No abstract available.
Meconium*

BACKGROUND: Clostridium difficile is the most common pathogen of antibiotic-associated diarrhea. Toxigenic strains produce toxin A and toxin B. The pathogenicity of C. difficile is due to the production of these two exotoxins. This study aimed to evaluate diagnostic value of two enzyme immunoassay by comparison of concordance rate to diagnose C. difficile-associated infection. METHODS: C. DIFF QUIK CHEK (TECHLAB, USA) that detect glutamate dehydrogenase antigen and VIDAS C. difficile Toxin A&B (BioMerieux, France) that detect toxin A and toxin B were done in 122 fecal specimens to detect C. difficile. RESULTS: In the total 122 stool specimens, 17 cases showed positive results in both tests. One specimen showed discrepancy that positive result in VIDAS C. difficile Toxin A&B (relative fluorescence value, RFV=2.93) but negative result in C. DIFF QUIK CHEK. Therefore, the concordance rate between two tests was 95.1% (116/122). Both anaerobic culture and in-house PCR for toxin B were negative in the discrepant fecal specimen and there was no clinical evidence that support C. difficile-associated diarrhea, so we concluded result in VIDAS C. difficile Toxin A&B as false positive. CONCLUSIONS: Although these two enzyme immunoassays targeted different antigen, they showed high concordance rate. The discrepant case was concluded to false positive in VIDAS C. difficile Toxin A&B test because it showed negative results in culture and PCR for toxin B and there were no clinical evidences of C. difficile-associated infection. It could be needed for analysis about conditions that cause false positive result in enzyme immunoassays to detect C. difficile toxin.
Azure Stains ; Clostridium difficile ; Diarrhea ; Exotoxins ; Fluorescence ; Glutamate Dehydrogenase ; Immunoenzyme Techniques ; Methylene Blue ; Polymerase Chain Reaction ; Xanthenes

PURPOSE: Brain metastasis is estimated to occur in 20~40% of solid tumor patients and the most common primary tumor is lung cancer. Even though the prognosis of brain metastasis is grave and the 1-year survival rate is only 15%, symptom palliations are made with whole brain radiation therapy. We retrospectively evaluated the clinical features and prognostic factors of lung cancer with brain metastasis. MATERIALS AND METHODS: From January 1987 to October 1999, 50 lung cancer patients with brain metastasis underwent whole brain radiation therapy. We reviewed the improvement in neurologic symptoms and survival according to the following parameters; performance status, histological type, presence of brain metastasis at the initial diagnosis of lung cancer, presence of extracranial metastasis, multiplicity of brain lesion, presence of primary lung symptom and treatment modalities. RESULTS: The most frequent symptom with brain metastasis was a headache (50%). Palliation of the headache and other symptoms was achieved in 81% of the patients. Median overall survival after brain metastasis was 21 weeks and the 1 year survival rate was 15%. Patients without extracranial metastasis had a longer median survival than those with, 38 weeks versus 15 weeks, respectively (p=0.01). CONCLUSION: In lung cancer with brain metastasis, neurologic symptoms can be palliated with whole brain radiation therapy, and in this study among such patients, absence of extracranial metastasis can be a good prognostic factor.
Brain* ; Diagnosis ; Headache ; Humans ; Lung Neoplasms* ; Lung* ; Neoplasm Metastasis* ; Neurologic Manifestations ; Prognosis* ; Retrospective Studies ; Survival Rate

BACKGROUND AND OBJECTIVES: The effect of electrical stimulation (ES) on vestibular compensation was investigated for 28 days after unilateral labyrinthectomy (Lx) in 24 rats. MATERIALS AND METHOD: The rats were divided into 4 groups and were treated as follows: A) Lx only, B) Lx with ES (0.6 mA) for 2 days, C) Lx with ES (0.6 mA) for 7 days, D) Lx with ES (1.2 mA) for 2 days. ES with pulse wave (10 Hz) was applied to temporal portion bilaterally (8 hr/day). Cathodal currents were transmitted to the electrode on the destructive side, anodal to that on the intact side. Postoperatively, spontaneous nystagmus (SN) was recorded with the video camera and yaw and roll head tilt (YHT, RHT) were measured using photo images. Horizontal vestibulo-ocular reflex (VOR) was evaluated at various frequencies (0.05, 0.1, 0.5, 1, 2, 3 Hz with peak angular velocity of 40degrees/sec) with the magnetic search coil system. Locomotor movement was monitored with a video camera. RESULTS: The ES groups showed faster compensation in SN, YHT, and RHT than the Lx group. At 3 days after Lx, the ES groups showed significant improvement in the gain over the whole frequency and asymmetry at low frequency compared to that of the Lx group. But the ES group had no effect on compensation of gain and asymmetry on and after 7 days of post-labyrinthectomy. There was no significant difference in vestibular compensation with respect to duration and intensity of ES. ES had no significant effect on the mean velocity and mean deviation of locomotor movements. CONCLUSION: These results suggest that ES has a favorable effect on the suppression of early static symptoms but has no effect on the compensation of dynamic symptoms after the recovery of resting discharge of the vestibular nuclei neurons.
Animals ; Compensation and Redress* ; Ear, Inner ; Electric Stimulation* ; Electrodes ; Head ; Neurons ; Rats* ; Reflex, Vestibulo-Ocular ; Vestibular Nuclei

