A total of 33 patients with infective endocarditis were observed in the Guro and Hye Hwa Hospitals of Korea University Between September, 1981 and Feb, 1987. Among thses patients four patients presented with heart murmur and heart failure and had vegetation like findings observed on the two dimensional echocardiography. But these patients did not have any fever or leukocytosis in the peripheral blood and the repeated blood cultures were negative. They showed the immunologic phenomena of infective endocarditis such as microscopic hematuria in 4 patients, rheumatoid factor in 3 patients, false positive VDRL in one patient. The serum complement was decreased in 2 patients in whom it was checked. We report these 4 patients because we think these patients might be in the clinical stage in which the infecting organism is spontaneously cleared but the immunologic sequelae are remained.
Complement System Proteins ; Echocardiography ; Endocarditis* ; Fever ; Heart Failure ; Heart Murmurs ; Hematuria ; Humans ; Korea ; Leukocytosis ; Rheumatoid Factor

PURPOSE: This study was conducted to evaluate the relationship between metabolic syndrome and the prostatic volume. MATERIALS AND METHODS: From January 1997 to December 2006, 555 male out-patients who visited our health care center were investigated and they underwent transrectal ultrasonogram of the prostate. The patients were divided into two groups; group A met the criteria for metabolic syndrome (128 patients) and group B did not meet the criteria (427 patients). The authors compared the age, the prostate-specific antigen (PSA) and the prostate volume between these two groups. RESULTS: There were no statistically significant differences in age and PSA between the two groups. The prostate volume was significantly larger in group A (39.5+/-17.3cc) than in group B (31.7+/-9.6cc). CONCLUSIONS: The results of this study proved that metabolic syndrome and the prostate volume are related. Therefore, proper clinical management of metabolic syndrome should accompany the treatment of benign prostatic hyperplasia (BPH).
Delivery of Health Care ; Humans ; Male ; Outpatients ; Prostate* ; Prostate-Specific Antigen ; Prostatic Hyperplasia ; Ultrasonography

PURPOSE: For the management of patent ductus arteriosus(PDA) in premature infants, fluid restriction, correction of anemia, mechanical ventilation, diuretics, and surgery have been used, and the closure rate of PDA has improved significantly since the introduction of indomethacin and mefenamic acid as pharmacologic treatments of PDA. We studied to evaluate and compare the therapeutic effects of indomethacin and mefenamic acid in the management of premature infants with PDA. METHODS: 32 inborn premature infants who were hospitalized in NICU and diagnosed as PDA by cardiac sector were retrospectively studied and divided into two groups : An indomethacin treated group and a mefenamic acid treated group. Their gestational age, birth weight, blood urea nitrogen(BUN), creatinine(Cr), platelet count, urine output, fluid therapy, postnatal age, closure rate of PDA, and etc. were examined and conpared through the medical record review. RESULTS: The mean postnatal age on drug use was 4.6 days in intravenous indomethacin treated group(n=18), 9.0 days in oral mefenamic acid treated group(n=14), and the mean gestational age was 32.0 weeks and 32.3 weeks, respectively. After the use of each drugs, platelet count and urine output decreased, whereas blood urea nitrogen and creatinine increased. The closure rate of PDA was 94.4%(17/18) in the indomethacin treated group and 85.7%(12/14) in the mefenamic acid treated group(P=0.568). On the multivariate analysis except for the drugs, the most significant factor on PDA closure in preterm neonates was total amount of intake(P=0.000). CONCLUSION: We conclude that intravenous indomethacin is as effective as oral mefenamic acid in the therapy of preterm infants with PDA.
Anemia ; Birth Weight ; Blood Urea Nitrogen ; Creatinine ; Diuretics ; Ductus Arteriosus, Patent* ; Fluid Therapy ; Gestational Age ; Humans ; Indomethacin* ; Infant, Newborn ; Infant, Premature* ; Medical Records ; Mefenamic Acid* ; Multivariate Analysis ; Platelet Count ; Respiration, Artificial ; Retrospective Studies ; Urea

