The May-Hegglin anomaly is a rare autosomal dominant trait characterized by platelet abnormalities in the peripheral blood and large (up to 5mu) pale blue staining inclusions in the cytoplasm of neutrophils, eosinophils, basophils, and monocytes. We experienced a case of May-Hegglin anomaly in a 7 year old male and another case out of his family. His initial complaints at the admission were petechiae and intermittent epistaxis. Diagnosis was confirmed by peripheral blood smear and family study. We report the case with brief review of related literature.
Basophils ; Blood Platelets ; Child ; Cytoplasm ; Diagnosis ; Eosinophils ; Epistaxis ; Humans ; Male ; Monocytes ; Neutrophils ; Purpura

OBJECTIVES: To investigate the total cholesterol levels and related factors in a rural adult population. METHODS: 3,207 adults( 1,272 men and 1,935 women) were examined in 1997. Their heights, weights, and fasting serum total cholesterol levels were measured, and their body mass indices were calculated. A questionnaire interviewing method was used to collect risk factor data. RESULTS: The mean value of total cholesterol were 190.5 mg/dl, and 198.8 mg/dl, and the age-adjusted prevalence rates for hypercholesterolemia (above 240 mg/dl) were 13.7% and 10.2%, in men and women, respectively. From simple analyses, age, educational level, coffee intake, amount of meat and food intake, waist circumference, waist-hip circumference ratio(WHR), and body mass index(BMI) were significant risk factors in men (p<0.05) relating to serum total cholesterol levels. In women, age, educational level, hypertension history, diabetes history, herbal drug history, amount of food intake, alcohol consumption, waist circumference, WHR, BMI, and menopausal status were significant risk factors (p<0.05). In multiple linear regression analyses, waist circumference (p<0.01), BMI (p<0.01), and coffee intake (p<0.05) proved to be significant risk factors in men. Whereas, menopausal status (p<0.01), BMI (p<0.01), herbal drug history (p<0.01), amount of food intake (p<0.05), waist circumference (p<0.05), and alcohol consumption (p<0.05) were significant risk factors in women. Conclusions : The significant risk factors, for both men and women, relating to the serum total cholesterol were waist circumference and BMI. Thus, for the reduction of serum total cholesterol level, it is recommended that health education for the control of obesity should be implemented.
Adult* ; Alcohol Drinking ; Cholesterol* ; Coffee ; Eating ; Fasting ; Female ; Health Education ; Humans ; Hypercholesterolemia ; Hypertension ; Life Style ; Linear Models ; Male ; Meat ; Obesity ; Prevalence ; Surveys and Questionnaires ; Risk Factors ; Waist Circumference ; Weights and Measures

OBJECTIVES: The purpose of this study was to find the protective effects of garlic on the halogenated hydrocarbon induced hepatotoxicities, and the possible protection mechanisms involved. METHODS: Male Sprague-Dawley rats received garlic (0.5 %) or regular diet, for 4 weeks. This was followed by a single dose of corn oil (the controls), carbon tetrachloride (400mg/kg body weight) and trichloroethylene (2,000mg/kg body weight) being administered to each diet group. Blood samples were collected 24 hours following the administration, and the serum aspartate aminotransferase (AST) and alanine aminotransferase (ALT) activities measured. The liver samples were studied for their cytochrome P450 and CYP2E1 contents, lipid peroxidation and histopathology. RESULTS: The results for the group receiving the 0.5 % garlic diet showed a slight decrease of CYP2E1 expression compared with the regular diet group. Carbon tetrachloride was significantly decreased the CYP2E1 contents in both the regular and garlic diet groups, but the trichloroethylene remained unchanged. Garlic did not decrease the lipid peroxidation of the liver in the control group, but attenuated the increase of lipid peroxidation caused by carbon tetrachloride. Garlic attenuated the increase of both the serum AST and ALT activities caused by carbon tetrachloride. The histopathological observations also showed that garlic attenuated centrilobular necrosis and vacuolar degenerative changes significantly in the carbon tetrachloride treated group. Conclusions : The results indicate that garlic attenuates the carbon tetrachloride-induced hepatotoxicity, through the prevention of the metabolic activation and lipid peroxidation.
Alanine Transaminase ; Aspartate Aminotransferases ; Biotransformation ; Carbon Tetrachloride ; Carbon* ; Corn Oil ; Cytochrome P-450 CYP2E1 ; Cytochrome P-450 Enzyme System ; Diet ; Garlic* ; Humans ; Lipid Peroxidation ; Liver ; Male ; Necrosis ; Protective Agents ; Rats, Sprague-Dawley ; Trichloroethylene

