No abstract available.
Meconium*

We have experienced a case of congenital pyloric atresia associated with epidermolysis bullosa in a premature newborn who was born at the gestation period of 33+3 week. She showed a few blisters on left ankle at birth and the easy formation of blisters involving the area of trauma or friction with depigmentation after healing. The histologic finding of the lesion showed junctional epidermolysis bullosa. Abdominal roentgenographic finding on day 2 showed single bubble sign. That suggested pyloric atresia. It was confirmed by upper gasrtointestinal series radiography and corrected by surgery, gastrojejunostomy on day 16. She discharged on day 50. The severity of the formation of blisters decreased but the poor weight agin became the main problem. The brief review of literatures was made.
Ankle ; Blister ; Epidermolysis Bullosa* ; Epidermolysis Bullosa, Junctional ; Friction ; Gastric Bypass ; Humans ; Infant, Newborn ; Parturition ; Pregnancy ; Radiography

Systemic lupus erythematosus is a systemic disorder which has frequent involvement of gastrointestinal tract. Non specific symptoms such as anorexia, nausea, diarrhea and abdominal pain are well known symptoms when the gastrointestinal tract is involved. The most feared gastrointestinal complication of systemic lupus erythematosus is lupus enteritis. The pathological change in lupus enteritis is usually a result of mesenteric vasculitis. Major complications such as intestinal bleeding and perforation may occur and sometimes result in sugery. Because of high mortality rate in case of major complications, early diagnosis and appropriate treatment is very important. We experienced three patients with lupus enteritis who presented with severe abdominal pain and dirrhea. They were diagnosed by characteristic radiographical findings of small bowel series and barium study. All radiographical findings has been resolved completely with the steroid therapy. Conclusively we can induce complete remission by steroid therapy alone, if we diagnose lupus enteritis in the early period of disease course.
Abdominal Pain ; Anorexia ; Barium ; Diarrhea ; Early Diagnosis ; Enteritis* ; Gastrointestinal Tract ; Hemorrhage ; Humans ; Lupus Erythematosus, Systemic ; Mortality ; Nausea ; Vasculitis

PURPOSE: To determine the factors predisposing to the intratumoral gas formation after TACE in the treatment of HCC. MATERIALS AND METHODS: A total of 176 pathologically or clinically proven patients with HCC on whom CT scan had been performed in 2 weeks to 3months after TACE were reviewed. The patients were classified in two groups; intratumoral gas-forming group(n=18) and non-gas forming group(n=158). Chi-square (X2) test was applied to analyze the factors influencing to gas formation. The radiological factors studied were the morphologic type and location of HCC, presence or absence of tumor capsule on CT, the degree of tumor vascularities, presence or absence of portal vein thrombosis, presence or absence of arterioportal shunt, and TACE catheterization method on angiegraphic examination and the duration of post-TAE fever. RESULT: Intratumoral gas foramtion after TACE occurred significantly in tumors with peripheral location or capsule on CT tumors with less vascularity or peripheral arterioportal shunt on angiegraphic examination, and TACE with selective catheterization method(p<0.05). But the morphologic types of HCC and presence of main portal vein thrombosis were not significantly different between the two groups (p>0.05). The average duration of fever sustained after TACE was longer in gas-forming group than those in non-gas forming group (p<0.05). CONCLUSION: TACE of HCC with weak collaterals or with peripherd prevent recanalization from collaterals has tendency to intratumoral gas form-his and prolonged fever duration.
Catheterization ; Catheters ; Fever ; Humans ; Tomography, X-Ray Computed ; Venous Thrombosis

Bilateral carotid-cavernous fistula are much less frequent and these double lesions are considered as a puzzling therapeutic problem. A case of bilateral traumatic carotid-cavernous fistula was confirmed by bilateral carotid angiography and was managed by method of muscle piece embolization without complications. Neuro-ophthalmological deficits improved progressively except minor bruit. We reviewed bilateral carotid-cavernous fistula in the literatures and discussed the surgical method.
Angiography ; Fistula*

BACKGROUND: Clostridium difficile is the most common pathogen of antibiotic-associated diarrhea. Toxigenic strains produce toxin A and toxin B. The pathogenicity of C. difficile is due to the production of these two exotoxins. This study aimed to evaluate diagnostic value of two enzyme immunoassay by comparison of concordance rate to diagnose C. difficile-associated infection. METHODS: C. DIFF QUIK CHEK (TECHLAB, USA) that detect glutamate dehydrogenase antigen and VIDAS C. difficile Toxin A&B (BioMerieux, France) that detect toxin A and toxin B were done in 122 fecal specimens to detect C. difficile. RESULTS: In the total 122 stool specimens, 17 cases showed positive results in both tests. One specimen showed discrepancy that positive result in VIDAS C. difficile Toxin A&B (relative fluorescence value, RFV=2.93) but negative result in C. DIFF QUIK CHEK. Therefore, the concordance rate between two tests was 95.1% (116/122). Both anaerobic culture and in-house PCR for toxin B were negative in the discrepant fecal specimen and there was no clinical evidence that support C. difficile-associated diarrhea, so we concluded result in VIDAS C. difficile Toxin A&B as false positive. CONCLUSIONS: Although these two enzyme immunoassays targeted different antigen, they showed high concordance rate. The discrepant case was concluded to false positive in VIDAS C. difficile Toxin A&B test because it showed negative results in culture and PCR for toxin B and there were no clinical evidences of C. difficile-associated infection. It could be needed for analysis about conditions that cause false positive result in enzyme immunoassays to detect C. difficile toxin.
Azure Stains ; Clostridium difficile ; Diarrhea ; Exotoxins ; Fluorescence ; Glutamate Dehydrogenase ; Immunoenzyme Techniques ; Methylene Blue ; Polymerase Chain Reaction ; Xanthenes

