The differential diagnosis of chorea can be challenging in patients without a family history of Huntington's disease or acute-onset hemichorea with stroke. A 50-year-old woman presented with generalized choreic movements and gait disturbance that first appeared 1 month previously. An extensive diagnostic workup including genetic testing, neuroimaging, and various laboratory investigations revealed that this patient had developed chorea as a result of mercury poisoning. She was treated successfully with chelation therapy.
Chelation Therapy ; Chorea ; Diagnosis, Differential ; Female ; Gait ; Genetic Testing ; Humans ; Huntington Disease ; Mercury Poisoning ; Neuroimaging ; Stroke

The differential diagnosis of chorea can be challenging in patients without a family history of Huntington's disease or acute-onset hemichorea with stroke. A 50-year-old woman presented with generalized choreic movements and gait disturbance that first appeared 1 month previously. An extensive diagnostic workup including genetic testing, neuroimaging, and various laboratory investigations revealed that this patient had developed chorea as a result of mercury poisoning. She was treated successfully with chelation therapy.
Chelation Therapy ; Chorea ; Diagnosis, Differential ; Female ; Gait ; Genetic Testing ; Humans ; Huntington Disease ; Mercury Poisoning ; Neuroimaging ; Stroke

A retrospective analysis of the ultrasonographic findings of 9 cases of tuberculous abscess, 5 cases of pyogenic abscess and 2 cases of hematoma of psoas and adjacent muscles was made. Fluid collection with or without internal echoes was seen in 12 cases out of total 16 cases. Other findings were 2 cases of only muscle swelling, 1 case of highly echogenic mass.like appearance and 1 case of fluid collection with septae. Ultrasonography is considered an accurate method in identifying early pathologic changes of the psoas muscle and determining its extent. and in differentiating tumor from fluid collection of the psoas muscle. Authors dare to say that ultrasound examination is a procedure of choice in the diagnosis of psoas abscess and hematoma.
Abscess ; Diagnosis ; Hematoma ; Methods ; Muscles ; Psoas Abscess ; Psoas Muscles ; Retrospective Studies ; Ultrasonography

Osteoprotegerin (OPG), a member of the tumor necrosis factor receptor superfamily, is known to inhibit osteoclastogenesis by acting as a soluble decoy receptor for the receptor activator of NF-kB ligand (RANKL). We report the presence of OPG on the membrane of osteoclasts and the possibility of the direct action of OPG on them. Highly pure osteoclast precursors were isolated from mouse long bones and induced to differentiate into mature osteoclasts by M-CSF and soluble RANKL (sRANKL). The presence of OPG on the membrane of these cells was confirmed by western blotting and immunostaining. Furthermore, sRANKL was found to be bound to the OPG on the osteoclast precursors. These results suggest that OPG might have a new role during the differentiation of osteoclasts beyond its role as a soluble decoy receptor. The mechanism of the existence of OPG on osteoclast precursors remains to be found.
Animals ; Bone and Bones/cytology/*metabolism ; Carrier Proteins/immunology/metabolism ; Cell Differentiation/drug effects/physiology ; Cell Membrane/*metabolism ; Cells, Cultured ; Glycoproteins/drug effects/*metabolism ; Macrophage Colony-Stimulating Factor/pharmacology ; Membrane Glycoproteins/immunology/metabolism ; Mice ; Mice, Inbred ICR ; Osteoclasts/drug effects/*metabolism ; Receptors, Cytoplasmic and Nuclear/drug effects/*metabolism ; Stem Cells/drug effects/metabolism

