Primary hepatic tuberculosis is extremely rare, but liver and spleen involvement secondary to tuberculosis isfrequentand of clinical importance, because of its demonstrability by biopsy. Complete absence of Tc-99m-SulfurColloid uptake of spleen due to splenic tubeculosis has not been reported. We experienced one case of liver andspleen tuberculosis which revealed complete absence of Tc-99m
Biopsy ; Colloids ; Liver ; Spleen ; Tuberculosis ; Tuberculosis, Hepatic

Letterer-Siwe disease, Hand-Schuller-Christian disease and eosinophilic granuloma of the bone are merely different clinical expressions of one disease. Lichtenstein grouped these three clinical syndromes and proposed that this disease be termed histiocytosis X. This grouping was based on the histologic similarities and the possibility of transformation of one syndrome into another. The cause of histiocytosis X remains unknown. Histiocytosis X is a condition that presents single or multiple lesions, distributed in the soft tissue, lymph nodes, various organ and bones, especially in the areas of marked reticuloendothelial activity. The authors reviewed the clinical findings, radiographs and the treatment of the twenty-six patients with histiocytosis X diagnosed on the base of pathologic findings at Severance Hospital, between January, 1971 and December, 1980. Among the twenty-six patients, twenty-one patients could be followed, ranging from one month to six years, with an average follow-up of 1.6 years. The results obtained were as follows: 1. There was a slight male predominance (61.6%). The age ranged from 2 months to 42 years (average 8.2 years). Sixty-five percents of patients were the child under 4 years of age. 2. Hand-Schuller-Christian disease (50%) was the most common form of this disease. Letterer-Siwe disease developed in the youngest (average 1.2 years) and eosinophilic granuloma in the eldest (average 20.4 years). 3. The common manifestations were hepatomegaly, skin rashes and anemia in Letterer-Siwe disease; palpable mass, pain and exophthalmos in Hand-Schuller-Christian disease; pain and mass in eosinophilic granuloma. 4. The common sites of the skeletal lesions were skull, spine and femur, etc. 5. The patients with single skeletal lesion improved regardless of the methods of treatment. 6. Vinblastine, methotrexate and/or prednisone were valuable agents for the multiply involved patients. 7. Prognosis was poor for the patients who were young at onest, or who had multiple systemic involvements, but in case only with skeletal involvement the prognosis was good. Eosinophilic granuloma is the most benign variant, while Letterer-Siwe disease is the most malignant type.
Anemia ; Child ; Clinical Study ; Eosinophilic Granuloma ; Exanthema ; Exophthalmos ; Femur ; Follow-Up Studies ; Hepatomegaly ; Histiocytosis ; Histiocytosis, Langerhans-Cell ; Humans ; Lymph Nodes ; Male ; Methotrexate ; Prednisone ; Prognosis ; Skull ; Spine ; Vinblastine

PTC is the single most valuable diagnostic method available to evaluate the size, shape and site of the causesof obstuctive jaundice among various radiological procedures. The authors reviewed and radiologically classifiedthe PTC films of 203 cases of obstructive jaundice from July 1977 to June 1983 at Presbyterian Medical Center,Jeon-ju confirmed clinically, operatively and pathologically. The resuls are as follows; 1. The most common causeof obstructive jaundice was bile duct stoen (64/203:31.53%) and the other causes were bile duct cancer(43/203:21.18%), pancreas cancer(41/203:20.19%), biliary ascariasis &/or clonorchiasis(20/203:9.85%), ampulla andduodenal cancer (7/203:3.45%), fibrotic stenosis of sphincter of Oddi(6/203: 2.96%) etc. in that order. Of theseprimary involvement with cancer was more frequent (91/203:44.33%) than stone. 2. 88.33%(179/203) of patients wasover 40-year-of- age and the sex ratio between male and female was about 2:1. 3. The average maximal diameter ofextrahepatic bile duct just proximal to the site of obstruction or stenosis by stones or by cancers was nearlyequal(2.36cm:2.38cm). 4. Cancers caused complete bile duct obstruction in about 75%(68/91) of cases and also wereassociated with intrahepatic duct dilatation about 92%(84/91) of cases. But in contrast biliary calculi showedgood drainage of contrast medium in 75%(48/64) of cases and 92%(59/64) showed normal diameter of intrahepaticduct. 5. The differential PTC findings between bile duct cancer and pancreas cancer were not so distinct but inbiel duct cancer the obstruction site of the bile duct was more irregular and serrated than pancreas cancer, whilethe latter showed a more downward convexity and a smoother end. Moreover annular filling defect with overhangingedges was seen only in bile duct cancer.
Ascariasis ; Bile Duct Neoplasms ; Bile Ducts ; Cholestasis ; Constriction, Pathologic ; Dilatation ; Drainage ; Female ; Gallstones ; Humans ; Jaundice ; Jaundice, Obstructive ; Male ; Methods ; Pancreas ; Pancreatic Neoplasms ; Protestantism ; Sex Ratio

No abstract available.

