Typhoid fever is an acute systemic febrile disease caused by Salmonella Typhi, characterized by persistent fever, headache, abdominal pain, diarrhea and rose spots. Salmonella infection can lead to diffuse organ involvement including bone, lung, thyroid, kidney, liver, spleen, heart, intestine and skin. While a variety of complications may be seen in typhoid fever, sensorineural hearing loss or pancreatitis has been rarely observed. Recently, we experienced a case of typhoid fever complicated by sensorineural hearing loss, acute pancreatitis and hepatitis in a 21-year-old female patient, who was improved with ceftriaxone and ciprofloxacin administration and supportive care. We report this case with a review of the literature.
Abdominal Pain ; Ceftriaxone ; Ciprofloxacin ; Diarrhea ; Female ; Fever ; Headache ; Hearing Loss, Sensorineural* ; Heart ; Hepatitis* ; Humans ; Intestines ; Kidney ; Liver ; Lung ; Pancreatitis* ; Salmonella Infections ; Salmonella typhi ; Skin ; Spleen ; Thyroid Gland ; Typhoid Fever* ; Young Adult

No abstract available.
Statistics as Topic*

In growing patients with Class III malocclusion, the various patterns of maxillofacial growth are a key element that affects the success or failure of treatment. Therefore it is important to correctly predict maxillofacial growth before initiating treatment. The purpose of this study was to find out the correlation between the maxillofacial morphology of parents and their Class III children by analyzing lateral cephalograms and hereditary factors. Among Class III preadolescent children, 50 families were obtained. To find out the specific hereditary factors involved, fingerprints were obtained and genetic correlation with the maxillofacial morphology was analyzed. The following conclusions were made. 1. A significant correlation (P<0.05-0.001) was found in many of the cephalometric measurements between the offspring and their parents. The correlation in the skeleton measurements was higher than in the denture measurements. The father-offspring correlation was higher than the mother-offspring correlation 2. A significant correlation (P<0.05-0.001) was found in fingerprint units between the offspring and their parents. The mother-offspring correlation was higher than the father-offspring correlation. 3. Between the maxillofacial morphology and fingerprint units, there was significant genetic correlation (P<0.05-0.01). Based on the analysis of genetic correlation, higher correlation was found in the parent-son pairing than the parent-daughter pairing.
Child ; Dentures ; Dermatoglyphics* ; Humans ; Malocclusion* ; Parents ; Skeleton

No abstract available.
HLA-DR Antigens* ; Thyroid Gland* ; Thyroid Neoplasms*

Angelicae Gigantis Radix (AGR, Angelica gigas) has been used for a long time as a traditional folk medicine in Korea and oriental countries. Decursinol angelate (DCA) is structurally isomeric decursin, one of the major components of AGR. This study was performed to confirm whether DCA augments pentobarbital-induced sleeping behaviors via the activation of GABA(A)-ergic systems in animals. Oral administration of DCA (10, 25 and 50 mg/kg) markedly suppressed spontaneous locomotor activity. DCA also prolonged sleeping time, and decreased the sleep latency by pentobarbital (42 mg/kg), in a dose-dependent manner, similar to muscimol, both at the hypnotic (42 mg/kg) and sub-hypnotic (28 mg/kg) dosages. Especially, DCA increased the number of sleeping animals in the sub-hypnotic dosage. DCA (50 mg/kg, p.o.) itself modulated sleep architectures; DCA reduced the counts of sleep/wake cycles. At the same time, DCA increased total sleep time, but not non-rapid eye movement (NREM) and rapid eye movement (REM) sleep. In the molecular experiments. DCA (0.001, 0.01 and 0.1 µg/ml) increased intracellular Cl- influx level in hypothalamic primary cultured neuronal cells of rats. In addition, DCA increased the protein expression of glutamic acid decarboxylase (GAD(65/67)) and GABA(A) receptors subtypes. Taken together, these results suggest that DCA potentiates pentobarbital-induced sleeping behaviors through the activation of GABA(A)-ergic systems, and can be useful in the treatment of insomnia.
Administration, Oral ; Angelica ; Animals ; Electroencephalography ; Eye Movements ; Glutamate Decarboxylase ; Korea ; Medicine, Traditional ; Motor Activity ; Muscimol ; Neurons ; Pentobarbital ; Rats ; Receptors, GABA-A ; Rodentia* ; Sleep Initiation and Maintenance Disorders ; Sleep, REM

