A 65-year-old female patient visited our clinic complaining of multiple skin lesions since one year ago. There were yellowish to brownish colored, bean to walnut-sized nodules on both lower extremities. Dylon stain with polarizing microscopy, immunohistochemical stain to amyloid P and immunoglobuhn-kappa chain showed positive reactivities but keratin stain was negative. According to histopathologic and immunohistochemical findings, she was diagnosed as nodular amyloidosis.
Aged ; Amyloid ; Amyloidosis* ; Female ; Humans ; Lower Extremity ; Microscopy ; Skin

Brugada syndrome can be unmasked by several conditions including a febrile state, marked leukocytosis, and electrolyte disturbances. Herein, we describe a 62-year-old man with cholangiocarcinoma in the first reported case of Brugada syndrome onset following photodynamic therapy.
Bile Duct Neoplasms/*drug therapy ; *Bile Ducts, Intrahepatic ; Brugada Syndrome/diagnosis/*etiology/therapy ; Cardiopulmonary Resuscitation ; Cholangiocarcinoma/*drug therapy ; Electrocardiography ; Fatal Outcome ; Fever/etiology ; Humans ; Klatskin's Tumor/*drug therapy ; Male ; Middle Aged ; Photochemotherapy/*adverse effects ; Predictive Value of Tests ; Treatment Outcome

The purpose of this study is to present a novel method of harvesting autogenous bone graft and to analyze the behavior of xenograft used for pelvic osteotomy in young children. Twenty hips of eighteen patients underwent pelvic osteotomies using xenograft (Lubhoc) from Sep. 1993 to Jun. 1996. In fitteen hips, we harvested autogenous bone avoiding damage to the chondroapophysis of iliac crest and t'illed the donor site with the xenograft. It supplemented the autogenous bone at the osteotomy site in eleven hips, and was used as a wedge without autogenous hone in five hips. During the followup, no growth disturbance of iliac crest was found. The xenograft incorporation was satisfactory at the graft donor sites and the osteotomy sites where it supplemented the autogenous bone, however, unsatistactory at the osteotomy sites where it was used alone. Our novel method of harvesting bone graft from young pelvis may help prevent growth disturbance of lilac crest, and Luhhoc is useful as space-filler of donor site and suppiementary to the autograft in pelvic osteotomy of young children.
Autografts ; Child* ; Follow-Up Studies ; Heterografts* ; Hip ; Humans ; Osteotomy* ; Pelvis ; Tissue Donors ; Transplants

Colorectal cancer consists of 8.2 percent of all malignancy in korea, and shows more increaing tendency. Despite the advances in the detection of calorectal cancer no single screening technique has achieved both high degree of diagnostic accuracy and minimal patient morbidity. We studied 24 patients, who underwent colonoscopy, with clinical suspicious colon cancer at Presbyterian Medical Center between Jan and Sep.1995, and evaluated the diagnostic feasibility of colon lavage cytology using oral cleansing solution.(continue...)
Colon* ; Colonic Neoplasms* ; Colonoscopy ; Colorectal Neoplasms ; Diagnosis* ; Humans ; Korea ; Mass Screening ; Protestantism ; Therapeutic Irrigation

Colorectal cancer consists of 8.2 percent of all malignancy in korea, and shows more increaing tendency. Despite the advances in the detection of calorectal cancer no single screening technique has achieved both high degree of diagnostic accuracy and minimal patient morbidity. We studied 24 patients, who underwent colonoscopy, with clinical suspicious colon cancer at Presbyterian Medical Center between Jan and Sep.1995, and evaluated the diagnostic feasibility of colon lavage cytology using oral cleansing solution.(continue...)
Colon* ; Colonic Neoplasms* ; Colonoscopy ; Colorectal Neoplasms ; Diagnosis* ; Humans ; Korea ; Mass Screening ; Protestantism ; Therapeutic Irrigation

PURPOSE: Airways eosinophilia and increased IgE, characteristic features of asthma, result from a predominant Th2 response. In this study, we investigated the effect of CpG oligodeoxynucleotides (ODNs) on the inhibition of airways eosinophilia in mice with established airway inflammation. We also investigated the immunological mechanisms involved. METHODS: Groups of BALB/c mice were sensitized intradermally with ovalbumin(OVA). At week 10, airway inflammation was induced by intranasal challenge of the mice with OVA. At week 14, the mice were challenged intranasally again with OVA in the presence and without the presence of CpG ODNs. Mice with saline administration served as negative controls. Bronchoalveolar lavage fluids(BALF) were obtained and eosinophils were counted. Th1 and Th2 cytokines in the spleen cell cultures were measured by ELISA. Serum OVA-specific IgE and IgG2a antibodies were also measured by ELISA. RESULTS: BALF eosinophils were significantly inhibited in the CpG ODNs-treated mice(P<0.01). IgE and IgG2a levels increased significantly in both CpG ODNs-treated and untreated groups as compared to the negative control group; there was, however, no significant difference between the two groups four days after intranasal administration of CpG ODNs. Cytokine analysis revealed decreased production of IL-4, IL-5, and IL-13 and increased production of IL-12 in the CpG ODNs-treated group as compared to the untreated group. Interestingly, IFN-gamma levels were not upregulated in the CpG ODNs-treated group. CONCLUSION: CpG ODNs vaccination is a potentially useful approach for reversing airways eosinophilia in mice with established airways inflammation.
Administration, Intranasal ; Animals ; Antibodies ; Asthma ; Bronchoalveolar Lavage ; Cell Culture Techniques ; Cytokines ; Enzyme-Linked Immunosorbent Assay ; Eosinophilia ; Eosinophils ; Immunoglobulin E ; Immunoglobulin G ; Inflammation* ; Interleukin-12 ; Interleukin-13 ; Interleukin-4 ; Interleukin-5 ; Mice* ; Oligodeoxyribonucleotides* ; Ovum ; Spleen ; Vaccination

