The autoinfective filariform larva of Strongyloides stercoralis causes hyperinfection in immunosuppressed hosts. Here we report on the case of a male patient who was admitted to the emergency room at Gwangju Veterans Hospital with a complaint of dyspnea, and who was receiving corticosteroid therapy for asthma. Many slender larvae of S. stercoralis with a notched tail were detected in Papanicolaou stained sputum. They measured 269 +/- 21.2 micrometer in length and 11 +/- 0.6 micrometer in width. The esophagus extended nearly half of the body length. The larvae were identified putatively as autoinfective third-stage filariform larvae, and their presence was fatal. The autoinfective filariform larva of S. stercoralis has not been previously reported in Korea.
Aged ; Animals ; Fatal Outcome ; Humans ; Immunocompromised Host ; Larva ; Male ; Sputum ; Strongyloides/growth & development/*isolation & purification ; Strongyloidiasis/*etiology ; Superinfection/*parasitology

OBJECTS: Depressive symptoms are common in the elderly medical inpatients. But depressive disorders are considerably underdiagnosed and undertreated. Especially in major depressive disorder, patients show cognitive impairments and do not respond adequately to medical treatment. The goals of this study were to examine what are the patterns of depressive symptoms of major depressive disorders which differentiate from minor depressive disorders in the elderly medical inpatients. METHODS: A 4-month prospective study of 312 patients (65 years and older) was conducted in a general hospital. Depression was screened with Hamilton Depression Rating Scale and cognitive function was screened with Mini-Mental State Examination-K. The subjects were diagnosed according to DSM-IV for depression. And according to DSM-IV diagnosis, HDRS and MMSE-K subscales were analysed. RESULTS: In the 228 patients who were investigated, 16 (7%) patients were major depressive disorder, 53 (23%) were minor depressive disorder. Females were more depressed than males but there was no statistical significance. While the patients of major depressive disorder complained of depression and anxiety, the control subjects complained of loss of body weight, somatic symptoms and somatic anxiety, and the minor depressive disorders shows mixed symptoms of the two. The complaining frequency of the somatic symptoms and somatic anxiety were similar among the three groups. Significant differences were found among the three groups in terms of HDRS total scores. Among the three groups in terms of HDRS subscale scores all subscale scores except for the genital symptoms and body weight were significantly high in depressive disorders. Initial insomnia (p<0.01), middle insomnia (p<0.05), GI symptoms (p<0.01) and somatic symptomgeneral (p<0.05) were significantly different between the control subjects and the depressive disorder group. The subscales of terminal insomnia, agitation and loss of insight were significantly different between the minor depressives and major depressives (p<0.01), but no difference between the control subjects and the minor depressives. MMSE total scores were significantly correlated in major depressive disorders among the 3 groups. Comparing subscales of the three groups, significant correlation were found in time orientation, attention and calculation (p<0.05) and language (p<0.01). CONCLUSION: Major depressive disorder patients in elderly medical inpatients chiefly complained of depression and anxiety, but they also complained somatic symptoms. If elderly medical inpatients complain of agitation, terminal insomnia, cognitive impairment associated with depressive symptoms, consultants will pay attention for the major depressive disorders. This study suggests that further systematic study is necessary for the recognition of major depressive disorder in the elderly medical inpatients.
Aged* ; Anxiety ; Body Weight ; Consultants ; Depression ; Depressive Disorder* ; Depressive Disorder, Major* ; Diagnosis ; Diagnostic and Statistical Manual of Mental Disorders ; Dihydroergotamine ; Female ; Hospitals, General ; Humans ; Inpatients* ; Male ; Prospective Studies ; Sleep Initiation and Maintenance Disorders

No abstract available.
Fertilization in Vitro* ; Humans* ; Micromanipulation* ; Pregnancy Rate* ; Pregnancy*

Invasive diseases caused by Trichosporon beigelii are rare, usually fatal, opportunistic infections that occur exclusively in immunocompromised patients. This fungus has been known to produce cutaneous involvement in immunocompetent hosts, and is rarely reported to cause systemic disease in patients with cardiac valve replacement. In this report, we described a case of invasive Trichosporon beigelii pneumonia in a 9-year-old boy who presented with persistent cough and dyspnea for 1 week. He showed no abnormality in immunologic function tests and had no predisposing factors. Trichosporon beigelii was isolated from the bronchoalveolar lavage culture.
Bronchoalveolar Lavage ; Causality ; Child ; Cough ; Dyspnea ; Fungi ; Heart Valves ; Humans ; Immunocompromised Host ; Male* ; Opportunistic Infections ; Pneumonia* ; Trichosporon*

