Tetrodotoxin (TTX) cause neurologic dysfunction by blocking the voltage-gated sodium channels located in all of the peripheral nerves and muscles. We experienced two patients presenting with generalized motor weakness after ingestion of pufferfish. The nerve conduction study showed diffuse slowing of motor and sensory nerve conduction velocity, prolonged motor terminal latency and decreased sensory nerve action potentials without temporal dispersion or conduction block. Abnormal findings of nerve conduction study improved rapidly without any deterioration. Clinical symptoms and signs ameliorated in accordance with findings of nerve conduction study without any neurologic sequelae. These imply that tetrodotoxication is reversible and functional neurologic disorder. We suggest that nerve conduction studies can be available in serial monitoring of tetrodotoxication as an objective means.
Action Potentials ; Eating ; Humans ; Muscles ; Nervous System Diseases ; Neural Conduction ; Neurologic Manifestations ; Peripheral Nerves* ; Tetraodontiformes ; Tetrodotoxin ; Voltage-Gated Sodium Channels

It is now generally accepted that most, if not all, colon cancers originate within previously benign adenomas. Endoscopic polyp resection and regular follow up endoscopic examination are essential for prevention of carcinoma fro benign adenoma. However, small colorectal polyps are difficult to recognize during follow up endoscopic examinations because of the lack of reliable endoscopic landmarkers. Endoscopic Indiaink marking of the colon was first described by Ponsky and King in l975. The method has subsequently been advocated by expert as the best available means to mark the site of a colonic lesion. We prospectively studied the effectiveness of India ink as a long term colonic mucosal marker. Twelve patients who were diagnosed as colorectal polyp had a India ink marking with standard sclerotherapy needle. All patients who were followed at 6 months interval (mean duration 13 months) continue to display intensely stained mucosa at the original sites. No side effects or complications were encountered. India ink appears to be a safe and effective long term marker for colonic mucosal lesions.
Adenoma ; Colon* ; Colonic Neoplasms ; Follow-Up Studies ; Humans ; India* ; Ink* ; Mucous Membrane* ; Needles ; Polyps ; Prospective Studies ; Sclerotherapy

PURPOSE: Chordoma is a rare primary osseous tumor arising from the remnants of the primitive notochord. It occurs once in 2,000,000. It is characterized by its slow growth, high frequency to invade destroy bone by direct extension. We experienced giant sacral chordoma and reconstructed with gluteal advancement flap. METHODS: A 52-year-old woman presented with a 2-years history of gluteal pain. In the biopsy study revealed sacral chordoma. MRI study showed 13 x 12 x 10 cm sized m0cs. We approached anterior and posterior resection and reconstructed with bilateral gluteus maximus advancement flap. RESULTS: After the operation, blader and anal function were slightly decreased. But, 4 months later those were almost fully recovered. There was no significant complication and recurrence after 2-years follow-up. CONCLUSION: Chordoma is characterized by its slow growth, high frequency to invade and destroy bone by direct extension. Wide surgical resection is the only curative procedure. We report a ase of giant sacral chordoma which was successfully treated by anterior and posterior approach and reconstructed with bilateral gluteal advancement flap.
Biopsy ; Chordoma ; Female ; Follow-Up Studies ; Humans ; Middle Aged ; Notochord ; Recurrence

PURPOSE: Chordoma is a rare primary osseous tumor arising from the remnants of the primitive notochord. It occurs once in 2,000,000. It is characterized by its slow growth, high frequency to invade destroy bone by direct extension. We experienced giant sacral chordoma and reconstructed with gluteal advancement flap. METHODS: A 52-year-old woman presented with a 2-years history of gluteal pain. In the biopsy study revealed sacral chordoma. MRI study showed 13 x 12 x 10 cm sized m0cs. We approached anterior and posterior resection and reconstructed with bilateral gluteus maximus advancement flap. RESULTS: After the operation, blader and anal function were slightly decreased. But, 4 months later those were almost fully recovered. There was no significant complication and recurrence after 2-years follow-up. CONCLUSION: Chordoma is characterized by its slow growth, high frequency to invade and destroy bone by direct extension. Wide surgical resection is the only curative procedure. We report a ase of giant sacral chordoma which was successfully treated by anterior and posterior approach and reconstructed with bilateral gluteal advancement flap.
Biopsy ; Chordoma ; Female ; Follow-Up Studies ; Humans ; Middle Aged ; Notochord ; Recurrence

We report a case of testicular tunica albuginea cyst with psammoma body which was treated with excision and testicular preservation. The presumptive diagnosis of a simple intratesticular cyst was made by ultrasound. The intraoperative pathological diagnosis was benign serous cyst and then simple excision of the lesion with testicular masses, and it may permit identification of lesions that can be excised locally with testicular preservation. To our knowledge tunica albuginea cyst with psammoma body, a characteristic histological finding, has not been reported. Its histogenesis was also discussed.
Diagnosis ; Testis ; Ultrasonography

Obstetrical procedures such as prolonged obstructed labour are responsible for the majority of vesicovaginal fistula(VVF) in developing countries, while gynecological procedures are more common causes in developed countries with hysterectomy accounting for 75% of fistulae. Other less common causes of VVF include uterine cancer, pelvic irradiation, gastrointestinal pelvic surgery, tuberculosis, intra-uterine device or Bechet's disease. Although radiation techniques are being advanced, several recent studies have shown the incidence of VVF after pelvic radiation therapy for cervical cancer to range from 0.6~2%. We report, a case of 47-year-old female with VVF after pelvic radiation therapy, which was treated by neurovascular pudendal-thigh flap.
Developed Countries ; Developing Countries ; Female ; Fistula ; Humans ; Hysterectomy ; Incidence ; Middle Aged ; Tuberculosis ; Uterine Cervical Neoplasms ; Uterine Neoplasms ; Vesicovaginal Fistula*

