Abdominal actinomycosis is very rare infectious disease and seldom reported as a cause of abdominal mass. This disease is diagnosed by pathologic findings and culture result but it is very difficult to differentiate with other granulomatous illammatory disease, diverticular disease, malignancy, etc. The radiologic findings were non-specific and CT scan revealed the inflammatory mass with multiple small abscesses and fibrous change. The treatment of choice for actinomycosis is medical treatment with penicillin but surgical intervention may be needed when complication such as obstruction, fistula formation, abscess formation develop. We report a patient with abdominal actinomycosis that presented with transverse colonic obstruction and severe abdominal wall inflammation. This patient had no past operative history but got intrauterine contraceptive devices during last 10 years. We treated this patient by surgical resection and antibiotic therapy.
Abdominal Wall ; Abscess ; Actinomycosis* ; Colon* ; Colon, Transverse ; Communicable Diseases ; Fistula ; Humans ; Inflammation ; Intrauterine Devices ; Penicillins ; Tomography, X-Ray Computed

BACKGROUND: N-methyl-D-aspartate (NMDA) antagonists can be useful as preemptive analgesic agents and effective in reducing central sensitization. The purpose of this study was to evaluate the preemptive effect of intravenous (IV) ketamine on the behavioral responses between a pre- versus post-formalin test in a rat model. METHODS: Sprague-Dawley rats (250 - 300 g) were prepared with a PE-50 indwelling IV catheter to receive either saline or ketamine. Rats received ketamine 1 mg/kg intravenously through a catheter either 1 min before or 5 min after formalin. The formalin test was performed with 5% formalin 100nl. All rats were randomly divided into one of three groups; a control (n = 8), pre-treatment (n = 7), or post-treatment (n = 7) group. Pain related behaviors were quantified by counting the numbers of flinching of the injected paw for 60 minutes. RESULTS: Intraplantar formalin injection produced a biphasic (phase 1, 0 - 10 minutes; phase 2, 10 - 60 minutes after formalin injection) appearance of flinching behavior in the control, pre-treatment, and post- treatment groups. The pre-treatment group showed less flinching in phase 2 than the control group (P < 0.05), but the post-treatment group didn't. CONCLUSIONS: These results suggest that pre-treatment of IV ketamine 1 mg/kg showed a preemptive analgesic effect.
Analgesics ; Animals ; Catheters ; Central Nervous System Sensitization ; Formaldehyde* ; Ketamine* ; Models, Animal ; N-Methylaspartate ; Pain Measurement* ; Rats* ; Rats, Sprague-Dawley

BACKGROUND: N-methyl-D-aspartate (NMDA) antagonists can be useful as preemptive analgesic agents and effective in reducing established central sensitization. The purpose of this study was to evaluate the preemptive effect of intrathecal ketamine and compare the behavioral antinociceptive responses between pre- versus post-formalin ketamine administration in a rat pain model. METHODS: Sprague-Dawley rats (250 - 300 g) were prepared with a PE 10 indwelling intrathecal catheter to receive either saline (control) or ketamine. Rats received ketamine 100ng intrathecally through a catheter either 7 min before or 5 min after formalin. The formalin test was performed with 5% formalin 100nl. The control (n = 8), pre-treatment (n = 7), and post-treatment (n = 7) groups were studied. Pain related behaviors were quantified by counting the incidences of flinching of the formalin injected paw for 60 minutes. RESULTS: Intraplantar formalin injection produced a biphasic (phase 1, 0 - 10 minutes; phase 2, 10 - 60 minutes after formalin injection) response of flinching behavior in control, pre-treatment, and post-treatment groups. The post-treatment group showed less frequent phase 2 flinching than the control group (P < 0.05). CONCLUSIONS: Post-treatment of intrathecal ketamine 100ng was effective on inhibition of phase 2 nociceptive behaviors following the formalin injection. These results suggested that intrathecal ketamine shows an analgesic effect when administered as a post-treatment.
Analgesics ; Animals ; Catheters ; Central Nervous System Sensitization ; Formaldehyde* ; Incidence ; Ketamine* ; N-Methylaspartate ; Pain Measurement* ; Rats* ; Rats, Sprague-Dawley

PURPOSE: To evaluate the usefulness in diagnosing the gallbladder perforation MATERIALS AND METHODS: CT scans of surgically proved 11 cases of gallbladder perforation were retrospectively reviewed. CT findings analyzed were iuminal diameter of GB, GB wall thickness and configuration, presence or absence of fluid collection in the pericholecystic or intraperitoneal space, and observation of pericholecystic anatomic structures. All patients underwent cholecystectomy, and surgical findings were also compared. RESULTS: The GB was distended in 6 cases(55% with a range of 4.0-7.5cm, mean :5.2cm). GB wall was thickened in most cases(9/11,82%) with homogeneous(n=7) or inhomogeneous(n=2) enhancement. At the sites of perforation, focal defect or contour bulging was seen in the GB wall in 3 cases. in 2 cases with gangrene, GB wall showed loss of normal contour with mottled contrast enhancement. Pericholecystic or intraperitoneal fluid co11ection was noted in 9 cases(82%), especially in the region of perforation. In all cases, there was evidence of diffuse infiltration in the pericholecystic space, omenturn or mesentery. Other findings included cholecy-stoenteric fistula in 1 case, and intrahepatic or intraperitoneal abscess formation in 2 cases. CONCLUSION: CT is useful in correct diagnosis of gallbladder perforation.
Abscess ; Cholecystectomy ; Diagnosis ; Fistula ; Gallbladder* ; Gangrene ; Humans ; Mesentery ; Retrospective Studies ; Tomography, X-Ray Computed

