Systemic lupus erythematosus is a connective tissue disease which can affect every organ system. Neurologic abnormalities are common, occuring in approximately half of all patients at some time during the course of their illness. But symptoms of nervous system as the sole presenting symptoms occur in less than 1% of lupus patients. In patients initially presenting with neurologic symptoms and signs, differential diagnosis is difficult and sometimes it may be misdiagnosed. Therefore extensive laboratory investigations should be carried out in all patients with unusual neurological symptoms, since early diagnosis of lupus can help in providing effective treatment. We report a patient with systemic lupus erythematosus who presented with dysarthria and dysphagia resembling multiple sclerosis.
Connective Tissue Diseases ; Deglutition Disorders ; Diagnosis, Differential ; Dysarthria ; Early Diagnosis ; Humans ; Lupus Erythematosus, Systemic* ; Multiple Sclerosis* ; Nervous System ; Neurologic Manifestations

No abstract available.
Animals ; Mice* ; Spermatozoa*

PURPOSE: Testicular volume is one of the important indices that represent the reproductive ability of adult males. In previous studies, however, testicular volume was measured by manual palpation or orchidometer, resulting in inaccuracy or subjectivity. Accordingly, the need for accurate data on the size of the testes is increasing, and we conducted testicular volume measurements by using scrotal ultrasonography. We investigated the relationship between testicular volume and body weight, height, and body mass index (BMI). MATERIALS AND METHODS: The testicular volumes of 1,002 young adult Korean men were measured for length, width, and thickness with ultrasonography, and data on BMI were collected conventionally. The correlation between testicular volume and BMI was analyzed with one-way ANOVA and Student's t-test. RESULTS: The mean age of the young men was 23.02+/-2.53 years. The mean testicular volume was 18.09+/-3.79 cc on the left and 18.26+/-3.21 cc on the right. Testicular volume was directly proportional to body weight, height, and body mass index. CONCLUSIONS: The testicular volume of Korean young adult men was about 18.17 cc. Testicular volume has a weak direct correlation with body weight, height, and body mass index.
Adult ; Body Mass Index ; Body Weight ; Humans ; Male ; Palpation ; Testis ; Young Adult

Thirty-four patients with suspected ectopic pregnancy whose serum hCG levels had been measured by beta-hCG EIA before surgery were evaluated retrospectively. The results were as follows: 1. Final diagnosis of thirty- four patients with suspected ectopic pregnancy comprised twenty-eight tubal pregnancy, five ruptures of hemorrhagic corpus luteum and one tubo-ovarian abscess. One of the five patients with rupture of hemorrhagic corpus luteum was accompanied by missed abortion. 2. Range of serum hCG levels in twenty-eight patients with tubal pregnancy was 59-21, 980 mIU/ml and that of four patients with rupture of hemorrhagic corpus luteum and one patient with tubo-ovarian abscess was 0.6-6.6 mIU/ml. Serum hCG level of a patient with rupture of hemorrhagic corpus luteum who was accompanied by missed abostion was 200 mIU/ml. 3. Serum hCG levels in twenty-two of twenty-eight patients with tubal pregnancy were lower than 3,000 mIU/ml. Low serum hCG level below 100 mIU/ml and high serum hCG levl above 6,500 mIU/ml were noticed in four and six patients with tubal pregnancy recpectively. 4. Mean serum hCG levels (±SD) of twelve patients with tubal pregnancy who had intraabdominal free blood of less than 500ml and sixteen patients with tubal pregnancy who had intraabdominal free blood of more than 500ml were 4,131 (±7,801) mIU/ml and 3,208 (±5,081) mIU/ml, respectively. There was no statistical difference in the mean level of serum hCG between both group (P>0.05). 5. Mean serum hCG levels (±SD) of thirteen patients with unruptured tubal pregnancy and fifteen patients with ruptured tubal pregnancy were 2,628 (±5,448) mIU/ml and 4,449 (±6,938) mIU/ml, respectively. Mean level of serum hCG was statistically higher in ruptured tubal pregnancy (P<0.01). 6. Positive rate of urine pregnancy test in the diagnosis of ectopic pregnancy was 64% (16/25) and mean range of serum hCG level of nine patients with false negative result were 353 mIU/ml and 59­933 mIU/ml.
Abortion, Missed ; Abscess ; Corpus Luteum ; Diagnosis ; Female ; Humans ; Pregnancy ; Pregnancy Tests ; Pregnancy, Ectopic* ; Pregnancy, Tubal ; Retrospective Studies ; Rupture