The association of malignancy with glomerulonephritis is well known. The most frequent observed renal lesions associated with malignancy are the membranous glomerulonephritis on carcinoma and minimal change nephrotic syndrome on Hodgkin's disease. Recently, IgA nephropathy associated with liver disease, connective tissue disease, gastrointestinal disease, dermatologic disease, hematologic disease and malignancy were reported. But the relationship between malignancy and IgA nephropathy is not clearly resolved. Here we report a case of IgA nephropathy associated with early gastirc cancer. Successful treatment of early gastric cancer didn't completely resolve the IgA nephropathy but led to a significant reduction of hematuria and loss of proteinuria. Therefore we suggest that a certain association between IgA nephropathy and early gastric cancer can be made by studying the course of the disease.
Connective Tissue Diseases ; Gastrointestinal Diseases ; Glomerulonephritis ; Glomerulonephritis, IGA* ; Glomerulonephritis, Membranous ; Hematologic Diseases ; Hematuria ; Hodgkin Disease ; Immunoglobulin A* ; Liver Diseases ; Nephrosis, Lipoid ; Proteinuria ; Stomach Neoplasms*

In one-stage transanal endorectal pull-through operation (TERPT) for Hirschsprung disease, preoperative evaluation by contrast enema (CE) is important tool in aspect of planning of surgical procedure as well as diagnosis. This study was to evaluate the significance of CE for identifying the extent of aganglionic bowel. A retrospective analysis was performed in 40 patients who underwent TERPT between 2003 and 2011. The authors reviewed the CE studies and their correlation with pathologic extent of aganglionosis. Total 66 contrast enemas were performed in 40 patients. Twenty patients underwent single CE, but 20 patients required multiple CEs. In single CE group, 17 had clear radiographic transition zone, but 3 had less definite transition zone. In multiple CE group, 17 patients who had equivocal finding in first or second CE had definite radiographic transition zone, but 3 patients of this group had less definite radiographic transition zones. Overall, 34 patients (85%) had clear radiographic transition zone by single or repeated CE. One (2.9%) out of 34 patients with clear radiographic transition zone had discordance between radiographic and pathologic transition zone. In contrast 4 (66.7%) out of 6 patients with equivocal radiographic transition zone had discordance between radiographic and pathologic transition zone. Observation of clear radiographic transition zone is important in preparation of TERPT, and repeated CE is helpful to reduce the discordance between radiographic and pathologic transition zone. Awareness of the possibility of discordance is also important if radiographic transitional zone is not clear.
Enema ; Hirschsprung Disease ; Humans ; Retrospective Studies

BACKGROUND AND OBJECTIVES: Measurement of the peak nasal inspiratory flow rate (PNIFR) is a useful technique for obtaining a quick measure of nasal obstruction and changes in PNIFR, reflecting changes in symptoms. The aim of the present study was to correlate changes in nasal obstruction symptoms with changes in several parameters of acoustic rhinometry (AR) and peak nasal inspiratory flow metry (PNIFM) before and after decongestion and to examine whether changes in PNIFR correlate with changes in nasal cross-sectional areas and volume. MATERIALS AND METHODS: The subjects of the current study were 30 patients with nasal obstruction symptoms and 20 normal subjects. Subjective nasal patency was assessed by visual analogue scale (VAS). We measured PNIFR and minimal cross-sectional area (MCA), cross-sectional area at distances of 3.3 (CA3.3), 4.0 (CA4.0), and 6.4 (CA6.4) cm from the nostril and volume from the nostril 6.4 cm (V6.4) towards the choanae, in each nasal cavity before and after decongestion. RESULTS: The VAS had no significant correlation with PNIFR, each cross-sectional area and volume in bilateral nasal cavities before decongestion. There was a significant correlation between the changes in VAS and PNIFR and MCA before and after decongestion. There was a significant correlation between changes in PNIFR and MCA and CA3.3 in one side and both sides of nasal cavity before and after decongestion. CONCLUSIONS: These results suggest that PNIFM and AR may have no sensitive diagnostic values in estimating the severity of nasal obstruction symptoms in the nondecongested state of the bilateral nasal cavities, but PNIFM and AR can be recommended especially in provocation studies because PNIFR and MCA reflect changes in subjective symptoms by mucosal changes.
Acoustics* ; Humans ; Nasal Cavity ; Nasal Obstruction* ; Nasopharynx ; Rhinometry, Acoustic*

