We experienced an unusual case of acute encephalopathy in a 4 month-old boy He was admitted to our hospital because of lethargy and seizures after preceding symptoms of upper respiratory tract infection a few days before admission. On admission, he was in semicomatous mental state with decorticated rigidity. Laboratory tests showed normal blood sugar, ammonia, and transaminase levels. CSF was acellular and sterile. Brain MRI in both 71 and 72 weighted-image showed high signal density in both thalami and caudate nucleus head. After recovery, neurologic sequales of developmental delay, mental retardation, right hemiplegia and seizure remained. We report a case of acute encephalopathy that have clinical course similar to Reye syndrome but have specific brain image.
Ammonia ; Blood Glucose ; Brain ; Caudate Nucleus ; Head ; Hemiplegia ; Humans ; Infant ; Intellectual Disability ; Lethargy ; Magnetic Resonance Imaging ; Male ; Respiratory Tract Infections ; Reye Syndrome ; Seizures

We report an autopsy case of secondary hemochromatosis associated with multiple frequent blood transfusion for the treatment of aplastic anemia. A 23-year-old man had been diagnosed as having aplastic anemia at the age of 13. He received a whole blood transfusion, about 1280 ml, every month during the past 10 years. Recently he developed diabetes mellitus and a congestive heart failure. The autopsy revealed that multiple organs were affected by secondary hemochromatosis, including the liver, heart, pancreas, spleen, bone marrow, stomach, thyroid gland, adrenal glands, and testes. The lungs and liver showed gross and microscopic findings consistent with a congestive heart failure in addition to hemochromatosis. The details are presented. This is a case of rare secondary hemochromatosis occurring in a young man and presenting the classic histopathologic changes indistinguishable from those of primary hemochromatosis.
Adrenal Glands ; Anemia ; Anemia, Aplastic* ; Autopsy* ; Blood Transfusion ; Bone Marrow ; Diabetes Mellitus ; Heart ; Heart Failure ; Hemochromatosis* ; Humans ; Liver ; Lung ; Pancreas ; Spleen ; Stomach ; Testis ; Thyroid Gland ; Young Adult

Infection with Helicobacter pylori (H. pylori) leads to gastritis, but the majority of infected persons are asymptomatic, and it has been recently described that the ability of H. pylori to cause more severe disease is related to the presence of the cytotoxin-associated gene A (cagA). We investigated the prevalence of cagA-bearing strains in a group of H. pylori-positive gastritis, and compared the morphologic differences between cagA-positive and cagA-negative cases on H&E stained slides. Polymerase chain reaction (PCR) assays for detection of H. pylori and cagA of 62 gastric biopsy specimens were performed. All the slides were analyzed by the updated Sydney system. Forty eight (77.4%) were PCR positive for H. pylori and thirty four (54.8%) were positive for cagA. There were no significant differences in numbers of H. pylori, degree of infiltration of mononuclear cells and degree of atrophy between cagA-positive and cagA-negative groups. The rates of neutrophilic infiltration and intestinal metaplasia were significantly higher in cagA-positive group than in cagA-negative group. In conclusion, the detection of H. pylori by PCR method is more sensitive than that of microscopic examination and H. pylori strains possessing cagA are associated with an enhanced induction of severe gastritis.
Atrophy ; Biopsy ; Gastritis* ; Helicobacter pylori ; Helicobacter* ; Humans ; Metaplasia ; Neutrophils ; Polymerase Chain Reaction ; Prevalence

PURPOSE: The present study purposed to investigate and analyze domestic websites providing information about dementia and to suggest future directions for the development of dementia-related websites. METHOD: For this purpose, the researcher selected 13 domestic websites that were available in November and December 2004, and evaluated them in terms of construction, operation, accessibility and contents on a scale 4 point (0~3). RESULT: The construction of dementia-related websites got 6~13 out of 18 points, which suggests that management policies for the operation of dementia-related websites are inadequate. The operation of dementia-related websites got 7~15 out of 24 points. In particular, all 13 sites got a low score in the aspect of continuance. With regard to accessibility, the sites were evaluated on how easily users could access the sites and they got 2~8 out of 15 points. In evaluating contents, the sites got 9~18 out of 21 points with regard to the purpose and appropriateness of the contents. CONCLUSION: This shows that most sites did not provide diverse types of dementia-related information. Because it is highly advantageous to perform primary dementia-preventing management through websites, this study proposes to develop a website evaluation system in order to provide high quality dementia-related informatio.
Korea ; *Internet ; Humans ; *Dementia

