Five cases of histologically proven polymorphic reticulosis were examined with computed tomography(CT). CT findings were mucosal thickening along the septal and lateral walls of the nasal cavities(n=4), obliteration of the contour of the nasopharynx(n=4), involvement of the paranasal sinuses (n=2), destruction of the nasal septum and/or sinus walls(n=3) and mass in the palate, tonsil or neck (n=1). CT examination was helpful in determining the extent of the disease in the nasal cavity and paranasal sinuses. However, lesions in the palate and tonsils could not be easily evaluated with CT. CT findings of polymorphic reticulosis are nonspecific and granulomatous diseases may show similar CT findings.
Granuloma, Lethal Midline* ; Nasal Cavity ; Nasal Septum ; Neck ; Palate ; Palatine Tonsil ; Paranasal Sinuses

OBJECTIVE: The purpose of this study was to compare the plasma amitriptyline and nortriptyline level between before and after fluoxetine addition with patients who were currently taking amitriptyline. METHOD: From the inpatient and outpatient unit of Soon Chun Hyang University Hospital, Chunan, fourteen subjects who were taking amitriptyline 25mg more than 1 week at least were given fluoxetine 20mg. Before and 2 weeks after fluoxetine addition the plasma level of amitriptyline and nortriptyline are analyzed simultaneously by High Performance Liquid Chromatography(HPLC) At the same times, HAM-D(Hamilton Rating Scale for Depression) score and the UKU(Uldvalg for Klinske Unders phi gelser) side effect scale were checked. RESULTS: After fluoxetine addition to the patients who were taking amitriptyline, the plasma level of amitriptyline, nortriptyline and sum of amitriptyline and nortriptyline had risen. The mean plasma amitriptyline level increased from 168.9+/-89.4ng/ml to 183.0+/-102.0ng/ml after fluoxetine addition(p=0.011) but the change was not statistically significant. The mean plasma nortriptyline level increased significantly from 114.3+/-70.2ng/ml to 168.0+/-86.2ng/ml after fluoxetine addition(p=0.011) In addition, the mean plasma level of total amitriptyline and nortriptyline increased significantly from 283.1+/-125.3ng/ml to 350.9+/-78.4ng/ml after fluoxetine addition(p=0.016) After fluoxetine addition, no significant change was noted in the UKU side effect scale score. CONCLUSION: As consequence of comparson of plasma amitriptyline and nortriptyline level before and after fluoxetine addition mean amitriptyline, nortriptyline and total plasma level was increased after fluoxetine addition. This suggests that coadministration of amitriptyline and fluoxetine may induce improvement of depressive symptom in depressive patients by way of increased plasma level of amitriptyline.
Amitriptyline* ; Chungcheongnam-do ; Depression ; Fluoxetine* ; Humans ; Inpatients ; Nortriptyline ; Outpatients ; Plasma*

After the report of the first case of pandemic influenza A virus H1N1 on April 2009, this infection caused more than 16 thousands deaths world-widely. Postinfectious cough is known to be one of the important causes of chronic cough. We experienced five cases of persistent cough, which developed after influenza A virus H1N1 infection. All of the cases showed bronchial hyperreactivity by methacholine inhalation challenge. We prescribed steroids, which resulted in complete symptomatic recovery within 50 days, but the bronchial hyperreactivity was not normalized. We describe these five cases in regard to clinical characteristics, methacholine challenge test, and anti-inflammatory treatment.
Bronchial Hyperreactivity ; Cough ; Influenza A virus ; Influenza, Human ; Inhalation ; Methacholine Chloride ; Pandemics ; Steroids

Polymyositis is uncommon, nonsuppurative Connective tissue disorder. We have experienced a case of polymyositis. Patient was a 20-y.ear old female in good healthy appearance with history of mild, progressive muscle weakness of lower extremities and inability to walk up and down of stairs in recent 3 weeks. Her symptoms were mainly subjective and individual muscle test revealed no abnormalities, but evidences of primary myopathy were easily obtained by muscle biopsy, electromyogram and several enzyme values. We are reporting a case of polymyositis with brief review of literature.
Biopsy ; Connective Tissue ; Female ; Humans ; Lower Extremity ; Muscle Weakness ; Muscular Diseases ; Polymyositis

