Giardiasis is one of the most common causes of infectious diarrhea and it has a worldwide distribution. Although it is a relatively common disorder, histologically confirmed Giardiasis is a rare occurrence and there have been no previous reports in Korea. A 34-year-old man presented with a 2-year history of epigastric discomfort and left flank pain. On stool examination, many cystic forms of Giardia lamblia were noted. In biopsy specimens of the small intestine, there was moderate chronic inflammatory cell infiltration and several trophozoites of Giardia were observed in the intervillous space and luminal surface. The trophozoites were pear shaped symmetrical organisms with two nuclei, and measured 9~10 micrometer in length.
Male ; Humans ; Biopsy

No abstract available.
Hepatitis B Surface Antigens* ; Interferons* ; Lymphocytes*

The mechanism of forward blood flow during closed chest cardiac massage remains controversial. Two theories have been suggested: the cardiac pump theory and the thoracic pump theory. Case report is presented to illustrate the use of transesophageal echocardiography during cardiopulmonary resuscitation. The findings included right and left ventricular compression, closure of the mitral valve during compression, opening of the mitral valve during the release phase, and atrioventricular regurgitation during compression, indicating a positive ventricular-to-atrial pressure gradient. These findings suggest that direct cardiac compression was the predominant mechanism of forward blood flow during cardiopulmonary resuscitation in this patient. Transesophageal echocardiography offers a new approach for study of the flows and cardiac morphologic features during chest compressions in humans. An understanding of the actual mechanisms involved is necessary if improved cardiopulmonary resuscitative techniques are to be rationally developed for enhancing the outcome of resuscitation.
Cardiopulmonary Resuscitation ; Echocardiography* ; Echocardiography, Transesophageal ; Heart Massage* ; Humans ; Mitral Valve ; Resuscitation ; Thorax*

Anetoderma is loose and wrinkled skin lesions that show the characteristic histopathological feature of focal loss of elastic fibers in the dermis. The primary type of anetoderma arises in clinically normal skin and the secondary type replaces the lesions of associated disorders including various infections, infiammatory diseases and tumors. However, anetoderma due to pilomatricoma is very rare. Our patient, a 21-year-old female, presented with a soft and wrinkled skin overlying a firm, pedunculated tumor on her left upper arm. The histopathological examination showed anetodermic cutaneous changes which were associated with the underlying pilomatricoma.
Anetoderma* ; Arm ; Dermis ; Elastic Tissue ; Female ; Humans ; Pilomatrixoma* ; Skin ; Young Adult

BACKGROUND: Hepatocellular carcinoma is the second most common cause of death among cancers in Korea. Epidemiological studies have revealed the carrier state of the hepatitis B virus and the dietary intake of aflatoxin B1 as possible causative agents of this neoplasm, but the precise molecular bases are still unknown. METHODS: We examined 24 cases of human hepatocellular carcinomas in Koreans for the presence of p53 aberrations in exons 4 to 9 of the gene by using single-strand conformation polymorphism (SSCP) analysis of the polymerase chain reaction (PCR) products. RESULTS: Four (17%) of the tumors demonstrated a SSCP band shift, 1 in exon 6 and 3 in exon 7. All of the abnormal DNA fragments were further characterized by direct DNA sequencing. All the mutations were missense mutations. One was an A to G transition at the second nucleotide of codon 214; 2 were G to T transversions at the second nucleotide of codon 245; and one was a G to T transversion at the third nucleotide of codon 249, a mutational 'hot spot' at which mutations have been frequently found, especially when aflatoxin B1 plays an important role in the hepatocarcinogenesis. CONCLUSIONS: These results indicate that the possibility of aflatoxin B1 being a causative agent of hepatocarcinogenesis in Korea can not be excluded.
Aflatoxin B1 ; Carcinoma, Hepatocellular* ; Carrier State ; Cause of Death ; Codon ; DNA ; Epidemiologic Studies ; Exons ; Genes, Tumor Suppressor* ; Hepatitis B virus ; Humans ; Korea ; Mutation, Missense ; Polymerase Chain Reaction ; Polymorphism, Single-Stranded Conformational ; Sequence Analysis, DNA

No abstract available.
Child* ; Emergencies* ; Emergency Service, Hospital* ; Humans ; Infant* ; Poisoning*

