In Korean, there has been an increasing concern on rickettsiosis as a possile common cause of unknown febrile illness since Tsutsugamushi fever among koreans was reported first in 1986. We experienced 10 cases of Tsutsugamushi fever ocurring in the Mokpo area during the period of 3 months (Oct, to Dcc.) in 1990, which were diagnosed clinically and serologically by indirect immunofluorescent antibody test. The following results were obtained. The most frequent symptoms were fever (100%), headache (90%), chill (60%), conjunctival injection, and lymphadenopathy. Common laboratory findings were leukopenia (WBC<5000/mm3 30%), elevated ESR (>20mm/hr, 30%), positive CRP (60%), and elevated Alt/AST. Antibody titers against R. tsutsugamushi ranged from 1:80 to 1:1,280, but they showed no antibody reaction to Hantaan virus and leptospira. All patients showed good response to antibiotic therapy with chloramphenicol.
Chloramphenicol ; Fever ; Hantaan virus ; Headache ; Humans ; Jeollanam-do ; Leptospira ; Leukopenia ; Lymphatic Diseases ; Scrub Typhus*

PURPOSE: The expression of c-Fos protein has been shown to be a useful marker for elevated levels of neuronal activity generated in the brain following different stimuli, including seizures. This study was conducted to investigate distribution and numbers of neurons where dentate and cingulate gyrus become activated following pentylenetetrazol-induced seizures by means of expression patterns of c-Fos protein. METHODS: Rats were sacrificed at increasing times(1 hour, 2 hours, 8 hours, 1 day, 4 days and 7 days) after pentylenetetrazol-induced seizure. Rat brains were removed and sliced in rat brain matrix. Brain slices were coronal sectioned at interaural 5.70-6.70mm. Serial sections were immunohistochemically reacted with polyclonal c-Fos antibody. The distribution and numbers of c-Fos protein immunoreactive neurons in dentate gyrus and cingulate gyrus were examined and analyzed statistically with Mann-Whitney U test. RESULTS: The numbers of c-Fos protein immunoreactive neurons in dentate gyrus peaked at 1 hours and reached almost normal conditions at 7 days after seizure. Also, same patterns were occurred in cingulate gyrus. Concentration value that pentylenetetrazol can induce was different from each animals and c-Fos immunoreactive cells were various kinds of neurons. CONCLUSION: Higher numbers of c-Fos protein immunoreactive neurons were found in dentate and cingulate gyrus at the same times after seizure. These findings suggest that neurons of dentate and cingulate gyrus play a crucial role in seizure onset following pentylenetetrazol-induced seizure.
Animals ; Brain* ; Dentate Gyrus ; Gyrus Cinguli ; Neurons ; Pentylenetetrazole ; Rats* ; Seizures*

Takayasu's arteritis is generally recognized as a chronic, idiopathic, inflammatory disease, which affects the aorta and the proximal portions of its major branches. We experienced a patient with Takayasu's arteritis who was presented with main pulmonary artery stenosis and right coronary ostial occlusion without involvement of aorta nor its major branches. She was managed with pulmonary arterioplasty and coronary artery bypass graft. This case emphasize that the disease cannot affect the aorta.
Aorta ; Constriction, Pathologic* ; Coronary Artery Bypass ; Coronary Vessels* ; Humans ; Pulmonary Artery* ; Takayasu Arteritis* ; Transplants

Fifteen cases of the primary duodenal malignancies were radically resected from July 1989 to September 1996. These cases were analysed retrospectively with the literature review. The male to female ratio was 8:7. The mean age was 49 years. Histopatholgically, adenocarcinomas were 10 cases, sarcomas were 4 cases and malignant lymphoma was 1 case. The symptoms and signs were abdominal pain and discomfort, weight loss, nausea and vomiting, jaundice, melena and diarrhea in the order of the frequency. We performed Whipple's operations in 11 cases, regional pancretectomy in 1 case, Whipple's operation with Right hemicolectomy in 2 cases and local resection in 3 cases. There was no operative mortality. The perioperative morbidity was 33%. The post operative complications were abscess in abdomen in 3 cases and wound infections in 2 cases. 1 year and 2 years survival rate were 93.3% and 33.3%. Aggressive and radical treatment with curative intention even in the presence of locally advanced disease, could be performed with acceptable mortality and morbidity and expect a better outcome.
Abdomen ; Abdominal Pain ; Abscess ; Adenocarcinoma ; Diarrhea ; Female ; Humans ; Intention ; Jaundice ; Lymphoma ; Male ; Melena ; Mortality ; Nausea ; Retrospective Studies ; Sarcoma ; Survival Rate ; Vomiting ; Weight Loss ; Wound Infection