The os calcis is fractured more frequently than any other tarsal bone. Fractures involving subtalar joint can, be associated with prolonged and severe disability. So there is no universal agreement in the treatment of these fractures. Calcaneal fractures of 64 feet in 56 patients who were treated at Severance Hospital, Yonsei University College of Medicine from Jan. 1971 to Dec. 1980 were analyzed in clinical and radiological aspects. The results obtained from this study were as follows; 1. Of 56 patients, 46 patients were male and 10 female. 2. The main cause of fractures of calcaneus was a fall from a height in 71.4 percents of cases, and spine injury was associated in 15 patients (26.8%) with calcaneal fractures. 3. The fractures were almostly closed (89.1%). 4. Fractures involving subtalar joint were in 52 feet (81.3%) and Rowe's type 5 were 38 fractures (39.4%). Of these type 5 fractures, 31 fractures were treated by closed reduction and axial pin fixation and then favourable results were obtained. 5. The most common complication after treatment was persistant foot pain. Pain beneath the lateral malleolus was the most common (8 feet), and correlated with the decrease of Bohler's angle.
Calcaneus ; Clinical Study ; Female ; Foot ; Humans ; Male ; Spine ; Subtalar Joint ; Tarsal Bones

Drug interactions between intraoperative epidural fentanyl and meperidine (pethidine) added to epidural local anesthetic agent and postoperative epidural morphine for potentiation of the quality of intraoperative and postoperative analgesia during Cesarean section are controversial. The purpose of this study was to determine the influence of epidural fentanyl or meperidine on the efficacy of epidural local anesthetics and morphine during and after Cesarean section, respectively. Epidural anesthesia was established using a local anesthetic mixture of 2% lidocaine 10 ml and 0.5% bupivacaine 20 ml with epinephrine 1: 200,000 by fractionated dose administered via epidural catheter to anesthetize the patient up to T-4 sensory dermatome in 107 patients scheduled for elective Cesarean section. After delivery, 107 patients were received one of the following study drugs epidurally in a randomized, double-blind manner: saline 10 ml in saline group (n=50), fentanyl 100 ug/10 ml in fentanyl group (n=33), and meperidine 25 mg/10 ml in meperidine group (n=24). All patients were received 3.5 mg of morphine diluted with saline 6 ml epidurally just after peritoneal closure. Additional administration of the epidural fentanyl or meperidine didn't influence analgesic effect of the local anesthetics injected epidurally. In fentanyl group, postoperative pain, nausea, and sedation were more severe than saline group. In meperidine group, the incidences of intraoperative nausea and vomiting were highest among the groups, but the degree of postoperative pain, nausea, itching, and sedation were not significant. In conclusion, intraoperative injection of epidural fentanyl or meperidine were ineffective for the efficacy of epidural local anesthetics and morphine.
Analgesia ; Anesthesia, Epidural ; Anesthetics, Local ; Bupivacaine ; Catheters ; Cesarean Section* ; Drug Interactions ; Epinephrine ; Female ; Fentanyl* ; Humans ; Incidence ; Lidocaine ; Meperidine* ; Morphine* ; Nausea ; Pain, Postoperative ; Pregnancy ; Pruritus ; Vomiting

No abstract available.
Catheterization* ; Fingers* ; Radial Artery*

In a study of primary brain tumors 104 cases having satisfactory clinical, operative and histological proofswere analyzed by computerized tomography at Presbyterian Medical Center from May, 1982 to April, 1985. The resultswere as follows: 1. The male to female ratio of primary brain tumor was 54:46. 2.The 2nd decade group (26%) wasthe most prevalent age group, followed by the 5th decade(16.3%), 1st decade(14.4%), 3rd decade(12.5%), 4thdecade(11.5%), 6th decade(10.6%), 7th decade(8.7%) in that order. 3. The incidence of primary brain tumors was found to be: glioma 64 cases(61.6%) (among the GM, the most frequent 17 cases(16.3%), followed by meningioma 12cases (11.5%), pituitary adenoma 10 cases (9.6%), craniopharyngioma 6 cases(5.8%), pinealoma and germinoma 3cases(2.9%) respectively, and dermoid cyst 2 cases(1.9%) in that order. 4. The locations of the primary braintumors were as follows: cb. hemisphere(49%) of these 24.5% in parietal region, 11.9% in temporal region, 9.7% infrontal region, 3.0% in occipital region: Juxtasella area(16.3%), cerebellar hemisphere(8.7%), Parapineal andintraventricle(7.7%) respectively, cerebello-pontine angle area(5.8%), vermis and 4th ventricular region(4.8%). 5.There were no remarkable differences in the findings of pre-and post-contast CT scanning of primary brain tumorscompared with others.
Brain ; Brain Neoplasms ; Craniopharyngioma ; Dermoid Cyst ; Female ; Germinoma ; Glioma ; Humans ; Incidence ; Male ; Meningioma ; Occipital Lobe ; Parietal Lobe ; Pinealoma ; Pituitary Neoplasms ; Protestantism ; Temporal Lobe ; Tomography, X-Ray Computed

