We report a 14-months-old infant who had obstructive jaundice caused by idiopathic fibrosing pancreatitis. Ultrasonography and abdominal computed tomography showed dilatation of the intrahepatic ducts, common bile duct, and the pancreatic duct. Diffuse swelling of the pancreas was also noted on CT. At laparotomy, the head portion of the pancreas revealed a stony hard consistency, and proliferation of fibrotic tissue was confirmed pathologically. Idiopathic fibrosing pancreatitis is a very rare disease entity in childhood, but should be considered in the differential diagnosis of obstructive jaundice in children who demonstrate bile duct and pancreatic duct dilatation and/or diffuse pancreas swelling.
Bile Ducts ; Child ; Common Bile Duct ; Diagnosis, Differential ; Dilatation ; Head ; Humans ; Infant ; Jaundice, Obstructive* ; Laparotomy ; Pancreas ; Pancreatic Ducts ; Pancreatitis* ; Rare Diseases ; Ultrasonography

After the clinical introduction of halothane, the problem of hepatotoxicity and mechanism has major implications for the practice of anesthesiology. This study was undertaken to investigate the liver function change after halothane anesthesia in 22 cases of electric burn patient. In this study, all cases had a great elevation of SGOT and SGPT levels, and previous experience of inhalation anesthesia, jaundice and who had not been transfused during this study. The following results were obtained: 1) Elevation of the SGOT and SGPT in electric burn patients may be influenced by damage of skeletal muscle and transaminase released into systemic circulation. 2) In the electric burn patients, elevation of the SGOT and SGPT does not enhance the susceptibility of the liver to injury by halothane.
Alanine Transaminase ; Anesthesia* ; Anesthesia, Inhalation ; Anesthesiology ; Aspartate Aminotransferases ; Burns, Electric* ; Halothane* ; Humans ; Jaundice ; Liver* ; Muscle, Skeletal

Cervical cancer and its precursors are caused principally, if not exclusively, by HPV infection and HPV DNA is found in more than 90% of cervical cancers. Cervical cytology is limited by its false negativity and this may be supplimented by other adjunctive test such as HPV test. It is therefore important to explore the use of HPV DNA detection as a primary or supplementary screening method and to determine whether HPV typing can be used as a predictor of a lesion's clinical behavior. Cervical cytology and Hybrid Capture test for HPV detection were performed in 450 asymtomatic wornen visited Health Care Center in Kangnam St. Mary's Hospital,and none of whom was believed to have current cervical disease. The Papanicolaou cytology results were classified by The Bethesda System : 333(74.%) women were classified to within normal limit, 19(4.2%) benign reactive change, 38(8.4%) ASCUS, 59(13%) low grade SIL, and only one woman high grade SIL. Twenty five of 450(5.6%) women showed HPV infection by Hybid Capture test. Among 98 wornen with abnormal Papanicolaou cytology, 16(16.3%) women showed HPV DNA positivity. (continue)
Delivery of Health Care ; DNA* ; Female ; Humans* ; Mass Screening* ; Papilloma* ; Uterine Cervical Neoplasms

Serum aspartate aminotransferase (AST) is a common enzyme for the evaluation of the hepatic, muscular and cardiac diseases and is produced also at kidney, brain, pancreas, lung, leukocytes, erythrocytes, etc. The elevation of its activity is usually caused by the necrosis of hepatocytes when there are not muscular injuries or myopathies. Recently, it is found that AST can exist as a macroenzyme by forming a complex with an immunoglobulin and this complex is erroneously considered to indicate the presence of liver disease as a result of elevation of AST activity on routine blood chemistry analysis. We experienced the patient with isolated AST elevation due to the formation of AST-mmunoglobulin complex confirmed by AST isoenzyme electrophoresis (EP).
Aspartate Aminotransferases ; Brain ; Chemistry ; Electrophoresis ; Erythrocytes ; Heart Diseases ; Hepatocytes ; Humans ; Immunoglobulins ; Kidney ; Leukocytes ; Liver Diseases ; Lung ; Muscular Diseases ; Necrosis ; Pancreas

Recently the change in medical informatics enabled us to use medical information whenever we want and wherever we are. There are many homepages on the web, which provide hospital information, medical counseling. Our multimedia center began its service as a internet Hospital in MIDAS Dongailbo, one of the major daily newspaper in Korea, on March 25th, 1997. The aim of this study is to examine the content and purpose of medical counseling on the web. The subjects consisted of 1,000 counsellings which were called 'Dongailbo Internet Hospital' for March, 25th, 1997 through October 30th, 1997. Many questioners wanted to know treatment principles, to make a diagnosis, and to know specific medical knowledges. The most common questions are as follows: general and unspecified, musculoskeletal, skin, digestive, respiratory, neurological problems.
Computer Communication Networks ; Counseling* ; Diagnosis ; Internet ; Korea ; Medical Informatics ; Multimedia ; Periodicals* ; Skin

