Mesenteric lymphadenitis due to Yersinia enterocolitica infection is not common in Korea. Although most cases of Yersinia enterocolitica-induced mesenteric adenitis are self limited, cardinal features of Yersinia enterocolitica-induced mesenteric adenitis are so similar to those of acute appendicitis that some of the patients undergo laparotomy with suspected appendicitis. The findings on laparotomy in such patients are usually enlarged mesenteric nodes with a normal or slightly inflamed appendix. Because histologic examination of the removed mesenteric lymph nodes reveals reactive hyperplasia in most cases, it is usually difficult to suspect Yersinia enterocolitica infection on morphology of the resected nodes. But suppurative granulomata of mesenteric lymph nodes, uncommonly encountered in Yersinia enterocolitica infection, strongly suggest yersinial infection. We report a case of mesenteric lymphadenitis in a 10-year-old boy, who underwent laparotomy with suspected acute appendicitis. The removed lymph node showed several suppurative granulomata in the cortex, suggesting yersinial infection. Serologic study confirmed Yersinia enterocolitica serotype O:3 infection.
Appendicitis ; Appendix ; Child ; Humans ; Hyperplasia ; Korea ; Laparotomy ; Lymph Nodes ; Lymphadenitis ; Male ; Mesenteric Lymphadenitis* ; Yemen ; Yersinia enterocolitica* ; Yersinia*

This article explores the medical system of the Koryo Dynasty period and its social characteristics. First, the structure of medical system and roles of medical institutions during the Koryo Dynasty period will be summarized. Then, the characteristics of the medical system will be identified through exploring the principles of its formation in a view of social recognition of medical care and a view of public policy. During the Koryo Dynasty period, medical experts were trained in national education institutions from the early days of Dynasty. After trained, they were appointed to the posts at government service with their medical profession. In the meantime, they sought ways to ascend their social position. Physicians of Oriental medicine were appointed to the posts at each local government and troops to take charge of medical treatments of the common people. Also, the state tried to assume the reins of medical system by actively taking part in circulation (collection and distribution) of herb. Taeuigam and Sangyakguk represent central medical institutions of the Koryo, taking charge of medical service for the aristocracy and the bureaucracy. The Common people were treated at DongSeoDaeBiWOn, JeWuiBo, HyeMinGuk, and YakJum in SeoKyung. However, activities of these institutions became less active around the days of military officials regime, as officers became negligent and financial base went broken. The roles of medical institutions of the Koryo government were not restricted to the treatment of diseases. Policies for the common people were constituted by two main policies, the policy for encouraging agriculture and the policy for giving relief to people. Medical institutions, with other social systems, had a social responsibility to support the governing system of the Koryo and maintain the stability of the society. In this aspect, medical institutions such as DongSeoDaeBiWon and JeWuiBo, and relief institutions such as UiChang, were all related and connected organically, and they were results of, and bases of the relief policy. However, medical system for the common people was made up first for practical needs and then improved successively. Allocation of medical experts and execution of relief work were carried out by each local government, except the case of serious disaster, which central government took part in. As the Koryo Dynasty went into its latter period, temporary institutions and one - time benefits replaced permanent institutions. These four characteristics described above were systemic characteristics of medical system during the Koryo Dynasty period.
English Abstract ; History of Medicine, Medieval ; Korea ; *Medicine ; Political Systems/*history

