Syphilitic aortitis, passing out of our mind, is the most common systemic manifestation of late syphilis and is more typically manifestated 10 to 30 years afterward. This diagnosis has been made less frequently in recent decades than in the past, because of public awareness of syphilis and screening program. Treponema pallidum lodge within vasa vasorum, especially ascending aorta cause the histologic changes, which are responsible for the three major forms of symptomatic cardiovascular syphilis, including aortic insufficiency, coronary ostial stenosis, and aortic aneurysm. We experienced a case of syphilitic aortitis with aortic insufficiency and aortic aneurysm in a 48-year-old man presented with progressive dyspnea. Echocardiography, chest CT, and later surgical correction were performed and surgical specimen revealed the histologic finding consistent with syphilitic aortitis. We report this case with a review of the literature.
Aorta ; Aortic Aneurysm* ; Aortitis ; Constriction, Pathologic ; Diagnosis ; Dyspnea ; Echocardiography ; Humans ; Mass Screening ; Middle Aged ; Syphilis ; Syphilis, Cardiovascular* ; Tomography, X-Ray Computed ; Treponema pallidum ; Vasa Vasorum

PURPOSE: To evaluate the possibility that human muscle derived stem cells (hMDSCs) can be differentiated into neurons in vitro. MATERIAL AND METHODS: Muscle derived stem cells were isolated from the hamstring muscles during the anterior cruciate ligament reconstruction by preplate technique. For the characterization of these cells, desmin staining, CD 34, Sca-1, CD 29 using the Flow cytometry were performed. In the experimental group, neuronal induction media was added to differentiate hMDSCs to neuronal cells. These cells were evaluated by neuronal markers such as neuron-specific enolase (NSE), neurofilament (NF), TrkA using immunocytochemistry. For the control group, no induction media was added. Statstical analyses were performed by use of Kruskal-Wallis H test and Student-Newman-Keuls test (P<0.01). RESULT: Desmin staining was positive in 92.3+/-6%. Flow cytometry was negative for CD 34 and Sca-1. However it was positive for CD 29. (69.4+/-10%). The immunocytochemical result revealed NSE, NF and TrkA positive with 63.2+/-2.3%, 59.2+/-2.5%, 55+/-2.4% respectively. However, these were negative in the control group. CONCLUSION: Our observations indicate that hMDSCs have the capacity to differentiate into neurons in a specialized culture media.
Anterior Cruciate Ligament Reconstruction ; Culture Media ; Desmin ; Flow Cytometry ; Humans* ; Immunohistochemistry ; Muscles ; Neurons* ; Phosphopyruvate Hydratase ; Stem Cells*

BACKGROUND AND OBJECTIVES: The measurement of the coronary flow velocity reserve (CFR) using transthoracic Doppler echocardiography (TTDE) has been reported to be useful for assessing the physiological significance of left anterior descending coronary artery (LAD) stenosis. This study was performed to evaluate the usefulness of CFR by TTDE for diagnosis of restenosis following revascularization procedures. SUBJECTS AND METHODS:Patients who were scheduled for follow-up coronary angiography following percutaneous intervention, or coronary bypass, surgery for a LAD lesion were enrolled. Prior to the follow-up coronary angiography, flow velocities in the distal LAD were measured by TTDE, both at rest and during the intravenous infusion of adenosine. CFR was defined as the ratio of the hyperemic to the basal peak diastolic velocities. Angiographic restenosis was defined as a diameter stenosis of more than 50% of the normal value by a quantitative coronary angiography. Of 142 consecutive patients, measurement of the CFR was possible in 95% (n=135), with 39 patients having a myocardial infarction in the LAD territory. The remaining 96 patients were used as the subjects ofin this study. RESULTS: The diameter stenosis was 41+/-26%, with angiographic restenosis found in 33 patients (34%). The mean CFR by TTDE was 2.5+/-1.1. CFR <2.0 was used to diagnose restenosis, with a sensitivity and specificity of 79% (26/33) and 89% (56/63), respectively. CONCLUSION: The noninvasive measurement of the CFR with TTDE is highly feasible, and can be a useful diagnostic modality for restenosis of a LAD following a revascularization procedure.
Adenosine ; Blood Flow Velocity ; Constriction, Pathologic ; Coronary Angiography ; Coronary Disease ; Coronary Vessels* ; Diagnosis ; Echocardiography, Doppler* ; Follow-Up Studies ; Humans ; Infusions, Intravenous ; Myocardial Infarction ; Reference Values ; Sensitivity and Specificity

