PURPOSE: Acute febrile illness in children frequently accompanies with abdominal symptoms such as vomiting, diarrhea, and abdominal pain, even if its etiology is not occured from the gastrointestinal tract. If the etiology of fever was unknown and the fever was accompanied with abdominal symptoms, we should be concerned about whether the etiology of fever was originated from the gastrointestinal tract or interpretated from the abnormality in the gastrointestinal tract. This study was performed to evaluate the diagnostic value of abdominal ultrasonography in patients with fever and abdominal symptoms. METHODS: We reviewed retrospectively the medical records of abdominal ultrasonographic (US) findings of 60 cases of acute febrile illness with abdominal symptoms at department of Pediatrics, Ulsan Dongang General RESULTS: (100%), splenomegaly in 4 cases (66.7%), ileocecitis in 1 case (16.7%), enlarged mesenteric lymph nodes and splenomegaly in 4 cases (66.7%), enlarged mesenteric lymph nodes, splenomegaly and ileocecitis in 1 cases (16.7%). 6) The enlarged mesenteric lymph nodes and the abnormalities around the appendix were seen in 7 cases (11.7%), which were confirmed as appendicitis all. 7) The thickening of wall in urinary bladder was seen in 2 cases (3.3%) of acute cystitis and acute hemorrhagic cystitis. 8) The subtle thickening of wall in colon was seen in 1 cases (1.7%) of shigellosis. CONCLUSIONS: The enlarged mesenteric lymph nodes, splenomegaly and ileocolitis on the abdominal ultrasonography in patients with fever and abdominal symptoms aree suggestive findings of typhoid fever. The enlarged mesenteric lymph nodes and the abnormalities around the appendix on abdominal ultrasonography make the rapid diagnosis of acute appendicitis and its complications, when physical examination is difficult in small children and diagnosis of their illnesses is obscure in patients with fever and abdominal pain.
Abdominal Pain ; Appendicitis ; Appendix ; Child ; Colon ; Crohn Disease ; Cystitis ; Diagnosis ; Diarrhea ; Dysentery, Bacillary ; Fever* ; Gastrointestinal Tract ; Humans ; Lymph Nodes ; Medical Records ; Pediatrics ; Physical Examination ; Retrospective Studies ; Splenomegaly ; Typhoid Fever ; Ulsan ; Ultrasonography ; Urinary Bladder ; Vomiting

OBJECTIVE: The retrospective study is undertaken to report clinical results of anterior cervical interbody fusion with an intradiscal cage with an integrated plate (PCB cervical plating system). METHODS: 38 patients underwent anterior cervical interbody fusion with PCB cervical plating system and followed 6~24 months. The authors investigated overall surgical results; clinical outcome, fusion rate, change of interspace height & lordotic angle, and complications. RESULTS: No complication was observed during the operation. Clinical improvement was identified in 34 cases (89.5%). Bone fusion observed in 44 out of 49 sites (90.7%). After operation, the interspace height increased from 5.4+/-1.3 mm to 7.8+/-1.5 mm and maintained 7.4+/-1.1 mm and, interspace angle went up from 4.2+/-0.7 degrees to 4.8+/-1.1 degrees and maintained 4.6+/-0.9 degrees. The loosening of screw was observed in 6 cases, one of which had reoperation because of the expulsion of the device accompanied. CONCLUSION: PCB cervical plating system could restore interbody height and lordosis in anterior cervical interbody fusion. But, if the insertion of the spacer is not precise, the frequencies of hardware failure are relatively high. It is considered necessary for the operator to be careful in the procedure.
Animals ; Humans ; Lordosis ; Reoperation ; Retrospective Studies

Cholangiolocellular carcinoma is a rare lesion, intermediate in type between hepatocellular and cholangio-cellular carcinoma. The radiologic findings of cholangiolocellular carcinomas have not been reported. We describe the ultrasound, CT, MR, and angiographic findings of a case of cholangiolocellular carcinoma not associated with liver cirrhosis.
Liver Cirrhosis ; Ultrasonography

OBJECTIVE: The purpose of this study is to review the surgical results of 19 patients with idiopathic trigeminal neuralgia treated by percutaneous ballooning compression(PBC) of trigeminal gasserian ganglion under brief general anesthesia. METHODS: The mean patient age was 63.5 years(range, 27-78). The mean follow-up period was 24 months(range, 1-46). Three patients had already undergone radiofreqnency trigeminal rhizotomy and two patients had previously microvascular decompression. The balloon was inflated by injecting radio-contrast media 0.7-1cc in amount. The mean inflating time is 81 seconds(range, 60-90). RESULTS: During the procedure, brief intraoperative bradycardia and hypotension were noted in seven cases(36.7%). All patients had immediate relief of pain except 1 case. 18 cases(94.5%) of patients were satisfied or very satisfied with their pain relief. There were immediate, mild to moderate sensory complication of hypesthesia, dysesthesia or paraesthesia in all cases and the immediate motor complication-difficulty of mastication in 3 cases, transient 6th nerve palsy in 2 cases. The immediate motor and sensory complications disappeared or much improved after 3-4 months. CONCLUSION: It is the simple technique that can be performed effectively in a brief period of general anesthesia. This procedure might be one of attractive methods in the treatment of idiopathic trigeminal neuralgia.
Abducens Nerve Diseases ; Anesthesia, General ; Bradycardia ; Follow-Up Studies ; Humans ; Hypesthesia ; Hypotension ; Mastication ; Microvascular Decompression Surgery ; Paresthesia ; Rhizotomy ; Trigeminal Ganglion* ; Trigeminal Neuralgia*

