Periductal mastitis is an inflammatory disease of uncertain etiology affecting the major breast ducts and has been given a variety of names by different authors. The treatment of this condition varies according to the clinical manifestations and the state of recurrence. Thirty-two cases of periductal mastitis during the period of 5 years from March 1991 to February 1996 were reviewed to investigate the clinical characteristics and to assess the results of different surgical procedures. The mean age of the patients was 41.2 years with a range of 26~64 years. The clinical manifestations included mastalgia (93.8%), abscess (43.8%), palpable mass (37.5%), nipple retraction (34.1%), and nipple discharge (21.9%). Aerobic and anaerobic bacteria were isolated in nine of 16 cultures. Acute inflammatory indurations in 6 patients were treated with antibiotics(cephalosporine combined with metronidazole) alone, and abscesses in 14 were treated by incision and drainage plus antibiotics. Twelve patients with a discrete mass had primary excision of the mass and diseased major ducts under antibiotics cover. Recurrence rates after initial treatment for inflammatory indurations, abscesses, and discrete masses were 66.7%, 50%, and 16.7%, respectively, and the median recurrence rate was 31.3%. Thirteen patients with recurrent diseases were treated by excision of the entire major duct system following appropriate preoperative management including, antibiotics and/or incision and drainage; this resulted in satisfactory healing in all without recurrences. In conclusion, initial treatment for patients with inflammatory indurations or abscesses should be more conservative even though nearly half of such patients eventually may require further surgery. Also, there were several recurrences even after excision of the diseased major duct system. To avoid these recurrences, we suggest that a discrete inflammatory mass that does not respond to antibiotic therapy and any recurrent diseases be treated by excision of the entire major duct system rather than by excision of only the diseased ducts.
Abscess ; Anti-Bacterial Agents ; Bacteria, Anaerobic ; Breast ; Drainage ; Female ; Humans ; Mastitis* ; Mastodynia ; Nipples ; Recurrence

The bladder neck contracture is not uncommon in children and adult. The etiology remains controversial despite extensive studies, however it is usually accepted that bladder neck contracture is congenital in children and is due to previous lower urogenital infections in most of adult males. In spite of various modalities of treatment its high recurrence rate has been a perplexing problem. During the period from January 1, 1973 to December 31, 1976, 90 cases of adult male bladder neck contractures were studied clinically. Transurethral vesical neck resection was performed on 15 cases and phenoxybenzamine treatment was taken on 9 cases. The following results were obtained. 1) The age range of the patients in this study was from 17 to 79 years. 27.8% of the cases were between 30 and 39 years old and the most patients of group III were observed beyond 40 years of age. 2) The patients of group III usually has longer history of symptoms than group I and II patients. 55.6% of the cases had the onset of one year to 5 years. 3) Analysis of the 90 cases shows that common urinary symptoms were frequency(70%), diminished and weak stream(66.7%) and tenesmus(44.4%). 4) 88% of the cases was associated with the one or more diseases of chronic prostatitis, posterior urethritis or verumontanitis. 5) The bladder trabeculation was the most common finding(91.1%). In 73.3% of the cases interureteric ridge was elevated. Vesical outlet was narrowed as reversed V shape in almost all cases. 6) In 68.8% of the cases urine findings was normal, Pyuria was observed in 20% and microscopic hematuria in 16.6%. 7) Transurethral vesical neck resection was performed in 15 cases; All preoperative symptoms were relieved in 10 cases, but no improvement was observed in 5 cases. 8) 9 cases were treated with sympatholytic drug, phenoxybenzamine and significant improvement of all obstructive symptoms was obtained after 10 days or 2 weeks of treatment in all cases.
Adult* ; Child ; Contracture* ; Hematuria ; Humans ; Male* ; Neck* ; Phenoxybenzamine ; Prostatitis ; Pyuria ; Recurrence ; Urethritis ; Urinary Bladder*

BACKGROUND: We evaluated 1) the sequential changes of angiotensin-converting enzyme (ACE) mRNA expression in lung (main site for circulating ACE synthesis) and left ventricle, and 2) whether such expression is modified by ACE inhibitor or angiotensin II receptor blocker treatment after acute myocardial infarction (MI) in rats. METHODS: Placebo, captopril (2 g/liter drinking water) or TCV-116 (10 mg/kg/day gavage) was administered 3 days before left coronary occlusion and continued for 6 weeks. At 1, 3 and 6 weeks after operation, hemodynamic measurement was performed and pulmonary and myocardial ACE mRNA expression was analyzed by quantitative RT-PCR using rcRNA as an internal standard. RESULTS: Mean BP and LVEDP increased in untreated rats compared with captopril- and TCV-116-treated rats (post-MI 6week, p<0.05). Pulmonary ACE mRNA increased in acute phase (post-MI 1 week, max. 1.4 fold, p<0.05 vs. pre-MI) and returned to pre-MI value thereafter. In contrast, cardiac ACE mRNA expression showed slightly decreasing tendency in acute phase, and was increased up to 1.6 fold in chronic phase after MI (post-MI 3 and 6weeks, p<0.05 vs. pre-MI). No changes in pulmonary ACE gene expression were found with RAS blockade. However, in acute phase after MI, cardiac ACE mRNA increased with both captopril and TCV-116 treatment (post-MI 24hour and 1week, max. 2 fold, p<0.05 vs. untreated group). CONCLUSION: 1) In contrast to the pulmonary ACE mRNA that is activated in acute phase, the cardiac ACE mRNA is activated in chronic phase after MI. 2) RAS blockade does not affect the change of pulmonary ACE expression, but modulate the change of cardiac ACE expression after MI.
Animals ; Captopril ; Coronary Occlusion ; Drinking ; Gene Expression* ; Heart Ventricles ; Hemodynamics ; Lung* ; Myocardial Infarction* ; Myocardium* ; Peptidyl-Dipeptidase A ; Rats ; Receptors, Angiotensin ; RNA, Messenger

