A clinical study was carried out in 15 patients with cryptococcosis who were seen at Severance Hospital from June, 1974 to September, 1983 and the following results were obtained. Age of patients ranged from 13/12 to 72 years (mean 23.9) with the peak incidence in child and adolescence. Common symptoms at admission were headache, fever, chilling etc. Initial impression at admission were Tbc. Meningitis, Aseptic Meningitis, Cryptococcal Meningitis, lymphoma and hepatitis etc. in that order. Involved organs were meninges in 14 patients (93.3%), lymphnodes 4 (26.6%), lung 2, liver 2, skin 1, Brain 1, adrenal gland 1. Variable findings were obtained in initial CSF study, but all cases except two were positive in initial CSF india ink preparation. In our study, the prognosis was better in patients without coexisting disease than with coexisting disease.
Adolescent ; Adrenal Glands ; Brain ; Child ; Cryptococcosis ; Fever ; Headache ; Hepatitis ; Humans ; Incidence ; India ; Ink ; Liver ; Lung ; Lymphoma ; Meninges ; Meningitis ; Meningitis, Aseptic ; Meningitis, Cryptococcal ; Prognosis ; Skin

Choledochocele is a kind of choledochal cyst and represents a prolapse or herniation of the intramural segment of the distal common bile duct into the duodenal lumen. It is rare congenital anomaly and, easlily overlooked due to non-specific clinical symptoms, signs, and non-characteristic radiologic features. The cause of choledochocele remains uncertain and it was suggested that thete are two distinct types in the pathogenesis of it, i.e., congenital and acquired. Recently, many cases of choledochocele were reported, which diagnosed by ERCP and safely treated with endoscopic unroofing and EST followed by continued observation as well as interval ERCP and/or endoscopic ultrasonography. We present here four cases of symptomaatic choledochoceles that had been managcd by end- oscopic therapy and continucd observation.
Biliary Tract* ; Cholangiopancreatography, Endoscopic Retrograde ; Choledochal Cyst* ; Common Bile Duct ; Endosonography ; Pancreas* ; Prolapse

OBJECTIVE: This study has been carried out to evaluation the effect of fertilization promoting peptide (FPP) on the kinematic parameters, capacitation and acrosome reaction of the frozen-thawed human spermatozoa. METHODS: After FPP treatment, we examined kinematic parameters, capacitation and acrosome reaction, using the methods of computer-aided sperm analysis (CASA) and chlortetracycline (CTC) fluorescence analysis. RESULTS: We have obtained the evidence that FPP can promote the capacitation and inhibit the spontaneous acrosome reaction of frozen-thawed human spermatozoa in vitro. Fpp (25~100 nM) induced a significant increase in the proportion of B-pattern capacitated spermatozoa, and a significant decrease in the proportion of F-pattern uncapacitated ones without significant stimulation of acrosomal exocytosis. In the kinematic parameters treatment, FPP treated groups maintained higher LIN, BCF and STR than those of control. The VAP, VSL, VCL and ALH were not different. Therefore it is suggested that FPP in human seminal plasma may play a positive role in promoting human sperm function.
Acrosome Reaction* ; Acrosome* ; Chlortetracycline ; Exocytosis ; Fertilization* ; Fluorescence ; Humans* ; Male ; Semen ; Spermatozoa*

Epidermolysis bullosa dystrophica is a rare skin disease characterized by milia, nail dystrophy, andblistering of the skin and mucous membranes in response to minimal trauma. A forty years old man had typical skinlesions on the extremities, and the presence of distal phalangeal wedge deformity with soft tissue webbing wasnoted. multiple segmental strictures and ulceration involved the cervical and distal esophagus. Esophageal balloondilatation was therefore performed and dysphagia was relieved. The authors describe a case involving multipleesophageal strictures and musculoskeletal lesion, with clinically and radiologically documented epidermolysisbullosa dystrophica.
Congenital Abnormalities ; Constriction, Pathologic* ; Deglutition Disorders ; Epidermolysis Bullosa Dystrophica* ; Epidermolysis Bullosa* ; Esophagus ; Extremities ; Mucous Membrane ; Skin ; Skin Diseases ; Ulcer

Castleman's disease is a rare disorder and thought to occur as a result of chronic antigenic stimulation due to an unknown infectious or inflammatory etiology. It has a heterogenous course: the symptoms persist in some cases for many years and have a progressive fatal course in others. Renal dysfunction in the form of nephrotic syndrome is quite a rare occurrence. Secondary amyloidosis due to Castleman's disease has also been reported in a few case reports. A 46-year-old female who had asymptomatic abdominal lymphadenopathy was diagnosed with Castleman's disease-plasma cell type in our hospital in 2006. Three years after diagnosis, she developed chronic diarrhea, weight loss, anemia and nephrotic range proteinuria. The etiology of symptom was found to be secondary amyloidosis based on renal and gastrointestinal biopsies. She was discharged with steroid therapy. Unfortunately, she had a progressive fatal course. One month after the treatment, she developed thrombocytopenia and died due to cerebral hemorrhage.
Amyloidosis ; Anemia ; Biopsy ; Diarrhea ; Female ; Giant Lymph Node Hyperplasia ; Humans ; Kidney ; Lymphatic Diseases ; Middle Aged ; Nephrotic Syndrome ; Plasma Cells ; Proteinuria ; Thrombocytopenia ; Weight Loss

