Strongyloides stercoralis is a nematodes and is prevalent in the tropical regions. In Korea, 6 cases have been reported in which the parasites were identified in feces. We report a case of hyperinfection syndrome with Strongyloides stercoralis confirmed in the tissue sections. A 52-year-old woman was admitted to the hospital because of generalized edema and weakness. She received steroid therapy for 30 years because of rheumatoid arthritis. One year ago, generalized edema and dyspnea were developed and she was diagnosed as minimal change nephrotic syndrome for which she received cyclosporin. On admission, she complained of generalized weakness and edema, multiple arthralgia and abdominal discomfort with nausea. The white-cell count was 14,600 without eosinophilia. A stool specimen was negative for occult blood, ova or parasites. Right lower quadrant abdominal pain and tenderness were developed, and the exploratory laparotomy was done under the impression of the acute appendicitis. An appendectomy with a biopsy of mesenteric lymph nodes was performed. From the 5th day after operation, the patient began to complain of the abdominal pain and constipation. Under the impression of adhesion bad formation, the laparotomy was done and disclosed that the proximal ileum was markedly dilated. On jejunotomy, a great amount of formed stool and barium was noticed in the proximal portion of small bowel. The jejunal tissue was biopsied. Grossly, the appendix was unremarkable. Microscopically, the inflammatory reaction was nearly absent, but in serosa, minute granulomas were found which contain a part of the parasite. Same feature was noted in the mesenteric lymph node. The biopsied jejunum contains numerous adult female, filariform and rhabdidiform larvae and eggs in the mucosa, submucosa and muscle wall. Their morphology was compatible with Strongyloides stercoralis. The patient died 5 days later in the state of multiple organ failure.
Adult ; Male ; Female ; Humans ; Biopsy

BACKGROUND: Few studies have demonstrated an enhanced skin responsiveness to opiates in atopic subjects. OBJECTIVE: To determine whether the skin response to morphine is increased in atopics and to assess the clinical usefulness of morphine skin prick test in diagnosis of allergic diseases. METHOD: Allergy skin prick tests were performed using 55 common allergens, histamine, and morphine in 158 patients with allergic diseases. RESULTS: Wheal and flare sizes for morphine (1mg/mL) were significantly related to and smaller than those for histamine (1mg/mL). Although the proportion of subjects with allergic rhinitis and the level of serum total IgE were not different between responders (wheal >- 2mm) and nonresponders to morphine, the positive response rate to allergens was significantly lower in nonresponders. The flare sizes for morphine were significantly higher in positive allergen test group (A/H ratio >- 0.5). Among positive allergen test group, the subjects with atopy score >- 5 showed a larger flare size for morphine than those with atopy score < 5 while the sizes for histamine were not different. CONCLUSION: Morphine skin prick test is helpful for detecting false negative responses to allergens, and morphine skin test responses are increased in highly atopic patients probably due to enhanced mast cell releasability.
Allergens ; Diagnosis* ; Histamine ; Humans ; Hypersensitivity ; Immunoglobulin E ; Mast Cells ; Morphine* ; Rhinitis ; Skin Tests ; Skin*

No abstract available.
Asthma, Exercise-Induced* ; Child* ; Humans ; Incidence*

No abstract available.
Child* ; Humans

Thrombosis of one or both renal veins occurs in a variety of settings such as trauma, dehydration, extrinsic compression, nephrotic syndrome, pregnancy, oral contraceptives or invasion by tumor. Nephrotic syndrome and certain carcinomas seem to predispose to the development of renal vein thrombosis. The most common carcinoma which is associated with renal vein thrombosis is the renal cell carcinoma. But, renal vein thrombosis associated with tumor other than renal cell carcinoma is extremely rare. Our patient was diagnosed as lung and uterine cervical cancer by histologic examination. The patient complained of left flank pain. Abdominal CT scan shows the dilated left renal vein filled with hypodense material and parenchymal infarction on the left kidney. Renal arteriography shows cut-off sign on a branch of the left renal artery. Inferior venacavography revealed contrast-filling defect in the left renal vein. To our knowledge, renal vein thrombosis with lung and uterine cervical carcinoma is the first report in English literature. So, we have presented a rare case of a renal vein thrombosis in a patient with lung and uterine cervical cancer.
Angiography ; Carcinoma, Renal Cell ; Contraceptives, Oral ; Dehydration ; Flank Pain ; Humans ; Infarction ; Kidney ; Lung Neoplasms ; Lung* ; Nephrotic Syndrome ; Pregnancy ; Renal Artery ; Renal Veins* ; Thrombosis* ; Tomography, X-Ray Computed ; Uterine Cervical Neoplasms*

Miescher syndrome comprises congenital acanthosis nigricans, hypertrichosis, failure to thrive and short stature, dysmorphism especially of the jaws and oral cavity, insulin-resistant diabetes mellitus, and a characteristic general appearance. This report concerns a rare case of 12-year-old girl having insulin resistant diabetic mellitus with Miescher syndrome. The relevant literature was reviewed.
Acanthosis Nigricans ; Child ; Diabetes Mellitus* ; Failure to Thrive ; Female ; Humans ; Hypertrichosis ; Insulin ; Jaw ; Mouth

