Infantile form of histiocytosis X is commonly presented as multiorgan desseminated form such as Letterer-Siwe disease. Lymph node involvement of histiocytosis X is usually accompanied by adjacent bone or skin lesion. Solitary nodal eosinophilic granuloma without evidence of other organ involvement is very rare. A case herein report is a 11 month-old female infant presented with fever and palpable both inguinal lymph nodes. There was neither skin lesion nor hepatosplenomegaly. Laboratory evaluation was within normal range except increased alkaline phosphatase and many neutrophils in urine. Radiologic examination revealed no remarkable bone lesions. And she showed good clinical outcome without evidence of other organ involvements. On microscopic examination of inguinal lymph node it was replaced by infiltration of histiocytes mainly along the sinusoid. Some of histiocytes showed morphologic features of "histiocytosis X cell" having nuclear grooves or multilobulation. Multinulceated giant cells were frequently see. Numerous eosinphils were also infiltrated and showed multifocal microabscess formation. Immunohistochemical staining revealed that majority of histiocytes were postitive for S-100 protein but multinucleated histriocytes, phagocytic histiocytes and those around the abscess were positive for macrophage marker, suck as CD68 and alpha-1-antichymotrypsin. Interestingly some histiocytes showed positivity for both S-100 protein and macrophage marker. These results suggest that histiocytosis X is proliferative disorder of phenotypically heterogenous population of histiocytes in contrast to the theory that it is a proliferative disorder of Langerhans cells.
Infant ; Male ; Female ; Humans

Endoscopic retrograde cholangiopancreatography(ERCP) procedures are more difficult in patients who have undergone partial gastrectomy with Billroth II anastomosis. Because its altered anatomical relationship. the endoscopist is presented with additional problems: (i) Dfficulties in entering the afferent loop, depending on the surgical techiques used. (ii) The endoscope may be too sort to reach the papillary region unless the loops are suecessfully straightened out. (iii) Difficulties in passing the ligament of Treitz, especially in patients with Braun's anastomosis, (iv) Problems in cannulating the papilla and especially the common bile duct from a reversed position. (v) Problems in carrying out a papillotomy in a correct position. We attempted endoscopic sphincterotomy in 3 opatients previously subjected to gastrectomy with needle knife, and succeeded in 2 of them. In the two patients, successful billary drainage was achieved. And one patients with Billroth II gastrectomy, presented with CBD stone and cholangit, was successfully treated with endoscopic stone retriveial. The patient with a Billroth-II operation may unergo endscopic diagnostic as well as therapeutic procedures with a high rate of success, and can be suitable candidates for ERCP and endoscopic sphincterotomy
Cholangiography* ; Cholangiopancreatography, Endoscopic Retrograde ; Common Bile Duct ; Drainage ; Endoscopes ; Gastrectomy* ; Gastroenterostomy* ; Humans ; Ligaments ; Needles ; Sphincterotomy, Endoscopic

No abstract available.
Immunoglobulin G* ; Pentetic Acid* ; Polymers*

Until now there are few available epidemiologic data of osteoporosis in Korea, and the severity of osteoporosis-related health problem has not been widely recognized yet. But the numbers of the old people are increasing in Korea, and in 2000, the proportion of people over 65 will be up to about 6.8% of total population. Therefore, osteoporosis, one of the most common metabolic bone disease among the old people, will be one of the most important public health problem. on this background this study was performed to find out risk factors of the development of osteoporosis in Korean women through case-control approach. The subject of this study were selected among the women one general hospital in seoul and were checked bone density from sep. 1988 to sep. 1993. Those who were diagnosed to have hypertension, diabetes mellitus, thyroid disease, breast disease, or liver disease, which are thought to influence bone density, were excluded. Also excluded those who are age-unknown. Finally the subjects were 2,139 women aged between 18 and 79. We operatively defined patient group as those whose bone density is below 1.03 g/cm2, 90% of average bone density of women of 4th decade who visited the same hospital. And we defined control group as whose bone density is above 1.15g/cm2. we randomly selected 201 women from the patient group and 202 from the control. As independent variables we chose age, menarche age, menopause age, menopause type, the number of siblings, the number of pregnancies, body mass index, taking oral pill or not, feeding type, and educational state. Multiple logistic regression analysis was done to see the influence of these variables on the risk of osteoporosis. Results are as follows; 1. menopausal status was statistically significant risk factor to all women irrespective of her age, while obesity and later menopause age were food to be statistically significant protective factors. 2. The more siblings and pregnancies, the greater the risk of osteoporosis, but these factors were not statistically significant. This result is not consistent with other studies. Further studies are strongly needed.
Body Mass Index ; Bone Density ; Bone Diseases, Metabolic ; Breast Diseases ; Case-Control Studies* ; Diabetes Mellitus ; Female ; Hospitals, General* ; Humans ; Hypertension ; Korea ; Liver Diseases ; Logistic Models ; Menarche ; Menopause ; Obesity ; Osteoporosis* ; Outpatients* ; Pregnancy ; Public Health ; Risk Factors* ; Seoul* ; Siblings ; Thyroid Diseases

