No abstract available.
Lipomatosis*

No abstract available.
Meningioma* ; Paragonimiasis*

BACKGROUND: Infrequent restriction site PCR (IRS-PCR) is a recently described DNA fingerprinting technique based on selective amplification of restriction endonuclease-cleaved fragments. We applied of IRS-PCR to clinical isolates of Vibrio parahaemolyticus associated with diarrhea. METHODS: IRS-PCR assay was performed with adaptors for XbaI and HhaI restriction sites. A total of 35 strains of V. parahaemolyticus which were isolated from clinical specimens of patients with diarrhea were analyzed. The isolates were collected from different geographic areas of Seoul (n=12), Incheon (n=21) and Gwangju (n=2) during 1998-2000 in Korea. RESULTS: In IRS-PCR, amplifed DNA fragments between 50 and 400 bp were found to be the most reproducible in this study. When V. parahaemolyticus isolates were amplified with AH1 and PX-G as primers, 35 isolates could be grouped into five IRS-PCR patterns: A (n=16), B (n=4), C (n=6), D (n=5) and E (n=4). The patterns were subdivided into 15 subtypes: A1, A2, B1, B2, B3, B4, C1, C2, C3, D1, D2, D3, E1, E2 and E3. The IRS-PCR patterns of V. parahaemolyticus did not show any relationship with serotype or geographic origin, but the isolates from same outbreak produced a same pattern(A1). CONCLUSION: The results provide evidence of the discriminatory power of the IRS-PCR method as it applies to V. parahaemolyticus.
Diarrhea ; DNA ; DNA Fingerprinting ; Gwangju ; Humans ; Incheon ; Korea ; Polymerase Chain Reaction* ; Seoul ; Vibrio parahaemolyticus* ; Vibrio*

No abstract available.
Cleft Palate* ; Humans

PURPOSE: Various electrocardiogram (ECG) changes can occur in patients with acute organophosphate poisoning (OPP) and may be associated with the clinical severity of poisoning. The present study aimed to evaluate the extent and frequency of ECG changes and cardiac manifestations, and their association with acute OPP clinical severity. METHODS: Seventy-two adult patients admitted to our emergency department with a diagnosis of acute OPP were studied retrospectively. ECG changes and cardiac manifestations at admission were evaluated. ECG changes between respiratory failure (RF) group and no respiratory failure (no RF) groups were compared. RESULTS: Prolongation of QTc interval (n=40, 55.6%) was the most common ECG change, followed by sinus tachycardia (n=36, 50.0%). ST-T wave changes such as ST segment elevation or depression and T wave change (inversion or non-specific change) were evident in 16 patients (22.2%). Prolongation of QTc interval was significantly higher in the RF group compared with the no RF group (p=0.03), but was not an independent predictor for RF in acute OPP (OR; 4.00, 95% CI; 0.70-23.12, p=0.12). CONCLUSION: While patients with acute OPP can display ECG changes that include prolongation of QTc interval, sinus tachycardia, and ST-T wave changes at admission, these changes are not predictors of respiratory failure.
Adult ; Depression ; Electrocardiography ; Emergencies ; Humans ; Organophosphate Poisoning ; Phenylpropionates ; Respiratory Insufficiency ; Retrospective Studies ; Tachycardia, Sinus

OBJECTIVE: The objective of this study is to evaluate the efficacy of microdecompression (MD) with microscope and tubular retractor in lumbar foraminal stenosis (FS) and to analyze the clinical outcomes. METHODS: From January 2006 to December 2007, 22 patients with symptomatic lumbar FS underwent conventional decompressive surgery (CDS) and MD was performed in other 20 patients. Clinical outcome was measured using a Visual Analogue Scale (VAS) and Macnab?fs criteria. Spinal instability was determined by radiologic assessment of flexion-extension radiographs. RESULTS: The CDS group included 14 men and 8 women. The MD group included 14 men and 6 women. The mean age was 66.2 years (range, 46-80 yrs) in the CDS group and 65.4 years (range, 59-74 yrs) in the MD group. Average follow-up periods were 18.6 months in the CDS group and 16.5 months in the MD group. Mean operating time was 126 minutes in the CDS group and 168 minutes in the MD group. The mean VAS of back pain decreased from 2.68 to 1.36 in the CDS group and from 2.85 to 1.25 in the MD group. The mean VAS score of leg pain decrea- sed from 6.68 to 1.48 in the CDS group and from 6.65 to 1.40 in the MD group. The success rate of CDS group was 86.3 % (19/22), compared with 85.0% (17/20) for MD group. Radiologically, there was no spinal instability. CONCLUSION:MD could achieve neural decompression and offer an effective treatment of lumbar FS. However it was a technically demanding procedure and effective in limited operative indications. We need to consider long-term follow-up.
Back Pain ; Constriction, Pathologic ; Decompression ; Female ; Follow-Up Studies ; Humans ; Leg ; Male

We describe the case of a patient with symptomatic left cervical ICA stenosis and aneurysm of the left distal anterior cerebral artery. She presented with chronic headache and recurrent attack of right hemiparesis, and underwent staged operations. Using the interhemispheric approach, the intracranial aneurysm was clipped, and there was no postoperative neurologic deterioration. Two months later, a carotid endarterectomy was performed. The patient recovered without complications and angiography revealed relief of carotid stenosis and non-visualization of the aneurysm. The coexistence of symptomatic carotid stenosis and an unruptured intracranial aneurysm poses a therapeutic dilemma; correction of significant stenosis of the internal carotid artery may increase the pressure and turbulence to which the aneurysm is subjected, while the intracranial approach to an aneurysm, when blood flow is decreased by carotid stenosis, may also involve increased risk. In view of the theoretical risk of increased blood flow and turbulence after carotid endarterectomy, aneurysm neck clipping followed by this procedure either in a single stage or separate stages seems to be the another safest management strategy.
Aneurysm* ; Angiography ; Anterior Cerebral Artery ; Carotid Artery, Internal ; Carotid Stenosis* ; Constriction, Pathologic ; Endarterectomy, Carotid ; Headache Disorders ; Humans ; Intracranial Aneurysm ; Neck ; Paresis

