We analysed 58 patients who were admitted to the Department of Pediatrics, Yonsei University College of Medicine due to infectious mononucleosis from January 1986 to August 1992. Of 58 patients who had responses to IgM to EBV viral capsid antigen and/or heterophil antibody, 35 patients had hapatitis. Of 35 hepatitis patients, group I consisted of 22 patients who had only EBV infection and group II consisted of 13 patients who had hepatitis B markers or cytomegaloviral markers. The results were as follows: 1) Sex distribution revealed males to females to be 1.1:1. In the age distribution, the proportion of patients with 1 to 3 years of age occupied 40.9% for group I and 30.8% for group II. In non-hepatitis group, 73.9% of patients were in 2 months to 3 years of age. 2) The common presenting symptoms and signs of hepatitis group included hepatomegaly in 24 cases (68.6%), fever in 19 (54.3%), anorexia in 17 (48.6%), throat injection in 16 (45.7%), splenomegaly in 5 (42.9%), and cervical lymphadenopathy in 10 cases (28.6%) etc. 3) In group I, complications or combined diseases included pneumonia in 4 case, disseminated intravascular coagulation in 2 and 1 case in acute pancreatitis. Group II included 1 case of iron deficiency anemia, acute renal failure, peritonitis and pulmonary hemorrhage respectively. 4) Anemia (Hb: <10g/dl) was found in 3 cases (13.6%) for group I, and in 2 cases (15.4%) for group II. Leukocytosis above 10,000/mm3 was demonstrated in 15 cases (68.2%)for group I and in 3 cases (23.1%)for group II. The higher percentage (>15%)of atypical lymphocytes were found in 3 cases (13.6%)for group I and in 1 case(7.7%) for group II. Thrombocytopenia (platelet: <100,000/mm3) was detected in 1 case (4.5%) for group I and in 3 cases (23.1%)for group II. Total bilirubin above 1.0mg/dl was found in 6 cases (27.3%)for group I and in 5 cases(58.1%)for group II. 5) AST level of 100~500IU/L was found in 10 cases(45.4%)for group I, and in 5 cases (38.5%) for group II. AST level above 500IU/L was demonstrated in 1 case (4.5%) and in 3 cases (23.1%) respectively. The mean values of AST level were 253.4 455.3IU/L and 316.7 102.4 IU/L, respectively. 6) Elevated ALT level of 100~500 IU/L was found in 9 cases (40.9%)for group I and in 9 cases(69.2%)for group II. ALT level above 500IU/L was detected in 5 cases (22.7%)for group I and in 3 cases (15.4%)for group II. The mean values of ALT level were 356.9 561.2IU/L and 308.3 259.1IU/L, respectively. 7) Elevated ALT levels returned to normal values within 3 weeks in 14 cases (82.4%) for group I and in 6 cases (66.7%)for group II. The mean duration of normalization of ALT level were 17.3 14.1 days for group I and 19.9 14.8 days for group II. Our results suggest that it AST/ALT levels are elevated and hepatitis A, B, C markers are negative, or if sudden elevated AST/ALT levels are noted in hepatitis B carriers or a patient with cytomegaloviral hepatitis, Epstein-Barr virus infection should be suspected.
Acute Kidney Injury ; Age Distribution ; Anemia ; Anemia, Iron-Deficiency ; Anorexia ; Bilirubin ; Capsid ; Disseminated Intravascular Coagulation ; Epstein-Barr Virus Infections ; Female ; Fever ; Hemorrhage ; Hepatitis A ; Hepatitis B ; Hepatitis* ; Hepatomegaly ; Herpesvirus 4, Human ; Humans ; Immunoglobulin M ; Infectious Mononucleosis ; Leukocytosis ; Lymphatic Diseases ; Lymphocytes ; Male ; Pancreatitis ; Pediatrics ; Peritonitis ; Pharynx ; Pneumonia ; Reference Values ; Sex Distribution ; Splenomegaly ; Thrombocytopenia

