Chylous ascites is defined as the accumulation of chyle in the peritoneum due to obstruction or rupture of the peritoneal or retroperitoneal lymphatic glands. Chylous ascites that arises from acute pancreatitis with portal vein thrombosis is very rare. We report here on a case of chylous ascite that was caused by acute pancreatitis with portal vein thrombosis, in which the patient showed an impressive response to conservative therapy with total parenteral nutrition and octerotide. We also review the relevant literature about chylous ascites with particular reference to the management of this rare disease.
Chyle ; Chylous Ascites ; Humans ; Pancreatic Neoplasms ; Pancreatitis ; Parenteral Nutrition, Total ; Peritoneum ; Portal Vein ; Rare Diseases ; Rupture ; Thrombosis

Electron microscopic study of two malignant fibrous histiocytomas confirmed the presence of previously described tumor cells in the literature. In addition, there existed intermediate cells with morphologic features of both myofibroblasts and histiocytes, or both histiocytes and smooth muscle cells. Our result supported the idea that malignant fibrous histiocytoma may be derived from the undifferentiated mesenchymal cells that differentiate primarily along a fibroblastic and histiocytic cells.

A study was performed to observe the sequential morphological change of the human placental barrier by means of light microscopy, immunohistochemistry, scanning electron microscopy and transmission electron microscopy. The examined placentas ranged in age from 4 weeks gestation to the full-term(40 weeks). Sixty seven placental specimens were obtained immediately after delivery. With the progression of gestation, the microvilli on the surface of syncytinum tended to be fewer, shorter and blunter. The syncytiotrophoblasts were getting thinner with formation of vasculo-syncytial membrane. The cytotrophoblasts formed a continuous layer which progressively disappeared but still present in the mature villi. In view of presence of intermediate cells and remnant of desmosomes, the cytotrophoblasts appeared to form the syncytiotrophoblasts. In early pregnancy, capillary formation took place by the aggregation and differentiation of the proliferation and aggregation of endothelial cells and pericytes. Myofibroblasts in villous stroma were examined by desmin immunohistochemical staining, and detected from 19 weeks to the full-term. During last period of pregancy definitive smooth muscle cells could be demonstrated, suggesting that the presence of myofibroblasts or smooth muscle cells are closely related to the placental maturity. Scanning electron microscopy of the early placenta showed numerous syncytial sprouts representing stages in the formation of new villi, but in the late period of gestation syncytial sprouts were diminished. It is concluded that the syncytiotrophoblast is originated from the cytotrophoblast in early pregnancy as the placental barrier is formulated. Moreover, myofibroblasts and smooth muscle cells in villous stroma play important role in placental maturation.
Pregnancy ; Female ; Humans

No abstract available.
Female ; Humans ; Urodynamics* ; Uterine Prolapse*

An isolated granulocytic sarcoma (chloroma) of the left ovary occured in the absence of leukemia in a 12-year-old woman. This lesion is defined as a localized tumor mass composed of immature cells of the granulocytic series. Granulocytic sarcomas can occur at extramedullary sites including ovary but, isolated myelosarcoma in the absence of usual manifestations of AML may be rare and has some difficulties in diagnosis. Contrary to findings in other series, granulocytic sarcoma arising in this nonleukemic patient did not progress to acute leukemia during two years she has been followed.
Child ; Diagnosis ; Female ; Humans ; Leukemia ; Ovary* ; Sarcoma, Myeloid*

