No abstract available.
Ascites* ; Pancreatitis, Chronic* ; Pleural Effusion*

A 69-year-old man presented with annular lichen planus involving both forearms, hand dorsa, wrists, inner sides of the thighs, knees and ankles. He was treated initially with systemic corticosteroids and etretinate, but rernission and recurr ence of the skin lesions were observed. During the follow-up, we found erythrasma on all his toewebs and both soles. After administration of erythromycin for the treatment of erythrasma, lesions of the lichen planus rapidly improved. Five months later, some lesions of lihen planus and erythrasma had recurred. After administration of erythromycin, the lesions of lichen planus improved again. No recurrence was observed for the following 8 months. We suspect that eradication of the chronic focus of infection and the anti-inflammatory effect, of erythromycin may lead to supression of abnormal immunological reactions and resolution of lichen planus.
Acitretin ; Adrenal Cortex Hormones ; Aged ; Ankle ; Erythrasma ; Erythromycin* ; Etretinate ; Follow-Up Studies ; Forearm ; Hand ; Humans ; Knee ; Lichen Planus* ; Lichens* ; Recurrence ; Skin ; Thigh ; Wrist

PURPOSE: The purpose of this study was to evaluate the accuracy of Tc-99m DTPA diuretic renal scans in children upper urinary tract. MATERIALS AND METHODS: We reviewed diuretic renal scans of 14 pediatric patients (age range: 3 days to 4 years) with unilateral hydronephrosis diagnosed by ultrasonography. Diuretic renal scan was done using Tc-99m DTPA and standardized protocol. In 3 neonates, diuretic renal scans were performed within 1 week and 3-7 months after birth. RESULTS: Six patients required pyeloplasty and eight were managed conservatively. All 6 patients requiring pyeloplasty were diagnosed as having ureteropelvic junction obstruction in the diuretic renal scan. In these 6 patients, post-operative renal scans at 3-12 months after surgery were converted to nonobstructive pattern in 5 and a nonobstructive patterns in 1. In 3 patients who underwent diuretic renal scan within 1 week after birth., nonobstructive patterns of initial scan were coverted to obstructive patterns in the follow-up scan. However, all patients with nonobstructive diuretic renal scans performed after the neonatal period did well on serial ultrasonography and showed favorable clinical outcome without progression to obstruction. CONCLUSION: Tc-99m DTPA diuretic renal scan with standarized protocol is useful in assessing suspected ureteropelvic junction obstruction in children as an initial diagnostic or post-operative follow-up modality. Nonobstructive or indeterminate scan RESULTS in the neonatal period requires follow-up scan to monitor development of the obstructive pattern.
Child* ; Follow-Up Studies ; Humans ; Hydronephrosis ; Infant, Newborn ; Kidney Pelvis ; Parturition ; Pentetic Acid* ; Radioisotope Renography* ; Ultrasonography ; Urinary Tract*

A granular cell tumor (GCT) is a relatively rare benign tumor that has been seldom reported since Abrikossoff first described it as a granular cell myoblastoma in 1926. While GCTs can occur anywhere in the human body, they are very rarely observed in the gastrointestinal tract and are especially rare in the large intestine. Most GCTs are small and asymptomatic and are often found by endoscopy, upper gastrointestinal series, and autopsy. We report two cases in which a submucosal tumor in the cecum was accidentally discovered by colonoscopy and was subsequently removed by colon polypectomy and endoscopic mucosal resection. Immunohistochemical analysis of the samples confirmed both cases as GCT. The literature review and reports of other growths in the gastrointestinal tracts support the necessity for proper identification of GCTs within the body to differentiate them from more malignant tumors.

A granular cell tumor (GCT) is a relatively rare benign tumor that has been seldom reported since Abrikossoff first described it as a granular cell myoblastoma in 1926. While GCTs can occur anywhere in the human body, they are very rarely observed in the gastrointestinal tract and are especially rare in the large intestine. Most GCTs are small and asymptomatic and are often found by endoscopy, upper gastrointestinal series, and autopsy. We report two cases in which a submucosal tumor in the cecum was accidentally discovered by colonoscopy and was subsequently removed by colon polypectomy and endoscopic mucosal resection. Immunohistochemical analysis of the samples confirmed both cases as GCT. The literature review and reports of other growths in the gastrointestinal tracts support the necessity for proper identification of GCTs within the body to differentiate them from more malignant tumors.