OBJECTIVES: This study aims to identify dietary factors related to metabolic syndrome in middle aged Korean men who were participants in the Fourth Korea National Health and Nutrition Examination Survey(KNHANES IV) in 2007. METHODS: The study targeted 361 of the 709 men aged between 40 and 64 years for a final analysis; the other 348 surveys had incomplete data which did not allow for the determination of metabolic syndrome. The definition of metabolic syndrome was based on the National Cholesterol Education Program Adult Treatment Panel III(NCEP ATP III). RESULTS: There were significant differences in the metabolic syndrome of middle-aged men according to age, smoking pack-years, and number of resturant meals per week. Dietary factors such as vitamins, riboflavin, natrium, carbohydrate, protein and lipid intakes were not significant. CONCLUSIONS: It was verified that metabolic syndrome in middle-aged men is related to age, smoking pack-years and number of resturant meals per week. Dietary factors were not significantly related. However, further detailed studies in this area are needed.
Adenosine Triphosphate ; Adult ; Aged ; Cholesterol ; Humans ; Korea ; Male ; Meals ; Middle Aged ; Multiple Endocrine Neoplasia Type 1 ; Riboflavin ; Smoke ; Smoking ; Vitamins

A lectin from the hemolymph of purse crab, Philyra pisum, was found to have anti-proliferative activity on human lung cancer cells by our laboratory. In this study, P. pisum lectin (PPL) was molecularly characterized including molecular mass, amino acid sequences, amino acid composition, and the effects of metal ions, temperature, and pH on the activity. We found that PPL showed mitogenic activity on human lymphocytes and BALB/c mouse splenocytes. The mitogenic activity (maximum stimulation index, SI=9.57+/-0.59) of PPL on human lymphocytes was higher than that of a standard well-known plant mitogen, concanavalin A (maximum SI=8.80+/-0.59). The mitogenic activity mediated by PPL is required for optimum dosing, and higher or lower concentrations caused decreases in mitogenic response. PPL also induced mitogenic activity on mouse splenocytes, however, the maximum SI (1.77+/-0.09) on mouse splenocytes of PPL was lower than that (2.14+/-0.15) of concanavalin A. In conclusion, PPL is a metal ion-dependent monomer lectin with mitogenic activity, and could be used as a lymphocyte or splenocyte stimulator.
Amino Acid Sequence ; Animals ; Concanavalin A ; Hemolymph ; Humans ; Hydrogen-Ion Concentration ; Ions ; Lung Neoplasms ; Lymphocytes ; Mice ; Plants

Intravascular lymphoma is characterized by an exclusively intravascular distribution of tumor cells. Intravascular natural killer/T-cell lymphoma (IVNKTL) is extremely rare, highly aggressive, commonly Epstein-Barr virus (EBV)–positive, and predominantly affects the skin and central nervous system. Here we report a case of IVNKTL diagnosed in a 67-year-old female, presenting with persistent intermittent fever and skin rashes throughout the body. Incisional biopsy of an erythematous lesion on the chest exhibited aggregation of medium to large-sized atypical lymphoid cells confined to the lumen of small vessels that were positive for CD3, granzyme B, and CD56 on immunohistochemistry and EBV-encoded RNA in situ hybridization. EBV DNA was also detected in serum after diagnosis. With a review of 26 cases of IVNKTL to date, we suggest that active biopsy based on EBV DNA detection may facilitate early diagnosis of IVNKTL.

BACKGROUND: Recent evidence demonstrates that high doses of epoetin-alpha (EPO-alpha) can be administrated at extended intervals, despite its relatively short serum half-life. However, no prospective randomized trials on the effects of extended dosing intervals of EPO-alpha compared with darbepoetin-alpha (DA-alpha) have been performed. This study was designed to investigate whether a single biweekly (Q2W) administration of a high dose of EPO-alpha is as effective as DA-alpha for anemia in chronic kidney disease (CKD) patients not receiving dialysis. METHODS: Sixty non-dialysis CKD patients were equally randomized to either Q2W subcutaneous EPO-alpha (10,000 unit) or DA-alpha (50microg) therapy groups for the first 6 weeks. After a 6-week washout period, the participants of the EPO-alpha and DA-alpha treatment groups switched to the alternate regimen for 6 weeks. The mean hemoglobin (Hb) levels after erythropoiesis stimulating agent (ESA) therapy and percentage change in Hb levels from baseline to the end of the study were analyzed. RESULTS: The mean Hb levels of postESA therapy increased significantly compared with those of preESA therapy in both ESA regimens. The percentage increase in Hb levels and erythropoietin resistance index did not show a significant difference between the different ESA regimens. No difference was observed between the regimens regarding mean Hb levels after ESA therapy. Additionally, there were no serious adverse effects leading to withdrawal from treatment. CONCLUSION: Biweekly high doses of EPO-alpha therapy may be equally as effective as Q2W DA-alpha therapy in maintaining target Hb levels in non-dialysis CKD patients.
Anemia ; Cross-Over Studies* ; Dialysis* ; Erythropoiesis ; Erythropoietin ; Half-Life ; Humans ; Renal Insufficiency, Chronic*