No abstract available.
Diagnosis* ; Exanthema* ; Lymphadenitis* ; Scrub Typhus*

Small airway diseases are seen in many clinical conditions. The locations of small airway diseases are small bronchioles including terminal and respiratory bronchioles, and alveolar duct. The histopathologic features of bronchiolar injury have been described variously and have led to confusing and overlapping terms. The purpose of this article is to describe the clinical characteristics and histopathologic interpretation of small airway diseases. We classify the small airway diseases as primary bronchiolar diseases, and secondary bronchiolar diseases including pulmonary parenchymal diseases, and large airway diseases with prominent bronchiolar involvement. Primary bronchiolar diseases include respiratory bronchiolitis, acute bronchiolitis, constrictive bronchiolitis, follicular bronchiolitis, diffuse panbronchiolitis, mineral dust airway diseases, and a few other variants. Pulmonary parenchymal diseases with bronchiolar involvement include respiratory bronchiolitis-associated interstitial lung disease, organizing pneumonia, hypersensitivity pneumonitis, pulmonary Langerhans' cell histiocytosis, sarcoidosis and idiopathic pulmonary fibrosis. Bronchiolar changes can also be seen in large airway diseases such as chronic bronchitis, bronchiectasis, cystic fibrosis and asthma. The patterns of bronchiolar response to various injuries are relatively limited and these patterns are generally non-specific in regard to the etiology. Appropriate interpretation and diagnosis of small airway diseases depend on judicious correlation of clinical, radiologic, and histopathologic characteristics.
Alveolitis, Extrinsic Allergic ; Asthma ; Bronchiectasis ; Bronchioles ; Bronchiolitis ; Bronchiolitis Obliterans ; Bronchitis, Chronic ; Cystic Fibrosis ; Diagnosis ; Dust ; Histiocytosis ; Idiopathic Pulmonary Fibrosis ; Lung Diseases, Interstitial ; Pneumonia ; Sarcoidosis

No abstract available.
Child* ; Hepatitis, Chronic* ; Humans ; Interferon-alpha*

PURPOSE: We studied the changes in the antibiotic sensitivity to the causative organisms of urinary tract infection, between 1979 and 2001, in order to provide useful information on the choice of adequate drugs in the treatment of urinary tract infection (UTI). MATERIALS AND METHODS: We retrospectively analysed 1,370 uropathogens, and their antimicrobial sensitivities, in 647 patients admitted to, or visiting our hospital, between January 1979 and December 2001, that had more than 105cfu/ml in urine culture. RESULTS: The incidence of UTI increased with age, and was highest in the 6th decades (21.0%). Mixed infections increased from 6.1%, in 1979, to 18.4%, by 2001. The common pathogens were E. coli (37.8%), enterococcus (15.0%), Pseudomonas (10.1%) and Klebsiella (9.1%). E. coli was the most important uropathogen during the stated time period. However, the incidence of Gram positive organisms increased from 14.2%, in 1979, to 26.0%, by 2001. In the Gram negative stained uropathogens, the antibiotic sensitivity was changed: ampicillin (11.8 to 14.6%), cephalothin (40.6 to 46.3%) and amikacin (80.5 to 74.8%). For E. coli, trimethoprim/Sulfamethoxazole (TMP/SMX) and ampicillin showed decreased sensitivities of 37.3 and 18.5%, respectively. However, sulbactam/cefoperazone, cefepime and imipenem showed high sensitivities of 96.1, 97.5 and 100%, respectively. CONCLUSIONS: Prior to receiving the bacteriological report, the use of TMP/SMX and ampicillin, as the first choices of treatment for UTI, should be reconsidered. Our results implied that amikacin, which showed the best effects, and was cheaper than fluoroquinolones, can be used as an alternative to these drugs as a primary empirical antibiotic for UTI.
Amikacin ; Ampicillin ; Cephalothin ; Coinfection ; Enterococcus ; Fluoroquinolones ; Humans ; Imipenem ; Incidence ; Klebsiella ; Pseudomonas ; Retrospective Studies ; Urinary Tract Infections* ; Urinary Tract*

