No abstract available.

Familial hemophagocytic lymphohistiocytosis (FHL) is a rare disease characterized by fever, hepatosplenomegaly, cytopenia and non-malignant lymphohistiocytic infiltration with hemophagocytosis in reticulendothelial organs. We experienced three cases of FHL in identical male twins and their younger brother who presented with fever and severe hepatosplenomegaly. Cytopenia, elevated serum transaminase and low serum albumin levels, hypertriglyceridemia were common laboratory findings of them. One of them showed markedly decreased phytohemagglutinin induced lymphocyte proliferation and reversed CD4/CD8 ratio (0.52) in flowcytometric lymphocyte subset analysis. Aspirate of bone marrow revealed typical features consistent with FHL in two of them. In spite of recent therapeutic approaches, none of them survived.
Bone Marrow ; Fever ; Humans ; Hypertriglyceridemia ; Lymphocyte Subsets ; Lymphocytes ; Lymphohistiocytosis, Hemophagocytic* ; Male ; Rare Diseases ; Serum Albumin ; Siblings

No abstract available.
Lymphangioma*

Adult ; Bicuspid ; Dental Arch ; Humans ; Maxilla ; Molar ; Osteotomy ; Palatal Expansion Technique ; Tooth

A clinical study was made of 14 cases of distal rectal cancer treated at the Department of Surgery, St. Mary's Hospital, Catholic University Medical College, from January 1995 to April 1996. The patients were treated in a modified Thomas Jefferson program and received high doses of preoperative radiation followed by a sphincter saving procedure. The results are as follows: 1) There were 5 male patients (35.7%) and 9 female patients(64.3%). There was also a large number of patients in their 50s and 60s. 2) The preoperative pathologic type was a moderately differentiated adenocarcinoma. 3) Rectal bleeding was the most common symptom, followed by tenesmus, constipation, anal pain, and a tarry stool. 4) At diagnosis, the Thomas Jefferson (T.J.) system was used for the clinical stage of the patients. The clinical stage of disease showed a preponderance of T.J. stage I (10 patients), T.J stage II, III, and IV occurred in 2, 1, and 1 patient, respectively. 5) The most common site was 0-3 cm above dentate line (8 patients), followed by 4-6 cm (5 patients) and > 7 cm (1 patient) above the dentate line. 6) The complications after preoperative radiation therapy were diarrhea (3 patients) and perianal dermatitis (5 patients). 7) After preoperative radiation therapy, one case showed pathologic complete remission. 8) The procedure was a Transanal Abdominal TransAnal proctosigmoidectomy and coloanal anastomosis (TATA) in 11 patients, a low anterior resection in 1 patient, an abdominal perineal resection in 1 patient, and a colostomy in 1 patient. 9) The pathologic stage showed a preponderance of Duke's B2 and B1; 5 were B2, 4 were B1, 3 were C2, 1 was D, and 1 was O. 10) The postoperative complications after colostomy repair in TATA were frequent defecation, tenesmus, anal pain at defecation, and rectovaginal fistulas which subsided 3 months after colostomy repair.
Adenocarcinoma ; Colostomy ; Constipation ; Defecation ; Dermatitis ; Diagnosis ; Diarrhea ; Female ; Hemorrhage ; Humans ; Male ; Postoperative Complications ; Rectal Neoplasms* ; Rectovaginal Fistula

A 38-year-old man, with recurrent oral ulcers for 10 years, was admitted because of recent aggravation of odynophagia and sore throat. About 4 years earlier, he had been performed abdominal surgery for intestinal perforation. Gastrofiberscopic examination showed small round ulcers at hypiopharynx and 6cm sized longitudinal linear ulcer at mid esophagus. Biopsy specimens at mid-esophagus showed chronic inflammation. Besides oral ulcer, he had perianal ulcers and skin rashes. He was managed with steroid, colchicine and sulfasalazine under the diagnosis of esophageal involvement in Behcet's disease. After 3 months from discharge, esophagogram and gastrofiberscopic examination showed some improved appearance, but symptoms recurred for steroid tapering. He has been followed in much improved status for 8 months after discharge.
Adult ; Biopsy ; Colchicine ; Diagnosis ; Esophagus ; Exanthema ; Humans ; Inflammation ; Intestinal Perforation ; Oral Ulcer ; Pharyngitis ; Sulfasalazine ; Ulcer*

