Alveolar echinococcosis (AE) caused by infection with E. multilocularis metacestode, represents one of the most fatal helminthic diseases. AE is principally manifested with infiltrative, proliferating hepatic mass, resembling primary hepatocellular carcinoma. Sometimes metastatic lesions are found in nearby or remote tissue. AE diagnosis largely depends on imaging studies, but atypical findings of imaging features frequently require differential diagnosis from other hepatic lesions. Serological tests may provide further evidence, while obtaining reliable AE materials is not easy. In this study, alternative antigens, specific to AE were identified by analyzing E. granulosus protoscolex proteins. An immunoblot analysis of E. granulosus protoscolex showed that a group of low-molecular-weight proteins in the range from 14 kDa to 16 kDa exhibited a sensitive and specific immune response to AE patient sera. Partial purification and proteomic analysis indicated that this protein group contained myosin, tubulin polymerization promoting protein, fatty-acid binding protein, uncharacterized DM9, heat shock protein 90 cochaperone tebp P-23, and antigen S. When the serological applicability of recombinant forms of these proteins was assessed using enzyme-linked immunosorbent assay, DM9 protein (rEgDM9) showed 90.1% sensitivity (73/81 sera tested) and 94.5% specificity (172/181 sera tested), respectively. rEgDM9 showed weak cross-reactions with patient sera from the transitional and chronic stages of cystic echinococcosis (3 to 5 stages). rEgDM9 would serve as a useful alternative antigen for serodiagnosis of both early- and advanced-stage AE cases.

Delayed emergence of speech or language are frequent causes for concern about development during early childhood. Delay in evaluation and proper management until school entry in more likely to result in frustration, anxiety and school failure. Many language disturbances and their attendant behavior disorders respond to intensive language therapy. Authors analyzed the medical records of 52 children with delayed language development evaluated during 30 months from January 1986 through June 1988. The results were as follows: 1. The majority of cases were evaluated at the age of 2-2.9 year old (16 cases, 30.8%) and 3-3.9 year old (11 cases, 21.2%) 2. Male to female ratio was 3:1 3. The most common cause was mental retardation (53.8%), followed by developmental language disorder (23.1%) and autism (13.5%) 4. The most common associated condition was dysarticulation (17.3%), followed by strabismus (9.6%) and seizures (7.7%) 5. Special education was recommended in cases of 23 (44.2%), speech therapy in 12 cases (23.1%) and consultation to child psychiatry in 7 cases (13.5%) Making diagnosis of underlying disorders in not simple because assessment of intelligence in young children in difficult and only a few tests are standardized. More detailed study on children with delayed language development and development of psychometric tests for handicapped children are necessary, especially in Korea.
Anxiety ; Autistic Disorder ; Child Psychiatry ; Child* ; Clinical Study* ; Diagnosis ; Disabled Children ; Education, Special ; Female ; Frustration ; Humans ; Intellectual Disability ; Intelligence ; Korea ; Language Development Disorders ; Language Development* ; Language Therapy ; Male ; Medical Records ; Mental Disorders ; Psychometrics ; Seizures ; Speech Therapy ; Strabismus

No abstract available.
Thyroid Diseases* ; Thyroid Gland* ; Vitiligo*

There are some effective methods for removing layers of skin to improve aging face and dermatologic defects : chemabrasion (chemical peeling), dermabrasion(surgical removal), laserabrasion. Chemabrasion, generally performed with a chemical solution, is most useful for removal of fine facial wrinkles and abnormal pigmentation. The application of chemical caustics, especially TCA (trichloroacetic acid), is known to be an effective and is now commonly practiced to improve the surface of the facial skin that has been blemished by pigmentation, wrinkles, solar damage and certain scars. Trichloroacetic acid is a colorless melting crystal and derivatives of acetic acid which das protein precipitating properties. It has specific odor but there is not systemic toxic effect like a phenol. It has heavy caustic effect on skin and mucosa and cause the coagulation necrosis of the skin and therefore, it must be handled carefully and stored in the proper condition. Especially, moderate to high concentrated TCA solution must be treated by well-trained persons. A 46-year-old woman visited a private clinic for removal of fine wrinkles around the lip. She was refered to our department because of acute upper lip coagulation necrosis which was caused by injection of 35% TCA solution mistaken for lidocaine, which was supposed to be used for anesthesia. At her arrival, cental half of upper lip showed severe coagulation necrosis. The lesion was well discriminated in a few days, then debridement and immediate reconstruction was done using an Abbe flap. Chemical peeling is a relatively effective procedure for improvement of aging skin lesion in a lower cost with a short time operation, if the practitioner has much experience and optimal indication is properly selected. But not so as, side effect and complication may be often ocurred in a mistake and as a result irreversible scars are remained. We experienced a rare case of upper lip necrosis which was caused by TCA injection mistaked for lidocaine in a private clinic and so, We report this case with the results of experiment of rabbit model which was observation of macroscopic and microscopic changes of the abdominal skin of the rabbit injected with serially diluted TCA solution.
Acetic Acid ; Aging ; Anesthesia ; Caustics ; Cicatrix ; Debridement ; Female ; Freezing ; Humans ; Lidocaine ; Lip* ; Middle Aged ; Mucous Membrane ; Necrosis* ; Odors ; Phenol ; Pigmentation ; Skin ; Trichloroacetic Acid