Effect of acute carbon monoxide poisoning on prostatic acid phosphatase in white rat hag been studied histochemically. The experimental animals were exposed to 0.25% and O. 5% of carbon monoxide from 5 minutes to 4 hours duration. Gomori's modified method was used for acid phosphatase test. Following results are obtained: 1. The acid phosphatase activity increases after 30minutes of exposure in both experimental groups, 0.25% and 0.5% of carbon monoxide, and the changes of acid phosphatase activity become more significant according to the duration of exposure. 2. The changes of acid phosphatase activity are similar in both experimental groups exposed to 0.25% and 0.5% of carbon monoxide. 3. No significant histopathological changes are observed in rat prostate gland.
Acid Phosphatase* ; Animals ; Carbon Monoxide Poisoning* ; Carbon Monoxide* ; Carbon* ; Poisoning ; Prostate* ; Rats*

No abstract available.
Fibronectins* ; Wound Healing* ; Wounds and Injuries*

No abstract available.
Neurons*

BACKGROUND: Currently, the incidence of hepatitis A is on the increase in Korea. Although there is emphasis on contact precautions, the nosocomial outbreak of hepatitis A virus (HAV) in healthcare personnel has increased within endemic areas because these workers inevitably come in close contact with patients and work under suboptimal hygiene conditions. In this study, we evaluated the necessity of immunization against HAV for healthcare personnel. METHODS: We investigated the seropositivity of serum immunoglobulin G (IgG) anti-HAV antibody (Ab) in 672 healthcare personnel on the basis of their age-group, sex, and occupation in Soon Chun Hyang University Hospital and Soon Chun Hyang University Bucheon Hospital. RESULTS: The subjects were divided into 6 groups on the basis of their ages to identify differences among the various age groups in the number of cases with HAV Ab seropositivity. Significant intergroup differences were noted in this respect: 21-25 years, 2/152 (1.3%); 26-30 years, 33/245 (13.5%); 31-35 years, 70/148 (47.3%); 36-40 years, 52/79 (65.8%); >40 years, 44/48 (91.7%). CONCLUSION: The number of seropositive cases was low among young healthy personnel: low seropositivity is an emerging risk for vulnerable population. With the increase in the incidence of hepatitis A, healthcare personnel have become a risk population for hepatitis A, as are community residents. Therefore, for healthcare personnel working in hospitals, immunization against HAV should be recommended for personnel younger than 30 years, and serological testing for older personnel.
Delivery of Health Care ; Hepatitis ; Hepatitis A ; Hepatitis A Antibodies ; Hepatitis A Vaccines ; Hepatitis A virus ; Humans ; Hygiene ; Immunization ; Immunoglobulin G ; Incidence ; Korea ; Occupations ; Serologic Tests ; Vulnerable Populations

Peritoneal mesothelioma is a rare disease which arises from the mesothelial lining cells in the peritoneum and spreads to the peritoneal wall, omentum and other abdomina1 organs. Aabestos is one etiologic factor and the other factors are genetic cause, radiation, exposure to toxic materials and recurrent yeritonitis. We experienced a case of multiple small nodular peritoneal mesothelioma after exposure to asbestos for over 20 years. He was a sailor and had worked in the engine department of the ship, in which he wrapped up the pipe of engine in asbestos. This person came to our hospital because of inconvenience due to a distended abdomen. Tumor markers were all within normal limits and there was no evidence of tuberculosis in the abdomen and chest. The CT findings of the abdomen were as follows: There was abundant ascites in the abdominal cavity and multiple small nodules on the parietal peritoneum and especially on the lower abdomen. The omentum thickened diffusely. It was difficult to distinguish from peritoneal mesothelioma and peritoneal carcinomatosis or intestinal tuberculosis. The laparoscopic findings were as follows: There were multiple small nodules on the parietal peritoneum and omentum. The small nodules were a gray white color and uneven compared to tuberculous peritonitis. Therefore, we observed the malignant mesothelial cells by means of the light microscope and electron microscope and concluded that this case was peritoneal mesothelioma.
Abdomen ; Abdominal Cavity ; Asbestos ; Ascites ; Carcinoma ; Humans ; Mesothelioma* ; Military Personnel ; Omentum ; Peritoneum ; Peritonitis, Tuberculous ; Rare Diseases ; Ships ; Thorax ; Tuberculosis ; Biomarkers, Tumor

Four children, with histopathologically confirmed posterior fossa primitive neuroectoderrnal tumors, were examined by plain radiography, computed tomography (CT) and cerebral angiography. The homogeneously well enhanced solid mass in the midline of the posterior fossa and hydrocephalus of various degree were seen on all CT scans. One case had calcifications and another case had low density areas in the tumor mass. Three cerebral angiograms showed vascular displacement without tumor vascularities. Unfortunately, these CT and angiography findings are and other tumors. when a well enhanced solid mass in the midline posterior fossa is seen on CT scan in children.
Angiography ; Cerebral Angiography ; Child ; Humans ; Hydrocephalus ; Medulloblastoma* ; Neuroectodermal Tumors, Primitive* ; Pathology* ; Radiography ; Tomography, X-Ray Computed

No abstract available.
Autoantibodies* ; Humans*