BACKGROUND: Although human parasitic infestations have decreased generally in Korea, Clonorchis sinensis, Paragonimus westermani, Cysticercus and Sparganum are still a serious concern due to their relatively high prevalence and severe complications. A definitive diagnosis, however cumbersome and occasionally invasive, is required in order to detect adult worms, eggs, or cysts. The parasite-specific IgG antibody (PSA) test using the ELISA method has been recently developed to diagnose and monitor the infestations of those four parasites. We analysed PSA positive patients for Clonorchis sinensis, Paragonimus westermani, Cysticercus and Sparganum. METHODS: The serum samples referred to the Neodin Medical Institute for PSA were tested by the ELISA method using crude extracts of C. sinensis, P. westermani, Sparganum and cystic fluid of Cysticercus. The PSA results during the 7-month period from January to July 2001 were retrospectively analysed. The medical records of the patients at Asan Medical Center (AMC) with positive PSA were reviewed with stool examinations for parasites, skin tests for C. sinensis and P. west-ermani, radiological findings and antiparasitic management. RESULTS: A total of 865 specimens were tested for PSA and 84 samples (9.7%) of 76 patients were positive; C. sinensis, Cysticercus, Sparganum, and P. westermani were positive in 26 patients (3.0%), 26 (3.0%), 14 (1.6%) and 10 (1.2%), respectively. 26 specimens from 18 AMC patients were positive for one or more PSA; 6 Cysticercus. 4 C. sinensis, 5 Sparganum and 3 P. westermani. All PSA-positive cases for Cysticercus, C. sinensis and P. westermani were compatible with the clinical diagnosis; however, it was difficult to elucidate in the clinical correlation of 3 out of 5 Sparganum-positive cases. CONCLUSION: Cysticercus, C. sinensis and P. westermani are currently prevalent in Korea. Positive PSA ELISA tests for Cysticercus, C. sinensis and P. westermani are reliable indicators in diagnosing present infestations among the clinically suspected patients.
Adult ; Chungcheongnam-do ; Clonorchis sinensis* ; Complex Mixtures ; Cysticercus* ; Diagnosis ; Eggs ; Enzyme-Linked Immunosorbent Assay* ; Humans ; Immunoglobulin G ; Korea ; Medical Records ; Ovum ; Paragonimus westermani* ; Parasites ; Prevalence ; Retrospective Studies ; Skin Tests ; Sparganum*

No abstract available.
Vulva*

The idiopathic calcinosis of the scrotum is multiple and asymptomatic nodules of scrotal skin which can onset either in childhood or early adulthood. It increases in size and number, while breakingdown to discharge chalky contents on occasions. We report a case of a 68-year-old-man who was effectively treated with a simple excision of the affected skin with an idiopathic scrotal calcinosis. There is no family history of scrotal calcification. Histopathologically, multiple nodules showed the epidermal cyst with partially degenerated wall and calcium deposits with a foreign body reaction in the dermis in this case. In most reported cases, some intact epidermal cysts are also present, and dystrophic calcification, and possible inflammation and rupture of epidermal cysts regarded as be the main pathogenetic mechanism of the disease.
Calcinosis* ; Calcium ; Dermis ; Epidermal Cyst ; Foreign-Body Reaction ; Humans ; Inflammation ; Rupture ; Scrotum* ; Skin

