Endoscopic retrograde cholangiopancreatography(ERCP) is a new diagnostic method for pancreatic and biliarydiseases which has been made possible by the development of fiberoptic duodenoscopy. It has been thought that ERCPwell serve an important role in the early detection of pancreatic cancer, but in order to detect minor lesions ofthe pancreas and improve the diagnostic accuracy of resectable pancreatic cancer, Endoscopic RetrogradeParechymography of the pancreas (ERPP) was developed recently. The authors analyzed 117 cases of ERCP performed atthe Kwangju Christian Hospital between Jan. and Dec. 1980, and compared them with the final diagnosis. The resultswere as follows; 1. Out of 117 cases, successful visualization of the duct of concern was achieved in 105 cases.Of these, 25 cases were ERPP. 2. The ratio of males to female was 1.44:1. Most patients were in the 4th to 6thdecade. 3. The commmonest clinical manifestations were upper abdominal pain (77cases), jaundice(23 cases),indigestion, vomiting and abdominal mass, in order of frequency. 4. Out of 46 cases of suspected pancreaticdiseases, the pancreatic duct was visualized in 36 cases, and 24 cases revealed pathognomonic findings. These werediagnosed as 16 cases of pancreatic cancer, 4 cases of chronic pancreatitis, 2 cases of pancreatic pseudocyst and2 cases of periampullary cancer with pancreas invasion. In pancreatic cancer findings were; encasement, localdilatation, delayed excretion, poor filling, obstruction of pancreatic duct, accompanying C.B.D. obstruction orstenosis and so called double duct sign. The chronic pancreatitis findings included; ductal dilatation (with orwtihout) obstruction, tortuosity with dilated saccular lateral branching, stone formation and the parenchymalfilling defect. 5. Out of 71 cases of suspected biliary tract diseases, the biliary tract was visualized in 57cases, and in 31 cases abnormalities were suggested; such as 20 cases of biliary stone, 1 cases of ascariasis, 1case of clonorchiasis with cholangitis, 1 case of clonorchiasis with stone, 2 cases of C.B.D. ca. 2 cases of G.B.ca, 3 cases of intrahepatic disease, 1 case of stones in the biliary tree with ampullary ca. 6. Complications ofERCP and ERPP were extremely raare. Transient abdominal distention, abdominal discomfort and elevated serumamylase were noted, but were not clinically significant.
Abdominal Pain ; Ascariasis ; Biliary Tract ; Biliary Tract Diseases ; Cholangiopancreatography, Endoscopic Retrograde ; Cholangitis ; Clonorchiasis ; Diagnosis ; Dilatation ; Duodenoscopy ; Female ; Gwangju ; Humans ; Male ; Methods ; Pancreas ; Pancreatic Ducts ; Pancreatic Neoplasms ; Pancreatic Pseudocyst ; Pancreatitis, Chronic ; Vomiting

On October 26, 1987, the authors encountered a case of human thelaziasis involving both eyes. The case in Chollapuk-do, Korea, a farmer aged 23, complained of mild lacrimation for 3 weeks followed by 1 week duration of foreign body sensation in both eyes prior to examination of eyes. The conjunctivae of both eyes appeared slightly reddened. No other abnormalities were noticed. Total 6 worms, one male and two females from each eye, were removed, parasitologically studied, and identified as Thelazia callipaeda Railliet and Henry, 1910.
parasitology-helminth-nematoda ; thelaziasis ; Thelazia callipaeda ; eye ; case report