No abstract available.
Drug Therapy, Combination* ; Head and Neck Neoplasms* ; Head* ; Humans

Hyponatremia is frequently seen in intracranial hemorrhagic patients and has been often attributed to inappropriate secretion of antidiuretic hormone. But in recent years, a number of studies have shown that hyponatremia in many patients with intracranial disease may actually be caused by cerebral salt wasting (CSW) syndrome and circulating Atrial natriuretic peptide (ANP) and Brain natriuretic peptide (BNP) are probably involved. This report describes a patient who developed bacterial meningites caused by pseudomonas aeruginosa and CSW syndrome after removal of pituitary adenoma. CSW syndrome resolved by fluid and salt replacement after 4 months.
Humans ; Hyponatremia ; Meningitis* ; Meningitis, Bacterial ; Natriuretic Peptide, Brain ; Pituitary Neoplasms* ; Pseudomonas aeruginosa ; Pseudomonas* ; Wasting Syndrome*

Neonatal Gaves disease is a relatively rare condition due to transplacental passage of Thyroid-stimulating antibody(TSAb) from a mother with active or inactive Graveses disease or autoimmune thyroiditis. A 11-day-old female newborn was referred to our department of pediatrics from a local clinic because of low level T4(3.55microg/dl) concurrent with high level TSH (501.74uIU/ml) on the 5th day neonatal metabolic screening. But, our repeated laboratory data showed very high serum T4(59.6microg/dl), T3(1,600ng/dl), suppressed TSH(0.43uIU/ml), and the presence of TSH receptor antibody. Her mother was treated with propylthiouracil(PTU) for Graves disease during pregnancy. Therefore, we thought it was a delayed-onset neonatal hyperthyroidism, because the fetal thyroid gland was initially suppressed by antithyroid drug taken during pregnancy. After initiating antithyroid drug therapy for the hyperthyroid nature, TSH levels became elevated again, while thyroid hormone levels decreased. Maternal and infant blood samples at the 23th day after birth were examined for serum autoantibodies directed towards the TSH receptor(Thyrotropin-binding inhibitory immunoglobulin:TBII, Thyroid-stimulating antibody:TSAb, Thyroid-stimulating blocking antibody:TSBAb) and high levels of TBII and TSAb were detected. About 2 months after birth, TBII and TSAb decreased within normal limit, and then we could stop antithyroid medication in safety. We report here a case of neonatal Graveses disease with very high level of T4 and T3, but firstly presented as hypothyroid nature on neonatal screening because of the maternally transferred antithyroid drug, PTU.
Autoantibodies ; Drug Therapy ; Female ; Graves Disease ; Humans ; Hyperthyroidism ; Infant ; Infant, Newborn ; Mass Screening ; Mothers ; Neonatal Screening ; Parturition ; Pediatrics ; Pregnancy ; Receptors, Thyrotropin ; Thyroid Gland ; Thyroiditis, Autoimmune