PURPOSE: This study was performed to investigate the oxidation and antioxidation capacity in the maternal venous plasma of preterm labor with intact membranes, and premature rupture of membranes (PPROM), and also to evaluate their roles in the pathophysiology of PPROM. METHODS: Seventy five women in the following categories had venous blood retrieved: (1) Group A, normal pregnancy (n=24). (2) Group B, preterm labor with intact membranes (n=25). (3) Group C, preterm premature rupture of membranes (n=26). Malondialdehyde (MDA) levels as a marker of lipid peroxidation by thiobarbituric acid reaction, protein carbonyl content by 2,4-dinitrophenylhydrazine reaction, and total antioxidant capacity by oxygen radical absorbance capacity assay (ORAC) were measured. Mann-Whitney U test, Kruskal-Wallis test were used for statistical analysis. RESULTS: Lipid peroxide levels in the venous plasma of group B and C were significantly higher than those of group A (group B: 4.59+/-0.30, group C: 5.40+/-0.22 vs. group A: 3.90+/-0.26 nmol/mg protein, P<0.05). Lipid peroxide levels in the venous plasma of group C were significantly higher than those of group B (P<0.05). Protein carbonyl levels in the venous plasma of group C were significantly higher than those of group A (group C: 5.68+/-0.42 vs. group A: 5.43+/-0.41 nmol/mg protein, P<0.05). There was no significant difference of protein carbonyl levels in the venous plasma between group A and B. ORAC levels in the venous plasma of group B and C were significantly lower than those of group A (group B: 117.90+/-0.48, group C: 111.68+/-1.23 vs. group A: 119.14+/-1.12 mM/mL, P<0.05). ORAC levels in the venous plasma of group C were significantly lower than those of group B (P<0.05). CONCLUSION: In the blood of the women with preterm premature rupture of membranes, the lipid peroxidation was increased and the antioxidant capacity was decreased compared to women with normal pregnancy and preterm labor with intact membranes. These results suggest that oxidative stress was increased in preterm premature rupture of membranes.
Female ; Humans ; Lipid Peroxidation ; Malondialdehyde ; Membranes* ; Obstetric Labor, Premature* ; Oxidative Stress* ; Oxygen ; Plasma* ; Pregnancy ; Rupture*

PURPOSE: CAPD is an important treatment modality along with hemodialysis and kidney transplantation in end stage renal disease. Malnutrition is very common and associated with increased morbidity and mortality in CAPD patients. The cause of malnutrion in CAPD patients might be multifactorial. This prospective study was carried out to investigate nutritional changes for 1 year after initiation of peritoneal dialysis by measurement body composition, especially lean body mass (LBM) using bioelectrical impedance analysis (BIA) and dual energy X-ray absorptiometry (DEXA) and to evaluate the factors associated with malnutrition in CAPD patients. METHODS: Among new CAPD patients from May, 2001 to Dec, 2002 in our hospital, 25 patients were enrolled. Body weight, LBM, LBM percen t (%LBM), fat mass, fat mass percent (%fat mass), ECF volume and ECF/TBW were compared between 1st month and 12th month after initiation of PD. The biochemical parameters, Urea kinetic modeling, Peritoneal equilibration test, the amounts of glucose absorption through the dialysate, the amounts of protein and albumin loss through the dialysate were measured at the same time point with measurement of the body composition. RESULTS: There were significantly decreased LBM (46.3+/-9.1 kg to 44.7+/-9.0 kg in BIA, 45.7+/-9.3 kg to 42.1+/-7.9 kg in DEXA, p< 0.05, respectively) but significantly increased fat mass (16.3+/-6.2 kg to 20.2+/-7.9 kg in BIA, 15.7+/-6.6 kg to 20.1+/-7.4 kg in DEXA, p<0.01, respectively) during first one year. Mean weekly Kt/V were significantly correlated with the changes of LBM (r=-0.64 in BIA, r=-0.81 in DEXA, p<0.01, respectively). With the multiple regression test, 1st month weekly Kt/V in BIA and DEXA were significant predictors of the changes of LBM for 1 year (beta-coefficients: -0.573 in BIA, -0.773 in DEXA, p<0.01, respectively). CONCLUSION: Adequate dialysis, especially 1st month adequacy, is very important for maintaining good nutritional status for one year after initiation of peritoneal dialysis.
Absorptiometry, Photon ; Absorption ; Body Composition* ; Body Weight ; Dialysis ; Electric Impedance ; Glucose ; Humans ; Kidney Failure, Chronic ; Kidney Transplantation ; Malnutrition ; Mortality ; Nutritional Status ; Peritoneal Dialysis ; Peritoneal Dialysis, Continuous Ambulatory* ; Prospective Studies ; Renal Dialysis ; Urea