PURPOSE: To evaluate the causative factors of the false positive CT findings of parametrial invasions of cervial cancer. MATERIALS AND METHODS: we analysed 17 parametria of 14 patients with the diseases staged over lib on CT, but confirmed to be under stage Ila on pathology. The CT findings were retrospectively reviewed, and compared with pathologic findings. RESULTS: The causes of false postive diagnosis of parametrial invasions on CT were prominent cardinal ligaments (n=12), vaginal fornix(n=3), and prominent uterine vessels(n=2). CONCLUSION: Familiarity with these CT finding may be helpful in avoiding false positive diagnosis of parametrial invasion in patients with uterine cervical carcinoma.
Diagnosis ; Humans ; Ligaments ; Pathology ; Recognition (Psychology) ; Retrospective Studies

There are considerable discrepacies between clinical symptoms and imaging diagnosis in the localization of the responsible radiculopathy. The purposes of this study are to analyzed the dynamic alteration of contrast filling of the spinal nerve sleeves during positional changes and to determine how the abnormalities of nerve sleeves no lateral bending A-P views correlate with sciatica. The criteria indicationg the root abnormality in functional myelography were (1) bad filling of ipsilateral root to sciatica and (2) good filling of contralateral root compared with those in neutral A-P view. Of total 77 patients, 67 had radiculopathy and 10 had no radiculopathy. In 23 (34.3%) of 67 patients with radiculopathy and 6 (60%) of 10 patients with no radiculopathy, their clinical symptoms well correlated with conventional myelographic findings. However, in 35 (52.2%) of 67 patients with radiculopathy and 6(60%) of 10 patients with no radiculopathy, their symptoms well correlated with functional myelographic findings. This study suggests that the functional myelogaphy using both lateral bending A-P views can be used as a complementary tool in the evaluation of the radiculopathy.
Diagnosis ; Humans ; Myelography* ; Radiculopathy* ; Sciatica ; Spinal Nerves

The operative treatment of intraarticular calcaneal fractures has three principal aims; restoration of the height and width of the calcaneus, reconstruction of the subtalar and calcaneocuboid joint surfaces, and stable osteosynthesis. The purpose of this study is to demonstrate the effectiveness of the open reduction and internal fixation by the extended lateral approach for the treatment of the intraarticular calcaneal fractures. Twenty-one calcaneal fractures of 20 patients were treated by open reduction and internal fixation using an extended lateral approach from April, 1993 to March, 1994. The autogenous iliac bone graft was done in all patients. These patients were evaluated from 12 to 24 months (average 15.2 months) after surgery. The following results were obtained; 1. Seventecn cases (80%) out of 21 were estimated as good or excellent result. 2. Preoperative Bohler's angles, Gissane's angles and inclination angles were observed as average -0.5degrees, 101degrees and 38degrees respectively, and these were improved as average 23.3degrees, 117degrees and 54degrees, postoperatively. 3. There were two cases of skin necrosis as complication. In conclusion, the extended lateral approach is one of the good methods for the treatment of intraarticular calcaneal fractures. We think that accurate reduction of the posterior facet, acceptable recovery of Bohler's angle and early postoperative mobilization are the most important things for the best result of the intraarticular calcaneal fracture surgery.
Calcaneus ; Humans ; Intra-Articular Fractures ; Joints ; Necrosis ; Skin ; Transplants

Sacral perineural cyst is one group of extradural meningeal cyst at the sacral region. These lesions are distinguished from other spinal cysts because perineural cyst does not communicate with subarachnoidal space. Fluid filled cysts may compress adjacent nerve roots causing low back pain and sciatica which are dramatically improved by surgical excision. Differential diagnosis from other cysts can be accomplished by failure of collection of dye into cyst by initial myelography. C-T myelography rules out other mass lesions and often reveals communication of perineural cyst that filled with contrast medium. Magnetic resonance imaging well demonstrates three dimensinnal configures of an intraspinal cystic mass in initial study. However it is important to recognize that these cysts are one of causes of radiculopathy. We report three cases of sacral perineural cysts with radiculopathy.
Diagnosis, Differential ; Low Back Pain ; Magnetic Resonance Imaging ; Myelography ; Radiculopathy ; Sacrococcygeal Region ; Sciatica ; Tarlov Cysts*