The purpose of this study is to obtain the clinicopathological characteristics of replication error-positive (RER ) gastric adenocarcinoma in Korean, and to identify the significance of RER in adenoma stage of gastric carcinogenesis. Microsatellite instability was examined at D2S71, D2S119, D3S1067, D6S87, D11S905, DM, AR, VWF, HPRT, and BAT-26 loci. Frameshift mutation of BAX gene was analyzed in RER tumors. Normal and tumor DNA of 76 cases of gastric carcinoma and 25 cases of adenoma were examined. RER was found in 8 of 76 cases (10.5%), and it was more frequently found in adenocarcinoma of female (17.7%) than those of male (4.8%). The frequency of RER was not different between the histologic types, age of the patient, anatomical location of the carcinoma, and the stage. The RER found in adenoma suggests that RER contributes to the malignant transformation early in the adenoma stage of the gastric carcinogenesis. None of the RER tumors revealed frameshift mutation of the BAX gene.
Adenocarcinoma* ; Adenoma ; Carcinogenesis ; DNA ; Female ; Frameshift Mutation ; Humans ; Hypoxanthine Phosphoribosyltransferase ; Male ; Microsatellite Instability

Tuberculosis can involve any part of the gastrointestinal tract but 80~90% of patients present the disease in the ileocecal region. The cases of colon cancer coexisting with colonic tuberculosis are relatively rare and ascending colon is the predominant site of the combined disease. A 46-year-old man, without specific past medical or family history, showed multiple colonic polyps and ulcers on colonoscopic examination. After surgery, the surgical specimen disclosed adenocarcinoma in the ascending colon, eleven adenomatous polyps throughout the colon, and multiple tuberculous ulcers in the entire colon. Tuberculosis of terminal ileum was also accompanied. The association of colonic tuberculosis and colon cancer with multiple polyps in this case may have been coincidental. The preoperative colonoscopic examination and pathologic diagnosis by frozen section during operation are necessary for the adequate treatment.
Adenocarcinoma ; Adenomatous Polyps ; Colon* ; Colon, Ascending ; Colonic Neoplasms* ; Colonic Polyps ; Diagnosis ; Frozen Sections ; Gastrointestinal Tract ; Humans ; Ileum ; Middle Aged ; Polyps ; Tuberculosis* ; Ulcer

STUDY DESIGN: This is a retrospective study OBJECTIVES: The coronal MR images were carefully evaluated to document the efficacy of diagnosing foraminal and extraforaminal disc herniations. SUMMARY OF LITERATURE REVIEW: Extraforaminal disc herniations constitute 1~11.7% of all disc herniations. The diagnosis of it demands great caution because it must be distinguished from intraspinal canal disc herniation. Diagnosing extraforaminal disc herniations can be neglected with using ordinary diagnostic methods. MATERIALS AND METHODS: A retrospective analysis was performed on 24 patients, (26 cases) that underwent lumbar spine MRI, with the T2 coronal images, for the evaluation of disc herniations from March 2006 to March 2007. Every MRI image of each patient who had foraminal or extraforaminal disc herniations was graded according to the Pfirrmann's classification of diagnostic efficacy by two spinal surgery specialists and two radiology specialists. RESULTS: There were 13 cases of foraminal disc herniation and 13 cases of extraforaminal disc herniation in all 26 cases that were diagnosed by MRI. The coronal and axial images were more effective than the sagittal images for the discrimination of a compressed root. Especially, for the extraforaminal disc herniation, all of the coronal images were graded as grade 3; on the other hand, all of the sagittal images were not helpful for the assessment and the axial images were graded as grade 2 for 38.5% of the and as grade 3 for 61.5%. So, the coronal images were most effective for making the diagnosis of extraforaminal disc herniation and this was statistically significant (p<0.05). CONCLUSION: For the accurate discrimination of the location and the grading of foraminal and extraforaminal disc herniation, MRI, and especially the coronal images, is an effective and useful method in addition to conducting a physical examination.
Discrimination (Psychology) ; Hand ; Humans ; Retrospective Studies ; Specialization ; Spine

An adrenocortical oncocytoma is very rare and unusual disease. Only 22 and 2 cases have been reported in the foreign and Korean literatures, respectively. Herein, the case of a left adrenocortical oncocytoma, observed by ultrasonography during a periodic medical examination of a 32 year old male patient is reported.
Adenoma ; Adenoma, Oxyphilic* ; Adult ; Humans ; Male ; Ultrasonography

