A 47-year-old man with end-stage renal disease due to diabetic nephropathy underwent a peritoneal scintigraphy to evaluate the cause of recently developed scrotal swelling. Two liters of dialysate mixed with 111 MBq of Tc-99m sulfur colloid were administered into the peritoneal cavity via the dialysis catheter. Various anterior images of the abdomen and pelvis were obtained at 15 min, 2 hr and 4 hr after the tracer instillation. At 15 min, anterior images of the abdomen and pelvis demonstrated linear tracts of activity through both inguinal canals, which were more prominent in the right side (A). Images at 2 hr revealed a passage of the radioactive fluid into the right hemiscrotum. At the same time, there was a considerable accumulation of activity in the right inguinal canal (B). In the delayed image, there was a progressive accumulation of activity in the inguinal canals and a prominent passage of the tracer into the scrotum (C). Both abdominal and inguinal hernias are commonly associated with continuous ambulatory peritoneal dialysis (CAPD). Overall incidence of CAPD-induced hernia ranges from 2.7% to 25%.1) Inguinal hernias were frequently manifested as scrotal swelling. Leakages of dialysate fluid into the scrotum has been noted in CAPD patients with scrotal swelling, with or without clinical findings of inguinal hernia.1,2) In the present case, the right side had leakage from a clinical inguinal hernia and the left side, leakage from a subclinial inguinal hernia. A subclinical inguinal hernia was easily demonstrable with peritoneal scintigraphy. Peritoneal scintigraphy is extremely helpful in the evaluation of scrotal swelling in a patient on CAPD.
Abdomen ; Catheters ; Diabetic Nephropathies ; Dialysis ; Hernia ; Hernia, Inguinal* ; Humans ; Incidence ; Inguinal Canal ; Kidney Failure, Chronic ; Middle Aged ; Pelvis ; Peritoneal Cavity ; Peritoneal Dialysis, Continuous Ambulatory* ; Radionuclide Imaging* ; Scrotum ; Technetium Tc 99m Sulfur Colloid

PURPOSE: There was little evidence that Tc-99m labeled ciprofloxacin (Infecton) located inside of bacteria. Antimicrobial activity of Infecton could be an indirect evidence of its location. We compared in vitro antimicrobial activities of Infecton and ciprofloxacin. MATERIALS AND METHODS: Minimum inhibitory concentration (MIC) and minimum bactericidal concentration (MBC) of Infecton and ciprofloxacin against three standard strains of bacteria, Staphylococcus aureus ATCC 29213, Escherichia coli ATCC 25922 and Pseudomonas aeruginosa ATCC 27853 were measured using modified broth macrodilution techniques and pour plate methods, respectively. Data were expressed as mean+/-SE (range). RESULTS: MICs of Infecton and ciprofloxacin were 1.12+/-0.20 (0.8~1.6) microgram/ml and 0.36+/-0.04 (0.2~0.4) microgram/ml for S. aureus, 0.03+/-0.005 (0.025~0.05) microgram/ml and 0.011+/-0.001 (0.006~0.012) microgram/ml for E. coli, and 0.96+/-0.16 (0.8~1.6) microgram/ml and 0.56+/-0.098 (0.4~0.8) microgram/ml for P. aeruginosa, respectively. MBCs of Infecton and ciprofloxacin were 2.56+/-0.39 (1.6~3.2) microgram/ml and 0.88+/-0.2 (0.4~1.6) microgram/ml for S. aureus, 0.04+/-0.06 (0.025~0.05) microgram/ml and 0.02+/-0.01 (0.025~0.05) microgram/ml for E. coli, and 2.24+/-0.39 (1.6~3.2) microgram/ml and 1.44+/-0.16 (0.8~1.6) microgram/ml for P. aeruginosa, respectively. CONCLUSION: Although both MICs and MBCs of Infecton were higher than those of ciprofloxacin, all three standard bacterial strains were sensitive to Infecton. It could be an indirect evidence that Tc-99m Infecton be a specific imaging agent for bacterial infection.
Bacteria ; Bacterial Infections ; Ciprofloxacin* ; Escherichia coli ; Microbial Sensitivity Tests ; Pseudomonas aeruginosa ; Staphylococcus aureus

