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

The acardiac twin, or twin reversal of arterial perfusion (TRAP) sequence is encountered in approximately 1% of monozygotic twins with an incidence of one in 35,000 births. The problem results from vascular anastomoses between the arterial and venous circulation of normal "pump" twin and that of recipient "perfused" acardiac twin. The recipient twin may display severe and lethal anomalies, including acardia and acephalus. The pump twin is structurally normal. Mortality of about 50-75% in cases without treatment is due to heart failure, prematurity or cord entanglement. We report a case of acardiac twin diagnosed by ultrasound prenatally.
Heart Failure ; Humans ; Incidence ; Mortality ; Parturition ; Perfusion ; Twins, Monozygotic ; Ultrasonography*

BACKGROUND: The purpose of this study was to identify health practices that would be helpful in order to reduce the prevalence of correctable cardiovascular risk factors (CVR), i.e. hypertension, hypercholesterolemia, and hyperglycemia in male workers by examining the association between health practices and the prevalence of the three risk factors. METHODS: For 1,815 male workers at a car manufacturer who participated in the basic health examination, survey on socioeconomic status and seven healthy practices suchas not currenly smoking, moderate alcohol drinking, proper weight control, regular exercise, 7-8 hour sleep, eating breakfast regularly, and not eating between meals was done and the prevalence of hypertension, hypercholesterolemia, and hyperglycemia as obtained. x2 test, Fisher's exact test, and multiple logistic regression analyses were done for workers under 40 years old and workers 40 and over in two, separate groups by adjusting socioeconomic variables. RESULTS: The prevalence of hypertension and hypercholesterolemia was 1.84 times and 5.22 times, respectively, showing, higher in overweight younger workers than in those of normal weight. The prevalence of hypercholesterolemia was 2.02 times higher in younger smokers than in younger non-smokers. In contrast, the prevalence of hyperglycemia was 4.99 times higher in older smokers than in older non-smokers. The prevalence of hyperglycemia was 16.5 times higher in older workers with regular snacking habit than in those without such a habit. The prevalence of hypercholesterolemia was 7.47 times higher only in younger workers practicing healthy behaviors below 3 than in those practicing at least 6 healthy behaviors. CONCLUSION: Our study suggests that overweight and smoking habit among younger workers, and smoking habit among older workers sould be controlled in order to decrease the prevalence of hypertension, hypercholesterolemia, and hyperglycemia.
Adult ; Alcohol Drinking ; Breakfast ; Eating ; Humans ; Hypercholesterolemia* ; Hyperglycemia* ; Hypertension* ; Logistic Models ; Male* ; Meals ; Overweight ; Prevalence ; Risk Factors ; Smoke ; Smoking ; Snacks ; Social Class

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