BACKGROUND AND OBJECTIVES: The endolymph produced from cochlear lateral wall regulates fluid balance and maintains positive endocochlear potentials. Although many immunohistochemical studies on ion transport enzymes have been reported, their mechanisms are still not completely understood. And there are no reports on the distribution of receptor tyrosine kinases in the cochlear lateral wall of the guinea pig. The purpose of this study is to evaluate the expression of the fibroblast growth factor receptor (FGFR) and transforming growth factor receptor-beta (TGFR-beta, type II) in the lateral wall of the guinea pig cochlea. MATERIALS AND METHODS: We investigated the immunohistochemical localization of the receptor tyrosine kinases (FGFR, TGFR-beta) in the lateral wall of the Preyer's positive, pigmented guinea pig. RESULTS: The results showed that receptor tyrosine kinases were expressed in the cytoplasm of the marginal cells, intermediate cells in the stria vascularis, and type II, III, IV, and V fibrocytes, but not the basal cells and type I fibrocytes, in the lateral wall of the guinea pig. CONCLUSION: The findings suggest that receptor tyrosine kinases are involved in the various ion transports and that they participate in the PLC-IP(3) second messenger system.
Animals ; Cochlea ; Cytoplasm ; Endolymph ; Guinea Pigs* ; Guinea* ; Ion Transport ; Phosphotransferases ; Receptors, Fibroblast Growth Factor ; Second Messenger Systems ; Signal Transduction ; Stria Vascularis ; Transforming Growth Factors ; Tyrosine ; Water-Electrolyte Balance

BACKGROUND AND OBJECTIVES: Damage in the auditory sensory epithelia is irreversible and the resulting hearing loss is permanent in mammals. Nevertheless, mammals like birds can recover their auditory function anatomically and physiologically after the sensorineural hearing loss. One of the functions of a receptor tyrosine kinase is to controll the cellular metabolisms like motility, growth, differentiation, regeneration, and ion transport via various pathways. There are no reports on the distribution of receptor tyrosine kinases in the guinea pig cochlea. The purpose of this study is to evaluate the expression of the fibroblast growth factor receptor (FGFR) and transforming growth factor receptor (TGFR-beta, type II ) in the cochlear sensory epithelia of guinea pigs. MATERIALS AND METHODS: We investigated the immunoreactivity and functional roles of the receptor tyrosine kinases-FGFR and TGFR-beta (type II) - by using surface preparation technique in the cochlea of the Preyer's positive, pigmented guinea pig. RESULTS: The results showed that receptor tyrosine kinases were expressed in the cytoplasm of Deiter's and Hensen's cells to FGFR and TGFR-beta (type II), and the stereocillia of inner and outer hair cells to FGFR by surface preparation technique. CONCLUSION: The findings suggest that receptor tyrosine kinases are involved in the cellular growth, differentiation and regeneration in the cochlear supporting cells, and ion transport in the hair cells of the mammals. We found that receptor tyrone kinases are not related to outer hair cells participating in the PLCgamma1-IP3 second messenger system.
Animals ; Birds ; Cochlea* ; Cytoplasm ; Guinea Pigs* ; Guinea* ; Hair ; Hearing Loss ; Hearing Loss, Sensorineural ; Ion Transport ; Mammals ; Phosphotransferases* ; Protein-Tyrosine Kinases ; Receptors, Fibroblast Growth Factor ; Regeneration ; Second Messenger Systems ; Signal Transduction ; Transforming Growth Factors ; Tyrosine*

PURPOSE: There have been some reports that DAX-1 (Dosage-sensitive sex reversal, Adrenal hypoplasia critical region, on chromosome X, gene 1) can modify the estrogen receptor-beta and the progesterone and androgen receptors. Therefore, the aims of this work were to evaluate the expression pattern of DAX-1 in human breast cancer and its relationship to the steroid hormone receptors and other prognostic factors. METHODS: A retrospective analysis was performed using the clinical records of 161 patients diagnosed with invasive breast cancer, and who underwent surgical treatment and hormonal therapy between 1994 and 2004. We evaluated the presence and distribution of DAX-1 expressions in breast cancers using immunohistochemical staining. RESULTS: DAX-1 was expressed in 57 (35.4%) of the 161 cases. Also, the DAX-1 expression showed significant correlations with the size and nodal metastasis. In the androgen receptor positive cases (85 cases), the DAX-1 positive cases were statistically younger than the DAX-1 negative cases. In the progesterone receptor positive cases (81 cases), a statistical significance was noted between the DAX-1 expression and nodal metastasis. CONCLUSION: We conclude that DAX-1 can modulate the steroid hormone receptors including the progesterone and androgen receptors, in breast cancer. It could also be assumed that the influence of DAX-1 on the prognosis of breast cancer is different according to the kind of steroid hormonal receptor expressed.
Breast Neoplasms* ; Breast* ; Estrogens ; Humans ; Neoplasm Metastasis ; Progesterone ; Prognosis ; Receptors, Androgen ; Receptors, Progesterone ; Retrospective Studies

