A 53-year-old man had skin-colored linear serpiginous plaque within brownish patch on his left thigh for one year. He habitually drank natural spring water for 3 years. We diagnosed this case as sparganosis infiltrated within dermis by histologic and parasitologic diagnosis. The skin lesion mimicked the cutaneous larva migrans by showing dermal migration of sparganum to pro-duce itchy linear serpiginous plaque. We report an interesting case of sparganosis mimicking cutaneous larva migrans.
Dermis ; Diagnosis ; Humans ; Larva Migrans* ; Middle Aged ; Natural Springs ; Skin ; Sparganosis* ; Sparganum ; Thigh ; Water

BACKGROUND: Herpes simplex virus thymidine kinase (HSVtk) phosphorylates the prodrug ganciclovir to a nucleoside analog that inhibits DNA synthesis, causing cell death. Neighbouring nontransfected cells may be affected through a 'bystander effect', thereby amplifying the antiproliferative actions. This study was carried out to determine whether retrovirus-mediated HSVtk gene therapy could reduce intimal hyperplasia and prevent stenosis following balloon injury of the rat carotid artery. METHODS: A replication-defective recombinant retroviral vector containing HSVtk cDNA (LtkSN) was constructed. Cultured primary rat smooth muscle cells (SMCs) infected with this vector (SMC/LtkSN) were transplanted to the balloon injured rat right carotid artery. One week after transplantation, HSVtk gene therapy group was administered a 2-week treatment of ganciclovir (30 mg/kg/d). Three weeks after balloon injury and SMC/LtkSN transplantation, carotid arteriography was performed and carotid arteries were perfusion-fixed for histologic examination. RESULTS: Carotid arteriographic evaluation comparing with the uninjured left carotid artery showed that the mean luminal diameter of HSVtk gene therapy group (n=5, 85+/-3%) was significantly larger than that of balloon injury only group (n=5, 65+/-5%). The neointimal mass of HSVtk gene therapy group was less than that of balloon injury only group. SMC/LtkSN transplantation without ganciclovir treatment group (n=3) showed asymmetric intimal proliferation probably because of gravitational pooling of seeding. There were inflammatory cell infiltrations at the gravity dependent portion of HSVtk gene therapy group. CONCLUSION: Retrovirus-mediated HSVtk gene therapy following balloon injury of the rat carotid artery reduced neointimal expansion and arteriographic stenosis.
Angiography ; Animals ; Carotid Arteries* ; Carotid Artery Injuries* ; Cell Death ; Constriction, Pathologic* ; DNA ; DNA, Complementary ; Ganciclovir ; Genetic Therapy* ; Gravitation ; Herpes Simplex* ; Hyperplasia ; Myocytes, Smooth Muscle ; Phenobarbital ; Phosphotransferases* ; Rats* ; Simplexvirus* ; Thymidine Kinase ; Zidovudine

Midazolam, a water soluble benzodiazepine, was compared with diazepam as a sedation for spinal anesthesia. Forthy healthy patients were allocated at random to receive midazolam 0.1mg/kg or diazepam 0.2mg/kg at 15 min after tetracaine inction for spinal anesthesia and increments of half of the initial dose every 2 min to induce sleep. Mean dose of midazolam 8.5 mg and diazepam 17.1 mg were injected for sedation throughout surgery. There was no difference concerning sedation level during surgery and speed of recovery. With the same degree of sedation, midazolam produced a higher frequency of anterograde amnesia(70% vs. 30%). Uenous tolerance was better for midazolam. Neither drug caused obstruction of airway nor significant cardiovascular change. Higher degree of amnesia and venous tolerance with midazolam may be advantages of sedation for spinal anesthesia.
Amnesia ; Anesthesia, Spinal* ; Benzodiazepines ; Diazepam* ; Humans ; Hypnotics and Sedatives* ; Midazolam* ; Tetracaine

