We report a patient with pachydermoperiostosis accompanied by hypertrophic gastritis. A 26-year-old man showed deep folds and furrows of the face and scalp, and terminal spade-like expansion of fingers and toes. Physical examination revealed no abnormalities except a grotesque appearance. Results of routine laboratory tests were unremarkable. Mild periosteal reactoins of both femurs and humeri were noted on long bone series, and hypertrophic gastritis on fibroscopic examination drew our attention. The relationship between pachydermoperiostosis and hypertrophic gastritis is uncertain. However it is probable that hypertrophic gastritis may be the endodermal counterpart of the ectodermal manifestations of pachydermoperiostosis.
Adult ; Ectoderm ; Endoderm ; Femur ; Fingers ; Gastritis, Hypertrophic* ; Humans ; Osteoarthropathy, Primary Hypertrophic* ; Physical Examination ; Scalp ; Toes

Eosinophilic granuloma of the lung, first described by Farrinaci et al. in 1951, is rare. A 35-year-old male smoker presented with recurrent pneumothorax. Open thoracotomy with bleb resection and biopsy was performed. Microscopically there was histological changes consistent with typical eosinophilic granuloma and intertitial fibrosis. The Langerhans cells showed positive reaction for S-100 protein and typical Birbeck granules in their cytoplasm. A brief summary of histopathological aspect of this disease and a review of literature are presented.
Male ; Humans ; Biopsy

BACKGROUND: As intravenous thrombolysis (IVT) has very restricted inclusion criteria, eligible patients of IVT constitute a very small proportion and studies about their mortality are rare. The long-term mortality in a patients with contraindication of ineligible patients of IVT still under the debate. So, we investigated the proportion of patients with contraindication of IVT and the short and long-term mortality of them in AIS on emergency department comparing with the long-term effect of IVT in patients with moderate-to-severe stroke.METHODS: Using acute stroke assessment indication registry & Health Insurance Review and Assessment Service database, a total of 5,407 patients with NIHSS≥5 were selected from a total of 169 acute stroke care hospital nationwide during October-December 2011 and March-June 2013. We divided AIS patients into two groups: 1) IVT group who received IVT within 4.5 hours, and 2) non-IVT group who did not receive the IVT because of contraindications. And we divided the subgroups according to the reason of contraindication of IVT. The 5-year survival rate of each group was assessed using Kaplan-Meyer survival analysis.RESULTS: Of the 5,407 patients, a total of 1,027 (19%) patients who received IVT using r-tPA within 4.5 h after onset. Compared with the IVT group, hazard ratios of non-IVT group were 1.33 at 3 months, 1.53 at 1 year and 1.47 at 5 years (p<.001). A total of 4,380 patients did not receive IVT because of the following contraindications to IVT. 1) Time restriction: 3,378 (77.1 %) patients were admitted after 4.5 h following stroke onset, and 144 (3.3%) patients failed to determine the stroke onset time. 2) Mild symptoms:137 (3.1%) patients had rapid improvement or mild stroke on emergency room, 3) Bleeding diathesis or non-adjustable hypertension: 53 (1.2%) patients showed a bleeding tendency or severe hypertension. Compared with the IVT group, the subgroups of non-IVT group showed consistently high mortality during short and long term follow up. Mild symptom and bleeding diathesis or non-adjustable hypertension subgroup in the non-IVT group consistently showed the higher mortality than time restriction subgroup during the short and long-term follow-up (log-rank p<.001). Patients who had rapid improvement or mild stroke on emergency department had the higher mortality than time restriction group in short and long term follow up.CONCLUSION: The AIS patients with rapid improvement or mild stroke on emergency room had higher mortality than ineligible patients of IVT due to time restriction during the short and long-term follow-up. A further management and special support on emergency department is needed for these patients with initially mild stroke and rapid improvement in AIS to reduce the poor outcome.
Disease Susceptibility ; Emergency Medical Services ; Emergency Service, Hospital ; Follow-Up Studies ; Hemorrhage ; Humans ; Hypertension ; Insurance, Health ; Mortality ; Prognosis ; Stroke ; Survival Rate ; Thrombolytic Therapy ; Tissue Plasminogen Activator

