Strongyloides stercoralis is a nematodes and is prevalent in the tropical regions. In Korea, 6 cases have been reported in which the parasites were identified in feces. We report a case of hyperinfection syndrome with Strongyloides stercoralis confirmed in the tissue sections. A 52-year-old woman was admitted to the hospital because of generalized edema and weakness. She received steroid therapy for 30 years because of rheumatoid arthritis. One year ago, generalized edema and dyspnea were developed and she was diagnosed as minimal change nephrotic syndrome for which she received cyclosporin. On admission, she complained of generalized weakness and edema, multiple arthralgia and abdominal discomfort with nausea. The white-cell count was 14,600 without eosinophilia. A stool specimen was negative for occult blood, ova or parasites. Right lower quadrant abdominal pain and tenderness were developed, and the exploratory laparotomy was done under the impression of the acute appendicitis. An appendectomy with a biopsy of mesenteric lymph nodes was performed. From the 5th day after operation, the patient began to complain of the abdominal pain and constipation. Under the impression of adhesion bad formation, the laparotomy was done and disclosed that the proximal ileum was markedly dilated. On jejunotomy, a great amount of formed stool and barium was noticed in the proximal portion of small bowel. The jejunal tissue was biopsied. Grossly, the appendix was unremarkable. Microscopically, the inflammatory reaction was nearly absent, but in serosa, minute granulomas were found which contain a part of the parasite. Same feature was noted in the mesenteric lymph node. The biopsied jejunum contains numerous adult female, filariform and rhabdidiform larvae and eggs in the mucosa, submucosa and muscle wall. Their morphology was compatible with Strongyloides stercoralis. The patient died 5 days later in the state of multiple organ failure.
Adult ; Male ; Female ; Humans ; Biopsy

No abstract available.
Ear, Middle*

No abstract available.
Hearing Loss* ; Hearing* ; Uveomeningoencephalitic Syndrome*

The retraction of anterior teeth could be performed more easier by inducing of skeletal anchorage system rather than by conventional method on orthodontic treatment. But, we wonder how effective the system draws well without anchorage loss and draws anterior teeth aside posteriorly, and if the system can reduce the time, in comparison with the anchorage of posterior teeth. For that reason we have studied on the subject of patients, who were required the maximum anchorage on orthodontic treatment and the cases without crowding. The subjects of the experimental group are 35 areas of 20 people who were inserted miniscrews after Mx or Mn 1st premolar extracted. Also, the subjects of the control group are 81 areas of 45 people who were not inserted miniscrews. Compared the anchorage loss of experimental group with control one, we could get the result that the anchorage loss of experimental group is 1.034+/-0.891mm and control group is 2.790+/-1.882mm(P<0.01). Compared the space closing time of experimental group with control one, we could get the result that the space closing time of experimental group is 369.40+/-110.81days and control group is 406.56+/-231.63days. But the result of comparing space closing time has no significance in statistics. We recognized that the experimental group is more faster than the control group in the canine retraction velocity from the result ; the speed of a experimental group has as much as 0.60+/-0.23mm/30days while the speed of a control group has 0.44+/-0.35mm/30days(P<0.05). So, we could convince that orthodontic miniscrew is used effectively in the cases required the maximum anchorage.
Bicuspid ; Crowding ; Humans ; Tooth*

We reviewed 48 skin bicpsies obtained from 48 patients with epidermal nevus during a 10 year period from January 1981 to December 1990. The results are summarized as follows : 1) Of our 48 patients, 23 were male and 25 were female, and male to female ratio was 1 to 1.1. 2) The average of the patients was 19.8 years at the time of diagnois. 3) Lesions were present at birth in 45.7 percent of patients, and most of the remainder de veloped in childhood. The mean age of onset was 7.7 years. 4) The clinical varieties of the nevi in 48 patients were classified according to caicegories of nevus verrucosus, including systematized epidermal nevus, nevu, unius lateris, ichthyosis hystrix, epidermal nevus syndrome and inflammatory linear veirucous epidermal nevus. The most common type was nevus verrucosus(88.6%). 5) A large variety of histopathologic changes can be seen in epidermal nevi. The most common histopathologic .ype was nonspecific(31.3%), follows by common(12.5%), epidermolytic hyperkertosis(12.5%), and acanthosis nigricans(10.4%). 6) The most commonly affected area was head and neck(48.5%) followed by trunk(28.6%), upper limb(11.4%) and lower limb(2.9%).
Age of Onset ; Female ; Head ; Humans ; Ichthyosis ; Male ; Nevus* ; Parturition ; Porcupines ; Skin

The facial patterns were expressed by the interrelation of variable factors such as heredity, function and environment. Such variable factors have an effect on the growth and development of maxillofacial bones. The malocclusions with skeletal discrepancies are caused by abnormal forms, sizes and positions of cranial base, maxilla and mandible. For the proper diagnosis and treatment planning, the analysis of such structures is necessary. Lateral cephalograms of 54 adults with class III malocclusion patients (test group) and 61 adults with normal occlusion (control group) were analyzed. Anteroposterior relations and sizes of cranial base, maxilla, mandible were estimated to compare with those of normal ones. In test group, the anterior cranial base length was within normal range, but posterior cranial base, maxilla and mandibular body were longer than those in control group, significantly. Based on the cranial base, the location of maxilla in test group was normal, but the location of mandible was more anterior than that in control. Based on the maxilla, the location of mandible was more anterior in test group than that in control. Both mandibular body and ramus anteroposterior lengths in test group were larger than those in control. Both mandibular plane angle and upper gonial angle were within normal range, but lower gonial angle was significantly high in test group.
Adult ; Diagnosis ; Growth and Development ; Heredity ; Humans ; Malocclusion ; Mandible* ; Maxilla* ; Reference Values ; Skull Base*

