No abstract available.
Occlusive Dressings* ; Skin*

Actinomycosis infection can involve most part of the human body including mouth, cervicoface, chest, abdomen and pelvis. Cardiac involvement occurs in less than 2 percent of the infection of actinomyces israelii and pericardial involvement is rare. 34 year male was admitted because of chest pain and general weakness for several months. Echocardiography revealed akinesia of apex suggesting myocardial infarction and large pericardial effusion. Under the impression of pericardial effusion from tuberculosis infection, the patient was started on anti-tuberculosis medicine. Pericardial window operation with pericardial biopsy was performed 7 days later when the patient failed to show a significant improvement. Pericardial biopsy confirmed actinomycosis infection. During admission, the patient had a cerebral infarction with left hemiparesis. The patient was treated with high dose penicillin and improved symptomatically. Echocardiography showed resolution of pericardial effusion.
Abdomen ; Actinomyces ; Actinomycosis* ; Biopsy ; Cerebral Infarction* ; Chest Pain ; Echocardiography ; Human Body ; Humans ; Male ; Mouth ; Myocardial Infarction* ; Paresis ; Pelvis ; Penicillins ; Pericardial Effusion ; Thorax ; Tuberculosis*

A spinal cord injury without radiographic abnormality(SCIWORA) was defined by Pang and Wilberger in 1982 as the "objective signs of myelopathy as a result of trauma" in which no evidence of fracture, subluxation, or instability on plain radiographs, or computed tomography is demonstrable. Inherent elasticity of the vertebral column in infants and young children, among other age-related anatomical peculiarities, render the pediatric bony cervical and thoracic spine exceedingly vulnerable to deforming forces. We report here on a case of SCIWORA in a 3-year-old girl who presented with lower extremity paralysis, paresthesia, and voiding difficulty. The mechanism of neural damage in this case was purely longitudinal distraction. Such stress on the spine resulted from severe pulling up the lower extremity by her father, which was not thought to be damaging at that time.
Child ; Child, Preschool ; Elasticity ; Fathers ; Female ; Humans ; Infant ; Lower Extremity ; Paralysis ; Paresthesia ; Spinal Cord Diseases ; Spinal Cord Injuries* ; Spinal Cord* ; Spine

BACKGROUND: Chronic low back pain(CLBP) is one of the most common afflictions of humans. Between 70% and 80% of the population experience back pain some time during their lives. Especially, back pain is the most common cause of limited activity in individual under age 45. METHODS: The prepared questionnaire and SCL-MPD(symptom check list-minor psychiatric disorders) were presented to subjects who visited our hospital for occupational routine check. The questionnaire was composed of duration and severity of back pain. The subject were divided into two groups, respectively with chronic low back pain history and without history. The differences of psychogenic symptoms between both groups were analysed. RESULTS: In general characteristics, there was no significant difference between both groups. There were significant differences in somatization, anxiety, depression, anger-hostilily, phobic anxiety, neurasthenic, hypochondriacal, interpersonal sensitivity and general dimensions between both groups(P<0.05). There was no significant difference in obsessive-compulsive dimension between both groups. CONCLUSIONS: These results showed the presence of various psychogenic symptoms in chronic low back pain patients. Such psychosocial variables will need to receive additional careful attention in primary care setting.
Anxiety ; Back Pain ; Depression ; Humans ; Low Back Pain* ; Primary Health Care ; Surveys and Questionnaires

We describe here a case of intraductal tubular carcinoma of the main pancreatic duct. Gadolinium-enhanced pancreas magnetic resonance (MR) imaging showed an enhancing mass that was confined in the dilated main pancreatic duct of the pancreatic body, along with dilatation of the upstream main pancreatic duct and chronic pancreatitis that was due to obstruction. MR cholangiopancreatography and an endoscopic retrograde pancreatogram showed a filling defect that was due to an intraductal mass of the pancreatic body, along with dilatation of the upstream main pancreatic duct and no dilatation of the downstream main pancreatic duct. The pathological findings demonstrated an intraductal nodular appearance without papillary projection or mucin hypersecretion.
Adenocarcinoma/*diagnosis/pathology ; Carcinoma, Intraductal, Noninfiltrating/*diagnosis/pathology ; Cholangiopancreatography, Endoscopic Retrograde ; Cholangiopancreatography, Magnetic Resonance ; Diagnosis, Differential ; Female ; Humans ; Magnetic Resonance Imaging ; Middle Aged ; Neoplasm Staging ; Pancreatic Neoplasms/*diagnosis/pathology ; Tomography, X-Ray Computed