A putative gamma herpesvirus, termed human herpesvirus 8 (HHV-8), discovered in recent years, has been implicated as a possible etiologic agent for Kaposi`s sarcoma (KS). In South Korea, the incidence of KS in HIV seropositive individuals is very low. The cause of its rarity as compared with other countries is unclear. The objective of this study was performed to determine the prevalence of infection with HHV-8 and to clarify the cause of low incidence of KS in Korean populations including HIV seropositive individuals. The study population was composed of 200 blood donors, 220 voluntary visitors for sexual transmitted infection (STI)-testing in the public health centers, and 214 HIV-seropositive individuals. For the detection of HHV-8 antibodies, all blood samples were tested using Advanced Biotechnologies Inc`s enzyme-linked immunosorbent assay (ELISA) kits and the reactive samples were retested using Biotrin International SARL`s immunofluorescent assay (IFA). Also, we investigated the seroprevalence of Cytomegalovirus (CMV), Varicella-Zoster virus (VZV) and Epstein-Barr Virus (EBV) in order to get more information of HHV-8 and other human herpesviruses transmission in Korea. The prevalence of specific IgG to HHV-8 among HIV seropositive individuals was 7.0% {95% confidential interval: 4.0-11.3%}. The specific antibody to HHV-8 could be detected only in HIV seropositive men. The prevalences of antibodies to other human herpesviruses unlike HHV-8 were very high even in blood donors. These observations strongly suggest that the rarity of KS in this country may be caused by very low prevalence of HHV-8.
Antibodies ; Biotechnology ; Blood Donors ; Cytomegalovirus ; Enzyme-Linked Immunosorbent Assay ; Herpesviridae ; Herpesvirus 3, Human ; Herpesvirus 4, Human ; Herpesvirus 8, Human* ; HIV ; Humans* ; Immunoglobulin G ; Incidence ; Korea* ; Male ; Prevalence ; Public Health ; Sarcoma* ; Sarcoma, Kaposi ; Seroepidemiologic Studies*

BACKGROUND: In recent years, the incidence of extended-spectrum beta-lactamase (ESBL) producing Klebsiella has been steadily increased, and the newer species K. planticola and K terrigena, formerly regarded as nonpathogen, have been reported with astonishing frequency from human infectious processes by some investigators. The aim of this study is to elucidate the isolation rate and antimicrobial susceptibility of recent clinical Klebsiella isolates. METHOD: For the clinical Klebsiella isolates during the period of June 1999 to May 2000, isolation frequency of Klebsiella species by specimen, departments, age, and sex were analyzed. And antimicrobial susceptibilities were also analyzed. RESULT: Isolation rate of Klebsiella in order of decreasing frequency were K. pneumoniae (74:7%), K. oxytoca (12.1%), K. ozaenae(1.7%), K. planticola(1.0%), K. terngena(0.9%), and K, ornithinolytica (0.7%), respectively. K. rhinoscleromatis was not isolated. Compared with outpatients, increase of resistance rates of inpatients's Klebsiella isolates were 10% in ciprofloxacin, 15% in cefoperazone/sulbactam, and the others were ranged from 24% to 31%. Isolation rate of ESBL producing K. pneumoniae by double disk (DD) synergy test was 41%, and detection rates by antimicrobial agents were as follows: cefotaxime (95%), aztreonam (58%), and ceftriaxone (37%). Antimicrobial susceptibility rate with the exception of ampicillin and imipenem decreased from the range of 81%-96% on admission day to 29-62% after one week on admission. CONCLUSION: The isolation rates of K. planticola and K. terrigena were less than 1%. The proportion of ESBL producing K. pneumoniae was 41 %. And the vast majority of multidrug resistant Klebsiella including ESBL producing strains are acquired by hospitalization.
Ampicillin ; Anti-Infective Agents ; Aztreonam ; beta-Lactamases ; Cefotaxime ; Ceftriaxone ; Ciprofloxacin ; Epidemiology* ; Hospitalization ; Humans ; Imipenem ; Incidence ; Klebsiella pneumoniae ; Klebsiella* ; Outpatients ; Pneumonia ; Research Personnel