Bacteroides fragilis is a Gram negative nonsporulating anaerobic rod bacterium that makes up about 1 to 2% of the norrnal human colonic microflora. In 1984, Myer et al. reported that some strains of B. fragilis produce enterotoxin and cause diarrheal disease in cattle and human. Since then it has been termed enterotoxigenic B. fragilis (ETBF). In this study, we tried to detect enterotoxin gene from 37 B. fragilis strains, isolated in Korean patients, to confirm the existence of ETBF and usefulness of PCR as a rapid diagnosis method. By this method, we identified 9 ETBF strains and confirmed their pathogenesis by cytotoxicity test. No significant cross- reactivity with other anaerobes or aerobes was observed. Thus, the PCR method may be considered useful for the sensitive and rapid detection of anaerobic infections. And the entire amplified PCR mixture was ligated into a pT7Blue T-vector and transformed into E. coli. When the nucleotide sequences of cloned PCR products were compared with reported enterotoxin gene, pBF529 inserted DNA sequence was nearly in good agreement with it but pBF570 inserted DNA sequence showed some difference at nucleotide 270-300. A search for nucleotide sequence homologies revealed that pBF529 exhibited 99%, but pBF570 indicated only 90% identity with reported enterotoxin gene. According to these results, it was suggested that ETBF toxin can be differentiated into at least 2 subtypes.
Animals ; Bacteroides fragilis* ; Bacteroides* ; Base Sequence ; Cattle ; Clone Cells ; Colon ; Diagnosis ; Enterotoxins* ; Humans ; Korea* ; Polymerase Chain Reaction*

Schwannomas are soft tissue sarcomas arising from neurilemma of Schwann cells in peripheral nerves, and is the most frequent type of benign tumor found in these nerves. We report a case of a Schwannoma of the ulnar nerve in the elbow joint, and along this report, give a review of the literature. A 46-year-old male patient was hospitalized with complaints of swelling and pain in the left elbow and a tingling sensation and hypoesthesia of the fourth and fifth fingers. Physical examination of the patient showed he was positive for Tinel's sign, and magnetic resonance imaging results demonstrated the presence of a Schwannoma. Subsequent biopsy and excision of the Schwannoma was carried out. The suspected mass, which had a clear margin separating it from the healthy nerve of the medial left elbow, was removed along with its 2 x 2 x 3 cm capsule after a histological diagnosis of a Schwannoma was made. Pathophysiological results confirmed the excised mass as a Schwannoma. Schwannoma of the ulnar nerve within the elbow joint is rare and differential diagnosis is difficult. Therefore, treatment can only proceed after the presence of Schwannoma has been confirmed by physical and radiological examinations.
Biopsy ; Diagnosis ; Diagnosis, Differential ; Elbow Joint ; Elbow* ; Fingers ; Humans ; Hypesthesia ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Neurilemma ; Neurilemmoma* ; Peripheral Nerves ; Physical Examination ; Sarcoma ; Schwann Cells ; Sensation ; Ulnar Nerve*

BACKGROUND: The purpose of this study is to administer conservative treatment in 30 patients diagnosed with idiopathic frozen shoulder, following the suggested frozen shoulder rehabilitation program and to assess the clinical outcome using a prospective study. METHODS: Thirty patients diagnosed with idiopathic frozen shoulder, treated with steroid hormone injection on the articular joint with an intra-articular steroid (triamcinolone 40 mg + lidocaine 4 ml) injection and started on stepwise shoulder extension exercise were chosen. The subjects were divided into two groups of 15 people each with one group undergoing rehabilitation with continuous passive motion (CPM) and the other group without it. Follow-ups were done before rehabilitation and at 4-week intervals with the 24th being the final week. At every follow-up, passive range of motion (ROM) was measured and surveys on pain and clinical score were administered. RESULTS: In the last follow-up, both groups showed statistically significant improvements in all evaluation criteria. However, no statistical difference in all values of the ROM and Constant score evaluation criteria was observed between the groups. Only in the last follow-up, group 1 had a visual analog scale (VAS) score of 2.4 +/- 2.1 points, which was lower, with statistical significance, than the VAS score of group 2, which was 4.4 +/- 3.1 points (p<0.001). CONCLUSIONS: Study using CPM in treatment of frozen shoulder has been inadequate, meaning that there is still room for improvement and need for more study on setting a more specific protocol and guidelines for this procedure.
Bursitis* ; Follow-Up Studies ; Humans ; Joints ; Lidocaine ; Motion Therapy, Continuous Passive ; Prospective Studies ; Range of Motion, Articular ; Rehabilitation ; Shoulder ; Visual Analog Scale

