Gastrointestinal cytomegalovirus(CMV) infection in adults is observed as a part of a generalized or localized infection in patients who are immunocompromized. We report a case of CMV infection of the small intestine. The patient is a 34 year-old woman who has complained of palpable purpura in the lower extremities and buttocks, and arthralgia of large joints. The skin biopsy showed fibrinoid necrosis and neutrophils with leukocytoclasis, which findings are compatible with hypersensitivity angiitis. The patient received steroid and cyclophosphamide. During the follow-up period, generalized edema and bloody stool were detected. Resected specimen of small bowel has multiple aphthous ulcer. Microscopically, cytomegalic cells are observed along the endothelial cells and mesenchymal cells. In situ hybridization using DNA probes against CMV revealed positive staining in the cytomegalic inclusions in vascular endothelial and mesenchymal cells.
Adult ; Male ; Female ; Humans ; Biopsy

No abstract available.
Animals ; Gonadotropin-Releasing Hormone* ; Rats*

Compliance of epileptic patients is one of the most important factors for adequate therapy. Recently, it had been shown that the variability of three serial measurement of the serum levels of antiepileptic drug(AED) may be used as an indication of the degree of compliance. Coefficient variation(CV) of serum drug levels calculated by only one AED had been used to determine the compliance in epileptic patients who took multiple AEDs. We attempted to evaluate the CV of AEDs and then find the objective clue of compliance and the compatible therapeutic planing according to CV. Ninety seven epileptic patients of outpatients department of the Gyengsang National University Hospital were entered to this study. All patients were taking medication at least for 6 months without any changes of drug regimen. Patient's information was acquired by reviewing the chart and interview with questionnaire. With these informations, we determined the compliance of the patients. Antiepileptic serum levels were measured three times at intervals of at least two to four weeks apart, and their CV was calculated. We compared the CV between the compliant and non-compliant group in each AED(phenytoin, carbamazepine , valproic acid) and three drugs in the compliant group. The mean CVs of phenytoin, carbamazepine and valproic acid in the compliant group were 18.3+/-13.0, 15.2+/-10.2 and 23.8+/-8.9, respectively(mean+/-SD). The mean of CV in the compliant and the non-compliant group were 17.9+/-10.9 and 38.8+/-27.2, respectively. The CVs of the compliant group were significantly lower than those of the non-compliant group(p<0.05). However, CVs had no significant difference between three antiepileptic drugs. This study showed that CVs of AEDs were not different between each AEDs, even though they possess different pharmacokinetic properties. Therefore, the CV of one AED can be used in determining the compliance of the epileptics who are taking multiple AEDs.
Anticonvulsants ; Carbamazepine* ; Compliance ; Humans ; Outpatients ; Phenytoin* ; Surveys and Questionnaires ; Valproic Acid*

A 73-year-old male presented with a rare dorsally sequestrated lumbar disc herniation manifesting as severe radiating pain in both leg, progressively worsening weakness in both lower extremities, and urinary incontinence, suggesting cauda equina syndrome. Magnetic resonance imaging suggested the sequestrated disc fragment located in the extradural space at the L4-L5 level had surrounded and compressed the dural sac from the lateral to dorsal sides. A bilateral decompressive laminectomy was performed under an operating microscope. A large extruded disc was found to have migrated from the ventral aspect, around the thecal sac, and into the dorsal aspect, which compressed the sac to the right. After removal of the disc fragment, his sciatica was relieved and the patient felt strength of lower extremity improved.
Aged ; Cauda Equina ; Humans ; Laminectomy ; Leg ; Lower Extremity ; Magnetic Resonance Imaging ; Male ; Polyradiculopathy ; Sciatica ; Urinary Incontinence

Interpositionally grafted arteries and veins were expanded with a 20cc tissue expanders in 50 Sprague-Dawley rats. The grafts were done on both hind legs, one side was expanded and the remaining side was used as control. The average gain in length of expanded grafted arteries and veins was over 4 and 6 times that of the controls respectively. The differences in the patency rates between expanded and control grafts were not statistically significant. Histologic examination revealed that there were no changes in the areas of the media and lengths of the inner elastic laminae of the expanded arterial grafts. In both expanded and control vein grafts, marked intimal thickening was noticed, although these changes were not statistically significant. Expansion of grafted vessels can be safely carried out without loss of vessel patency. Tissue expander, grafted vessels
Animal ; Femoral Artery/*anatomy and histology/transplantation ; Male ; Rats ; Rats, Inbred Strains ; *Tissue Expanders ; Vascular Patency ; Veins/*anatomy and histology/transplantation

Interpositionally grafted arteries and veins were expanded with a 20cc tissue expanders in 50 Sprague-Dawley rats. The grafts were done on both hind legs, one side was expanded and the remaining side was used as control. The average gain in length of expanded grafted arteries and veins was over 4 and 6 times that of the controls respectively. The differences in the patency rates between expanded and control grafts were not statistically significant. Histologic examination revealed that there were no changes in the areas of the media and lengths of the inner elastic laminae of the expanded arterial grafts. In both expanded and control vein grafts, marked intimal thickening was noticed, although these changes were not statistically significant. Expansion of grafted vessels can be safely carried out without loss of vessel patency. Tissue expander, grafted vessels
Animal ; Femoral Artery/*anatomy and histology/transplantation ; Male ; Rats ; Rats, Inbred Strains ; *Tissue Expanders ; Vascular Patency ; Veins/*anatomy and histology/transplantation

