In order to understand the tissue responses of albino rat host against Paragonimus iloktsuenensis infection, the histopathological changes of the spleen and the lungs in 6 experimental groups of rats were observed in relation with the growth, maturation and migration of this lung fluke. Rats of the experimental groups, each group consisted of 5 rats, were infected with the metacercariae of P. iloktsuenensis which were isolated from brackish water crab, Sesarma dehaani, and were kept for 3 days, 3 weeks, 4 weeks, 7 weeks, 10 weeks and 14 weeks of infection period. Peripheral blood smear slides for the differential leukocyte count were prepared and also worm collection was completed immediately after the infection period. Paraffin sections of the spleen and the lung tissue were stained with hematoxylin-eosin and methyl-green-pyronin (MGP) stain. Those materials from the experimental groups were examined in comparison with the materials obtained from control group, with special reference to immunologic aspects of host response. The results obtained were as follows: The counts of large pyroninophilic cell (LPC) in the periarterial sheath of spleen were rapidly increased in earlier period of infection, and those of peribronchial lymphatic tissue started to increase after the penetration of lungfluke into the lungs. The LPC counts of both the spleen and the lungs were on the decrease in conjunction with the necrosis of the lung fluke in 14th week of infection. On observing differential leukocyte count of peripheral blood smear, the fluctuation of lymphocyte count was proportional to that of LPC count, and the lymphocyte count was consistently higher than that of normal rats. On the other hand, neutrophil count of experimental group showed reciprocal relation to the LPC counts. The nature and characteristics of pulmonary lesion produced by the P. iloktsuenensis were just the same as those produced by P. westermani. The lesions were represented by thick and fibrosclerotic cavern, granuloma due to eggs, pneumonic process and cellular infiltrations.
parasitology-helminth-trematoda ; paragonimiasis ; Paragonimus iloktsuenensis ; histology ; pathology ; lung ; spleen ; granuloma ; pneumonia ; hematoxylin-eosin ; methyl-green-pyronin

Human sparganosis in Korea was discussed on the bases of five human cases experienced by the present authors and 58 case records already reported by many previous authors, in aspects of epidemiology and clinical features. Sparganosis is not infrequent tissue helminthiasis now in Korea and the incidence has been evidently increased during past 10 years. It might be interpreted that improved medical delivery system and health care exposed the hidden but prevalent disease. The distribution of sparganosis in Korea is apparently subdivided into three major endemic areas; Kyunggi Do, Kyungsang Do and Hamkyung Nam Do. Although scanty in other areas of Korea, the distribution of this disease is presumably throughout the whole peninsula of Korea except Cheju Do. The majority of human cases of sparganosis in Korea has revealed raw consuming of snakes for treatment of tuberculosis, syphilis and joint pain, for tonics and for the belief of special nutrition among very limited group of Korean population. Because of this kinds of mode of infection, comprising four fifths of all cases, the majority of cases detected were male adult consisting of about 70% of total cases. And drinking of untreated water in rural area where no protective, sanitary measures for water sources were provided in the past, seems another important causes of infection especially in women and children in Korea. Thus it may be concluded that sparganosis in Korea is concluded by eating of infective stages per os voluntarily or involuntarily, but not through the direct invasion. Clinically, subcutaneous mass or lump was the most frequent problem in those patients and those masses were associated with inflammatory signs. By the anatomical location of the lesion, some peculiar manifestations could be developed as in orbital, abdominal, urethral, ureteral and vertebral cases. And the lesions could be complicated by haemorrhage or abscess formations. The larval worms hitherto collected in Korea has been identified tentatively as Sparganum mansoni because neither branched larvae nor Sparganum proliferum were ever reported.
parasitology-helminth-trematode ; Spirometra sp. ; sparganum ; case reoprt ; epidemiology

