Syphilitic granulomatous pancreatitis is an extremely rare condition,and can occur in the generalized acquired syphilitic patient in tertiary or secondary phase. The most serious problem with granulomatous pancreatic lesion is clinical or radiological misdiagnosis as cancer. We experienced a case of syphilitic granulomatous pancreatitis arising in 54 year old female patient. She was treated for syphilis 20years ago. But she and her husband are still strong positive to VDRL and TPHA. On abdominal computed tomography and endoscopic pancreatico- duodenography, there was an obstructive mass of low density in the distal common bile duct or pancreatic head. Under the preoperative diagnosis of pancreatic head carcinoma, Whipple's operation was done. On gross examination, the pancreas was fibrotic, and the common bile duct was well preserved without tumor mass. Microscopically, numerous intralobular noncaseating epithelioid cell granulomas with multinucleated giant cells are identified. They surround thick-walled, small to medium sized arteries and involve vascular wall with luminal narrowing or obliteration, which are characteristic findings of the syphilitic granuloma. The remaining parenchyme shows fibrosis, acinar atrophy or destruction with dense infiltration of lymphohistiocytes, plasma cells with granuloma formation. Although the Warthin-Starry stain reveals no spirochetes, the serologic result and pathologic findings are compatible with syphilitic granulomatous pancreatitis.
Female ; Humans

Papillary and solid epithelial neoplasm is a rare pancreatic tumor of low-grade malignancy. We report a case of a 23 year old female having solid and papillary neoplasm of the pancreatic tail with mutiple omental and peritoneal metastases. Microscopically, the main tumor showed typical histologic findings including solid and papillary areas with cystic change. But the metastasizing nodules were largely solid and the tumor cells demonstrated increased nuclear pleomorphism, hyperchromasia and an increased mitotic rate. The tumor cells contained considerable amount of intracellular and extracellular eosinophilic inclusions which were ultrastructually zymogen-like granules. These inclusions were more frequently found in the metastatic nodules. By flow cytometric study, the tumor was hyperdiploid. The DNA index was not significant.
Female ; Humans ; Neoplasm Metastasis

This study was conducted to examine the species differences in the urinary excretion of trichloroethanol(TCE-OH) and trichloroacetic acid(TCA) of trichloroethylene(TCE) metabolites and the effect of ethanol on these metabolites in mice and rats. TCE administered to Male Sprague Dawley rats and ICR mice as a single oral dose(100, 200, 500, 1,000 or 2,000 mg/kg body weight) and ethanol(3.0 g/kg body weight) was taken orally 12 hours before TCE administration. The metabolites in urine were measured 0, 12, 24, 36 and 48 hours after TCE administration. The results of metabolite excretion were as follows; Total trichlorocompounds(TTC) in urine increased with TCE dose in mice while increased only below dose of 1,000 mg/kg TCE in rats. The net excretion of TCE metabolites was significantly greater in mice than rats, although the proportion of TCE-OH to TCA was not different between mice and rats. These findings indicate that mice were internally exposed to significantly higher concentration of TCE metabolites than rats and this trend appeared to be more prominent with the increase of TCE dose. Ethanol increased significantly TCE-OH in urine of rats while the increase of TCE-OH induced by ethanol was not significant in mice, and didn't increase TCA of urine in both of rats and mice. This result suggests that the effect of ethanol on TCE metabolism may be due to the increase of TCE-OH.
Animals ; Ethanol* ; Humans ; Male ; Metabolism ; Mice* ; Mice, Inbred ICR ; Rats* ; Rats, Sprague-Dawley ; Trichloroethylene*

Acetabular fracture can result in severe limitation of the motion of the hip joint, which supports totalweight of human body. Beause of different methods of surgical approach a ccording to fracture type, preciseinterpretation of X-ray films of acetabular fracture is required. We reviewed 38 cases of simple X-ray filmsshowing acetabular fracture. The results were as follows: 1. Almomst 60% of the cases-were in their 2nd and 3rddecades. 2. Twenty cases were male, and 18 cases were female. 3. The most common cause of the injury was trafficaccident(33 cases, 86.8%), followed by fall down (4 ases, 10.5%) and slip down(1 case, 2.7%). 4. Elementaryfractures were 21 cases(55.3%) and associated fractures were 17 cases(44.7%). 5. Among elementary fractures,posterior wall fractures were 9 cases(23.7%), followed by anterior column fractures(8 ases, 21.1%), anterior wallfractures(4 cases, 10.5%). 6. Among associated fractures, T-shaped fractures were 8 cases(21.1%), followed by bothcolumn fractures(6 cases, 15.8%), anterior and hemitransverse fractures(3 cases, 7.8%). 7. Other pelvic bonefractures associated with the acetabular fracture were as follows: farcture of contralateral pubic rami(6 ases,15.8%) contralateral iliac bone (1 case, 2.6%) and ipsilateral iliac bone (1 case, 2.6%). 8. Injuries of otherorgans adjacent to the acetabulum were as follows: rupture of the bladder (3 cases, 7.9%), urethra(2 cases, 5.3%)and uterus (1 cases, 2.6%).
Acetabulum ; Female ; Hip Joint ; Human Body ; Humans ; Male ; Rupture ; Urinary Bladder ; Uterus ; X-Ray Film

