Urachal disease, a disorder where embryonic remnant of the cloaca and the allantois present after birth as a midline fibrous cord, is usually detected in infancy and childhood. But urachal disease in adults is rare. We report a case of a huge abscess derived from a urachal cyst in an adult. A 52-year-old man presented with peri-umbilical distension and abdominal pain for 2 weeks. Ultrasonography and abdominal computed tomography scan demonstrated a huge abscess derived from the abdominal wall. After prompt incision and drainage, the remaining abscess cavity was removed completely under general anesthesia. Pathologic report was consistent with urachal duct cyst, and the patient was discharged in a week without complication.
Abdominal Pain ; Abdominal Wall ; Abscess ; Adult ; Allantois ; Anesthesia, General ; Cloaca ; Drainage ; Humans ; Middle Aged ; Parturition ; Urachal Cyst

BACKGROUND: Antistreptolysin O (ASO) has been widely used to diagnose Streptococcus Pyogenes infections and their sequelae, rheumatic fever and acute glomerulonephritis. Butt in some cases there is no elevation of ASO that it is necessary to add one or more tests detecting immune response to S. pyogenes.. The authors analyzed the distribution of antideoxyibonuclease (ADNase) B and antistreptolysin O (ASO) among the children of an elementary school in Seoul and calculated their upper limit of normal (ULN) value. METHODS: ADNase B concentrations were determined by nephelometry (Behring Nephelometer 100 Analyzer, Germany) on 236 sera of healthy elementary school children in Seoul. Throat cultures were taken at the same time to compare ADNase B lovels between S. pyogenes carriers and non-carriers. RESULTS: The distribution of ADNase B concentrations among school children ranged from 77 (detection limit) to 1616 IU/ml and the ULN was estimated to be 362 IU/mL. The carriers of S. pyogenes clad significantly higher ADNase B levels (mean 392 IU/ml) than carriers of non-group A beta-hemolytic streptococci (BHS, 236 IU/ml) oY non-carriers of BHS (234 IU/ml). The relationship between ADNase B (Y) and ASO (X) levels was Y=0.4X+173 (r2=0.209). CONCLUSIONS: The distribution of ADNase B levels showed no close correlation with that of ASO, and ADNase B test was considered to have additive value to ASO test for detecting S. pyogenes infection.
Antistreptolysin ; Child* ; Glomerulonephritis ; Humans ; Nephelometry and Turbidimetry ; Pharynx* ; Rheumatic Fever ; Seoul* ; Streptococcus pyogenes

Vibrio damsela is a halophilic bacterium that has been reported to cause skin ulcers and death in damselfish (Chromis punctipinnis) as well as wound and soft-tissue infections in human. Most of the previously reported cases in humans haute involved wound infections associated with exposure to seawater or handling fish. We experienced a case of primary septicemia due to V. damsela after eating raw fists in a healthy 66-year-old woman who had neither wounds nor history of exposure to sea- water. She presented fever and diarrhea followed by rapidly pregressive bullae and painful edema on left band and forearm. The patient was Improved by intensive surgical debrldement of necrotic tissue and antibiotic therapy.
Aged ; Diarrhea ; Eating ; Edema ; Female ; Fever ; Forearm ; Humans ; Seawater ; Sepsis* ; Skin Ulcer ; Vibrio* ; Wound Infection ; Wounds and Injuries

No abstract available.
Asthma* ; Theophylline*

Cardiovascular syphilis is one of the most important complications of tertiary syphilis, although its incidence is decreasing in recent years. Aortitis is the primary manifestation of cardiovascular syphilis, resulting most commonly in aortic aneurysm, aortic regurgitation and coronary artery ostial obstruction. The authors experienced 46-year-ole male with a history of chancre 20 years ago, and several bouts of right chest pain since last year. Serologic tests revealed reactive in VDRL (1:64) and in TPHA test. Chest x-ray, chest CT, echocardiogram and aortogram showed aneurysm of ascending aorta with no evidence of aortic regrugitation of coronary obstruction. Histologic findings of involved aorta revealed "tree bark" appearance in gross, and microscopically adventitial thickening with endarteritis of the vasa vasorum and destruction of elastic tissue of media, showing moth-eaten appearance. The patient was underwent excision of the aneurysm and dacron aortic prosthetic graft was replaced with success.
Aneurysm* ; Aorta* ; Aortic Aneurysm ; Aortic Valve Insufficiency ; Aortitis ; Chancre ; Chest Pain ; Coronary Vessels ; Elastic Tissue ; Endarteritis ; Humans ; Incidence ; Male ; Polyethylene Terephthalates ; Serologic Tests ; Syphilis ; Syphilis, Cardiovascular ; Thorax ; Tomography, X-Ray Computed ; Transplants ; Vasa Vasorum