The estrogen hormone receptor (ER) content of human breast cancer has assumed an important role as a predictor of hormone therapy response and as a prognostic indicator. The conventional technique is the dextran-coated charcoal (DCC) method or a ligand-binding assay (LBA) based on the measurement of radiolabeled steroids in cytosolic extracts of tissue homogenate. The recent introduction of monoclonal antibodies with high specificity for human ERs has allowed the application of immunocytochemical assays (ICA) in human cancer tissue. An extension of the ICA technique to cytologic specimens is also widely used. Our aim was to evaluate the reliability of ER-ICAs on fine needle aspirates(FNA) from breast cancer patients by comparing it with ER-ICAs and ER-LBAs performed on surgically removed tissues. During a recent 6-month period, ER-ICAs and ER-LBAs were performed in 83 cases. Among these 83 cases, only the 40 cases for which the ER-ICA and the ER-LBA were performed simultaneously ere included in this study. As positive cutoff values, we assumed 10 fmol/mg protein for the ER-LBAs and a semiquantitative score of 4 for the ER-ICAs. The results were as follows : 1) The ER positive rate was 55% (22/40) for ICAs and 47.5% (19/40) for LBAs. The concordance rate between the ER of ICAs and that of LBAs was 82.5% (33/40). 2) The Pearson correlation coefficient between ER-ICAs of fine needle aspirates and that of surgically removed tissue was good (r=0.94, p<0.005) 3) The Spearman correlation coefficient between ER-ICAs of fine needle aspirates and ER-LBAs of surgically removed tissue was good (r=0.57, p=0.0001) In conclusion, ER determination by using the fine needle aspirate is a reliable method in palpable breast cancer. FNA-ER may be a useful method when it is difficult to take sufficient breast cancer tissue, i.e., in cases of diffusely recurrent cancer, liver metastasis, malignant pleural effusion, etc.
Antibodies, Monoclonal ; Biopsy* ; Breast Neoplasms* ; Breast* ; Charcoal ; Cytosol ; Estrogens* ; Humans ; Liver Neoplasms ; Needles* ; Neoplasm Metastasis ; Pleural Effusion, Malignant ; Sensitivity and Specificity ; Steroids

In the rat hippocampal formation, the time-course and dose-response of the expression of enkephalin and dynorphin gene were examined after kainate (KA) treatment with in situ hybridization histochemistry. The KA induced enkephalin and dynorphin mRNA expression in hippocampus occurred mainly in the dentate gyrus. The enkephalin mRNA expression appeared at 3hour after KA injection, increased dramatically at 6hour, and then decreses. At 24hour after KA injection, the expression of enkephalin mRNA disappeared. The dynorphin mRNA expression appeared at once after injection and increased dramatically at 3hour. Unexpectedly at 6hour after injection, the expression was decreased, and then increased less than the 3hour expression. The increased pattern persisted to 24hour after injection. Unexpected result was also encounted in the experiment of KA dose-response of enkephalin mRNA and dynorphin mRNA. In the hippocampal formation, in contrast with other areas, low dosage (8mg/kg) of KA induced more significant expression of both genes than high dosage (16mg/kg) of KA.
Animals ; Dentate Gyrus ; Dynorphins ; Enkephalins ; Gene Expression* ; Hippocampus* ; In Situ Hybridization ; Kainic Acid ; Opioid Peptides* ; Rats* ; RNA, Messenger ; Seizures*