Rasmussen's encephalitis is a rare autoimmune disorder characterized by intractable epilepsy and progressive unilateral hemispheric dysfunction as well as mental deterioration. Although the disorder typically begins in childhood, a few cases have been reported with symptom onset in adulthood showing variable clinical characteristics. We report a 63-year-old woman with adult-onset partial seizure with intermittent secondary generalization, progressive right hemiparesis, and aphasia, who showed positive response to high-dose steroid and antiepileptic drugs.
Anticonvulsants ; Aphasia ; Encephalitis* ; Epilepsy ; Female ; Generalization (Psychology) ; Humans ; Middle Aged ; Paresis ; Seizures

Anatomical shape of the mandibular ramus, which includes the area from the rear of the mandibular second molar to the mandibular posterior border and from the mandibular sigmoid notch to the inferior mandibular border, must be carefully considered to perform orthognathic surgery. The locations of the lingula and mandibular foramen in medial side of mandibular ramus are one of the most important factors to decide the location of the horizontal medial osteotomy in sagittal split ramus osteotomy and to select the line of vertical osteotomy in intraoral vertical ramus osteotomy. Sixty-five different Korean human dry mandibles were surveyed. All mandible have permanent dentition including complete eruption of the mandibular second molar. The locations of the lingula and mandibular foramen in medial side of the ramus were identified and following results were obtained. Anterior ramal horizontal distance from lingula was 16.13+/-3.53mm(range:8.6~24.3mm), anterior ramal horizontal distance from mandibular foramen was 23.91+/-4.79mm(range: 14.1~39.7mm), horizontal width of mandibular foramen was 2.79+/-0.95mm(range: 1.5 ~6.1mm), height of lingula was 10.51+/-3.84mm(range: 3.1~22.4mm), vertical distance from sigmoid notch to lingula was 19.82+/-5.11mm(range: 9.1~35.3mm). From this study, the result could be used to select the location of osteotomy lines and to decide amount of periosteal elevation to avoid injury of neurovascular bundle, and to accomplish the appropriate split in Korean patients in mandibular orthognathic surgery.
Colon, Sigmoid ; Dentition, Permanent ; Humans ; Mandible ; Molar ; Orthognathic Surgery* ; Osteotomy ; Osteotomy, Sagittal Split Ramus

OBJECTIVE: To compare the safety and efficacy of intravaginally administered misoprostol (PGE1 analogue) versus intravenously administered oxytocin for labor induction at term. METHODS: Among 63 patients over 37 weeks, randomly selected 42 patients were vaginally administered 25 micro gram of misoprostol every 3 hours and the other 21 patients were intravenously administered every minute from 1 mIU/min to 10 mIU/min increasingly. RESULT: The average interval from initiation of induction to labor was notably shorter in oxytocin group than in misoprostol group (204.5+/-332.6 min versus 528.1+/-591.8 min, p<0.02). The average interval from initiation of induction to vaginal delivery was shorter in oxytocin group than in misoprostol group (414.4+/-309.4 min versus 528.1+/-519.8 min, P<0.01) and the difference has statistical meaning. Procedure of labor were divided by 3 stages. We checked the duration of each stage between the two comparative groups. 1st stage (242.7+/-150.14 min versus 605.5+/-805.8 min, P<0.05) 2nd stage (12.6+/-11.9 min versus 19.5+/-11.2 min, P<0.05) The stage duration of oxytocin group was shortened. There was no difference between two groups at the third stage. The incidence of tachysystole, hypertonics, hyperstimulation, meconium passage, abnormal fetal heart rate, fetal weight, apgar score, neonatal morbidity were not different between two group. CONCLUSION: Intravenously administered oxytocin was more effective in shortening labor time than intravaginally administered misoprostol in overall induction labor, but there was no notable difference in the effects on mothers and babies. Considering various situational factors, careful selection should be administered.
Apgar Score ; Female ; Fetal Weight ; Heart Rate, Fetal ; Humans ; Incidence ; Meconium ; Misoprostol* ; Mothers ; Oxytocin* ; Pregnancy

Pulmonary alveolar proteinosis (PAP) is a noninflammatory diffuse lung disease, characterized by a dense accumulation of lipoproteinaceous material within the alveoli, causing hypoxemia, restrictive lung disease, and abnormalities on chest radiograph. The etiology of PAP is uncertain and various forms, including idiopathic and disease secondary to dust or fume exposure. Bronchopulmonary lavage (BPL) is a safe and effective treatment in PAP, and a unique procedure which requires general anesthesia and separation of the lung with a double lumen endobronchial tube. We experienced anesthetic management of BPL for the successful treatment of a 33 years old female patient with PAP.
Adult ; Anesthesia, General ; Anoxia ; Bronchoalveolar Lavage* ; Dust ; Female ; Humans ; Lung ; Lung Diseases ; Pulmonary Alveolar Proteinosis* ; Radiography, Thoracic