Spontaneous rectus sheath hematoma (SRSH) is a rare entity that mimics acute abdomen. Rectus sheath hematoma is the accumulation of blood in rectus sheath due to muscle or epigastric vessel injury. However, SRSH without a trauma or anticoagulation is rare. It frequently mimics acute abdomen and it may lead to misdiagnosis and unnecessary laparotomy. In this article, we described two cases of SRSH with their diagnostic and therapeutic strategy. Both of our patients in report were neither consumed antiplatelet nor coagulopathy. They both had abdominal muscle straining before their symptoms pre-sentation. We hypothesized that the SRSH may be induced by rectus muscle injury secondary to inappropriate straining or posture. To diagnose SRSH, clinical findings are important but radiologic imaging such as computed tomography, can be diagnostic. In expanding SRSH, percutaneous arterial embolization of epigastric artery is useful to secure the bleeding. If embolization is not feasible, surgical exploration hemostasis is curative. In non-expanding SRSH, it can be managed nonoperatively. SRSH is an important initial differential for acute abdomen. Radiologic imaging helps in diagnosis. Stable SRSH can be managed conservatively with good outcome.

Objective To explore the therapeutic effect of two-stage delayed open reduction and internal fixation on Pilon fractures.Methods The clinical data of 38 patients with type Ⅱ and type Ⅲ Pilon fracture were analyzed retrospectively.According to the Ruedi-Allgower classification,there were 18 cases with type Ⅱand 20 cases with type Ⅲ fracture.All patients underwent temporary fixation with calcaneal traction or external fixation for 7 to 17 days,and then they were treated with delayed surgery when the soft tissue injuries subsided.Results Follow-up was performed for 10 to 18 months.Based on the Mazur classification,the ankle function in 12 cases was excellent,18 cases as good,6 cases as fair and 2 cases as poor,with a satisfactory rate of 78.9％.Conclusion Two-stage delayed open reduction and internal fixation is a reasonable and effective procedure in treating type Ⅱ and type Ⅲ Pilon fractures with advantages of few complications and satisfactory ankle function.

Objective: To compare the chemical compositions of Scutellariae Radix (SR) before and after wine-frying, and provide a reference for establishing a comprehensive quality evaluation method for SR decoction pieces. Methods: Characteristic chromatogram of SR and wine-processed Scutellariae Radix (wpSR) were established using HPLC, the control characteristic chromatogram maps were generated, the common peaks were calibrated and the similarity was evaluated. Chemical compositions of SR and wpSR were identified by UPLC-Q-TOF/MS. The content profiles of 11 flavonoids (baicalin, baicalein, wogonoside, wogonin, oroxylin A, oroxyloside, scutellarin, apigenin, hispidulin, luteoloside and chrysin) of SR and wpSR was determined by UPLC-TQMS, and PCA was used to analysis the content of 11 flavonoids. Results: The characteristic chromatogram of SR and wpSR were established, and nine common peaks were calibrated. The similarity of two pieces were all greater than 0.947. Through the analysis of the multistage tandem mass spectrometry, retention time matching combined with the software of database search and literatures, 50 compositions were found and 44 compositions were identified in two pieces. The quantitative results showed that the content of flavonoid glycosides such as baicalin and wogonoside decreased slightly, while the content of flavonoid aglycones such as baicalein and wogonin increased slightly. After multivariate statistical analysis, two pieces were divided into two types. The differences of the content of baicalin, wogonoside and oroxyloside may be the main factors causing the change of chemical compositions of wine-frying of SR. Conclusion: Chemical profiles did not change after wine-frying of SR, but the content profiles of some compositions were changed. The established method can provide reproducible, efficient, as well as accurate analysis for Chinese medicinal materials. And it should be an eligible tool for the quality evaluation of SR.