PURPOSE: Recently, a new animal model for permanent focal brain ischemia using macrospheres was developed wherein the hypothalamic area was free from ischemic injury. The purpose of this study was to evaluate spatiotemporal changes in the expressions of cFos, pERK, and pAkt proteins in the macrosphere model. METHOD: Three or four macrospheres were injected into the internal carotid artery after ligation of the external carotid artery to induce permanent focal brain ischemic injury. RESULT: Twenty-four hours after macrosphere injection, 2,3,5-Triphenyltetrazlium (TTC) staining showed a marked ischemic injury in the blood supply territory of the middle cerebral artery, for example, the cerebral cortex and striatum. Furthermore, TUNEL staining revealed apoptotic cell death in the ischemic injury region of the cerebral cortex and striatum. Expression of the cFos protein was significant in the penumbral zone, but not in the ischemic core of the cortex and striatum, two and six hours after ischemic insult. A transient prominent expression of the pERK1/2 protein was noted in the penumbral zone of the cortex and striatum two hours after injection of macrospheres. In contrast, there was a strong immunoreactivity for the pAkt protein in the ischemic core, but not in the penumbral zone of the cortex and striatum, six hours after ischemic injury. CONCLUSION: The above results suggest that early expressions of cFos, pERK1/2, and pAkt proteins take part in different signaling cascades for cell survival or death in macrosphere animal model of permanent focal brain ischemic injury.
Animals* ; Brain Ischemia ; Brain* ; Carotid Artery, External ; Carotid Artery, Internal ; Cell Death ; Cell Survival ; Cerebral Cortex ; In Situ Nick-End Labeling ; Ligation ; Middle Cerebral Artery ; Models, Animal*

PURPOSE: Minimal Change Nephrotic Syndrome (MCNS) is one of the most common primary nephrotic syndromes in children. T-cell dysfunction has been thought to be involved in the pathogenesis of MCNS. However, the exact pathogenesis of MCNS has not been proven yet in spite of many studies which support T-cell dysfunction being involved in the pathogenesis of MCNS. A present study was done to determine the role of IL-8 and TNF-alpha in the pathogenesis of MCNS. METHODS: Study patients consisted of 19 biopsy-proven MCNS children aged 2-15 years old. Ten age-matched healthy children were used as controls. Both plasma and urinary IL-8 and TNF-alpha were measured during relapse and remission period using ELISA kit. Urinary cytokine values were corrected for urinary creatinine. RESULTS: Each value of urinary IL-8 measured during relapse and remission period in MCNS and controls was 13,996+/-2,811, 2,811+/-3,734 and 5,331+/-6,403ng/mg cr, respectively, and we noted that the value of urinary IL-8 measured during relapse period in MCNS significantly increased compared to those measured during remission period and in controls(p< 0.05). And each value of urinary TNF-alpha measured in the same group was 364.4+/-512.1, 55.3+/-208.0 and 36.0+/-45.0ng/mg cr, respectively, and we also noted that the value of urinary TNF-alpha measured during relapse period in MCNS was signficantly increased compared to those measured during remission period and in controls. The plasma cytokine values measured during relapse and remission period and in controls were 1.19+/-1.23, 0.51+/-0.84 and 0.77+/-0.62ng/mL, respectively, in the case of IL-8 and 2.42+/-3.86, 1.95+/-3.24 and 2.25+/-3.50ng/mL, respectively, in the case of TNF-alpha, and we noted the value of plasma IL-8 measured during relpase was also significantly increased compared to those of remission period and in control(p<0.05), but the change of plasma TNF-alpha values was not significant. CONCLUSION: It can be said that both IL-8 and TNF-alpha play an important role in the pathogenesis of MCNS in children. The fact that changes of urinary IL-8 and TNF-alpha were more prominent than those of plasma suggests that immune dysregulation may occur intrarenally rather than systemically in MCNS.
Child* ; Creatinine ; Enzyme-Linked Immunosorbent Assay ; Humans ; Interleukin-8* ; Nephrosis, Lipoid* ; Nephrotic Syndrome ; Plasma* ; Recurrence ; T-Lymphocytes ; Tumor Necrosis Factor-alpha*

We evaluated in vitro microleakage of Mineral Trioxide Aggregate (MTA) powder with 4-methacryloxyethyl trimellitate anhydride (4-META) / methyl methacrylate (MMA) & tri-n-butylborane (TBB) resin as a retrograde filling material by using methylene blue dye method. Fifty-two single rooted, extracted teeth were instrumented and obturated with gutta percha and AH plus sealer. The apical 3mm of each root was resected and 3mm deep ultrasonic root end preparation was done. External surface of roots was coated with nail varnish. Prepared teeth were randomly divided into five groups; Negative control: completely covered with nail varnish; Positive control: coated with nail varnish except for apical foramen; Group 1 (retrofilled with Portland cement); Group 2 (retrofilled with MTA); Group 3 (retrofilled with MTA powder mixed with 4-META/MMA & TBB resin). Immediately after completion of root-end filling, all specimens were submerged in methylene blue dye for 72 hours in 37degrees C incubator. The roots were longitudinally sectioned and measured for extent of dye penetration by three different examiners under microscope (x10). The results were statistically analyzed using one way ANOVA and Turkey's HSD test. No leakage was evident in negative control and complete leakage in positive control group. Group 3 showed significantly less leakage than group 1 and 2 (p < 0.01). There was no significant difference between group 1 and 2 (p > 0.01). It was concluded that MTA powder with 4-META/MMA & TBB resin was excellent in reducing initial apical microleakage.
Aluminum Compounds ; Boron Compounds ; Calcium Compounds ; Drug Combinations ; Epoxy Resins ; Glutamates ; Guanine ; Gutta-Percha ; Incubators ; Methylene Blue ; Nails ; Oxides ; Paint ; Root Canal Filling Materials ; Silicates ; Tooth ; Ultrasonics ; Pemetrexed

