No abstract available.
Burns* ; Hand* ; Humans ; Infant*

Anthrax in man is usually cutaneous, resulting from contact with materials derived from infected livestock. Internal organs are infrequently involved,. This report concerns a case of primary anthrax of intestine. The first case of primary anthrax of intestine is to our knowledge in Korea. The patient was a 14-year-old male who has complained of nausea, vomiting and acute abdominal pain. History was otherwise noncontributory except for ingestion raw meat of the dead cattle, one day before the onset of the disease. The cattle presumably died due to Bacillus anthracis in a village Bae-Ban Dong in the city of Kyung ju, Kyung Pook. Among 15 sufferers, 2 cases died 3 days later. Bacillus anthracis isolated from the raw beef, blood samples of two patients and throat culture of one patient. At laparotomy, the peritoneal cavity was full of serosanginous fluid. Right hemicolectomy including partial resection of ileum was done. The bowel was segmentally dilated, hemorrhagic and necrotic, especially at terminal ileum. The mucosa was edematous and largely ulcerated covered with greenish yellow exudate. The intense vascular congestion with hemorrhage and numerous colonization of bacteria were present through the entire wall. The organisms were large, gram-positive and PAS-negative bacilli in long chain. Bacterial emboli were scattered in lymphatics. The other feature was band like lymphoid cell infiltration in ulcer base and submucosal layer. Payer's patches were prominent and the germinal centers were necrotic. Interfollicular spaces exhibited aggregates of numerous atypical lymphoid cells. The cells were five times larger than resting lymphocytes and had several prominent nucleoli and abundant amphophilic cytoplasm. On immunohistochemical staining, most of atypical cells were positive for T-cell marker and Ki-I Ag. The mesenteric lymph nodes were enlarged, showing reactive feature, and the atypical cells were also demonstrated. The patient recovered completely.
Male ; Humans

TGF-beta1 expression was studied in 25 patients with tuberculosis (lung, 9 cases and lymph node, 16 cases) using a polyclonal antibody in formalin-fixed paraffin embedded tissue. Nineteen cases (76.0%) out of 25 cases showed TGF-beta1 expression. TGF-beta1 was present in cytoplasm of epithelioid cells and Langhans' giant cells. Pulmonary tuberculosis and tuberculous lymphadenitis showed different patterns of staining. Five of 9 cases of pulmonary tuberculosis were positive for TGF-beta1: four of acid-fast bacilli positive cases (4/5, 80.0%) and one of acid-fast bacilli negative cases (1/4, 25.0%). However, high expression of TGF-beta1 was detected in tuberculous lymphadenitis of both acid-fast bacilli positive group (3/4, 75.0%) and acid-fast bacilli negative group (11/12, 91.7%). TGF-beta1 was also expressed in all of 6 cases of BCG-induced tuberculous lymphadenitis: 2 acid-fast bacilli positive and 4 acid-fast bacilli negative cases. TGF-beta1 expression was shown in 19 cases (86.4%) of 22 in active tuberculosis, while no TGF-beta1 expression was detected in any cases of inactive, healed tuberculosis (p<0.008). This study supports that the TGF-beta1 expression of epithelioid cells may alter their function resulting in the impaired antimycobacterial activity. Thus the increased production of TGF-beta1 may be one of the important mechanisms by which Mycobacterium tuberculosis avoids destruction by host macrophages.
Cytoplasm ; Epithelioid Cells ; Giant Cells ; Granuloma* ; Humans ; Lymph Nodes ; Macrophages* ; Mycobacterium tuberculosis ; Paraffin ; Transforming Growth Factor beta1* ; Tuberculosis ; Tuberculosis, Lymph Node ; Tuberculosis, Pulmonary

OBJECTIVE: To define the anatomy of the lateral antebrachial cutaneous nerve (LABCN) and the cephalic vein (CV) in the anterior forearm region of living humans using ultrasonography for preventing LABCN injury during cephalic venipuncture. METHODS: Thirty forearms of 15 healthy volunteers were evaluated using ultrasonography to identify the point where the LABCN begins to contact with the CV, and the point where the LABCN separates from the CV. The LABCN pathway in the forearm in relation to a nerve conduction study was also evaluated. RESULTS: The LABCNs came in contact with the CV at a mean of 0.6±1.6 cm distal to the elbow crease, and separated from the CV at a mean of 7.0±3.4 cm distal to the elbow crease. The mean distance between the conventionally used recording points (point R) for the LABCN conduction study and the actual sonographic measured LABCN was 2.4±2.4 mm. LABCN usually presented laterally at the point R (83.3%). CONCLUSION: The LABCN had close proximity to the CV in the proximal first quarter of the forearm. Cephalic venipuncture in this area should be avoided, and performed with caution if needed.
Elbow ; Forearm ; Healthy Volunteers ; Humans ; Neural Conduction ; Phlebotomy ; Ultrasonography ; Veins*

