BACKGROUND/AIMS: Anisakiasis is a well known parasitosis resulted from eating raw seafoods and there were many reports of cases. However, its endoscopic and clinical characteristics have not been reviewed well. The aim of this study was to clarify the gastric mucosal changes and influencing factors of upper gastrointestinal (UGI) anisakiasis. METHODS: We analyzed retrospectively the endoscopic and clinical characteristics of 141 cases with UGI anisakiasis diagnosed during UGI endoscopy, based on the review of medical records. The patients' data were collected consecutively from October 1999 through September 2006. RESULTS: In the 141 patients with UGI anisakiasis, the peak age was the 40s (44.7%). The female to male ratio was 1.82:1. The most prevailed season was winter (41.1%). The most frequent symptom was acute epigastric pain and 76.6% of the patients developed symptoms within 12 hours after the ingestion of raw seafoods. The greater curvature of body was the most preferred site of anisakid larvae. The median time from meal to symptom onset was shortest in esophageal location and longest in fundus location (3 vs. 18.7 hours). The various mucosal changes were observed and the most frequent mucosal change was edema (90.8%). Submucosal tumor was also found in 31.9% of the patients. The severity of mucosal change was related inversely with the time interval from meal to endoscopy (p=0.048). CONCLUSIONS: Anisakiasis presented various mucosal changes depending on the time interval from ingestion of raw seafood to endoscopy. Delayed endoscopy may lead chronic mucosal change and cause difficulty in the detection of anisakiasis. Therefore, the prompt endoscopic examination is required for the patients presenting acute gastrointestinal symptoms after taking raw fish.
Adult ; Aged ; Animals ; Anisakiasis/*diagnosis/parasitology ; Edema/etiology ; Esophageal Diseases/*parasitology/pathology ; Female ; Gastric Mucosa/parasitology/*pathology ; Gastroscopy ; Humans ; Male ; Medical Records ; Middle Aged ; Retrospective Studies ; Seafood ; Stomach Diseases/*parasitology/pathology ; Time Factors ; Upper Gastrointestinal Tract/parasitology/*pathology

PURPOSE: To report a case of acute endophthalmitis associated with 23-gauge transconjunctival sutureless vitrectomy and gas tamponade for macular hole surgery. CASE SUMMARY: A 66-year-old female patient who presented with a macular hole in the left eye was treated with 23-gauge transconjunctival sutureless vitrectomy. On postoperative day 2, the patient developed acute endophthalmitis and was treated with gas-fluid exchange, lensectomy and intravitreal antibiotic injection. Staphylococcus epidermidis was detected in the vitreous fluid of the operated eye. Intraoperative fundus findings showed severe retinal hemorrhage, vascular occlusion and fibrous membranes due to inflammatory response. After treatment, the patient's fundus findings markedly improved and the inflammatory response was controlled. CONCLUSIONS: Acute endophthalmitis after sutureless vitrectomy performed via intraocular gas injection may quickly result in inflammation and disease due to infection. Immediate reoperation and intravitreal antibiotic injections are recommended in such cases.
Aged ; Endophthalmitis ; Eye ; Female ; Humans ; Inflammation ; Membranes ; Reoperation ; Retinal Hemorrhage ; Retinal Perforations ; Staphylococcus epidermidis ; Vitrectomy

DCRV is a rare cause of right ventricular outflow obstruction by anomalous muscle bundle at the level of sinus portion. The symptoms due to DCRV itself were mild inspite of significant pressure gradient over 90mmHg between proximal and distal chamber, and became severe by associated complication of bacterial endocarditis or aortic regurgitation in ventricular septal defect. In 12 cases(40%), right ventricular hypertrophy configuration in electrocardiogram was characteristic. Although R wave in V1 was tall, S wave in V6 and R wave in aVR were indistinctive. Those were very useful findings for diagnosis of DCRV which was thought to be possible only invasively. With operation prior to overt right ventricular faliure, the prognosis was good with only minor complication.
Adolescent* ; Adult* ; Aortic Valve Insufficiency ; Diagnosis ; Electrocardiography ; Endocarditis, Bacterial ; Heart Septal Defects, Ventricular ; Humans ; Hypertrophy, Right Ventricular ; Prognosis ; Ventricular Outflow Obstruction