To evaluate the risk and factors associated with seizure recurrence in children with epilepsy while receiving the adequate anticonvulsant treament, we studied 58 patients with newly diagnosed epilepsy who were followed prospectively for a median of 26 months (range 7 to 54). The results were as follows: 1) Forty-four of the 58 patients (75.9%) had recurrence of seizure. 2) The rate of recurrence according to type of seizure was observed to be 22 patients (68.8%) in generalized tonic-clonic seizure, 6 patients (85.7%) in simple partial seizure, 5 patients (83.3%) in complex partial seizure, 3 patients (100%) in mixed seizure, 2 patients (100%) in absence, 3 patients (100%) in infantile spasm, 1 patient (100%) in atonic seizure, 2 patients (50%) in secondary generalized seizure. There was no significant difference in the risk of recurrence observed among these seizure types. 3) The risk of recurrence varied according to the history of seizure, seizure recurrence was observed in 100% of the cases with history of neonatal seizure, 72.7% of the cases with febrile convulsion, and 73.3% of the cases with non-specific history. No significant difference was observed among these past history of seizure. 4) The rate of seizure recurrence according to electroencephalographic abnormalities did not differ significantly. Seizure recurrence was noted in 13 of the 18 patients with mildly disordered tracings (72.2%), 15 of the 20 patients with moderate abnormality (75.0%), and 12 of the 16 patients with severe abnormality (75.0%). 5) Recurrence rate according to cause of seizure was more significantly frequent in those with symptomatic epilepsy than in those with idiopathic type (100% vs 70.2%, p<0.05). 6) The frequency percentage of seizure recurrence by age groups of below 1 year, 1 to 3 years, 4 to 6 years, and above 6 years at onset of seizure were 100, 66.7, 57.1, and 72.7, respectively. The rate of seizure recurrence was significantly highest in patients aged below 1 year at onset of seizure. 7) There was significant difference in seizure recurrence between those with and without abnormalities as shown by neurologic examination (100% vs 70.8%, p<0.05). 8) There was no consistent difference in valproic acid serum levels between those who had a recurrence and those who did not. The patients receiving phenobarbital had significantly high serum levels of the phenobarbital in recurrent groups than those who had no recurrence. In conclusion, factors associated with an increased risk of seizure recurrence were early age at onset of epilepsy, symptomatic epilepsy, and neurologic abnormalities. We found no associations between risks of recurrence and types of epilepsy, or electroencephalographic abnormalities.
Anticonvulsants* ; Child ; Epilepsy ; Humans ; Infant ; Infant, Newborn ; Neurologic Examination ; Phenobarbital ; Prospective Studies ; Recurrence* ; Risk Factors ; Seizures* ; Seizures, Febrile ; Spasms, Infantile ; Valproic Acid

PURPOSE: The purpose of this study was to evaluate the morphologic changes of the injured hepatic acini following ligation of common bile duct and to investigate the pathophysiologic process of hepatic failure and biliary liver cirrhosis in the extrahepatic cholestasis. MATERIALS AND METHODS: The common bile ducts of 18 rabbits were ligated partially. The rabbits were killed and selective microangiography was carried out with infusion of barium suspension via portal vein 4 to 24 weeks after ligation. Selective microangiography was also carried out in two normal rabbits. The microangiographic findings were evaluated and correlated with histopathologic features. RESULTS: The sinusolds of the liver acinus showed distortion, varying degrees of luminal widening, and irregularities in architecture. Terminal branches of the portal vein (TPV) showed increased number of branches, luminal narrowing, tortuosity, distortion, and beaded appearance. Peribiliary plexi were found as thin curvilinear, barium-filled structures along the wall of the dilated bile duct. The microangiographic findings were well correlated with histopathologic findings. The grades of microangiographic and histopathologic findings were poorly correlated with the duration of the ligation of CBD. CONCLUSION: Changes in microvasculature of the liver acinus following partial ligation of common bile duct were demonstrated by microangiography. Although the microvascular changes were evoked secondary to the injury, they might have some active roles in the pathophysiologic process in the liver.
Barium ; Bile Ducts ; Cholestasis, Extrahepatic ; Common Bile Duct* ; Ligation* ; Liver Cirrhosis ; Liver Failure ; Liver* ; Microvessels ; Phenobarbital ; Portal Vein ; Rabbits

BACKGROUND: Flow interruption technique has been used to measure respiratory system mechanics, and its prominent advantage is to partitionate the respiratory system resistance into airway and tissue component. In this study, we investigated the effects of varing concentrations of enflurane on respiratory system mechanics using flow interruption technique. METHODS: Six cats, weighing 3.0~3.6 kg were used. Pentobarbital sodium was injected intraperitonially and endotracheal intubation was followed. Intermittent mandatory ventilation was applied with Siemens Servo 900C ventilator. The inspiratory flow rate, tidal volume, and respiratory rate were fixed, and normocarbia (PaCO2; 30~35 mmHg) was maintained throughout the experiment. The changes in the pressure and volume were recorded with Bicore CP100 pulmonary monitor at control, 0.5, 1, 1.5, and 2 MAC of enflurane. The data were transfered to a PC and analyzed by Anadat processing software. Respiratory system, airway and tissue viscoelastic resistances, and dynamic and static compliances were calculated. RESULTS: Respiratory system resistances decreased up to 1 MAC of enflurane compared to the control value (p<0.05), but there were no significant differences in the values of resistance among 1, 1.5, 2 MAC of enflurane. There were no significant differences in tissue viscoelastic resistances, and dynamic and static compliances with varying concentrations of enflurane. CONCLUSIONS: Enflurane significantly reduces the respiratory system resistance mainly by decreasing airway resistance. Tissue viscoelastic resistance and respiratory system compliances are not influenced by changes in concentration of enflurane.
Airway Resistance ; Animals ; Cats* ; Enflurane* ; Intubation, Intratracheal ; Mechanics* ; Pentobarbital ; Respiratory Rate ; Respiratory System* ; Tidal Volume ; Ventilation ; Ventilators, Mechanical