We report herein s case of subcutaneous aspergillosis in a 41-year-old woman with lumbar spondylitis(L4~L5). The patient had received high doses of corticosteroids and broad-spectrum antibiotics and two times of operation due to lumbar problems. The diagnosis of Aspergillus fumigatus infection was established by the mycologic study of cultures from wound exudate and histopathologic examination of the second surgical specimens of subcutaneous soft tissue, which was assumed to be iatrogenically susceptible infection. Intravenous amphotericin B therapy was discontinued because of the immediste adverse effects. After twelve-week therapy of oral ketoconazole(400mg/day), open wound healed and spondylitis with neurologic signs eventually resolved. No evidence of recurrent infection was noted during six months of follow-up.
Adrenal Cortex Hormones ; Adult ; Amphotericin B ; Anti-Bacterial Agents ; Aspergillosis* ; Aspergillus fumigatus ; Diagnosis ; Exudates and Transudates ; Female ; Follow-Up Studies ; Humans ; Ketoconazole* ; Neurologic Manifestations ; Spondylitis* ; Wounds and Injuries

Predisposing factors for venous thrombosis can be identified in the majority of patients with established venous thromboembolism (VTE). However, an obvious precipitant may not be identified during the initial evaluation of such patients. In the present case, a 47-year-old female presented to the emergency department of our hospital after ingesting multiple drugs. She had no VTE-related risk factors or previous episodes, nor any family history of VTE. After admission to the intensive care unit sudden hypoxemia developed, and during the evaluation cerebral, renal, and splenic infarctions with pulmonary embolisms were diagnosed. However, the sources of the emboli could not be identified by transthoracic echocardiography or computed tomography angiography. Protein C deficiency was identified several days later. We recommend that hypercoagulable states be taken into consideration, especially when unexplained thromboembolic events develop in multiple or unusual venous sites.
Angiography ; Anoxia ; Causality ; Echocardiography ; Emergency Service, Hospital ; Female ; Humans ; Infarction* ; Intensive Care Units ; Middle Aged ; Protein C Deficiency ; Pulmonary Embolism ; Risk Factors ; Splenic Infarction ; Thrombophilia ; Venous Thromboembolism ; Venous Thrombosis

Inflammatory pseudotumor, originally described in the lung, is a relatively rare tumor-like lesion that occurs in various organs and tissues. It is usually well demarcated from the surrounding tissue, however it can be unfortunately resected as a malignant tumor. A few inflammtory pseudotumor in the kidney have been reported in English literature, but there have been no reports in Korea. We report a case with inflammatory pseudotumor of the kidney. A 48 year old woman had an intermittent flank pain on the right side. An ultrasonographic study suggested a renal cell carcinoma and a nephrectomy was done. Grossly, there were two separate masses with a well demarcated yellowish appearance, measuring 2.3 cm and 1.3 cm in diameter, respectively. Histologically, they were composed of smooth muscle actin positive spindle cells and a large number of foamy histiocytes, lymphocytes, and plasma cells in the fibrotic backgound.
Actins ; Carcinoma, Renal Cell ; Female ; Flank Pain ; Granuloma, Plasma Cell* ; Histiocytes ; Humans ; Kidney* ; Korea ; Lung ; Lymphocytes ; Middle Aged ; Muscle, Smooth ; Nephrectomy ; Plasma Cells

No abstract available.
Paraplegia* ; Pseudarthrosis* ; Spondylitis, Ankylosing*

Hirayama disease usually selectively involves lower cervical myotomes (C8, T1). Thus, patients usually manifest with atrophy and weakness of small hand muscle. Predominant isolated involvement of proximal arm is rarely reported in Hirayama disease. Here, we report a case of Hirayama disease who had focal weakness and wasting, mainly confined to right biceps brachii muscle, with prominent shifting of dural sac in C4-5 segment by dynamic flexion magnetic resonance imaging (dfMRI), which may explain this unusual distribution of the disease.
Amyotrophy, monomelic

No abstract available.
Leukemia, Plasma Cell* ; Plasma Cells* ; Plasma*

No abstract available.
Angiofibroma*

The purpose of this study was to classify noodle meals into a few groups according to their menu patterns and cooking methods from the 318 noodles and Ttokgook menus of 360 elementary school foodservices around Busan and Gyeongnam province. Noodle meals with high frequency were also analyzed by season and region to give information for menu planning and to improve elementary school foodservices. The menus were collected from the internet (http://www.kdclub.com) and the home pages of elementary schools between December 2004 and September 2005. Taking all kinds of noodle meals together, the serving frequencies were significantly different among regions, but were not different from season to season. Three different menu patterns were revealed from the collected noodle menus. The most frequently served menu pattern was "main dish + starchy food & dessert + fruit & beverage + kimchi" Gooksu, Ttokgook, Udong, and Kalgooksu meals were served with this menu pattern. The menu pattern of Jajangmeon meal was "main dish + side-dish + starchy food & dessert + fruit & beverage + (kimchi)" . For the Bibimmeon and the spaghetti meals "main dish + soup + starchy food & dessert + fruit & beverage + kimchi" was used. Ttigim, Danmugy, Saengchae, and chicken were frequently selected as side dishes in the overall noodle menus. More side dishes of a wide variety were served in Ttokgook meal, whereas Danmugy was the most preferred food item as a side dish with Jajangmeon and Udong meals. Corndog, Mandu, Ttok, Matang, and doughnut were preferred food items as a "starchy food & dessert" with most kinds of noodle meals, except spaghetti with which only garlic-bread was served. The fruit and beverage items were not different with the majority of noodle meals. These results suggest that cost, food habits, compatible flavor combinations, and food preference of children rather than nutritional considerations contributed to the selection of food items for the components of noodle meals in the school foodservices.
Beverages ; Busan* ; Chickens ; Child ; Cooking ; Food Habits ; Food Preferences ; Fruit ; Humans ; Internet ; Meals* ; Menu Planning ; Seasons