Toxic epidermal necrolysis (TEN) is an exfoliative disease of skin and characterized by flaccid bullae and spreading erythema so that the skin has the appearance of being scalded. It results primarily from a toxic reaction to various drugs, but occasionally occurs as a result of infection, neoplastic conditions, or other exposure. Enterovirus 71 (EV 71), the most recently described serotype of the genus Enterovirus (family Picornaviridae), causes a variety of diseases, including aseptic meningitis, encephalitis, poliomyelitis-like paralysis, hand-foot-mouth disease, gastroenteritis, fever and rash. A 3-year-old boy presented at the Department of Pediatrics, Soonchunhyang University Cheonan Hospital due to TEN. There were no definite causes such as drug toxicity, Graft-Versus-Host disease (GVHD) and infection. However, we could have isolated EV 71 from the patient's stool. Until now, there have been no reports showing the relationship between EV 71 and TEN, we report here in a case of TEN-associated with EV 71. Further evaluation is needed to study the relationship of TEN with EV 71.
Blister ; Child ; Drug Toxicity ; Encephalitis ; Enterovirus ; Epidermal Necrolysis, Toxic ; Erythema ; Exanthema ; Fever ; Gastroenteritis ; Graft vs Host Disease ; Humans ; Meningitis, Aseptic ; Paralysis ; Pediatrics ; Preschool Child ; Skin ; Stress, Psychological

Basal cell carcinomas(BCCs) are the most common skin cancers in Korea and a proportion of BCCs contain pigment. Pigmented basal cell carcinomas(PBCCs) are included in the differential diagnosis of invasive melanoma and other benign pigmented skin lesions(PSLs) because of their growth patterns and asymmetry of pigmentation. Epiluminescence microscopy(ELM) describes the non-invasive in vivo examination of skin lesions with a microscope using incident light delivered from an acute angle and oil immersion. Many studies have shown that epiluminescence microscopy can improve the diagnostic accuracy of PSLs. Menzies et al analyzed the morphologic features of a large set of 142 pigmented BCCs and produced a simple ELM method for diagnosis that would allow differentiation from melanomas and benign pigmented lesions. We observed morphologic features of two PSLs with a handheld 10 epiluminescence microscopy (Episcope, Welch Allyn Inc, Skaneateles Falls, NY). After the ELM examination, two PSLs were excised and processed for histopathology. The ELM findings and histopathologic diagnosis were compared for each lesion. ELM permits the recognition of two PBCCs and the fact that it is a non-invasive in vivo method makes it even more attractive as a diagnostic tool in clinical practice.
Carcinoma, Basal Cell* ; Dermoscopy* ; Diagnosis ; Diagnosis, Differential ; Immersion ; Korea ; Melanoma ; Pigmentation ; Skin ; Skin Neoplasms

Although some reports have been published on the protective effect of antibodies to Toxoplasma gondii surface membrane proteins, few address the inhibitory activity of antibodies to dense granular proteins (GRA proteins). Therefore, we performed a series of experiments to evaluate the inhibitory effects of monoclonal antibodies (mAbs) to GRA proteins (GRA2, 28 kDa; GRA6, 32 kDa) and surface membrane protein (SAG1, 30 kDa) on the invasion of T. gondii tachyzoites. Passive immunization of mice with one of three mAbs following challenge with a lethal dose of tachyzoites significantly increased survival compared with results for mice treated with control ascites. The survival times of mice challenged with tachyzoites pretreated with anti-GRA6 or anti-SAG1 mAb were significantly increased. Mice that received tachyzoites pretreated with both mAb and complement had longer survival times than those that received tachyzoites pretreated with mAb alone. Invasion of tachyzoites into fibroblasts and macrophages was significantly inhibited in the anti-GRA2, anti-GRA6 or anti-SAG1 mAb pretreated group. Pretreatment with mAb and complement inhibited invasion of tachyzoites in both fibroblasts and macrophages. These results suggest that specific antibodies to dense-granule molecules may be useful for controlling infection with T. gondii.
Animals ; Antibodies, Monoclonal/*pharmacology/therapeutic use ; *Antigens, Protozoan ; Female ; Fibroblasts/parasitology ; Host-Parasite Relations ; Immunization, Passive ; Macrophages/parasitology ; Mice ; Mice, Inbred BALB C ; Protozoan Proteins/*immunology ; Support, Non-U.S. Gov't ; Toxoplasma/*pathogenicity ; Toxoplasmosis/parasitology/*therapy

BACKGROUND AND OBJECTIVES: Acute sinusitis is a mild, self-limiting disease. In children, however, sinusitis may lead to other severe, even life-threatening, conditions. Therefore, appropriate diagnosis and management are needed. Orbital complications from sinusitis are caused by expansion through natural suture lines, foramen, dehiscence of lamina bone and bony erosion due to acute infection and necrosis. The purpose of this study was to analyze the common types of orbital complications and to compare the symptoms, prognoses and treatments of children and of adults, respectively. Materials and Method: Twenty-one children under15 years of age and thirteen adults over 15 were enrolled in the study. Symptoms, durations of treatment, treatment modalities, prognoses, and CT findings were analyzed. RESULTS: Preseptal cellulitis was found in 6 children (28.6%) and 8 adults (61.5%) ; subperiosteal abscess in 9 children (42.9%) and 3 adults (23.1%) ; and orbital cellulitis in 6 children (28.6%) and 2 adults (15.4%). Eye lid swelling was found in all subjects, while diplopia and limitation of eye movement was found in 4 children (19%) and 2 adults (15.4%). Medical treatment was the first line of therapy for both children (76.2%) and adults (61.5%), with the remaining children (23.8%) and adults (38.5%) receiving surgical treatment. CONCLUSION: While generally more severe, orbital complications in children can be treated more conservatively than those arising in adults.
Abscess ; Adult ; Cellulitis ; Child ; Diagnosis ; Diplopia ; Eye Movements ; Humans ; Necrosis ; Orbit* ; Orbital Cellulitis ; Prognosis ; Sinusitis* ; Sutures