Purpose: Despite decreased prevalence of tuberculosis, the incidence of the diseases associated with nontuberculous mycobacteria (NTM) has been increasing in South Korea and around the world. The present retrospective study was conducted to determine longitudinal changes in the epidemiology and distribution of NTM over 13 years at a tertiary care hospital in Korea. Materials and Methods: We retrospectively analyzed data on Mycobacterium species over 13 years (January 2007 to December 2019) by utilizing the laboratory information system. Mycobacterium species were identified using biochemical tests and PCR-restriction fragment length polymorphism and Mycobacteria GenoBlot assays. Results: After excluding duplicates from the initial pool of 17996 mycobacterial isolates, 7674 strains were analyzed and 2984 (38.9%) NTM were isolated. The proportion of NTM continuously increased over the 13-year period, from 17.0% in 2007 to 57.5% in 2019. Among the NTM isolates, the most common species were Mycobacterium intracellulare (50.6%), M. avium (18.3%), M. fortuitum complex (4.9%), M. abscessus (4.5%), M. gordonae (3.3%), M. kansasii (1.1%), M. chelonae (1.0%), and M. massiliense (0.9%).In patients over the age of 70 years, the proportion of NTM among the isolates increased from 26.6% in 2007 to 62.0% in 2019, and that of M. intracellulare isolates among the NTM increased from 13.9% (11/79) in 2007 to 37.4% (175/468) in 2019. Conclusion The number of NTM isolates continuously increased over the study period, and the increase in the proportion of M. intracellulare in patients aged over 70 years was notable.

Purpose: Despite decreased prevalence of tuberculosis, the incidence of the diseases associated with nontuberculous mycobacteria (NTM) has been increasing in South Korea and around the world. The present retrospective study was conducted to determine longitudinal changes in the epidemiology and distribution of NTM over 13 years at a tertiary care hospital in Korea. Materials and Methods: We retrospectively analyzed data on Mycobacterium species over 13 years (January 2007 to December 2019) by utilizing the laboratory information system. Mycobacterium species were identified using biochemical tests and PCR-restriction fragment length polymorphism and Mycobacteria GenoBlot assays. Results: After excluding duplicates from the initial pool of 17996 mycobacterial isolates, 7674 strains were analyzed and 2984 (38.9%) NTM were isolated. The proportion of NTM continuously increased over the 13-year period, from 17.0% in 2007 to 57.5% in 2019. Among the NTM isolates, the most common species were Mycobacterium intracellulare (50.6%), M. avium (18.3%), M. fortuitum complex (4.9%), M. abscessus (4.5%), M. gordonae (3.3%), M. kansasii (1.1%), M. chelonae (1.0%), and M. massiliense (0.9%).In patients over the age of 70 years, the proportion of NTM among the isolates increased from 26.6% in 2007 to 62.0% in 2019, and that of M. intracellulare isolates among the NTM increased from 13.9% (11/79) in 2007 to 37.4% (175/468) in 2019. Conclusion The number of NTM isolates continuously increased over the study period, and the increase in the proportion of M. intracellulare in patients aged over 70 years was notable.

Biliary-enteric fistula is in 0.5% to 5% of patients undergoing biliary tract surgery. The most common cause of biliary-enteric fistula is gallstones and their complications, Much less common causes are complieation of peptic ulcer, malignancy, trauma, and rarely, Crohns, disease. The most common type of biliary-enteric fistula is cholecysto-duadenal. Cholecysto-colic, cholecysto-gastric, and choledocho-duodenal fistula are reported much less frequently. The combination of cholecysto-duodenal fistula with cholecysto-colic fistula is a very rare. Symptoms are generally nonspecific, so diagnosis has depended on plain film of abdomen and barium studies. Recently, endoscopic examination and cannulation of the fistula for precise radiographic delineation will help to make a diagnosis. A 78-year-old man was admitted our hospital because of epigastric discomfort, indigestion, nausea and vomiting for 10 days. He was confirmed as cholecysto-duodeno-colic fistula by gastroduodenoscopy, colonoscopy, and endoscopic cholangio-graphic techniques. So, we report a case of cholecysto-duodeno-colic fistula of the patient with a review of relevant literatures.
Abdomen ; Aged ; Barium ; Biliary Tract ; Catheterization ; Colic* ; Colonoscopy ; Diagnosis ; Dyspepsia ; Fistula* ; Gallstones ; Humans ; Nausea ; Peptic Ulcer ; Vomiting