STATEMENT OF PROBLEM: There are many studies focused on the effect of shape of fixtures on stress distribution in the mandibular bone. However, there are no studies focused on the effect of the abutment types on stress distribution in mandibular bone. PURPOSE: The purpose of this study is to investigate the effect of three different abutment types on the stress distributions in the mandibular bone due to various loads by performing finite element analysis. Material and method : Three different implant systems produced by Warantec (Seoul, Korea) were modeled to study the effect of abutment types on the stress distribution in the mandibular bone. The three implant systems are classified into oneplant (Oneplant, OP-TH-S11.5), internal implant (Inplant, IO-S11.5) and external implant (Hexplant, EH-S11.5). All abutments were made of titanium grade ELI, and all fixtures were made of titanium grade IV. The mandibular bone used in this study is constituted of compact and spongeous bone assumed to be homogeneous, isotropic and linearly elastic. A comparative study of stress distributions in the mandibular bone with three different types of abutment was conducted. RESULTS: It was found that the types of abutments have significant influence on the stress distribution in the mandibular bone. It was due to difference in the load transfer mechanism and the size of contact area between abutment and fixture. Also the maximum effective stress in the mandibular bone was increased with the increase of inclination angle of load. CONCLUSION: It was concluded that the maximum effective stress in the bone by the internal implant was the lowest among the maximum effective stresses by other two types.
Finite Element Analysis ; Titanium

The liver is a distinctly unusual locus for a primary leiomyosarcoma. In October 1994, a 64-year-old female patient was admitted with palpable mass at the right upper abdomen for 2 months. Ultrasonography and Computed Tomography revealed a big cystic nature tumor at the right lobe of the liver. A right lobectomy was undertaken. On gross examination of the specimen, the tumor size was measured a 7.5 cm 16.0 cm 4.5 cm. On a cut section, cystic degeneration was showed and the color of the solid component was grayish. Microscopic examination growth pattern of the tumor to be expansive with no capsule. Finally the leiomyosarcoma of the liver was diagnosed with 5 to 6 mitosis per 10 high power fields. In September 1995, follow-up Computed Tomography revealed a recurred mass on segment 4 of the liver. A tumonectomy was performed. Twenty-one months after the second operation, recurrence was noted on the remaining liver and intraabdomen. Debulking surgery of the intraabdominal mass with intraperitoneal chemotherapy was undertaken. We report this case of primary hepatic leiomyosarcoma with a review of the literatures.
Abdomen ; Drug Therapy ; Female ; Follow-Up Studies ; Hepatectomy ; Humans ; Leiomyosarcoma* ; Liver ; Middle Aged ; Mitosis ; Recurrence ; Ultrasonography

Systemic antibiotic therapy is widely used for prophylaxis in major head and neck surgery, but the efficacy of topical oral antibiotic therapy has not been fully investigated. Therefore we planned to study the efficacy of topical clindamycin gargle on oral flora. Thirty-six healthy adults(20 males, 16 females) were included in the study, and we tried with three oral-washing agents; 0.9% normal saline, 10% povidone iodine, and 75mg clindamycin in 52ml tap water. Samples of saliva were cultured for aerobic and anaerobic bacteria immediately before, immediately after, and at 1- and 4-hour intervals after, washing the mouth with a solution of either control(normal saline or povidone iodine) or clindamycin. Quantitative analysis demonstrated significant reduction of oral flora level after use of the topical antibiotic at the 1-, 4-, and 8- hour interval. It is postulated that topical clindamycin, by reducing concentrations of oral flora, may also reduce the incidence of regional infection following major upper aerodigestive tract surgery.
Anti-Bacterial Agents ; Bacteria, Anaerobic ; Clindamycin* ; Head ; Humans ; Incidence ; Male ; Mouth ; Neck ; Povidone ; Povidone-Iodine ; Saliva ; Water

We trapped a rat (Rattus norvegicus) infected with Capillaria hepatica. At necropsy, grossly yellowish-white nodules (2-3 mm in diameter) were noted to be scattered on the liver's surface. Microscopically, granulomatous and fibrotic nodules that contained the eggs and/or adult worms of Capillaria hepatica were detected in the liver. Septal fibrosis was diffusely formed throughout the liver. There were a number of ED1-positive macrophages located in the sinusoids of the pseudolobules. On the double staining, myofibroblasts and mast cells were generally observed within the fibrous septa with the mast cells in close proximity to the myofibroblasts. We suggest that the interactions between macrophages, myofibroblasts and mast cells play a role in the septal fibrosis observed in rats infected by Capillaria hepatica.
Animals ; *Capillaria ; Enoplida Infections/immunology/parasitology/*veterinary ; Fibroblasts/immunology ; Liver/parasitology/pathology ; Macrophages/immunology ; Mast Cells/immunology ; Rats ; Rodent Diseases/*immunology/*parasitology/pathology