This study was done to evaluate the effect reducing artificial dead space on intubated children. Data were collected from July 1st, 1998 to August 31st, 1999. The subjects were selected from a pediatric intensive care unit of 'S' hospital and intubated with 3.5 mm or 4.5 mm endotracheal tube after open heart surgery. They were composed of 34 patients : 17 patients were assigned to the experimental group and the rest of them were placed in the control group. The artificial airway volume was minimized in the experimental group, and the control group maintained the artificial airway volume. ETCO2, PaCO2, SPO2 were measured as indicators of pulmonary ventilation. The tools of this study were GEM-Premier and Space-Lab patient monitors. The data were analyzed using the SPSS/PC+ program. The Chi2 -test was used to find general characteristics. The t-test was used to test the homogenety of the pulmonary ventilation status and mechanical ventilation setting before intervention between the two groups. Also, the paired t-test was used to examine the hypothesis. The results can be summerized as : 1. CO2 can be expelled effectively from the body in case artificial dead space was decreased. 2. As the artificial dead space was reduced, the difference between ETCO2 and PaCO2 was decreased, in other words pulmonary ventilation was improved. 3. If the artificial dead space occupied above 15 percent of tidal volume, the effect of CO2 was retention revealed in the body. 4. If the artificial dead space occupied below 1.5 percent of tidal volume, there was no dead space effect. Based on the results, the following is suggested to be applied practically : 1. A kind of the ventilator circuit acting artificial dead space should be removed from the intubated children with mechanical ventilaion. 2. The endotracheal tube should not be cut because extra-body space of the endotracheal tube did not have an effect on the dead space of the intubated children. Since the researcher could not cover this aspect in the study, they recommend the following. 1. The study should be extended to the other pulmonary disease patients for the effect of improving pulmonary ventilation. 2. Also, further studying with a more narrow interval in the extra-body space of the artificial airway will be able to explain the point of artificial dead space with proper ventilation.
Child* ; Humans ; Intensive Care Units ; Lung Diseases ; Pulmonary Ventilation* ; Respiration, Artificial* ; Thoracic Surgery ; Tidal Volume ; Ventilation ; Ventilators, Mechanical

Purpose: The purpose of this study was to investigate effects of NXP031, an inhibitor of oxidation by specifically binding to the complex of DNA aptamer/vitamin C, on dopaminergic neurons loss and the reaction of microglia in an animal model of 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP)-induced subchronic Parkinson’s disease (PD). Methods: A subchronic PD mouse model was induced via an intraperitoneal (IP) injection of MPTP 30 mg/kg per day for five days. NXP031 (vitamin C/aptamer at 200 mg/4 mg/kg) and vitamin C at 200 mg/kg were administered via IP injections at one hour after performing MPTP injection. This process was performed for five days. Motor function was then evaluated with pole and rotarod tests, after which an immunohistochemical analysis was performed. Results: NXP031 administration after MPTP injection significantly improved motor functions (via both pole and rotarod tests) compared to the control (MPTP injection only) (p < .001). NXP031 alleviated the loss of dopaminergic neurons in the substantia nigra (SN) and striatum caused by MPTP injection. It was found to have a neuroprotective effect by reducing microglia activity. Conclusion NXP031 can improve impaired motor function, showing neuroprotective effects on dopaminergic neurons in the SN and striatum of MPTP-induced subchronic Parkinson’s disease mouse model. Results of this study suggest that NXP031 has potential in future treatments for PD and interventions for nerve recovery.

Purpose: The purpose of this study was to investigate effects of NXP031, an inhibitor of oxidation by specifically binding to the complex of DNA aptamer/vitamin C, on dopaminergic neurons loss and the reaction of microglia in an animal model of 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP)-induced subchronic Parkinson’s disease (PD). Methods: A subchronic PD mouse model was induced via an intraperitoneal (IP) injection of MPTP 30 mg/kg per day for five days. NXP031 (vitamin C/aptamer at 200 mg/4 mg/kg) and vitamin C at 200 mg/kg were administered via IP injections at one hour after performing MPTP injection. This process was performed for five days. Motor function was then evaluated with pole and rotarod tests, after which an immunohistochemical analysis was performed. Results: NXP031 administration after MPTP injection significantly improved motor functions (via both pole and rotarod tests) compared to the control (MPTP injection only) (p < .001). NXP031 alleviated the loss of dopaminergic neurons in the substantia nigra (SN) and striatum caused by MPTP injection. It was found to have a neuroprotective effect by reducing microglia activity. Conclusion NXP031 can improve impaired motor function, showing neuroprotective effects on dopaminergic neurons in the SN and striatum of MPTP-induced subchronic Parkinson’s disease mouse model. Results of this study suggest that NXP031 has potential in future treatments for PD and interventions for nerve recovery.

