A case of sparganosis was presented. The patient was a 43-year-old Korean male who had a history of having eaten raw flesh of snake and frog in Keoje Island during 1950 to 1952 for the purpose of treatment of arthritis by the oriental custom. In the summer, l959, he had slight itching sensation in the left lower scrotal area. A few months later, he noticed the appearance of a peanut-sized mass in that area. However, the mass enlarged gradually to a hen's egg size during two years. On surgical exploration, the mass was found to be a fibro-connective tissue capsule(3 to 4 cm in diameter) in the lower left scrotal area. From the capsule three larvae(l9 to 28 cm by 2 to 6 mm) were freed by dissection without much difficulty. The sources of infection of some formerly reported sparganosis in Korea were discussed. It is most probable that human sparganosis is acquired by ingestion of raw flesh of snake and frog in this country.
parasitology-helminth-cestoda-sparagnum ; sparganosis ; case report

No abstract available.
Cardiomyopathy, Dilated* ; Child* ; Humans

A survey of intestinal parasites was performed in South Vietnam. Samples were collected from 717 Vietnameses, 1,933 U.S. Forces, 433 stool specimens of Korean Troops in South Vietnam. And 114 of Korean Army patients in home land were also examined as a control. Findings were discussed with others and summarized as follows: A parasitic rate, incidence in general, was 44.8 %. Koreans in South Vietnam showed 82.4 % of infection rate, Vietnamese 64.6% and U.S. Forces 26.1 %. Korean home patients revealed 93.9 %. Following 10 species of helminths ova and 5 kinds of protozoa were found: Ascaris lumbricoides, Hookworm, Trichocephalus trichiurus, Strongyloides stercoralis, Trichostrongylus orientalis, Enterobius vermicularis, Metagonimus yokogawai, Clonorchis sinensis, Hymenolepis nana, Taenia sp., Entamoeba histolytica, Entamoeba coli, Endolimax nana, Giardia lamblia and Trichomonas hominis. The incidence of Ascaris lumbricoides among Koreans in South Vietnam was 15.9 %, much less than Korean home patients. The infection rate of A. lumbricoides in Saigon residents was 47.2% but in Chulai 36.8% and in Quinhon 35.8 %. Trichocephalus trichiurus was most frequently found in Koreans. Quinhon residents showed 78.7 % positive in hookworn infection and Chulai 24.7 %. In Saigon, on the contrary, infection rate was only 3.1 %. No Strongyloides stercoralis, but two cases of Trichomonas hominis were found among Koreans in South Vietnam. U.S. Forces showed higher incidences than Koreans and Vietnameses in the incidences of Entamoeba histolytica and Endolimax nana. Most of the U.S. Forces revealed single infection. Korean home patients showed the highest per centage of polyparasitism. Non-autochthonous infections in Korea could not be found among Koreans in this survey.
parasitology-epidemiology ; stool examination ; Vietnam ; U.S. Forces ; Ascaris lumbriocides ; Hookworm ; Trichocephalus ; trichiurus ; Strongyloides stercoralis ; Trichostrongylus orientalis ; Enterobius vermicularis ; Metagnimus yokogawai ; Clonorchis sinensis ; Hymenolepis nana ; Taenia sp. ; Entamoeba histolytica ; Entamoeba coli ; Endolimax nana ; Giardia lamblia ; Trichomonas hominis

A parasitological study was performed with 452 malaria patients evacuated from South Vietnam by examinations of their peripheral blood. Results were as follows: The peripheral blood examinations revealed that 52.0% of the examined have parasitemia, of which 95.3% was P. falciparum, one case of P. vivax and the other 10 patients were mixed infected. Neither P. malaria nor P. ovale were found. A total of 1,500 thick and thin blood films was prepared and 707 slides of them (47.1%) showed positive. In P. falciparum, ring forms were found most frequently and the next was gametocytes. Eighty slides (50%) showed mixed together with both ring form and gametocytes. All of the erythrocytic stages were seen in three slides of P. vivax. Weekly periodical examinations showed 233.8 parasite density every 1,000 W.B.C count in average, while occasional at fever attacks 531.7.Size of gametocytes in P. falciparum was 9.31(+/-0.89) by 2.16(+/-0.53) in macrogametocyte and 6.61(+/-0.82) by 2.51(+/-0.35) in microgametocyte. Their sex ratio was 100 : 92. Repeated blood examinations showed increased detection rates. The positive rate of parasitemia was 52.0% in single examination, increasing in succession with repetitions.
parasitology-protozoology-malaria ; Plasmodium falciparum ; Plasmodium vivax ; Plasmodium ovale ; Plasmodium malariae ; ring form gametocyte ; epidemiologyk Vietnam ; parasitemia