BACKGROUND: Leptin, produced in the adipose tissue, is involved in the regulation of body weight. The release of the leptin is increased in obese adults even in children. This study investigated whether the serum leptin in cord blood was related to babys birth weight and metabolic parameters. METHODS: 71 pairs of singleton pregnancy babies and their mother were studied. Babies are classified in LGA (large for gestational age), AGA (appropriate for gestational age), SGA (small for gestational age) three groups. After delivery, cord blood and maternal venous blood samples were drawn. We measured the plasma leptin, insulin-like growth factor (IGF)-1, insulin and proinsulin in cord and maternal serum. RESULTS: The concentration of leptin from cord blood was increased in LGA babies and decreased in SGA babies compued with the level in AGA babies. There was positive correlatian (r=0.55, p<0.01) between the plasma leptin level in cord and birth weight. There were positive correlatian between both the plasma proinsulin (r=0.37, p<0.01) and IGF-1 (r=0.32, p<0.01) and birth weight, too. But there was no difference between female and male baby's cord blood leptin level. In multiple regression analysis, cord blood leptin level was found independent factor related to birth weight ( p=0.001) CONCLUDION : The plasma leptin, proinsulin and IGF-1 is correlates to the birth weight. These data provide evidence that leptin and proinsulin are highly related to the nutritional status already during the fetal periods, and effect on the intrauterine fetal growth.
Adipose Tissue ; Adult ; Birth Weight* ; Body Weight ; Child ; Female ; Fetal Blood* ; Fetal Development ; Humans ; Insulin ; Insulin-Like Growth Factor I ; Leptin* ; Male ; Mothers ; Nutritional Status ; Parturition* ; Plasma ; Pregnancy ; Proinsulin

BACKGROUND AND OBJECTIVES: Chlamydia pneumoniae (C. pneumoniae) is a well-known pathogen of upper and lower respiratory tract infection. For a more efficient and practical cell culture system, we studied the growth of two clinical isolates of C. pneumoniae in selected cell lines derived from the human respiratory tract. MATERIALS AND METHOD: HeLa 229, HEp-2, which are well-known cell lines for the culture of C. pneumoniae, and AMC-HN-4, AMC-HN-7, AMC-HN-8, which are the newly developed cell lines in Korea were examined. Strains of C. pneumoniae used in this study were TW-183 and LKK-1 (the first Korean strain). Chlamydia was inoculated on each confluent cell line and incubated for 48 hrs. After staining with anti-Chlamydial lipopolysaccharide monoclonal antibody, we compared the efficiency of the C. pneumoniae infection on each cell line by counting the inclusion bodies. RESULTS: In culturing C. pneumoniae LKK-1, AMC-HN-4 cells consistently yielded higher inclusion body counts than HeLa 229 cells did, whereas inclusion body counts by AMC-HN-7 cells was low. AMC-HN-7, AMC HN-8 cells yielded lower inclusion body counts than HEp-2 cells. In culturing C. pneumoniae TW-183, AMC-HN-4, AMC-HN-7, and AMC-HN-8 cells did not yield lower inclusion body counts than HeLa 229 cells did. AMC-HN-7 cells yielded lower inclusion body counts than HEp-2 cells. CONCLUSION: The newly established upper airway epithelial cell lines, AMC HN-4 and AMC HN-8, had similar culture efficiency as HeLa 229 and HEp-2 cells for Chlamydial infection; therefore, these two cell lines could be used for the future studies of C. pneumoniae.
Cell Culture Techniques ; Cell Line ; Chlamydia ; Chlamydophila pneumoniae ; Epithelial Cells ; Epithelium ; Humans ; Inclusion Bodies ; Korea ; Pneumonia ; Respiratory Tract Infections