Mn (manganese) is known to induce Parkinsonian neurological disorder. Several lines of evidence suggest that apoptosis is involved not only in physiological cell death during normal development but also in neurodegenerative disease. The mechanism of Mn induced cell death remains poorly understood. In the present study, we evaluated the morphologic changes and apoptotic profile in basal ganglia using rat model of Mn toxicity. The rats were divided into three groups: the first group was a control; the second group was subdivided by administration dosage of Mn into group A (5, 10 mg MnC12/ kg) and group B (20, 40 mg MnC12/kg). The rats of each subgroup received a injection of Mn via tail vein every week for 4 weeks. The second group received 4 repeated injection of 10 mg MnC12/kg in the same manner and the rats were sacrificed at day 1, 3 & 7 in group I and at day 10, 21, 42, and 90 in group II after the last injection. A significant loss of neuron and gliosis were observed in the basal ganglia in the experimental groups (p<0.05), which were more pronounced in group II than in the control or group I. No significant difference in number of nerve cells or degree of gliosis was identified in the substantia nigra. Apoptotic cells were also increased in basal ganglia of experimental groups and appeared among neurons (10%), glial cells (10%), and endothelial cells (60%). Apoptotic figures were consistently noted through the entire experimental period after Mn injection in basal ganglia. In conclusion, these results demonstrate that Mn-induced cytopathic insult affects various cell types in basal ganglia and shows variable sensitivity in the different regions of brain, especially in the apoptotic cell death of the neuron. The overaccumulation of Mn in the brain might be attributed from the breakdown of blood-brain barrier due to the injury through the apoptosis.
Animals ; Apoptosis ; Basal Ganglia* ; Blood-Brain Barrier ; Brain ; Cell Death ; Endothelial Cells ; Gliosis ; Manganese* ; Models, Animal ; Nervous System Diseases ; Neurodegenerative Diseases ; Neuroglia ; Neurons ; Rats* ; Substantia Nigra ; Veins

BACKGROUND AND OBJECTIVES: Recurrent vestibulopathy is defined a disease characterized by more than a single episode of vertigo of duration characteristic of endolymphatic hydrops but without auditory or clinical neurological symptoms or signs. To investigate the clinical characteristics and the efficacy of combination therapy, we analyzed the clinical records of the patients diagnosed as recurrent vestibulopathy. MATERIALS AND METHOD: Clinical records of sixty four patients diagnosed as recurrent vestibulopathy were retrospectively reviewed. The data on age, sex distribution, natural history, family history of recurrent vestibulopathy, concurrent headache, caloric response was analyzed. The efficacy of combination therapy for vertigo control in the patients with a minimum 24-month follow-up was also evaluated. RESULTS: Mean onset age of recurrent vestibulopathy was 43 years and there was a female preponderance. Concurrent headache and elevated SP/AP ratio in electrocochleogram was frequently observed in these patients. After the combination medical therapy, patients with severe recurrent vestibulopathy showed significant decrease in the number of vertigo spells with 37.5% of complete control of vertigo. CONCLUSION: As a distinctive clinical disorder with unknown cause, recurrent vestibulopathy should be always considered to the patients complaining recurrent episodic vertigo. Combination therapy individualized to the symptoms and signs of the patients with recurrent vestibulopathy might be effective in reducing the frequency of vertigo attacks. Further case-control studies with large population should be necessary.
Age of Onset ; Case-Control Studies ; Endolymphatic Hydrops ; Female ; Follow-Up Studies ; Headache ; Humans ; Natural History ; Retrospective Studies ; Sex Distribution ; Vertigo ; Vestibular Neuronitis*

Celecoxib (Celebrex(R)) is a nonsteroidal anti-inflammatory drug (NSAID) which inhibits cycloxygenase (COX)-2 selectively. It is widely used in osteoarthritis and rheumatoid arthritis patients because it causes less gastrointestinal injury than conventional NSAIDs. We report a case of erythema multiforme probably induced by this drug. A 63 year old female patient had taken celecoxib for osteoarthritis and 8 days after she developed erythema multiforme on the whole body.
Anti-Inflammatory Agents, Non-Steroidal ; Arthritis, Rheumatoid ; Drug Eruptions ; Erythema Multiforme* ; Erythema* ; Female ; Humans ; Middle Aged ; Osteoarthritis ; Celecoxib

