PURPOSE: Introduction of low osmolality contrast agent(LOCA) has allowed safer, more comfortable contrast-enhanced CT examination, but there has been significant increase in image degradation when evaluating the kidneys due to streaky artifact. The authors reviewed findings of contrast-enhanced abdominal and pelvic computed tomography(CT) to know the difference of renal streaky artifact between a high osmolality contrast agent (HOCA) and LOCA. MATERIALS AND METHODS: This study included two hundred contrast-enhanced CT in 200 patients, 100 performed with HOCA(meglumine ioglicate, 150ml) and 100 performed with LOCA (iopromide, 150ml). The severity of renal streaky artifact was compared between HOCA and LOCA groups. RESULTS: Of the scans performed with HOCA, 40 had no artifact, 52 had grade I artifact, 6 had grade II artifact, and 2 had grade III artifact Of the scans performed with LOCA, 23 had no artifact, 44 had grade I artifact, 29 had grade II artifact, and 4 had grade III artifact. There was significant difference in the degree of the streaky artifact depending upon the osmolality of the contrast media used(by {{{{x^2}}}}-test, P=.0001). CONCLUSION: The results of this study revealed a statistically significant increased incidence of artifacts and distortions of renal image with LOCA when compared with HOCA.
Artifacts* ; Contrast Media* ; Humans ; Incidence ; Kidney ; Osmolar Concentration* ; Tomography, X-Ray Computed

BACKGROUND: Laryngoscopy and tracheal intubation for general anesthesia are potent stimuli to the cardiovascular system due to sympathetic stimulation. The aim of this study was to compare the hemodynamic responses with different administration routes of lidocaine on blood pressure and heart rate changes associated with tracheal intubation. METHODS: Sixty patients were randomly assigned to spray group (Group 1, n=20) received 10% lidocaine 1.5 mg/kg spray to intratracheally immediately before tracheal intubation, IV group (Group 2, n=20) received 2% lidocaine 1.5 mg/kg intravenously before 90 sec tracheal intubation and control group (Group 3, n=20). Anesthesia was induced with thiopental 5 mg/kg IV, vecuronium 0.1 mg/kg and 50% N2O-O2- 2vol % enflurane. After 5 minutes, tracheal intubation was performed. Mean arterial pressure and heart rate were measured at preintubation and immediately postintubation, 1, 3, 5 mins after tracheal intubation. RESULTS:The differences of mean arterial pressure which were measured at preintubation and immediately postintubation and 1 minute after intubation in group 1 were significantly lower than those in other group (p<0.05). The differences of heart rate which measured at preintubation and 1 minute after intubation were lower than those in group 3 (p<0.05). CONCLUSIONS: For the suppression of sympathetic stimulation following tracheal intubation, 10% lidocaine spray to the laryngotrachea is an effective method to suppress cardiovascular response.
Anesthesia ; Anesthesia, General ; Arterial Pressure ; Blood Pressure ; Cardiovascular System ; Enflurane ; Heart Rate* ; Heart* ; Hemodynamics ; Humans ; Intubation* ; Laryngoscopy ; Lidocaine* ; Thiopental ; Vecuronium Bromide

A perplexing developmental error is 46,XX congenital absence of vagina ( Mayer-Rokitan-sky-Kster-Hauser syndrome, Mullerian dysgenesis, vaginal aplasia ). The Mayer-Rokitansky-Kster-Hauser syndrome refers to the climical entity consisting of primary amenorrhea associated with congenital absence of the vagina, 46,XX karyototype, a rudimentary uterus or complete absense, normal overian function and normal ovulation, normal female breast development, body proprotion and body hair, frequent association of renal, skeletal and other cpngenital anomalies. This syndrome results from agenesis of both Mllerian ducts or from a failure of the Mllerian ducts to estavlish a proper communication with that part of the vagina from the urogenital sinus. A case of mayer-Rokitansky-Kster-Hauser syndrom was reviewed briefly.
Amenorrhea ; Breast ; Female ; Hair ; Humans ; Ovulation ; Uterus ; Vagina

