No abstract available.
Cesarean Section* ; Female ; Pregnancy

BACKGROUND: Organophosphate induced delayed polyneuropathy(OIDP) by ingestion is not common, and the mechanism is not well known. In this study, we present clinical characteristics, electrophysiological findings and pathology of sural nerve in our four cases with OIDP. METHODS: Retrospectively, we reviewed 38 patients diagnosed as organophosphate intoxication at Asan Medical Center from January, 1990 to July, 1998. Among these patients we present four patients with OIDP, who received electrophysiological and pathological studies and discuss similar cases from the literature. RESULTS: OIDP occurred usually 2-4 weeks after exposure. They complained quadriplegia, paresthesia and pain mainly in distal extremities. Two patients had facial diplegia. No definite pyramidal sign was found in all patients. Elelctrophysiological study showed sensorimotor(predominantly motor) axonal polyneuropathy with marked denervation potentials in all tested muscles. Follow-up electrophysiological study after two years showed slightly increased amplitude of sensory nerve or compound motor action potentials with persistent denervation potentials in the distal muscles. Sural nerve biopsy confirmed severe axonal neuropathy with marked decrease of large and small myelinated fibers with myelin ovoids. CONCLUSIONS: OIDP was a cause of severe generalized weakness and paresthesia, decreased sensation in distal extremities after high dose organophosphate ingestion and usually occurred two to four weeks later. The prognosis was poor in patients who had severe weakness of four extremities with facial diplegia at the initial examination.
Action Potentials ; Axons ; Biopsy ; Chungcheongnam-do ; Denervation ; Eating ; Extremities ; Follow-Up Studies ; Humans ; Muscles ; Myelin Sheath ; Organophosphate Poisoning* ; Paresthesia ; Pathology ; Polyneuropathies* ; Prognosis ; Quadriplegia ; Retrospective Studies ; Sensation ; Sural Nerve

Intramedullary myelitis due to bacterial meningitis associated with cervical epidural abscess is very rare. Its cause and clinical features are non-specific, therefore exact diagnosis is often missed or mistaken for other disease and immediate treatment may be delayed. We report a case of intramedullary myelitis due to epidural abscess presented with prominent symptoms of meningitis and manifestations of acute cerebrovacular accident. A 69 -year-old man was admitted due to right hemicranial headache with pain on right posterior neck and febrile sensation. At first, the patient's headache was improved by conservative therapy. Three weeks later, the patient showed abrupt right hemiparesis (MRC grade 2/5) with drowsy mentality. The CSF findings of the patient were compatible with acute bacterial meningitis. Cervical spine MRI showed cervical epidural abscess and extensive intramedullary myelitis from cervical to lumbar spinal cord. After antibiotic therapy, mentality of the patient became to be alert and right hemiparesis was improved to MRC grade 4/5. Follow up cervical spine MRI after several weeks represented that the lesions of cervical epidural abscess and intramedullary myelitis were significantly diminished.
Diagnosis ; Epidural Abscess* ; Follow-Up Studies ; Headache ; Humans ; Magnetic Resonance Imaging ; Meningitis ; Meningitis, Bacterial* ; Myelitis* ; Neck ; Paresis ; Sensation ; Spinal Cord ; Spine

We report a case of ciliated hepatic foregut cyst which was incidentally found in a 64 year-old man. The cyst, 6 cm in diameter, was unilocular, solitary and was located in the medial segment of left lobe, just below the Glisson's capsule. Microscopically, the cyst wall consisted of 4 layers; pseudostratified ciliated columnar epithelium, subepithelial loose connective tissue, smooth muscle bundles and an outermost fibrous capsule. Although cartilage or subepithelial sero-mucous glands were absent, the morphologic features of the cyst correspond with those of an incomplete form of brochogenic cyst.
Cysts

No abstract available.