The author fractographically analyzed the cause of metal failure (the first time this procedure has been used for this metal failure) and also analyzed in clinically. In this study, I selected eight cases which have been analyzed fractographically. In all these cases, the analysis was done after treatment of metal failure of implants internally fixed to femur shaft fractures at the Department of Orthopedic Surgery, Yeung-Nam University Hospital during the six year period from May 1983 to September 1989. 1. Metal failure occurred in five dynamic-compression plates, one Jewett nail, one screw in Rowe plate, and one interlocking nail. 2. The clinical cause of metal failure was deficiency of medial buttes in five cases, incorrect position of implant in one case, and incorrect selection of implant in two cases. 3. The time interval between internal fixation and metal failure was four months in one case, between five months to twelve months in six cases, three years in one case. 4. The fractographically analytical cause of metal failure was ; first, impact failure, one case, second, fatigue failure, six cases, machining mark (stress riser), four case type: low consistent cyclic fatigue failure irregular cyclic fatigue failure third, stress corrosion crack, one case. 5. 316 L Stainless Steel has good resistance to corrosion. However, when its peculiar surface film is destroyed by fretting, it shows pitting corrosion. This is, perhaps, the main cause of metal failure. 6. It is possible that mechanical injury occurred in implants during the manufacturing of implants or that making a screw hole in the main cause of metal failure.
Corrosion ; Fatigue ; Femur* ; Orthopedics ; Stainless Steel

BACKGROUND: Diabetic ketoacidosis(DKA) is serious acute metabolic complication and the most important cause of high morbidity and mortality of diabetes. The object of this study is to examine the clinical characteristics of patients with DKA who had a prior history of diabetes or not. METHOD: Authors reviewed retrospectively the medical records of 49 cases adimitted to Kyungpook National University Hospital from January 1991 to June 1997 with a diagnosis of DKA and classified cases as type I, type II and newly diagnosed diabetics according to prior history of diabetes. RESULTS: 1. Of 49 cases of DKA, 24(49%) were classified as type I, 17(35%) as type II from data available in the medical records, and 8(16%) had DKA as the initial manifestation of the disease. 2. The male to female ratio was 0.5 : 1 in type I, 1.1 : 1 in type II and 1.7 : 1 in newly diagnosed diabetics, and the mean age was 24.4 in type I, 57.9 in type II and 23.9 years old in newly diagnosed diabetics. 3. The mean duration between initial diagnosis of diabetes and the occurrence of DKA was 2.6 in type I and 6.9 years in type II diabetes. The occurrence of DKA within 2 years of initial diagnosis of diabetes was 54% in type I and 18% in type II diabetes, but the occurrence of DKA after 5 years of initial diagnosis of diabetes was 17% in type I and 47% in type II diabetes. 4. The precipitating factors of DKA were identified in 88% in type I, 76% in type II and 38% in newly diagnosed diabetics, and the most common precipitating factor was omission of treatment in both type I and type II(type I: 56%, type II: 35%). 5. The altered mental status was correlated with increased osmolality (p<0.05), but not with other laboratory values such as pH, bicabonate, glucose, anion gap and dehydration status(p>0.05). CONCLUSION: It is necessary to conduct early aggressive evaluation for early diagnosis and proper treatment of DKA, because DKA occurs in patients with prior history of type II diabetes and without prior diabetic history as well as patients with prior history of type I diabetes.
Acid-Base Equilibrium ; Dehydration ; Diagnosis ; Early Diagnosis ; Female ; Glucose ; Gyeongsangbuk-do ; Humans ; Hydrogen-Ion Concentration ; Male ; Medical Records ; Mortality ; Osmolar Concentration ; Precipitating Factors ; Retrospective Studies

