Colonic angiodysplasia is important because of the likelihood of lower gastrointestinal tract bleeding, either massively or chronically. A 66-year-old male patient visited our hospital because of hematochezia and lower abdominal discomfort. He underwent colonoscopy, which revealed 0.5 cm sized, cherry red colored, branching, ozzing vessel with fern-like margin on cecum. Although he received endoscopic injection therapy with hypertonic saline and oral estrogen-progesterone therapy, subsequent ileocecal resection was performed due to recurrent bleeding. Histology of the resected specimen showed irregularly dilated, distorted, thin-walled vessels in submucosa.
Aged ; Angiodysplasia* ; Cecum ; Colon* ; Colonoscopy ; Gastrointestinal Hemorrhage ; Hemorrhage* ; Humans ; Lower Gastrointestinal Tract ; Male ; Prunus

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

BACKGROUND: The use of autologous transfusion is gradually increasing since it eliminates transfusion-transmitted viral diseases, and avoids the risk of alloimmunization of red blood cells and posttransfusion graft-versus-host disease. The majority of premature neonates born at less than 1500 g need one or more red blood cell transfusion during the hospitalization and cord blood is considered as the most ideal blood for neonate autologous transfusion. In order to evaluate the adequacy of stored cord blood for autologous transfusion for neonates, the levels of plasma free hemoglobin, red blood cell adenosine triphosphate (ATP) and 2,3-diphosphoglycerate (2,3-DPG) were measured at the time of collection, and then a week interval by 4 weeks. METHODS: The cord blood was collected in a single donor bag with CPDA-1 by aseptic technique from 28 newborns, stored for 28 days at 4degrees C, and changes in the levels of plasma free hemoglobin, red blood cell ATP and 2,3-DPG were measured at the time of collection, and then a week interval by 4 weeks for 26 cord bloods which were not presented with any bacterial growth during the storage. RESULTS: At the time of sampling, hemolysis was 0.11+/-0.16%, and intracellular ATP and 2,3-DPG were 3.74+/-0.99 mumol/g Hb and 11.67+/-1.21 mumol/g Hb, respectively. During the storage, hemolysis gradually increased to 0.61+/-1.09% on 28 days (p<0.05). ATP gradually decreased to 2.98+/-0.92 mumol/g Hb (80% of initial level) on 28 days(p<0.05). The levels of 2,3-DPG were 4.20+/-0.87 mumol/g Hb (about 35% of initial level) on 7 days(p<0.05) and 1.16+/-0.74 mumol/g Hb (less than 10% of initial level) on 28 days (p<0.001). CONCLUSIONS: In conclusion, ATP and 2,3-DPG levels of cord blood that are related to the viability of red blood cells during the storage were similar to those of adults. Thus the cord blood appeared to be an appropriate source for neonate autologous transfusion, however, more intensive studies on the effects of 2,3-DPG and metabolic products in vivo are necessary since physical conditions and physiology of the red blood cells in the neonates are different in many aspects from those of adults and children.
2,3-Diphosphoglycerate* ; Adenosine Triphosphate* ; Adenosine* ; Adult ; Child ; Erythrocyte Transfusion ; Erythrocytes ; Fetal Blood* ; Graft vs Host Disease ; Hemolysis ; Hospitalization ; Humans ; Infant, Newborn ; Physiology ; Plasma* ; Tissue Donors ; Virus Diseases

Citrullinemia is one of the five urea cycle defects and is caused by argininosuccinic acid synthetase deficiency ; conversion of citrulline to argininosuccinic acid is blocked. Severe hyperammonemia typically develops in the neonate within a few days and symptoms such as vomiting, lethargy, convulsion, coma follows rapidly. The diagnosis is supported by high citrulline level in serum, urine, CSF and decreased activity of argininosuccinic acid synthetase in liver biopsy. We experienced a 3-day-old male neonate with poor activity, lethargy, convulsion, and coma who was diagnosed as citrullinemia by markedly elevated plasma and urine citrulline level with hyperammonemia. We report this case with brief review of the related literature.
Argininosuccinic Acid ; Biopsy ; Citrulline ; Citrullinemia* ; Coma ; Diagnosis ; Humans ; Hyperammonemia ; Infant, Newborn ; Lethargy ; Ligases ; Liver ; Male ; Plasma ; Seizures ; Urea ; Vomiting

Citrullinemia is one of the five urea cycle defects and is caused by argininosuccinic acid synthetase deficiency ; conversion of citrulline to argininosuccinic acid is blocked. Severe hyperammonemia typically develops in the neonate within a few days and symptoms such as vomiting, lethargy, convulsion, coma follows rapidly. The diagnosis is supported by high citrulline level in serum, urine, CSF and decreased activity of argininosuccinic acid synthetase in liver biopsy. We experienced a 3-day-old male neonate with poor activity, lethargy, convulsion, and coma who was diagnosed as citrullinemia by markedly elevated plasma and urine citrulline level with hyperammonemia. We report this case with brief review of the related literature.
Argininosuccinic Acid ; Biopsy ; Citrulline ; Citrullinemia* ; Coma ; Diagnosis ; Humans ; Hyperammonemia ; Infant, Newborn ; Lethargy ; Ligases ; Liver ; Male ; Plasma ; Seizures ; Urea ; Vomiting

