Chronic sclerosing sialadenitis, Mikulicz disease or Kuttner tumor has been recently recognized as a spectrum of IgG4-related sclerosing disease. IgG4-related disease is characterized by a high serum IgG4 level and tissue infiltration of IgG4-positive plasmacytes. We report three cases of chronic sclerosing sialadenitis with variably associated systemic involvement. All patients presented with a submandibular mass or swelling, and all the resected submandibular glands showed diffuse lymphocytic infiltration, lymphoid follicles, and septal fibrosis. Two of the specimens revealed numerous IgG-positive plasma cells, most of which were IgG4-positive on immunohistochemical staining. One of them was associated with dacryoadenitis and hypophysitis. The other patient had ureterorenal lesions. Immunohistochemical study was unavailable in remaining one case, but the histologic features along with elevated IgG level and associated pancreatitis supported the diagnosis. All patients received steroid therapy postoperatively and are doing well. Salivary gland involvement in IgG4-related fibrosclerosis should be recognized in systemic medical pathology.
Dacryocystitis ; Fibrosis ; Humans ; Immunoglobulin G ; Mikulicz' Disease ; Pancreatitis ; Plasma Cells ; Salivary Glands ; Sialadenitis ; Submandibular Gland

PURPOSE: An inexperienced mother depends on the recommendation by an experienced person on how to bring up her child. Therefore, we performed a study to evaluate the wrong methods of childcare and to establish effective childcare counselling. METHODS: Two thousand eighty questionnaires filled out by mothers who visited local pediatric clinics and medical centers in Chonbuk, from March 2001 to April 2001, were analyzed according to the distribution of location, age of infant, maternal age and the question of each field. RESULTS: Many mothers have been known to squeeze the breast causing hypertrophy of the neonate. Most infants are placed on their side or supine for sleep. The most common reason for stopping breast feeding was insufficient amount of breast milk. The appropriate age to start whole cow's milk is after the first year of life. The main food used for weaning was commercial baby food. The main oral hydration solution for diarrhea has been boiled water. The main reasons for using a pacifier were to help the mother. The most common reason to use herbs was for the prevention of disease. The use of infant walkers has been widespread among infants and young children. The most common reason was to keep the infant quiet and happy. Most mothers did not use car safety seats for young children. CONCLUSION: The findings of this study revealed that many mothers were misinformed concerning childcare, so pediatricians should make more efforts and perform more studies to establish rational methods of childcare.
Breast ; Breast Feeding ; Child ; Diarrhea ; Humans ; Hypertrophy ; Infant ; Infant Equipment ; Infant, Newborn ; Jeollabuk-do ; Maternal Age ; Milk ; Milk, Human ; Mothers ; Pacifiers ; Surveys and Questionnaires ; Water ; Weaning

Enteric duplications are uncommon congenital anomalies. Duplications of the stomach account for only 3.8% of gastrointestinal duplication. More particularly, duplications involving the pylorus are extremely rare. These are characterized by firm attachment to at least one point of the alimentary tract with a well developed coat of smooth muscle and mucous membrane. The most frequent presentation is an abdominal mass with vomiting, mainly discovered during the first year of life. We experienced a 24-day-old boy with non-bilous, non-projectile vomiting and palpable abdominal mass, clinically similar to hypertrophic pyloric stenosis. He was diagnosed as having gastropyloric duplication cyst by abdominal ultrasonography, upper gastrointestinal series and abdominal computerized tomography. Thus we report a newborn infant with gastric outlet obstruction secondary to a duplication of the pylorus which is a rare cause of gastric obstruction.
Gastric Outlet Obstruction ; Humans ; Infant, Newborn* ; Male ; Mucous Membrane ; Muscle, Smooth ; Pyloric Stenosis, Hypertrophic ; Pylorus* ; Stomach ; Ultrasonography ; Vomiting

Lipoid pneumonia is chronic, interstitial, proliferative inflammation resulting from aspiration of lipoid material. Mineral oil is a hydrocarbon that physicians often use to treat chronic constipation in children and adults. Mineral oil may not elicit a normal protective cough reflex and may impair mucociliary transport. We experienced a case of exogenous lipoid pneumonia caused by aspiration of mineral oil given as a laxatives confirmed by fiberoptic bronchoscopy with bronchoalveolar lavage and bronchial biopsy in a 9-month-old boy with chronic cough and radiologic evidence of parenchymal lung disease.We reported this case with a brief review of related literatures.
Adult ; Biopsy ; Bronchoalveolar Lavage ; Bronchoscopy ; Child ; Constipation ; Cough ; Humans ; Infant ; Inflammation ; Laxatives* ; Lung ; Male ; Mineral Oil ; Mucociliary Clearance ; Pneumonia* ; Reflex