Tsutsugamushi disease is an acute febrile illness caused by Orientia tsutsugamushi. It is characterized by fever, myalgia, lymphadenopathy, and rash. And it can be easily diagnosed by characteristic eschar and serologic testing. Nearly all of the patients with tsutsugamushi disease improve with antibiotics such as doxycycline. However, the fatality rate of untreated cases is seven to ten percent. The well-known causes of mortality are respiratory failure associated with pulmonary edema or adult respiratory distress syndrome. We report a case of tsutsugamushi disease complicated with acute respiratory distress syndrome and disseminated intravascular coagulopathy, despite of doxycycline treatment. A 78-year old woman was admitted to the hospital because of fever. Twelve days before admission she had suffered myalgia and some days later she developed a rash. Despite of management at a local clinic, her condition deteriorated and she was transferred to our hospital. On admission she presented with altered consciousness and two eschars on her right arm and right thigh. Under the initial diagnosis of scrub typhus, doxycycline was administered. Her fever subsided with the initiation of doxycycline. However, her hypoxia worsened progressively and she died on the fifth hospital day.
Adult* ; Aged ; Anoxia ; Anti-Bacterial Agents ; Arm ; Consciousness ; Diagnosis ; Doxycycline ; Exanthema ; Female ; Fever ; Humans ; Lymphatic Diseases ; Mortality ; Myalgia ; Orientia tsutsugamushi ; Pulmonary Edema ; Respiratory Distress Syndrome, Adult* ; Respiratory Insufficiency ; Scrub Typhus* ; Serologic Tests ; Thigh

Congenital myotonic dystrophy is an autosomal dominantly inherited myotonic dystrophy, rare form, with an incidence estimated to be 13/100,000 liveborns. Affected newborns can present with intrauterine growth retardation, prematurity, birth asphyxia, respiratory distress, and always exhibit generalized muscular hypotonia. Feeding problems are common and an association with protein losing enteropathy, hydrops fetalis, and persistent pulmonary hypertension of the newborn has been described. Twenty-five percent of the affected infants die within the first 18 months of life. The molecular basis is an unstable DNA fragment consisting of a variable expansion of a CTG triplet, Dystrophia myotonica-protein kinase (DMPK) which is localized on chromosome 19q 13.3. The severity of the disease is directly correlated to the length of the CTG sequence. Women with idiopathic polyhydroamnios, decreased fetal movement, prematurity, hypotonia, should be counselled family, and mother, father and baby should be evaluated congenital myotonic dystrophy, as PCR (polymerase chain reaction). It is possible to diagnose congenital myotonic dystrophy, by PCR, antenatal test, such as CVS, amniocentensis. We experienced a case of recurrent congenital myotonic dystrophy, with neonatal death, twice, and report with a review of related literatures.
Asphyxia ; DNA ; Fathers ; Female ; Fetal Growth Retardation ; Fetal Movement ; Humans ; Hydrops Fetalis ; Hypertension, Pulmonary ; Incidence ; Infant ; Infant, Newborn ; Mothers ; Muscle Hypotonia ; Myotonic Dystrophy* ; Parturition ; Phosphotransferases ; Polymerase Chain Reaction ; Protein-Losing Enteropathies ; Triplets

The potential hepatotoxicity of herbal remedies and/or health foods is usually ignored in daily life. There have been cases showing the toxic hepatitis and renal failure associated with the ingestion of raw carp bile. We experienced a case of toxic hepatitis without any evidence of renal failure that was associated with carp juice ingestion. The clinical manifestations were characterized by nausea and vomiting after the ingestion of carp juice for 3 months. The diagnosis of toxic hepatitis was made on the basis of the patient's history, laboratory data, RUCAM (Russel Uclaf Causality Assessment) and the results of ultrasonography guided liver biopsy. The patient showed rapid improvement after instituting supportive therapy.
Male ; Korea ; Humans ; Hepatitis, Toxic/*etiology ; *Carps ; *Bile ; Animals ; Adult

Alkaline Phosphatase ; Animals ; Bone Marrow ; Child ; Collagen ; Dexamethasone ; Humans ; Integrin-Binding Sialoprotein ; Mice ; Osteoblasts ; Osteocalcin ; Osteogenesis ; Osteopontin ; Rats ; Rodentia ; Stem Cells ; Stromal Cells ; Tissue Donors ; Vitamin D

Adipocytes ; Alkaline Phosphatase ; Animals ; Bone Marrow ; Bone Regeneration ; Collagen Type I ; Culture Media ; Flushing ; Humans ; Integrin-Binding Sialoprotein ; Mesenchymal Stromal Cells ; Osteoblasts ; Osteopontin ; Plastics ; PPAR gamma ; Rats ; RNA, Messenger ; Stem Cells ; Stromal Cells