Prompt, precise differentiation between various forms of meningitis-aseptic, bacterial and tuberculous-is critical difficult problem for the practicing pediatrician. The present invesigation was carried out to assess the diagnostic usefullness of lactic acid levels in CSF. Fresh samples of CSF and blood were collected from 75 infant and children with meningitis and 25 normal children. CSF lactic acid. CSF sugar, blood lactic acid and blood sugar were estimated from them. These subjects were divided into 4 groups : Group 1 (normal-25 cases), Group 2 (aseptic meningitis-25 cases), Group 3 (purulent meningitis-20 cases), Group 4 (T.B. meningitis-30 cases). The results were as follows : 1. In normal gruop, CSF lactic acid was 5.8mg/dl and blood lactic acid was 7.1mg/dl, The ratio of CSF Lactic acid to blood lactic acid was approximately 0.8. 2. In Group 2. (aseptic meningitis), CSF lactic acid was 8.8mg/dl and blood lactic acid was 7.4mg/dl. The CSF value was slightly increased compare to normal CSF lactic acid levels. CSF suger and lactic acid were not correlated. 3. In the purulent meningitis group, CSF lactic acid was markedly increased to a significant level compare to the normal value. The mean was 36.4mg/dl. Blood lactic acid was 26.2mg/dl. 4. In T.B. meningitis, There as a mederate increase of lactic acid significantly ifferent from normal values. The mean was 25.8mg/dl. Blood lactic acid also increased. The mean was 18.9mg/dl. A positive linear correlation between CSF lactic acid and blood lactic was noted. 5. On the 3rd hospital day, CSF lactic acid level wsa approximately half level of the initial values inpurulent meningitis. It returned to normal level on 6th hospital day. In T.B. meningitis, CSF lactic acid also showeda decrease from the 5th hospital day. And returned to normal values on 20th hospital day. Concerning the above results, CSF lactic acid could be a possiblely be a good index in differential diagnosis of meningitis and in evaluation of it's clinical course.
Blood Glucose ; Cerebrospinal Fluid* ; Child* ; Diagnosis, Differential ; Humans ; Infant* ; Lactic Acid* ; Meningitis* ; Reference Values

Hypertrophic osteoarthropathy, known as Marie-Bamberger's Disease, is characterized by bone and joint changes and clubbing of the fingers and toes. It is well known to occur after longstanding disease of the thorax and intestines. The authors have tried to find patients with hypertrophic osteo-arthropathy in cases with pure silicosis and silscosis complicated by pulmonary tuberculosis. but failed. Recently, the authors discovered 3 cases of hypertrophic osteoarthropathy among some patients with pulmonary tuberculosis. All had had a long history of pulmonary tuberculosis, at least over 1 year duration.
Fingers ; Humans ; Intestines ; Joints ; Silicosis ; Thorax ; Toes ; Tuberculosis, Pulmonary

Brain abscess is a common bacterial infection of the central nervous system. Previously, the most common source of brain abscess is from the otorrhinologic infection, the hematogenous spread of infection from a distant site to the central ner vous system is increased(Alvord & Shaw, 1977; Zimmerman & Weingerten, 1991). Since intact brain parenchyma is usually resistant to inecton, focal areas of ischemia or necrosis are a prequisite to invasion by pathogenic microorganisms(Patric & Kaplan, 1988). There have been a few reports about the stroke lesions changed into brain abscess(Chen et al, 1995; Scully et al. 1991). We report serial brain images with the clinical observations in a patient with a transformation of spontaneous intracerebral hemorrhage into brain abscess.
Bacterial Infections ; Brain Abscess* ; Brain* ; Central Nervous System ; Cerebral Hemorrhage* ; Humans ; Ischemia ; Necrosis ; Stroke

Chinese herb medicines have traditionally been used to treat or alleviate the symptom of various diseases. The rationale for use of certain herbs to certain disorder is now getting unveiled by modern technology. In the present study, we investigated whether herb mix extract (HMX), which is alleged to be useful for gastric ulcer, protects stomach from oxidative stress. Rats were allowed to normal diet with and without HMX (1, 5, 10 mg/kg) for 30 days. To induce gastric ulcer, ethanol (75%, 1.5 ml) or acidified aspirin (100 mg/kg in 0.2 N HCl) was administered by oral route in 24 h-fasted rats and examined the gastric ulceration (bleeding) by measuring the size 1 h after the treatment. Results indicated the area of gastric bleeding was significantly less in HMX fed rats than in normal diet fed ones, and it was dependent on the duration and amount of HMX. To investigate the underlying mechanism by which HMX protects stomach from oxidative stress, expression of enzymes like heme oxygenase (HO), cyclooxygenase (COX), and inducible nitric oxide (iNOS) were investigated in MKN-74 cells, where aspirin or H. pylori was introduced. The results were compared with RAW 264.7 cells to check if there's cell specificities exist. The expression of HO-1 but not COX-2, iNOS was significantly increased by HMX. Furthermore, HO-1 inhibitor, SnPP IX reduced the HO-1 activity and reversed the survival rate in HMX-treated MKN-74 cells. There's no difference between RAW 264.7 cells and MKN-74 cells. We, thus, concluded that HMX is beneficial for protection from oxidative injury, and induction of HO-1 by HMX in gastric cells is, at least, responsible for protection from oxidative stress such as ethanol, aspirin and possibly H. pylori infection.
Animals ; Asian Continental Ancestry Group ; Aspirin* ; Cell Survival* ; Diet ; Ethanol* ; Heme Oxygenase (Decyclizing) ; Heme Oxygenase-1* ; Heme* ; Hemorrhage* ; Humans ; Nitric Oxide ; Oxidative Stress ; Prostaglandin-Endoperoxide Synthases ; Rats* ; Reactive Oxygen Species ; Stomach Ulcer ; Stomach* ; Survival Rate