OBJECTIVE: The imbalance between pro-inflammatory and anti-inflammatory cytokines may underlie different pain states. Although ascorbic acid is the most important physiological antioxidant that affects host defense mechanisms and immune homeostasis, there is limited information on the effects of ascorbic acid on the production of cytokines. METHODS: In this study, we investigated the in vitro effect of L-ascorbic acid (AA) on the production of pro-inflammatory and anti-inflammatory cytokines by stimulating C57BL/6 mouse splenocytes with the polyclonal activators lipopolysaccharide or concanavalin A. RESULTS: AA significantly downregulated the expression of IL-6, IL-12, and TNF-alpha at 48 h and 72 h in mouse splenocytes treated with a combination of polyclonal activators and AA. AA treatment also resulted in upregulation of IL-4 and IL-10 at 72 h. These findings demonstrated that AA significantly potentiated production of anti-inflammatory cytokines whereas there was an inverse association between AA and expression of pro-inflammatory cytokines in mouse splenocytes. CONCLUSION: AA may have potential applications in the reduction of inflammatory pain because of its function in modulating the production of cytokines. However, further in vivo investigations are necessary to elucidate the mechanisms involved.
Animals ; Ascorbic Acid* ; Concanavalin A ; Cytokines* ; Defense Mechanisms ; Homeostasis ; Interleukin-10 ; Interleukin-12 ; Interleukin-4 ; Interleukin-6 ; Interleukins ; Mice* ; Tumor Necrosis Factor-alpha ; Up-Regulation

BACKGROUND: pH measurement is an important test in assessing the etiology of pleurisy and in identifying complicated parapneumonic effusion. Although the blood gas analyzer is the' gold standard method' for pleural pH measurement, pH meter & pH strip methods are also used for this purpose interchangably. However, the correlation among the pH data measured by the three different methods needs to be evaluated. In this study, we measured the pH of pleural fluid with the three different methods respectively and evaluated the correlation among the measured data. METHODS: From August 1999 to March 2000, were measured the pleural fluid pH in 34 clinical samples with three methods-blood gas analyzer, pH meter, and pH strip. In the blood gas analyzer and pH meter methods, the temperature of plerual fluid was maintained around 0℃ in air-tight condition before analysis and measurement was performed within 30 minutes after collection. As for the pH strip method, the pleural fluid pH was checked in the ward immediately after tapping and in the clinical laboratory of our hospital. This part is unclear. RESULTS: The causes of pleural effusion were tuberculosis pleurisy in 16 cases, malignant pleural effusion 5 cases, parapneumonic effusion 9 cases, empyema 3 cases, and congestive heart failure 1 case. The pH of pleural fluid (mean±SD) was 7.34±0.12 with blood gas analyser, 7.52±0.25 with pH meter, 7.37±0.16 with pH strip of immediate measurement and 6.93±0.201 with pH strip of delayed measurement. The pH measured by delayed pH strip measurement was lower than those of other methods(p<0.05). The correlation of the results between the blood gas analyzer and pH meter(p=0.002, r=0.518) and the blood gas analyzer and pH strip of immediate measurement(p<0.001, r=0.607). CONCLUSION: In the determination of pH of pleural fluid, pH strip method could be a simple and reliable method under immediate measurement conditions after fluid tapping.
Empyema ; Heart Failure ; Hydrogen-Ion Concentration* ; Methods* ; Pleural Effusion ; Pleural Effusion, Malignant ; Pleurisy ; Tuberculosis

Phosphate is an essential ion and plays a vital role in many physiological processes. Carpopedal spasm is known as a symptom of hypocalcemia, or rarely, hypomagnesemia. We present an unusual case of carpal spasm seen in a patient with hypophosphatemia. A fourteen year old boy was admitted with acute onset of both carpal spasm after vomiting and diarrhea. Biochemical investigation revealed only moderate hypophosphatemia without hypocalcemia. Other laboratory findings including hormone tests were normal. Carpal spasm improved with correction of hypophosphatemia. The phathophysiology of neurologic dysfunction related to hypophosphatemia is not clear yet. Careful observation of serum electrolytes including phosphate is necessary when the patient has neurologic symptoms.
Diarrhea ; Electrolytes ; Humans ; Hypocalcemia ; Hypophosphatemia* ; Male ; Neurologic Manifestations ; Physiological Processes ; Spasm* ; Vomiting