Recently the change in medical informatics enabled us to use medical information whenever we want and wherever we are. There are many homepages on the web, which provide hospital information, medical counseling. Our multimedia center began its service as a internet Hospital in MIDAS Dongailbo, one of the major daily newspaper in Korea, on March 25th, 1997. The aim of this study is to examine the content and purpose of medical counseling on the web. The subjects consisted of 1,000 counsellings which were called 'Dongailbo Internet Hospital' for March, 25th, 1997 through October 30th, 1997. Many questioners wanted to know treatment principles, to make a diagnosis, and to know specific medical knowledges. The most common questions are as follows: general and unspecified, musculoskeletal, skin, digestive, respiratory, neurological problems.
Computer Communication Networks ; Counseling* ; Diagnosis ; Internet ; Korea ; Medical Informatics ; Multimedia ; Periodicals* ; Skin

OBJECTIVE: The toxicity and effectivity of intravenous paclitaxel and cisplatin as neoadjuvant chemotherapy were assessed in cervical cancer patients. METHODS: Thirty seven consecutive patients affected by FIGO stage IB2 to \\'a5\\'b1B were treated with paclitaxel 60 mg/m2 that was administered intravenously over a 3-hour period, followed by cisplatin 60 mg/m2, also administered intravenously. The chemotherapy was administered every 10 days and for three courses. The toxicity of the regimen in each cycle was determined according to the WHO toxicity criteria and in cases with grade 3 or 4 toxicity, chemotherapy was postponed for one week. The size of the tumor mass was measured prior to the neoadjuvant chemotherapy by means of pelvic examination and pelvic magnetic resonance imaging (MRI). The response to the treatment was determined 10 days after 3 cycles of chemotherapy by means of pelvic examination and pelvic MRI. Two weeks after the neoadjuvant chemotherapy was completed, the patients were either given an operation or radiation therapy, depending on their overall condition, the operational risks and personal willingness for an operation. RESULTS: A total of 37 patients were given a radical hysterectomy and enrolled in this study. Mild myalgia was the most common toxicity. Granulocytopenia was seen in four patients but there was no grade 3 or 4. Grade 1 neurotoxicities developed in four patients. Clinical responses occurred in 94.6% (35/37) of patients, including 35.1% (13/37) with a complete response, 10.8% (4/37) with a pathologically determined complete response, 59.5% (22/37) with a partial response, and 5.4% (2/37) showed stable disease. A down-staging response was seen in 75.7% (28/37) of those patients showing a response. CONCLUSIONS: The combination of paclitaxel with cisplatin for use in neoadjuvnant chemotherapy seems to be tolerated and very active in cervical cancer. Especially, every 10 days treatment did not delay the surgically or radologically optimal time. A larger number of cases need to be studied in order to confirm the efficacy of the treatment.
Agranulocytosis ; Cervix Uteri* ; Cisplatin* ; Drug Therapy ; Female ; Gynecological Examination ; Humans ; Hysterectomy ; Magnetic Resonance Imaging ; Myalgia ; Paclitaxel* ; Uterine Cervical Neoplasms

