Carp which receive intraperitoneal injections of sodium alginate show a high survival rate after being challenged with Edwardsiella tarda. To elucidate the immunoenhancement by sodium alginate, its effects on the non-specific defense system of carp were investigated. Sodium alginate had little influence either on the activity of the alternative complement pathway or on the phagocytic and respiratory burst activities of head kidney phagocytes (HKP), yet it greatly enhanced the migration of HKP to the peritoneal cavity (the site of injection) and concurrently elevated their phagocytic activity. The number of phagocytes mobilized by sodium alginate was 2 to 50 times greater than that by the well-known peritoneal exudate cell-eliciting agents when injected at the same dose. Accordingly, it is highly probable that the early elimination of challenge bacteria by such mobilized and activated phagocytes was responsible for the high survival rate of the alginateinjected fish. In chemotaxis assays, it was revealed that sodium alginate stimulated sorne leukocyte subpopulation (s) within the peritoneal cavity to produce and/or secrete chemotactic factor (s), while concurrently enhancing the sensitivity of HKP to the factor (s).
Bacteria ; Carps* ; Chemotaxis ; Complement Pathway, Alternative ; Edwardsiella tarda ; Exudates and Transudates ; Head Kidney ; Injections, Intraperitoneal ; Leukocytes ; Peritoneal Cavity ; Phagocytes ; Respiratory Burst ; Sodium* ; Survival Rate

Although osteltis fibrosa cystica was the clinical manifestation originally recognized as a feature of the primary hyperparathyroidism, its frequency in diagnosed cases currently has decreased. Affected patients are now being detected in earlier stages of the disease. We have experienced a case of primary hyperparathyroldism with the typical bony changes and the pathologic, subtrochanteric fracture of left femur. We have treated the fracture with Zickel nalling and parathyroidectomy was performed. Four months after the removal of parathyoid adenoma the fractured femur healed well.
Adenoma ; Femur ; Fractures, Spontaneous ; Humans ; Hyperparathyroidism, Primary ; Parathyroidectomy

The purpose of this study was to investigate the causes of food impaction and to explore solutions as well. For this study, 39 patients with food impaction wee selected. 77 contact areas in these patients were investigated mobility, tightness of contact area, gingival index, plaque index, attachment loss, alveolar bone loss, proximal caries, marginal ridge distance and occlusal relationships. The results were as follows ; 1. Teeth without distal support were found to be the most frequent site of food impaction (41.6%). Food impaction was found to be more frequent in the upper teeth (66.2%) than the lower teeth (33.8%). 2. Food impaction was found in tight contact cases (71.4%). Alveolar bone loss was not found in the early stage of food impaction (83.1%) 3. The distance between the marginal ridges of food impaction sites (mean=0.48mm) was shorter than that of the control group. (mean=0.77mm) (p<0.001) 4. In 18.2% of t he cases, proximal carries were found at the food impaction site. 5. Food impaction affected patient's occlusion with the following frequencies ; cusp to marginal ridge relationship (72.7%), cusp to fossa relationship (3.9%) and stepped relationship (23.4%).
Alveolar Bone Loss ; Humans ; Periodontal Index ; Tooth

No abstract available.
Arthroplasty* ; Arthroplasty, Replacement, Hip* ; Head* ; Hemiarthroplasty* ; Necrosis*

Voluntary habitual dislocation of the hip is very rarely reported in children, and only 13 cases have been reported in the literature. We add a new case in a 5 year old boy. The boy did not have previous history of trauma, skeletal and/or soft tissue anomalies, nor known connective disease. He was treated by intertrochanteric varusinward rotation osteotomy of the affected hip on February 25, 1985 and was followed until January 11, 1993. Postoperative convalescence was uneventfully successful, and the hip developed well without any obvious dysplasia at the latest follow-up.
Child ; Convalescence ; Dislocations ; Follow-Up Studies ; Hip Dislocation ; Hip ; Humans ; Male ; Osteotomy

We report two cases of malignant lymphoma of mucosa-associated lymphoid tissue arising in the conjunctiva. Case 1, an 18-year-old girl, showed her left lower conjunctival swelling for four months and Case 2, a 29-year-old man, showed similar lesions on both his eyes for one year. Histologically, both cases revealed monomorphous dense lymphoid infiltrates invading the overlying conjunctival epithelium with diffuse patterns. The infiltrates were composed of small lymphocytes admixed with centrocyte-like cells within the conjunctival epithelium and stroma in association with B-cell lineage. No relapse was noted during the period of about 1½ years follow-up in case 1 treated by local excision only and in the follow-up period of 2 months in case 2 treated by local excision and subsequent chemotherapy.
Adolescent ; Adult ; B-Lymphocytes ; Conjunctiva* ; Drug Therapy ; Epithelium ; Female ; Follow-Up Studies ; Humans ; Lymphocytes ; Lymphoid Tissue* ; Lymphoma* ; Recurrence