Pulmonary Fibrosis*

This study is to verify the protective ability against experimental Naegleria meningoencephalitis by immunization with Naegleria fowleri in mice. Naegleria fowleri, strain 0359, and Naegleria gruberi, strain EGB, were used in this study, and cultured in CGVS medium axenically. Inbred BALB/c mice, weighing about 20 g, were immunized by three intraperitoneal injection of 1 x 10(6) N. fowleri trophozoites at the interval of one week. This N. fowleri trophozoites antigen was fixed with 5 percent formaldehyde. N. fowleri trophozoites from culture were homogenized with sonicator at 4C as monitored by phase contrast microscopy, and their membrane and cell content preparations were made for the immunization of mice. Their inoculation dose in volume was equivalent to the 1 x 10(6) trophozoites in each injection for immunization. And N. gruberi trophozoites, which was fixed with 5 percent formaldehyde, were also used for immunization. Mice were inoculated intranasally with 5 x 10(4) N. fowleri trophozoites in a 5 microliter suspension under anesthesia by as intraperitoneal injection of about l mg secobarbiturate. Nervousness, rotation or sluggish behaviour were observed in the mice which were infected with N. fowleri. Necrotic lesion was demonstrated in the anterior portion of brain, especially in the olfactory lobe. The inflammatory cell infiltration with numerous N. fowleri trophozoites was noticed. This pathological changes were more extensive in the control than in the experimental groups. Mice were dead due to experimental primary amoebic meningoencephalitis that developed between 8 days and 23 days after inoculation. Mortality rate of the mice was low in the immunized experimental group. Mean survival time, which is the survival duration of mice from the infection to death, was prolonged significantly in the immunized mice except in the mice immunized with N. fowleri membrane. Even in the mice immunized with N. gruberi, survival time was delayed. In summary, the effectiveness of immunization is demonstrated in terms of protective immunity against Naegleria meningoencephalitis in mice.
parasitology-protozoa ; Naegleria fowleri ; meningoencephalitis ; immunology ; mouse ; brain

Tumoral form of pseudoangiomatous stromal hyperplasia (PASH) of male breast is a rare disease entity. We report on a case of PASH that presented as a palpable subareolar breast mass in a 46-year-old male who has been on hemodialysis due to chronic renal failure. To the best of our knowledge, no case of PASH in a male with chronic renal failure has yet been reported. We describe its mammographic and sonographic findings with correlative histopathologic features, confirmed by surgical excision.
Angiomatosis ; Breast ; Breast Diseases ; Humans ; Hyperplasia ; Kidney Failure, Chronic ; Male ; Rare Diseases ; Renal Dialysis

PURPOSE: Bilirubin values may vary depending on the site of sampling. The purpose of this study is to compare simultaneously obtained capillary and venous serum bilirubin to assess neonatal jaundice. METHODS: The subjects for the study included 135 healthy inborn as well as outborn full-term infants admitted to Dong-Eui Medical Center for evaluation of jaundice from May 1997 to February 1999. A paired capillary and venous sample was simultaneously drawn from each neonate, and their serum bilirubins were measured by direct spectrophotometric method. RESULTS: A high correlation between capillary and venous serum bilirubin(correlation coefficient(r) =0.949, P<0.05) was observed. No significant difference between mean capillary and venous bilirubin was detected when capillary bilirubin was less than 10 mg/dL(P>0.05), however, the mean venous bilirubin was significantly higher than the mean capillary bilirubin(mean difference;0.65+/-1.04 mg/dL, P<0.0001) when the capillary bilirubin was greater or equal to 10 g/dL(P>0.05). CONCLUSION: There was a trend toward venous bilirubin being higher than capillary bilirubin at higher serum bilirubin levels. However, further studies are needed to ascer-tain the relationship between the site of the sampling and methodology in measurement of bilirubin.
Bilirubin* ; Capillaries* ; Humans ; Infant ; Infant, Newborn ; Jaundice ; Jaundice, Neonatal*

BACKGROUND: Elements of informed consent including capacity, disclosure, understanding, voluntariness, and permission of the participant, are all crucial for clinical trials to be legally and ethically valid. During the informed consent process, the patient information leaflet is an important information source which prospective research subjects can utilize in their decision-making. In the adequate provision of information, KGCP guideline necessitate 20 specific items, as well as the use language that individuals can understand. This study measures the vocabulary level of patient information leaflets in an effort to provide an objective evaluation on the readability of such material. METHODS: The word difficulty of 13 leaflets was quantitatively evaluated using Kim kwang Hae's vocabulary grading framework, which was compared to the difficulty level of words found in the 6th grade Korean textbook. The quantitative outcomes were statistically analyzed using chi-squared tests and linear by linear association for ordinal data. RESULTS: There was a statistically significant difference between the vocabulary level and frequency of words in leaflets and the 6th Korean textbook. The leaflets were on average 260 sentences and about roughly 15 pages long, including lay language (easier or equal to language used in primary school) of around 12% less; technical language of around 4.5% more. As the vocabulary grades increase, there was a distinct difference in vocabulary level between Korean textbook and each information leaflet (p < 0.001). CONCLUSION: Patient information leaflets may fail to provide appropriate information for self-determination by clinical trial subject through the difficulty level of its wording. Improvements in the degree of patients' understanding and appropriate use of information leaflets are collaboratively equipped to strengthen patient's autonomy and therefore guaranteeing participant's rights.
Comprehension* ; Disclosure ; Human Rights ; Humans ; Informed Consent ; Prospective Studies ; Research Subjects ; Vocabulary