Graves disease occur in association with myasthenia gravis is rare. We report a case of Graves disease and myasthenia gravis treated by bilateral subtotal thyroidectomy and total thymectomy simultaneously. A 37 year old woman was admitted with anterior neck mass and ptosis. Various examinations were compatible with combined Graves disease and myasthenia gravis. The bilateral subtotal thyroidectomy and total thymectomy were done simultaneously. The pathologic diagnosis was Graves disease and thymic hyperplasia. The patients postoperative course was uneventful. The thyroid function of patient became euthyroid and the clinical symptoms related with myastenia gravis resolved during follow up period.
Adult ; Diagnosis ; Female ; Follow-Up Studies ; Graves Disease* ; Humans ; Myasthenia Gravis* ; Neck ; Thymectomy* ; Thymus Hyperplasia ; Thyroid Gland ; Thyroidectomy*

BACKGROUND: Bacteriokiller system(BKS) produces disinfectant which is generated by the mixture of active oxygen and hypochlorous acid with tap water. Previous studies showed that BKS disinfectant is highly bacteridal against clinical isolates in in vitro testings and more effective than general soap and water for the disinfecttion of contaminated handa. This study was performed to evaluate ling-trem effects of BKS as a handwasing agent in clinical settings. METHODS: Five BKS were installed for the 9-month period from June 1995 to February 1996 in 16-bed Neurosurgery Intensive Care Unit. Handwashing was frequency was observed after 1, 6, and 8 month of BKS use. Six-month incidences of nosocomial infecrion before and after BKS installation were compared to evaluate the possible effect of handwashings on nosocomial infection rates. A self-administered questionaire was used to collect data on handwashing frequency and their opinions of the BKS disinfectant at 2 and 8 months after the installation. RESULTS: Handwashing frequency of healthcare workers(HCWs) before and after patient contacts was increased from 34.1%(137/402) to 50.3%(193/384) (p<0.00001). At the same time, the 6-month nosocomial infection rate was down to 10.5%(43/411) from the pre-BKS rate of 13.0%( 51/431) and the patient-day rate was also decreased from 18.3(56/3068) to 15.1(43/2,844). Most (80.5%) of HCWs thought that BKS promote handwashing and "convenience" was the main reason for more frequent handwashing. Ninety three percent of HCWs would recommend the replacement of tne existing sinks and handwashing disinfectants with BKS. NO adverse skin reaction were reported after 8 months. Conclusions: BKS appears to promote handwashing because it is easy to use with no skin irritation and may contribute toward the prevention of nosocomial infections.
Cross Infection ; Delivery of Health Care ; Disinfectants ; Hand Disinfection ; Humans ; Hypochlorous Acid ; Incidence ; Intensive Care Units ; Neurosurgery ; Reactive Oxygen Species ; Skin ; Soaps

Tumor necrosis factor-n (TNF - alpha) involved in the pathogenesis of multiple sclerosis and contribute to the degeneration of oligodendrocytes as well as neurons. TNF - alpha is produced by miocroglia and astrocytes, which also produce hormones and cytokines that influence its biological activity. Astrocytes, the major glial cells in the CNS, are capable of producing TNF - alpha at both the mRNA and protein levels in response to interleukine-1 (IL-1) or TNF - alpha. Two immunosuppressive cytokines, transforming growth factor - beta (TGF - beta) and IL-10, have been shown to influence glial cell function. TGF - beta can modulate the activity of glial cells by inhibiting interferon-gamma (IFN - gamma) induced expression of class II major histocompatibility complex (MHC) molecules on astrocytes and microglia. To explore the role of astrocytes in the production of TNF - alpha, astrocytes were pretreated with IL-10 or TGF - beta and then stimulated with IL-1p to determine their effects on TNF - alpha production. The secretion of TNF - alpha by human fetal astrocytes was markedly inhibited by TGF - beta at a low concentration. In contrast IL-10 had no effect on TNF - alpha mRNA level. These results show that TGF - beta may regulate the expression of TNF - alpha in activated human fetal astrocytes.
Astrocytes* ; Cytokines ; Gene Expression* ; Humans* ; Interferon-gamma ; Interleukin-10 ; Major Histocompatibility Complex ; Microglia ; Multiple Sclerosis ; Necrosis ; Neuroglia ; Neurons ; Oligodendroglia ; RNA, Messenger ; Transforming Growth Factors