A novel bacteriophage, designated as VPP97, that infects the strains of Vibiro parahaemolyticus (hallophilic, Gram-negative bacterium) isolated most commonly from marine environments, has been discovered, and several of its properties have been determined. The plaques were clear and sized 0.6-1.0 mm in diameter. The virion forms a single band on 70% sucrose gradient and p1.50 CsC1 gradient by sucrose gradient centrifugation and CsCI gradient centrifugation respectively. It has a hexagonal head and a relatively long tail, as shown by electron microscopy. Vibrio alginolyticus, Vibrio fluvialis and Vibrio furnissii were also sensitive to this phage It was almost totally inactivated at 70 degree C and at pH below 5 or over 10. The nucleic acid of VPP97 is composed of DNA. The VPP97 had 9 specific structural proteins sized between 21.5 kDa and 97.4 kDa on SDS-PAGE. When V. parahaemolyticus cultures were treated with either phage VPP97 or one of the several antibiotics for 2 hours, the viable number of V. parahaemolyticus treated with the phage VPP97 is lower than that treated with chloramphenicol, erythromycin or penicillin, but not lower than that treated with tetracycline. Mice that have responded to the phage treatment revealed the lower numbers of V. parahaemolyticus in small intestine and less damage on small intestine compared to the untreated mice. Therefore, we suggest that the phage treatment appears effective to the infection by V. parahaemolyticus.
Animals ; Anti-Bacterial Agents ; Bacteriophages* ; Centrifugation ; Chloramphenicol ; DNA ; Electrophoresis, Polyacrylamide Gel ; Erythromycin ; Head ; Hydrogen-Ion Concentration ; Intestine, Small ; Mice ; Microscopy, Electron ; Penicillins ; Sucrose ; Tail ; Tetracycline ; Vibrio alginolyticus ; Vibrio parahaemolyticus* ; Vibrio* ; Virion

The halophilic bacterium, Vibrio vulnificus, causes acute fulminating wound infections and septicemia in human. Especially the septicemia shows high mortality above 50%. In Korea, septicemia by V. vulnificus was reported at westem and southern coast in every year. Here, we try to isolate this V. vulnipcus at Kyoung-nam area and coast of Pusan during 1996. Purposed sites were Dadaepo, Songjung, Chungsapo and Mipo of Pusan and Kijang, Ilkuang, Juksoung, Dongam, Waljun and Chilam of southern sea. Total 40 strains of V. vulnipcus were isolated from sea samples. Biochemical characteristics of isolated V. vulnificus were almost same with reference strain V. vulnificus ATCC 27562 on Farmer's tests and on API 20E kit test. V. vulnificus isolates in 1996, fermented cellobiose and salicin but arabinose. and had resistance to 7% sodium chloride.
Arabinose ; Busan* ; Cellobiose ; Humans ; Korea* ; Mortality ; Sepsis ; Sodium Chloride ; Vibrio vulnificus* ; Vibrio* ; Wound Infection

Brunner's gland adenoma(or Brunneroma) is clinically relevant tumor-like lesion of the duodenum which is composed of submucosal Brunner's gland tissue. Since the first case by autopsy was described by Cruveihier in l935, there have been less than 190 reports in the world literature, Brunner's gland adenoma is an extremely rare entity that accounts for only 10.6% of benign duodenal tumors, which are themselves relatively rare representing 0.008% of all surgical and autopsy specimens. The clinical manifestation of this tumor are non-specific gastrointestinal complaints, such as bloating or epigastric pain, and tumor often gives rise to melena or obstruction, It is postulated that this tumor are hamartomas rather than true neoplasm. However, they undergo rarely malignant transformation. We report on a case of a large pedunculated Brunner's gland adenoma, which was successfully polypectomized.
Adenoma* ; Autopsy ; Duodenum ; Hamartoma ; Melena

Brunner's gland adenoma(or Brunneroma) is clinically relevant tumor-like lesion of the duodenum which is composed of submucosal Brunner's gland tissue. Since the first case by autopsy was described by Cruveihier in l935, there have been less than 190 reports in the world literature, Brunner's gland adenoma is an extremely rare entity that accounts for only 10.6% of benign duodenal tumors, which are themselves relatively rare representing 0.008% of all surgical and autopsy specimens. The clinical manifestation of this tumor are non-specific gastrointestinal complaints, such as bloating or epigastric pain, and tumor often gives rise to melena or obstruction, It is postulated that this tumor are hamartomas rather than true neoplasm. However, they undergo rarely malignant transformation. We report on a case of a large pedunculated Brunner's gland adenoma, which was successfully polypectomized.
Adenoma* ; Autopsy ; Duodenum ; Hamartoma ; Melena