PURPOSE: To evaluate the significance of T2-weighted MR imaging(T2WI) in the diagnosis of pituitarymicroadenoma. MATERIAL AND METHODS: We retrospectively evaluated the MR imaging findings of 30 cases of pituitarymicroadenoma. Diagnosis was made on the basis of surgery, serum hormonal level, and the presence of mass lesion onMR (T1WI and T2WI), and conventional as well as dynamic contrast enhanced T1WI images were obtained. In each MRsequence, signal intensity and detectability of the tumor were evaluated. We also determined whether diagnosis waspossible on both T1WI and T2WI. In eight cases, histopathologic findings (cellularity, fibrosis, and cysticchange) were correlated with T2 signal intensity of the tumor. RESULTS: T2WI, T1WI, and dynamic and conventionalenhanced T1WI detected the tumor in 21 cases (70%), 21 cases (70%), 28 cases (93.3%), and 22 cases (73.3%),respectively. On T2WI, pituitary microadenomas showed a high signal in 18 cases (60%), an iso-signal in nine(30%), and a low signal in three (10%) compared with normal pituitary gland. In 20 cases (66.7%), diagnosis ofpituitary microadenoma was possible on both T1WI and T2WI, but in one case, the tumor was detected only on T2WI.Three cases with fibrosis, as seen on histopathologic examination showed an iso or low signal on T2WI. CONCLUSION: T2WI is useful in the diagnosis of pituitary microadenoma Decreased signal intensity on T2WI may suggestfibrosis.
Diagnosis* ; Fibrosis ; Magnetic Resonance Imaging ; Pituitary Gland ; Retrospective Studies

BACKGROUND AND OBJECTIVES: Recently, the result of total correction in tetralogy of Fallot(TOF) is improved dramatically. But, residual anatomical changes of right ventricular outflow tract(RVOT) and pulmonary artery junctional stenosis result in bad prognosis. Therefore we sought to analyze risk factors for pulmonary artery junctional stenosis after correction of TOF. METHODS: From 1991 to 1998, 146 patients underwent the follow-up catheterizations after total correction of TOF in our institution and were analysed risk factors for pulmonary artery junctional stenosis. Of this patients group [age on operation 20.119.8 months, follow-up duration after operation 13.95.0 months, male(64%)], 20 cases(13.7%) had a PDA and 26 cases(17.8%) had a systemic-to-pulmonary shunt operation before total correction of TOF. RESULTS: 1) Residual PS is correlated significantly with post-operative RVP/LVP(r=.776, p<0.01) and post-operative RVEDP(r=.196, p<0.05). 2) Post-operative RVP/LVP and residual PS increased significantly in grade II of residual PI than grade III~IV. 3) The left pulmonary artery junctional stenosis(LPAJS) was observed in 31 cases, this group decreased significantly in pre-operative LPA diameter(p<0.01), increased in post-operative RVP/LVP(p<0.01), and increased in post-operative RPA diameter(p<0.01), decreased in post-operative LPA diameter(p<0.01) and was more severe in post-operative PI(p<0.01) than the other group respectively. 4) Of the patients group which went patch enlargement of RVOT to LPA junction, the pressure gradient on LPA junction increased significantly in PDA and false aneurysmal change. 5) Factors significantly associated with pulmonary artery junctional stenosis were patch enlargement of RVOT to LPA junction, aneurysmal change of RVOT, PDA, systemic-to-pulmonary shunt and pre-operative LPAJS. 6) LPAJS(P, mmHg) =5.43 +16.24*[false aneurysmal change of RVOT] +14.13*[RVOT patch enlargement to LPA] +16.89*PDA. CONCLUSION: Several factors significantly associated with pulmonary artery junctional stenosis influenced each other. And the LPAJS led to secondary changes (volume overload of RV, increasing diameter of RPA, et. al) therefore more active diagnosis and treatment after total correction is recommended.
Aneurysm ; Aneurysm, False ; Catheterization ; Catheters ; Constriction, Pathologic* ; Diagnosis ; Follow-Up Studies ; Humans ; Prognosis ; Pulmonary Artery* ; Risk Factors* ; Tetralogy of Fallot*