PURPOSE: The aim of this study was to evaluate the usefulness of whole body positron emission tomography (PET) using 18F-fluorodeoxyglucose (18F-FDG) for cancer screening in asymptomatic subjects. MATERIALS AND METHODS: The subjects were 1,762 men and 259 women who voluntarily underwent 18F-FDG PET for cancer screening as a part of a routine health examination. Final diagnosis was decided by other diagnostic studies, pathological results or clinical follow-up for 1 year. RESULTS: Of 2,021 subjects, 40 (2.0%) were finally proved to have cancer. Abnormal focal 18F-FDG uptake suggesting malignancy was found in 102 subjects (5.0%). Among them, 21 subjects (1.0%) were proved to have cancer. Other tests in the routine health examination could not find 9 of 21 cancers (42.9%) detected by PET. The sensitivity, specificity, positive predictive value, and negative predictive value of PET for cancer screening were 52.5%, 95.9%, 20.6%, and 99.0%, respectively. Pathologies of cancers missed on PET were adenocarcinoma (n=9; 3 colon cancers, 3 prostate cancers, 2 stomach cancers, and 1 rectal cancer), differentiated thyroid carcinoma (n=6), bronchioalveolar cell carcinoma (n=2), urinary bladder cancer (n=1), and melanoma (n=1). More than half of cancers which were not detected by PET were smaller than 1 cm in diameter. CONCLUSION: 18F-FDG PET might be useful for cancer screening in asymptomatic subjects due to its high specificity and negative predictive value and play a supplementary role to the conventional health check-up, but it could not replace due to limited sensitivity for urological cancers, small-sized tumors and some hypometaboic cancers.
Adenocarcinoma ; Colonic Neoplasms ; Early Detection of Cancer ; Female ; Fluorodeoxyglucose F18 ; Follow-Up Studies ; Humans ; Male ; Melanoma ; Positron-Emission Tomography ; Prostatic Neoplasms ; Sensitivity and Specificity ; Stomach Neoplasms ; Thyroid Neoplasms ; Urinary Bladder Neoplasms ; Urologic Neoplasms

BACKGROUND/AIMS: The caudal-related homeobox transcription factor, Cdx2, plays an important role in proliferation and differentiation of intestinal epithelial cells. Its expression is confined to normal and neoplastic intestinal epithelium. We evaluated Cdx2 expression in advanced colorectal cancers to determine the correlation between Cdx2 expression and clinicopathologic characteristics. METHODS: Four hundreds twenty consecutive colorectal cancers were included in the study. Cdx2 expression was investigated by immunohistochemistry using tissue microarrays constructed from surgically resected specimens. 145 invasive breast cancers, normal tissues from gastric mucosa, liver, lung, kidney and ovary were used as control. Nuclear staining was considered to be positive and the result was divided into 3 categories. RESULTS: In the colorectal cancers, Cdx2 was expressed in 380 of 420 (90.5%) cases, and 349 of 380 (83%) cases showed strong and diffuse staining and 31 of 420 (7.5%) cases showed weakly positive staining. Forty patients (9.5%) of colorectal cancer were negative for Cdx2. All of the invasive breast cancers and all non-neoplastic control tissues except the regions of intestinal metaplasia in gastric mucosa, which showed strong Cdx2 expression, were negative for Cdx2. Loss of Cdx2 expression was observed more frequently in cases with deeper invasion (p<0.05), lymph node metastasis (p<0.05), poor histologic differentiation (p<0.001), and distant metastasis (p<0.05). CONCLUSIONS: Cdx2 could be a highly sensitive marker to detect metastasis from intestine and might be useful as a novel prognostic marker in colorectal cancers.
Adult ; Aged ; Aged, 80 and over ; Colorectal Neoplasms/*metabolism/pathology ; Female ; Homeodomain Proteins/*metabolism ; Humans ; Immunohistochemistry ; Male ; Middle Aged ; Tumor Markers, Biological/analysis

