To understand the ability of producing cellulolytic enzyme activity in the sapstaining fungi, four species of Ophiostoma and two species of Leptographium were investigated in the culture media containing each of cellulose substrates such as CM-cellulose, Avicel and D-cellobiose and each of chromogenic dyes such as Congo-Red, Phenol Red, Remazol Brilliant Blue and Tryphan Blue. When the fungi were grown for 5~7 days at 25degrees C, the formation of clear zone by chromogenic reaction around the margin of the fungal colony was demonstrated in all the culture media Congo-Red containing CM-cellulose. There was difference in the formation of clear zone among the dyes. Only Ophiostoma setosum and Leptographium spp. showed cellulolytic activity to the three substrates. Overall, the results of this study show that ophiostomatoid sapstaining fungi can produce cellulolytic enzymes.
Cellulose ; Coloring Agents ; Culture Media ; Fungi ; Ophiostoma* ; Phenolsulfonphthalein

BACKGROUND: Phantom limb sensation is an unusual position sense of the extremity during nerve block that the position of extremity is misinterpreted as being flexed, or elevated, when actually they are in neutral position. Whether it is from the fixation of proprioceptive input at the time of motor blockade or from unmasking of the pattern which has been already present in the CNS is still controversial. We perfomed this study under the assumption that phantom limb sensation can still be reproduced without the influence of position at the time of nerve blockade. METHODS: Thirty-six patients scheduled for elective orthopedic surgery were randomly assigned. For 26 patients, spinal anesthesia was performed with hyperbaric 0.5% tetracaine or bupivacaine at lateral decubitus position and the position was changed to supine immediately. Existence of phantom limb sensation and the level of anesthesia was recorded at 10 and 20 minutes after injection of local anesthetics. For 10 patients, same local anesthetics were injected after patient's legs were straightened in lateral decubitus position. RESULTS: Forteen out of 26 patients whose position were changed to supine immediately after the injection of local anesthetics experienced phantom limb sensations. Five out of 10 patients whose legs were kept straight before the injection of local anesthetics experienced phantom limb sensations. Previous history of trauma was positively related to the expression of phantom limb sensation. CONCLUSION: Our data showed that the expression of phantom limb sensation is reproducible. And this was not related to the position at the time of spinal anesthesia. Trauma seems to be an important factor related to the expression of phantom limb sensation.
Anesthesia ; Anesthesia, Spinal* ; Anesthetics, Local ; Bupivacaine ; Extremities ; Humans ; Leg ; Nerve Block ; Orthopedics ; Phantom Limb* ; Proprioception ; Sensation* ; Tetracaine

PURPOSE: To evaluate the risk of gastrointestinal bleeding associated with use of low-dose aspirin in children. METHODS: Among about 250 children who received low-dose aspirin (5 mg/kg/day) under the diagnosis of Kawasaki disease, from March 1995 to May 2001, at Eul-Ji general hospital, 100 children were enrolled in this study. We reviewed the medical records and interviewed the children's parents over the phone to confirm the existence of gross gastrointestinal bleeding. RESULTS: The age of the children at the beginning of medication ranged 4~118 months. About 75% of them was younger than 3 years old. The duration of medication ranged 0.5~17 months. About 70% of the children took the medicine for 2~3 months. Only 1 child (1%) had hematochezia during medication without any accompanying gastrointestinal symptom, and cimetidine for 1 week had cleared up the bleeding. The total duration of medication of 100 children was 341.5 months, and only 1 child had gastrointestinal bleeding. This translates into a rate of clinically significant gastrointestinal bleeding of 3.5 episodes/100 children/year. CONCLUSION: The long-term use of low-dose aspirin is safe, but, is associated with the risk of gastrointestinal bleeding in children. Careful follow-up and efforts to reduce the risk of gastrointestinal bleeding are necessary during long-term low-dose aspirin therapy in children.
Aspirin* ; Child* ; Child, Preschool ; Cimetidine ; Diagnosis ; Follow-Up Studies ; Gastrointestinal Hemorrhage ; Hemorrhage* ; Hospitals, General ; Humans ; Medical Records ; Mucocutaneous Lymph Node Syndrome ; Parents