BACKGROUND: Antistreptolysin O (ASO) has been widely used to diagnose Streptococcus Pyogenes infections and their sequelae, rheumatic fever and acute glomerulonephritis. Butt in some cases there is no elevation of ASO that it is necessary to add one or more tests detecting immune response to S. pyogenes.. The authors analyzed the distribution of antideoxyibonuclease (ADNase) B and antistreptolysin O (ASO) among the children of an elementary school in Seoul and calculated their upper limit of normal (ULN) value. METHODS: ADNase B concentrations were determined by nephelometry (Behring Nephelometer 100 Analyzer, Germany) on 236 sera of healthy elementary school children in Seoul. Throat cultures were taken at the same time to compare ADNase B lovels between S. pyogenes carriers and non-carriers. RESULTS: The distribution of ADNase B concentrations among school children ranged from 77 (detection limit) to 1616 IU/ml and the ULN was estimated to be 362 IU/mL. The carriers of S. pyogenes clad significantly higher ADNase B levels (mean 392 IU/ml) than carriers of non-group A beta-hemolytic streptococci (BHS, 236 IU/ml) oY non-carriers of BHS (234 IU/ml). The relationship between ADNase B (Y) and ASO (X) levels was Y=0.4X+173 (r2=0.209). CONCLUSIONS: The distribution of ADNase B levels showed no close correlation with that of ASO, and ADNase B test was considered to have additive value to ASO test for detecting S. pyogenes infection.
Antistreptolysin ; Child* ; Glomerulonephritis ; Humans ; Nephelometry and Turbidimetry ; Pharynx* ; Rheumatic Fever ; Seoul* ; Streptococcus pyogenes

Fetal bilateral renal agenesis is a lethal congenital anomaly. An early and reliable prenatal diagnosis is extremely important as it may offer options for pregnancy termination as early as possible. The criteria for the ultrasonographic diagnosis of bilateral renal agenesis are severe oligohydramnios, nonvisualization of the bladder, and the empty renal fossa. However, severe oligohydramnios makes it difficult to diagnose the disease because of poor sonographic resolution. We present two cases of bilateral renal agenesis, one is diagnosed by ultrasonography after amnioinfusion at 24 weeks gestation, the other is diagnosed postnatally after term delivery.
Diagnosis ; Female ; Oligohydramnios ; Pregnancy ; Prenatal Diagnosis ; Ultrasonography ; Urinary Bladder

We report a case of colonic type-papillary adenocarcinoma of appendiceal origin in a 73-year-old male patient. The patient presented with right lower quadrant mass and was operated for a preoperative diagnosis of inflammatory small bowel mass. The mid one-third of the appendix showed a 3.5x3.3 cm sized, broad-based, intraluminal papillary mass. Microscopically, it was a well differentiated papillary adenocarcinoma and revealed a strong immunoreactivity to carcinoembryonic antigen. Tumor desmoplasia and acute inflammatory change were prominent.
Male ; Humans ; Adenocarcinoma

OBJECTIVES: The purposes of this study were to evaluate the relationship between therapeutic compliance and emotional variables in the patients on maintenance hemodialysis and to make a help in planning the treatment in order to promote the therapeutic outcomes. METHODS: Subjects consisted of 43 end-stage renal disease patients who had been treated with hemodialysis for more than one year. Hostility was measured with Cook-Medly Hostility Scale and depressive symptom, with beck Depression Inventory(BDI) and anxiety, with Self-rating Anxiety Scale of Zung(SAS). Serum potassium(K), and phosphorus(P) level, and interdialytic weight gain(IWG) were selected as compliance indices, for they were said to reflect the effect of diet, medication and salts restriction, respectively. RESULTS: (1) While the patients on hemodialysis got the scores within the normal range in their anxiety and hostility scale, they showed higher score of BDI than normal person, which was wtatistically significant. (2) Considering the relationship between therapeutic compliance and emotional variables, diet compliance was significantly associated with the emotional variables such as depression and anxiety. The relationship would be drawn with the equation listed below; Compliance Value=4.656 x (Depression) + 2.592 x (Anxiety)-0.13 x (Depression)x(Anxiety)-9.742 (3) When the patients were given a series of supportive psychotherapy for about 1 month, they showed the decrease in the scores of anxiety and depression scales, and the elevation in compliance value. However, there was no room for saving that the compliance ratio was improved, because of the limitation in the research methodology. CONCLUSION: Therapeutic compliance depended on between depression and anxiety among the emotional variables, the supportive psychotherapy was useful method to improved the therapeutic compliance.
Anxiety ; Compliance* ; Depression ; Diet ; Hostility ; Humans ; Kidney Failure, Chronic ; Psychotherapy ; Reference Values ; Renal Dialysis* ; Research Design ; Salts ; Weights and Measures

No abstract available.