Computed tomographic findings of 24 cases of cervical tuberculous lymphadenitis were retrospectively analyzed. We classified the CT findings as 4 types: type 1(homogeneous soft tissue density mass), type 2(central low density with peripheral rim enhancement and with preservation of surrounding fat plane), type 3(central low density with peripheral rim enhancement and with obliteration of surrounding fat plane), type 4(large confluent low density mass, so called "cold abscess") As a result, there were 2 cases(8.3%) of type 1, 7 cases(29.2%) of type 2, 9 cases(37.5%) of type 3, 3 cases(12.5%) of type 4, 1 cases(4.2%) of type 1 combined with type 3, and 2 cases(8.3%) of type 2 combined with type 4. So 22 cases(91.7%) revealed central low density and peripheral rim enhancement, which suggest necrosis. The maximum thickness of enhancing rim was above 2mm in all of 64 definable necrotic lymph nodes and above 4mm in 42(65.5%) lymph nodes, suggesting that the wall of necrotic tuberculous lymphadenitis tends to be thick. We conclude that CT is useful not only for the diagnosis but also for the evaluation of the extent and the status of cervical tuberculous lymphadenitis.
Diagnosis ; Lymph Nodes ; Necrosis ; Retrospective Studies ; Tuberculosis, Lymph Node*

Emphysematous pyelonephritis is rare but freuently fatal complication of renal parenchymal infection, mostcommonly occurs in diabetic patients and is often associated with urinary obstruction, prior urologicalabnormality or infection. From 1898 to 1984 , about 50 cases of empysematous pyelonephritis have been reporteduniversally. The diaignosis of emphysematous pyelonephritis can be made only roentgenographically. In the last 2years, we have had two cases of emphysematous pyelonephritis at our hospital. It is our purpose to report twopatients who have survived wtih a brief review of the previous literature.
Humans ; Pyelonephritis

No abstract available.
Cryopreservation* ; Humans* ; Spermatozoa*

OBJECT: Currently, the alteration of cytokine system has been known to play an important role in regard to depressive symptom. We focused on the relationship between immunological parameters and clinical improvement in major depressive disorder. METHOD: Data were collected on 26 patients with major depressive disorder using a 8-week prospective follow-up design. After 8-week treatment period with fluoxetine, patients were classified into a response group and a non-response group according to their psychopathological outcome as evaluated by Hamilton Depression Rating Scale. The differences of the immunological parameters between pre-treatment phase and post-treatment phase were compared among patients. The difference of those was also compared within each phase among them. The relationship between socio-demographic variables, depression, cytokine, mononuclear cells was examined by correlation analysis. Multiple regression analyses were performed to explore the predictors of clinical improvement of major depressive disorder. RESULT: Pre-treatment levels of IL-1beta in the response group were significantly higher than those in the non-response group. Pre-treatment levels of IL-1beta of all patients and in the response group were positively correlated with pre-treatment monocyte counts. Patients with subsequent remission showed significantly lower IL-6 values at baseline than those with non-response. Post-treatment values of IL-6 did not differ significantly among the patients. The correlation test showed more frequent relations among cytokines and mononuclear cells in the response group than in the non-responder group. Especially, serum level of IL-6 in pre-treatment phase was only significantly correlated with HAMD score after 8-week treatement phase, while other cytokines and mononuclear cells were not. Pretreatment level of IL-6 was of paramount importance in predicting clinical improvement of depressive symptom. CONCLUSION: The immune system of major depressive disorder patients might dichotomize the patients into subsequent responders and non-responders. Immune system might be of great influence on the clinical improvement of major depressive disorder. The mode of interaction between depression and cellular immune function and the mediators responsible for the cytokine production need to be studied further.
Cytokines ; Depression ; Depressive Disorder, Major* ; Fluoxetine ; Follow-Up Studies ; Humans ; Immune System ; Interleukin-6 ; Lymphocytes ; Monocytes ; Prospective Studies ; Tumor Necrosis Factor-alpha