Eimeria tenella, an intracellular protozoan parasite infecting the epithelial cells of the ceca of chickens, causes severe diarrhea and bleeding that can lead its host to death. It is of interest that E. tenella first penetrate into the mucosal intraepithelial lymphocytes (IEL) before they parasitize crypt or villous epithelial cells. This in vitro study was undertaken to know whether the penetration of E. tenella into such a lymphoid cell is a beneficial step for the parasite survival and development. Three sequential experiments were performed. First, the in vitro established bovine kidney cell line, MDBK cells, were evaluated for use as host cells for E. tenella, through morphological observation. Second, the degree of parasite development and multiplication in MDBK cells was quantitatively assayed using radioisotope-labelled uracil (3H-uracil). Third, the E. tenella sporozoites viability was assayed after preincubation of them with chicken spleen cells. E. tenella oocysts obtained from the ceca of the infected chickens were used for the source of the sporozoites. Spleen cells (E) obtained from normal chickens (FP strain) were preincubated with the sporozoites (T) at the E:T ratio of 100:1, 50:1 or 25:1 for 4 or 12 hours, and then the mixture was inoculated into the MDBK cell monolayer. Morphologically the infected MDBK cells revealed active schizogonic cycle of E. tenella in 3-4 days, which was characterized by the appearance of trophozoites, and immature and mature schizonts containing merozoites. The 3H-uracil uptake by E. tenella increased gradually in the MDBK cells, which made a plateau after 48-60 hours, and decreased thereafter. The uptake amount of 3H-uracil depended not only upon the inoculum size of the sporozoites but also on the degree of time delay (preincubation; sporozoites only) from excystation to inoculation into MDBK cells. The 3H-uracil uptake became lower as the preincubation time was prolonged. In comparison, after preincubation of sporozoites with spleen cells for 4 or 12 hours, the 3H-uracil uptake was significantly increased compared with that of control group. From the results, it was inferred that, although the penetration of E. tenella sporozoites into the lymphoid cells such as IEL is not an essential step, it should be at least a beneficial one for the survival and development of sporozoites in the chicken intestine.
Cattle- ; Cell-Line ; Cells,-Cultured ; Chickens- ; English-Abstract ; *Eimeria-growth-and-development ; *Kidney-parasitology ; *Lymphocytes-parasitology ; *Spleen-cytology

Cryptosporidium, a coccidian parasite first described by Tyzzer (1907) from a laboratory mouse, has become an important human enteric pathogen causing overwhelming diarrhea especially in immunocompromised patients such as AIDS. This parasite has been reported from over 20 countries and is recognized as a cosmopolitan species. In Korea, however, there has been no report on human as well as animal cryptosporidiosis. This study was performed so as to verify the presence of Cryptosporidium in Korea by activating the parasite from laboratory mice by immunosuppression. Total 65 conventionally-bred ICR mice including a control (5 mice) and 3 experimental groups (20 each) were used for this study. Group I was immunosuppressed with prednisolone injection (1 mg IM, every other day) for 7 weeks. Group II (prednisolone injection and tetracycline administration) and Group III (prednisolone injection and trimethoprim-sulfamethoxazole administration) were prepared to observe the effect of antibacterial agents on the activation of cryptosporidiosis. In fecal examinations of mice Cryptosporidium oocysts (4-6 microns in size) were detected from 1 week after the start of immunosuppression and the mice began to die. In H-E stained tissue sections of the lower jejunum, numerous very small (2-4 microns), dense, ovoid or spherical, slightly basophilic bodies were seen attached on the free border of mucosal epithelial cells. In scanning and transmission electron microscopic observations, these organisms were identified as various developmental stages of Cryptosporidium. The species is considered to be C. parvum.(ABSTRACT TRUNCATED AT 250 WORDS)
Cryptosporidiosis-etiology ; Cryptosporidiosis-immunology ; Cryptosporidium-growth-and-development ; English-Abstract ; Immune-Tolerance ; Intestinal-Diseases,-Parasitic-etiology ; Intestinal-Diseases,-Parasitic-immunology ; Mice- ; Mice,-Inbred-ICR ; *Cryptosporidiosis-parasitology ; *Cryptosporidium-pathogenicity ; *Immunosuppression- ; *Intestinal-Diseases,-Parasitic-parasitology

A quantitative assay was performed on the effects of gamma-irradiation (30-300 Gy) on intracellular proliferation of Toxoplasma gondii RH tachyzoites in human leukemic HL-60 cells and murine peritoneal macrophages by means of 3H-uracil uptake assay. Infected non- irradiation group (NI) and uninfected group (incubating only host cells) were prepared. The 3H-uracil uptake by tachyzoites of NI group 12-24 hrs after infection was 2,190-4,787 counts per minute for macrophages and 2,967-8,254 for HL-60 cells, whereas the irradiated tachyzoites revealed only 381-703 (100 Gy) and 218-408 (300 Gy) for macrophages, and 1,911-2,618 (30 Gy), 1,253-1,384 (70 Gy), 1,013-1,090 (100 Gy), and 483-588 (300 Gy) for HL-60 cells. The proliferation inhibition rate was similar in macrophages and HL-60 cells, for example, 89-94% and 80-94% respectively by 300 Gy, 12-24 hrs after infection. It is concluded that RH tachyzoites of T. gondii are severely affected by gamma-irradiation in their capability of intracellular proliferation.
Animal ; Cell Division/RADIATION EFFECTS ; Cells, Cultured ; Gamma Rays ; Human ; HL-60 Cells/PARASITOLOGY ; Macrophages/PARASITOLOGY ; Mice ; Mice, Inbred BALB C ; Mice, Inbred ICR ; Radiation Dosage ; Support, Non-U.S. Gov't ; Toxoplasma/*RADIATION EFFECTS/*CYTOLOGY