We observed clinical features of 18 bronchopulmonary dysplasia (BPD) patients who were admitted to the neonatal intensive care unit in the Severance Hospital of Yonsel University College of Medicine from January 1. 1987 to June 30. 1991. Eight patients in whom ventilator settings were unchanged for more than 5 days because of lack of improvement in pulmonary function. The effects of dexamethasone in ventilator-dependent were included in the short-term dexamethasone therapy. 1) Eighteen BPD patients consisted of 15 premature infants (83%), 1 full-term infant, and 2 post-term infants, The mean gestational age of the patients were 30 weeks and the mean birth weight was 1,420gm. And there were 13 male and 5 female infants. 2) The underlying conditions which necessitated ventilatory support support were hyaline membrane disease in 13 patients (72%), apnea in 2 (11%), and meconium aspiration syndrome in 3. There patients with meconium aspiration syndrome were either full-term or post-term infants, of whom 2 had neonatal persistent pulmonary hypertension. 3) The mean age at the start of ventilator care was 8 hours and the mean PIP was 32 cm H2O. The mean duration of ventilator care of oxygen therapy and of high O2 requirement (FiO2>0.8) were 39 days, 75 days and 20 days, respectively. 4) Patent ductus arteriosus developed in 8 patients during mechanical ventilation, but they were all closed with the use of mefenamic acid, There were also 4 cases of pneumothorax, 2 cases of pulmonary parenchymal emphysema, and 1 case each of pneumomediastinum and pneumoperitoneum. 5) The mean gestational age of the dexamethasone-treated group was 30 weeks and the mean birth weight was 1,320gm, The mean age at which dexamethasone therapy was started was 39 days after birth, and in only 3.3 days 6 patients were successfully weaned from ventilator, In 5 cases the first trial of dexamethasone therapy was enough but the rest needed the 2nd trial for ventilator weaning. 6) In 6 BPD patient who were weaned from the ventilator after dexamethasone therapy, there were significant decreases in MAP (11.1 vs 8.0 cmH2O), and FiO2 (0.73 vs 0.61), but a significant increase in the urine output (2.56 vs 3.7ml/kg/hr) for the pretreatment (5 days prior to therapy) versus posttreatment period (first day of therapy). 7) The complications of dexamethasone treatment were transient hypertension and hyperglycemia in 3 patients, and systemic candidiasis and gastrointestinal bleeding in 2 patients who failed to be weaned after dexamethasone therapy. Our results suggest that the short-term dexamethasone therapy in bronchopulmonary dysplasia patients who are dependent on mechanical ventilation enables weaning in a short period of time. The inspiratory oxygen concentration and the mean airway pressure may be decreased and the urine output may be increased from the first day of medication, improves pulmonary function and decreases pulmonary interstitial edema.
Apnea ; Birth Weight ; Bronchopulmonary Dysplasia* ; Candidiasis ; Dexamethasone* ; Ductus Arteriosus, Patent ; Edema ; Emphysema ; Female ; Gestational Age ; Hemorrhage ; Humans ; Hyaline Membrane Disease ; Hyperglycemia ; Hypertension ; Hypertension, Pulmonary ; Infant ; Infant, Newborn ; Infant, Premature ; Intensive Care, Neonatal ; Male ; Meconium Aspiration Syndrome ; Mediastinal Emphysema ; Mefenamic Acid ; Oxygen ; Parturition ; Pneumoperitoneum ; Pneumothorax ; Respiration, Artificial ; Ventilator Weaning ; Ventilators, Mechanical ; Weaning

Extrapyramidal tract motor disorder in calcification of basal ganglia probably occurs when the deposition of acid mucopolysaccharides in the basal ganglia is severe enough to lead to neuronal loss. Basal ganglia calcification has been noted to occur with higher incidence and intensity in encephalitis lethargica, carbon monocide intoxication, anoxia, tuberous sclerosis, toxoplasmosis, hypothyroidism and hypoparathyroidism. The neurologic disorder is frequently reversible with treatment in patients with basal ganglia calcification who have hypoparathy-roidism. We report a patient with idiopathic hypoparathyroidism associated with bilateral calcification of the basal ganglia and athetoid movement. This is the first case report in Korea.
Anoxia ; Athetosis* ; Basal Ganglia* ; Carbon ; Cefonicid ; Encephalitis ; Extrapyramidal Tracts ; Glycosaminoglycans ; Humans ; Hypoparathyroidism* ; Hypothyroidism ; Incidence ; Korea ; Nervous System Diseases ; Neurons ; Toxoplasmosis ; Tuberous Sclerosis

5-Fluorouracil is one of the most commonly used anticancer drug. We report a case of leukoencephalopathy who had received 5-fluorouracil injection following operation of carcinoid tumor in intestine. The case had dementia, dysarthria and gait disturbance. Brain CT showed bilaterally symmetric diffuse low densities in the white matter of cerebrum and cytologic examination of cerebrospinal fluid was negative for malignancy. Discontinuation of 5- fluorouracil injection for several days and then improved the clinical symptoms.
Brain ; Carcinoid Tumor ; Cerebrospinal Fluid ; Cerebrum ; Dementia ; Dysarthria ; Fluorouracil* ; Gait ; Intestines ; Leukoencephalopathies*