The purpose of this study was to evaluate the amount and interrelationship of hard and soft tissue changes after mandibular setback osteotomy and reduction genioplasty in mandibular prognathism with long anterior facial height. The control group (Group A) consisted of 20 patients who had severe horizontal discrepancy. They experienced presurgical orthodontic treatment and orthognathic surgery via mandibular setback. The experimental group (Group B) consisted of 20 patients who had severe horizontal and vertical discrepancy. They experienced presurgical orthodontic treatment and orthognathic surgery via mandibular setback and reduction genioplasty. The presurgical and postsurgical lateral cephalograms were valuated. The computerized statistical analysis was carried on with EXCEL 97 program. The results were as follows : 1. The correlation of hard and soft tissue horizontal changes in lower 2/3 of lower anterior facial height were high for both groups. The correlation coefficients of hard tissue changes and Ls, Stm, Li changes in group B were moderately higher than Group A. 2. The correlation of hard and soft tissue vertical changes in Group B were lower than Group A. (except for pointB-Ils, Me-Me') 3. The ratio for soft tissue to Pog in Group B was lower than Group A. The ratios of hard and soft tissue vertical changes were 32% at Ils, 54% at Pog', and 60% at Me'. 4. The ratio of lower anterior facial height to total anterior facial height was reduced for both group. But ratio of upper 1/3 of lower anterior facial height to total anterior facial height did not changed significantly in Group B. 5. Reduction genioplasty combined with mandibular setback procedure showed no change in upper one third(Sn-Stm) and significant decrease(Stm-Me') in the lower two thirds of the soft-tissue anterior lower facial height.
Genioplasty* ; Humans ; Orthognathic Surgery ; Osteotomy* ; Prognathism*

We present the case of a 38-year-old male who complained of repeated dizziness and syncope. Rotational vertebral artery syndrome (RVAS) was diagnosed via videonystagmoraphy (VNG), computed tomography angiography (CTA) and three-position digital subtraction angiography (DSA). In the neutral position, CTA and DSA revealed left vertebral artery (VA) stenosis at the C2 transverse foramen and right VA hypoplasia. When the head was turned to the right, the blood flow stopped at the C2 level. The bony structure around the VA at the C2 transverse foramen was decompressed via an anterior surgical approach, and the symptoms resolved. This case present the precise stenotic point evaluation by three-position DSA is crucial for the planning of surgical treatment.
Adult ; Angiography ; Angiography, Digital Subtraction ; Constriction, Pathologic ; Decompression ; Dizziness ; Head ; Humans ; Male ; Syncope ; Vertebral Artery

STUDY DESIGN: Retrospective study. OBJECTIVES: To determine the influence of trauma on the neurologic course in patients who have undergone surgery for cervical myelopathy. SUMMARY OF LITERATURE REVIEW: The postsurgical outcomes were worse from trauma in patients who had a cervical ossification of the posterior longitudinal ligament (OPLL) or cervical canal stenosis, in comparison with patients who did not. MATERIALS AND METHODS: The study was conducted on 70 patients who had undergone surgery due to cervical myelopathy from January 2004 to December 2013 and had at least 1 year of follow-up. Depending on trauma history, the patients were divided into two groups, and their radiological (simple radiographic, computed tomographic, and magnetic resonance imaging) and clinical (Japanese Orthopaedic Association [JOA] score, motor power of upper extremities) results were compared retrospectively. RESULTS: Among 70 patients in total, 18 patients were in the trauma group and 52 were in the non-trauma group, and all cases in the trauma group had a history of minor trauma (11 cases of drivers traffic accidents, 4 cases of slipping and falling, 2 cases of minor pedestrian accidents, and 1 case of falling). Radiologically narrower diameter of the spinal canal showed statistically significant difference between two groups (p=0.042). The JOA scores before and after surgery and the recovery rate did not have a clinically meaningful difference with trauma. However, the degree of motor improvement was significantly higher for the trauma group within 1 week after surgery (p=0.040). CONCLUSIONS: Minor trauma itself may adversely affect the patients' clinical courses.
Accidents, Traffic ; Constriction, Pathologic ; Follow-Up Studies ; Humans ; Longitudinal Ligaments ; Retrospective Studies ; Spinal Canal ; Spinal Cord Diseases*