We used in situ hybridization histochemistry with synthetic oligonucleotide probes to examined the effects of unilateral 6-hydroxydopamine lesions (which eliminated tyrosine hydroxylase mRNA containing cells in mesencephalon) on enkephalin, dynorphin, and substance P mRNA exprssion in the striatum. The expression of tyroxine hydroxylase mRNA on ipsilateral substantia nigra pars compacta, which reflect dopamine activity, totally decreased for 2weeks after lesioning. After lesioning 1week, 2weeks, and 4weeks, a significant increase of the expression of enkephalin mRNA in ipsilateral to the lesioned striatum was observed (p<0.05). Substance P mRNA expressions were depressed significantly in ispsilateral to the lesioned striaturm, whereas enkephalin mRNA expressions were elevated in consecutive sections from striatal aresas in all rat model. The effect of lesions on dynorphin mRNA expressions in ipsilateral to the lesioned striatum less robust, but significant decreased tendency was observed (p<0.05). These data show that the expression of enkephalin, dynorphin and substance P mRNA is differentially regulated by mesostriatal dopaminergic system.
Animals ; Basal Ganglia* ; Dopamine ; Dynorphins ; Enkephalins ; In Situ Hybridization ; Models, Animal* ; Neuropeptides* ; Oligonucleotide Probes ; Oxidopamine ; Rats* ; RNA, Messenger ; Substance P ; Substantia Nigra ; Tyrosine 3-Monooxygenase

Myocardial infarction (MI) secondary to coronary artery fistula and the subsequent occlusion of the distal right coronary artery (RCA) after blunt chest trauma is a rare entity. Here, we describe a case of coronary artery fistula and occlusion with an inferior MI that occurred following blunt chest trauma. At the initial visit to the emergency room after a car accident, this patient had been undiagnosed with acute myocardial infarction, readmitted five months after ischemic insult, and revealed to have experienced MI due to RCA-right atrial fistula and occlusion of the distal RCA. He underwent coronary surgery and recovered without complications.
Coronary Vessels* ; Emergency Service, Hospital ; Fistula* ; Humans ; Myocardial Infarction* ; Thorax*

Classical galactosemia is an autosomal recessive disorder of galactose metabolism, caused by a deficiency of the enzyme galactose-1-phosphate uridyltransferase (GALT). Buildup of galactose-1-phosphate is toxic at high levels and can damage the liver, brain, eyes, and other vital organs. The case presented here was that of an 11-day-old female infant who had elevated galatose levels upon initial neonatal screening test with persistent cholestatic jaundice, coagulopathy, and hepatomegaly. The patient was transferred due to aggravation of clinical symptoms including bleeding and jaundice. She had a delayed galactose free diet because of an inappropriate diagnosis. We quickly provided her with a lactose/ galactose-restricted diet as per her final diagnosis. Clinical and laboratory results were improved after a few days of treatment. For confirmatory testing for classical galactosaemia, we simultaneously analyzed for GALT enzyme activity and allele-specific PCR/fragments for seven mutations and two polymorphisms in the GALT gene. We were able to find several GALT-deficient and compound heterozygous mutations of the GALT gene.
Brain ; Diet ; Eye ; Female ; Galactose ; Galactosemias ; Galactosephosphates ; Hemorrhage ; Hepatomegaly ; Humans ; Infant ; Infant, Newborn ; Jaundice ; Jaundice, Obstructive ; Liver ; Neonatal Screening ; UTP-Hexose-1-Phosphate Uridylyltransferase

Most cases of mucosa-associated lymphoid tissue (MALT) lymphoma occur in adults. MALT lymphoma is very rare in children. Helicobacter pylori (H. pylori) infection is known to be an important etiologic factor predisposing to the development of gastric MALT lymphoma. A 12-year-old girl was admitted because of intermittent abdominal pain occurring over the preceding 2 years. Nodular gastritis of the stomach was demonstrated on endoscopy. H. pylori infection was confirmed using the rapid urease test and histopathology. Histopathological examination of gastric biopsy specimens revealed lymphoepithelial lesions pathognomonic of MALT lymphoma, and immunohistochemical staining for CD20 was diffusely positive. Therefore, the patient was diagnosed with gastric MALT lymphoma. Clinical manifestations and histopathologic findings compatible with MALT lymphoma improved with the eradication of H. pylori infection. We report a case of primary gastric MALT lymphoma in a child, associated with H. pylori infection and presenting as nodular gastritis.
Abdominal Pain ; Adult ; Biopsy ; Child ; Endoscopy ; Gastritis ; Helicobacter pylori ; Humans ; Lymphoid Tissue ; Lymphoma ; Lymphoma, B-Cell, Marginal Zone ; Stomach ; Urease