To study factors related to release of atrial natriuretic polypeptide(ANP) in human subjects, instracardiac pressure and plasma ANP concentration in peripheral and central circulation were measured in patients with various heart disease (18 valvular heart disease, 4 congenital heart disease, 2 cardiomyopathy). 1) The concentration in peripheral venous plasma were increased in 14 patients with New York Heart Associaion (NYHA) functional class III-IV (87+/-38 pg/ml) as compared with that in 10 patients with NYHA functional class I-II (39+/-21 pg/ml, P<0.005)and 15 normal subjects (51+/-21 pg/ml, P<0.01). 2)The concentration of plasma ANP in inferior vena cava, right ventricle, pulonary artery, left ventricle and aorta were markedly increased in patient with NYHA functional class III-IV, elevated mean right atrial pressure (MRAP> or =8 mmHg) elevated mean pulmonary capllary wedge pressure (MPCWP> or =15 mmHg) and/or elevated pulminary artery systolic pressure (PASP> or =35 mmHg), as compared with those in patients with NYHA functional class I-II and/or lower intracardiac pressure (MRAP<8 mmHg, MPCWP<15 mmHg, and/or PASP<35 mmHg). 3) A step up in ANP concentration between inferior vena cava and right atrium was seen in patients with elevated MRAP (81+/-28pg/ml, 137+/-60pg/ml, P<0.05), MPCWP (74+/-37pg/ml,112+/-62pg/ml, P<0.05) and/or PASP (75+/-29 pg/ml,119+/-64 pg/ml, P<0.05). But there were no differences among intracardiac ANP concentrations from right atrium though aorta. 4) Plasma concentrations in right atrium, pulmonary artery, left ventricle and aorta correlated with MRAP (r=0.82, 0.63, 0.56, p<0.005 and r=0.52, P<0.01, respectively), MPCWP (r=0.86, 0.75, 0.73 and 0.72 respectively, P<0.005 in all) and PASP (r=0.73, 0.57, 0.68 and 0.59 respectively P<0.005 in all). 5) Left atrial diameter correlated with plasma ANP concentration in peripheral plasma (r=0.55, P<0.01), inferior vena cava (r=0.51, P<0.025), right atrium (r=0.45, P<0.05), right ventricle (r=0.55, P<0.01), pulmonary artery (r=0.52, P<0.01), left ventricle (r=0.55, P<0.01) and aorta (r=0.56, P<0.005). These results suggest that the heart secrets atrial natriuretic polypeptide into right atrium in response to increased mean right atrial pressure, mean pulmonary capillary wedge pressure, pulmonary artery systolic pressure and/or left atrial distention.
Aorta ; Arteries ; Atrial Natriuretic Factor ; Atrial Pressure ; Blood Pressure ; Heart ; Heart Atria ; Heart Defects, Congenital ; Heart Diseases* ; Heart Valve Diseases ; Heart Ventricles ; Humans ; Plasma* ; Pulmonary Artery ; Pulmonary Wedge Pressure ; Vena Cava, Inferior

Thirty-nine patients with fixed drug eruption who visited the Department of Dermatology in National Medical Center from January 1g7g to December 1982 were selected. Among them, twentyseven patients performed skin biopsy and were evaluated histopathologically on the basis of duration. The results were as follows; ].In the early stage less than 1 week of duration, hydropic degeneration of basal cells, necrotic keratinocytes with eosinophilic cytoplasm and pknotic nucleus in the epidermis, and mixed cell infiltration with eosinophlis in the upper dermis were prominently. In the late stage more than 20 days of duration, acanthosis, an increased amount of melanin in the basal cell layer and presence of melanophages were found more prominent, however, hydropic degeneration of basal cells, papillary dermal ederna, inflammatory infiltration of mononuclear cells were found less prounced or absent.
Biopsy ; Cytoplasm ; Dermatology ; Dermis ; Drug Eruptions* ; Eosinophils ; Epidermis ; Humans ; Keratinocytes ; Melanins ; Skin

Aortopulmonary septal defect is a rare congenital cardiac anomaly. A 15 year old boy was admitted to Department of Internal Medicine of Seoul National University Hospital because of exertional dyspnea. Aortopulmonary septal defect was confirmed by cardiac catheterization demonstrating severe pulmonary hypertension and patent foramen ovale, and retrograde aortogram showing contrast material passing from the ascending aorta just above the aortic valve into the pulmonary trunk. We present a case of aortopulmonary septal defect with a review of literatures.
Adolescent ; Aorta ; Aortic Valve ; Aortopulmonary Septal Defect* ; Cardiac Catheterization ; Cardiac Catheters ; Dyspnea ; Foramen Ovale, Patent ; Humans ; Hypertension, Pulmonary ; Internal Medicine ; Male ; Seoul