The antigenic characterizations and serological reactions of human liver flukes, Clonorchis sinensis and Opisthorchis viverrini, were analyzed by immunoblot. The antigenic profiles of the crude extract of Clonorchis contained major proteins of 8, 26-28, 34-37, 43, and 70 kDa, and those of Opisthorchis 34-37, 43, 70, and 100 kDa. Of these, the 8, 26-28 and 34-37 kDa bands of Clonorchis and the 100 kDa of Opisthorchis were major components of each excretory-secretory antigen. The 8 and 26-28 kDa bands were specific to Clonorchis but the 100 kDa of Opisthorchis cross-reacted with the sera of clonorchiasis, and the 34-37, 70 and 100 kDa bands cross-reacted with sera of other helminthiases. The frequency and intensity of the immunoblot reactions were positively correlated with the intensity of the liver fluke infection.
Animals ; Antigens, Helminth/analysis/*chemistry/immunology ; Clonorchiasis/*diagnosis ; Clonorchis sinensis/*immunology ; Cross Reactions ; Electrophoresis, Polyacrylamide Gel/veterinary ; Humans ; Immunoblotting/veterinary ; Molecular Weight ; Opisthorchiasis/*diagnosis ; Opisthorchis/*immunology

The left parasternal impulse was evaluated by inspection and palpation, and it's contour was confirmed with graphic display using a pilse pickup in 45 normal subjects and 33 patients with various cardiac disease.Using an upper limit of normal echocardiographic LV end-diastolic dimension insides, 3.7cm/m2, LV mass index, 80g/m2, RV dimension index, 2.9cm/m2, and RV free wall thickness, 0.4cm, the patients were subdivided into four groups. In 9 patients with pure RV hypertrophy or dilation, the hyperdynamic impulse or sustained heave was noticed in 7 cases(sensitivity 78%, specificity 76%). In 12 patients with pure LV hypertrophy or dilation, striking parasternal systolic retraction was noticed in 5 cases(sensitivity 42%, speccificity 86%). But in 7 patient with biventricular hypertrophy or dilation, either striking systolic retraction or hyperdynamic impulse was noticed in 4 cases. These findings suggest that the evaluation of the parasternal movement is helpful for the cardiac examination.
Echocardiography ; Humans ; Hypertrophy ; Palpation ; Sensitivity and Specificity ; Strikes, Employee

No abstract available.
Lupus Erythematosus, Systemic*

Emphysematous osteomyelitis, especially that involving the extra-axial skeleton, is an extremely rare presentation but associated with significant morbidity and mortality. Here, we report a case in which a 58-year-old female patient with diabetes mellitus presented with emphysematous osteomyelitis that involved the sternum, clavicle, and pelvic bone and was caused by Escherichia coli via hematogenous spread of urinary tract infection. We successfully treated her with urgent and aggressive surgical drainage with prolonged antibiotics therapy. Early diagnosis and immediate surgical intervention are required for better outcomes in cases of emphysematous osteomyelitis.
Anti-Bacterial Agents ; Clavicle ; Diabetes Mellitus ; Drainage ; Early Diagnosis ; Escherichia coli* ; Escherichia* ; Female ; Humans ; Middle Aged ; Mortality ; Osteomyelitis* ; Pelvic Bones ; Skeleton ; Sternum ; Urinary Tract Infections

PURPOSE: The purpose of this study was to determine the biological effects of cyanoacrylate-combined calcium phosphate (CCP), in particular its potential to act as a physical barrier - functioning like a membrane - in rabbit calvarial defects. METHODS: In each animal, four circular calvarial defects with a diameter of 8 mm were prepared and then filled with either nothing (control group) or one of three different experimental materials. In the experimental conditions, they were filled with CCP alone (CCP group), filled with biphasic calcium phosphate (BCP) and then covered with an absorbable collagen sponge (ACS; BCP/ACS group), or filled with BCP and then covered by CCP (BCP/CCP group). RESULTS: After 4 and 8 weeks of healing, new bone formation appeared to be lower in the CCP group than in the control group, but the difference was not statistically significant. In both the CCP and BCP/CCP groups, inflammatory cells could be seen after 4 and 8 weeks of healing. CONCLUSIONS: Within the limits of this study, CCP exhibited limited osteoconductivity in rabbit calvarial defects and was histologically associated with the presence of inflammatory cells. However, CCP demonstrated its ability to stabilize graft particles and its potential as an effective defect filler in bone augmentation, if the biocompatibility and osteoconductivity of CCP were improved.
Animals ; Bone Regeneration ; Calcium ; Calcium Phosphates ; Collagen ; Cyanoacrylates ; Hydroxyapatites ; Membranes ; Osteogenesis ; Porifera ; Rabbits ; Transplants