OBJECTIVES: To learn which inhibition of nitric oxide synthase with L-nitro arginine methylester(L-NAME) induces a preeclampsia-like syndrome in pregnant rabbits and high dose of L-arginine reverse the adverse changes induced by nitric oxide synthesis inhibition in pregnant rabbits. MTERIAL AND METHOD: Twenty Newzealand rabbits with 22-days of gestation were injected subcutaneously with 400mg of L-NAME for 7days and 100mg/kg L-arginine was also given intravenously 10 of 20 L-NAME injected pregnant rabbits. They are compared with the control group in which same volume of saline was subcutaneously injected to 5 rabbits with same condition. They were anesthesized by ketamine 50 mg/kg and roupum 2 mg/kg intramuscularly. Cutdown of femoral artery was performed and 22 gauge angioneedle was inserted. On manometer,three way catheter was connected, zeroed with saline, and blood pressure was read. Blood samples were taken from the vein of ear and checked for count of blood cells and bood chemistry (BUN/Cr, GOT/GPT, LDH, Uric acid). Urine protein was measured with nelaton catheterized urine. We injected drugs for 7 days begining on 22 days after mating and performed cesarian section to deliver fetus. To observe their effects on organs, lung, liver, placenta and kidney were taken and fixed with formalin. The sliced kidney tissue in thickness of 1 mm, was fixed with glutaraldehyde for electron microscopy and stored at 4degree C. Special staining was done for closed observation of pattern changes. For statistical analysis, mean+/-SEM was used. The control and experimental groups were compared by unpaired t-test and the differences were significant if probability level is less than 0.05(<0.05). RESULT: Mean blood pressure(MAP) in the experimental group I was significantly high compared to the control group(P<0.05). There was no significant differences in MAP between experimental group II and control group. Urine Protein, BUN, Cr, GOT/GPT, LDH, platelet count in the experimental group I was significantly high(p<0.05) compared to the control group. There was no significant difference between experimental group II and control group. In light microscopic examination, lung, liver, kidney, placenta showed specific finding in experimental group I. Misconstructive of glomerulus in the experimental kidney was well preserved under EM examination. Interstitium of kidney was widened by increase of mesangial matrix. Mild effacement of foot process and cytoplasm of proximal tubule containing electron dense myelin figure like structure were observed. CONCLUSION: Long term injection of L-arginine analogue produced preeclampsia like syndrome and pathologic changes of organ system in pregnant rabbits. Concurrent high dose of L-arginine reversed such chages.
Arginine* ; Blood Cells ; Blood Pressure ; Catheters ; Chemistry ; Cytoplasm ; Ear ; Femoral Artery ; Fetus ; Foot ; Formaldehyde ; Glutaral ; Ketamine ; Kidney ; Liver ; Lung ; Microscopy, Electron ; Models, Animal* ; Myelin Sheath ; NG-Nitroarginine Methyl Ester ; Nitric Oxide Synthase* ; Nitric Oxide* ; Placenta ; Platelet Count ; Pre-Eclampsia* ; Pregnancy ; Rabbits ; Veins

We report a rare case of adenoid basal carcinoma in uterine cervix. The patient was a 43-year-old Korean female. She received neoadjuvant chemotherapy with Quick Cis-VP16 (cisplatin and VP16 with 7-10 days interval), three times and radical hysterectomy with pelvic lymph nodes dissection under the diagnosis of cervical cancer stage IIa. After the neoadjuvant chemotherapy, the mass size was 3 x 2.5 Cm and which was protruded in exocervical region. Microscopically, scattered small nests of uniformed small cells with dark nuclei and scant cytoplasm were observed. Peripheral palisading as well as the formation of gland-like or acinar structures were noted. There were also foci of squamous differentiation in same portion of the small nests. The epithelial surface in other portions showed squamous cell carcinoma, large cell non-keratinizing cell type. Distribution between adenoid basal carcinoma of the cervix and other disease, such as adenoid cystic carcinoma and squamous cell carcinoma with basaloid features, is important for clinical management because the clinical behavior of adenoid basal carcinoma is less malignant than adenoid cystic carcinoma.
Adenoids* ; Adult ; Carcinoma, Adenoid Cystic ; Carcinoma, Squamous Cell ; Cervix Uteri* ; Cytoplasm ; Diagnosis ; Drug Therapy ; Etoposide ; Female ; Humans ; Hysterectomy ; Lymph Nodes ; Uterine Cervical Neoplasms

Ten patients with muscle-invading bladder carcinoma (clinical stage T2-TsB Nx Mo, T.C.C.) who were not candidates for cystectomy were treated with combined cisplatin and external-beam radiotherapy From Mar. 1990 through Feb. 1992. Results of the combined therapy had been compared with those of the radiation therapy alone. Using this combined therapy, 5(71.4%) of 7 patients achieved partial remission with a mean follow-up of 10.8 months. Three patients died of unrelated causes. Partial remission following radialion therapy alone was 6 (60%) of 10 patients. Patients with complete remission was none in the two groups. All patients in the combined therapy group were nauseated on the day treatment was given and 7 patients developed total atopecia. The malaise associated with cisplatin therapy tended to increase with the number of courses. All patients refused further treatment on this account (mean amount of cisplatin received: 3 courses). Combined cisplatin and radiotherapy may be applied to patients unsuited for radical cystectomy. Tolerance to cisplatin and radiotherapy was poor due to relatively severe toxicity, poor performance status with old age and underlying medical disease. Refinement of this protocol, careful selection of patients and longer follow-up will be necessary to determine the real benefit of this alternative modality.
Cisplatin* ; Cystectomy ; Drug Therapy ; Follow-Up Studies ; Humans ; Radiotherapy* ; Urinary Bladder*