Biliary ascariasis is a rare complication of intestinal ascaris infestation. Retrograde migration of the adult worm through the papilla of Vater causes biliary colic, and may give rise to pancreatic and biliary obstruction, choledocholithiasis, cholecystitis, cholangitis, hemobilia, and if the worm lodges in intrahepatic bile ducts, to liver absceases. In the past, treatment of biliary ascariasis has usually involved the direct removal of ascaris throagh a surgical choledochatomy and subsequent saline lavage of the common duct through an indwelling T tube. Recently, the worm in the bile duct can be seen by ERCP and it can be removed during the endoscopic procedure. A 55-year-old woman with intermittent colicky right upper quadrant abdominal pain was admitted to out hospital. Abdominai sonogram disclosed an echogenic structure within a mildly dilated common bile duct and a high ehogenic structure with acoustic shadowing in the distal common bile duct(CBD), which suggests a CBD stone. ERCP after obtaining the sonogram revealed a thick, long, linear, smooth filling defect in the CBD with a distal CBD stone. A distal CBD stone was removed by sphinctetotomy and lithotripsy, then we directly extracted ascaris with a tripod forcep without any complication.
Abdominal Pain ; Acoustics ; Adult ; Ascariasis* ; Ascaris ; Bile ; Bile Ducts ; Bile Ducts, Intrahepatic ; Cholangiopancreatography, Endoscopic Retrograde ; Cholangitis ; Cholecystitis ; Choledocholithiasis ; Colic ; Common Bile Duct* ; Female ; Hemobilia ; Humans ; Lithotripsy ; Liver ; Middle Aged ; Shadowing (Histology) ; Surgical Instruments ; Therapeutic Irrigation

BACKGROUND: Deep Hypothermic circulatory Arrest (DHCA) is widely used during heart surgery in neonates and infants and complicated surgeries in adults such as a pulmonary thromboendarterectomy (PTE). However safe limits of time and temperature during DHCA still remain controversial. Futhermore it's effects on neurologic outcome has been controversial. METHODS: On the postoperative 3 days, we examined the neurologic function of 12 patients who received a PTE. During the PTE, DHCA was done 2 or 3 times within 20 minutes. Between DHCAs the patients were perfused at a low flow rate with 18degreesC blood until their venous saturation returned to 90%. Neurologic evaluations included level of consciousness, Glasgow coma scale (GCS), and motor and sensory functions. RESULTS: Neurologic functions of all of the patients assessed on the 3 days postoperatively was grossly normal. All 12 patients were oriented to time, place, and person with normal gross motor and sensory functions. CONCLUSIONS: No significant neurologic complications were related to the technique of two or three times of short DHCA within 20 minutes, for a total not exceeding 60 minutes.
Adult* ; Brain* ; Circulatory Arrest, Deep Hypothermia Induced* ; Consciousness ; Endarterectomy ; Glasgow Coma Scale ; Humans ; Infant ; Infant, Newborn ; Sensation ; Thoracic Surgery

BACKGROUND: Today, the eradication of H. pylori represents a generally accepted and beneficial therapeutic strategy for treatment and prevention of peptic ulcer relapse. Major factors that have affected H. pylori eradication are eradication rate of regimen, compliance of patients and complications of drugs. Recently, the combination of omeprazole, amoxicillin and clarithromycin has been accepted as one of the most effective treatment for the eradication of H. pylori. The primary aim of this study was to evaluate the efficacy of this therapeutic modality in Korean patients. METHODS: Two hundred twenty three patients with peptic ulcer and H. pylori infection were taken two types of triple therapy. Group A were treated with omeprazole 20 mg bid, amoxicillin 500 mg tid, clarithromycin 500 mg tid daily for 14 days. Group B were treated with omeprazole 20 mg bid, amoxicillin 1g bid, clarithromycin 500 mg bid daily for 7 days. Endoscopy with H. pylori tests was repeated 4 weeks after the end of treatment and then biopsy specimens were taken in antrum and body. CLO test and Warthin Starry silver stain were conducted concordantly. RESULTS: The H. pylori eradication rate was 92.5% in group A, 90.4% in group B. There was no significant difference in eradication rate. More than 50% of ulcer size reduction was observed 90.5% in group A, 86.3% in group B. There was no significant difference in ulcer healing(p > 0.05). The incidence of all side effects in both group were as follows; 22.6% in group A, 19.1% in group B. But major side effect was found only group A, of whom the symptom was too serious for the treatment to continue. CONCLUSION: We concluded that the seven days regimen was more favorable, because the eradication rate was almost the same as the 14 days regimen. And drug compliance and cost effectiveness were better than 14 days treatment regimen.
Amoxicillin* ; Biopsy ; Clarithromycin* ; Compliance ; Cost-Benefit Analysis ; Endoscopy ; Helicobacter pylori* ; Helicobacter* ; Humans ; Incidence ; Omeprazole* ; Peptic Ulcer ; Recurrence ; Silver ; Ulcer