Porphyromonas gingivalis has been implicated as an important periodontophathic bacterium in the etiology and progression of periodontal diseases. It has been reported that P.gingivalis may mediate periodontal destruction not only directly through its virulence factors, but also indirectly by inducing complex host mediated inflammatory reponses. The purpose of this study was to evaluate the effects of P.gingivalis on the bone formation and resorption by osteoblasts. For this purpose, after determining the concentration below which sonicated P.gingivalis extracts (SPEs) have no cytotoxicity on mouse calvarial primary osteoblastic (POB) cells, we investigated the effects of SPEs on the alkaline phosphatase (ALP) activity, matrix metalloproteinase (MMP) expression (MMP-2, -9, 13), and prostaglandin E2 (PGE2) release in POB cells by treament with SPEs below that concentration. The results were as follows; 1. SPEs showed no cytotoxic effect on POB cells up to a concentration of 1 microgram/ml. 2. The treatment with SPEs reduced ALP activity in a dose-dependent manner in POB cells. In addition, when we investigated the effect of SPEs (1 microgram/ml) on ALP activity for different exposure periods, statistically significant inhibition of ALP activity was shown at 2 days of exposure, and further significant inhibition occurred by extending the periods of exposure. 3. The treatment with SPEs stimulated the gene expression of MMP-9 in POB cells. 4. The pre-treatment with SPEs increased the amount of PGE2 released in POB cells. In summary, the present study shows that P.gingivalis could inhibit osteogenesis and stimulate bone resorption not only by reducing ALP activity but also by increasing MMP-9 mRNA expression in osteoblasts, possibly through an endogenous PGE2 pathway. In addition, our results suggest that if P.gingivalis affects osteoblasts in early differentiation stage, such effects by P.ingivalis could be irreversible.
Alkaline Phosphatase ; Animals ; Bone Resorption ; Dinoprostone ; Gene Expression ; Mice* ; Osteoblasts* ; Osteogenesis ; Periodontal Diseases ; Porphyromonas gingivalis* ; Porphyromonas* ; RNA, Messenger ; Virulence Factors

Nowdays, the awareness of implant treatment has grown rapidly among dentists and patients alike in Korea, as it becomes a widely accepted treatment. The reason is that unlike crown and bridge or denture treatment, implant treatment helps preserve existing bone and improve masticatory functions. So, It is needed understanding about the type, distribution of implant patient. The following results on patient type and implant distribution were compiled from 4433 implant cases of 1596 patients treated at the periodontal dept. of Y University Hospital during 1992 to 2004. 1. There are no dissimilarities between men and women, with patients in their 40, 50s accounting for 52.5% of patients and 57.5% of implant treatments; the largest share of patients and implant treatments. 2. Mn. posterior area accounted for 54.9% of implant treatments followed by Mx. posterior area(27.6%), Mx anterior area(11.9%) and Mn anterior area(5.6%). 3. Partial edentulous patients treated by single crown and bridge-type prosthesis accounted for 97.5% and fully edentulous patient accounted for the remaining 2.5%. 4. The major cause of tooth loss is periodontal disease, followed by dental caries, trauma and congenital missing. Also, older people are more likely to suffer from tooth loss due to periodontal disease rather than dental caries. 5. In the distribution of bone quality for maxillae, type III was most, followed by type II, r type IV and r type I. As for mandible, type II was most, followed by type III, type IV and for type I. 6. In the distribution of bone quantity for maxillae, type C was most, followed by type B, type D, type A, and for type E. As for mandible, type B was 52% most, followed by type C, type D, type A and type E. 7. The majority of implants were those of 10-14mm in length (85.2%) and regular diameter in width (64%). The results provided us with basic data on patient type, implant distribution, bone condition, etc. We wish that our results coupled with other research data helps assist in the further study for better implant success/survival rates, etc.
Crowns ; Dental Caries ; Dentists ; Dentures ; Female ; Humans ; Korea ; Male ; Mandible ; Maxilla ; Periodontal Diseases ; Prostheses and Implants ; Tooth Loss