Hemophagocytic syndrome has been identified as a benign reactive histocytic proliferation with marked hemophagocytosis and usually associated with systemic viral infection. Recently similar cases that were associated with bacteria have been described. The syndrome is clinically characterized by fever, severe constitutional symptoms, hepatosplenomegaly, lymphadenopathy and laboratory findings of pancytopenia, hemophagocytosis, abnormal liver function test and coagulopathy. The authors experienced a case of bacteria associated hemophagocytic syndrome in a 11-year old girl following Mycoplasma pneumoniae infection. The patient showed characteristic clinical features of hemophagocytic syndrome, peripheral pancytopenia and phagocytized histiocytes in bone marrow. The brief review of the literature was made.
Bacteria* ; Bone Marrow ; Child ; Female ; Fever ; Histiocytes ; Humans ; Liver Function Tests ; Lymphatic Diseases ; Lymphohistiocytosis, Hemophagocytic* ; Mycoplasma pneumoniae ; Pancytopenia ; Pneumonia, Mycoplasma

Here we report a case of Strongyloides stercoralis infection of the gastric and pancolonic mucosa in a 79-year-old female with a monoclonal gammopathy of undetermined significance. Endoscopic biopsies were performed in gastric antrum, cecum, distal ascending colon, and hepatic flexure of the colon. On microscopic examination, there were many adult worms, larvae and eggs in the gastric and colonic mucosa. Worms, larvae, and eggs were located in the crypts and within the lumen of the crypts. The body wall of the adult worm was composed of cuticle and a weak muscle layer. A routine stool examination failed to detect larvae or ova. Based on the histopathologic examination, these parasites were confirmed as S. stercoralis.
Adult ; Aged ; Biopsy ; Cecum ; Colon ; Colon, Ascending ; Eggs ; Female ; Humans ; Larva ; Monoclonal Gammopathy of Undetermined Significance ; Mucous Membrane ; Muscles ; Ovum ; Paraproteinemias ; Parasites ; Pyloric Antrum ; Stomach ; Strongyloides stercoralis ; Strongyloidiasis

Here we report a case of Strongyloides stercoralis infection of the gastric and pancolonic mucosa in a 79-year-old female with a monoclonal gammopathy of undetermined significance. Endoscopic biopsies were performed in gastric antrum, cecum, distal ascending colon, and hepatic flexure of the colon. On microscopic examination, there were many adult worms, larvae and eggs in the gastric and colonic mucosa. Worms, larvae, and eggs were located in the crypts and within the lumen of the crypts. The body wall of the adult worm was composed of cuticle and a weak muscle layer. A routine stool examination failed to detect larvae or ova. Based on the histopathologic examination, these parasites were confirmed as S. stercoralis.
Adult ; Aged ; Biopsy ; Cecum ; Colon ; Colon, Ascending ; Eggs ; Female ; Humans ; Larva ; Monoclonal Gammopathy of Undetermined Significance ; Mucous Membrane ; Muscles ; Ovum ; Paraproteinemias ; Parasites ; Pyloric Antrum ; Stomach ; Strongyloides stercoralis ; Strongyloidiasis

No abstract available.
Child* ; Edema* ; Humans ; Renal Insufficiency*

BACKGROUNDS: The first step for the recovery of alcoholics is the formation of true insight which enables them to admit that they are alcoholic. This study was designed to analyze the changes in insight status by treatment programs. METHOD: The subjects were 214 alcohol dependents who participated in the insight-oriented treatment programs for at least 1 week. Their insight status were measured through HAIS before and after treatment. RESULTS: Of 214 subjects, 83 (38.8%) were in poor-, 103 (48.1%) in fair-, and 28 (13.1%) in good-insight before treatment, and 56 (26.2%) in poor-, 97 (45.3%) in fair-, and 61 (28.5%) in good-insight after treatment. Mean HAIS scores of the subjects were 5.35 (SD=8.33) before treatment and significantly increased to 9.00 (SD=8.04) after treatment. The magnitude of insight-improvement was negatively correlated with the HAIS scores before treatment in poor-insight group and positively correlated with the duration of participation in treatment in fair-insight group. CONCLUSION: We confirmed the fact that the insight status of patients could be improved by treatment. It was also suggested that the therapeutic strategy needed an individual approach according to the insight state of a patient.
Alcoholics ; Alcoholism* ; Humans

Hematuria is a important clinical sign that is a consequence of significant fenal. urologic or sytemic disease. Recently the morphology of the red cell in hematuria has been used to indicate a renal or non-renal source and also the measurement of red cell volume by red cell analyzer has been used to distinguish glomerular from non-glomerular hematuria. In this study. the MCV(mean corpsular red cell voume). RDW(red cell distribution width) and HDW (hemoglobin distribution width) were measured using H-1 system in57 children with hematuria to assess the diagnostic usefulness of the urinary red cell analyzer in the differentation of glomerular and non-glomerular hematuria. The patients were divided into two groups as glomerular diseases(40cases)and non-glomerular diseases(17 cases)and the location of the bleeding was confirmed by renal biopsy, radiology and the clinical findings. The results were as follows. 1) The urinary red cell MCV waslower in patients with glomerular diseases than that in patients with non-glomerular diseases (79.89 +/- 12.0fl vs. 90.93 +/- 9.71fl vs. 90.93+/-9.71 fL; p<0.01) 2) The urinary RDW and HDW were significantly higher in glomerular diseases than those in non-glomerular diseases (RDW; 19.86 +/- 11.28% vs 11.34+/-5.88%, HDW; 3.37+/-2.07 gm vs. 1.86+/-1.43gm). 3) The urinary red cell MCV was correlated well with the RDW and HDW while there was no correlation between the urinary red cell MCV and the urinary SG or pH. 4) The sensitivity, specificity and positive predictability of the urinsary MCV were 37.8%, 94.1% and 93.7% and those of RDW were 62.5%, 82.3% and 89.2% 5) The sensitivity, specificity and positive predictability of the urinary HDW were 42.5%, 88.2% and 89.4% We concluded from above date that the measurment of the urinary MCV, RDW and HDW would be useful as a primary non-invasive screening test in differentation of glomerular and non-glomerular hematuria in children.
Biopsy ; Cell Size* ; Child* ; Diagnosis* ; Hematuria* ; Hemorrhage ; Humans ; Hydrogen-Ion Concentration ; Mass Screening ; Sensitivity and Specificity