Sternocostoclavicular hyperostosis is a benign ossifying diathetic disorder characterized by hyperostosis and soft tissue ossification of the clavicles, anterior portion of the first ribs, and manubrium, with variable hyperostosis or ankylosis in the spine and sacroiliac joints. A review of the literature and our own case describes the clinical findings and its characteristic features in RI, CT, and plain film.
Ankylosis ; Clavicle ; Hyperostosis ; Hyperostosis, Sternocostoclavicular* ; Manubrium ; Ribs ; Sacroiliac Joint ; Spine

PURPOSE: This study was conducted to identify the effects of diabetes education and telephone counseling on depression in diabetic patients. METHODS: 49 diabetic patients(24 in the control group and 25 in the experimental group) completed diabetes education and telephone counseling. Data were analyzed using chi-square test, paired t-test and unpaired t-tests. RESULTS: There were no significant differences in depression between the experimental and control groups. But, Depression scores were much decreased in the experimental group. CONCLUSION: Depression decreased following the diabetes education and telephone counseling. These findings indicate that diabetes education and telephone counseling could be one of the way to decrease depression.
Counseling ; Depression ; Diabetes Mellitus ; Humans ; Telephone

We report herein three cases of subcutaneous sarcoidosis without apparent internal lesion. The patients had multiple subcutaneous nodules on the extremities and abdomen. Hyper-gammaglobulinemia, a relative increase of T suppressor cells, and increased serum angiotensin converting enzyme level and skin anergy were observed. Histopathologic findings revealed sarcoidal granulomas involving the subcutaneous fat tissue. The lesions of two cases resolved spontaneously and the other one case required systemic corticosteroid therapy.
Abdomen ; Extremities ; Granuloma ; Humans ; Peptidyl-Dipeptidase A ; Sarcoidosis* ; Skin ; Subcutaneous Fat

BACKGROUND: This study was performed to evaluate our experience on laparoscopic appendectomy. METHODS: Retrospective analysis was performed on 2,856 patients who had been operated by laparoscopic appendectomy under diagnosis of acute appendicitis at the Sung-Ae Hospital and Kwang-Myoung Sung-Ae Hospital from October 1991 to July 1998. RESULTS: Among 2,856 patients who had undergone laparoscopic appendectomy,2,379 patients (83.3%) were operated due to simple acute appendicitis, 275 patients (9.6%) due to perforated appendicitis. Operation time was 44.6 minutes for simple acute appendicitis and 60.3 minutes for perforated appendicitis. In perforated appendicitis, intra-peritoneal irrigation and drain insertion was performed. The length of hospital stay in patient with simple acute appendicitis was 3.7 days (5.82 days in conventional appendectomy) and patients with perfotrated appendicitis was 6.1 days (9.91 days in conventional appen-dectomy). Complications such as wound infection, intra-abdomen abscess, trocar site bleeding, subcutaneous emphysema developed in 43 (1.5%) patients (79/1,947, 4.5% in conventional appendectomy). In 202 (7.1%) patients, appendix was normal, but another diseases were detected, including acute pelvic inflammation, ovarian cyst, mesenteric lymphadenitis, enteritis, diverticulitis in order. CONCLUSION: Overall complication rate was lower in laparoscopic appendectomy compared with conventional appendectomy and the length of hospitalization of laparoscopic appendectomy was shorter. When the acute appendicitis is suspected, especially in the reproductive women, the laparoscopic approach would be better diagnostic and therapeutic value than conventional method. Therefore laparoscopic appendectomy would be replaced with conventional appendectomy.
Abscess ; Appendectomy* ; Appendicitis ; Appendix ; Diagnosis ; Diverticulitis ; Enteritis ; Female ; Hemorrhage ; Hospitalization ; Humans ; Inflammation ; Length of Stay ; Mesenteric Lymphadenitis ; Ovarian Cysts ; Retrospective Studies ; Subcutaneous Emphysema ; Surgical Instruments ; Wound Infection

Myocardial scintigraphy is a widely used noninvasive procedure with high sensitivity for the detection of patients with suspected coronary artery disease. The purpose of this study was to determine the prognostic value of a normal myocardial scintigraphy in 292 patients (150 males, 142 females, mean age 53+/-12 years) with chest pain who were followed from 7 to 58 (mean 25) months. Myocardial SPECT was performed with Tc-99m MIBI in 173 patients, with Tc-99m tetrofosmin in 74 patients and with T1-201 in 45 patients. During the follow-up period, there were 2 cardiac deaths and 2 nonfatal myocardial infarctions resulting in cardiac event rate of 1.37% (0.66% per year). The cardiac event rate was not different in patients with angiographically normal coronary arteries (1/30, 3.3%) and in those who had significant coronary a disease (2/27, 7.4%) (p=0.60). In conclusion, patients with chest pain and normal myocardial scintigraphy have a low cardiac event rate, and there was no significant difference of cardiac event rates between patients with normal and abnormal coronary angiograms.
Chest Pain* ; Coronary Artery Disease ; Coronary Vessels ; Death ; Female ; Follow-Up Studies ; Humans ; Male ; Myocardial Infarction ; Myocardial Perfusion Imaging ; Perfusion Imaging* ; Perfusion* ; Prognosis ; Thorax* ; Tomography, Emission-Computed, Single-Photon