PURPOSE: Although papillary thyroid carcinomas are known to have a good prognosis, invasive papillary thyroid carcinomas have different outcomes. There are many studies on the prognostic factors for thyroid carcinomas, but few studies have been performed for invasive papillary thyroid carcinomas. We performed this study to investigate the prognosis and the prognostic factors for invasive papillary thyroid carcinomas. METHODS: We analyzed 184 patients with papillary thyroid carcinomas who had undergone a thyroidectomy between 1985 and 1990, especially for the clinicopathologic entity of an invasive papillary thyroid carcinoma, and made univariate and multivariate analyses for various clinical and pathological factors to evaluate whether they would be of value in estimating the prognosis in papillary thyroid carcinoma patients. RESULTS: In the univariate analysis of the 10-year disease-free survival rate of the overall cases, sex, tumor size, and lymph-node metastasis were confirmed to be significant prognostic factors. In the multivariate analysis, all of these factors were independent significant prognostic factors. Invasive papillary thyroid carcinoma patients, compared to non-invasive papillary thyroid carcinoma patients, were older and more prone to metastasis to cervical lymph nodes. In the univariate analysis of the 10-year disease-free survival rate of patients with an invasive papillary thyroid carcinoma, sex, tumor size, and lymph-node metastasis were significant prognostic factors. However, in the multivariate analysis, sex and tumor size appeared to be independent significant prognostic factors. CONCLUSION: We conclude that invasive papillary thyroid carcinomas have a the tendency to occur in elderly patients and are more prone to metastasis to cervical lymph nodes. The male sex, a tumor size more than 5 cm, and positive cervical-lymph-node metastasis present the worse prognosis. However, a randomized prospective study may be needed to better understand how to manage invasive papillary thyroid carcinomas.
Aged ; Disease-Free Survival ; Humans ; Lymph Nodes ; Male ; Multivariate Analysis ; Neoplasm Metastasis ; Prognosis ; Thyroid Gland* ; Thyroid Neoplasms* ; Thyroidectomy

PURPOSE: To evaluate the effect of Imatinib which is tyrosine kinase inhibitor used for the treatment of chronic myelogenous leukemia on the proliferation of the lens epithelial cells and the activities of growth factors. METHODS: In the experimental group I, the cells were exposed to Imatinib for 3, 5 min with various concentration. In the experimental group II, the cells were cultured with PDGF, bFGF, TGF-beta2. In the experimental group III, the cells were exposed to Imatinib for 3, 5 min with the various concentration in the presence of each growth factor. The cell viability was assessed by MTT assay. And the cell proliferation were evaluated by BrdU staining. The phosphorylation of ERK (Extracellular-signal regulated kinase) and the amount of collagen type I produced by TGF-beta2 were analyzed with western blot. RESULTS: MTT assay showed that the viability of lens epithelial cells was decreased about 50% at the concentration above Imatinib 30 micro M for 5 mins exposure in group I. Both PDGF and bFFG induced significantly increased cell viability in group II. The group III that was treated with both PDGF and bFGF showed the decrease of cell viability after being exposed to Imatinib. As the concentration of Imatinib increased, BrdU incorporation of experimental group I was decreased compared with control group. It also found that The BrdU incorporation of experimental group III was also decreased compared with experimental group II. The phosphorylation of ERK 1/2 and the amount of collagen type I production was significantly decreased in addition of Imatinib 20 to 30 micro M for 3 mins exposure. CONCLUSIONS: The proliferation of lens epithelial cells could be inhibited by Imatinib. And the activities of PDGF, bFGF, TGF-beta2 were also inhibited by Imatinib.
Blotting, Western ; Bromodeoxyuridine ; Cell Proliferation ; Cell Survival ; Collagen Type I ; Epithelial Cells* ; Intercellular Signaling Peptides and Proteins* ; Leukemia, Myelogenous, Chronic, BCR-ABL Positive ; Phosphorylation ; Protein-Tyrosine Kinases ; Transforming Growth Factor beta2 ; Imatinib Mesylate