BACKGROUND: Fine Needle Aspiration Cytology (FNAC) is widely accepted as the most accurate procedure to differentiate malignant from benign thyroid nodules. It is a simple, safe, and inexpensive procedure, and the accuracy of FNAC is relatively high; however, its success usually depends upon the skill in using the aspiration technique and the experience and skill of the cytologist. The authors confirmed the diagnostic value of preoperative FNAC in differential diagnosis of thyroid nodules treated by the surgical resection. METHODS: Three hundred fifty specimens were taken in the Department of Surgery, Inje University College of Medicine, from July 1990 to June 1996. Fifty-one males and 299 females with ages ranging from 11 to 73 years were enrolled. The cytology of FNAC was compared to the final histologic diagnosis. RESULTS: The number of inadequate smears (or sampling error) was 15.7%. Preoperative cytologic diagnoses was consisted of 198 cases of benign disease (92 cases of nodular goiters, 96 cases of follicular lesion types III, and 10 cases of thyroiditis), 12 cases of highly suspicious malignant lesions (follicular lesions type II), and 85 cases of malignant disease (71 cases of papillary carcinomas and 14 cases of follicular lesions type I). Histologic diagnoses consisted of nodular goiters in 116 cases, adenomas in 66 cases, thyroiditis in 9 cases, papillary carcinomas in 84 cases, and follicular carcinomas in 20 cases. These results has an 84.6% sensitivity, a 95.2% specificity, a 15.3% false negative rate, and a 4.7% false positive rate. In the fifty-five cases of inadequate sampling, 13 cases (23.6%) were malignant lesions histologically. In the 16 cases proven as false negative, nine cases were papillary carcinomas, and 7 cases were follicular carcinomas histologically. Thirteen cases (16.1% of 27 cases of cystic lesions) of cystic nodules revealed malignant neoplasms histologically. CONCLUSION: FNAC is a single, useful diagnostic procedure for the initial screening for malignancy in thyroid nodules. Performing repeated aspiration in cystic nodules and clinically suspicious cases could reduce inadeguate sampling and the false negative rate.
Adenoma ; Biopsy, Fine-Needle* ; Carcinoma, Papillary ; Diagnosis ; Diagnosis, Differential* ; Female ; Goiter, Nodular ; Humans ; Male ; Mass Screening ; Sensitivity and Specificity ; Thyroid Gland* ; Thyroid Nodule* ; Thyroiditis

Limb salvage operation in primary malignant bone tumors is increasing recently, according to the improvement of diagnostic methods, surgical technique and adjuvant chemotherapy. The purpose of this study is to obtain the interim results of survival rate and the functional grade of the limb in primary malignant bone tumors treated by limb salvage operation. Between 1985 to 1993, 63 primary malignant bone tumors treated by limb salvage operations. Tumor prosthesis arthroplasty was performed in 49 patients, resection arthrodesis in 9 patients, and IM nailing with cement molding in 5 patients. Autoclave autograft was combined in 2 patients. Adjuvant chemotherapy and postoperative radiotherapy were performed in selected patients. The average follow-up period was 50 months(ranged 12 months to 116 months). In the cases of osteosarcoma, estimated survival rate was 61.9% based on Kaplan-Meier survival plot. In the parosteal sarcoma, the survival rate was 87.5% and 80% in chondrosarcoma patients. According to functional grading by Enneking, 66% was excellent, 20% was good, 11% was fair and one patients was poor. Complications occurred in 16 patients:wound infection was developed in 6 patients, local recurrence in 4, peroneal nerve palsy in 2 patients and femoral stem loosening in 2 patients. Fracture in resection arthrodesis and pulmonary metastasis were also occurred. Reoperation was performed in 10 patients at average 31 months after initial operation. Revision tumor persthesis arthroplasty was performed in one patient due to local recurrence and in 2 patients due to femoral stem loosening. Three amputations were done due to recurrence of tumor. IM nailing with cement molding was performed in one patient due to deep infection and repeated arthrodesis was done in a fracture patients. Scheduled custom-made tumor prosthesis arthroplasty was performed within a year in 2 patients treated with IM nailing with cement molding. In conclusion, with the careful preoperative assessment, adjuvant chemotherapy and skillful surgical technique, limb salvage operation would provide the primary malignant bone tumor patients for longer survival and better quality of life.
Amputation ; Arthrodesis ; Arthroplasty ; Autografts ; Chemotherapy, Adjuvant ; Chondrosarcoma ; Extremities ; Follow-Up Studies ; Fungi ; Humans ; Limb Salvage ; Neoplasm Metastasis ; Osteosarcoma ; Paralysis ; Peroneal Nerve ; Prostheses and Implants ; Quality of Life ; Radiotherapy ; Recurrence ; Reoperation ; Sarcoma ; Survival Rate