PURPOSE: There have been some reports that DAX-1 (Dosage-sensitive sex reversal, Adrenal hypoplasia critical region, on chromosome X, gene 1) can modify the estrogen receptor-beta and the progesterone and androgen receptors. Therefore, the aims of this work were to evaluate the expression pattern of DAX-1 in human breast cancer and its relationship to the steroid hormone receptors and other prognostic factors. METHODS: A retrospective analysis was performed using the clinical records of 161 patients diagnosed with invasive breast cancer, and who underwent surgical treatment and hormonal therapy between 1994 and 2004. We evaluated the presence and distribution of DAX-1 expressions in breast cancers using immunohistochemical staining. RESULTS: DAX-1 was expressed in 57 (35.4%) of the 161 cases. Also, the DAX-1 expression showed significant correlations with the size and nodal metastasis. In the androgen receptor positive cases (85 cases), the DAX-1 positive cases were statistically younger than the DAX-1 negative cases. In the progesterone receptor positive cases (81 cases), a statistical significance was noted between the DAX-1 expression and nodal metastasis. CONCLUSION: We conclude that DAX-1 can modulate the steroid hormone receptors including the progesterone and androgen receptors, in breast cancer. It could also be assumed that the influence of DAX-1 on the prognosis of breast cancer is different according to the kind of steroid hormonal receptor expressed.
Breast Neoplasms* ; Breast* ; Estrogens ; Humans ; Neoplasm Metastasis ; Progesterone ; Prognosis ; Receptors, Androgen ; Receptors, Progesterone ; Retrospective Studies

Hypokalemia periodic paralysis, a clinical syndrome characterised by systemic weakness and low serum potassium, is a rare but treatable cause of acute weakness. Attacks of flaccid paralysis can be associated with hypokalemia triggered by insulin. Insulin reduce the conductance of the inward rectifier K+ channel for outward-flowing currents. Therefore, insulin potentiates depolarization of hypokalmeic periodic paralysis. We have experienced a case of hypokalemic periodic paralysis induced by hyperinsulinemia in 38-year old man, with complaint of intermittent paralysis of extremities. On admission, serum K+ was 2.1 mEq/L. He was no family history of muscle weakness. Thyroid function was normal. Serum levels of aldosterone, renin and cortisol were normal. Random plasma glucose level was 129 mg/dL and serum insulin was 131 uIU/mL. Shortly after intravenous supplementation of potassium, muscle weakness was improved. Oral glucose tolerance test revealed impaired glucose tolerance and hyperresponse of insulin and phosphate.
Adult ; Aldosterone ; Blood Glucose ; Extremities ; Glucose ; Glucose Tolerance Test ; Humans ; Hydrocortisone ; Hyperinsulinism* ; Hypokalemia ; Hypokalemic Periodic Paralysis ; Insulin ; Muscle Weakness ; Paralysis* ; Potassium ; Potassium Channels, Inwardly Rectifying ; Renin ; Thyroid Gland

PURPOSE: We wanted to evaluate the value of intravenous contrast enhanced abdomen-pelvis computed tomography (CT) for diagnosing acute appendicitis and we wanted to determine which patients groups will benefit from preoperative CT. METHODS: Between January and June 2006, the medical records of 354 patients who had clinically suspected acute appendicitis were retrospectively reviewed. Appendectomy was performed in 260 patients and CT was conducted in 108 patients of the 260 patients. The 5mm slice CT scans were evaluated for the presence of appendicitis. The sensitivity, specificity and accuracy of CT were calculated. The negative appendectomy rate (NAR) was compared between the patients with CT scans and those without CT scans. Furthermore, the patients were classified into the children and adults groups and the male and female groups and the differences of the NARs were analyzed for each group. RESULTS: The sensitivity, specificity and accuracy were 95%, 93% and 94%, respectively. The NAR was lower for the patients with a CT scan (12%) compared to 27% for those patients without CT scans (P=0.002). The difference of the NAR between the preoperative CT group and the without CT group was statistically significant for the female (P=0.004) and adult groups (P=0.012) (14% vs 36%, 11% vs 26%, respectively). CONCLUSION: Preoperative intravenous contrast enhanced abdomen-pelvis CT was effective in reducing the negative appendectomy rate in patients who were suspected of having acute appendicitis. Especially, the adults and women benefit more from CT scanning and they had a significantly lower negative appendectomy rate than the children and men, respectively.
Adult ; Appendectomy ; Appendicitis ; Child ; Female ; Humans ; Male ; Medical Records ; Retrospective Studies ; Sensitivity and Specificity