Angiodysplasia has been recognized as an important cause of lower gastrointestinal bleeding, but it is difficult to confirm the lesions. Angiodysplasia in the small bowel could be the most probable cause of bleeding particularly in the elderly patients when usual methods fail to document the focus. Small bowel angiodysplasias have been diagnosed by angiography and/or surgery at the sites where usual endoscope could not reach, and treated by medical therapy, angiographic embolization or surgery. We experienced a case of a bleeding angiodysplasia in the terminal ileum in a 51-year-old man who was taking anti-platelet agents. The lesion was diagnosed by colonoscopy, and bleeding was easily controlled with hemoclipping.
Aged ; Angiodysplasia* ; Angiography ; Colonoscopy ; Endoscopes ; Hemorrhage* ; Humans ; Ileum* ; Middle Aged

PURPOSE: To determine (1) the relationship between the cortical defects seen on 99 mTc-DMSA renal scans and age, and (2) the presence and degree of vesicoureteral reflux, and then to depict the risk factors for cortical defects in children with acute urinary tract infection (UTI). Furthermore, to assess the diagnostic value of VCUG in predicting a defect on 99 mTc-DMSA renal scans. MATERIALS AND METHODS: We studied 134 kidneys in 67 children aged 15 days-10 years (M:F=39:28) in whom symptomatic UTI was present. In all these children, both DMSA renal scans and voiding cystourethrography (VCUG) were performed. Scanning took place within 7 days of diagnosis and VCUG was performed after one month of diagnosis. Scintigraphic findings were graded according to the extent and number of cortical defects. We evaluated the relationships between the cortical defects seen on DMSA scans and age, and the grade of vesicoureteral reflux. The diagnostic value of VCUG in predicting cortical defects was analysed. Results: The prevalence of cortical defects was greater in patients older than two years (38/54, 70%) than in those aged less than two (38/80, 48%). The frequency of cortical defects was related to vesicoureteral reflux (p<0.05) and grade of reflux (p<0.05). As this latter increased, the extent of cortical defects also increased (p<0.05), and DMSA scans revealed the presence of these in 76 of the 134 kidneys (57%) with acute UTI. In 30 of these 76 (39.5%), VCUG demonstrated the presence of vesicoureteral reflex. On the other hand, vesi-coureteral reflex was found in 36 of the 134 kidneys (27%), and in 30 of these 36 (83%), cortical defects were noted. The sensitivity of VCUG in predicting cortical defect was 39.5%, while specificity was 89.7%. The positive predictive value for defects was 83.3%, and the negative predictive value was 53.1%. The relative risk of cortical defect in the presence of vesicoureteral reflux was 1.78. CONCLUSION: Renal cortical defects are significantly related to age and grade of vesicoureteral reflux. Risk factors for developing cortical defects were older age (> or =2yrs) at the time of acute UTI, and high grade of vesicoureteral reflux. The specificity of VCUG in predicting cortical defects is relatively high but the sensitivitiy is low, and a significant proportion of cortical defects therefore occurred in the absence of vesicoureteral reflux.
Child* ; Diagnosis ; Hand ; Humans ; Kidney ; Prevalence ; Radionuclide Imaging* ; Reflex ; Risk Factors* ; Sensitivity and Specificity ; Succimer* ; Urinary Tract Infections* ; Urinary Tract* ; Vesico-Ureteral Reflux

Fractures, Comminuted ; Humans ; Immobilization ; Incidence ; Mandibular Fractures ; Wounds and Injuries