No abstract available.
Metronidazole

The purpose of this study was to examine the ultrastructural characteristic of the normal pylorus mucosa, and their structural changes induced by the ligation of common bile duct of the male rabbits weighing about 1.5 kg each. Experiment animals were divided into normal, sham operation, and experimental groups. Common bile duct ligation was performed under ether anesthesia and anjmals were sacrificed on the 1st, 3rd, 5th, 7th and 14th day after operation. The mucosal specimen of the pylorus, were fixed and embedded with common method. The sections were cut on a LKB-V ultratome, and observed under a JEM 100CX II electron microscope. The results were as follow : 1. In the early stages (1st, 3rd, 5th day groups) following the ligation, surface mucous cells have the various electron densities and shape of the mucous granules. In the late stages (7th, 14th day groups) following the ligation, many surface mucose cells containing numerous electron dense mucous granules are seen. 2. In the early stage of the ligation of bile duct, secretory function of EC cells was depressed, but in the later stage, the cells showed recovered secretory activity. 3. Secretory function of D cells was depressed on the early groups after the ligation of common bile duct, but they showed recovered secretory activity from the late groups after the ligation of the common bile duct. 4. Secretory function of G cells was activated on the early groups after the ligation of common bile duct, but they showed depressed secretory activity from the late groups after the ligation of the common bile duct. Considering the above findings, common bile duct ligation probably causes the dysfunction of the pyloric surface mucous cells that results in delayed mucous formation and secretion, and recovered mucous secretory function on the late stages. EC cells and G cells, depressed the secretory activities on the early stages and recovered on the late stages of the ligation of common bile duct. But D cells in the pyloric mucosa was activated on the early groups after the ligation of common bile duct ligation, but they was depressed secretory activities on the late groups.
Anesthesia ; Animals ; Bile Ducts ; Common Bile Duct* ; Ether ; Gastrin-Secreting Cells ; Humans ; Ligation* ; Male ; Mucous Membrane* ; Pylorus ; Rabbits ; Somatostatin-Secreting Cells

Intussusception is a relatively common disease in children, but it is a rare clinical entity in adults. More than 80% of all patients with intussusception are less than two years of age, but adults account for only 5 to 10 percent of all intussusception cases. The significance of this disease in the aspect of statistics is mentioned as "rule of fives", which means 5% of all intussusceptions occur in adults, and it accounts for up to 5% of all cases of bowel obstruction in adults. In children, classic symptoms include episodic abdominal pain, "current-jelly" stool and a sausage-shaped abdominal mass on examination. However, in adults, it is likely to appear with non-specific gastrointestinal trouble without classic symptoms. Therefore, it is very important to use early diagnositic tool. In contrast to childhood intussusception, which is idiopathic in 90% of cases, adult intussusception has a definable lesion in more than 90% of cases 3). Tumors, both benign and malignant, are the most frequent cause of intussusecption in adults. We experienced seven cases of adult intussusception at Inha hospital from Jan. 1994 to Dec. 1997. The patients of adult intussusception are classified as three cases of ileoileal type and four ileocecal type. There were no specific signs or symptoms with patient experienced. It included abdominal pain, diarrhea and palpable mass. Their diagnosis was made in six patients using abdominal CT scan. It is difficult to define a diagnosis preoperatively, because the symptom of adult intussusception are variable and insignificant among individuals. We had been taken the final diagnostic tool with the abdominal CT scan in six of seven patients, which revealed "target lesions" in all cases. So, it is useful in the diagnosis of adult intussusception. Bowels were resected for the treatment of adult intussusception. The extent of the resection was contained the lesion and the defunctioned segments. The operations were performed as four segmental resections of small bowel and three ileocecal resections. The pathological findings were disclosed as three tumors, three lymphadenopathies and a adhesion of bowel. We concluded that the abdominal CT scanning is a usefull diagnostic tool in the diagnosis of adult intussusception.
Abdominal Pain ; Adult* ; Child ; Diagnosis ; Diarrhea ; Humans ; Intussusception* ; Tomography, X-Ray Computed*

Hypertrichosis is a condition of excessive hair growing in areas of the body where androgen is not predominantly dependent. It has been classified into localized and generalized based on the extent of distribution. Generalized hypertrichosis may occur as part of a syndrome or a metabolic disorder. A 55-month-old girl visited our department with accentuation of thick hairs on her mid-back and face since birth. She was diagnosed as developmental retardation at the age of 10 months. None of her family members had hypertrichosis. No abnormal findings were shown on chromosomal and laboratory studies. Therefore, we diagnosed her as generalized hypertrichosis with developmental delay.
Hair ; Humans ; Hypertrichosis ; Parturition