This study was undertaken to elucidate any quantitative abnormalities of Tlymphocyte subsets (helper/inducer T cell; T cell and suppressor/cytotoxic T cell: T cell) and IgE levels in the peripheraI blood in atopic dermatitis patients by using monoclonal antibodies and enzyme immunoassay, respectively. In addition we have tried to ascertain whether there are any correlations betveen such immuiiologic abnormalities and the severity of the disease. The results showed that there were significant decrease in the mean percentage of T Cells and increase in the mean value of T/T cell ratios in patients with atopic dermatitis. These changes seem to relate to the severity of the disease when evaluated as groups. A significant increase in the mean value of serum IgE was found in atopic dermatitis patients and the change was related to the severity of the disease. But increase of serum IgE level did not correlated closely with the T cell abnormalities in each patients.
Antibodies, Monoclonal ; Dermatitis, Atopic* ; Humans ; Immunoenzyme Techniques ; Immunoglobulin E* ; T-Lymphocyte Subsets* ; T-Lymphocytes

No abstract available.
Heart Rate* ; Heart* ; Shock, Hemorrhagic*

We experienced one case of severe pituitary dwarfism in a 10 years old female girl. Magnetic resonance image (MRI) revealed transection of the pituitary stalk stalk with the formation of high intensity ectopic posterior lobe located at the median eminence and agenesis of an anterior lobe of pituitary gland. The serum growth Hormone (GH) response to clonidine and L-dopa revealed severe GH deficiency. The patient had responses to TRH, normal TSH and partial prolactin response, respectively. There was not response LH and FSH to GnRH. The morning cortisol concentration and serum T4 concentration were decreased below the normal range. These findings and no hyperprolactinemia suggested the presence of a vascular connection between the pituitary gland and hypothalamus, which is not visible on MRI. Sofar, the primary cause of idiopathic pituitary dwarfism in many patients is injury to hypothalamus by perinatal insults. In this patient, there was no history of perinatal insults and postnatal head trauma but transection of the pituitary stalk. We report a case of severe pituitary dwarfism due to agenesis with brief review of related litereature.
Child ; Clonidine ; Craniocerebral Trauma ; Dwarfism, Pituitary* ; Female ; Gonadotropin-Releasing Hormone ; Growth Hormone ; Humans ; Hydrocortisone ; Hyperprolactinemia ; Hypothalamus ; Levodopa ; Magnetic Resonance Imaging ; Median Eminence ; Pituitary Gland* ; Pituitary Gland, Anterior* ; Prolactin ; Reference Values

Fifteen cases of genital warts were examined for the presence of human papillomavirus (HPV) using polymerise chain reaction (PCR). HPV6/11 DNA were found in all cases of genital warts. The PCR based methods described here provide a sensitive, accurate means of detecting genital HPVs.
Condylomata Acuminata ; DNA ; Humans* ; Papillomaviridae* ; Polymerase Chain Reaction*

PURPOSE: Renal infarction is one of the uncommon causes of acute abdominal pain, and it is often difficult to make a clinical diagnosis. This study was designed to investigate clinical predictors of the acute renal infarction and to suggest useful diagnostic tools to use in the emergency department(ED). METHODS: We reviewed medical records of the patients with a final diagnosis of acute renal infarction, which was confirmed by contrast-enhanced computed tomography (CT) scan or angiography of the abdomen between Jan. 1998 and Dec. 2000. RESULTS: Among 24 patients with acute nontraumatic renal infarction, 17 patients (71.0%) had a thromboembolic disease. A number of patients presented with nonspecific abdominal pain. 23 patients (95.8%) had elevated serum LDH after 24 hours of presention. On initial urinalysis, 75.0% of patients (18/24) showed hematuria. CONCLUSION: This study suggests that the patients with pain in the flank or the abdomen or the low back area should be performed a contrast-enhanced CT scan as soon as possible to rule out the possibility of acute renal infaction, especially when the patient has the high-risk triad of thromboembolism, elevated serum LDH, and hematuria.
Abdomen ; Abdominal Pain ; Angiography ; Diagnosis ; Emergencies* ; Emergency Service, Hospital* ; Hematuria ; Humans ; Infarction* ; Medical Records ; Thromboembolism ; Tomography, X-Ray Computed ; Urinalysis

Actinomycosis, in which the principal causative agent in man is known to Actinomyces israelii, is a chronic, suppurative diseases characterized by extensive fibrosis, multiple abscesses, and formation of sinus tracts that drain suppurative exudates. On the basis of the anatomical sites involved; it can be subclassified into the cervicofacial form, which is the most common form, pulmonary form and abdominal form. Kidneys are rarely affected. Clinically, radiologically, and at operation it is difficult to differentiate the renal actinomycosis from renal tuberculosis and renal carcinoma. The prognosis is excellent after nephrectomy followed by appropriate antibiotic therapy. We presented a case of renal actinomycosis with a brief review of the literatures.
Male ; Humans