PURPOSE: Rebamipide is a propionic acid derivative that inhibits superoxide production and removes hydroxyl radicals. This study was performed to investigate the effects of adding rebamipide to semen, in an effort to determine if reactive oxygen species (ROS) production and lipid peroxidation of the sperm cell membrane as well as an improvement in seminal parameter and fertilizing capacity under oxidative stress was inhibited. MATERIALS AND MTHODS: Semen was collected from 30 normal healthy volunteers by masturbation after at least 48 hours abstinence. After liquefaction of the semen at room temperature, the prepared sperm was diluted with a sperm wash media to a uniform density of 20x106/ml. The semen was treated with 0.25ml of 0.2mM FeSO4 and 1mM sodium ascorbate for 60 min in the presence of various rebamipide concentrations (0, 10, 30, 100, and 300microM). ROS production, sperm motility, vitality, fertilizing capacity and the level of lipid peroxidation were analyzed by chemiluminescence, computer assisted semen analysis, eosin-nigrosin staining, a hypo-osmotic swelling test and the thiobarbituric acid method, respectively. RESULTS: Rebamipide at 100 and 300microM increased the sperm motility (p<0.05) but did not affect the sperm vitality. The ROS production and lipid peroxidation in the sperms treated with FeSO4/sodium ascorbate were inhibited by rebamipide in a dose-dependent fashion (p<0.05 in each). The total swelling rate of the hypo-osmotic swelling test was also increased by high rebamipide concentrations (100 and 300microM), respectively 49.2 17.9 and 50.8 21.7% (p<0.05). CONCLUSIONS: These results suggest rebamipide is an effective free radical scavenger and may be useful as an oral antioxidant in patients with male infertility due to increased ROS generation. However, further study to be possible the clinical use of rebamipide for improve the fertilizing capacity in male infertility is required.
Antioxidants* ; Ascorbic Acid ; Cell Membrane ; Diethylpropion ; Healthy Volunteers ; Humans* ; Infertility, Male ; Lipid Peroxidation ; Luminescence ; Male ; Masturbation ; Oxidative Stress ; Reactive Oxygen Species ; Semen Analysis ; Semen* ; Sperm Motility ; Spermatozoa ; Superoxides

PURPOSE: Rebamipide is a propionic acid derivative that inhibits superoxide production and removes hydroxyl radicals. This study was performed to investigate the effects of adding rebamipide to semen, in an effort to determine if reactive oxygen species (ROS) production and lipid peroxidation of the sperm cell membrane as well as an improvement in seminal parameter and fertilizing capacity under oxidative stress was inhibited. MATERIALS AND MTHODS: Semen was collected from 30 normal healthy volunteers by masturbation after at least 48 hours abstinence. After liquefaction of the semen at room temperature, the prepared sperm was diluted with a sperm wash media to a uniform density of 20x106/ml. The semen was treated with 0.25ml of 0.2mM FeSO4 and 1mM sodium ascorbate for 60 min in the presence of various rebamipide concentrations (0, 10, 30, 100, and 300microM). ROS production, sperm motility, vitality, fertilizing capacity and the level of lipid peroxidation were analyzed by chemiluminescence, computer assisted semen analysis, eosin-nigrosin staining, a hypo-osmotic swelling test and the thiobarbituric acid method, respectively. RESULTS: Rebamipide at 100 and 300microM increased the sperm motility (p<0.05) but did not affect the sperm vitality. The ROS production and lipid peroxidation in the sperms treated with FeSO4/sodium ascorbate were inhibited by rebamipide in a dose-dependent fashion (p<0.05 in each). The total swelling rate of the hypo-osmotic swelling test was also increased by high rebamipide concentrations (100 and 300microM), respectively 49.2 17.9 and 50.8 21.7% (p<0.05). CONCLUSIONS: These results suggest rebamipide is an effective free radical scavenger and may be useful as an oral antioxidant in patients with male infertility due to increased ROS generation. However, further study to be possible the clinical use of rebamipide for improve the fertilizing capacity in male infertility is required.
Antioxidants* ; Ascorbic Acid ; Cell Membrane ; Diethylpropion ; Healthy Volunteers ; Humans* ; Infertility, Male ; Lipid Peroxidation ; Luminescence ; Male ; Masturbation ; Oxidative Stress ; Reactive Oxygen Species ; Semen Analysis ; Semen* ; Sperm Motility ; Spermatozoa ; Superoxides