The anterior cruciate ligament(ACL) is one of the most important structure for maintenance of the sta- bility of the knee joint. Chronic instability as a result of insufficiency can lead to functional disability, pain, meniscal tears, and degenerative change in articular cartilage. The incidence of injuries of this liga- ment is increasing tendency due to development of vehicle system, industrial system and sports activities. Different authors have recommended both operative and nonoperative treatment for anterior cruciate ligament injuries. Variable methods for functional recovery of anterior cruciate ligament were introduced and argued about ideal method. As arthroscopic techniques improve, surgeons are more inclined to rec- ommend surgical treatment. The methods of repair of acute rupture of the anterior cruciate ligament through the arthrotomy tech- nique have been used widely, but the arthroscopic repair is a relatively new technique. This arthroscopic technique is idealy applicable for rupture at femoral and tibial attachment site. A arthroscopic repair of anterior cruciate ligament was performed with use of the arthroscopy, in 15 consecutive, selected anterior cruciate ligaments that were ruptured at femoral or tibial attachment site, and within 2 weeks after injury. The 15 patients were followed for a minimum of one year(mean, eighteen months; maximum, thirty-eight months). The mean age of the 15 patients at the operation was thirty years(range, seventeen to forty-eight years). The results of arthroscopic repair of anterior cruciate ligament in 15 cases were satisfactory, and as fol- lows. l. All of the 15 cases, the laxity of repaired anterior cruciate ligaments were decreased. 2. The average Lysholm Knee Score Scale was increased from 16 points preoperatively to 89 points postoperatively. Five of the patients(33%) were rated as excellent, and ten patients(67%) were rated as good. 3. The range of motion of the repaired knee joints were from Oo to 135o that results were achieved at postoperative 6 months.
Anterior Cruciate Ligament* ; Arthroscopy ; Cartilage, Articular ; Humans ; Incidence ; Knee ; Knee Joint ; Range of Motion, Articular ; Rupture* ; Sports

Benign ductal or glandular neoplasms of the esophagus unrelated to Barrett esophagus are extremely rare. Only 9 cases have been reported in the English language literature. We now report a case of esophageal gland duct adenoma incidentally found in a 73-year-old man. A 0.8 cm-sized, polypoid submucosal lesion in the distal esophagus was removed. Histologically, the lesion was well circumscribed and consisted of several ducts or cysts with focal papillary configurations. Interstitial lymphocytic infiltration with germinal centers was also observed. The lining cells of ducts or cysts were composed of two layers: an inner intensely eosinophilic luminal duct cell layer and an outer myoepithelial cell layer that was accentuated by alpha-smooth muscle actin. There was no significant nuclear atypia or mitosis. Mucin production was occasionally observed in a few goblet cells. To the best of our knowledge, this is the first case of benign ductal or glandular neoplasm of the esophagus among Koreans.
Actins ; Adenoma ; Aged ; Barrett Esophagus ; Eosinophils ; Esophagus ; Germinal Center ; Goblet Cells ; Humans ; Mitosis ; Mucins ; Muscles ; Neoplasms, Glandular and Epithelial ; Phenobarbital

No abstract available.
Cardiomyopathy, Hypertrophic* ; Humans ; Twins, Monozygotic*

Allergic bronchopulmonary aspergillosis(ABPA) is an inflammatory disease which causes a hypersensitivity to Aspergillus spores growing in the bronchi. The clinical syndrome is characterized by asthma, recurrent pulmonary infiltrations or mucoid impaction, eosinophilia, and central bronchiectasis. A 12-year-old boy was admitted to our hospital because of right lower chest pain and cystic mass-like shadows on a chest X-ray film. He had asthma as an infant, but had no asthmatic symptoms on admission. Chest CT scan showed low density cystic mass of the right lower lobe. The total eosinophil count and IgE level were abnormally high. Test for immediate skin reaction to Aspergillus fumigatus was positive but precipitating antibody to Aspergillus antigen was negative. After steroid treatment, he became asymptomatic. Radiologic abnormalities including mass-like shadows were resolved by two months after the start of treatment and a follow-up high resolution CT scan obtained after clinical improvement revealed central saccular bronchiectasis. We report one case of ABPA with review of literature.
Aspergillosis, Allergic Bronchopulmonary* ; Aspergillus ; Aspergillus fumigatus ; Asthma ; Bronchi ; Bronchiectasis ; Chest Pain ; Child ; Eosinophilia ; Eosinophils ; Follow-Up Studies ; Humans ; Hypersensitivity ; Immunoglobulin E ; Infant ; Male ; Skin ; Spores ; Thorax ; Tomography, X-Ray Computed ; X-Ray Film