A 25 years old male received an emergency operation for tendon repair of the right 3rd. finger under axillary brachial plexus block using a paresthesia technique. He had no specific medical problem in hand function except limitation of the right 3rd. finger flexion. After the operation, he complained about hand numbness, especially around the palm side of the 3rd. finger, and a tingling sensation which originated from the axilla to the 3rd. finger. Those symptoms did not subside, thus the patient was advised to seek rehabilitation medicine. On the 21st post operative day, EMG (Electromyography) indicated a right median nerve injury at the median branch level of the brachial plexus. The complete withdrawal of the symptoms was reported at the 7th week after the operation. In this case, the highly suggestive cause of selective median nerve injury was a direct nerve injury by injection needle or intraneural injection of local anesthetic drug during the brachial plexus block procedure. However, we didn't completely rule out the possibility of nerve damage by tourniquet and improper position.
Adult ; Axilla ; Brachial Plexus* ; Emergencies ; Fingers ; Hand ; Humans ; Hypesthesia ; Male ; Median Nerve* ; Needles ; Paresthesia ; Rehabilitation ; Sensation ; Tendons ; Tourniquets

No abstract available.
Lipodystrophy, Congenital Generalized*

Three cases of cutaneous larva migrans (CLM) were diagnosed in a returnee from a trip to Thailand and in 2 domestic farmers during July and September, 2003. The linear and serpiginous skin lesions on the lower extremities were presented in all 3 cases. Routine laboratory findings were normal. In the imported case, a 650 x 30 micrometer sized filariform nematode larva, presumably a species of hookworm, was detected in the lesion. All cases were treated with 400 mg albendazole once daily for 3-5 days, and their skin lesions gradually improved. In the present study, a causative agent of CLM was isolated for the first time in the Republic of Korea. Moreover, we speculate that CLM is prevalent in farmers who are in frequent contact with soil in the Republic of Korea.
Middle Aged ; Male ; Larva Migrans/*diagnosis/drug therapy/*pathology ; Humans ; Female ; Anthelmintics/therapeutic use ; Albendazole/therapeutic use ; Aged ; Adult

The incidence of gastric cancer is high in old age group and low in young age group, extremely rare in child age. So the diagnosis of gastric cancer in young age is often delayed, and this, with other factors such as poorly differentiated histopathologic tendency and rapid growing nature, makes the prognosis poorer than in other age guoup. Therefore it should always be remembered that the young who has gastric symptom may have malignancy in his stomach in spite of the age. We report a case of early gastric cancer in a 16-years old male with the review of the literature.
Adolescent ; Child ; Diagnosis ; Humans ; Incidence ; Male ; Prognosis ; Stomach ; Stomach Neoplasms*

Antibody to hepatitis A antigen was detected, by radiommuncassay, in sera froom 455 hospitalized children and adolescents without a liver disease or a clinically recognizable hepatitis history. The positive rate of antibody was over 90% in newborn infants and then progressively decreased and reached its lowest level, 9.1%, at age 7-12 months. The high positive rate in newborn infants is suggested to be a result of transplacental passive immunity, which seems to nearly disappear by the age of 7 months. The positive rate gradually increased throughout childhood: 3% at age 4-6 years, 51.1% at 7-9 years, 83.0% at age 13-15 years and 93.1% at age 16-19 years. This finding indicate that hepatitis A had developed in about one half of children until the age of 10 years and in nearly all until the age of 19 years. The prevalence of antibody was independent of sex, socioeconomic status and resident area and did not correlate significantly with serologic evidence of hepatitis B virus infection.
Adolescent* ; Child* ; Child, Hospitalized ; Hepatitis A* ; Hepatitis B virus ; Hepatitis* ; Humans ; Infant, Newborn ; Korea* ; Liver Diseases ; Prevalence ; Social Class

No abstract available.