Homograft has been the conduit of choice in various types of congenital malformations which require right ventricular outflow tract reconstruction. However it has been proven to be less than ideal in young age group because of early failure of the conduite due to valve dysfunction and calcification. Furthermore limitation of availability of homograft particularly small sized conduits for neonates and infants is the most serious problem. A 19 month old female patient with pulmonary atresia and ventricular septal defect was operated on with a bovine jugular venous valved conduit as an alternative to the homograft for her right ventricular outflow tract reconstruction. Postoperative hemodynamic performance of the conduit was excellent without pressure gradient or valve regurgitation. With this early result bovine jugular venous valved conduit seems to be another excellent conduit because of good hemodynamics and size availability but long term follow up is necessary.
Allografts ; Female ; Follow-Up Studies ; Heart Septal Defects, Ventricular ; Hemodynamics ; Humans ; Infant ; Infant, Newborn ; Pulmonary Atresia

PURPOSE:NT-proBNP (N-terminal pro-brain natriuretic peptide) is mainly secreted by cardiac myocytes of ventricle and can be used asdiagnosis and prognostic factor for heart failure. The aim of this study was evaluating the usefulness of NT-ProBNP in children with chronic kidney disease. METHODS:A total of ninety - two children with chronic kidney disease (CKD) were analyzed. The serum level of NT-proBNP were compared to age, sex, serum creatinine (Cr), estimated glomerular filtration rate (eGFR), blood pressure (BP), and body mass index (BMI). And we also compared it to ejection fraction (EF), fractional shortening (FS), cardio-thoracic ratio (CTR), intact parathyroid hormone (iPTH), hemoglobin (Hb), and Ca x P product in 11 dialysis children. RESULTS:Among 92 patients, 75 patients had a normal Cr, and 17 patients had increased Cr. Dialysis patients were 11. Serum level of NT-proBNP showed positive correlation of serum Cr, and negative correlation of eGFR. In dialysis patients, serum level of NT-pro BNP showed negative correlation of EF on echocardiography. And was no relation with CTR, iPTH, Hb, Ca x P product, and BMI. CONCLUSION:NT-proBNP is a useful marker for evaluating the cardiac function and determining the ultrafiltration in pediatric dialysis patients.
Blood Pressure ; Body Mass Index ; Child ; Creatinine ; Dialysis ; Echocardiography ; Glomerular Filtration Rate ; Heart Failure ; Hemoglobins ; Humans ; Kidney ; Kidney Diseases ; Myocytes, Cardiac ; Natriuretic Peptide, Brain ; Parathyroid Hormone ; Peptide Fragments ; Renal Insufficiency, Chronic ; Ultrafiltration

OBJECTIVE: Gamma knife radiosurgery (GKRS) is the least invasive surgical option for patients with trigeminal neuralgia (TN). However, the indications and long term outcomes of GKRS are still controversial. Additionally, a series with uniform long-term follow-up data for all patients has been lacking. In the present study, the authors analyzed long-term outcomes in a series of patients with TN who underwent a single GKRS treatment followed by a minimum follow-up of 60 months. METHODS: From 1994 to 2009, 40 consecutive patients with typical, intractable TN received GKRS. Among these, 22 patients were followed for >60 months. The mean maximum radiation dose was 77.1 Gy (65.2-83.6 Gy), and the 4 mm collimator was used to target the radiation to the root entry zone. RESULTS: The mean age was 61.5 years (25-84 years). The mean follow-up period was 92.2 months (60-144 months). According to the pain intensity scale in the last follow-up, 6 cases were grades I-II (pain-free with or without medication; 27.3%) and 7 cases were grade IV-V (<50% pain relief with medication or no pain relief; 31.8%). There was 1 case (facial dysesthesia) with post-operative complications (4.54%). CONCLUSION: The long-term results of GKRS for TN are not as satisfactory as those of microvascular decompression and other conventional modalities, but GKRS is a safe, effective and minimally invasive technique which might be considered a first-line therapy for a limited group of patients for whom a more invasive kind of treatment is unsuitable.
Follow-Up Studies ; Humans ; Microvascular Decompression Surgery ; Radiosurgery ; Trigeminal Neuralgia