The human microbiome is known to play an essential role in influencing host health. Extracellular vesicles (EVs) have also been reported to act on a variety of signaling pathways, distally transport cellular components such as proteins, lipids, and nucleic acid, and have immunomodulatory effects. Here we shall review the current understanding of the intersectionality of the human microbiome and EVs in the emerging field of microbiota-derived EVs and their pharmacological potential. Microbes secrete several classes of EVs: outer membrane vesicles (OMVs), membrane vesicles (MVs), and apoptotic bodies. EV biogenesis is unique to each cell and regulated by sophisticated signaling pathways. EVs are primarily composed of lipids, proteins, nucleic acids, and recent evidence suggests they may also carry metabolites. These components interact with host cells and control various cellular processes by transferring their constituents. The pharmacological potential of microbiomederived EVs as vaccine candidates, biomarkers, and a smart drug delivery system is a promising area of future research. Therefore, it is necessary to elucidate in detail the mechanisms of microbiome-derived EV action in host health in a multi-disciplinary manner.
Biomarkers ; Drug Delivery Systems ; Extracellular Vesicles ; Membranes ; Microbiota ; Nucleic Acids

OBJECTIVE: This study was designed to assess the influences of skin temperature and age on latency and amplitude of the sympathetic skin response (SSR). METHOD: We examined the sympathetic skin responses in 77 normal subjects aged 25 to 73 years. With stimulation of both median nerve and both tibial nerve at the wrist and ankle, the SSRs were recorded from both palms and soles simulaneously. To determine the effects of skin temperature change on SSR, we examined the SSRs in 12 healthy subjects before and after heating. The heat was applied on right forearm by infra-red lamp. RESULTS: The mean latency and the mean amplitude of SSR with stimulation of the right median nerve at the wrist were 1.47 sec and 6.08 mV at the right palm, 1.50 sec and 6.07 mV at the left palm, 1.95 sec and 3.38 mV at right sole, and 1.95 sec and 3.09 mV at left sole. There was no side-to-side difference in the latency and the amplitude. Regardless of the site of stimulation, latency was longer at the sole than at the palm, and amplitude was greater at the palm than at the sole (p<0.05). The latency of the SSR was positively correlated with the age of subjects (p<0.05), and the amplitude was negatively correlated with the age of subjects (p<0.05). At higher skin temperature, the latency of SSR was shortened and the amplitude was reduced significantly (p<0.05). CONCLUSION: The amplitude of the SSR decreases with aging and the latency increases with aging. As the skin temperature rises, the latency and amplitude show tendency to decrease. We suggest that the skin temperature and age are important factors to be considered carefully in assessing the SSR parameters.
Aging* ; Ankle ; Forearm ; Heating ; Hot Temperature ; Median Nerve ; Skin Temperature* ; Skin* ; Tibial Nerve ; Wrist

Abdominal pregnancy is very rare and potentially life-threatening variation of ectopic pregnancy. Early diagnosis is very difficult. In the last several decades prenatal care has improved and noninvasive procedures such as ultrasound scanning and fetal cardiotocography have led to us a better assessment of fetal and maternal disorders. In the last 30 years an increase of diagnosed ectopic pregnancies has been noted and attributed to the greater frequency of pelvic inflammatory disease. Although the incidence of ectopic pregnancy is rising, the incidence of abdominal pregnancy, which is primarily a sequel of a missed ruptured ectopic pregnancy, remains low. We presented a case of secondary abdominal pregnancy in 14 wks with its review of literature.
Cardiotocography ; Early Diagnosis ; Female ; Incidence ; Pelvic Inflammatory Disease ; Pregnancy ; Pregnancy, Abdominal* ; Pregnancy, Ectopic ; Prenatal Care ; Ultrasonography