PURPOSE: This study was conducted to examine the effects of osteoporosis prevention education on Korean breast cancer patients' knowledge and health promoting behavior. METHODS: The participants in this study included breast cancer patients who were registered at a self-help group organized by the Breast Cancer Center of a university hospital in Seoul, Korea. The intervention group received 60 minutes'didactic instruction followed by 30 minutes' interactive session, and reinforcement education with leaflets was given three weeks after the group intervention. In order to measure the effects of the intervention, this study used valid and reliable scales on the knowledge of osteoporosis and health promoting behavior for preventing osteoporosis. A post-test was conducted 12 weeks after the intervention. RESULTS: The results showed significant improvement in three of the five factors of osteoporosis knowledge including bone physiology, the characteristics of osteoporosis, and preventive behaviors in the intervention group. Overall health promoting behavior for preventing osteoporosis had significantly increased in the intervention group compared to the control group. CONCLUSION: Osteoporosis preventive education improved breast cancer patients' knowledge of osteoporosis and health promoting behavior for preventing osteoporosis by inducing their voluntary participation in self-care activities.
Breast Neoplasms* ; Breast* ; Education ; Health Promotion ; Humans ; Korea ; Osteoporosis* ; Physiology ; Self Care ; Self-Help Groups ; Seoul ; Weights and Measures

Tumoral calcinosis is an uncommon condition which has been described to exist in primary and secondary forms. A lack of awareness of this entity can lead to unnecessary procedures and incorrect management. We report a case of a patient on peritoneal dialysis who presented with multiple painful joint swellings to the orthopaedic department. An initial diagnosis of septic arthritis was made, then revised to chronic tophaceous gout and referred to the rheumatology unit.

Accidental carbon monoxide poisoning in countries with cold climates is commonly related to indoor heating. This condition appears to be relatively uncommon in tropical Asian countries and therefore the diagnosis may be unsuspected. We report a case of a Malaysian patient who presented with a severe, and ultimately fatal, delayed (biphasic) neuropsychiatric syndrome due to carbon monoxide poisoning. The diagnosis was made only when a history compatible with carbon monoxide poisoning subsequently surfaced, and neuroimaging demonstrated the typical pallidal lesions, associated with marked leukoencephalopathy, seen in this condition. Our case is unique because the poisoning occurred in the setting of indoor operation of a portable electricity generator in a karaoke centre because of power failure. Karaoke is a highly popular form of entertainment in many parts of Asia and we suggest that a high index of suspicion of carbon monoxide poisoning is required in this setting.

Melioidosis is an infectious disease caused by an aerobic, non-spore forming gram negative bacillus, Burkholderia pseudomallei. It is known to be of high incidence in parts of rural South East Asia, and in Northern Australia. Pneumonia is the commonest manifestation. We report here three cases of neurological melioidosis from the registry of 169 cases of melioidosis in Bintulu Hospital, Sarawak, East Malaysia, with a review of neurological melioidosis in the literature. The annual incidence of melioidosis is estimated to be 8 per 100,000 populations in the Bintulu district. Neurological melioidosis accounts for 1.8% of our melioidosis cases. A review of 76 cases of neurological melioidosis reported in the literature inclusive of our 3 cases shows that localized brain or spinal inflammation or abscess is the most common manifestation occurring in 80% of patients. Close to half (53%) have intra axial abscess (brain or spinal cord), a quarter (27%) have extra axial lesions only (epidural or subdural collection, osteomyelitis or scalp abscess), and another quarter (27%) have both intra and extra axial lesions. Thus, B. pseudomallei appears to be unique among the bacterial central nervous system infection to be able to affect the brain and its contiguous tissues, crossing the tissue plane particularly resulting in osteomyelitis, scalp abscess and vice versa. Two thirds of the neurologicalmelioidosis patients have only neurological disease with no evidence of disease elsewhere. Key words: Burkholderia pseudomallei; neurological melioidosis; Bintulu; Sarawak; Malaysia
Melioidosis