BACKGROUND AND OBJECTIVE: Murine system for studying allergic diseases has been popular in the fields of food allergy and development of their therapeutic strategies. However, there has been no information about the age-dependent changes of natural immune responses of naive C3H/HeJ mice. The purpose of this study was to evaluate the age-dependent changes of B and T-cell mediated immunologic parameters in naive C3H/HeJ mice, which can provide information for experimental planning and analysis of research results. SUBJECTS AND METHODS: Eight naive, female, 5-week-old C3H/HeJ mice were grown under the regular mouse chow feeding conditions for 6 weeks. Sera were obtained at week (w) 5, w6, w8 and w10 for measuring total and chow-specific IgE, IgG1 and IgG2a antibodies. Splenocyte proliferation (at w8 and w10) and cytokine production (at w6, w8 and w10) were evaluated with or without Con A stimulation with pooled splenocytes from two mice of each age group. Serum antibodies and cytokines (IL-4, IL-5, IL-12, INF-gamma, TGF-beta1) were measured by ELISA. Using RT-PCR, IL-4 and INF-gamma mRNA expressions were measured in Peyer's patch and spleen tissue at w10. RESULTS: The levels of total IgE and IgG1 were increased by age while the level of IgG2a was decreased. Chow-specific IgE and IgG2a responses were neglectable through out the whole experimental period (20-30 ng/ml or less). Chow-specific IgG1 levels were measured in the significant concentrations (200-300 ng/ml) but there was no age-dependent change through out the experiment. Con A stimulated-splenocyte proliferation indexes were variable according to the culture-durations and ages of mice. The higher proliferation indexes were observed in the wells receiving thymidine pulse at 48-hour culture, especially in the mice at w10. Con A stimulated IL-4 production in the 72-hour splenocyte culture supernatant was significantly increased at w8, and w10 while INF-gamma production increased only at w10. The changes in the production of IL-5, IL-12 and TGF-beta did not provide significant information in the present study. The ratio of IL-4/IFN-gamma mRNA expression was higher in Peyer's patch than in the spleen. CONCLUSION: The changes of B-cell and T-cell mediated immunologic parameters were complex and variable according to the age in naive C3H/HeJ mice under regular chow feeding conditions. For that reason, the information from the present study needs to be considered in the course of planning or analysing research/data using murine systems.
Animals ; Antibodies ; B-Lymphocytes ; Cytokines ; Enzyme-Linked Immunosorbent Assay ; Female ; Food Hypersensitivity ; Humans ; Immunoglobulin E ; Immunoglobulin G ; Interleukin-12 ; Interleukin-4 ; Interleukin-5 ; Mice* ; RNA, Messenger ; Spleen ; T-Lymphocytes ; Thymidine ; Transforming Growth Factor beta

The bullectomy through the limited transaxillary thoracotomy and video-assisted thoracic surgery (VATS) had been used in operative management of spontaneous pneumothorax from Jan. 1994 to July 1997. The study comprised a retrospective review of 42 cases which were treated by limited thoracotomy, and 61 cases treated by video-assisted thoracoscopic sugery. We retrospectively reviewed annual incidnce of bullectomy. Analysis of video-assised thoracoscopic surgery and open bullectomy including age, sex, operative sites, surgical indications, associated diseases, operative time, posoperatve complications and hospital courses. There was no significant difference for operation time in two groups, 98.3+/-38.4 minutes in thoracotomy and 95.7+/-31.5 minutes in VATS. Prolonged air leakage over 7 days was observed in 8 cases from thoracotomy group, 4 cases from VATS group. 3 cases of recurrent pneumothorax were found from VATS group, but no recurrence was occurred from open bullectomy group. There were significant differences in postoperative hospital stay (8.0+/-3.9 day in thoracotomy vs 5.9+/-2.4day in VATS (P=0.001)), and indwelling period of chest tube after operation ( 5.8+/-3.0day in thoracotomy vs 4.0+/-2.0day in VATS (P=0.0006)).
Chest Tubes ; Length of Stay ; Operative Time ; Pneumothorax* ; Recurrence ; Retrospective Studies ; Thoracic Surgery, Video-Assisted* ; Thoracoscopy ; Thoracotomy*