BACKGROUND: When used to reverse the anticoagulant effect of heparin, protamine administration after cardiovascular bypass often can lead to systemic hypotension. During the reversal of heparin-induced anticoagulation, the effects of protamine on both a heparin-protamine complex and free protamine on the cardiovascular system should be considered. METHOD: To determine whether the hypotensive effect of heparin-protamine and/or protamine could be caused by endothelium-dependent and-independent component, we studied rings of the arotic arteries in rats suspended in organ chambers containing Tris Tyrode solution at 37oC and 100% O2. Arterial rings with or without endothelium were contracted with 40 mM KCl or 3 +/- 10-6M phenylephrine and then exposed to increasing concentrations of protamine (final organ bath concentration, 40~400 g/ml) both in the absence and presence of heparin (200 U/ml). RESULTS: Protamine induced concentration-dependent relaxation in arterial rings with endothelium, which were significantly greater than in rings without endothelium. The endothelium-dependent relaxation induced by protamine was inhibited by NG-monomethyl-L-arginine (L-NMMA) (10-5M) pretreatment, but was not inhibited by indomethacin (3x10-6M) pretreatment on rings with endothelium. Furthermore, the contractile inhibition was enhanced by superoxide dismutase (100 U/ml). Also, such vasodilating actions were not influenced in the presence of heparin (200 U/ml). In endothelium-denuded strips, protamine (400ug/ml) inhibited Ca++ induced contraction, which was evoked in Ca++-free solution containing 40 mM K+, and also inhibited the norepinephrine (NE)-induced contraction. Protamine inhibited on the NE-induced contraction, but not the caffein-induced contration in Ca++ free, 2 mM EGTA solution. Also, such inhibition of contracions were not inluenced in the presence of heparin (40 U/ml). CONCLUSION: This study demonstrates that protamine (in the presence or absence of heparin) acts on endothelial cell receptors to stimulate the production of nitric oxide and inhibits both Ca++-influx and the NE-induced Ca++ release from intracellular stores.
Animals ; Arteries* ; Baths ; Cardiovascular System ; Egtazic Acid ; Endothelial Cells ; Endothelium ; Heparin* ; Hypotension ; Indomethacin ; Nitric Oxide ; Norepinephrine ; omega-N-Methylarginine ; Phenylephrine ; Rats* ; Relaxation ; Superoxide Dismutase ; Vasodilation*

BACKGROUND: Adiponectin is a fat cell-secreted cytokine, which has been reported to improve insulin sensitivity and have antiatherogenic properties. However, it is still unclear whether resistin plays a significant role in the development of insulin resistance in humans. The aim of this study was to investigate the relationship of the adiponectin and resistin concentrations with insulin resistance, metabolic markers and adiposity in healthy and type 2 diabetic subjects. METHODS: Eighty-three type 2 diabetic and 139 healthy subjects were studied. Blood samples were drawn after fasting to determine the fasting plasma glucose, insulin, resistin, adiponectin, total cholesterol, triglyceride and HDL-cholesterol levels. The subcutaneous and visceral fat areas were measured at the umbilical level using computed tomography. RESULTS: The serum adiponectin concentrations were significantly lower in the diabetic(6.7+/-2.3microgram/mL) than in the obese(8.2+/-2.4microgram/mL, P<0.01) and non-obese subjects(9.9+/-4.5microgram/mL, P<0.01). The serum resistin concentrations were Similar between the non-obese, obese and type 2 diabetic subjects. From a multiple regression analysis, the fasting glucose, HDL-cholesterol and HOMA-IR were found to be independent determinants of the log of the adiponectin level in the diabetes group. In healthy subjects, the gender, BMI, HOMA-IR, visceral fat area and HDL-cholesterol were associated with the log of the adiponectin level. However, the log of the resistin level was not associated with the markers of insulin resistance and obesity. CONCLUSION: This study showed that the serum adiponectin concentration was closely related to the insulin resistance marker in both healthy and type 2 diabetic subjects. However, the resistin concentration was not associated with the markers of insulin resistance and/or obesity.
Adiponectin* ; Adiposity ; Blood Glucose ; Cholesterol ; Diabetes Mellitus, Type 2 ; Fasting ; Glucose ; Humans ; Insulin ; Insulin Resistance ; Intra-Abdominal Fat ; Obesity ; Resistin* ; Risk Factors* ; Triglycerides