We retrospectively reviewed the medical records of 284 patients with neutropenic fever following chemotherapy for acute leukemia at the Catholic Hematopoietic Stem Cell Transplantation Center from January 1998 to December 1999, to identify prognostic factors for infection related mortality. Twenty-eight patients died of infections. There was no difference in median age, gender ratio, or underlying disease between the dying and surviving groups. Bacteria were the main pathogens following chemotherapy, and Gram positive organisms predominated in the dying group. Pneumonia and sepsis were the main causes of death. There were 72 cases of invasive fungal infection and their mortality was 27.8%. Invasive fungal infection and previous history of fungal infection were independent prognostic factors for outcome. Recovery from neutropenia was the significant protective factor for mortality. In conclusion, the prognostic factors identified in this study could be useful for deciding on more intensive treatment for those patients at greater risk of death. To our knowledge, this is the first Korean study delineating prognostic factors in acute leukemic patients with infectious complications.
Adolescent ; Adult ; Aged ; Bacterial Infections/complications/*mortality ; Cause of Death ; Female ; Humans ; Korea ; Leukemia ; Leukemia, Lymphocytic, Acute/complications/*microbiology/*mortality ; Leukemia, Myelocytic, Acute/complications/*microbiology/*mortality ; Male ; Middle Aged ; Morbidity ; Multivariate Analysis ; Mycoses/complications/mortality ; Neutropenia ; Pneumonia/complications/mortality ; Prognosis ; Retrospective Studies ; Sepsis/complications/mortality ; Survival Rate

It is difficult to estimate PMI of whom died long times ago, because corpse goes by many decomposition stages. So it makes investigation more difficult. Nowadays many studies about PMI estimation have been performed. In other countries, forensic entomology studies which is possible to estimate not characteristic of death site but also exact death time are actively advanced. So forensic entomology has been more important related not PMI estimation but also many lawsuits in other countries. In Korea, the necessity of Forensic entomology has increased after occuring of the case 'Gaeguri Sonyeon(missing boys who went to catch a flog)'. In this case, regional characteristic is known by insects found on the corpse or clothes. We suggest possibility of applying forensic entomology, consideration, some limitations and the direction of the future study through the analysis, comparison with true facts, and PMI estimation using collected fly larvae in "Hwaseong Case".
Cadaver ; Diptera ; Entomology* ; Female ; Humans ; Insects ; Korea ; Larva

BACKGROUND: During the era of increasing penicillin resistant Streptococcus pneumoniae, it is important to have knowledge about adequate dosage and dosing interval of ceftriaxone (CTR). We examined efficacies of once-daily CTR and compared results in an in vitro pharmacodynamic infection model (IVPDIM) supplemented with albumin and those without albumin. METHODS: Using three clinically isolated S. pneumoniae that were susceptible (SM24), intermediate (SM47) and resistant (SM60) against CTR, we utilized a two-compartment IVPDIM. CTR 2 g was administered intravenously every 24 h. Human albumin was added with concentration of 4 g/dL. Samples were removed at multiple time points over a 48-h period to determine the colony counts. RESULTS: In SM24 and SM60, bactericidal effects were observed within 6 hours in groups without albumin. The number of colonies during 1st 6 hours were more decreased in albumin-free groups than in albumin-supplemented groups (P<0.05). In SM47, similar results were found during 1st 6 hours (P=0.03). But, regrowth was observed in albumin supplemented group at 30 h. Irrespective of results of minimal inhibitory concentrations and albumin supplementation, bactericidal effects were shown at 24 h in all 3 strains. All groups were decreased below the detection limit at 48 h. Development of resistance was not detected throughout the entire study period in either strain. CONCLUSIONS: Although extents of killing in albumin supplemented broth of once-daily CTR dosing were delayed in all 3 strains compared with those of albumin free broth, final efficacies were not different between the two groups.
Ceftriaxone* ; Homicide ; Humans ; Limit of Detection ; Penicillins ; Pneumonia ; Streptococcus pneumoniae* ; Streptococcus*