Neurofibromatosis type 1 is characterized by cutaneous neurofibromas and pigmented lesions of the skin called cafe au lait spots. Although neurofibromatosis type 1 represents a major risk factor for the development of malignancy, especially of nervous system tumors, malignant lymphoma rarely occurs in a patients with neurofibromatosis type 1. Recently, a 77-year-old woman with neurofibromatosis type 1 was diagnosed as non-Hodgkin's Lymphoma (diffuse large B cell). She had multiple cafe au lait spots, neurofibromas and right axillary lymph node enlargement. An abdominal CT scan demonstrated a left pelvic mass and para-aortic lymphadenopathy. Because non-Hodgkin's Lymphoma in a neurofibromatosis patient has never been reported in Korea, herein, we describe this case and include a review of the literature.
Aged ; Cafe-au-Lait Spots/complications/pathology ; Female ; Human ; Lung Neoplasms/*complications/pathology/radiography ; Lymphoma, Non-Hodgkin/*complications/pathology/radiography ; Neurofibromatosis 1/*complications/pathology/radiography ; Tomography, X-Ray Computed

BACKGROUND: The standard PCR with sequence-specific primers (SSP) is a widely used method of HLA-B27 typing in clinical practice. The aim of our study was to evaluate 2 Korean HLA-B27 kits with different real-time PCR chemistries. METHODS: To validate the accuracy of real-time PCR kits, we selected 28 HLA-B27-positive samples and 33 HLA-B27-negative samples with a wide range of different HLA-B specificities typed by standard PCR-SSP. The 2 real-time PCR kits used were the AccuPower(R) HLA-B27 real-time PCR kit (Bioneer, Korea) with TaqMan probes and the Real-Q(TM) HLA-B*27 detection kit (BioSewoom, Korea) with SYBR Green I dye for melting curve analysis. RESULTS: All 61 samples typed by PCR-SSP demonstrated a perfect concordance with the 2 real-time PCR assays. It was possible to clearly discriminate between HLA-B27-positive and -negative samples in both real-time assays. CONCLUSIONS: In summary, both real-time PCR assays for HLA-B27 were fast, reliable, well-adapted for routine laboratory testing, and attractive alternatives to the conventional PCR-SSP method.
HLA-B27 Antigen/*analysis ; Histocompatibility Testing/*methods ; Humans ; Organic Chemicals/chemistry ; Polymerase Chain Reaction ; Reagent Kits, Diagnostic ; Transition Temperature

PURPOSE: Epidural anesthesia(EPA) has been performed in various operations; however, it frequently induces postoperative voiding dysfunction. The frequency, duration and risk factors of voiding dysfunction occurring after EPA using long-acting anesthetics bupivacaine were evaluated. MATERIALS AND METHODS: 100 patients, who underwent orthopedic surgery (under knee, operation time Anesthesia, Epidural* ; Anesthetics ; Bupivacaine* ; Catheterization ; Catheters ; Humans ; Knee ; Male ; Orthopedics ; Postoperative Period ; Prospective Studies ; Residual Volume ; Risk Factors