OBJECTIVE: To identify differences in the expression of the genes for peroxisome proliferator-activated receptor (PPAR)-γ, cyclooxygenase (COX)-2, and the proinflammatory cytokines interleukin (IL)-6 and tumor necrosis factor (TNF)-α in granulosa cells (GCs) from polycystic ovary syndrome (PCOS) patients and controls undergoing controlled ovarian stimulation. METHODS: Nine patients with PCOS and six controls were enrolled in this study. On the day of oocyte retrieval, GCs were collected from pooled follicular fluid. Total mRNA was extracted from GCs. Reverse transcription was performed and gene expression levels were quantified by realtime quantitative polymerase chain reaction. RESULTS: There were no significant differences in age, body mass index, and total gonadotropin dose, except for the ratio of luteinizing hormone to follicle-stimulating hormone between the PCOS and control groups. PPAR-γ and COX-2 mRNA was significantly downregulated in the GCs of PCOS women compared with controls (p=0.034 and p=0.018, respectively), but the expression of IL-6 and TNF-α mRNA did not show significant differences. No significant correlation was detected between the expression of these mRNA sequences and clinical characteristics, including the number of retrieved oocytes, oocyte maturity, cleavage, or the good embryo rate. Positive correlations were found among the PPAR-γ, COX-2, IL-6, and TNF-α mRNA levels. CONCLUSION: Our data may provide novel clues regarding ovarian GC dysfunction in PCOS, and indirectly provide evidence that the effect of PPAR-γ agonists in PCOS might result from alterations in the ovarian follicular environment. Further studies with a larger sample size are required to confirm these proposals.
Body Mass Index ; Cyclooxygenase 2* ; Cytokines* ; Embryonic Structures ; Female ; Follicle Stimulating Hormone ; Follicular Fluid ; Gene Expression ; Gonadotropins ; Granulosa Cells* ; Humans ; Interleukin-6 ; Interleukins ; Luteinizing Hormone ; Oocyte Retrieval ; Oocytes ; Ovulation Induction ; Peroxisomes* ; Polycystic Ovary Syndrome* ; Polymerase Chain Reaction ; PPAR gamma ; Prostaglandin-Endoperoxide Synthases ; Reverse Transcription ; RNA, Messenger ; Sample Size ; Tumor Necrosis Factor-alpha

Pyomysitis is a primary acute bacterial infection of large skeletal muscule, usually occuring in the absence of specific cause of infection. Pyomyositis has been reported mainly in tropical countries and was rare in temperate climates. but it has been recognized with increasing frequency. Toxic shock syndrome(TSS) is an acute mutisystemic disease characterized by high fever, hypotension, multisystem dysfunction and erythematous rash followed by skin desquamation 8-12 days after onset. Especially, TSS and pyomyositis are rare conditions in the pediatric population. We experienced one case in a healthy 13-year-girl who developed pyomyositis of the right ileac and gluteal muscles associated with TSS caused by methicillin resistant Staphylococcus aureus. We reports a case of acute pyomyositis with TSS, in which the diagnosis was difficult because of the relative rare incidence in temperate climates and its vague symptoms. To our knowledge, this is the first reported case of pyomyositis with TSS in Korean pediatric population.
Bacterial Infections ; Climate ; Diagnosis ; Exanthema ; Fever ; Hypotension ; Incidence ; Methicillin Resistance* ; Methicillin* ; Muscles ; Myositis ; Pyomyositis* ; Shock, Septic* ; Skin ; Staphylococcus aureus* ; Staphylococcus*

Gaucher's disease is an autosomal recessive genetic disorder of lipid metabolism. A deficiency of beta-glucocerebrosidase causes an accumulation of glucocerebroside in the reticulo-endothelial system and bone marrow. Total or partial splenectomy has been used in case of massive splenomegaly with hypersplenism and/or mechanical pressure symtoms. Partial splenectomy is preferred to prevent susceptibility to overwhelming postsplenectomy sepsis and to delay the massive deposition of glucocerebroside in the liver and bones. We report the case of a 20-year-old woman with Gaucher's disease and who had a splenic embolization 4 years ago. The spleen cross the midline of the abdomen reached to the true pelvis and elevated the left diaphragm. Angiotensin-converting enzyme, acid phophatase and ESR were increased but beta-glucocerebrosidase was normal. Osteosclerotic changes of the distal femur was observed. Hepatomegaly and splenomegaly with mutiple accessory spleens were seen on abdominal CT. On isotope scan for liver and spleen, multiple accessory spleens had isotope uptake, but spleen did not. We noted severe adhesion of spleen to neighboring structure and no viable splenic tissue for preservation. Total splenectomy with preservation of four accessory spleens was performed. We needed multiple transfusion during dissection and bleeding was continuous for 3 days postoperatively. The patient was discharged without problems on the postoperative 15 th day.
Abdomen ; Bone Marrow ; Diaphragm ; Female ; Femur ; Gaucher Disease* ; Glucosylceramidase ; Hemorrhage ; Hepatomegaly ; Humans ; Hypersplenism ; Lesser Pelvis ; Lipid Metabolism ; Liver ; Sepsis ; Spleen* ; Splenectomy* ; Splenomegaly ; Tomography, X-Ray Computed ; Young Adult