Provocation test made no 90 cases of chronic prostatitis using prednisolone with a dose of 20-30 mg. per day for 1~2 weeks, was done. The results are as follows. 1. In provocation group the incidence of cases with 10/HPF or more of WBC was 10~21% as compared to 0~10 % of control group. 2. There was no difference between the two groups in the number and species of bacteria found in the prostatic secretion. 3. On palpation no remarkable difference was found between the two groups except the tenderness which was less in incidence in the provocation group. 4. As mentioned above the prostatic secretion of the provocation group disclosed increasing tendency in WBC appearance and the prednisolone provocation test was proved to de valuable for the diagnosis of chronic prostatitis.
Bacteria ; Diagnosis ; Incidence ; Palpation ; Prednisolone* ; Prostatitis*

BACKGROUND/AIMS: To compare treatment outcome of hepatocellular carcinoma(HCC) under the size of 5 cm in relation to underlying liver function and treatment modalities, analysis of data from 145 patients was performed. METHODS: In this study, the records of 145 patients with small HCC (< 5 cm in diameter determined by hepatic angiography) were reviewed. Clinical parameters were analyzed and survival rate, recurrence rate were calculated. RESULTS: There were 107(73.8%) men and 38 women. Mean age at diagnosis was 55.1(range .' 25 83 year-old). HBsAg was detected in 97(66.9%) patients. Seventy two(50.0%) patients showed markedly elevated(>40 ng/mL) serum alpha-fetoprotein(AFP) level. Liver cirrhosis was associated in 109(75.2%) patients. Sixty five(44.8%) patients underwent surge, 63(43.5%) underwent transarterial therapy(TAT), 8(5.5%) underwent other modalities of therapy and the remaining 9(6.2% ) patients did not receive any specific treatment for HCC. In relation to the underlying liver function, 119(82.1% ) patients belonged to the non-cirrhotic or Child-Pugh class A, 20(13.8%) to class B and 6(4.1%) to class C. The median follow-up duration was 21 months. When analyzed with respect to treatment modalities alone, median survival was 43 months for all patients, 60 months for surgery, 29 months for TAT, 20 months for other treatment and 18 months for patients who received no specific treatment. Without considering liver function, cumulative 3 year survival rate was 68.6% for surgery, 43.9% for TAT, 29.2% for other treatment and 0% for no treatment. The survival rate for the patients who underwent surgery was significantly higher than for any other treatment modalities without considering the underlying liver function or in the non-cirrhotic/Child-Pugh class A(p<0.001). In patients whose tumor size was equal to or less than 3 cm, there was no difference in survival rate in relation to the treatment modalities when not considering the underlying liver function of each patient(p>0.05). But in patients classified as the non-cirrhotic/Child-Pugh class A, better survival was observed in the surgep group than the TAT group(p<0.05). The only factor influencing survival was the pre-treatment serum AFP level(p<0.05). The overall recurrence rate was 30.3%. For the entire patients, the factor significantly influencing the recurrence rate was the presence of underlying cirrhosis. When considering only the patients in the surgery group, the different types of surgical procedures significantly influenced the recurrence rate. CONCLUSION: Surgery is the treatment of choice for patients with HCC equal to or smaller than 5 cm. But for those patients whose tumor size is less than 3 cm, TAT may be a reasonable alternative to surgep when the liver function is not adequate for hepatic resection. Because overall recurrence rate exceeded 30% and median time of recurrence was only 9.5 months after definitive treatment, careful follow-up is required for all patients who undergo treatment for small HCC.
Carcinoma, Hepatocellular* ; Diagnosis ; Female ; Fibrosis ; Follow-Up Studies ; Hepatitis B Surface Antigens ; Humans ; Liver Cirrhosis ; Liver* ; Male ; Recurrence ; Survival Rate ; Treatment Outcome*

Chronic mucocutaneous candidiasis is a rare syndrome characterized by persistent and refractory infection of the skin, nail and mucosal tissue by yeasts of the genus Candida. A 70-year-old woman presented with the following skin lesions: ill-defined annular shaped whitish macules on the upper and lower lips accompanying dryness, pain and burning sensation, and yellowish discoloration with onycholysis of the right 4th finger nail. The upper lip lesion showed histopathologic feature of band-like infiltration of lymphocytes in the upper dermis, consistent with lichen planus. But, systemic glucocorticoid was not effective in treating erosive lip lesions. KOH examination and fungal culture of specimens from the upper lip showed hyphal elements and growth of Candida albicans, respectively. Antifungal agent was administered. After the oral medication, skin lesions were improved but there was repeated recurrence. We report a case of chronic mucocutaneous candidiasis misdiagnosed as lichen planus.
Burns ; Candida ; Candida albicans ; Candidiasis, Chronic Mucocutaneous ; Dermis ; Female ; Fingers ; Humans ; Lichen Planus ; Lichens ; Lip ; Lymphocytes ; Mucous Membrane ; Nails ; Onycholysis ; Recurrence ; Sensation ; Skin ; Yeasts