BACKGROUND AND OBJECTIVES: Microbiologic data in chronic sinusitis with nasal polyps, which is the foundation of proper antibiotic treatment, is insufficient due to problems with sampling and culture technique. Therefore, the objective of this study is to identify the causative agents in chronic sinusitis with nasal polyps based on culture results in adults and children and the relationship between the results of the middle meatus and maxillary sinus. Materials and Method: Samples were obtained with middle meatus swabs and endoscopically guided maxillary sinus aspirations and then transferred to a microbiology laboratory using different media for aerobic and anaerobic cultures. RESULTS: Eighty one samples were studied. Sixty six from the middle meatus and sixty four from the maxillary sinus bacterial isolates were recovered. The most frequently isolated aerobic organisms were the Staphylococcus, Haemophilus influenza and Streptococcus while those of the anaerobic organisms in adults were the Prevotella and Peptostreptococcus. No anaerobic microorganisms were isolated in the children. Concordance rates of aerobic bacteria were 75.4% among adults and 90.0% among children. That of anaerobic bacteria was 83.6% among adults and 100% among children between the middle meatal swab and the maxillary sinus aspiration. CONCLUSION: Authors recommend amoxacillin/clavulanate, cephalosporins and macrolide as the first-line medical treatment. In cases where there are no improvement of symptoms, cultures should be taken from the middle meatus, followed by appropriate selection of second-line antibiotics according to the sensitivity test results.
Adult ; Anti-Bacterial Agents ; Aspirations (Psychology) ; Bacteria ; Bacteria, Aerobic ; Bacteria, Anaerobic ; Cephalosporins ; Child ; Culture Techniques ; Haemophilus ; Humans ; Influenza, Human ; Maxillary Sinus ; Nasal Polyps* ; Peptostreptococcus ; Prevotella ; Sinusitis* ; Staphylococcus ; Streptococcus

PURPOSE: The distal chevron osteotomy has gained popularity for the mild to moderate hallux valgus, but necessity of fixation is controversy. No fixation of distal chevron osteotomy cause instability, but fixation has problem which has pin site infection and irritability, extension of operation time, discomfort of rehabilitation. So, the author was going to analyse and compare with and without in the fixation of distal chevron osteotomy. MATERIALS AND METHODS: Between 2004 and 2005, a total 18 patients (20 feet) following with and without in fixation of distal chevron osteotomies. The fixation group (A) was performed for the treatment of 10 patients (10 feet) and no fixation group (B) was done to 8 patients (10 feet). RESULTS: On group A, the mean first MTP (metatarsophalangeal) angle corrected 17 degrees pre-operatively to average 29 degrees (range; 20-37 degrees) and the mean first IM (intermetatarsal) angle corrected 10 degrees pre-operatively to average 15 degrees (range; 9-18 degrees). On Group B, the mean first MTP angle corrected 16 degrees pre-operatively to average 29 degrees (range; 18-33 degrees) and the mean first IM angle corrected 7 degrees pre-operatively to average 13 degrees (range; 9-16 degrees) (P>0.05). Clinical results, based on AOFAS score showed an improvement in the overall results. CONCLUSIONS: Comparing the clinical and radiographic results of the distal chevron osteotomies no difference in with and without fixation of distal chevron osteotomies.
Hallux Valgus* ; Hallux* ; Humans ; Osteotomy* ; Rehabilitation

INTRODUCTION: To evaluate the efficacy of superior gluteal artery-pedicled iliac crest for the treatment of avascular necrosis of femoral head. MATERIAL & METHOD: From January 2001 to October 2001, we used the superior deep branches of superior gluteal artery for the pedicled posterior iliac crest bone graft to revascularize the avascular femoral head in 4 patients. They were 1 man and 3 women, and the mean age of the patients was 34 years (range, 27 to 60). The average follow-up after surgery was over 57 months (range, 15 to 82). We analyzed the clinical results by the Harris hip score, and evaluated the vascularity of the femoral head by radiographic methods. RESULTS: All cases showed no evidence of collapse on femoral heads and good revascularizations on the radiographic images. The average Harris hip score was 88.5 points. There was no complication. CONCLUSION: The revascularization procedure using the superior gluteal artery-pedicled posterior iliac crest was thought to be one of the effective and promising techniques for the treatment of the avascular necrosis of femoral head.
Arteries ; Female ; Follow-Up Studies ; Head ; Hip ; Humans ; Necrosis ; Transplants