Purpose: Brachymetatarsia is a relatively rare disease that is characterized by one or more metatarsals shorter than the adjacent metatarsal bones by 5 mm or more. Corrective treatment is done, not only for cosmetic purposes but also to improve function. The aim of this study was to evaluate radiologic and clinical results after distraction osteogenesis using external fixators for the fourth brachymetatarsia. Materials and Methods: From January 2005 to September 2018, 45 patients (60 cases) with brachymetatarsia who underwent distraction osteogenesis using external fixators and who were followed up for at least 6 months were studied retrospectively. At the final follow-up, the application time of the external fixator was measured and the percentage of lengthening, healing index, complication, and the patient’s satisfaction were analyzed. The patient’s satisfaction was evaluated using the American Orthopedic Foot and Ankle Society (AOFAS) scores, based on the level of stiffness, pain, function, and alignment. Results: The average gain in length and the percentage increase in the fourth metatarsals were 13.8 mm and 30.0%, and the mean followup period was 14.2 months after the removal of the external fixator. Bony union was obtained in the metatarsal bones in almost all the cases except for one case of non-union. According to the AOFAS score, 39 cases were rated excellent, and 6 cases were good at the final follow-up. The patients showed satisfactory cosmetic and functional results. Complications were pin site infections in 3 cases, all improved by oral antibiotic administration and dressing for about 2 weeks. Decreased sensation of the distal phalanx occurred in one case, and there was one case of non-union where we performed revision with an autogenous bone graft. In one case metatarsal joint subluxation occurred due to angular deformity, for which corrective osteotomy was performed. Conclusion Satisfactory results were obtained after distraction osteoplasty using external fixation for the treatment of the fourth brachymetatarsia.

No abstract available.
Drug Eruptions*

PURPOSE: To investigate the natural course of iatrogenic Horner's syndrome induced by procedures in the neck and upper thoracic areas. METHODS: Four patients who developed ptosis after undergoing procedures near the neck and upper thoracic areas were diagnosed with iatrogenic Horner's syndrome. We evaluated the clinical courses of the patients retrospectively. We also performed a systematic Medline search through Pubmed to find patients with iatrogenic Horner's syndrome. We summarized onset times and natural courses of reported cases. RESULTS: In two cases, ptosis improved completely within 2 and 4 months. In the other two cases, ptosis persisted through the last follow-up. As a result of our Medline search, we identified 51 cases in 47 journals. In 31 patients (62%), symptoms improved from 17 minutes to 3 months after surgery. However, in 20 patients (38%), symptoms persisted for up to 20 months. CONCLUSIONS: Although the mechanism underlying iatrogenic Horner's syndrome induced by procedures in the neck and upper thoracic area is not clearly understood, the syndrome may occur when the sympathetic nerve pathway is damaged directly or indirectly. Surgical correction should be postponed because this rare complication may resolve spontaneously within 4 months. The surgeon should explain the possibility of Horner's syndrome to patients after neck and upper thoracic surgery.
Catheterization ; Follow-Up Studies ; Horner Syndrome ; Humans ; Neck ; Retrospective Studies ; Stellate Ganglion ; Thoracic Surgery

The occurrence of a trigeminal neuropathy associated with connective tissue disease is rare. Trigeminal neuropathy in connective tissue disease is predominantly sensory and it is characterized by numbness, hypesthesia, slurred speech, and touch pain. Although the pathogenesis of trigeminal neuropathy associated with connective tissue disease remains obscure, the main pathologic findings are vasculitis and neuritis. A case of trigeminal neuropathy associated with mixed connective tissue disease is described, and the incidence, symptoms, pathophysiology, treatment of the disease is discussed.
Connective Tissue Diseases ; Hypesthesia ; Incidence ; Mixed Connective Tissue Disease* ; Neuritis ; Trigeminal Nerve Diseases* ; Vasculitis