BACKGROUND: Limited ischemic tolerance of the lung has remained one of the factors that limits the expansion of pulmonary transplantation as a treatment for end-stage pulmonary disease. Numerous studies on safe long term preservation for lung transplantation has been performed for the purpose of developing ideal preservation solution with extracellular type or intracellular type solutions. In this study, we examined the efficacy of LPDG solution in lung preservation longer than 20 hours by comparison with modified Euro-Collins solution. METHODS: Thirty-four adult mongrel dogs were divided into two groups. Donor lungs were flushed with LPDG solution(n=9) or modified Euro-Collins(MEC) solution(n=8) and stored for 24 hours at 10degrees C. All donor lungs were perfused through the pulmonary arteries with solutions containing prostaglandin E1 and verapamil. Left canine lung allotransplantations wereperformed. Assessment(hemodynamic indices and arterial blood gas analysis) of left implanted lung was made by occluding the right pulmonary artery for ten minutes using pulmonary artery Cuff. Assessment was repeated at the interval of 30 minutes, one hour, and two hours later after reperfusion and then chest X-ray, computed tomogram and lung perfusion scan were obtained. In survival dogs follow-up studies were done with assessment with chest X-ray, computed tomogram of the chest and lung perfusion scan on 7th day postoperatively. After preservation above 20 hours, pathological examinations for ultrastructural findings on right lung were performed in each group. RESULTS: With respect to arterial oxygen tension, LPDG group was superior to MEC but there was no statistical significance for 2 hours after reperfusion. Mean pulmonary artery pressure was less increased(p<0.05) and cardiac output higher(p<0.05) than MEC group until 2 hours after reperfusion. After 2 hours of reperfusion, both groups showed transplanted lung function deteriorated gradually. Perfusion scan of the transplanted lung in LPDG group showed better perfusion rate in immediate post-reperfusion, 3 days and 7 days later respectively but there was no statistical significance and corelation with PaO2 and computed tomographic views. In scanning electron microscopy of pulmonary artery after preservation, LPDG group relatively shows less irregular protrusion of the inner surface of endothelial cell of poulmonary artery than MEC group. CONCLUSIONS: We concluded that LPDG solution can offer safe lung preservation above 20 hours with adequate immunosuppressive therapy and prevention of the infection.
Adult ; Alprostadil ; Animals ; Arteries ; Cardiac Output ; Dogs ; Endothelial Cells ; Follow-Up Studies ; Humans ; Lung Diseases ; Lung Transplantation ; Lung* ; Microscopy, Electron, Scanning ; Organ Preservation ; Oxygen ; Perfusion ; Pulmonary Artery ; Reperfusion ; Thorax ; Tissue Donors ; Verapamil

BACKGROUND: Fungi are eukaryotic microorganisms including yeast and molds. Many studies have focused on modifying bacterial growth, but few on fungal growth. Microcurrent electricity may stimulate fungal growth. OBJECTIVE: This study aims to investigate effects of microcurrent electric stimulation on Trichophyton rubrum growth. METHODS: Standard-sized inoculums of T. rubrum derived from a spore suspension were applied to potato dextrose cornmeal agar (PDACC) plates, gently withdrawn with a sterile pipette, and were applied to twelve PDACC plates with a sterile spreader. Twelve Petri dishes were divided into four groups. The given amperage of electric current was 500 nA, 2 µA, and 4 µA in groups A, B, and C, respectively. No electric current was given in group D. RESULTS: In the first 48 hours, colonies only appeared in groups A and B (500 nA and 2 µA exposure). Colonies in group A (500 nA) were denser. Group C (4 µA) plates showed a barely visible film of fungus after 96 hours of incubation. Fungal growth became visible after 144 hours in the control group. CONCLUSION: Lower intensities of electric current caused faster fungal growth within the amperage range used in this study. Based on these results, further studies with a larger sample size, various fungal species, and various intensities of electric stimulation should be conducted.
Agar ; Electric Stimulation ; Electricity ; Fungi ; Glucose ; Sample Size ; Solanum tuberosum ; Spores ; Trichophyton* ; Yeasts