BACKGROUND: Atopic asthma is characterized by activation of Th2-type T cells in the bronchial mucosa. Several reports have suggested an important role for costimulation through the CD28/CTLA4 (cytotoxic T lymphocyte-associated antigen 4)-B7 (CD80/CD86) pathway in allergen activation of T cells in animal models of allergen-induced asthma, because B7-CD28/ CTLA4 interaction can promote the differentiation and development of the Th2 lymphocyte subset. OBJECTIVE: In the present study, we intended to investigate a potential role of humanized CTLA4-Ig on the inhibition of T and B cell activation by blocking B7/CD28 interactions. METHOD: For this purpose we produced humanized CTLA4-Ig fusion protein by transfection to CHO cell and examined its inhibitory effects for activated T and B cell responses. We evaluated the inhibitory effect of MLR (mixed lymphocyte reaction) and con A-stimulated T cell proliferation. And we assayed wheather B cell was inhibited by stimulation of costimulatory signal in LPS-induced B cell response and PFC assay. RESULT: In vitro assay, humanized CTLA4-Ig fusion protein inhibited T cell-specific immune response in dose-dependent manner: CTLA4-Ig inhibited allogeneic stimulation in murine MLR, and the proliferation of T cell by the stimulation of Con A. But CTLA4-Ig did not inhibit directly the proliferative response of B cell by the stimulation of LPS. In addition, in vivo assay, CTLA4-Ig inhibited the production of antibody from B cell, which was presented by plaque-forming cell (PFC) assay. CONCLUSION: These findings suggest that humanized CTLA4-Ig is effective to inhibit the proliferation of activated T cell directly by blocking B7/CD28 costimulation. And humanized CTLA4-Ig influences antibody-producing capacity of B cell indirectly by regulating T cell.
Abatacept ; Animals ; Antibody Formation* ; Asthma ; Cell Proliferation ; CHO Cells ; Cricetinae ; Humans ; Lymphocyte Subsets ; Lymphocytes ; Models, Animal ; Mucous Membrane ; T-Lymphocytes ; Transfection

A 10-year-old boy with arteriovenous malformation (AVM) of the right lower limb was scheduled for an amputation of the affected limb. Limb amputation was necessary because of the ineffectiveness of previous sclerotherapy and the rapid progression of AVM causing pain and heart failure. Right hip disarticulation was considered the best option to improve his quality of life. To prevent congestive heart failure and uncontrollable hemorrhage during surgery, the disarticulation was done under a partial cardiopulmonary bypass. The patient underwent surgery successfully without complications.
Amputation ; Arteriovenous Malformations* ; Cardiopulmonary Bypass ; Child ; Disarticulation ; Extremities ; Heart Failure ; Hemorrhage ; Hip ; Humans ; Lower Extremity* ; Male ; Quality of Life ; Sclerotherapy

No abstract available.
Panax* ; Saponins* ; Water*

No abstract available.
Blepharophimosis* ; Humans

No abstract available.

Adenoid is a kind of tonsil located in the posterior wall of nasopharynx. Enlargement of the adenoid can produce obstruction of the nasopharynx and Eustachian tube. Disturbance in discharge of nasal and paranasal secretions can be a cause of chronic rhinitis, sinusitis, and otitis media. Diagnosis of enlarged adenoid simply by inspection is difficult due to its location. Measurement of nasopharyngeal airway and adenoid using lateral radiographs of nasopharynx may be inaccurate for magnification and rotation. It was some limitations in demonstrating the actual state of nasopharyngeal airway and adenoid because it gives only two-dimensional informations. The authors measured the sizes and areas of nasopharyngeal airway and adenoid using MRI with sagittal and oblique coronal pilot views of T1 weighted spin echo. We categorized the patients into 4 groups according to the scoring system by symptoms such as apnea, mouth breathing, and snoring. The results of several measurements and their ratios were evaluated in these 4 categorized patients. The ratios of area of adenoid and nasopharyngeal airway(AA/Na) in each patient group were 6.52, 7.76, 10.53, 15.93, respectively. And the ratios of adenoid and nasopharyngeal airway (A/N) by Fujioka's method were 0.6, 0.65, 0.69, 0.71, respectively. We found that AA/Na might be the most effective index as an objective indicator in the evaluation of nasopharyngeal obstruction by the enlarged adenoid.
Adenoids* ; Apnea ; Diagnosis ; Eustachian Tube ; Humans ; Magnetic Resonance Imaging* ; Methods ; Mouth Breathing ; Nasopharynx ; Otitis Media ; Palatine Tonsil ; Rhinitis ; Sinusitis ; Snoring