BACKGROUND: In renal transplantation, a good HLA-DR match Is associated with successive graft outcome. But due to a number of technical problems, reliable serological DR typing cannot always be obtained. To compare the serological DR typing with DRBI DNA typing, we tested 103 specimens that had been frozen after serological typing, by PCR-SSOP typing method. METHODS: Serological DR typing was performed by complement-dependent microlymphocytotoxicity technique using commercial antisera kits, and DNA gyp ins was performed by PCR-SSOP, using one of the methods recommended by 12th International Histocompatibility Workshop. DNA amplification was done by DRBAMP-A and DRBAMP-B primers, and hybridization by 18 oligonucleotides labelled with digoxigenin.. RESULTS: The concordance rate between serologic typing and DNA typing was 76.7%. Most (79.0%) of discordant results were due to serological blanks turning out to be definable antigens by DNA typing and these antigens consisted of mainly DR5 splits but none of DR1, DR2, or DR7. CONCLUSIONS: In spite of technical improvement, serological typing method often can not define the accurate HLA-DR type. It is thought that combining serological typing with DNA typing Is necessary to achieve a higher success rate of graft outcome.
Digoxigenin ; DNA ; DNA Fingerprinting ; Education ; Histocompatibility ; HLA-DR Antigens* ; Immune Sera ; Kidney Transplantation ; Oligonucleotides ; Transplants

The purpose of this study was to provide basic data useful to the training of hospice care members. For this study carried out to investigate the degree of death orientation of hospice care members. The subjects of study were 22 nurses, 85 clergies, 59 volunteers who registered on Hospice Education Programs. The data were analysed by descriptive analysis, t-test, ANOVA, Duncan test and Person's correlation coefficient. The results of the study can be summarized as follows; 1. The degree of death orientation were 85.95 in nurses group, 73.05 in clergies group, and 88.49 in volunteers group. So, clergies group has more positive death orientation than others. 2. The degree of death orientation showed significant differences between age group(F=4.62, p=.004), education program group(F=27.25, p=.000), and religiosity(t=3.77, p=.000). There were no significant differences between the degree of death orientation and the others general characteristics of hospice care members. In conclusion, the urgent need for educational preparation of death orientation and spiritual care of hospice care team, especially volunteers group and nurses group is emphasized. Furthermore, all of the hospice care members those who complete the hospice education program, should be performed efficient hospice care intervention for dying patients and their families.
Clergy ; Education ; Hospice Care* ; Hospices* ; Humans ; Volunteers

A 58-year-old female with an episode of gross hematuria two months before and fever and chill for the past three days presented oliguric acute renal failure. She has taken NSAID intermittently for 18 years due to rheumatoid arthritis, and herb medicine for one week two months ago when gross hematuria developed. Physical examination revealed mild tenderness on costovertebral angles. Her blood pressure was 170/100 mmHg, the urinalysis showed >300 mg protein with many RBCs and 10-20 WBCs and the serum creatinine was 5.8 mg/dl. A renal biopsy performed on the 4th hospital day showed that it was overwhelmed by severe tubular lesions which reveal intratubular obstruction by massive erythrocyte casts and tubular necrosis. The glomeruli showed focal minimal crescents with many red blood cells entrapped in the crescents and in the capillaries. Immune deposits were not present. A renal failure resolved spontaneously and the patient was discharged three weeks later with creatinine of 2.4 mg/dl. In this patient, acute renal failure was considered to be due to a tubular lesion related to the glomerular bleeding from focal glomerulonephritis revealing minimal crescents.
Acute Kidney Injury* ; Arthritis, Rheumatoid ; Biopsy ; Blood Pressure ; Capillaries ; Creatinine ; Erythrocytes ; Female ; Fever ; Glomerulonephritis* ; Hematuria* ; Hemorrhage ; Humans ; Middle Aged ; Necrosis ; Physical Examination ; Renal Insufficiency ; Urinalysis

No abstract available.
Humans ; Infant, Very Low Birth Weight* ; Critical Care*

No abstract available.
Child* ; Drug Therapy* ; Graves Disease* ; Humans ; Receptors, Thyrotropin* ; Thyroid Function Tests* ; Thyroid Gland*

Decubitus ulcer is often seen in the skin and underlying tissue of debilitated or immobilized patients as the result of prolonged pressure and impaired circulation. It manifests chiefly as an ulcer over bony prominences, but tumefaction is an extremely unusual presentation. A 53-year old male, a paralytic of the lower extremity for 18 years, developed a recurrent decubital ulcer despite repeated surgical repair, from which a rapidly growing, large fungating mass grew within a month. The last resected mass was bosselated and measured 15x9x3 cm with a major area of cicatrix-like induration, interdigitated with skeletal muscle bundles at the central area. Microscopically, the mass was composed of an upper half of active granulation tissue layer and a deeper half of dense, poorly cellular, fibrocollagenous bundles admixed with florid proliferation of atypical fibroblasts, but the absence of mitosis and the multifocal admixture of active inflammatory process-granulation tissue formation seemed to help exclude genuine fibromatosis, nodular fasciitis or proliferative myositis. We assume that this rapidly growing pseudofibromatosis is an additional manifestation of a prolonged decubitus ulcer, possibly related to the modified reparative process of decubitus ulcer following repeated excisions, for which we propose a term of decubitoma.