PURPOSE: In the Spring 1995, there was an outbreak of adenoviral infection, which caused four death out of ten patients with adenoviral pneumonia in our hospital. Clinical courses of ten patients with severe pneumonia were similar each other, and two were confirmed as adenoviral pneumonia by postmortem autopsy. Although not proven, we believe eight patients had adenoviral pneumonia. Therefore, we report clinical features in ten cases of severe adenoviral pneumonia. METHODS: Two cases with adenoviral pneumonia and eight cases with presumed adenoviral pneumonia were admitted in this hospital from March to June, 1995. Age and sex distribution, clinical manifestations, laboratory data, chest X-ray findings were reviewed. RESULTS: They were young children between 4 to 25 months of age(mean 12.7+/-6.1 months), and male to female ratio was 9:1. They presented with abrupt fever, cough, tachypnea, and dyspnea. Mean duration of fever were 12.7+/-6.1 days. Crackles on auscultation were heard in all patients. Studies for Mycoplasma and Tuberculosis were all negative. Cultures of bacteria and fungi were negative, and they did not respond to the antibiotics. The chest X-ray revealed the diffuse lobar consolidation with varying amount of pleural effusions. The findings of pleural fluid showed characteristics of transudate with predominant monocyte. Eight of our severe adenoviral pneumonia patients were enjoying normal health previously. Only two patients had previous medical problems, one with chronic cytomegalovirus pneumonia and the other with neutropenia induced by phenobarbital. The course of illness suggests that the infection was hospital acquired and the final outcome was fatal. Three of them developed seizure with fever, five change of consciousness, four conjunctivitis, three otitis media, and two gastro-intestinal symptoms. Autopsy was done in two of four patients. Grossly, the lungs were heavy and dark- red in color. There were bilateral pneumonic consolidation with patchy areas of hemorrhage. Microscopically, severe necrotizing bronchitis and bronchiolitis with numerous intranuclear inclusion of Cowdry type A and B were found. Alveoli were edematous and filled with fibrinous exudate, and covered with hyaline membrane. Ultrastructurally, typical adenoviral particles showing hexagonal shape in paracrystalline array symmetry were found in the nucleus of aleveolar lining cells. CONCLUSIONS: Yet, occasionally, adenoviral infection becomes most aggressive form of pneumonia. We should consider adenoviral pneumonia when clinical findings of pneumonia are very similar with baterial pneumonia except poor response to broad spectrum antibiotics. There is no specific treatment for adenoviral infection. So, for prevention of adenoviral pneumonia, we recommend isolation in suspicious adenoviral infection.
Adenoviridae ; Anti-Bacterial Agents ; Auscultation ; Autopsy ; Bacteria ; Bronchiolitis ; Bronchitis ; Child ; Conjunctivitis ; Consciousness ; Cough ; Cytomegalovirus ; Dyspnea ; Exudates and Transudates ; Female ; Fever ; Fibrin ; Fungi ; Hemorrhage ; Humans ; Hyalin ; Intranuclear Inclusion Bodies ; Lung ; Male ; Membranes ; Monocytes ; Mycoplasma ; Neutropenia ; Otitis Media ; Phenobarbital ; Pleural Effusion ; Pneumonia* ; Respiratory Sounds ; Seizures ; Sex Distribution ; Tachypnea ; Thorax ; Tuberculosis

Transmission of animal scabies to human is probably rare because of the relative host specificity of the mites. However, recurrent exposure to animal scabies mites can produce troublesome and diagnostically puzzling lesions. We report herein on a human infestation of canine scabies and this occurred in a 26-year-old male who presented with a 4-month history of severe pruritic skin lesions. His puppy was diagnosed with scabies infestation by a veterinarian two months previously. Since that time, he no longer raised the puppy. Microscopic examination of a mineral oil preparation after scraping the papules revealed a mite. He was diagnosed with canine scabies.
Adult ; Animals ; Host Specificity ; Humans ; Male ; Mineral Oil ; Mites ; Scabies ; Skin ; Veterinarians