapy ; Esophageal Stenosis* ; Esophagectomy ; Esophagitis ; Esophagitis, Peptic ; Fibrosis ; Humans ; Induction Chemotherapy* ; Leukemia ; Leukemia, Myeloid, Acute

One of the problems of conjunctivodacryocystorhinostomy which employs the conventional Jones tube is that the end of Jones tube has to be manipulated by the surgeon so that the tube resides within the nasal cavity while not touching the middle turbinate and the nasal septum. As a result, for most of the patients who have high nasal septal deviation, paradoxical curvature, or middle turbinate hypertrophy, there wasn't enough room within the nasal cavity where one end of Jones tube could rest. Such patients required either septoplasty or turbinectomy before they underwent conjunctivodacryocystorhinostomy. In order to overcome such a problem, the authors connected a 4 Fr. rubber tube to the conventional Jones tube, and helped the end of the tube to reside within the nasal cavity regardless of the anatomical variation of either the nasal septum or the middle turbinate. When such modified procedure is used, the conven tional Jones tube will make contact with the conjunctiva, lacrimal sac, and the nasal mucosa while the rubber tube remained afloat within the nasal conjunctiva. Such modification helps the tube to reside within the nasal cavity without foreign body reactions and granulation tissue complications, and there is no need to change tubes in order to make up for the loss of tube length due to post operative tissue contracture. Between April 2000 and August 2001, the authors performed conjunctivodacryo cystorhinostomy with rubber-tipped Jones tube on 8 patients with nasolacrimal duct obstruction, and obtained satisfactory results without complications.
Conjunctiva ; Contracture ; Foreign Bodies ; Granulation Tissue ; Humans ; Hypertrophy ; Nasal Cavity ; Nasal Mucosa ; Nasal Septum ; Nasolacrimal Duct ; Rubber ; Turbinates