Endomyocardial biopsy (EMB) is a valuable diagnostic procedure for the surveillance of cardiac allograft rejection. Interpretation of individual cases is still problematic due to variations of findings for grading of rejection and other associated lesions. We reevaluated an experience on endomyocardial biopsies to develop better diagnostic criteria for rejection and other complications. Immunohistochemical studies against cytokines were performed to assess the usefulness of the method for the diagnosis or researches. A total of 249 EMBs taken from 33 cardiac allograft recipients were reviewed. There were 25 males and 8 females. Dilated cardiomyopathy was present (24 cases) and valvular heart disease (4 cases), restrictive cardiomyopathy (3 cases) were also common conditions. We applied the grading system of the International Society for Heart Transplantation (ISHT) for the assessment of acute cellular rejection. Grades of 0, 1A, 1B, 2, 3A and 3B were 39.0%, 28.1%, 11.2%, 11.5%, 12.4% and 1.6% respectively, but 3.2% were inadequate. Thirty five episodes of grade 3A or 3B were present in 17 patients. The response to therapy was assessed using a next follow up biopsy, which revealed resolving or resolved rejection in 85% of patients. The intensity of immunohistochemical stains for IL-6 and TNF-alpha was increased in proportion to the histologic grade but Quilty lesion and cardiomyopathy also showed a positive reaction. The other pathologic findings were ischemic change, previous biopsy site, interstitial edema and fibrosis, and Quilty lesion. These findings showed usefulness of endomyocardial biopsy not only for the evaluation of cardiac allograft rejection but also for the diagnosis of associated cardiac lesions. Immunohistochemical study of the cytokines was related to the degree of inflammation rather than degree of rejection.
Allografts ; Biopsy* ; Cardiomyopathies ; Cardiomyopathy, Dilated ; Cardiomyopathy, Restrictive ; Coloring Agents ; Cytokines ; Diagnosis ; Edema ; Female ; Fibrosis ; Follow-Up Studies ; Heart Transplantation* ; Heart Valve Diseases ; Heart* ; Humans ; Inflammation ; Interleukin-6 ; Male ; Tumor Necrosis Factor-alpha

The purpose of this study was to compare the marginal fit of provisional restorations by differentiating the removal time and setting temperature during resin polymerization. After mixing autopolymerizing methyl metharcrylate resin, the material was placed in a preformed resin shell crown. The crown was seated on a die with 1mm shoulder margin. Crowns were removed after 3,4,5,6 minutes and polymerization was continued under the following conditions : 25degrees C air,30degrees C, 40degrees C, 50degrees C,60degrees C,70degrees C water. After polymerization, the crown was sectioned. The marginal & occlusal discrepancies were measured. The mean marginal discrelpancies at 3 minutes, 4 minutes, 5 minutes and 6 minutes of removing time were 96.6micrometer,84.6micrometer, 86.7micrometer and 105.6micrometer.The mean occlusal discrepancies at 3 minutes, 4 minutes, 5 minutes and 6 minutes of removing time were 106.7micrometer, 89.3micrometer, 98.6micrometer and 127.7micrometer.There was significant difference between 4 minutes group and 6 minutes group in occlusal discrepancies. The mean marginal & occlusal discrepancies for crowns polymerized in 25degrees C air were 98.2micrometer and 124.1micrometer. The crowns polymerized in 50degrees C water demonstrated the smallest marginal & occlusal discrepancies. The mean value of marginal & occlusal discrepancies in 50degrees C water were 73.1micrometer and 77.5micrometer. These values were smaller than that of 25degrees C air.There were significant differences in the occlusal discrepancies between 25degrees C air and water conditions of 50degrees C water (alpha=0.05) but, no significant differences in marginal discrepancies. There was no significant difference in the interaction between time and temperature. 4 minutes waiting time & 50degrees C water polymerizing condition produces the best fit at the margin of the provisional crown.
Crowns* ; Polymerization* ; Polymers* ; Shoulder ; Water

Nutrition labels are helpful for chronic disease management in patients requiring balanced nutritional intake. This study aimed to investigate the association between the use of nutrition labels and chronic diseases (hypertension, diabetes mellitus, and hyperlipidemia) by using the 2008-2009 Korea National Health and Nutrition Examination Survey data. A total of 10,695 individuals aged 20 and over was included in the analysis. Using multiple logistic regressions, there was no difference in nutrition label use between the chronic disease and normal groups (men with hypertension OR, 0.97; 95% CI, 0.75-1.27; women with hypertension OR, 0.83; 95% CI, 0.67-1.03; men with diabetes OR, 0.70; 95% CI, 0.45-1.08; women with diabetes OR, 1.13; 95% CI, 0.84-1.53; men with hyperlipidemia OR, 0.85; 95% CI, 0.59-1.23; women with hyperlipidemia OR, 1.14; 95% CI, 0.91-1.44). In hyperlipidemia patients, awareness (OR, 1.55; 95% CI, 1.03-2.35) and control (OR, 2.19; 95% CI, 2.32-3.63) of disease were related to nutrition label use; however, no significant associations were found for the hypertension and diabetes mellitus patients. Considering the importance of dietary habits in the management of chronic diseases, an improvement in nutrition label use by patients with these diseases is required.
Adult ; Aged ; Chronic Disease ; Demography ; Diabetes Mellitus/pathology/*prevention & control ; Female ; Health Knowledge, Attitudes, Practice ; Humans ; Hyperlipidemias/pathology/*prevention & control ; Hypertension/pathology/*prevention & control ; Logistic Models ; Male ; Middle Aged ; *Nutrition Surveys ; Nutritive Value ; Odds Ratio ; Republic of Korea