No abstract available.
HLA-DR Antigens* ; Thyroid Gland* ; Thyroid Neoplasms*

BACKGROUND: A light plane of general anesthesia is chosen for fetal safety during a cesarean section. Therefore an experience of wakefulness and pain perception is not infrequent and can be distressful to patients. The electroencephalogram-derived bispectral index (BIS) is a promising new method to assess anesthetic adequacy. This study was designed to assess the adequacy of general anesthesia and to evaluate the usefulness of the BIS in monitoring the awareness during a cesarean section. METHODS: Twenty one parturients undergoing general anesthesia for an elective caesarean section were examined. Anesthesia was induced with 4 mg/kg thiopental and 1 mg/kg succinylcholine, and then followed with a mixture of 50% N2O, 50% O2 and 0.8% enflurane at a flow of 4 L/min. Before administration of succinylcholine, a tourniquet was applied to the free arm and inflated to 250 mmHg. Responsiveness to verbal commands using the Tunstall isolated forearm technique was detected and the BIS was monitored throughout the study period. RESULTS: The incidence of responsiveness to verbal commands were 33% at the time of skin incision and fetal delivery respectively. BIS values of response to commands were significantly higher than that of no respose at both time points (p < 0.05). Fisher's exact test suggested that the BIS value less than 75 was related to unresponsiveness to verbal commands at time of skin incision (p < 0.05) and the BIS less than 85 at fetal delivery (p < 0.05). CONCLSIONS: These results suggest that adequate anesthesia is not provided with a mixture of 50% N2O, 50% O2 and 0.8% enflurane at a flow of 4 L/min at the time of skin incision and fetal delivery. In addition BIS could be a predictor of awareness during cesarean section under general anesthesia.
Anesthesia ; Anesthesia, General* ; Arm ; Cesarean Section* ; Consciousness Monitors* ; Enflurane ; Female ; Forearm ; Humans ; Incidence ; Pain Perception ; Pregnancy ; Skin ; Succinylcholine ; Thiopental ; Tourniquets ; Wakefulness

The aim of this study is to analyze the current status and performance evaluation systems of faculty in Korean medical colleges and professional graduate medical schools (called medical schools). We developed a research tool based on previous studies and distributed it to 40 medical schools from July to October 2017. The response rate was 100%. We calculated the number of faculty members and analyzed the faculty evaluation systems and awareness according to national and private medical schools. As of 2017, the number of medical faculty in Korea was 11,111 (4,973 faculty were employed by their alma mater, which is 44.76% of the total), with non-medical doctor faculty accounting for 754 of the total. The medical schools reflect research achievements as most important for re-appointment and screening to promote faculty, and the area of education is secondary excepting clinical faculty of private medical schools. However, important issues in the faculty evaluation deal with the relevance of research achievement and the need for qualitative assessment. Some medical schools revised or have been revising the faculty evaluation system in areas such as minimum standards of education for promotion and separation of promotion and tenure review. Opening non-tenure track lines for faculty show positive effects such as increasing the number of positions for hire and easing the financial burdens of medical schools. Downfalls include inconsistencies between the responsibilities and actual practices of tenure not being available and the instability of faculty's status. In conclusion, medical schools need to prepare a faculty evaluation system that fits the position of faculty members and attempt to establish a reasonable compensation system.
Compensation and Redress ; Education ; Faculty, Medical ; Health Personnel ; Humans ; Korea ; Mass Screening ; Reward ; Schools, Medical ; Social Responsibility

Posterior reversible encephalopathy syndrome is a clinicoradiological syndrome characterized by a unique reversible pattern on imaging and total regression of clinical symptoms and signs. Hypertensive brainstem encephalopathy (HBE), a brainstem variant of posterior reversible encephalopathy syndrome, is rare. In addition, a concomitant occurrence of acute ischemic stroke and HBE is even more rare. We here report three patients with HBE accompanied by acute cerebral infarction detected by brain magnetic resonance imaging and the importance of initial blood pressure control.

A 48-year-old man came with a left-sided headache that was compatible with diagnostic criteria of cluster headache. Left oculomotor nerve palsy developed 2 weeks after headache onset. Magnetic resonance imaging showed wall thickening and enhancement by contrast material in the lateral aspect of the left cavernous sinus, consistent with a possible inflammatory lesion. The patient reported the almost complete remission of the pain and diplopia after steroid therapy. We speculate that Tolosa-Hunt syndrome should be included as a cause of cluster-like headaches.

BACKGROUND: Caveolin, a family of integral membrane proteins are a principal component of caveolae membranes. In this study, we investigated the effect of p38 kinase on differentiation and on inflammatory responses in sodium nitroprusside (SNP)- treated chondrocytes. METHODS: Rabbit articular chondrocytes were prepared from cartilage slices of 2-week-old New Zealand white rabbits by enzymatic digestion. SNP was used as a nitric oxide (NO) donor. In this experiments measuring SNP dose response, primary chondrocytes were treated with various concentrations of SNP for 24 h. The time course of the SNP response was determined by incubating cells with 1 mM SNP for the indicated time period (0~24 h). The cyclooxygenase-2 (COX-2) and type II collagen expression levels were determined by immunoblot analysis, and prostaglandin E2 (PGE2) assay was used to measure the COX-2 activity. The tyrosine phosphorylation of caveolin-1 was determined by immunoblot analysis and immunostaining. RESULTS: SNP treatment stimulated tyrosine phosphorylation of caveolin-1 and activation of p38 kinase. SNP additionally caused dedifferentiation and inflammatory response. We showed previously that SNP treatment stimulated activation of p38 kinase and ERK-1/-2. Inhibition of p38 kinase with SB203580 reduced caveolin-1 tyrosine phosphorylation and COX-2 expression but enhanced dedifferentiation, whereas inhibition of ERK with PD98059 did not affect caveolin-1 tyrosine phosphorylation levels, suggesting that ERK at least is not related to dedifferentiation and COX-2 expression through caveolin-1 tyrosine phosphorylation. CONCLUSION: Our results indicate that SNP in articular chondrocytes stimulates dedifferentiation and inflammatory response via p38 kinase signaling in association with caveolin-1 phosphorylation.
Cartilage ; Caveolae ; Caveolin 1 ; Chondrocytes* ; Collagen Type II ; Cyclooxygenase 2* ; Digestion ; Dinoprostone ; Humans ; Membrane Proteins ; Membranes ; Nitric Oxide ; Nitroprusside ; Phosphorylation ; Phosphotransferases* ; Rabbits ; Tissue Donors ; Tyrosine