OBJECTIVE: Currently available therapies for human malignant gliomas have limited efficacy. Toxoplasma gondii, an obligate intracellular protozoan parasite, and Quil-A are nonspecific, potent immune stimulants. T. gondii is shown to have antitumor activity in some types of cancers. Therefore, this study is undertaken to evaluate the antitumor effect of Toxoplasma lysate antigen (TLA), alone or in combination with Quil-A, on human glioma U373MG and U87MG cells. METHODS: The in vitro effects of TLA alone or in combination with Quil-A on the proliferation, invasion, and apoptosis of glioma cells were tested using MTT, Matrigel invasion, and DNA fragmentation assays, and the in vivo effects on the growth of gliomas were evaluated in athymic nude mice transplanted with glioma cells. RESULTS: Treatment with TLA resulted in the suppressed proliferation and invasion of both U373MG and U87MG cells, in a dose-dependent manner. In addition, at high concentration, TLA induced glioma cell apoptosis. When TLA was administered in the mouse glioma model, malignant glioma growth was decreased. The combined treatment of TLA with Quil-A significantly inhibited the proliferation and invasion of cultured cells as well as tumor mass of implanted mice. CONCLUSION: TLA inhibits the proliferation and invasion of glioma cells in vitro and in vivo, and these antitumor effects of TLA are significantly enhanced by the addition of Quil-A.
Animals ; Apoptosis ; Cells, Cultured ; DNA Fragmentation ; Glioma* ; Humans* ; Mice ; Mice, Nude ; Parasites ; Toxoplasma*

OBJECTIVE: The goal of this study is to establish the value of the programmable valve system. METHODS: The authors conducted a single center retrospective study of 41 consecutive patients who had undergone ventriculoperitoneal shunt with programmable valve for hydrocephalus of various etiology from March 1999 to February 2002. RESULTS: In 10 patients(24%), valve pressure adjustment was required at least 3 times or more for the reason of underdrainage or overdrainage. The range of pressure reprogramming was 10 to 120mmH2O. The clinical symptoms improved in 37 patients(90%). The radiologic improvement was obtained in 88%. Shunt was minimally functioning in 3 cases without any clinical effect at the pressure of 30mmH2O. CONCLUSION: The programmable valve has been particularly useful in changing ventricular size for the correction of overdrainage or underdranage by the easy control of valve pressure without any invasive procedure. The authors' preference is to use the programmable valve system for all conditions.
Humans ; Hydrocephalus* ; Retrospective Studies ; Ventriculoperitoneal Shunt

Congenital anomaly of the extrahepatic biliary system is relatively common, especially vascular variations are much more frequent than anatomic variations. The normal anatomical structure is encountered in only 35 percent of individuals, many of these variations have little or no clinical improtance, but some cases induce symptoms and signs or may lead to incorrect diagnosis and inappropriate management. These are very important to correct diagnosis of biliary variations observed during ultrasonography, cholangiography and endoscopic retrograde cholangiopancreatography(ERCP) and to accurate management by surgeon or endoscopist since accidental section or ligation of aberrant structures can lead to serious complications. We experienced a very rare case of extrahepatic bile duct anomaly confirmed by ERCP. The right and left extrahepatic ducts were connected at the level of the pancreatic segment of the common bile duct and the cystic duct drains to the right extrahepatic duct. There were several stones in the distal portion of the left extrahepatic duct and gallbladder.
Bile Ducts, Extrahepatic* ; Cholangiography ; Cholangiopancreatography, Endoscopic Retrograde ; Choledocholithiasis ; Common Bile Duct ; Cystic Duct ; Diagnosis ; Gallbladder ; Ligation ; Ultrasonography

Congenital anomaly of the extrahepatic biliary system is relatively common, especially vascular variations are much more frequent than anatomic variations. The normal anatomical structure is encountered in only 35 percent of individuals, many of these variations have little or no clinical improtance, but some cases induce symptoms and signs or may lead to incorrect diagnosis and inappropriate management. These are very important to correct diagnosis of biliary variations observed during ultrasonography, cholangiography and endoscopic retrograde cholangiopancreatography(ERCP) and to accurate management by surgeon or endoscopist since accidental section or ligation of aberrant structures can lead to serious complications. We experienced a very rare case of extrahepatic bile duct anomaly confirmed by ERCP. The right and left extrahepatic ducts were connected at the level of the pancreatic segment of the common bile duct and the cystic duct drains to the right extrahepatic duct. There were several stones in the distal portion of the left extrahepatic duct and gallbladder.
Bile Ducts, Extrahepatic* ; Cholangiography ; Cholangiopancreatography, Endoscopic Retrograde ; Choledocholithiasis ; Common Bile Duct ; Cystic Duct ; Diagnosis ; Gallbladder ; Ligation ; Ultrasonography