PURPOSE: To evaluate the results of anterolateral thigh perforator free flap for reconstruction of foot and ankle in old diabetic patients. MATERIALS AND METHODS: Fifteen diabetic foot ulcer patients over the age of 55 were operated with anterolateral thigh perforator free flap. Hematological, hemodynamic, diabetic, bacteriologic and radiologic tests were checked with examination of blood vessel state in both the donor site and the recipient site. After surgery, serial check-up was performed at 6 week, 6 month, and 1 year postoperatively on the survival of transplantation tissue, condition of foot, and condition of walking. RESULTS: There are one case of transplantation failure and four cases of partial tissue-necrosis. Delayed wound-healing was observed both recipient and donor tissue sites. At the final follow up, three cases of small ulcer were found at junction of flap and recipient tissue in plantar area. Fourteen out of fifteen patients could walk without any brace or walking aids. CONCLUSION: Reconstruction of foot and ankle region in old diabetic patients with the anterolateral thigh perforator free flap is a useful method which can prevent the amputation of foot and ankle
Aged ; Amputation ; Animals ; Ankle ; Blood Vessels ; Braces ; Diabetic Foot ; Follow-Up Studies ; Foot ; Free Tissue Flaps ; Glycosaminoglycans ; Hemodynamics ; Humans ; Thigh ; Tissue Donors ; Transplants ; Ulcer ; Walking

Vaccination is considered a frequently used tool to prevent and control foot-and-mouth disease (FMD). However, the effectiveness of conventional FMD virus (FMDV) vaccines in pigs has been controversial because the massive prophylactic vaccination could not elicit proper immune response nor prevent the broad spread of FMD outbreak, mainly in pig farms, in South Korea during outbreaks of 2014. In addition, there has been little information on the efficacy of inactivated, high potency, multivalent, oil-based FMDV vaccine in pigs, because an evaluation of FMDV vaccines had been mainly carried out using cattle. In this study, we evaluated the genetic identification of commercial inactivated FMDV vaccine and monitored the immune responses in pigs under the field condition. Results implied that it contained three different serotypes with a high level of antigen payload. However, serological results showed low mean percentage of inhibition, and positive rate reached its peak at 6-week post-vaccination, indicating current FMDV vaccine need to improve for a prophylactic vaccination policy in pigs. Therefore, there is an imperative need to develop FMDV vaccine that can provide rapid and long-lasting protective immunity in pigs.
Agriculture ; Animals ; Antibody Formation ; Cattle ; Disease Outbreaks ; Foot-and-Mouth Disease Virus* ; Foot-and-Mouth Disease* ; Korea ; Real-Time Polymerase Chain Reaction ; Serogroup ; Swine* ; Vaccination ; Vaccines

OBJECTIVE: To determine the optimal scan timing for contrast-enhanced magnetic resonance angiography and to evaluate a new timing method based on the arteriovenous circulation time. MATERIALS AND METHODS: Eighty-nine contrast-enhanced magnetic resonance angiographic examinations were performed mainly in the extremities. A 1.5T scanner with a 3-D turbo-FLASH sequence was used, and during each study, two consecutive arterial phases and one venous phase were acquired. Scan delay time was calculated from the time-intensity curve by the traditional (n = 48) and/or the new (n = 41) method. This latter was based on arteriovenous circulation time rather than peak arterial enhancement time, as used in the traditional method. The numbers of first-phase images showing a properly enhanced arterial phase were compared between the two methods. RESULTS: Mean scan delay time was 5.4 sec longer with the new method than with the traditional. Properly enhanced first-phase images were found in 65% of cases (31/48) using the traditional timing method, and 95% (39/41) using the new method. When cases in which there was mismatch between the target vessel and the time-intensity curve acquisition site are excluded, erroneous acquisition occurred in seven cases with the traditional method, but in none with the new method. CONCLUSION: The calculation of scan delay time on the basis of arteriovenous circulation time provides better timing for arterial phase acquisition than the traditional method.
*Contrast Media ; Female ; Gadolinium DTPA/*diagnostic use ; Human ; Image Processing, Computer-Assisted ; Injections, Intravenous ; Magnetic Resonance Angiography/*methods ; Male ; Middle Age ; Time Factors

PURPOSE: To construct a useful index for use as a prognostic factor in cases of aortic aneurysm. MATERIALS AND METHODS: Using CT or EBT, we studied nine ruptured aortic aneurysms, 40 unruptured aneurysms, and 42 normalaortas, measuring aortic diameter and wall thickness. Systolic, mean or diastolic blood pressure was used as apressure parameter. Tangential stress(TS) and the tangential stress index ( TSI) were calculated by modified Laplace's law. RESULTS: Average diastolic TS's (TSI's) were 1938 (4.13), 905 (1.84) and 554 (0.94) in rupturedaneurysm, unruptured aneurysm and normal groups, respectively (p<0.01). ROC curves of diastolic TS and TSI wereseen in a "useful study" zone. With a threshold of 1230 (2.90) for TS (TSI), the sensitivity and thespecificity for differentiation of ruptured and unruptured aneurysms were 100% (100%) and 75% (88%), and thepositive and the negative predictive values were 47% (64%) and 100% (100%), respectively (p<0.01). Amongsystolic, mean and diastolic TS 's and TS I 's, the diastolic TSI showed the highest specificity at its maximalsensitivity. CONCLUSION: Diastolic TSI is a more accurate prognostic factor for aortic aneurysm.
Aneurysm ; Aortic Aneurysm* ; Aortic Rupture ; Blood Pressure ; Jurisprudence ; ROC Curve ; Sensitivity and Specificity