No abstract available.
Child* ; Humans ; Hypercalciuria*

Coronary artery fistula is an unusual anomaly in elderly patients that consists of a communication bet- ween one of the coronary arteries and other cardiac chambers or veins. It causes many cardiac compli- cations due to hemodynamic changes, and thus has recognized its clinical significance. It occurs usually in congenital origin, but also occurs secondarily in traumatic or neoplastic or artherosclerotic coronary diseases. Congenital coronary artery fistula is a very rare congenital anomaly that results in multiple hemodynamic complications. It has reported rarely in elderly patients, that induces myocardial ischemia due to coronary steal syndrome and heart failure that caused by diastolic volume overload via a left to left shunt. We observed a 68-year-old male patient with exertional chest pain and dyspnea, in whom selective coronary angiography revealed abnormal reticular communication between left anterior descending artery and left circumflex artery and drained to left ventricle through multiple microfistulous channels. We report this patient case who complicated by myocardial ischemia and left ventricular failure those caused by hemodynamic complication due to multiple coronary artery-left ventricular fistulae.
Aged ; Arteries ; Cations ; Chest Pain ; Coronary Angiography ; Coronary Disease ; Coronary Vessels ; Dyspnea ; Fistula ; Heart Failure* ; Heart Ventricles ; Heart* ; Hemodynamics ; Humans ; Male ; Myocardial Ischemia ; Veins

Coronary artery fistula is an unusual anomaly in elderly patients that consists of a communication bet- ween one of the coronary arteries and other cardiac chambers or veins. It causes many cardiac compli- cations due to hemodynamic changes, and thus has recognized its clinical significance. It occurs usually in congenital origin, but also occurs secondarily in traumatic or neoplastic or artherosclerotic coronary diseases. Congenital coronary artery fistula is a very rare congenital anomaly that results in multiple hemodynamic complications. It has reported rarely in elderly patients, that induces myocardial ischemia due to coronary steal syndrome and heart failure that caused by diastolic volume overload via a left to left shunt. We observed a 68-year-old male patient with exertional chest pain and dyspnea, in whom selective coronary angiography revealed abnormal reticular communication between left anterior descending artery and left circumflex artery and drained to left ventricle through multiple microfistulous channels. We report this patient case who complicated by myocardial ischemia and left ventricular failure those caused by hemodynamic complication due to multiple coronary artery-left ventricular fistulae.
Aged ; Arteries ; Cations ; Chest Pain ; Coronary Angiography ; Coronary Disease ; Coronary Vessels ; Dyspnea ; Fistula ; Heart Failure* ; Heart Ventricles ; Heart* ; Hemodynamics ; Humans ; Male ; Myocardial Ischemia ; Veins

In our preliminary study to find antiviral or antitumor agents from Korean natural products, we found that the Shope fibroma virus (SFV) induced fibromas reaching maximum size at 5~6 days with spontaneous disappearance at 15~20 days after SFV intracutaneous inoculation into Korean domestic rabbits. However, the sizes of fibromas of rabbits at day 5 after virus inoculation were significantly different individually. Assuming that the variation of tumor size was due to either susceptibility or the preexisting antibodies against SFV in the Korean domestic rabbits, the rabbits were checked for the antibodies against SFV by IFAT using SFV infected RKl3 cells. The antibody positive rate of normal Korean domestic rabbits was 32.8% and the sizes of the fibromas of the positive rabbits were significantly smaller than those of negative rabbits (p<0.0001). The fibroma sizes were dependent on the antibody titers of rabbits to SFV. The sizes of fibromas after inoculation of SFV into immunized rabbits were about one tenth of those by the first inoculation into normal rabbits. This is the first report on the antibody prevalence against SFV among normal Korean domestic rabbits and it suggest the existence of a wild fibroma virus or related virus in Korea.
Antibodies* ; Antineoplastic Agents ; Biological Products ; Fibroma Virus, Rabbit* ; Fibroma* ; Korea ; Prevalence ; Rabbits* ; Tumor Virus Infections*

No abstract available.
Astrocytes* ; Gene Expression* ; Humans* ; Polymerase Chain Reaction*

No abstract available.
Astrocytes* ; Humans*

OBJECTIVE: The aim of the present study was to evaluate the E-cadherin expression in normal cervical epithelium, carcinoma in situ of the cervix, and invasive carcinoma of the cervix, and to define the role of E-cadlherin expression in tumor invasion with respect to clinicopathologic parameters. METHODS: We conducted immunodetection of E-cadherin in 58 cases of cervical carcinoma using immunohistochemistry in formalin-fixed, paraffin-embbeded sections, RUSULTS: E-cadherin expression was different between normal cervical epithelium and carcinoma in situ of the cervix, and between normal cervical epithelium and invasive carcinoma of the cervix(p<0.05). However, there was no difference in E-cadherin expression between carcinoma in situ and invasive carcinoma of the cervix. In invasive cervical carcinomas, expression of E-cadherin and the intensity of cytoplasmic E-cadherin expression did not correlate with histologic type, lymphvascular space invasion, lymph node metastasis, and stage of disease. CONCLUSION: It is mncluded that expression of E-cadherin is related to tumor invasion in cervical tissues, but further studies with regard toE-cadherin/catenin/cytoskeleton complex are needed to clarify the prognostic role of E-cadherin with respect to clinicopathologic parameters in invasive cervical carcinoma,
Cadherins ; Carcinoma in Situ ; Cervix Uteri* ; Cytoplasm ; Epithelium ; Female ; Immunohistochemistry ; Lymph Nodes ; Neoplasm Metastasis ; Uterine Cervical Neoplasms