Although ERCP has been widely used to diagnose and occasionally treat chronic pancreatitis, it is not always easy to differentiate between malignancy and benign disease by ERCP alone. So peroral pancreatoscopy(PPS) using mother and baby type scopes was developed and several types of peroral pancreatoscopes with various diameters have been used at several institutes. To assess the clinical usefulness of ultrathin-caliber pancreatoscopy on diagnosis of various pancreatic diseases, we performed peroral pancreatoscopy with PF 8P (Olympus, external diameter: 0.8 mm) in 12 cases(6 cases of chronic pancreatitis, 5 cases of pancreatic tumor, and 1 case of mucinous ductal ectasia) of pancreatic diseases. The pancreatoscope was successfully inserted into main pancreatic duct in 11 cases and permitted satisfactory endoscopic observation. The endoscopic findings of chronic pancreatitis were smooth stenosis, protein plug, and stones in pancreatic duct. Peroral pancreatoscopic findings of pancreatic cancer were characteristically seen as stenosis with irregular mucosal protrusion. In the mucin-producing tumor cases, the lesions were generally not clearly visualized due to the presence of copious amount of mucin. We conclude that pancreatoscopy is a valuable alternative or supplementary procedure to diagnostic imaging method of arriving at a more definite diagnosis in difficult cases. But several limitations, such as poor visual field, absence of biopsy channel and controllable tip, and poor durability of endoscope will be overcomed to serve as essential diagnosic tool for pancratic diseases.
Academies and Institutes ; Biopsy ; Cholangiopancreatography, Endoscopic Retrograde ; Constriction, Pathologic ; Diagnosis* ; Diagnostic Imaging ; Endoscopes ; Humans ; Mothers ; Mucins ; Pancreatic Diseases ; Pancreatic Ducts ; Pancreatic Neoplasms ; Pancreatitis, Chronic ; Visual Fields

Atrial septal aneurysm (ASA) was reported as a cause of unknown origin of central or peripheral thromboembolism with patent foramen ovale, aortic debris and spontaneous echo contrast. Especially the paradoxical right to left shunt via micro-fenestration on this sac may be the important cause of this embolism. We report a case of 39 year-old female patient who had atrial septal aneurysm with multiple renal infarction. Symptom was improved with aneurysmectomy and patch closure, then long term anticoagulation has been continued.
Adult ; Aneurysm* ; Embolism ; Female ; Foramen Ovale, Patent ; Humans ; Infarction* ; Thromboembolism

PURPOSE: Angiogenesis plays an important role in the growth, progression, and metastasis of tumors. Vascular endothelial growth factor (VEGF) overexpression has been associated with advanced stage and poor survival in several cancers. We investigated the present case-control study to determine whether there is an association between the VEGF 936C>T polymorphism and stomach cancer. PATIENTS AND METHODS: The association of functional single nucleotide polymorphisms (SNPs) of the VEGF gene with stomach cancer development was evaluated in a case-control study of 154 Korean stomach cancer patients. Genotypes were determined by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) analysis. RESULTS: Our results revealed significant association of T allele-bearing genotypes with increased risk for stomach cancer development. Genotype frequencies of the VEGF 936C>T polymorphisms were significantly different between patient and control groups (CT, AOR: 2.007, 95% CI: 1.277-3.156, TT, AOR: 4.790, 95% CI: 1.174-19.539, CT+TT, AOR: 2.147, 95% CI: 1.382-3.337). When stratified by gender and age, genotype frequencies were significantly different for stomach cancer in women and in patients younger than 55 years (in women, CT, OR: 3.049, 95% CI: 1.568-5.930, CT+TT, OR: 3.132, 95% CI: 1.638-5.990; in < 55 years, CT, OR: 3.306, 95% CI: 1.413-7.732, CT+TT, OR: 3.967, 95% CI: 1.729-9.104). In addition, this association partially remained in cases with intestinal and diffuse-type stomach cancer. CONCLUSION: Our present study suggests that the VEGF 936C>T polymorphism is a susceptibility factor for stomach cancer, at least in Korean. These observations, however, require further confirmation by a larger multi-ethnic study.
Adult ; Aged ; Aged, 80 and over ; Case-Control Studies ; Female ; Genotype ; Humans ; Male ; Middle Aged ; *Polymorphism, Genetic ; Sex Factors ; Stomach Neoplasms/*genetics ; Vascular Endothelial Growth Factor A/*genetics