BACKGROUND: Horner's syndrome, including ptosis and miosis, is a sign of success following stellate ganglion block (SGB). However, it is not sufficient to ensure adequate sympathetic block to the upper extremity. There are numerous recommended local anesthetic volumes for SGB. The aim of this study was to evaluate the effects of differing volumes used in SGB on the elevation of skin temperature of ipsilateral upper extremity, and to find the volume required to elevate skin temperature most frequently. METHODS: Patients with sensory neural hearing loss underwent SGB, repeated daily in the paratracheal approach using different volumes (6, 8, 10, 12 and 16 ml) of 0.2% bupivacaine. Skin temperatures were checked in the hypothenar area before SGB, and 1, 2, 3, 4, 5, 10 and 15 minutes following SGB. Time intervals required for the elevation of skin temperature 1oC above the preblock level, and for the appearance of Horner's syndrome were recorded. RESULTS: Twenty-three patients repeatedly received SGB over 4 times at different volumes. The total SGB was 100 times, and all displayed Horner's syndrome. The total incidence of skin temperature elevation was 48%. Horner's syndrome appeared prior to the elevation of skin temperature (2.0 2.1 vs 5.3 3.8 min). There were significant differences in the incidence of skin temperature elevation, depending on the volume of the local anesthetics; 6 ml (17.6%), 8 ml (34.8%), 10 ml (52.2%), 12 ml (73.9%) and 16 ml (57.1%); greater volumes resulted in high incidences (pearson chi-square test, P = 0.005). The volume of twelve ml resulted in the highest incidence. Each patient needed different minimal volume to lead to the skin temperature elevation; 6 ml (13.1%), 8 ml (21.7%), 10 ml (17.4%), 12 ml (26.1%) and 16 ml (4.4%), and several patients (17.4%) did not have elevated skin temperature at any volumes. CONCLUSIONS: This study reveals that a large volume of local anesthetic (e.g. 12 ml) is needed in SGB for adequate sympathetic blockade to the upper extremity, and that each patient needs a different minimal volume for the skin temperature elevation to occur.
Anesthetics, Local ; Bupivacaine ; Hearing Loss ; Horner Syndrome ; Humans ; Incidence ; Miosis ; Skin Temperature* ; Skin* ; Stellate Ganglion* ; Upper Extremity*

BACKGROUND: Horner's syndrome, including ptosis and miosis, is a sign of success following stellate ganglion block (SGB). However, it is not sufficient to ensure adequate sympathetic block to the upper extremity. There are numerous recommended local anesthetic volumes for SGB. The aim of this study was to evaluate the effects of differing volumes used in SGB on the elevation of skin temperature of ipsilateral upper extremity, and to find the volume required to elevate skin temperature most frequently. METHODS: Patients with sensory neural hearing loss underwent SGB, repeated daily in the paratracheal approach using different volumes (6, 8, 10, 12 and 16 ml) of 0.2% bupivacaine. Skin temperatures were checked in the hypothenar area before SGB, and 1, 2, 3, 4, 5, 10 and 15 minutes following SGB. Time intervals required for the elevation of skin temperature 1oC above the preblock level, and for the appearance of Horner's syndrome were recorded. RESULTS: Twenty-three patients repeatedly received SGB over 4 times at different volumes. The total SGB was 100 times, and all displayed Horner's syndrome. The total incidence of skin temperature elevation was 48%. Horner's syndrome appeared prior to the elevation of skin temperature (2.0 2.1 vs 5.3 3.8 min). There were significant differences in the incidence of skin temperature elevation, depending on the volume of the local anesthetics; 6 ml (17.6%), 8 ml (34.8%), 10 ml (52.2%), 12 ml (73.9%) and 16 ml (57.1%); greater volumes resulted in high incidences (pearson chi-square test, P = 0.005). The volume of twelve ml resulted in the highest incidence. Each patient needed different minimal volume to lead to the skin temperature elevation; 6 ml (13.1%), 8 ml (21.7%), 10 ml (17.4%), 12 ml (26.1%) and 16 ml (4.4%), and several patients (17.4%) did not have elevated skin temperature at any volumes. CONCLUSIONS: This study reveals that a large volume of local anesthetic (e.g. 12 ml) is needed in SGB for adequate sympathetic blockade to the upper extremity, and that each patient needs a different minimal volume for the skin temperature elevation to occur.
Anesthetics, Local ; Bupivacaine ; Hearing Loss ; Horner Syndrome ; Humans ; Incidence ; Miosis ; Skin Temperature* ; Skin* ; Stellate Ganglion* ; Upper Extremity*