Total 9 cases of extraintestinal amoebiasis, amebic liver abscess and amebic lung abscess, were treated with metronidazole. The diagnosis and progress check were done by (1) stool examination, (2) size and pain of liver, (3) hematological examination, (4) urinanalysis, (5) X-ray or liver scanning (6) examination of aspirated pus from liver and (7) immobilization test of E. histolytica. Results are summarized as follows: Amebic hepatitis: Metronidazole was given to 3 cases with daily dose of 0.9-1.2 gm for 3-7 days. Clinical symptoms were completely restored by the treatment. Amebic lung abscess: One case was treated with metronidazole for 3 days with the daily dose 1.2 gm. X-ray findings showed remarkable improvement by the treatment. An additional administration of the drug for 6 days resulted complete resolution of the pneumonic changes. Amebic liver abscess: Four cases were treated with metronidazole. The daily doses were 0.4-2.4 gm and continued for 2-10 days. Aspiration of the abscess for 1-10 times or continuous drainage of pus were performed during the course supplementarily. All cases were recovered to normal by the combining treatment. No remarkable side effect was noticed by the drug administration, and no relapse was experienced up to date.
parasitology-protozoa-Entamoeba histolytica ; chemotherapy ; metronidazole ; liver ; lung ; amoebiasis

BACKGROUND: Thyroid nodules are among the most common endocrine diseases requiring surgical treatment. To determine the appropriate treatment methods for thyroid nodules, we conducted this study by analyzed the clinical characteristics of thyroid nodules, the surgical procedure, and postoperative complications. METHODS: We experienced 39 cases of thyroid nodules below 1 cm in size and treated them by surgical intervention at the Department of Surgery, Masan St. Mary's Hospital, from April 1994 to June 1996. We examined the age and the sex distributions, the clinical manifestations, the locations of the thyroid nodules, the pathologic findings, the ultrasonographic findings, the aspiration biopsy cytology findings, the surgical procedures, and the postoperative complications. RESULTS: 1) The mean age of the patients was 45 years, and the sex ratio of males to females was 1:18.5. 2) The nodules were located in the right lobe (24 cases), the left lobe (10 cases), both lobes (3 cases), isthmus (2 cases). 3) When 39 cases were examined by ultrasonography, the malignant nodules were found in 1 of 14 cases of anechoic nodules and 10 of 25 cases of isoechoic nodules. 4) Aspiration biopsy cytology was performed in 21 cases, and the false negativity was 25%, the false positivity was 25%, and the accuracy rate was 75%. 5) The histopathologic classification of the benign nodules were follicular adenomas, 13 cases; adenomatous goiters, 12 cases; Hashimoto's thyroiditis, 1 case; Hurthle cell adenoma, 1 case; and simple cyst, 1 case. The malignant diseases were papillary carcinoma, 10 cases; and follicular carcinoma, 1 case. 6) Most cases of benign nodules were treated with a lobectomy (72.4%). Malignant nodules were treated with an extended lobectomy and anterior compartment node dissection. 7) The major postoperative complication was transient hypocalcemia. CONCLUSIONS: When voice change or hoarseness is observed and a thyroid nodule is suspected on ultrasonography, aspiration biopsy cytology is considered to be required to exactly distinguish benign nodules from malignant nodules. Further, in case of malignant nodules, it can be concluded that a more active and careful operation may be required to minimize the complications, to decrease the recurrence rate, and to increase the survival rate.
Adenoma ; Biopsy, Needle ; Carcinoma, Papillary ; Classification ; Endocrine System Diseases ; Female ; Goiter ; Hoarseness ; Humans ; Hypocalcemia ; Male ; Postoperative Complications ; Recurrence ; Sex Distribution ; Sex Ratio ; Survival Rate ; Thyroid Gland* ; Thyroid Nodule* ; Thyroiditis ; Ultrasonography ; Voice

Brunner's gland hamartomas are rare, benign duodenal tumors. But, they are the commonest hamartomas in the small intestine and believed to represent hyperplasia of Brunner's glands, perhaps in response to excessive gastric acid secretion. Brunner's gland hamartomas are usually smaller than 1cm and asymptomatic, incidental finding during endoscopy or radiographic examination. We report a case of large Brunner's gland hamartoma which prolapsed into gastric antrum and caused gastric outlet obstruction, and was resected by endoscopic polypectomy.
Brunner Glands ; Endoscopy ; Gastric Acid ; Gastric Outlet Obstruction* ; Hamartoma* ; Hyperplasia ; Incidental Findings ; Intestine, Small ; Pyloric Antrum

No abstract available.