PURPOSE: Transcatheter arterial chemoembolization (TACE) and subsequent percutaneous ethanol injection (PEi) was attempted in 8 patients with 9 hepatocellular carcinomas (HCCs) for complete tumor necrosis of HCCs less than 5cm in greatest diameter. MATERIALS AND METHODS: PEI was performed with 2-8ml of absolute (99.9%) ethanol two weeks after TACE under CT or ultrasound guidance. For each patient PEI was done twice to four times within 4-10 days of each procedure. After completion of a series of PEI, follow up examination (range:3 months-l.5 year period) was done with angiography, CT or ultrasound and correlated with serum alpha-fetoprotein (AFP) level. RESULTS: On follow up anglograms, the lesions completely disappeared or decreased in size without tumor vessels or staining in 5 of 6 patients. On follow up CT of 6 patients, the lipiodol-laden HCCs were surrounded by non-enhancing low density and the losion sizes were slightly decreased or not changed. These are suggestive of necrosis of tumor itself and adjacent liver parenchyma. The tumors could not be detected on follow up ultrasound examination in 2 patients. Serum AFP was decreased in 7 patients and was well corresponded to the results of imaging modalities. CONCLUSION: The authors concluded that the combined TACE and PEI is an appropriate treatment for small HCCs having high surgical risks.
alpha-Fetoproteins ; Angiography ; Carcinoma, Hepatocellular* ; Ethanol* ; Follow-Up Studies ; Humans ; Liver ; Necrosis ; Ultrasonography

We studied the intradiscal pressure in order to understand the biophysics of the lumbar intervertebral disk. We evaluated the relationship between disk morphology and intradiscal pressure in 90 lumbar intervertebral disks of 64 patients. The intrinsic intradiscal pressure in the ruptured disks was much lower than that in the normal or bulging disk, but intrinsic intradiscal pressure alone did not correlate in a statistically significant way to the absence, or presence and/or type of disk herniation. The elastance of normal disks was statistically significantly higher than that of the protruded disk(p<0.05) ; however, the elastance of lumbar disk was not affected by type of disk protrusion. Factors affecting disk elastance were the degeneration and the integrity of the annulus fibrosus and the posterior longitudinal ligament. The authors experienced no complication during the procedure. The measurement of the intradiscal pressure to evaluated the biophysical function of lumbar intervertebral disks is only a simple and risk-free procedure. Also it is suggested that patients with bulging disks of high elastance may be treated by reducing intradiscal pressure with percutaneous procedures such as chemonucleolysis, and automated discectomy using Nucleotome.
Biophysics ; Diskectomy ; Humans ; Intervertebral Disc Chemolysis ; Intervertebral Disc* ; Longitudinal Ligaments

No abstract available.

The authors experienced a case of delayed traumatic intracerebral hemorrhage following a closed head injury. The patient had epidural hematoma at the right temporal area which was confirmed by the computed tomography. The hematoma was successfully evacuated and immediate postoperative course was uneventful. On the second day after operation the patient's condition deteriorated again and repeated computed tomography showed a large delayed intracerebral hematoma in the left occipital lobe. He was immediately treated surgically for the intracerebral hematoma with good result.
Cerebral Hemorrhage, Traumatic* ; Head Injuries, Closed ; Hematoma ; Humans ; Occipital Lobe

A myxoma is a benign tumor found in the heart and in various soft tissues; however, a corneal myxoma is rare. A mucinous mass of unknown etiology was observed on the left cornea of a 32-year-old male patient. We performed deep anterior lamellar keratoplasty using acellular corneal tissue and concurrent amniotic membrane transplantation. Hematoxylin and eosin staining revealed vacuolation of the parenchyma and myxoid change in the corneal tissue that occurred in the anterior half of the corneal parenchyma. We identified a myxoid stroma by Alcian blue staining and observed collagen fibers with denatured stroma by Masson trichrome staining. The patient's visual acuity improved from light perception to 20 / 200, and the intraocular pressure remained within the normal range for one year after surgery. The transplanted cornea survived successfully with well-maintained transparency, and recurrence was not observed one year after surgery.
Adult ; *Cornea ; Corneal Stroma/cytology/*transplantation ; Corneal Transplantation/*methods ; Eye Neoplasms/diagnosis/*surgery ; Humans ; Male ; Myxoma/diagnosis/*surgery

A myxoma is a benign tumor found in the heart and in various soft tissues; however, a corneal myxoma is rare. A mucinous mass of unknown etiology was observed on the left cornea of a 32-year-old male patient. We performed deep anterior lamellar keratoplasty using acellular corneal tissue and concurrent amniotic membrane transplantation. Hematoxylin and eosin staining revealed vacuolation of the parenchyma and myxoid change in the corneal tissue that occurred in the anterior half of the corneal parenchyma. We identified a myxoid stroma by Alcian blue staining and observed collagen fibers with denatured stroma by Masson trichrome staining. The patient's visual acuity improved from light perception to 20 / 200, and the intraocular pressure remained within the normal range for one year after surgery. The transplanted cornea survived successfully with well-maintained transparency, and recurrence was not observed one year after surgery.
Adult ; *Cornea ; Corneal Stroma/cytology/*transplantation ; Corneal Transplantation/*methods ; Eye Neoplasms/diagnosis/*surgery ; Humans ; Male ; Myxoma/diagnosis/*surgery