BACKGROUND: Quinidine appeared to increase serum digoxin levels when given with quinidine. Therefore elevated serum digoxin concentrations and clinical toxicity have been reported in patient receiving quinidine. Currently, Bayesian method which estimates the most probable parameters of the drug for each patient from population parameters data is useful approach for adjusting digoxin dosage. To increase the accuracy of Bayesian method, it is desirable to use population parameters of Korean. Therefore we evaluated the effect of quinidine on digoxin clearance in Korea. METHOD: Patient's records from 19 adult cardiac disease without CHF having normal renal and liver function from Seoul National University of Hospital respectively wre evaluated. Digoxin pharmacokinetic parameters, CL and Vd, were obtained from serum concentration of digoxin of single and combined therapy at each steady-state by using bayesian method. RESULTS: This study show that quinidine reduced the total body clearance of digoxin from 2.39+/-0.17 to 1.51+/-0.08ml/min/kg(p<0.05) and reduced the digoxin volume of distribution from 8.57+/-0.29 to 4.98+/-0.19L/kg(p<0.05). This results show that digoxin dosage reduced to 40-50% in Korean, if quinidine therapy is initiated.
Adult ; Bayes Theorem ; Digoxin* ; Drug Interactions ; Heart Diseases ; Humans ; Korea ; Liver ; Pharmacokinetics ; Quinidine* ; Seoul

A 7 day old female baby suffered from perinatal asphyxia and trauma at birth. Subsequently, she had a violeceous subcutaneous plaque on back. The clinical setting, the skin manifestation and the histologic findings of the lesion were diagnostic of subcutaneous fat necrosis of the newborn. Histologic findings revealed fat necrosis with infiltration of inflammatory cells, foreign body giant cells and several fat cells contain needle shaped cleft in radial arrangement. Four weeks latter, the skin lesion was healed spontaneously.
Adipocytes ; Asphyxia ; Fat Necrosis ; Female ; Giant Cells, Foreign-Body ; Humans ; Infant, Newborn* ; Necrosis* ; Needles ; Parturition ; Skin ; Skin Manifestations ; Subcutaneous Fat*

PURPOSE: We evaluated the outcomes of a tubularized incised plate (TIP) urethroplasty on reoperative hypospadias repairs. MATERIALS AND METHODS: A total of 17 reoperative hypospadias repairs were performed. We retrospectively reviewed the medical records of all patients, which included the level of meatus, technique of repair, age at surgery and complications. The mean patient age and number of prior repairs were 6.3 years and 1.6 times, respectively. Before the reoperation the level of meatus was the anterior type in 2, the middle type in 7 and the posterior type in 8 patients. RESULTS: The follow-up periods ranged from 1 to 35 months (average 18.5 months). The success rates, according to the type of hypospadias, were 2/2 (100%) in the anterior type, 4/7 (57.1%) in the middle type and 6/8 (75%) in the posterior type (70.6% overall success rate). The patients had undergone TIP repairs (5), Denis-Brown-Crawford flaps (2), Thiersch-Duplay tubes (2), Mathieu repairs (1), onlay island flaps (1), transverse prepubital island flaps (TPIF) (1), a TPIF and Mathieu repair (1) and Flip-flaps (1), with an unknown (3) as the primary procedures. An urethrocutaneous fistula occurred in 3 patients, and 1 each of meatal stenosis and a glans repair breakdown also occurred (29.4% overall complication rate). Fistula repairs were successfully performed 7, 9 and 10 months later in the 3 patients. The patient with meatal stenosis was treated with simple dilatation. CONCLUSIONS: This preliminary experience provides further proof of the versatility of TIP urethroplasty, showing its potential use following a reoperative hypospadias repair.
Constriction, Pathologic ; Dilatation ; Female ; Fistula ; Follow-Up Studies ; Humans ; Hypospadias* ; Inlays ; Male ; Medical Records ; Reoperation* ; Retrospective Studies ; Surgical Flaps

No abstract available.
Cytokines* ; Mast Cells*

A malignant rhabdoid tumor of the kidney, an uncommon renal tumor of children, is one of the most lethal neoplasms in early life. It was considered to be a sarcomatous variant of Wilms' tumor; however, further studies of its histological and clinical characteristics have proven it to be a distinct entity. We report a case of malignant rhabdoid tumor of the kidney in a 3-month-old girl, with a left abdominal palpable mass that had developed over the previous month. A left radical nephrectomy, with a regional lymph node biopsy, and 4 cycles of adjuvant chemotherapy, was performed. On the 45th postoperative day, multiple metastasises in liver, contralateral kidney and left upper lobe of lung were found. The patient expired 2 months after the operation.
Biopsy ; Chemotherapy, Adjuvant ; Child ; Female ; Humans ; Infant* ; Kidney* ; Liver ; Lung ; Lymph Nodes ; Neoplasm Metastasis ; Nephrectomy ; Rhabdoid Tumor* ; Wilms Tumor