PURPOSE: To assess the utility of magnetic resonance(MR) cerebral blood volume (CBV) map in the evaluation of brain tumors. MATERIALS AND METHODS: We performed perfusion MR imaging preoperatively in the consecutive 15 patients with intracranial masses (3 meningiomas, 2 glioblastoma multiformes, 3 low grade gliomas, 1 lymphoma, 1 germinoma, 1 neurcyotma, 1 metastasis, 2 abscesses, 1 radionecrosis ). The averages age of the patients was 42 years (22yr-68yr), composed of 10 males and 5 females. All MR images were obtained at 1.5T imager(Signa, GE Medical systems, Milwaukee, Wisconsin). The regional CBV map was obtained on the theoretical basis of susceptibility difference induced by first pass circulation of contrast media.(contrast media: 15cc of gadopentate dimeglumine, about 2ml/sec by hand, staring at 10 second after first baseline scan). For each patient, a total of 480 images (6 slices, 80 images/slice in 160 sec) were obtained by using gradient echo(GE) single shot echo-planar image(EPI) sequence (TR 2000ms, TE 50ms, flip angle 90degree, FOV 240x240, matrix 128x128, slice-thick/gap 5/2.5). After data collection, the raw data were transferred to GE workstation and rCBV maps were generated from the numerical integration of deltaR2* on a voxel by voxel basis, with home made software(deltaR2*=-ln(S/S0/TE). For easy visual interpretation, relative RGB color coding with reference to the normal white matter was applied and color rCBV maps were obtained. The findings of perfusion MR image were retrospectively correlated with Gd-enhanced images with focus on the degree and extent of perfusin and contrast enhancement. RESULTS: Two cases of glioblastoma multiforme with rim enhancement on Gd-enhanced T1 weighed image showed increased perfusion in the peripheral rim and decreased perfusion in the central necrosis portion. The low grade gliomas appeared as a low perfusion area with poorly defined margin, In 2 cases of brain abscess, the degree of perfusion was similar to that of the normal white matter in the peripheral enhancing rim and was low in the central portion. All meningiomas showed diffuse homogeneous increased perfusion moderate or high degree. One each of lymphoma and germinoma showed homogenously decreased perfusion with well defined margin. The central neurocytoma showed multifocal increased perfusion areas of moderate or high degree. A few nodules of the multiple metastasis showed increased perfusion of moderate degree. One radionecrosis revealed multiple foci of increased perfusion within the area of decreased perfusion. CONCLUSION: The rCBV map appears to correlate well with the perfusion state of brain tumor, and may be helpful in discrimination between low grade and high grade glioma. The further study is needed to clarify the role of perfusion MR image in the evaluation of brain tumor.
Abscess ; Blood Volume ; Brain Abscess ; Brain Neoplasms* ; Brain* ; Clinical Coding ; Data Collection ; Discrimination (Psychology) ; Female ; Germinoma ; Glioblastoma ; Glioma ; Hand ; Humans ; Lymphoma ; Magnetic Resonance Imaging* ; Male ; Meningioma ; Necrosis ; Neoplasm Metastasis ; Neurocytoma ; Perfusion* ; Retrospective Studies