PURPOSE: There are no specific clinical and histopathologic characteristics of malignant pheochromocytoma and the optimal treatment modality has not been established yet. We analyzed the clinical and histopathologic features of malignant pheochromocytoma and treatment results. MATERIALS AND METHODS: We reviewed the clinical records of 10 patients with malignant pheochromocytoma diagnosed at Seoul National University Hospital from March 1987 to June 1998. RESULTS: Nine of 10 (90%) patients had functional tumors. The biochemical laboratory findings showed elevated 24-hour urine VMA level in nine patients available. The median size of the tumors was 11x11 cm. Six of 10 (60%) patients were initially diagnosed as malignant tumors because of direct invasions to adjacent tissues or distant metastases. On the other hand, remaining 4 patients were initially diagnosed as benign, but the distant metastases developed metachronously after resection of the primary lesion. The median duration between the initial operation and the detection of metastases was 57 months (range: 47~72 months) in these patients. The liver was the most common site of metastases (60%). With regards to the histopathological features, most of the tumors (87.5%) showed capsulation, necrosis and hemorrhage. The findings of lymphatic invasion, angio-invasion, and mitosis were found in 62.5% of the cases. All but 2 patients were initially treated with radical operation for the primary lesions. The disease recurrences or metastases occurred in 7 out of 10 patients. Of these, 4 patients were treated with chemotherapy or interferon- a after recurrences. Overall, the median survival for all patients was 82 months (range: 37~143 months). Two patients is alive and only one patient is alive without recurrence. CONCLUSION: The careful follow-up for at least 5 years and the aggressive multi-disciplinary therapy may be needed for the diagnosis and the management of malignant pheochromocytoma.
Diagnosis ; Drug Therapy ; Follow-Up Studies ; Hand ; Hemorrhage ; Humans ; Liver ; Mitosis ; Necrosis ; Neoplasm Metastasis ; Pheochromocytoma* ; Recurrence ; Seoul

PURPOSE: H rthle cell neoplasm of the thyroid gland is a rare disease. The reported cases in Korea are not so many; thus, there has been a lack of common therapeutic and prognostic guidance. METHODS: The cases of 15 patients with a H rthle cell neoplasm of the thyroid gland, hospitalized at Seoul National University Hospital from Nov. 1981 to Feb. 1998, were retrospectively reviewed. RESULTS: There were 4 males and 11 females. The ages varied from 23 to 69 years old (mean: 46.3 years old). Among them, 13 had neck masses with a mean size of 3.3 cm (1.2-6.0 cm), and the mean duration of the symptom was 4 years (5 months-8 years). Of the other two, one had laryngeal discomfort for 2 months, and the other one was diagnosed through a fine needle aspiration follow-up. One of the 15 patients had hyperthyroidism whereas the others had euthyroidism. The thyroid scans for 10 of them showed cold nodules. The operations consisted of a unilateral lobectomy in 2 cases, a unilateral lobectomy and isth mectomy in 11 cases, a unilateral lobectomy, isthmectomy and contralateral partial lobectomy in 1 case, and a total thyroidectomy and neck lymph node dissection in the 1 case that was combined with a papillary carcinoma. Thirteen patients (86.7%) had a H rthle cell adenoma, and two of them (13.3%) had a H rthle cell carcinoma. The mean duration of follow-up was 33 months (range 1 month-12 years), and no recurrence or death occurred during the follow-up period. CONCLUSIONS: The incidence of H rthle cell neoplasms is higher in women and the sex ratio is 1:2.8. The incidence of H rthle cell carcinomas among H rthle cell neoplasms is 13.3% (2/15). We found no specific clinical features for differentiating a H rthle cell adenoma from a H rthle cell carcinoma and no factors for adequate operative methods and prognosis due to the rarity of the condition and the short duration of the follow-up. Because of the low incidence of H rthle cell neoplasms and our limited experience, not only co-research of centers but also pathologic research is needed.
Adenoma ; Aged ; Biopsy, Fine-Needle ; Carcinoma, Papillary ; Female ; Follow-Up Studies ; Humans ; Hyperthyroidism ; Incidence ; Korea ; Lymph Node Excision ; Male ; Neck ; Prognosis ; Rare Diseases ; Recurrence ; Retrospective Studies ; Seoul ; Sex Ratio ; Thyroid Gland* ; Thyroidectomy

