Pemphigus is a rare, blistering autoimmune disease in which the action of antibodies is now well established. The most effective therapy is the administration of cortioseroids. Prior to the use of steroids, it was commonly fatal. Since the availability of corticosteroidsnortality has been markedly reduced. However prolonged administration of steroids may be difficult to sustain because of severe side effects. For these, other sdjuvant therapies were considered. Such as immunosuppresive drugs, gold, dapsone, plasmapheresis and intralesional injection of corticosteroid. Of these, immunosuppressive therapies are most commonly used. Recently cyclosporine which was for human organ transplantation is used in dermatology. Cyclosporine is a potent immunosupprc save agent with no appreciable effect on bone marrow and a selective inhibition to helper T cells. In our case, cyclosporine was administrated to the patient who had suffered from severe pemphigis vulgaris for 3 years without responding to treatment. We gave cyclosporine 400mg and prednisolon, 90mg per day. But we found a sudden increase of the RUN/Cr level and a shut down of the renal funtion. Therefore we discontinued cyclosporine and treated acute renal failure. However the renal damag e was irreversible and two days later the patient died.
Acute Kidney Injury* ; Antibodies ; Autoimmune Diseases ; Blister ; Bone Marrow ; Cyclosporine ; Dapsone ; Dermatology ; Humans ; Injections, Intralesional ; Organ Transplantation ; Pemphigus* ; Plasmapheresis ; Steroids ; T-Lymphocytes, Helper-Inducer ; Transplants

By performing the county-wide surveys of Paragonimus westermani infection in several areas in the Chilgok county, Kyungpook Province, three endemic foci of Paragonimus westermani were found. The foci found in this survey were Haksan first dong, Haksan second dong, and Settom in Kumhwa village, all in Kasan myun, Chilgok county. In the three communities, the positive rates for the fluke among the residents by the intradermal test with Paragonimus antigen varied from 22.3 per cent to 25.0 per cent; school children from these areas showed infection rates above 50 per cent. The rate in males and females was 23.9 and 23.0 per cent, respectively. This difference was not significant. The presence and number of Semisulcospira snails and Astacus crayfish, the intermediate hosts of Paragonimus westermani in the stream communities and the high infection rates for the fluke in the residents were the supporting factors in determining the foci.
parasitology-helminth-trematoda ; Paragonimus westermani ; paragonimiasis ; epidemiology ; host ; snail ; Semisulcospira snails ; Astacus crayfish

BACKGROUNDS: Carbon Dioxide (CO2) insufflation during thoracoscopy may result in adverse hemodynamic consequences such as increase in central venous pressure, decrease in cardiac output and increase in arterial carbon dioxide pressure. But the cerebral effects of CO2 insufflation during thoracoscopy are not known yet. To evaluate the cerebral effect of CO2 insufflation during thoracoscopy, jugular bulb venous blood oxygen saturation and pressure were measured. METHODS: Nine patients were underwent thoracic surgery by thoracoscopy and one lung ventilation. After operation, CO2 was insufflated and hemodynamic parameters, arterial blood pressure, heart rate, central venous pressure, jugular bulb pressure, arterial blood gases and jugular bulb venous blood gases were measured at intrathoracic pressure 5 mmHg, 10 mmHg and 15 mmHg respectively. RESULTS: Central venous pressure was increased with insufflation of CO2 of 10 mmHg and 15 mmHg. Jugular bulb pressure was increased with insufflationof of CO2 of 5mmHg, 10 mmHg and 15 mmHg. Arterial PCO2, jugular bulb venous PO2 and jugular bulb venous blood oxygen saturation were increased with insufflation of CO2 of 5 mmHg, 10 mmHg and 15 mmHg. CONCLUSION: CO2 insufflation pressure of 5 mmHg or greater resulted in significant increase in jugular bulb venous blood oxygen saturation and pressure.
Arterial Pressure ; Carbon Dioxide ; Cardiac Output ; Central Venous Pressure ; Gases ; Heart Rate ; Hemodynamics ; Humans ; Insufflation* ; Jugular Veins ; One-Lung Ventilation ; Oxygen* ; Thoracic Surgery ; Thoracoscopy*

PURPOSES: We experienced a case of infected cephalhematoma drained spontaneously. So we wanted to review the most appropriate method for investigating cephalhematomas for possible infection and to clarify the indications for the diagnostic aspiration. METHODS: MEDLINE searches were conducted for the period from 1972 to 1997, and all reports were obtained. 15 articles reporting 18 infected cephalhematomas were identified in the literature. We analyzed the medical records in patients according to age: sex ; associated infections especially sepsis or osteomyelitis, risk factors such as scalp electrode or vacuum use, local signs such as increase in size, fluctuation, local redness: organisrns: and radiographic findings. RESULTS: Escherichia coli was isolated from over 50% of the cephalhematomas that were aspirated. Most patients presented with sepsis, meningitis, and/or osteomyelitis. Plain radiographs, bone scans, and enhanced CT scans were limited in their ability to determine if a cephalhematoma was infected unless associated osteomyelitis existed. Local signs of scalp infection, such as increase in size, fluctuation, local redness were obvious in almost all cases. CONCLUSIONS: Aspiration is the diagnostic procedure of choice for cephalhematomas suspected of being infected. The indications for aspiration were increase in size, development of erythema, development of fluctuation, relapse of systemic infection, or a delay in the resolution of clinical symptoms of infection.
Diagnosis ; Electrodes ; Erythema ; Escherichia coli ; Humans ; Infant, Newborn ; Medical Records ; Meningitis ; Osteomyelitis ; Recurrence ; Risk Factors ; Scalp ; Sepsis ; Tomography, X-Ray Computed ; Vacuum