Clinico-pathological, parasitological, microbiological and immunologic studies were made in 238 of islanders Cheju, a highly endemic area of amebiasis in Korea. Ameba immobilization test was carried out using immunized rabbit sera and several strains of Entamoeba histolytica. The results are summarized and concluded as follows; I. The number of males with liver abscess was markedly greater than female, and the largest group distribution was observed in ages 30-39. In liver abscess patients, an increase of white blood cells(W.B.C.) and a decrease of red blood cells'R.B.C.) was noted. The differential count of W.B.C. showed an increase of segmented neutrophils and a decrease of 1ymphocytes. The level of total cholesterol and its ester was also diminished, and urobilinogen in patients, urine was increased in comparison with healthy controls. 2. The detection rate for microorganisms in aspirated liver abscess was 42.1%. Most of the recovered microorganisms were Gram negative enteric bacilli; Escherichia coli, Alkaligenes fecalis, Aerobacder aerogenes and paracolon group. Fungi and cocci were not observed. 3. In the immobilization test using immune rabbit sera immunized with a 48-hour-culture of E. histolytica, the highest immobilization reaction occurred 45-105 minutes after the beginning of the test and remobilization of the parasite took place gradually. Immobilization of ameba continued for more hours and at higher rate in the inactivated rabbit sera group, and the differences among ameba strains were not remarkable. In human amebiasis sera, the highest peak of immobilization reaction occurred at 45-90 minutes after testing with the parasite. 4. Positive rates for the immobilization test according to clinical feature were 83.3-100% in liver abscess cases, 83.3-90.7% in hepatomegaly cases, 45.4% in asymptomatic cyst-passers and 31.5% in healthy controls. 5. For 56 patients who showed a high rate of immobilization, the follow-up positive rate after treatment for amebiasis was markedly reduced in 2-3 months.
Adolescent ; Adult ; Animals ; Child ; Entamoeba histolytica/isolation & purification ; Female ; Human ; Korea ; Liver Abscess/*microbiology ; Liver Abscess, Amebic/immunology/*microbiology ; Male ; Middle Aged ; Serologic Tests

BACKGROUND: Chlamydia trachomatis is most common sexually transmitted pathogen in the world, and a common cause of urethritis and cervicitis. Also it is common cause of preterm premature rupture of membranes and premature labor in pregnant women, and pneumonitis and conjunctivitis in neonate. A rapid and sensitive polymerase chain reaction(PCR)-based assay for detection of C. trachomatis is recently introduced. OBJECTIVES: We studied to determine whether a PCR assay is useful to detect Chlamydial infection in pregnant women. We also studied to compare its prevalence rate according to maternal age, trimester and parity, respectively. Study Design: Specimens were collected from 149 pregnant women by transcervical swab or endocervical lavage. If a specific band was detected in PCR assay, we considered as Chlamydial infection. RESULTS: In general, the positive bands were detected in the 45 of 149 pregnant women(30.2%). The positive bands were detected the 6 of 55(10.9%), 16 of 49(32.7%), and 23 of 45(51.1%) pregnant women in each trimester, respectively. Therefore, there was significantly increased according to the gestational age(p<0.05). However, there were not significantly different according to maternal age and parity(p> 0.05). CONCLUSION: We concluded that the PCR assay is a fast and useful test for the detection of C. trachomatis in transcevical cells from the pregnant women. This study suggested that Chlamydial infection seems to be increased according to the gestational age.
Chlamydia trachomatis* ; Chlamydia* ; Conjunctivitis ; Diagnosis* ; Female ; Gestational Age ; Humans ; Infant, Newborn ; Maternal Age ; Membranes ; Obstetric Labor, Premature ; Parity ; Pneumonia ; Polymerase Chain Reaction* ; Pregnancy ; Pregnant Women* ; Prevalence ; Rupture ; Therapeutic Irrigation ; Urethritis ; Uterine Cervicitis

Drug-induced acute interstitial nephritis is characterized by renal interstitial inflammatory cell infiltration and commonly presents as acute renal failure. This is caused mainly by methicillin, non-steroidal antiinflammatory drugs, sulfonamide diuretics such as thiazide, but cases induced by furosemide are rare. We report a patient with acute interstitial nephritis causing reversible acute renal failure and dermatitis while she was taking furosemide. A 37-year old woman was referred to our hospital because of generalized skin rash and non-oliguric acute renal failure. She had peripheral eosinophilia (1,577/mm3) and serum creatinine level of 6.8mg/dL. Skin biopsy showed leukoclastic vasculitis and percutaneous renal biopsy showed severe interstitial infiltration of lymph ocyte and mild interstitial fibrosis with focal tubular atrophy. After withdrawal of furosemide, renal function and skin lesions were completely recovered.
Acute Kidney Injury ; Adult ; Atrophy ; Biopsy ; Creatinine ; Dermatitis ; Diuretics ; Eosinophilia ; Exanthema ; Female ; Fibrosis ; Furosemide* ; Humans ; Methicillin ; Nephritis, Interstitial* ; Skin ; Vasculitis