BACKGROUND: There were several studies for the incidence of gastroesophageal reflux associated with the laryngeal mask airway(LMA), but the results of those studies were much different much different from one another. The aim of this study was to compare the incidence of gastroesophageal reflux and regurgitation of gastric contents between the LMA and the endotracheal tube(ETT). METHOD: Ninety patients scheduled for elective orthopedic surgery with a standardized general anesthetic technique were randomly allocated to receive either a LMA(n-49) or a ETT(n=41) for airway management. The esophageal manometry was carried out for the exclusion of esophageal motility disorders and the 24-hour ambulatory pH metry was done from one day before the operation. A methylene blue(50mg) capsule was swallowed just before the induction and the simultaneous recordings of pH were maintained during anesthesia. At the end of anesthesia, the episodes of regurgitation of gastric contents above hypopharynx were analyzed by the pharyngeal blue staining and the pH metric data were analyzed for the detection of gastroesophageal relux episodes during anesthesia. RESULTS: There was no significant difference in the incidence of gastroesophageal relux(pH< or =4) between two groups; only two patients in LMA and three patients in ETT had reflux episodes during the removal or arousal phase. There was no episode of the pharyngeal blue staining in both group. All of the gastroesophageal reflux patients in both group developed a cough or straining during those phases. There was no clinical evidence of aspiration of gastric contents in both group. CONCLUSION: In comparison with ETT, use of LMA does not appear to increase the incidence of gastroesophageal reflux and regurgitation above hypophryngeal level in positive pressure ventilating patients during long surgical procedures. Therefore, the risk of aspiration in LMA will not be much more than ETT.
Airway Management ; Anesthesia ; Arousal ; Cough ; Esophageal Motility Disorders ; Gastroesophageal Reflux ; Humans ; Hydrogen-Ion Concentration ; Hypopharynx ; Incidence ; Laryngeal Masks* ; Manometry ; Masks* ; Orthopedics

BACKGROUND: The early diagnosis of invasive candidiasis is the most important for reducing of morbidity and mortality rates in the immunocompromised patients. The study of antigen detection was performed by Cand-Tec kit, but antibody detection by Western blot, had not been reported. OBJECTIVE: We reviewed 62 cases of suspected invasive candidiasis(10), immunocompromised patients with leukemia, leukopenia, pneumonia, et al(44) and normal colonization control(8) in the urine and sputum for the immunological diagnosis of invasive candidiasis by Cand-Tec and Western blot assays. METHODS: The antigen and antibody detection were done by both Cand-Tec kit and Western blot assay, in the sera of the patients collected from several hospitals. RESULTS: The sera from 4(40%) and 8(80%) of 10 suspected invasive candidiasis had a threshold positive titers of > or = 1:4 by latex agglutination (Cand-Tec) and the results of positive antibody to the immunodominant antigen (47KDa) of Candida spp. by Western blot assay, each other. Both antigen and antibody we.e detected from 21(47%) of 44 patients in the immunocompromised group and 1(12%) of 8 cases with normal flora, separately, but the antibodies from 3(18%) of 16 healthy controls were detected by Western blot analysis, only. CONCLUSION: This study confirm that the Western blot method of detecting antibody against immunodominant antigen(47KDa) of Candida spp. was more effective than antigen detection by Cand-Tec method for immunodiagnosis of invasive candidiasis.
Agglutination ; Antibodies ; Blotting, Western ; Candida ; Candidiasis, Invasive* ; Colon ; Diagnosis* ; Early Diagnosis ; Humans ; Immunocompromised Host ; Immunologic Tests ; Latex ; Leukemia ; Leukopenia ; Mortality ; Pneumonia ; Sputum