Double J stents have been advocated for drainage or splintage of the ureter. Fifty-four attempts at double J stent insertion were made in 46 patients. In 93% attempts the stent was satisfactorily placed. Their use in adjunct to urologic and gynecologic surgery, percutaneous nephrolithotomy and ureterorenoscopy has been encouraging but poor results have been obtained in patients with ureteral obstruction due to tuberculosis and malignancy.
Drainage ; Female ; Gynecologic Surgical Procedures ; Humans ; Nephrostomy, Percutaneous ; Stents* ; Tuberculosis ; Ureter ; Ureteral Obstruction ; Urinary Diversion*

PURPOSE: Chronic lung disease is a cause of significant morbidity and mortality in the neonatal respiratory distress syndrome. Although the exact mechanisms leading to the development of chronic lung disease are unknown, there is increasing evidence indicating that pulmonary inflammation contributes to the pathogenesis. The proinflammatory cytokines, interleukin(IL)-1beta, IL-8 may have a role to play in initiating the inflammatory response that is seen in chronic lung disease. In contrast, IL-10 is an antiinflammatory cytokine. The abnormal persistent inflammatory process in chronic lung disease may be due to dysregulation of these proinflammatory cytokines. So, to describe cytokine profiles of chronic lung disease in neonate, we analysed the IL-1beta, IL-8 and IL-10 levels in bronchoalveolar lavage fluid by ELISA technique. METHODS: We obtained bronchoalveolar lavage samples from 14 respiratory distress syndrome infants without chronic lung disease and 8 respiratory distress syndrome infants with chronic lungisease. The cytokine levels were assayed. RESULTS: The results were as follows: 1) IL-1beta levels were higher in chronic lung disease group(205.16+/-360.21pg/rnl) than group without chronic lung disease(21.21+/-26.14pg/ml)(P<0.05). 2) IL-8 levels were also higher in chronic lung disease group(166.16+/-347.26pg/ml) than group without chronic lung disease(49.85+/-105.27pg/ml)(P>0.05). 3) In contrast, IL-10 levels were lower in chronic lung disease group(78.29+/-138.69pg/ml) than group without chronic lung disease(111.29+/-155.27pg/ml)(P>0.05). CONCLUSION: These results suggest that the dysregulation of cytokines contributes to the pathogenesis of chronic lung disease. The difference in cytokine levels of bronchoalveolar lavage fluid can be used as a predictor for development of chronic lung disease.
Bronchoalveolar Lavage Fluid* ; Bronchoalveolar Lavage* ; Cytokines* ; Enzyme-Linked Immunosorbent Assay ; Humans ; Infant ; Infant, Newborn ; Interleukin-10 ; Interleukin-8 ; Lung Diseases* ; Lung* ; Mortality ; Pneumonia ; Respiratory Distress Syndrome, Newborn

We describe a case of cutaneous chylous reflux, which is thought to be a kind of primary lymphedema, in a 19-year-old male who had suffered from multiple vesiculobullae and intermittent swelling on scrotum for about 6 years. Histopathologic findings showed multiple dilated lymphatic vascular channels in papillary dermis.
Dermis ; Humans ; Lymphedema ; Male ; Scrotum ; Young Adult

One case of congenital hypoplastic kidney associated with tuberculosis in 28 year old man is presented and related literatures reviewed.
Adult ; Humans ; Kidney* ; Tuberculosis* ; Tuberculosis, Renal

A clinical review was done on 343 infants and children diagnosed and operated at the Department of Pediatric Surgery in Keimyung University, Dong San Medical Center for congenital gastrointestinal anomalies from January, 1988 to December, 1991. The results are summarized as follows; The most prevalent age group of congenital gastrointestinal anomaly was within first week after birth, and infants within 3months occupied 70% of total, and male to female ratio was 2:1. 2) The moat common lesion of congenital gastrointestinal anomalies was stomach with 87cases (25.4%), followed by anus with 80 cases (23.3%), colon with 63 cases (18.4%) and biliary tract with 38 cases(11.1%). 3) The most common congenital anomaly was congenital hypertophic pyloric stenosis with 87 cases (25.4%), followed by imperforate anus with 70 cases (20.4%), congenital megacolon with 63 cases (18.4%), and prevalent age was 2 week-3month, first week after birth, 1month-3year. 4) The incidence of common congenital gastrointestinal anomalies were mostly higher in male than in female but choledochal cyst was higher in female than in male. 5) Associated anomalies were observed in 14 cases (4%) of total cases, duodenal atresia was seen the highest rate of the associated anomalies and the most common associated anomaly was annular pancreas, followed by Down syndrome, congenital diaphragmatic hernia.
Anal Canal ; Anus, Imperforate ; Biliary Tract ; Child ; Choledochal Cyst ; Colon ; Down Syndrome ; Female ; Hernia, Diaphragmatic ; Hirschsprung Disease ; Humans ; Incidence ; Infant ; Male ; Pancreas ; Parturition ; Pyloric Stenosis ; Stomach

A case of the traumatic avulsion of the penis in a 18 year-old male, which was resulted by accident while working in a flour mill, is presented.
Adolescent ; Flour ; Humans ; Male ; Penis*