This experimental studies was to investigate the location of CNS labeled neurons following injection of pseudorabies virus (PRV), Bartha strain, into the rat thymus. After survival times of 96~120 hours following injection of PRV, the rats were perfused, and their spinal cord and brain were frozen sectioned(30micrometer). These sections were stained by PRV immunohistochemical staining method, and observed with light microscope The results were as follows: 1. The PRV labeled spinal cord segments projecting to the rat thymus were founded in cervical and thoracic segments. Densely labeled areas of each spinal cord segment were founded in lamina V, VII, X, intermediolateral nucleus and dorsal nucleus. 2. In the rhombencephalon, PRV labeled neurons projecting to the thymus were founded in the A1 noradrenalin cells/C1 adrenalin cells/caudoventrolateral reticular nucleus, rostroventro-lateral reticular nucleus, medullary reticular nucleus, area postrema, nucleus solitary tract, nucleus raphe obscurus, nucleus raphe pallidus, nucleus raphe magnus, gigantocellular reticular nucleus, lateral paragigantocellular nucleus and spinal trigeminal nucleus. 3. In the mesencephalon, PRV labeled neurons were founded in parabrachial nucleus, Kolliker-Fuse nucleus, central gray matter, substantia nigra, nucleus dorsal raphe, A8 dopamin cells of retrorubral field, Edinger-Westphal nucleus, locus coeruleus, subcoeruleus nucleus and A5 noradrenalin cells. 4. In the prosencephalon, PRV labeled neurons were founded in reuniens thalamic nucleus, paraventricular thalamic nucleus, precommissural nucleus, paraventricular hypothalamic nucleus, anterior hypothalamic nucleus, lateral hypothalamic nucleus, preoptic hypothalamic nucleus, retrochiasmatic area, arcuate nucleus, dorsomedial hypothalamic nucleus and ventromedial hypothalamic nucleus. These results suggest that PRV labeled neurons of the spinal cord projecting to the rat thymus might be the neurons related to the viscero-somatic sensory and sympathetic preganglionic neurons, and PRV labeled neurons of the brain may be the neurons response to the movement of smooth muscle in blood vessels. These PRV labeled neurons may be central autonomic center related to the integration and modulation of reflex control linked to the sensory system monitoring the internal environment. These observations provide evidence for previously unknown projections from spinal cord and brain to the thymus which may be play an important role in the regulation of thymic function.
Animals ; Anterior Hypothalamic Nucleus ; Arcuate Nucleus ; Area Postrema ; Blood Vessels ; Brain ; Dorsomedial Hypothalamic Nucleus ; Herpesvirus 1, Suid* ; Hypothalamic Area, Lateral ; Immunohistochemistry ; Locus Coeruleus ; Mesencephalon ; Midline Thalamic Nuclei ; Muscle, Smooth ; Neurons* ; Paraventricular Hypothalamic Nucleus ; Prosencephalon ; Pseudorabies* ; Rats* ; Reflex ; Rhombencephalon ; Spinal Cord ; Substantia Nigra ; Thymus Gland* ; Trigeminal Nucleus, Spinal ; Ventromedial Hypothalamic Nucleus

BACKGROUND: In the presence of anticipated or established acute tubular necrosis (ATN) immediately after cadaveric kidney transplantation, induction with monoclonal or polyclonal antibody is recommended in preparation of increased risk of acute rejection caused by ATN. Tacrolimus is a potent immunosuppressive agent than cyclosporine. In this study, we analyzed retrospectively the clinical outcome of patients who had taken tacrolimus as a replacement of cyclosporine in the period of delayed graft function(DGF) to determine the eligibility of tacrolimus instead of antilymphocyte antibody in this situation. METHODS: Between March 1, 1991 and August 31, 2000, DGF developed in eighteen first cadaveric renal transplant recipients in our center. During DGF period, twelve patients received tacrolimus based immunosuppression without OKT3. We reviewed the complete clinical course of the 12 patients. RESULTS: Among the 12 patients, 1 patient underwent graft nephrectomy at postoperative 27 days, because of poor renal function and concomitant aspergillosis infection. In the remaining 11 patients, however, for whom tacrolimus was maintained continuously without OKT3 therapy, renal function was recovered successfully. One acute rejection developed at postoperative 15 months. One patient died at postoperative 5 months with functioning graft. One-year graft survival rate was 83%. CONCLUSION: Tacrolimus could be used in replacement of cyclosporine for the prevention of acute rejection in DGF. This could provide a graft survival comparable to that by the monoclonal or polyclonal antibodies without the potential risk of life- threatening side effects in this situation.
Antibodies ; Antilymphocyte Serum ; Aspergillosis ; Cadaver* ; Cyclosporine ; Delayed Graft Function* ; Graft Survival ; Humans ; Immunosuppression ; Kidney Transplantation* ; Muromonab-CD3 ; Necrosis ; Nephrectomy ; Retrospective Studies ; Tacrolimus* ; Transplantation ; Transplants