Herein, a new left renal vein stenting procedure (expandable metallic stent placement), which provided relief for an 18-year-old man incapacitated by an intermittent gross hematuria, is reported. The placement of an expandable metallic stent is a minimally invasive therapy, and a simpler and more physiological therapy than previous approaches to Nutcracker syndrome.
Adolescent ; Hematuria ; Humans ; Renal Veins ; Stents*

Amyloidosis is characterized by a deposition of insoluble fibrils in various organs and tissues. Amyloid deposition, in the gastrointestinal track, provokes a dysfunction of the organ, due to an accumulation of fibrils, and causes a variety of clinical symptoms and endoscopic findings. Primary amyloidosis in the gastrointestinal tract is rarely reported in Korea. We experienced a case of recurrent intestinal bleeding, in a 59-year-old female patient with primary amyloidosis. A colonoscopy revealed the presence of multiple large circular ulcers. In the entire colon, diffuse nodular lesions with edema and bleeding were found. A colonoscopic biopsy established the diagnosis of amyloidosis, to the exclusion of other disease components. We concluded that the patient had localized amyloidosis. Though a definitive therapeutic strategy has not been established for localized gastrointestinal amyloidosis, the patient has been successfully treated with a high-dose of steroids and azathioprine.
6-Mercaptopurine/analogs & derivatives/therapeutic use ; Amyloidosis/*diagnosis/drug therapy/pathology ; Antimetabolites/therapeutic use ; Colon/pathology ; Colonoscopy ; Female ; Gastrointestinal Hemorrhage ; Humans ; Middle Aged ; Steroids/therapeutic use ; Tomography, X-Ray Computed

The congenital nasal piriform aperture stenosis (CNPAS) is a rare cause of neonatal airway obstruction and could be easily mistaken as the choanal stenosis or atresia. The piriform aperture is a term used to refer to the anterior nasal openings. The nasal airway obstruction in the neonate can result in respiratory difficulties and may be going to life threatening consequences. Computed tomography demonstrates in detail the underlying anatomic abnormalities which allows differentiation of the CNPAS from other upper airway abnormalities. We reported a case of CNPAS, a 1-month-old male infant presented with respiratory difficulties. Shortly after birth, he had mild respiratory difficulties and there was difficulty passing a nasal catheter intranasally. But he was improved through only conservative management and discharged at the age of 5 days. At the age of 1 month, CT scan revealed bilateral CNPAS.
Airway Obstruction ; Catheters ; Constriction, Pathologic* ; Humans ; Infant ; Infant, Newborn ; Male ; Nasal Obstruction ; Parturition ; Tomography, X-Ray Computed

Multiple pterygium (Escobar) syndrome is a rare disorder manifested by growth retardation, facial and genital anomalies, and widespread musculo-skeletal deformities. This disorder was originally described by Bussiere in 1902. And then in 1976, Gorlin et al. described an autosomal recessive disorder characterized by congenital arthrogryposis, skin webs across joints and unusual faces. It was fully delineated as a distinct entity by Escobar et al. in 1978 and an alternative name, Escobar syndrome. In this report, we present an multiple pterygium syndrome that manifested by arthrogryposis, pterygium in shoulder, elbow, wrist, severe deviation of lower leg and ankle, webbed neck, microphthalmia, low set ears, small mouth and high arched palate, and genital anomalies.
Ankle ; Arthrogryposis ; Congenital Abnormalities ; Ear ; Elbow ; Joints ; Leg ; Microphthalmos ; Mouth ; Neck ; Palate ; Pterygium* ; Shoulder ; Skin ; Wrist