Toxoplasma gondii tachyzoites were isolated from the blood of an ocular patient, and have been successfully passaged in the laboratory, for over a year, by peritoneal inoculation in mice. The isolated parasite was designated the Korean Isolate-1 (KI-1) and its characteristics were compared with those of the RH strain, a wellknown virulent strain originating from a child who suffered from encephalitis. The morphology, pathogenicity, infectivity and cell culture characteristics of the KI-1 were similar to those of the RH strain. Both RH and KI-1 antigens were detected by an anti-T. gondii monoclonal antibody (mAb), Tg563, against the major surface protein SAG1 (30 kDa), whereas no reaction was observed against an anti-Neospora caninum mAb, 12B4. The KI-1 was confirmed as an isolate of T. gondii. A long-term laboratory maintenance and characterization of a local T. gondii isolate is reported for the first time in the Republic of Korea.
Animals ; Antigens, Protozoan/analysis ; Female ; Humans ; Korea ; Mice ; Mice, Inbred BALB C ; Microscopy, Electron ; Middle Aged ; Parasitemia/parasitology ; Sarcoma 180 ; Serial Passage ; Specific Pathogen-Free Organisms ; *Toxoplasma/classification/growth & development/isolation & purification/pathogenicity ; Toxoplasmosis, Ocular/*diagnosis/parasitology ; Tumor Cells, Cultured ; Virulence

Sparganosis is an infection caused by sparganum, the generic term for the migrating plerocercoid larva of tapeworm which belongs to the species Spirometra. We experienced two cases of sparganosis. The first patient was a 49-year-old woman. She visited our hospital because of a painful subcutaneous nodule on her left forearm, which had developed on her left shoulder at first and migrated to the medial aspect of the forearm. She had drunk fresh water 12 years ago at a mountain. The second patient was a 39-year-old man who showed a subcutaneous nodule on the right lower leg. He had eaten raw snake about 20 years ago. Sparganosis was confirmed after the larval worms were found in the excised tissues in both cases.
Adult ; Cestoda ; Female ; Forearm ; Fresh Water ; Humans ; Larva ; Leg ; Middle Aged ; Shoulder ; Snakes ; Sparganosis* ; Sparganum ; Spirometra

The morphdogical changes in mast cells, induced by horseradish peroxidase (HRP) and distilled water were studied, using light and electron microscopy. The mesenteries of rats sacrificed at 30 minutes; at 1, 2, 4 and 18 hours; and at 1, 2, 3 and 6 weeks after an intraperitoneal injection of 250 microgram or 500 microgram of HRP or 10 ml of distilled water were used for observation of degranulation rates and morphological changes in cell organelles during specified time intervals. The results were as follows: 1) A distinct increase in the mast cell degranulation was observed in the mesenteries after injection of HRP. In particular, all mast cells were disrupted or degranulated significantly 18 hours after injection of distilled water. 2) The degranulating mast cells of the group injected with HRP showed a progressive decrease in electron density of the granules, formation of perigranular cavities, and extrusion of the granules after partial loss of the plasma membrane. 3) At 2 weeks after injection of HRP, some indicators of the early stage of regeneration, that is, peripherally placed nucleus, the expanded Golgi area containing numerous vesicles, and progranules in these vesicles, were observed. 4) After 6 weeks, the morphological characteristics of most mast cells in the group injected with HRP were nearly the same as those of the control group. 5) In degranulating mast cells of the group injected with distilled water, partial rupture of the plasma and cytoplasm with wide dispersion of the granules.
Animal ; Cytoplasmic Granules/ultrastructure* ; Female ; Horseradish Peroxidase ; Male ; Mast Cells/ultrastructure* ; Microscopy, Electron ; Rats ; Rats, Inbred Strains