BACKGROUND: The prevalence of cognitive impairment in the elderly has been increasing in recent years with the growing of the aged population. Clinical assessment of cognitive function and mood is very important because cognitive impairment and depression commonly coexist in the elderly. The elderly interacts with the other family members, so cognitive impairment of the elderly influence family function. The objectives of this study were to delineate the factors correlated with cognitive function and to explore the relationship of depression and family function with cognitive function. METHODS: This study was done during 20 day period from July to August, 1996. The subjects were home residents aged 60 years or more living in a subcounty of Kyungpook Province, Korea. The final analysis included 195 subjects(male 95, female 100). The questionnaire included sociodemographic data, MMSE-K(Korean version of Mini Mental State Examination) for evaluation of cognitive function, BDI for evaluation of depression and family APGAR score for evaluation of family function. The results were analyzed by descriptive, comparative and correlative analysis. RESULTS: Mean MMSE-K score was 25.3+/-4.3 with female subjects(23.9+/-4.8) having significantly higher cognitive impairment when compaired to male subjects(26.6+/-3.2)(P<0.001). MMSE-K score was associated with gender, age, year of education(P<0.001), BDI and APGAR score(P<0.05). Religion, smoking and alcohol use were not associated with MMSE-K score. The prevalence of dementia by MMSE-K was 9.7% in definite dementia (MMSE-K<_19) and 23.1% with questionable dementia(20<_MMSE-K<_23). In male, the prevalence was 1.1% and 20.0% respectively. In female, the prevalence was 18.0% and 26% respectively, indicating difference between male and female subjects(P<0.001). CONCLUSIONS: In the elderly, female gender, older age and lower educational level were associated with cognitive function impairment. There was a positive correlation between cognitive function and family function. The group with impaired cognitive function had more depression than the normal group.
Aged* ; Apgar Score ; Dementia ; Depression* ; Female ; Gyeongsangbuk-do ; Humans ; Korea ; Male ; Prevalence ; Smoke ; Smoking ; Surveys and Questionnaires

An endoscopic retrograde cholangiographic study of 25 consecutive cases of hepatic clonorchiasis was performed during the period from Aug. 1986 to Sep. 1991 Hepatic clonorchiasis was confirmed by stool of examination for Clonorchis sinensis. The findings consist of characteristic filling defects and changes in the intrahepatic and extrahepatic bile ducts. The filling defects due to adult worms are significant diagnostic criteria of clonorchiasis. Its appearance is elliptical and/or round. The change in the intrahepatic bile ducts consisits of dilatation, irregularity(tortousity and elongation) and blunting of termieal branches of bile tree, irregular stenosis, fuzziness and raggedness. The characteristic changes in the extrahepatic bile ducts in clonorchiasis are duct wall irregularities and mild dilatation of bile duct. ERCP is an excellent method to evaluate biliary tree in patient with clonorchiasis because it reveals not only its characteristic findings of clonorchiasis but also its severity and associated lesions.
Adult ; Bile ; Bile Ducts ; Bile Ducts, Extrahepatic ; Bile Ducts, Intrahepatic ; Biliary Tract ; Cholangiopancreatography, Endoscopic Retrograde* ; Clonorchiasis* ; Clonorchis sinensis ; Constriction, Pathologic ; Dilatation ; Humans

An endoscopic retrograde cholangiographic study of 25 consecutive cases of hepatic clonorchiasis was performed during the period from Aug. 1986 to Sep. 1991 Hepatic clonorchiasis was confirmed by stool of examination for Clonorchis sinensis. The findings consist of characteristic filling defects and changes in the intrahepatic and extrahepatic bile ducts. The filling defects due to adult worms are significant diagnostic criteria of clonorchiasis. Its appearance is elliptical and/or round. The change in the intrahepatic bile ducts consisits of dilatation, irregularity(tortousity and elongation) and blunting of termieal branches of bile tree, irregular stenosis, fuzziness and raggedness. The characteristic changes in the extrahepatic bile ducts in clonorchiasis are duct wall irregularities and mild dilatation of bile duct. ERCP is an excellent method to evaluate biliary tree in patient with clonorchiasis because it reveals not only its characteristic findings of clonorchiasis but also its severity and associated lesions.
Adult ; Bile ; Bile Ducts ; Bile Ducts, Extrahepatic ; Bile Ducts, Intrahepatic ; Biliary Tract ; Cholangiopancreatography, Endoscopic Retrograde* ; Clonorchiasis* ; Clonorchis sinensis ; Constriction, Pathologic ; Dilatation ; Humans