Effects of adrenocorticosteroid in the rabbits given repeated sublethal doses of diphtheria toxin were studied with respects to survival time, electrocardiographic behavior, change in serum potassium, and histopathology of the heart, kidney and adrenal gland. Experiments were performed twice with different doses of toxin and prednisolone and with different methods of administration. In the first experiment, all fourteen rabbits received daily subcutaneous injections of 0.1 M.L.D. of toxin per kg of body weight for three consecutive days, and eight of them received daily intramuscular injections of 6mg of prednisolone per kg of body weight beginning soon after the first injection of toxin until death. In the second experiment, all sixteen rabbits received subcutaneous injections with daily doses of 0.2, 0.3, 0.4, 0.5, 0.6 and 0.7 M.L.D. of toxin per kg of body weight in this order for six consecutive days, and nine of them received daily intramuscular injections of 10mg of prednisolone per kg of body weight beginning two days prior to the first injection of toxin until death. As control groups, six rabbits in the first experiment and seven in the second, received daily intramuscular injections of normal saline for the same period. Electrocardiograms were taken in six rabbits given intravenous KCI solution only to compare the findings with those of the first and second experimental animals. The results are as follows: 1. In the first experiment, mean survival times were 118.024.6 hours in the prednisolone-treated group and 145.842.6 in the control and in the second experiment, 159.226.1 in the prednisolone-treated group and 176.324.1 in the control. The difference was not statistically significant in the first experiment while significant in the second. 2. Major electrocardiographic findings consisted of tenting of T wave, change in S-T segment, inversion of T wave, widening of QRS duration and P-R interval, deviation of QRS axis, disappearance of P wave and decrease in heart rate. No significant differences were found between the prednisolone-treated and control groups. In general, electrocardiographic patterns showed marked similarities to those of progressive hyperpotassemia. 3. After toxin injection, hyperpotassemia developed and progressed to 11.2 mEq/1 (mean) just before death. No significant differences were found between the prednisolone-treated and control groups. 4. Electrocardiographic findings in six rabbits given intravenous KCI solution only were similar to those of the toxin-treated rabbits with or without prednisolone administration, in which left deviation of QRS axis and inversion of T wave in lead I and V6 were also observed in addition to other hyperpotassemia findings. 5. Gross findings at autopsy showed; a) Multiple petechiae were frequently observed on the surface of the kidney. b) Brownish black discoloration of the adrenal gland probably due to hemorrhage and necrosis was found mainly in the rabbits of preliminary study group given relatively large doses of toxin. c) Abnormalities were rare in the heart. 6. Microscopically, the kidney showed more pronounced change than those of the heart and the adrenal gland. In the kidney, severe dilatation of the glomerular capillary with fibrin thrombi, many casts in the tubule, and relatively mild tubular degeneration and dilatation were observed in most cases. Interstitial hemorrhage was also seen in some cases, but necrosis was rare. In the heart, granular degeneration of the muscle cell and interstitial hemorrhage were relatively prominent in most cases. Mild myocytolysis and fibrin thrombi in interstitium were also observed frequently, but interstitial infiltration, loss of striation and myocardial necrosis were rare. Fatty change of the muscle cell, although found in most, was very mild. In the adrenal gland, cortical hemcorrhage and necrosis were found mainly in the rabbits of preliminary study group. Among the findings mentioned above, dilatation of the glomerular capillary with fibrin thrombi and interstitial hemorrhage in the kidney were more pronounced in the prednisolone-treated groups than in the control. 7. Fibrin thrombi observed in the kidney and the heart suggest that disseminated intravascular coagulation was developed during toxemia.
Adrenal Glands ; Animals ; Autopsy ; Axis, Cervical Vertebra ; Body Weight ; Capillaries ; Dilatation ; Diphtheria Toxin* ; Diphtheria* ; Disseminated Intravascular Coagulation ; Electrocardiography ; Fibrin ; Heart ; Heart Rate ; Hemorrhage ; Hyperkalemia ; Injections, Intramuscular ; Injections, Subcutaneous ; Kidney ; Muscle Cells ; Necrosis ; Potassium ; Prednisolone ; Purpura ; Rabbits* ; Survival Rate ; Toxemia