Systemic lupus erythematosus is a multisystemic autoimmune disease in which the kidneys are frequently involved. Clinical diagnosis of SLE is based on the criteria of American Rheumatism Association (ARA). A few cases who were classified as SLE by the ARA criteria but were antinuclear antibody (ANA)-negative have been reported. It was reported that critical factor in ANA positivity is the choice of substrate. It is generally accepted that the cultured cell of human origin, especially HEP-2 cell, is better than tissue section or animal cells. Thus, the ANA test is negative only in approximately 2M of SLE patients when human tissue culture cells are used as substrate. We report a 25-year-old man admitted to our hospital because of generalized edema. He was found to have active lupus nephritis(WHO class IV), photosensitivity and pancytopenia. The result of FANA test which used HEP-2 cell as substrate was repeatedly negative, but anti-ds DNA and anti-Ro antibody were positive.
Adult ; Animals ; Antibodies, Antinuclear ; Autoimmune Diseases ; Cells, Cultured ; Diagnosis ; DNA ; Edema ; Humans ; Kidney ; Lupus Erythematosus, Systemic ; Lupus Nephritis* ; Pancytopenia ; Rheumatic Diseases

BACKGROUND: The goal of this study is to identify the factors that predict mortality in elderly trauma patients. METHOD: We reviewed retrospectively the medical record of 144 cases of geriatric trauma admitted to Kyungpook National University Hospital firm January 1998 to December 1998. We evaluated the general characteristics, mechanisms of injury, Revised Trauma Score(RTS), Injury Severity Score(ISS), Probability of survival(Ps) by TRISS(Trauma and Injury Severity Score) method, amount of blood transfused, preexisting disease, complications, length of stay, and mortality. RESULTS: 1. The mean age was 75.39+/-7.89 years old, and male to female ratio was 0.89 : 1. 2. The mechanisms of injury were primarily frills(56.3%) followed by bicycle or motorcycle(13.9%), and pedestrian injuries(13.2%) and motor vehicle accidents(6.9%). 3. The mean Glasgow Coma Scale(GCS), RTS and ISS ate 13.3+/-3.5, 7.2+/-1.4 and 14.2 +/-11.6 respectively. 4. The actual mortality rate was 18.1% (26/144). But by TRISS method, predicted mortality rate was 9.3%(12.5/144), excess mortality rate was 108% and Z score was 3.99 indicating that actual number of death exceed predicted number of death. 5. Between the survivors and nonsurvivors, the insults were significantly different as follows ; systolic blood pressure(141.9+/-28.3 vs. 116.8+/-48.7 mmHg), GCS(14.3+/-2.0 vs. 9.0 +/-5.1), RTS(7.8+/-0.7 vs 5.4+/-2.3), ISS(11.3+/-5.6 vs 27.2+/-20.2), Ps by TRISS(0.97+/-0.06 vs 0.65+/-0.37), preexisting diseases(50.8 vs 69.8%). CONCLUSION: Geriatric patients are more likely to die after trauma than other age groups. The cause of higher actual mortality rate compared to predicted mortality rate was considered as the higher incidence of delayed death due to sepsis or multiple organ failure. In order to reduce the mortality, even with relatively stable initial vile sign, invasive hemodynamic monitoring and intensive treatment are recommended and also, prevention and treatment of nosocomial infection are very important.
Aged ; Coma ; Cross Infection ; Female ; Gyeongsangbuk-do ; Hemodynamics ; Humans ; Incidence ; Length of Stay ; Male ; Medical Records ; Mortality* ; Motor Vehicles ; Multiple Organ Failure ; Preexisting Condition Coverage ; Retrospective Studies ; Sepsis ; Survivors

BACKGROUND: To examine whether nonemergency patients can be identified and be safely triaged out of the emergency department. METHODS: Adult patients(16 years or older) who visited to the emergency department were prospectively studied from July 1 to August 31, 1997. Authors developed a new triage composed of vital signs, mental status, chief complaints, etiology, and a mode of transfer. Chi-square test and a discriminant analysis were applied for statistical analysis. RESULTS: In a discriminant analysis, mode of transfer, chief complaint, age, heart rate, mental status, etiology, and body temperature were significant variables in order. In a canonical discriminant value at group mean, a nonemergent value is 0.450 and a emergent value -0.219. CONCLUSIONS: In simply applicable triage method, mode of transfer and chief complaints are more important than vital sign and mental status. This method is useful in disaster situation and non-medical personnel may use this triage method easily. But some patients are not triaged by this triage method, thus more studies and discussions are necessary.
Adult ; Body Temperature ; Disasters ; Emergencies* ; Emergency Service, Hospital* ; Heart Rate ; Humans ; Prospective Studies ; Triage* ; Vital Signs