The accumulation of abnormal protein aggregates is a major characteristic of many neurodegenerative disorders, including Parkinson's disease (PD). The intracytoplasmic deposition of alpha-synuclein aggregates and Lewy bodies, often found in PD and other alpha-synucleinopathies, is thought to be linked to inefficient cellular clearance mechanisms, such as the proteasome and autophagy/lysosome pathways. The accumulation of alpha-synuclein aggregates in neuronal cytoplasm causes numerous autonomous changes in neurons. However, it can also affect the neighboring cells through transcellular transmission of the aggregates. Indeed, a progressive spreading of Lewy pathology among brain regions has been hypothesized from autopsy studies. We tested whether inhibition of the autophagy/lysosome pathway in alpha-synuclein-expressing cells would increase the secretion of alpha-synuclein, subsequently affecting the alpha-synuclein deposition in and viability of neighboring cells. Our results demonstrated that autophagic inhibition, via both pharmacological and genetic methods, led to increased exocytosis of alpha-synuclein. In a mixed culture of alpha-synuclein-expressing donor cells with recipient cells, autophagic inhibition resulted in elevated transcellular alpha-synuclein transmission. This increase in protein transmission coincided with elevated apoptotic cell death in the recipient cells. These results suggest that the inefficient clearance of alpha-synuclein aggregates, which can be caused by reduced autophagic activity, leads to elevated alpha-synuclein exocytosis, thereby promoting alpha-synuclein deposition and cell death in neighboring neurons. This finding provides a potential link between autophagic dysfunction and the progressive spread of Lewy pathology.
Adenine/analogs & derivatives/pharmacology ; Animals ; *Autophagy/drug effects ; Cell Line ; *Exocytosis/drug effects ; Extracellular Space/*metabolism ; Humans ; Mice ; Mice, Knockout ; Microtubule-Associated Proteins/deficiency/metabolism ; Phagosomes/drug effects/metabolism ; Protein Structure, Quaternary ; Protein Transport/drug effects ; alpha-Synuclein/chemistry/*metabolism/secretion/toxicity

PURPOSE: Brain metastasis is estimated to occur in 20~40% of solid tumor patients and the most common primary tumor is lung cancer. Even though the prognosis of brain metastasis is grave and the 1-year survival rate is only 15%, symptom palliations are made with whole brain radiation therapy. We retrospectively evaluated the clinical features and prognostic factors of lung cancer with brain metastasis. MATERIALS AND METHODS: From January 1987 to October 1999, 50 lung cancer patients with brain metastasis underwent whole brain radiation therapy. We reviewed the improvement in neurologic symptoms and survival according to the following parameters; performance status, histological type, presence of brain metastasis at the initial diagnosis of lung cancer, presence of extracranial metastasis, multiplicity of brain lesion, presence of primary lung symptom and treatment modalities. RESULTS: The most frequent symptom with brain metastasis was a headache (50%). Palliation of the headache and other symptoms was achieved in 81% of the patients. Median overall survival after brain metastasis was 21 weeks and the 1 year survival rate was 15%. Patients without extracranial metastasis had a longer median survival than those with, 38 weeks versus 15 weeks, respectively (p=0.01). CONCLUSION: In lung cancer with brain metastasis, neurologic symptoms can be palliated with whole brain radiation therapy, and in this study among such patients, absence of extracranial metastasis can be a good prognostic factor.
Brain* ; Diagnosis ; Headache ; Humans ; Lung Neoplasms* ; Lung* ; Neoplasm Metastasis* ; Neurologic Manifestations ; Prognosis* ; Retrospective Studies ; Survival Rate

Five to fifteen percent of patients affected by human immunodeficiency virus(HIV) are children in developing countries. In Korea, most of HIV infections in children have been transfusion-related, and cases of vertical transmission have been very rare so far and are usually suspected due to a maternal positive history. We experienced a case of vertical transmission of HIV in a 19 month- old girl, incidentally diagnosed in the process of work-up for failure to thrive without suspicion from maternal HIV history. With the increasing number of adult HIV patients in Korea, HIV in fection should be included in the differential diagnosis of children with symptoms compatible with HIV infection even when parental HIV history is not suggestive.
Acquired Immunodeficiency Syndrome ; Adult ; Child ; Developing Countries ; Diagnosis, Differential ; Failure to Thrive* ; Female ; HIV Infections ; HIV* ; Humans ; Humans* ; Infant* ; Korea ; Parents

Abdominal pregnancy is a rare variation of ectopic pregnancy, which has been classified as primary or secondary. The clinical characteristics of abdominal pregnancy are extremely variable, so early diagnosis is very difficult. Because of high maternal morbidity and mortality, the prompt surgical intervention is required. Omental pregnancy is a very rare form of abdominal pregnancy, which is hard to detect early. The diagnosis of omental pregnancy is hardly ever made prior to laparotomy. We have experienced a case of omental pregnancy in a 36-year-old woman and report this case with brief review of literature.
Adult ; Diagnosis ; Early Diagnosis ; Female ; Humans ; Laparotomy ; Mortality ; Pregnancy* ; Pregnancy, Abdominal ; Pregnancy, Ectopic