BACKGROUND: The purposes of this study were to evaluate the effect of myocardial protection with our cold blood cardioplegic solution and to observe the relationship between ultrastructural study and other evaluation methods and its effectiveness. MATERIAL AND METHOD: We evaluated the changes of myocardial ultrastructure using semiquantitative scoring system, CK-MB fraction, SGOT and LDH1/LDH2, and EKG in 18 patients undergoing valvular heart surgery and coronary artery bypass grafting (CABG). Right atrial auricular biopsies were taken before the cardiopulmonary bypass (CPB) and shortly after the end of CPB. Myocardium-related serum enzymes & EKG were checked for 3 days of postoperative period and their postoperative peak enzyme value and observed new Q wave & ST segment elevation in EKG were choosen. RESULT: There were 8 males and 10 females, and their mean age was 55.6+/-13. Eight patients underwent valvular heart surgery and ten coronary artery bypass grafting. The mean CPB time was 119+/-29minutes and the mean aortic cross-clamp (ACC) time was 75.4+/-24 minutes. Before the start of CPB, the mean mitochondrial score was 1.28+/-0.53 and after the end of CPB, it significantly increased to 2.35+/-0.79. There was no evidence of perioperative myocardial infarction in terms of myocardiumrelated serum enzyme value and Q wave and ST change in EKG. There was no significant relationship between pre-CPB and post-CPB mitochondrial score and the mean time of CPB and ACC, and the mean value of postoperative peak CK-MB, SGOT and LDH1/LDH2, but there was relatively positive correlation of CPB time with peak LDH1/LDH2. CONCLUSION: Despite the apparent satisfactory results in myocardium-related serum enzymes & EKG, with this study using the cold blood cardioplegic solution, there were many changes in myocardial ultrastructures, and more studies are needed to obtain further information.
Aspartate Aminotransferases ; Biopsy ; Cardioplegic Solutions ; Cardiopulmonary Bypass ; Coronary Artery Bypass ; Electrocardiography ; Female ; Heart Arrest, Induced* ; Humans ; Male ; Mitochondria ; Myocardial Infarction ; Myocardium* ; Postoperative Period ; Thoracic Surgery*

PURPOSE: Chemoradiation therapy prior to pancreaticoduodenectomy has several effects. First, it ensures that patient who undergo resection subsequently complete multimodality therapy and helps to avoid resection in patients with rapid progressive disease. Second, it allows radiation therapy to be delivered to well oxygenated cells before surgical devasculation. Finally, in such cases there is a chance of resection of unresectable pancreatic cancer by downstaging. METHODS: A patient with cytologic proof of localized adenocarcinoma of the pancreatic head recieved preoperative chemoradiation (Taxol, 50 mg/m2 IV for 3 hours weekly 3 cycles, Gemcytabine 1,000 mg/m2/day IV for 3 days weekly 2 cycles, 4,500 cGy) with the intent of proceeding to resection, Restaging was performed by computed tomography and magnetic resonance imaging every months from 5 weeks due to the ongoing decreasing of tumor size following the completion of chemoradiation. Upon laparotomy, the patient was found to not have any suspected metastatic disease and the tumor size was 2 3 cm on the pancreas head infiltrating to the portal vein approximately 3 cm in length along right side. Pancreaticoduodenectomy was performed with partial portal vein and superior mesenteric vein resection followed by reconstruction of the vascular anastomosis by using the right side internal jugular vein. Perioperative complication did not occur. RESULTS AND CONCLUSION: Preoperative chemoradiation of localized advanced pancreatic has a low incidence of operative complication and enhanced resectability.
Incidence ; Adenocarcinoma ; Neoplasm Metastasis ; Pancreatic Neoplasms

PURPOSE: Pain is the most distressing feature of cancer patients. Thoracoscopic splanchnicectomy, first performed in 1993, has caused a resurgence of interest in surgical treatment of such excruciating pain. We wish to introduce a method of splanchnicectomy. METHODS: Five patients underwent a splanchnicectomy for intractable cancer pain, over a period of 11 months. We evaluated the type of splanchnicectomy performed and the results. The procedure was done using a double lumen catheter to deflate the lung at the operation side under general anesthesia with the patient in the lateral decubitus position. A small opening was made with scissors in the pleura of the 5th intercostal space to expose the terminal branch of the greater splanchnic nerve. Six-Seven branches of splanchnic nerve were cut downward until the splanchnic nerve trunk and then cut. A left thoracoscopic splanchnicectomy was done in one case, and a bilateral thoracoscopic splanchnicectomy in four cases. RESULTS: The splanchicectomy appears to result in significant reduction of abdominal pain in all cases. There were no postoperative complications. CONCLUSION: As a conclusion, thoracoscopic splanchnicectomy is the treatment of choice for intractable intraabdominal cancer pain, affording drug cessation and recovery of daily activity in most patients.
Abdominal Pain ; Anesthesia, General ; Catheters ; Humans ; Lung ; Pleura ; Postoperative Complications ; Splanchnic Nerves ; Thoracoscopy