Linezolid has been used for treatment of vancomycin-resistant Enterococcus faecium infection, nosocomial pneumonia caused by Staphylococcus aureus, including methicillin-resistant Staphylococcus aureus or Streptococcus pneumoniae, and complicated and uncomplicated skin and skin structure infections. Lactic acidosis is an adverse effect associated with drugs, including metformin, the nucleoside reverse-transcriptase inhibitors and, rarely, linezolid. We report a case in which severe lactic acidosis developed as an adverse effect of linezolid in a 75-year-old woman who had been on linezolid for 30 days for treatment of a wound infection caused by methicillin-resistant coagulase-negative Staphylococcus. Discontinuation of linezolid and hemodialysis improved her lactic acidosis.
Acetamides ; Acidosis, Lactic ; Aged ; Cross Infection ; Enterococcus faecium ; Female ; Humans ; Metformin ; Methicillin Resistance ; Methicillin-Resistant Staphylococcus aureus ; Oxazolidinones ; Pneumonia ; Renal Dialysis ; Skin ; Staphylococcus ; Staphylococcus aureus ; Streptococcus pneumoniae ; Wound Infection ; Linezolid

IgA nephropathy is recognized worldwide as one of the most common form of primary glomerulonephritis. Clinical manifestations vary, ranging from microscopic hematuria to nephrotic syndrome. Most cases of IgA nephropathy are idiopathic. A variety of additional disorders have been associated with IgA nephropathy, some of which shed light on possible pathogenetic mechanism. Association with psoriasis has been debated for a long time. Secondary renal amyloidosis in psoriatic arthropathy and drug-induced renal lesions secondary to methotrexate or cyclosporine are accepted accompaniments of psoriasis. We report 3 cases of IgA nephropathy which was diagnosed by renal biopsy in a patient with psoriasis.
Amyloidosis ; Arthritis, Psoriatic ; Biopsy ; Cyclosporine ; Glomerulonephritis ; Glomerulonephritis, IGA* ; Hematuria ; Humans ; Immunoglobulin A* ; Methotrexate ; Nephrotic Syndrome ; Psoriasis*

BACKGROUND: Carotid endarterectomy (CEA) is an effective treatment for the prevention of stroke in patients with high grade carotid stenosis. Electroencephalographic (EEG) monitoring and measurement of stump pressure are the most widely used methods for assessing the risk of cerebral ischemia during CEA. We designed this study to assess the usefulness of EEG and stump pressure for shunt insertion during CEA. METHODS: Nineteen patients were enrolled from January, 1996 to April, 1999. We calculated the percent of carotid stenosis in the patients by the NASCET (North American Symptomatic Carotid Endarterectomy Trial) criteria. The inclusion criteria of the CEA were high grade stenosis (>70%), or moderate stenosis (>50%) with ulcerated plaque. Intra-operative monitoring by using stump pres-sure, and an EEG was performed in 19 operations. RESULTS: The number of patients with asymptomatic and sympto-matic carotid stenosis were 6 and 13 respectively. Shunt during the operations was used in 12 patients; nine had both significant EEG changes and low stump pressures, two had only low stump pressure, one patient had only a significant EEG change. The peri-operative complications of mortality and stroke were found in one case. In the other patients, there no stroke recurrences during the mean follow-up period of 24 months. CONCLUSIONS: EEG and stump pressure may be useful in deciding shunt insertion during CEA for detecting ischemic changes.
Brain Ischemia ; Carotid Stenosis ; Constriction, Pathologic ; Electroencephalography* ; Endarterectomy, Carotid* ; Follow-Up Studies ; Humans ; Mortality ; Recurrence ; Stroke ; Ulcer

Linezolid has been used for treatment of vancomycin-resistant Enterococcus faecium infection, nosocomial pneumonia caused by Staphylococcus aureus, including methicillin-resistant Staphylococcus aureus or Streptococcus pneumoniae, and complicated and uncomplicated skin and skin structure infections. Lactic acidosis is an adverse effect associated with drugs, including metformin, the nucleoside reverse-transcriptase inhibitors and, rarely, linezolid. We report a case in which severe lactic acidosis developed as an adverse effect of linezolid in a 75-year-old woman who had been on linezolid for 30 days for treatment of a wound infection caused by methicillin-resistant coagulase-negative Staphylococcus. Discontinuation of linezolid and hemodialysis improved her lactic acidosis.
Acetamides ; Acidosis, Lactic ; Aged ; Cross Infection ; Enterococcus faecium ; Female ; Humans ; Metformin ; Methicillin Resistance ; Methicillin-Resistant Staphylococcus aureus ; Oxazolidinones ; Pneumonia ; Renal Dialysis ; Skin ; Staphylococcus ; Staphylococcus aureus ; Streptococcus pneumoniae ; Wound Infection ; Linezolid

Phlegmonous gastritis is a rare and rapidly progressive bacterial infection of the stomach wall, with a high mortality rate. Antibiotics with or without surgical treatment are required for treatment. We present a case in which phlegmonous gastritis occurred during the diagnostic evaluation of early gastric cancer. The patient showed improvement after antibiotic treatment, but attempted endoscopic submucosal dissection failed because of submucosal pus. We immediately applied argon plasma coagulation since surgical resection was also considered a high-risk procedure because of the submucosal pus and multiple comorbidities. However, there was local recurrence two years later, and the patient underwent subtotal gastrectomy with lymph node dissection. Considering the risk of incomplete treatment immediately after recovery from phlegmonous gastritis and that recurrent disease can be more difficult to manage, delaying treatment and evaluation until after complete recovery of PG might be a better option in this particular clinical situation.
Anti-Bacterial Agents ; Argon Plasma Coagulation ; Bacterial Infections ; Cellulitis* ; Comorbidity ; Gastrectomy ; Gastritis* ; Humans ; Lymph Node Excision ; Mortality ; Recurrence ; Stomach ; Stomach Neoplasms* ; Suppuration