PURPOSE: To determine the prevalence and characteristics of the hypoechoic halo sign in peripheral cholangiocarcinoma. MATERIALS AND METHODS: Seventeen sonograms of 17 patients with peripheral cholangiocarcinoma histologically proven by either percutaneous needle biopsy (n=16) or surgical biopsy (n=1) were retrospectively reviewed. The size, margin, homogeneity and internal echogenicity of the masses as well as their peritumoral ductal dilatation and intratumoral calcification were ascertained, and the presence of a hypoechoic halo, and if present, its thickness and type, were also determined. We arbitrarily defined a 'thin' and 'thick' halo respectively, as one with a thickness less than of less than 3 mm, and 3 mm or more, and classified halos as 'intratumoral', 'extratumoral', or 'mixed'. RESULTS: Tumor diameter ranged from 4 to 13.5 (mean, 7.3) cm, and the margin was well-defined in 15 cases (smooth: n=2; lobulated: n=13) and irregular in two. Echogenicity was slightly heterogeneous in 11 cases, severely heterogeneous in three, and homogeneous in three, while the central portion was hyperechoic in eight cases, isoechoic in seven, and hypoechoic in only two. A hypoechoic halo was detected in 10 of 15 tumors(67%) with isoechoic centers. In evaluating the halo, two cases in which the mass was hypoechoic were excluded. All ten hypoechoic halos were at least 3 (range, 4-13; mean, 8.3) mm thick; in two cases the presence of a halo was equivocal, and in three there was no halo. Eight of ten halos were the mixed type, two were intratumoral, and none were extratumoral. Peritumoral ductal dilatation was seen in four cases (24%), but no internal calcification was observed. CONCLUSION: US showed that the margins of peripheral cholangiocarcinomas were mostly well-defined and smooth (12%) or lobulated (76%), and that masses were mainly heterogeneous (64%). A hypoechoic halo, which in all cases was thick and in 80% of cases was mixed, was noted in 67% of tumors with a hyper (47%) or isoechoic (41%) center. A halo of this kind may be useful in isoechoic mass detection and also in the differentiation of hyperechoic peripheral cholangiocarcinoma from hepatic hemangioma, the most common hyperechoic benign tumor.
Biopsy ; Biopsy, Needle ; Cholangiocarcinoma* ; Dilatation ; Hemangioma ; Humans ; Prevalence ; Retrospective Studies

Primary biliary cirrhosis (PBC) is characterized by histological findings of an immunoinflammatory destruction of small- and medium-sized bile ducts with progressive portal fibrosis, and the presence of anti-mitochondrial antibody (AMA) with a laboratory evidence of chronic cholestasis. The term "autoimmune cholangitis" (AIC) is used for a disease with the clinical and pathologic features of primary biliary cirrhosis (PBC) but with negative AMA and positive anti-nuclear antibody (ANA) tests. Eight cases of AIC and ten cases of PBC were reviewed in order to determine whether there was any difference between two diseases in clinico-pathologic aspects. All of the patients were female and the mean ages of AIC and PBC patients were 48 and 47 years, respectively. ANA test was positive in six of ten PBC paients and their mean titer was lower than that of AIC patients. IgM level was significantly higher in PBC group than in AIC group. No significant difference was found between two groups with respect to biochemical and histopathological features. Since the only consistently distinguishing features between these two conditions are the autoantibody profile (AMA vs ANA) and immunoglobulin level (IgM), these two conditions might be part of a spectrum. PBC can be considered to be the same as AMA-positive AIC or alternatively AIC to be the same as AMA-negative PBC.
Bile Ducts ; Cholangitis* ; Cholestasis ; Female ; Fibrosis ; Humans ; Immunoglobulin M ; Immunoglobulins ; Liver Cirrhosis, Biliary*

We made a mistake in our recently published article.

No abstract available.
Myxoma* ; Perineum*

No abstract available.
Female ; Lymphoma* ; Ovary*

Pigmented contact dermatitis denotes a kind of secondary hyperpigmentation resulting from recurrent contact dermatitis of low degree. Cinnamic aldehyde is a component of cinnamon,which is widely used in foods and fragrances. A 21 year-old girl presented with a well-defined dark brownish patch on right side of chest for 4 years. Histopathologic examination revealed epidermal spongiosis, hypermelanosis of basal layer, scattered melanophages and mild perivascular inflammatory cell infiltration in the upper dermis Patch test findings were positive to fragrance mix, cinnamic aldehyde and body shampoo which was used by the patient. Peroral challenge with cinnamon tea resulted in flare-up of the positive patch-test sites and the skin lesion.
Aldehydes* ; Cinnamomum zeylanicum ; Dermatitis, Contact* ; Dermis ; Female ; Humans ; Hyperpigmentation ; Patch Tests ; Skin ; Tea ; Thorax ; Young Adult