OBJECTIVE: to investigate the effect of high glucose and spent peritoneal dialysate on the TGF-beta1 synthesis of cultured human peritoneal MC(HPMC); to examine the effect of costimulation with high glucose or dialysate and cytokines, interleukin-1beta(IL-1beta) and tumor necrosis factor-alpha(TNF-alpha), on transforming growth factor(TGF-beta1) synthesis of HPMC. DISIGN: HPMCs were exposed to different concentrations of glucose(30, 60 & 90 mM/L) or spent peritoneal dialysate for 48 hours in the absence or presence of IL-1beta(1ng/ml) and TNF-alpha(1ng/ml). TGF-beta1 mRNA expression was assessed by Northern blot analysis and TGF-beta1 protein synthesis and release by Western blot analysis with immunoprecipitation. RESULTS: Exposure of MC to high glucose condition(30mM, 60mM & 90mM of D- glucose) induced 2.3-, 3.6- and 4.0-fold increases in TGF-beta1 mRNA expression of MC with enhanced TGF-beta1 protein synthesis and secretion into the media. Incubation with spent dialysate also significantly increased TGF-beta1 mRNA expression & protein secretion compared to control media(P<0.05) Stimulation with IL-1beta(1ng/ml) or TNF-alpha(1ng/ml) significantly increased TGF-beta1 mRNA expression after 48 hours above the control level by 2.7-fold and 2.1-fold, respectively. However, TNF-alpha-induced increase in TGF-beta1 mRNA expression was not translated into TGF-beta1 protein secretion whereas IL-1beta stimulation induced a significant increase in TGF-beta1 protein secretion as well as TGF-beta1 mRNA expression. Combined stimulation of high glucose or spent dialysate together with IL-1beta or TNF-alpha showed a greater increase in TGF-beta1 mRNA expression and protein secretion compared to stimulation with high glucose or spent dialysate alone. CONCLUSION: Our results clearly show that high glucose concentration of peritoneal dialysate and spent dialysate themselves might be sufficient to stimulate the production of TGF-beta1 by peritoneal mesothelial cell. This state of chronic induction of TGF-beta1 is further exaggerated in the presence of peritonitis because of stimulatory effect of proinflammatory cytokines, resulting in the augmented TGF-beta1 synthesis, thus promoting peritoneal fibrosis.
Blotting, Northern ; Blotting, Western ; Cytokines ; Glucose ; Humans* ; Immunoprecipitation ; Necrosis ; Peritoneal Fibrosis ; Peritonitis ; RNA, Messenger ; Transforming Growth Factor beta1 ; Tumor Necrosis Factor-alpha

Aged ; Depression ; Esthetics ; Humans ; Mandible ; Nylons ; Orbit ; Physical Examination ; Polyethylene ; Proplast ; Silicones ; Surgery, Oral

BACKGROUND: Pharmacists could dispense medicines without doctors' prescription in Korea before July 2000. The aim of this study was to compare the prescription behaviors of practicing doctors and pharmacists to common cold by the simulated patients. We selected the common cold as a subject of simulation because it was the most frequent health problem to visit doctors and pharmacists and the abuse of antibiotics might be prevalent in management of it. METHODS: Seventy five private clinics and drug stores were selected in Seoul, Korea. The simulated patients were selected and trained standardized symptoms of common cold. The simulated patients recorded the prescription behaviors of doctors and pharmacists. RESULTS: Average number of prescribed medicines were 5.0 and 5.6 in clinic and drug store respectively. 54.7% of the clinics and 61.3% of the drug stores prescribed antibiotics respectively with no significant difference between them. The most frequently prescribed antibiotics were penicillines. About 7% of the doctors and 11% of the pharmacist prescribed glucocorticoid to simulated patients respectively. About 20% of the pharmacists performed some kinds of physical examination to the simulated patients. Both doctors and pharmacist gave little information or advice on use of medicines, possible side effects and past side effects of medicines. CONCLUSION: There were frequent abuse of antibiotics and occasional use of glucocorticoid in private clinics and drug stores. Both doctors and pharmacists did not give enough information on use of medicines to the simulated patients.
Anti-Bacterial Agents ; Common Cold* ; Humans ; Korea ; Patient Simulation ; Penicillins ; Pharmacists* ; Physical Examination ; Prescriptions* ; Seoul

BACKGROUND: Pharmacists could dispense medicines without doctors' prescription in Korea before July 2000. The aim of this study was to compare the prescription behaviors of practicing doctors and pharmacists to arthritis by the simulated patients. We selected the arthritis as a subject of simulation because the arthritis was one of the major health problem and the abuse of corticosteroids might be prevalent in management of arthritis patients. METHODS: Seventy five private clinics and drug stores were selected in Seoul, Korea. The simulated patients were selected and trained standardized symptoms of arthritis. The simulated patients recorded the prescription behaviors of doctors and pharmacists. RESULTS: Mean number of prescribed medicines were 3.6 and 4.4 in clinic and drug store respectively. 16.2% of the clinics and 25.3% of the drug stores prescribed corticosteroids respectively with no significant difference. 45.3% of the pharmacists prescribed more than two kinds of anti inflammatory or analgesics and it was significantly higher than those of doctors. 65.3% of doctors intended to prescribe parenteral injection and 40% of the pharmacists performed some kinds of physical examination to the simulated patients. Both doctors and pharmacist gave little information or advice on use of medicines, possible side effects and past side effects of medicines. CONCLUSION: There were frequent abuse of corticosteroids and analgesics in private clinics and drug stores. Both doctors and pharmacists did not give enough information on use of medicines to the simulated patients.
Adrenal Cortex Hormones ; Analgesics ; Arthritis* ; Humans ; Korea ; Patient Simulation ; Pharmacists* ; Physical Examination ; Prescriptions* ; Seoul