Familial hemiplegic migraine(FHM) is an autosomal dominant subtype of migraine with aura, characterized by the occurrence of hemiplegia during the aura. Two subforms of FHM families exist; pure FHM in 80% and FHM families with cerebellar symptoms in 20%. Half of the known FHM families show genetic linkage to chromosome 19p13, and in these families FHM is caused by missense mutations in a neuronal P/Q type calcium channel alpha-1 subunit gene(CACNA1A gene). Linkages to 1q31 and 1q21-23 have also been established. Other families are linked neither to chromosome 19 nor 1. Clinical variabilities are partially associated with the various types of CACNA1A gene mutations. FHM is distinguished from more frequent migraine types by a clear, dominant inheritance pattern and the relative absense of other headache types. Further investigation of FHM will help to clarify the genetics of more common migraine. We describe a male patient with FHM with a brief review of the literature.
Calcium Channels ; Chromosomes, Human, Pair 19 ; Epilepsy ; Genetic Linkage ; Genetics ; Headache ; Hemiplegia ; Humans ; Inheritance Patterns ; Male ; Migraine Disorders ; Migraine with Aura* ; Migraine without Aura ; Mutation, Missense ; Neurons

No abstract available.
Rhytidoplasty*

PURPOSE: This study was performed to find out the role of routine lumbar puncture in children presented with their first seizure with Fever. METHODS: This study included 220 children, over a 5 year period, from April 1999 to March 2003, who visited or were admitted at Dae Dong Hospital with their first febrile convulsion. Lumbar puncture was performed in all children. We analyzed their age, family history, type of seizure, duration of seizure, cause of fever, and the results of lumbar puncture. RESULTS: In the sex distribution, males(58.6%) outnumbered females(41.4%) and the ratio was 1.2:1. 81.7% of the patients had febrile convulsion from 6 months- to 3 years of age(P<0.05). 30.5% also had family history of febrile convulsion. The types of seizure were generalized tonic-clonic(72.7%), generalized tonic(17.7%), and generalized clonic(6.4 %). For the duration of seizure, 90.4% of the patients were estimated less than 15 minutes(P<0.05). The causes of fever were pharyngotonsilitis(40.5%), gastroenteritis(19.1 %), pneumonia or bronchitis(13.2%), meningitis(11%), otitis media, urinary tract infection, and exanthem subitum. However, 9.1% of the patients were diagnosed meningitis, with 18 of 20 patients under 3 years of age. CONCLUSION: In the first seizure with fever, lumbar puncture is a useful method for meningitis, especially under 3 years of age.
Child* ; Exanthema ; Fever* ; Humans ; Meningitis ; Otitis Media ; Pneumonia ; Seizures* ; Seizures, Febrile ; Sex Distribution ; Spinal Puncture* ; Urinary Tract Infections

PURPOSE: The authors report their experience with four cases of paralytic exotropia from a pit viper snakebite, accompanied with a literature review. METHODS: Four patients (two males and two females) visited the emergency room in the hospital with symptoms including diplopia, limitation of eye movement, exotropia, and blepharoptosis, after being bitten by a presumed pit viper, and were treated by antivenom. RESULTS: No visual disturbance was observed in the first examination, while limitation of adduction was found in four cases in the ocular movement test. As to the type of tropia, three patients showed intermittent exotropia and the other showed exotropia. The angle of strabismus in the distance was 20~30 prism diopters (PD) while that in the near was 18~35 PD. Two cases were accompanied with blepharoptosis. Except one case which was unavailable for follow-up observation, three cases became normal in diplopia, blepharoptosis, and limitation of ocular movement between the 4th and 11th day after the snakebite. CONCLUSIONS: Neurotoxicity induced by a pit viper snakebite is rare. However, neurotoxicity including strabismus and blepharoptosis can occur because extraocular muscles have a higher ratio of nerve fibers to the extraocular muscle fibers compared with skeletal muscles.
Blepharoptosis ; Diplopia ; Emergency Service, Hospital ; Exotropia* ; Eye Movements ; Follow-Up Studies ; Humans ; Male ; Muscle, Skeletal ; Muscles ; Nerve Fibers ; Snake Bites* ; Strabismus

PURPOSE: This study was performed to find out whether tibial bone defect preceeding the surgery has an effect on the outcome of patients who have undergone total knee replacement therapy with an evaluation period of more than five years. MATERIAL AND METHOD: Osteoarthritis patients who were treated with total knee replacement and evaluated for more than 5 years were selected, of which 42 patients were with tibial bone defects, and 21 without. Clinical evaluation were made on the basis of pre- and post-operative Knee Society Knee Score and Functional Score, radiological evaluation using the American Knee Society Score. and range of motion, tibio-femoral angle, subjective satisfaction, complication were evaluated. RESULTS: Knee fuction score and subjective satisfaction of the two groups showed significant improvement after the surgery, but comparison between the two was statistically insignificant. Radiological evaluation showed radiolucency in zone 1 and 2 of tibia in the majority of both groups, but dissociation of the inserted device was not shown. CONCLUSION: In the cases of tibial bone defect, bone cement, screw fixation enforced with autograft, and wedge metal insertions can be considered to be effective in treating patients by total knee replacement surgery.
Arthroplasty, Replacement, Knee* ; Autografts ; Humans ; Knee ; Osteoarthritis ; Range of Motion, Articular ; Tibia