BACKGROUND: Animals with zoophilic dermatophytes are important sources of dermatophytoses in man, because zoophilic dermatophytes are frequently transmitted directly or indirectly from domestic and wild animals. Trichophyton(T.) mentogrophytes has a wide range of hosts. Among these, rodents are well-known reservoirs in many other countries. In our country a few sporadic reports of incidence in experimental rats have been reported, but there is no study on the incidence in wild rodents in Korea. OBJECTIVE: The purpose of this study is to investigate the role of wild rodents as a host of dermatophytes and keratinophilic fungi in Korea. METHODS: Forty-nine wild rodents (Apodemus(A.) agrarius; 44, Crocidura spp; 5) were captured from 6 different regions of Kyungi-do with Sherman traps. Fungi were isolated by using the Mackenzie's brush technique. RESULTS: 1. Isolation rate of dermatophytes from wild rodents in Korea was 16.3%. 2. T. mentagrophytes was isolated from six A. agrarius (12.2%). Isolation rates from dorsum hairs, ventral hairs and feet were 4.5%, 9.1% and 9.1% respectively 3. Other dermatophytes and related keratinophilic fungi isolated were Chrysosporium spp.(65.3%), Scopulariopsis spp.(10.2%) and T. terrestre(4.1%). 4. Chrysosporium. was the most frequently isolated species from four out of six Kyonggi-do regions ranging 58.3%~83.3%. Scopulaiopsis was isolated the most in Kumgwang-myun Ansung-gun, and T. terrestre in Kimpo-gun. CONCLUSION: These results suggest that wild rodents, especially A. agrarius may be the important reservoirs of T. mentagrophytes and other keratinophilic fungi in Korea.
Animals ; Animals, Wild ; Arthrodermataceae* ; Chrysosporium ; Foot ; Fungi* ; Gyeonggi-do ; Hair ; Incidence ; Korea* ; Rats ; Rodentia* ; Scopulariopsis ; Tinea

PURPOSE: The purpose of this study was to evaluate the utility of Half-Fourier Acquisition Single Shot Turbo Spin Echo (HASTE) imaging of the brain, and to compare the results with those of the Turbo Spin Echo (TSE) technique. MATERIALS AND METHODS: TSE and HASTE sequences were retrospectively compared in 31 patients (19 men and 12 women) with cerebral lesions seen on TSE MR images. The related diagnoses were neoplasm (n=4), hematoma (n=5), cerebromalacia (n=4), infarct or ischemia (n=17), and granuloma (n=1). Qualitative analysis involved the independent review by two radiologists of TSE and HASTE images with regard to overall image quality, conspicuity of the lesion, delineation of the gray-white matter, conspicuity of the basal ganglia, degree of flow and ghost artifacts. All parameters were graded 1-4 (1=poor, 4=excellent), and for quantitative analysis, lesion-white matter, gray-white matter, and putamen-white matter contrast to noise ratios (CNR) were measured. RESULTS: During qualitative analysis, all lesions seen on a TSE image were detected on the corresponding HASTE image, but with regard to overall image quality, conspicuity of the lesion, delineation of gray-white matter, and conspicuity of the basal ganglia, HASTE imaging was inferior to that of TSE ; on TSE, these parameters were scored 4.0, 4.0, 3.7, and 3.7 respectively, and on HASTE, the corresponding figures were 2.9, 3.0, 1.5, and 1.9 (p<0.05). For ghost and flow artifacts, no significant differences were demonstrated (p>0.05). Quantitative assessment showed that lesion-white matter CNR was not significantly different between the two techniques (p>0.05). Gray-white matter and putamen-white matter CNRs were 100.4+/-81.8 and 92.6+/-84.6 on TSE and 45.8+/-39.2 and 42.7+/-40.6 on HASTE, respectively (p<0.05). CONCLUSION: With regard to image quality, delineation of lesion and anatomic details, HASTE imaging is inferior to that of TSE, and this indicates that for routine brain imaging, HASTE cannot replace TSE. In view of its fast acquisition time, however, HASTE might sometimes be a useful alternative to TSE.
Artifacts ; Basal Ganglia ; Brain* ; Diagnosis ; Encephalomalacia ; Granuloma ; Hematoma ; Humans ; Ischemia ; Magnetic Resonance Imaging* ; Male ; Neuroimaging ; Noise ; Retrospective Studies