The main cause of failure in glaucoma filtering surgery is obstruction of aqueous outflow due to subconjunctival fibrosis. Transforming growth factor-beta(TGF-beta) is known to be a growth factor for subconjunctival fibroblast. Recently, mannose-6-phosphate(M-6-P) is reported to be an inhibitor of TGF-beta activity. In this study, we evaluated the effects of TGF-betas and M-6-P on the proliferation of cultured subconjunctival fibroblast of white rabbit in vitro. Cell proliferation was determined by 3H-thymidine DNA incorporation method. TGF-beta1, 2, 3 all promoted proliferation of subconjunctival fibroblast in a concentration dependent fashion and the effect of TGF-beta1 was most prominent among 3 types. Low concentration (0.01mM) of M-6-P paradoxically increased cell proliferation, but with the concentration of 1.0mM, the inhibitory effects were varied in the range of 45% to 7%.
Cell Proliferation ; DNA ; Fibroblasts* ; Fibrosis ; Filtering Surgery ; Glaucoma ; Transforming Growth Factor beta ; Transforming Growth Factor beta1

Dental caries is a chronic disease that causes the destruction of tooth structure by the interaction of plaque bacteria, food debris, and saliva. There has been attempts to induce remineralization by supersaturating the intra-oral environment around the surface enamel, where there is incipient caries. In this study, supersaturated remineralized solution "R" was applied to specimens with incipient enamel caries, and the quantitative ananlysis of remineralization was evaluated using microradiography. Thirty subjects volunteered to participate in this study. Removable appliances were constructed for the subjects, and the enamel specimen with incipient caries were embedded in the appliances. The subjects wore the intra-oral appliance for 15 days except while eating and sleeping. The removable appliance were soaked in supersaturated solution "R", saline, or Senstime(R) to expose the specimen to those solutions three times a day, 5 minutes each time. After 15 days, microradiography was retaken to compare and evaluate remineralization. The results were as the following: 1. The ratio of remineralized area to demineralized area was significantly higher in the supersaturated solution "R" and Senstime(R) than in the saline. (p<0.05) 2. Remineralization in the supersaturated buffer solution "R" occurred in the significantly deeper parts of the tooth, compared to the Senstime(R) group containing high concentration of fluoride.(p<0.05) As in the above results, the remineralization effect of remineralized buffer solution "R" on incipient enamel caries has been proven. For clinical utilization, further studies on soft tissue reaction and the effect on dentin and cementum are necessary. In conclusion compared to commercially available fluoride solution, remineralization solution "R" showed better remineralization effect on early enamel caries lesion, so it is considered as effecient solution for clinical application.
Bacteria ; Chronic Disease ; Dental Caries ; Dental Cementum ; Dental Enamel ; Dentin ; Eating ; Fluorides ; Microradiography ; Tooth

We report a case of reticulum cell sarcoma in the right cervical lymph node of a 42-year-old male. It was a slowly growing, non-tender movable mass of 8 months duration. Microscopically, the lymph node was effaced by proliferating spindle cells arranged in broad sheets, bands, or fascicular patterns in paracortical area sparing of B-cell region. The tumor component was divided by fibrous band. The individual cells had oval to round or elongated nuclei, with inconspicuous nucleoli and moderate amounts of cytoplasms with indistinct cell borders. Pleomorphic large cells with binucleated, or multinucleated bizarre nuclei with prominent nucleoli, were partly admixed. In immunohistochemical stain, the tumor cell was strong positive for S-100 protein, HLA-DR, Mac387 and weakly positive for Leukocyte common antigen and equivocal for Vimentin. But it was negative for CD21, Ki-1, Desmin, Epithelial membrane antigen and Cytokeratin. These immunohistochemical findings suggested that the neoplastic cell was originated from the interdigitating reticulum cell of lymph node. The patient was treated by radiation therapy, and alive well at 37 months of follow-up.

Tsutsugamushi fever is a serious febrile disease outwardly similar to malaria and various arboviral infections. The endemic area is Asia-Pacific. This disease are generally associated with disturbed habitats favoring large populations of vector larval trombiculid mites. Therapy with tetracycline, chloramphenicol or ciprofloxacin is currently recommanded. Unfortunately these drugs is suboptimal for children and pregnant women. Recently, azithromycin has been proven to be effective in therapy of scrub typhus. There is no evidence that azithromycin causes adverse reaction to developing fetus or children. We report four cases of tsutsugamushi fever in children successfully treated with azithromycin. This is the first report describing clinical application of azithromycin to tsutsugamushi fever in Korean children.
Azithromycin* ; Child* ; Chloramphenicol ; Ciprofloxacin ; Ecosystem ; Female ; Fetus ; Humans ; Malaria ; Pregnant Women ; Scrub Typhus* ; Tetracycline ; Trombiculidae