Authors measured the bone marrow pressure(B.M.P.) of 59 femoral heads in cases of either suspicious or diagnosed osteonecrosis and obtained the significant relationship between increased B.M.P. and the osteonecrosis. Increased bone marrow pressure provided both predictive and early diagnostic importance in even the preclinical stage of evolution of the disease, which subsequently had core biopsy proved osteonecrosis of femoral head. The results obstained were as follows; 1. Roentgenographically apperent osteonecrosis showed abnormal B.M.P. pattern, which were proved by the core biopsy. 2. In 21 cases of preclinical osteonecrosis, which did not show roentgenographic changes of osteonecrosis, measured B.M.P. parterns indicated as early stage of osteonecrosis in core biopsy at all. 3. The incidence of abnormal pressure pattern I was 51% and that of pattern II was 30%. 4. Enneking radiological staging did not correlate with the results of B.M.P. 5. The measurement of B.M.P. is relatively easy and simple method without any remarkable risk. The results of this study had great meaning in emphasizing the contribution of the bone marrow pressure measurement dianosing the preclinical stage of osteonecrosis, which had no roentgenographical changes and diagnostic symptoms.
Biopsy ; Bone Marrow ; Head ; Incidence ; Methods ; Osteonecrosis

A rare case of giant invasive intraosseous schwannoma in lumbar vertebra with no neurologic deficit is reported. This tumor had vertebral body, left paravertebral tissue and lamina invasion and thus classified as type V giant invasive schwannoma according to Sridhar's classification of benign nerve sheath tumor. Because intraosseous portion was significantly larger than extraosseous portion, this tumor was mentioned as intraosseous schwannoma. Tumor was successfully resected using corpectomy, mesh cage insertion and posterior fixation. Pathological diagnosis was benign schwannoma.
Neurilemmoma ; Neurologic Manifestations ; Spine

IMR is useful for assessing the microvascular dysfunction after primary percutaneous coronary intervention (PCI). It remains unknown whether index of microcirculatory resistance (IMR) reflects the functional outcome in patients with anterior myocardial infarction (AMI) with or without microvascular obstruction (MO).This study was performed to evaluate the clinical value of the IMR for assessing myocardial injury and predicting microvascular functional recovery in patients with AMI undergoing primary PCI. We enrolled 34 patients with first anterior AMI. After successful primary PCI, the mean distal coronary artery pressure (Pa), coronary wedge pressure (Pcw), mean aortic pressure (Pa), mean transit time (Tmn), and IMR (Pd * hyperemic Tmn) were measured. The presence and extent of MO were measured using cardiac magnetic resonance image (MRI). All patients underwent follow-up echocardiography after 6 months. We divided the patients into two groups according to the existence of MO (present; n = 16, absent; n = 18) on MRI. The extent of MO correlated with IMR (r = 0.754; P < 0.001), Pcw (r = 0.404; P = 0.031), and Pcw/Pd of infarct-related arteries (r = 0.502; P = 0.016). The IMR was significantly correlated with the DeltaRegional wall motion score index (r = -0.61, P < 0.01) and DeltaLeft ventricular ejection fraction (r = -0.52, P < 0.01), implying a higher IMR is associated with worse functional improvement. Therefore, Intracoronary wedge pressures and IMR, as parameters for specific and quantitative assessment of coronary microvascular dysfunction, are reliable on-site predictors of short-term myocardial viability and Left ventricle functional recovery in patients undergoing primary PCI for AMI.
Adult ; Aged ; Aged, 80 and over ; Anterior Wall Myocardial Infarction/*physiopathology ; Arterial Pressure/physiology ; Coronary Occlusion/pathology ; Echocardiography ; Female ; Humans ; Magnetic Resonance Imaging ; Male ; Microcirculation/*physiology ; Middle Aged ; Percutaneous Coronary Intervention ; *Predictive Value of Tests ; Prospective Studies ; Recovery of Function ; Risk Factors

PURPOSE: The purpose of this study is to determine for upper abdominal pain, the accuracy of emergency abdominal ultrasonography (EAU) performed by emergency physicians with limited training. METHODS: Two PGY-3 emergency physicians, who had received 2 hours of hands-on training, including the normal anatomy of a biliary system, liver, kindney, spleen, and pancreas, and who had studied the pathologic findings for another month were the subjects of this study. They used a Sonosite 180 R to perform EAU on patients with upper abdominal pain within 2 months after training. We determined the agreement between the radiologist 's abdominal ultrasonography(RAU) and EAU by using Kappa statistics. RESULTS: A total of 59 patients were enrolled. The agreement between the EAU and the RAU findings was 0.97, 0.88, 0.79, 0.73, 0.62, and 0.57 for gall bladder (GB) distension, cholelithiasis, GB wall thickening, duct dilatation, choledocholithiasis, and pericholecystic fluid, respectively (p<0.05). CONCLUSION: The results of EAU, performed by emergency physician with limited training on patients suffering from upper abdominal pain had a significant agreement with the RAU. However, more educations and cautions are warranted for diagnosing pericholecystic fluid and choledocholithiasis.
Abdominal Pain ; Biliary Tract ; Choledocholithiasis ; Cholelithiasis ; Dilatation ; Emergencies* ; Humans ; Liver ; Pancreas ; Spleen ; Ultrasonography* ; Urinary Bladder