PURPOSE: To determine whether the maximal enhancement time in dynamic CT is different between benign and malignant solitary pulmonary nodules (SPN)s, and to evaluate the value of densitometry on dynamic CT in predicting the malignancy of SPN. MATERIALS AND METHODS: Fifty-six patients with SPN of less than 4cm in diameter as seen on chest radiograph and SPN without benign pattern of calcification or fat, as seen on pre-enhancement spiral CT scans were included in this study. SPN with small cavitation sufficient to measure CT density, were also included.Thirty-four SPNs were diagnosed pathologically or radiologically as 20 malignant nodules and 14 benign nodules.Dynamic CT was performed by two techniques after injection of 50ml of nonionic contrast media at the rate of 2ml/sec. In 28 patients, incremental dynamic CT was performed before and of 15 seconds, 1 minute, 2 minutes, 3 minutes, and 4 minutes after injection of contrast media during shallow respiration. In 28 patients, double spiral CT was performed 2 minutes and 3 minutes after injection of contrast media during single breath hold. CT readings were taken at the central portion of SPNs, with a circular region of interest. The degree and time of maximal enhancement were recorded. RESULTS: In dynamic CT the maximal enhancement time of SPNs was not significantly different between malignant (2.73+/-1.27 minute) and benign nodules (2.56+/-1.24 minute). The enhancement of malignant nodules was significantly greater (21.42+/-12.17 HU) than of benign nodules (5.15+/-5.25 HU) (p<.0001). CONCLUSION: In dynamic CT of SPNs, there is no difference in maximal enhancement time between benign and malignant nodules ; enhancement of the latter is significantly greater than that of the former. Maximal enhancement greater than 15 HU can be a good predictor of malignancy of SPNs.
Contrast Media ; Densitometry ; Humans ; Radiography, Thoracic ; Reading ; Respiration ; Solitary Pulmonary Nodule* ; Tomography, Spiral Computed

PURPOSE: To analyze early postoperative complications of calcaneal fractures operated by a lateral extensile approach and to identify risk factors for wound complications. MATERIALS AND METHODS: From July 1990 to February 2003, 116 calcaneal fractures in 104 patients were treated by open reduction and internal fixation through a lateral extensile approach. The patient's records were reviewed for early postoperative complications. Statistical analysis was performed to determine significant relationships between predicted variables and the development of wound complications. RESULTS: Fourteen fractures (12.0%) developed infection. Ten of them were superficial infection and four were deep infection that required surgical treatment. Eight fractures (6.9%) developed skin necrosis. Six of them were marginal skin necrosis and two were flap necrosis that required surgical treatment. Seven fractures (6.0%) developed sural nerve injury, but their symptoms were improved without additional treatment. Open fracture (p=0.003) and prolonged operating time (p=0.049) increased significantly the rate of wound complications. CONCLUSION: The rate of early postoperative complications of calcaneal fractures operated by a lateral extensile approach is high. These complications can be reduced by meticulous treatment of an open wound, reduced operating time within 90 minutes through preoperative planning and skillful technique, and correct incision to avoid damage of the sural nerve.
Fractures, Open ; Humans ; Necrosis ; Postoperative Complications* ; Risk Factors ; Skin ; Sural Nerve ; Wounds and Injuries

The aim of this study was to evaluate the ability of newly marketed NRT instruments to maintain the original root canal configuration and curvature during preparation in comparison with the three existing instruments in simulated root canals. Simulated canals in resin blocks were prepared with ProFile, K3, ProTaper, and NRT instrument (n = 10 canals in each case). Pre- and post-operative images were recorded, and assessment of canal shape was completed with a computer image analysis program. The data were analyzed statistically using the One-way ANOVA followed by Duncan's test. The ability of instruments to remain centered in prepared canals at 1-, 2-mm levels was significantly better in ProFile groups than in other groups (p < 0.05). The change of centering ratio in NRT groups at 5-mm level was significantly greater than ProFile group and at 6- and 7-mm level than all other groups (p < 0.05). Although the NRT system was comparable to other systems in regards to its ability to maintain the canal configuration of apical portion, this system was more influenced by the mid-root curvature due to its stainless-steel files for coronal preflaring.
Dental Pulp Cavity*