PURPOSE: A new classification of gastrointestinal food allergy was published, but the changes of terminology between previously reported terms and the new ones were in a state of disorder. This has resulted in confusion between medical communication and diagnostic and therapeutic approaches. The clinical observations of infants presenting with gastrointestinal cow milk allergy (GI-CMA) were performed, and the changes in the terminology reviewed through the published Korean literature. METHODS: Between March 2003 and July 2003, data from 37 consecutive infants with GI-CMA, aged 2 weeks to 15 months, were reviewed. The challenge and elimination test of cow milk, and the endoscopic and histologic findings, were used for the seven subdivisions of GI-CMA according to a new classification on the basis of patients' ages, clinical manifestations and location of gastrointestinal lesions. RESULTS: The 37 patients had a mean age of 5.4+/-4.8 months, with those observed in 26 (70.3%) of patients being below 6 months of age. The seven final diagnoses were; cow milk protein-induced enterocolitis (CMPIE) in 12 (32.4%), cow milk protein proctitis (PROC) in 12 (32.4%), IgE-mediated (IGE) in 6 (16.2%), gastroesophageal reflux-associated cow milk allergy (GERA) in 5 (13.5%) and eosinophilic gastroenterocolitis in 2 (5.4%). CMPIE was revealed as the typical type in 7 (18.9%) and the atypical type in 5 (13.5%), and all of typical CMPIE revealed cow milk protein-induced enteropathy. The mean age at symptom onset was 4.3+/-0.8 months, and for those with typical and atypical CMPIE, and PROC and GERA were 3.8+/-4.6, 10.4+/-3.8, 3.4+/-3.9 and 7.8+/-5.7 months, respectively (p<0.05). The period from onset of symptom to diagnosis was 2.4+/-3.3 (0.5~12) months, with those observed in atypical CMPIE and GERA being over 3months. Although the birth weights in all patients were within the 10~90 percentile range, the body weights on diagnoses were below the 3 percentile in 48.6%; IGE 16.7%, EOS 0%, typical CMPIE 85.7%, atypical CMPIE 60.0%, PROC 25.0% and GERA 100% (p<0.05). Through the review of the Korean literature, 8 case reports and 14 original articles for GI-CMA were found. CONCLUSION: GI-CMA is not a rare clinical disorder and is subdivided into seven categories on the basis of the patient's age, clinical manifestations and location of the gastrointestinal lesions. The terms for GI-CMA are changing with new classifications, and careful approaches are necessary for medical communications.
Birth Weight ; Body Weight ; Child* ; Classification* ; Diagnosis ; Enterocolitis ; Eosinophils ; Food Hypersensitivity ; Humans ; Immunoglobulin E ; Infant ; Milk Hypersensitivity* ; Milk Proteins ; Milk* ; Proctitis