BACKGROUND: The fas (CD95/Apo-1)/Fas ligand (FasL) system is reported to be involved in the suppression and stimulation of immune responses, and the reactive oxygen species (ROS) play a key role in the mechanism for resisting Fas-induced apoptosis of tumor cells. In this work, we investigated the effect of endogenous interleukin (IL)-18 on the regulation of immune related factors such as Fas/Fas ligand and intercellular adhesion molecules (ICAM), and of the ROS level in IL-18 receptor (IL-18R) transfected C-33A cells. METHODS: The cervical cancer cell line C-33A was transfected with IL-18R (C-33A/IL-18R). For the detection of pro-inflammatory cytokines in C-33A/IL-18R, reverse-transcriptase (RT) polymerase chain reaction (PCR), in situ enzyme-linked immunosorbent assay (ELISA), Western blot, and Northern blot analyses were performed. The level of p53 was determined by Western blot. Intracellular ROS, ICAM-1, FasL, and apoptosis in C-33A/IL-18R were measured by flow cytometry. RESULTS: In situ ELISA and RT-PCR showed that, among pro-inflammatory cytokines, IL-18 was induced in C-33A/IL-18R whereas there appeared no induction of the IL-1alpha, IL-1beta, tumor necrosis factor (TNF)-alpha, and IL-6. IL-18R transfection showed a slight enhancement of the Fas via upregulation of intracellular ROS and IL-18 in C-33A cells whereas there was no effect on the expression of p53, ICAM-1 and FasL. However, treatment with the agonistic anti-Fas antibody showed that the enhanced surface Fas was not functional or was not enough to induce apoptosis and the C-33A/IL-18R cells escaped still resistant to Fas-mediated apoptosis. CONCLUSIONS: IL-18R transfection induced IL-18 expression and enhanced ROS and Fas expression in C-33A cells. These results show that C-33A/IL-18R cells escaped from immunuosurveillance by failure to express ICAM-1 adhesion molecules and Fas ligand, and are resistant to Fas-mediated apoptosis.
Apoptosis* ; Blotting, Northern ; Blotting, Western ; Cell Adhesion Molecules ; Cell Line* ; Cytokines ; Enzyme-Linked Immunosorbent Assay ; Fas Ligand Protein ; Flow Cytometry ; Intercellular Adhesion Molecule-1 ; Interleukin-18 ; Interleukin-6 ; Interleukins ; Polymerase Chain Reaction ; Reactive Oxygen Species* ; Receptors, Interleukin-18* ; Transfection ; Tumor Necrosis Factor-alpha ; United Nations ; Up-Regulation* ; Uterine Cervical Neoplasms*

PURPOSE: We used MRI to retrospectively analyze the brain of patients suffering from cerebral palsy. Our aim is to determine MRI's role in the assessment of brain damage, the relationship of gestational age. METHODS: A total of 66 patients(29 preform group and 37 term group), who visited Kang-Dong Sacred Heart Hospital from January, 1994 to July, 1998, were enrolled in this study. RESULTS: Among the 29 in the preform group, 13 patients showed MR images of hypoxic ischemic injury in which periventricular leukomalacid(PVL) and multifocal ischemic necrosis in 12(41.3%) and 1(3.4%) respectively. Neuronal migration disorders were 6(20.8%), other congenital malformations 5(17%) and normal MR images 5(17%) in this preform group. Among the 37 in the term group, 22 patients showed MR images of hypoxic ischemic injury in which selective neuronal necrosis were 11(29.7%), PVL 4(10.8%), focal and multifocal ischemic necrosis 4(10.8%) and status marmoratus 3(8.1%). Neuronal migration disorders were 4(10.8%), other congenital malformations 5(13.5%) and normal MR images 6(16.2%) in the term group. CONCLUSION: MRI provided useful information in a majority of children with cerebral palsy. Hypoxic ischemic injury was significantly different in preform and term groups. PVL was frequent in the preterm group and selective neuronal necrosis was statistically common in the term group.
Brain* ; Cerebral Palsy ; Child* ; Gestational Age ; Heart ; Humans ; Magnetic Resonance Imaging* ; Movement Disorders ; Necrosis ; Neuronal Migration Disorders ; Neurons ; Paralysis* ; Retrospective Studies

Kawasaki disease is an acute febrile illness of unknown etiology that occurs predominantly in infants and early childhood. It had aroused intense interest because of the sequelae of coronary arteritis accompanied by coronary artery aneurysms and thrombotic occlusion, which may lead to ischemic heart disease or sudden death. Atypical Kawasaki disease is coined to describe patients who have coronary abnormalities, pathognomic findings of Kawasaki disease, but who do not exhibit at least four criteria of the disease. Giant coronary arterial aneurysm is a very rare complication after atypical Kawasaki disease, and in cases of coronary occlusion, the surface electrocardiograms usually show common ischemic changes. We report a case of right coronary arterial occlusion complicated after atypical Kawasaki disease. During 12 months, the serial electrocardiograms showed no evidence of ischemia, but coronary angiography disclosed giant aneurysms accompanied with occlusion and several collaterals in right side.
Aneurysm ; Arteritis ; Coronary Angiography ; Coronary Occlusion ; Coronary Vessels ; Death, Sudden ; Electrocardiography* ; Humans ; Infant ; Ischemia ; Mucocutaneous Lymph Node Syndrome ; Myocardial Ischemia ; Numismatics