A 47-years-old woman presented with a 2-month history of a dry mouth and dry cough. The patient had been taking medication for Sjogren's syndrome for approximately 7 years. The chest radiography showed multiple cystic lesions and a hazy density in both lower lung fields. The HRCT showed a diffuse ground glass like appearance and multiple variable sized cystic lesions in both lung fields. After medication, the symptoms were aggravated. Bronchoscopy was preformed with a transbronchial lung biopsy. The biopsies showed an infiltration of lymphocytes, neutrophils, monocytes and histiocytes through the interstitial space of the alveola and a widening of the alveolar septa. However, the histological findings of the cysts were not obtained. Sjogren's syndrome is a slowly progressive inflammatory autoimmune disease, which is characterized by lymphocyte mediated destruction of the exocrine glands, with pulmonary involvement in approximately 19-65%, High-resolution CT is a sensitive technique for assessing the pulmonary involvement in patients with Sjogren's syndrome. Although a lung biopsy is not always necessary for establishing a diagnosis of an interstitial lung disease in Sjogren's syndrome. A lung biopsy may reveal a wide spectrum of changes ranging from a mild inflammatory response to end stage fibrosis with honeycombing. Because of the predominantly peribronchiolar inflammatory infiltration and inspissated secretions the cysts were suspected to have been formed by the ballvalve phenomenon. However, no definite evidence was obtained.
Autoimmune Diseases ; Biopsy ; Bronchoscopy ; Cough ; Diagnosis ; Exocrine Glands ; Female ; Fibrosis ; Glass ; Histiocytes ; Humans ; Lung Diseases* ; Lung Diseases, Interstitial* ; Lung* ; Lymphocytes ; Monocytes ; Mouth ; Neutrophils ; Radiography ; Sjogren's Syndrome* ; Thorax

PURPOSE: The visual analogue scale (VAS) pain score is widely and frequently used to evaluate the severity of pain. However, statistically significant differences in the VAS scores may not always mean differences in pain severity. This study is to determine clinically meaningful reductions in pain severity as measured by the VAS and by a verbal categorical rating of pain. METHODS: Three hundred adult patients presenting to the emergency department (ED) with acute pain resulting from trauma or non-traumatic diseases were enrolled in this prospective, descriptive study. A 100-mm non-hatched, horizontal visual analogue scale was used to measure pain severity. The VAS measurements were obtained two times 1 minute apart at admission, 30 minutes after admission, and 1 hour after treatment. At each VAS measurements, patients also gave verbal ratings of their pain as "more pain,""the same pain," or "less pain." Data from the groups reporting "the same pain" or "less pain" were compared with their preceding descriptions and yielded a VAS difference. The mean VAS change was calculated, from which a grand means and 95% confidence intervals (95% CI) were determined. RESULTS: At 30 minutes after admission and 1 hour after treatment, 256 and 31 patients, respectively described their pain as "the same pain,"and 33 and 269 patients described it as "less pain." The mean reduction in VAS for the group reporting that pain was "the same pain" was 13 to 16 mm (95% CI, 8 to 20 mm) instead of 'zero.'For the group reporting that pain was "less pain," the mean reductions in VAS score were 24 mm (95% CI, 20 to 28 mm) at 30 minutes after admission and 44 mm (95% CI, 42 to 46 mm) at 1 hour after treatment. CONCLUSION: When evaluating management for acute pain in the ED, a difference in VAS score of less than 20 mm without regard to the presence or absence of treatment is unlikely to signify a clinically meaningful reduction in pain severity. This study provides guidance to those who design and interpret clinical studies of the acute pain experience in the ED.
Acute Pain ; Adult ; Emergency Service, Hospital ; Humans ; Pain Management ; Prospective Studies

BACKGROUND: Cell culture is the golden standard method for Herpes simplex virus (HSV) isolation. However, some specimens require many days to develop any cytopathic effect (CPE). We developeda rapid sensitive culture technique for HSV isolations. METHODS: This study included a total of 133 patients with suspected HSV infection. Specimens were centrifuged onto a Vero cell monolayer in a shell vial. The CPE was observed daily during the5-day incubation by inverted-phase microscope. The direct immunofluorescence (DIF) stain with aHSV specific antibody was performed 2 days after sample inoculation. The negative samples in theDIF stain were reinoculated in the new shell vials after extraction of the monolayer. Polymerase chainreaction for HSV detection was performed using the original samples. RESULTS: The CPE was observed 30 (64%), 39 (83%), 43 (92%), 44 (94%), and 46 (98%) cases at1, 2, 3, 4, and 5 days incubation, respectively. The DIF stain detected 46 cases (98%) at 2 days incubation. The CPE was observed in another 7 cases at 1-day incubation after the reinoculation of negative samples. The PCR detected 47 (100%) of 133 cases. CONCLUSIONS: The reinoculation of negative sample in a shell vial culture is a rapid sensitive methodfor HSV isolation.
Cell Culture Techniques ; Culture Techniques ; Fluorescent Antibody Technique, Direct ; Humans ; Polymerase Chain Reaction ; Simplexvirus* ; Vero Cells