This paper describes that invasive aspergillosis was found in oral cavity, especially in lower molar periodontium in a immunocompromised 34-year-old woman who had been admitted in hemato-oncology with the diagnosis of acute myeloid leukemia. Antifungal therapy and surgical excision of involved teeth, bone and gingiva were the treatment of choice. After treatment infected area was healed very well. We would like to report our case because we could not find any paper reporting on invasive aspergillosis occurring in lower molar periodontium.
Adult ; Aspergillosis* ; Diagnosis ; Female ; Gingiva ; Humans ; Leukemia, Myeloid, Acute ; Molar* ; Mouth ; Periodontium ; Tooth

BACKGROUND: To reduce or prevent myocardial injury during an ischemia-reperfusion episode, some pharmacological interventions, including administering nicorandil or verapamil, have becomepopular in clinical situations. Nicorandil is a N-(2-hydroxyethyl)- nicotinamide nitrate ester, and it's effective mainly by opening the K+ ATP channels in the mitochondrial membrane, and verapamil is useful for reducing the endothelial injury of coronary vessels during ischemia. In this study, we aimed to determine the cardioprotective effect when both drugs are used simultaneously. METHODS: Isolated rat hearts (the Langendorff perfusion model) were perfused with Krebs-Henseleit bicarbonate buffer. After 30 minutes of controlled perfusion, we added nicorandil or verapamil separately and both drugs were administered together in another group (the mixed group) and we then induced ischemia for 30 minutes. We measured the heart rate, the developed ventricularpressure and the dP/dT during the control period during drug infusion and during reperfusion at 15, 30, 45 and 60 minutes. RESULTS: During reperfusion, the mixed group showed more favorable results for the developed left ventricular pressure (LVP), the dP/dT and the rate pressure product (RPP). The heart rate was significantly decreased as reperfusion processed in all the groups. CONCLUSIONS: For myocardial protection during ischemia-reperfusion, a mixed drug regimen is more beneficial than a single drug regimen, and this occurs without inducing a significant decrease of the heart rate.
Adenosine Triphosphate ; Animals ; Coronary Vessels ; Heart ; Heart Rate ; Ischemia ; Mitochondrial Membranes ; Niacinamide ; Nicorandil ; Perfusion ; Rats ; Reperfusion ; Ventricular Pressure ; Verapamil

PURPOSE: The purpose of this study was to understand the principle of percutaneous nephrolithotomy(PNL), toincrease its success rate, and to base the radiologic approach on preoperative interventional tract dilatation. MATERIALS AND METHODS: Twenty-six patients(male, 19, female, 7) with staghorn or pelviocalyceal calculi who hadundergone PNL were included in this study. After percutaneous nephrostomy(PCN) was performed in each patient, thetract was dilated to 30F with Amplatz dilators using coaxial techniques or a 30F, 10cm high-pressure tractdilatation balloon. One day before the calculi were fragmented and removed by PNL, a 30F Amplatz sheath wasinserted under local anesthesia. The time required for tract dilatation, complications, and surgery was analyzed. RESULTS: Percutaneous tract dilatation were successful in all patients, and forceps, a nephrolithotome and anephroscope were successfully introduced into the pelvocalyceal system. The average procedure time was 19.5minutes ; a double J stent was replaced in the pelvocalyceal system of 13 of 26 patients (50%) ; because ofimproper catheter direction or/and bleeding, the Amplatz sheath was replaced in three. After PNL, complicationsinvolving renal hematoma occurred in one patient. This did not affect the patient's prognosis, however. CONCLUSION:Owing to its short procedure time and low complication rate, interventional preoperative tract dilatation forPNL is thought to be an effective technique for patients with staghorn or pelvocalceal calculi.
Anesthesia, Local ; Calculi ; Catheters ; Dilatation* ; Female ; Hematoma ; Hemorrhage ; Humans ; Nephrostomy, Percutaneous* ; Prognosis ; Stents ; Surgical Instruments

Burkitt lymphoma is a type of B-cell lymphoma that occurs mostly in children, and rarely in adults. The sporadic type is known to occur mostly at the ileum and cecum. Cytarabine, which is used for central nervous system prophylaxis during chemotherapy for Burkitt lymphoma, has known neurotoxicity, and its side effects include motor ataxia due to cerebellar injury, ataxic dysarthria, dysfunction of ocular movement, confusion, somnolence and lethargy. This case report is about a patient diagnosed with Burkitt lymphoma who manifested motor ataxia after chemotherapy that included cytarabine.
Adult ; Ataxia ; Burkitt Lymphoma ; Cecum ; Central Nervous System ; Child ; Cytarabine ; Dysarthria ; Humans ; Ileum ; Lethargy ; Lymphoma, B-Cell ; Rectum