T cell mediated immunity amlifies macrophage capacities to kill and digest the bacilli through production of interferon-gamma (IFN-gamma). The secreted cytokines of Th1 and Th2 cells can mutually regulate and inhibit each other's function. Therefore, the fine balance between the secreted cytokines is important for the resulting nature of tuberculosis. In this study, activation marker and cytokine production profiles were compared in patients with active tuberculosis and healthy control, and according to degree of radiographic extent and pleural involvement. METHOD:Forty-four patients with active pulmonary tuberculosis and 25 normal controls were recruited. We measuerd soluble interleukin-2 receptor(sIL-2R), IFN-r, IL-4 and IL-5 produced from blood mononuclear cells in vitro stimulation with phytohemagglutinin by ELISA. RESULTS: The sIL-2R and IFN-gamma from patients with active pulmonary tuberculosis were significantly lower than normal control, while IL-4 and IL-5 were not different between two group. The sIL-2R and IFN-r decreased in proportion to the extent of pulmonary involvement, and the sIL-2R and IFN-r from pulmonary tuberculosis with pleural effusion were significantly lower than those without pleural effusion. CONCLUSION: At the level of systemic T cells, development of tuberculosis is associated with diminished Th1 but not enhanced Th2 response.
Cytokines ; Enzyme-Linked Immunosorbent Assay ; Humans ; Immunity, Cellular ; Interferon-gamma ; Interleukin-2 ; Interleukin-4 ; Interleukin-5 ; Macrophages ; Pleural Effusion ; T-Lymphocytes ; Th2 Cells ; Tuberculosis ; Tuberculosis, Pulmonary

OBJECTIVES: Primary IgA nephropathy is the most common type of glomerulonephritis, which may progress to end stage renal failure in about 30-35% of the cases. The incidence of recurrence of IgA nephropathy in transplanted kidney is approximately 50-60% but IgA nephropathy which is recurred in graft has relatively benign clinical course so the rate of graft loss due to recurrent IgA nephropathy is about 10%. Overall graft survival rate of IgA nephropathy is higher than other glomerular disorders which cause end stage renal disease according to recent clinical studies. However accurate causative disorders of end stage renal failure had seldom been reported by pathologic examination and accurate graft survival rate and recurrence rate of original disease after renal transplantation couldn't be investigated. We performed analysis of clinical outcome and prognosis for IgA group. METHODS: 1259 cases of kidney transplantation were performed in the Severance hospital between Apr 1979 and Dec.1994. We selected 178 cases of those who got renal biopsy and excluded the cases of cadaveric transplants, hepatitis B antigen carrier, diabetes mellitus and not taking cyclosporine A. 178 cases of those were divided into two groups, IgA and nonIgA group. We performed analysis of 5 year graft and patient survival rate between two groups. The IgA group was divided into two group, recurrent and not-recurrent IgA group. We also performed analysis of recurrence rate and graft survival rate between two groups. RESULTS: 1) 62 cases(35.2M) were IgA group and 116 cases were non-IgA group. 2) Male to female ratio of IgA group was 2.9:1, whose age averaged 35 years old. 3) Among 6 cases of the IgA group, 3 cases lost their graft due to chronic rejection, 2 cases due to recurrence and 1 case due to acute rejection. 4) The 5 year graft survival rate of IgA and nonIgA group were 85%, 90% each without statistical significance(p>0.05). The 5 year patient survival rate of IgA and nonlgA group after renal allograft were 100%, 97% each without statistical significance(p>0.05). 5) 266 cases of posttransplant kidney biopsies were performed and 10 cases were diagnosed as recurrent IgA nephropathy with recurrence rate of 15%. 6) Renal insufficiency was noted in 4 cases of recurrent IgA nephropathy, 2 cases of those were chronic renal failure and the other 2 cases lost their graft. The histologic findings of these cases included mesangial widening and proliferation(4 cases), glomerulosclerosis(2 cases), crescent formation(1 cases). 7) The interval between transplantation and recurrence averaged 41 months. 24hr proteinuria and serum level of creatinine at the time of diagnosis averaged 2.6g and 2.2 mg/dl each. 8) Male to female ratio, age, HLA type and degree of HLA match showed no significant difference between nonrecurrent and recurrent IgA group in graft but 5 year graft survival rate of recurrent IgA group was lower than nonrecurrent group with statistical significance(71% vs 83%, p<0.05). CONCLUSION: Recurrent IgA nephropathy in transplanted kidney might be one of major cause of graft loss with chronic rejection. However precise pathologic examination of before k after transplantation on larger patient population and more long term follow-up are advised.
Adult ; Allografts ; Biopsy ; Cadaver ; Creatinine ; Cyclosporine ; Diabetes Mellitus ; Diagnosis ; Female ; Follow-Up Studies ; Glomerulonephritis ; Glomerulonephritis, IGA* ; Graft Survival ; Hepatitis B ; Humans ; Immunoglobulin A* ; Incidence ; Kidney ; Kidney Failure, Chronic ; Kidney Transplantation* ; Male ; Prognosis ; Proteinuria ; Recurrence ; Renal Insufficiency ; Survival Rate ; Transplants