BACKGROUND: The failure to achieve satisfactory anesthesia following the administration of local anesthetic agents in acute inflammatory tissues is a recognized clinical phenomenon. Many inflammatory mediators can reduce the threshold of nociception during inflammation, and histamine, one of the most important inflammatory mediator, may attenuated local anesthetic effect during inflammation. The purpose of this study was to investigate if histamine can antagonize a lidocaine induced nerve block in vitro. METHODS: Recordings of the compound action potentials (CAP) of A-fiber components were obtained from the isolated sciatic nerves of male Sprague-Dawley rats. The nerve sheath of the sciatic nerve was removed and desheathed nerve was mounted in a recording chamber. Single pulse stimuli (0.5 msec, supramaximal stimuli) were repeatedly applied (2 Hz) to one end of the nerve and CAP recordings were made at the other. The effect of histamine on the suppression of CAP by lidocaine and the effect of histamine on the recovery time to the nerve block by lidocaine were measured. RESULTS: Compared with the baseline amplitude, the amplitudes of CAP were 11.7+/-4.1% for the lidocaine group, 18.3+/-4.6% for the lidocaine histamine 0.05% group, and 26.1+/-5.6% for the lidocaine histamine 0.5% group. Nerve block recovery times were: 38.6+/-3.5 min for the modified Krebs group, 29.8+/-4.2 min for histamine 0.05% in the modified Krebs group, and 19.2+/-1.1 min for histamine 0.5% in the modified Krebs group. CONCLUSIONS: Histamine shortened the recovery time induced by lidocaine. We suggest that histamine may significantly attenuate the effects of local anesthetics in inflammed tissue.
Action Potentials ; Anesthesia ; Anesthetics ; Anesthetics, Local ; Histamine* ; Humans ; Inflammation ; Lidocaine* ; Male ; Nerve Block* ; Nociception ; Rats, Sprague-Dawley ; Sciatic Nerve

No abstract available.
C-Peptide* ; Child* ; Diabetes Mellitus* ; Histocompatibility Testing* ; Humans ; Insulin* ; Islets of Langerhans*

A 54-year-old male patient who was suffering from bipolar I disorder for 19 years and was admitted to the National Bugok Mental Hospital due to a depressive episode, was referred to the Kosin University Gospel Hospital. On arrival at the emergency room, he had confused mentality with disorientation, memory impairment, hypomania, marked anxiety and hyperirritability. The change of neuromuscular activity such as ataxia, gait disturbance, tremor, shivering, myoclonus and epileptic seizures was also shown. In addition, the symptoms and signs of autonomic instability including diaphoresis, tachycardia, hypotension, fever and facial flushing were noticed. The above symptoms developed after the administration of sertraline successive to the discontinuation of fluoxetine without any washout period. The degree of severity seemed to be severe because he had epileptic seizures, fever and hypotension. He was recovered from the severe serotonin syndrome by the supportive symptomatic treatment with sodium valproate, clonazepam, lorazepam and cyproheptadine after cessation of the selective serotonin reuptake inhibitors during hospitalization. Therefore, this rare case of severe serotonin syndrome was reported and related literatures were also reviewed.
Anxiety ; Clonazepam ; Cyproheptadine ; Emergency Service, Hospital ; Epilepsy ; Fever ; Fluoxetine* ; Flushing ; Gait Ataxia ; Hospitalization ; Hospitals, Psychiatric ; Humans ; Hypotension ; Lorazepam ; Male ; Memory ; Middle Aged ; Myoclonus ; Serotonin Syndrome* ; Serotonin Uptake Inhibitors ; Serotonin* ; Sertraline* ; Shivering ; Tachycardia ; Tremor ; Valproic Acid

BACKGROUND: In elderly, chronic diseases are common, and depression is frequently associated with the chronic physical conditions and their progress. This study was conducted to propose the basic data to assist the comprehensive care of chronically ill elderly through draw-up the trimmed model to explain the factors affecting depression. METHODS: The subjects were 402 elderly patients (114 men, 288 women) who had been taking medication more than one year at the community health centers in the city of Busan. During March 2000, the questionnaire survey was performed on their demographic characteristics, the state of chronic disease and depression, psychosocial resources(mastery, self esteem, social support), nutritional state, economic strain, stress and functional state(ADL and IADL). The state of depression was assessed with the Short Form of Geriatric Depression Scale(SGDS) The reliability test and path analysis were done by SPSS(ver7.5) and LISREL(ver 8.3) RESULTS: The reliability of the scales were fair in all items(Cronbach's alpha>0.5) In the state of present chronic diseases, hypertension(30.4%), musculoskeletal disorders(28.6%), and diabetes mellitus(12.8%) were common. The prevalence of depression(>6 scale in SGDS) was relatively high as 61.2%. In the result of path analysis, depression was aggravated with undermined self-esteem and mastery, chronic disease, economic strain, poor functional and nutritional state (p<0.01). Chronic disease affected depression directly(65.6%) as well as indirectly through psychosocial resources, untritional state, functional state and stress. CONCLUSION: The results show that chronic disease were closely associated with depression, though this study was questionnaire based and limited to the elderly who visited the health centers. concludingly, when take care elderly with chronic disease, physicians'considerations about the depression as well as physically ill conditions were important for the comprehensive care.
Aged* ; Busan ; Chronic Disease* ; Community Health Centers ; Depression* ; Humans ; Male ; Prevalence ; Surveys and Questionnaires ; Self Concept ; Weights and Measures