PURPOSE: Due to their comorbidities, dialysis patients have many chances to undergo radiologic procedures using iodinated contrast media. We aimed to assess time-sequenced blood oxidative stress level after contrast exposure in hemodialysis (HD) patients compared to those in the non-dialysis population. MATERIALS AND METHODS: We included 21 anuric HD patients [HD-coronary angiography (CAG) group] and 23 persons with normal renal function (nonHD-CAG group) scheduled for CAG, and assessed 4 oxidative stress markers [advanced oxidation protein products (AOPP); catalase; 8-hydroxydeoxyguanosine; and malondialdehyde] before and after CAG, and subsequently up to 28 days. RESULTS: In the nonHD-CAG group, only AOPP increased immediately after CAG and returned to baseline within one day. However, in the HD-CAG group, all four oxidative stress markers were significantly increased starting one day after CAG, and remained elevated longer than those in the nonHD-CAG group. Especially, AOPP level remained elevated for a month after contrast exposure. CONCLUSION: Our study showed that iodinated contrast media induces severe and prolonged oxidative stress in HD patients.
Aged ; Contrast Media/*adverse effects ; Female ; Humans ; Male ; Middle Aged ; Oxidative Stress/*drug effects ; Renal Dialysis/*adverse effects

BACKGROUND/AIMS: Mesenchymal tumors are the most frequent submucosal tumors in gastrointestinal trail. We reviewed the mesenchymal tumors which are confirmed by pathology to examine whether the invasive approach of all mesenchymal tumors is necessary. METHODS: This study was performed on fifty-nine patients who has mesenchymal tumors confirmed by endoscopic or surgical resection from January 2000 to June 2004. RESULTS: Mesenchymal tumors consisted of thirty-six gastrointestinal stromal tumors (GISTs), 20 leiomyomas and 3 schwannomas. All the esophageal tumors were leiomyoma (12/12, 100%). In stomach, there were 32 GISTs (76.2%), 7 leiomyomas (16.7%) and 3 schwannomas (7.1%). And there were 4 GISTs (80.0%) and 1 leiomyoma (20.0%) in duodenum. Tumors less than 1 cm in maximal diameter were leiomyoma or GISTs with very low risk of aggressive behavior. 56.1% of the tumors larger than 1 cm consisted of low, intermediate or high risk GISTs. CONCLUSIONS: Biopsy must be considered according to its size and anatomic location of mesenchymal tumors. The invasive approach for every esophageal submucosal tumor is not necessary unless the size is very large, because most of them are benign in nature. However, the gastric submucosal tumor with more than 1 cm in diameter should be carefully and regularly followed up or biopsied because it cannot be assumed to be benign for any GIST more than 1 cm in size at the present time, safely.
Adult ; Aged ; *Biopsy, Needle ; Endoscopy, Gastrointestinal ; Female ; Gastrointestinal Neoplasms/*pathology ; Gastrointestinal Stromal Tumors/*pathology ; Humans ; Leiomyoma/pathology ; Male ; Middle Aged ; Neurilemmoma/pathology ; Upper Gastrointestinal Tract

Hemolytic uremic syndrome (HUS) is a rare thrombotic complication characterized by a triad of microangiopathic hemolytic anemia, thrombocytopenia, and acute renal failure. HUS may be caused by several different conditions, including infection, malignancy, and chemotherapeutic agents, such as mitomycin, cisplatin, and most recently, gemcitabine. The outcome of gemcitabine-induced HUS is poor, and the disease has a high mortality rate. This study reports a case of gemcitabine-induced HUS in a patient with pancreatic cancer in Korea.
Antimetabolites, Antineoplastic/*adverse effects ; Deoxycytidine/adverse effects/*analogs & derivatives ; Hemolytic-Uremic Syndrome/*chemically induced ; Humans ; Male ; Middle Aged ; Pancreatic Neoplasms/*drug therapy ; Treatment Outcome

BACKGROUND/AIMS: Although the viral load is correlated with HBcAg, liver injury was not correlated to viral load in HBeAg positive patient. We aimed to study the inter-relationship of clinical parameters such as the level of HBV-DNA, the level of aminotransferase, intrahepatic expression of HBcAg and severity of histological liver damage in the young male chronic HBV carriers according to HBeAg status. METHODS: The study group included 85 young male patients (mean age: 19.8) with biopsy-proven chronic hepatitis B (HBeAg-positive group: n=60, HBeAg-negative group: n=25). RESUTLS: Serum levels of HBV-DNA and the expression of intrahepatic HBcAg in the HBeAg-positive group were significantly higher than in the HBeAg-negative (p<0.001), but fibrosis score was lower (p<0.01). Serum levels of HBV-DNA positively correlated with lobular activity, portal/periportal activity, biochemical activities in the HBeAg-negative group but negatively correlated in the HBeAg-positive group. There were no significant differences in histological activity according to the pattern of expression of intrahepatic HBcAg in both groups. The lobular activity correlated positively with biochemical activity in both groups, and portal/periportal activity correlated with biochemical activity only in the HBeAg-positive group. CONCLUSIONS: There are close correlations among liver injury, intrahepatic expression of HBcAg, and detectable HBV-DNA in the young male chronic HBV carriers with HBeAg-negativity, but in the HBeAg-positive group, the correlations are diversified.
Adolescent ; Adult ; DNA, Viral/*analysis ; English Abstract ; Hepatitis B Core Antigens/*analysis ; Hepatitis B virus/genetics/*isolation & purification ; Hepatitis B, Chronic/pathology/*virology ; Humans ; Liver/*pathology/virology ; Male ; Viral Load