PURPOSE: A partial bladder outlet obstruction(PBOO) related detrusor hypertrophy is associated with up-regulation of the Rho kinase activity in an experimental animal model, and has been implicated in PBOO induced bladder dysfunction. The effect of a Rho kinase inhibitor on the voiding function in anesthetized rats with PBOO was investigated. MATERIALS AND METHODS: Eighteen Sprague-Dawley rats were divided into control(9 rats) and experimental(9 rats) groups. The experimental group was partially obstructed for 6 weeks, with cystometrograms(CMG) then were performed. The number of voids, and the intercontraction interval (ICI) and peak pressure(PP) were recorded. Rho kinase inhibitors were administered to the experimental group. An additional CMG was performed to observe the effects of Rho kinase inhibition. Bladder tissues were immunohistochemically(IHC) evaluated for the expression of RhoA protein. RESULTS: The bladder weights of the PBOO group were significantly increased compared with the control group(p<0.05). Significant increases in the voiding frequency and PP, but a significant decrease in the ICI was observed in the PBOO group compared to the control group on the CMG (p<0.05). The voiding frequency of the PBOO group was significantly decreased after Rho kinase inhibitor treatment(p<0.05). The Rho kinase inhibitor treated group showed a decrease in the PP and an increase in the ICI compared to the PBOO group. The IHC showed a higher RhoA protein expression in the bladder tissues of the PBOO group. CONCLUSIONS: H-1152, a specific inhibitor of Rho kinase, attenuates the PBOO-related detrusor overactivity in a rat model. The Rho kinase inhibitor appears to be a novel strategy for the management of bladder overactivity.
Animals ; Hypertrophy ; Models, Animal ; Rats* ; Rats, Sprague-Dawley ; rho-Associated Kinases* ; rhoA GTP-Binding Protein ; Up-Regulation ; Urinary Bladder Neck Obstruction* ; Urinary Bladder* ; Weights and Measures

PURPOSE: We investigated the occurrence rate of recurrent abdominal pain (RAP) in general population of elementary school children, accompanied symptoms, symptom-aggravating factors such as emotional stresses, food and personality characters, which time of day the pain develops and whether they visited hospital for RAP. METHODS: From 1995. 4.27. to 1995. 5. 12. questionnaires were given to the parents of 1,783 elementary school children in Seoul. The qestions were as follow; 1) Have your child ever experienced abdominal pain more than 3 months and more than 3 times? 2) Were there any accompanied symptoms? 3) Does emotional stress encrease or induce the abdominal pain of your child? 4) Which time of day does the abdominal pain occur? 5) Have your child visited hospital for the RAP? 6)How is your child's personality and emotional characters? 7) Which foods induce or aggravate the abdominal pain? 8) Does your child with RAP like meat foods or vegetable foods? 9) If you think an emotional stressful factor for RAP, do you have such factors in the environment of your child? RESULTS: 1) Among the 1,783 children, 296 children had RAP (16.6%), boys 143 (15.4%), girl 153 (7.9%). The distribution of school grade of the children with RAP were in the order of the 2nd. grade (23.5%), 5th. grade (19.6%), 4th grade (15.8%), 6th. grade (15.0%), 1st. grade (14.3%), and 3rd.grade (11.9). 2) Symptoms which were accompained with abdominal pain was poor appetite (35.1%), diarrhea (31.8%), headache (27.1%), constipation (21.7%) vomiting (18.4%), urinary symptoms (11.1%) and 73 children (24.4%) had no accompanied symptom. 3) In 181 children (60.5% of RAP children), abdominal pain was induced or aggravated by emotional or psychologic stress. 4) In 130 children (43.5% of RAP children) abdominal pain occurred at postprandial time, in 80 children (28.6%) before meal, and in 70 children (23.4) early morning or night time. 5) Main personality characteristics of children with RAP were poor self confidences (111, 37.1%), strong desires for sucess (104,34.8%), and compulsivenesses (55,18.4%). 6) 135 children with RAP (45.2%) visited doctor due to RAP 7) Foods which induced or aggravated the abdominal symptoms were dairy food (56 children,19.4% of RAP children), greasy food (50,17.3%), wheat (29,10%), pork (21,7.3%) and in 165 children with RAP (57.1) foods had no relation with the abdominal pain. 8) 218 children with RAP (75.4%) liked meat foods (75.4%), and 73 children (25.3%) vegetable foods. 9) Specific emotional stresses of children with RAP which were described by the parents were school problems in 41 children (14.2%), divorces of parents in 3 children (1.4%). CONCLUSIONS: RAP in school children were more frequent than previously reported. We suspected organic causes for the RAP in many children who developed abdominal pain at night time, who had some accompanied symptoms, whose symptoms had no relation with emotional stresses or foods. Further active investigations in children with RAP are needed to elucidate the role of associated disorders.
Abdominal Pain* ; Appetite ; Child* ; Constipation ; Diarrhea ; Divorce ; Female ; Headache ; Humans ; Meals ; Meat ; Parents ; Surveys and Questionnaires ; Seoul* ; Stress, Psychological ; Triticum ; Vegetables ; Vomiting