Ulnar neuropathy around the elbow in patients with rheumatoid arthritis can occur by synovial invasion, flexion contracture or valgus deformity of the elbow. However, attritional rupture of the ulnar nerve by medial osteophyte with synovial invasion of the rheumatoid elbow is extremely rare. We reported a case of attritional rupture of the ulnar nerve by medial osteophyte in 62 years-old male with rheumatoid arthritis. Exact diagnosis and proper treatment are required if symptoms of ulnar neuropathy present in rheumatoid arthritis with contracture and valgus deformity of the elbow.
Arthritis, Rheumatoid ; Congenital Abnormalities ; Contracture ; Elbow ; Humans ; Male ; Osteophyte ; Rupture ; Ulnar Nerve ; Ulnar Neuropathies

PURPOSE: To investigate the neuroprotective effect of Ginexin (Ginkgo biloba extract) on rat retinal ganglion cell in the optic nerve crush injury model. METHODS: From 1 week before the optic nerve injury, Ginexin 100 mg/kg/day (100 mg group), 200 mg/kg/day (200 mg group) or carboxymethylcellulose as a control group (CMC group) was administrated orally 4 weeks in Spraque-Dawley rats. At 3 weeks after the optic nerve injury, the RGCs were counted and the concentration of intravitreal glutamate was measured. RESULTS: The RGC density of CMC group (103+/-22 cells/mm2) was significantly lower than that of 100 mg group (182+/-39 cells/mm2) and 200 mg group (201+/-63 cells/mm2). There was no difference between the 100 mg group and 200 mg group. The concentration of invtravitreal glutamate did not significantly differ among normal, CMC group, 100 mg group and 200 mg group. CONCLUSIONS: Ginexin increased the survival of the retinal ganglion cell in rat optic nerve crush injury model, but, did not influence on the concentration of intravitreal glutamate.
Animals ; Carboxymethylcellulose Sodium ; Glutamic Acid ; Neuroprotective Agents* ; Optic Nerve Injuries ; Optic Nerve* ; Rats* ; Retinal Ganglion Cells* ; Retinaldehyde*

BACKGROUND: Iron deficiency still remains the most common single nutrient deficiency disorder in the world, especially among young children and adolescent girls. As little is recently known about iron deficiency in infants and preschool children in Korea, this study is aimed to determine the prevalence of iron deficiency in healthy population and to determine the proportion of children in whom iron deficiency goes undetected using the current screening technique. METHODS: We collected venous samples from 410 apparently healthy preschool children during March to June, 1997, as a part of a regular health check-up program. We measured hemoglobin, hematocrit, mean corpuscular volume(MCV), mean corpuscular hemoglobin(MCH), serum ferritin, serum iron, and total iron binding capacity(TIBC). RESULTS: A total of 410 infants and preschool children aged 1~6 years were included in this study. The prevalence of anemia was 7.9%(3/38) in infants and children aged 1~2 years, 6.3%(12/190) in 3~4 years and 1.6%(3/182) in 5~6 years. The prevalence of iron deficiency(ferritin <10 ng/mL or transferrin saturation <10%) was 31.6%(12/38) in 1~2 years, 23.7%(45/190) in 3~4 years and 14.3%(26/182) in 5~6 years. The prevalence of IDA was 5.3% (2/38) in 1~2 years, 1.1% (2/190) in 3~4 years and 0.5%(1/182) in 5~6 years. Microcytic anemia was found in only 2 cases, both of which is included in 1~2 years of age. CONCLUSION: The prevalence of iron deficiency and IDA was relatively high in 1~2 years of age, critical period for neurologic development. Nutritional education including iron fortification for mothers having caring babies especially of this age group should be warranted.
Adolescent ; Anemia ; Anemia, Iron-Deficiency ; Child ; Child, Preschool* ; Critical Period (Psychology) ; Education ; Female ; Ferritins ; Hematocrit ; Humans ; Infant ; Iron* ; Korea ; Mass Screening ; Mothers ; Prevalence* ; Transferrin