BACKGROUND: Improved diagnostic and therapeutic strategies for infective for infective endocarditis such as proposed diagnostic criteria, Duke criteria and echocardiography resulted to increased life-spans of patients. METHODS: Retrospective analysis of medical records including medical history, laboratory data such as echocardiographic data and blood culture, and clinical outcomes was done for 106 patients with clinical diagnosis of infective endocarditis at Seoul National University Hospital from January 1990 to May 2000. Then we analysed differences of clinical features between elderly patients aged > or =60-years and the adult patients aged <60-years with infective endocarditis. RESULTS: The elderly patients >or=60-year are cases of 14%(15/106) and the mean ages are 67+/-8 years in elderly patient, 38+/-12 years in the adults patients respectively. Valvular heart disease was the most common predisposing heart disease with 9 cases(40%) followed by prosthetic valve endocarditis 2 cases (13%) in elderly patients, and there was no significant difference of frequencies with adult patients (valvular heart diseases, 33%; prosthetic valvular heart diseases, 25%). Although culture positive rates were not different with two groups: 47%(7/15) in elderly patients and 45%(41/91) in adult patients, the most common pathogen was staphylococcal species in elderly patients(27%, 4/15) but streptococcus species, in the adult patients(25%, 26/106, p<0.05). The frequencies of embolic complication were not different between two groups(20%, 3/15 vs 22%, 20/91: Elderly vs adult, respectively), but congestive heart failure was more developed in elderly patients, 33%(5/15) than in adult patients, 10%(9/91, p<0.05). Surgical intervention was more required in the elderly(47%, 7/15) than in adult patients(22%, 20/91, p<0.05). Out of 106 patients, 11 died and the overall mortality was 10.4%(11/106). In-hospital death was more common in the elderly than in adult patients: 4 cases(27%) vs 8%(7/91), p<0.05. Determinants of in-hospital death were patients with 60 years of age and older, Staphylococcus aureus endocarditis, and the presence of congestive heart failure(p<0.05) in univariate analysis. CONCLUSION: Infective endocarditis in elderly patients(age> or =60) had more poor outcomes than adult patients(age<60) such as the development of congestive heart failure, the need of surgical intervention, and the high mortality rate.
Adult ; Aged* ; Diagnosis ; Echocardiography ; Endocarditis* ; Estrogens, Conjugated (USP) ; Heart ; Heart Diseases ; Heart Failure ; Heart Valve Diseases ; Humans ; Medical Records ; Mortality ; Retrospective Studies ; Seoul ; Staphylococcus aureus ; Streptococcus

BACKGROUND: There are many rating scales for assessment of geriatrics. But each of these scales were not sufficient to evaluate comprehensive geriatric assessment, physical and psychologic efforts for care. METHODS: We developed new scales to comprehensive geriatric assessment for care of geriatric patients. The Geriatrics Physical Support Scale(GPSS) evaluates physical effort consists of 10 areas and the Geriatrics Global Support Scale(GGSS) evaluates general condition of patients consist of 6 areas. Eighty probable and possible AD patients received the Clinical Dementia Rating Rating Scale(CDR), Korearn version of Mini-Mental State Examination(K-MMSE), Barthel Activity of Daily Living Index(B-ADL) GPSS, GGSS. We tested internal consistency, correlation among dementia rating scales. RESULTS: The GPSS correlated to CDR -0.63(p<0.01), B-ADL -0.90(p<0.01) and the GGSS correlated to CDR -0.60(p<0.01), B-ADL -0.75(p<0.01). The internal consistency were 0.69(GGSS), 0.92(GPSS). CONCLUSION: The Geriatrics Global Support Scale evaluate general condition of patients and the Geriatrics Physical Support Scale evaluate physical efforts needed for care of geriatric patients. These scales an also brief and easy rating scales to grade degree of caregiver`s burden.
Dementia ; Geriatric Assessment ; Geriatrics* ; Humans ; Physical Exertion ; Reproducibility of Results* ; Weights and Measures