No abstract available.
Abdominal Cavity* ; Catheters* ; Diaphragm*

BACKGROUND: Blunted perception of dyspnea, which may be related to the increased mortality, has been demonstrated in patients with a history of near-fatal asthma and in the elderly. OBJECTIVE: The purpose of this study was to evaluate the relationship between the perception of dyspnea and the severity of asthma. METHOD: Baseline spirometry and Borg score change(A Borg score) during breathing through an inspiratory muscle trainer were measured in 27 consecutive asthma patients and 11 normal subjects. RESULTS: The baseline Borg score was negatively related to FEV1 A Borg score was significantly lower in asthmatics than in controls at high level of loads. A Borg score was lower in severe asthma than in mild asthma. A Borg score was positively related to the baseline FEV1. Seventy-five percent of severe asthma, 62.5% of moderate one, and 9.1% of mild one showed impaired dyspnea perception. Dyspnea perception was related to age(r, = -0.49, p<0.001). CONCLUSION: Three quarters of patients with severe asthma showed impaired dyspnea perception to inspiratory resistive load. Dyspnea perception was related to asthma severity and age.
Aged ; Asthma ; Dyspnea* ; Humans ; Mortality ; Respiration ; Spirometry

This study was aimed at investigation of the stimulatory innervations on the rat urinary bladder. Detrusor muscle strips of 15 mm long were suspended in isolated muscle chambers containing 1 ml of PSS maintained at 37℃ and aerated with 95% O²/5% Co². Isometric myography was performed, and the results were as followings: Muscle strips showed “on-contraction” by electric field stimulation (EFS) frequency-dependently. The EFS-induced contraction was not affected by hexamethonium, a ganglion blocker, but abolished by tetrodotoxin, a nerve conduction blocker. Physostigmine, a cholinesterase inhibitor enhanced the EFS-induced contraction which was inhibited by hemicholinium, an inhibitor of choline uptake at the cholinergic nerve ending. Such an EFS-induced contraction was antagonized by atropine only partially, and the atropine-resistant portion was completely abolished by the desensitization of purinergic receptors by prolonged incubating of the strips in the presence of high concentration of ATP. Bethanechol, a cholinergic agonist, elicited concentration-dependent contraction. Adenosine triphosphate (ATP), a purinergic agonist, induced a weak but concentration-dependent contraction of short duration. Bethanechol-induced contraction was not affected by ATP-desensitization, and ATP-induced contraction was not affected by tetrodotoxin. These results suggest that there are at least two main stimulatory components of innervations in the detrusor muscle, cholinergic muscarinic and purinergic; and those receptors are independent each other.
Adenosine Triphosphate ; Animals ; Atropine ; Bethanechol ; Choline ; Cholinergic Agonists ; Cholinesterases ; Ganglion Cysts ; Hemicholinium 3 ; Hexamethonium ; Myography ; Nerve Endings ; Neural Conduction ; Physostigmine ; Rats* ; Receptors, Purinergic ; Tetrodotoxin ; Urinary Bladder*

Since Gustave Simon performed the first planned nephrectomy in 1869, it has been one of the most important procedures in the field of urologic surgery. It may be required in a wide variety of circumstances and various methods of operative procedures have been introduced. Also its complications have been documented according to the particular operative methods. A clinical observation was made on the 76 patients nephrecromized in the Dept. of Urology, Ehwa Woman`s University Hospital, during the period from April, 1976 to March, 1981 and a brief review of literature was made. The results were as follows; 1. The total number of in-patients during the above period was 1,025 and nephrectomies were performed in 76 patients of the 605 total urologic operations (12. 5%). 2. Age distributions revealed the highest in 21-30 year old with 22.3% and the youngest age was 9 year old and the oldest 68 years. Sex distribution was nearly equal. 3. The causative diseases of the nephrectomy were renal tuberculosis 31 cases (40. 8%), calculous disease 13 cases (17. 2%), renal neoplasms 8 cases (10. 5%) and renal injury 8 cases (10. 5%) in its descending order. 4. Lumbar approach with resection of the 11th rib was the most frequently employed (32. 9%) and post-operative complications were seen in 10 cases (13. 1%), of which wound infection was the highest(5. 3%). 5. 53 cases (69. 8%) were discharged within 10 days after operation and only 5 cases (6. 5%) remained more than on month. 6. Blood transfusion were necessary in 39 cases (51. 3%) during operation and its average amounts of transfusion were 3. 1 pints. Average time of operation was 2 hours and 22 minutes.
Age Distribution ; Blood Transfusion ; Child ; Humans ; Kidney Neoplasms ; Nephrectomy ; Ribs ; Sex Distribution ; Surgical Procedures, Operative ; Tuberculosis, Renal ; Urology ; Wound Infection