BACKGROUND AND OBJECTIVES: Measurement of the peak nasal inspiratory flow rate (PNIFR) is a useful technique for obtaining a quick measure of nasal obstruction and changes in PNIFR, reflecting changes in symptoms. The aim of the present study was to correlate changes in nasal obstruction symptoms with changes in several parameters of acoustic rhinometry (AR) and peak nasal inspiratory flow metry (PNIFM) before and after decongestion and to examine whether changes in PNIFR correlate with changes in nasal cross-sectional areas and volume. MATERIALS AND METHODS: The subjects of the current study were 30 patients with nasal obstruction symptoms and 20 normal subjects. Subjective nasal patency was assessed by visual analogue scale (VAS). We measured PNIFR and minimal cross-sectional area (MCA), cross-sectional area at distances of 3.3 (CA3.3), 4.0 (CA4.0), and 6.4 (CA6.4) cm from the nostril and volume from the nostril 6.4 cm (V6.4) towards the choanae, in each nasal cavity before and after decongestion. RESULTS: The VAS had no significant correlation with PNIFR, each cross-sectional area and volume in bilateral nasal cavities before decongestion. There was a significant correlation between the changes in VAS and PNIFR and MCA before and after decongestion. There was a significant correlation between changes in PNIFR and MCA and CA3.3 in one side and both sides of nasal cavity before and after decongestion. CONCLUSIONS: These results suggest that PNIFM and AR may have no sensitive diagnostic values in estimating the severity of nasal obstruction symptoms in the nondecongested state of the bilateral nasal cavities, but PNIFM and AR can be recommended especially in provocation studies because PNIFR and MCA reflect changes in subjective symptoms by mucosal changes.
Acoustics* ; Humans ; Nasal Cavity ; Nasal Obstruction* ; Nasopharynx ; Rhinometry, Acoustic*

BACKGROUND AND OBJECTIVES: Nitric oxide (NO) in exhaled air is elevated in allergy. Topical corticosteroid therapy which has been shown to reduce airway inflammation is associated with reduction in exhaled levels of NO in allergy. The aim of this study is to investigate the induction of inducible nitric oxide synthase (iNOS) and the effect of steroid on the expression of iNOS in the nasal mucosa of TDI (toluene diisecyanate)-induced nasal hyperreactive guinea pig. MATERIALS AND METHODS: We developed an allergy model in guinea pigs using the intranasal application of TDI, We evaluated the iNOS expression and in vivo effects of triamcinolone on the expression of iNOS and infiltration of eosinophil in TDI-sensitized guinea pigs by immunohistochemical stain. RESULTS: Nasal symptoms were significantly suppressed and the number of eosinophils in the nasal mucosa were significantly inhibited by the treatment of triamcinolone. Immunoreactivity to iNOS was localized to ciliated cells of epithelium, vascular endothelial cells, secretory cells of nasal glands and some inflammatory cells in the mucosa of the control group. High expression of iNOS in the nasal mucosa of the TDI-sensitized group was demonstrated, and it was suppressed by triamcinolone therapy. CONCLUSION: These results show that increased expression of iNOS may contribute to allergic inflammation and the antiinflammatory effect of steroid in allergy is partly mediated by the reduction of iNOS expression.
Animals ; Endothelial Cells ; Eosinophils ; Epithelium ; Guinea Pigs* ; Guinea* ; Hypersensitivity ; Inflammation ; Mucous Membrane ; Nasal Mucosa ; Nitric Oxide ; Nitric Oxide Synthase ; Nitric Oxide Synthase Type II* ; Steroids ; Toluene 2,4-Diisocyanate ; Triamcinolone

BACKGROUND AND OBJECTIVES: The presence and distribution of NADPH-diaphorase activity in the olfactory bulb during development has been reported. But the precise localization of NO-synthase (NOS) in the olfactory bulb during the developmental stages has not been studied yet. Therefore, we investigated the localization of NOS-immunoreactivity in a developing rat olfactory bulb by immunohistochemistry. MATERIALS AND METHODS: A total of 32 male and female Sprague-Dawley rats. They were of several prenatal and postnatal stages, such as the following: embryonic day 16 (E16), E18, E20, postnatal day 1 (P1), P5, P7, P14 and adult. Indirect immunoperoxidase method using rabbit polyclonal anti-bNOS antibody was performed for detecting the NOS immunoreactivity. RESULTS: In the main olfactory bulb, the first NOS-immunoreactive (IR) neurons were observed in the presumptive granule cell layer (GCL) by E18, and in the glomerular layer (GL) by P1. The density of these neurons was increased as the development stage approached the adult stage. In the GCL, two types of NOS-immunoreactive neurons were observed: intensively stained large, short axon cells and weakly stained small, granule cells. The first, localized in the deeper part of the GCL, was observed in the earlier developmental stages, and the latter which increased in number to the adult period was observed by P1. In the accessory olfactory bulb, NOS-IR neurons were first detected in the GCL by P1, and increased in number to the adult period. The pattern of NOS-IR neurons in the GCL of the accessory olfactory bulb is similar to that in the main olfactory bulb. CONCLUSION: Our results demonstrated that bNOS had a characteristic temporal and spatial patterns of expression in the main and accessory olfactory bulb of the rat during development.
Adult ; Animals ; Axons ; Female ; Humans ; Immunohistochemistry ; Male ; Neurons ; Nitric Oxide Synthase* ; Nitric Oxide* ; Olfactory Bulb* ; Rats* ; Rats, Sprague-Dawley